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

BACKGROUND: The present study was aimed at investigating whether there is a mechanism exerted by endogenous nitric oxide(NO) in the regulation of aquaporin(AQP) water channels in the kidney. METHODS: Male Sprague-Dawley rats were treated with N(G)-nitro-L-arginine methyl ester(L-NAME, 40 mg/L drinking water) to inhibit the endogenous generation of nitric oxide. Four weeks later, total abundance and shuttling of AQP2 proteins were determined in different regions of the kidney. RESULTS: Chronic inhibition of NO synthesis increased the expression of AQP2 channels in cortex, outer medulla, and inner medulla of the kidney. The AQP2 shuttling was not significantly altered, as evidenced by an unaltered ratio of AQP2 expression in the membrane fraction versus that in the cytoplasmic fraction. CONCLUSION: It is suggested that endogenous NO activity plays a tonic inhibitory role in the expression of AQP2 channels in the kidney.
Animals ; Aquaporin 2* ; Aquaporins* ; Cytoplasm ; Drinking ; Humans ; Kidney* ; Male ; Membranes ; Nitric Oxide* ; Rats* ; Rats, Sprague-Dawley

A 45-year-old male with alleged asymptomatic hepatic hemangioma of 4 years duration had right upper-quadrant pain and was referred to a tertiary hospital. Computed tomography and magnetic resonance imaging scans revealed a hypervascular mass of about 7 cm containing intratumoral multilobulated cysts. A preoperative liver biopsy was performed, but this failed to provide a definitive diagnosis. The patient underwent a partial hepatectomy of segments IV and VIII. The histologic findings revealed multifocal proliferation of flattened or cuboidal epithelioid cells and a highly vascular edematous stroma. Immunohistochemistry findings demonstrated that the epithelioid tumor cells were positive for cytokeratin (AE1/AE3), vimentin, calretinin, and cytokeratin 5/6, and were focally positive for CD10, and negative for WT1 and CD34, all of which support their mesothelial origin. Immunohistochemistry for a mesothelial marker should be performed for determining the presence of an adenomatoid tumor when benign epithelioid cells are seen.
Adenomatoid Tumor/*diagnosis/pathology/surgery ; Calcium-Binding Protein, Vitamin D-Dependent/metabolism ; Hemangioma/*diagnosis/pathology/surgery ; Hepatectomy ; Humans ; Keratins/metabolism ; Liver Neoplasms/*diagnosis/pathology/surgery ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neprilysin/metabolism ; Tomography, X-Ray Computed ; Vimentin/metabolism

48-year-old woman was admitted to emergency room due to left flank pain. It was diagnosed with left ureteral stone and underwent extracorporeal shock wave lithotripsy (ESWL). However, 12 hours later, the patient complained acute upper abdominal pain with pulmonary edema and low blood pressure. A diagnosis of moderate acute pancreatitis with local complication was considered and we decided conservative therapy including fluid resuscitation, inotropics and antibiotics. It was suggested that ESWL was responsible for the acute pancreatitis. The patient gradually recovered and was discharged on 13th day of admission. ESWL is considered the standard treatment for urolithiasis. Although, it has proved to be safe and effective, serious complications have been reported in 1% of patients, including acute pancreatitis, perirenal hematoma, urosepsis, venous thrombosis, biliary obstruction, bowel perforation, lung injury, and cardiac arrhythmia. Although the possibility of post-ESWL acute pancreatitis is extremely low, physicians should take care of this complication.
Abdominal Pain ; Anti-Bacterial Agents ; Arrhythmias, Cardiac ; Diagnosis ; Emergency Service, Hospital ; Female ; Flank Pain ; Hematoma ; Humans ; Hypotension ; Lithotripsy* ; Lung Injury ; Middle Aged ; Pancreatitis* ; Pulmonary Edema ; Resuscitation ; Shock* ; Ureter ; Urolithiasis* ; Venous Thrombosis

Congenital anomalies of the coronary artery are associated with various symptoms including syncope, myocardial ischemia, and sudden cardiac death. The abnormality depends on the adjacent structure and pathway of the coronary artery. Most patients with an anomalous left coronary artery that arises from a right coronary sinus of the valsalva have no symptoms and are usually diagnosed at autopsy. Therefore, their first symptom might present as sudden death, particularly when the left coronary arterial course is between the aorta and the pulmonary trunk. Symptomatic patients could be diagnosed early with an anomalous coronary artery, and the risk of fatal events could be decreased by surgical correction. Here, we report the case of 62-year-old male who experienced a first episode of syncope with an anomalous left coronary artery arising from the right sinus of the valsalva with a separate orifice from the right coronary artery. He is alive and in good health receiving medical treatment, and has had no medical events for over 2 years.
Aorta ; Autopsy ; Coronary Sinus ; Coronary Vessel Anomalies ; Coronary Vessels* ; Death, Sudden ; Death, Sudden, Cardiac ; Humans ; Male ; Middle Aged ; Myocardial Ischemia ; Sinus of Valsalva ; Syncope*

PURPOSE: Chronic constipation is not uncommon even in children. Recently biofeedback treatment (BT) is considered as a useful modality in the treatment of various types of constipation. The aim of this study was to evaulate the effectiveness of BT in children with chronic constipation. METHODS: We reviewed 24 cases of childhood constipation (17 boys, 7 girls) who visited the Jinju Hakmoon colorectal surgery clinic and GNUH1 between April, 2001 and September, 2002. Balloon-mediated anorectal manometry system was used for BT. The effects of therapy was assessed by bowel movement, defecation time, fecal soiling and balloon evacuation test in the early course of therapy. The long term follow up survey was done by telephone interview at January 2003 and the effects of therapy was assessed by bowel movement, defecation time, fecal soiling and parents' satisfaction. RESULTS: Patients received the BT for the three times on average, and as the result of the therapy, 20 patients experienced disappearance of symptoms (87%) or at least improvement of symptoms. In terms of manometric values, the mean resting pressure was 113.4 mmHg before the BT, but decreased to 86.3 mmHg after the BT (P=0.0012). Mean pushing pressure dropped to 85.98 mmHg from 130.45 mmHg (P=<0.0001). Mean sensitivity decreased from 55 ml to 35 ml (P=0.0053). Mean compliance decreased from 20.28 H2O/cm to 4.21 H2O/cm (P=0.0015). 13 patients (76%) showed disappearance or improvement of symptoms in the long term follow up. CONCLUSIONS: The Balloon mediated biofeedback therapy is effective in children with chronic constipation. It is safe, easy to administer and also improve symptoms and objective parameters of anorectal function. Balloon mediated biofeedback therapy could be the first-line therapy in child patient with chronic constipation who failed conservative management.
Biofeedback, Psychology* ; Child* ; Colorectal Surgery ; Compliance ; Constipation* ; Defecation ; Follow-Up Studies ; Gyeongsangnam-do ; Humans ; Interviews as Topic ; Manometry ; Soil

BACKGROUND/AIMS: Endoscopic resection is the first-line treatment for rectal neuroendocrine tumors (NETs) measuring < 1 cm and those between 1 and 2 cm in size. However, conventional endoscopic resection cannot achieve complete resection in all cases. We aimed to analyze clinical outcomes of precut endoscopic mucosal resection (EMR-P) used for the management of rectal NET. METHODS: EMR-P was used to treat rectal NET in 72 patients at a single tertiary center between 2011 and 2015. Both, circumferential precutting and EMR were performed with the same snare device in all patients. Demographics, procedural details, and histopathological features were reviewed for all cases. RESULTS: Mean size of the tumor measured endoscopically was 6.8±2.8 mm. En bloc and complete resection was achieved in 71 (98.6%) and 67 patients (93.1%), respectively. The mean time required for resection was 9.0±5.6 min. Immediate and delayed bleeding developed in six (8.3%) and 4 patients (5.6%), respectively. Immediate bleeding observed during EMR-P was associated with the risk of delayed bleeding. CONCLUSIONS: Both, the en bloc and complete resection rates of EMR-P in the treatment of rectal NETs using the same snare for precutting and EMR were noted to be high. The procedure was short and safe. EMR-P may be a good treatment choice for the management of rectal NETs.
Carcinoid Tumor ; Demography ; Hemorrhage ; Humans ; Neuroendocrine Tumors* ; Rectum ; SNARE Proteins

BACKGROUND: Vitiligo is an acquired depigmentary disorder of the skin and hair. The etiology is unknown, however an autoimmune hypothesis is favored. OBJECTIVE: We performed this study to develop a better understanding of the clinical features of vitiligo patients. METHOD: We evaluated clinical manifestations of 1203 vitiligo patients(556 males and 647 females). RESULTS AND CONCLUSIONS: 1. The mean age of onset and that of the first visits made by patients were 22.9+/-18 and 27.9+/-19 years, respectively. 2. The face(37.4%) was the most common site of initial involvement. In decreasing order of frequency, the common sites of involvement were the face and neck(65.9%), thorax and abdomen(42.9%), upper extremities(42.3%). 44.5% of the cases had the vulgaris type, 26.1% the focal type, and 21.1% the segmental type. During the three months before a visit, 44% of patients experienced progression of disease. Within one year, about 75% of patients reported that the disease had progressed. 3. Precipitating or aggravating factors such as trauma(13.1%), psychological stress(9.2%), sun light (2.8%) and pregnancy(2.5%), were found in 30.9% of patients. Thyroid disease was the most common associated disease.
Age of Onset ; Hair ; Humans ; Male ; Skin ; Solar System ; Thorax ; Thyroid Diseases ; Vitiligo*

Muinous gastric carcinoma (MGC) is a rare histological type that accounts for approximately 3~7% of all gastric carcinomas. The results of clinicopathological studies suggest that the overall survival rate for patients with MGC is worse than that for patients with non-mucinous tumors as MGC is more frequently diagnosed in the advanced stage. In this report, we preoperatively predicted the type of a tumor from its endoscopic finding. An endoscopic ultrasonographic examination showed a submucosal tumor like mass showing mucin waterfall on the gastric cardia. A total gastrectomy with splenectomy was performed. The pathology of the tumor identified the lesion as a mucinous adenocarcinoma.
Adenocarcinoma ; Adenocarcinoma, Mucinous ; Cardia ; Gastrectomy ; Gastric Mucins ; Humans ; Mucins ; Splenectomy ; Survival Rate

BACKGROUND/AIMS: The reported rates of current smoking at the time of Crohn’s disease (CD) diagnosis tend to be low in East Asian studies. However, we hypothesized that East Asian patients may be reluctant to disclose their smoking history, likely because of the influence of the Confucian culture. METHODS: We prospectively re-evaluated the smoking status at diagnosis in 1,437 Korean CD patients whose smoking status had been reported in our previous study. RESULTS: After re-evaluation, the current smokers at diagnosis increased from 388 patients (27.0%) to 445 patients (31.0%), indicating that 12.8% (57 of 445 patients) of the current smokers at diagnosis did not disclose their smoking status at their initial evaluation. The proportion of current smokers at diagnosis who had initially concealed their smoking status was significantly higher among the female patients (29.7%, 11/37) compared with the male patients (11.3%, 46/408) (p<0.005) and among the patients who were ≤18 years old at diagnosis (56.4%, 22/39) compared with the patients >18 years old at diagnosis (8.6%, 35/406) (p<0.001). CONCLUSIONS: Subgroups of Korean CD patients, particularly young patients and female patients, are reluctant to disclose their smoking history. Therefore, the suggestion that smoking is not a risk factor for the development of CD in East Asians should be made with caution.
Asian Continental Ancestry Group* ; Crohn Disease* ; Diagnosis ; Female ; Humans ; Male ; Prospective Studies ; Risk Factors ; Smoke* ; Smoking*