BACKGROUND: Although adults in 30s and 40s are at risk for hypertension management due to low rates of awareness, treatment, and control of hypertension, there has been a lack of study on hypertension management for this population. Thus, the purpose of this study is to examine blood pressure screening and other associated factors with hypertension management in terms of awareness, control, and treatment. METHODS: Secondary data analysis was performed on the data from the Fourth Korea National Health and Nutrition Examination Survey in 2007-2009. To examine whether blood pressure screening affects hypertension management in 929 subjects aged 30s and 40s with hypertension. Other factors, such as socio-demographics, health status, and health behaviors, were also included for data analysis. Chi-square test and multiple logistic regression analysis were carried out using SAS 9.1. RESULTS: Hypertension awareness rates were high in those who had diabetes mellitus (odds ratio [OR] 2.23; 95% confidence interval [CI] 1.27-3.90), self-rated their health status as poor (OR 2.89; 95% CI 1.82-4.58), and received a blood pressure check up (OR 5.96; 95% CI 2.90-12.25). Hypertension treatment rates were high in women (OR 2.50; 95% CI 1.47-4.27), and high in those who had diabetes mellitus (OR 2.59; 95% CI 1.49-4.47), self-rated their health status as poor (OR 2.53; 95% CI 1.54-4.14), self-reported as past smoker (OR 2.01; 95% CI 1.22-3.29), and received a blood pressure check up (OR 12.64; 95% CI 4.87-32.77). Hypertension control rates were high in women (OR 2.47; 95% CI 1.29-4.72), and high in those who self-reported as past smoker (OR 2.46; 95% CI 1.35-4.50), and received a blood pressure check up (OR 9.24; 95% CI 3.15-27.15). CONCLUSIONS: For effective hypertension management in 30s and 40s, we should encourage this population to have a regular blood pressure screening.
Adult ; Aged ; Blood Pressure ; Diabetes Mellitus ; Female ; Health Behavior ; Humans ; Hypertension ; Korea ; Logistic Models ; Mass Screening ; Nutrition Surveys ; Phenothiazines ; Statistics as Topic

Accepted methods of treatment of lumbar burst fractures include conservative therapy, posterior reduction and instrumentation, and anterior decompression and instrumentation. Surgery aims at the correction of the kyphotic deformity and at the decompression of the spinal cord thereby reducing pain and allowing early patient mobilization. Posterior-only procedures usually rely on ligamentotaxis or manual tamping of bone fragments for decompression of the spinal canal. Transpedicular corpectomy allow for circumferential surgery through a single posterior approach. The authors use an expandable cage to restore the normal spinal curvature and to prevent the kyphotic deformity.
Congenital Abnormalities ; Decompression ; Humans ; Spinal Canal ; Spinal Cord ; Spinal Curvatures

PURPOSE: To report the first domestic case of choroidal neovascularization in a choroideremia patient treated with intravitreal bevacizumab injection. CASE SUMMARY: A 29-year-old male presented with a sudden decline in vision in the left eye. Fundus examination revealed areas of choriocapillaries and retinal pigment epithelium atrophy with macular hemorrhage. Fluorescein angiogram revealed vascular hyperfluorescence in the juxtafoveal area. Neurosensory detachment around the macula and increased central macular thickness was also observed using optical coherence tomography. Upon the diagnosis of choroideremia with choroidal neovascularization, the patient was treated with 1.25 mg intravitreal bevacizumab. Visual acuity improved after four injections of intravitreal Bevacizumab with improvement in both detachment and fluorescein leakage. CONCLUSIONS: In patients with choroideremia presenting sudden decline in vision, ophthalmologists should detect for possible choroidal neovascularization. The results from the present study show that judicious use of intravitreal Bevacizumab may be effective in such cases. Further studies with a large sample size and sufficiently long follow-up periods are required.
Adult ; Antibodies, Monoclonal, Humanized ; Atrophy ; Choroid ; Choroidal Neovascularization ; Choroideremia ; Eye ; Fluorescein ; Follow-Up Studies ; Hemorrhage ; Humans ; Male ; Retinal Pigment Epithelium ; Sample Size ; Tomography, Optical Coherence ; Vision, Ocular ; Visual Acuity ; Bevacizumab

Purpura fulminans may be seen in three different clinical settings: (1) in the neonatal period from protein C and S deficiencies, (2) during severe bacterial infections such as “sepsis-associated” purpura fulminans, and (3) during the convalescence of an otherwise benign “preparatory” infectious disease most commonly involving the skin. We report a case of a 20-month-old male child with purpura fulminans as a presenting sign of disseminated intravascular coagulopathy (DIC). He had suffered from fever of unknown origin for a month. Although purpura fulminans is not a common disorder to dermatologists, the awareness of this disorder may be the clue to diagnose and treat underlying diseases.
Bacterial Infections ; Child ; Communicable Diseases ; Convalescence ; Fever of Unknown Origin ; Humans ; Infant ; Male ; Protein C ; Purpura Fulminans* ; Purpura* ; Skin

Sclerosing panniculitis refers to the skin induration and hyperpigmentation of the legs that often occurs in patients who have venous insufficiency. Sclerosing panniculitis is similar to those described under the designations hypodermitis sclerodermiformis or lipodermatosclerosis. Histologically the septa of the subcutis become thickening by inflammation and fibrosis. Adipocytes coalesce to form small and large pseudocysts. Some of these are lined by refractile, amphophilic crenulated membranes. This alteration was referred to as lipomembranous change. We report a case of sclerosing panniculitis in a 40-year-old female patient presented as induration and depression of the skin and subcutaneous tissues of the lower third of the leg.
Adipocytes ; Adult ; Depression ; Female ; Fibrosis ; Humans ; Hyperpigmentation ; Inflammation ; Leg ; Membranes ; Panniculitis* ; Skin ; Subcutaneous Tissue ; Venous Insufficiency

BACKGROUND: Psoriasis is a chronic skin disease characterized histologically by prominent keratinocyte hyperplasia and an early inflammatory cell infiltrate. However, the pathogenesis is not fully understood yet. Recently, there has been growing interest in the probable role of a T cell mediated immune response in the pathogenesis. Especially, cytokine network involved in psoriasis has been studied. OBJECTIVE: This study was done to investigate the role of Interleukin-8(IL-8) and its inducer, Tumor necrosis factor-alpha(TNF-alpha) for pathogenesis of psoriasis. METHODS: We performed immunohistochemical staining using antibodies for IL-8 and TNF-alpha in frozen skin samples of 14 psoriatic patients who had not been treated for psoriatic lesion for 1 month and 3 normal skin samples as controls. RESULTS: There was no detectable discrete immunoreactivity for either TNF-alpha and IL-8 in epidermis and dermis of normal controls. In psoriatic lesions, the expression of TNF-alpha was found in dermal cells within the papillary dermis, particularly around blood vessels. The expression of IL-8 was presented on suprabasal keratinocytes above TNF-alpha-positive dermal tissue. CONCLUSION: Our results strongly suggest that histologic expression and functional interaction between IL-8 and its inducer, TNF-alpha have significant roles in the pathogenesis of psoriasis.
Antibodies ; Blood Vessels ; Dermis ; Epidermis ; Humans ; Hyperplasia ; Interleukin-8* ; Keratinocytes ; Necrosis ; Psoriasis ; Skin ; Skin Diseases ; Tumor Necrosis Factor-alpha*

BACKGROUND: Chronic telogen effluvium is a common problem in middle-aged women. It has been suggested that reduced iron stores are a cause of this type of baldness. OBJECTIVE: We performed this study in order to elucidate the pathogenesis of chronic telogen effluvium and to evaluate the differences in serum stored iron levels between normal females and those with chronic telogen effluvium. METHODS: Blood levels of hemoglobin, iron, ferritin, and TIBC were examined in 20 patients with chronic telogen effluvium and 20 normal females. RESULT: 1) Ferritin levels were significantly decreased in the patients group(p=0.008). 2) TIBC levels were significantly increased in the patients group(p=0.001). 3) There were no significant differences in Hb and serum iron in both groups (p<0.05). CONCLUSION: These findings suggested that the variation of serum ferritin level may play a role in the pathogenesis of chronic telogen effluvium, but further studies will be needed for evaluation of this condition.
Alopecia ; Female* ; Ferritins ; Humans ; Iron*

Anatomical examinations on Bruch's membrane have almost been by light microscopy or transmission electron microscopy. Scanning electron microscopy allowed us to evaluate surface features topographically. Each layer of Bruch's membrane was exposed sequentially to mechanical or enzymatic treatment of the retinal pigment epithelium choroid complex from human cadavar eye. The authors examined the surface features of the membrane by dry-cracking scanning electron microscopy. The basement membrane of retinal pigment epithelium appeared like a smooth thin plastic membrane which was framed by collagen fibers. The inner collagenous layer was composed of many collagen fiber bundles which were placed in order and the ground substance between them was not visible. Elastic layer of Burch's membrane appeared to be coarse and fine fibers matted together by some amorphous substance. This layer had many openings on its solid sheet and the outer collagenous zone was visible though these openings.
Basement Membrane ; Bruch Membrane* ; Choroid ; Collagen ; Humans* ; Membranes ; Microscopy ; Microscopy, Electron, Scanning ; Microscopy, Electron, Transmission ; Plastics ; Retinal Pigment Epithelium

BACKGROUND: Adult-onset Still's disease (AOSD), one of the causes of fever of unknown origin, is accompanied by skin rash. This is the reason why the clinical significance of skin lesions has been of interest. However, its skin manifestations and the histopathological findings are not clearly documented. OBJECTIVE: This study aimed to identify characteristic clinical and histopathological features of skin manifestation of AOSD. METHODS: We evaluated the medical records and histopathologic slides of five patients who had been diagnosed with AOSD in the rheumatology department and referred to our department between 1996 and 2009. RESULTS: An asymptomatic evanescent salmon colored macular rash was seen in three patients (60%). A persistent brown plaque was seen in two patients (40%). Histopathologically, superficial perivascular infiltrates of neutrophils and lymphocytes were observed in all patients (100%) and necrotic keratinocytes were observed in the upper epidermis in three patients (60%). CONCLUSION: In addition to typical Still's rash, atypical cutaneous findings such as persistent plaque lesions were found in AOSD patients. The results of this study may help clinicians to diagnose this rare disease more easily.
Adult ; Male ; Female ; Humans

OBJECTIVE: In order to investigate more accurate patterns of intrauterine growth in twin fetuses, we constructed the twin-specific growth curve based on gestational age in live-born non-anomalous infants. METHODS: 563 twin pairs, 1,126 infants delivered between January 1994 and October 1999 were comprised our study population. The newborns were grouped according to gestational age and the median, 10th, 50th, and 90th percentile birth weight for each gestational week were calculated. Curves were plotted for the general population and for each gender and parity and compared with previously reported singleton's growth curve. RESULTS: After 32 weeks gestation, birth weight of twins falls below that of singleton, so that by 38 weeks the 50th percentile for twins falls below the singleton 10th percentile. This difference was also present among all subgroups of twins, such as gender and parity. And the mean birth weight in male twin infant was heavier than in female twin infant throughout all gestational week. CONCLUSION: The pattern of growth in twin infants differed from those of singleton. We recommend twin-specific growth curve for clinical use in the management of twin gestations.
Birth Weight ; Female ; Fetus ; Gestational Age* ; Humans ; Infant ; Infant, Newborn ; Male ; Parity ; Pregnancy ; Twins*