Telomeres undergo attrition with each cell division, and telomere length is associated with age-related diseases and mortality in the elderly. Estrogen can influence the attrition of telomeres by diverse mechanisms. This is a retrospective case control study that investigated the influence of long-term hormone therapy (HT) on telomere length in postmenopausal women. We recruited 130 postmenopausal women from 55 to 69 years of age for this study, and divided them into two groups. The first group included 65 women who had been on estrogen and progesterone therapy for more than five years (HT group). The other group was composed of 65 women matched in age to the HT group who had never had HT (non- HT group). The relative ratios of telomere length of study subjects to a reference DNA from a healthy young female were measured using quantitative PCR. Plasma levels of lipid profiles, total antioxidant status (TAS), C-reactive proteins (CRP), fasting glucose levels, and estradiol levels were measured. Age at menopause, vitamin use, and exercise, alcohol, and cigarette smoking histories were also assessed in a questionnaire. Mean duration (+/- SD) of HT was 8.4 +/- 2.3 years. Prevalence of vitamin use and regular exercise were higher in the HT group than in the non-HT group (p < 0.01). Relative telomere length ratios in the HT group were significantly greater than those in the non-HT group (p < 0.01). HT was significantly correlated with the relative telomere length ratio in multivariate analysis when potential confounding variables were controlled for (p < 0.05). In conclusion, telomere lengths were longer in postmenopausal women who had a history of long-term HT than in postmenopausal women without HT. Long-term HT in postmenopausal women may alleviate telomere attrition.
Aged ; DNA Damage ; Estrogens/*administration & dosage ; Female ; *Hormone Replacement Therapy ; Humans ; Middle Aged ; Postmenopause ; Progesterone/*administration & dosage ; Research Support, Non-U.S. Gov't ; Telomere/*drug effects ; Time Factors

PURPOSE: The variability in insulin-like growth factor binding protein-3 (IGFBP-3) levels is related to polymorphic variants of the promoter region of the gene. The most common single nucleotide polymorphism of IGFBP promoter region is -202 locus. In vitro, significantly higher promoter activity of the A allele at the -202 locus compared with the C allele, consistent with the relationship observed between genotype and circulating IGFBP-3 was documented. The polymorphic variation occurs frequently and may influence GH responsiveness, somatic growth, but the effects of IGFBP-3 promoter polymorphism on growth in children are unknown. METHODS: RFLP genotyping of the -202 single nucleotide polymorphism was performed in 33 Korean children who visited our clinic for evaluation of their growth. The serum levels of IGF-I and IGFBP-3 were compared according to genotyping. RESULTS: Height SDS of subjects was -1.48+/-1.10. 11 of 33 children (33%) were heterozygous AC and the others are homozygous AA in genetic distribution, but no homozygous CC was detected. C allele frequency was 16.7%. There were no significant differences in height, body mass index, serum IGF-I and IGFBP-3 levels between AC and AA groups. CONCLUSION: The effects of IGFBP-3 promoter polymorphism on growth at the -202 locus deserve investigation because there is no CC and the children were relatively short in this study.
Alleles ; Body Height ; Child ; Gene Frequency ; Genotype ; Humans ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor Binding Proteins ; Insulin-Like Growth Factor I ; Polymorphism, Restriction Fragment Length ; Polymorphism, Single Nucleotide ; Promoter Regions, Genetic

BACKGROUND: There has been no systematic investigation of the necessary core procedures in primary care in Korea. The purpose of this study is to examine the core procedures necessary in primary care and to have the results reflected in residency programs. METHODS: A mail survey was conducted fram May 2, to August 20, 1997 among 478 physicians who qualified as a family physician specialist since 1989. The contents of the questionnaire included 1) sex, age, locatian and size of the hospital 2) of the 93 procedures that should be taught during residency pragrams as suggested by the [American Academy of Family Physicians] and the [Korean Academy of Family Physicians a) procedures taught in residency programs, b) procedures performed by practicing family physicians, and, c) procedures considered as necessary in primary care. RESULTS: 1) Of the 93 procedures, 78 were taught in residency programs, 35 were performed by practicing family physicians, and 77 were considered necessary in primary care. 2) All of the 35 procedures performed by family physicians were taught in the residency programs. Of the 77 procedures considered necessary in primary care, 71 were taught but the remaining 6 were infrequently taught. 3) 7 procedures were taught but was considered unnecessary ; Procedures taught but not actually performed amounted to a total of 43. 4) 42 procedures were considered necessary but not performed. 5) More procedures were performed by male doctors(p<0.05). Surgical procedures were performed more often in regional hospitals than those in Seoul and in the larger cities(p<0.05), and more were performed in private practice(p<0.05). CONCLUSIONS: Although almost all of the procedures considered necessary in primary care were taught in residency programs, many procedure's were not being performed in current medical practice. We suggest that it would be more effective to intensively train the core procedures than to provide exposure to a wide array of procedures. As the procedures performed were found to vary in relat
Humans ; Internship and Residency* ; Korea ; Male ; Physicians, Family ; Postal Service ; Primary Health Care ; Seoul ; Specialization ; Surveys and Questionnaires

BACKGROUND: Increased abdominal obesity is clearly associated with metabolic diseases and associated with increased risk for atherosclerosis and cardiovascular diseases. But the mechanisms underlying these associations are not completely understood. The aim of this study was to correlate the regional body composition with pulse wave velocity in the overweight and obese women. METHODS: We investigated 104 overweight and obese participants. Regional body composition was distinguished by anthropometry, dual-energy X-ray absorptiometry, and computed tomography (CT). For estimates of arterial stiffness, we measured brachial ankle pulse wave velocity (baPWV). Fasting blood glucose, lipid parameters, CRP, and free fatty acid were measured. Pearson's correlation analysis and multiple regression analysis were conducted to identify the relationship between baPWV and regional body composition. RESULTS: Average age, fasting blood sugar, HDL-cholesterol, triglyceride, HOMA-IR, abdominal visceral fat area measured by CT, visceral fat area/ subcutaneous fat area (VSR), and visceral fat area/midthigh muscle area (VMR) were all significantly higher in the visceral obesity group than the subcutaneous obesity group. BaPWV was positively correlated with age, blood pressure, triglyceride, waist circumference, waist hip ratio, abdominal visceral fat area measured by CT, and VSR and inversely correlated with thigh subcutaneous fat area. In multiple regression models, after adjustment for confounding factors, baPWV was independently correlated with abdominal visceral fat area measured by CT (R2=0.560, P=0.006). CONCLUSION: Abdominal visceral fat area measured by CT was the only measurement positively associated with baPWV which explains the relationship of regional body composition and arterial stiffness.
Abdominal Fat* ; Absorptiometry, Photon ; Ankle ; Anthropometry ; Atherosclerosis ; Blood Glucose ; Blood Pressure ; Body Composition ; Cardiovascular Diseases ; Fasting ; Female ; Humans ; Intra-Abdominal Fat ; Metabolic Diseases ; Obesity ; Obesity, Abdominal ; Overweight* ; Pulse Wave Analysis ; Subcutaneous Fat ; Thigh ; Triglycerides ; Vascular Stiffness* ; Waist Circumference ; Waist-Hip Ratio

BACKGROUND: Serum gamma-GT is one of the biliary enzymes with the only enzymatic activity capable of cleaving extracellular glutathione, thus originating precursor amino acids for the intracellular resynthesis of glutathione. Several population-based studies have shown a strong cross-sectional association between serum gamma-GT concentration and cardiovascular risk factors. And prospective studies showed that serum gamma-GT concentration had a prognostic impact on cardiovascular mortality. But, the mechanism by which gamma-GT is associated with cardiovascular disease is not elucidated. We hypothesized that there was an association between serum gamma-GT and ferritin, a marker of oxidative stress. In this study, we investigated the relationship between serum gamma-GT and serum ferritin. METHODS: By reviewing the medical records of 288 healthy adults, we determined the serum levels of gamma-GT and ferritin according to age, body mass index, systolic blood pressure, diastolic blood pressure, triglycerides, total cholesterol, LDL-cholesterol, fasting blood sugar, hs-CRP, serum ferritin, AST, ALT, uric acid and smoking history. We studied the relationship between the variables by Pearson correlation coefficients and multiple stepwise regression analysis. Mean values of serum gamma-GT according to the smoking history were compared using t-test. RESULTS: Serum gamma-GT correlated positively with serum ferritin (r=0.42; P<0.001). BMI, triglycerides, total cholesterol, fasting blood sugar, AST and ALT also showed statistically significant correlation. Smokers showed significantly higher serum gamma-GT. Serum gamma-GT correlated with serum ferritin, ALT, current smoking and triglycerides by multiple stepwise regression analysis. CONCLUSION: Serum gamma-GT correlated positively with serum ferritin.
Adult* ; Amino Acids ; Blood Glucose ; Blood Pressure ; Body Mass Index ; Cardiovascular Diseases ; Cholesterol ; Fasting ; Ferritins* ; gamma-Glutamyltransferase* ; Glutathione ; Humans ; Medical Records ; Mortality ; Oxidative Stress ; Risk Factors ; Smoke ; Smoking ; Triglycerides ; Uric Acid

Stroke is the most common cause of death as single-diseases in South Korea. And it generates additional medical cost through high incidence of related disabilities and complications, which would become more important with the rapid aging process in Korean society. This study was preformed to identify stroke patients' mortality and its associated factors. Patients diagnosed as stroke (ICD-10 code I60-I63) in 2003 were identified. Their follow-up mortality rate in 5 years and related factors (stroke type, sex, age, type of first admission hospital, comorbidity score) were analyzed using national health insurance claim data and national cause of death statistics. The mortality rate peaked in early days after attack, and decreased subsequently as the survive time gets longer. The mortality rate was higher in hemorrhagic stroke than ischemic stroke, in female than male, with the older age, and with the higher comorbidity score. It is recommended that the early intervention at general hospital or tertiary referral hospital should be promoted to decrease the mortality rate in stroke patients, and related quality assurance programs have to be enforced.
Aging ; Cause of Death ; Comorbidity ; Early Intervention (Education) ; Female ; Follow-Up Studies ; Hospitals, General ; Humans ; Incidence ; Male ; National Health Programs ; Republic of Korea ; Stroke ; Tertiary Care Centers

Mucosa-associated lymphoid tissue (MALT) lymphoma is a neoplasm with low-grade malignancy that arises from the MALT of various organs. Among the various MALT lymphomas, gastric MALT lymphoma is the most frequently reported, and it has been correlated with Helicobacter pylori infection. In contrast, duodenal MALT lymphoma is very rare, and a relationship with H. pylori has not been established. This case report describes a very rare case of MALT lymphoma arising in both the stomach and duodenum that regressed after eradication of H. pylori.
Duodenum ; Helicobacter ; Helicobacter pylori ; Lymphoid Tissue ; Lymphoma ; Lymphoma, B-Cell, Marginal Zone ; Stomach

BACKGROUND: DHEA is the most abundant steroid hormone secreted from the adrenal cortex and has several roles such as increasing insulin sensitivity, lowering serum lipid, improving obesity, and anti-cancer effects. DHEA levels vary profoundly and levels decline as age increases. But the role of DHEA in the aging process is not yet fully understood. TAS which provides information of one's antioxidant capacity, also decreases with age. In this study, we investigated the relationship between TAS and serum DHEA-s concentration. METHODS: By reviewing the medical records of 197 healthy adults, we determined the serum levels of DHEA-s and TAS according to BMI, pulse pressure, WBC, hs-CRP, A/G ratio, LDL-cholesterol, triglyceride, ferritin, uric acid and total bilirubin. We studied the relationship between the parameters by Pearson correlation coefficients and multiple regression analysis. RESULTS: The mean level for TAS and serum DHEA-s was 1.20 mml/L and 177.3 ug/mL, respectively. Serum DHEA-s correlated positively with TAS (r=0.44) and negatively for age (r=-0.44). WBC triglyceride and uric acid also showed statistically significant correlations. But, according to multiple regression analysis DHEA-s only correlated with TAS and age. CONCLUSION: Serum DHEA-s correlates positively with TAS.
Adrenal Cortex ; Adult* ; Aging ; Bilirubin ; Blood Pressure ; Dehydroepiandrosterone ; Ferritins ; Humans ; Insulin Resistance ; Medical Records ; Obesity ; Triglycerides ; Uric Acid

BACKGROUND: DHEA is the most abundant steroid hormone secreted from the adrenal cortex and has several roles such as increasing insulin sensitivity, lowering serum lipid, improving obesity, and anti-cancer effects. DHEA levels vary profoundly and levels decline as age increases. But the role of DHEA in the aging process is not yet fully understood. TAS which provides information of one's antioxidant capacity, also decreases with age. In this study, we investigated the relationship between TAS and serum DHEA-s concentration. METHODS: By reviewing the medical records of 197 healthy adults, we determined the serum levels of DHEA-s and TAS according to BMI, pulse pressure, WBC, hs-CRP, A/G ratio, LDL-cholesterol, triglyceride, ferritin, uric acid and total bilirubin. We studied the relationship between the parameters by Pearson correlation coefficients and multiple regression analysis. RESULTS: The mean level for TAS and serum DHEA-s was 1.20 mml/L and 177.3 ug/mL, respectively. Serum DHEA-s correlated positively with TAS (r=0.44) and negatively for age (r=-0.44). WBC triglyceride and uric acid also showed statistically significant correlations. But, according to multiple regression analysis DHEA-s only correlated with TAS and age. CONCLUSION: Serum DHEA-s correlates positively with TAS.
Adrenal Cortex ; Adult* ; Aging ; Bilirubin ; Blood Pressure ; Dehydroepiandrosterone ; Ferritins ; Humans ; Insulin Resistance ; Medical Records ; Obesity ; Triglycerides ; Uric Acid

OBJECTIVE: To determine the relationships among the grade of cervical pathology, HPV infection status, p16 expression, and p53 expression in cervical neoplasia. METHODS: From July of 2002 to June of 2003, authors did HPV typing with HPV Oligonucleotide Microarray DNA Chip (Biomed, Seoul, Korea), p16 and p53 immunochemical staining in cervical tissues obtained from conization or hysterectomy RESULTS: 41 patients were enrolled in this study. There were 16 normal (WNL) patients, 9 CIN patients, 8 microinvasive cancer (MIC) patients, and 8 invasive cervical cancer (ICC) patients. The HPV infection rate in WNL, CIN, MIC and ICC were 0%, 100%, 50% and 50% retrospectively. The expression rate of p16 was 13% in WNL, 67% in CIN, 50% in MIC and 100% in ICC. That of p53 was 0% in WNL, 67% in CIN, 75% in MIC and 100% in ICC. With regard to p16 staining in HPV negative cases, negative staining was 67%, weakly positive was 13% and strongly positive was 21%. But in HPV-infected cases, negative staining of p16 was 29%, weakly positive was 53% and strongly positive was 18%. With regard to p53 staining in HPV negative cases, without HPV infection, negative staining was 62%, weakly positive was 33% and strongly positive was 4%. But in HPV infected cased, negative staining of p53 was 18%, weakly positive was 53% and strongly positive was 29%. Finally, in p16 negative cases, negative staining of p53 was 62%, weakly positive was 38% and strongly positive was 0%. But in p16 weakly positive cases, with weakly positive p16, negative staining of p53 was 33%, weakly positive was 42%, and strongly positive was 25%. In p16 strongly positive cases, negative staining of p53 was 13%, weakly positive was 50% and strongly positive was 38%. CONCLUSION: There were significant associations among grades of cervical pathology, HPV infection, p16 and p53 expression. Thus there might be some possibilities that expression of p16 and p53 induced by E7 and E6 proteins of HPV can impact on the tumorigenesis.
Carcinogenesis ; Conization ; Humans ; Hysterectomy ; Negative Staining ; Oligonucleotide Array Sequence Analysis ; Pathology ; Retrospective Studies ; Seoul ; Uterine Cervical Neoplasms