Occupational Risk Factors for Stroke: A Comprehensive Review / 대한뇌졸중학회지

For primary prevention, it is important for public health and clinical medicine to identify and characterize modifiable risk factors of stroke. In existing literature, the impact of occupational variables on ischemic and hemorrhagic stroke has been extensively studied. This review summarizes the available data on the significance of occupational variables in stroke. The results of this review suggest that there is sufficient evidence for the relationship between increased risk of stroke and job stress, working in extreme temperatures, long working hours, and/or shift work. The association between long working hours and occupational exposure to noise and chemicals remains inconclusive although several studies have reported this finding. This review will act as a step toward future research and provide information that may serve as a baseline for developing targeted interventions to prevent stroke in the working population.

Antibacterial effect of biodegradable gelatin methacryloyl loaded with ginger rhizome extract / 대한치과재료학회지

Gelatin methacryloyl 3d mesh mimics the natural extracellular matrix which allow loading as promising drug delivery systems.However, insufficient mechanical and degradation properties remain the biggest obstacle for this material application. In this study, a modified hydrogel with natural phytochemical was developed to improve the antibacterial effect by the addition of ginger extract, a natural spicy used in traditional medicine. GelMA hydrogels with ginger extract were fabricated and their chemical and morphological characteristics were analyzed by Fourier transformer infrared spectroscopy and scanning electron microscopy, structural characteristic were evaluated by compressive test and surface wettability analysis. S. mutans, S. aureus and P. gingivalis were used to confirm the antibacterial effect of the modified hydrogels. The FT-IR spectra of the hydrogels modified with ginger presented an increase in intensity of some peaks in comparison with the 10% GelMA hydrogel. The pores of ginger-modified hydrogels decreased it size which affected the hydrogels physical properties, decreasing the compressive modulus and increasing the durability, swelling ratio and, hydrophobicity of the surface. The ginger-modified hydrogels exhibited excellent antibacterial properties against S. mutans and S. aureus at high concentrations of ginger extract, while P. gingivalis presented a higher sensitivity at all tested concentrations. Hence, this study concludes that ginger-modified GelMA hydrogels presented better antibacterial effect, durability over time and, swelling stability.

Removal of a Left Upper Lobar Bronchial Foreign Body Using Fogarty Catheter and Rigid Bronchoscope

Airway foreign body aspiration in children can lead to accidental death, due to the foreign body itself or the removal procedure. Depending on its location, removal of the foreign body can be challenging. Here, we present a case of successful removal of a foreign body from the left upper lobar bronchus via ventilating bronchoscopy with a rigid bronchoscope and Fogarty arterial embolectomy catheter. Tracheobronchial foreign bodies in locations that are difficult to reach with forceps, due to an acute angle or the small diameter of the pediatric bronchial tree, can be effectively removed with a Fogarty arterial embolectomy catheter.

Evaluation of bone regeneration ability of Mg mesh coated with calcium phosphate by cyclic precalcification treatment / 대한치과재료학회지

Surface treatment was conducted to reduce dissolution of Mg mesh and to improve bioactivity in physiological environment. Mg mesh was immersed in 40 wt% hydrofluoric (HF) solution for 2 hours to form a protective coating layer. Then, hydrothermal treatment was performed in a mixed solution of Ca(NO3)2·4H2O and Na2HPO 4 at 90 ℃ for 30 minutes, and cyclic precalcification treatment was conducted by soaking in each 0.06 M NH 4H 2PO4 solution and 0.011 M Ca(OH)2 solution in turn at 90 ℃. Immersion test was performed in simulated body fluid (SBF) to investigate solubility and bioactivity. Release characteristics were investigated after loading ibandronate to suppress initial bone resorption. Bone regeneration ability was evaluated through micro-CT analysis and conforming inflammatory cytokines levels in blood. Fine granular calcium phosphate-based materials were precipitated as clusters on the surface treated in cyclic precalcification. Agglomerated calcium phosphate precipitates on the surface were observed after SBF immersion. pH in SBF during immersion increased slowly in hydrothermal treatment and cyclic precalcification groups compared to pure Mg group. Release of ibandronate occurred over 6 days in cyclic precalcification treatment group (CP-H1). IL-1β and IL-6 were significantly lower than those of untreated group in all test groups except for the group (CP-H4) that was heat-treated at 400 ℃ after pretreatment with circulating calcification. As a result of micro-CT analysis, the new bone volume and density were significantly higher in the CP-H1 group. It was concluded that cyclic precalcification treatment after formation of fluorine protective layer on Mg mesh could retard the dissolution and enhanced bone regeneration ability.

Osteoblast cytocompatibility and antibacterial effect of ginger main compounds / 대한치과재료학회지

Ginger has been used worldwide in traditional medicine. It has been reported that phenolic compounds such as gingerol and shogaol in ginger have beneficial cellular effect and antibacterial effect. The purpose of this study was to investigate the effect of gingerol and shogaol on the cytocompatibility for the osteoblastic cells and antibacterial activity against oral microorganisms. Chemical structures of gingerol and shogaol were determined by Fourier transform infrared (FT-IR). Thermal and pH stability was analyzed by UPLC assay. Streptococcus mutans, and Porphyromonas gingivalis were used to confirm the antibacterial effect of the ginger compounds and MC3T3-E1 cells were used to identify biocompatibility test. Cell viability and bacterial growth was determined by water-soluble tetrazolium salt (WST-8) colorimetric assay. Cellular morphology was identified with optical microscope after crystal violet staining. Cell differentiation and oxidative stress were evaluated by Alkaline phosphatase (ALP) assay and hydrogen peroxide colorimetric assay. The chemical bonding related with hydroxyl groups, carbonyl groups and aromatic ring was identified in all ginger compounds. Gingerol and shogaol presented good stability at acid and neutral pH at room temperature. All compounds showed better antibacterial effect against Porphyromonas gingivalis than Streptococcus mutans. 10-gingerol and all shogaol groups below 10-6 M presented suitable cytocompatibility for osteoblastic cells compared to control group. All groups showed similar Oxidative stress to control group, and ALP activity in all groups below 10-6 M was not statistically significant compared to control. Hence, this study concludes that shogaol groups presented better antibacterial effect and suitable cytocompatibility than gingerol groups.

Predictors of Aspiration Pneumonia in the Elderly With Swallowing Dysfunction: Videofluoroscopic Swallowing Study

Objective@#To identify the variables of videofluoroscopic swallowing study (VFSS) that are useful for predicting the risk of aspiration pneumonia in elderly patients with dysphagia. @*Methods@#A total of 251 patients (aged 65 years or more) were included and divided into a pneumonia group (n=133) and a non-pneumonia group (n=118). The pneumonia group included patients who had been diagnosed with aspiration pneumonia, and individuals in the non-pneumonia group did not have pneumonia but were referred for VFSS. The medical records and results of VFSS were reviewed and compared between the groups retrospectively. @*Results@#The pneumonia group exhibited a male preponderance and a higher 8-point Penetration-Aspiration Scale (8PPAS) score. The mean values of 8PPAS score for swallowing thick liquid and rice porridge was significantly higher in the pneumonia group. The pharyngeal delay time (PDT) and pharyngeal transit time (PTT) were significantly longer in the pneumonia group. The amounts of vallecular and pyriform sinus residue were increased in the pneumonia group. The delay in swallowing reflex and the decrease in laryngeal elevation were more frequently observed in the pneumonia group. Among those variables, PDT and PTT were identified as significant predictors of aspiration pneumonia based on logistic regression analysis. @*Conclusion@#The present study delineated the findings of VFSS, suggesting an increased risk of aspiration pneumonia in elderly patients with dysphagia. The results demonstrate that prolonged PDT and PTT are significant predictors of aspiration pneumonia.

Predictors of Aspiration Pneumonia in the Elderly With Swallowing Dysfunction: Videofluoroscopic Swallowing Study

Objective@#To identify the variables of videofluoroscopic swallowing study (VFSS) that are useful for predicting the risk of aspiration pneumonia in elderly patients with dysphagia. @*Methods@#A total of 251 patients (aged 65 years or more) were included and divided into a pneumonia group (n=133) and a non-pneumonia group (n=118). The pneumonia group included patients who had been diagnosed with aspiration pneumonia, and individuals in the non-pneumonia group did not have pneumonia but were referred for VFSS. The medical records and results of VFSS were reviewed and compared between the groups retrospectively. @*Results@#The pneumonia group exhibited a male preponderance and a higher 8-point Penetration-Aspiration Scale (8PPAS) score. The mean values of 8PPAS score for swallowing thick liquid and rice porridge was significantly higher in the pneumonia group. The pharyngeal delay time (PDT) and pharyngeal transit time (PTT) were significantly longer in the pneumonia group. The amounts of vallecular and pyriform sinus residue were increased in the pneumonia group. The delay in swallowing reflex and the decrease in laryngeal elevation were more frequently observed in the pneumonia group. Among those variables, PDT and PTT were identified as significant predictors of aspiration pneumonia based on logistic regression analysis. @*Conclusion@#The present study delineated the findings of VFSS, suggesting an increased risk of aspiration pneumonia in elderly patients with dysphagia. The results demonstrate that prolonged PDT and PTT are significant predictors of aspiration pneumonia.

Anti-senescence and anti-wrinkle activities of 3-bromo-4,5-dihydroxybenzaldehyde from Polysiphonia morrowii Harvey in human dermal fibroblasts

Objective:To investigate the anti-senescence effect of 3-bromo-4,5-dihydroxybenzaldehyde (BDB) from Polysiphonia morrowii Harvey in human dermal fibroblasts (HDF). Methods:HDF were subjected to treatment of BDB and then treated with hydrogen peroxide (H2O2) to induce premature senescence. Senescence-associated β-galactosidase (SA-β-gal) activity in HDF was determined using the SA-β-gal staining method. Intracellular reactive oxygen species (ROS) production was measured using the 2',7'-dichlorodihydrofluorescein diacetate assay. Western blotting assay was performed to assess the level of antioxidant enzyme glutathione peroxidase 1 (GPX1). In addition, intracellular collagen and collagenase contents were analyzed using the respective ELISA kits. Elastase activity in HDF supernatants was measured from p-nitroaniline release and normalized using total protein content. Results:Treatment of HDF with H2O2 increased the activity of SA-β-gal, but BDB pre-treatment resulted in the reduction of SA-β-gal activity. Moreover, BDB significantly reduced H2O2-induced intracellular ROS production. BDB also markedly increased the level of GPX1, which was inhibited by 400 μM of H2O2. Furthermore, in in vitro study, BDB significantly increased intracellular collagen content and decreased matrix metalloproteinase-1 and elastase activities in HDF. Conclusions:Our results demonstrate that BDB shows anti-senescence and anti-wrinkle activities in vitro.

Osteoblast cytocompatibility and antibacterial effect of ginger main compounds / 대한치과재료학회지

Ginger has been used worldwide in traditional medicine. It has been reported that phenolic compounds such as gingerol and shogaol in ginger have beneficial cellular effect and antibacterial effect. The purpose of this study was to investigate the effect of gingerol and shogaol on the cytocompatibility for the osteoblastic cells and antibacterial activity against oral microorganisms. Chemical structures of gingerol and shogaol were determined by Fourier transform infrared (FT-IR). Thermal and pH stability was analyzed by UPLC assay. Streptococcus mutans, and Porphyromonas gingivalis were used to confirm the antibacterial effect of the ginger compounds and MC3T3-E1 cells were used to identify biocompatibility test. Cell viability and bacterial growth was determined by water-soluble tetrazolium salt (WST-8) colorimetric assay. Cellular morphology was identified with optical microscope after crystal violet staining. Cell differentiation and oxidative stress were evaluated by Alkaline phosphatase (ALP) assay and hydrogen peroxide colorimetric assay. The chemical bonding related with hydroxyl groups, carbonyl groups and aromatic ring was identified in all ginger compounds. Gingerol and shogaol presented good stability at acid and neutral pH at room temperature. All compounds showed better antibacterial effect against Porphyromonas gingivalis than Streptococcus mutans. 10-gingerol and all shogaol groups below 10-6 M presented suitable cytocompatibility for osteoblastic cells compared to control group. All groups showed similar Oxidative stress to control group, and ALP activity in all groups below 10-6 M was not statistically significant compared to control. Hence, this study concludes that shogaol groups presented better antibacterial effect and suitable cytocompatibility than gingerol groups.

Post-stroke Aphasia as a Prognostic Factor for Cognitive and Functional Changes in Patients With Stroke: Ischemic Versus Hemorrhagic

Objective@#To investigate the comprehensive outcomes in aphasic patients, including their cognitive and functional status after ischemic or hemorrhagic stroke. It also aimed to clarify whether aphasia is a prognostic factor for cognitive and functional improvements in stroke patients. @*Methods@#Sixty-seven ischemic or hemorrhagic stroke patients in the subacute stage who had been diagnosed with aphasia using the Korean version of Frenchay Aphasia Screening Test (K-FAST) were included in the study. Forty-six stroke patients without aphasia were used as controls. All patients were examined with the Korean version of the Western Aphasia Battery (K-WAB). Cognitive and functional assessments of the patients including the Korean version of Mini-Mental State Examination (K-MMSE), and the Korean version of Modified Barthel Index (K-MBI) were performed during admission and 4 weeks after the initial assessments. @*Results@#The initial and follow-up total K-MMSE and K-MBI scores were significantly lower in aphasic patients than in non-aphasic controls. The K-WAB scores highly correlated with the total K-MMSE scores at the follow-up stage in all aphasic stroke patients. The K-WAB scores moderately correlated with the follow-up scores of the K-MBI in ischemic stroke patients but not in hemorrhagic stroke patients. @*Conclusion@#Aphasia influences the cognitive and functional status of stroke patients and has a greater impact on cognitive improvement. Aphasia severity can be one of the prognostic factors for cognitive status in aphasic patients with stroke.

Usage Status and Characteristics of Mobile Devices for the Geriatric Population

OBJECTIVE: This study aims to investigate the current usage status and identify the needs of mobile devices in the geriatric population, thus grasping the accessibility and possibility of mobile devices which can be positively used to allow them to obtain health information and manage their mental health. METHODS: All self-reported questionnaires, such as demographics, mobile phone usage, and several mental health-related scales, were completed by two elderly groups (14 males ; aged over 60, mean=73) who visited Seodaemun-gu center for dementia: 1) 54 feature phone and 2) 57 smartphone users. RESULTS: The results revealed that they have had the need to receive health information and healthcare particularly on psychiatric disorders such as dementia, geriatric depression, and anxiety. The relation between wireless calling plan and the two groups was significant. The two groups showed a significant difference only in the Short form of Geriatric Depression Scale (SGDS) score; The feature phone group had significantly higher SGDS score than the smartphone group did. CONCLUSION: As the elderly mobile phone users showed a high level of need for health information and healthcare via their own mobile phones, the data of this study are expected to serve as a foundation for the development of elderly-friendly mobile applications and programs.

Influence of Hip Fracture on Knee Pain During Postoperative Rehabilitation

OBJECTIVE: To investigate whether fracture type, surgical procedure, or fracture grade affect knee pain during postoperative rehabilitation after a hip fracture. METHODS: We conducted a retrospective case-controlled study of 139 patients during postoperative rehabilitation after surgery for hip fractures. Patients were divided into two groups: patients experiencing knee pain during the first week of postoperative rehabilitation, and patients without knee pain. We compared the types of fracture, surgical procedure, and fracture grade between the two groups. RESULTS: We enrolled 52 patients (37.4%) with knee pain during the first weeks of postoperative rehabilitation. For type of fracture, knee pain was more common with intertrochanteric fracture than with femur neck fracture (48.8% vs. 21.1%, respectively; p=0.001). For the surgical procedure, there was no significant difference between the groups. For the fracture grade, the grades classified as unstable fractures were more common in the group of intertrochanteric fracture patients with knee pain than in those without knee pain (74.1% vs. 36.4%, respectively; p=0.002). CONCLUSION: Intertrochanteric fracture affected knee pain after hip fracture surgery more than did femur neck fracture, particularly in unstable fractures. Furthermore, there was no difference in each fracture type according to the surgical procedure. Careful examination and management for knee pain is needed in patients with hip fracture surgery.

Botulinum Toxin Injection in the Treatment of Postextubation Dysphagia: A Case Report

Prolonged intubation is known to bring on postextubation dysphagia (PED) in some patients. We have noted that there were some studies to investigate specific type and pattern of PED, which showed large variety of different swallowing abnormalities as mechanisms of PED that are multifactorial. There are several options of treatment in accordance with the management of these abnormalities. A botulinum toxin (BoT) injection into the upper esophageal sphincter (UES) can improve swallowing functions for patients with this disorder, by working to help the muscle relax. In this case, the conventional treatment was not effective in patients with PED, whereas the BoT injection made a great improvement for these patients. This study suggests that the UES pathology could be the main cause of PED.

Vertical Mammaplasty for Varying Degrees of Reduction

BACKGROUND: Vertical reduction mammaplasty has been criticized for its inability to address larger cases of mammary hypertrophy, with a relatively high frequency of sensory loss reported. This article describes our single-institution experience with modified vertical reduction mammaplasty for varying degrees of breast reduction. METHODS: Thirty-three patients underwent breast reduction using the modified vertical reduction mammaplasty technique with a superomedial dermoglandular pedicle and modifications involving breast parenchyma excision. The degree of sensory preservation in the nipple-areola complex (NAC) was compared with preoperative sensation using an ordinal scale (0, insensate; 10, unchanged). Postoperative outcomes were evaluated through a photogrammetric analysis. Satisfaction with postoperative outcomes was assessed using a telephone questionnaire survey (1, very poor; 5, very good). RESULTS: The modified vertical mammaplasty technique allowed for reductions of up to 1,800 g per side. The mean resection weight was 459.24 g per breast (range, 76-1,800 g). Of the 59 operations, 9 involved complications without significant morbidity. The sensibility of the NAC recovered in most patients by 5 months after the operation. The mean satisfaction score was 3.4, which was between 'no change' and 'satisfied.' CONCLUSIONS: Modified vertical reduction mammaplasty allows a single surgeon to address varying degrees of breast hypertrophy.

Factors Associated With Upper Extremity Functional Recovery Following Low-Frequency Repetitive Transcranial Magnetic Stimulation in Stroke Patients

OBJECTIVE: To investigate the factors related to upper extremity functional improvement following inhibitory repetitive transcranial magnetic stimulation (rTMS) in stroke patients. METHODS: Forty-one stroke patients received low-frequency rTMS over the contralesional hemisphere according to a standard protocol, in addition to conventional physical and occupational therapy. The rTMS-treated patients were divided into two groups according to their responsiveness to rTMS measured by the self-care score of the Korean version of Modified Barthel Index (K-MBI): responded group (n=19) and non-responded group (n=22). Forty-one age-matched stroke patients who had not received rTMS served as controls. Neurological, cognitive and functional assessments were performed before rTMS and 4 weeks after rTMS treatment. RESULTS: Among the rTMS-treated patients, the responded group was significantly younger than the non-responded group (51.6±10.5 years and 65.5±13.7 years, respectively; p=0.001). Four weeks after rTMS, the National Institutes of Health Stroke Scale, the Brunnstrom recovery stage and upper extremity muscle power scores were significantly more improved in the responded group than in the control group. Besides the self-care score, the mobility score of the K-MBI was also more improved in the responded group than in the non-responded group or controls. CONCLUSION: Age is the most obvious factor determining upper extremity functional responsiveness to low-frequency rTMS in stroke patients.

Multiple Evanescent White-Dot Syndrome in a 14-Year-Old Girl

PURPOSE: To report a case of multiple evanescent white-dot syndrome (MEWDS) in a 14-year-old female. CASE SUMMARY: A 14-year-old female presented with decreased visual acuity. Review of systems was unremarkable except for a recent upper respiratory infection prior to her symptoms. On examination, her visual acuity was 20/20 in the right eye and 20/200 in the left eye. Relative afferent pupillary defect was observed. Examination of the left fundus revealed optic disc edema and multiple white dots in the posterior pole. Humphrey visual field test showed enlargement of the blind spot in the left eye. Fluorescein angiography revealed hyperfluorescence and late leakage of the white dots. Indocyanine green angiography showed enlarged late hypofluorescence of the white dots. MEWDS was diagnosed and the patient was followed up with serial examinations. At a follow-up examination 2 weeks later, visual acuity in the left eye improved to 20/70. The majority of white dots on fundus had disappeared and the enlarged scotoma in the left eye recovered to normal size on Humphrey visual field test. At a follow-up examination 3 months later, visual acuity in the left eye improved to 20/30 and residual white dots had further disappeared. CONCLUSIONS: Cases of MEWDS have been reported in patients as old as 67 years; however, MEWDS is a rare disease and most patients are young females. The authors describe the youngest case to date in Korea of MEWDS in 14-year-old female with typical clinical course.

Evaluation of Anterior Stromal Puncture Using Nd:YAG Laser for Refractory Recurrent Corneal Erosion

PURPOSE: To evaluate the clinical results of anterior stromal puncture (ASP) using neodymium:yttrium-aluminum-garnet (Nd:YAG) laser for refractory recurrent corneal erosion (RCE). METHODS: Ten eyes of eight patients with RCE showing poor response to conservative therapy who were treated with Nd:YAG laser ASP and followed up for at least 4 months were studied. The cause and duration of erosions, times, and total energy of the laser were recorded. The preoperative and postoperative best corrected visual acuity (BCVA), intraocular pressure, complications, and recurrence were reviewed. RESULTS: The mean follow-up time was 9.6 months. The laser energy setting was 0.2 or 0.3 mJ per shot. The average total laser energy was 6.2 mJ. Two of 10 eyes received another Nd:YAG laser treatment. All 10 eyes were successfully treated and had no recurrence after the operation during follow-up. Postoperative BCVAs were equal to or better than the preoperative BCVAs. No significant complications except faint corneal haze were observed. CONCLUSIONS: Nd:YAG laser ASP is an effective and safe procedure to treat refractory RCE in short-term follow-up.

Comparison of four diagnostic methods for detecting rabies viruses circulating in Korea

It is essential to rapidly and precisely diagnose rabies. In this study, we evaluated four diagnostic methods, indirect fluorescent antibody test (FAT), virus isolation (VI), reverse transcriptase polymerase chain reaction (RT-PCR), and rapid immunodiagnostic assay (RIDA), to detect rabies in animal brain homogenates. Out of the 110 animal brain samples tested, 20 (18.2%) were positive for rabies according to the FAT. Compared to the FAT, the sensitivities of VI, RT-PCR, and RIDA were 100, 100, and 95%, respectively. The specificities of VI, RT-PCR and RIDA were found to be 100, 100, and 98.9%, respectively. Rabies viruses circulating in Korea were isolated and propagated in murine neuroblastoma (NG108-15) cells with titers ranging from 101.5 to 104.5 TCID50/mL. Although the RIDA findings did not completely coincide with results obtained from FAT, VI, and RT-PCR, RIDA appears to be a fast and reliable assay that can be used to analyze brain samples. In summary, the results from our study showed that VI, RT-PCR, and RIDA can be used as supplementary diagnostic tools for detecting rabies viruses in both laboratory and field settings.

Epidemiological Characteristics of Rabies in South Korea from January 2004 to March 2011

Over the seven years from January 2004 to March 2011, 105 rabies cases in three different animal species and one case in human were recorded in South Korea. Forty three (40.6%) cattle and 33 (31.1%) dogs, 29 (27.4%) raccoon dogs were affected and one (0.9%) death in human was reported. The highest annual incidence of rabies was recorded with 27 cases in 2004, and then decreased to a median of 14 cases per year. Eighty cases (76.2%) occurred in Gangwon and 24 cases (22.9%) in Gyeonggi and one case in Seoul Province. All rabies cases occurred in the northern part of the country, namely, Seoul, Gyeonggi and Gangwon Provinces. Since 2007, rabies cases were not reported in Gyeonggi Province, but continued to occur and move eastward in Gangwon Province. The monthly distribution of animal rabies during the seven year period peaked in January, and the incidence was the highest during winter, from December to February, and the least common in summer, from June to September. The epidemiological study indicated that preventive measures including distribution of bait vaccine for the control of rabies in wild animals was helpful to a substantial decrease in number of rabies cases in South Korea.

Characteristics of Sodium Sensitivity in Korean Populations

Sodium sensitivity (SS) is a variable response of blood pressure (BP) to changes in sodium intake. The present study evaluated the existence and the characteristics of subjects with SS in Koreans. One hundred one subjects with (n = 31, 57.7 +/- 9.8 yr) or without hypertension (n = 70, 40.8 +/- 16.5 yr) were given a low-sodium dietary approache to stop hypertension (DASH) diet (LSD) for 7 days and a high-sodium DASH diet (HSD) for the following 7 days. The prevalence of SS in the present study population was 27.7% (17.6% in the non-hypertensive subjects and 51.6% in the hypertensive subjects). Analysis of the non-hypertensive subjects showed that systolic BP, diastolic BP, and mean arterial pressure at baseline and after HSD were higher in the subjects with SS than the subjects without SS, and there were no differences after LSD. In the hypertensive subjects, there was no difference in the BP at baseline and after HSD whether or not the subjects had SS. However, the systolic BP of hypertensive subjects with SS was lower than hypertensive subjects without SS after LSD. In the present study population, subjects with SS have distinctive BP features unlike to subjects without SS.