BACKGROUND: As the prevalence of obesity has increased, the management of obesity has become important as well. The assessment of abdominal obesity is necessary, because it is an independent risk factor of cardiovascular disease. Although WHO Western Pacific Region recommends measurement of waist circumference as well as BMI, there is no data that supports screening and management of obesity in a Health Promotion Center (HPC). Therefore, surveys concerning such issues were done among HPCs in Seoul, Incheon and Kyonggi. METHODS: From April to May 2002, we investigated 115 general hospitals in Seoul, Incheon, Kyonggi and recruited 94 subjects. We obtained the data from a doctor or a nurse who worked in a HPC by telephone survey. RESULTS: The number of respondents was 100 among 115 and in 94 subjects we obtained detailed information. For criteria of obesity, the proportion of hospitals that used the BMI was 35.1%, and those that use the ideal body weight was 50.0%. For criteria of overweight, the BMI was used in 19.1%, and the ideal body weight in 44.7%. Those who did not use any method was 27.7%. Those using the criteria of abdominal obesity was 35.1%, but only 14.9% used waist circumference and 16.9% used bioelectrical impedance analysis. Diet control and exercise was recommended in 57.4% and 61.4%, respectively. Drug therapy was used in 38.2%. CONCLUSION: Although WHO Western Pacific Region recommends a new criteria of obesity, many HPCs do not follow them. Especially, the degree of recognition for abdominal obesity was low. Effort to assess and manage obesity adequately is necessary.
Cardiovascular Diseases ; Surveys and Questionnaires ; Diet ; Drug Therapy ; Electric Impedance ; Gyeonggi-do ; Health Promotion* ; Hospitals, General ; Ideal Body Weight ; Incheon ; Mass Screening* ; Obesity* ; Obesity, Abdominal ; Overweight ; Prevalence ; Risk Factors ; Seoul ; Telephone ; Waist Circumference

OBJECTIVE: To evaluate the diagnostic accuracy of a new ultrasound (US) classification system for differentiating between benign and malignant solid thyroid nodules. MATERIALS AND METHODS: In this study, we enrolled 191 consecutive patients who received real-time US and subsequent US diagnoses for solid thyroid nodules, and underwent US-guided fine-needle aspiration. Each thyroid nodule was prospectively classified into 1 of 5 diagnostic categories by real-time US: "malignant," "suspicious for malignancy," "borderline," "probably benign," and "benign". We evaluated the diagnostic accuracy of thyroid US and the cut-off US criteria by comparing the US diagnoses of thyroid nodules with cytopathologic results. RESULTS: Of the 191 solid nodules, 103 were subjected to thyroid surgery. US categories for these 191 nodules were malignant (n = 52), suspicious for malignancy (n = 16), borderline (n = 23), probably benign (n = 18), and benign (n = 82). A receiver-operating characteristic curve analysis revealed that the US diagnosis for solid thyroid nodules using the 5-category US classification system was very good. The sensitivity, specificity, positive and negative predictive values, and accuracy of US diagnosis were 86%, 95%, 91%, 92%, and 92%, respectively, when benign, probably benign, and borderline categories were collectively classified as benign (negative). CONCLUSION: The diagnostic accuracy of thyroid US for solid thyroid nodules is high when the above-mentioned US classification system is applied.
Biopsy, Fine-Needle ; Cytodiagnosis ; Diagnosis, Differential ; Female ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Sensitivity and Specificity ; Thyroid Neoplasms/classification/congenital/pathology/*ultrasonography ; Thyroid Nodule/classification/pathology/*ultrasonography ; Ultrasonography, Interventional

Papular elastolytic giant cell granuloma is an unusual variant of annular elastolytic giant cell granuloma, characterized by the development of asymptomatic, multiple, small erythematous papules on both sun-exposed and non-sun-exposed area. Histopathologically, it shows a granulomatous infiltration, accompanied by the absence of the elastic tissue and phagocytosis of elastic fibers by multinucleated giant cell. An 83-year-old man was presented with a 1 year history of multiple erythematous papules on his abdomen and lower legs. Histopathologic finding showed a non-palisading granulomatous infiltration with multinucleated giant cells and engulfing elastic fibers. We, herein, report an unusual case of papular elastolytic giant cell granuloma, which occurred on non-sun-exposed skin.
Abdomen ; Aged, 80 and over ; Elastic Tissue ; Giant Cells ; Granuloma, Giant Cell ; Humans ; Leg ; Phagocytosis ; Skin

BACKGROUND: Pitted keratolysis (PK) is a bacterial infection of the stratum corneum. The infection is characterized by 1 to 7 mm discrete and coalescing craterlike pits on the plantar surfaces of the feet and toes, especially the weight-bearing areas. Topically applied antibiotics such as clindamycin, benzoyl peroxide erythromycin, and clotrimazole are curative. OBJECTIVE: We performed this study to compare treatment efficacy of benzoyl peroxide (BP) and clindamycin phosphate (CP) in PK. METHOD: The clinical study was made in 44 patients with PK. Among 44 patients, 17 patients were treated by BP topical application alone, 15 patients treated by CP. And the others by combined topical application of BP and CP. RESULT: There were no significant differences in the treatment efficacy between BP and CP, and between monotherapy and combination therapy, neither. 1) Gender ratio showed extreme male predominance (M: F = 43: 1), and the mean age of onset was 22 years old. 2) Mean disease duration was 2.8 months and mean period for complete cure was 2.6 weeks. And there was no significant relation between disease duration and mean period for complete cure. 3) Hyperhidrosis (18.1%) was the most commonly associated condition with PK. The followings were Tinea pedis (13.6%), T. cruris (6.8%), erythrasma (6.8%), cellulitis (6.8%), osmidrosis (6.8%), wart (6.8%), and corn (6.8%) in the order of frequency. 4) There was no statistically significant difference in the treatment efficacy between BP and CP (p> 0.05). 5) Among 44 patients, irritation was observed in 4 cases (9.1%). Two cases were related with BP, and the others with CP. But these adverse effects were trivial and disappeared soon. 6) Four cases (9.1%) showed recurrence within 3 month-follow up. And they were all related with hyperhidrosis. There was no statistically significant difference in the recurrence rate between BP and CP, although patients treated with CP showed slightly higher recurrence rate (p> 0.05). CONCLUSION: Our study shows that no significant difference in the treatment efficacy between benzoyl peroxide and clindamycin phosphate, and between monotherapy and combined therapy, neither. Therefore, combination therapy should be spared for only intractable PK.
Age of Onset ; Anti-Bacterial Agents ; Bacterial Infections ; Benzoyl Peroxide* ; Cellulitis ; Clindamycin* ; Clotrimazole ; Erythrasma ; Erythromycin ; Foot ; Humans ; Hyperhidrosis ; Male ; Recurrence ; Tinea Pedis ; Toes ; Treatment Outcome ; Warts ; Weight-Bearing ; Young Adult ; Zea mays

OBJECTIVE: To compare the clinical results between laparoscopically assisted vaginal hysterectomy (LAVH) and total vaginal hysterectomy (TVH). METHODS: We reviewed the medical records of patients who underwent LAVH and TVH from January 2002 to December 2004 in 00 university hospital without the history of uterine prolapse or pelvic relaxation. We evaluated age, parity, previous abdominal operations, indication of hysterectomy, size of the uterus, operation time, hemoglobin change, hospital day, the degree of postoperative pain and initiation of diet and postoperative complications. RESULTS: The age and parity of the patients in both groups were not different statistically. There were history of previous abdominal operations in 20.8% of LAVH group and 25.3% of TVH group which didn't have statistic significance. Major indications of the operation were uterine myomas in both groups. The average weight of the extracted uterus were 272.9+/-114.5 gm and 225.6+/-87.0 gm in the LAVH group and the TVH group respectively which had significance, and the operation time were 81.1+/-23.4 minutes and 71.1+/-37.8 minutes respectively which had significance. There were no difference in the hemoglobin drop of the postoperative day 1, but the hemoglobin drop of the postoperative day 4 was larger in the LAVH group. Postoperative complications occurred more often in the TVH group (15.2%) than LAVH group (11.9%) but didn't have significance, and the complications were treated by conservative managements and observation of the progress. And also the hospital day, the degree of postoperative pain and initiation of diet had no significance. CONCLUSION: Both LAVH and TVH had no statistic difference in the postoperative morbidity and recuperation. Moreover the indications of operation for both surgeries had no statistic difference, but LAVH had a preference for the larger size of uterus. Furthermore in order to increase the satisfactions of patients and remedy the weak points of procedures, research on the indications and contra-indications between the operative approaches and training on the operative procedures are required.
Diet ; Female ; Humans ; Hysterectomy ; Hysterectomy, Vaginal* ; Leiomyoma ; Medical Records ; Pain, Postoperative ; Parity ; Postoperative Complications ; Relaxation ; Surgical Procedures, Operative ; Uterine Prolapse ; Uterus

OBJECTIVE: The aim of this study is to prove the clinical significance by evaluating pregnancy outcomes from intrauterine growth restriction using waves of the Doppler velocimetry of uterine and umbilical artery and amniotic fluid index. METHODS: Throughout the period of January 2000 to May 2005 at our hospital, we reviewed 127 cases diagnosed with intrauterine growth restriction after 24 weeks of pregnancy and the existences of diastolic notch of uterine artery (DNUT), absent or reversed end-diastolic velocity of umbilical artery (AEDV) and oligohydramnios were considered abnormal. We set the group that had no abnormal signs as the control group (62 cases), and respectively compared the groups that had oligohydramnios (24 cases), unilateral DNUT (27 cases), bilateral DNUT (10 cases) and AEDV (13 cases) with the control group. And we compared the groups that had only one abnormal sign, that is oligohydramnios (20 cases), bilateral DNUT (7 cases), AEDV (7 cases) and the group showing 2 or more complicated abnormal signs those above (9 cases) with the control group. RESULTS: Perinatal outcomes such as preterm birth, low birth weight, lower 5-min Apgar score (A/S), neonatal acidosis, admission rate of neonatal intensive care unit (NICU) and perinatal mortality were poor statistically in groups with DNUT, AEDV and oligohydramnios compared to those which have none of these abnormal signs. And those with DNUT had worse results when affected on both sides. And those with AEDV showed worse perinatal outcomes compared to those with bilateral DNUT or oligohydramnios; any overlapping of these abnormal signs indicated worse perinatal outcomes, which had statistic significance. CONCLUSION: Close observation of the fetal well-being by analysis on the wave velocimetry of the blood flow such as the uterine arteries and umbilical arteries and the measurement of the amniotic fluid volume enables predicting the perinatal prognosis of the intrauterine-growth restricted fetuses which may contribute in reducing the perinatal morbidity and mortality.
Acidosis ; Amniotic Fluid ; Apgar Score ; Female ; Fetus ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Intensive Care, Neonatal ; Mortality ; Oligohydramnios* ; Perinatal Mortality ; Pregnancy ; Pregnancy Outcome ; Premature Birth ; Prognosis ; Rheology* ; Umbilical Arteries ; Uterine Artery

BACKGROUND AND OBJECTIVES: Little evidence is available on the optimal antithrombotic therapy following percutaneous coronary intervention (PCI) in patients with atrial fibrillation (AF). We investigated the outcomes of antithrombotic treatment strategies in AF patients who underwent PCI. SUBJECTS AND METHODS: Three hundred sixty-two patients (68.0% men, mean age: 68.3+/-7.8 years) with AF and who had undergone PCI with stent implantation between 2005 and 2007 were enrolled. The clinical, demographic and procedural characteristics were reviewed and the stroke risk factors as well as antithrombotic regimens were analyzed. RESULTS: The accompanying comorbidities were as follows: hypertension (59.4%), diabetes (37.3%) and congestive heart failure (16.6%). The average number of stroke risk factors was 1.6. At the time of discharge after PCI, warfarin was prescribed for 84 patients (23.2%). Cilostazol was used in addition to dual antiplatelet therapy in 35% of the patients who did not receive warfarin. The mean follow-up period was 615+/-385 days. The incidences of major adverse cardiac events (MACE), stroke and major bleeding were 11.3%, 3.6% and 4.1%, respectively. By Kaplan-Meier survival analysis, warfarin treatment was not associated with a lower risk of MACE (p=0.886), but it was associated with an increased risk of major bleeding (p=0.002). CONCLUSION: Oral anticoagulation therapy after PCI may increase hemorrhagic events in Korean AF patients.
Angioplasty ; Anticoagulants ; Atrial Fibrillation ; Comorbidity ; Follow-Up Studies ; Heart Failure ; Hemorrhage ; Humans ; Hypertension ; Incidence ; Male ; Percutaneous Coronary Intervention ; Platelet Aggregation Inhibitors ; Risk Factors ; Stents ; Stroke ; Tetrazoles ; Warfarin

Background: This study aimed to investigate the recent prevalence, management, and comorbidities of diabetes among Korean adults aged ≥30 years by analyzing nationally representative data. Methods: This study used data from the Korea National Health and Nutrition Examination Survey from 2016 to 2018, and the percentage and total number of people ≥30 years of age with diabetes and impaired fasting glucose (IFG) were estimated. Results: In 2018, 13.8% of Korean adults aged ≥30 years had diabetes, and adults aged ≥65 years showed a prevalence rate of 28%. The prevalence of IFG was 26.9% in adults aged ≥30 years. From 2016 to 2018, 35% of the subjects with diabetes were not aware of their condition. Regarding comorbidities, 53.2% and 61.3% were obese and hypertensive, respectively, and 72% had hypercholesterolemia as defined by low-density lipoprotein cholesterol (LDL-C) ≥100 mg/dL in people with diabetes. Of the subjects with diabetes, 43.7% had both hypertension and hypercholesterolemia. With regard to glycemic control, only 28.3% reached the target level of <6.5%. Moreover, only 11.5% of subjects with diabetes met all three targets of glycosylated hemoglobin, blood pressure, and LDL-C. The percentage of energy intake from carbohydrates was higher in diabetes patients than in those without diabetes, while that from protein and fat was lower in subjects with diabetes. Conclusion The high prevalence and low control rate of diabetes and its comorbidities in Korean adults were confirmed. More stringent efforts are needed to improve the comprehensive management of diabetes to reduce diabetes-related morbidity and mortality.