BACKGROUND: Hepatitis B virus (HBV) infection leads to hepatic and extrahepatic manifestations including chronic kidney disease (CKD). However, the association between HBV and CKD is not clear. This study investigated the association between chronic HBV infection and CKD in a nationwide multicenter study. METHODS: A total of 265,086 subjects who underwent health-check examinations in 33 hospitals from January 2015 to December 2015 were enrolled. HBV surface antigen (HBsAg) positive cases (n = 10,048), and age- and gender-matched HBsAg negative controls (n = 40,192) were identified. CKD was defined as a glomerular filtration rate (GFR) < 60 mL/min/1.73 m² or proteinuria as at least grade 2+ of urine protein. RESULTS: HBsAg positive cases showed a significantly higher prevalence of GFR < 60 mL/min/1.73 m² (3.3%), and proteinuria (18.9%) than that of the controls (2.6%, P < 0.001, and 14.1%, P < 0.001, respectively). In the multivariate analysis, HBsAg positivity was an independent factor associated with GFR < 60 mL/min/1.73 m² along with age, blood levels of albumin, bilirubin, anemia, and hemoglobin A1c (HbA1c). Likewise, HBsAg positivity was an independent factor for proteinuria along with age, male, blood levels of bilirubin, protein, albumin, and HbA1c. A subgroup analysis showed that HBsAg positive men but not women had a significantly increased risk for GFR < 60 mL/min/1.73 m². CONCLUSION: Chronic HBV infection was significantly associated with a GFR < 60 mL/min/1.73 m² and proteinuria (≥ 2+). Therefore, clinical concern about CKD in chronic HBV infected patients, especially in male, is warranted.
Anemia ; Antigens, Surface ; Bilirubin ; Case-Control Studies* ; Female ; Glomerular Filtration Rate ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Hepatitis B, Chronic* ; Hepatitis, Chronic* ; Humans ; Male ; Multivariate Analysis ; Prevalence ; Proteinuria ; Renal Insufficiency, Chronic*

PURPOSE: To evaluate the incidence and clinical features of age-related macular degeneration (AMD) in Korea. METHODS: Web-based (www.armd-nova.or.kr) registration was conducted for AMD patients aged 50 or more who were newly diagnosed by retinal specialists in Korea from August 20, 2005 to August 20, 2006. Patient data including ophthalmologic examination, fundus photography, fluorescein angiogram and/or indocyanin green angiogram (ICG), past medical history, behavioral habit, combined systemic diseases were up-loaded. RESULTS: Among finally enrolled 1,141 newly diagnosed AMD patients, 690 patients (60.5%) were male and 451 patients (39.5%) were female. The average age of AMD patients was 69.7+/-8.0. Early AMD was observed in 190 patients and 951 patients had late AMD. Classic choroidal neovascular membrane (CNVM) was observed in 18.6% of exudative AMD patients and 63.4 % had occult CNVM. Subfoveal CNVM was observed in 80.4% of the patients with CNVM. Among the 580 exudative AMD eyes that performed indocyanin green angiography (ICG), 184 eyes (31.7%) had polypoidal choroidal vasculopathy (PCV) and 36 eyes (6.2%) showed retinal angiomatous proliferation (RAP). Age, male gender, smoking, diabetes and hypertension significantly increased the risk of the AMD among Koreans. CONCLUSIONS: Because of the low rate of participation by retinal specialists, definite incidence of AMD was not obtainable. However, the estimated 1-year AMD incidence in the Pusan area of Korea is at least 0.4%. In contrast to Western people, 31.7% of exudative AMD cases were revealed to be PCV and 6.2% were revealed to be RAP. This discrepancy between ethnic groups should be considered in the diagnosis and treatment modality selection of Korean AMD patients.
Aged ; Angiography ; Choroid ; Ethnic Groups ; Eye ; Female ; Fluorescein ; Humans ; Hypertension ; Incidence ; Korea ; Macular Degeneration ; Male ; Membranes ; Photography ; Retinaldehyde ; Smoke ; Smoking ; Specialization

Angiomyolipoma occurs most commonly in the kidneys; the liver is the second most frequent site of involvement. Hepatic angiomyolipoma is a rare, benign, mesenchymal neoplasm, composed mainly of blood vessels, smooth muscle cells, fat, and myelocomponents. Radiologic findings are non-specific because the various elements of these neoplasms vary in their proportion and distribution within the tumor. Thus, data obtained by imaging technologies such as computed tomography, ultrasonography, or magnetic resonance imaging tend to be merely suggestive; definitive diagnosis usually requires histologic confirmation. We report here a case of angiomyolipoma in an incidental tumor of the liver of a 53-year-old female. Tissue was removed from the tumor by ultrasonography-guided gun biopsy and subjected to immunohistochemical analysis. Data showed that tumor cells were positive for HMB-45 and SMA, but negative for cytokeratin, anti-hepatocyte antigen, and alpha-fetoprotein. The patient did not receive any treatment and is being followed up.
alpha-Fetoproteins ; Angiomyolipoma ; Biopsy ; Blood Vessels ; Female ; Humans ; Keratins ; Liver ; Magnetic Resonance Imaging ; Middle Aged ; Myocytes, Smooth Muscle

TNF-alpha is a major cytokine involved in inflammatory bowel disease (IBD). In this study, water extract of Grifola frondosa (GFW) was evaluated for its protective effects against colon inflammation through the modulation of TNF-alpha action. In coculture of HT-29 human colon cancer cells with U937 human monocytic cells, TNF-alpha-induced monocyte adhesion to HT-29 cells was significantly suppressed by GFW (10, 50, 100 microg/ml). The reduced adhesion by GFW correlated with the suppressed expression of MCP-1 and IL-8, the major IBD-associated chemokines. In addition, treatment with GFW significantly suppressed TNF-alpha-induced reactive oxygen species production and NF-kappaB transcriptional activity in HT-29 cells. In differentiated U937 monocytic cells, LPS-induced TNF-alpha production, which is known to be mediated through NF-kappaB activation, was significantly suppressed by GFW. In an in vivo rat model of IBD, oral administration of GFW for 5 days (1 g/kg per day) significantly inhibited the trinitrobenzene sulfonic acid (TNBS)-induced weight loss, colon ulceration, myeloperoxidase activity, and TNF-alpha expression in the colon tissue. Moreover, the effect of GFW was similar to that of intra-peritoneal injection of 5-aminosalicylic acid (5-ASA), an active metabolite of sulfasalazine, commonly used drug for the treatment of IBD. The results suggest that GFW ameliorates colon inflammation by suppressing production of TNF-alpha as well as its signaling through NF-kappaB leading to the expression of inflammatory chemokines, MCP-1 and IL-8. Taken together, the results strongly suggest GFW is a valuable medicinal food for IBD treatment, and thus may be used as an alternative medicine for IBD.
Animals ; Cell Adhesion/drug effects/immunology ; Cell Extracts/administration & dosage/*pharmacology ; Chemokine CCL2/biosynthesis/genetics ; Coculture Techniques ; Colon/drug effects/*metabolism/pathology ; Grifola ; HT29 Cells ; Humans ; Inflammatory Bowel Diseases/chemically induced/*drug therapy/pathology/physiopathology ; Interleukin-8/biosynthesis/genetics ; Intestinal Mucosa/*drug effects/metabolism/pathology ; Monocytes/*drug effects/metabolism/pathology ; NF-kappa B/genetics/metabolism ; Peroxidase/metabolism ; Rats ; Rats, Sprague-Dawley ; Reactive Oxygen Species/metabolism ; Stomach Ulcer ; Transcription, Genetic/drug effects ; Trinitrobenzenesulfonic Acid/administration & dosage ; Tumor Necrosis Factor-alpha/*biosynthesis/genetics ; U937 Cells ; Weight Loss

To report cases of metastasectomy for metastatic gynecologic malignancies, we reviewed the medical records of all patients who have undergone metastasectomy for metastatic gynecologic malignancies in Center for Uterine Cancer from June 2001 to October 2002. Six patients were identified with median age of 55 years (range 52-66 years). The metastatic sites and primary sites were as follows: 3 liver metastasis from ovary; 1 abdominal wall metastasis from uterus (endometrial cancer), 1 brain metastasis from ovary, 1 lung metastasis from uterus (sarcoma). The median disease free interval was 48 months (range 10 months-13 years). There was no perioperative mortality. Postoperative morbidity was tolerable with 1 case of bile leakage. In three patients with hepatectomy, one patient was dead of disease after 15 months, one patient is alive with disease at 20 months of follow up, one patient have no evidence of recurrence at 7 months follow up. The patient with brain metastasis was dead due to lung metastsis after 9 months later postoperatively. Remaining two patients with abdominal wall and lung metastasis have no evidence of tumor recurrence at 4, 7 months follow up respectively. Metastasectomy for metastatic gynecologic malignancies can be performed safely and may help prolong survival in carefully selected patients.
Abdominal Wall ; Bile ; Brain ; Female ; Follow-Up Studies ; Hepatectomy ; Humans ; Liver ; Lung ; Medical Records ; Metastasectomy ; Mortality ; Neoplasm Metastasis ; Ovary ; Recurrence ; Uterine Neoplasms ; Uterus

OBJECTIVES: To investigate the prevalence of cognitive impairment and dementia in elderly people, aged 65 or above, residing in Busan Metropolitan City. METHODS: Total of 1, 101 old people, aged 65 or above, living in Busan as of December 31, 2001 were selected using stratified three-stage cluster sampling. Cognitive impairment was determined from the MMSE-K score, and dementia confirmed from five psychometric measures and the Barthel index. The crude prevalence, sex-age adjusted for the Korean population, were obtained. RESULTS: With the cut-off point for cognitive impairment was set at 24 points, or below, on the MMSE-K scale, the crude rate of cognitive impairment was 29.3% (15.7% for men and 37.5% for women), and the sex-age adjusted prevalence was 30.5% (17.5% for men and 37.0% for women). When the cut-off point for cognitive impairment was set at 20 points, or below, on the MMSE-K scale, the crude rate of cognitive impairments were 10.0% (4.1% for men and 13.5% for women), and 10.6% (4.7% for men and 13.1% for women), respectively. The crude dementia, and the sex-age adjusted rates were 7.4% (2.4% for men and 10.5% for women), and 8.0% (2.7% for men and 10.0% for women), respectively. CONCLUSIONS: The prevalence of dementia in this study was somewhat lower than that reported by other domestic and foreign studies. Our results related to the difference in time and space, diagnostic tools, response rates, and distribution of male and female subjects, etc.
Aged* ; Busan* ; Cognition Disorders* ; Dementia* ; Female ; Humans ; Male ; Prevalence* ; Psychometrics

Membranous glumerulonephrophy was found in two men who were diagnosed as psoriasis vulgaris. In the first patient, membranous glumerulonephropathy was developed during treatment of psoriasis and deterioration of proteinuria was appeared with aggravation of skin lesion although treated with cyclophosphamide. In the second patient, psoriasis developed during treatment of membranous glomerulonephropathy and we observed the improvement of nephrotic syndrome and psoriasis with prednisolone treatment. The simultaneous deterioration and improvement of proteinuria and skin lesion of psoriasis suggests that underlying common immune abnormalities may be involved in the pathogenesis of both psoriasis and membranous glomerulopathy.
Cyclophosphamide ; Glomerulonephritis, Membranous* ; Humans ; Male ; Nephrotic Syndrome ; Prednisolone ; Proteinuria ; Psoriasis* ; Skin

Enterococcus is a normal flora of the gastrointestinal or genitourinary tract. With the increased use of vancomycin and third generation cephalosporins, vancomycin-resistant enterococci (VRE) have become one of the major nosocomial pathogens in USA and Europe since 1986. In Korea, patients with VRE infection or colonization were increasingly reported recently and VRE may become a serious nosocomial pathogen in the near future. So we report a case of vancomycin-resistant E. faecium peritonitis in a patient on continuous ambulatory peritoneal dialysis.
Cephalosporins ; Colon ; Enterococcus ; Europe ; Humans ; Korea ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis* ; Vancomycin

BACKGROUND: In hypertensive patients, the left ventricular hypertrophy(LVH) is very important as an independent risk factor along with developing complications. The present study was attempted to assess whether LVE assessed by echocardiography is related to diurnal variations of blood pressure in patiens with essential hypertension. METHOD: After 24hr ambulatory blood pressure monitoring, echocardiographic parameters were investigated in 30 healthy normotensive subjects and 17 patients with diurnal variation of blood pressure and 19 patients without diurnal variation respectively. RESULTS: Left ventricular mass index was higher in essential hypertensive patients than normotensive subjects. In patients without nocturnal fall in systolic blood pressure, left ventricular mass tended to be higher than in patients with a nocturnal fall without statistic significance. In the hypertensive patients with nocturnal fall, there was a correlationship between LVMI and changes in systolic blood pressure, but no correlation between left ventricular mass index and changes in diastolic blood pressure. In the hypertensive patients without nocturnal fall, changes of both systolic and diastolic pressure did not affect LVMI. CONCLUSION: It is suggested strongly that left ventricular hypertrophy may occur highly in the hypertensive patients without nocturnal(diurnal) variation in blood pressure and may be associated with changes in diastolic and systolic blood pressure. But in hypertensive patient with nocurnal fall, left ventricular hypertrophy may be associated with changes in systolic blood pressure.
Blood Pressure Monitoring, Ambulatory ; Blood Pressure* ; Echocardiography ; Humans ; Hypertension* ; Hypertrophy, Left Ventricular ; Risk Factors

The purpose of this study is to analyze the relationship between the blood pressure level and their sexual maturity and physical growth in the children at puberty. For this purpose, we estimated the blood pressure, physical growth and sexual maturity of the boys of 335 and girls of 373 who are in the middle schools which are located in Kang-wha County, KyungKi-Do. Both systolic and diastolic pressure were measured twice. Such physical growth as height, body weight, skin fold thickness, waist circumference, hip circumference and arm circumference were measured. The sexual maturity was estimated according to the classification of Tanner's 5-phase-sexual-maturity; in boys, their pubic hair development phase; in girls, their pubic hair and breast development phase and the menstrual experience. In the phase of the pubic hair development, the boy's sexual maturity was distributed into this; the 1 st 56.4%, the 2nd 29.3%, the 3rd 9.9%, the 4th 4.1% and the 5th 0.3%. While the girls sexual maturity was distributed into this : the 1 st 20.5%, the 2nd 34.9%, the 3rd 30.6% the 4th 12.6% and the 5th 1.3% in the phase of the pubic hair development, and the 1 st 0.8%, the 2nd 13.7%, the 3rd 36.2%, the 4th 18.8% and the 5th 30.5% in the phase of the breast development. This indicated that the girls sexual maturity was higher than those of the boys. The girls menstrual experience rate accounted to the 58.2%. In order to see the relationship between the children's sexual maturity and blood pressure level, we regress blood pressure level on physical growth(i.e., height, BMI) and sexual maturity. Sexual maturity in treats as dummy variables. As the result of this analysis, the boys' sexual maturity has nothing to do with the blood pressure either systolic or diastolic. But the girl's systolic pressure was statistically significant; the 9% of the physical growth, the 5% of the pubic hair development and the 4% of the breast development in sexual maturity was explained. In the girls' diastolic pressure, only their pubic hair development was statistically significant; the 7% of the physical growth and the 7% of the pubic hair development in the diastolic was explained and the 5% of the physical growth in the diastolic Korotokoff phase was explained, especially, the girls experienced menstruation, their systolic and diastolic pressure were significantly high(P<0.01). Conclusively, in the first grade children attending middle schools who are in the early process of the sexual development, the sexual maturity was not related to blood pressure level, on the other hand, the blood pressure level of the girls who are more sexual development than those of the boys' have something to do with sexual maturity and physical growth.
Adolescent ; Arm ; Blood Pressure* ; Body Height ; Breast ; Child* ; Classification ; Female ; Gyeonggi-do ; Hair ; Hand ; Hip ; Humans ; Menstruation ; Puberty* ; Sexual Development ; Skin ; Waist Circumference