OBJECTIVES: To investigate possible seasonal patterns of pre-term birth in Korea. METHODS: A total number of 2,669,357 single live births reported to the National Statistical Office from 1995 to 1998 were analyzed. Composite monthly cohorts of ongoing pregnancies were constructed for each month of the year and the probability of pre-term birth was estimated. RESULTS: Increases in the probability of a pre-term birth occurred during winter for the birth of first child and during summer for the birth of second or later child. This seasonal variation was similar among groups divided by sex, residency, age of mother, and education of mother. CONCLUSIONS: These findings suggests that some environmental factors related to season may partially explain the incidence of premature births.
Child ; Cohort Studies ; Education ; Humans ; Incidence ; Internship and Residency ; Korea* ; Live Birth ; Mothers ; Parturition* ; Pregnancy ; Premature Birth ; Seasons*

Venous anomalies, including portal vein thrombosis (PVT) and prior portosystemic shunts, are not uncommon in orthotopic liver transplantation (OLT) and require vascular reconstruction. PVT has been considered as a contraindication to OLT because of surgical complexity and increased postoperative morbidity and mortailty rates. Postoperative chylous ascites occur following disruption of abdominal lymphatics after retroperitoneal dissection. Chyloperitoeum after OLT is very rare. We report a case of piggyback OLT in a cirrhotic patient with portal vein thrombosis. A thromboendarterectomy was attempted first, and a venous jump graft was required between the donor portal vein and the infrapancreatic superior mesenteric vein. An aortic conduit was used for the hepatic arterial reconstruction. Retroperitoneal dissection was inevitable. Chylous ascites developed after the operation and were managed successfully with a low-at diet. In conclusion, we suggest that the presence of PVT is not a contraindication for OLT. Chylous ascites are rare after OLT, and the treatment of choice is a conservative one based on diet control.
Chylous Ascites* ; Diet ; Endarterectomy ; Humans ; Liver Transplantation* ; Liver* ; Mesenteric Veins ; Portal Vein* ; Portasystemic Shunt, Surgical ; Tissue Donors ; Transplants* ; Venous Thrombosis*

Background/Aims: This study aimed to investigate whether urinary angiotensinogen (UAGT) excretion was associated with elevated blood pressure in patients with chronic kidney disease (CKD) and to evaluate the relationship among blood pressure, intra-renal renin-angiotensin system (RAS) activity, and dietary sodium in patients with CKD. Methods: Participants from the Korean Cohort Study for Outcome in Patients with Chronic Kidney Disease (KNOW-CKD) were included. Of the total cohort of 2,238 individuals with CKD, we included 1,955 participants who underwent complete 24-hour urinary sodium (24-hour UNa) analysis. They were categorized into three groups according to three tertiles of their 24-hour UNa, reflecting daily salt intake. To measure intra-renal RAS activity, the UAGT excretion was assayed with an enzyme-linked immunosorbent assay. Results: Elevated 24-hour UNa levels, logarithm of UAGT-to-creatinine ratio (UAGT/Cr), increased waist-to-hip ratio, and decreased estimated glomerular filtration rate were the risk factors for increased systolic blood pressure. Systolic blood pressure showed a positive correlation with 24-hour UNa levels and logarithm of UAGT/Cr. Conclusions UAGT and urinary sodium excretion are independent determinants of systolic blood pressure in patients with CKD. These findings suggest that increased systolic blood pressure in CKD patients is associated with both increased dietary sodium levels and intra-renal RAS activity. The risk of elevated systolic blood pressure in the 3rd tertile of both the UAGT/Cr and 24-hour UNa groups was about 2.3 times higher than that in the reference group.

Background/Aims: This study aimed to investigate whether urinary angiotensinogen (UAGT) excretion was associated with elevated blood pressure in patients with chronic kidney disease (CKD) and to evaluate the relationship among blood pressure, intra-renal renin-angiotensin system (RAS) activity, and dietary sodium in patients with CKD. Methods: Participants from the Korean Cohort Study for Outcome in Patients with Chronic Kidney Disease (KNOW-CKD) were included. Of the total cohort of 2,238 individuals with CKD, we included 1,955 participants who underwent complete 24-hour urinary sodium (24-hour UNa) analysis. They were categorized into three groups according to three tertiles of their 24-hour UNa, reflecting daily salt intake. To measure intra-renal RAS activity, the UAGT excretion was assayed with an enzyme-linked immunosorbent assay. Results: Elevated 24-hour UNa levels, logarithm of UAGT-to-creatinine ratio (UAGT/Cr), increased waist-to-hip ratio, and decreased estimated glomerular filtration rate were the risk factors for increased systolic blood pressure. Systolic blood pressure showed a positive correlation with 24-hour UNa levels and logarithm of UAGT/Cr. Conclusions UAGT and urinary sodium excretion are independent determinants of systolic blood pressure in patients with CKD. These findings suggest that increased systolic blood pressure in CKD patients is associated with both increased dietary sodium levels and intra-renal RAS activity. The risk of elevated systolic blood pressure in the 3rd tertile of both the UAGT/Cr and 24-hour UNa groups was about 2.3 times higher than that in the reference group.

OBJECTIVE: The aim of this retrospective study was to evaluate the survival, recurrence and prognostic factors of endometrial stromal sarcoma (ESS). METHODS: Twenty three patients who had diagnosed with ESS and managed between June 1989 and December 2004 were included. Clinicopathologic characteristics were evaluated including age, parity, menopause, stage, grade, type of surgery, adjuvant therapy, overall survival, disease free survival. RESULTS: The mean age of the group was 44 years. Eighty two percents of patients were premenopause and the most common symptom was vaginal bleeding. Thirteen patients were in stage I and four patients were in stage II and III. Six patients were not able to determine the stage. Eighteen patients were low grade ESS and five patients were high grade. The median overall survival was 179 months and the median disease free survival was 134 months. Disease had recurred in 6 patients and 2 patients died of the disease. Higher tumor grade was associated with lower overall survival (P=0.047) and disease free survival (P=0.035). CONCLUSION: The prognostic factor of ESS is tumor grade.
Disease-Free Survival ; Female ; Humans ; Menopause ; Parity ; Premenopause ; Recurrence ; Retrospective Studies ; Sarcoma, Endometrial Stromal* ; Uterine Hemorrhage

OBJECTIVE: The purpose of this study was to review the therapeutic results and the clinical outcome of the patients treated with optimal cytoreductive surgery and platinum-based chemotherapy for malignant mixed mullerian tumors (MMMTs) of the ovary. The evaluate the role of such treatments in ovarian MMMTs. METHODS: A retrospective analysis was performed with medical records that nine patients underwent complete surgical staging from February 1993 to January 2004 at Asan Medical Center, Korea. Seven patients received IP (ifosfamide/cisplatin) chemotherapy as a first-line chemotherapy and the other patients received other platinum-based combination chemotherapy. Demographic data, pathologic findings, treatment and survival time were studied. RESULTS: Nine patients diagnosed with MMMTs of the ovary after optimal cytoreductive surgery. The International Federation of Gynecology and Obstetrics stages for the 9 women were none stage I, 1 stage II, 6 stage III, 2 stage IV. The median survival time of all patients was 41 months (1-76 months). The overall survival rate was 55.5% at 1 year and 40% at 2 years. CONCLUSION: Malignant mixed mullerian tumors of the ovary grow very rapidly and are usually in advanced stages when diagnosed. But our results of clinical experience for platinum-based combination chemotherapy after optimal cytoreductive surgery could be a standard treatment for ovarian MMMTs.
Chungcheongnam-do ; Drug Therapy ; Drug Therapy, Combination* ; Female ; Gynecology ; Humans ; Korea ; Medical Records ; Obstetrics ; Ovary* ; Retrospective Studies ; Survival Rate

BACKGROUND: Sleep problems commonly occur in patients with Parkinson's disease (PD), and are associated with a lower quality of life. The aim of the current study was to translate the English version of the Scales for Outcomes in Parkinson's Disease-Sleep (SCOPA-S) into the Korean version of SCOPA-S (K-SCOPA-S), and to evaluate its reliability and validity for use by Korean-speaking patients with PD. METHODS: In total, 136 patients with PD from 27 movement disorder centres of university-affiliated hospitals in Korea were enrolled in this study. They were assessed using SCOPA, Hoehn and Yahr Scale (HYS), Unified Parkinson's Disease Rating Scale (UPDRS), Parkinson's Disease Sleep Scale 2nd version (PDSS-2), Non-motor Symptoms Scale (NMSS), Montgomery Asberg Depression Scale (MADS), 39-item Parkinson's Disease Questionnaire (PDQ39), Neurogenic Orthostatic Hypotension Questionnaire (NOHQ), and Rapid Eye Movement Sleep Behaviour Disorder Questionnaire (RBDQ). The test-retest reliability was assessed over a time interval of 10–14 days. RESULTS: The internal consistency (Cronbach's α-coefficients) of K-SCOPA-S was 0.88 for nighttime sleep (NS) and 0.75 for daytime sleepiness (DS). Test-retest reliability was 0.88 and 0.85 for the NS and DS, respectively. There was a moderate correlation between the NS sub-score and PDSS-2 total score. The NS and DS sub-scores of K-SCOPA-S were correlated with motor scale such as HYS, and non-motor scales such as UPDRS I, UPDRS II, MADS, NMSS, PDQ39, and NOHQ while the DS sub-score was with RBDQ. CONCLUSION: The K-SCOPA-S exhibited good reliability and validity for the assessment of sleep problems in the Korean patients with PD.
Depression ; Humans ; Hypotension, Orthostatic ; Korea ; Movement Disorders ; Parkinson Disease ; Quality of Life ; Reproducibility of Results ; Sleep, REM ; Weights and Measures

Objective: The Scales for Outcomes in Parkinson’s Disease–Cognition (SCOPA-Cog) was developed to assess cognition in patients with Parkinson’s disease (PD). In this study, we aimed to evaluate the validity and reliability of the Korean version of the SCOPACog (K-SCOPA-Cog). Methods: We enrolled 129 PD patients with movement disorders from 31 clinics in South Korea. The original version of the SCOPA-Cog was translated into Korean using the translation-retranslation method. The test–retest method with an intraclass correlation coefficient (ICC) and Cronbach’s alpha coefficient were used to assess reliability. Spearman’s rank correlation analysis with the Montreal Cognitive Assessment-Korean version (MOCA-K) and the Korean Mini-Mental State Examination (K-MMSE) were used to assess concurrent validity. Results: The Cronbach’s alpha coefficient was 0.797, and the ICC was 0.887. Spearman’s rank correlation analysis revealed a significant correlation with the K-MMSE and MOCA-K scores (r = 0.546 and r = 0.683, respectively). Conclusion Our results demonstrate that the K-SCOPA-Cog has good reliability and validity.

OBJECTIVE: Autonomic symptoms are commonly observed in patients with Parkinson's disease (PD) and often limit the activities of daily living. The Scale for Outcomes in Parkinson's disease-Autonomic (SCOPA-AUT) was developed to evaluate and quantify autonomic symptoms in PD. The goal of this study was to translate the original SCOPA-AUT, which was written in English, into Korean and to evaluate its reliability and validity for Korean PD patients. METHODS: For the translation, the following processes were performed: forward translation, backward translation, expert review, pretest of the pre-final version and development of the final Korean version of SCOPA-AUT (K-SCOPA-AUT). In total, 127 patients with PD from 31 movement disorder clinics of university-affiliated hospitals in Korea were enrolled in this study. All patients were assessed using the K-SCOPA-AUT and other motor, non-motor, and quality of life scores. Test-retest reliability for the K-SCOPA-AUT was assessed over a time interval of 10−14 days. RESULTS: The internal consistency and reliability of the K-SCOPA-AUT was 0.727 as measured by the mean Cronbach's α-coefficient. The test-retest correlation reliability was 0.859 by the Guttman split-half coefficient. The total K-SCOPA-AUT score showed a positive correlation with other non-motor symptoms [the Korean version of non-motor symptom scale (K-NMSS)], activities of daily living (Unified Parkinson's Disease Rating Scale part II) and quality of life [the Korean version of Parkinson's Disease Quality of Life 39 (K-PDQ39)]. CONCLUSION: The K-SCOPA-AUT had good reliability and validity for the assessment of autonomic dysfunction in Korean PD patients. Autonomic symptom severities were associated with many other motor and non-motor impairments and influenced quality of life.
Activities of Daily Living ; Humans ; Korea ; Movement Disorders ; Parkinson Disease ; Quality of Life ; Reproducibility of Results

Background: and PurposeImpulse-control disorder is an important nonmotor symptom of Parkinson's disease (PD) that can lead to financial and social problems, and be related to a poor quality of life. A nationwide multicenter prospective study was performed with the aim of validating the Korean Version of the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease Rating Scale (K-QUIP-RS). Methods: The K-QUIP-RS was constructed using forward and backward translation, and pretesting of the prefinal version. PD patients on stable medical condition were recruited from 27 movement-disorder clinics. Participants were assessed using the K-QUIP-RS and evaluated for parkinsonian motor and nonmotor statuses and for PD-related quality of life using a predefined evaluation battery. The test–retest reliability of the K-QUIP-RS was assessed over an interval of 10–14 days, and correlations between the KQUIP-RS and other clinical scales were analyzed. Results: This study enrolled 136 patients. The internal consistency of the K-QUIP-RS was indicated by a Cronbach's α coefficient of 0.846, as was the test–retest reliability by a Guttman split-half coefficient of 0.808. The total K-QUIP-RS score was positively correlated with the scores for depression and motivation items on the Unified PD Rating Scale (UPDRS), Montgomery-Asberg Depression Scale, and Rapid-Eye-Movement Sleep-Behavior-Disorders Questionnaire. The total K-QUIP-RS score was also correlated with the scores on part II of the UPDRS and the PD Quality of Life-39 questionnaire, and the dopaminergic medication dose. Conclusions The K-QUIP-RS appears to be a reliable assessment tool for impulse-control and related behavioral disturbances in the Korean PD population.