Objectives: In South Korea, a significant number of patients with obstructive sleep apnea have benefited from the insured continuous positive pressure for sleep apnea as of 2018. However, there is limited information on public awareness of sleep apnea syndrome in the country. A nationwide survey was conducted to evaluate the current status of public awareness on the diagnosis and treatment of sleep apnea. Methods: We conducted an online survey using structured questionnaires on symptoms and knowledge of diagnosis and treatment modalities for sleep apnea. A total of 4,000 participants aged 21 to 69 were proportionally allocated according to the residential area, gender, and age group. Results: The STOP questionnaire, a screening tool for sleep apnea, revealed that 1,044 (21.6%) scored ≥2 points, 327 (8.1%) scored ≥3 points, and 64 (1.6%) scored 4 points. However, only 19 of the 1,044 patients were being treated for sleep apnea, and 13 had been using continuous positive airway pressure. For the diagnosis of sleep apnea, 1,318 participants (33.0%) responded that polysomnography was necessary. For sleep apnea treatment, 1,954 (48.9%) participants responded that lifestyle modification was the treatment of choice, while 1,036 (25.9%) chose continuous positive pressure. Conclusions Although one-fifth were at high risk for sleep apnea, this disorder is still underestimated. Therefore, publicity and support are needed to improve public awareness of sleep apnea.

PURPOSE: Human adenovirus infection mimics Kawasaki disease (KD) but can be detected in KD patients. The aim of this study was to determine the clinical differences between KD with adenovirus infection and only adenoviral infection and to identify biomarkers for prediction of adenovirus-positive KD from isolated adenoviral infection. METHODS: A total of 147 patients with isolated adenovirus were identified by quantitative polymerase chain reaction. In addition, 11 patients having KD with adenovirus, who were treated with intravenous immunoglobulin therapy during the acute phase of KD were also evaluated. RESULTS: Compared with the adenoviral infection group, the KD with adenovirus group was significantly associated with frequent lip and tongue changes, skin rash and changes in the extremities. In the laboratory parameters, higher C-reactive protein (CRP) level and presence of hypoalbuminemia and sterile pyuria were significantly associated with the KD group. In the multivariate analysis, lip and tongue changes (odds ratio [OR], 1.416; 95% confidence interval [CI], 1.151–1.741; P=0.001), high CRP level (OR, 1.039; 95% CI 1.743–1.454; P= 0.021) and sterile pyuria (OR 1.052; 95% CI 0.861–1.286; P=0.041) were the significant predictive factors of KD. In addition, the cutoff CRP level related to KD with adenoviral detection was 56 mg/L, with a sensitivity of 81.8% and a specificity of 75.9%. CONCLUSION: Lip and tongue changes, higher serum CRP level and sterile pyuria were significantly correlated with adenovirus-positive KD.
Adenoviridae ; Adenoviridae Infections ; Adenovirus Infections, Human ; Biomarkers ; C-Reactive Protein ; Discrimination (Psychology) ; Exanthema ; Extremities ; Humans ; Hypoalbuminemia ; Immunization, Passive ; Lip ; Mucocutaneous Lymph Node Syndrome ; Multivariate Analysis ; Polymerase Chain Reaction ; Pyuria ; Sensitivity and Specificity ; Tongue

OBJECTIVES: The objectives of this study are to assess marital and sexual satisfaction among patients with schizophrenia compared to the general population and to evaluate the factors that may affect these levels. METHODS: Marital and sexual satisfaction of 66 married schizophrenic patients and 162 married normal controls were assessed with Enriching and Nurturing Relationship Issues, Communication and Happiness and Derogatis Sexual Function Inventory. We compared the differences in marital and sexual satisfaction and influential variables between these two groups through analysis of covariance with adjustment for age and the duration of marriage. Factors associated with marital and sexual satisfaction were identified with multiple regression analysis. RESULTS: Patients with schizophrenia showed lower satisfaction with their marriage (p=0.018) and sexual lives (p<0.001) compared to the controls. Marital satisfaction of schizophrenics was influenced by violence from spouse, whereas their sexual satisfaction was affected by age, violence from spouse, conversation frequency after sexual relations, and revealing psychiatric history to spouse before marriage. There was a significant relationship between marital and sexual satisfaction in both groups. CONCLUSION: Patients with schizophrenia may have marital and sexual problems which can be caused directly or indirectly by symptoms and course of the disease. These results suggest that evaluation and appropriate intervention in the marriage and sexual lives of schizophrenics is necessary and important.
Happiness ; Humans ; Marriage ; Schizophrenia ; Spouses ; Violence

BACKGROUND: Several studies showed the relationship between serum homocysteine and pulse wave velocity, but their subjects were confined to high risk group for cardiovascular diseases and recent study revealed no relationship in young healthy adults. We hypothesized that time interval would be needed for serum homocysteine to infl uence pulse wave velocity after exposure to vascular endothelium. The purpose of this study was to determine the relationship between serum homocysteine and pulse wave velocity in middle aged women on the basis of that hypothesis and necessity for further study in general population. METHODS: The study subjects were 110 middle aged women who visited a health promotion center of a general hospital. We collected medical history by means of self-reported questionnaire and measured height, weight, blood pressure and brachial-ankle pulse wave velocity (baPWV). Blood sampling was performed after overnight fasting. We analyzed the relationship between several cardiovascular risk factors and baPWV and performed multiple regression analysis. RESULTS: BaPWV velocity was correlated significantly with age, mean blood pressure, serum homocysteine, total cholesterol and diabetes mellitus, but not with body mass index, high-density lipoprotein cholesterol, triglyceride, creatinine clearance, alcohol intake, hypertension and smoking. In multiple regression, there was a significant association between age (P = 0.04), moderate hyperhomocysteinemia (P = 0.02), mean blood pressure (P < 0.001) and baPWV. CONCLUSION: In middle aged women, there was an independently positive association between serum homocysteine and baPWV
Adult ; Blood Pressure ; Body Mass Index ; Cardiovascular Diseases ; Cholesterol ; Creatinine ; Diabetes Mellitus ; Endothelium, Vascular ; Fasting ; Female ; Health Promotion ; Homocysteine ; Hospitals, General ; Humans ; Hyperhomocysteinemia ; Hypertension ; Lipoproteins ; Middle Aged ; Pulse Wave Analysis ; Risk Factors ; Smoke ; Smoking

The etiology and pathogenesis of type 2 diabetes mellitus (T2DM) are not completely understood although it is often associated with other conditions such as obesity, hypertension, and dyslipidemia. Lipoprotein lipase (LPL) is a key enzyme in human lipid metabolism that facilitates the removal of triglyceride-rich lipoproteins from the bloodstream. LPL hydrolyzes the core of triglyceride-rich lipoproteins (chylomicrons and very low density lipoprotein) into free fatty acids and monoacylglycerol. To gain insight into the possible role of LPL in T2DM, nine single nucleotide polymorphisms (SNPs) of LPL were analyzed for the association with T2DM using 944 unrelated Koreans, including 474 T2DM subjects and 470 normal healthy controls. Of the nine LPL SNPs we analyzed, a significant association with multiple tests by the false discovery rate (FDR) was observed between T2DM and SNP rs343 (+13836C>A in intron 3). SNP rs343 was also marginally associated with some of T2DM-related phenotypes including total cholesterol, high density lipoprotein cholesterol (HDLc), and log transformed glycosylated hemoglobin in 470 normal controls, although no significant association was detected by multiple tests. In total, our results suggest that the control of lipid level by LPL in the bloodstream might be an important factor in T2DM pathogenesis in the Korean population.
Aged ; Asian Continental Ancestry Group ; Cohort Studies ; Databases, Genetic ; Diabetes Mellitus, Type 2/*genetics ; Female ; Gene Frequency ; Genetic Predisposition to Disease ; Genotype ; Humans ; Lipoprotein Lipase/*genetics ; Male ; Middle Aged ; *Polymorphism, Single Nucleotide

Blood pressure refers to the force exerted by circulating blood on the walls of blood vessels, and chronical elevation of blood pressure is known as hypertension. Although hypertension is affected by genetic and environmental factors, the genetic background of hypertension is not fully understood. One of the candidate genetic factors, Prostaglandin-endoperoxide synthase 2 (PTGS2), is a membrane-bound enzyme, catalyzing the conversion of arachidonic acid to prostaglandin, and recently SNPs of PTGS2 gene was associated with hypertension in Japanese population. Therefore the association of PTGS2 polymorphisms was investigated with blood pressure in healthy Korean subjects, 470 unrelated individuals randomly selected from Ansung and Ansan cohorts. The 25 SNPs of PTGS2 gene were identified by the sequencing analysis of 24 Korean samples. Among identified polymorphisms, three SNPs (rs689466, -1329A>G; rs5275, +6365T>C; rs4648308, +8806G> A) were selected for further association analysis, and rs689466 located in promoter region was associated with blood pressure as well as triglyceride level in the blood. By in silico analysis, rs689466 locates in v-Myb transcription factor binding site, and the v-Myb site disappears when the SNP is changed from A to G nucleotide. Individuals with A/G and G/G genotype in rs689466 have higher blood pressure than those with A/A genotype, and the regression p-value is 0.008 for systolic and 0.004 for diastolic blood pressure. In summary, the PTGS2 polymorphism (rs689466) is associated with blood pressure in Asian populations based on this and Japanese studies, shedding light on it as a genetic risk marker of hypertension.
Arachidonic Acid ; Asian Continental Ancestry Group ; Binding Sites ; Blood Pressure ; Blood Vessels ; Cohort Studies ; Computer Simulation ; Cyclooxygenase 2 ; Genotype ; Humans ; Hypertension ; Light ; Polymorphism, Single Nucleotide ; Promoter Regions, Genetic ; Prostaglandin-Endoperoxide Synthases ; Transcription Factors

BACKGROUND: Serum gamma-GT is one of the biliary enzymes with the only enzymatic activity capable of cleaving extracellular glutathione, thus originating precursor amino acids for the intracellular resynthesis of glutathione. Several population-based studies have shown a strong cross-sectional association between serum gamma-GT concentration and cardiovascular risk factors. And prospective studies showed that serum gamma-GT concentration had a prognostic impact on cardiovascular mortality. But, the mechanism by which gamma-GT is associated with cardiovascular disease is not elucidated. We hypothesized that there was an association between serum gamma-GT and ferritin, a marker of oxidative stress. In this study, we investigated the relationship between serum gamma-GT and serum ferritin. METHODS: By reviewing the medical records of 288 healthy adults, we determined the serum levels of gamma-GT and ferritin according to age, body mass index, systolic blood pressure, diastolic blood pressure, triglycerides, total cholesterol, LDL-cholesterol, fasting blood sugar, hs-CRP, serum ferritin, AST, ALT, uric acid and smoking history. We studied the relationship between the variables by Pearson correlation coefficients and multiple stepwise regression analysis. Mean values of serum gamma-GT according to the smoking history were compared using t-test. RESULTS: Serum gamma-GT correlated positively with serum ferritin (r=0.42; P<0.001). BMI, triglycerides, total cholesterol, fasting blood sugar, AST and ALT also showed statistically significant correlation. Smokers showed significantly higher serum gamma-GT. Serum gamma-GT correlated with serum ferritin, ALT, current smoking and triglycerides by multiple stepwise regression analysis. CONCLUSION: Serum gamma-GT correlated positively with serum ferritin.
Adult* ; Amino Acids ; Blood Glucose ; Blood Pressure ; Body Mass Index ; Cardiovascular Diseases ; Cholesterol ; Fasting ; Ferritins* ; gamma-Glutamyltransferase* ; Glutathione ; Humans ; Medical Records ; Mortality ; Oxidative Stress ; Risk Factors ; Smoke ; Smoking ; Triglycerides ; Uric Acid

BACKGROUND: Recently, thermal therapy such as sauna and sweating room is popular as a health behavior. In patients with heart failure, sauna treatment improves hemodynamic data and clinical symptoms by restoring endothelial function. The purpose of this study was to investigate that sauna bath could decrease pulse wave velocity reflecting vascular function of people in the community. METHODS: A total of 43 volunteers (11 male, 32 female) older than 40 years old were kept in 60 degrees C dry sauna for 15 to 20 minutes. We measured the brachial-ankle pulse wave velocity (baPWV), blood pressure, heart rate, body weight and body temperature before and, 30 and 60 minutes after sauna bath and assessed the differences of the means of these measurements with repeated measures of ANOVA. Then, we peformed multiple regression analysis to find out the factors independently associated with the amount of baPWV change. RESULTS: The BaPWV and systolic and diastolic blood pressure decreased significantly 30 and 60 minutes after sauna bath comparing to those before (P<0.001, P=0.003, P=0.011, respectively). Multiple regression analysis showed that baseline baPWV and history of hypercholesterolemia independently influenced on the amount of baPWV change (beta=-0.47, P=0.002; beta=-0.36, P=0.013, respectively). CONCLUSION: We studied the acute reduction of pulse wave velocity after sauna bath in adults over 40 years old. This change was striking in the subjects with faster baseline baPWV. This result suggests that sauna bath can improve vascular function in the high risk group of cardiovascular diseases.
Adult* ; Baths ; Blood Pressure ; Body Temperature ; Body Weight ; Cardiovascular Diseases ; Health Behavior ; Heart Failure ; Heart Rate ; Hemodynamics ; Humans ; Hypercholesterolemia ; Male ; Pulse Wave Analysis* ; Steam Bath* ; Strikes, Employee ; Sweat ; Sweating ; Volunteers

BACKGROUND: Sullivan has suggested that higher incidence of coronary heart disease in men and postmenopausal women is due to higher levels of stored iron in these two groups. A few epidemiologic studies in humans have reported the association between iron stores and increased risk of cardiovascular diseases. But there is conflicting evidence regarding the relationship between iron and cardiovascular diseases. The present study evaluated the relationship between ferritin and well established cardiovascular risk factors. METHODS: There were 288 healthy subjects who visited a health promotion center of a general hospital. We collected data by means of self-reported questionnare and measured height, weight and blood pressure. Serum ferritin, fasting blood glucose, lipid profiles, and C-reactive protein were measured at a fasting state. RESULTS: Mean serum ferritin values were 150.1+/-82.2 ng/mL in men and 61.7+/-38.2 ng/mL in women (P<0.001). Serum ferritin level in current smoker was higher than in non-smoker (157.6+/-111.8 ng/mL versus 100.5+/-64.2 ng/mL, P=0.006). Serum ferritin was significantly and positively correlated with body mass index, systolic blood pressure, diastolic blood pressure, fasting blood glucose, total cholesterol and triglyceride. There was no statistical significance in age, C-reactive protein, high-density lipoprotein cholesterol and low-density lipoprotein cholesterol. In multiple regression analysis, there was association between ferritin and sex (beta=-80.333, P<0.001) and triglycerides (beta=0.182, P=0.030). CONCLUSION: The serum ferritin level in men is higher than in women in healthy adults. Serum ferritin is positively associated with triglycerides.
Adult ; Atherosclerosis ; Blood Glucose ; Blood Pressure ; Body Mass Index ; C-Reactive Protein ; Cardiovascular Diseases ; Cholesterol ; Coronary Disease ; Epidemiologic Studies ; Fasting ; Female ; Ferritins* ; Health Promotion ; Hospitals, General ; Humans ; Incidence ; Iron ; Lipoproteins ; Male ; Multiple Endocrine Neoplasia Type 1 ; Risk Factors* ; Triglycerides

BACKGROUND: C-reactive protein is an acute phase reactant, which can be increased by either (both) infectious or (and) non-infectious and non-specific reaction of cells and tissue metabolism. Also C-reactive protein is known to have a relationship between changes in lipid and glucose metabolism. In recent studies, the possibility of being a prognostic factor of cardiovascular risk factors and serum C-reactive protein concentration within conventional reference ranges in otherwise normal people has also received little attention. Therefore, in this study, we tried to look for the relationship between C-reactive protein and cardiovascular risk factors of a healthy adult. METHODS: We analyzed the results of the surveys and chemistries given to 3,548 healthy men and women who have visited the heath promotion center in a certain university hospital. We assayed the C-reactive protein by means of rate nephelometry. We omitted the case of 123 people who went over 1mg/dL. We compared C-reactive protein of normal and abnormal range of each risk factor and went through the multiple regression analysis for the factors with significant differences. RESULTS: When C-reactive protein concentration of normal and abnormal of cardiovascular risk factors were compared by t-test, there were differences according to age (p<0.001), sex (p<0.001), body mass index (p<0.001), WBC (p<0.001), systolic blood pressure (p<0.001), diastolic pressure (p<0.001), total cholesterol (p<0.00), HDL-cholesterol (p<0.05) and smoking (p<0.01). We could not find any significant difference of triglycerides. After going through multiple regression analysis for the risk factors, which showed a significant difference by t-test, we found out that the C-reactive protein increased as cholesterol (p<0.01), body mass index (p<0.01) and WBC (p<0.001) increased. As for HDL-cholesterol (p<0.001), the C-reactive protein increased as it decreased. Age, sex, smoking history, systolic blood pressure, and diastolic blood pressure did not show significant relationship we were looking for. CONCLUSION: C-reactive protein was not related to age, smoking history ,blood pressure, and triglycerides among cardiovascular risk factors, but was related to body mass index, cholesterol, HDL-cholesterol and WBC. This relationship indicated that even if the C-reactive protein was in normal range a person with C-reactive protein should be aware of the risk involved for cardiovascular diseases.
Adult ; Blood Pressure ; Body Mass Index ; C-Reactive Protein* ; Cardiovascular Diseases ; Cholesterol ; Female ; Glucose ; Humans ; Male ; Metabolism ; Nephelometry and Turbidimetry ; Reference Values ; Risk Factors* ; Smoke ; Smoking ; Triglycerides