PURPOSE: Low urinary pH is a risk factor for uric acid stones, and acidic urine has been described as a renal manifestation of the metabolic syndrome. We evaluated the association between metabolic syndrome and urinary pH in adult Korean men who visited a health promotion center. MATERIALS AND METHODS: From 2004 to 2008, a total of 18,513 adult men who visited our health promotion center were enrolled in this study. The relation between urinary pH and various parameters associated with the metabolic syndrome were evaluated. RESULTS: The average age was 45.6 years (range, 18-95 years), and 4987 men (26.9%) were classified as having the metabolic syndrome. The mean urinary pH of the metabolic syndrome group was 5.91, which was significantly lower than that of the normal group (6.08). In univariate and multivariate analysis, body mass index, serum triglyceride, and blood sugar were negatively correlated with urinary pH (p<0.05). In multivariate logistic regression analysis, obesity (body mass index > or =25 kg/m2), hypertriglyceridemia (> or =150 mg/dl), high fasting glucose (> or =110 mg/dl), and low high-density lipoprotein cholesterol (<45 mg/dl) were the significant factors that predicted low urinary pH (< or =5.5). CONCLUSIONS: Metabolic syndrome was related to lower urinary pH in ostensively healthy adult Korean men. Further studies are needed to elucidate the exact mechanism responsible for the lower urinary pH in individuals with the metabolic syndrome.
Adult ; Blood Glucose ; Body Mass Index ; Cholesterol ; Fasting ; Glucose ; Health Promotion ; Humans ; Hydrogen-Ion Concentration ; Hypertriglyceridemia ; Lipoproteins ; Logistic Models ; Male ; Metabolic Syndrome X ; Multivariate Analysis ; Obesity ; Risk Factors ; Uric Acid ; Urinalysis

PURPOSE: hear stress (SS) and cyclic strain (CS) influence the expression of membrane type 1-matrix metalloproteinase (MT1-MMP) in microvascular endothelial cells (MVECs). It is known that changes in the level of Sp1 phosphorylation are important for MT1-MMP expression following SS and CS. However, the exact mechanism underlying this process is poorly understood. The aim of this study was to determine the effect of PKCzeta on serine phosphorylation and activation of Sp1 in response to SS and CS. METHOD: MVECs were exposed to SS or CS for up to 8 hours with or without PKCzeta inhibitors. The activity and phosphorylation of Sp1 were assessed by Western blot analysis and immunoprecipitation. MT1-MMP protein expression was assessed by Western blot analysis. RESULT: PKCzeta was phosphorylated and activated under SS, whereas no significant changes were noted under CS. SS increased Sp1 phosphorylation in a time-dependent manner, but no changes in the Sp1 phosphorylation were observed when the MVECs were pretreated with the PKCzeta inhibitors. By contrast, MVECs exposed to CS in the presence or absence of PKCzeta inhibitors showed no change in the phosphorylation of Sp1. SS decreased MT1-MMP protein expression in a time-dependent manner, but in the presence of PKCzeta inhibitors, MT1-MMP expression was not changed compared with the static levels after SS. CS increases MT1-MMP expression in a time-dependent manner. Similar expression was observed when the cells were pretreated with PKCzeta inhibitors under CS. CONCLUSION: These data demonstrate that the increased affinity of Sp1 for the MT1-MMP's promoter site occurs because of PKCzeta induced phosphorylation of Sp1 in response to SS.
Blotting, Western ; Endothelial Cells* ; Immunoprecipitation ; Matrix Metalloproteinase 14* ; Membranes ; Phosphorylation ; Serine

PURPOSE: A prospective, controlled trial was conducted to evaluate growth, bone mineralization, and nutritional status receiving preterm human milk supplemented with a newly formulated Maeil human milk fortifier. METHODS: Twenty five fortified human milk-fed and preterm formula-fed infants with a birth weight < 1, 800 g and gestational age <35 weeks, who were born at Ajou University Hospital from March, 2003 through August, 2004 were studied. Growth, biochemical indices of bone mineralization, feeding tolerance, morbidity and wrist X-ray were assessed serially. Total body bone mineral density was measured by dual energy X-ray absorptiometry at 2 and 5months of age. RESULTS: There were no differences in growth, including weight, height and head circumference, between two groups. Serum Ca, P, ALP and other biochemical indices were similar. Although low grade rickets (grade I and II) were occasionally found on wrist X-ray, the rate of occurrence and severity were similar. The bone mineral densities of both group showed no difference. CONCLUSION: The fortified human milk-fed infants and preterm formula-fed infants showed no difference in growth, and bone mineralization. This newly formulated Maeil human milk fortifier can be safely used in preterm infants.
Absorptiometry, Photon ; Birth Weight ; Bone Density ; Calcification, Physiologic* ; Gestational Age ; Head ; Humans* ; Infant ; Infant, Newborn ; Infant, Premature* ; Milk, Human* ; Nutritional Status ; Prospective Studies ; Rickets ; Wrist

Ectopia cordis is defined as a congenital malposition of the heart partially or completely outside the thorax and often associated with sternal and congenital heart defects:surgical repair is generally unsuccessful because of the magnitude of the deformity and the associat-ed intracardiac anormalies. Four types of ectopia cordis are described : cervical, thoracic, abdominal and thoracoa- bdominal. Cervical and thoracic type are often fatal within days, because the heart is expo- sed and malformed. Abdominal type carries a better prognosis because cardiac abnormalities are less often found. The prognosis of thoraco-abdominal type mainly depends on the pre- sence of intracardiac abnormalities. We have experienced a case of thoracic ectopia cordis at 25 weeks' gestation by ultra- sonography, so present the case and the review with literature briefly.
Congenital Abnormalities ; Ectopia Cordis* ; Heart ; Pregnancy ; Prenatal Diagnosis* ; Prognosis ; Thorax

PURPOSE: There are several ways of treating for right colon diverticulitis, based on its complications or location. The kind of operation emplolyed with cecal diverticulitis is still controversial, due to its similar symptoms to those of acute appendicitis, and is usually diagnosed during an appendectomy. This study is an analysis of 65 patients, which we experienced over the past 10 year, with right colon diverticulitis. METHODS: The hospital records of 65 patients with right colon diverticulitis, between January 1991 and January 2001, from the Catholic University School of Medicine, St. Paul's Hospital department of surgery were retrospectively reviewed. We analyzed the clinical data and outcomes, according to three different types of operation. RESULTS: The male to female ratio of the patients was 1.4:1, with a mean age of 36.8, ranging from 14 to 81 years. The most common manifestation was abdominal pain and tenderness (100%). Of the 65 cases, 53 underwent a diverticulectomy and an appendectomy, 5 a right hemicolectomy or an ileocecetomy and 7 an appendectomy only. The most common location of the diverticulum was cecum (62 cases), and the majority were single diverticulum (62 cases). There were complications in 4 cases (6.1%) following the operation, but their symptoms were mild. The complication rates in the diverticulectomy and appendectomy and appendectomy only groups were 5.6 and 14.2% respectively. However, there were no significant differences in the complication rates among 3 groups. There was no recurrence in the group with a right hemicolectomy or ileocecectomy, or in the group with a diverticulectomy and an appendectomy. The recurrences in the appendectomy only group were significantly higher than the groups, with 3 (42.8%) out of 7 cases (P=0.001). CONCLUSION: We suggest that an operation may be the primary safe treatment of right colon diverticulitis and that a diverticulectomy and an appendectomy may be reasonable operative methods that decrease the recurrence and morbidity of right colon diverticulitis.
Abdominal Pain ; Appendectomy ; Appendicitis ; Cecum ; Colon* ; Diverticulitis* ; Diverticulum ; Female ; Hospital Departments ; Hospital Records ; Humans ; Male ; Recurrence ; Retrospective Studies

Choledochocele is a rare cystic dilatation of the distal common bile duct in the wall of the duodenum. It is a type III choledochal cyst among the five types according to Todani's modification of the Alonso-Lej classification, and this type lll cyst comprises less than 4% of all choledochal cysts. We experienced one case of choledochocele in a 41-year-old woman who presented with recurrent pancreatitis, and we report on this case, along with a review of the literature.
Adult ; Choledochal Cyst ; Common Bile Duct ; Dilatation ; Duodenum ; Female ; Humans ; Pancreatitis

Mesocolic hernias are rare congenital anormalies resulting from abnormalities in the intestinal rotation during embryonic development, and comprise approximately 53% of all congenital internal hernias. A right mesocolic hernia is formed by the arrest of further rotation of the prearterial segment of gut in the right side of the abdomen, with continued rotation of the postarterial segment, during the second stage of embryonic intestinal rotation, leading to the entrapment of almost the entire small bowel behind the right colonic mesentery. The condition may be discovered incidentally during at laparotomy, or may be the cause of an acute small bowel obstruction. Cecal diverticulitis is a rare disease, whose symptoms are similar to acute appendicitis. It is difficult to diagnose the two diseases accurately prior to operation. We report on a 48-year old man, who had perforated cecal diverticulitis and an incidental right mesocolic hernia, with a review of the literature.
Abdomen ; Appendicitis ; Colon ; Diverticulitis* ; Embryonic Development ; Female ; Hernia* ; Humans ; Laparotomy ; Mesentery ; Middle Aged ; Pregnancy ; Rare Diseases

The seminiferous tubules merge and connect with the tubuli recti that form the spaces known as the rete testis. Cystic ectasia of the rete testis is a rare benign testicular lesion. We report the cystic ectasia of the rete testis in a 66-year-old man.
Aged ; Dilatation, Pathologic ; Humans ; Rete Testis ; Seminiferous Tubules ; Testis

A diaphragmatic hernia in adult can result from delayed presentation of congenital or traumatic diaphragmatic defect. of all congenital diaphragmatic hernia, 5~25% present beyond the neonatal period. Diaphragmatic injury due to blunt or penetrating truncal trauma is relatively common, and can be missed during immediate posttraumatic period. If the diaphragmatic injury is not recognized at the time of the initial trauma, the patient may recover and remain symptom free, or suffer from chronic nonspecific abdominal and/or chest symptoms. After a variable interval acute symptom associated with intestinal obstruction or strangulation can arise because of a herniation of the abdominal organs through the diaphragmatic defect. A delay in diagnosis may occur and be associated with a high morbidity, so a careful history and examination, are essential for the successful management of patients, as is maintaining an awareness of the possibility of the delayed presentation of traumatic diaphragmatic hernia and its complication. We present a 35-years-old male patient with delayed presenting, traumatic diaphragmatic hernia, and discuss a literature a review.
Adult* ; Diagnosis ; Hernia, Diaphragmatic ; Hernia, Diaphragmatic, Traumatic* ; Humans ; Intestinal Obstruction ; Male ; Thorax

PURPOSE: Alfuzosin XL (Sanofi-Aventis, UroXatral(R)) has to be taken just after a meal for the best efficacy due to its specific pharmacokinetics. We studied patient compliance and associated factors with regard to the correct instructions for taking alfuzosin XL. MATERIALS AND METHODS: Alfuzosin XL was prescribed to 62 patients from February to May 2008. At the first visit, we provided a prescription for alfuzosin XL with the instructions to "take one tablet just after dinner once a day". At the second visit, we evaluated patient compliance and the factors that influenced the patient compliance for taking the alfuzosin XL. The physician explained the instructions to the patients. At the third visit, we compared the compliance and associated factors with the results from the first visit. RESULTS: A total of 50 patients completed the study. After the first visit, twenty one patients (42.0%) were not taking the alfuzosin XL according to the prescription, that is, 20 patients took alfuzosin XL before going to bed, and one patient before meals. (p<0.05) After direct instructions by a physician, 49 patients (98.0%) took the alfuzosin XL correctly. (p<0.001) CONCLUSIONS: Taking alfuzosin XL as prescribed was accomplished in only 58% of patients. When alfuzosin XL is prescribed, the physicians should be aware of the importance of providing instructions directly to patients.
Compliance ; Humans ; Meals ; Patient Compliance ; Prescriptions ; Quinazolines