Background/Aims: Effect of proton pump inhibitor (PPI) use on the risk of hipfracture is controversial. This study aimed to clarify the association between PPIuse and hip fracture risk using a large cohort. Methods: This study recruited participants from the nationwide cohort (n =1,025,340). After exclusion of participants who had hip fractures or were aged less than 40 years during the baseline period (2002 to 2004), 371,806 participants were followed to 2013. Participants prescribed PPIs for more than 90 days during baseline period were defined as users. Fracture cases were defined when participants were hospitalized with claims of a hip fracture. Results During 4,159,343 person-years of follow-up, fractures developed more oftenin PPI users than in nonusers (relative risk [RR], 1.787; 95% confidence interval [CI], 1.260 to 2.534; p = 0.002). The results persisted after adjusting for age, sex, andmany drugs relevant to osteoporosis or influential in bone health. Furthermore,fracture risk associated with PPI use increased with duration of use ( p trend < 0.001). The fully adjusted RRs of hip fracture development were 1.350 (95% CI, 1.203 to 1.515) for 1- to 90-day users, 1.487 (95% CI, 0.957 to 2.311) for 91- to 180-day users, and 1.771 (95% CI, 0.931 to 3.368) for > 180-day users. The positive association between PPI use and fracture was also confirmed in a subgroup with health screening data where further adjustment for body mass index, smoking status, alcohol consumption, and physical activity was available (adjusted RR, 2.025; 95% CI, 1.151 to 3.564, p = 0.014). Conclusions: PPI use is associated with hip fracture development.

OBJECTIVES: There is a great deal of interest in the possibility that environmental factors may influence the risk of developing allergic rhinitis (AR) in early life. We investigated the simultaneous effects of mode of delivery and duration of breastfeeding on the development of AR in children. METHODS: Data from 1,374 children participating in the Allergic Rhinitis Cohort Study for kids (ARCO-kids study) was analyzed. All subjects were divided into AR or non-allergic rhinitis (NAR) groups. Data on environmental factors, mode of delivery and duration of breastfeeding were collected using a questionnaire. RESULTS: Compared with short-term breastfeeding (<6 months), long-term breastfeeding (≥12 months) was significantly associated with a lower prevalence of AR (adjusted odds ratio [aOR], 0.54; 95% confidence interval [CI], 0.34 to 0.88). Children in the AR group also had a higher cesarean delivery rate than those in the NAR group (39.1% vs. 32.8%, P=0.05). Regarding the combined effects of mode of delivery and duration of breastfeeding, long-term breastfeeding with a vaginal delivery strongly suppressed the development of AR, compared to short-term breastfeeding with a cesarean delivery (aOR, 0.47; 95% CI, 0.30 to 0.73). CONCLUSION: Long-term breastfeeding (≥12 months) and a vaginal delivery are associated with a lower risk of developing childhood AR.
Breast Feeding ; Cesarean Section ; Child ; Cohort Studies ; Delivery, Obstetric ; Female ; Humans ; Odds Ratio ; Pregnancy ; Prevalence ; Rhinitis ; Rhinitis, Allergic

The purpose of the study was to assess the effects of a 12 weeks aged garlic extract (AGE) regimen with regular exercise on cardiovascular disease (CVD) risk in postmenopausal women. A total of 30 postmenopausal women (54.4 +/- 5.4 years) were randomly divided into the following four groups: Placebo (Placebo; n = 6), AGE intake (AGEI; n = 8), exercise and placebo (Ex + Placebo; n = 8), exercise and AGE (Ex + AGE; n = 8) groups. The AGE group consume 80 mg per day, and exercise groups performed moderate exercise (aerobic and resistance) three times per week. After 12 weeks of treatment, body composition, lipid profile, and CVD risk factors were analyzed. Body weight was significantly decreased in AGEI, Ex + Placebo, and Ex + AGE groups compared to baseline. Body fat % was significantly decreased in the AGEI and Ex + Placebo groups. Body mass index (BMI) was significantly decreased in the AGEI, Ex + Placebo, and Ex + AGE groups. Fat-free mass was significantly decreased in the AGEI group. Total cholesterol (TC) was significantly lower in the Ex + Placebo compared to the Placebo group. AGE supplementation or exercise effectively reduced low-density lipoprotein (LDL-C). Triglyceride (TG) was significantly increased in the AGEI group. Malondialdehyde (MDA) levels were significantly decreased in the AGEI, Ex + Placebo, and Ex + AGE compared to the placebo group. AGE supplementation reduced homocysteine levels regardless of whether the women also exercised. The present results suggest that AGE supplementation reduces cardiovascular risk factors independently of exercise in postmenopausal women.
Adipose Tissue ; Aged ; Body Composition ; Body Mass Index ; Body Weight ; Cardiovascular Diseases ; Cholesterol ; Female ; Garlic ; Homocysteine ; Humans ; Lipoproteins ; Malondialdehyde ; Risk Factors

BACKGROUND AND OBJECTIVES: Fibrous dysplasia of the paranasal sinus is rare. It is usually secondary to the extension of disease from adjacent bones and rarely limited to the sinuses. The purpose of this study is to get an improved appreciation of the clinical features and courses of fibrous dysplasia involving paranasal sinuses. SUBJECTS AND METHOD: Medical records of 15 patients diagnosed as fibrous dysplasia involving paranasal sinuses from 1990 to 2004 were reviewed retrospectively. Clinical informations including age of diagnosis, presenting symptoms, radiographic findings, treatment and clinical outcome for each patient were analyzed. The male to female ratio was 7 : 8. Their ages ranged from 7 to 68 with the median of 32. Seven patients were younger than 30 years old at presentation. RESULTS: The most common complaint was headache followed by facial swelling. The mean duration of illness was 11 months. In the findings of CT, eight patients belonged to the sclerotic type, six to the pagetoid type, and one the tocystic type. Eight patients were polyostotic while the others were monostotic. The most commonly involved sinus was the sphenoid sinus followed by ethmoid sinus. Seven patients who had facial swelling, exophthalmos or nasal obstruction underwent surgery, and in four of them, the lesion was in progression or recurred. Lesions in eight patients who were older than 30 years old and had no symptoms except headache did not progress thereafter. CONCLUSION: The progression of fibrous dysplasia stops when the bony growth is completed. Thus, if the patients are diagnosed with fibrous dysplasia over the age of 30 and do not have specific symptoms, there may be no need for surgical treatment.
Adult ; Diagnosis ; Ethmoid Sinus ; Exophthalmos ; Female ; Headache ; Humans ; Male ; Medical Records ; Nasal Obstruction ; Paranasal Sinuses* ; Retrospective Studies ; Sphenoid Sinus

BACKGROUND: Adiponectin, an adipocyte-secreted protein, is known to have anti-atherogenic, anti-inflammatory and anti-diabetic properties. Adiponectin levels are decreased in obesity, type 2 diabetes, and coronary artery disease. Several studies have been performed aiming to investigate the association of genetic variations in the adiponectin with obesity, insulin resistance, and type 2 diabetes but few studies were performed in association with coronary artery disease. Therefore we examined the association between two single nucleotide polymorphisms (SNPs) (+45T>G and +276G>T) of the adiponectin gene and coronary artery diseases (CAD). METHODS: One hundred fifty six subjects were enrolled in which coronary angiograms were performed due to chest pain in Kangbuk Samsung Hospital from April to August, 2003 (97 males, 59 females, mean age 57.40+/-11.15 yrs). Body mass index, fasting blood glucose, lipid profiles were measured in every subject. Single nucleotide polymorphisms (SNPs) in the adiponectin gene were determined by Taqman polymerase chain reaction (PCR) method. The presence of CAD was defined as a >50% reduction of coronary artery diameter. RESULTS: Among 156 subjects, the allele frequencies were 0.683 for G allele and 0.317 for T allele in SNP +276G>T and 0.705 for T allele and 0.295 for G allele in SNP +45T>G. Both genotypes were in compliance with Hardy-Weinberg equlibrium. Mean serum fasting glucose level was significantly higher and mean high-density lipoprotein cholesterol (HDL-C) level was lower in CAD groups (p=0.015, p=0.004). No association with the presence of CAD was observed for adiponectin gene SNP276 and SNP45 (p=0.954, p=0.843). Also, no significant association was observed between the severity of CAD and either SNPs (p=0.571, p=0.955). CONCLUSIONS: Our study showed that SNP +276G>T and +45T>G in adiponectin gene were not associated with the presence of CAD. Further studies will be necessary to confirm the role of SNP 276G>T and 45T>G in the development of CAD.
Adiponectin* ; Alleles ; Blood Glucose ; Body Mass Index ; Chest Pain ; Cholesterol ; Compliance ; Coronary Artery Disease* ; Coronary Vessels* ; Fasting ; Female ; Gene Frequency ; Genetic Variation ; Genotype ; Glucose ; Humans ; Insulin Resistance ; Lipoproteins ; Male ; Obesity ; Polymerase Chain Reaction ; Polymorphism, Single Nucleotide*

BACKGROUND AND OBJECTIVES: Mucociliary movement of respiratory ciliated epithelium is one of important protective mechanisms in the upper respiratory airway. It is well known that methacholine induces a ciliostimulation. This study designed to investigate the regulatory mechanism of methacholine induced ciliostimulation. MATERIALS AND METHOD: We investigated in vitro effect of methacholine, a beta-methyl ester of acetylcholine, and nitric oxide on ciliary beat frequency (CBF) of nasal septal mucosa of SD rat. CBF was measured using a video computerized analysis system. RESULTS: Methacholine (10(-6) mol/L) increased CBF upto 6 hours with a maximum increase of 44%. Diclofenac inhibited the ciliostimulatory effect of methacholine completely. LNAME inhibited the increase in CBF by methacholine significantly (p<.05). CONCLUSION: The results suggest that ciliostimulatory effects by methacholine in airway epithelium involves prostaglandin pathway and may be regulated by nitric oxide.
Acetylcholine ; Animals ; Diclofenac ; Epithelium ; Methacholine Chloride* ; Mucociliary Clearance ; Mucous Membrane ; Nitric Oxide* ; Prostaglandin-Endoperoxide Synthases* ; Rats

BACKGROUND AND OBJECTIVES: Allergic rhinitis (AR) is commonly sub-classified into seasonal and perennial rhinitis. The recent "Allergic Rhinitis and its impact on Asthma (ARIA) Workshop" proposed to replace these terms by intermittent vs persistent AR. But the validity of this new classification is still largely unknown. SUBJECTS AND METHOD: Three hundred-eleven allergic rhinitis patients were included in this study. Patients were categorized into seasonal allergic rhinitis (SAR) and perennial allergic rhinitis (PAR) groups, according to sensitized allergens. Twenty-eight items questionnaire filled out by patients were designed for this study. Based on the questionnaire, patients were classified into either intermittent or persistent AR. Patients' information and associated factors were analysed between the groups. RESULTS: Within the population with AR, 58% of the subjects had persistent AR. About 41% of the patients were classified as moderate-severe persistent AR. There was no association between the intermittent/persistent and the SAR/PAR classifications. Subjects with persistent AR had more severe symptoms, higher rate of self-awareness and had been previously diagnosed with AR. There were no significant difference in sensitization to allergens. However, grass, tree, house dust mite allergy is more common in persistent AR than in intermittent AR. More patients in "Blockers" and "Mixed" groups had persistent AR. CONCLUSION: A statistical comparison of the two classifications showed that they cannot be used interchangeably, as they do not represent the same stratum of disease. There is also an evidence that the persistent type describes a distinct group with characteristics that differentiates them from intermittent AR. These results support the validity of the new ARIA classification as shown in other studies.
Allergens ; Asthma ; Classification* ; Humans ; Hypersensitivity ; Poaceae ; Prevalence* ; Pyroglyphidae ; Surveys and Questionnaires ; Rhinitis* ; Rhinitis, Allergic, Seasonal ; Seasons

BACKGROUND AND OBJECTIVES: Mucosal malignant melanoma of the nasal cavity and paranasal sinuses is an uncommon tumor with poorer prognosis compared with its cutaneous counterpart. The purpose of this study is to investigate the clinical features and treatment outcomes of mucosal malignant melanoma of the nasal cavity and paranasal sinuses. SUBJECTS AND METHOD: Eighteen patients who were diagnosed and treated as mucosal malignant melanoma of nasal cavity and paranasal sinuses from 1995 to 2004 were included. Male to female ratio was 10 to 8. Their ages ranged from 43 to 87 years with median of 62 years. The medical records were reviewed retrospectively with respect to presenting symptoms, stage, treatment modalities and outcome. RESULT: The most common symptoms were epistaxis and nasal obstruction. The mean duration of symptom was 4.2 months. Commonly involved sites were middle turbinate, inferior turbinate, maxillary sinus and ethmoid sinus. Eight cases belonged to stage I, nine cases to stage II and only one case to stage III. Among them, seventeen patients underwent surgery with or without radiotherapy and immunotherapy. Of the seventeen patients who underwent surgery, twelve had recurrence and the mean period for recurrence was 8.2 months. During the follow-up periods, five had distant metastases. Five-year survival rate was 27.2% and the survival rates according to age, sex, tumor size and stage were not statistically significant. CONCLUSION: Mucosal malignant melanomas of the nasal cavity and paranasal sinuses developed commonly in the 6th to 8th decades. Epistaxis and nasal obstruction were the most common presenting symptoms. Almost all cases belonged to the stage I or II and the mainstay of the treatment was surgery. However, it was associated with frequent recurrences and a poor prognosis.
Epistaxis ; Ethmoid Sinus ; Female ; Follow-Up Studies ; Humans ; Immunotherapy ; Male ; Maxillary Sinus ; Medical Records ; Melanoma* ; Nasal Cavity* ; Nasal Obstruction ; Neoplasm Metastasis ; Paranasal Sinuses* ; Prognosis ; Radiotherapy ; Recurrence ; Retrospective Studies ; Survival Rate ; Turbinates

BACKGROUND AND OBJECTIVES: In 2002, Friedman et al. suggested a clinical staging system of obstructive sleep disorder patients based on palate position, tonsil size, and body mass index. The purpose of this study was to compare the treatment outcomes of uvulopalatopharyngoplasty (UPPP) and coblation assisted uvulopalatopharyngoplasty (CAUP) according to the Friedman staging system. SUBJECTS AND METHOD: Fifty patients with obstructive sleep apnea who underwent UPPP or CAUP were included. Apnea index (AI), Respiratory distress index (RDI), and Body-mass index (BMI) of preoperative polysomnography were measured. The questionnaires about snoring, apnea, and Epworth sleepiness scale (ESS) were taken by the patients and their bed partners before and after operation. All patients were stratified according to the Friedman staging system. RESULTS: Stage II patients were most common (41 cases, 82%). There was no difference in preoperative polysomnography parameters among stages. Preoperative polysomnography was decisive parameters on the determination of operative modality. UPPP was more effective than CAUP for symptom of sleep apnea with high success rate of 92.7%. CONCLUSION: In stage II, the success rates of sleep apnea and snoring were 80.4% and 63.4%. Though UPPP showed better success rate in treating sleep apnea, the success rate of CAUP in treating snoring was comparable to that of UPPP. CAUP is a good alternative to UPPP in treating snoring.
Apnea ; Body Mass Index ; Humans ; Palate ; Palatine Tonsil ; Polysomnography ; Surveys and Questionnaires ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive* ; Snoring

BACKGROUND AND OBJECTIVES: Recently, the incidence of allergic diseases such as asthma, allergic rhinitis and atopic dermatitis is on the increase with the society getting more and more industrialized. Although many therapeutic options for prevention and treatment of the allergic diseases have been developed, true allergen desensitization remains a challenging goal. The classic immunotherapy using protein-based allergen has limited efficacy, is inconvenient, and has a risk of anaphylaxis. Recent reports revealed that immunostimulatory DNA sequences (ISS-ODN, CpG motif) have been shown to act as a strong Th1 response-inducing adjuvants and that DNA-based vaccination might be an effective therapeutic option for treatment of allergic diseases. In this study, we investigated whether ISS-ODN/Dermatophagoides farinae (Der f) conjugate has anti-allergic effects in the mouse model of allergic rhinitis, which is sensitive to house dust mites. Der f is the most common allergen inducing allergic rhinitis in Korea. MATERIALS AND METHOD: C57BL/6 mice were systemically and locally sensitized with crude extracts of Der f. After the injection of ISS-ODN/Der f conjugate and the mutant-ODN/Der f conjugate, several parameters of allergic response were evaluated. RESULTS: Scratching and sneezing symptoms, and eosinophilic infiltration into nasal mucosa were suppressed by the injection of ISS-ODN/Der f conjugate. IL-5 level in nasal lavage fluid (NLF) was decreased and IFN gamma level was increased. Der f-specific IgE was decreased, however, as it was not statistically significant. CONCLUSION: The results showed that ISS-ODN/Der f conjugate has anti-allergic effects and biased Th1 reaction in the allergic rhinitis model of Der f allergen.
Anaphylaxis ; Animals ; Asthma ; Base Sequence ; Bias (Epidemiology) ; Complex Mixtures ; Dermatitis, Atopic ; Dermatophagoides farinae ; Eosinophils ; Immunoglobulin E ; Immunotherapy ; Incidence ; Interleukin-5 ; Korea ; Mice ; Nasal Lavage Fluid ; Nasal Mucosa ; Pyroglyphidae ; Rhinitis* ; Sneezing ; Vaccination ; Vaccines, Conjugate