OBJECTIVES: This study was conducted to determine the prevalence of hypertension in adolescents and to find the relationship between an increase of body mass index and waist circumference (WC) and blood pressure (BP). METHODS: Four hundred twenty-nine adolescents between the ages of 15 and 18 at high school in Seoul were enrolled and their anthropometric data and body composition were measured. BP was measured by oscillometric devices at least twice. Hypertension was defined according to the normative BP reference for Korean children and adolescents. RESULTS: The prevalence of prehypertension and hypertension was 14.0%, 9.2% in boys and 9.0%, 10.2% in girls. The prevalence of prehypertension and hypertension was 9.0%, 6.0% in the normal body mass index group, 14.6 %, 16.7% in the overweight group, 21.7%, 29.8% in the obese group. The prevalence of systolic hypertension was 3.6% in the normal group, 12.5% in the overweight group and 29.8% in the obese group. However, the prevalence of diastolic hypertension had significant differences between the groups, which were 3.3% in the normal group, 6.3% in the overweight group and 4.3% in the obese group. According to WC, the prevalence of hypertension was 6.2% in the below 75th percentile WC group, 22.2% in the75th to 90th percentile WC group and 25.6% in ≥90th percentile WC group. The risk of hypertension was 5.55 times higher in the obese group and 2.04 times higher in the overweight group, 3.93 times higher in ≥90th percentile of WC group. CONCLUSION: The risk of hypertension is markedly increased with obesity in high school students.
Adolescent ; Blood Pressure ; Body Composition ; Body Mass Index ; Child ; Female ; Humans ; Hypertension ; Obesity ; Obesity, Abdominal ; Overweight ; Prehypertension ; Prevalence ; Seoul ; Waist Circumference

Although coagulase-negative staphylococci (CNS) have been considered part of the resident flora on the human skin, Staphylococcus lugdunensis is an unusually virulent CNS and can cause many types of infection. We report a rare case of acute lymphadenitis with cellulitis in the right infraauricular region caused by S. lugdunensis. A 62-yr-old woman visited the Department of Otolaryngology of Busan Paik university hospital. She had a palpable mass and swelling in the right infraauricular region and complained of aggressive pain and a febrile sensation in the region for 5 days. On the suspicion of abscess with infection, percutaneous aspiration was performed and smooth, flat, white, opaque colonies grew on a blood agar plate as a pure culture. The biochemical test results showed the organism to be catalase positive, tube coagulase negative, ornithine decarboxylase positive, slide coagulase positive, and latex agglutination tests for coagulase positive. The API Staph Kit was used to identify the isolate to the species level as S. lugdunensis with a 64.6% probability (profile 6716152). We confirmed the species identification of this strain by 16S rDNA sequence analysis. The patient's clinical condition improved with appropriate antimicrobial therapy and pus drainage.
Acute Disease ; Cellulitis/*diagnosis/*microbiology ; Drainage ; Ear, External ; Female ; Humans ; Lymphadenitis/*diagnosis/drug therapy/*microbiology ; Microbial Sensitivity Tests ; Middle Aged ; RNA, Ribosomal, 16S/genetics ; Sequence Analysis, DNA ; Staphylococcal Infections/*diagnosis/microbiology

OBJECTIVES: Inhalation exposure to humidifier disinfectants has resulted to various types of health damages in Korea. To determine the epidemiological correlation necessary for presuming the legal causation, we aimed to develop a method to synthesize the entire evidence. METHODS: Epidemiological and toxicological studies are systematically reviewed. Target health problems are selected by criteria such as frequent complaints of claimants. Relevant epidemiologic studies are reviewed and the risk of bias and confidence level of the total evidence are evaluated. Toxicological literature reviews are conducted on three lines of evidence including hazard information, animal studies, and mechanistic studies, considering the source-to-exposure-to-outcome continuum. The confidence level of the body of evidence is then translated into the toxicological evidence levels for the causality between humidifier disinfectant exposure and health effects. Finally, the levels of epidemiological and toxicological evidence are synthesized. RESULTS: Under the Special Act revised in 2020, if the history of exposure and the disease occurred/worsened after exposure were approved, and the epidemiological correlation between the exposure and disease was verified, the legal causation is presumed unless the company proves the evidence against it. The epidemiological correlation can be verified through epidemiological investigations, health monitoring, cohort investigations and/or toxicological studies. It is not simply as statistical association as understood in judicial precedents, but a general causation established by the evidence as a whole, i.e., through weight-of-the-evidence approach. CONCLUSIONS The weight-of-the-evidence approach differs from the conclusive single study approach and this systematic evidence integration can be used in presumption of causation.

PURPOSE: The patients treated with hemodialysis have been known to have a high 1-year mortality rate after percutaneous coronary intervention (PCI). We evaluated the clinical benefits of drug-eluting stent (DES), compared to bare-metal stent (BMS) in Korean hemodialysis patients. METHODS: We studied 72 hemodialysis patients (M:F=49:23, age 60+/-11 years) treated with percutaneous coronary intervention (PCI) from January, 1999 to February, 2006. Forty four patients (M:F=28: 16, age 60+/-11 years) treated with DES and 28 patients (M:F=21:7, age 60+/-12 years) with BMS were enrolled. A composite of major adverse cardiac and cerebral endpoints (MACCE) was defined as all-cause death, myocardial infarction, stroke, and target-vessel revascularization (TVR). We compared the incidence of MACCE between DES and BMS group. RESULTS: A composite of MACCE occurred in none in DES group (n=44) and 4 in BMS group (n=28) within 3 months after coronary stenting (Kaplan-Meier survival analysis: 0% vs 14%, respectively, p= 0.02). After 3 months, there was no difference in the incidence of primary end points between two groups. Multi-vessel disease (OR 2.47, 95% CI 1.02-6.11, p<0.05) was associated with a significant increase in the incidence of MACCE within 18 months after coronary artery stenting CONCLUSION: DES may be superior to BMS in reducing adverse cardiac outcome at early period after coronary stenting in HD patients. However, this study showed no significant difference with the lapse of time.
Coronary Artery Disease ; Coronary Vessels ; Drug-Eluting Stents ; Humans ; Incidence ; Myocardial Infarction ; Percutaneous Coronary Intervention ; Renal Dialysis ; Stents ; Stroke

BACKGROUND: We noticed a sudden increase in the isolation of Klebsiella oxytoca from bronchial washing specimens during May to June 2006. An epidemiological investigation was conducted to identify the cause of the outbreak and to implement appropriate infection control measures. METHODS: A total of 18 isolates of K. oxytoca were found. The 14 bronchial washing specimens that yielded K. oxytoca were taken in the outpatient bronchoscopy suite, and the other 4 specimens were obtained by a portable bronchoscopy. The medical records and microbiologic findings of these patients were reviewed. Environmental samples from two bronchoscopes and the bronchoscopy suite were cultured. The relations between the available 10 isolates from bronchial washing fluid were investigated by pulsed-field gel electrophoresis (PFGE). RESULTS: No patients were judged to have had true infections attributable to K. oxytoca either before or after bronchoscopy. Cultures of samples from two bronchoscopes and related environment did not grow K. oxytoca. The PFGE analysis showed that 8 of 10 isolates had a similar pattern of DNA fragments. An infection control strategy was implemented, including adequately cleaning and disinfecting the bronchoscopes, and a sharp reduction in the incidence of K. oxytoca from bronchial washing samples followed. CONCLUSION: The sudden increase of K. oxytoca from bronchial washing specimens was a pseudo-outbreak. We presumed that the bronchoscopes became contaminated during a procedure in a patient colonized with K. oxytoca in the upper-respiratory tract.
Bronchoscopes ; Bronchoscopy ; Colon ; DNA ; Electrophoresis, Gel, Pulsed-Field ; Humans ; Incidence ; Infection Control ; Klebsiella ; Klebsiella oxytoca ; Medical Records ; Outpatients