Prevalence of Hyperuricemia and Its Association with Obesity in Korean Adults: Analysis Based on 2018 Korea National Health and Nutrition Examination Survey

Background@#This study aimed to analyze the association between the prevalence of hyperuricemia and obesity in Korean adults. @*Methods@#The participants included 5,922 adults from the 2018 Korea National Health and Nutrition Examination Survey. We examined the relationship between obesity status and serum uric acid levels using a chi-square test and multiple logistic regression. @*Results@#There was an increase in the prevalence of hyperuricemia with higher body mass index (P<0.001 and P=0.003, respectively). Both male and female in a higher obesity class also had a higher odds ratio for the prevalence of hyperuricemia (P<0.001). This trend remained consistent after adjusting for all confounding factors. The obesity class III group was found to be associated with the highest risk of hyperuricemia. @*Conclusion@#In this study, we found that hyperuricemia was significantly associated with obesity in Korean adults. In a clinical setting, this finding presents objective data for more aggressive management and ultimate prevention of obesity.

Correlation between Smoking and Depression in Korean Adult Group: The Korean National Health and Nutrition Examination Survey (2014)

BACKGROUND: Though several factors have been found to be associated with depression, yet many others remain uncovered. A few studies have focused on the correlation between smoking and depression. This study was designed to explore whether there was a relationship between smoking and depression in a Korean adult group.METHODS: This study was based on the 2014 data of 17,780 Koreans obtained from the sixth Korea National Health and Nutrition Examination Survey (KNHNES, 2013–2015). The participants' depression status was evaluated based on their responses to survey. The correlation between smoking and depression was examined using multiple linear regression analysis after adjusting confounders. The result was represented as correlation factors, and a P-value of less than 0.05 was considered statistically significant.RESULTS: Our study revealed higher depression prevalence in the current smoker group as compared to non-smokers and ex-smokers and this difference was statistically significant.CONCLUSION: Smoking status was statistically significantly related to depression. Among the three smoking status groups, the current smoker group had the highest prevalence of depression. Hence s stopping smoking was considered to be effective and important to prevent depression.

Trends in Blood Pressure and Prevalence of Hypertension in Korean Adults Based on the 1998–2014 KNHANES

PURPOSE: To investigate trends in blood pressure (BP) and hypertension prevalence in Korea. MATERIALS AND METHODS: Based on the Korean National Health and Nutrition Examination Survey (KNHANES) I (1998), II (2001), III (2005), IV (2007–2009), V (2010–2012), and VI (2013–2014), 56077 participants (23974 men and 32103 women) were included. RESULTS: Mean systolic BP (SBP) and diastolic BP (DBP) decreased in both sexes (male SBP: 128.1 to 120.2 mm Hg, male DBP: 82.0 to 78.5 mm Hg; female SBP: 125.7 to 116.0 mm Hg and female DBP: 77.4 to 73.2 mm Hg from the KNHANES I–VI). The age-standardized prevalence of hypertension was significantly decreased in both sexes (male; 33.3% to 30.3%, female; 28.7% to 22.7%, all p for trend < 0.001). Regardless of taking anti-hypertensive medication or not, SBP and DBP declined universally in both sexes. Compared to the KNHANES I, the odds ratios (95% confidence intervals) of the KNHANES II to VI for less-than-normotensive and less-than-hypertensive BP increased in both sexes. CONCLUSION: Mean BP levels in both sexes and hypertension prevalence showed downward trends during the 16-year period.

Relationship between Coffee Consumption and Metabolic Syndrome in Korean Adults: Data from the 2013–2014 Korea National Health and Nutrition Examination Survey / 가정의학회지

BACKGROUND: The gradually increasing demand for coffee worldwide has prompted increased interest in the relationship between coffee and health issues as well as a need for research on metabolic syndrome in adults. METHODS: Data from 3,321 subjects (1,268 men and 2,053 women) enrolled in the 2013–2014 Korean National Health and Nutrition Examination Survey were analyzed. The subjects were divided into three groups according to their daily coffee consumption. The odds ratios (ORs) and 95% confidence intervals (95% CIs) for metabolic syndrome in the coffee-drinking groups were calculated using multiple logistic regression analysis by adjusting for confounding variables. RESULTS: The prevalence of metabolic syndrome was 15.5%, 10.7%, and 9.7% in men and 3.0%, 7.1%, and 6.5% in women according to their coffee consumption (less than one, one or two, or more than three cups of coffee per day), respectively. Compared with the non-coffee consumption group, the ORs (95% CIs) for metabolic syndrome in the group that consumed more than three cups of coffee was 0.638 (0.328–1.244) for men and 1.344 (0.627–2.881) for women after adjusting for age, body mass index, household income, education, smoking, alcohol, regular exercise, and daily caloric intake. CONCLUSION: The OR of metabolic syndrome was not statistically significant in both men and women.

Association between Spiritual Well-Being and Pain, Anxiety and Depression in Terminal Cancer Patients: A Pilot Study / 한국호스피스완화의료학회지

PURPOSE: Spirituality is an important domain and is related with physical and psychological symptoms in terminal cancer patient. The aim of this study is to examine how patients' spirituality is associated with their physical and psychological symptoms as it has been explored by few studies. METHODS: In this cross sectional study, 50 patients in the palliative ward of a tertiary hospital were interviewed. Spiritual well-being, depression, anxiety and pain is measured by Functional Assessment of Chronic-Illness Therapy-Spirituality (FACIT-Sp), hospital anxiety and depression scale (HADS) and the Korean version of the Brief Pain Inventory (BPI-K). The correlations between patients' spiritual well-being and anxiety, depression and pain were analysed. The association between spiritual well-being and age, gender, palliative performance scale (PPS), religion, mean pain intensity, anxiety, depression were assessed by univariate and multivariate regression analyses. RESULTS: Spiritual well-being was negatively correlated with the mean pain intensity (r=-0.283, P<0.05), anxiety (r=-0.613, P<0.05) and depression (r=-0.526, P<0.05). In multivariate regression analysis, spiritual well-being showed negative association with anxiety (OR=-1.03, 95% CI=-1.657~-0.403, P=0.002) and positive association with the existence of religion (OR=9.193, 95% CI=4.158~14.229, P<0.001). CONCLUSION: In this study, patients' anxiety and existence of religion were significantly associated with spiritual well-being after adjusting age, gender, PPS, mean pain intensity, depression. Prospective studies are warranted.

Low-Grade Inflammation, Metabolic Syndrome and the Risk of Chronic Kidney Disease: the 2005 Korean National Health and Nutrition Examination Survey

Either chronic inflammation or metabolic syndrome (MetS) is associated with renal impairment. This cross-sectional study was designed to investigate the relationship between elevated white blood cell (WBC) counts and chronic kidney disease (CKD) stage 3 or more according to the presence of MetS in adult Koreans. In total, 5,291 subjects (> or = 20 yr-old) participating in the 2005 Korean National Health and Nutrition Examination were included. CKD stage 3 or more was defined as having an estimated glomerular filtration rate below 60 mL/min/1.73 m2, as calculated using the formula from the Modification of Diet in Renal Disease study. The odds ratio (95% confidence interval) for CKD stage 3 or more in the highest WBC quartile (> or = 7,200 cells/microL) was 1.70 (1.17-2.39) after adjusting for MetS and other covariates, compared with the lowest WBC quartile (< 5,100 cells/microL). In subjects with MetS, the prevalence risk for CKD stage 3 or more in the highest WBC quartile was 2.25 (1.28-3.95) even after fully adjusting for confounding variables. In contrast, this positive association between WBC quartile and CKD stage 3 or more disappeared in subjects without MetS. Low-grade inflammation is significantly associated with CKD stage 3 or more in subjects with MetS but not in those without MetS.

Cardiovascular Disease, Cancer and Reproductive Hazards in Firefighters

Firefighters are facing occupational hazards such as exposures to a variety of carcinogens and toxic agents, heat, physical stress and psychological stress. This occupation involves an increased risk of particular health concerns including cardiovascular diseases, cancers, and reproductive hazards. Cardiovascular diseases are the leading cause of lifetime mortality among the firefighters as well as the principal cause of on-duty deaths. In spite of "healthy worker effect", a number of studies have found an increased risk of cardiovascular disease morbidity and mortality in firefighters. There are various carcinogens in the fire smoke. Many studies address that some types of cancers are related to firefighting. These cancers include brain tumors, cancers of hematopoietic and lymphatic systems, cancers of genitourinary tract, and skin cancers. To date, the relationship between firefighting and reproductive hazards has not been widely studied. However, since firefighters are exposed to various chemical and physical hazards which might influence the reproductive systems, the concerns are raising. It is important to recognize that firefighters are at a risk of several significant health problems. To reduce the risk, it should be encouraged to use protective equipments efficiently and manage physically exerted firefighters appropriately at the fire scene. Furthermore, we should activate not only screening programs to detect health risk factors, but also medical programs to help firefighters maintain a good physical fitness.

Analysis of Clinical Presentations of Bruton Disease: A Review of 20 Years of Accumulated Data from Pediatric Patients at Severance Hospital

PURPOSE: X-linked agammaglobulinemia (XLA) is a humoral immunodeficiency disease caused by a mutation in the Bruton tyrosine kinase (BTK) gene resulting in defective B cell differentiation. Because it is a relatively rare disorder, it is difficult for clinicians to have a comprehensive understanding of XLA due to a lack of exposure to the disease. Clinical presentations of patients with XLA were analyzed and discussed to improve care plans. MATERIALS AND METHODS: During a 20 year period, from January 1987 to June 2006, a total of 19 patients were diagnosed as XLA in the Department of Pediatrics at Severance Hospital, Seoul, Korea. A retrospective analysis of the clinical presentations of those patients was performed. RESULTS: The mean age of the XLA patients included in the study was 4.89 years, with a range of 6 months to 13 years. Twelve patients were diagnosed before age 5, while the other 7 patients were diagnosed after age 5. Recurrent infections observed in the patients included pneumonia, acute otitis media, septic arthritis, skin infection, sepsis, sinusitis, acute gastroenteritis, cervical lymphadenitis, epididymitis, meningitis, osteomyelitis, urinary tract infection and encephalitis. Frequency of admissions was variable from 0 to 12 times, depending on the time at which immunoglobulin therapy was started. Six cases had family histories positive for XLA. BTK gene mutations were found in 8 cases. CONCLUSION: The overall prognosis of XLA is good as long as patients are diagnosed and treated early with regular intra venous gamma globulin therapy before the sequelae of recurrent infections appear.

Comparison of a whole blood Interferon-gamma assay and A tuberculin skin test for detecting latent tuberculosis infection in children / 소아과

PURPOSE: Surveillance for detecting and managing latent tuberculosis infection (LTBI) is a key component of tuberculosis control. The classic surveillance tool, the tuberculin skin test (TST), may have some limitations when used in the Bacillus Calmette-Guerin (BCG)-vaccinated population. The object was to perform a blood test QuantiFERON(R)-TB Gold In Tube (QFT-G IT) based on the detection of interferon-gamma (IFN-gamma) released by T cells in response to Mycobacterium tuberculosis-specific antigens, and to compare the efficacy of this new diagnostic tool for LTBI with that of TST. METHODS: For six months, between October 1, 2006 and April 30, 2007, data were collected from 111 patients under 15 years of age at Severance Children's Hospital. TST and QFT-G IT tests were performed with children with or without contact histories of tuberculosis. In addition to these tests, we examined comparative data from 29 adults who had tuberculosis, to detect false negative rates in the QFT-G IT method. RESULTS: Thirty-three children had household contact histories. In this group, 15% and 42% of cases were found to be positive using the QFT-G IT assay and TST, respectively. Agreement was low between these two tests (kappa=0.39). In the adult active tuberculosis group, the QFT-G IT false negative rate defined as a positive culture and a negative QFT-G IT result was 12.5%. CONCLUSION: In diagnosing LTBI in children, the usefulness of a whole-blood IFN-gamma assay employing TB-specific antigens will be revealed only by examining additional longitudinal clinical data; this study serves as a starting point in that process.

Comparison of a whole blood Interferon-gamma assay and A tuberculin skin test for detecting latent tuberculosis infection in children / 소아과

PURPOSE: Surveillance for detecting and managing latent tuberculosis infection (LTBI) is a key component of tuberculosis control. The classic surveillance tool, the tuberculin skin test (TST), may have some limitations when used in the Bacillus Calmette-Guerin (BCG)-vaccinated population. The object was to perform a blood test QuantiFERON(R)-TB Gold In Tube (QFT-G IT) based on the detection of interferon-gamma (IFN-gamma) released by T cells in response to Mycobacterium tuberculosis-specific antigens, and to compare the efficacy of this new diagnostic tool for LTBI with that of TST. METHODS: For six months, between October 1, 2006 and April 30, 2007, data were collected from 111 patients under 15 years of age at Severance Children's Hospital. TST and QFT-G IT tests were performed with children with or without contact histories of tuberculosis. In addition to these tests, we examined comparative data from 29 adults who had tuberculosis, to detect false negative rates in the QFT-G IT method. RESULTS: Thirty-three children had household contact histories. In this group, 15% and 42% of cases were found to be positive using the QFT-G IT assay and TST, respectively. Agreement was low between these two tests (kappa=0.39). In the adult active tuberculosis group, the QFT-G IT false negative rate defined as a positive culture and a negative QFT-G IT result was 12.5%. CONCLUSION: In diagnosing LTBI in children, the usefulness of a whole-blood IFN-gamma assay employing TB-specific antigens will be revealed only by examining additional longitudinal clinical data; this study serves as a starting point in that process.

Proteus Syndrome: A Natural Clinical Course of Proteus Syndrome

A 16-year-old Korean male patient presented with macrodactyly, hemihypertrophy of the face and extremities, plantar cerebriform hyperplasia, a subcutaneous mass of the left chest, macrocephaly and verrucous epidermal nevi. These findings are consistent with Proteus Syndrome. The clinical features, etiology, management, natural course and differential diagnosis of this case are discussed.

Extraovarian Granulosa Cell Tumor

A 54-year-old woman was admitted to our hospital complaining of postcoital bleeding. Sonography of the abdomen showed a 8.2 x 8.9 cm-sized solid heterogeneous mass occupying the cul-de-sac, which appeared to be in no way connected with the ovary. On exploratory laparotomy, the tumor mass protruded from the posterolateral retroperitoneum of the pelvic cavity and severely replaced the uterus and adnexa with the outer surface being grossly intact. It grossly measured 10 cm in maximal diameter. The histologic features closely resembled those of ovarian granulosa cell tumor. The primary extraovarian granulosa cell tumor is extremely rare such that in the English literature only 7 cases have been reported to date. Of those granulosa cell tumors are especially rare and only two cases have been reported to arise from retroperitoneum. We herein present a case of retroperitoneal granulosa cell tumor with special regard to differential diagnosis from other solid tumors with similar histology.

Clinicopathologic study of Wegener's granulomatosis with special emphasis on early lesions in 10 Korean patients

We reviewed ten cases of Wegener's granulomatosis with special emphasis on the characteristics of the early stage of Wegener's granulomatosis. All patients presented with nonspecific symptoms and signs, so that Wegener's granulomatosis was not initially considered. However, half of the patients had clinical or radiologic disease in the nose/or paranasal sinuses as the primary presenting problems and showed neutrophil microabscess surrounded by palisading epithelioid cells and irregularly arranged giant cells in the nasal biopsy as the most characteristic feature. Five of ten patients were believed to have a protracted superficial phenomenon before involvement of other organs, specifically the lung or kidney. Four of ten patients showed nonreactivity to ANCA test at the time of presentation. Although the number of cases reviewed in this study was small, the rate of nonreactivity to ANCA was higher than those of the larger series. The importance of early diagnosis of Wegener's granulomatosis can not be overemphasized in view of the fact that cases unrecognized clinicopathologically finally progress to full-blown systemic form of Wegener's granulomatosis with poor prognosis. The diagnosis of Wegener's granulomatosis should be based on a thorough and meticulous examination of its characteristic histologic changes in biopsied tissue particularly extravascular foci.

Apoptosis of Peripheral Blood Mononuclear Cells in Different Ages of Normal Children

PURPOSE: To survive in an ecological environment, an individual must develop immunity to various antigens. Therefore, populations of peripheral blood mononuclear cells (PBMC) in humans change continuously with growth. The object of this study is to evaluate the apoptosis of peripheral blood mononuclear cells (PBMC) in normal children of different ages. METHODS: PBMC were isolated from the study groups. Ten cord blood samples of normal babies, 10 blood samples of normal children each from 4 different age groups (0-1, 2-5, 6-10, 11-15 year- old and adult), and 20 from normal adults were included in this study. After 24 and 48 hrs incubation in RPMI1640 media containing 10% fetal calf serum, cells were stained with Annexin V and PI and then analyzed with FACScan flowcytometer. RESULTS: Cord blood mononuclear cells showed the lowest percentage of apoptosis compared to other age groups. PBMC isolated from the 0-1 year-old normal children showed the highest percentage of apoptosis, and the percentage of apoptosis decreased with increase of age. After the age of 10, the percentage of PBMC apoptosis was the same as that of adults. CONCLUSION: The differences in the percentage of PBMC apoptosis with different age groups might be from immunologically different state of the hosts with different age. This result could be a useful reference data for the study of apoptosis in pediatric disease in the future.

Retroperitoneal multilocular bronchogenic cyst adjacent to adrenal gland

Bronchogenic cysts are generally found in the mediastinum, particularly posterior to the carina, but they rarely occur in such unusual sites as the skin, subcutaneous tissue, pericardium, and even the retroperitoneum. A 30-year-old Korean man underwent surgery to remove a cystic adrenal mass incidentally discovered during routine physical checkup. At surgery, it proved to be a multilocular cyst located in the retroperitoneum adjacent to the left adrenal gland. Microscopically, the cyst was lined by respiratory epithelium over connective tissue with submucous glands, cartilage and smooth muscle, thereby histologically confirming bronchogenic cyst. This is the first reported case of retroperitoneal bronchogenic cyst in an adult without other congenital anomalies in Korea.