Background: This study aimed to investigate stress, depression, sleeping time, physical activity, and dietary patterns as factors causing weight gain and investigate which of these factors have a greater effect on weight gain. Methods: Data were obtained from the seventh Korea National Health and Nutrition Examination Survey, 2016. Among the respondents, 3,163 adults aged 19–64 years were included in the survey, after excluding non-responders and those with diseases that may affect weight change. The t-test and chi-square test were used to analyze the relationship between weight gain and general characteristics. Logistic regression analysis was performed to evaluate weight changes according to stress, depression, sleep time, physical activity, and dietary patterns and evaluate the odds ratios (ORs) for measuring these associations. Results: Participants in the weight gain group were younger and more likely to be obese than those in the control group. Factors that could cause weight gain among women were stress awareness (OR, 1.271; 95% confidence interval [CI], 1.012–1.597), physical inactivity (OR, 1.250; 95% CI, 1.018–1.535), and skipping breakfast (OR, 1.277; 95% CI, 1.028–1.587). Depression was significantly associated with weight gain among women, but not after adjusting for other variables. There were no significant associations with sleeping time. None of these factors in men were significantly associated with weight gain. Conclusion Stress awareness was significantly associated with weight gain among women, while other psychological factors were not significantly associated with weight gain.

A colonic mucosa-associated lymphoid-tissue (MALT) lymphoma is relatively rare compared to lymphomas of the stomach or small intestine. We present a case of a MALT lymphoma in the cecum and rectum found during screening colonoscopy. A 54-year-old female, who had undergone right-breast-conserving surgery with axillary dissection due to an invasive ductal carcinoma and a left-breast excisional biopsy due to microcalcification following adjuvant chemoradiation therapy 3 years earlier, was found to have 3-mm-sized smooth elevated lesions in both the cecum and rectum. No pathologic lesion or lymphadenopathy was found at any other site, but chronic gastritis negative for Helicobacter pylori infection was found. The polyps were removed by using an endoscopic biopsy and revealed an extra nodal marginal zone B-cell MALT lymphoma, showing positive for CD3 and CD20 by immunohistochemical staining. The patient underwent close observation without any additional treatment and has shown no evidence of recurrence as of her last visit.
B-Lymphocytes ; Biopsy ; Carcinoma, Ductal ; Cecum* ; Colon ; Colonoscopy ; Female ; Gastritis ; Helicobacter pylori ; Humans ; Intestine, Small ; Lymphatic Diseases ; Lymphoma* ; Lymphoma, B-Cell, Marginal Zone ; Mass Screening ; Middle Aged ; Polyps ; Rectum* ; Recurrence ; Stomach

PURPOSE: Precise localization of tumors and creation of sufficient proximal resection margins are complicated processes during total laparoscopic distal gastrectomy (TLDG) for clinical T1/T2 gastric cancers. Various solutions to this problem have also yielded many disadvantages. In this study, we reviewed a preoperative endoscopic clipping method based on the results of negative biopsy and selective intraoperative radiography. MATERIALS AND METHODS: A retrospective review of 345 consecutive patients who underwent TLDG and preoperative endoscopic clipping for tumor localization was conducted. During preoperative endoscopy, the endoscopists performed negative biopsies just 1–2 cm selectively above the tumor's upper limit. After confirming the biopsy results, endoscopic metal clips were applied just proximal to the negative biopsy site the day before surgery. Selective intraoperative tumor localization using portable abdominal radiography was performed only when we could not ensure a precise resection line. RESULTS: Negative biopsy was performed in 244 patients. Larger tumor size (P=0.008) and more distally located tumors (P=0.052) were observed more frequently in the negative biopsy group than in the non-negative biopsy group. The non-negative biopsy group had significantly higher frequencies of differentiated tumor types than the negative biopsy group (P=0.003). Of the 244 patients who underwent negative biopsies, 6 had cancer cells in their biopsy specimens. We performed intraoperative radiography in 12 patients whose tumors had difficult-to-determine proximal margins. No tumors were found in the proximal resection margins of any patients. CONCLUSIONS: Our tumor localization method is a promising and accurate method for securing a sufficient resection margin during TLDG.
Biopsy* ; Endoscopy ; Gastrectomy* ; Humans ; Laparoscopy ; Methods* ; Radiography* ; Radiography, Abdominal ; Retrospective Studies ; Stomach Neoplasms

The aim of this study was to examine the anti-inflammatory effect of abciximab-coated stent in a porcine coronary overstretch restenosis model. Ten abciximab-coated stents, ten sirolimus-eluting stents (SES), and ten paclitaxel-eluting stents (PES) were deployed with oversizing (stent/artery ratio 1.3:1) in porcine coronary arteries, and histopathologic analysis was done at 28 days after stenting. There were no significant differences in the neointima area normalized to injury score and inflammation score among the three stent groups (1.58+/-0.43 mm2, 1.57+/-0.39 mm2 in abciximab-coated stent group vs. 1.69+/-0.57 mm2, 1.72+/-0.49 mm2 in the SES group vs. 1.92+/-0.86 mm2, 1.79+/-0.87 mm2 in the PES group, respectively). In the neointima, most inflammatory cells were lymphohistiocytes. Significant positive correlations were found between the extent of inflammatory reaction and the neointima area (r=0.567, p<0.001) and percent area stenosis (r=0.587, p<0.001). Significant correlations were found between the injury score and neointimal area (r=0.645, p<0.001), between the injury score and the inflammation score (r=0.837, p<0.001), and between the inflammation score and neointimal area (r=0.536, p=0.001). There was no significant difference in the inflammatory cell counts normalized to injury score among the three stent groups (75.5+/-23.1/microliter in abciximabcoated stent group vs. 78.8+/-33.2/microliter in the SES group vs. 130.3+/-46.9/microliter in the PES group). Abciximab-coated stent showed comparable inhibition of inflammatory cell infiltration and neointimal hyperplasia with other drug-eluting stents in a porcine coronary restenosis model.
Animals ; Anti-Bacterial Agents/administration & dosage ; Anti-Inflammatory Agents/*pharmacology ; Antibodies, Monoclonal/administration & dosage/*pharmacology ; Arteries/injuries/pathology ; Constriction, Pathologic ; Coronary Restenosis/*therapy ; Disease Models, Animal ; *Drug-Eluting Stents ; Female ; Hyperplasia ; Immunoglobulin Fab Fragments/administration & dosage/*pharmacology ; Inflammation ; Paclitaxel/administration & dosage ; Sirolimus/administration & dosage ; Swine ; Tunica Intima/pathology

We describe the case of a 30-year-old man with systemic lupus erythematosus (SLE) and he was struck with non-ST segment elevation myocardial infarction: this was due to the presence of multiple coronary artery aneurysms those were full of thrombi. A diagnostic coronary angiogram revealed huge dilatations in the proximal three coronary arteries with multiple filling defects and a decreased flow rate, and these were suggestive of thrombi within the coronary artery aneurysms. An intravascular ultrasound (IVUS) examination revealed huge aneurysmal dilatations with movable thrombi in three coronary arteries. He had an uneventful recovery without us having to perform any percutaneous coronary intervention.
Adult ; Aneurysm* ; Coronary Disease ; Coronary Vessels* ; Dilatation ; Humans ; Lupus Erythematosus, Systemic ; Male* ; Myocardial Infarction* ; Percutaneous Coronary Intervention ; Ultrasonography

BACKGROUND AND OBJECTIVES: Diffuse coronary artery disease presents physicians with a therapeutic challenge. The results after the use of bare metal stents (BMS) are limited by the high rate of restenosis. The introduction of drugeluting stent (DES) has prompted interventional cardiologists to treat long diffuse lesions with multiple overlapping stents. The purpose of this study is to determine the safety and efficacy of using multiple overlapping DESs for patients with diffuse coronary artery disease. SUBJECTS AND METHODS: From Jan. 2002 to Dec 2004, 83 consecutive patients suffering with diffuse coronary artery disease who underwent stent implantation with a minimum of 50 mm long BMSs or DESs were analyzed. The patients who had overlapping stents for dissection without diffuse lesion or they had BMS with overlapping DES were excluded from the study. The patients were divided into two group, the BMS group (group I: 29 patients, 63.0+/-8.2 years) and the DES group (group II: 56 patients, 60.6+/-9.3 years). The major adverse cardiac events (MACE), including death, myocardial infarction (MI), target vessel revascularization (TVR) and coronary artery bypass grafting (CABG), were examined. RESULTS: The mean number of stents implanted was 2.19+/-0.4 in group I and 2.08+/-0.2 in group II, whereas the total mean length of the stents was 61.5+/-9.3 mm in group I and 61.4+/-9.1 mm in group II (p=NS). Procedural success was achieved for 89.7% of the patients in group I and for 96.3% of the patients in group II. No acute stent thrombosis was observed in both groups. All the patients underwent clinical follow-up (mean follow-up: 15+/-8.9 months, range: 7-36 months), and 66.2 % had an angiographic follow-up done at six months. During the follow-up, MACE was the cause of two deaths; there were thirteen TVRs and one CABG in group I, and there was one MI and five TVRs in group II. The TVR rate was lower in group II compared with group I (44.8% vs. 9.3%, respectively; p<0.001). Late stent thrombosis developed for one patient in group II. CONCLUSION: The implantation of overlapping DESs in patients with diffuse coronary artery disease is safe and this treatment is associated with better clinical outcomes than that with using BMS.
Coronary Artery Bypass ; Coronary Artery Disease* ; Coronary Disease ; Coronary Restenosis ; Coronary Vessels* ; Drug-Eluting Stents* ; Follow-Up Studies ; Humans ; Myocardial Infarction ; Stents ; Thrombosis

BACKGROUND AND OBJECTIVES: Systemic activation of the inflammatory system after aortic injury may play a role in the development of complications. The aim of this study was to determine the significance of the inflammatory markers for the mortality of patients suffering with medically treated type B acute aortic syndrome (AAS). SUBJECTS AND METHODS: We analyzed a total of 81 patients who were admitted with AAS within 24 hours from the onset of the symptoms and who were medically treated between January 2000 and December 2004. The patients were divided into two groups: the moribund patients who died within 2 weeks (group I: n=8, mean age: 64.0+/-11.0 years) and the patients who survived over 2 weeks (group II: n=73, mean age: 62.6+/-13.7 years). The serum high-sensitivity C-reactive protein (hsCRP) levels, the white blood cell (WBC) and monocyte counts, and the plasma D-dimer levels were measured on admission. RESULTS: The baseline clinical characteristics were not different between the two groups. The major causes of in-hospital death in group I were extensions or rupture of type B dissection (6 cases) and acute renal failure (2 cases). The multivariate analysis demonstrated that a high monocyte count (>1,250/mm3), and high levels of hsCRP (>11 mg/dL) and D-dimer (>1.2 mg/dL) were independent determinants of the short-term mortality (OR=6.39, 6.14 and 9.00; 95% CI=1.19 to 34.1, 1.14 to 32.9 and 1.20 to 67.4; p=0.02, 0.04 and 0.03, respectively). CONCLUSION: Systemic activation of the inflammatory system in type B AAS patients may be one of the important factors associated with the development of short-term mortality.
Acute Kidney Injury ; C-Reactive Protein ; Humans ; Inflammation ; Leukocytes ; Monocytes ; Mortality* ; Multivariate Analysis ; Plasma ; Prognosis ; Rupture

BACKGROUND AND OBJECTIVES: Atrioventricular nodal reentrant tachycardia (AVNRT) is the most common regular supraventricular tachycardias in both the general population and elderly patients. The aim of this study is to investigate the clinical and electrophysiologic characteristics and efficacy of radiofrequency catheter ablation (RFCA) for treating AVNRT in the elderly. SUBJECTS AND METHODS: This study included 273 consecutive symptomatic AVNRT patients who underwent RFCA for the slow-pathway. The study population was divided into two groups: group I patients were younger than 65 years (n=227, average age: 44.6+/-12.9 years, male : female=89 : 138) and group II patients were older than 65 years (n=46, average age: 69.0+/-3.6, male : female=9 : 37). We compared the baseline clinical, electrocardiographic and electrophysiologic characteristics and the outcomes of RFCA between the two groups. RESULTS: The prevalence of a baseline prolonged PR interval (>200 ms) was not different between the 2 groups (1.8% vs. 6.5%, p>0.05). The baseline sinus cycle length, QT interval and AVNRT cycle length were significantly longer in group II than in group 1 (799.3+/-146.1 ms vs. 864.3+/-159.8 ms, 374.2+/-42.1 ms vs. 397.6+/-40.4 ms, 351.3+/-43.2 ms vs. 384.9+/-57.0 ms, respectively p<0.05). There was no difference in the rate of RFCA-related complications, including transient AV block. The incidence of AV block (> or =second degree) was not different between the two groups (4.0% vs. 6.5%, p>0.05). One patient in group I required permanent pacemaker implantation. CONCLUSION: RFCA in elderly patients is safe and effective as in younger patients. Therefore, performing RFCA for treating AVNRT should also be considered in the elderly patients.
Aged* ; Atrioventricular Block ; Atrioventricular Node ; Catheter Ablation* ; Electrocardiography ; Humans ; Incidence ; Male ; Prevalence ; Tachycardia ; Tachycardia, Atrioventricular Nodal Reentry* ; Tachycardia, Supraventricular

BACKGROUND AND OBJECTIVES: Treating coronary in-stent restenosis (ISR) has become one of the major challenges for interventional cardiologists. The aim of this study was to compare the clinical effect of performing cutting balloon angioplasty (CBA) with implanting drug eluting stent (DES) for treating the focal type of instent restenosis (ISR). SUBJECTS AND METHODS: We retrospectively analyzed 56 patients who were treated by CBA (Group I: 59.6+/-9.6 years, male : female=46 : 10) and 20 patients who were treated by DES (Group II: 61.0+/-8.5 year, male : female=15 : 5) between January 2002 and December 2004. All the patients had the focal type of ISR (Group I - type IB : IC : ID=23 : 9 : 26, Group II - type IB : IC : ID=10 : 3 : 7). The 6-month angiographically determined late loss and the major adverse cardiac events (MACE) were compared between the two groups. RESULTS: The baseline clinical characteristics were similar between the two groups except for the high proportion of old myocardial infarction [4 (7.1%) and 3 (15%); respectively, p=0.02] and low left ventricular ejection fraction (62.6+/-8.8% vs. 55.2+/-13.8%, respectively, p=0.02) in group II. The acute gain after the procedure was higher in group II (1.86+/-0.53 mm vs. 2.54+/-0.20 mm, respectively, p<0.01). Follow-up angiography at 6 months was achieved in 40 of 56 (71.4%) patients in group I and in 15 of 20 patients (75%) in group II. The late loss was lower in group II than in group I (0.49+/-0.35 mm vs. 0.14+/-0.24 mm respectively, p<0.01). MACE during the 6-month follow-up developed in 8 patients (14.3%) of group I and in 1 patient (5.0%) of group II (p=0.04). CONCLUSION: DES is associated with a better clinical outcome than CBA for the treatment of the focal type of ISR.
Angiography ; Angioplasty, Balloon* ; Constriction, Pathologic ; Coronary Disease ; Drug-Eluting Stents* ; Follow-Up Studies ; Humans ; Male ; Myocardial Infarction ; Retrospective Studies ; Stents ; Stroke Volume

BACKGROUND AND OBJECTIVES : The aim of this study was to investigate the clinical features and long-term outcomes of atrial septal defect (ASD) that presents in adulthood, according to the treatment modalities. SUBJECTS AND METHODS : A total of 134 patients (mean age: 42.7+/-17.7 years, 79 females) with ASD were divided into two groups: group I (the surgical treatment group; 100 patients, mean age: 38.3+/-14.7 years, 65 females) and group II (the medical treatment group; 34 patients, mean age: 55.9+/-19.3 years, 14 females). The clinical characteristics at presentation and the long-term clinical outcomes were analyzed between the groups. RESULTS : The clinical symptoms at presentation were usually mild. Most of the patients had sinus rhythm except for 14 patients (10.4%) who had atrial fibrillation. The defect size, the systolic pulmonary artery pressure (SPAP) and the pulmonary to systemic flow ratio (Qp/Qs) according to echocardiography were 1.8+/-0.8 cm, 41.1+/-14.2 mmHg and 2.7+/-1.4 respectively. The age at presentation showed a significant positive correlation with the New York Heart Association (NYHA) class (r=0.44), the degree of tricuspid regurgitation (TR)(r=0.31), and the severity of pulmonary hypertension (r=0.45). Group I showed an improved NYHA class (from 1.9+/-0.7 to 1.4+/-0.6, respectively, p<0.001), a decreased SPAP (from 39.3+/-12.7 to 27.5+/-6.6 mmHg, respectively, p<0.001) and a decreased degree of TR (from 1.4+/-0.8 to 0.6+/-0.6, respectively, p<0.001) during the follow-up period. However, group II showed no significant changes. The incidence of hospitalization (10.1% in group I and 32.4% in group II, p=0.005) or arrhythmia (17.2% in group I and 35.3% in group II, p=0.011) was more frequent, and the NYHA functional class (1.4+/-0.6 in group I and 2.2+/-0.9 in group II, p<0.001) was more severe in group II than in group I. The mortality rate was higher in group II than in group I (3 patients: 8.8% in group II, 1 patient and 1.0% in group I, p=0.02) by uni-variate analysis. However, bon the multi-variate analysis, the mortality rate was not different between the groups (p=0.48). CONCLUSION : ASD presenting in adulthood showed mild clinical symptoms and a good prognosis. Surgical treatment showed symptomatic improvement, but there was no mortality benefit as compared with medical treatment.
Adult* ; Arrhythmias, Cardiac ; Atrial Fibrillation ; Echocardiography ; Follow-Up Studies ; Heart ; Heart Septal Defects, Atrial* ; Hospitalization ; Humans ; Hypertension, Pulmonary ; Incidence ; Mortality ; Prognosis ; Pulmonary Artery ; Tricuspid Valve Insufficiency