Association between Hepatitis B Surface Antigen Seropositivity and Metabolic Syndrome / 가정의학회지

BACKGROUND: Infection with hepatitis B virus (HBV) may be a risk factor for cardiovascular disease. We investigated the relationship between HBV infection and metabolic syndrome. METHODS: We performed a cross-sectional study of 9,474 Korean men and women who were at least 20 years old and who underwent a routine health check-up at Ulsan University Hospital in Ulsan, South Korea between March 2008 and February 2009. The associations of hepatitis B surface antigen (HBsAg) seropositivity with the presence of metabolic syndrome and its components were investigated by logistic regression analysis. Data were analyzed separately for males and females. RESULTS: HBsAg seropositivity was significantly negatively associated with hypertriglyceridemia and metabolic syndrome in men (odds ratio [OR], 0.39; 95% confidence interval [CI], 0.29 to 0.50; P < 0.001 and OR, 0.75; 95% CI, 0.57 to 0.98, P = 0.033). In women, HBsAg seropositivity was also significantly negatively associated with hypertriglyceridemia, but not with metabolic syndrome (OR, 0.40; 95% CI, 0.17 to 0.91; P = 0.029 and OR, 0.80; 95% CI, 0.38 to 1.66, P = 0.545). CONCLUSION: HBV infection was significantly negatively associated with hypertriglyceridemia and metabolic syndrome in men and hypertriglyceridemia in women.

Factors of Compliance in Patients with Hypercholesterolemia Using Rosuvastatin in Primary Care / 가정의학회지

BACKGROUND: In order to evaluate the factors of compliance with a lipid lowering therapy, a prospective observational study of patients with hypercholesterolemia using rosuvastatin was carried out. METHODS: A total of 2,607 patients who were newly prescribed rosuvastatin were enrolled from 32 family physicians in Korea from March 2009 to December 2009. Of them, 301 patients were excluded due to incomplete data or follow-up compliance data. The patients were regularly observed to ascertain the compliance associated with rosuvastatin at intervals of 12 and 24 weeks. We collected risk factors for the compliance using a structured questionnaire. The criteria for evaluating compliance are to measure clinic attendance, to assess the continuity of therapy, and to calculate the percentage of doses taken. RESULTS: Among a total of 2,306 patients, the degree of compliance was 54.1%. According to logistic regression analysis, the factors for compliance with the lipid lowering drug included old age (odds ratio [OR], 2.68; 95% confidence interval [CI], 2.09 to 3.45), frequent exercise (OR, 1.76; 95% CI, 1.43 to 2.18), previous statin therapy (OR, 4.02; 95% CI, 3.22 to 5.01), hypertension (OR, 1.80; 95% CI, 1.48 to 2.19), diabetes mellitus (OR, 2.20; 95% CI, 1.69 to 2.87), concomitant medication (OR, 2.28; 95% CI, 1.88 to 2.77), and high coronary heart disease (CHD) risk category (OR, 1.82; 95% CI, 1.39 to 2.38). The compliance decreased with high low density lipoprotein cholesterol levels (OR, 0.20; 95% CI, 0.16 to 0.26). CONCLUSION: The compliance of patients using rosuvastatin was 54.1% in primary care. The factors related to higher compliance were old age, regular exercise, previous statin therapy, concomitant medication, presence of hypertension or diabetes, and higher CHD risk level.

The Impact of Weight Changes on Metabolic Syndrome over a Time period of 8 years in Korean Male Workers / 대한산업의학회지

OBJECTIVES: Cardiovascular diseases are common causes of diseases and death for workers. With the increasing prevalence of obesity, the social costs for obesity related diseases are a growing burden in Korea. We aimed to investigate the impact of weight change on metabolic syndrome and its components in Korean male workers. METHODS: We analyzed the data from 2,785 male workers obtained during health checkups in 2000 and in 2008. The subjects were classified into 5 groups as Loss ( or = 9.0 kg) group according to the amount of weight change between the 2 health checkups. The mean values of metabolic syndrome components were compared across the 5 weight change groups by ANCOVA. After classifying subjects into 2 groups according to the normality of their body weight at baseline, the odds ratios for metabolic syndrome and its components each weight-change group were computed by multiple logistic regression analyses, using the Stable group as the reference. RESULTS: There was a strong linear relationship between weight gain and a worsening of the components of metabolic syndrome in 2008 (p<0.001). In normal body weight group, the odds ratios for metabolic syndrome significantly increased in the Mild, Moderate, and Severe gain groups (OR 1.83, 2.82, and 7.56, respectively), and increased with weight gain (p<0.001). In subjects who were obese, the odds ratios for metabolic syndrome significantly increased if their amount of weight gain placed them in the Mild or Moderate gain groups(OR 1.75 and 3.97), increased with the increase of weight gain (p<0.001), and decreased in the Loss group(OR 0.51, 95%CI 0.30 to 0.85). CONCLUSIONS: Weight gain in male workers was positively associated with metabolic syndrome through worsening of metabolic syndrome components. On the other hand, weight loss in obese male workers had a protective effect against metabolic syndrome through the improvement of the components of metabolic syndrome.

The Association between Helicobacter Pylori Infection and Metabolic Syndrome in Korean Men and Women / 가정의학회지

BACKGROUND: Metabolic syndrome is a cluster of metabolic abnormalities leading diabetes and cardiovascular diseases. Helicobacter pylori (H. pylori) infection is suggested to be a risk factor of cardiovascular diseases. We aimed to investigate the association between H. pylori infection and metabolic syndrome. METHODS: This study was designed with Korean adults having a health check-up in a university hospital in Ulsan from March 2008 to February 2009. The subjects were 17,448 over 20 years old. The analysis was undertaken according to sex separately. The association of H. pylori seropositivity (IgG) with metabolic syndrome components was investigated by multiple linear regression analysis. The association of H. pylori seropositivity with metabolic syndrome was investigated by multiple logistic regression analysis. RESULTS: H. pylori seropositivity was significantly inversely associated with high density lipoprotein cholesterol in men (Coefficient, -0.02; 95% confidence interval [CI], -0.03 to -0.004; P = 0.01). However, H. pylori seropositivity was not significantly associated with metabolic syndrome in both men and women (OR, 1.01; 95% CI, 0.90 to 1.14; P = 0.81 for men; OR, 0.75; 95% CI, 0.55 to 1.02; P = 0.06 for women). CONCLUSION: H. pylori infection was significantly negatively associated with high density lipoprotein cholesterol in men, but not significantly associated with metabolic syndrome in both men and women.

The Association between Marital Status and Metabolic Syndrome in Korean Men / 가정의학회지

BACKGROUND: We aimed to investigate the association between marital status and metabolic syndrome, and observed how their lifestyle may influence within their relationship. METHODS: We analyzed the data from 12,288 Korean men over 20 years old taking a health checkup in a university hospital in Ulsan from March 2008 to February 2009. The subjects were classified as married, unmarried, separated, widowed, and divorced. The odds ratios for metabolic syndrome in each marital status were calculated after adjusting for age, educational level, and family income. In only married men and divorced men, odds ratios were calculated again after adjusting for alcohol intake, smoking, or exercise added to age, educational level, and family income. RESULTS: After adjustment for age, educational level, and family income, the odds ratio for metabolic syndrome in divorced men was 1.48 (95% confidence internal [CI], 1.03 to 2.12; P = 0.03) compared to married men. However, the odds ratios in divorced men decreased to 1.47 (95% CI, 0.97 to 2.24; P = 0.07) after adjusting for alcohol intake added to age, educational level, and family income, 1.42 (95% CI, 0.99 to 2.04; P = 0.06) after adjusting for smoking added, 1.35 (95% CI, 0.93 to 1.96; P = 0.12) after adjusting for exercise added, and 1.37 (95% CI, 0.89 to 2.12; P = 0.15) after adjusting for alcohol intake, smoking, and exercise added. CONCLUSION: Divorced men were likely to have metabolic syndrome compared to married men and this finding may be mediated by their bad lifestyle.

Lifestyle and Cardiovascular Risk Factors in Divorced Male Workers / 가정의학회지

BACKGROUND: Considering the unhealthy lifestyle observed in divorced men, we planned this study to compare the lifestyle and cardiovascular risk factors between married and divorced man. METHODS: A total of 11,855 male workers took a health check-up in a University Hospital in Ulsan from March to December 2004. One hundred eight workers were recognized to have checked affirmative on "divorced" check item on the marital status and 400 workers were matched for age and randomly selected from the "married" 10,177 workers. Comparison was performed between the two groups with the results of the main laboratory data and self-recorded life style questionnaire. RESULTS: The divorced men were shorter in height than the married men (P = 0.022), and showed significantly higher diastolic blood pressure (P = 0.033) and gamma-glutamyl transferase (P = 0.001). In lifestyle, the divorced men had significantly lower educational level, lower monthly household income, higher smoking rate, and more frequent irregular meals than the married men. Divorcing had 1.88 times the odds of having higher diastolic blood pressure compared to staying married. CONCLUSION: The divorced men had poorer lifestyle and higher diastolic blood pressure than the married men.

Lifestyle in Relation to Increase in Weight in Korean Middle-aged Men

BACKGROUND: The relationship of lifestyle and socioeconomic factors with weight change over 4 years in Korean middle-aged group was assessed. METHODS: A total of 1,167 men, aged 40~59 years, were selected from the Health Promotion Center of Ulsan University Hospital during the period of Jan. 2000 through Mar. 2000. Including anthropometric measures, designed questionnaires were administered concern lifestyle behavior topics with cigarette smoking, exercise, alcohol consumption, dairy product consumption and socioeconomic factors of monthly income and education. The subjects were divided into three groups by body mass index (BMI: kg/m(2)); normal ( or =25 kg/m(2)). After 4 years of follow-up, the men were classified into weight change categories; 1) stable weight group (from normal to normal, from overweight to overweight) and 2) weight gain group (from normal to overweight/obesity, from overweight to obesity). RESULTS: The weight gain group were 18.4% (n=215) and the stable overweight group were 81.6% (n=952). Adjusted for age, the frequency of dairy product consumption, the frequency of alcohol drinking, the regularity of exercise, education and monthly income, the smokers (> or =10/day) had significantly high incidence rates of increase in weight (odds ratio=1.77, 95% CI 1.07~2.90). The increased dairy consumers (> or =4/week) had significantly low incidence rates of increase in weight (odds ratio=0.43, 95% CI 0.20~0.93). Otherwise, there were no significant relationships in weight change. CONCLUSION: Smoking and decreased dairy product consumption were related to the increase in weight.

The Association between Distal Colon Adenoma and the Metabolic Syndrome and Lifestyle Factors in Male Examinees in a University Hospital

BACKGROUND: According to previous epidemiologic studies, the metabolic syndrome, dietary and lifestyle factors were associated with colon polyps. The aim of this cross-sectional study was to assess the relationship between the risk of the colorectal adenoma incidence and the individual components of the metabolic syndrome with lifestyle factors such as drinking, cigarette smoking and physical activity. METHODS: Sigmoidoscopic examination for colon cancer screening was performed from January 2002 to December 2003 at the Health Promotion Center of Ulsan University Hospital in Ulsan, Korea. A total of 1,565 subjects underwent satisfactory sigmoidoscopy. The subjects with a history of colon cancer or polyps or inflammatory bowel disease were excluded from the study. Alcohol consumption, cigarette smoking and other confounding factors were included as covariates in the models. RESULTS: After adjusting for age, physical activity,smoking and alcohol intake, the subjects of metabolic syndrome (> or =3 vs. 0 components) combined with cigarette smoking had a positive association with colorectal adenoma incidence (OR 3.63, 95% CI 1.49~8.89). Physical activity was negatively associated the risk of the colorectal adenoma incidence (OR 0.60 95% CI 0.44~0.81). CONCLUSION: These results suggest that clustering of components of the metabolic syndrome combined with cigarette smoking significantly increased the colorectal adenoma risk, but physical activity reduced the risk of colorectal adenoma incidence in Korean adult males after multivariate adjustment.

Prevalence and Risk Factors for Adenomatous Polyp in Koreans (A Cross-sectional Study)

BACKGROUND: According to previous epidemiologic studies, dietary and life style factors were associated with colon polyps. Despite the high prevalence of colon polyps, little is known about its risk factors in Korean adults. The aim of this cross-sectional study was to assess the relationship between alcohol consumption, smoking, obesity, physical activity and the presence of colorectal polyps. METHODS: Sigmoidoscopic examinations for colon cancer screening were performed from January 2002 to December 2003 at the Health Promotion Center of Ulsan University Hospital. Alcohol consumption, smoking and other confounding factors were assessed by self-administered questionnaire. RESULTS: After adjusting for age, physical activity, obesity, total fat and total energy intake, current smokers who had smoked more than 21 pack-years were at significantly higher risk of adenomatous polyps compared to non-smokers (OR 2.56, 95% CI 1.30~5.01). Alcohol consumption was positively associated with risk of adenomatous polyps compared to non-drinkers (OR 1.48, 95% CI 1.03~2.13). Physical activity was negatively associated withs risk of distal colon polyps. CONCLUSION: These results suggest that alcohol consumption, cigarette smoking, and obesity were positively associated with risk of colorectal polyps and physical activity was negatively associated in Korean adult males.

Relationship between Abdominal Obesity and Electrocardiographic QTc Interval Prolongation

BACKGROUND: Electrocardiographic QTc interval prolongation can cause serious arrhythmias such as ventricular tachycardia, ventricular fibrillation, torsade de pointes, and even sudden death. Many studies have been performed to clarify whether QTc interval prolongation is related to increasing body mass index (BMI) and abdominal obesity. However, there is no study about the relationship between abdominal obesity and QTc interval prolongation in Korea. We, therefore, studied the relationship between QTc interval prolongation and abdominal obesity among Korean adults. METHODS: The measurement of height, weight, and waist circumference, and standard 12-lead ECG was performed on 3,086 subjects at a health promotion center of a university hospital from March to April, 2003. We excluded: 37 subjects whose ECG or body measurement was not performed, 17 with a past history of cardiac disease or current cardiac medications which can influence QTc interval, 9 taking neuropsychiatric medications, 25 with abnormal serum concentration of potassium or calcium, 1 foreigner and 59 with underweight. First, we studied the correlation between BMI and waist circumference. Then, we analyzed the relationship between QTc interval prolongation and the index of obesity. RESULTS: A total of 2,938 subjects consisted of 2,411 men and 527 women. BMI and waist circumference were shown to have a significant correlation with QTc interval after age was adjusted in men (P<0.01, P<0.01). The odds ratio between QTc interval prolongation and the subjects of normal, overweight, and obesity by BMI were not significant in both men and women. In men with abdominal obesity, the odds ratio between QTc interval prolongation and abdominal obesity by waist circumference was 1.33 (0.99~1.79). CONCLUSION: In men, abdominal obesity was shown a positive correlation with QTc interval prolongation. But these results were not statistically significant.

The Effect of Physical Activity on Colorectal Polyps

BACKGROUND: The results of previous epidemiologic studies showed that dietary and life style factors are associated with colon polyps. Despite the high prevalence of colon polyps, little is known about its risk factors in Korean adults. The aim of this study was to assess the relationship between physical activity and the presence of colorectal polyps. METHODS: In 859 subjects, rectosigmoidoscopy was performed at Ulsan University Hospital Health Promotion Center from January 2002 to October 2002. Drinking, smoking and other confounding factors were assessed by self-administered questionnaire in 161 subjects with colon polyps and 698 controls. RESULTS: Among the total of 859 cases the prevalence of colorectal adenomatous polyps was 18.7%. After adjusting for age, sex, physical activity, obesity, calcium and total energy intake,using multiple logistic regression, decreasing risk of colorectal polyps were observed with increasing level of physical activities. The odds ratio for 3 to 4 hours per week exercise group was 0.460 (CI=0.262~0.089). The frequency and intensity of exercise also had an inverse association with colon polyps (4~5 times/ week group: OR=0.428, CI=0.220~0.832. vigorous exercise group: OR=0.454, CI=0.298~0.693). CONCLUSION: Physical activities were inversely associated with colorectal polyps in Korean adults.

Factors Associated with Distorted Self-perception of Body Weight in Korean Adults

BACKGROUND: This study was done to examine the relationship between distorted self-perception of body weight and some sociodemographic factors in Korean adults. METHODS: This study was conducted among 14,621 adults (men 10,833, women 3,788), who visited Ulsan University Hospital Health Promotion Center to take a routine health examination. The objective body weight status was classified as underweight, normal, overweight, and obesity by body mass index. We compared the self- perception of body weight with in objective body weight status. We used multiple logistic regression to assess the odds ratio for distorted self-perception of body weight by age, marital status, monthly income, and level of education. RESULTS: Among the total 72.8% of obese men had a distorted self-perception of being slightly excess, 48% of overweight men considered themselves as just about right, and 39.5% of men with normal body weight as underweight. In women, 36.5% with normal body weight had a distorted self-perception of being slightly excess or very excess. In both men and women who were overweight or obesity, the distorted self-perception of being just about right was increased with higher age and lower education. The odds ratio of distorted self-perception in normal as being slightly excess or very excess was higher in women with higher income and higher education. CONCLUSION: In both men and women, many people had a distorted self-perception of Body weight. Some sociodemographic factors were found to be related to the self- perception of body weight.

Role of Stress in Functional Dyspepsia / 대한소화관운동학회지

BACKGROUND/AIMS: Pathogenesis of functional dyspepsia consists of motor abnormality, sensory abnormality, and psychologic abnormality. Anxiety, depression, and psychosomatic disorders are well known psychopathologies that lead to dyspepsia, and stress seems to be an additional etiology. The aim of this study is to assess whether stress can cause and/or provoke dyspepsia. METHODS: Functional dyspepsia was defined and classified by Rome criteria. SCL-90-R for the detection of psychopathology, measurement of life stress scale by self-administered questionnaire, and measurement of stress coping mechanisms using a multidimensional stress coping scale test were performed in 79 functional dyspeptic patients and 25 normal controls. RESULTS: No significant difference was found in the total amount of stress between functional dyspeptic patients and the normal control. However, the patients were more stressful about issues relating to health and marital relationship among stresses in individual daily life. As the patients become more stressful, they used more negative coping mechanisms such as restraint, fatalism, criticism, religiousness, and negativism. These seem to provoke several psychopathologies including interpersonal sensitivity, depression, anxiety, hostility. However, there was no relationship in the amount of stress, the stress coping mechanism, and psychopathology among the dyspeptic symptoms and subgroups of functional dyspepsia. CONCLUSION: There was no difference in the total amount of stress between functional dyspeptic patients and the normal control. In some individuals who utilize inadequate coping mechanisms against stress, the stress can provoke dyspepsia.

Role of Stress in Functional Dyspepsia / 대한소화관운동학회지

BACKGROUND/AIMS: Pathogenesis of functional dyspepsia consists of motor abnormality, sensory abnormality, and psychologic abnormality. Anxiety, depression, and psychosomatic disorders are well known psychopathologies that lead to dyspepsia, and stress seems to be an additional etiology. The aim of this study is to assess whether stress can cause and/or provoke dyspepsia. METHODS: Functional dyspepsia was defined and classified by Rome criteria. SCL-90-R for the detection of psychopathology, measurement of life stress scale by self-administered questionnaire, and measurement of stress coping mechanisms using a multidimensional stress coping scale test were performed in 79 functional dyspeptic patients and 25 normal controls. RESULTS: No significant difference was found in the total amount of stress between functional dyspeptic patients and the normal control. However, the patients were more stressful about issues relating to health and marital relationship among stresses in individual daily life. As the patients become more stressful, they used more negative coping mechanisms such as restraint, fatalism, criticism, religiousness, and negativism. These seem to provoke several psychopathologies including interpersonal sensitivity, depression, anxiety, hostility. However, there was no relationship in the amount of stress, the stress coping mechanism, and psychopathology among the dyspeptic symptoms and subgroups of functional dyspepsia. CONCLUSION: There was no difference in the total amount of stress between functional dyspeptic patients and the normal control. In some individuals who utilize inadequate coping mechanisms against stress, the stress can provoke dyspepsia.

The comparison of recognition between non-medicated and medicated group in hypertensive patients

BACKGROUND: With proper management, hypertensive patients can maintain their health and prevent complications. But poor compliance is a main problem for management of hypertension. This study was designed to investigate the reasons among hypertensive patients who did not initiate antihypertensive medication despite recommendations. METHODS: Questionnaires were used for hypertensive patients who visited a health care center and an outpatient clinic of family medicine department in a university hospital, from March to July, 1998. The non-medicated(noncompliant)group were those who had not taken antihypertensive drug at all with high blood pressure(higher than 160mmHg at systolic, or 100mmHg at diastolic phase initially and hypertensive range on the follow up), despite doctor's recommendations. The medicated(compliant) group were those hypertensive patients who had taken antihypertensive drug well and visited the clinic regularly at least for 9 months during the recent 12 months. RESULTS: The total number of the noncompliant was 65, and the compliant 57. The mean age of the noncompliant was 50.8, and the compliant 58.0 years old. The mean blood pressure in the noncompliant was 162.6/106.6mmHg, higher than in the compliant 138.1/85.7mmHg. The main reasons refusing antihypertensive drug were fearful feeling for `lifelong medication'(47.7%), followed by complications from drugs(30.8%). The reason for delaying treatment with antihypertensive drug is that the noncompliant showed more tendency to think `It would be the same', or `better than starting medication early' than the compliant. For the complications from drugs, 59.5% of the noncompliant answered. `I'm not sure, but it'll be not good', and those who answered `it'll be not bad to have medication' seemed to be less than in the noncompliant. CONCLUSION: The patients who had been recommended but did not start on medication had less knowledge about the benefits of medication. We can assume that they are refusing antihyper-tensives because of their excessive anxiety about complications of and lifelong medication.

The Role of Autonomic Dysfunction in Patients with Functional Dyspepsia / 대한소화관운동학회지

BACKGROUND/AIMS: The role of autonomic dysfunction in patients with functional dyspepsia has not been completely understood. The purposes of our study are (1) to prospectively assess the abnormalities of the autonomic function in patients with functional dyspepsia and (2) to assess whether the presence of autonomic dysfunction in patients with functional dyspepsia correlates with the presence of visceral hypersensitivity or with the severity of dyspeptic symptoms. METHODS: Twenty eight patients with functional dyspepsia (4 men and 24 women; age range, 29-57) and 14 healthy volunteers without gastrointestinal symptoms (6 men and 8 women; age range, 23-61) were included in this study. All patients and controls were submitted to a battery of five standard cardiovascular autonomic reflex tests and gastric barostat tests. A modified version of the Glasgow Dyspeptic questionnaire was used in this study. RESULTS: (1) Autonomic function tests showed that both sympathetic and parasympathetic scores of dyspeptic patients were significantly higher than those of the control group. (2) Visceral hypersensitivity could be confirmed in some of our dyspeptic patients in response to proximal gastric distension, demonstrating lower pain threshold in this group. (3) We could not find significant association between the presence of autonomic dysfunction and the presence of visceral hypersensitivity or severity of dyspeptic symptoms in patients with functional dyspepsia. CONCLUSION: Autonomic dysfunction was more prevalent in dyspeptic patients than in the control group. However, it did not correlate with the presence of visceral hypersensitivity or severity of dyspeptic symptoms. It is suggested that a defect in the spinal region or at the CNS level may be a major mechanism of visceral hypersensitivity in functional dyspepsia.

Habits of smoking and pulmonary function in current smokers

BACKGROUND: It is well known that there is an adverse effect of longterm cigarette smoking on pulmonary function. But there are few reports about the effect of different habits of cigarette smoking on pulmonary function. Some smokers think that different habits of cigarette smoking are more safe than athers and this can be, an obstacle to the education of smoking cessation. Therefore, we have obtained applicable basic information for education of smoking cessation by analysing the effects of different habits of cigarette smoking on pulmonary function. METHODS: We surveyed current smokers on different habits of smoking who had performed puhnonary function test at the pulmonary function laboratory of one tertiary hospital in Seoul and pulmonary function test was done as a part of comprehensive health check-up at health promotion center of one secondary hospital at Ulsan from May 1998 to July 1998. We analysed the effects of different habits of cigarette smoking on pulmonary function in 160 subjects who has no specific respiratory disease. RESULTS: The factors were age, height, weight and amount of total smoking that had effect on pulmonary function. There were six different habits of smoking that we could analyse time of first smoking after sleep, average time of one cigarette smoked, current amount of smoking, length of one cigarette smoked, effort to quit smoking, smoking with drinking and all these six habits of sking had no relationship with the results of the pulmonary function test. CONCLUSIONS: The damage in pulmonary function was not protected by different habits of smoking that were previously known to be more safe or healthy. Therefore, we concluded that smoking cessation is the only way to prevent the damage in pulmonary function from cigarette smoking.

Cardiovascular Regulation of GABAB Receptor in the Spinal Cord of the Rats / 대한내과학회지

OBJECTIVES: The purpose of present study is to investigate the influence of a spinal gamma-aminobutyric acid B (GABAB) receptor on a central regulation of blood pressure(BP) and heart rate(HR), and to define its mechanism in the spinal cord. METHODS: In urethane-anesthetized, d-tubocurarine- paralyzed and artificially ventilated male Sprague-Dawley rats, intrathecal administration of drugs were carried out using injecton cannula(33-gauge stainless steel) through the guide cannula(PE 10) which was inserted intrathecally at lower thoracic level through the puncture of a atlantooccipital membrane. RESULTS: Intrathecal injection of an GABAB receptor agonist baclofen(30, 60, 100 nmol) decreased both blood pressure and heart rate dose-dependently. Pretreatment with 8-bromo-cAMP(50 nmol), a cAMP analog or glipizide(50 nmol), a ATP-sensitive K+ channel blocker attenuated the depressor and bradycardic effects of baclofen (100 nmol) but not with 8-bromo-cGMP(50 nmol) a cGMP analog. CONCLUSIONS: The GABAB receptor in the spinal cord plays an inhibitory role in central cardiovascular regulation and that this depressor and bradycardic actions are mediated by the decrease of cAMP via the inhibition of adenylate cyclase and the opening of K+ channel.

A Case of Primary Hyperparathyroidism Associated with Proximal Renal Tubular Acidosis and Postoperative Hungry Bone Syndrome / 대한내분비학회지

Primary hyperparathyroidism is a generalezed disorder of calcium, phosphorus and bone metabolism due to an increased secretion of parathyroid hormone. Single parathyroid adenoma is the most common cause of primary hyperparathyroidism. Because parathyroid hormone has been proposed as an important inhibitor of renal bicarbonate reabsorption of proximal tubule, proximal renal tubular acidosis is not rare in primary hyperparaphyroidism. After parathyroid resection, significant hypocalcemia and hypophosphatemia requiring prolonged medical management may develop, termed hungery bone syndrome. We experienced a case of primary hyperparathyroidism associated with proximal renal tubular acidosis, and severe hungry bone syndrome after resection of the adenoma of parathyroid gland.