Sleep Status among Older Adults in Korea according to Urban or Rural Area Residence

Objectives@#Older adults have more sleep disorders than younger individuals and are more vulnerable to environmental factors affecting sleep. We sought to study sleep status among older adults in Korea according to the residential area. @*Methods@#The present study used data from a nationwide, cross-sectional study on sleep status among older Koreans aged 65 to 86 years. Epworth Sleepiness Scale (ESS) and Pittsburgh Sleep Quality Index (PSQI) values were used to classify sleepiness. The Insomnia Severity Index (ISI) was applied to evaluate insomnia symptoms, and the Berlin Questionnaire was utilized to identify those at high risk of sleep apnea. The Cambridge-Hopkins diagnostic questionnaire was used to assess the prevalence of restless legs syndrome. @*Results@#Study participants were divided according to the residential area: metropolitan city, city, or rural area. Total sleep time on weekdays and weekend days showed no difference. ESS and PSQI scores did not differ among residential area groups. Meanwhile, the average ISI score was higher among residents in rural areas. The risk of obstructive sleep apnea and the prevalence of restless legs syndrome were similar in all groups. @*Conclusions@#Our results indicate that poor sleepers and high ISI are more common in rural areas of Korea. Future studies of the causes and proper treatments thereof are warranted.

Difference in Adenoma Detection Rates according to Colonoscopic Withdrawal Times and the Level of Expertise / 대한소화기학회지

BACKGROUND/AIMS: Adequate screening colonoscopy in the general population decreases the mortality associated with colorectal cancer through detection and removal of adenomatous polyps. Prolonged colonoscopic withdrawal times (>6 min) are reportedly beneficial for adenoma detection rates (ADRs). However, the quality of the endoscopist compared with colonoscopic withdrawal times is not known. The aims of this study were to investigate the difference in ADRs between trainees and experienced examiners. METHODS: A total of 967 consecutive patients who underwent screening colonoscopy in a single University hospital from June 2010 to November 2011 were enrolled in this prospective observational study. Colonoscopy was performed by four experienced staff and seven gastroenterology fellows. RESULTS: Seven gastroenterology fellows performed 633 colonoscopies and four experienced staff performed 334 colonoscopies. The overall detection rates of colorectal adenoma were 31.5% with ADRs of fellows and staff of 29.4% and 35.6%, respectively (p=0.047). Fellows also showed lower advanced ADRs (5.7% vs. 9.9%, p=0.016), and fellows had longer mean withdrawal times than staff (12.4+/-4.9 min vs. 8.2+/-4.1 min, p<0.001). Multivariate analysis showed significantly increased ADRs and advanced ADRs for staff compared with fellows (adjusted OR 2.41, 95% CI 1.70-3.43; adjusted OR 2.55, 95% CI 1.47-4.45, respectively). CONCLUSIONS: ADRs were significantly lower when colonoscopy was performed by trainees, although withdrawal times were longer than those of staff. Our results demonstrated that the quality of colonoscopy, as measured by ADRs, may be improved by experienced examiners.

Lentinus edodes Suppresses Allergen-Induced Airway Hyperresponsiveness and Inflammation by Downregulating Nuclear Factor-kappa B Activity in a Murine Model of Allergic Asthma / 체질인류학회지

Medicinal mushrooms have been shown to have profound health promoting benefits. Among them, Lentinus edodes is well-known to have anti-tumor, anti-inflammatory, and immunomodulatory effects. The aim of the present study is to evaluate whether Lentinus edodes ethanol extract (LE) inhibit airway inflammatory response in a murine asthma model induced by exposure to ovalbumin (OVA). The pretreatment of LE substantially attenuated airway hyperresponsiveness and eosinophilic inflammation in OVA-challenged mice. In addition, the increased levels of Th2 cytokines (IL-4, IL-5, and IL-13), eotaxin, and adhesion molecules in bronchoalveolar lavage fluids at 48 h after OVA inhalation was significantly reduced by the administration of LE. Furthermore, LE suppressed OVA-induced activation of nuclear factor-kappa B and p38 mitogen-activated protein kinase in lung tissues. Taken together, it is proposed that LE may serve as an effective therapeutic agent for allergic airway disease.

Phellinus linteus Extract Exerts Anti-asthmatic Effects by Suppressing NF-kappaB and p38 MAPK Activity in an OVA-induced Mouse Model of Asthma

Phellinus linteus has been used as a traditional herbal medicine in Asian countries and is known to have anti-tumor, immunomodulatory, anti-inflammatory, and anti-allergic activities. However, the protective effects of P. linteus against experimental asthma have not been fully investigated. The objective of this study was to determine whether P. linteus ethanol extract (PLE) suppresses inflammatory response in an OVA-induced asthma model. As expected, the oral administration of PLE significantly inhibited eosinophilic airway inflammation and airway hyperresponsiveness in OVA-challenged BALB/c mice. Supporting these data, the augmentation of Th2 cytokines (IL-4, IL-5, and IL-13), eotaxin, and adhesion molecules in lung tissues and bronchoalveolar lavage fluid after OVA inhalation was markedly attenuated by PLE. Furthermore, PLE reduced OVA-induced activation of NF-kappaB and p38 MAPK in lung tissues. Therefore, our results suggest the potential of P. linteus as a therapeutic agent for asthma.

Sparassis crispa Attenuates Carbon Tetrachloride-Induced Hepatic Injury in Rats / 체질인류학회지

Sparassis crispa is an edible mushroom with various medicinal properties. Here we demonstrate the effect of Sparassis crispa on carbon tetrachloride (CCl4)-induced hepatotoxicity and the underlying mechanism. To evaluate the hepatoprotective effects of Sparassis crispa ethanol extract (SCE), 50 male Sprague-Dawley rats were equally divided into 5 groups. Group I is the normal control rats with an intraperitoneal (i.p.) 0.5% carboxy methyl cellulose (CMC) pretreatment and olive oil treatment. Group II is the model group with an i.p. 0.5% CMC and 0.5 mL/kg CCl4 treatment. Group III and IV is the CCl4-administered rats pretreated with an i.p. 100 and 200 mg/kg SCE, respectively. Group V includes the silymarin group with an i.p. 50 mg/kg silymarin and CCl4 treatment. At 16 h after the CCl4 treatment, the levels of serum aminotransferases, TNF-alpha, and lipid peroxidation were substantially increased, whereas the activity of hepatic antioxidative enzymes, such as superoxide dismutase and catalase, was decreased. These changes were attenuated by SCE. The histological studies also showed that SCE inhibited the CCl4-induced liver injury. Furthermore, the contents of hepatic nitrite, inducible nitric oxide synthase (iNOS), and cyclooxygenase-2 (COX-2) were elevated after CCl4 treatment, while the cytochrome P450 2E1 (CYP2E1) expression was suppressed. SCE treatment inhibited the formation of liver nitrite, reduced the over-expression of iNOS and COX-2 proteins, but restored the liver CYP2E1 content compared with the CCl4-treated model group. The present data elucidate that SCE protects the liver against CCl4-induced acute hepatotoxicity, which might be due to its ability to restore the CYP2E1 function and suppress the inflammatory responses, in combination with its capacity to reduce oxidative stress.

Association between Serum Cholesterol Level and Bone Mineral Density at Lumbar Spine and Femur Neck in Postmenopausal Korean Women / 가정의학회지

BACKGROUND: Blood lipid profiles have been suggested to be a risk factor for osteoporosis. However, the association between lipid profiles and bone mineral density (BMD) is still unclear. This study aimed to evaluate an association between blood lipid profiles and BMD through both a cross-sectional and a longitudinal study. METHODS: Study subjects were 958 postmenopausal Korean women who have repeatedly undertaken laboratory tests and BMD measurements at lumbar spine and femur neck with an interval of 7.1 years. The associations between lipid profiles and BMD were examined using Spearman correlation analysis with an adjustment for age, smoking, alcohol drinking, physical activity, body mass index, and follow-up duration. RESULTS: Lumbar spine BMD was not associated with total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), and high density lipoprotein cholesterol (HLD-C) regardless of when the measurement was performed. In an analysis using data measured at the beginning of the study, femur neck BMD was not associated with TC and LDL-C. However, femur neck BMD showed weak but significantly positive correlation with HDL-C (correlation coefficient, 0.077; 95% confidence interval, 0.005 to 0.149). When the analysis was repeated with data measured at the end of the follow-up, there was no significant correlation between femur neck BMD and any lipid profile. In addition, change in femur neck BMD during follow-up was not associated with the change in lipid profiles. CONCLUSION: Although further study with a consideration of calcium intake and osteoporosis medication seems necessary, this study found no association between serum lipid profiles and BMD in postmenopausal Korean women.

Differential Diagnostic Value of Transient Increase of Plasma Ammonia Level in Seizure and Syncope

BACKGROUND: Differential diagnosis between a generalized tonic-clonic seizure and syncope may be difficult due to similar clinical features. The need for a biological marker to distinguish a seizure from syncope has been emphasized from past studies. Transient hyperammonemia could be an indicator of recent convulsive seizure. The purpose of this study is to review the use of plasma ammonia level in the differential diagnosis of seizure and syncope. METHODS: Adult patients who were admitted to the Department of Neurology at Gangnam Severance Hospital with final diagnosis of a generalized tonic-clonic seizure or syncope were eligible for this study. Plasma ammonia levels were checked within 8 hr after an insult. RESULTS: Among the patients with a loss of consciousness who underwent analysis of plasma ammonia level, diagnoses were made with a seizure (n=65) and syncope (n=38). The seizure group had 70.29+/-70.86 micromol/L and the syncope group had 28.37+/-10.27 micromol/L of ammonia level, respectively. The seizure group presented with a significantly increased plasma ammonia (p<0.05) compared to the syncope group. The cut-off value with the reliable diagnostic level was defined as 36 micromol/L (=61.308 microg/dL) with a sensitivity of 0.65 and specificity of 0.80 by receiver operating characteristic (ROC) curve analysis. CONCLUSIONS: Plasma ammonia measurement during acute post-ictal period may be a useful test for the identification and the differential diagnosis of seizures and syncope.

Lipoic acid suppresses compound 48/80-induced anaphylaxis-like reaction / 대한해부학회지

Alpha-lipoic acid (LA), a naturally occurring dithiol compound, is an essential cofactor in metabolic reactions involved in energy utilization. LA improves glycemic control, reduces diabetic polyneuropathies, atherosclerosis, and allergic inflammation. The effects of LA on mast cell-mediated anaphylactic reactions, however, are unknown. LA dose-dependently inhibited systemic and passive cutaneous anaphylaxis-like reactions in mice induced by compound 48/80, a condensation product of N-methyl-p-methoxyphenethylamine and formaldehyde. Pretreatment with LA, prior to induction of the systemic anaphylaxis-like reaction with compound 48/80, reduced plasma histamine levels in a dose-dependent manner. In our in vitro study, LA decreased histamine release from rat peritoneal mast cells (RPMCs) triggered by compound 48/80. Moreover, an increase in calcium uptake activated by compound 48/80 was inhibited by LA. LA also significantly elevated intracellular cyclic adenosine-3',5' monophosphate (cAMP) levels in RPMCs. This inhibition of mediator release from RPMCs may be due to inhibition of calcium uptake and augmentation of intracellular cAMP levels. Based on these results, we suggest that LA may be a potential remedy for allergy-related diseases.

Inhibitory effects of curcumin on passive cutaneous anaphylactoid response and compound 48/80-induced mast cell activation / 대한해부학회지

Mast cells participate in allergies and inflammation by secreting a variety of pro-inflammatory mediators. Curcumin, the active component of turmeric, is a polyphenolic phytochemical with anti-tumor, anti-inflammatory, anti-oxidative, and anti-allergic properties. The effects of curcumin on compound 48/80-induced mast cell activation and passive cutaneous anaphylactoid reactions are unknown. In this report, we investigated the influences of curcumin on the passive cutaneous anaphylactoid response in vivo and compound 48/80-induced mast cell activation in vitro. The mechanism of action was examined by calcium uptake measurements and cAMP assays in mast cells. Curcumin significantly attenuated the mast cell-mediated passive cutaneous anaphylactoid reaction in an animal model. In agreement with this in vivo activity, curcumin suppressed compound 48/80-induced rat peritoneal mast cell (RPMC) degranulation and histamine release from RPMCs. Moreover, compound 48/80-elicited calcium uptake into RPMCs was reduced in a dose-dependent manner by curcumin. Furthermore, curcumin increased the level of intracellular cAMP and significantly inhibited the compound 48/80-induced reduction of cAMP in RPMCs. These results corroborate the finding that curcumin may have anti-allergic activity.

Scutellaria baicalensis Inhibits Mast Cell-Mediated Anaphylactic Reactions / 체질인류학회지

Mast cells play a critical role in the effector phase of immediate hypersensitivity and allergic diseases. Scutellaria baicalensis is a widely used herb in traditional oriental medicine with anticancer, antiviral, antibacterial and anti-inflammatory properties. However, the roles of Scutellaria baicalensis in mast cell-mediated anaphylactic reactions have not fully been investigated. In this study, we examined the influences of the methanol extract of Scutellaria baicalensis (MESB) on compound 48/80- or anti-dinitrophenyl (DNP) IgE-induced anaphylaxis-like response in vivo. To further prove these in vivo results, the inhibitory effect of MESB on mast cell activation was evaluated, focusing on the histamine release from rat peritoneal mast cells (RPMC). MESB inhibited compound 48/80-induced systemic anaphylaxis-like reaction, plasma histamine release and ear swelling response in mice. MESB also attenuated passive systemic and cutaneous anaphylaxis evoked by anti-DNP IgE. In in vitro experiments, MESB dose-dependently reduced histamine release from RPMC activated by compound 48/80 or anti-DNP IgE. Moreover, compound 48/80-elicited calcium uptake was suppressed in a concentration-dependent manner of MESB. Furthermore, MESB transiently increased the level of intracellular cAMP. From these results, it is suggested that MESB possesses effective anti-anaphylactic activity.

A case of metastatic mycotic pseudoaneurysms that developed after aortic surgery / 대한내과학회지

Multiple mycotic pseudoaneurysms that develop after aortic surgery are a rare infectious complication. The clinical course of this disease is severe and associated with a high mortality. Few published cases have described mycotic pseudoaneurysms that are localized mainly in the brain, heart, and aorta. In this case, a 33-year-old woman was admitted with abdominal pain and mild fever after graft surgery for a ruptured thoracic aorta that occurred following a vehicle accident. Thoracoabdominal computed tomography (CT), angiography, and transesophageal echocardiography (TEE) demonstrated multiple pseudoaneurysms and thromboembolic obstructions in the thoracic aorta and its branches. She was treated with anticoagulation, coil embolization, and surgical resection. Microscopically, a resected pseudoaneurysm showed the characteristic features of fungal colonies with thrombi. This patient has been well for 2 months after removing the pseudoaneurysms and treatment with systemic antifungal agents.

The Pulmonary Embolism Severity Index in Predicting the Prognosis of Patients With Pulmonary Embolism

BACKGROUND/AIMS: Many prognostic models have been developed to help physicians make medical decisions on treating patients with pulmonary embolism. Among these models, the Pulmonary Embolism Severity Index (PESI) has been shown to be a successful risk stratification tool for patients with acute pulmonary embolism. The PESI, however, had not been applied to patients with pulmonary embolism in Korea. METHODS: The patients included in this study were diagnosed by computed tomography at Inje University's Ilsan Paik Hospital between December 1999 and March 2007. Risk stratification for the patients was performed using the PESI. The mortality rate was calculated according to each PESI risk class. RESULTS: Of the 90 patients enrolled in this study, ten were assigned to PESI class I, 29 to PESI class II, 22 to PESI class III, eight to PESI class IV, and ten to PESI class V. The mortality rate after 30 days in each class was 0, 10.3, 9.1, 0, and 50% (p=0.0016), respectively, whereas the respective hospital mortality rate was 4.8, 13.8, 13.6, 12.5, and 50% (p=0.0065). The overall mortality was 9.5, 27.6, 31.8, 50.0, and 60%, respectively (p=0.0019). The mortality rate was significantly associated with the PESI class. CONCLUSIONS: The PESI class was found to be significantly correlated with the 30-day mortality rate, hospital mortality, and overall mortality. Our data indicate that the PESI can be used to predict the prognosis of patients with pulmonary embolism and in making medical decisions regarding the treatment of patients with pulmonary embolism.

Inhibitory Effect of Bear Bile on Compound 48/80-induced Mast Cell Activation and IgE-mediated Vascular Permeability / 체질인류학회지

The bear bile has been used as a traditional drug medicine and has been known to have anti-tumor, anti-inflammatory and anti-oxidant effects. The purpose of this study is to investigate the inhibitory effect of bear bile on compound 48/80-induced mast cell activation in vitro and anti-dinitrophenyl (DNP) IgE-mediated vascular permeability in vivo. For this, the effects of bear bile on the degranulation, histamine release, calcium influx and the change of the intracellular cAMP levels of rat peritoneal mast cells (RPMCs) and the influences of the oral treatment of bear bile on IgE-mediated cutaneous vascular permeability were studied. the results were as follows; the compound 48/80-induced degranulation, histamine release and calcium influx of RPMCs were inhibited by pretreatment with bear bile, the cAMP levels of RPMCs were increased by pretreatment with bear bile, and bear bile inhibited anti-DNP IgE-mediated cutaneous vascular permeability. From the above results, it is suggested that bear bile contains some substances which inhibit anti-DNP IgE-mediated vascular permeability and mast cell activation. Bear bile potentially may serve as an effective therapeutic agent for allergic diseases.

Three Cases of Arterial Occlusion That Occurred After the Use of Angioseal(R)

Femoral arterial closure devices are now commonly used after both diagnostic and therapeutic coronary procedures. They have been shown to reduce the time to ambulation and to decrease the length of the hospital stay. Angioseal is a commercially available femoral artery closure device that has been approved by the Food and Drug Administration (FDA). The device sandwiches an intra-arterial absorbable anchor on the luminal side of the vessel and a thrombin plug on the surface of the vessel with using a self-cinching stitch. We report here on three patients who presented with acute and delayed arterial occlusive complications that were found to be due to an Angioseal anchor that was not appropriately reabsorbed.

A Case of Bilateral Xanthogranulomatous Pyelonephritis with Renal Failure / 대한신장학회지

Xanthogranlomatous pyelonephritis is a rare chronic inflammatory renal disease. Its clinical and radiological findings resemble other renal parenchymal diseases, such as a renal abscess or renal cell carcinoma. Only a histologic examination can confirm xanthogranulomatous pyelonephritis. It usually presents unilaterally and displays relatively normal renal function. Bilateral xanthogranulomatous pyelonephritis is extremely rare. The renal function of bilateral xanthogranulomatous pyelonephritis is usually normal at the time of diagnosis, but progresses to end stage renal failure as the disease progresses. We experienced a case of bilateral xanthogranulomatous pyelonephritis, and its initial manifestation was renal failure. We report this case with a review of the literatures.

New Thresholds for Prostate-specific Antigen Velocity for Prostate Cancer Screening in Korean Patients Younger than 60 Years Old / 대한비뇨기과학회지

PURPOSE: We identified new thresholds for prostate-specific antigen velocity(PSAV) for screening of prostate cancer in Korean patients younger than 60 years old based on PSA serial data obtained from our hospital's health promotion center. MATERIALS AND METHODS: The study population was retrieved from 10,011 patients, 40 to 79 years old, with 2 or more PSA values within five years who visited our hospital's health promotion center between January 2002 and December 2006, including 100 patients with prostate cancer. These subjects were divided into 2 age groups, 40-59 years old and 60-79 years old, and their PSAV were calculated as the rate of PSA change using the first and last values only. A receiver operating characteristic(ROC) curve was used to analyze the performance of PSAV in the screening of prostate cancer, and we developed new PSAV thresholds by comparing sensitivity and specificity at different PSAV levels. RESULTS Overall prostate cancer prevalence was 0.6%(45) in younger(40-59 years old) patients and 2.1%(55) in older(60 to 79 years old) patients. The median PSAV in the normal control group and the cancer group were 0.047ng/ml/year vs 0.877ng/ml/year in younger patients(p<0.0001) and 0.067ng/ml/year vs 0.642ng/ml/year in older patients(p<0.0001). For younger patients, the sensitivity and specificity were 55.6% and 99.2% at PSAV 0.75ng/ml/year, but decreasing the PSAV cut-points to 0.35ng/ ml/year improved sensitivity to 78% for cancer detection in this age group. CONCLUSIONS: The previous PSAV threshold for prostate biopsy, 0.75 ng/ml/year or greater, probably underestimate cancer risk in younger Korean men. Decreasing PSAV thresholds to 0.35ng/ml/year would improve screening sensitivity.

Risk Factors of Cardiovascular Disease in Korean Exceptional Longevity

BACKGROUND: It has been shown that subjects with exceptional longevity and their offsprings have a lower incidence and delayed onset of age-related diseases. Cardiovascular protective effect through over-presentation of Apo E2 with lower LDL cholesterol level, high HDL cholesterol, and larger size of HDL and LDL particle with cholesteryl ester transfer protein(CETP) genetic variation were suggested as a mechanism of less cardiovascular disease in exceptional longevity. Objective of this study is to examine what risk factors of cardiovascular diseases were related with exceptional longevity in Korea. METHODS: One hundred seventeen centenarians, 179 nonagenarians, 61 octogenarian regional controls were visited and joined after informed written consent was obtained. Age was first identified by National Residence Registry with help of regional government and verified by visiting researchers with birth year animal, age of first child and neighbor's connection memory. Detailed interview with questionnaires about health status and life style, physical examination, physical and cognitive function, and blood tests were performed. Data about risk factors of cardiovascular disease was analyzed and compared exceptional longevity group with regional control group and 455 octogenarian control data from 2001 National Health and Nutrition Examination. RESULTS: Hypertension and diabetes history, hypercholesterolemia and hypertriglyceridemia, obesity and abdominal obesity, and physical inactivity ratio of longevity groups were significantly less than control group. Level of homocysteine, and C-reactive protein and low serum HDL cholesterol ratio were not much different between longevity and control group. CONCLUSION: Fewer risk factors and delayed onset of cardiovascular disease were observed in Korean exceptional longevity group. Future research about genetic protective effect of cardiovascular disease in longevity is required.

Prevalence of Thyrotoxicosis and Hypothyroidism in the Subjects for Health Check-Up / 대한내분비학회지

BACKGROUND: The prevalence of ovat hyperthyroidism ar hypothyroidism has been estimated up to 5% in the general populatian. Subclinical hyperthyroidism and subclinical hypothyroidism have pevalences of approximately 1% and 6%, ectively. The prevalence of hypothyroidism may be associated with excessive intake of iodine in iodine sufficient areas. Therefore, we assumed the prevalence of thyroid dysfunction in Karea might be different from those af Western cauntries. However, thete have been no surveys to examine the prevalence of thyroid dysfunction in Karea. We performed the study to investigate the prevalence of thyrotoxicosis and hypothyroidism in Korean adults. METHODS: This study was performed in 15019 subjects (8275 men, 6744 women; between 17 and 87 years of age) visited in health promotion center of Samsung Medical Center for 12 months in 1996. Serum T3, T4, and TSH concentrations were measured with RIA or IRMA using commercial kits. History of thyroid dysfunction and current medication were obtained from medical records. The criteria for thyrotoxicosis were TSH level below than 0.30 mU/L and increased T3 or T4 levels (T3 > 3.1 nmol/L or T4 > 152 nmol/L). Patients who had TSH level above than 5.0 mU/L and T4 level below than 77 nmol/L met the criteria for hypothyroidism. RESULTS: The prevalence of thyrotoxicosis was 5.5/1000 population (men 3.6/1000, women 7.7/1000) with peak prevalence in fifth decade. The prevalence of previously undiagnosed thyrotoxicosis was 4.0/1000 (men 2.9/1000, women 5.3/1000). The prevalence of hypothyroidism was 2.8/1000 population (men 1.1/1000, women 4.9/1000) with peak prevalence in seventh decade. The prevalence of previously undiagnosed hypothyroidism was 1.6/1000 (men 0.6/1000, women 2.S/1000). The prevalence of subclinical thyrotoxicosis was 12.4/1000 population (men 11.8/1000, women 13.0/1000). The prevalence of subclinical hypothyroidism was 18.2/1000 population (men 11.2/1000, women 26.7/1000) which frequency was increased with age. CONCLUSION: Although the prevalence of thyrotoxicosis and hypothyroidism was not significantly different from those of other countries, it was lower than expected and female preponderance is not significant. The prevalence of subclinical thyrotoxicosis and subclinical hypothyroidism was lower than those of other countries. The prevalence of subclinical hypothyroidism was higher in women and old ages. (J Kor Soc Endecrinol 14:301~313, 1999)

A Frequency of Hypothyroidism in a Population of Hypercholesterolemin Subjects / 대한내분비학회지

BACKGROUND: Hypothyroidism is a treatable cause of secondary hyperlipidemia. The lipid profile usually seen is an increased total and low density lipoprotein(LDL) cholesterol, and the plasma triglyceride may also be increased. Hypercholesterolemia associated with hypothyroidism is an important factor in the pathogenesis of coronary artery disease(CAD). And the hyperchole-sterolemia caused by hypothyroidism is potentially reversible by thyroid hormone replacement therapy. Hypothyroidism should be ruled out by routine laboratory screening as a treatable cause of secondary hyperlipidemia and increased CAD risk. We carried out this study aimed at evaluating the frequency of hypothyroidism and its relationship with serum cholesterol concentration in Koreans. METHODS: We investigated 15028(men 8273, women 6755) Korean subjects who visited our hospital center for health promotion during an one year period(from January 1, 1996, to December 31, 1996). Among them, we analyzed 6756 hypercholesterolemic subjects whose serum cholesterol levels were greater than 200 mg/dL. They performed thyroid function tests(total T, T4, and TSH) and lipid profiles(total cholesterol, triglyceride and HDL-cholesterol) were measured by enzyme assay. We defined hypothyroidism by serum thyrotropin values greater than 5 U/mL. RESULTS: The observed prevalence of hypothyroidism was 2.4%(163/6756). Among those with high TSH levels, 17(10.4%) had overt hypothyroidism with a low T4 (below 6 g/dL) level. As we analyzed the frequency of hypothyroidism according to cholesterol range by 20 mg/dL, the frequency was significantly increased in the group whose serum cholesterol levels were greater than 300 mg/dL, especially in women over 50 years of age. Analysis of lipid parameters showed that hypertriglyceridemia was frequent and hyperHDLaemia was observed in hypothyroidic populations. CONCLUSION: Screening for hypothyroidism by measurement of thyrotropin values is of particular importance in patients with hypercholesterolemia. And the frequency of hypothyroidism was more significantly increased in whose serum cholesterol levels were greater than 300 mg/dL, especially in the group of women over 50 years of age.

Three cases of acute lobar nephronia in children / 대한신장학회잡지

No abstract available.