BACKGROUND: Obesity is linked to a wide range of respiratory diseases. Several studies have shown that body weight at baseline and weight change were related to pulmonary function. The purpose of this study was to investigate the relationship between change in body mass index (BMI) and pulmonary function in adults. METHODS: Of those aged 40-64 years at baseline who had initially visited the health promotion center at one university-level hospital from January 2000 to December 2002, 499 (men: 309, women: 190) patients revisited the center over a 5-year period up to December 2009 and were enrolled in the study. Subjects were classified into 4 groups- group 1: normal-normal, group 2: normal-obese, group 3: obese-normal, and group 4: obese-obese, based on their BMI at baseline and follow-up. Forced expiratory volume in one second (FEV1), forced vital capacity (FVC) and FEV1/FVC were measured by spirometry. RESULTS: Change in FEV1/FVC was significantly associated with change in BMI for men in all 4 groups. Change in FEV1/FVC was significantly different between group 1 and 3 and between group 1 and 4. Changes in FEV1, FVC and FEV1/FVC were significantly associated with change in BMI for women in all 4 groups. Change in FEV1 was significantly different between group 3 and 4, and change in FVC was significantly different between group 1 and 3. CONCLUSIONS: These results suggest that a change in BMI is negatively associated with change in pulmonary function. Obesity itself can be a risk factor for pulmonary dysfunction, and a decrease in BMI through weight reduction could reduce pulmonary dysfunction or improve pulmonary function in adults.
Adult ; Aged ; Body Mass Index ; Body Weight ; Female ; Follow-Up Studies ; Forced Expiratory Volume ; Health Promotion ; Humans ; Male ; Obesity ; Risk Factors ; Vital Capacity ; Weight Loss

BACKGROUND: The combined induction using two or more agents has a potential benefit that anesthesia could be induced with smaller anesthetic agents with fewer side effects. We studied the effects of co-administration with midazolam and remifentanil on the dose of propofol, the time to loss of consciousness (LOC) and hemodynamics during tracheal intubation. METHODS: Sixty patients were randomly assigned to three groups. Group 1 was induced with target-controlled propofol alone. Group 2 received midazolam (0.05 mg/kg) and target-controlled propofol. Group 3 received midazolam (0.025 mg/kg), remifentanil (2 ng/ml) and target-controlled propofol. The time to LOC, the infused propofol dose and the effect site concentration at LOC were recorded. After LOC, rocuronium (0.6 mg/kg) was given and tracheal intubation was performed. The noninvasive blood pressure, heart rate (HR) and bispectral index were recorded. RESULTS: The time and the dose of propofol to LOC were significantly reduced in group 2, 3 than in group 1 (P < 0.05). Compared with pre-induction values, mean blood pressure at immediately after intubation was increased in group 1, 2 with no change in group 3. The HR immediately after intubation was significantly increased in all groups compared to the pre-induction values, but the rate of increase of HR in group 3 were significantly lower than those group 1, 2 (P < 0.05). CONCLUSIONS: The co-administration with midazolam and remifentanil reduces the time to LOC and the dose of propofol. That also attenuates hemodynamics during tracheal intubation under target-controlled infusion of propofol.
Androstanols ; Anesthesia ; Anesthetics ; Blood Pressure ; Heart Rate ; Hemodynamics ; Humans ; Intubation ; Midazolam ; Piperidines ; Propofol ; Unconsciousness

Actinomycosis causes a chronic suppurative, granulomatous disease which is characterized by extensive abscess formation, and sulfur granule formation. Actinomycosis may present different clinical forms: cervicofacial, thoracic, abdominal and cerebral actinomycosis. The diagnosis can only be made after surgery. In general, patients with abdominal actinomycosis have undergone abdominal surgery. We report four cases of primary appendiceal actinomycosis presenting as acute appendicitis without history of abdomen surgery.
Abdomen ; Abscess ; Actinomycosis* ; Appendicitis* ; Diagnosis ; Humans ; Sulfur

The systematic study of products from bacteria and fungi has led to the development of two immunosuppressive drugs, cyclosporin A and FK 506 (tacrolimus) which are useful to suppress adaptive immune responses to the grafted tissue. However, they affect all immune responses indiscriminately and are both toxic to kidneys and other organs. To facilitate the development of immunosuppressor to block the T cell receptor (TcR)-mediated signaling cascade specifically, a novel Jurkat T cell transfectants, JK NFAT-SEAP were generated in which the expression of the secreted alkaline phosphatase (SEAP) is driven by the multiple NFAT binding sites plus minimal IL-2 promoter. Upon stimulation with ionomycin or anti-TcR mAb OKT3 in the presence of PMA, these transfectants secreted high level of SEAP into the medium, which was conveniently analyzed by SEAP analysis. The secretion of SEAP was effectively inhibited by cyclosporin A or FK 506 at the concentration of [10 ' ug/ml], [10 ug/ml] respectively. JK NFAT-SEAP transfectants will provide two major advantages for the development of a novel immunosuppressor. First, analysis of SEAP secreted into the culture medium by SEAP analysis enables us to test a large number of samples within a short period of time. Second, Usage of IL-2 promoter for the expression of SEAP makes us identify bioproducts to target specifically on TcR-mediated signaling pathway.
Alkaline Phosphatase ; Bacteria ; Binding Sites ; Cell Line* ; Cyclosporine ; Fungi ; Interleukin-2 ; Ionomycin ; Kidney ; Mass Screening* ; Muromonab-CD3 ; Receptors, Antigen, T-Cell ; T-Lymphocytes* ; Tacrolimus ; Transplants

Hydranencehaly is an abnormality consisting of complete or almost absence of the cerebral hemispheres, which are replaced by a large fluid-filled cavity. The midbrain and brain stem are relatively intact, and rudiments of frontal, temporal and occipital cortex may be present. We diagnosed it through the evaluation of clinical features, prenatal US (intrauterine pregnancy, 37 wks) and brain CT. Authors have experienced a case of hydranencephaly combined with twin pregnancy and reported with a brief literature review.
Brain ; Brain Stem ; Cerebrum ; Humans ; Hydranencephaly* ; Mesencephalon ; Pregnancy ; Pregnancy, Twin* ; Twins*

OBJECTIVES: This study was performed to evaluate the relationships between psychosocial characteristics and changes in the stage of breast cancer screening behavior. METHODS: The 474 study subjects were randomly sampled from 21,459 women (age range, 40-70 years) who were eligible for the Korean National Cancer Screening Program in 2006 in Jinju, Gyeongsangnam-do. The information, including behaviors and sociodemographic characteristics, attitudes, subjective norms and self-efficacy, was collected by trained interviewers via home visits. The breast cancer screening stages were grouped as precontemplation, contemplation, action, maintenance and relapse, according to Rakowski. RESULTS: Of the 474 women, 18.8% were in the precontemplation stage, 23.3% were in the contemplation stage, 13.1% were in the action stage, 36.6% were in the maintenance stage, and 8.2% were in the relapse stage. The distribution of stages was associated with attitude, subjective norms and self-efficacy (p for trend<0.01). To investigate the overall relationship between the variables, we conducted a linear structural equation model analysis based on the theory of planned behavior. The subjective norms and self-efficacy influenced the stage of the women's screening behavior. CONCLUSIONS: We should target on self-efficacy about the screening behavior of women by performing timely, thoughtful interventions. The support from family members, friends and other people is crucial for women to undergo breast cancer screening and to improve the breast cancer screening rate.
Adult ; Aged ; Asian Continental Ancestry Group ; Breast Neoplasms/prevention & control/*psychology ; Data Interpretation, Statistical ; *Early Detection of Cancer ; Female ; *Health Behavior ; Humans ; Interviews as Topic ; Korea ; Mass Screening/*psychology ; Middle Aged ; Models, Theoretical ; Questionnaires ; Self Efficacy ; Socioeconomic Factors ; Women's Health

OBJECTIVES: This study, as for activating measures for capable medical physicians to penetrate into the public health sector, is to provide a basic informations which are used for the enlargement of human resources of physicians in the public health sector, by investigating the perception of physicians, who are now working in the public health center, on the training and development of physicians in the public health sector. METHODS: The subjects of this study were 126 individuals. The data was analyzed by frequency analysis using SPSS ver. 17.0K. RESULTS: According to the investigation of 'how to support physicians in public health sector', the necessity of almost questions is considered to be important. Especially, regarding to investigation on 'obstacles of physicians' entrance to public health sector', 'relatively low salary' and 'lack of promotion chances' were thought to be considerable. The most significant education programs to work for public health sector is to improve the ability of health administration planning and service performance. CONCLUSIONS: The important methods to reinforce and easily obtain the human resources of physicians in public health sector are not only to improve the penetration of physicians to public health sector, but also to enhance the ability of present physicians, even though sufficient recruitment of physicians is essential.
Humans ; Public Health

OBJECTIVE: The purpose of this study was to assess the dentoalveolar compensation in facial asymmetry individuals using an integration of a CBCT image and a laser scanned dental cast image. METHODS: The subjects consisted of 30 adults with asymmetric mandibles and 20 adults with symmetric mandibles. The CBCT and laser scanned dental cast images were integrated with a registration technique. Canine and first molar position and angulation were assessed from reference coordinates. The differences between deviated and non-deviated sides were analyzed with the paired t-test. The differences shown according to menton deviation were also statistically analyzed using Pearson correlation analysis. RESULTS: The experimental group showed deviated and non-deviated side differences (dev.-ndev.) in the position and angle of the canine and first molars. Menton deviation showed positive correlation with the deviation side (dev.-ndev.) for the maxillary and mandibular 1st molar angles, negative correlation with the deviation side for the vertical position of the maxillary 1st molars, transverse position of the mandibular canine, transverse position and vertical position of the mesio-lingual cusp of the mandibular 1st molars. CONCLUSIONS: The upper and lower canine and first molars of facial asymmetry individuals were compensated, so the transverse position, vertical position, and angle showed differences between the deviated/non-deviated sides.
Adult ; Compensation and Redress ; Cone-Beam Computed Tomography ; Facial Asymmetry ; Humans ; Mandible ; Molar

Background: This study evaluated changes in nasal airway function following Le Fort I osteotomy with maxillary impaction according to the Nasal Obstruction Symptom Evaluation (NOSE) scale. Methods: This cohort study included 13 patients who underwent Le Fort I osteotomy with maxillary impaction. Nasal airway function was evaluated based on the NOSE scale preoperatively and at 3 months postoperatively. The change in the NOSE score was calculated as the preoperative score minus the postoperative score. If the normality assumptions for changes in the NOSE score were not met, a nonparametric test (the Wilcoxon signed-rank test) was used. Differences in NOSE score changes according to patient characteristics and surgical factors were evaluated using the Kruskal-Wallis test and the Mann-Whitney test. Results: Patients ranged in age from 18 to 29 years (mean±standard deviation [SD], 23.00±3.87 years). Three were men and 10 were women. Eleven patients (84%) had an acquired dentofacial deformity with skeletal class III malocclusion. The preoperative NOSE scores ranged from 40 to 90 (mean±SD, 68.92±16.68), and the postoperative NOSE scores ranged from 25 to 80 (53.84±18.83). The cohort as a whole showed significant improvement in nasal airway function following maxillary impaction (P=0.028). Eleven patients (84%) had either improved (n=8) or unchanged (n=3) postoperative NOSE scores. However, nasal airway function deteriorated in two patients. Patient characteristics and surgical factors were not correlated with preoperative or postoperative NOSE scores. Conclusions Nasal airway function as evaluated using the NOSE scale improved after maxillary impaction.

Background: Excessive bleeding is one of the most severe complications of orthognathic surgery (OGS). This study investigated the associations of intraoperative blood loss and surgical time with the direction of maxillary movement. Methods: This retrospective study involved patients who underwent OGS from October 2017 to February 2020. They were classified based on whether maxillary setback was performed into groups A1 and B1, respectively. Relative blood loss (RBL, %) was used as an indicator to compare intraoperative blood loss between the two groups. The surgical time of the two groups was also measured. Subsequently, the patients were reclassified based on whether posterior impaction of the maxilla was performed into groups A2 and B2, respectively. RBL and surgical time were measured in the two groups. Simple linear and multiple regression analyses were performed. P-values <0.05 were considered to indicate statistical significance. Results: Eighteen patients were included. The RBL and surgical time for the groups were: A1, 13.15%±5.99% and 194.37±42.04 minutes; B1, 12.41%±1.89% and 196.50±46.07 minutes; A2, 13.94%±3.82% and 201.00±39.70 minutes; and B2, 9.61%±3.27% and 188.84±38.63 minutes, respectively. Only RBL showed a statistically significant difference between the two groups (A2 and B2, P=0.04). Conclusions Unlike maxillary setback, posterior impaction of the maxilla showed a significant association with RBL during surgery. When performing posterior impaction of the maxilla, clinicians need to pay particular attention to surgery and postoperative care.