The objective of this study was to examine the prevalence and risk factors for widespread pain and its influence on quality of life in residents of Korean communities. A rural and an urban community were selected, and 5,037 subjects were surveyed. Participants were asked if they had pain, aching, or stiffness in any of their joints on most days. Widespread pain was defined as pain above the waist, below the waist, on both sides of the body and in the axial region. The prevalence of widespread pain was 12% (16.2% and 5.5% in females and males, respectively). It was more frequent among females and increased with age in both genders. Age, female gender, and the presence of hand or knee arthritis were significantly associated with widespread pain after multivariate analysis. Except for mental health, all the items in the SF-12 were adversely affected in the widespread pain group after adjustment for confounding factors. Our findings show that the prevalence of widespread pain among residents of Korean communities is comparable to that reported among Caucasians. The significantly worse quality of life among subjects with widespread pain suggests that it may cause major health issues in the aging population.
Adult ; Age Factors ; Aged ; Demography ; Female ; Health Status ; Humans ; Male ; Middle Aged ; Odds Ratio ; Pain/*epidemiology/psychology ; Prevalence ; *Quality of Life ; Republic of Korea/epidemiology ; Risk Factors ; Rural Population ; Sex Factors ; Urban Population

PURPOSE: Vascular endothelial growth factor (VEGF) has been identified as an endothelial cell-specific angiogenic factor of intraocular neovascularization, a pathologic complication of many vitreoretinal disorders. We studied to evaluate clinical correlation of intravitreal VEGF concentration and various vitreoretinal disorders. METHODS: Forty eight vitreous fluid samples were obtained at the time of vitreoretinal surgery from 43 patients of various disorders. Concentrations of VEGF1 6 5 in vitreous fluid were determined by Human VEGF ELISA kit and its correlation with diabetes, intraocular hemorrhage, neovascularization, proliferative vitreoretinopathy, retinal detachment, pan retinal photocoagulation, and postoperative condition was statistically analyzed. RESULTS: Intravitreal concentrations of VEGF in case of intraocular hemorrhage (0.809+/-1.467 ng/ml), neovascularization (1.167+/-1.656 ng/ml), and anterior segment neovascularization (2.381+/-2.043 ng/ml) were significantly high (P<0.05). CONCLUSIONS: VEGF plays a major role in the development of neovascularization in the various retinal disorders.
Angiogenesis Inducing Agents ; Enzyme-Linked Immunosorbent Assay ; Hemorrhage ; Humans ; Light Coagulation ; Retinal Detachment ; Retinaldehyde ; Vascular Endothelial Growth Factor A* ; Vitreoretinal Surgery ; Vitreoretinopathy, Proliferative

BACKGROUND: The quantification of hepatitis C virus (HCV) is useful in diagnosis and monitoring of HCV infection. We evaluated clinical usefulness of HCV quantification and two quantification methods using different assay principles. METHODS: HCV RNA quantities and liver function were measured in patients with different disease severity using bDNA assay (QuantiplexTM, Chiron, USA). HCV RNA loads were quantified at the time of pre/post-interferon treatment in some of them using RT-PCR hybridization assay (AMPLICORTM, Roche, USA). These two quantification methods were also compared. RESULTS: HCV RNA loads showed no significant difference according to disease severity (group I, 3.8 5.3 MEq/mL; group II, 3.8 7.4 MEq/mL; group III, 5.9 13.0 MEq/mL; P=0.181) or interferon response (complete responders, 1.5 105/mL; partial or non responders, 2.2 105/mL; P=0.670). But HCV viral loads decreased at 6th month after interferon treatment (P=0.063) and correlated poorly with liver function tests. The bDNA assay correlated well with the RT-PCR hybridization method (r2=0.854). CONCLUSIONS: The quantificaion of HCV RNA is useful in following up treatment effect but not in predicting therapeutic failure or assessment of disease severity. HCV RNA quantities are independent of liver function. The bDNA assay showed good correlation with the RT-PCR hybridization method.
Branched DNA Signal Amplification Assay ; Diagnosis ; Hepacivirus* ; Hepatitis C* ; Hepatitis* ; Humans ; Interferons ; Liver Diseases* ; Liver Function Tests ; Liver* ; RNA ; Viral Load

Purpose: Alzheimer disease (AD) is one of the most complex diseases and is characterized by AD-related neuropathological features, including accumulation of amyloid-β plaques and tau neurofibrillary tangles. Dysregulation of alternative splicing (AS) contributes to these features, and there is heterogeneity in features across brain regions between AD patients, leading to different severity and progression rates; however, brain region-specific AS mechanisms still remain unclear. Therefore, we aimed to systemically investigate AS in multiple brain regions of AD patients and how they affect clinical features. Methods: We analyzed RNA sequencing (RNA-Seq) data obtained from brain regions (frontal and temporal) of AD patients. Reads were mapped to the hg19 reference genome using the STAR aligner, and exon skipping (ES) rates were estimated as percent spliced in (PSI) by rMATs. We focused on AD-risk genes discovered by genome-wide association studies, and accordingly evaluated associations between PSI of skipped exons in AD-risk genes and Braak stage and plaque density mean (PM) for each brain region. We also integrated whole-genome sequencing data of the ascertained samples with RNA-Seq data to identify genetic regulators of feature-associated ES. Results: We identified 26 and 41 ES associated with Braak stage in frontal and temporal regions, respectively, and 10 and 50 ES associated with PM. Among those, 10 were frontal-specific (CLU and NTRK2), 65 temporal-specific (HIF1A and TRPC4AP), and 26 shared ES (APP) that accompanied functional Gene Ontology terms, including axonogenesis in shared-ES genes. We further identified genetic regulators that account for 44 ES (44% of the total). Finally, we present as a case study the systematic regulation of an ES in APP, which is important in AD pathogenesis. Conclusions This study provides new insights into brain region-dependent AS regulation of the architecture of AD-risk genes that contributes to AD pathologies, ultimately allowing identification of a treatment target and region-specific biomarkers for AD.

Overnight fasting before elective surgery has been the routine to reduce the risk of pulmonary aspiration. Recently, several international guidelines for preoperative fasting recommend to intake carbohydrate-containing fluids up to 2 to 3 hours before the induction of anesthesia to improve postoperative recovery. Based on the recommendations, we developed a "preoperative carbohydrate diet" provided for the preoperative patients. The purpose of this case report is to share our experience of applying preoperative carbohydrate loading prior to surgery.
Anesthesia ; Fasting ; Humans ; Insulin Resistance ; Pancreaticoduodenectomy*

Osteoma cutis is a rare disorder characterized by compact bone formation in the dermis or subcutaneous tissue. According to the absence or presence of previous cutaneous lesions, it is classified as primary and secondary forms. Miliary osteoma of the face is a form of primary osteoma cutis that generally occurs in middle-aged to older adult women. A 50-year-old woman presented with asymptomatic, multiple, 2~3 mm-diameter, skin-colored, firm papules on both cheeks for 5 years. The histopathologic specimen of the papule showed compact bone formation in the dermis. We herein report a rare case of military osteoma cutis on the face.
Adult ; Cheek ; Dermis ; Female ; Humans ; Middle Aged ; Military Personnel ; Osteogenesis ; Osteoma* ; Subcutaneous Tissue

PURPOSE: To find the applicability of adjuvant radiotherapy for extrahepatic bile duct cancer (EBDC), we analyzed the pattern of failure and evaluate prognostic factors of locoregional failure after curative resection without adjuvant treatment. MATERIALS AND METHODS: In 97 patients with resected EBDC, the location of tumor was classified as proximal (n = 26) and distal (n = 71), using the junction of the cystic duct and common hepatic duct as the dividing point. Locoregional failure sites were categorized as follows: the hepatoduodenal ligament and tumor bed, the celiac artery and superior mesenteric artery, and other sites. RESULTS: The median follow-up time was 29 months for surviving patients. Three-year locoregional progression-free survival, progression-free survival, and overall survival rates were 50%, 42%, and 52%, respectively. Regarding initial failures, 79% and 81% were locoregional failures in proximal and distal EBDC patients, respectively. The most common site was the hepatoduodenal ligament and tumor bed. In the multivariate analysis, perineural invasion was associated with poor locoregional progression-free survival (p = 0.023) and progression-free survival (p = 0.012); and elevated postoperative CA19-9 (> or =37 U/mL) did with poor locoregional progression-free survival (p = 0.002), progression-free survival (p < 0.001) and overall survival (p < 0.001). CONCLUSION: Both proximal and distal EBDC showed remarkable proportion of locoregional failure. Perineural invasion and elevated postoperative CA19-9 were risk factors of locoregional failure. In these patients with high risk of locoregional failure, adjuvant radiotherapy could be considered to improve locoregional control.
Bile Duct Neoplasms ; Bile Ducts, Extrahepatic* ; Celiac Artery ; Cystic Duct ; Disease-Free Survival ; Follow-Up Studies ; Hepatic Duct, Common ; Humans ; Ligaments ; Mesenteric Artery, Superior ; Multivariate Analysis ; Prognosis ; Radiotherapy, Adjuvant* ; Recurrence ; Risk Factors ; Survival Analysis ; Survival Rate

Calcifying aponeurotic fibroma is a rare soft tissue tumor that mostly occurs in the distal extremities of children and adolescents. We report here on a case of calcifying aponeurotic fibroma of the right elbow in an 8-year-old boy, and the tumor was diagnosed by surgical excision. The patient complained of painless swelling and mild limitation of the range of motion of the elbow joint. Radiologically, the mass was ill-defined and showed stippled calcification with shallow bony erosion. Microscopically, the tumor was composed of spindle cells with nodular deposits of hyalination and calcification, and these deposits were surrounded by palisading polygonal plump cells. Immunohistochemically, the tumor showed a diffuse positive expression for CD99 and negativity for smooth muscle actin, S-100 protein and CD34. The patient has been well with no signs of recurrence during the 42 months after surgery.
Actins ; Adolescent ; Child ; Elbow ; Elbow Joint ; Extremities ; Fibroma ; Humans ; Hyalin ; Muscle, Smooth ; Range of Motion, Articular ; Recurrence ; S100 Proteins ; Soft Tissue Neoplasms

BACKGROUND: Weight loss through low-calorie diets (LCDs) decreases visceral fat (VF). However, the effects on muscle mass, changes of dietary quality, and insulin sensitivity are unknown for Korean obese type 2 diabetic subjects. Therefore, this study examined such effects of LCDs. METHODS: A total of 30 obese type 2 diabetic subjects (body mass index, 27.0 +/- 2.2 kg/m2) were randomly assigned to an LCD or control group. Subjects on LCDs took 500~1,000 kcal fewer energy than their usual dietary intake (1,000~1,500 kcal/day) over the course of 12 weeks. The abdominal VF and femoral muscle mass were evaluated by computed tomography, and insulin sensitivity was assessed using an insulin tolerance test (Kitt; rate constant for plasma glucose disappearance, %/min). Dietary nutrient intake consumed by subjects was assessed by 3-day food records. RESULTS: The percent VF reduction was -23.4 +/- 17.2% in the LCD group and -9.8 +/- 11.8% in the control group after 12 weeks (P < 0.001, P = 0.002). However, significant decrease in femoral mass or proportional change of marcronutrient intake and mean adequacy ratio were not found in the LCD group, as compared to the control group. Insulin sensitivity improved in the LCD group, as compared to the control group (P = 0.040). CONCLUSION: LCD effectively improved insulin sensitivity and reduced abdominal VF without reduction of femoral muscle and dietary quality in obese type 2 diabetic subjects.
Caloric Restriction ; Diabetes Mellitus, Type 2 ; Glucose ; Insulin ; Insulin Resistance ; Intra-Abdominal Fat ; Muscles ; Plasma ; Weight Loss

The main purpose of this study is to examine the concepts appeared on research and provide future research directions in field of child health nursing. 205 studies of the total 318 studies had been analyzed first for the concepts of the client domain and this time 113 studies were analyzed for the practice, the client-nurse and the environmental domain in nursing. The practice domain includes mentalistitic, enactment, knowledge utilization, role related phenomenon, the client-nurse domain includes touch, communication, interaction phenomenon, and the environmental domain includes physical, social, symbolic environment. All were originally published between 1990 and 2000 in Korea. An analysis of concepts for this study was used the metaparadigm framework for nursing proposed by H. S. Kim(2000). 1. 103 studies belonged to the practice domain. Among them, 56(54%) studies used concepts related to enactment phenomenon like education(21.4%), giving information(7.1%), breast feeding(5.4%), caring(5.4%), airway suction(5.4%), nonnutritive sucking(5.4%). 44(43%) studies used concepts related to knowledge utilization like program development and evaluation of smoking, mother-infant interaction, home health nursing, obesity management. And only 3(3%) studies used role related concepts like quality of nursing, direction of health education, contents of child health nursing education. 2. Only 2(0.006%) studies belonged to the client-nurse domain. One concept is empathy in communication phenomenon and the other concept is role conflict in interaction phenomenon. 3. 8(0.02%) studies belonged to the environmental domain. Among them, 3 studies related to physical environment like space, noise and 5 studies related to social environment like social support, home environment. But the concept of symbolic environment was not used. The findings of this study provide the evidence that research related to the client-nurse domain and the environmental domain should be conducted actively to improve the practice of child health nursing. So that the research in field of child health nursing should be dealt with the concepts of four domains to develop knowledge systematically.
Breast ; Child ; Child Health* ; Child* ; Education, Nursing ; Empathy ; Health Education ; Home Health Nursing ; Humans ; Korea* ; Mother-Child Relations ; Noise ; Nursing* ; Obesity ; Program Development ; Smoke ; Smoking ; Social Environment