BACKGROUND: The waist-to-height ratio (WHtR) is an easy and inexpensive adiposity index that reflects central obesity. In this study, we examined the association of baseline WHtR and progression of coronary artery calcification (CAC) over 4 years of follow-up in apparently healthy Korean men. METHODS: A total of 1,048 male participants (mean age, 40.9 years) in a health-screening program in Kangbuk Samsung Hospital, Seoul, Korea who repeated a medical check-up in 2010 and 2014 were recruited. Baseline WHtR was calculated using the value for the waist in 2010 divided by the value for height in 2010. The CAC score (CACS) of each subject was measured by multi-detector computed tomography in both 2010 and 2014. Progression of CAC was defined as a CACS change over 4 years greater than 0. RESULTS: During the follow-up period, progression of CAC occurred in 278 subjects (26.5%). The subjects with CAC progression had slightly higher but significant baseline WHtR compared to those who did not show CAC progression (0.51+/-0.04 vs. 0.50+/-0.04, P<0.01). The proportion of subjects with CAC progression significantly increased as the baseline WHtR increased from the 1st quartile to 4th quartile groups (18.3%, 18.7%, 28.8%, and 34.2%; P<0.01). The risk for CAC progression was elevated with an odds ratio of 1.602 in the 4th quartile group of baseline WHtR even after adjustment for confounding variables (95% confidence interval, 1.040 to 2.466). CONCLUSION: Increased baseline WHtR was associated with increased risk for CAC progression. WHtR might be a useful screening tool to identify individuals at high risk for subclinical atherosclerosis.
Adiposity ; Atherosclerosis ; Confounding Factors (Epidemiology) ; Coronary Vessels* ; Follow-Up Studies ; Humans ; Korea ; Male* ; Mass Screening ; Obesity, Abdominal ; Odds Ratio ; Seoul

No abstract available.
Neurilemmoma* ; Neurofibromatosis 1*

OBJECTIVE: In 2013, a new risk calculator known as the Pooled Cohort Equation (PCE) was introduced with the new cholesterol guideline. We aimed to calculate the 10-year atherosclerotic cardiovascular disease (ASCVD) risk using PCE in non-diabetic Korean subjects with glycated hemoglobin (HbA1c) lower than 6.5%. METHODS: A total of 17,519 participants were evaluated in a health screening program. The 10-year ASCVD risk was calculated using the PCE. Subjects with underlying diabetes or HbA1c > or =6.5% were excluded. Subjects were divided into four groups according to fasting blood glucose (FBG) and HbA1c levels: FBG <100 mg/dL, 100< or =FBG<110 mg/dL, 110< or =FBG<120 mg/dL, and FBG > or =120 mg/dL; HbA1c <5.5%, 5.5%< or =HbA1c<5.6%, 5.6%< or =HbA1c<5.8%, and HbA1c > or =5.8%. RESULTS: The mean 10-year ASCVD risk significantly increased as FBG increased from <100 mg/dL to >120 mg/dL in the four divided groups (2.6%, 3.3%, 3.8%, 4.1%; p<0.01), and as HbA1c increased from <5.5% to >5.8% (2.4%, 2.7%, 3.0%, 3.6%; p<0.01). The odds ratio for 10-year ASCVD risk > or =10% significantly increased from group I to IV according to FBG and HbA1c levels after adjusting for age, body mass index and fasting insulin level (1.187, 1.753, and 2.390 vs. 1.0 in the lowest FBG group; 1.626, 1.574, and 1.645 vs. 1.0 in the lowest HbA1c group). CONCLUSION: The 10-year ASCVD risk calculated using the PCE significantly increased as the FBG and HbA1c increased even in Korean subjects without underlying diabetes.
Blood Glucose ; Body Mass Index ; Cardiovascular Diseases* ; Cholesterol ; Cohort Studies* ; Fasting ; Hemoglobin A, Glycosylated ; Insulin ; Mass Screening ; Odds Ratio ; Prediabetic State

No abstract available.
Lymphangioma*

Flatfoot deformity, defined as loss of medial longitudinal arch, sometimes involves symptoms such as medial arch pain or Achilles tendon tightening, etc. Whether the etiology of deformity is congenital or acquired, i.e., posterior tibial tendon dysfunction, symptoms are largely resolved with conservative treatment including medication, orthoses, and activity modification. Surgery should be considered in cases of failure of conservative treatment and clinicians can select an appropriate technique among many surgical options including calcaneal osteotomy or flexor digitorum longus tendon transfer. Principles of corrective surgery include the recovery of alignment and the preservation of joint motion.
Achilles Tendon ; Congenital Abnormalities* ; Flatfoot* ; Joints ; Orthotic Devices ; Osteotomy ; Posterior Tibial Tendon Dysfunction ; Tendon Transfer

No abstract available.

PURPOSE: Heart rate variability (HRV) is a tool used to measure autonomic nervous function; however, there is no evidence that it can be used to define sympathetic hyperactivity in men with lower urinary tract symptoms (LUTS). We suspected that LUTS would differ between sympathetic hyperactive and hypoactive patients. Therefore, we measured HRV and divided the LUTS patients into two groups, a sympathetic hyperactive group and a sympathetic hypoactive group according to the low frequency/high frequency (LF/HF) ratio and made clinical comparisons between the groups. METHODS: A total of 43 patients with symptomatic LUTS (International Prostate Symptom Score [IPSS] over 8) and 49 healthy volunteers were enrolled. No subjects had diseases that could affect the autonomic nervous system, such as diabetes or hypertension. Electrocardiographic signals were obtained from subjects in the resting state and HRV indexes were calculated with spectral analyses. We divided the LUTS patients into two groups by an LF/HF ratio of 1.9, which was the median value in the healthy volunteers, and compared the differences in clinical characteristics, IPSS, prostate-specific antigen (PSA), and transrectal ultrasound (TRUS) results. The parameters were compared by independent sample t-test by use of SPSS ver. 19. RESULTS: There were no significant differences in age, serum PSA, or volume of the prostate between the 2 LUTS groups. However, analyzing IPSS questionnaires between two groups showed that there were significant differences in mean of Q2 score (frequency) and storage symptom score ([Q2+Q4+Q7]/3) (P<0.05). CONCLUSIONS: We suggest that an imbalance of autonomic nervous system activity may be a factor that evokes varieties of symptoms in men with LUTS. LUTS patients with hypoactive sympathetic tone may suffer from frequency and storage symptoms.
Autonomic Nervous System ; Electrocardiography ; Heart Rate ; Humans ; Hypertension ; Lower Urinary Tract Symptoms ; Male ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia

Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disorder that causes progressive muscular weakness, severe weight loss, and ultimately death. Gastrostomy or nasogastric tube is beneficial for ALS patients with severe weight loss and dysphagia. However, the development of superior mesenteric artery (SMA) syndrome in ALS patients when the enteral feeding time is delayed is rarely reported. We report herein the first case of SMA syndrome in a Korean ALS patient who showed improvement after percutaneous endoscopic gastrojejunostomy(PEGJ).
Amyotrophic Lateral Sclerosis* ; Deglutition Disorders ; Enteral Nutrition ; Gastric Bypass ; Gastrostomy ; Humans ; Mesenteric Artery, Superior ; Muscle Weakness ; Neurodegenerative Diseases ; Superior Mesenteric Artery Syndrome* ; Weight Loss

Angiomyolipoma is a benign renal tumor composed of thick- walled blood vessels, smooth muscle cells, and adipose tissue. Despite the aggressive biological and histological features associated with angiomyolipoma, the lack of distant metastasis led us to conclude that angiomyolipoma is a benign neoplasm. Epithelioid angiomyolipoma is a recently described variant type of angiomyolipoma of the kidney. Diagnosis is usually made by histological method and immunohistochemical staining with HMB-45. Several reports suggested the presence of malignant epithelioid angiomyolipomas showing multiple metastases and local aggressiveness. We report a case of epithelioid angiomyolipoma with multiple metastases. Local recurrence and liver, bone and lung metastases developed 11 months after radical nephrectomy. Right hepatectomy and wedge resection of left lobe of the liver with radiation therapy were done.
Adipose Tissue ; Angiomyolipoma* ; Blood Vessels ; Diagnosis ; Hepatectomy ; Kidney ; Liver ; Lung ; Myocytes, Smooth Muscle ; Neoplasm Metastasis* ; Nephrectomy ; Recurrence

PURPOSE: To assess the clinical features and laboratory findings in Kawasaki patients with nonresponsibility to the acute antiinflammatory treatment, and identify the risk factors for the nonresponsibility, we reviewed the medical records of patients with Kawasaki disease. METHODS: A retrospective study of 177 patients with Kawasaki disease at Wonkwang University Medical Center from June, 1997 to June, 2002, was performed. High dose intravenous immune globulin(IVIG) and aspirin were all used for the initial acute antiinflammatory treatment. Two groups, group A(n=19) of initial nonresponders and group B(n=158) of initial responders were compared clinically and laboratorically. RESULTS: Nineteen(10.7%) of 177 patients hardly responded to the initial antiinflammatory treatment. Patients with failure to respond to initial treatment(group A) did not differ from the control group in terms of age, sex, WBC count, coronary abnormalities, and evidence of pyuria. Compared with initial responders(group B), the patients who were retreated(group A) had a significantly shorter fever- admission interval(P=0.041), and a higher level of both AST/ALT(P=0.011) and ASO titier(P=0.000). CONCLUSION: Among Kawasaki disease patients studied, retreatment group with initial nonresponders had significantly shorter fever-admission interval, and higher both AST/ALT level and ASO titer, than the initial response group.
Academic Medical Centers ; Aspirin ; Humans ; Medical Records ; Mucocutaneous Lymph Node Syndrome* ; Pyuria ; Retreatment ; Retrospective Studies ; Risk Factors