To examine the prevalence and correlates of orthostatic hypotension (OH) in middle-aged adults enrolled in the Korean Health and Genome Study. Participants were 8908 individuals aged 40-69 years. Supine blood pressure (BP) was measured three times at 30-s intervals after at least 5 min of rest in the supine position and single standing BP was measured at 0 and 2 min after standing, respectively. OH was defined as a reduction in systolic BP or diastolic BPX20 and 10 mmHg, respectively. The prevalence of OH at 0 and 2 min after standing was 12.3 and 2.9%, respectively. At 0 min of standing, OH frequency increased significantly with age from 6.4% in those aged 40-44 years to 23.1% in those aged 65-69 (Po0.001). After adjustment for age and other characteristics, hypertension was associated with a 1.7-fold excess in the odds of OH in men and a 1.6-fold excess in women (Po0.001). In contrast, an increase in body mass index (BMI) on the order of 5 kg/ m 2 was associated with a 20-30% reduction in the odds of OH (Po0.001). Diabetes in women was also associated with a 1.4-fold excess in the odds of OH (Po0.05). An increase in triglyceride by 136 mg/dl in men was associated with an increase in the odds of OH (Po0.05).In conclusion, the prevalence and correlates of OH other than diabetes and triglycerides were notably similar in men and women. While the association between hypertension and OH has been observed elsewhere, low BMI in Korean adults with OH may be an important marker for subclinical morbidity or coexisting risk factors that need to be identified.
Introduction Human papillomavirus (HPV) prevalence and genotype distribution are different between various nations and regions. Additionally, previous studies have mainly focused on HPV infection in women and epidemiological studies of HPV infection in men have been rarely reported. The lack of information on the HPV genotype distribution of men in each individual country or region raises questions about the effectiveness of the current 9-valent vaccination. Objective Therefore, we aimed to investigate the HPV infection status in men in Korea to establish vaccine-based HPV prevention strategies. Methods Between January 2014 to June 2022, samples of 44,065 men, who were volunteered for testing or recommended to be tested by a clinician, were tested for the HPV detection and genotyping. Samples were collected from the coronal sulcus, glans penis, shaft, and scrotum. HPV detection and typing was conducted using the Anyplex™ II HPV 28 Detection system, which detects 19 high-risk (HR) HPVs and 9 low-risk (LR) HPVs. Results Overall HPV prevalence was 59.7%, and overall prevalence of HR and LR HPVs were 30.6% and 50.1%, respectively. The most prevalent genotypes of HR were 16 (5.2%), 53 (4.6%), 51 (4.2%), 52 (3.8%), 58 (3.7%), 39(3.6%) and 66(3.4%). Overall HPV prevalence was not associated with age. However, the prevalence of HR HPVs in teens (34.1%) and 20s (33.8%) were significantly higher than in other age groups. Of the 26,299 men with HR HPV infection, 9259 (35.2%) had a genotype that could not prevented by the 9-valent vaccine. Conclusions In this study, men aged under 30 years show high prevalence of HR HPVs. A significant number of infections of genotypes that were not prevented by 9-valent vaccine were observed. Based on this, it is considered necessary to evaluate the usefulness of developing HPV vaccination for men. Disclosure No
Introduction Recently, there have been reports on partial plaque excision and grafting with collagen fleece technique regarding long term efficacy. However, there is still concern regarding complete regeneration of tunical defect from collagen fleece graft in terms of regenerative medicine. Previously, we introduced a less invasive modified technique by multiple grid incisions of Peyronie's plaque to minimize weakness of regenerated tunica from the collagen fleece graft and consequent veno-occlusive erectile dysfunction. Objective To assess the efficacy of Modified Grid Incision of plaque and sealing with Collagen Fleece through post-operative progress of 31 patients with prospective follow-up study. Methods From Aug 2018, 31 patients with stable Peyronie's disease (PD) were included. Surgical technique was composed 3 major steps; 1) dissection of the neurovascular bundle or urethra according to the location of plaque, 2) multiple deep grid plaque incisions for complete correction of curvature and deformity and 3) sealing with collagen fleece (TachoSil®) without suturing. Prospectively, we assessed the stretched penile length (SPL), totally straightness, penile sono, erectile function preoperatively and 6, 12, 24, 36 months postoperatively. This study was approved by the Institutional Review Board of the Korea University Hospital. Results Mean patient age was 58.5 years (range: 46–75). The mean curvature was 45.95 (15-90) degrees, 8 with hinge and 7with hourglass deformity. Inflatable penile prosthesis (IPP) was inserted in 4 patients and postoperative 30 months in a patient for poor erectile function. Mean follow-up was 15 months (6-36). Daily massage softened the hard thickening of penis gradually from 3 months until 2 year. On follow-up sonography, subcutaneous thickening gradually decreased to near normal at 1 year and the breakage of tunica by grid incision reunited at postoperative 10-12 months. All patients achieved totally straightness. All patients gained preoperative length after 1.6 year. 96% of patients satisfied in GAQ at 1 year. Minor skin problem was occurred in three patients of IPP. Subcutaneous bulging hematoma was occurred in 2 patients but subsided within 3 months. In postoperative erectile function of 27 patients without IPP, spontaneous hard erection was recovered in 10 and the rest are satisfied with PED5 inhibitors. Conclusions Our prospective progress reports with technical modification of various plaque incisions shows that one can achieve a sufficient surgical effect without making defect of tunica albuginea. Precise understanding of the postoperative progressions are necessary for physician's confidence and encouraging the patients for successful clinical outcomes. Disclosure No
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