Associations of Sarcopenia and Sarcopenic Obesity With Metabolic Syndrome Considering Both Muscle Mass and Muscle Strength / 예방의학회지

OBJECTIVES: We investigated the associations of sarcopenia-defined both in terms of muscle mass and muscle strength-and sarcopenic obesity with metabolic syndrome. METHODS: Secondary data pertaining to 309 subjects (85 men and 224 women) were collected from participants in exercise programs at a health center in a suburban area. Muscle mass was measured using bioelectrical impedance analysis, and muscle strength was measured via handgrip strength. Sarcopenia based on muscle mass alone was defined as a weight-adjusted skeletal muscle mass index more than two standard deviations below the mean of a sex-specific young reference group (class II sarcopenia). Two cut-off values for low handgrip strength were used: the first criteria were <26 kg for men and <18 kg for women, and the second criteria were the lowest quintile of handgrip strength among the study subjects. Sarcopenic obesity was defined as the combination of class II sarcopenia and being in the two highest quintiles of total body fat percentage among the subjects. The associations of sarcopenia and sarcopenic obesity with metabolic syndrome were evaluated using logistic regression models. RESULTS: The age-adjusted risk ratios (RRs) of metabolic syndrome being compared in people with or without sarcopenia defined in terms of muscle mass were 1.25 (95% confidence interval [CI], 1.06 to 1.47, p=0.008) in men and 1.12 (95% CI, 1.06 to 1.19, p<0.001) in women, which were found to be statistically significant relationships. The RRs of metabolic syndrome being compared in people with or without sarcopenic obesity were 1.31 in men (95% CI, 1.10 to 1.56, p=0.003) and 1.17 in women (95% CI, 1.10 to 1.25, p<0.001), which were likewise found to be statistically significant relationships. CONCLUSIONS: The associations of sarcopenia defined in terms of muscle mass and sarcopenic obesity with metabolic syndrome were statistically significant in both men and women. Therefore, sarcopenia and sarcopenic obesity must be considered as part of the community-based management of non-communicable diseases.

Prescription Drug Use in Primary Health Care Posts and Its Improvement Scheme

PURPOSE: The prescription drug list for primary treatment by community health practitioners has been maintained for 30 years without any modification. Thus, this study will suggest an improvement scheme of prescription drug list for primary health care posts through an analysis of drug use in those posts. METHODS: A questionnaire survey was implemented with community health practitioners from April to June in 2012. A total of 1,249 copies were analyzed. As for the databases of drug use in the integrated information, a total of 154,229 diagnoses selected in the method of stratified cluster sampling from 39 primary health care posts'data were analyzed. We consulted some experts about the prescription medication list, and referred to the medication information on-line home page for up-to-date drug information. RESULTS: This study ultimately suggests 77 prescription drug items for primary health care posts by eliminating 35 items and replacing 1 item from the original list, and adding 4 items to it. CONCLUSION: This study will provide basic data for revising the prescription drug list in primary health care posts by periodically reflecting adverse effects in the existing drugs, demographic and environmental changes, and development of new drugs.

Comparison of apical sealing ability of continuous wave of obturation technique using EndoTwinn and System B / 대한치과보존학회지

The purpose of this study was to compare the apical leakage of the root canal filled with the System B and the EndoTwinn (the combined application of heat and ultrasonic vibration). Sixty extracted premolars with straight root were cleaned and shaped to size 35. Group SB was obturated using System B and Group ET was filled with EndoTwinn. A size 35 of 0.06 tapered gutta- percha and Adseal were used and the plugger which could be introduced to 4 mm short of working length was selected in the obturation procedure. As the positive control, Group PC was not filled. In Group SB, ET and PC, all external surfaces of each tooth were coated with nail varnish leaving only 1 mm area around the apical foramen. In the negative control of Group NSB and Group NET, all of external tooth surface including apical foramen was coated with the nail varnish. The specimens were immersed in methylene blue dye solution for 2 days. Then the specimens were sectioned at each 1 mm from apex to 5 mm level. The final score of one specimen was given by summing up of the points at all levels. The dye leakage of Group ET was significantly less than that observed in Group SB (p < 0.05). And the frequency of gutta-percha pulling out from root canal when the plugger was removed was more often with the System B than with EndoTwinn but there was no significant difference.

Meningococcal Cellulitis in a Patient with Systemic Lupus Erythematosus

Neisseria meningitidis is an important cause of sporadic meningitis and fatal sepsis. Skin manifestations like urticaria, maculopapular eruption, and petechial rash occur in the majority of patients with meningococcal infections. However, meningococcal cellulitis is extremely rare and has not been reported in patients with systemic lupus erythematosus (SLE). SLE patients who have low complement level are more susceptible to meningococcal infections than healthy population with normal complement level. We report a case of cellulitis associated with meningococcal infection, which manifested as knee arthritis, skin erythema, and low grade fever mimiking SLE flare in a 54 year-old female patient who had long standing SLE and hypocomplementemia.

Meningococcal Cellulitis in a Patient with Systemic Lupus Erythematosus

Neisseria meningitidis is an important cause of sporadic meningitis and fatal sepsis. Skin manifestations like urticaria, maculopapular eruption, and petechial rash occur in the majority of patients with meningococcal infections. However, meningococcal cellulitis is extremely rare and has not been reported in patients with systemic lupus erythematosus (SLE). SLE patients who have low complement level are more susceptible to meningococcal infections than healthy population with normal complement level. We report a case of cellulitis associated with meningococcal infection, which manifested as knee arthritis, skin erythema, and low grade fever mimiking SLE flare in a 54 year-old female patient who had long standing SLE and hypocomplementemia.

A Case of Left Vocal Cord Palsy and Pulmonary Hypertension in a Patient with Systemic Lupus Erythematosus / 대한류마티스학회지

Laryngeal involvement in systemic lupus erythematosus (SLE) is rare. It can range from mild ulcerations, vocal cord paralysis, and edema to necrotizing vasculitis with airway obstruction. The causes of vocal cord paralysis included vasculitis of the vasa nervorum, neuritis, thromboembolic effect on recurrent laryngeal nerves, and compression of the left recurrent laryngeal nerve by an enlarged left pulmonary artery. Few cases on the association of vocal cord palsy and pulmonary hypertension in SLE patient have been reported. We report a case of left vocal cord palsy and pulmonary hypertension in a patient with SLE who experienced improvement of vocal cord palsy and dyspnea after steroid pulse therapy.

Wide QRS tachycardia during treatment with class ic antiarrhythmic agents in a patient with atrial fibrillation: report of 2 cases / 대한내과학회지

Wide QRS tachycardia may represent a rare proarrhythmic effect of some antiarrhythmic agents. Class Ic antiarrhythmic agents produce rate- dependent ventricular conduction slowing due to use-dependent sodium channel blockade, causing QRS prolongation in cases with an increased heart rate. The authors describe two cases of atrial flutter with 1:1 atrioventricular conduction exhibiting a wide QRS tachycardia while on therapy using flecainide and propafenone, and the difficulty in interpreting the ECG.

Wide QRS tachycardia during treatment with class ic antiarrhythmic agents in a patient with atrial fibrillation: report of 2 cases / 대한내과학회지

Wide QRS tachycardia may represent a rare proarrhythmic effect of some antiarrhythmic agents. Class Ic antiarrhythmic agents produce rate- dependent ventricular conduction slowing due to use-dependent sodium channel blockade, causing QRS prolongation in cases with an increased heart rate. The authors describe two cases of atrial flutter with 1:1 atrioventricular conduction exhibiting a wide QRS tachycardia while on therapy using flecainide and propafenone, and the difficulty in interpreting the ECG.