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

For the assessment the effect of succinylcholine (SCh) on pipecuronium, 52 adult patients undergoing elective surgery under general anesthesia were subjected to this study in which the EMG response (twitch height of the hand to TOF stimulation with 2Hz) of ulnar nerve was monitored and recorded with Datex Relaxograph. According to the amount and mode of the drugs administered, the patients were divided into four experimental groups: 1) Group I: a bolus injection of pipecuronium in dose of 0.05 mg/kg. 2) Group II: pipecuronium 0.1 mg/kg, a double dose of group l. 3) Group IU: pipecuronium 0.05 mg/kg given when the depressed twitch height by SCh (1 mg/kg) recovered to 25%6 of initial twitch height. 4) Group IV: mixed injection of SCh (1 mg/kg) and pipecumnium (0.05 mg/kg). The results were as follows ; 1) Mean onset time of pipecuronium was 6.5+/-0.5 minutes in group I and 4.1+/-0.5 minutes in group II, the latter being significantly shorter than group I (p<0.01). In group Ill, it was 2.1+/-0.23 minutes being significantly shorter than group I, II (p<0.001). In group IV it was 1.1+/-0.1 minutes which was more significantly shorter than group I, II, and IU. 2) Mean action duration of pipecuronium was 50.9+/-6.7 minutes in group I and 141.9+/-15.4 minutes in group II, the latter being longer significantly (p<0.001). In group IIl, it was 53.9+/-5.2 minutes which was similar to group I, but it was 69.8+/-6.5 minutes in group IV, being significantly longer than those of group I and III (p<0.05). 3) Mean potency of pipecuronium expressed by the percentage change of initial twitch height was 7.6+/-1.9% in group I, but it was significantly decreased to 4.2+/-0.9% in group II (p<0.05). In group III, it was 0.2+/-0.1% being sinificantly decreased than group I, II (p<0.001). In group IV, it was 0.0+0.0% being more significantly decreased than other groups (p<0.001). 4) Presence of pipecuronium in group IV did not affect on the intensity of fasciculation induced by SCh. These results indicate that succinylcholine may potentiate the pipecuronium based on the findings that succinylcholine increased the potency and lengthened the duration of action of pipecuronium.
Adult ; Anesthesia, General ; Fasciculation ; Hand ; Humans ; Pipecuronium* ; Succinylcholine* ; Ulnar Nerve

BACKGROUND: Recurrent aphthous stomatitis (RAS) is usually the earliest sign of Behcet's disease. Hyperhomocysteinemia can damage endothelial cells and progress to obstructive vascular disease. It has been reported that hyperhomocysteinemia is a marker of activation in Behcet's disease. Enzyme 5,10-methylenetetrahydrofolate reductase may be one of the main factors that regulates plasma homocysteine levels. Homozygosity for the C677T (MTHFR C677T) mutation is associated with reduced activity of this enzyme and considered the most common genetic cause of elevated serum homocyteine levels. However its relationship to vascular injury in Behcet's disease remains controversial, and its relationship to RAS is unknown. Apolipoprotein E (Apo E) has both immunoregulatory and anti-infective features. Search for Apo E polymorphism and lipid composition in RAS patients might be a clue to pathogenesis of RAS. OBJECTIVE: To analyze the relationship of MTHFR gene C677T polymorphism, several epidemiologic factors such as age and sex, smoking, lipid composition and Apo E polymorphism to vasculitis in RAS, we assessed the MTHFR gene C677T polymorphism, Apo E polymorphism and lipid composition in RAS and normal population. METHODS: We analyzed data from the General Health survey conducted on 1,243 participants (M:F=281:962) over a 20 year-old in Incheon city. Medical interview and laboratory test for methylenetetrahydrofolate reductase (MTHFR) C677T gene polymorphism, apolipoprotein E polymorphism were completed. Statistical significance was analyzed by chi-square test and multistep logistic regression analysis. RESULTS: Among normal population over the age of twenty, a total of 34.2% (426/1,243) had RAS. Female predominance (4.5:1, p=0.003) was noted. The incidence of RAS in age group 20 to 39 year old is higher than the over 40 age group. The incidence is higher in smoking group compared to the nonsmoking group in multistepwise logistic regression analysis. Frequency of the MTHFR C677T genotypes was highest at CT compared to CC and TT homozygous genotype in normal and RAS patients group. There was no significant statistical differences in MTHFR genotypes in RAS patients compared to the control group. Similarly, Apo E genotype analysis revealed no significant statistical differences either. Apo E genotype and total cholesterol, HDL-cholesterol, triglyceride level didn't show any associations. CONCLUSION: This study revealed insignificant association between the MTHFR C677T mutation and RAS. Apo E genotype didn't show a significant statistical difference in RAS patients compared to normal controls.
Apolipoproteins ; Apolipoproteins E ; Cholesterol ; Endothelial Cells ; Epidemiologic Factors ; Female ; Genotype ; Health Surveys ; Homocysteine ; Humans ; Hyperhomocysteinemia ; Incidence ; Logistic Models ; Methylenetetrahydrofolate Reductase (NADPH2) ; Oxidoreductases ; Plasma ; Smoke ; Smoking ; Stomatitis, Aphthous ; Tetrahydrofolates ; Vascular Diseases ; Vascular System Injuries ; Vasculitis

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

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

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*

PURPOSE: A lymph node metastasis is one of most important prognostic factors of a malignancy. There is a growing interest in the role of the sentinel node (SN) in the detection of lymph node metastasis. However, the high false negative rate of a sentinel lymph node biopsy limits its utility. The aim of this study is to evaluate a micrometastasis of a gastric cancer to the histologically negative sentinel lymph nodes using the usual stains. METHODS: The SN in 44 out of 57 patients revealed no lymph node metastasis with usual hematoxylin and eosin (H&E) staining. Those nodes were embedded in paraffin and 4-micrometer-thick sections underwent, H&E staining, and cytokeratin immunohisto-chemical (IHC) staining between March 2002 and December 2002. RESULTS: Micrometastases were detected in 3 of the 44 patients without a SN metastasis. All micrometastases were detected in the patients who had metastases to the non-SN without a SN metastasis (3 of 5, 60%). Micrometastases to the SN were significantly frequent in those patients with a metastasis to the non-SN than those without a metastasis (P<0.001). From the detection of micrometastases, the sensitivity and false-negative rate of a sentinel lymph node biopsy ranged from 72.2% (13/18) to 88.9% (16/18), and from 12.8% (5/39) to 4.9% (2/41), respectively. CONCLUSION: 3 cases of micrometastasis of the SN without a metastasis were detected, and this increased the sensitivity and decreased the false negative rate of a SN biopsy. Micrometastases of the SNs were detected only in patients with a skip metastasis of the lymph nodes in this study.
Biopsy ; Coloring Agents ; Eosine Yellowish-(YS) ; Hematoxylin ; Humans ; Keratins ; Lymph Nodes* ; Neoplasm Metastasis ; Neoplasm Micrometastasis* ; Paraffin ; Sentinel Lymph Node Biopsy ; Stomach Neoplasms*