Examining the Relationship between Exercise and Psychological Stress among the Rural Population / 대한스포츠의학회지

This study aimed to examine the relationship between exercise and psychological stress among the rural population. We performed logistic regression to calculate the odds ratio (OR) and 95% confidence interval (CI) of the relationship between exercise and psychological stress after adjusting for sex, age, drinking, smoking, and BMI. In the results, the OR value (95% CI) for the people who worked out regularly, as compared to non-participation, was 0.540 (0.392-0.744). In the case of exercise frequency per week, OR values for the people who exercised 1-4 days per week and more than 5 days per week, as referred to non-participation, were 0.506 (0.265-0.968), 0.453 (0.233-0.879), respectively. In the case of exercise amount per week, OR values for the people who took part in exercising less than 150 minutes, more than 150 minutes and less than 300 minutes, more than 300 minutes and less than 600 minutes, and more than 600 minutes, as compared to non-participation, were 0.535 (0.295-0.972), 0.315 (0.161-0.619), 0.475 (0.282-0.802), 0.762 (0.406-1.430), respectively. Regardless of exercise frequency, there was an inverse association between exercise participation more than 150 minutes and less than 600 minutes per week and psychological stress, and the most effective way to reduce psychological stress was taking part in exercise more than 150 minutes and less than 300 minutes per week.

Colon Transit Time According to Physical Activity Level in Adults

BACKGROUND/AIMS: Physical activity (PA) is associated with a reduced risk of colorectal cancer. Thus, we examined the colon transit time (CTT) according to the physical activity level (PAL) in Korean adults. METHODS: The study subjects were 49 adults: 24 males and 25 females. The subjects used an accelerometer for 7 consecutive days to measure the 1-week PAL. The subjects took a capsule containing 20 radio-opaque markers for 3 days. On the fourth day, a supine abdominal radiography was performed. According to the total activity count of all study subjects, the upper 25%, middle 50% and lower 25% were classified into the high (H), moderate (M) and low (L) physical activity (PA) groups, respectively. RESULTS: The total CTT was significantly longer in the female (25.8 hours) than in the male subjects (7.4 hours) (P = 0.002). In regard to difference on PAL, although there was no significant difference among the male subjects, the right CTT in the female subjects was significantly shorter in H group than in M group (P = 0.048), and the recto-sigmoid CTT was significantly shorter in H group than in L group (P = 0.023). Furthermore, there were significant differences in total CTT between L and M groups (P = 0.022), M and H groups (P = 0.026) and between L and H groups (P = 0.002). CONCLUSIONS: The female, but not male, subjects showed that moderate and high PAL assisted colon transit.

Castleman Disease Misdiagnosed as a Neoplasm of the Kidney

Castleman disease, or angiofollicular lymph node hyperplasia, is a fairly rare benign tumor of lymphoid origin. Most cases tend to present as a mediastinal mass. We report a 58-year-old man with Castleman disease of the right perirenal space. This case was diagnosed preoperatively as nonconventional renal cell carcinoma (RCC) or renal oncocytoma because the enhancing mass abutted the renal cortex. The patient underwent a radical nephrectomy and a histopathological analysis showed the unicentric plasma cell type of Castleman disease. A preoperative diagnosis of Castleman disease is difficult; therefore, a surgical resection and a histological evaluation can provide an accurate diagnosis of this tumor. Taking this case into consideration, we suggest that Castleman disease should be included in the differential diagnosis of renal tumors.

Prostate Cancer Detection Rate of Rebiopsy in Patients with an Initial Diagnosis of Atypical Small Acinar Proliferation of the Prostate

PURPOSE: Atypical small acinar proliferation (ASAP) denotes the presence of suspicious glands with insufficient cytological architecture for a definitive prostate cancer diagnosis. We evaluated the subsequent prostate cancer detection rate of rebiopsy in patients with an initial diagnosis of ASAP. MATERIALS AND METHODS: Between January 2003 and December 2006, 1,416 men with suspected prostate cancer underwent a transrectal ultrasound-guided prostate biopsy, and 214 (15.1%) were diagnosed as having ASAP. Ninety-five of the 215 patients underwent at least one more biopsy. We evaluated the cancer detection rates after rebiopsy. RESULTS: In men with ASAP, 36 patients (37.9%) had prostate cancer. The cancer detection rates of the 1st, 2nd, and 3rd rebiopsies were 30.5%, 23.8%, and 40%, respectively. Mean patient age and prostate-specific antigen did not differ significantly between the prostate cancer and noncancer groups after rebiopsy. Prostate volume, however, was significantly smaller in the cancer group (p<0.05). CONCLUSIONS: Our results showed a detection rate for prostate cancer of 37.9% after an initial diagnosis of ASAP, which indicates that an initial diagnosis of ASAP mandates rebiopsy.

The Function of Cytokines in Several Vitre oretinal Diseases

Many cytokines are known as inducing or aggravating factors in several vitreoretinal diseases. Especially transforming growth factor-beta(TGF-beta), basic fibroblast growth factor(bFGF)and vascular endothelial growth factor(VEGF)are implicated in proliferative diabetic retinopathy(PDR), proliferative vitreoretinopathy(PVR)and many other vitreoretinal diseases . The aim of this study is to analyze the an aggravating roles of cytokines in the pathogenesis of vitreoretinal disease. We analyzed levels of TGF-beta1, TGF-beta 2, bFGF and VEGF in vitreous of 82 patients with several vitreoretinal diseases. Vitreous samples were obtained using vitrector as dry vitrectomy and levels of TGF-beta1, TGF-beta2, bFGF and VEGF were determined by ELISA. The level of VEGF was higher only in PDR group. But in the rest of conditions, no changes in any cytokine level was detected. On clinical situation, the higher level of VEGF was found in group with vitreous hemorrhage, retinal neovascularization and vitreoretinal fibrosis. The level of VEGF was lower in the eyes with preoperative panretinal photocoagulation . In the eyes with vitreoretinal fibrosis, the level of TGF-beta2 is lower, whereas the level of VEGF is higher. These results supports that VEGF is one of the important angiogenic and proliferative factors and when increased, induce vitreous hemorrhage. Our study also suggests the possibility that increased TGF-beta2 may play a role in the regression of proliferation.

Analysis about Diffe rences of Preoperative Measurement of Strabismic Angle in Exodeviation

Preoperarive measurement of strabismic angle is most important procedure in determining the amount of surgery.But measured angles are not always the same at each examination, which is quite a steress to both the operator and the patient because additional examination has to be done for accurate determination of surgical amount and also because the confidence for planned amount of surgery may be reduced.Therefore we investigated the variance of preoperative measurements and evaluated the necessity of repeated examinations. We compared the variance of measurement and investigated the bias and reliability of repeated examinations, from 104 patients who were examined initially by a resident at first visit and examined repeatedly at least 3 times before operation by a specialist.Also, the degree of variance in measurement and its relation with postoperative result were evaluated. The differences in measurement between resident and specialist was average 2.37 prism diopters, which was not significant on reliability analysis.Also, there were no significant differneces among 3 measurements by specialist. The degree of variance decreased with increasing age and the larger the degree of variance in measurement, the larger the deviation which may be remained postoperatively. The results suggest that the angle of deviation measured by resident is reliable and repeated measurements do not differ significantly[p>0.05], and also confirms that the variation of these measurements is an important factor which can influence postoperative results.

Corneal Endothelial change following Par Plana Vitrectomy with Expanding Gas

We performed prospective study of corneal endothelial damage associated with expanding gas during pars plana vitrectomy in 33 patients. A total of 16 eyes were performed vitrectomy with lens removal(intact anterior capsule), only 6 eyes in the gas treated group and 10 eyes in the control group. Among 19 eyes underwent vitrectomy without lens removal, 10 eyes treated with the expanding gas, which was not performed in the other 9 patients. The corneal endothelium was examined with a noncontact specular microscopy preoperatively and 3 months postoperatively. Endothelial changes were analyzed by comuterized morphometric data of individual cells and represented cell density, coefficient of variation, and hexaponality. The mean endothelial cell loss was 2.73% in 9 phakic eyes which underwent vitrectomy without expanding gas and 5.99% in 10 phakic eyes which underwent vitrectomy with expanding gas. In aphakic eyes, vitrectomy was comvined with lensectomy and expanding gas, the mean endothelial cell loss was 6.81%. The changes of endothelial cell density and hexagonality were not statistically significant. But coefficient of variation in aphakic eyes with vitrectomy using expanding gas was higher compared with other groups. As our results, although the difference of coefficient of expanding gas during vitrectomy in aphakic eyes seems to be safe. Because during vitrectomy with expanding gas in aphakic eyes.

Analysis of Systemic Risk Factorsin Normal Tension Glaucoma

It has been suggested that normal tension glaucoma could be the result of pressure independent factors. One of the current theories is that normal tension glaucoma is the result of decreased optic nerve perfusion on the basis of vascular disease or other systemic factors such as altered blood viscosity or coagulation state. This study compared the vascular viscosity profiles, coagulation tests, and biochemical tests of 30 consecutive cases of normal tension glaucoma with 30 control cases to evaluate association of particular systemic state with normal tension glaucoma in Korean population. The data of total cholesterol and low density lipoprotein (LDL) cholesterol were significantly higher in the normal tension glaucoma group than in the control group. But there were no significant differences between the two groups with respect to the many other factors examined. These results support the vascular ischmic theory due to hyperlipidemia in the pathogenesis of the normal tension glaucoma. Inadequate circulation of optic nerve due to atherosclerotic change might play an important role in the pathogenesis of normal tension glaucoma.

Analysis of Typing in Patients with Uveitis in Korean Population

In order to evaluate association of particular HLA typing with certain uveitis in Korean population, HLA antigens were analyzed in 114 uneitis patients(acute anterior uveitis: 32 cases, Behcet`s disease: 25 cases, intermediate uveitis: 19 cases, Vogt-Koyanagi-Harada (V-K-H) syndrome: 10 cases, retinal vasculitis: 12 cases, Eale`s disease: 3 cases, posterior uveitis: 9 cases, pan.uveitis: 4 cases). The stronger association between acute anterior uveitis and HLA-B27 was statistically significant, and this result was similar to reports in other ethnic groups. Also, the association between V-K-H syndrome and HLA-DR4 showed same results. But the high frequency of HLA-DR7 in the patients with V-K-H syndrome was unque in patients of Korean popjlation and statistically significant. The association between HLA-A2 and posterior uveitis was high in patients of Korean population and statistically significant. Behcet`s disease was stronger association with HLA-B51 but not statistically significant and much weaker association than reports in Japanese group. Although many similarities of associations between particular uveitis and HLA typing were detected as compared with other ethnic groups, distinctive HLA associations were demonstrated in Korean population. Additional cases and long-term follow-up are required to confirm the association with HLA typing and the relationship with prognosis including clinical and laboratory variabilities.

Surgical Results of Vitrectomy for Longstanding Idiopathic Macular Hole: Factors Affecting Postoperative Prognosis

Results of vitrectomy as treatment of full thickness(stage 3,4) macular hole were reported large variability and difference n anatomical and funtional success rate. So many surgeons fely difficulty in expectation of postoperative results before operation on stage 3,4. To use decision of proper operation time & effective treatment and expect the postoperative results before operation, after anatomical & functional factor affecting postoperative results & prognosis were arranged, relationship of these data after vitrectomy were evaluated. Pars plana vitrectomy in 25 patients(25 eyes) with stage 3(8 eyes) and stage 4(17 eyes) macular hole was performed. Functional success was seen in 7 eye(28%) and Anatomical success was seen in 12 eyes(48%). Preoperative factors such an stage of macular hole, preoperative visual acuity, size or macular hole, and sex were not found any association with postoperative functional & anatomical success rate. the group that had completely attached hole after vitrectomy and small preoperative cuff size(<1.0mm) were showed improvement of visual acuity compared with the other group. But these results were statistically not significant. And patients (5 eyes) with additional removal of ILM with PVD or memb peeling were showed good anatomical success rate(80%), but no difference of postoperative visual acuity compared with the other group. Although preoperative fluid cuff size and around hole and completely closure of hole after surgery were statistically not significant, highly correlated with postoperative visual acuity compared with the other factor. But long-term follow-up & recruitment of additional cases are required to consider as one of the significant factor on deciding operation time & expecting postoperative result.

Comparison of Corneal Astigmatism after Keratolasty with 3 Kinds of Suture Techniques

In order to evaluate the comparison of corneal astigmatism after keratoplasty with 3 kinds of suture techniques, penetrating keratoplasty was performed in 25 patients(25 eyes) with different suture techniques, single continuous(group I, N=7), interrupted(II, N=7), and combined sutures(III, N=11) with 10-0 nylon. In group I, suture control was made from postoperative 1 month and selective suture removal was done in group II and III. The corneal astimatism was analyzed prospectively with corneal topography more than 1 year in all except 2 patients. The amout of corneal astigmatism in group I, II and III at postoperatie 1 month was 2.12D, 3.14D and 3.08D respectively (P>0.05, Kruskal-Willis test) and showed marked reduction upon postoperative 3 months. At postoperative 1 year, corneal astigmatism of each group was 2,62D, 1.49D and 2,18D respectively(P>0.05). The corneal astigmatism between keratoconus and other corneal disorders was not statistically ignificant. Interrupted suture induced least corneal astigmatism after keratoplasty compared to other suture methods even if there was no statistical significance.