Background: As the prevalence of hypertension is increasing in Korea, the government is seeking policy actions to manage patients with hypertension more efficiently. In this paper, we aimed to identify factors associated with the use of medical care at hospitals among outpatients with hypertension. Methods: We analyzed a total of 15,040 cases of 3,877 outpatients with hypertension obtained from the Korea Medical Panel database from 2010 to 2016. The dependent variable was whether a patient with hypertension visited a hospital or not; and independent variables were the patient’s various socio-demographic, health-related, and heath-status characteristics. We conducted a generalized linear mixed model analysis with logit link for all the cases and then conducted it stratified by gender. Results: As a result of a multivariable analysis, women were less likely than to visit at a hospital (odds ratio [OR], 0.44; 95% confidence interval [CI], 0.32–0.61) and people aged 65 years and older than those aged less than 65 years (OR, 0.71; 95% CI, 0.57– 0.89). Residents in Busan, Ulsan, and Gyeongnam were more likely than those in than Seoul, Gyeonggi, Incheon, and Jeju to visit a hospital (OR, 1.40; 95% CI, 1.05–1.86). The likelihood of visiting a hospital was high in people belonging to a group of: the highest level of annual household income (OR, 1.73; 95% CI, 1.30–2.29); Medical care aid recipients (OR, 1.94; 95% CI, 1.34–2.83); people having three or more complex chronic diseases (OR, 1.59; 95% CI, 1.19–2.11); people having diabetes (OR, 1.81; 95% CI, 1.41–2.32);or people having ischemic heart disease or cerebrovascular disease (OR, 6.80; 95% CI, 5.28–8.76). Also, we found that factors associated with the use of medical care at hospitals among outpatients with hypertension differed between genders. Conclusion A variety of factors seem to be associated with the use of medical care at hospitals among outpatients with hypertension.Future research needs to find a way to help patients with hypertension visit an appropriate medical institution between clinics and hospitals.

Background: There have been many studies on the associations between body mass index (BMI) and cognitive function. However, no study has ever compared the associations across the methods of categorizing BMI. In this study, we aimed to fill the gap in the previous studies and examine whether the obesity paradox is valid in the risk of cognitive function. Methods: Of the 10,254 people aged 45 and older from the Korean Longitudinal Study of Ageing from 2006 to 2016, 8,970 people were finalized as the study population. The dependent variable was whether a person has a normal cognitive function or not, and the independent variables of interest were BMI categorized by the World Health Organization Western Pacific Regional Office (WHO-WPRO) method, the WHO method, and a 10-group method. Covariates included sociodemographic factors, health behavior factors, and health status factors. A generalized linear mixed model analysis with a logit link was used. Results: In the adjusted model with all covariates, first, in the case of BMI categories of the WHO-WPRO method, underweight (odds ratio [OR], 1.16; 95% confidence interval [CI], 1.15–1.17), overweight (OR, 1.36; 95% CI, 1.35–1.36), and obese (OR, 1.34; 95% CI, 1.33–1.34) groups were more likely to have a normal cognitive function than a normal-weight group. Next, in the case of BMI categories of the WHO method, compared to a normal-weight group, underweight (OR, 1.15; 95% CI, 1.14–1.16) and overweight (OR, 1.06; 95% CI, 1.06–1.07) groups were more likely to have a normal cognitive function; however, obese (OR, 0.62; 95% CI, 0.61–0.63) group was less likely to have it. Lastly, in the case of the 10-group method, as BMI increased, the likelihood to have a normal cognitive function changed like a wave, reaching a global top at group-7 (26.5 kg/㎡ ≤ BMI <28.0 kg/㎡ ). Conclusion The associations between BMI and cognitive function differed according to how BMI was categorized among people aged 45 and older in Korea, which suggests that cognitive function may be positively associated with BMI in some categories of BMI but negatively in its other categories. Health policies to reduce cognitive impairment need to consider this association between BMI and cognitive function.

BACKGROUND: With the development of information and communication technology, there is a growing number of people looking for health information on the internet. This pilot study was performed to analyze the pattern of pharmacist consultation on the internet portal site. METHODS: Questions and answers posted on the portal site “Naver Jisik-iN” from March 1st to 31th in 2016 were collected. Medications asked were categorized into prescription drugs, nonprescription drugs, sanitary aids, emergency drugs, functional health foods, and others. Medications were subcategorized into 14 according to the anatomical therapeutic chemical classification system. Questions were divided into 10 categories based on Hepler's drug-related problems. RESULTS: Of the 955 cases, females accounted for 59.5% and inquirers from 11 to 40 years old, 89.4%. The number of prescription drugs, nonprescription drugs, sanitary aids, emergency drugs, functional health foods, and others were 428 (44.8%), 328 (34.3%), 31 (3.3%), 2 (0.2%), 122 (12.8%), and 44 (4.6%), respectively. Questions for drugs acting on alimentary tract and metabolism took up 27.4% followed by those on nervous system, 13.6% and anti-infectives for systemic use, 12.2%. Pharmacist consultation regarding drug information, drug interaction, and adverse reaction occupied 47.9%, 15.2%, and 12.3%, respectively. CONCLUSION: Health counseling through online is predicted to increase steadily, so pharmacists should broaden their boundaries beyond off-line pharmacies to meet social needs.
Classification ; Counseling* ; Drug Interactions ; Emergencies ; Female ; Humans ; Information Services ; Internet* ; Metabolism ; Nervous System ; Nonprescription Drugs ; Pharmacies ; Pharmacists* ; Pilot Projects* ; Prescription Drugs

Local alignment is an important task in molecular biology to see if two sequences contain regions that are similar. The most popular approach to local alignment is the use of dynamic programming due to Smith and Waterman, but the alignment reported by the Smith-Waterman algorithm has some undesirable properties. The recent approach to fix these problems is to use the notion of normalized scores for local alignments by Arslan, Egecioglu and Pevzner. In this paper we consider the problem of finding all local alignments whose normalized scores are above a given threshold, and present a fast heuristic algorithm. Our algorithm is 180-330 times faster than Arslan et al.''s for sequences of length about 120 kbp and about 40-50 times faster for sequences of length about 30 kbp.
Molecular Biology

Mucinous adenocarcinoma arising from a chronic anorectal fistula is a rare condition. It is often confused with a hemorrhoid or perineal abscess, which consequently delays accurate diagnosis. Here, we report the case of a 58-year-old man with blood-tinged stool who reported a rectal mass, which was diagnosed as mucinous adenocarcinoma arising from an anal fistula. After initial computed tomography-guided needle aspiration biopsy had failed to provide an accurate diagnosis, transrectal punch biopsy was performed to obtained adequate tissue sample for confirmative histological diagnosis. The patient was successfully treated with neoadjuvant concurrent chemoradiotherapy followed by surgical intervention.
Abscess ; Adenocarcinoma, Mucinous* ; Biopsy* ; Biopsy, Needle ; Chemoradiotherapy* ; Fistula* ; Hemorrhoids ; Humans ; Middle Aged ; Mucins* ; Needles ; Neoadjuvant Therapy ; Rectal Fistula

Purpose: To assess associations between surveillance intervals in a national hepatocellular carcinoma (HCC) surveillance program and receiving curative treatment and mortality using nationwide cohort data for Korea. Materials and Methods: Using the National Health Insurance Service Database of Korea, we retrospectively identified 3201852 patients, the target population of the national HCC surveillance program, between 2008 and 2017. After exclusion, a total of 64674 HCC patients were divided based on surveillance intervals: never screened, ≤6 months (6M), 7–12 months (1Y), 13–24 months (2Y), and 25–36 months (3Y). Associations for surveillance interval with the chance to receive curative therapy and all-cause mortality were analyzed. Results: The 6M group (51.9%) received curative therapy more often than the other groups (1Y, 48.3%; 2Y, 43.8%; 3Y, 41.3%; never screened, 34.5%). Odds ratio for receiving curative therapy among the other surveillance interval groups (1Y, 0.87; 2Y, 0.76; 3Y, 0.77;never screened, 0.57; p<0.001) were significantly lower than that of the 6M group. The hazard ratios (HRs) of all-cause mortality were 1.07, 1.14, and 1.37 for 2Y, 3Y, and never screened groups. The HR for the 1Y group (0.96; p=0.092) was not significantly different, and it was lower (0.91; p<0.001) than that of the 6M group after adjustment for lead-time bias. Curative therapy was associated with survival benefits (HR, 0.26; p<0.001). Conclusion HCC surveillance, especially at a surveillance interval of 6 months, increases the chance to receive curative therapy.

Purpose: To assess associations between surveillance intervals in a national hepatocellular carcinoma (HCC) surveillance program and receiving curative treatment and mortality using nationwide cohort data for Korea. Materials and Methods: Using the National Health Insurance Service Database of Korea, we retrospectively identified 3201852 patients, the target population of the national HCC surveillance program, between 2008 and 2017. After exclusion, a total of 64674 HCC patients were divided based on surveillance intervals: never screened, ≤6 months (6M), 7–12 months (1Y), 13–24 months (2Y), and 25–36 months (3Y). Associations for surveillance interval with the chance to receive curative therapy and all-cause mortality were analyzed. Results: The 6M group (51.9%) received curative therapy more often than the other groups (1Y, 48.3%; 2Y, 43.8%; 3Y, 41.3%; never screened, 34.5%). Odds ratio for receiving curative therapy among the other surveillance interval groups (1Y, 0.87; 2Y, 0.76; 3Y, 0.77;never screened, 0.57; p<0.001) were significantly lower than that of the 6M group. The hazard ratios (HRs) of all-cause mortality were 1.07, 1.14, and 1.37 for 2Y, 3Y, and never screened groups. The HR for the 1Y group (0.96; p=0.092) was not significantly different, and it was lower (0.91; p<0.001) than that of the 6M group after adjustment for lead-time bias. Curative therapy was associated with survival benefits (HR, 0.26; p<0.001). Conclusion HCC surveillance, especially at a surveillance interval of 6 months, increases the chance to receive curative therapy.

In South Korea, deaths caused by poisoning are mostly suicides due to drug overdoses, or agrochemical poisonings. Even though the latter is becoming less frequent, they are still occurring in large numbers across the country. In some cases, deaths result from toxicity of organic solvents contained in the agrochemical products. In this study, we identified organic solvents in post-mortem blood of acute agrochemical poisoning cases using solid phase microextraction-gas chromatography/mass spectrometry with black fiber. Out of 42 cases, organic solvents were detected in 29, with toluene and butanol detected simultaneously in 13 cases. In these 13 cases, the original pesticides were of various types, including organophosphorus compounds, carbamate, nicotine, and oxadiazine. Xylene and ethyl benzene were simultaneously detected six times. In these six cases, the original pesticides were mainly pyrethroid-based pesticides, such as cypermethrin and deltamethrin. Methoxypropanol was detected in five cases in which the water-soluble pesticide glufosinate was detected. These organic solvents may cause acute poisoning and even death in some agrochemical poisoning cases.

Littoral cell angioma (LCA) of spleen is an uncommon vascular neoplasm of littoral cell origin. It is well established that LCA may be associated with other malignancy or autoimmune disorders. We describe a 34-year-old woman with viral hepatitis C associated liver cirrhosis who presented with the incidental finding of LCA. She showed ascites, esophageal varix and drowsy mentality. Abdominal computed tomography (CT) showed multiple benign looking nodules in both hepatic lobes, but no abnormality in spleen. Liver transplantation and splenectomy were performed. Microscopic findings revealed narrow anastomosing vascular channels lined with plump cells that exfoliated into the lumen. Immunohistochemically the lining cells were positive for CD31, CD68 and negative for CD34, consistent with LCA. Herein, a second case of an incidentally detected LCA with cirrhosis, viral hepatitis C associated in Korea is reported.
Adult ; Ascites ; Esophageal and Gastric Varices ; Female ; Fibrosis ; Hemangioma ; Hepatitis ; Hepatitis C ; Humans ; Incidental Findings ; Korea ; Liver ; Liver Cirrhosis ; Liver Transplantation ; Spleen ; Splenectomy ; Splenic Neoplasms ; Vascular Neoplasms

Changes in radial and longitudinal left ventricular (LV) function were investigated in beagles with iatrogenic hypercortisolism. A total of 11 normal dogs were used, and 2 mg/kg prednisone was administered per oral q12 h for 28 days to 7 out of 11 dogs to induce iatrogenic hypercortisolism. Body weight, blood pressure, conventional echocardiography and tissue Doppler imaging (TDI) of normal and iatrogenic hypercortisolism groups were conducted. The myocardial wall velocity of the LV was measured using color TDI and myocardial deformation was determined by the strain and strain rate. Conventional echocardiography revealed that the diastolic LV free wall and interventricular septum in the hypercortisolism group were thickened relative to those in the normal group. The peak early diastolic myocardial velocity and early to late diastolic myocardial velocity ratio of TDI in the hypercortisolism group were significantly lower than those in the normal group. The strain values in the hypercortisolism group were significantly lower than those in the normal group, particularly for longitudinal wall motion. The lower values of myocardium from TDI and strain imaging could be used to investigate subclinical LV systolic and diastolic dysfunction in dogs with the iatrogenic hypercortisolism.
Animals ; Cushing Syndrome/etiology/*veterinary ; Dogs ; Echocardiography, Doppler/*veterinary ; Heart Ventricles/*ultrasonography ; Iatrogenic Disease/veterinary ; Male ; Reproducibility of Results ; *Ventricular Function, Left