No abstract available.
Humans ; Infant*

BACKGROUND: The regional fat distribution is known to be related with some cardiovasular risk factors independently to total body fat amount. Regional fat distribution pattern can be assessed by waist to-hip ratio(WHR). WHR distribution patterns depend on age, sex, race and show regional difference. But, our own unique data are inadequate, so we tried to investigate distribution patterns, cut off points and related factors of WHR in middle aged men and women among Korean. METHODS: The study population were middle aged men and women above 40 years old who visited our hospital for routine check up from April to July, 1996. We measured height, weight, blood pressure, waist circumference, hip circumference, fasting blood sugar and total cholesterol in 1,000 persons. We gathered data about diet habits, exercise, smoking and drinking status by standard questionnaire. We analized above data by using SAS for Window 6.10. RESULTS: The study population numbers of men and women were 494 and 499, and average ages of men and women were 49.3 and 50.5 years respectively. For men, the average WHRs as a whole were 0.895, and 0.893, 0.893 and 0.911 in their forties, fifties and above sixties respectively. For women, the average WHRs as a whole were 0.827, and 0.816, 0.837 and 0.850 in their forties, fifties and above sixties respectively. The percentage above WHR 1.0, 0.95, and 0.90 in men were 2.4%, 11.7% and 46% and the percentage above WHR 0.90, 0.85, and 0.80 in women were 8.2%, 32.9% and 68.7%. Adjusting by age, body mass index, WHR was significantly correlated with weight, systolic blood pressure, diastolic blood pressure in men only. For men, WHR was associated with alcohol drinking positively and with exercise negatively. For women, WHR was associated with alcohol drinking and smoking status positively. CONCLUSIONS: The WHR had a tendency to increase according to age. The 90th percentile points in men and women were 0.957 and 0.894 respectively. WHR was related with several cardiovascular risk factors and several life styles.
Adipose Tissue ; Adult ; Alcohol Drinking ; Blood Glucose ; Blood Pressure ; Body Mass Index ; Cholesterol ; Continental Population Groups ; Drinking ; Fasting ; Female ; Food Habits ; Hip ; Humans ; Life Style ; Male ; Middle Aged* ; Risk Factors ; Smoke ; Smoking ; Waist Circumference ; Waist-Hip Ratio* ; Surveys and Questionnaires

BACKGROUND/AIMS: Hepatitis C virus(HCV) was known to most common etiologic agent of chronic liver disease in United states and Japan. Although hepatitis B virus(HBV) was well known to be a its major etiologic agent in Korea, it has been showed that HCV and HBV are associated with liver cirrhosis and hepatocellular carcinoma as major causative agent of chronic liver disease. Interferon alpha therapy is generally accepted as effective single agent for chronic hepatitis or to decrease the chronicity of acute hepatitis C. So, we evaluated the efficacy of interferon alpha in hepatitis C. METHODS: 46 patients who were positive for anti-HCV antibody and HCV RNA were included in this study. Liver biopsy was per formed on all patients and all of them were tested as negative for serum HBsAg, anti Hbe. Patients were divided into 2 groups . 30 patients received interferon therapy(treated group) and 16 patients received no therapy(untreated group). We compared the change of liver function test and HCV RNA before and after therapy between two groups. Treated group was subdivided into 5 groups according to response to interferon therapy '. Non-response, partial response, breakthrough, relapse and sustained response. RESULTS: 1) The mean age and sex distribution were 49.9 year old, male 19, female 11 in treated group and 48.7 years, male 12, female 4 in untreated group. 2) The number of patients with acute hepatitis, chronic persistent hepatitis, chronic active hepatitis and liver cirrhosis were 1, 2, 23, 4 in treated group and 0, 1, 12, 3 in untreated group, respectively. 3) The mean follow up period was 1.7 year and 2.3 years in treated and untreated group, respectively. 4) The activity of serum ALT before and after therapy were 195+ 134.6 IU/L, 87.4+ 40.5 IU/L and 186.7+ 106.4 IU/L, 157+ 87.1 IU/L in treated and untreated group, respectively. Serum ALT after therapy in treated group was significantly lower than untreated group(P<0.01). 5) The number of patients for patterns of reponse in treated group was non-response 5, partial response 8, breakthrough 1, relapse 4, sustained response 12 and there was no difference in age among them(P>0.05). 6) The case of negative conversion for HCV RNA in treated group was 12, but there was no case in untreated group. 7) Sex distribution of sustained response was 6(31% ) of 19 male, 6(54.5%) of 11 female and 12 patients(40.0%)(1 of 1 patients with acute hepatitis, 1 of 2 chronic persistent hepatitis, 10 of 23 chronic active heaptitis) included in sustained reponse, but any patients with liver cirrhosis had response. 8) Mean total dose and duration of interferon therapy was non-response 10353.6 million unit(MU)/5.8month(M), partial response 20025.06MU/6.4 M, breakthrough 36000.0MU/5.0M, relapse 11700.0MU/3.3M, sustained response 28100.0MU/6.6M, respectively. 9) 3 of 7 patients who were followed up over 1 year in sustained response and mean time to the relapse was 2.2 years. CONCLUSION: Our results showed that interferon alpha therapy is effective in patients with hepatitis C and further study and attempts should be performed to augument the efficacy of interferon alpha for the treatment of hepatitis C.
Biopsy ; Carcinoma, Hepatocellular ; Female ; Follow-Up Studies ; Hepatitis B ; Hepatitis B Surface Antigens ; Hepatitis C* ; Hepatitis* ; Hepatitis, Chronic ; Humans ; Interferon-alpha* ; Interferons* ; Japan ; Korea ; Liver ; Liver Cirrhosis ; Liver Diseases ; Liver Function Tests ; Male ; Recurrence ; RNA ; Sex Distribution ; United States

Despite the continually improving results of total knee arthroplasty, infection remains the most debilitating complication. The treatments of infected total knee arthroplasty were variable, but initially we removed infected implants and inserted antibiotic containing cemented spacer. Postoperatively, patients were mobilized in a 30 knee flexion state and treated with parenteral antibiotics. After control of infection was clinically and radiologically determined, we inserted PCL substitute total knee prosthesis. Five days postoperatively, patient began touch down standing exercise. We observed two cases in whom infected total knee arthroplasty had been salvaged successfully with two-stage implantation using cement spacers containing antibiotics.
Anti-Bacterial Agents* ; Arthroplasty* ; Humans ; Knee Prosthesis ; Knee* ; Replantation*

Despite continually improving results of total hip arthroplasty, infection remains the major debilitating complication. The treatments of infected total hip arthroplasty were variable. but initially we removed infected implants and inserted antibiotic containing cemented spacer so called PRSTALAC to prevent scar contracture and disuse osteoporosis. After 6 weeks later, control of infection was clinically and radiologically determined, we inserted new prosthesis with cement. Three weeks postoperatively, patient began touch down standing exercise. We observed infected total hip patient in whom hip had been salvaged successfuily with twostage implantation using so called "" PROSTALAC "" which was made with Moore stem.
Arthroplasty, Replacement, Hip* ; Cicatrix ; Contracture ; Hip ; Humans ; Osteoporosis ; Prostheses and Implants ; Replantation*

The discovery and synthesis of vitamin D and the elucidation of the role of sunlight in the activation of the vitamin D precursors changed the syndromes of rickets from a therapeutic enigma to a socioeconomic and public health problem. Since Albright in 1937 first described vitamin D resistsnt rickets, which did not respond to treatment with the usual dose of vitamin D, it has progressively become a common form of rickets in practice. In addition, as the result of increasing understanding of renal physiology and careful investigation, a spectrum of renal tubular abnormalities have been identified which cause clinical rickets and which in many cases are insensitive to even large doses of vitamin D. We have reported a case of an unusual form of vitamin D resistant rickets which did not easily respond to treatment with high doses of vitamin D and was associated with hypocalcemia in multiple pathologic fractures in the lower extremities of the patient.
Familial Hypophosphatemic Rickets ; Fractures, Spontaneous ; Humans ; Hypocalcemia ; Lower Extremity ; Physiology ; Public Health ; Rickets ; Sunlight ; Vitamin D ; Vitamins

No abstract available.
Cardiopulmonary Bypass*

OBJECTIVES: The aim of this study was to evaluate the differences in patients with positional dependent sleep apnea according to their non-supine apnea-hypopnea index (AHI, > or =5 vs. <5). METHODS: 92 patients with positional sleep apnea were evaluated. The patients were divided into two groups : group I was non-supine AHI having > or =5 ; group II was non-supine AHI having less than 5. Statistical analysis was performed to find the difference between two groups. RESULTS: In 92 patients, the number of group I patients was 11 (12%) and the number of group II patients was 81 (88%). In the severe AHI group, percentage of group I was dominated (70%) and showing a significant difference compared with the mild and moderate AHI groups (p<.05). In the severe body mass index (BMI) group, percentage of group I was dominated (54.5%) and showing a significant difference compared with of the mild and moderate BMI groups (p<.05). The percentage of group I was significantly higher than group II (p<.05) in the AHI, supine AHI, non-supine AHI and snore time. CONCLUSIONS: In patients with positional sleep apnea, severe OSA and high BMI are more common in patients with non-supine AHI> or =5 than non-supine AHI<5.
Body Mass Index ; Humans ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive

Fracture of the femoral neck occurred after internal fixation of intertrochanteric fracture of the femur is very rare and have been described previously in terms of stress fracture, stress-riser fracture, Youngs modulus fracture or iatrogenic fracture in the literature. This fracture documented about 20 cases in the English literature and usually occurred in elderly patients with osteoporosis and it always occur in the subcapital region. We report a case of subcapital stress fracture of the femur occurred after internal fixation with compression hip screw of intertrochanteric femur fracture.
Aged ; Elastic Modulus ; Femur Neck ; Femur* ; Fractures, Stress* ; Hip ; Humans ; Osteoporosis

BACKGROUND: We conducted this study to describe the epidemiology of community-acquired bacteremia and identify its prognostic factors. MATERIALS AND METHODS: All patients admitted to a community-based tertiary hospital with community-acquired bacteremia from June 2002 to May 2004 were included and analyzed retrospectively. RESULTS: During the study period, clinically significant community-acquired bacteremia occurred in 223 patients with the frequency of 5.3 patients per 1,000 patient-admission. The commonly isolated organisms were E. coli (47.1%), K. pneumoniae (13.0%), S. aureus (8.1%), and S. pneumoniae (4.5 %). The leading source of bacteremia were urinary tract infection (34.5%), intraabdominal infection (33.6%), primary bacteremia (10.3%), and skin & soft tissue infection (8.1%). The overall mortality was 17%. S. aureus (34.8%) and K. pneumoniae (30.4%) were two major organisms of primary bacteremia with high case fatality of 50% and 28.6%, respectively. Univariate analysis showed that the followings were associated with significant increase in mortality: male patient; S. aureus and other streptococci bacteremia; increasing APACHE II score; definite diagnosis after 3 days of admission; inappropriate antibiotics therapy within 24 hours of admission; emergency room; admission to ICU. The independent predictors of mortality were male patient (RR 3.02, P=0.031), increasing APACHE II score (RR 1.12, P=0.011), and admission to ICU (RR 9.73, P<0.001). CONCLUSION: Rapid definite diagnosis and prompt administration of appropriate antibiotics according to the local epidemiologic pattern are the most important controllable factors for the better outcome.
Anti-Bacterial Agents ; APACHE ; Bacteremia* ; Diagnosis ; Emergency Service, Hospital ; Epidemiology ; Humans ; Intraabdominal Infections ; Male ; Mortality ; Pneumonia ; Prognosis ; Retrospective Studies ; Skin ; Soft Tissue Infections ; Tertiary Care Centers* ; Urinary Tract Infections