To compare the differences between hemodialysis and essential hypertension patients and its affecting factors of left ventricular hypertrophy and left ventricular systolic dysfucntion in patients with hemodialysis, M-mode and two dimensional echocardiography were performed in 77 essential hypertension without azotemia and 78 chronic renal failure patients receiving maintenance hemodialysis. M-mode measurement including LV mass (192.56+/-63.6g vs 300.01+/-95.99g, P=0.000), r/th (radius/LV thickness, 4.41+/-0.97 vs 4.74+/-1.0, P=0.039), LV dimemsion and fractional shortening (4.68+/-0.6 vs 5.63+/-0.97, P=0.000, 30.0+/-19.7% vs 36.6+/-97%, P=0.000 respectively) showed more severe eccentric LV hypertrophy and LV dysfunction in patients with hemodialysis than those of essential hypertension. Using Pearson correlation in hemodialysis patients, Interdialytic weight gain was positively correlated with LVEDD (r=0.318, P=0.005). In addition to the determinant, serum PTH level was negatively (r=-0.344, P=0.002) and Kt/V (r= 0.0487, P=0.003) was positively correalated with systolic function. The hypertension and dialysis duration, patient's age, had no relationship with LV function and mass in this study. In Conclusion, LV hypertrophy and LV systolic dysfunction occur more frequently in hemodialysis patients than in essential hypertension patients. And the LV systolic dysfunction, which is acutally related with the patient's quality of life, was partially explained by serum parathyroid level and Kt/V. But additional laboratory and prospective clinical studies are needed to further elucidate the mechanisms involved in the development of LVH and LV impairment in hemodialysis patients.
Azotemia ; Dialysis ; Echocardiography* ; Humans ; Hypertension* ; Hypertrophy ; Hypertrophy, Left Ventricular ; Kidney Failure, Chronic ; Quality of Life ; Renal Dialysis* ; Ventricular Dysfunction, Left ; Weight Gain

Chronic idiopathic intestinal pseudo-obstruction syndrome is a clinical condition induced by an impaired function of intestinal motility. Although its clinical symptoms are those of intestinal obstruction, mechanical obstruction of the intestine cannot be found by vigorous studies, even by operative exploration. We have experienced nine cases of chronic idiopathic intestinal pseudo-obstruction syndrome. It will help in diagnosis and treatment of the pseudo-obstruction to present the patients with these syndromes. In all cases severely delayed intestinal transit times were noted in radiological gastrointestinal studies without evidence of mechanical obstruction. The most frequent tentative diagnoses were congenital megacolons. But all of the patients showed the presence of ganglion cells in the intestinal wall. Histological abnormalities of the muscle layer were found in three patients. We could not resolve the symptoms by the surgical decompression of the intestine (such as colostomy, ileostomy etc.). But the symptoms were improved after total colectomy in a patient whose main affected site was confined to the colon. The megacystis was the most frequent combined anomaly. All patients had been improved with NPO and total parenteral nutrition therapies were inevitable. The drugs which facilitate the intestinal activities such as cisapride could not resolve the symptoms of obstruction. Three patients were died with the complications of total parenteral nutrition, and four patients improved clinically. Early diagnosis and proper management will reduce the mortality and morbidity.
Child ; Cisapride ; Colectomy ; Colon ; Colostomy ; Decompression, Surgical ; Diagnosis ; Early Diagnosis ; Ganglion Cysts ; Gastrointestinal Motility ; Hirschsprung Disease ; Humans ; Ileostomy ; Intestinal Obstruction ; Intestinal Pseudo-Obstruction* ; Intestines ; Mortality ; Parenteral Nutrition, Total

No abstract available.
Child* ; Humans

Exact titration of anti-HBs with mIU/mL unit is necessary in evaluating the success of HBV vaccination or in making a decision to increase the dose of HBV vaccination. Data of distribution of anti-HBs titers can contribute to cutting of public health costs by reducing unnecessary HBV booster doses. Moreover, anti-HBc is also an important marker for differentiation of vaccination-induced anti-HBs from infection-acquired anti-HBs. However, not much study about these subjects has been done in Korea. So we evaluated anti-HBs associated with anti-HBc and vaccination history. HBsAg and anti-HBs tests were done in 1,465 cases. The positive rates of HBsAg and anti-HBs were 4.5% and 74.6%, respectively. Anti-HBs positive rate was higher in the vaccinated group than that in the non-vaccinated group. The rates of anti-HBs positive cases with lower titers (10-< 100 mIU/mL) were 31.9%, while cases with higher titers (> or = 100 mIU/mL) were 68.1%. This suggested about 70% of anti-HBs-positive Korean adults (about 53% of the general adult population) have long-lasting immunity against HBV infection and may not require booster doses of HBV vaccination for a long time. Anti-HBs titers in the vaccine-induced anti-HBs group were higher than those in the infection-acquired anti-HBs group. No statistical differences were noted between male and female or among age groups. 25.7% of the HBsAg (-)/anti-HBs (-) group showed anti-HBc positive and HBV-DNA was detected in 11.1% among HBsAg (-)/anti-HBs (-)/anti-HBcAb (+) cases. Further study about post vaccination anti-HBs titer decay in Korean should be performed to help cut vaccination costs.
Adult ; Age Distribution ; Aged ; Female ; Hepatitis B Antibodies/analysis* ; Hepatitis B Surface Antigens/immunology* ; Hepatitis B Vaccines/therapeutic use ; Human ; Immunization ; Korea ; Male ; Medical Records ; Middle Age ; Sex Distribution

No abstract available.
Intestinal Pseudo-Obstruction*

BACKGROUND AND OBJECTIVES: It is rare to find any studies reporting on the practical measurements of landmarks in the paranasal sinuses that are done intraoperatively as well as comparative analysis on the anatomical and radiological measurements of the paranasal sinuses. The aim of this study was to analyze the anatomical measurements of the paranasal sinuses using nasal endoscope and CT scout films to determine the statistical significance. MATERIALS AND METHODS: In 130 patients the authors used bayonet forceps and seekers to measure the distances from the anterior nares to some of the intranasal structures, such as the uncinate process, bulla ethmoidalis, basal lamella, maxillary ostium, posterior wall of ethmoid sinus, anterior wall of sphenoid sinus and posterior wall of sphenoid sinus. Then, using the CT scout films, we measured the distances between the anterior nasal spine and the basal lamella (B.L.), the anterior wall of sphenoid sinus (A.W.S.), and the posterior wall of sphenoid sinus (P.W.S.). We analyzed the mean values of the basal lamella, the anterior and posterior wall of sphenoid sinus from all the available data in order to compare the endoscopic and radiologic measurements, and carried out a paired t-test. RESULTS: There was a statistically significant discrepancy in the comparative analysis of the CT scout film and the endoscopic measurements of the basal lamella, anterior wall of sphenoid sinus and posterior wall of sphenoid sinus, althought there were no significant discrepancy for basal lamella in female patients (p>0.05). CONCLUSION: The differnces between the CT and operative measurements observed in this study were due to differnt measuring points, differences in the measuring angles, and inaccurate locations of the landmarks on the CT scout films owing to their small sizes. These findings indicate that a more accurate method need to be introduced in using the CT films to measure the anatomical landmarks in the paranasl sinuses.
Endoscopes* ; Ethmoid Sinus ; Female ; Humans ; Paranasal Sinuses* ; Sphenoid Sinus ; Spine ; Surgical Instruments

Background: Early-onset and severe atopic dermatitis (AD) in patients increase the probability of the development of allergic rhinitis or asthma. Treatment and prevention strategies in infants and young children with AD are targeted toward treating the symptoms, restoring skin barrier functions, and reducing the absorption of environmental allergens in an attempt to attenuate or block the onset of asthma and food allergy. Objective: Given that the initiating events in AD remain poorly understood, identifying those at risk and implementing strategies to prevent AD is necessary. Methods: Whole-exome sequencing (WES) was performed in a 43 control group and a disease group with 20 AD patients without atopic march (AM) and 20 with AM. Sanger sequencing was carried out to validate found variants in cohorts. Results: DOCK8, IL17RA, and KLK12 single-nucleotide polymorphisms were identified by WES as missense mutations: c.1289C＞ A, p.P97T (rs529208); c.1685C＞A, p.P562G (rs12484684); and c.457+27＞C, rs3745540, respectively. A case-control study show that total immunoglobulin E (IgE) level was significantly increased in the AA genotype of DOCK8 compared to the CA genotype in allergic patients. The rs12484684 of IL17RA increased risk of adult-onset AD (odds ratio: 1.63) compared to the control for (A) allele frequency. AD and AM Patients with the IL17RA CA genotype also had elevated IgE levels. rs3745540 of KLK12 was associated with AD in dominant model (odds ratio: 2.86). Conclusion DOCK8 (rs529208), IL17RA (rs12484684), and KLK12 (rs3745540), were identified using a new WES filtering method. the result suggests that polymorphism of DOCK8 and IL17RA might be related to increase the total IgE level.

The methods for the early diagnoses of breast cancer are mammography, physical examination, breast self-examination(BSE). This study was conducted to investigate the knowledge and practice of BSE by structured questionnaire which included questions on general characteristics, performance of mammography, physical examination of breast, knowledge and practice of BSE. The subjects in this study were 412 females between 20 and 69 years old who visit to the Health Care Center of College of medicine of Inje University from December 1997 to February 1998. The results were as follows: 1. Women who have gotten the regular mammography are 8.19% of these subjects and women who have gotten the regular physical examination by doctors are 4.19% of these subjects. 2. Regarding BSE, 77.4% of these subjects said that they knew BSE and 3.88% of these subjects said that they practiced BSE regularly. It was that women who knew BSE were more younger, better-educated and higher economic status(p=0.001) and lived a normal life with her husband(p=0.033). And women who practiced BSE regularly were more younger, and married(p=0.001). 3. The most common barrier to doing BSE is 'Do not see the needs/Worry unnecessarily', and the most common reasons for doing BSE is 'Early detection'. 4. The overall frequency and percentage distribution of recommended BSE step in Korea is lower than U.S.A.
Aged ; Breast Neoplasms ; Breast Self-Examination* ; Breast* ; Delivery of Health Care ; Diagnosis ; Female ; Humans ; Korea ; Mammography ; Physical Examination ; Surveys and Questionnaires

Irritable bowel syndrome(IBS) is one of the common health problem that has been considered as stress-induced. This study was conducted to investigate the relationship between life style and the level of stress and IBS by structured questionnaire which included questions on life style, the self-esteemed gastrointestinal symptoms, and Psychosocial Well-being Index(PWI). Subjects were 1,498 male white collars who get the regular health check and participated in survey at Inje University Health Promotion Center from January to December, 1996. The overall prevalence of IBS was 37.5%(561 cases), and the level of stress by PWI score was higher in IBS group(41.8+/-14.2) than symptom-free group(34.6+/-12.6). As the result of comparison between the two groups, heavier smoking (adjusted OR=2.48, 95% CI 1.81-3.41), longer daily working time (adjusted OR=5.19, 95% CI 3.59-7.56), stimulatory food materials-mainly hot or salty (adjusted OR=1.87, 95% CI 1.44-2.45), higher body mass index (adjusted OR=1.80, 95% CI 1.27-2.57), and higher level of stress (adjusted OR=2.81, 95% CI 1.80-4.43) were estimated as risk factors of IBS. On the contrary, 6-8 hours sleeping per day (adjusted OR=0.38 95% CI 0.21-0.70), 3-4 times exercise per week (adjusted OR=0.57 95% CI 0.39-0.83), and tenure more than 20 years (adjusted OR=0.25 95% CI 0.16-0.35) were considered as protective factors to IBS. In summary, the assessment of the stress level might be placed in the first priority to control IBS, at least by some degree, which suggested that IBS could be controlled by avoiding such risk factors and by encouraging such protective factors.
Body Mass Index ; Health Promotion ; Humans ; Irritable Bowel Syndrome* ; Life Style* ; Male* ; Prevalence ; Surveys and Questionnaires ; Risk Factors ; Smoke ; Smoking