No abstract available.
Bronchopulmonary Sequestration*

Metabolically healthy obesity (MHO) is a new concept in which an individual may exhibit an obese phenotype in the absence of any metabolic abnormalities. There are a number of definitions of MHO that utilize a variety of components. The findings of clinical and basic studies indicate that subjects with MHO do not exhibit an increased mortality, an increased risk of cardiovascular disease, or an increased risk of type 2 diabetes mellitus, as compared to normal-weight controls. Although these findings imply that metabolic health is a more important factor than obesity, several studies have shown that subjects with MHO have a similar risk of metabolic or cardiovascular diseases as those with metabolically unhealthy obesity. Thus, there is still debate regarding not only the implications of the MHO phenotype but its very existence. Accordingly, future studies should focus on developing a unified definition of MHO and distinguishing subjects who will be at a high risk for metabolic and cardiovascular diseases.
Cardiovascular Diseases ; Diabetes Mellitus, Type 2 ; Mortality ; Obesity* ; Phenotype*

No abstract available.
Biopsy*

PURPOSE: To evaluate the prevalence of capsular retraction in malignant hepatic tumors and the factorsinvolved. MATERIALS AND METHODS: Between January 1994 and December 1996, we retrospectively reviewed the CT scansof 152 patients with pathologically-proven, peripherally-located, malignant hepatic tumors. We evaluated size,site, portal and hepatic venous obstruction, bile duct dilatation, and liver atrophy in 18 cases involvingcapsular retraction. RESULTS: The overall prevalence of capsular retraction among malignant hepatic tumors was18/152(12%) ; the prevalence was 9/129(7%) in hepatocellular carcinoma, 6/14(43%) in cholangiocarcinoma and3/9(33%) in metastatic cancer ; among cases of cholangiocarcinoma and metastatic cancer, the prevalence washigh(p <0.05). Portal venous obstruction was seen in six patients with hepatocellular carcinoma (a high incidence ;p=0.041) and one with cholangiocarcinoma. Hepatic venous obstruction was demonstrated in one patient withhepatocellular carcinoma and one with cholangiocarcinoma. Among cholangiocarcinoma patients, bile duct obstructionwas seen in four and liver atrophy in three, but among metastatic cancer cases there were no similar findings. CONCLUSION: The main factors causing capsular retraction were portal venous obstruction in hepatocellularcarcinoma and bile duct obstruction and liver atrophy in cholangiocarcinoma.
Atrophy ; Bile Ducts ; Carcinoma, Hepatocellular ; Cholangiocarcinoma ; Cholestasis ; Dilatation ; Humans ; Incidence ; Liver ; Prevalence ; Retrospective Studies

The purpose of this study is to compare the level of health-related quality of life and relating factor between institutional elderly and community living elderly. The subjects were 390 from Sanatorium or Nursing home and 467 from the community, in Kwangju. The results are followed : l) A comparison of ADL between two groups, institutional elderly and community living elderly, resulted in that community elderly were more significantly independent in the areas of bathing and transfer than institutional elderly. 2) A comparison of IADL between two groups resulted in that ; Community elderly, were more independent in the areas of using telephone and transportation, food preparation, house keeping, and doing laundry. Institutional elderly were more independent in the area of handling finances. 3) In the case of poor health-related quality of life, institutional elderly showed 2.4 times in the dimension of physical fitness, l.8 times in daily activity, 2 times in social activity, 2 times in pain, 26.7 times in social support, and 0.4 times in subjective quality of life higher than community elderly. There was no significant differences in the rest of dimensions. 4) In institutional elderly, the analysis of variables related to the health-related quality, of life resulted in that; The relating factors were sex, education, and chronic illness in the dimension of physical function. Direct contact with family or significant others in the dimension of social activity. Chronic illness in the dimension of pain and perceived health status. Direct or indirect contact with family or significant others over the phone or through letters in the dimension of social support. 5) The analysis of variables relatd to the health-related quality of life showed that community elderly has more relating variables in each area than institutional elderly. The relating factors were age, sex, and chronic illness in the dimension of physical function. Education and chronic illness in the dimension of emotional status. Age and chronic illness in the dimension of daily activity and social activity. Education and chronic illness in the dimension of pain and perceived health status. Sex, education, family size in the dimension of social support. Education and chronic illness in the dimension of subjective quality-of-life. Throughout general daily activity, community elderly showed more satisfactory results than institutional elderly, but in the subjective area of health-related quality of life, such as subjective quality of life, institutional elderly, group showed more positive results. And community elderly had more relating factors than institutional elderly. For the health care of the elderly that focused on quality, of life, new approaches considering the characteristics of both group, institutional and community, living elderly, are needed.
Activities of Daily Living ; Aged* ; Baths ; Chronic Disease ; Delivery of Health Care ; Education ; Family Characteristics ; Gwangju ; Humans ; Nursing Homes ; Physical Fitness ; Quality of Life* ; Telephone ; Transportation

BACKGROUND/AIMS: The aim was to determine which of three sets of metabolic syndrome (MetS) criteria (International Diabetes Federation [IDF], National Cholesterol Education Program Adult Treatment Panel III [ATP III], and European Group for the Study of Insulin Resistance [EGIR]) best predicts the coronary artery calcification (CAC) score in a cross-sectional study. This has not been evaluated in previous studies. METHODS: A total of 24,060 subjects were screened for CAC by multi-detector computed tomography. The presence of CAC was defined as a CAC score > 0. The odds ratio for the presence of CAC was analyzed for three different sets of MetS criteria and according to number of MetS components. RESULTS: CAC was observed in 12.6% (3,037) of the subjects. Patients with MetS, as defined by the IDF, ATP III, and EGIR criteria, had a CAC rate of 23.0%, 25.1%, and 29.5%, respectively (p < 0.001). Comparisons of C statistics for multivariate regression models revealed no significant difference among the three sets of criteria. After adjustment for risk factors, the ATP III criteria produced a slightly higher odds ratio for CAC compared with the other criteria, but this difference was not significant. The risk factor-adjusted odds ratio for the presence of CAC increased from 1 to 1.679 as the number of MetS components defined by ATP III increased from 0 to > or = 3 (p for trend < 0.001). CONCLUSIONS: The presence of MetS was associated with the presence of CAC. There was no significant difference among the three sets of MetS criteria in terms of the ability to predict CAC. An increase in the number of MetS components was associated with an increased odds of CAC.
Adult ; Asymptomatic Diseases ; Biological Markers/blood ; Calcium/*analysis ; Coronary Angiography/methods ; Coronary Artery Disease/blood/*epidemiology/radiography ; Coronary Vessels/*chemistry/radiography ; Cross-Sectional Studies ; Female ; Humans ; Male ; Metabolic Syndrome X/blood/diagnosis/*epidemiology ; Middle Aged ; Multidetector Computed Tomography ; Multivariate Analysis ; Odds Ratio ; Predictive Value of Tests ; Prevalence ; Republic of Korea/epidemiology ; Risk Assessment ; Risk Factors ; Vascular Calcification/blood/*epidemiology/metabolism/radiography

BACKGROUND AND OBJECTIVES: Recently, the incidence of allergic diseases such as asthma, allergic rhinitis and atopic dermatitis is on the increase with the society getting more and more industrialized. Although many therapeutic options for prevention and treatment of the allergic diseases have been developed, true allergen desensitization remains a challenging goal. The classic immunotherapy using protein-based allergen has limited efficacy, is inconvenient, and has a risk of anaphylaxis. Recent reports revealed that immunostimulatory DNA sequences (ISS-ODN, CpG motif) have been shown to act as a strong Th1 response-inducing adjuvants and that DNA-based vaccination might be an effective therapeutic option for treatment of allergic diseases. In this study, we investigated whether ISS-ODN/Dermatophagoides farinae (Der f) conjugate has anti-allergic effects in the mouse model of allergic rhinitis, which is sensitive to house dust mites. Der f is the most common allergen inducing allergic rhinitis in Korea. MATERIALS AND METHOD: C57BL/6 mice were systemically and locally sensitized with crude extracts of Der f. After the injection of ISS-ODN/Der f conjugate and the mutant-ODN/Der f conjugate, several parameters of allergic response were evaluated. RESULTS: Scratching and sneezing symptoms, and eosinophilic infiltration into nasal mucosa were suppressed by the injection of ISS-ODN/Der f conjugate. IL-5 level in nasal lavage fluid (NLF) was decreased and IFN gamma level was increased. Der f-specific IgE was decreased, however, as it was not statistically significant. CONCLUSION: The results showed that ISS-ODN/Der f conjugate has anti-allergic effects and biased Th1 reaction in the allergic rhinitis model of Der f allergen.
Anaphylaxis ; Animals ; Asthma ; Base Sequence ; Bias (Epidemiology) ; Complex Mixtures ; Dermatitis, Atopic ; Dermatophagoides farinae ; Eosinophils ; Immunoglobulin E ; Immunotherapy ; Incidence ; Interleukin-5 ; Korea ; Mice ; Nasal Lavage Fluid ; Nasal Mucosa ; Pyroglyphidae ; Rhinitis* ; Sneezing ; Vaccination ; Vaccines, Conjugate

BACKGROUND: Tumor necrosis factor (TNF)-alpha is associated with insulin resistance and systemic inflammatory responses. The aim of this study was to investigate the relationship between TNF-alpha and the development of nonalcoholic fatty liver disease (NAFLD) in a longitudinal study. METHODS: Three hundred and sixty-three apparently healthy subjects (mean age, 40.5+/-6.1 years; male, 57.6%) without NAFLD were enrolled in 2003. Anthropometric and laboratory measurements were performed. The participants were grouped into tertiles according to their serum TNF-alpha levels from samples taken in 2003. At a 4-year follow-up, we compared the odds ratios (ORs) of the development of NAFLD according to the tertiles of TNF-alpha levels measured in 2003. RESULTS: At the 4-year follow-up, the cumulative incidence of NAFLD was 29.2% (106/363). The group that developed NAFLD had higher levels of TNF-alpha than those in the group without NAFLD (3.65+/-1.79 pg/mL vs. 3.15+/-1.78 pg/mL; P=0.016). When the 2003 serum TNF-alpha levels were categorized into tertiles: incidence of NAFLD observed in 2007 was significantly higher with increasing tertiles (22.6%, 35.8%, and 41.5%, respectively; P<0.05). The risk of developing NAFLD was significantly greater in the highest tertile of TNF-alpha than in the lowest tertile after adjusting for age, smoking, and BMI (OR, 2.20; 95% confidence interval, 1.12 to 4.01; P<0.05). CONCLUSION: Higher serum TNF-alpha levels in subjects without NAFLD were associated with the development of NAFLD. The results of study might suggest a pathologic role of inflammation in NAFLD.
Fatty Liver ; Follow-Up Studies ; Humans ; Incidence ; Inflammation ; Insulin Resistance ; Male ; Odds Ratio ; Smoke ; Smoking ; Tumor Necrosis Factor-alpha

BACKGROUND: We investigated the association of coronary artery calcium score (CACS) with body composition and insulin resistance in apparently healthy Korean adults. METHODS: Nine hundred forty-five participants (mean age, 48.9 years; 628 men) in a medical check-up program were selected for analysis. Body composition was assessed by bioelectrical impedance analysis (BIA). Insulin resistance was evaluated using the homeostasis model assessment of insulin resistance (HOMA-IR). The CACS was assessed by multidetector computed tomography. RESULTS: One hundred forty-six subjects (15.4%) showed coronary artery calcification and 148 subjects (15.7%) had metabolic syndrome. CACS showed a significant positive correlation with age, fasting glucose level, waist circumference (WC), blood pressure, hemoglobin A1c, HOMA-IR, and waist-hip ratio (WHR) assessed by BIA. CACS had a negative correlation with high density lipoprotein cholesterol (HDL-C). Subjects with high CACS showed significantly higher mean WHRs and lower mean values for lean body mass compared with subjects without coronary artery calcification. In logistic regression analyses with coronary artery calcification as the dependent variable, the highest quartile of WHR showed a 3.125-fold increased odds ratio for coronary artery calcification compared with the lowest quartile after adjustment for confounding variables. When receiver operating characteristics analyses were performed with coronary artery calcification as the result variable, WHR showed the largest area under the curve (AUC) value among other variables except for age and WC in women (AUC=0.696 for WHR, 0.790 for age, and 0.719 for WC in women). CONCLUSION: In our study population of apparently healthy Korean adults, WHR was the most significant predictor for coronary artery calcification among other confounding factors, suggesting that it may have implication as a marker for early atherosclerosis.
Adult ; Atherosclerosis ; Blood Pressure ; Body Composition ; Calcium ; Cholesterol ; Cholesterol, HDL ; Confounding Factors (Epidemiology) ; Coronary Vessels ; Electric Impedance ; Fasting ; Female ; Glucose ; Hemoglobins ; Homeostasis ; Humans ; Insulin Resistance ; Lipoproteins ; Logistic Models ; Obesity, Abdominal ; Odds Ratio ; ROC Curve ; Waist Circumference ; Waist-Hip Ratio

BACKGROUND: To review the important features and treatment modalities of phalloides syndrome. METHOD: We performed a retrospective analysis of 16 patients with phalloides syndrome who visited the Emergency Center of Seoul National University ospital, Uijongbu St. Mary 's Hospital, Gachon Medical College Hospital, and Kyungpook National University Hospital from July 1st to August 31st, 1998. Mann-Whitney U test was used for statistical analysis(p < 0.05). RESULTS: 9 were male and 7 were female. The mean age was 54 years(men 46 years, women 65 years). Fourteen cases(88%) occurred in Kyungpook area. All cases of phalloides syndrome RESULT:ed from mistaking toxic mushrooms for edible mushrooms. The doses of ingestion of mushroom were not available because the patient could not remember the exact amounts. The identification of mushrooms in 4 cases was confirmed by mycologist, 6 cases by mushroom photoatlas, and remained 6 cases were not confirmed. The initial symptoms of mushroom poisoning were abdominal pain, nausea, and watery diarrhea. The time intervals from the ingestion of mushroom to the onset of symptom were from 6 to 13 hours(mean 11.3 +/-2.68 hours). The laboratory data showed the increased GOT and GPT, prolonged prothrombin time, elevated serum creatinine level, and decreased platelet count. The initial management of phalloides mushroom poisoning was done conservatively, but the early specific treatments such as gastrointestinal decontamination, administration of activated charcoal, IV penicillin or silymarin were not perfomed in all cases. The mortality rate was 18.8%. There were significant differences in total bilirubin, prothrombin time, platelet count, and serum creatinine between survival and non-survival group(p<0.05). CONCLUSION: It is important to know the morphological differences between edible and toxic mushroom for prevention of phalloides syndrome. If the patient with acute gastroenteritis has a history of mushroom ingestion, the emergency physician should suspect phalloides syndrome and start early proper treatment. For the identification of mushroom, it is desirable to contact a mycologist.
Abdominal Pain ; Agaricales ; Bilirubin ; Charcoal ; Creatinine ; Decontamination ; Diarrhea ; Eating ; Emergencies ; Female ; Gastroenteritis ; Gyeongsangbuk-do ; Humans ; Male ; Mortality ; Mushroom Poisoning ; Nausea ; Penicillins ; Platelet Count ; Prothrombin Time ; Retrospective Studies ; Seoul ; Silymarin