Proximal humerus fractures are the third most common fractures, totaling 4% to 5% of all fractures. Here, we present the case of a 39-yearold man with a dislocated four-part fracture of the proximal humerus with a huge bony Bankart lesion. Preoperatively, the bony Bankart lesion of the glenoid was not visualized on computed tomography scans or magnetic resonance imaging because the fracture of the proximal humerus was comminuted, displaced, and complex. It was planned for only the humerus fracture to be treated by open reduction and internal fixation using a locking plate. However, a fractured fragment remained under the scapula after reduction of the dislocated humeral head. This was mistaken for a dislocated bone fragment of the greater tuberosity and repositioning was attempted. After failure, visual confirmation showed that the bone fragment was a piece of the glenoid. After reduction and fixation of this glenoid part with suture anchors, we acquired a well-reduced fluoroscopic image. Given this case of complex proximal humerus fracture, a glenoid fracture such as a bony Bankart lesion should be considered preoperatively and intraoperatively in such cases.

To date, numerous investigations have identified the role of exercise and physical activity in prevention and treatment of Type 2 diabetes and cardiovascular disease (CVD). This review paper analyzed epidemiological findings which investigated the effects of obesity, physical activity participation and the level of fitness levels on prevalence and risk factors of Type 2 diabetes and CVD. These studies showed that not only prevention of obesity, but also participation of physical activity and maintenance of good level of fitness are important to prevent and treat Type 2 diabetes and CVD. In addition, prevention of obesity and improvement of high fitness levels at early ages (childhood and adolescence) are important to prevent the prevalence and incidence of Type 2 diabetes and CVD.
Cardiovascular Diseases ; Incidence ; Insulin Resistance ; Korea ; Motor Activity ; Obesity ; Prevalence ; Risk Factors

This study aims to investigate the nutritional status of night eaters using the data from 2005 Korean National Health and Nutrition Examination Survey. A total of 3,903 subjects aged 20 and above were divided into 3 groups by using 24-hr recall data according to the night snack calorie intake: non-night snack, night snack less than 500 kcal and 500 kcal and more. Their data were analyzed to find out the difference on the socio-demographic, anthropometric, blood pressure, blood parameters and dietary characteristics. Among the subjects, non-night eaters were 66.0%, night eaters of less than 500 kcal were 28.4% and 500 kcal and above were 5.6%. Male adults, young-aged, higher educated, higher income earner, breakfast skipper and frequent dine-outer (3 times and more a day) were found more in the night eaters with 500 kcal and above. Night eaters above 500 kcal showed higher waist circumference, Glu-FBS, Glu-PP120 and also showed higher daily intake of fat and alcohol per 1,000 kcal and food groups of meat & eggs, beverages and alcohol drinks (p < 0.05), while they showed the lowest carbohydrate energy ratio of 58.3 +/- 13.7 among the three groups. These results suggest that habitual night snack intake above 500 kcal could lead to abdominal obesity and diabetes due to higher intake of meat, fat and alcohol.
Adult ; Aged ; Beverages ; Blood Pressure ; Breakfast ; Eggs ; Humans ; Male ; Meat ; Nutrition Surveys ; Nutritional Status ; Obesity, Abdominal ; Ovum ; Snacks ; Waist Circumference

The purpose of this study was to examine the relationship of dietary self-efficacy and illness beliefs, perceived benefits, and perceived barriers for the reduction of sodium intake in the elderly. A cross-sectional study was performed on 252 elderly people, aged 65 yrs and above, living in Daejeon Metropolitan city and Jecheon city, Chungbuk from March 21 to March 30, 2011. Dietary self-efficacy of three factors (resisting relapse, reducing salt and behavioral skills), perceived benefits and barriers, accurate and inaccurate illness beliefs were measured by 5 or 4 point Likert scale. With the increasing education level of the elderly, dietary self-efficacy, and accurate illness belief score increased and perceived barrier score decreased. Perceived benefits score was higher in the subject living alone compared to those living with siblings or spouses. Among three factors of dietary self-efficacy, reducing salt was scored highest and behavioral skills scored lowest in the elderly. Recording meal diary and reading labels for salt content in the items of behavioral skills showed lower score than other items. Accurate illness beliefs and perceived benefits were more scored than inaccurate illness beliefs and perceived barriers respectively in the subjects. The subjects with higher accurate illness beliefs, lower inaccurate illness beliefs, higher perceived benefits, and lower perceived barriers for the reduction of sodium intake showed higher dietary self-efficacy. In summary, accurate illness beliefs and perceived benefits positively correlated with dietary self-efficacy for the reduction of sodium intake in the elderly, whereas inaccurate illness beliefs and perceived barriers are negatively correlated.
Aged ; Cross-Sectional Studies ; Humans ; Meals ; Recurrence ; Siblings ; Sodium ; Spouses

The purpose of this study was to compare the mineral and vitamin intake according to the stage of change in fruit and vegetable intake. The subjects consisted of 256 students, 122 males and 134 females, who are fourth, fifth and sixth grade in an elementary school located in Yeongi-Gun, Chungnam province. The dietary intake was examined by 24 hr dietary recall for 1 day and by food record for 2 days from April 19 to May 01, 2007. Stage of change of intake of fruits and vegetables of the students was categorized into three groups: precontemplation, contemplation and preparation, and action. The subjects at the stage of action took kimchi and vegetables more frequently, and also took more vitamin C as well. But the subjects at other two stages did not show any difference in the intake of any food group and nutrients. Percentage of the male subjects who took less than EAR did not show any significant difference by stage of change in all the nutrients. However, there was gradual decrease in the percentage of female taking less than EAR of vitamin C and vitamin B2. The result concludes that vitamin C intake significantly increase gradually as the stages of behavioral change of fruit and vegetable intake proceed although almost all vitamins and minerals tended to increase.
Ascorbic Acid ; Ear ; Female ; Fruit ; Humans ; Male ; Minerals ; Riboflavin ; Vegetables ; Vitamins

This study investigates the change of level of psychosocial factors of decisional balance, processes of change, and self-efficacy after nutrition education on vegetable and fruit intake of children in pre-action stages. Forty-seven 5th grade elementary school children in Yeongi-Gun, Chungnam-Do were categorized into pre-action stages from a total of 71 children by four-stage questions, and then finally into two stages of precontemplation and contemplation & preparation. After 6 weeks nutrition education, recognition of both of pros and cons of vegetable intake were improved in the two groups of precontemplation and contemplation & preparation. In fruits intake, however, recognition of pros was not changed after nutrition education in either stage, but recognition of cons was improved only in the precontemplation stage. However, no difference in any psychosocial variables was found between precontemplation stage and contemplation & preparation stage. After the nutrition education, the score of consciousness raising of vegetable intake belonging to cognitive process of change increased in the subjects of the precontemplation stage, wheres the scores of dramatic relief, self-reevaluation, environment reevaluation and social liberation increased in the group of contemplation & preparation. In fruit intake, however, no change was found except in the environment reevaluation in the precontemplation group. The behavioral process of change of vegetable and fruit intake did not show any change in either group after nutrition education. Self-efficacy scores of vegetable intake of keeping the foods at hand, eating the recommended number of servings and making time to eat increased in the precontemplation group, while in the contemplation & preparation group, self efficacy scores of shopping for a variety of vegetables, instead of keeping the foods at hands, as well as the scores of the rest two items of eating the recommended number of servings and making time to eat increased after nutrition education. However, in case of fruits intake, no difference was shown in the precontemplation stage except an item of keeping the foods at hand. The results indicated that the stage of change was progressed in the pre-action stage after nutrition education and the scores of many psychosocial factors increased in both pre-action stages. It is suggested that the recognition of cons as well as the cognitive process of change and self-efficacy could be best used as indicators of the assessment of nutrition education program for vegetable intake.
Child ; Consciousness ; Eating ; Fruit ; Hand ; Humans ; Self Efficacy ; Vegetables

Many packages for a meta-analysis of genome-wide association studies (GWAS) have beendeveloped to discover genetic variants. Although variations across studies must be considered, there are not many currently-accessible packages that estimate between-study heterogeneity. Thus, we propose a python based application called Beta-Meta which can easilyprocess a meta-analysis by automatically selecting between a fixed effects and a randomeffects model based on heterogeneity. Beta-Meta implements flexible input data manipulation to allow multiple meta-analyses of different genotype-phenotype associations in asingle process. It provides a step-by-step meta-analysis of GWAS for each association inthe following order: heterogeneity test, two different calculations of an effect size and ap-value based on heterogeneity, and the Benjamini-Hochberg p-value adjustment. Thesemethods enable users to validate the results of individual studies with greater statisticalpower and better estimation precision. We elaborate on these and illustrate them with examples from several studies of infertility-related disorders.

OBJECTIVES: The objective of this study was to assess the relationship between systolic and diastolic blood pressure (SBP, DBP) and the risk of death from specific causes other than cardiovascular diseases. METHODS: We calculated the risk of specific death by SBP and DBP categories for 506 508 health examinees in 2002-2003 using hazard ratios (HRs) and 95% confidence intervals (CIs) in a Cox proportional hazards model. RESULTS: Compared to normal levels (SBP < 120 or DBP < 90 mmHg), stage I systolic and diastolic hypertension (SBP 140-159, DBP 85- 89 mmHg, respectively) were associated with an increased risk of death from diabetes mellitus, alcoholic liver disease, and renal failure (HR, 1.83; 95% CI, 1.51 to 2.22; HR, 1.24; 95% CI, 1.06 to 1.46; HR, 2.30; 95% CI, 1.64 to 3.21; HR, 1.67; 95% CI, 1.27 to 2.20; HR, 1.99; 95% CI, 1.41 to 2.81; HR, 1.31; 95% CI, 0.99 to 1.73, respectively), but a decreased risk of death from intestinal pneumonia (HR, 0.64; 95% CI, 0.42 to 0.98; HR, 0.59; 95% CI, 0.39 to 0.91). Only stage II systolic hypertension (SBP ≥160 mmHg) was associated with an increased risk of death from pneumonia, liver cirrhosis, and intestinal ischemia (HR, 1.54; 95% CI, 1.19 to 1.98; HR, 1.46; 95% CI, 1.00 to 2.15; HR, 3.77; 95% CI, 1.24 to 11.40, respectively), and stage I and II diastolic hypertension (SBP 140-159 and ≥160 mmHg) were associated with an increased risk of death from intestinal ischemia (HR, 3.07; 95% CI, 1.27 to 7.38; HR, 4.39; 95% CI, 1.62 to 11.88, respectively). CONCLUSIONS: An increase in blood pressure levels may alter the risk of death from certain causes other than cardiovascular diseases, a well-known outcome of hypertension, although the mechanism of these associations is not well documented.
Adult* ; Blood Pressure* ; Cardiovascular Diseases ; Cohort Studies* ; Diabetes Mellitus ; Humans ; Hypertension ; Ischemia ; Liver Cirrhosis ; Liver Diseases, Alcoholic ; Pneumonia ; Proportional Hazards Models ; Renal Insufficiency

Livedoid vasculopathy (LV) is a chronic coagulation disorder characterized by recurrent, painful ulcers on the lower extremities. Methylene tetrahydrofolate reductase (MTHFR) gene polymorphism is associated with coagulopathy. Therapeutic options usually include anti-inflammatory or immunosuppressive agents. However, the condition is still highly challenging to manage and no consensus over the first-line treatment for LV exists. Furthermore, when LV is accompanied with MTHFR gene polymorphism, clinical presentations could be more severe and resistant to treatment. We report a case of refractory LV accompanied by MTHFR gene polymorphism, which was successfully treated with hyperbaric oxygen therapy (HBOT). A 63-year-old female patient presented with multiple painful ulcers, atrophie blanches, and retiform purpura on both lower legs and feet. Histopathologic findings were compatible with LV. LV was diagnosed based on these clinicopathological findings. Following the diagnosis, we treated the patient with pentoxifylline, aspirin, systemic corticosteroid, antihistamine, and antibiotics. In spite of six-month treatment, the skin lesions did not improve; hence, HBOT was performed. It was performed at 2.0 absolute atmosphere for 120 minutes each time, three times a week. After 4 sessions, the ulcers began to heal and after 13 sessions, the skin lesions almost healed. During the eight-month followup period, the skin ulcers did not recur and the symptoms remained stable. Additionally, it was confirmed that she had MTHFR gene polymorphism after a genetic test. In conclusion, we wish to provide evidence regarding the effectiveness of HBOT and suggest that HBOT might be a considerable treatment option in refractory LV.

BACKGROUND: The purpose of the current study was to investigate the association between the level of obesity and physical fitness (PF) during adolescence and the risk factors of metabolic disorders during adulthood. METHODS: In the current analysis, 3,993 Korean adults (mean age, 38.70 +/- 1.69 years) were recruited. The level of body index (BI) and PF were examined during adolescence through high school record, and their health examination data, including systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting glucose (FG), total cholesterol (TC), and current body mass index (BMI) were obtained from National Health Insurance Corporation Data. Gender-specific analyses were administered to compare health exam data across the level of BI, the level of PF, and a mixed level of BI and PF. RESULTS: Most obese males during high school had statistically higher SBP, DBP, FG, and BMI in adulthood, and most obese females had higher BMI, as compared to most lean males or females. Least fit males during high school had statistically higher BMI in adulthood, and least fit females had statistically higher SBP, DBP, FG, TC, and BMI, as compared to most fit males or females. There was a significant relationship between the mixed level of BI and PF and SBP, DBP, TC and current BMI in both genders. CONCLUSION: Maintaining a healthy level of body weight and PF during adolescence is recommended to prevent the development of metabolic diseases in adulthood.
Adolescent ; Adult ; Blood Pressure ; Body Mass Index ; Body Weight ; Cholesterol ; Fasting ; Female ; Glucose ; Humans ; Male ; Metabolic Diseases ; National Health Programs ; Obesity ; Physical Fitness ; Risk Factors