Trends in Secondhand Smoking and Urine Cotinine Concentration in Non-Smoking Adults in Korea: The 2008–2011, 2014–2018 Korea National Health and Nutrition Examination Survey

Background@#The risk of secondhand smoke (SHS) is gradually becoming apparent, and as smoking cessation zones are expanding, the exposure to SHS in workplaces, homes, and public places is decreasing. The objective of this study was to evaluate the actual exposure to SHS in nonsmokers. @*Methods@#This study used data from 2008 to 2011 and 2014 to 2018 from the Korean National Health and Nutrition Examination Survey (KNHANES). The urine cotinine concentration values were compared by the geometric mean according to sex, age group, and rurality for non-smokers aged 19 years or older who were tested for urine cotinine. @*Results@#The overall trend of urine cotinine concentration in Korean adult non-smokers have shown a decline since 2011. It gradually decreased from 2.82 ng/mL in 2010 to 0.50 ng/mL in 2016 but slightly increased to 0.79 ng/mL in 2018. Both male and female showed this trend. The decline tended to be lower in those aged 60 years and older, with higher urine cotinine concentrations in the recent 3 years in the rural than in urban residents. @*Conclusion@#The urinary cotinine concentration levels in Korean non-smokers increased from 2008 to 2010, then decreased till 2016, but gradually increased thereafter. This is possibly due to limiting the exposure to SHS through expanding the smoking area. Furthermore, a policy to lower the smoking rate with strict implementation and monitoring of the existing policy will be needed.

How Well Can Matrix of Ferritin and Neutrophil to Lymphocyte Ratio Predict Metabolic Syndromein Korean Adults?

Background@#Previous studies have shown that elevated ferritin level and neutrophil to lymphocyte ratio (NLR) are risk factors of chronic low-gradeinflammation and contribute to the onset and progression of cardiovascular disease. In addition, metabolic syndrome has a similar relevance; thus,in this study, we aimed to determine how well metabolic syndrome could be predicted by measuring ferritin level and NLR. @*Methods@#From January 2016 to September 2018, 1,815 adults who underwent medical interviews, physical measurements, and blood tests at amedical examination center of a university hospital in Seoul were evaluated. Data were analyzed using the Spearman correlation analysis, anaverage comparison using analysis of variance, and a t test. The prevalence of metabolic syndrome was determined according to ferritin level andNLR. @*Results@#We found a significant correlation between the components of metabolic syndrome and ferritin level, but not NLR. The NLRs were divided intoquartiles for comparison with the mean values of the components of metabolic syndrome, but the results were not significant. A significantdifference was found only in ferritin level when we compared the mean values of ferritin level and NLR according to the presence or absence of ametabolic syndrome diagnosis. When ferritin level and NLR were considered simultaneously, the prevalence of metabolic syndrome tended tochange only when the ferritin level changed. @*Conclusion@#In healthy Korean adults, ferritin level, but not NLR, could be used as a predictor of metabolic syndrome.

Application of Relative Fat Mass Equation in Korean Adults

Background@#Body mass index (BMI) has limitations in determining body fat percentage and body fat distribution, and causes misclassification of body fat-defined obesity. As high body fat percentage is associated with mortality, an accurate assessment of body fat percentage is considered clinically important. Recently, Woolcott and Bergman reported a relative fat mass (RFM) equation which calculated the body fat percentage using the height and waist circumferences. However, as RFM has been studied only in European-, Mexican-, and African-Americans, an assessment in Asians was needed. Therefore, we aimed to evaluate the applicability of RFM in Korean adults. @*Methods@#This study included 7,733 adults who visited a Sanggye Paik Hospital Health Promotion Center from May 1, 2016 to November 12, 2018. BMI and RFM were calculated by measuring height, weight, and waist circumference. The total body fat (TBF) percentage was measured by bioelectrical impedance analysis. We compared the BMI, RFM, and TBF percentage to assess the applicability of RFM in Korean adults. @*Results@#RFM had a statistically significant correlation with TBF percentage in both male and female (male: β=0.808, R2=0.653, female: β=0.766, R2=0.587, P<0.001). In the Bland-Altman plot, RFM showed good agreement with the TBF percentage within the 95% confidence interval. @*Conclusion@#The RFM equation can be used to predict TBF percentage in Korean adults.

The Relationship between Serum Uric Acid and Ankle Brachial Index in Korean Men

BACKGROUND: Elevated serum uric acid (UA) level is a known risk factor for atherosclerotic diseases, including peripheral arterial disease (PAD). PAD is easily diagnosed by determining the ankle-brachial index (ABI). The relationship between serum UA and subclinical atherosclerotic diseases remains controversial. We therefore aimed to explore an independent association between UA and ABI in healthy Korean men.METHODS: A cross-sectional study was conducted in 664 male participants aged ≥19 years who visited our Center for Health Promotion. The ABI and serum UA were determined for all participants and the relationship between these parameters and between ABI and other variables was assessed with the Pearson correlation coefficient. Multiple regression analysis was conducted to determine an independent correlation between serum UA and ABI after adjustment for certain variables. Analysis of covariance was employed to identify a trend in the ABI relative to UA quartiles.RESULTS: The ABI correlated inversely with UA and variables such as body mass index, diastolic blood pressure, heart rate, total cholesterol, triglycerides, and low-density lipoprotein-cholesterol. UA showed an independent inverse correlation with the ABI after serial adjustment for these variables (β=−0.265, P < 0.001). A decreasing trend in the ABI was observed with increasing UA quartile (P < 0.001).CONCLUSION: UA shows an independent inverse correlation with ABI in healthy Korean men.

Correlation between Serum Uric Acid and Carotid Intima-Media Thickness in Korean Women

BACKGROUND: Serum uric acid (UA) has been found to be associated with hypertension, obesity, dyslipidemia, and metabolic syndrome; however, its role as an independent risk factor of cardiovascular disease (CVD) is still controversial. There have been very few studies reporting an association between UA levels and carotid intima-media thickness (CIMT), especially in women.METHODS: The study included 245 subjects whose CIMT was evaluated between February 2016 and December 2017 at a health promotion center. We divided the population into two groups on the basis of menopausal status: premenopausal women (n=78) and postmenopausal women (n=167). We measured blood pressure, serum lipid profile, fasting blood glucose (FBG), and creatinine and UA levels. CIMT was measured using high-resolution B-mode ultrasonography.RESULTS: UA levels and CIMT were higher in postmenopausal women (P=0.029, P < 0.001). In premenopausal women, age (r=0.438), body mass index (r=0.373), UA (r=0.205), and FBG (r=0.336) were associated with CIMT, whereas in postmenopausal women, age (r=0.326), body mass index (r=0.167), UA (r=0.166), systolic blood pressure (r=0.200), and HDL-cholesterol (r=−0.140) were associated with CIMT. The UA level was independently associated with CIMT in premenopausal women (β=0.208, P=0.031), whereas age was the only factor independently associated with CIMT in postmenopausal women (β=0.253, P=0.002). Women in the highest tertile of uric acid level exhibited a higher CIMT than did those in the lowest tertile after age adjustment (P for trend < 0.001).CONCLUSION: UA may be an independent risk factor for CIMT, suggesting that UA is a risk factor for the early detection of CVD, especially in premenopausal women.

Association between Vitamin D Concentration and Visceral Fat Area in Healthy Korean Adults

BACKGROUND: Studies on the relationship between vitamin D and visceral fat area (VFA; intra-abdominal fat area) have been actively conducted. But, there is a few Korean population-based studies about the association between serum vitamin D level and VFA. The aim of our study was to explore the correlation between serum 25-hydroxyvitamin D (25[OH]D) levels and VFA measured using bioelectrical impedance analysis (BIA; electric impedance) in healthy Korean adults. METHODS: This cross-sectional study involved 1,945 adults aged 20-70 years who visited a health promotion center. All subjects underwent the BIA to estimate the VFA. Serum 25(OH)D level was measured using chemiluminescent immunoassay. Multiple regression analysis was performed to identify independent correlation of VFA and serum 25(OH)D level. RESULTS: The prevalence of vitamin D deficiency (25[OH]D: 20-29 ng/mL) and insufficiency (25[OH]D <20 ng/mL) were 54.4% and 38.1%, respectively. After having adjusted age and season, VFA were negatively associated with serum 25(OH)D levels in both men (P<0.001) and women (P<0.001). The obese group with VFA ≥ 100 cm² had significant lower serum 25(OH)D level in men (P<0.001) and women (P=0.0034). CONCLUSIONS: VFA measured using BIA could be negatively associated with serum 25(OH)D levels in healthy Korean adult.

Martin's Equation as the Most Suitable Method for Estimation of Low-Density Lipoprotein Cholesterol Levels in Korean Adults / 가정의학회지

BACKGROUND: Friedewald equation is the most widely used method for estimating low-density lipoprotein cholesterol (LDL-C) level. However, due to potential over- or underestimation, many studies have used a modified equation. This study aimed to compare estimates by 4 different equations to directly measured LDL-C concentrations in order to propose the most appropriate method for LDL-C estimation in the Korean population. METHODS: We studied data of 4,350 subjects that included total cholesterol, high-density lipoprotein cholesterol (HDL-C), triglyceride (TG), and LDL-C concentrations that had been measured at one university hospital in Seoul. We investigated 4 equations: LDL-C by Friedewald's original equation (LDL-C(F)) and its 3 modifications. Pearson correlation analysis was performed to compare these estimates to the direct measurement. RESULTS: Pearson correlation analysis revealed a good correlation among all 4 estimated LDL-C values and the directly measured LDL-C value. The Pearson coefficients were 0.951 for LDL-C(F), 0.917 for LDL-C by Hatta equation (LDL-C(H)), 0.968 for LDL-C by Puavilai equation (LDL-C(P)), and 0.983 for LDL-C by Martin equation (LDL-C(M)). Martin equation (LDL-C(M)) resulted in the best approximation (mean difference from the direct measurement, 5.5 mg/dL; mean percentage difference from the direct measurement, 5.1%) and the best agreement with the direct measurement (86.1%). LDL-C(P) resulted in the second-best approximation (mean difference, 7.0 mg/dL; mean percentage difference, 6.2%; concordance, 82.5%). LDL-C(M) was found to be less influenced by TG and HDL-C levels than by LDL-C(F). CONCLUSION: Estimates by Martin equation had the best agreement with direct LDL-C concentrations and both Martin and Puavilai equations were superior to Friedewald equation for estimating LDL-C concentrations in Korean adults.

Total Unilateral Obstruction by Sputum Immediately after Tracheal Bougienage / 대한구급학회지

A 25-year-old man developed tracheal stenosis due to prolonged intubation for five days. Immediately after bougienage, his left lung was not possible to ventilate and emergency tracheostomy was performed to produce ample space for airflow. Fiberoptic bronchoscopy showed that his left main bronchus was totally obstructed by sputum at the entrance of the superior and inferior lobar bronchi. Inadequate airway clearance increases the risk of infection and airway obstruction. We suggest chest physiotherapy be applied to all patients in the intensive care unit (ICU), especially patients with tracheal stenosis, due to its positive impact on pulmonary functional ability and ICU stay.

Outbreak of Swine-Origin Influenza A (H1N1); Experience of a Regional Center in Seoul during a Month, August-September 2009 / 대한임상미생물학회지

BACKGROUND: The aim of this study is to clarify the epidemiology of swine-origin influenza A (H1N1) virus 2009 (S-OIV) during the first month of outbreak at one of influenza clinic in Seoul, Korea. METHODS: We documented the epidemiologic and clinical features of S-OIV-confirmed cases who visited a university hospital in Northeastern Seoul between August 21 and September 20, 2009. Nasopharyngeal swab of patients with acute febrile respiratory illnesses were evaluated with rapid influenza antigen tests and multiplex RT-PCR for S-OIV and seasonal influenza A. RESULTS: A total of 5,322 patients with acute febrile respiratory illnesses were identified at our influenza clinic for the study period. S-OIV was confirmed in 309 patients by RT-PCR. The patients ranged from 2 months to 61 years of age and 189 patients (61.2%) were teenagers. Eighty-one patients had known contact with S-OIV-confirmed patients in schools (N=61), households (N=15), and healthcare facilities (N=3). Frequent symptoms were fever (94.5%), cough (73.1%), sore throat (52.1%), and rhinorrhea (50.5%). Gastrointestinal symptoms were also present in 10 patients (4.9%). Ten patients (4.9%) required hospitalizations. Seventy patients (22.7%) could not take oseltamivir at the first visits, however, all of them recovered without complication. Rapid antigen tests showed the sensitivity of 44.4% (130/294). Patients with positive antigen tests, compared with negative antigen tests, showed higher frequencies of rhinorrhea (60.8% vs 43.3%, P=0.004) and stuffy nose (33.8% vs 20.1%, P=0.012). CONCLUSION: S-OIV infections spread predominately in school-aged children during the early accelerating phase of the outbreak. Rapid influenza antigen tests were correlated with nasal discharge and obstruction.

Evidence Based Nutritional Therapy of Premenstrual Syndrome, Dysmenorrhea, and Mastalgia

No abstract available.

Pharmacological Therapy of Erectile Dysfunction: Current Oral Agents

No abstract available.