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*

No abstract available.

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

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

PURPOSE: Reconstructive surgeries for equinocavovarus foot deformities are quite variable, including hind-midfoot osteotomy or arthrodesis, soft tissue procedure, tendon transfers, etc. Comprehensive evaluation of the deformity and its etiology is mandatory for achievement of successful deformity correction. Few studies in this field have been reported. We report on the clinical and radiographic outcome of reconstruction for cavovarus foot deformities. MATERIALS AND METHODS: The study is based on 16 feet with cavovarus foot deformities that underwent bony and soft tissue reconstructive surgery from 2004 to 2008. We evaluated the etiologies, varieties of surgical procedures performed, pain score, functional scores, and patient satisfaction and measured the radiographic parameters. RESULTS: The average age at the time of surgery was 39.4 years old, with a male/female ratio of 9/4 and an average follow-up period of 23.9 months (range, 12~49 months). The etiologies of the cavovarus deformity were idiopathic 7 feet, residual poliomyelitis 5 feet, Charcot-Marie-Tooth disease 2 feet, and Guillain-Barre syndrome and hemiplegia due to cerebrovascular accident sequela 1 foot each. Lateral sliding calcaneal osteotomies were performed in 12 feet (75%), followed by Achilles tendon lengthening and plantar fascia release in 11 feet (69%), and first metatarsal dorsiflexion osteotomy/arthrodesis and tendon transfer in 10 feet (63%). Visual analogue scale pain score showed improvement, from an average of 4.2 to 0.5 points. American Orthopaedic Foot and Ankle Society ankle-hindfoot score showed significant improvement, from 47.8 to 90.0 points (p<0.05). All patients were satisfied. Ankle range of motion improved from 27.5degrees to 46.7degrees. In radiographic measurements, calcaneal pitch angle improved from 19.1degrees to 15.8degrees, Meary angle from 13.0degrees to 9.3degrees, Hibb's angle from 44.3degrees to 37.0degrees, and tibio-calcaneal axis angle from varus 17.5degrees to varus 1.5degrees. CONCLUSION: We achieved successful correction of cavovarus foot deformities by performing appropriate comprehensive reconstructive procedures with improved functional, radiographic measures and high patient satisfaction.
Achilles Tendon ; Ankle ; Arthrodesis ; Axis, Cervical Vertebra ; Charcot-Marie-Tooth Disease ; Congenital Abnormalities ; Fascia ; Follow-Up Studies ; Foot ; Foot Deformities* ; Guillain-Barre Syndrome ; Hemiplegia ; Humans ; Metatarsal Bones ; Osteotomy ; Patient Satisfaction ; Poliomyelitis ; Range of Motion, Articular ; Stroke ; Tendon Transfer

PURPOSE: Multiple primary cancers are not a rare disease. The clinicopathologic characteristics of a hepatocellular carcinoma with extrahepatic malignancies, have not been identified. To address these points, the clinical data of patients with a hepatocellular carcinoma, with extrahepatic malignancies, treated with surgical resections at our hospital, were retrospectively reviewed. METHODS: We reviewed the clinical records of ten hepatocellular carcinoma patients, with extrahepatic malignancies, who had undergone an operation between January, 1986 and December, 2002 at the Hanyang University Hospital. RESULTS: 10 patients were comprised of 9 males and 1 female, with a mean age of 58.6 years, ranging from 34 to 75. There were 9 stomach cancers and 1 rectal cancer extrahepatic malignancies associated with the hepatocellular carcinomas. Four of these were synchronous type and six were metachronous type. The treatments used for the HCCs were: 1 extended right lobectomy, 6 right lobectomies, 1 each of a TAE with RFTA, a segmentectomy with RFTA, and a segmentectomy. The operations for the extrahepatic malignancies included 1 low anterior resection, for the rectal cancer and 9 subtotal gastrectomies, for the stomach cancers. During the mean follow up time of 66.1 months, five patients survived and five died. CONCLUSION: Patients who have a hepatocellular carcinoma, associated with extrahepatic malignancies, have been treated with aggressive operations and combination therapies. Stomach cancer is the most common extrahepatic malignancy associated with a hepatocellular carcinoma.
Carcinoma, Hepatocellular* ; Female ; Follow-Up Studies ; Gastrectomy ; Humans ; Male ; Mastectomy, Segmental ; Rare Diseases ; Rectal Neoplasms ; Retrospective Studies ; Stomach Neoplasms