BACKGROUND: Hypertension is one of the common diseases which family physicians encounter to manage. Various research proved that appropriate aerobic exercise had effect on lowering blood pressure efficiently. This study was to find out the status of exercise, the change of exercise according to time and its predicting factors in hypertensive patients. METHODS: A total of 193 of the followed-up hypertensive patients of family physicians in Seoul and kyoungkido from May 11, 2001 to June 10, 2001 were interviewed by doctor according to the previously designed structured questionnaire. RESULTS: Eighty two patients (42.57) were male and mean and was 57.4 +/- 9.9 fears. Using Kaplan-Meier's method, 8% of non-exercise group (N= 115) in diagnosing hypertension started exercise after 1 fear and 40%, after 5 years. Otherwise, 5% of exercise group(N=78) stopped exercise after 1 year and 30%, after 5 years. The characteristics of 5 exercise groups according to sex, age, level of education and adequacy of exercise showed significant difference. In average blood pressure, lately started group showed the lowest (137/84 mmHg) and non-exercise group, the highest (146/91 mmHg) In the degree of recommendation. sporadic group showed the highest and non-exercise group, the lowest which showed significant difference (p =0.0024) . CONCLUSION: I conclude that lately started group among non-exercise group and continuous exercise group were mainly affected by recommendation to exercise of physician. As well as exercise, other nonpharmacologic treatment should be promoted by physician as an important strategy for treatment of hypertension.
Blood Pressure ; Education ; Exercise ; Gyeonggi-do ; Humans ; Hypertension ; Male ; Physicians, Family* ; Seoul ; Surveys and Questionnaires

BACKGROUND/AIMS: The study proposed to evaluate the efficacy of anticancer drugs of intraarterial chemoinfusion and investigate prognostic factors influencing survival. METHODS: A total of 127 patients diagnosed as having advanced hepatocellular carcinoma(HCC) of same stage (TNM stage IVa) from 1996 to 1998 were examined. Two intraarterial infusion chemotherapeutic regimens were employed: Adriamycin(Group I) and Cisplatin(Group II). RESULTS: Overall survival was significantly diffrent(10.0 vs 5.7months) and favored Group I. By the univariate analysis, significant prognostic factors included: age, portal vein thrombosis(PVT), size(>5cm) and type of tumor, response rate (size & -fetoprotein) at 3 months after therapy, level of albumin, alkaline phosphatase, and total bilirubin. After repeated therapy, Group I showed better survival (14.0 vs 7.9 months), but there was no statistical difference in survival rate between two groups in the case of large size, PVT, and diffuse type. CONCLUSION: Group I showed better survival than Group II in advanced HCC of TNM stage IVa. But, considering prognostic factors, there was no significant difference in survival rate between two groups except small size or nodular type of HCC. TNM classification of stage IVa should be reconsidered to include prognostic factors influencing survival rate such as PVT, size and type of HCC.
Alkaline Phosphatase ; Bilirubin ; Carcinoma, Hepatocellular* ; Classification ; Humans ; Infusions, Intra-Arterial ; Neoplasm Staging ; Portal Vein ; Psychotherapy, Group ; Survival Rate ; Treatment Outcome*

OBJECTIVE: This study was conducted to elucidate the associations of HLA with systemic sclerosis (SSc) in Koreans. METHODS: HLA associations with SSc according to SSc-specific autoantibody status and clinical subsets (diffuse and limited) were investigated. HLA-A, B, and C antigens were typed by the serological method using microlymphocytotoxicity test, and HLA-DR by DNA typing method using PCR-reverse hybridization and PCR-SSCP in 56 Korean patients with SSc and 226 healthy controls. For SSc patients, anti-Scl-70 and anicentromere antibodies were tested by double immunodiffusion and indirect immunofluorescence, respectively. RESULTS: The results of HLA class I antigen typing showed that the frequencies of HLA-A24, B52 and B62 were increased, whereas those of A33, B44 and B58 were decreased in SSc patients compared to healthy controls. The frequency of HLA-DR2 was significantly increased, whereas that of HLA-DR13 was decreased in patients with SSc compared to controls. Among HLA-DR2 alleles, both HLA-DRB1*1501 and *1502 were increased in SSc patients compared to controls. According to clinical status, HLA-DRB1*1501 was increased in limited SSc patients and that of DRB1*1502 was increased both in diffuse and limited SSc patients compared to controls. According to autoantibody status, HLA- DRB1 1502 was significantly increased in anti-Scl-70-positive SSc patients and that of DRB1 1501 was increased in anti-Scl-70-negative SSc patients compared to controls. The association of HLA-DR2 alleles with SSc according to clinical subsets and anti-Scl-70 antibody status revealed that the frequency of HLA- DRB1 *1501 was significantly increased in anti-Scl-70-negative limited SSc patients compared to controls. CONCLUSIONS: These results suggest that different HLA-DR2 alleles are associated with different types of SSc in Koreans. HLA-DRB1 1502 shows strong association with anti-Scl-70-positive SSc, and DRB1 1501 with anti-Scl-70-negative limited SSc. It is concluded that the pathogenesis of SSc in Koreans is in part, based on the same genetic background.
Alleles ; Antibodies ; Asian Continental Ancestry Group ; DNA Fingerprinting ; Fluorescent Antibody Technique, Indirect ; HLA-A Antigens ; HLA-A24 Antigen ; HLA-DR Antigens ; HLA-DR2 Antigen ; HLA-DRB1 Chains ; Humans ; Immunodiffusion ; Scleroderma, Systemic*

A 55-year-old woman presented with frequent episodes of syncope due to sinus pauses. During ambulatory Holter monitoring, atrial fibrillation and first-degree atrioventricular nodal block were observed. Magnetic resonance imaging and CT scans showed a tumor-like mass from the superior vena cava to the right atrial septum. Open chest cardiac biopsy was performed. The tumor was composed of proliferating IgG4-positive plasma cells and lymphocytes with surrounding sclerosis. The patient was diagnosed with IgG4-related sclerosing disease. Because of frequent sinus pauses and syncope, a permanent pacemaker was implanted. The cardiac mass was inoperable, but it did not progress during the one-year follow-up.
Atrial Septum/*pathology ; Female ; Humans ; Immunoglobulin G/*blood ; Middle Aged ; Pacemaker, Artificial ; Sclerosis/complications/diagnosis/therapy ; Syncope/etiology ; Vena Cava, Superior/*pathology

PURPOSE: Headache is a common disorder in childhood and adolescence and frequently associated with emotional or psychological problems. In this study we studied behavioral and psychological characteristics of recurrent headache patients. METHODS: We evaluated 120 patients over 9 years old with headache who visited Kangnam Sacred Heart Hospital. 33 patients who didn't have headache were included in the control group. Diagnosis was confirmed according to ICHD-2 classification and KCBCL, TAIC, CDI, and SAIC were conducted in all participants. RESULTS: Male to female ratio was 0.7:1 in the study group and 1.1:1 in the control group and the mean age was 11.5+/-2.1 and 12.6+/-2.0 years old respectively. 73.3% of patients were migraine and 26.7% were tension type headache. The mean of KCBCL total scores was 56.2 in the migraine group, 54.0 in the tension type headache group, and 38.3 in the control group and the score was higher in the headache group(P<0.001). The means of internalizing and externalizing scores were 59.8 and 54.1 in the migraine group, 57.4 and 51.3 in the tension headache group, and 40.1 and 42.4 in the control group respectively and the scores were higher in the headache group(P<0.001). The mean scores of SAIC and TAIC were 36.3 and 33.6 in the migraine group, 36.3 and 34.6 in the tension type headache group, and 25.3 and 26.9 in the control group respectively and the scores were higher in the headache group(P<0.001). The mean scores of CDI were 14.9 in the migraine group, 14.5 in the tension type headache group, and 9.1 in the control group and the scores were higher in the headache group(P=0.002). CONCLUSION: The patients with recurrent headache showed statistically significant higher scores in CBCL total, internalizing, and externalizing scores, SAIC, TAIC, and CDI in comparison with the control group.
Adolescent ; Child ; Female ; Headache ; Heart ; Humans ; Male ; Migraine Disorders ; Stress, Psychological ; Tension-Type Headache

No abstract available.
Adult* ; Humans ; Urinary Tract Infections* ; Urinary Tract*

Migration of inflammatory cells into damaged tissue is essential to host defense mechanisms and immune responses. Monocyte chemoattractant protein-1(MCP-1), a member of the CC or beta-chemokine family is a powerful leukocyte recruitment factor that is relatively specific for monocyte/macrophage. The purpose of present study was to evaluate temporal change of expression of mRNA for MCP-1 in the sciatic nerve and hindlimb muscle of Sprague-Dawley rat. The mid-portion of the sciatic nerve was exposed, cut under aseptic condition and then animals were sacrificed 1, 2, 3, 7, 14 days after denervation of the sciatic nerve. Semiquantitative RT-PCR method and image analysis system were used to analyze change in expression of mRNA for MCP-1. Expression of mRNA for MCP-1 in the distal stump of the denervated sciatic nerve was up-regulated within 1 day and peaked on the second day following transection of the sciatic nerve. Thereafter high expression of mRNA for MCP-1 lasted for 7 days after transection of the nerve. However the expression of mRNA for MCP-1 was rapidly decreased on the 14th day after denervation. Temporal change of expression of mRNA for MCP-1 in the proximal portion of the denervated sciatic nerve was very similar with that of distal one. The gastrocnemius muscle also showed significant increase in expression of mRNA for MCP-1 on the 1st day with maximal expression on the 7th day after denervation of the sciatic nerve. In contrast, the expression of mRNA for MCP-1 in the soleus muscle was lower than the gastrocnemius muscle in the course of the denervation-induced atrophy. Additionally alpha-lipoic acid, a potent antioxidant that is used in treatment for diabetic neuropathy, suppressed significantly expression of mRNA for MCP-1 in the denervated sciatic nerve but not in atrophied hindlimb muscles.
Animals ; Atrophy ; Chemokine CCL2* ; Defense Mechanisms ; Denervation* ; Diabetic Neuropathies ; Hindlimb* ; Humans ; Leukocytes ; Monocytes* ; Muscle, Skeletal ; Muscles ; Rats ; Rats, Sprague-Dawley ; RNA, Messenger* ; Sciatic Nerve* ; Thioctic Acid

PURPOSE:The aim of this study was to determine whether postnatal sepsis is a risk factor for developing bronchopulmonary dysplasia (BPD) in premature infants. METHODS:Premature infants of less than 32 weeks of gestation or birth weight under 1,500 g who admitted at Kangnam Sacred Heart Hospital of Hallym University during 1997-2005 were investigated. Among them, infants born at other hospitals or died within 4 weeks of life and infants who got sepsis after neonatal period were all excluded. Total 268 cases were included in this study. They were divided into those with respiratory distress syndrome (RDS) (n=77) and without RDS (n=191) and each was subdivided into groups with sepsis and without sepsis. Based on the medical records, the incidence of BPD and its correlation with sepsis were analyzed. RESULTS:Incidence of typical BPD was 63.0% in group with sepsis and 26% in group without sepsis. In case of atypical BPD, incidence was 20.5% in group with sepsis and 1.3% in group without sepsis. When logistic regression analysis was performed for correcting the confounding factors, sepsis was found to be statistically significant for BPD de development (OR 3.159, 95% CI=1.241-8.039, P<0.05). RDS, birth weight were also independently significant. Other perinatal factors such as gestational age, 1 min & 5 min Apgar score, total duration of assisted ventilation, total duration of O2 administration, PDA, ROP, and IVH were found to be significant risk factors for developing BPD. We could not find any statistically significant maternal risk factors for BPD occurrence. CONCLUSION:For premature infants under 1,500 g of birth weight or 32 week of gestational age and less, sepsis during the first 4 weeks of age was a significant risk factor for developing both typical and atypical BPD.
Apgar Score ; Birth Weight ; Bronchopulmonary Dysplasia* ; Gestational Age ; Heart ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature* ; Logistic Models ; Medical Records ; Pregnancy ; Risk Factors ; Sepsis* ; Ventilation

After the introduction of antibiotics, empyema is a rare complication of retropharyngeal abscess caused by acute epiglottitis. But once it occurs, it may be a fatal outcome. Retropharyngeal abscess may spread to mediastinum and pleural cavity along the deep cervical fascia, then it can induce pneumonia, mediastinitis, empyema, and sepsis. Because of its fatal complication, early diagnosis and intensive surgical treatment, such as incision and drainage, is necessary. Now we have a experience of empyema caused by retropharyngeal abscess in a 56-year old diabetic patient with nephropathy. He was admitted to our hospital because of hoarseness and sore throat due to acute epiglottitis. Several days after his admission, he complained of swelling of neck, which was diagnosed as retropharyngeal abscess by the computerized tomography. Retropharyngeal abscess was managed with antibiotics, incision and drainage and culture revealed Peptostreptococcus prevotii. Subsequently empyema developed in his right chest, which was managed with closed thoracotomy, though, he expired due to progression of sepsis.
Anti-Bacterial Agents ; Drainage ; Early Diagnosis ; Empyema* ; Epiglottitis* ; Fascia ; Fatal Outcome ; Hoarseness ; Humans ; Mediastinitis ; Mediastinum ; Middle Aged ; Neck ; Peptostreptococcus ; Pharyngitis ; Pleural Cavity ; Pneumonia ; Retropharyngeal Abscess* ; Sepsis ; Thoracotomy ; Thorax

We report two cases of tsutsugamushi disease which occurred in the spring of 1998. One patient presented with fever, rash, lymphadenopathy and eschar. He was exposed to bush areas on March 29, 1998 and developed symptoms starting April 6, 1998. The other patient visited our hospital because of fever, headache, and vomiting which developed since May 21, 1998. Physical examination revealed rash, lymphadenopathy, and eschar. Cerebrospinal fluid was positive for Orientia tsutsugamushi by using polymerase chain reaction. Most tsutsugamushi cases occur between October and December in Korea. The seasonal variation in the incidence of tsutsugamushi disease is probably related to the life cycle of the vector mite. The frequency of Leptotrombidium pallidum, a major vector mite in Korea, shows a large peak in autumn and a smaller peak in spring. Our cases confirm that tsutsugamushi disease can occur in the spring in Korea.
Cerebrospinal Fluid ; Epidemiology ; Exanthema ; Fever ; Headache ; Humans ; Incidence ; Korea ; Life Cycle Stages ; Lymphatic Diseases ; Mites ; Orientia tsutsugamushi ; Physical Examination ; Polymerase Chain Reaction ; Scrub Typhus* ; Seasons ; Trombiculidae ; Vomiting