Purpose: Here we aimed to examine the association of breastfeeding (BF) with the metabolic syndrome (Mets) and its components among premenopausal parous Korean women. Methods: We conducted a cross-sectional study on 7,116 Korean women by using nationally representa tive data from the Korea National Health and Nutrition Examination Survey, between 2010 and 2016. Mul­tivariate logistic regression analysis was performed for examining the association of BF with Mets and its components. Results: A total 7,116 women were selected for this study. Mets was present in 12.9% of the study parti cipants. The prevalence of Mets in the BF group (12.38%) was lower than that of the non-BF group (14.69 %) (p<0.05). The prevalence of hypertension and hypertriglyceridemia was significantly higher in the non-BF group compared to that of the BF group. For each of Mets components, the total cholestrol level and systolic blood pressure were significantly higher in the non-BF group, compared to those of the BF group (p<0.05). The BF group was associated with a decreased risk of Mets (odds ratio [OR], 0.82; 95% confidence interval [CI], 0.68–0.99). and lower risks of hypo-high-density lipoprotein-cholesterolemia (OR, 0.78; 95% CI, 0.62–0.68), compared to those of the non-BF group. Conclusion BF is an important factor in reducing the risks of Mets. These results provide fundamental evidence for the establishment of policies for promoting BF.

Purpose: The importance of breastfeeding is well known. Socioeconomic status is one of the factors affecting breastfeeding. We investigated the association between breastfeeding and parental socioeconomic status to help design future breastfeeding promotion projects. Methods: Data on demographic characteristics and socioeconomic status of parents of 1,220 children aged under 60months were extracted from the 2013–2017 Korea National Health and Nutrition Examination Survey. Results: Some socioeconomic factors were associated with breastfeeding. Maternal factors such as education level (≥13 years: odds ratio [OR], 2.79; 95% confidence interval [CI], 1.21–6.42), middle high income level (OR, 2.30; 95% CI, 1.18–4.49), no smoking status (OR, 3.07; 95% CI, 1.28–7.36) and body mass index (BMI) (<25 kg/m2 : OR, 1.82; 95%CI, 1.12–2.95) were associated with breastfeeding (p<0.05). In addition, paternal factors such as age (30s: OR, 4.88; 95%CI, 1.82–13.04) and education level (≥13 years: OR, 7.94; 95% CI, 3.12–20.18) were associated with breastfeeding (p<0.05). After controlling for confounding factors, mother’s BMI, father’s age, and father’s educational level were found to be statistically significant predictors of breastfeeding. Conclusion This study demonstrated that some parental socioeconomic factors were associated with breastfeeding in Korea.

An important, albeit rare, cause of fetal bradycardia is long QT syndrome (LQTS). Congenital LQTS is an ion channelopathy caused by mutations in genes encoding cardiac ion channel proteins. Fetal onset of LQTS imposes high risk of life-threatening tachyarrhythmias and sudden cardiac death. Here, we report the case of a female newborn with fetal onset of bradycardia and a 2:1 atrioventricular (AV) block. After birth, a 12-lead electrocardiogram (ECG) revealed bradycardia with QT prolongation of a corrected QT (QTc) interval of 680 ms and pseudo 2:1 AV block. Genetic testing identified a heterozygous Gly402Ser (c.1204G>A) mutation in CACNA1C, confirming the diagnosis of LQTS type 8 (LQT8). The patient received propranolol at a daily dose of 2 mg/kg. Mexiletine was subsequently administered owing to the sustained prolongation of the QT interval and pseudo 2:1 AV block. One week after mexiletine inception, the ECG still showed QT interval prolongation (QTc, 632 ms), but no AV block was observed. There were no life-threatening tachyarrhythmias in a follow-up period of 13 months.

An important, albeit rare, cause of fetal bradycardia is long QT syndrome (LQTS). Congenital LQTS is an ion channelopathy caused by mutations in genes encoding cardiac ion channel proteins. Fetal onset of LQTS imposes high risk of life-threatening tachyarrhythmias and sudden cardiac death. Here, we report the case of a female newborn with fetal onset of bradycardia and a 2:1 atrioventricular (AV) block. After birth, a 12-lead electrocardiogram (ECG) revealed bradycardia with QT prolongation of a corrected QT (QTc) interval of 680 ms and pseudo 2:1 AV block. Genetic testing identified a heterozygous Gly402Ser (c.1204G>A) mutation in CACNA1C, confirming the diagnosis of LQTS type 8 (LQT8). The patient received propranolol at a daily dose of 2 mg/kg. Mexiletine was subsequently administered owing to the sustained prolongation of the QT interval and pseudo 2:1 AV block. One week after mexiletine inception, the ECG still showed QT interval prolongation (QTc, 632 ms), but no AV block was observed. There were no life-threatening tachyarrhythmias in a follow-up period of 13 months.

Most reported cases of hypermagnesemia are related to laxative abuse and impaired renal function, while hypermagnesemia is uncommon without iatrogenic magnesium administration and decreased renal function. Magnesium-containing bowel-cleansing agents are widely used before colonoscopy, usually without complications. However, we experienced a case of symptomatic hypermagnesemia with normal renal function after using a bowel-cleansing agent. A 74-year-old man with normal renal function complained of lethargy and motor weakness after taking a bowel-cleansing agent containing 14 grams of magnesium before a colonoscopy for hematochezia. His magnesium level was 12 mg/dL. Fluid stasis in the gut due to colonic obstruction might have caused the hypermagnesemia. He was treated successfully with a bowel enema and intravenous calcium. We should be cautious when prescribing drugs for colonoscopy if colonic obstruction is suspected.
Aged ; Calcium ; Cathartics ; Colon* ; Colonoscopy ; Detergents* ; Enema ; Gastrointestinal Hemorrhage ; Humans ; Kidney* ; Lethargy ; Magnesium

Ectopic varices are rare among patients with portal hypertension, especially in the ascending colon. It is difficult to evaluate massive lower gastrointestinal bleeding in patients with liver cirrhosis by colonoscopy due to hemodynamic instability and poor bowel preparation. In Korea, there has only been one case report about ascending colon variceal bleeding, in which hemostasis was performed by venous coil embolization. We report another rare case of ascending colon variceal bleeding in a patient with alcoholic cirrhosis, who was successfully treated via two sessions of N-butyl-2-cyanoacrylate injection through colonoscopy. This case suggests that the careful endoscopic approach and hemostasis with glue injection might be an option for treating massive bleeding in the lower gastrointestinal varix.
Adhesives ; Colon, Ascending* ; Colonoscopy ; Cyanoacrylates ; Embolization, Therapeutic ; Enbucrilate* ; Esophageal and Gastric Varices* ; Hemodynamics ; Hemorrhage ; Hemostasis ; Humans ; Hypertension, Portal ; Korea ; Liver Cirrhosis ; Liver Cirrhosis, Alcoholic ; Varicose Veins

Phlebosclerotic colitis is a rare form of intestinal ischemia. It is caused by calcified peripheral mesenteric veins and a thickened colonic wall. These characteristic findings can be identified on CT and colonoscopy. A 37-year-old female with a history of long-term herbal medicine use presented with acute lower abdominal pain and vomiting of sudden onset. Colonoscopic findings showed dark-blue discolored edematous mucosa and multiple ulcers from the ascending colon to the sigmoid colon. Abdominal CT findings showed diffuse thickening of the colonic wall and calcifications of the peripheral mesenteric veins from the ascending colon to the sigmoid colon. Based on these findings, the patient was diagnosed with phlebosclerotic colitis. We report this rare case of phlebosclerotic colitis in a healthy young female patient with a history of long-term herbal medicine use and include a review of the relevant literature.

An 88-year-old woman complained of right quadrant abdominal pain and severe edema in both legs. She had a history of pulmonary embolism one month ago. Abdomen CT showed a huge hepatic cyst compressing the intrahepatic portion of the inferior vena cava (IVC). The venogram CT showed multifocal thrombosis in the iliocaval and both lower extremity veins. Percutaneous hepatic cyst drainage was carried out. Fluid analysis presented leukocytosis, which suggested an infected hepatic cyst. To prevent secondary pulmonary thromboembolism, an IVC filter was inserted before catheter drainage for the hepatic cyst. One week later, abdominal pain was relieved. Then, sclerotherapy for the remnant hepatic cyst was performed by ethanol. Follow-up CT showed an increased amount of thrombosis in the iliocaval and left calf vein, but the IVC filter prevented another thromboembolic event successfully. The patient started dabigatran, a new oral anticoagulant, and compression stockings were applied to both legs. After one month, no visible thrombosis in the pelvis or either extremity was detected in abdominal CT. This case suggests that a huge hepatic cyst, especially with infection, should be considered as a possible cause of deep vein thrombosis if no other risk factors for thromboembolism exist.
Abdomen ; Abdominal Pain ; Aged, 80 and over ; Catheters ; Dabigatran ; Drainage* ; Edema ; Ethanol ; Extremities ; Female ; Follow-Up Studies ; Humans ; Leg ; Leukocytosis ; Liver ; Lower Extremity ; Pelvis ; Pulmonary Embolism ; Risk Factors ; Sclerotherapy ; Stockings, Compression ; Thromboembolism ; Thrombosis ; Tomography, X-Ray Computed ; Veins ; Vena Cava Filters* ; Vena Cava, Inferior* ; Venous Thrombosis*

OBJECTIVES: The purpose of this study is to examine the state of demographic findings with clinical characteristics, cognitive impairment and behavioral psychological symptoms of demented elderly in Busan-Gyeongnam Province. METHODS: Patients with dementia who were registered at nine medical centers in Busan Metropolitan City and Gyeongnam Province were the major subjects of this study. Data was collected by face-to-face interview. The final sample consisted of 144 cases after eliminating several incomplete questionnaires. Based on the collected data, the authors evaluated demographic findings, clinical characteristics, and cognitive impairment and behavioral psychological symptoms of the patients with dementia using statistical analyses. All of the patients were taken the Korean version of Mini-Mental State Examination(K-MMSE), the Clinical Dementia Rating Scale(CDR) and the the Korean version of Neuropsychiatric Inventory(K-NPI). RESULTS: Approximately 61% of the patients with dementia in Busan-Gyeongnam Province were women, and their mean age was 72.9(SD=8.3) years old. Their average education level was 2.3(SD=1.3) years. Among the demented elderly, Alzheimer's disease accounted for 68% compared with vascular dementia(32%) and the proportion of mild stage of dementia was above 50%. The mean K-MMSE score was 16.7(SD=6.2), the mean CDR score was 1.3(SD=0.8), and the Barthel Index with K-IADL score were 16.7(SD=5.4) and 1.5(SD=0.9). The average score of K-NPI was 22.6(SD=22.5) and the number of manifested K-NPI was 4.9(SD=2.8). The K-NPI score has increased in demented elderly as the severity of dementia getting worse according to the CDR score. The number of manifested K-NPI was significantly more prevalent in patients with AD than that of patients with VD. CONCLUSION: This study is a meaningful approach to the state of demographic findings, clinical characteristics, cognitive impairment and behavioral psychological symptoms associated with the dementied elderly who were comprehensively examined in Busan-Gyeongnam Province. Based on this study, we found that the demographic information was comparable with other epidemiologic study in Korea and our study patients were relatively mild stage of demenitia according to the assessment of cognition and behavioral symptom scales.
Aged* ; Alzheimer Disease ; Behavioral Symptoms ; Busan ; Cognition ; Dementia ; Dementia, Vascular ; Education ; Female ; Humans ; Korea ; Surveys and Questionnaires ; Weights and Measures

BACKGROUND: The differences in clinical features are important when differentiating between Alzheimer's disease (AD) and vascular dementia (VD). There have been many studies comparing the severity of progression in both diseases. They have assessed individual symptoms but have not explained the differences and global change of progression comprehensively. We have evaluated the cognitive and non-cognitive functions at the same time and evaluated the differences between AD and VD. METHODS: One hundred and thirty-eight dementia patients from Busan?Gyeongnam Dementia Association outpatient clinics were analyzed. All of the patients underwent the Korean version of the Mini-Mental State Examination (K-MMSE), the expanded version of the Korean Clinical Dementia Rating Scale (CDR), the Korean version of the Neuropsychiatric Inventory (K-NPI), the scales for activity of daily living, and the Short form of the Samsung Dementia Questionnaire (S-SDQ). RESULTS: There were 93 patients with AD and 45 with VD. VD patients revealed more severe Barthel Index of Activity of Daily Living (B-ADL) deficits. AD patients had more severe memory and orientation deficiency in CDR 1 and CDR 2. VD patients revealed much faster decline of K-MMSE score between CDR 2 and CDR 3. CONCLUSIONS: These results suggest that VD patients display more severe B-ADL difficulty, while AD patients display more severe memory difficulty and disorientation. B-ADL progresses in the earlier stages in VD and in the later stages in AD. Global cognitive dysfunction progression is the opposite: in the earlier stages in AD and in the later stages in VD.
Alzheimer Disease* ; Ambulatory Care Facilities ; Dementia ; Dementia, Vascular* ; Humans ; Memory ; Surveys and Questionnaires ; Weights and Measures