BACKGROUND: The prevalence of metabolic syndrome is increasing in Korea. The aim of this study was to establish if there is an association between the presence of metabolic syndrome and the development of gallbladder stones in Koreans. METHODS: Among the subjects who visited a health promotion center of a general hospital from January 2001 to December 2005, a total of 34,574 adults was examined. Among them, the final 34,470 adults (males 20,277, females 14,193) were included. Metabolic syndrome was defined if they fell under the three conditions of BMI > or = 25 kg/m2, blood pressure > or = 130/85 mmHg, fasting glucose 110 mg/dL, triglyceride > or = 150 mmHg and low HDL-cholesterol (< 40 mg/dL in men, < 50 mg/dL in women). After adjusting for age and sex, logistic regression analysis was done to evaluate the relationship between metabolic syndrome and gallstones. RESULTS: This study showed that the prevalence of metabolic syndrome was 17.6% (males 21.1%, females 12.4%). Gallbladder stone risk was increased according to BMI, high blood pressure, high fasting blood glucose and low HDL. Gallbladder stone risk was increased according to clustering of components of metabolic syndrome after adjustment for age and sex (1 criterion: OR = 1.42, 95% CI, 1.20-1.69, P = 0.000; 2 criterion: OR = 1.86, 95% CI, 1.57-2.21, P = 0.000; 3 criterion: OR = 2.02, 95% CI, 1.66-2.45, P = 0.000; 4 criterion: OR = 2.17, 95% CI, 1.66-2.85, P = 0.000; 5 criterion: OR = 2.17, 95% CI, 1.17-4.02, P < 0.014). CONCLUSION: Gallbladder stone risk was increased according to BMI, and increased with people who had combination of more metabolic syndrome components.
Adult ; Blood Glucose ; Blood Pressure ; Body Mass Index ; Fasting ; Female ; Gallbladder ; Gallstones ; Glucose ; Health Promotion ; Hospitals, General ; Humans ; Hypertension ; Korea ; Logistic Models ; Male ; Metabolic Syndrome X ; Obesity ; Prevalence

Coagulopathies are a relatively common cause of young-age stroke. We present herein a 15-year-old male who was admitted for acute cerebral infarction with dysarthria and weakness of the right side. He had previously been diagnosed with autosomal dominant protein-S deficiency. His left internal carotid artery was totally occluded. Emergency mechanical thrombolysis resulted in recanalization of that occluded artery and consequent improvement in symptoms. The patient was discharged with an oral anticoagulant.
Adolescent ; Arteries ; Carotid Artery, Internal ; Cerebral Infarction* ; Dysarthria ; Emergencies ; Humans ; Male ; Mechanical Thrombolysis ; Protein S Deficiency* ; Stroke

We investigated that the relationship between body fat content and maximal muscle strength when skeletal muscle mass was matched. Muscle mass was measured from 140 preliminary selected people, and 30 males were finally selected and divided into one of four experimental groups: low body fat (group 1, ≤11.9%), low-moderate fat (group 2, 12.0%-16.9%), moderate-high fat (group 3, 17.0%-22.9%), high fat (group 4, ≥23.0%). All subjects undertook one repetition maximum (1RM) test of abdominal and back upper body's and lower body's, and bench press, squat, and back strength dynamometer was used. Repeated oneway analysis of variance and Tukey's post-hoc test was adopted to specify mean differences among groups. Statistical significance level was set at α=0.05. 1RM of bench press was not different among groups (p>0.05) even though values from group 2 was marginally higher (15.9%) than group 1 values (p=0.091). 1RM of squat was higher in group 4 compared to group 2 and group 3 (p<0.05), and maximal back muscular strength was higher in group 1 and group 3 than group 2 (p<0.05). However, total 1RM values, sum of 1RM obtained from different exercises, did not reveal any statistical differences. No notable correlation was found between percent body fat (%BF) and maximal muscular strength. Interestingly, negative correlation of muscular strength was observed between %BF and relative (per kilogram) body mass (p<0.001), but not with between %BF and relative skeletal muscle mass. Therefore, it was concluded that maximal muscular strength is influenced not by fat mass but by skeletal muscle mass.
Adipose Tissue* ; Exercise ; Humans ; Male ; Muscle Strength* ; Muscle, Skeletal

BACKGROUND: C-reactive protein (CRP) is one of the increasing plasma proteins in inflammatory diseases and tissue necrosis and recent evidence show that increased elevated levels of CRP are associated with an increased risk of coronary heart disease (CHD) and obesity. To investigate the relationship of obesity and CRP, we evaluated the correlation of CRP with obesity index in healthy adults. METHODS: The subjects included 1,926 healthy adults (1,168 men and 758 women) who visited the Health Promotion Center of a general hospital from May to December 2004. We excluded subjects who had inflammatory diseases, and investigated based on age, physical examination, blood pressure, fasting plasma glucose, serum lipid profile, percentage of body fat, and body mass index (BMI). CRP was analyzed by method of Turbid Immuno Assay (TIA) which has high sensitivity-CRP. We evaluated serum level of CRP in relation to %body fat, BMI, and clustering of metabolic risk factors. RESULTS: Comparing the median CRP with the percentage of body fat, BMI, clustering of metabolic risk factors the value of CRP significantly increased according to increase in %body fat BMI and metabolic risk fakfor (P<0.001). The proportion of elevated CRP levels (> or =0.22 mg/dL) was increased as %body fat, BMI, and clustering of metabolic risk factor increased. The Odds Ratios for elevated levels of CRP were 1.5 (95% CI 1.0~2.1) in men and 2.9 (95% CI 1.7~4.8) in women for subjects with obesity (BMI> or =25 kg/m2), 2.0 (95% CI 1.3~2.9) in men with more than 25% %body fat, and 2.5 (95% CI 1.4~4.1) in women with more than 30% %body fat. CONCLUSION: As %body fat increased, the proportion of elevated CRP (> or =0.22 mg/dL) level increased in men and women. We conclude that obesity is related with CRP.
Adipose Tissue ; Adult* ; Blood Glucose ; Blood Pressure ; Blood Proteins ; Body Mass Index ; C-Reactive Protein* ; Coronary Disease ; Fasting ; Female ; Health Promotion ; Hospitals, General ; Humans ; Male ; Necrosis ; Obesity* ; Odds Ratio ; Physical Examination ; Risk Factors*

PURPOSE: The effect of delays in surgical treatment on survival outcomes in patients with breast cancer remains uncertain, but it is an issue of importance to both patients and clinicians. The purpose of this study was to determine the impact of delayed surgical treatment on survival and tumor progression such as changes in tumor size and lymph node metastasis. METHODS: Among 1,219 patients who underwent breast cancer surgery at Asan Medical Center between January 2008 and December 2008, 1,074 patients were finally included in the study following the application of inclusion and exclusion criteria. Patients were divided into two groups based on the interval between diagnosis and surgery: ≤30 days (group 1) and >30 days (group 2). We retrospectively analyzed clinical characteristics, changes in tumor size and axillary lymph-node status, and overall survival (OS) and disease-free survival (DFS) rates. RESULTS: Between group 1 and group 2, there were no differences in clinical characteristics or in changes in tumor size between findings based on ultrasonography (USG) with biopsy at diagnosis and pathologic results (p=0.134). Furthermore, changes in tumor size and lymph-node status between USG results at Asan Medical Center and pathologic results also showed no differences (p=0.249 and p=0.233, respectively). There were also no significant differences in DFS (p=0.395) or OS (p=0.813). CONCLUSION: Our study showed that short-term delays of ≤2 months between diagnosis and surgery for breast cancer do not negatively affect cancer progression or survival rates.

PURPOSE: Lacunar stroke, in the context of small vessel disease, is a type of cerebral infarction caused by occlusion of a penetrating artery. Pulsatility index (PI) is an easily measurable parameter in Transcranial Doppler ultrasound (TCD) study. PI reflects distal cerebral vascular resistance and has been interpreted as a surrogate marker of small vessel disease. We hypothesized that an increased PI, a marker of small vessel disease, might be associated with a larger infarct volume in acute lacunar stroke. MATERIALS AND METHODS: This study included 64 patients with acute lacunar stroke who underwent TCD and brain MRI. We evaluated the association between the mean PI value of bilateral middle cerebral arteries and infarct volume on diffusion-weighted MRI using univariate and multivariate linear regression. RESULTS: The mean infarct volume and PI were 482.18±406.40 mm3 and 0.86±0.18, respectively. On univariate linear regression, there was a significant positive association between PI and infarct volume (p=0.001). In the multivariate model, a single standard deviation increase of PI (per 0.18) was associated with an increase of 139.05 mm3 in infarct volume (95% confidence interval, 21.25 to 256.85; p=0.022). CONCLUSION: We demonstrated that PI was an independent determinant of infarct volume in acute lacunar stroke. The PI value measured in acute stroke may be a surrogate marker of the extent of ischemic injury.
Aged ; Cerebral Infarction/*diagnostic imaging/*physiopathology ; *Diffusion Magnetic Resonance Imaging ; Female ; Humans ; Linear Models ; Male ; Middle Aged ; Middle Cerebral Artery ; Pulsatile Flow/physiology ; Retrospective Studies ; Stroke, Lacunar/*diagnostic imaging/*physiopathology ; *Ultrasonography, Doppler, Transcranial ; Vascular Resistance/physiology

Purpose: Cutting balloon-percutaneous transluminal angioplasty (CB-PTA) is a feasible treatment option for in-stent restenosis (ISR) after carotid artery stenting (CAS). However, the longterm durability and safety of CB-PTA for ISR after CAS have not been well established. Materials and Methods: We retrospectively reviewed medical records of patients with ISR after CAS who had been treated with CB-PTA from 2012 to 2021 in our center. Detailed information of baseline characteristics, periprocedural and long-term outcomes, and follow-up imaging was collected. Results: During 2012–2021, a total of 301 patients underwent CAS. Of which, CB-PTA was performed on 20 lesions exhibiting severe ISR in 18 patients following CAS. No patient had any history of receiving carotid endarterectomy or radiation therapy. These lesions were located at the cervical segment of the internal carotid artery (n=16), proximal external carotid artery (n=1), and distal common carotid artery (n=1). The median time interval between initial CAS and detection of ISR was 390 days (interquartile range 324–666 days). The follow-up period ranged from 9 months to 9 years with a median value of 21 months. Four patients (22.2%) were symptomatic. The average of stenotic degree before and after the procedure was 79.2% and 34.7%, respectively. Out of the 18 patients receiving CB-PTA, 16 (88.9%) did not require additional stenting, and 16 (88.9%) did not experience recurrent ISR during the follow-up period. Two patients who experienced recurrent ISR were successfully treated with CB-PTA and additional stenting. No periprocedural complication was observed in any case. Conclusion Regarding favorable periprocedural and long-term outcomes in our single-center experience, CB-PTA was a feasible and safe option for the treatment of severe ISR after CAS.

Background: Korea recently established 70 emergency medical service areas. However, there are many concerns that medical resources for stroke could not be evenly distributed through the country. We aimed to compare the treatment quality and outcomes of acute stroke among the emergency medical service areas. Methods: This study analyzed the data of 28,800 patients admitted in 248 hospitals which participated in the 8th acute stroke quality assessment by Health Insurance Review and Assessment Service. Individual hospitals were regrouped into emergency service areas according to the address of the location. Assessment indicators and fatality were compared by the service areas. We defined the appropriate hospital by the performance of intravenous thrombolysis. Results: In seven service areas, there were no hospitals which received more than 10 stroke patients for 6 months. In nine service areas, there were no patients who underwent intravenous thrombolysis (IVT). Among 167 designated emergency medical centers, 50 hospitals (29.9%) responded that IVT was impossible 24 hours a day. There are 97 (39.1%) hospitals that meet the definitions of appropriate hospital. In 23 service areas (32.9%) had no appropriate or feasible hospitals. The fatality of service areas with stroke centers were 6.9% within 30 days and 15.6% within 1 year from stroke onset than those without stroke centers (7.7%, 16.9%, respectively). Conclusions There was a wide regional gap in the medical resource and the quality of treatments for acute stroke among emergency medical service areas in Korea. The poststroke fatality rate of the service areas which have stroke centers or appropriate hospitals were significantly low.