PURPOSE: The purpose of this study was to investigate the individual and working environment-related factors affecting hypertension among middle-aged and elderly self-employed workers in South Korea. METHODS: This was a secondary data analysis of data from the Korean Longitudinal Study of Aging (KLoSA). The study sample included 1,319 middle-aged and elderly self-employed workers who were diagnosed without hypertension and older than 45 years at Wave 1 of the KLoSA. Data were analyzed using descriptive statistics and Cox proportional hazards regression analysis using SPSS 20.0. RESULTS: About 20% of the middle-aged and elderly self-employed workers were diagnosed with hypertension within about 8 years from the baseline. the significant predictors of hypertension among the participants were age, diabetes mellitus, body mass index, frequency of health examinations, working hours per week, the presence of regular day off, and the type of job. CONCLUSION: Middle-aged and elderly self-employed workers are vulnerable to work-related health problems. In order to prevent hypertension among self-employed workers, it is necessary to improve the work environment-related factors as well as individual life styles.
Aged* ; Aging* ; Body Mass Index ; Diabetes Mellitus ; Humans ; Hypertension* ; Korea ; Life Style ; Longitudinal Studies* ; Middle Aged ; Statistics as Topic ; Surveys and Questionnaires*

PURPOSE: The purpose of this research is to determine whether pontic metal substructures, which are currently used in clinical surgeries, are designed appropriately and identify the problems that can occur due to their shape, size, and position. Then it aimed to emphasize the importance of making and designing pontic metal substructures based on basic principles. MATERIALS AND METHODS: This research measured pontic basal surface (P1) used sample metal substructures in this study, gingiva margin (P2), and the porcelain thickness of maximum infrabulge of labial surface around 1/3 of cervix dentis (P3). One-way ANOVA analysis was carried out to test the differences among groups, Tukey Honestly Significant Difference Test was conducted for statistical analysis among groups. RESULTS: For porcelain thickness and SD value, the P1 part was 1.2 - 1.8 (±0.17) mm for experimental group 1, 1.2 - 1.7 (±0.17) mm for experimental group 2, and 0.4 - 2.8 (±0.92) mm for experimental group 3. Next, the P2 part was 1.4 - 1.6 (±0.07) mm for experimental group 1, 1.3 - 1.8 (±0.07) mm for experimental group 2, and 0.5 - 2.7 (±0.67) mm for experimental group 3. The P3 part was 1.4 - 1.7 (±0.10) mm for experimental group 1, 1.5 - 2 (±0.10) mm for experimental group 2, and 0.9 - 3.1 mm (±0.90) for experimental group 3. There was no significance when One-way ANOVA analysis/Tukey Honestly Significant Difference Test was conducted for statistical analysis among groups (P > 0.05). CONCLUSION: The suggested metal substructures can be used clinically as they meet the requirements that pontic must have.
Dental Porcelain ; Denture, Partial, Fixed* ; Gingiva ; Tooth Cervix

BACKGROUND/OBJECTIVES: This study evaluated whether a mobile health (mHealth) application can instigate healthy behavioral changes and improvements in metabolic disorders in individuals with metabolic abnormalities. SUBJECTS/METHODS: Participants were divided into an mHealth intervention group (IG), which used a mobile app for 24 weeks, and a conventional IG. All mobile apps featured activity monitors, with blood pressure and glucose monitors, and body-composition measuring devices. The two groups were compared after 24 weeks in terms of health-behavior practice rate and changes in the proportion of people with health risks, and health behaviors performed by the IG that contributed to reductions in more than one health risk factor were analyzed using multiple logistic regression. RESULTS: Preference for low-sodium diet, reading nutritional facts, having breakfast, and performing moderate physical activity significantly increased in the mHealth IG. Furthermore, the mHealth IG showed a significant increase of eight items in the mini-dietary assessment; particularly, the items “I eat at least two types of vegetables of various colors at every meal” and “I consume dairies, such as milk, yogurt, and cheese, every day.” The proportion of people with health risks, with the exception of fasting glucose, significantly decreased in the mHealth IG, while only the proportion of people with at-risk triglycerides and waist circumference of females significantly decreased in the control group. Finally, compared to those who did not show improvements of health risks, those who showed improvements of health risks in the mHealth IG had an odds ratio of 1.61 for moderate to vigorous physical activity, 1.65 for “I do not add more salt or soy sauce in my food,” and 1.77 for “I remove fat in my meat before eating.” CONCLUSIONS: The findings suggest that the additional use of a community-based mHealth service through a mobile application is effective for improving health behaviors and lowering metabolic risks in Koreans.
Blood Pressure ; Breakfast ; Cheese ; Delivery of Health Care ; Diet ; Diet, Sodium-Restricted ; Disease Management ; Fasting ; Female ; Glucose ; Health Behavior ; Humans ; Logistic Models ; Meat ; Milk ; Mobile Applications ; Motor Activity ; Odds Ratio ; Public Health ; Risk Factors ; Smartphone ; Soy Foods ; Telemedicine ; Triglycerides ; Vegetables ; Waist Circumference ; Yogurt

BACKGROUND: In this study, we aimed to investigate the relationship between echocardiographic epicardial fat thickness (EFT), neutrophil to lymphocyte ratio (NLR; an important inflammatory marker), and diurnal blood pressure (BP) changes in patients with recently diagnosed essential hypertension. METHODS: A total of 647 patients underwent echocardiography and 24 hours of ambulatory BP monitoring. EFT was measured by echocardiography, while NLR was measured by dividing the neutrophil count by the lymphocyte count. Patients were categorized into three groups according to BP pattern: the normotensive group, the dipper group, and the non-dipper group. RESULTS: The mean EFT was highest in the non-dipper group (non-dipper group, 7.3 ± 3.0 mm; dipper group, 6.1 ± 2.0 mm; control group, 5.6 ± 2.0 mm; p < 0.001). NLR was also highest in the non-dipper group (non-dipper, 2.75 ± 2.81; dipper, 2.01 ± 1.32; control, 1.92 ± 1.11; p < 0.001). EFT was significantly correlated with age (r = 0.160, p < 0.001) and NLR (r = 0.353, p < 0.001). Furthermore, an EFT ≥ 7.0 mm was associated with the non-dipper BP pattern with 51.3% sensitivity and 71.6% specificity [95% confidence interval (CI) = 0.56–0.65, p < 0.001]. In a multivariate analysis, EFT [adjusted odds ratio (OR) = 3.99, 95% CI = 1.22–13.10, p = 0.022] and NLR (OR = 1.34, 95% CI = 1.05–1.71, p = 0.018) were independent parameters that distinguished a non-dipper pattern after adjustment for cardiovascular risk factors. CONCLUSION: EFT and NLR are independently associated with impaired diurnal BP profiles in hypertensive individuals. EFT (as measured by echocardiography) and NLR appear to be helpful in stratifying cardiometabolic risk.
Blood Pressure ; Echocardiography ; Humans ; Hypertension ; Lymphocyte Count ; Lymphocytes* ; Multivariate Analysis ; Neutrophils* ; Odds Ratio ; Risk Factors ; Sensitivity and Specificity

OBJECTIVES: To evaluate the hypothesis that air pollution could increase emergency room visits for respiratory diseases, and if so, to quantify the strength of association between those. METHODS: We compiled daily records of hospital emergency room visits for respiratory diseases in Seoul, from November 1. 1995 to October 31. 1996, by using medical utilization data of unscheduled visits. In addition, air quality and weather data for the same period was collected. And a case-crossover design was applied by adopting conditional logistic regression analysis to determine the relationship between air pollutants and emergency room visits for respiratory diseases. In particular, the control periods were chosen by a bidirectional paired matching technique 7, 14, and 21days before and after the case periods. RESULTS: Only ozone was associated with the increased number of emergency room visits for respiratory diseases. The relative risk according to a 30ppb increase of ozone concentration (24hr mean, lagged 1day) was 1.91 (95% confidence interval = 1.78-2.05). CONCLUSION: There was a statistically significant association between the ambient ozone and daily emergency room visits for respiratory diseases.
Air Pollutants ; Air Pollution* ; Emergency Service, Hospital ; Logistic Models ; Ozone ; Seoul* ; Weather

As the number of elderly people increases, the incidence of stroke, especially the hemorrhagic stroke, is increasing. A large-scale survey of the entire country pertaining to the incidence and demographic characteristics of hemorrhagic stroke in elderly is necessary. Through information garnered from a basic survey and clinical study, we must design a treatment program to reduce the mortality of elderly people through elucidating the specific properties of stroke pathophysiology.
Aged* ; Humans ; Incidence* ; Mortality ; Stroke*

The authors report two cases of epidermoid cyst in the cerebellopontine angle which presented as trigeminal neuralgia. The tumors were surgically removed by suboccipital craniectomy. The cysts were densely adherent to multiple cranial nerves, including the trigeminal nerve, and the tumors occupied adjacent cisterns. After removal of the cystic content, it was sometimes difficult to differentiate the tumor capsule from the arachnoid membrane. In one patient, trigeminal neuralgia was resolved immediately after the operation, while for two weeks postoperatively, the other suffered severe headache and facial dysesthesia due to aseptic meningitis. To avoid surgical complications, it is resonable to leave a minute capsule attached to cranial nerves or blood vessels.
Arachnoid ; Blood Vessels ; Cerebellopontine Angle* ; Cranial Nerves ; Epidermal Cyst* ; Headache ; Humans ; Membranes ; Meningitis, Aseptic ; Paresthesia ; Trigeminal Nerve ; Trigeminal Neuralgia*

It is important to obtain a good exposure of the root exit zone(REZ) of the facial nerve during microvascular decompression(MVD) for hemifacial spasm(HFS). For this purpose, authors dissected cerebellar cortical artery in addition to exposing the proximal portion of lower cranial nerves. During MVD for HFS, surgeons frequently meet a cerebellar cortical artery along the inferolateral aspect of cerebellar hemisphere. It is usually hemispheric branch of anterior inferior cerebellar artery(AICA) or posterior inferior cerebellar artery(PICA). It is reason that authors have dissected the outside arachnoid membrane attached pia mater of cerebellar cortical artery with a arachnoid knife or microscissor but preserve the inside arachnoid membrane attached dura mater. Microsurgical retractor is placed inferolaterally between cerebellar cortical artery and cerebellar hemisphere and elevated from the floor of the posterior fossa. The subarachnoid cisterns over the lower cranial nerves are opened with sharp dissector and wide operative fields and good exposure of REZ of facial nerve is obtained.
Arachnoid ; Arteries* ; Cranial Nerves ; Dura Mater ; Facial Nerve ; Hemifacial Spasm* ; Membranes ; Microvascular Decompression Surgery* ; Pia Mater

BACKGROUND AND OBJECTIVES: Subclinical hypothyroidism is associated with endothelial dysfunction and impaired coronary flow reserve. However, the effect of subclinical hypothyroidism or thyroid autoimmunity on variant angina has yet to be determined. SUBJECTS AND METHODS: Among 385 consecutive patients without associated cardiovascular risk factors who underwent coronary angiography with the ergonovine provocation test (EPT), 165 had a positive EPT {EPT(+)} and 220 had a negative EPT {EPT(-)}. The relationship between coronary artery spasm and the presence of subclinical thyroid dysfunction as well as serum thyroid peroxidase autoantibody (TPO Ab) was evaluated. RESULTS: The proportion of patients with subclinical hypothyroidism among those who were EPT(+) was significantly higher than that in those who were EPT(-) (18% vs. 11%, p=0.001). However, there was no significant difference in the proportion of patients with subclinical hyperthyroidism between the groups. Moreover, EPT(+) patients showed significantly more positive TPO Ab (33% vs. 14%, p<0.001) than those with EPT(-). There was a positive correlation between EPT(+) and TPO positivity (r=0.226, p<0.001), subclinical hypothyroidism (r=0.112, p=0.033), and body mass index (r=0.123, p=0.018). Binary logistic regression analysis revealed that the significant predictors of EPT(+) were body mass index {adjusted odds ratio (OR)=1.042, 95% confidence interval (CI)=1.005-1.080}, presence of subclinical hypothyroidism (OR=3.047, 95% CI=1.083-8.572), TPO Ab titer (OR=1.028, 95% CI=1.015-1.041), and the presence of TPO Ab (OR=4.904, 95% CI=1.544-15.567). CONCLUSION: Subclinical hypothyroidism and the presence of TPO Ab are significantly associated with coronary vasospasm in patients without cardiovascular risk factors.
Autoimmunity* ; Body Mass Index ; Coronary Angiography ; Coronary Vasospasm* ; Coronary Vessels ; Ergonovine ; Humans ; Hyperthyroidism ; Hypothyroidism* ; Iodide Peroxidase ; Logistic Models ; Odds Ratio ; Risk Factors* ; Spasm ; Thyroid Gland*

Intraoperative monitoring has been a valuable part in the cerebral aneurysm surgery. Insight into the nervous system and the relationship of the aneurysm to the adjacent structure during the surgery provide critical information to the surgeon allowing reversal or avoidance of neural insults and the complete clipping of the aneurysm. The goal of cerebral aneurysm surgery is to eliminate the risk of hemorrhage but not disrupt the surrounding vascular and neural structures. Several techniques including microvascular doppler ultrasonography, monitoring cerebral blood flow, evoked potentials, intraoperative angiography, endoscope assisted aneurysm surgery and neuronavigator system are used for the surveillance in the aneurysm surgery. The abnormal findings in these procedures can change surgical management during the surgery such as removal or readjustment of temporary or permanent clips and a decrease in brain retraction or manipulation. The additional feedback provided by intraoperative monitoring promises to improve the safety and efficacy of aneurysm surgery.
Aneurysm ; Angiography ; Brain ; Endoscopes ; Evoked Potentials ; Hemorrhage ; Intracranial Aneurysm* ; Monitoring, Intraoperative ; Nervous System ; Ultrasonography, Doppler