BACKGROUND: Aging can serve as an underlying mechanism of chronic obstructive pulmonary disease (COPD). Also, smoking, which is the most common cause of COPD, is responsible for the systemic manifestations of the disease, independently from the lung function alterations. The purpose of this study was to analyze the effect of aging on the occurrence of cigarette smoking induced COPD. METHODS: For this analysis, we evaluated smoking status by a lifestyle intervention program and measured the occurrence of COPD by the Korea National Health and Nutrition Examination Survey (KNHANES) from 2005 to 2015. RESULTS: Aging and smoking were significantly effected on the lung function of COPD patients. Especially, the smoking duration is exaggerated in the presence of old age for older COPD patients. CONCLUSION The result showed that COPD patients exhibit aging and smoking duration related severity. The prevalence of COPD kept increasing internationally. Knowing the risk factor of COPD quantitatively and finding out the interaction among risk factors could be valuable predictors for preventing COPD.

Cri-du-chat syndrome is a rare genetic disorder in which the patient presents with a characteristic high-pitched monotonous cry and recurrent aspiration pneumonia, attributed to abnormalities in the larynx, epiglottis, and nervous system. The most prominent brain MRI findings are the presence of pontine and cerebellar hypoplasia, which primarily involve posterior cranial fossa structures. Although atrophy of supratentorial structures were also a common radiological finding, it was considered to be a secondary change due to pontine hypoplasia. Here, we present the case of a three-month-old patient presenting with cri-du-chat at our institution. The patient also showed the presence of prominent pontine hypoplasia similar to previously reported cases; however, contrary to other cases, there was a general delayed myelination of brain instead of decreased myelination of anterior limb of internal capsule. Since the larynx, pons, and cerebellum all originated from similar notochord level, which suggests anomaly in early stage of development, laryngeal, and brain anomaly characteristically observed in the cridu- chat syndrome.

Fentanyl intoxication has occasionally been reported since fentanyl patches became available for medical use. Delayed post-hypoxic leukoencephalopathy is a complication of hypoxia. However, its neuropsychiatric symptoms can be delayed, and it can progress to leukoencephalopathy even after full recovery from coma due to acute intoxication. Herein, we report a case of fentanyl intoxication in a 65-year-old man who was presented to the hospital because of unconsciousness for 13 hours after using ten fentanyl patches simultaneously. Initial brain CT findings were non-specific. Twenty days later, delayed neuropathologic symptoms manifested, and MRI showed bilaterally symmetrical, heterogeneous, confluent high signal intensities on T2-weighted/fluid attenuated inversion recovery MRI in the cerebral white matter with diffusion restriction. This was followed by rapid exacerbation of neuropathological symptoms with diffuse severe cerebral atrophy over 1 year.

BACKGROUND: Reducing the gaps in health inequality at a regional level and improving health equity have been emphasized in Korea, it is essential to accurately measure the burden of disease by region. This study aimed to estimate years of life lost (YLLs) in 17 Si and Do of Korea from 1997 to 2015 and determine the trends of regional differences in health status and disease structure. METHODS: YLL was calculated by subtracting the age at death from the life expectancy. Data on the region, gender, and age-stratified cause-specific death were obtained from the Korean Statistical Information Service of Statistics Korea. RESULTS: Age-standardized YLLs per 100,000 population decreased by year in all regions from 1997 to 2015 by 27.4% (27.5% for men; 27.2% for women). Despite the decline in YLLs, the regions with the highest and lowest YLLs did not change between 1997 and 2015. The diseases showing regional differences were caused by injury, often classified as avoidable mortality. We also confirmed that YLLs were higher in the regions with a higher deprivation index. CONCLUSION The present study identified that YLLs differed by regions in Korea with specific causes. The findings of this study can be used by decision-makers to prioritize the reduction of regional gaps in premature deaths.

Pheochromocytomas are neoplasms of the adrenal gland that are derived from chromaffin cells. One of the most important features of this tumor is that it can synthesize and release catecholamines such as norepinephrine and epinephrine. Due to this, arterial hypertension is one of the most common manifestations of the tumor. Although arterial hypertension is a substantial risk factor for aortic dissection, aortic dissection is actually a rare manifestation of pheochromocytoma. Here, we report a patient with pheochromocytoma who presented with acute type B aortic dissection.
Adrenal Glands ; Catecholamines ; Chromaffin Cells ; Epinephrine ; Humans ; Hypertension ; Norepinephrine ; Pheochromocytoma* ; Risk Factors

PURPOSE: Liver metabolism plays a pivotal role in the development of metabolic disorders. We aimed to investigate the clinical and laboratory risk factors associated with alanine aminotransferase (ALT) levels in young adolescents from an urban population in Korea. METHODS: A population of 120 apparently healthy adolescents aged 12–13 years was included in the cross-sectional design study; 58 were overweight or obese and 62 were of normal weight. We estimated anthropometric and laboratory measurements, including waist-to-height ratio, blood pressure, insulin sensitivity, aspartate aminotransferases (AST), ALT, and lipid profiles. RESULTS: The mean ages of the overweight or obese and normal weight participants were 12.9±0.3 and 13.0±0.3 years, respectively. Height, weight, body mass index, waist circumference, waist-to-height ratio, systolic and diastolic blood pressure, AST, ALT, total cholesterol, low-density lipoprotein-cholesterol, triglyceride, insulin, and the homeostatic model assessment of insulin resistance (HOMA-IR) score were significantly higher and the high-density lipoprotein-cholesterol and quantitative insulin-sensitivity check index were significantly lower in the overweight/obese participants in comparison to the normal-weight participants (all P < 0.05). In multivariate linear regression analysis, waist-to-height ratio, systolic blood pressure, and HOMA-IR score were independently and positively associated with serum ALT levels. CONCLUSION: Screening for ALT levels in adolescents may help to differentiate those at risk of metabolic abnormalities and thus prevent disease progression at an early age.
Adolescent ; Alanine Transaminase ; Alanine ; Aspartate Aminotransferases ; Blood Pressure ; Body Weight ; Cholesterol ; Disease Progression ; Humans ; Insulin ; Insulin Resistance ; Korea ; Linear Models ; Liver ; Mass Screening ; Metabolism ; Obesity ; Overweight ; Risk Factors ; Triglycerides ; Urban Population ; Waist Circumference

Clay-shoveler’s fractures are rare stress-type avulsion fractures of the spinous processes especially in sports. There have been two case reports that discussed clay-shoveler’s fractures in golf. A 36-year-old beginner golfer presented with a pain in the back after practicing golf swing. No fractures were detected using cervical radiography; however, computed tomography (CT) and magnetic resonance imaging (MRI) revealed T2∼T3 spinous process fractures. The patient was treated conservatively and his pain subsided. The mechanism of injury is speculated to that of clay-shoveler’s fractures. Therefore, if a golfer suffers persistent pain in the cervicothoracic region, clay-shoveler’s fracture is one possibility to consider.

OBJECTIVE: To quantitatively evaluate the side- and level-specific change of the multifidus muscle in unilateral radicular pain caused by lumbar disc herniation using magnetic resonance imaging (MRI).METHOD: Sixty-nine patients with L4-5 disc herniation who underwent electrodiagnostic study and spine MRI were enrolled and divided into the radiculopathy group (n=30) and the control group (n=39) according to the presence of L5 radiculopathy. The radiculopathy group was subdivided into the paraspinalis group (n=12) and the limb group (n=18) according to whether or not paraspinalis muscle was denervated. The cross-sectional area (CSA) and signal intensity (SI) of the multifidus muscle were measured bilaterally at L4-5 and L5-S1 middle intervertebral levels on axial T2-weighted MRI.RESULTS: There was no significant difference in the CSA of the multifidus muscle between the radiculopathy group and the control group. In the radiculopathy group, multifidus SI was greater than the control group on the affected side and below the level of herniation (p=0.015). In the subgroup comparison, affected side L5-S1 multifidus SI was significantly different between the paraspinalis group and the control group (p=0.001), but not between the limb group and the control group (p>0.05).CONCLUSION: Our findings suggest that quantitative measurement of multifidus SI may be indicative of the location of nerve root compromise through side- and level- specific changes.
Electromyography ; Extremities ; Humans ; Magnetic Resonance Imaging ; Methods ; Paraspinal Muscles ; Radiculopathy ; Spine

BACKGROUND: Chronic kidney disease (CKD)-mineral and bone disorder (MBD) and fracture risk are both closely related to declining renal function. Controlling hyperphosphatemia with phosphate binders is a basic principle of CKD-MBD treatment. The aim of this study was to identify differences in fracture risk between pre-dialysis CKD patients and end-stage renal disease (ESRD) on dialysis, and to evaluate the effects of phosphate binders on fracture risk in ESRD patients. METHODS: Data from a total of 89,533 CKD patients comprising CKD diagnosis, dialysis, fracture history, and phosphate binder prescription history from 2012 to 2016 were retrieved from the Health Insurance Review and Assessment Service Database. Multivariate Cox regression analyses were performed to identify whether dialysis or phosphate binders were associated with an increased fracture risk. RESULTS: Overall, the rate of fractures in pre-dialysis CKD patients was 74 per 1,000 patient-years, while that in dialysis patients was 84 per 1,000 patient-years. The risk of fracture in ESRD patients was higher than pre-dialysis CKD patients (hazard ratio, 1.16; 95% confidence interval, 1.12–1.21; P < 0.001) after adjusting for confounding variables. In addition, the fracture risk in patients who were not taking phosphate binders was 20.0% higher compared to ESRD patients taking phosphate binders. CONCLUSION: Fractures were more prevalent in ESRD patients on dialysis than pre-dialysis CKD patients. Use of phosphate binders was associated with a lower fracture risk in ESRD patients.
Cohort Studies ; Confounding Factors (Epidemiology) ; Diagnosis ; Dialysis ; Humans ; Hyperphosphatemia ; Insurance, Health ; Kidney Failure, Chronic ; Prescriptions ; Renal Insufficiency, Chronic

The purpose of this research was to provide basic information for cookies made with black soybeans, chick peas, lentils, oatmeal, and brewer's yeast and to establish the optimum formula for the development of low glycemic index (GI) cookies with high biotin content for lactating women. This study was performed to determine the optimal composite recipe of oatmeal cookies with two different concentrations levels of bean powder (black soybeans, chick peas, lentils) and brewer's yeast using a central composite design. In addition, the mixing conditions of oatmeal cookies were optimized using response surface methodology of sensory evaluation and mechanical and physicochemical analysis. As a result, mechanical and physicochemical analyses showed significant values for lightness, redness, yellowness, hardness, and water content (P < 0.05), while sensory evaluation showed significant values for flavor, taste, crispness, and overall acceptability (P < 0.05). The optimal sensory combination was suggested to be 3.73 g of bean powder and 1.59 g of brewer's yeast. Considering all outcomes obtained throughout the experiments, brewer's yeast, black soybeans, chick peas, lentils, and oatmeal are suitable ingredients for increasing functionality and consumer acceptability of cookies. In addition, these results are expected to be useful in producing cookies of optimal quality, contributing to the development of various nutritious foods, and improving the food industry for lactating women.
Biotin ; Female ; Food Industry ; Glycemic Index ; Hardness ; Humans ; Lens Plant ; Peas ; Saccharomyces cerevisiae ; Skin ; Soybeans ; Water