BACKGROUND: Elevated serum cholesterol level is a major risk factor for cardiovascular morbidity and mortality. Simvastatin is effective for treating hypercholesterolemia. The aim of the study was to evaluate efficacy and safety of 6-month therapy with simvastatin with relatively low dose, 10 mg and 20 mg/day over 60-year-old patients. METHODS: Seventy-senven patients with hyperlipidemia(triglycerides <400 g/dL and low-density lipoprotein(LDL) cholesterol >130 mg/dL) were randomized to receive either simvastatin 10 mg/day(n=32) or 20 mg/day(n=45). Efficacy was determined by measuring changes from baseline in lipid parameters including LDL cholesterol, total cholesterol, triglycerides and high-density lipoprotein(HDL) cholesterol. RESULTS: Of the senventy-seven patients randomized to treatment, eighteen patients were men and fiftynine patients were women. sixty-five percent of patients had hypertension, eighteen percent coronary artery disease and fourteen percent type 2 diabetes mellitus. Mean baseline lipid concentrations were 254 (total cholesterol), 291(triglycerides), 50(HDL) and 166 mg/dL(LDL). Both 10 mg and 20 mg of simvastatin produced statistically significant improvements in all measured serum lipid parameters(p<0.001). Compared with 10 mg of simvastatin, 20 mg of simvastatin produced significantly greater(p<0.001) reductions from baseline LDL cholesterol(32.9 mg/dL vs 24.2 mg/d). There was no significant difference in both doses at improving total cholesterol and HDL cholesterol level and TG cholesterol level. Percentage of patients at goal LDL as recommended by NCEP guideline(ATP III) were 100% and 89% for patients in low risk but 25% and 38.5% for patients in coronary heart disease and its risk equivalents, taking 10 mg and 20 mg/day respectively. Both doses were well tolerated. Only 3 patients(6.6%) in the 20 mg group and one patient(3. 1%) in the 10 mg group experienced mild adverse events. Most patients contacted by telephone wanted to take 10 mg of simvastatin. CONCLUSION: In patients with hypercholesterolemia over 60 year old in Korea, both doses(10 mg, 20 mg) of simvastatin were effective in improving serum lipid parameters and well-tolerated. We recommend, considering patients preference, that 10 mg of simvastatin be intial dosage and in patients with coronary heart disease, higher doses than 20 mg should be prescribed to allow most patients to reach their NCEP target levels.
Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Coronary Artery Disease ; Coronary Disease ; Diabetes Mellitus, Type 2 ; Female ; Humans ; Hypercholesterolemia* ; Hypertension ; Korea ; Male ; Middle Aged* ; Mortality ; Risk Factors ; Simvastatin* ; Telephone ; Triglycerides

BACKGROUND/AIMS: In Korea, the prevalence of pancreatic cancer (PC) in general population has been reported as 7 in 100,000. However, that in diabetes mellitus (DM) has not been elucidated yet. This study was designed to estimate the prevalence of PC among DM patients, and characterize and compare the patients with DM with and without PC. METHODS: 5,082 patients (4,890 DM without PC, 78 PC with DM, and 114 PC without DM) were enrolled from Korea University Guro Hospital during a period of 4 years between January 2004 and January 2008. RESULTS: The prevalence of PC in DM patients was 1.6% and that of DM in PC patients was 40.6%. No significant differences in the clinical characteristics except HbAIc and ALP were observed between PC patients with DM and without DM. Among 78 PC patients with DM, DM was diagnosed in 19 (29.4%) and 29 (37.1%) patients concomitantly or within 2 years prior to the diagnosis of PC, respectively. Among the cases with recent onset DM (less than 2 years' duration), the disease duration of DM before the diagnosis of PC was less than 1 year in 14 patients (17.9%) and 1 to 2 years in 15 patients (19.2%). DM patients with PC were found to have significantly higher ALT, total bilirubin, and ALP levels than in DM patients without PC. CONCLUSIONS: The prevalence of PC in DM patients was 1.6% and was higher than in the general population. Recent onset DM was frequent in PC patients (less than 2 years' duration). We recommend close follow-up for at least 2 years in new-onset diabetes.
Aged ; Alanine Transaminase/blood ; Alkaline Phosphatase/blood ; Bilirubin/blood ; Diabetes Complications/diagnosis/*epidemiology ; Diabetes Mellitus/diagnosis/*epidemiology ; Female ; Hemoglobin A, Glycosylated/analysis ; Humans ; Male ; Middle Aged ; Pancreatic Neoplasms/complications/diagnosis/*epidemiology ; Prevalence ; Time Factors

BACKGROUND/AIMS: Recent studies suggest that the prevalence of erosive esophagitis (EE) is increasing in Asia. The aims of this study were to determine the prevalence of EE among outpatients visiting gastroenterology clinics of secondary and tertiary hospitals in Korea, and to analyze their symptoms. METHODS: From May to July 2003, outpatients undergoing their first upper gastrointestinal endoscopies after visiting gastroenterology clinics in secondary and tertiary hospitals in Korea were enrolled. Prevalence of EE was calculated from their endoscopic findings, and symptoms were analyzed from the validated symptom questionnaire. RESULTS: Among 4,275 cases from 24 hospitals, 506 (11.8%) had EE. Among 836 cases with predominantly typical GERD symptoms, EE was diagnosed in 140 (16.7%). Among 530 cases having predominantly typical GERD symptoms with a frequency of at least twice a week or with a significant impact on their daily lives, EE was found in 104 (19.6%). The prevalence of EE was positively associated with males irrespective of age, old aged (> or =65 years) females, predominantly typical GERD symptoms at least twice a week, and the numbers of typical GERD symptoms. The severity of GERD symptoms did not affect the prevalence of EE. The most common typical and atypical GERD symptoms in cases with EE were regurgitation and epigastric soreness, respectively. CONCLUSIONS: The prevalence of EE among outpatients visiting gastroenterology clinics in Korea was 11.8%. Independent factors associated with increased prevalence of EE were males irrespective of age, old aged (> or =65 years) females, number of typical GERD symptoms, and frequent typical GERD symptoms.
Adolescent ; Adult ; Aged ; Child ; Data Interpretation, Statistical ; Esophagitis, Peptic/diagnosis/*epidemiology ; Female ; Gastroesophageal Reflux/diagnosis/epidemiology ; Hospitals ; Humans ; Korea ; Male ; Middle Aged ; Prospective Studies ; Questionnaires ; Risk Factors

BACKGROUND/AIMS: The purpose of this study was to estimate the prevalence of Barrett's esophagus (BE) and its association with reflux esophagitis (RE) and peptic ulcer disease detected by free charge endoscopy which was covered by the National Health Insurance at a secondary care hospital, and to compare the results of the biopsy of BE with that of cardiac intestinal metaplasia (CIM). METHODS: A total of 4,002 patients underwent endoscopy from March 2010 to December 2012. BE was diagnosed if there was histologically proven specialized intestinal metaplasia, and CIM was diagnosed if intestinal metaplasia was accompanied with chronic gastritis. RESULTS: Four hundred twenty four patients underwent endoscopic biopsy, and the prevalence of BE was 1.0% (42/4,002). The mean age and the proportion of males in BE were significantly higher than those of the rest of study population, and BE had slight tendency related to RE than the rest of study population. CIM was observed in 34 patients and BE and CIM showed similar results, regarding age, sex and association with RE. The mean length of endoscopic Barrett's mucosa of BE group was 9.2+/-5.1 mm, and it was similar to that of CIM. CONCLUSIONS: The prevalence of BE in the secondary care hospital was not low, and old age and male sex were significantly associated with BE. Because BE was observed in about 10% of biopsied patients and CIM was observed in a similar percentage with BE, the precise targeted biopsy is warranted and the biopsy method should be reestablished through the large prospective study of multiple secondary care hospitals.
Adult ; Aged ; Aged, 80 and over ; Barrett Esophagus/complications/epidemiology/*pathology ; Duodenal Ulcer/complications/epidemiology/pathology ; Esophagoscopy ; Female ; Gastroesophageal Reflux/complications/epidemiology/pathology ; Hospitals ; Humans ; Male ; Metaplasia/complications/epidemiology/*pathology ; Middle Aged ; Prevalence ; Secondary Care ; Stomach Ulcer/complications/epidemiology/pathology

BACKGROUND: This investigation was to perform the epidemiological surveillance and genetic analysis on respiratory viral agents from children with acute respiratory infections in Gwangju. MATERIALS AND METHODS: For this study, 3,695 specimens obtained from patients with acute respiratory infections were collected by collaboration with pediatric hospitals in Gwangju between 2005 and 2007. Specimens were screened for 8 respiratory viruses including influenza viruses (IFV), human rhinoviruses (HRV), human coronaviruses (HCoV), adenoviruses (ADV), parainfluenza viruses (PIV), human enteroviruses (HEV), respiratory synthitial viruses (RSV) and human bocaviruses (HBoV). Respiratory viruses were detected using multiplex (RT) PCR with viral specific primers. RESULTS: Out of 3,695 specimens, the ratio of virus detection was 24.9% (919). Overall, HRV (35.5%) and IFV (34.9%) were the most common viruses found, followed by HBoV (14.8%), HCoV (10.6%), RSV (3.7%), ADV (3.4%), PIV (3.2%) and HEV (3.0%). In addition, multiple infections were detected in 80 patients (8.7%). When the prevalence was analyzed according to season, HBoV, IFV and HCoV showed two epidemic points in late spring and early winter. ADV, HRV, RSV PIV and HEV, however, were all found to have only one epidemic point, with RSV being most common during winter and the others being most prominent during spring. CONCLUSIONS: Through this epidemiological surveillance, the respiratory viruses prevalent in children in Gwangju area were investigated. We strongly recommend the development of nationwide policy for the management of prevalent respiratory virus that includes long term collection of data and samples, vaccine development and prevention education of the misuse of antibiotics.
Adenoviridae ; Anti-Bacterial Agents ; Child ; Cooperative Behavior ; Coronavirus ; Enterovirus ; Hospitals, Pediatric ; Human bocavirus ; Humans ; Orthomyxoviridae ; Paramyxoviridae Infections ; Polymerase Chain Reaction ; Prevalence ; Respiratory Tract Infections ; Rhinovirus ; Seasons ; Viruses

BACKGROUND: This investigation was to perform the epidemiological surveillance and genetic analysis on respiratory viral agents from children with acute respiratory infections in Gwangju. MATERIALS AND METHODS: For this study, 3,695 specimens obtained from patients with acute respiratory infections were collected by collaboration with pediatric hospitals in Gwangju between 2005 and 2007. Specimens were screened for 8 respiratory viruses including influenza viruses (IFV), human rhinoviruses (HRV), human coronaviruses (HCoV), adenoviruses (ADV), parainfluenza viruses (PIV), human enteroviruses (HEV), respiratory synthitial viruses (RSV) and human bocaviruses (HBoV). Respiratory viruses were detected using multiplex (RT) PCR with viral specific primers. RESULTS: Out of 3,695 specimens, the ratio of virus detection was 24.9% (919). Overall, HRV (35.5%) and IFV (34.9%) were the most common viruses found, followed by HBoV (14.8%), HCoV (10.6%), RSV (3.7%), ADV (3.4%), PIV (3.2%) and HEV (3.0%). In addition, multiple infections were detected in 80 patients (8.7%). When the prevalence was analyzed according to season, HBoV, IFV and HCoV showed two epidemic points in late spring and early winter. ADV, HRV, RSV PIV and HEV, however, were all found to have only one epidemic point, with RSV being most common during winter and the others being most prominent during spring. CONCLUSIONS: Through this epidemiological surveillance, the respiratory viruses prevalent in children in Gwangju area were investigated. We strongly recommend the development of nationwide policy for the management of prevalent respiratory virus that includes long term collection of data and samples, vaccine development and prevention education of the misuse of antibiotics.
Adenoviridae ; Anti-Bacterial Agents ; Child ; Cooperative Behavior ; Coronavirus ; Enterovirus ; Hospitals, Pediatric ; Human bocavirus ; Humans ; Orthomyxoviridae ; Paramyxoviridae Infections ; Polymerase Chain Reaction ; Prevalence ; Respiratory Tract Infections ; Rhinovirus ; Seasons ; Viruses

BACKGROUND/AIMS: It has been known that chronic trauma and inflammation of gallbladder (GB) mucosa by gallstones (GS) can induce epithelial dysplasia, carcinoma in situ, and invasive cancer. This study was designed to investigate the usefulness of cholecystectomy in patients with asymptomatic GS for the early diagnosis and removal of dysplasia or cancer. METHODS: From January 2004 to July 2008, the clinical records of 703 cases with GS who underwent cholecystectomy at Korea University Guro Hospital were reviewed, and the prevalence of dysplasia and cancer was analyzed. RESULTS: In symptomatic GS (542 cases) group, low grade dysplasia was found in 4 cases (0.74%) and high grade dysplasia in 1 case (0.18%). In asymptomatic GS (161 cases) group, low grade dysplasia was found in 4 cases (2.48%) and cancer in 2 cases (1.24%) (p=0.012 vs. symptomatic cases). Dysplasias in symptomatic GS group were not associated with polyps, but dysplasias and cancers in asymptomatic GS group were associated. Patients with asymptomatic GS and polyps were analyzed according to the size of polyps. In those (12 cases) with larger polyps (> or =1 cm), low grade dysplasia was found in 2 cases and cancer in 2 cases. And in those (12 cases) with smaller polyps (<1 cm), low grade dysplasia was found in 2 cases. CONCLUSIONS: Extending indication of prophylactic cholecystectomy in patients with asymptomatic GS without polyp to prevent GB dysplasia or cancer beyond the existing indication does not seem to be justifiable in Korea. However, further studies are needed in patients with asymptomatic GS and polyp of any size.
Adult ; *Cholecystectomy ; Diagnosis, Differential ; Female ; Gallbladder Neoplasms/*diagnosis/etiology ; Gallstones/complications/*surgery ; Humans ; Male ; Middle Aged ; Polyps/diagnosis/surgery ; Precancerous Conditions/*diagnosis ; Retrospective Studies

BACKGROUND/AIMS: It has been known that chronic trauma and inflammation of gallbladder (GB) mucosa by gallstones (GS) can induce epithelial dysplasia, carcinoma in situ, and invasive cancer. This study was designed to investigate the usefulness of cholecystectomy in patients with asymptomatic GS for the early diagnosis and removal of dysplasia or cancer. METHODS: From January 2004 to July 2008, the clinical records of 703 cases with GS who underwent cholecystectomy at Korea University Guro Hospital were reviewed, and the prevalence of dysplasia and cancer was analyzed. RESULTS: In symptomatic GS (542 cases) group, low grade dysplasia was found in 4 cases (0.74%) and high grade dysplasia in 1 case (0.18%). In asymptomatic GS (161 cases) group, low grade dysplasia was found in 4 cases (2.48%) and cancer in 2 cases (1.24%) (p=0.012 vs. symptomatic cases). Dysplasias in symptomatic GS group were not associated with polyps, but dysplasias and cancers in asymptomatic GS group were associated. Patients with asymptomatic GS and polyps were analyzed according to the size of polyps. In those (12 cases) with larger polyps (> or =1 cm), low grade dysplasia was found in 2 cases and cancer in 2 cases. And in those (12 cases) with smaller polyps (<1 cm), low grade dysplasia was found in 2 cases. CONCLUSIONS: Extending indication of prophylactic cholecystectomy in patients with asymptomatic GS without polyp to prevent GB dysplasia or cancer beyond the existing indication does not seem to be justifiable in Korea. However, further studies are needed in patients with asymptomatic GS and polyp of any size.
Adult ; *Cholecystectomy ; Diagnosis, Differential ; Female ; Gallbladder Neoplasms/*diagnosis/etiology ; Gallstones/complications/*surgery ; Humans ; Male ; Middle Aged ; Polyps/diagnosis/surgery ; Precancerous Conditions/*diagnosis ; Retrospective Studies

BACKGROUND/AIMS: An association between past history of hepatitis B virus (HBV) infection and pancreatic cancer (PC) has recently been reported. We investigated whether HBV and hepatitis C virus (HCV) infections are associated with the development of PC in Korea. METHODS: We retrospectively recruited patients with PC and sex- and, age-matched control patients with stomach cancer (SC) during the previous 5 years. Serum HBsAg and anti-HCV were examined, and data on smoking, alcohol intake, diabetes, and the history of chronic pancreatitis (CP) were collected. RESULTS: A total of 506 PC and 1008 SC were enrolled, with respectively 58.1% and 97.3% of these cases being confirmed histologically. The mean age and sex ratio (male:female) were 63.5 years and 1.5:1 in the PC patients and 63.9 years and 1.5:1 in the SC patients respectively (P>0.05). The odds ratios (95% confidence interval, 95% CI) in univariate analysis were 0.90 (0.52-1.56; P=0.70) for HBsAg, 1.87 (0.87-4.01; P=0.11) for anti-HCV, 2.66 (2.04-3.48; P<0.001) for the presence of diabetes, 2.30 (1.83-2.90; P<0.001) for smoking, 1.14 (0.89-1.46; P=0.31) for alcohol intake, and 4.40 (1.66-11.66; P=0.003) for the history of CP. Independent risk factors for PC were presence of diabetes (OR, 2.67; 95% CI, 2.00-3.56; P<0.001), smoking (OR, 2.49; 95% CI, 1.93-3.21; P<0.001) and history of CP (OR, 4.60; 95% CI, 1.56-13.53; P=0.006). CONCLUSIONS: There was no significant association between seropositivity for HBsAg or anti-HCV and PC. Further studies are warranted to clarify the association between HBV infection and PC in regions where HBV is endemic.
Aged ; Case-Control Studies ; Data Interpretation, Statistical ; Female ; Hepatitis B/*complications/diagnosis ; Hepatitis C/complications/diagnosis ; Humans ; Incidence ; Male ; Middle Aged ; Odds Ratio ; Pancreatic Neoplasms/diagnosis/*epidemiology/etiology ; Retrospective Studies ; Risk Factors