Since the new hypertension guideline published by the American Heart Association/American College Cardiology/American Society of Hypertension in 2017, the Korean Society of Hypertension and the European Society of Hypertension revised and announced new hypertension guidelines. Also the Korean Society of Hypertension published Korea hypertension fact sheet 2018, including prevalence, awareness, management status of hypertension, and their trends in Korea. Herein, I provide information on diagnosis and treatment of hypertension based on the new guidelines of the Korean Society of Hypertension.
Blood Pressure ; Cardiovascular Diseases ; Diagnosis ; Heart ; Hypertension ; Korea ; Prevalence

BACKGROUND AND OBJECTIVES: The acceptable noise level (ANL) test measures the maximum noise level that a subject can tolerate while following speech. Given the limited investigation of ANL across different languages, this study aimed to compare ANLs using both Korean semantic speech and non-semantic speech signals (reversed Korean speech and international speech test signal, ISTS) in normal-hearing subjects. SUBJECTS AND METHOD: Twenty-five subjects with normal hearing (9 males, 16 females, with the mean age of 28.5±3.15 years) were included in the study. ANLs were obtained using three speech materials (Korean speech, reversed Korean speech, and ISTS) as the target speech material and an eight-talker babble noise as the competing background noise. RESULTS: Generally, the inter-subject variability was large. The ANLs did not differ statistically regardless of the type of speech signal. CONCLUSION: The ANLs seemed to be unaffected by the meaningfulness or semantic contents of the target speech, at least in normal-hearing adults. Thus, non-meaningful speech signals or non-semantic material can be considered as the target signal for the implementation of ANL test.
Adult ; Female ; Hearing* ; Humans ; Male ; Methods ; Noise* ; Semantics

PURPOSE: The tertiary lymphoid structure (TLS) is an important source of tumor-infiltrating lymphocytes (TILs), which have a strong prognostic and predictive value in triple-negative breast cancer (TNBC). A previous study reported that the levels of CXCL13 mRNA expression were associated with TLSs, but measuring the gene expression is challenging in routine practice. Therefore, this study evaluated the MECA79-positive high endothelial venule (HEV) densities and their association with the histopathologically assessed TLSs in biopsy samples. In addition, the relationship of TLSs with the CXCL13 transcript levels and clinical outcomes were examined. MATERIALS AND METHODS: A total of 108 TNBC patients treated with neoadjuvant chemotherapy (NAC) were studied. The amounts of TILs and TLSs were measured histopathologically using hematoxylin and eosin–stained slides. The HEV densities and TIL subpopulations were measured by immunohistochemistry for MECA79, CD3, CD8, and CD20. CXCL13mRNA expression levels using a NanoString assay (NanoString Technologies). RESULTS: The mean number of HEVs in pre-NAC biopsies was 12 (range, 0 to 72). The amounts of TILs and TLSs, HEV density, and CXCL13 expression showed robust correlations with each other. A lower pre-NAC clinical T stage, higher TIL and TLS levels, a higher HEV density, CD20-positive cell density, and CXCL13 expression were significant predictors of a pathologic complete response (pCR). Higher CD8-positive cell density and levels of CXCL13 expression were significantly associated with a better disease-free survival rate. CONCLUSION: MECA79-positive HEV density in pre-NAC biopsies is an objective and quantitative surrogate marker of TLS and might be a valuable tool for predicting pCR of TNBC in routine pathology practice.
Biomarkers ; Biopsy ; Cell Count ; Disease-Free Survival ; Drug Therapy ; Gene Expression ; Hematoxylin ; Humans ; Immunohistochemistry ; Lymphocytes, Tumor-Infiltrating ; Pathology ; Polymerase Chain Reaction ; Prognosis ; RNA, Messenger ; Triple Negative Breast Neoplasms* ; Venules*

PURPOSE: Since most terminally ill cancer patients die of multiple organ failure, plasma endotoxin concentration levels may be used to predict the life expectancy. This study was performed to evaluate the clinical significance of endotoxin level in plasma as a prognostic factor for survival in patients with terminal cancer. METHODS: This study was conducted with 56 terminally ill cancer patients, above 20 years old, from April 2009 through October 2009. Demographic characteristics, Karnofsky performance status, and survival time were evaluated. We analyzed blood levels of white blood cell hemoglobin, hematocrit, aspartate aminotransferase, alanine aminotransferase, c-reactive protein, total bilirubin and endotoxin in each patient. RESULTS: We considered following variable for univariate analysis: plasma endotoxin level, sex, age, WBC, hemoglobin, hematocrit, AST, ALT, total bilirubin, CRP and severity of pain. Univariate analysis did not show a significant association between plasma endotoxin level and survival time. However, in a multivariate analysis with factors that were found to be significantly associated with survival sex, WBC count and total bilirubin level in univariate analysis, high levels of plasma endotoxin and short survival time were significantly related. CONCLUSION: Plasma endotoxin level could be used as a prognostic factor to predict the life expectancy of terminally ill cancer patients.
Alanine Transaminase ; Aspartate Aminotransferases ; Bilirubin ; C-Reactive Protein ; Endotoxins ; Hematocrit ; Hospice Care ; Humans ; Karnofsky Performance Status ; Leukocytes ; Life Expectancy ; Multiple Organ Failure ; Multivariate Analysis ; Plasma* ; Prognosis ; Terminal Care ; Terminally Ill*

OBJECTIVE: The present study was conducted to evaluate the viability of germ cells form the adult and fetal ovarian tissues after vitrification followed by xenografting. METHOD: The human adult ovarian tissues were obtained from 33 years old patients, and the fetal ovarian tissues were obtained from 22 weeks and 25 weeks in gestation. ovarian tissues were cryopreserved by vitrification with 5.5 M ethylene glycol (EG 5.5) and 1.0 M sucrose as cryoprotectants. Adult and fetal ovarian tissues were pre-equilivrated with EG 5.5 at room temperature for 10 and 5 minutes, respectively and plunged into liquid nitrogen immediately. Frozen-thawed tissues were xenografted into NOD-SCID mice to evaluated the viability and capacity for further growth of the primordial follicles. Grafts were recovered from the recipients 4 weeks after transplantation and histological analysis was accomplished. RESULT AND CONCLUSION: Grafts recovered 4 weeks after transplantation contained less number of oocytes and primordial follicles compared to that of the fresh tissues. Survived follicles were mainly primordial and intermediary with larger diameter and more granulosa cells. It is confirmed that 1) the ovarian tissues were healthy and the germ cells were survived after vitrification, and 2) the survived fetal primordial follicles after vitrification resumed the growth in the xenofrafts.
Adult ; Animals* ; Ethylene Glycol ; Female ; Germ Cells ; Granulosa Cells ; Heterografts* ; Humans* ; Mice ; Nitrogen ; Oocytes ; Pregnancy ; Sucrose ; Transplantation, Heterologous* ; Transplants ; Vitrification

Myasthenia gravis is an autoimmune disease involving neuromuscular junction. It can be associated with thymic hyperplasia, thymoma and various tumors involving thymus, but extrathymic malignant lymphoma associated with myasthenia gravis has been rarely reported. We experienced a 62-year-old woman diagnosed with ocular myasthenia gravis associated with small lymphocytic lymphoma without thymic involvement. She had complete remission after 6 cycles of chemotherapy, and symptoms of myasthenia gravis were completely resolved.
Autoimmune Diseases ; Drug Therapy ; Female ; Humans ; Leukemia, Lymphocytic, Chronic, B-Cell ; Lymphoma* ; Middle Aged ; Myasthenia Gravis* ; Neuromuscular Junction ; Thymoma ; Thymus Gland ; Thymus Hyperplasia

Purpose: The concept of hidden hearing loss can explain the discrepancy between a listener’s perception of hearing ability and hearing evaluation using pure tone audiograms. This study investigated the utility of the suprathreshold auditory brainstem response (ABR) for the evaluation of hidden hearing loss in noise-exposed ear with normal audiograms. Materials and Methods: A total of 15 patients (24 ears) with normal auditory thresholds and normal distortion product otoacoustic emissions were included in a retrospective analysis of medical records of 80 patients presenting with histories of acute noise exposure. The control group included 12 subjects (24 ears) with normal audiograms and no history of noise exposure. Pure tone audiometry and suprathreshold ABR testing at 90 dB peSPL were performed. The amplitudes and latencies of ABR waves I and V were compared between the noise-exposed and control groups. Results: We found no significant difference in the wave I or V amplitude, or the wave I/V ratio, between the two groups. The latencies of ABR wave I, V, and I–V interpeak interval were compared, and no significant intergroup difference was observed. Conclusion The results suggest that either hidden hearing loss may not be significant in this cohort of patients with acute noise exposure history, or the possible damage by noise exposure is not reflected in the ABRs. Further studies are needed to inquire about the role of ABR in identification of hidden hearing loss.

Purpose: The concept of hidden hearing loss can explain the discrepancy between a listener’s perception of hearing ability and hearing evaluation using pure tone audiograms. This study investigated the utility of the suprathreshold auditory brainstem response (ABR) for the evaluation of hidden hearing loss in noise-exposed ear with normal audiograms. Materials and Methods: A total of 15 patients (24 ears) with normal auditory thresholds and normal distortion product otoacoustic emissions were included in a retrospective analysis of medical records of 80 patients presenting with histories of acute noise exposure. The control group included 12 subjects (24 ears) with normal audiograms and no history of noise exposure. Pure tone audiometry and suprathreshold ABR testing at 90 dB peSPL were performed. The amplitudes and latencies of ABR waves I and V were compared between the noise-exposed and control groups. Results: We found no significant difference in the wave I or V amplitude, or the wave I/V ratio, between the two groups. The latencies of ABR wave I, V, and I–V interpeak interval were compared, and no significant intergroup difference was observed. Conclusion The results suggest that either hidden hearing loss may not be significant in this cohort of patients with acute noise exposure history, or the possible damage by noise exposure is not reflected in the ABRs. Further studies are needed to inquire about the role of ABR in identification of hidden hearing loss.

Purpose: This study aimed to evaluate the influence of surface sealants on the surface roughness of composite resins. Materials and Methods: The study used microfilled composite resin (Metafil CX, Sun Medical Co.) and hybrid composite resin (Aelite™ LS posterior, Bisco). Sixty specimens (8 mm in diameter and 4 mm in height) of each composite resin type were prepared and divided into 3 groups. Each specimen was ground with 600, 1000, and 2000-grit sandpaper. The Surface roughness (Ra) values were measured using a surface roughness tester (SJ-301, Mytutoyo) before and after surface sealant application. Surface sealants, BisCover™ LV (Bisco), Optiguard® (Kerr), and Seal-n-Shine™ (Pulpdent), were applied to the specimens, as instructed and observed by scanning electron microscope (JSM-7500, JEOL) and atomic force microscope (MultiMode IV, Veeco Instruments). Results: Specimens ground with 600-grit sandpaper coated with surface sealants exhibited significantly lower Ra values than the untreated group (P < 0.05).Specimens ground with 1000 and 2000-grit sandpaper showed statistically no difference. There was no significant difference in surface roughness among BisCover™ LV, Optiguard®, and Seal-n-Shine™. SEM and AFM revealed remarkably decreased microdefects on the surfaces of composite resins after surface sealant application. Conclusion Surface sealants can influence surface roughness when applied on the rough surface of composite resins but not on highly polished composite resins.

BACKGROUND AND OBJECTIVES: Even patients with compensated peripheral vestibular dysfunction may report a sense of disequilibrium during daily activities, which often fail conventional vestibular function tests as attentional demand required for postural control may increase in these patients. The study aims to assess the feasibility of dual task test using concurrent cognitive tasks in a modified clinical test of sensory interaction on balance (mCTSIB) to measure increased attentional demand for posture control. SUBJECTS AND METHOD: Nineteen patients suspected with chronic dizziness were recruited by history reviews and physical examinations. Data for center of pressure (COP) variability and mean velocity during mCTSIB on a force long plate were analyzed, and time taken to react to the auditory stimuli were used to measure the attentional demand required for adequate postural control during platform perturbation. RESULTS: The mean COP range and velocity during mCTSIB were comparable between single and dual task conditions in patients with dizziness. Reaction time (RT) to auditory stimulus of 1 kHz pure tone in patients with chronic dizziness was also comparable to normal subjects. Interestingly, there was a tendency for increased RT in patients with documented caloric weakness, suggesting that attentional demand is increased in these patients. CONCLUSION: RT of dual task tests using auditory stimuli during mCTSIB may provide additional information about increased attentional demand for postural control in patients with vestibular dysfunction.
Dizziness* ; Humans ; Methods ; Physical Examination ; Posture ; Reaction Time ; Task Performance and Analysis ; Vestibular Diseases ; Vestibular Function Tests