BACKGROUND: Metabolic syndrome (MetS), characterized by abdominal obesity, hypertriglyceridemia, low high-density lipoprotein (HDL) cholesterol, high blood pressure, and high fasting glucose level, is a common risk factor for cardiovascular diseases and associated complications. We examined the relationship between the metabolic syndrome and risk of chronic kidney disease (CKD) in Korean women. METHODS: We used data from 10,170 women, aged 30-89 years, who had visited a health examination center at a tertiary care hospital in 2006. The data were studied cross-sectionally. MetS was identified using the modified criteria of the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III). CKD was defined as an estimated GFR < 60 ml/min per 1.73 m2. The multivariable-adjusted (adjustment for age, education, body mass index (BMI), alcohol drinking, smoking, previous coronary heart disease, menopauses and physical inactivity) odds ratio of CKD (95% CI) associated with each component of the metabolic syndrome was calculated using the logistic regression models. RESULTS: A total of 1,039 participants have MetS. The multivariable-adjusted odds ratios (OR) of CKD in participants with MetS, hypertriglyceridemia and high blood pressure compared with participants without such factors were 2.68 (95% CI, 1.77-4.06), 1.96 (95% CI, 1.34-2.88), and 2.00 (95% CI, 1.38-2.89). Compared with the participants with no MetS traits, those with one, two, equal to or more than three traits of MetS had OR of CKD of 1.24 (95% CI, 0.75-2.06), 1.56 (95% CI, 0.89-2.75), and 2.18 (95% CI, 1.21-3.93), respectively. CONCLUSION: We found that Korean women with MetS had an increased risk for developing CKD. Finally, earlier identification and management of MetS might improve patient health and prevent progression of CKD.
Adult ; Aged ; Alcohol Drinking ; Body Mass Index ; Cardiovascular Diseases ; Cholesterol ; Coronary Disease ; Fasting ; Female ; Glomerular Filtration Rate ; Glucose ; Humans ; Hypertension ; Hypertriglyceridemia ; Lipoproteins ; Logistic Models ; Obesity, Abdominal ; Odds Ratio ; Renal Insufficiency, Chronic ; Risk Factors ; Smoke ; Smoking ; Tertiary Healthcare

Subcutaneous fat necrosis of the newborn is an uncommon disorder characterized by firm b-cutaneous plaques and nodules usually appearing shortly after birth. It runs a relatively be, n course and may completely resolve in a few months without any recurrence. We report a case of subcutaneous fat necrosis in a 15 day-old male suffering from severe p inatal asphyxia and hypoxic cardiomyopathy, who presented with indurated subcutane s nodules and plaques on the both shoulders and the back. Histologically the subcutaneous fat showed focal necrosis with needle-shaped clefts, lymphohistiocytic infiltration and foreign body reactions consistent with subcutaneous fat necrosis of the newborn. In our patient, compromised cardiac output due to cardiomyopathy might have aggravated hypoxic condition and it could be speculated that cardiomyopathy-induced systemic hypoxia gave rise to hypothermia of the skin as a result of peripheral vasoconstriction. This report presents a causal relationship of cardiomyopathy and subcutaneous fat necrosis of the newborn.
Anoxia ; Asphyxia ; Cardiac Output ; Cardiomyopathies* ; Foreign Bodies ; Humans ; Hypothermia ; Infant, Newborn* ; Male ; Necrosis* ; Parturition ; Recurrence ; Shoulder ; Skin ; Subcutaneous Fat* ; Vasoconstriction

PURPOSE: There are several reports that the risk of development of leukemias is much higher in Down syndrome (DS) children than in non DS children. But there are a few reports about the clinical features of leukemia in Down syndrome and the prognosis in Korea. The object of this study is to evaluate clinical features, treatment results and the prognosis of leukemia of Down syndrome patients. METHODS: We conducted retrospective reviews in 10 children with leukemia of Down syndrome who were admitted to the Department of Pediatrics in Yonsei University Hospital between March 1986 and December 2000. We analyzed the clinical features, laboratory findings and survival rates. RESULTS: A male to female ratio was 1:1.25. Median age at diagnosis was 2 years 8 months. Initial symptoms were hepatosplenomegaly, petechiae, fever and upper respiratory infection symptoms. The number of patients by the type was as followed:acute myeloid leukemia (AML) 7 (70%), acute lymphocytic leukemia 2 (20%), acute mixed lineage leukemia 1 (10%). There were 4 cases of M7 subtype in AML. The median peripheral blood cell counts were as followed; leukocyte was 41,000/muL, hemoglobin was 8.7 g/dL, the platelet was 103,000/muL. The five years event free survival rate after diagnosis was 87.5% (7/8). The one patient relapsed and another one patient died of cardiac anomaly. CONCLUSION: There seemed to be several differences of clinical features between DS leukemia and non DS leukemia, especially prognosis. Multi-centered well organized study should be done to confirm our observation.
Blood Cell Count ; Blood Platelets ; Child ; Chromosomes, Human, Pair 21 ; Diagnosis ; Disease-Free Survival ; Down Syndrome* ; Female ; Fever ; Humans ; Korea ; Leukemia* ; Leukemia, Myeloid ; Leukemia, Myeloid, Acute ; Leukocytes ; Male ; Pediatrics ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Prognosis* ; Purpura ; Retrospective Studies ; Survival Rate

OBJECTIVE: We wanted to evaluate the MR findings for differentiating between necrotizing fasciitis (NF) and pyomyositis (PM). MATERIALS AND METHODS: The MR images of 19 patients with surgically confirmed NF (n = 11) and pathologically confirmed PM (n = 8) were retrospectively reviewed with regard to the presence or absence of any MRI finding criteria that could differentiate between them. RESULTS: The patients with NF had a significantly greater prevalence of the following MR findings (p < 0.05): a peripheral band-like hyperintense signal in muscles on fat-suppressed T2-weighted images (73% of the patients with NF vs. 0% of the patients with PM), peripheral band-like contrast enhancement (CE) of muscles (82% vs. 0%, respectively) and thin smooth enhancement of the deep fascia (82% vs. 13%, respectively). The patients with PM had a significantly greater prevalence of the following MRI findings (p < 0.05): a diffuse hyperintense signal in muscles on fat-suppressed T2-weighted images (27% of the patients with NF vs. 100% in the patients with PM), diffuse CE of muscles (18% vs. 100%, respectively), thick irregular enhancement of the deep fascia (0% vs. 75%, respectively) and intramuscular abscess (0% vs. 88%, respectively). For all patients with NF and PM, the superficial fascia and muscle showed hyperintense signals on T2-weighted images and CE was seen on fat-suppressed CE T1-weighted images. The subcutaneous tissue and deep fascia showed hyperintense signals on T2-weighted images and CE was seen in all the patients with NF and in seven (88%) of the eight patients with PM, respectively. CONCLUSION: MR imaging is helpful for differentiating between NF and PM.
Abscess/pathology ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Diagnosis, Differential ; Fascia/pathology ; Fasciitis, Necrotizing/*pathology ; Female ; Humans ; Image Processing, Computer-Assisted ; *Magnetic Resonance Imaging ; Male ; Middle Aged ; Muscle, Skeletal/pathology ; Pyomyositis/*pathology ; Retrospective Studies ; Young Adult

OBJECTIVE: Rotavirus and norovirus are the most common pathogens causing acute gastroenteritis in children. As the incidence of noroviral gastroenteritis increases, it is becoming more important to identify the clinical features of noroviral infection. We compared the clinical features of noroviral gastroenteritis and rotaviral gastroenteritis. METHODS: This study included 79 children with noroviral and 151 children with rotaviral gastroenteritis, who were admitted to the Soonchunhyang University Gumi Hospital between January 2013 and December 2014. We reviewed their medical records and compared the clinical features of gastroenteritis between the two groups respectively. RESULTS: In those belonging to the norovirus group, the mean age was 29.65 months, which was younger than that of the rotavirus group, at 34.74 months. Patients suffering from noroviral gastroenteritis experienced more vomiting (5.6 episodes/day) than diarrhea (3.5 episodes/day). Vomiting, diarrhea, and fever were all less severe in those suffering from noroviral gastroenteritis. It is commonly noted that patients with noroviral infection have vomiting and diarrhea without fever (55.0%), while those with rotaviral infection present with vomiting, diarrhea, and fever (44.3%). CONCLUSION: Although noroviral gastroenteritis is less severe than rotaviral gastroenteritis, the incidence of noroviral infection is increasing, and the mean age group infected with this virus is getting younger; thus, noroviral infection must be considered in the differential diagnoses in young patients with gastroenteritis.
Child ; Diagnosis, Differential ; Diarrhea ; Fever ; Gastroenteritis* ; Gyeongsangbuk-do ; Humans ; Incidence ; Medical Records ; Norovirus ; Rotavirus ; Vomiting

OBJECTIVES: The purpose of the present study was to explore a possible interaction effect of stress and social support on the smoking status and identify smoking related factors of high school students. METHODS: A cross-sectional design was used for this study. A total of 1, 251 high school students from Gyeonggi-do were selected using stratified-proportional random cluster sampling methods. The participants completed a set of questionnaires to measure their smoking status, stress, social support and sociodemographic information. The obtained data were analyzed using descriptive statistics, x2-tests and hierarchical logistic regressions. RESULTS: The interaction effect of stress and social support on smoking status was not supported. However, stress, sex, types of school, parent's smoking and friends' smoking were significantly predicted the smoking status of the high school students. CONCLUSIONS: In relation to the prevention of adolescents' smoking, it is recommended to decrease the stress levels of students, to make adolescents' parents cease smoking, and to educate adolescents on how to refuse the temptation to smoke or pressure from their smoking friend.
Adolescent ; Friends ; Gyeonggi-do ; Humans ; Logistic Models ; Parents ; Smoke* ; Smoking*

Pulmonary thromboembolism is one of the most important causes of morbidity and mortality in patients undergoing lower extremity orthopedic surgery. Early diagnosis and appropriate management are important clinical challenges. In this case, massive pulmonary embolism causing sudden cardiac arrest was attributed to use of tourniquet inflation during lower extremity orthopedic surgery. Resuscitation procedures were initiated and transesophageal echocardiography revealed pulmonary thromboembolism. Patients with high suspicion for the presence of deep vein thrombus must be monitored thoroughly during limb exsanguinations.
Anesthesia, Spinal ; Death, Sudden, Cardiac ; Early Diagnosis ; Echocardiography, Transesophageal ; Extremities ; Heart Arrest ; Humans ; Inflation, Economic ; Lower Extremity ; Orthopedics ; Pulmonary Embolism ; Resuscitation ; Thrombosis ; Tourniquets ; Veins

PURPOSE: To report a case of ocular surface reconstruction using nasal and oral mucosa auto grafts on a man whose ocular surface was deformed by a chemical burn. CASE SUMMARY: A 48-year-old man was injured when his right eye was exposed to alkali solution. He underwent fifteen operations, including amniotic membrane auto grafts and fornix reconstructions. However, his right eye still suffered from symble pharon, drying, corneal neovascularization, and erosion. We performed ocular surface reconstruction with free autologous nasal and oral mucosal transplantation and amniotic membrane graft. By one month after surgery, his eye showed no evidence of symble pharon or fibrovascularization recurrence on the cornea or conjunctiva. By six months after surgery, his ocular surface had stabilized. CONCLUSIONS: Ocular surface reconstruction with free autologous nasal and oral mucosal transplantation is a useful method on eyes that are injured by chemical burns.
Alkalies ; Amnion ; Burns, Chemical ; Conjunctiva ; Cornea ; Corneal Neovascularization ; Eye ; Humans ; Middle Aged ; Mouth Mucosa ; Nasal Mucosa ; Recurrence ; Transplants

OBJECTIVE: This study was performed to evaluate the efficiency of preimplantation genetic diagnosis (PGD) using fluorescence in-situ hybridization (FISH) in Robertsonian or balanced reciprocal translocation carriers in human IVF-ET programm. METHOD: FISH was carried out in 25 cycles of 15 couples. Two-color FISH analysis was performed on 54 polar bodies in 3 cycles and 234 blastomeres in 22 cycles. After FISH analysis, the embryos with normal FISH signals were transferred into mother's uterus. RESULTS: In FISH analysis of polar bodies, 18 nuclei of polar bodies were normal and 12 embryos were transferred in 3 cycles. FISH efficiency per oocyte was 95.0% in cases using polar bodies. In FISH analysis of blastomeres, 49 embryos were normal and transferred in 21 cycles. FISH efficiency per embryo was 92.7% using blastomeres. At present, three pregnancies were achieved. A girl and a boy were delivered. Both of them were translocation carriers. The other conceptus showed normal karyotype. CONCLUSIONS: According to this study, PGD using FISH can be successfully applied for the patients with translocations of chromosomes.
Blastomeres ; Embryonic Structures ; Family Characteristics ; Female ; Fluorescence* ; Humans* ; Karyotype ; Male ; Oocytes ; Polar Bodies ; Pregnancy ; Preimplantation Diagnosis* ; Prostaglandins D ; Uterus

OBJECTIVES: This study was carried out to estimate the prevalence of isocyanate-induced occupational asthma in toluene diisocyanate (TDI) exposed workers. METHODS: We examined 170 workers who had been directly exposed to TDI through a medical questionnaire, physical examination, and pulmonary function test. Based on screening examination, workers with suspected occupational asthma were selected for further evaluation such as methacholine and TDI challenge tests. RESULTS: Eleven (6.9%) among 170 workers complained of symptoms of occupational asthma, and 7 among these 11 symptomatic workers showed positive responses to the methacholine challenge test (4.1%). One spray painter was confirmed as having the TDI induced occupational asthma following a positive response to TDI challenge test. CONCLUSIONS: The prevalence of TDI-induced asthma was at 0.58% was lower than that for former studies (2-20%). Improved workplace environment, lower level of TDI exposure compared to the past, and the healthy workers effect may have contributed to this low rate of asthma prevalence in workers with TDI exposure.
Asthma ; Asthma, Occupational* ; Mass Screening ; Methacholine Chloride ; Physical Examination ; Prevalence* ; Questionnaires ; Respiratory Function Tests ; Toluene 2,4-Diisocyanate