Gender Difference in the Level of HDL Cholesterol in Korean Adults / 가정의학회지

BACKGROUND: High density lipoprotein (HDL) cholesterol level varies with ethnicity and gender. In Korea there has not been an agreement on standards for HDL cholesterol level. Therefore, in order to establish a foundation for research on HDL cholesterol, we investigated the gender difference in HDL cholesterol level after adjusting associated factors. METHODS: The study population included 4,465 individuals (1,833 men, 2,632 women) representing 33,502,918 Koreans 20 years of age or older, who participated in the 2005 Korean National Health and Nutrition Survey. After stratifying by gender, we analyzed the HDL cholesterol level according to the general characteristics of the study population. Then we identified independent factors associated with HDL cholesterol level. After adjusting for covariates, we estimated the gender difference in HDL cholesterol level. RESULTS: We demonstrated that age, current smoking, body mass index, alcohol intake, triglyceride and low density lipoprotein cholesterol level have significant impact on HDL cholesterol level. In addition, educational status was also an important factor for men, while fat intake was a significant factor for women. After adjusting associated factors, the means (standard errors) of HDL cholesterol level were 43.8 (0.2) mg/dL in men and 46.3 (0.2) mg/dL in women, respectively. CONCLUSION: The mean gender difference in HDL level (2.5 mg/dL) in Korean adults was, therefore, less than those observed in previous western studies.

Lifestyle Habits Related to Abdominal Obesity in Korean Adolescents / 가정의학회지

BACKGROUND: It has been reported that the abdominal obesity can cause various metabolic abnormalities not only in adults but also in adolescents. This study was conducted to investigate lifestyle habits related to abdominal obesity in Korean adolescents. METHODS: This study is a cross-sectional study on 561 adolescents (305 boys and 256 girls) aged 12-18 years from the Korean National Health and Nutrition Examination Survey 2005. The abdominal obesity was defined as waist circumference at or above the 90th percentile for each age and gender based on the 2007 growth chart for Korean children. The frequency of physical activity, screen time, and the intake amount of energy and macronutrients were investigated as lifestyle habits. RESULTS: The prevalence of abdominal obesity in Korean adolescents aged 12-18 years was 9.1% (Boys, 9.4%; Girls, 8.7%). The mean of daily screen time was 4.3 +/- 0.1 hours (Boys, 4.4 +/- 0.2 hours; Girls, 4.2 +/- 0.2 hours). The subjects with daily screen time > or = 5 hours had a 3.0 times increased risk of abdominal obesity compared to subjects with daily screen time or = 35% of energy was 2.57 (95% confidence interval, 1.16 to 5.68; P-value = 0.020) with fat intake < 25% of energy as reference. The relationship between long screen time and abdominal obesity was observed in girls and high fat intake was related to abdominal obesity in boys. CONCLUSION: This study shows that abdominal obesity in Korean adolescents is associated to long screen time and high fat intake.

What Types of Dietary Supplements Are Used in Korea? Data from the Korean National Health and Nutritional Examination Survey 2005 / 가정의학회지

BACKGROUND: Dietary supplements affect the health and disease status of Koreans. We assessed the patterns of dietary supplements use and the related factors in Korean adults from the 2005 Korea National Health and Nutrition Survey (KNHANES). METHODS: Among the subjects, 2,024 men and 2,811 women underwent all the three parts of 2005 KNHANES, which consisted the health survey, the health examination, and the nutritional survey. Reported supplements were classified according to the 2008 Korea Food and Drug Administration Notification. We assessed the relationship between supplements use and socioeconomic state, health behaviors, and chronic diseases. RESULTS: Twenty-nine percent of Korean adults was taking dietary supplements. Vitamin/mineral supplements were the most commonly taken one. Glucosamine/mucopolysaccharide, ginseng, spirulina/chlorella, omega-3, and aloe followed in listing. Supplement users were likely to be woman and middle-aged. Supplement use was associated with older, high income, with spouse, higher education, urban-living, regular exercise, non-smoker, and lower BMI. Musculoskeletal diseases were associated with supplement use. CONCLUSION: Dietary supplement use is prevalent in Korean adults. The supplement use was associated with some demographics characteristics, health behavior, and chronic diseases. These factors should be considered when evaluating the efficacy of dietary supplements.

Relationship between Passive Smoke and Urinary Cotinine Level

BACKGROUND: Cotinine, a nicotine metabolite detected in urine, has been recommended as the best quantitative marker of smoking and environmental tobacco smoke (ETS) exposure. The aim of this study was to analyze the relationship between indoor ETS and urinary cotinine level of the passive smokers. METHODS: We selected 42 nonsmokers who lived in Seoul and were not exposed to passive smoking at least 5 days before test. Urinary cotinine levels were measured by Smokescreen Colorimeter (Surescreen Diagnostics LTD, U.K.). We measured urinary cotinine levels twice (before and after smoking exposure). RESULTS: The mean urinary cotinine level was 0.33microgram/mL before smoking exposure, and 0.46microgram/mL after smoking exposure. There was statistically significant difference (P-value=0.003). There was no significant difference between exposure time and increase of urinary cotinine level(P=0.138, r=-0.233). There was also no significant difference between measuring time taking after exposure and increase of urinary cotinine level (P=0.671, r=0.067). CONCLUSION: One experience of indoor exposure to ETS caused significant elevation of urinary cotinine level.

Relationship between Passive Smoke and Urinary Cotinine Level

BACKGROUND: Cotinine, a nicotine metabolite detected in urine, has been recommended as the best quantitative marker of smoking and environmental tobacco smoke (ETS) exposure. The aim of this study was to analyze the relationship between indoor ETS and urinary cotinine level of the passive smokers. METHODS: We selected 42 nonsmokers who lived in Seoul and were not exposed to passive smoking at least 5 days before test. Urinary cotinine levels were measured by Smokescreen Colorimeter (Surescreen Diagnostics LTD, U.K.). We measured urinary cotinine levels twice (before and after smoking exposure). RESULTS: The mean urinary cotinine level was 0.33microgram/mL before smoking exposure, and 0.46microgram/mL after smoking exposure. There was statistically significant difference (P-value=0.003). There was no significant difference between exposure time and increase of urinary cotinine level(P=0.138, r=-0.233). There was also no significant difference between measuring time taking after exposure and increase of urinary cotinine level (P=0.671, r=0.067). CONCLUSION: One experience of indoor exposure to ETS caused significant elevation of urinary cotinine level.

Comparison of the Diagnostic Value between Mammography and Mammography with Breast Ultrasonography in Diagnosing Breast Cancer

BACKGROUND: Because the sensitivity of mammography (MAM) is lower in young women than in old and in women with dense breast than those without, many physicians utilize breast ultrasonography (US) with MAM. But the addictive value of US is unclear. This study compared the diagnostic value between MAM and MAM US. METHODS: Between September, 2002, and February, 2003, there were 89 cases of breast disease confirmed by surgery, that had both MAM and US results. The results of MAM and US were classifed by Breast Imaging Reporting and Data System (BI-RADS) and were categorized as positive or negative. Among the positive results, BI-RADS Category 0 and Category 3 with recommendation of other test were regarded as an intermediate result. RESULTS: Among all 89 cases, 38 cases were malignancies. The receiver operating characteristic curves showed non-significant increase in diagnostic value by adding US to MAM. The sensitivity of MAM was non-significantly higher in above-50-years women than in below- 49-years women and in women with dense breast than in women with non-dense breast. Among positive results of MAM, 21 cases were 'intermediate results'. US correctly regraded 8 benign lesions from 19 cases of false-positive MAM and 1 extra malignancy with palpable lump from 4 false-negative MAM. CONCLUSION: MAM is a valuable test in diagnosing breast cancer. US is a valuable complementary test to MAM in evaluating palpable lump with negative MAM and intermediate result of MAM.

Iatrogenic Pseudoaneurysm of Iliac-femoral Artery; the Efficacy of Ultrasound-guided Thrombin Injection Therapy

PURPOSE: As a consequence of the widespread application of coronary and peripheral interventional procedures, the incidence of a femoral pseudoaneurysm is increasing. Along with the traditional surgical approach, ultrasound-guided compression or thrombin injection therapy has recently been developed and is widely used to reduce surgical morbidity. The efficacy of these therapies was compared to define the guidelines for treating an iatrogenic femoral pseudoaneurysm in Korean patients. METHODS: Ultrasound-guided therapies were performed prospectively since October 2000. The results of the surgical repair from July 1996 were reviewed retrospectively. A total 22 patients with an iliofemoral pseudoaneurysm were enrolled in this study. RESULTS: Surgical repair was performed in 12 cases, ultrasound-guided compression therapy in 1 case, and ultrasound-guided thrombin injection in 9 cases. A primary closure of the puncture site (11 cases) and an iliac artery interposition graft (1 case) were performed. Postoperative complications developed in 4 cases; wound hematoma, wound infection and ureter injury. Compression therapy was successfully performed in 1 case. A thrombin injection was performed in 9 cases. Immediate thrombotic obliteration of the pseudoaneurysm occurred in all cases. Partial recannalization was detected during follow-up duplex sonography in 1 case, who was successfully treated by an additional thrombin injection. There were no complications associated with the thrombin injection and no recurrence had occurred during the 4 weeks follow-up. CONCLUSION: Thrombin injection therapy is highly efficient, safe, and comfortable. Ultrasound-guided thrombin injection could be the initial treatment of choice for treating iatrogenic femoral pseudoaneurysm.

Clinical Usefulness of Prostatic Acid Phosphatase in Prostate Cancer : A Comparative Study with Prostate Specific Antigen / 대한비뇨기과학회지

PURPOSE: To evaluate the clinical usefulness of PAP in staging and monitoring of patient with prostate cancer, we performed a comparative study with PSA, retrospectively. METHODS: We evaluated 72 patients with prostate cancer. Of these patients 11 had stage A, 6 stage B, 10 stage C, 5 stage D1 and 40 stage D2 prostate cancer. Serum PAP level was measured in all 72 patients and serum PSA level was measured concomitantly in 42 patients. RESULTS: The mean initial PAP value was 13.40+/- 7.00 U/L. But only 40 (55.6%) had elevated PAP value above 1.5U/L at presentation. Of 55 advanced cases (stage C, D), 39 (76.9%) had elevated PAP values. Of the 42 patients, who underwent longitudinal PSA assessment, the mean initial PSA value was 178.0 +/- 33.3 ng/ml. Forty (95.2%) had elevated PSA value above 4 ng/ml at presentation. Of 41 advanced cases (stage C, D1, D2), 33 (80.5%) exceeded 50 ng/ml. None of the patient had elevated PAP value with normal PSA value at presentation. Among 42 patients, who had followed with longitudinal serum PSA and PAP, progression of the disease to the bone, lung, and rectum occurred in 26 patients; in all PSA was the first indicator of progression and in none of them PAP anticipated PSA elevation. CONCLUSIONS: Although PAP value usually reflects advanced prostate cancer (70.9%), serum PSA also reflects it (80.5%). Serum PSA monitoring is superior to serum PAP monitoring in predicting disease progression. The use of PSA and PAP jointly to stage and monitor prostate cancer did not appear to enhance the clinical utility over that of PSA alone.

Outcome Analysis of Pyeloplasty in Children / 대한비뇨기과학회지

PURPOSE: To elucidate factors affecting the outcome of pyeloplasty, we retrospectively reviewed a consecutive series of children who underwent dismembered pyeloplasty. METHODS: We encountered 37 kidneys in 30 patients with primary UPJ obstruction. Twenty eight were male and 2 were female. Sixteen patients (19 renal units) were younger than 1 year of age. There was a 2.3: 1 predominance of left side. In all 37 renal units, postoperative calyceal dilatations were compared to those of preoperative degrees by excretory urography or ultrasonography. In 20 of 23 unilateral disease, postoperative split renal functions measured by 99mTc MAG-3 or DTPA renal scan were compared to those of preoperative values. Mean follow up was 48.4 months. To assess the degree of improvement of renal function and calyceal dilatation, multivariant analysis was performed by groups according to age, initial presentation, preoperative split renal fuction, laterality and the degree of preoperative calyceal dilatation. RESULTS: In patients younger than 1 year, the most common initial presentation was prenatally detected hydronephrosis (9/16) and in older children, abdominal mass or pain (10/14). In all 20 patients who had renal scan, split renal function was improved in 13 (65.0%) and unchanged in 7 (35.0%) after the surgery. In 9 kidneys with impaired preoperative split renal function (less than 35%), renal function was improved greater than 5% in 8 (88.9%) after the surgery. in the other 11 renal units, the function was greater than 35% before and after the surgery. The improvement of calyceal dilatation was noticed in 33 (89.2%) of the renal units and more significant in groups of children who had high grade (IV,V) hydronephrosis with preoperative renal function of greater than 35%. The degree of functional improvement was better in groups of patients whose age were under 12 months and also who had impaired renal function with mild to moderate calyceal dilatation. The half time clearance was well correlated to the degree of calyceal dilatation. No one underwent repeated operation. CONCLUSIONS: Dismembered pyeloplasty is safe and highly successful procedure. The greatest potential recovery of renal function was noticed in patients with decreased renal function but mild to moderate hydronephrosis. And the resolution of calyceal dilatation was most likely in patients with severe hydronephrosis but well preserved renal function.

Vanished Testis: A Histological Study / 대한비뇨기과학회지

PURPOSE: A histological study was undertaken to characterized the vanished testes in boys who had impalpable cryptorchidism and found to have nubbin remnant during last 9-years period. METHODS: Of 108 impalpable cryptorchid boys, 42(44 nubbins, 38.9%) were found to have vanished testes at exploration. RESULTS: Thirty nine(88.6%) were located on the left side and the other 5(11.4%) were on the right side. The age range was 6 months to 14 years(mean;52.2 months). All 44 nubbin remnants were excised and examined microscopically. Grossly it was characterized by several centimeters of spermatic cord with small fibrotic tissue at distal end. Microscopically fibrous tissues were identified in all 44 specimens(100%), vasa deferens in 36(81. 8%), epididymis in 19(43.2%), calcifications in 18(40.9%), hemosiderin deposits in 6(13. 6%), germ cells in 5(11.4%), seminiferous tubules in 7(15.9%), tunicae albuginea in 7(15.9%) and hyalinizations in 3(6.8%). CONCLUSIONS: The finding of scattered foci of calcifications, hemosiderin deposits and the presence of relatively normal spermatic cord and epididymis, supports the concept of in utero torsion of the testis as the etiology of vanished testis. The 11.4% incidence of viable germ cells warrants exploration and removal of remnant tissue in boys with a impalpable cryptorchidism.

Resistive Index Values of Normal Kidneys in Children / 대한비뇨기과학회지

In hydronephrosis, it is very important for its management to determine. RI value using Doppler sonography is one of the least invasive modality available for differentiating the obstructed from the nonobstructed dilated upper urinary tract and particularly useful in following the patient who has hydronephrosis. However its normal value and discriminating point were not established yet in children. To assess better utility of RI in diagnosis of obstructive hydronephrosis, we evaluated 66 undilated renal units with the intention of establishing a nomogram of RI values in children. There was no significant relationship between the RI values and age, sex or laterality Overall mean of RI value was 0.74+/-0.07 in this study and 22 of 66 undilated kidneys (33.3%) had RI values above 0.7, which has thought to be discriminatory value in adult. We think that RI values of normal kidneys need to be evaluated further in children.