Purpose: We examined the association between age-related macular degeneration (AMD) and arthritis. Methods: Using data from the Korea National Health and Nutrition Examination Survey for 2017 and 2018, we conducted a complex sample analysis of 6,993 individuals with recorded information on AMD, as well as the diagnosis and treatment of osteoarthritis (OA) and rheumatoid arthritis (RA). We compared the diagnosis and treatment of arthritis between the AMD and control groups using logistic regression analysis, with a specific focus on the treatment among patients with arthritis. Results: In the AMD group (n = 1,118) and the control group (n = 5,875), univariate logistic regression analysis showed substantial differences in the diagnosis and treatment of OA and RA. However, after adjusting for age, alcohol consumption, diabetes mellitus, and hypertension in multivariate logistic regression analysis, these differences were no longer substantial. Among patients with OA (n = 246 in the AMD group and n = 821 in the control group), there was a significant association between AMD and OA treatments (odds ratio 1.511, 95% confidence interval 1.051-2.172). Conclusions Patients diagnosed with and treated for OA had a higher likelihood of concurrent AMD than those who did not receive treatment. Therefore, ophthalmic examinations and closer monitoring are recommended for these patients.

Purpose: To analyze the incidence of vitreous floaters after intravitreal antivascular endothelial growth factor injection and the effectiveness of the inverse tapping technique, which involves tapping the syringe with the needle downwards to prevent the entry of air bubbles during injection. Methods: The study enrolled patients undergoing their first intravitreal injection for exudative age-related macular degeneration or diabetic macular edema. The patients were divided into two groups: those who received an injection after inverse tapping (IT group) and controls who received the injection without tapping. Patients who consented to the study were randomly assigned to the IT group and the control group through block randomization. One week after injection, a questionnaire was used to assess the presence of vitreous floaters; those who reported them were examined via optical coherence tomography and wide fundus photography. Results: Of the 39 patients in the IT group, two (5.1%) reported floaters 1 week after injection. By contrast, eight (20.5%) of the 39 controls reported them, with a significant difference (p = 0.042). Patients with floaters were significantly younger. Posterior vitreous detachment, as evaluated by pre-injection optical coherence tomography, was observed in 10.0% of those with floaters and 76.5% of those without them. Conclusions The occurrence of vitreous floaters after intravitreal injection is related to age and the presence of posterior vitreous detachment. The use of the inverse tapping technique may help reduce these after intravitreal injection.

Purpose: To predict the presence of tractional retinal detachment (TRD) in eyes with dense vitreous hemorrhage (VH) and proliferative diabetic retinopathy (PDR) by evaluating the status of posterior vitreous detachment (PVD) in fellow eyes using optical coherence tomography (OCT). Methods: A total of 44 eyes from 22 patients who underwent vitrectomy due to dense VH with PDR were enrolled. Using OCT, the PVD status in the fellow eye was divided into two groups (incomplete and complete PVD). The incomplete PVD group included eyes without PVD and eyes with partial PVD. B-scan ultrasonography was performed on eyes with dense VH to evaluate the presence of TRD. Both OCT and B-scan images were reviewed by four ophthalmologists (two novices and two experienced), and the interobserver agreement was evaluated. Results: There was a difference in the interobserver agreement regarding the presence of TRD in eyes with dense VH evaluated by B scan between novice and experienced ophthalmologists (novice, κ = 0.421 vs. experienced, κ = 0.814), although there was no difference between novice and experienced ophthalmologists in the interobserver agreement regarding the status of PVD in the fellow eye evaluated by OCT (novice, κ = 1.000 vs. experienced, κ = 1.000). All observed TRD during vitrectomy occurred in eyes with incomplete PVD in the fellow eye. Logistic regression analysis revealed a statistically significant relation between TRD and the age of the patient (odds ratio [OR], 0.874; p = 0.047), and between TRD and incomplete PVD in the fellow eye evaluated by OCT (OR, 13.904; p = 0.042). Conclusions Evaluation of the PVD status in the fellow eye using OCT may be a useful predictor for detecting the presence of TRD in eyes with dense VH and PDR.

Background/Aims: Fexuprazan is a novel potassium-competitive acid blocker that could be of benefit to patients with gastric mucosal injury. The aim of this study was to assess the 2-week efficacy and safety of fexuprazan in patients with acute or chronic gastritis. Methods: In this study, 327 patients with acute or chronic gastritis who had one or more gastric erosions on endoscopy and subjective symptoms were randomized into three groups receiving fexuprazan 20 mg once a day (q.d.), fexuprazan 10 mg twice a day (b.i.d.), or placebo for 2 weeks. The posttreatment assessments were the primary endpoint (erosion improvement rate), secondary endpoints (cure rates of erosion and edema and improvement rates of redness, hemorrhage, and subjective symptoms), and drug-related adverse events. Results: Among the patients, 57.8% (59/102), 65.7% (67/102), and 40.6% (39/96) showed erosion improvement 2 weeks after receiving fexuprazan 20 mg q.d., fexuprazan 10 mg b.i.d., and placebo, respectively. Both fexuprazan 20 mg q.d. and 10 mg b.i.d. showed superior efficacy to the placebo (p=0.017 and p<0.001, respectively). Likewise, both fexuprazan 20 mg q.d. and 10 mg b.i.d. also showed higher erosion healing rates than the placebo (p=0.033 and p=0.010, respectively). No difference was noted in the edema healing rate and the improvement rates for redness, hemorrhage, and subjective symptoms between the fexuprazan and placebo groups.No significant difference was noted in the incidence of adverse drug reactions. Conclusions Fexuprazan 20 mg q.d. and 10 mg b.i.d. for 2 weeks showed therapeutic efficacy superior to that of placebo in patients with acute or chronic gastritis (ClinicalTrials.gov identifier NCT04341454).

Purpose: To explore the association between the visual and anatomical outcomes and the choroidal vascularity index (CVI) post-intravitreal injection in patients with macular edema associated with branch retinal vein occlusion (BRVO). Methods: We conducted a retrospective review of medical records of 50 patients (27 eyes treated with anti-vascular endothelial growth factor and 23 eyes treated with a dexamethasone implant) with BRVO and macular edema who underwent intravitreal injections from January 2017 to October 2020. We measured the central macular thickness (CMT), subfoveal choroidal thickness, and CVI of the BRVO eyes and the fellow eyes using optical coherence tomography and then analyzed the correlation between these measurements and visual and anatomical outcomes. Results: After six months of treatment, the best corrected visual acuity improved, and CMT decreased. Multiple linear regression analysis revealed that factors associated with best corrected visual acuity improvement at six months were fellow eye CVI (standardized β = 0.346, p = 0.008), ellipsoid zone integrity (standardized β = 0.398, p = 0.001), and initial best corrected visual acuity (standardized β = 0.590, p < 0.001). Initial CMT (standardized β = 0.563, p < 0.001) was the only factor associated with the decrease in CMT at six months. Conclusions In cases of severe macular edema, accurate evaluation of choroidal vessels can be challenging due to shadowing. We discovered that a larger CVI in the fellow eye was associated with greater visual improvement in patients with BRVO and macular edema. CVI could be a prognostic factor for predicting treatment outcomes in BRVO patients, suggesting that the choroidal vascular status may play a role in the pathophysiology of BRVO.

Follow-Up Studies ; Humans ; Medical Records ; Membranes ; Multivariate Analysis ; Retrospective Studies ; Tomography, Optical Coherence ; Traction ; Visual Acuity ; Vitrectomy

PURPOSE: There are few reports from Asian countries about the long-term results of aromatase inhibitor adjuvant treatment for breast cancer. This observational study aimed to evaluate the long-term effects of letrozole in postmenopausal Korean women with operable breast cancer. METHODS: Self-reported quality of life (QoL) scores were serially assessed for 3 years during adjuvant letrozole treatment using the Korean version of the Functional Assessment of Cancer Therapy-Breast questionnaires (version 3). Changes in bone mineral density (BMD) and serum cholesterol levels were also examined. RESULTS: All 897 patients received the documented informed consent form and completed a baseline questionnaire before treatment. Adjuvant chemotherapy was administered to 684 (76.3%) subjects, and 410 (45.7%) and 396 (44.1%) patients had stage I and II breast cancer, respectively. Each patient completed questionnaires at 3, 6, 12, 18, 24, 30, and 36 months after enrollment. Of 897 patients, 749 (83.5%) completed the study. The dropout rate was 16.5%. The serial trial outcome index, the sum of the physical and functional well-being subscales, increased gradually and significantly from baseline during letrozole treatment (p<0.001). The mean serum cholesterol level increased significantly from 199 to 205 after 36 months (p=0.042). The mean BMD significantly decreased from −0.39 at baseline to −0.87 after 36 months (p<0.001). CONCLUSION: QoL gradually improved during letrozole treatment. BMD and serum cholesterol level changes were similar to those in Western countries, indicating that adjuvant letrozole treatment is well tolerated in Korean women, with minimal ethnic variation.
Aromatase ; Asian Continental Ancestry Group ; Bone Density ; Breast Neoplasms* ; Breast* ; Chemotherapy, Adjuvant ; Cholesterol ; Consent Forms ; Female ; Humans ; Observational Study ; Quality of Life*

BACKGROUND/AIMS: Gout is a common inf lammatory arthritis triggered by the crystallization of uric acid in the joints. Serum uric acid levels are highly heritable, suggesting a strong genetic component. Independent studies to confirm the genetic associations with gout in various ethnic populations are warranted. We investigated the association of polymorphisms in the ABCG2 and SLC2A9 genes with gout in Korean patients and healthy individuals. METHODS: We consecutively enrolled 109 patients with gout and 102 healthy controls. The diagnosis of gout was based on the preliminary criteria of the America College of Rheumatology. Genomic DNA was extracted from whole blood samples. We identified single nucleotide polymorphism (SNP) changes in the ABCG2 and SLC2A9 genes using a direct sequencing technique. rs2231142 in ABCG2 and rs6449213 and rs16890979 in SLC2A9 and nearby regions were amplified by polymerase chain reaction. RESULTS: Patients with gout had significantly higher A/A genotype (29.3% vs. 4.9%, respectively) and A allele (52.8% vs. 26.5%, respectively) frequencies of rs2231142 in ABCG2 than did controls (chi2 = 29.42, p < 0.001; odds ratio, 3.32; 95% confidence interval, 2.11 to 5.20). We found novel polymorphisms (c.881A>G and c.1002+78G>A) in the SLC2A9 gene. The univariate logistic regression analysis revealed that the c.881A>G and c.1002+78G>A SNPs were significantly higher in patients than in controls. CONCLUSIONS: We demonstrated a significant association between rs2231142 in the ABCG2 gene and gout and identified novel SNPs, c.881A>G and c.1002+78G>A, in the SLC2A9 gene that may be associated with gout in a Korean population.
ATP-Binding Cassette Transporters/*genetics ; Arthritis, Gouty/blood/diagnosis/ethnology/*genetics ; Asian Continental Ancestry Group/genetics ; Biomarkers/blood ; Case-Control Studies ; Chi-Square Distribution ; Gene Frequency ; Genetic Association Studies ; Genetic Predisposition to Disease ; Glucose Transport Proteins, Facilitative/*genetics ; Haplotypes ; Humans ; Logistic Models ; Neoplasm Proteins/*genetics ; Odds Ratio ; Phenotype ; *Polymorphism, Single Nucleotide ; Republic of Korea ; Risk Factors ; Uric Acid/blood

Using the Korean public health insurance database, we analyzed patients diagnosed as benign prostatic hyperplasia (BPH) from 2004 to 2008. Age and year-specific amount and seasonal variation of hospital visits (HV), duration of treatment (DT), the total and per capita amount of insurance payment (TAIP, PCIP) were evaluated. A total of 12,088,995 HV were studied. Total HV increased 1.7 times and DT almost doubled in 2008 compared to those in 2004. HV, DT, and TAIP showed linearly increasing patterns year by year. In a time series analysis, HV increased in winter and demonstrated seasonality in a 12-month cycle. In a Poisson regression analysis, the annual variations of HV, DT, TAIP, and PCIP were different by age groups. In patients older than 40 yr, HV significantly increased 1.10-1.16 times compared to that of the previous year. DT markedly increased in their 60s and 80s patients. The rate of increase in PCIP was steeper in patients 50 yr and older than in the others.Health care utilization due to BPH was rapidly increasing in Korea and it was remarkable in the elderly population. Seasonal variation of HV demonstrated that health care utilization increased in winter.
Adult ; Aged ; Aged, 80 and over ; Cost of Illness ; Health Care Costs ; Humans ; Insurance, Health/*economics/statistics & numerical data ; Male ; Middle Aged ; Patient Acceptance of Health Care/*statistics & numerical data ; Prostatic Hyperplasia/*economics/*epidemiology/therapy ; Republic of Korea/epidemiology ; Retrospective Studies ; Seasons ; Young Adult

Using the Korean public health insurance database, we analyzed patients diagnosed as benign prostatic hyperplasia (BPH) from 2004 to 2008. Age and year-specific amount and seasonal variation of hospital visits (HV), duration of treatment (DT), the total and per capita amount of insurance payment (TAIP, PCIP) were evaluated. A total of 12,088,995 HV were studied. Total HV increased 1.7 times and DT almost doubled in 2008 compared to those in 2004. HV, DT, and TAIP showed linearly increasing patterns year by year. In a time series analysis, HV increased in winter and demonstrated seasonality in a 12-month cycle. In a Poisson regression analysis, the annual variations of HV, DT, TAIP, and PCIP were different by age groups. In patients older than 40 yr, HV significantly increased 1.10-1.16 times compared to that of the previous year. DT markedly increased in their 60s and 80s patients. The rate of increase in PCIP was steeper in patients 50 yr and older than in the others.Health care utilization due to BPH was rapidly increasing in Korea and it was remarkable in the elderly population. Seasonal variation of HV demonstrated that health care utilization increased in winter.
Adult ; Aged ; Aged, 80 and over ; Cost of Illness ; Health Care Costs ; Humans ; Insurance, Health/*economics/statistics & numerical data ; Male ; Middle Aged ; Patient Acceptance of Health Care/*statistics & numerical data ; Prostatic Hyperplasia/*economics/*epidemiology/therapy ; Republic of Korea/epidemiology ; Retrospective Studies ; Seasons ; Young Adult