BACKGROUND: Alcohol has much effect on our lives as a taste food that people in almost all of the world generally have had. The effects of alcohol cause social problems as well as physical and psychological problems. Recently, interest about drinkirg increasingly rises as the rate of drinking accident increases in Korea. For this, our study examined the amount of alcohol consumption and early at-risk alcohol intake. METHODS: The prepared questionnaire was presented to subjects who were employees in Inchon . The anonymous, self-administered questionnaire was composed of questionnaire concerning alcohol consumption, early at-risk alcohol intake and doctor's role in drinking behaviour. RESULTS: Among 305 subjects, there were 189 (62%) men, 116 (38%) women whose mean age was 37. 9years. 87(28.5%)subjects were classified as high alcohol group and 218(71.5%) low alcohol group. High alcohol group was defined as early at-risk alcohol intake for men who were consuming 135g of alcohol per day, 630 per week and for women 90g per day, 270g per week. Low alcohol group was defined as early at-risk alcohol intake for men whose consumption was 90g per day, 450 per week and for women 45g per day, 270g per week . Mean alcohol consumption of drinker was 158.9g per week. 3 days per week people should not drink in order to avoid risk Although 54% of respondents thought doctors should ask about their drinkirg habits, only 16.4% of respondents reported ever being asked about alcohol intake on the subject. CONCLUSION: Early at-risk drinking subject in the study was much more than those suggested by NIH(National Institutes of Health). We conclude that primary care physicians should take more interest in screening, treating and preventing alcohol related problems and advise and educate patients to cut down or quit drinking.
Academies and Institutes ; Alcohol Drinking ; Anonyms and Pseudonyms ; Surveys and Questionnaires ; Drinking ; Female ; Humans ; Incheon ; Korea ; Male ; Mass Screening ; Physicians, Primary Care ; Social Problems

PURPOSE: Neonatal lupus is characterized by congenital complete heart block(CCHB), cutaneous rash, and laboratory abnormalities in infants born to mothers with systemic lupus erythematosus(SLE). This study aims to examine the incidence of CCHB and clinical outcome in neonates born to mothers with SLE. METHODS: The study group consisted of 49 neonates, born from 57 pregnancies of 55 women with SLE, diagnosed at Hanyang University Hospital for the period between January 1997 and January 2005. Clinical and laboratory data were retrospectively identified from medical record. RESULTS: There were 5(8.8 percent) spontaneous abortions and one(1.8 percent) still births among 57 pregnancies of 55 mothers. Of 49 live births, 15(26.3 percent) were premature and eight(12.3 percent) were small for their gestational age. There was one(1.8 percent) CCHB suspected during pregnancy on fetal echocardiograpy in a fetus of mother with systemic lupus erythematosus and the fetus was not born by artificial abortion because of mother. There was no CCHB among EKG findings of 49 newborns. Laboratory testing showed hematologic abnormalities among 25.6 percent(10/39) of the babies. 5.1 percent(2/39) and 7.7 percent(3/39) of them were diagnosed as neutropenia, and thrombocytopenia was seen respectively. Anti-SSA(Ro) and antiphospholipid antibodies were predictive factors for prematurity(P=0.003, P=0.049). Anticardiolipin antibodies were predictive factors for ventilatory care(P=0.018). CONCLUSION: The incidence of CCHB among neonates born to mothers with SLE, which was measured in this study, was lower than that in earlier studies. A high incidence of hematologic abnormalities was found in our study. It is suggested that careful examination should be made of skin for the diagnosis of neonatal lupus.
Abortion, Spontaneous ; Antibodies, Anticardiolipin ; Antibodies, Antiphospholipid ; Diagnosis ; Electrocardiography ; Exanthema ; Female ; Fetus ; Gestational Age ; Heart* ; Humans ; Incidence ; Infant ; Infant, Newborn ; Live Birth ; Lupus Erythematosus, Systemic* ; Medical Records ; Mothers* ; Neutropenia ; Parturition ; Pregnancy ; Retrospective Studies ; Skin ; Thrombocytopenia

BACKGROUND: Endovascular stent graft placement is a useful treatment option in lesions of the thoracic aorta. The aim of this study was to assess the possibility of sedation with dexmedetomidine compared with general anesthesia in patients undergoing thoracic endovascular aortic repair (TEVAR) in a multi-center clinical trial. METHODS: Data from 38 patients with thoracic aorta lesions treated by TEVAR between April 2010 and November 2013 were retrospectively collected at two hospitals. General anesthesia or sedation with dexmedetomidine was determined according to the hospital. Demographics, anesthetic recordings, and complications were reviewed. RESULTS: Stent graft placement was technically successful in all patients. There were no events during the anesthetic period. A total of 38 patients underwent TEVAR; 29 patients received general anesthesia, and 9 received sedation. Dexmedetomidine sedation (loading dose: 0.5-1.0 microg/kg for 10 min, maintenance: 0.2-0.8 microg/kg/h) was successfully performed without anesthesia-related complications or mortality. During the procedure, mean arterial pressure, heart rate, and saturation of peripheral oxygen were not statistically different between general anesthesia and dexmedetomidine sedation. CONCLUSIONS: In our study, TEVAR under sedation with dexmedetomidine was shown to be a feasible procedure that was well tolerated without specific complications.
Anesthesia, General* ; Aorta, Thoracic ; Arterial Pressure ; Blood Vessel Prosthesis ; Demography ; Dexmedetomidine* ; Heart Rate ; Humans ; Mortality ; Oxygen ; Retrospective Studies*

Parkinson's disease (PD) is the second most common neurodegenerative motor disease caused by degeneration of dopaminergic neurons in the substantia nigra. Because brain inflammation has been considered a risk factor for PD, we analyzed whether PTEN induced putative kinase 1 (PINK1), an autosomal recessive familial PD gene, regulates brain inflammation during injury states. Using acutely prepared cortical slices to mimic injury, we analyzed expression of the pro-inflammatory cytokines tumor necrosis factor-alpha, interleukin (IL)-1beta, and IL-6 at the mRNA and protein levels. Both mRNA and protein expression of these cytokines was higher at 6-24 h after slicing in PINK1 knockout (KO) slices compared to that in wild-type (WT) slices. In serial experiments to understand the signaling pathways that increase inflammatory responses in KO slices, we found that IkappaB degradation was enhanced but Akt phosphorylation decreased in KO slices compared to those in WT slices. In further experiments, an inhibitor of PI3K (LY294002) upstream of Akt increased expression of pro-inflammatory cytokines. Taken together, these results suggest that PINK1 deficiency enhance brain inflammation through reduced Akt activation and enhanced IkappaB degradation in response to brain injury.
Brain ; Brain Injuries ; Cytokines ; Dopaminergic Neurons ; Encephalitis ; Hydrazines ; Inflammation ; Interleukin-6 ; Interleukins ; Parkinson Disease ; Phosphorylation ; Phosphotransferases ; Risk Factors ; RNA, Messenger ; Substantia Nigra ; Tumor Necrosis Factor-alpha

BACKGROUND: The purpose of this study is to find out the effect of ApoE genotype on the relationship between nutritional risk and cognition of the elderly in a community. METHODS: A total of 996 subjects (343 men and 653 women) aged 60~91 years were analyzed from preliminary data of GDEMCIS (Gwangju Dementia and MCI Study). The study questionnaire consisted of demographic characteristics, current and past illness history, drug history, K-SGDS (Korean version of Short Form Geriatric Depression Scale), K-MMSE (Korean version-Mini Mental State Examina- tion), and NSI (Nutritional Screening Initiative) checklist. We also examined blood pressure, fasting serum glucose, lipid profile, body mass index, and ApoE genotyping. RESULTS: 649 subjects (65.2%) were on good nutritional state (NSI score < or = 2) and 347 subjects (34.8%) were on moderate or high nutritional risk (NSI score > or = 3). On multiple logistic regression analysis, moderate or high nutritional risk was associated with an increa- sed risk for cognitive impairment (K-MMSE score < or = 17) after adjustment with age, sex, K-GDS and educational level in the absence of ApoE epsilon4 allele (OR 1.78, 95% CI 1.15-2.77). CONCLUSION: These results suggest that nutritional risk may be associated with cognitive function in the elderly only in the absence of ApoE epsilon4 allele.
Aged* ; Alleles ; Apolipoproteins E* ; Blood Glucose ; Blood Pressure ; Body Mass Index ; Checklist ; Cognition* ; Dementia ; Depression ; Fasting ; Genotype* ; Humans ; Logistic Models ; Male ; Mass Screening ; Surveys and Questionnaires

PURPOSE: Both atopy and bronchial hyperresponsiveness (BHR) are characteristic features of asthma. Several BHR studies comparing groups of atopic and nonatopic asthmatics have reported conflicting results. The aim of this study was to compare BHR to indirect stimuli, such as mannitol or exercise, between atopic and nonatopic asthmatics in children. METHODS: We performed a retrospective analysis of data from 110 children with asthma, aged 6–18 years using skin prick tests, and serum total and specific IgE levels. Atopy degree was measured using the sum of graded wheal size or the sum of the allergen-specific IgE. Bronchial provocation tests (BPTs) using methacholine were performed on all subjects. BPTs using indirect simuli, including exercise and mannitol, were also performed. RESULTS: Asthma cases were classified as atopic asthma (n=83) or nonatopic asthma (n=27) from skin prick or allergen-specific IgE test results. There was no significant difference in the prevalence of BHR to mannitol or exercise between atopic and nonatopic asthmatics. Atopic asthma had a significantly lower postexercise maximum decrease in % forced expiratory volume in 1 second (FEV1) (geometric mean [95% confidence interval]: 31.9 [22.9–40.9] vs. 14.0 [9.4–18.6], P=0.015) and a methacholine PC20 (provocative concentration of methacholine inducing a 20% fall in FEV1) than nonatopic asthmatics (geometric mean [95% confidence interval]: 1.24 [0.60–1.87] ng/mL vs. 4.97 [3.47–6.47]) ng/mL, P=0.001), whereas mannitol PD15 (cumulative provocative dose causing a 15% fall in FEV1) was not significantly different between the 2 groups. CONCLUSION: There was no significant difference in the prevalence of BHR to mannitol or exercise between atopic and nonatopic asthmatics in children.
Asthma ; Bronchial Provocation Tests ; Child* ; Forced Expiratory Volume ; Humans ; Immunoglobulin E ; Mannitol ; Methacholine Chloride ; Prevalence ; Retrospective Studies ; Skin

PURPOSE: It was found that periostin and squamous cell carcinoma-related antigens (SCCAs) were strongly interleukin-13-inducible gene products. This study measures the serum periostin and SCCA levels in children suffering from atopic dermatitis (AD) and to evaluate the association between the severity of AD and their values. METHODS: Seventy AD children aged 1 month to 10 years were included in our study. Subjects were characterized as having atopic eczema (AE; n=55) or non-AE (NAE; n=15) by atopic sensitization. Serum SCCA and periostin levels were measured. RESULTS: The serum periostin levels were significantly higher in children with AE than in those with NAE (geometric mean [95% confidence interval]: 80.47 ng/mL [75.06–85.93 ng/mL] vs. 67.45 ng/mL [59.99–75.64] ng/mL, P=0.020). The serum concentrations of both SCCA1 and SCCA2 were significantly higher in children with AE than in those with NAE (geometric mean [95% confidence interval]: 1.401 [1.198–1.643] ng/mL vs. 0.969 [0.723–1.268] ng/mL, P=0.039 for SCCA1) (1.178 [0.974–1.455] ng/mL vs. 0.711 [0.540–0.994] ng/mL, P=0.025 for SCCA2). The serum periostin levels were significantly correlated with disease severity and with peripheral blood eosinophil counts. The SCCA levels were not significantly correlated with disease severity. Both SCCA1 and SCCA2 were significantly correlated with serum periostin levels and blood eosinophil counts. CONCLUSION: Serum periostin levels may be significantly correlated with disease severity and blood eosinophil counts in children with AD. Serum SCCA levels can be significantly correlated with serum periostin levels and blood eosinophil counts in children with AD.
Child* ; Dermatitis, Atopic* ; Eosinophils ; Epithelial Cells* ; Humans

OBJECTIVES: The purpose of this study was as follows: 1) to compare the current status of management for dementia between city and country health center. 2) to check the amount and detailed items of budgets for dementia in dementia counseling center, referral courses for registration of dementia patient, number of dementia patient referred to welfare institutions for the elderly. 3) to understand the troubles in management for dementia in health center and to provide baseline data about future community dementia management system. METHOD: The questionnaire was administered to 248 public health centers. The 162 collected questionnaires were used in analysis and the whole response rate was 65.3%. Questionnaire composed by general contents about dementia management in health center and dementia counseling center. Statistical analysis was conducted to compare the difference about each item in city and country health center. RESULTS: City and country health center showed differences in number of registered dementia patient, budgets for dementia, referral courses for registration of dementia patient, number of dementia patient referred to institution, troubles in management for dementia in health center. CONCLUSION: Current dementia management system does not meet the various needs of community for management of dementia. Thus, complementary strategies are needed to solve this problem.
Aged ; Budgets ; Counseling ; Dementia* ; Humans ; Public Health ; Surveys and Questionnaires ; Referral and Consultation

Complex regional pain syndrome (CRPS) is a syndrome of pain and sudomotor or vasomotor instabilities. The perioperative pain management in CRPS patients is very important, as surgery can aggravate preexisting symptoms, especially when performed around the lesion site. Despite the increasing interest in CRPS research, little is known about the optimal perioperative treatment strategy for CRPS patients. Herein, the case of a female CRPS patient, who underwent elective surgery at the lesion site, is reported. As a preemptive analgesia, the patient was satisfactorily managed with two weeks of patient-controlled epidural analgesia, initiated 2 days prior to surgery. The techniques for the prevention of perioperative pain, including preemptive analgesia, as well as its importance, are discussed.
Analgesia ; Analgesia, Epidural ; Female ; Humans ; Pain Management*

Background: Use of opioids for chronic intractable pain is increasing globally, and their proper use can improve patients’ quality of life. In contrast, opioid use disorders, such as abuse or addiction, caused by prescribing opioids, are a worldwide issue. This study aimed to understand current opioid prescribing patterns and pain physicians’ experiences with opioid use in South Korea. Methods: Pain physicians in 42 university hospitals in South Korea were asked to complete anonymous questionnaires regarding opioid prescriptions. Results: A total of 69 surveys were completed. Most pain physicians started prescribing opioids at a pain score of 7/10 and aimed to reduce pain by 50%. Most physicians (73.1%) actively explained the prescribed medications and possible side effects, and 61.2% of physicians preferred the prescription interval of 4 weeks.Immediate-release opioids were the most popular treatment for breakthrough pain (92.6%). The most common side effect encountered by physicians was constipation (43.3%), followed by nausea/vomiting (34.3%). Of the physicians, 56.5% replied that addiction and misuse prevalences were less than 5%. However, the most concerning side effect was addiction (33.0%). Conclusions The survey results showed that the prescribing patterns of pain physicians generally followed Korean guidelines. Physicians were most interested in the safety and effectiveness of opioid prescriptions. They were most concerned about respiratory depression and abuse or addiction. A significant number of physicians agreed that the NHIS regulations needed improvement for patient convenience and safe and effective treatment, though there were pros and cons of the NHIS restrictions on prescription conditions.