Hypertensive encephalopathy is an acute clinical syndrome that shows central nerve dysfunction with sudden and marked elevation in blood pressure. But its pathophysiologic mechanisms, clinical courses and prognosis are still not clear. In order to study clinical manifestations and response to treatment in patients with hypertensive encephalopathy, we reviewed 45 patients with hypertensive encephalopathy who were admitted in Dept. of Internal Medicine, National Medical Center, from January 1975 to December 1984. The following results were obtained: 1) The ratio of male to female was 1.1:1. The peak age of incidence was in the 6th and 7th decade with mean age of 57.5 years. 2) Among 45 patients, only 29 had known history of hypertension and the average duration of hypertension was 8.1+/-3.6 years. 3) The most common sympotm was severe headache (68.9%). And altered consciousness, nausea and/or vomiting, focal neurologic signs and visual disturbance were also common symptoms in decreasing order of frequency. 4) Funduscopic examination showed hypertensive retinopathy in 20 of 24 (91.7%) patients and lumbar puncture revealed increased CSF pressure in 12 of 20 (60%) patients. 5) In most patients, the mean interval to symptomatic improvement was 2.1 days after administration of anti hypertensive agents, but in 6 patients with initial mean arterial blood pressure above 170mmHg, 4 patients showed delayed response and 2 patients were expired.
Antihypertensive Agents ; Arterial Pressure ; Blood Pressure ; Consciousness ; Female ; Headache ; Humans ; Hypertension ; Hypertensive Encephalopathy* ; Hypertensive Retinopathy ; Incidence ; Internal Medicine ; Male ; Nausea ; Neurologic Manifestations ; Prognosis ; Spinal Puncture ; Vomiting

No abstract available.
Bone Density* ; Estrogens* ; Female ; Humans

Adipose tissue is now considered as an active hormone-secreting organ, which secretes a number of biologically active adipokines such as free fatty acids, leptin, tumor necrosis factor alpha (TNFalpha), interleukin-6, plasminogen activator inhibitor-1, adiponectin and retinol binding protein 4 (RBP4). Among these, adiponectin has attracted considerable attention as an adipokine that has important role in the development of type 2 diabetes, atherosclerosis and cardiovascular diseases. Adiponectin was discovered to be the most abundant adipose-specific transcript. Many epidemiological and clinical studies have demonstrated that serum levels of adiponectin are inversely associated with body weight, especially abdominal visceral fat accumulation. Studies among Japanese and Pima Indians have reported lower concentrations of adiponectin in patients with type 2 diabetes than in those with normal glucose tolerance. A low level of adiponectin was found to be a significant risk factor for the development of cardiovascular events in the Korean patients with type 2 diabetes. We recently published that exercise, having an insulin-sensitizing effect, could be a good therapy to prevent or delay diabetes and cardiovascular diseases in middle-aged women through the modification of adiponectin. These results suggest that the clinical implication of adiponectin. A number of studies have been conducted to clarify the biological role of adiponectin. Recent studies have showed that adiponectin has anti-inflammatory, anti-atherogenic, and glucose-lowering properties. Taken together, it is conceivable that adiponectin plays as a backbone of metabolic syndrome. Finally, pleiotropic functions of adiponectin may possibly serve to prevent and treat atherosclerosis, type 2 diabetes and cardiovascular diseases. Furthermore, enhancement of adiponectin secretion or action may be a good therapeutic target for preventing type 2 diabetes or cardiovascular diseases.
Adipokines ; Adiponectin ; Adipose Tissue ; Asian Continental Ancestry Group ; Atherosclerosis ; Body Weight ; Cardiovascular Diseases ; Carrier Proteins ; Fatty Acids, Nonesterified ; Female ; Glucose ; Humans ; Insulin Resistance ; Interleukin-6 ; Intra-Abdominal Fat ; Leptin ; Plasminogen Activators ; Potassium Iodide ; Risk Factors ; Tumor Necrosis Factor-alpha ; Vitamin A

Aging processes are inevitably accompanied by structural and functional changes in vital organs. Skeletal muscle, which accounts for 40% of total body weight, deteriorates quantitatively and qualitatively with aging. Skeletal muscle is known to play diverse crucial physical and metabolic roles in humans. Sarcopenia is a condition characterized by significant loss of muscle mass and strength. It is related to subsequent frailty and instability in the elderly population. Because muscle tissue is involved in multiple functions, sarcopenia is closely related to various adverse health outcomes. Along with increasing recognition of the clinical importance of sarcopenia, several international study groups have recently released their consensus on the definition and diagnosis of sarcopenia. In practical terms, various skeletal muscle mass indices have been suggested for assessing sarcopenia: appendicular skeletal muscle mass adjusted for height squared, weight, or body mass index. A different prevalence and different clinical implications of sarcopenia are highlighted by each definition. The discordances among these indices have emerged as an issue in defining sarcopenia, and a unifying definition for sarcopenia has not yet been attained. This review aims to compare these three operational definitions and to introduce an optimal skeletal muscle mass index that reflects the clinical implications of sarcopenia from a metabolic perspective.
Aged ; Aging ; Body Mass Index ; Body Weight ; Consensus ; Diagnosis ; Humans ; Muscle, Skeletal* ; Prevalence ; Sarcopenia*

No abstract available.
Aging* ; Humans ; Hyperglycemia* ; Longitudinal Studies* ; Male

Populations are aging and the prevalence of diabetes mellitus is increasing tremendously. The number of older people with diabetes is increasing unexpectedly. Aging and diabetes are both risk factors for functional disability. Thus, increasing numbers of frail or disabled older patients with diabetes will increase both direct and indirect health-related costs. Diabetes has been reported as an important risk factor of developing physical disability in older adults. Older people with diabetes have lower muscle mass and weaker muscle strength. In addition, muscle quality is poorer in diabetic patients. Sarcopenia and frailty have a common soil and may share a similar pathway for multiple pathologic processes in older people. Sarcopenia is thought to be an intermediate step in the development of frailty in patients with diabetes. Thus, early detection of sarcopenia and frailty in older adults with diabetes should be routine clinical practice to prevent frailty or to intervene earlier in frail patients.
Adult* ; Aging ; Diabetes Mellitus ; Humans ; Muscle Strength ; Pathologic Processes ; Prevalence ; Risk Factors ; Sarcopenia* ; Soil

A sound understanding of the preferred appearance of the external nose is central to successful rhinoplasty. A survey using photographs was conducted among college students and employees aged 20 to 39 years in Inchon, Korea. Three hundred and twenty-one subjects filled out a questionnaire about their preferences regarding external nasal appearance. The most commonly preferred height of the nasion, measured from the corneal plane, was 6 mm among both sexes, and the most commonly preferred depth of the nasion, measured from the glabella plane, was 3 mm among both sexes. Regarding the nasofrontal angle, men preferred an angle of 135 degrees and women preferred an angle of 140 degrees. Men preferred a nasofacial angle of 33 degrees while women preferred an angle of 30 degrees. A straight nasal dorsum was most commonly preferred among both sexes and the most commonly preferred dorsal width was 13 mm among men and 10 mm among women. The most commonly preferred tip projection was 30 mm among men and 27 mm among women and the preferred tip angle was 105 degrees among both sexes. The angle of the apex in the most commonly preferred nasal base configuration was 85 degrees among men and 70 degrees among women. The angle of the apex in the most commonly preferred lobular configuration was 65 degrees among both sexes. The most commonly preferred ratio between nostril length and the distance from the subnasale to the tip was 45 percent among both sexes. The most commonly preferred angle between both nostril axes was 60 degrees among both sexes. The most commonly preferred nasolabial angle was 90 degrees among men and 95 degrees among women. The main difference in preference between Koreans and Caucasians seemed to center on the radix area rather than the tip. These results can be useful as basic guidelines for rhinoplasty.
Female ; Humans ; Incheon ; Korea ; Male ; Nose ; Rhinoplasty ; Surveys and Questionnaires

Korean women with a history of gestational diabetes mellitus (GDM) have a 3.5 times greater risk of developing postpartum diabetes than the general population. The incidence of type 2 diabetes mellitus in early postpartum is reported as 10-15% in Korean women. A prospective follow-up study on Korean women with GDM showed that approximately 40% of women with previous GDM were expected to develop diabetes within 5 years postpartum. Independent risk factors for the development of diabetes in Korean women with previous GDM are pre-pregnancy body weight, gestational age at diagnosis, antepartum hyperglycemia on oral glucose tolerance test, low insulin response to oral glucose load, and family history of diabetes. Women with postpartum diabetes have greater body mass indexes, body weight, and waist circumferences than women with normal glucose tolerance. Multiple logistic regression analysis has revealed that waist circumference is the strongest obesity index along with systolic blood pressure and that triglyceride levels are a major independent risk factor for developing diabetes. These results in Korean women with previous GDM underline the importance of postpartum testing in Korean women diagnosed with GDM, and demonstrate that impaired B-cell function, obesity, and especially visceral obesity, are associated with the development of diabetes.
B-Lymphocytes ; Blood Pressure ; Body Mass Index ; Body Weight ; Diabetes Mellitus, Type 2 ; Diabetes, Gestational ; Female ; Follow-Up Studies ; Gestational Age ; Glucose ; Glucose Tolerance Test ; Humans ; Hyperglycemia ; Incidence ; Insulin ; Logistic Models ; Obesity ; Obesity, Abdominal ; Postpartum Period ; Pregnancy ; Risk Factors ; Waist Circumference

Gestational diabetes mellitus (GDM) is defined as abnormal glucose tolerance diagnosed for the first time during pregnancy. The pathogenesis of GDM is characterized by relatively reduced insulin secretion insufficient to meet the increased insulin demand, which is quite similar to that of type 2 diabetes mellitus. Thus GDM is considered to have a common genetic background as type 2 diabetes mellitus. However, only limited information is available for the genetic basis of GDM. In this review article, we will briefly discuss the definition, epidemiologic features, and pathophysiology of GDM. In addition, we will present the data of two recent genetic association studies regarding GDM. Most of the previously proven type 2 diabetes associated with single nucleotide polymorphisms were also associated with the risk of GDM. Rapidly increasing knowledge in genetics of GDM will generate new insights into the pathophysiology, treatment, and prevention of GDM.
Diabetes Mellitus, Type 2 ; Diabetes, Gestational ; Female ; Genetic Association Studies ; Glucose ; Insulin ; Insulin Resistance ; Polymorphism, Single Nucleotide ; Pregnancy

Gestational diabetes mellitus (GDM) is defined as abnormal glucose tolerance diagnosed for the first time during pregnancy. The pathogenesis of GDM is characterized by relatively reduced insulin secretion insufficient to meet the increased insulin demand, which is quite similar to that of type 2 diabetes mellitus. Thus GDM is considered to have a common genetic background as type 2 diabetes mellitus. However, only limited information is available for the genetic basis of GDM. In this review article, we will briefly discuss the definition, epidemiologic features, and pathophysiology of GDM. In addition, we will present the data of two recent genetic association studies regarding GDM. Most of the previously proven type 2 diabetes associated with single nucleotide polymorphisms were also associated with the risk of GDM. Rapidly increasing knowledge in genetics of GDM will generate new insights into the pathophysiology, treatment, and prevention of GDM.
Diabetes Mellitus, Type 2 ; Diabetes, Gestational ; Female ; Genetic Association Studies ; Glucose ; Insulin ; Insulin Resistance ; Polymorphism, Single Nucleotide ; Pregnancy