BACKGROUND: Previous studies have revealed that sleep duration is linked to both obesity and hypertension. Here, we evaluated the association between sleep duration and hypertension in obese and non-obese premenopausal women using representative national survey data from the Korean population. METHODS: A total of 4,748 subjects over 20 years of age from the Korean National Health and Nutrition Examination Survey from 2010 to 2012 were included. To control for risk factors, multivariable logistic regression was used to calculate the adjusted odds ratios and 95% confidence intervals of hypertension across the following sleep duration categories: <6, 6-8, and >8 h/d. RESULTS: Among the participants, 367 subjects (7.7%) had hypertension. Their mean sleep duration was 7 hours. In the non-obese subjects, after controlling for potential confounding variables, the odds ratio for hypertension was 1.86 fold greater in those with a sleep duration of <6 hours (odds ratio, 1.79; 95% confidence interval, 1.05 to 3.03) as compared to those who slept for 6.8 hours. However, there was no association between sleep duration and the risk of hypertension in obese subjects. Long sleep duration (over 8 h/d) was not associated with hypertension in either the non-obese or the obese subjects in this study. CONCLUSION: Short sleep duration (less than 6 h/d) may be a significant risk factor for hypertension in non-obese premenopausal women. However, there is no association between sleep duration and the risk of hypertension in obese women.
Confounding Factors (Epidemiology) ; Female ; Humans ; Hypertension* ; Korea* ; Logistic Models ; Nutrition Surveys ; Obesity ; Odds Ratio ; Risk Factors

PURPOSE: Diesel exhaust particles (DEPs) can induce and trigger airway hyperresponsiveness (AHR) and inflammation. The aim of this study was to investigate the effect of long-term DEP exposure on AHR, inflammation, lung fibrosis, and goblet cell hyperplasia in a mouse model. METHODS: BALB/c mice were exposed to DEPs 1 hour a day for 5 days a week for 3 months in a closed-system chamber attached to a ultrasonic nebulizer (low dose: 100 microg/m3 DEPs, high dose: 3 mg/m3 DEPs). The control group was exposed to saline. Enhanced pause was measured as an indicator of AHR. Animals were subjected to whole-body plethysmography and then sacrificed to determine the performance of bronchoalveolar lavage and histology. RESULTS: AHR was higher in the DEP group than in the control group, and higher in the high-dose DEP than in the low-dose DEP groups at 4, 8, and 12 weeks. The numbers of neutrophils and lymphocytes were higher in the high-dose DEP group than in the low-dose DEP group and control group at 4, 8, and 12 weeks. The levels of interleukin (IL)-5, IL-13, and interferon-gamma were higher in the low-dose DEP group than in the control group at 12 weeks. The level of IL-10 was higher in the high-dose DEP group than in the control group at 12 weeks. The level of vascular endothelial growth factor was higher in the low-dose and high-dose DEP groups than in the control group at 12 weeks. The level of IL-6 was higher in the low-dose DEP group than in the control group at 12 weeks. The level of transforming growth factor-beta was higher in the high-dose DEP group than in the control group at 4, 8, and 12 weeks. The collagen content and lung fibrosis in lung tissue was higher in the high-dose DEP group at 8 and 12 weeks. CONCLUSIONS: These results suggest that long-term DEP exposure may increase AHR, inflammation, lung fibrosis, and goblet cell hyperplasia in a mouse model.
Airway Remodeling ; Animals ; Bronchoalveolar Lavage ; Collagen ; Fibrosis ; Goblet Cells ; Hyperplasia ; Inflammation* ; Interferon-gamma ; Interleukin-10 ; Interleukin-13 ; Interleukin-6 ; Interleukins ; Lung ; Lymphocytes ; Mice* ; Nebulizers and Vaporizers ; Neutrophils ; Plethysmography ; Pneumonia ; Ultrasonics ; Vascular Endothelial Growth Factor A ; Vehicle Emissions*

BACKGROUND: The epidemiology of tuberculosis (TB) has been assessed based on the data of the analysis of TB patients notified to the surveillance system in Korea. However, the national status of TB is not validated through this surveillance system. The objective is to determine the epidemiology of TB and to understand the accurate status of TB patients treated in private institutions. METHODS: Medical records of 53,579 patients who had been diagnosed with TB in 2008 were analyzed. RESULTS: Among 53,579 patients, the number of sputum smear positive cases was 15,639(29.2%) and the number of new cases was 39,191 (73.1%). The drug resistance rate of new cases was 5.3%, while the rate stood at 13.3% for TB patients with treatment history. The number of multi-drug resistant TB (MDR-TB) patients was 2,472 (4.6%), which consists of 2.9% of new cases and 9.3% of TB patients with prior treatment history. The number of extensively drug-resistant TB patients was 749 (1.4%), consisting of 1.1% of new cases and 2.2% of TB patients with prior treatment history. In terms of treatment outcomes, 66.4% of all TB patients, 70.5% of new cases, 64.4% of relapse cases, and 46.8% of MDR-TB cases were cured or completed. It was inferred that in 2008, the total number of TB patients reached 70,767, 145.6 per 100,000 people (95% confidence interval, 145.5~145.7). CONCLUSION: We conclude that the medical records review of the Health Insurance Review and Assessment Service (HIRA) data can be very effective in promoting the understanding of the current status of TB in private institutions.
Data Collection ; Disease Notification ; Drug Resistance ; Humans ; Insurance, Health ; Korea ; Medical Records ; Recurrence ; Sputum ; Tuberculosis ; Tuberculosis, Multidrug-Resistant

BACKGROUND: The epidemiology of tuberculosis (TB) has been assessed based on the data of the analysis of TB patients notified to the surveillance system in Korea. However, the national status of TB is not validated through this surveillance system. The objective is to determine the epidemiology of TB and to understand the accurate status of TB patients treated in private institutions. METHODS: Medical records of 53,579 patients who had been diagnosed with TB in 2008 were analyzed. RESULTS: Among 53,579 patients, the number of sputum smear positive cases was 15,639(29.2%) and the number of new cases was 39,191 (73.1%). The drug resistance rate of new cases was 5.3%, while the rate stood at 13.3% for TB patients with treatment history. The number of multi-drug resistant TB (MDR-TB) patients was 2,472 (4.6%), which consists of 2.9% of new cases and 9.3% of TB patients with prior treatment history. The number of extensively drug-resistant TB patients was 749 (1.4%), consisting of 1.1% of new cases and 2.2% of TB patients with prior treatment history. In terms of treatment outcomes, 66.4% of all TB patients, 70.5% of new cases, 64.4% of relapse cases, and 46.8% of MDR-TB cases were cured or completed. It was inferred that in 2008, the total number of TB patients reached 70,767, 145.6 per 100,000 people (95% confidence interval, 145.5~145.7). CONCLUSION: We conclude that the medical records review of the Health Insurance Review and Assessment Service (HIRA) data can be very effective in promoting the understanding of the current status of TB in private institutions.
Data Collection ; Disease Notification ; Drug Resistance ; Humans ; Insurance, Health ; Korea ; Medical Records ; Recurrence ; Sputum ; Tuberculosis ; Tuberculosis, Multidrug-Resistant

OBJECTIVES: Diabetes and obesity each increases mortality, but recent papers have shown that lean Asian persons were at greater risk for mortality than were obese persons. The objective of this study is to determine whether an interaction exists between body mass index (BMI) and diabetes, which can modify the risk of death by cardiovascular disease (CVD). METHODS: Subjects who were over 20 years of age, and who had information regarding BMI, past history of diabetes, and fasting blood glucose levels (n=16 048), were selected from the Korea Multi-center Cancer Cohort study participants. By 2008, a total of 1290 participants had died; 251 and 155 had died of CVD and stroke, respectively. The hazard for deaths was calculated with hazard ratio (HR) and 95% confidence interval (95% CI) by Cox proportional hazard model. RESULTS: Compared with the normal population, patients with diabetes were at higher risk for CVD and stroke deaths (HR, 1.84; 95% CI, 1.33 to 2.56; HR, 1.82; 95% CI, 1.20 to 2.76; respectively). Relative to subjects with no diabetes and normal BMI (21 to 22.9 kg/m2), lean subjects with diabetes (BMI <21 kg/m2) had a greater risk for CVD and stroke deaths (HR, 2.83; 95% CI, 1.57 to 5.09; HR, 3.27; 95% CI, 1.58 to 6.76; respectively), while obese subjects with diabetes (BMI > or =25 kg/m2) had no increased death risk (p-interaction <0.05). This pattern was consistent in sub-populations with no incidence of hypertension. CONCLUSIONS: This study suggests that diabetes in lean people is more critical to CVD deaths than it is in obese people.
Aged ; Blood Glucose/analysis ; *Body Mass Index ; Cardiovascular Diseases/etiology/*mortality ; Cohort Studies ; Diabetes Complications ; Diabetes Mellitus/*pathology ; Female ; Humans ; Male ; Middle Aged ; Proportional Hazards Models ; Risk Factors ; Stroke/etiology/mortality

OBJECTIVES: To examine the association between alcohol consumption habit, types of beverages, alcohol consumption quantity, and overall and cancer-specific mortality among Korean adults. METHODS: The alcohol consumption information of a total of 16 320 participants who were 20 years or older from the Korean Multi-center Cancer Cohort were analyzed to examine the association between alcohol consumption habit and mortality (median follow-up of 9.3 years). The Cox proportional hazard model was used to estimate the hazard ratio (HR) of alcohol consumption to mortality adjusting for age, sex, geographic areas, education, smoking status, and body mass index. RESULTS: Alcohol drinkers showed an increased risk for total mortality compared with never drinkers (HR, 1.72; 95% confidence interval [CI], 1.38 to 2.14 for past drinkers; HR, 1.21; 95% CI, 1.06 to 1.39 for current drinkers), while past drinkers only were associated with higher risk for cancer deaths (HR, 1.84; 95% CI, 1.34 to 2.53). The quantity of alcohol consumed per week showed a J-shaped association with risk of mortality. Relative to light drinkers (0.01 to 90 g/wk), never drinkers and heavy drinkers (>504 g/wk) had an increased risk for all-cause and cancer deaths: (HR, 1.18; 95% CI, 0.96 to 1.45) and (HR, 1.39; 95% CI, 1.05 to 1.83) for all-cause mortality; and (HR, 1.55; 95% CI, 1.15 to 2.11) and (HR, 2.07; 95% CI, 1.39 to 3.09) for all cancer mortality, respectively. Heavy drinkers (>504 g/wk) showed an elevated risk for death from stomach and liver cancers. CONCLUSIONS: The present study supports the existence of a J-shaped association between alcohol consumption quantity and the risk of all-cause and cancer deaths. Heavy drinkers had an increased risk of death from cancer overall and liver and stomach cancer.
Adult ; Age Factors ; Aged ; Alcohol Drinking/adverse effects/*mortality ; Analysis of Variance ; Cohort Studies ; Female ; Humans ; Male ; Middle Aged ; Neoplasms/etiology/*mortality ; Proportional Hazards Models ; Republic of Korea/epidemiology ; Risk Factors ; Sex Factors ; Young Adult

PURPOSE: The aim of this study is to evaluate the relationship of menopause and serum follicle stimulating hormone (FSH) level and estradiol (E2) in Korean women with breast cancer. METHODS: We reviewed 1,404 women aged from 20- to 82-year-old (median 47 years) with breast cancer who had got surgery at Asan Medical Center in 2008. All patients were checked serum FSH before the operation. Three hundred fifty-three patients were in postmenopause state at the time of surgery. Their ages were from 40- to 60-year-old (median 50.3 years). RESULTS: The proportion of postmenopausal status in each age-group were 5.1% (45- to 49-year-old), 41% (50- to 54-year-old), 86.1% (55- to 59-year-old), and 100% over the age of 60, respectively. And the proportion of the patients with FSH over 30 mUI/mL were 68.6% (45- to 49-year-old), 87.5% (55- to 59-year-old), 75.0% (55- to 59-year-old) and 30.0% (over the age of 60), respectively. CONCLUSION: Our study shows that even though patients had been in amenorrhea over 1 year, not all patients have their FSH level over 30 mUI/mL. And this finding is more prominent in age group from 45- to 49-year-old.
Female ; Humans ; Breast Neoplasms

BACKGROUND: To evaluate the usefulness and compliance of a hospital-based tabletop exercise in setting of pandemic influenza in hospitals. MATERIALS AND METHODS: Tabletop exercise was held in Pusan National University Hospital and forty two hospital employees were invited to participate in the exercise. The scenario for hospital-based tabletop exercise was designed. It consisted of three modules, which simulated the influx and outbreak of H5N1 influenza that was epidemic in Southeast Asia. Pre-, post-exercise surveys were completed by anonymous questions. RESULTS: Thirty-seven (88%) of 42 invited participants attended exercise. All members of the administration group and the ancillary services group participated. But, only 77% members of the clinical services group participated. In pre-exercise survey, priorities of eight goals regarding skills and knowledge during exercise were inquired., The highest priorities pointed out by the respondents were "Increase the knowledge of pandemic influenza" (22%), "Development of strategies for optimal communication among employees within specific department" (19%) and "Development of strategies for improved coordination between facilities within the health system" (19%). Twenty-one (57%) of participants completed the post-exercise surveys. At post-exercise surveys, 81% of the participants stated that the tabletop exercise was extremely or very useful, 86% of the participants also stated that it increased their knowledge of pandemic influenza. CONCLUSION: Tabletop exercise is an effective modality for increasing pandemic influenza preparedness in hospitals, and this method is useful for guiding preparedness activities within the hospital environment. Further studies to determine the appropriate method of discussion, questionnaire, duration of exercise and injection are needed.
Anonyms and Pseudonyms ; Asia, Southeastern ; Compliance ; Influenza, Human ; Pandemics ; Surveys and Questionnaires

BACKGROUND: To evaluate the usefulness and compliance of a hospital-based tabletop exercise in setting of pandemic influenza in hospitals. MATERIALS AND METHODS: Tabletop exercise was held in Pusan National University Hospital and forty two hospital employees were invited to participate in the exercise. The scenario for hospital-based tabletop exercise was designed. It consisted of three modules, which simulated the influx and outbreak of H5N1 influenza that was epidemic in Southeast Asia. Pre-, post-exercise surveys were completed by anonymous questions. RESULTS: Thirty-seven (88%) of 42 invited participants attended exercise. All members of the administration group and the ancillary services group participated. But, only 77% members of the clinical services group participated. In pre-exercise survey, priorities of eight goals regarding skills and knowledge during exercise were inquired., The highest priorities pointed out by the respondents were "Increase the knowledge of pandemic influenza" (22%), "Development of strategies for optimal communication among employees within specific department" (19%) and "Development of strategies for improved coordination between facilities within the health system" (19%). Twenty-one (57%) of participants completed the post-exercise surveys. At post-exercise surveys, 81% of the participants stated that the tabletop exercise was extremely or very useful, 86% of the participants also stated that it increased their knowledge of pandemic influenza. CONCLUSION: Tabletop exercise is an effective modality for increasing pandemic influenza preparedness in hospitals, and this method is useful for guiding preparedness activities within the hospital environment. Further studies to determine the appropriate method of discussion, questionnaire, duration of exercise and injection are needed.
Anonyms and Pseudonyms ; Asia, Southeastern ; Compliance ; Influenza, Human ; Pandemics ; Surveys and Questionnaires

PURPOSE: The availability of living donors is the major limiting factor in living related kidney transplantion. In 1997, Ross et al. proposed that the living unrelated kidney transplantation through exchange arrangement of ABO-incompatible donors-recipient pairs to expand donor pool is ethically acceptable as living related kidney transplantation. We analyzed exchange donor program whether this could expand the kidney donor pool in living donor renal transplantation. METHODS: We retrospectively reviewed the records of the 121 exchange donor renal transplantations performed from 1991 to 2005 in our center. Recipient's and donor's mean age were 38.8 (15~64) and 40.4 (21~60) year-old, respectively. Mean follow up period is 81 months (1~170). The reasons of exchanging donor were ABO incompatibility (92/121, 76%), positive HLA cross matching (20/121, 16%) and patients who received kidneys from unknown volunteer donors (9/121, 7%). We compared graft survival and acute rejection rate of exchange donor group and living related donor group. RESULTS: The graft survival rate (1, 5, 10 year) of exchange donor group (92%, 80.6%, 72%) was similar to living related donor groups (95%, 77%, 66%). The acute rejection rate were 34% (42/121 ) and 24%, respectively. We have observed acute rejections during the same time in both groups from 1991 to 2005. Although acute rejection rate of exchange donor group is higher, we see the similar survival rate of transplanted kidneys in exchange donor group. CONCLUSION: We suggest that exchange donor program could expand the donor pool in living donor renal transplantation, when recipient cannot receive kidney from healthy donor because of ABO incompatibility or positive HLA cross matching.
Follow-Up Studies ; Graft Survival ; Humans ; Kidney ; Kidney Transplantation* ; Living Donors ; Retrospective Studies ; Survival Rate ; Tissue Donors* ; Volunteers