PURPOSE: This study aimed to identify factors influencing intra-operative core body temperature (CBT), and to develop a predictive model for intra-operative CBT in laparoscopic abdominal surgery. METHODS: The prospective observational study involved 161 subjects, whose age, weight, and height were collected. The basal pre-operative CBT, pre-operative blood pressure, and heartbeat were measured. CBT was measured 1 hour and 2 hours after pneumoperitoneum. RESULTS: Explanatory factors of intra-operative hypothermia (<36℃) were weight (β=.361, p<.001) and pre-operative CBT (β=.280, p=.001) 1 hour after pneumoperitoneum (Adjusted R2=.198, F=7.56, p<.001). Weight was (β=.423, p<.001) and pre-operative CBT was (β=.206, p=.011) 2 hours after pneumoperitoneum (Adjusted R2=.177, F=5.93, p<.001). The researchers developed a predictive model for intra-operative CBT (℃) by observing intra-operative CBT, body weight, and pre-operative CBT. The predictive model revealed that intra-operative CBT was positively correlated with body weight and pre-operative CBT. CONCLUSION: Influence of weight on intra-operative hypothermia increased over time from 1 hour to 2 hours after pneumoperitoneum, whereas influence of pre-operative CBT on intraoperative hypothermia decreased over time from 1 hour to 2 hours after pneumoperitoneum. The research recommends pre-warming for laparoscopic surgical patients to guard against intra-operative hypothermia.
Anesthesia, General* ; Blood Pressure ; Body Temperature* ; Body Weight ; Cohort Studies* ; Colectomy* ; Humans ; Hypothermia ; Laparoscopy ; Observational Study ; Pneumoperitoneum ; Prospective Studies

To investigate the risk factors and clinical characteristics of postrenal transplant diabetes mellitus (PTDM), we reviewed the records of 177 renal allograft recipients in Maryknoll Hospiatal whose allografts had functioned longer than 6 months. Nineteen patients (10.7%) developed PTDM at 5.0+/-7.8 (1-52) months; 9 (47%) of these within 1 month. PTDM patients were older than nondiabetic renal transplants (42+/-2 vs 37+/-1 years, P<0.05). Body mass index tended to be higher in PTDM (23.5+/-1.0 vs 21.8+/-0.3kg/m2, P=0.09). Number of acute rejections (0.6+/-0.2 vs 0.5+/-0.1) and serum creatinine at 1 year after transplantation (1.2+/-0.8 vs 1.3+/-0.3mg/dL) were not different. Fasting (103.6+/-10.4 vs 84.4+/-1.6mg/dL, P<0.05) and postprandial (189.2+/-24.8 vs 118.6+/-2.3 mg/dL, P<0.01) blood sugars, measured before transplantation, were higher in PTDM. CsA blood level at 1 month posttransplantation was higher in PTDM (350+/-34 vs 279+/-8ng/mL, P<0.05). Fasting serum insulin was significantly higher (28.2+/-12.2 vs 7.3+/-2.0 microunit/dL, P<0.05) and serum C-peptide tended to be higher in PTDM patients compared with euglycemic renal recipients (6.3+/-1.6 vs 3.8+/-0.9ng/dL, P=0.08). All the PTDM patients were treated by either insulin or oral agent; 15 of 19 required no treatment after 4.7+/-6.9 months. In conclusion, prevalence of PTDM was 10.7%. PTDM patients were older. Body mass index was tended to be higher. Fasting and postprandial blood sugars, measured before transplantation, were higher in PTDM. Faslting serum insulin was higher and C-peptide tended to be higher in diabetics. These results suggested that increased insulin resistance plays a major role in the pathogenesis of PTDM.
Allografts ; Blood Glucose ; Body Mass Index ; C-Peptide ; Creatinine ; Cyclosporine ; Diabetes Mellitus* ; Fasting ; Humans ; Insulin ; Insulin Resistance ; Prevalence ; Risk Factors*

No abstract available.
Bezoars*

BACKGROUND: The metabolic syndrome is a cluster of related cardiovascular risk factors and it is the cause of morbidity and mortality in cardiovascular diseases. Recently, new diagnostic criteria of glucose metabolism impairment has been recommended. The purpose of this study was to estimate the difference of cardiovascular risk by investigating the prevalence of metabolic syndrome according to the degree of glucose metabolism impairment. METHODS: A population of 757 subjects was selected from a database of individuals who visited a health promotion center. We classified these subjects into 5 groups [Normal, Isolated impaired glucose tolerance (I-IGT), Isolated impaired fasting glucose (I-IFG), combined IGT with IFG (IGT/IFG) and Diabetes]. We compared the general characteristics, Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) and the prevalence of metabolic syndrome in these groups. RESULTS: HOMA-IR and the prevalence of metabolic syndrome in the IGT/IFG and the Diabetes group were significantly greater than the Normal group. HOMA-IR and the prevalence of metabolic syndrome of the I-IGT and the I-IFG group were not significantly different with the Normal group. CONCLUSION: The insulin resistance and the prevalence of metabolic syndrome in the IGT/IFG group was significantly greater than the Normal group, and its presence may increase the risk of cardiovascular diseases. Therefore, it is important to control other combined metabolic disorders to prevent cardiovascular events after effective selection for IGT/ IFG.
Cardiovascular Diseases ; Fasting ; Glucose* ; Health Promotion ; Homeostasis ; Insulin Resistance ; Metabolism* ; Mortality ; Prevalence* ; Risk Factors

BACKGROUND: Advising lifestyle modification to patients suffering from hypertension is important. However, how strictly hypertensive patients in korea are adherent to non-pharmacologic recommendation has not been well known. This study was performed to determine the compliance of hypertensive patients to the recommendation for life style modification and to find out on factors related to compliance. METHODS: Ninety-six patients, diagnosed as hypertensives between November 1997 and April 1998 in the Department of Family Medicine, Samsung Medical Center were educated on lifestyle modifications by their physicians during routine outpatient consult questionnaires inquiring of demographic and clinical characteristics, and health habits were Self administered done before and after the education. Blood pressure, height, and weight were measured repeatedly. The relationships between various characteristics and the compliance with lifestyle modification and follow-up visits were evaluated using Chi-square test and multiple logistic regression analysis. RESULTS: Among 96 patients, 47 patients (49.0%) attended for regular check-up two months after being diagnosed as hypertension. Being prescribed with antihypertensive agent, non-smoking, and doing regular exercise were the significant factors related to higher compliance with regular check-up. A total of 19 patients (40.4%) among 47 patients who have attended for regular check-up were adherent to the recommendation for modification of one or more health habits. The proportion of patients doing regular exercise increased significantly after education. Although 15 patients(53.6%) among 28 patients whose body mass indices were over 25 kg/m2 reported that they had made efforts to reduce body weight, no significant differences were observed in the change of body mass index between patients who reported their efforts for reducing body weight and those who did not. There was no association between various characteristics and compliance with lifestyle modification. CONCLUSIONS: Low compliance with recommendation for lifestyle modification during routine outpatient consultation and no association between various clinical and demographic characteristics and patient compliance suggests the necessity of developing special program and its active application to all hypertensive patients.
Blood Pressure ; Body Mass Index ; Body Weight ; Compliance* ; Education ; Follow-Up Studies ; Humans ; Hypertension* ; Korea ; Life Style* ; Logistic Models ; Outpatients ; Patient Compliance ; Surveys and Questionnaires

Pulmonary tumor thrombotic microangiopathy (PTTM) is a rare, malignancy-related complication that causes marked pulmonary hypertension, right heart failure, and death. We report on a patient with locally advanced breast cancer whose course was complicated by fatal PTTM based on clinical and laboratory findings.
Breast ; Breast Neoplasms ; Heart Failure ; Humans ; Hypertension, Pulmonary ; Thrombotic Microangiopathies

BACKGROUND: Benign prostatic hyperplasia (BPH) is a common condition in males over 40 years old, and the incidence of BPH has a tendency to increase with age. Obesity is state of excessive accumulation of fat in the body that leads to changes in the body's metabolism and endocrine function. Therefore, progression of BPH occurs in the obese state according to many articles. The purpose of this study was to compare the efficacy of obesity indices which correlate with prostate volume. METHODS: The study was carried out in 285 males, who visited a health promotion center and underwent transrectal ultrasonography and abdominal fat computed tomography from April, 2010 to June, 2013. Anthropometric parameters were measured directly and blood samples were obtained in the morning after over eight hours of fasting. The correlation between obesity indices and prostate volume was analyzed. RESULTS: After adjusting for age, prostate volume was positively correlated with BMI (r=0.227, P<0.001), waist circumference (WC) (r=0.151, P=0.011), waist to height ratio (WHtR) (r=0.149, P=0.012), and visceral fat area (VFA) (r=0.157, P=0.008). However prostate volume showed no correlation with subcutaneous fat area (SFA) and visceral to subcutaneous ratio (VSR). WHtR had the largest area under the curve (AUC) for the identification of prostate volume more than 30 mL (AUC=0.595, P=0.017) followed by VFA and BMI in order. CONCLUSION: Prostate volume was positively correlated with BMI, WC, WHtR, and VFA among the obesity indices and WHtR had the largest AUC followed by VFA and BMI in order.
Abdominal Fat ; Area Under Curve ; Fasting ; Health Promotion ; Humans ; Incidence ; Intra-Abdominal Fat ; Male ; Metabolism ; Obesity ; Prostate ; Prostatic Hyperplasia ; Subcutaneous Fat ; Ultrasonography ; Waist Circumference

Background: Not so many reports about the association between head and neck cancer (HNC) and oral health status related to periodontitis (OHS-P) has been published in different countries with different methods. So, there is a need for an extensive meta-analysis with the total articles published until 2020. Hence, this study aimed to estimate the association between HNC and OHS-P through a meta-analysis. Methods: Based on Preferred Reporting Items for Systematic Reviews and Meta Analyses guidelines, 22 studies were selected through PubMed and Cochrane Library databases. Metaanalysis using them was performed to evaluate the association. The risk of bias assessment using the Newcastle-Ottawa Scale (NOS) was applied to evaluate the quality of nonrandomized studies. Publication bias was evaluated by funnel plot and Egger's regression test. Results: Since heterogeneity was significant (I2 = 88%, P < 0.001), we adopted the random effect model for 22 studies. Those with bad OHS-P, compared to those with good OHS-P, were more likely to have the risk of HNC by 2.4 times (odds ratio [OR], 2.42; 95% confidence interval [CI], 1.88–3.13) for random effect model. The association included publication bias (Egger's regression, P value < 0.001). The association among five studies (I2 = 39%, P = 0.16) using alveolar bone loss (ABL) or clinical attachment level (CAL) for assessing periodontitis increased to OR of 3.85 (CI, 3.04–4.88) in the fixed effect model without publication bias (Egger's regression, P = 0.66). Moreover, the association was higher in 10 fair or good NOS studies (OR, 3.08) and in 7 Asian studies (OR, 2.68), which were from the fixed model without publication bias. Conclusion Our meta-analysis showed that bad OHS-P was associated with the risk of HNC.The association was stronger in studies using ABL or CAL for assessing periodontitis.

Background: Not so many reports about the association between head and neck cancer (HNC) and oral health status related to periodontitis (OHS-P) has been published in different countries with different methods. So, there is a need for an extensive meta-analysis with the total articles published until 2020. Hence, this study aimed to estimate the association between HNC and OHS-P through a meta-analysis. Methods: Based on Preferred Reporting Items for Systematic Reviews and Meta Analyses guidelines, 22 studies were selected through PubMed and Cochrane Library databases. Metaanalysis using them was performed to evaluate the association. The risk of bias assessment using the Newcastle-Ottawa Scale (NOS) was applied to evaluate the quality of nonrandomized studies. Publication bias was evaluated by funnel plot and Egger's regression test. Results: Since heterogeneity was significant (I2 = 88%, P < 0.001), we adopted the random effect model for 22 studies. Those with bad OHS-P, compared to those with good OHS-P, were more likely to have the risk of HNC by 2.4 times (odds ratio [OR], 2.42; 95% confidence interval [CI], 1.88–3.13) for random effect model. The association included publication bias (Egger's regression, P value < 0.001). The association among five studies (I2 = 39%, P = 0.16) using alveolar bone loss (ABL) or clinical attachment level (CAL) for assessing periodontitis increased to OR of 3.85 (CI, 3.04–4.88) in the fixed effect model without publication bias (Egger's regression, P = 0.66). Moreover, the association was higher in 10 fair or good NOS studies (OR, 3.08) and in 7 Asian studies (OR, 2.68), which were from the fixed model without publication bias. Conclusion Our meta-analysis showed that bad OHS-P was associated with the risk of HNC.The association was stronger in studies using ABL or CAL for assessing periodontitis.