Prevalence of the Metabolic Syndrome among Korean Workers by Occupational Group: Fifth Korean National Health and Nutrition Examination Survey (KNHANES) 2010

OBJECTIVES: The prevalence of the metabolic syndrome has increased rapidly in South Korea over the past 10 years. However, the occurrence of the metabolic syndrome in workers grouped according to the specific type of work is not well understood in Korea. In this study, we assessed the differences in the prevalence of the metabolic syndrome by occupational group and evaluated the risk of the metabolic syndrome among occupational groups. METHODS: From the Fifth Korean National Health and Nutrition Examination Survey (2010), 3,303 employed participants were included in this study. The unadjusted and age-adjusted prevalences of the metabolic syndrome were estimated and multiple logistic regression analysis was conducted using the presence of the metabolic syndrome as a dependent variable, and adjusting for age, education level, household income, drinking behavior, smoking status, physical activity, work hours, and work scheduling pattern. RESULTS: Among male workers, non-manual workers had the greatest age-adjusted prevalence (26.4%, 95% CI: 22.3-30.5%) among the occupational groups. In a logistic regression analysis, male manual workers had a significantly lower odds ratio for the metabolic syndrome relative to non-manual workers (0.59, 95% CI: 0.41-0.85). CONCLUSION: Our study demonstrated differences in the prevalence of the metabolic syndrome by occupational group and identified the greatest risk for the metabolic syndrome in male non-manual workers.

Clinical Characteristics of Papillary Thyroid Microcarcinoma / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Most papillary thyroid microcarcinoma (PTMC) carry a favorable prognosis, but a few patients present with aggressiveness. We classified PTMC according to the tumor size, and investigated the treatment, pathological finding and clinical behavior. SUBJECTS AND METHOD: Out of 714 patients submitted to surgical treatment for well differentiated thyroid cancer between 1996 and 2006, 179 (25%) patients had been identified as PTMC. These records were reviewed retrospectively, and followed up for 4 to 114 months (mean 43.3 months). RESULTS: The incidentaloma was 53 from 179 PTMC. The surgical procedures were hemithyroidectomy (n=79) or total thyroidectomy (n=100) including completion thyroidectomy. In the pathologic finding, 46 cases (25%) had extrathyroidal extensions and 37 cases (20%) had lymph node metastasis. In the total thyroidectomy cases, 35 cases had multiplicity, including 18 bilateral cases. When mass sizes were divided into those either bigger or smaller than 5 mm, statistical significance was found only in the extrathyroidal extensions (p=0.023). There were 2 recurrences in the total thyroidectomy cases and 4 in hemithyroidectomy, but without any statistical difference. With respect to size, there was only 1 recurrence in patients whose mass size was smaller than 5 mm and 5 in patients whose mass size was bigger than 5 mm; there was no statistical difference, however. CONCLUSION: Pathologically, extrathyroidal extension was more common in cases with tumor size more than 5 mm. This finding could be the evidence of poorer prognosis in these cases. However, there was no difference in the recurrence rate between the groups of different sizes and thyroidectomy methods. Therefore, surgical options should be carefully decided in the treatment of PTMC.

Diagnostic Value of Cochlear Hydrops Analysis Masking Procedure in Meniere's Disease / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The diagnosis of Meniere's disease is based on audiological test and clinical symptoms. Cochlear Hydrops Analysis Masking Procedure (CHAMP) was introduced as a test for detecting changes in physical characteristics of basilar membrane by hydrops of endolympahtic system. The aim of this study is to evaluate the diagnostic value and usefulness of CHAMP tests for detection of endolymphatic hydrops. SUBJECTS AND METHOD: This study was performed on 11 cases of Meniere's disease and 10 cases of vestibular neuritis who visited ENT outpatient clinic and 25 cases of normal healthy volunteers. We defined the positive value as being less than 0.3 ms in latency delay (0.5 kHz HPN-click alone) and less than 0.95 nV in compound amplitude ratio (click alone 0.5 kHz HPN/ click alone) regardless of age or sex. RESULTS: There were significant latency delays in the Meniere's disease group compared with the vestibular neuritis and normal control group. The amplitude ratio gave significant differences between the Meniere's disease group and the normal group but there were no differences between the Meniere's disease group and the vestibular neuritis group. Without assuming the test failure, the sensitivity and specificity of latency delay was 81% and 100%, respectively, and the sensitivity and specificity of amplitude ratio was 100% and 84%, respectively. In 8 of 54 cases (14.8%), we couldn't get interpretable wave. CONCLUSION: CHAMP test is a clinically useful method that can detect endolymphatic hydrops and it can be used as an objective test for the diagonosis of Meniere's disease.

Usefulness of Sialendoscopy in Unusual Obstructive Salivary Ductal Diseases / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Ductal calculi and stenosis are well known causes of salivary ductal obstructive lesions. As a direct view of the ductal systems was not possible for the surgeons, sialendoscopy has been a convenient tool for finding out these obstructive lesions. This study contains some unusual endoscopic findings that we have found during diagnostic and interventional sialendoscopy. SUBJECTS AND METHOD: Retrospective chart reviews were done, and endoscopic findings were reviewed for patients who received sialendoscopy from September 2003 to January 2007. Sixtyfour patients received sialendoscopy for either diagnostic or interventional method. RESULTS: We found unusual findings in 7 cases (10.9%). Three cases of basin malformation were observed. Two cases had spontaneous ductal perforation, and we also observed 2 cases of occult stone. CONCLUSION: The sialendoscopy is an excellent method in evaluating and treating salivary ductal diseases. We found out that the sialendoscopy made it possible to explore ductal systems completely, as well as to detect unusual findings, and to help in the management of some salivary ductal diseases.

A Comparison of Histopathologic Findings in the Nasal Polyp, Maxillary Sinus Mucosa, and Inferior Turbinate Mucosa

BACKGROUND AND OBJECTIVES: The nasal polyp is the most common form of mass lesion in the nose with an unclear etiology and pathogenesis among patients in Asia. Also, the pathological characteristic of nasal polyps in these patients is eosinophil infiltration. These findings, as reported in Asia, are distinct from those of the West. Moreover, the role of eosinophil is recently found to be on the increase even in Asia. So, we investigated the proportion of eosinophil infiltration in the nasal polyp among patients in Korea. MATERIALS AND METHODS: The study group consisted of 35 patients with a mean age of 43 years (ranging from 6 to 72 years). Tissue samples were taken via endoscopic sinus surgeries from the nasal polyp, inflammatory sinus mucosa, and the inferior turbinate. We compared 5 parameters of mucosal histopathology. RESULT: The incidence of a severe eosinophilic infiltration in the nasal polyp was 70%. Nasal polyp and inflammatory sinus mucosa had a larger eosinophil, lymphocyte and polymorphonuclear leukocyte infiltration than a normal nasal mucosa. Also, the nasal polyp and sinus mucosa had a more severe basement membrane thickening and goblet cell hyperplasia. Distinctively, the nasal polyp had a severe eosinophilic infiltration and a more thickened basement membrane. CONCLUSION: The present histopathologic feature of the nasal polyp among Koreans indicates that cases of eosinophilic nasal polyp seems to be on the increase.

Benign Recurrent Vertigo: Clinical Manifestations And Vestibular Function Test

BACKGROUND AND OBJECTIVES: Benign recurrent vertigo has been defined as recurrent spells of vertigo lasting minutes to hours without cochlear and neurologic signs. The etiology is still unclear, but viral and vasospastic etiology as migraine equivalent has been suggested. We attempt to analyze the symptoms and vestibular function test of Benign recurrent vertigo that has clinically diagnosed. MATERIALS AND METHODS: We analyzed retrospectively the clinical characteristics and vestibular function test including ocular-motor test, rotation test and computerized dynamic posturography from 100 patients with a Benign recurrent vertigo diagnosis. RESULTS: Eight two percent of the patients were female, mean age was 52 years, and mean duration of prevalence was 47.3 months. In the characteristics of vertigo, 91% of patients have spinning sensation during attack. The vertigo attacks most commonly lasts several hours (57%), and frequency of attack is three to twelve time per year in 47%. A high incidence (40%) of headache was detected, but incidence of other associated symptoms including fluctuating hearing loss (3%), tinnitus (27%), aural fullness (9%) was relatively low. The incidence of spontaneous nystagmus and positional nystagmus was 18% and 10% each. Saccadic undershoot was observed in 21% of patients, but it was not associated with other ocular-motor test abnormalities. In rotation test, low gain, phase lead and asymmetry was observed in 18%, 3% and 9%, respectively. There were no abnormal findings in posturography. CONCLUSIONS: Although benign recurrent vertigo did not show any characteristic clinical findings or vestibular function test, it deserves to be considered for differential diagnosis of episodic vertigo.

Intraoperative Monitoring Using Somatosensory Evoked Potential during Spinal Deformity Surgery

OBJECTIVE: Intraoperative monitoring using somatosensory evoked potential (SEP) study has been used increasingly to monitor neurological function during scoliosis surgery and other high-risk spinal surgeries. However, there are few studies related to this intraoperative monitoring, particularly in severe spinal deformity surgery, in Korea. So we evaluated the clinical efficacy of intraoperative SEP monitoring and considered the risk factors related to spinal surgery. METHOD: We performed a posterior tibial nerve somatosensory evoked potential study for intraoperative monitoring during surgical procedures in 101 patients (male 46, female 55). RESULTS: Neurologic damage occurred in 16 patients (10 congenital scoliosis cases, 5 tuberculous kyphosis cases, and 1 degenerative spondylosis case) after surgical procedures. Delayed postoperative neurologic damage occurred in 4 patients (2 mild damage cases, 2 severe damage cases) among 85 cases which showed normal responses during surgical procedures. Sensitivity of this study was 75%, and specificity was 95.3%. CONCLUSION: Somatosensory evoked potential study for intraoperaive monitoring is a sensitive and very useful method to detect iatrogenic lesions during spinal deformity surgery with satisfactory specificity. However, to improve the sensitivity and specificity of the intraoperative monitoring, combination of motor evoked potentials is recommended.