BACKGROUND: In recent years, the incidence of obesity increased in Koreans. The main cause suggested is the diet style of Korean changed to that of Western. It has been proved that obesity is a risk factor or an aggravating factor of hypertension and diabetes mellitus, cardiovascular disease, etc. Primary physician has been interested in the correlation of blood pressure with relative body weight and aging. The purpose of this study was to focus on the influence of age and relative body weight on blood pressure. METHODS: Subjects were collected from 2,068 adults who had received Adult Health Examination. That subjects were divided according to age, relative body weight and then the relation of blood pressure with age according to relative body weight and relation with relative body weight according to age were investigated. RESULTS: Systolic blood pressure increased significantly according to age in all male and female three weight groups and then increased significantly according to relative body weight in all male and female three age groups except male seventh decade group. Diastolic blood pressure increased significantly according to age in all male and female three weight groups except male obesity group and then increased significantly according to the relative body weight in all male and female three age groups except male and female seventh decade groups. Systolic blood pressure has higher correlation with age than relative body weight and diastolic blood pressure has higher correlation with relative body weight in male. In female, systolic and diastolic blood pressure have higher correlations with age. CONCLUSIONS: It can be suggested that blood pressure increase significantly according to aging process and relative body weight. These two factors have a little different effects to systolic and diastolic blood pressure according to sex. Relative body weight has more effect to diastolic blood pressure than systolic blood pressure in male.
Adult ; Aging ; Blood Pressure* ; Body Weight ; Cardiovascular Diseases ; Diabetes Mellitus ; Diet ; Female ; Humans ; Hypertension ; Incidence ; Male ; Obesity* ; Risk Factors

Although the incidence is not high in the general surgical population, pulmonary aspiration of gastric contents can result in serious long-term morbidity and mortality. We report a case of early use of extracorporeal membrane oxygenation (ECMO) to correct severe hypoxemia refractory to conventional mechanical ventilation in a patient with massive aspiration of gastric contents immediately followed by acute lung injury during general anesthesia induction. A 64-year-old woman diagnosed with stomach cancer was scheduled for elective diagnostic laparoscopy. Although there was no sign of gastrointestinal tract obstruction and midnight Nil per Os (NPO) was performed before the operation, pulmonary aspiration occurred during the induction of anesthesia. Despite the endotracheal intubation with mechanical ventilation, severe hypoxemia with hypercapnea persisted. Medical team agreed with applying veno-venous (VV) ECMO, and her blood gas analysis results became stable. ECMO was weaned successfully 9 days after the first aspiration event had occurred. Based on this case, early application of extracorporeal life support can have survival benefits.
Acute Lung Injury ; Anesthesia* ; Anesthesia, General ; Anoxia ; Blood Gas Analysis ; Extracorporeal Membrane Oxygenation* ; Female ; Gastrointestinal Tract ; Humans ; Incidence ; Intubation, Intratracheal ; Laparoscopy ; Middle Aged ; Mortality ; Pneumonia, Aspiration ; Respiration, Artificial ; Stomach Neoplasms

PURPOSE: Anticonvulsants have a number of side effects and some of them may be attributed to a disturbance of serum trace metal homeostasis. Although they are minor building components in tissues, they play important functional roles in the peripheral and central nervous system. We measured serum copper and zinc levels in epileptic children who were treated with anticonvulsants to know the effects of anticonvulsants on serum copper and zinc levels. METHODS: Serum copper and zinc levels were determined in 64 epileptic patients receiving anticonvulsant therapy in Chungnam National University Hospital, and in 20 normal controls. Sixty-four epileptic patients were divided into three groups:16 patients who were treated with valproic acid monotherapy; 26 patients who were treated with valproic acid in addition to other anticonvulsants; and 22 patients who were treated with anticonvulsants except for valporic acid. RESULTS: All patients receiving anticonvulsants had significantly lower serum copper levels(80.21+/-19.42 microgram/dL) in comparison to the normal controls(102.12+/-32.8 microgram/dL). Serum zinc levels in patients receiving anticonvulsants(79.78+/-21.88 microgram/dL) were not statistically different from those of controls (85.26+/-29.81 microgram/dL). There were no significant difference of serum copper and zinc levels among the three groups. CONCLUSION: In this study, we clearly showed that anticonvulsants decreased serum copper levels. Although we did not observe any clinical findings related to copper deficiency, we should pay attention to potent copper deficiency in patients with anticonvulsant treatment.
Anticonvulsants* ; Central Nervous System ; Child ; Chungcheongnam-do ; Copper* ; Epilepsy ; Homeostasis ; Humans ; Valproic Acid ; Zinc*

OBJECTIVE: This prospective study evaluated the ability of indirect 16-row multidetector CT venography, in comparison with Doppler sonography, to detect deep vein thrombosis after total hip or knee replacement. MATERIALS AND METHODS: Sixty-two patients had undergone orthopedic replacement surgery on a total of 30 hip joints and 54 knee joints. The CT venography (scan delay time: 180 seconds; slice thickness/increment: 2/1.5 mm) and Doppler sonography were performed 8 to 40 days after surgery. We measured the z-axis length of the beam hardening artifact that degraded the image quality so that the presence of deep vein thrombosis couldn't be evaluated on the axial CT images. The incidence and location of deep vein thrombosis was analyzed. The diagnostic performance of the CT venograms was evaluated and compared with that of Doppler sonography as a standard of reference. RESULTS: The z-axis length (mean +/- standard deviation) of the beam hardening artifact was 4.5 +/- 0.8 cm in the arthroplastic knees and 3.9 +/- 2.9 cm in the arthroplastic hips. Deep vein thrombosis (DVT) was found in the popliteal or calf veins on Doppler sonography in 30 (48%) of the 62 patients. The CT venography has a sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 90%, 97%, 96%, 91% and 94%, respectively. CONCLUSION: The ability of CT venography to detect DVT was comparable to that of Doppler sonography despite of beam hardening artifact. Therefore, CT venography is feasible to use as an alternative modality for evaluating post-arthroplasty patients.
Adult ; Aged ; Aged, 80 and over ; *Arthroplasty, Replacement, Hip ; *Arthroplasty, Replacement, Knee ; Artifacts ; Female ; Humans ; Leg/*blood supply ; Male ; Middle Aged ; Predictive Value of Tests ; Prospective Studies ; Sensitivity and Specificity ; Tomography, X-Ray Computed/*methods ; Venous Thrombosis/etiology/*radiography/*ultrasonography

Glycogen Storage Disease Type II is caused by the deficiency of acid maltase resulting in lysosomal accumulation of glycogen. There are two major clinical syndromes, a severe generalized and invariable fatal disease of infancy, and a myopathy starting in juvenile or adult life. The clinical and laboratory findings of a patient with Glycogen Storage Disease Type II are presented. The patient, a 17-year-old male, experienced slowly progressive weakness of muscle of the pelvis shoulder girdles and trunk. Muscle biopsy showed vacuolar myopathy and electromyograph showed features of myopathy with fibrillation potentials, positive sharp waves, myotonic discharges, without clinical myotonia at rest, and polyphasic potentials on volition. Clinical features, histopathologic and electrophysiologic findings of this disease and differential diagnosis were reviewed.
Adolescent ; Adult ; alpha-Glucosidases ; Biopsy ; Diagnosis, Differential ; Glycogen Storage Disease Type II* ; Glycogen Storage Disease* ; Glycogen* ; Humans ; Male ; Muscular Diseases ; Myotonia ; Pelvis ; Shoulder ; Volition

BACKGROUND: Most studies on the incidence rate (IR) and post-exposure reporting rate (RR) of needle-stick injuries (NSIs) were performed using retrospective surveillance, which is vulnerable to recall bias. This study aimed to identify the agreement between IRs and RRs obtained from prospective and retrospective surveillance. METHODS: The prospective surveillance was performed with 716 nurses working at 3 hospitals from August to September in 2012. They prospectively reported when they experienced the NSIs, and the investigator retrospectively calculated the RR from records in the infection control unit or health care unit during the same periods when they reported the number of NSIs. The retrospective surveillance was carried out with 312 nurses who participated in the prospective surveillance. They retrospectively answered the question on the number of NSIs and post-exposure reporting after recalling the experienced NSI from August to September in 2012. RESULTS: The IR of NSIs was 9.8 per 100 nurses by the prospective surveillance and 36.4 per 100 nurses by the retrospective surveillance, which was statistically significantly different (P<0.001). The RR of NSIs was 14.3% by the prospective surveillance and 8.5% by the retrospective surveillance, which was not statistically significantly different. CONCLUSION: We recommend using a prospective approach for calculating the IR of NSIs to reduce the risk of recall bias. However, the RR of NSIs can be calculated using both prospective and retrospective approaches.
Bias (Epidemiology) ; Delivery of Health Care ; Humans ; Incidence* ; Infection Control ; Memory ; Needlestick Injuries* ; Prospective Studies* ; Research Personnel ; Retrospective Studies*

As the interest in health is increasing and the population enjoyed the leisure sports is steadily increasing, the stress fracture, fracture or variant of metatarsal bone of foot has been shown frequently. The mistaken estimation about the length and rank of metatarsal bones during the osteotomy of the metatarsal bones of foot can be complicated. It is essential to have detailed knowledges about the anatomical structure of surgical region. This study aimed to investigate the metatarsal bones of foot and to develop a regression equation that can predict the length of metatarsal bones during the osteotomy. The subject of this study is fifty four feet (30M/224F). We measured the whole length and the article length of metatarsal bone. Also, we measured the whole width and the article width in the head, body, base of the metatarsal bone. The data was analyzed using SPSS win 13.0. The regression equation models of length of the metatarsal bones were developed by multiple regression analysis. The regression equation predicted first metatarsal length was second metatarsal articular length x0.770+7.780, second metatarsal length was third metatarsal length x0.976+6.050, third metatarsal length was fourth metatarsal length x1.000+0.922, fourth metatarsal length was third metatarsal length x0.917+4.167, fifth metatarsal length was fourth metatarsal length x0.901+7.972. The results of this study would be useful to clarify the characteristics of the metatarsal bone of the foot, to develop a regression equation for prediction of the length of the metatarsal bone.
Foot ; Fractures, Stress ; Head ; Leisure Activities ; Metatarsal Bones ; Osteotomy ; Sports

We experienced a case of isolated fetal pleural effusion diagnosed by antenatal ultrasonogram in the 33th week of gestational age. Chest PA at birth showed massive pleural effusion in both lungs. The serous pleural fluid changed to a milky nature after feeding so we diagnosed it as congenital chylothorax. The infant was managed by chest tube drainage, NPO & TPN with good response and was discharged on the 28th hospital day. We report the case with a brief review of its related literature.
Chest Tubes ; Chylothorax* ; Drainage ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Lung ; Parturition ; Pleural Effusion ; Thorax ; Ultrasonography

PURPOSE: We taught medical students how to break bad news to medical students using the SPIKES protocol and investigated its efficacy. METHODS: After developing the program, we taught the 16 medical students doing their family medicine rotation. We surveyed their self-reported performance prior to the teaching and their satisfaction and change in confidence level after the teaching. Using standardized patients(SP), we also analyzed the difference in clinical performance between educated and non-educated groups. RESULTS: Students were satisfied with the education program and 12 students showed increased confidence levels. However, there was no difference in clinical performance between eduated and non-educated group, even after categorization of the exam. CONCLUSION: Self-confidence for delivering bad news increased but there was no evidence of improvement in clinical performance. Communication skills training should be repeatedly performed in each medical educational curriculum.
Curriculum ; Education ; Humans ; Students, Medical