Myopathy in primary aldosteronism in relatively rare disease in Korea. A 42-year-old woman with hypokalemic periodic paralysis, proximal muscle weakness and hypertension was found to have myopathy associated with adenoma in the right adrenal gland. She showed marked elevation of muscle enzymes and myopathic pattern in EMG.
Adenoma ; Adrenal Glands ; Adult ; Female ; Humans ; Hyperaldosteronism ; Hypertension ; Hypokalemic Periodic Paralysis ; Korea ; Muscle Weakness ; Muscular Diseases* ; Rare Diseases

We, at Department of Orthopedic Surgery, College of Medicine, Pusan National University, applied epiphyseal distraction as a method of limb lengthening, using unilateral one-plane pin fixator(ORTHOFIX) and bilateral multi-plane ring fixator(SEQUOIA) to three children with limb length discrepancies and angulation deformity due to injury of epiphyseal plate, and obtained following results. l. At first case, on whose distal femoral physis, bone bridge occupied about 20% of total epiphyseal plate and distributed mainly on the lateral side. At 10 days of distraction, epiphysiolysis occurred from the lateral side at first and angulation deformity was corrected. Epiphysiolysis on the medial side of physis appeared apparently after 60mm distraction. Bone lengthening of 4.2cm and correction of 25 valgus deformity were achieved after 72mm distraction for about 10 weeks. The percentage of increase in the initial length achieved was 11.67% and healing index was 27.86. 7 months later, loss of lengthening of 2.7cm was observed and it was considered that this was due to relatively short corticalization phase. 2. At second case, on whose distal tibial physis, bone bridge occupied about 40% of total epiphyseal plate and distributed on the medial side. At 10 days of distraction, epiphysiolysis occurred on the medial side of the epiphyseal plate, but not on the lateral side and instead of further lengthening, valgus deformity of the ankle appeared. It was thought that asymmetric distraction was attributed to the difference between the force applied on the medial side and that applied on the lateral side of the epiphyseal plate by unilateral one-plane pin fixation. 3. At third case, on whose distal tibial physis, bone bridge occupied about 75% of total epiphyseal plate. No epiphysiolysis occurred. there was a difficulty in observation of epiphysiolysis because ring fixator was overlapped with the epiphyseal plate on radiographs.
Ankle ; Bone Lengthening ; Busan ; Child ; Congenital Abnormalities ; Epiphyses, Slipped ; Extremities ; Growth Plate ; Humans ; Methods ; Orthopedics

PURPOSE: Health care professionals represent an immediately available resource to promote smoking cessation. However, the content in smoking cessation intervention courses in most institutions is insufficiently covered due to the limited number of class hours. The purpose of this study was to develop a comprehensive tobacco cessation-web-based, multimedia, educational program for a range of medical professionals. METHODS: Based on Jung's Teaching and Learning Structure Plan Model, a development process was proposed comprising four stages: (1) analysis, (2) planning, (3) production, and (4) operation/evaluation. The effectiveness of the program was tested using quasi-experimental design, and the participants in experimental group were required to complete the program. Changes in the level of knowledge and attitude were measured. RESULTS: The educational program developed includes nine topics and 26 sub-topics. A total of 180 storyboards, 15 videos, and 27 pictures were made. After the education, the level of knowledge was significantly increased in the experimental group. CONCLUSION: This web-based program can be recommended as a potential medium for health care professionals to use in counseling smoking cessation. The study findings also indicated that the program may be either offered as a teaching aid or utilized concurrently with lectures for students studying health care-related topics.
Counseling ; Delivery of Health Care ; Humans ; Leadership ; Learning ; Lectures ; Multimedia ; Program Development ; Smoke ; Smoking ; Smoking Cessation ; Tobacco

BACKGROUND: Left ventricular thrombus is a common complication after acute myocardial infarction. Methods and RESULTS: To Study the incidence of left ventricular thrombosis (LVT) after acute myocardial infarction, we performed serial two-dimensional echocardiography (2D-Echo) in 35 consecutive patients with acute myocardial infarction prospectively ; 10 patients had inferior wall myocardial infarction, 25 patients had anterior wall myocardial infarction. 2D-Echo was obtained within 3 days of acute myocardial infarction, at 4-10 days after symptom onset, and 2-4 weeks after symptom onset serially in each case. 19 out of 35 patients received thrombolytic therapy with urokinase. Left ventricular thrombi were identified in 9(25.7%) of the 35 study patients. The location of myocardial infarction was anterior and apical in all cases with left ventricular thrombi. The shape of thrombi was mural in 6 cases and protruding in 3 cases. The incidence of left ventricular thrombi in patients who received urokinase was not significantly different from that in patients who didn't(31.9% vs 18.8%,p=0.22). Wall motion score was significantly higher in patients who developed left ventricular thrombi than in patients who had no left ventricular thrombus(8.2+/-1.9 vs 5.8+/-2.6, p<0.005). All thrombi appeared within 10 days after myocardial infarction. CONCLUSIONS: Thus left ventricular thrombi develops within 10 days following myocardial infarction with large anterior and apical location. The thrombolysis therapy has no effect in the incidence of left ventricular thrombi in this study. But because of confounding effect of thrombolysis and location of myocardial infarction and extent of myocardial infarction, further investigation is needed.
Anterior Wall Myocardial Infarction ; Echocardiography ; Humans ; Incidence* ; Inferior Wall Myocardial Infarction ; Myocardial Infarction* ; Prospective Studies ; Thrombolytic Therapy ; Thrombosis* ; Urokinase-Type Plasminogen Activator

Central obesity carries more metabolic risks compared with total obesity assessed by Body mass index (BMI). Also, there’s paradoxical relationship between BMI and all-cause mortality in overweight group (23 kg/㎡ ≤ BMI < 25 kg/㎡). The aim of this study is to assess relationship between waist-to-height ratio (WHtR) and lifestyle-related diseases such as metabolic syndrome, hypertension, and type 2 diabetes in overweight group, and to find the most predictable and useful obesity index for screening lifestyle-related diseases.A total of 3,994 overweight (23 kg/㎡ ≤ BMI < 25 kg/㎡) adults from the Korea National Health and Nutrition Examination Survey, 2013-2015 (KNHANES VI) were included. We assessed the relationship between WHtR and metabolic syndrome components using multiple regression analysis, and assessed the relationship between abdominal obesity (WHtR ≥ 0.5) and lifestyle-related diseases using complex samples logistic regression analysis. Also, to find the most useful index to predict lifestyle-related diseases, we calculated the areas under the Receiver operating characteristic (ROC) curves.WHtR was significantly related to metabolic syndrome components. Odds ratios of metabolic syndrome, hypertension and type 2 diabetes were 2.187, 1.445, 2.463 in abdominal obese group (WHtR ≥ 0.5), respectively. Area under the curve of WHtR was the most significantly highest among those of obesity indices.WHtR is a simple and useful obesity index to predict lifestyle-related diseases in overweight Korean adults. Further investigations for other obesity indices are needed to predict lifestyle-related diseases better.

Central obesity carries more metabolic risks compared with total obesity assessed by Body mass index (BMI). Also, there’s paradoxical relationship between BMI and all-cause mortality in overweight group (23 kg/㎡ ≤ BMI < 25 kg/㎡). The aim of this study is to assess relationship between waist-to-height ratio (WHtR) and lifestyle-related diseases such as metabolic syndrome, hypertension, and type 2 diabetes in overweight group, and to find the most predictable and useful obesity index for screening lifestyle-related diseases.A total of 3,994 overweight (23 kg/㎡ ≤ BMI < 25 kg/㎡) adults from the Korea National Health and Nutrition Examination Survey, 2013-2015 (KNHANES VI) were included. We assessed the relationship between WHtR and metabolic syndrome components using multiple regression analysis, and assessed the relationship between abdominal obesity (WHtR ≥ 0.5) and lifestyle-related diseases using complex samples logistic regression analysis. Also, to find the most useful index to predict lifestyle-related diseases, we calculated the areas under the Receiver operating characteristic (ROC) curves.WHtR was significantly related to metabolic syndrome components. Odds ratios of metabolic syndrome, hypertension and type 2 diabetes were 2.187, 1.445, 2.463 in abdominal obese group (WHtR ≥ 0.5), respectively. Area under the curve of WHtR was the most significantly highest among those of obesity indices.WHtR is a simple and useful obesity index to predict lifestyle-related diseases in overweight Korean adults. Further investigations for other obesity indices are needed to predict lifestyle-related diseases better.

BACKGROUND: Water is essential to body homeostasis. But there are little attention to basic impact or attribute of response to drinking water. We investigated the factors related to drinking water through the ‘5th Korea National Health and Nutrition Examination Survey’ (KNHANESV). METHODS: From the database of the 5th KNHANESV conducted in 2010 to 2012, data of 15,716 adults who aged 19 or above, and responded to all the questionnaires of health interview, nutrition survey and had health examination were included in this analysis. SPSS 21.0 was used for statistical analysis with complex sample survey modules. RESULTS: The study subjects drink 5.2 ± 0.48 cups of water for a day. The elderly (>65 yrs) drink less water (p < 0.000), and male drink more than female (p < 0.000). And obesity is significantly associated with higher water intake (p < 0.000). Calorie and sodium intake, HbA1c, low-density lipoprotein, triglyceride, feritin, Fe, creatinine are significantly associated with higher water intake. Physical activity and serum vitamin D level are also associated with higher water intake (p < 0.000). CONCLUSION: Older people drink less water and several disease is related with water intake amount. Further studies need to be done about the value of water intake in healthy life style, and measuring the effect of water intake.
Adult* ; Aged ; Creatinine ; Drinking Water ; Drinking* ; Female ; Homeostasis ; Humans ; Korea* ; Life Style ; Lipoproteins ; Male ; Motor Activity ; Nutrition Surveys* ; Obesity ; Sodium ; Triglycerides ; Vitamin D ; Water*

In Korea, skipping breakfast is of concern as an unhealthy dietary habit. While the relationship between skipping breakfast and overweight and obesity has been established in children and adolescents in Europe, studies on this topic in Korean adolescents are scarce. Therefore, we investigated the relationship between body mass index (BMI) and skipping breakfast in Korean adolescents. Data from the 13th Korea Youth Risk Behavior Web-based Survey (2017) were analyzed. This anonymous, self-administered online questionnaire examined health behaviors including smoking, drinking, obesity, eating habits, sleep duration, and physical activity in Korean youth. Questions included those on general characteristics, such as economic status, parental education level, etc. This study included data from 56,933 adolescents aged 12–18 years. Skipping breakfast was defined as consuming breakfast fewer than five times per week. BMI, health behaviors, and general characteristics were compared between the breakfast-skipping and control groups. The skipping-breakfast and control groups comprised 25,836 (45.4%) and 31,097 (54.6%) subjects, respectively. BMI was significantly higher in the breakfast-skipping group than that in the control group (21.6 ± 3.24 kg/m2 vs. 21.4 ± 3.26 kg/m2, p < 0.001). Among the normal-weight and overweight groups, 44.9% and 47.3% skipped breakfast, respectively (p < 0.001). After adjusting for health behaviors and general characteristics, the risk of overweight was higher in those who skipped breakfast than that in the control group (odds ratio; 1.125, 95% confidence interval; 1.077–1.176).Skipping breakfast was related to overweight in Korean adolescents. Therefore, longitudinal research is needed to determine whether skipping breakfast is associated with overweight.

Background: This study examined the effect of housing affordability on the incidence of depression in Korean adults aged 45 years and above usingthe Korean Longitudinal Study of Aging (KLoSA). Methods: Five-year data from wave two to wave six of the KLoSA provided by the Ministry of Labor were used. In the first year of KLoSA in 2006, amongthose who did not suffer from depression, ones who had one or more of the survey data from the second to the sixth were analyzed. generalizedestimating equation (GEE) regression analysis and chi-square test were used as data processing methods. Results: According to the 2010 data, out of 4,606 people, 3,558 (77.3%) were in the affordable group, and 1,048 (22.8%) in the experienced overburdengroup. The result of regression analysis with controlling general characteristics as covariates showed that the experienced overburden group had ahigher incidence of depression than the affordable group. A longitudinal analysis of housing affordability and incidence of depression for five yearsrevealed no significant difference in the incidence of depression. However, the overall share of overburden experience increased steadily. Acomparison of the incidence of depression between the affordable and experienced overburden groups in each year showed that the incidence ofdepression was statistically higher each year. Conclusion Housing affordability increases the incidence of depression, and eight years of data indicated depression in the experienced overburdengroup to be higher than the affordable group.

PURPOSE: Staged operation employing temporary enterostomy is still the standard treatment of malignant colonic obstruction (MCO). Expandable metal stent has been used for the palliation of unresectable gastrointestinal obstruction. We applied this metal stent technique to the MCO to achieve temporary alleviation of the obstruction so that the bowel preparation and one-stage operation were enabled. In this study we examined the efficacy of temporary indwelling of metal stent to obviate the need of staged operation in the treatment of MCO. METHODS: From December 1998 to January 2001, 35 MCO patients were treated. Patients had typical symptoms of colonic obstruction such as abdominal pain and distension. When they were admitted, an self-expandable metal stent was introduced under the guide of flexible colonoscopy. For three days, formal bowel preparation (both chemical and mechanical) were followed. With regard to achievement of bowel preparation, postoperative complications and hospital stay, these 35 patients were compared with control group (N=20) of patients who underwent two staged operations for MCO. RESULTS: The tumor locations were upper rectum (N=10), sigmoid colon (N=22) and left colon (N=3). Metal stent slipped off in one patient. Double contrast barium enema was possible in 34 patients. One stage operation was performed in all patients. Anastomotic complications were not observed in both groups. Intraabdominal abscess requiring reoperation was noted in one patient in each group. Wound infection was noted in 3 (8.6%) stent patients whereas 16 (80%) patients had wound complication in the control group (P<0.05). Mean hospital stay was 12.2 days in stent group and 29.4 days in control group (P<0.05). CONCLUSIONS: Even though our series is limited in patient number, these data suggested that temporary indwelling of self-expandable metal stent may obviate the need of staged operation in the treatment of MCO.
Abdominal Pain ; Abscess ; Barium ; Colon* ; Colon, Sigmoid ; Colonoscopy ; Enema ; Enterostomy ; Humans ; Length of Stay ; Postoperative Complications ; Rectum ; Reoperation ; Stents* ; Wound Infection ; Wounds and Injuries