OBJECTIVE: This study was performed to determine the prevalence and age-adjusted prevalence of anti-HCV antibody among the employees and their partners in Korea, and whether prevalence varies with job type. METHOD: The blood serum of 29, 278 people, employees and their partners aged between 20 and 60 residing in Seoul or Kyung-gee province, were tested with Immunoradiometric Assay (IRMA) method using third generation anti-HCV serum. RESULTS: Twenty-five among the 29, 278 people tested positive; a prevalence rate of 0.9 per 1, 000 (95% CI 0.6-1.3). The prevalences of different age groups were 0, 0.5, 1.3, and 4.2 per 1, 000 among the subjects in their 20s, 30s, 40s and 50s respectively, which shows the increasing rate of prevalence with age. Age adjusted prevalence among employees was 1.3 per 1, 000. The prevalences among different kinds of job were 1.9 per 1, 000 (95% CI: 0.5~7.0) for construction, 1.7 per 1, 000 (95% CI: 0.7~3.9) for finance, and 1.2 per 1, 000 (95% CI: 0.2~6.6) for telecommunication. No significant statistical difference was found in the prevalence according to job type(p>0.05). CONCLUSIONS: Employees in Korea showed a lower prevalence rate of anti-HCV antibody than that of blood donors, health screening examinees and the general population. This result is in line with that of other studies abroad and is considered to be because employees may have lower rates of Hepatitis C risk activities, such as needle sharing, than unemployed.
Blood Donors ; Hepacivirus* ; Hepatitis C* ; Hepatitis* ; Humans ; Immunoradiometric Assay ; Korea* ; Mass Screening ; Needle Sharing ; Prevalence* ; Seoul ; Serum ; Telecommunications

BACKGROUND: The kidney function with aging is the dramatic changes of human organ system. Recent studies have suggested that many risk factors such as smoking and obesity could contribute to the progression of chronic kidney disease, though there is a little evidence in the literature showing this relationship in the general population prospectively. We aimed to identify the change of calculated glomerular filtration rate (GFR) with aging in healthy adults and to evaluate the effect of prior risk factors to the change of GFR after 5 years follow-up. METHODS: This study included 3,928 healthy adults who participated in health screening examinations in 1997 and 2002. Average age was 42 +/- 5 years in 2002 (2,955 males, 973 females). The study population had no diabetes, hypertension, renal disease and other major diseases. The clinical and laboratory monitoring were performed each on 1997 and 2002; 5 years follow-up. In this study population, GFR was calculated using the MDRD (Modification of Diet in Renal Disease) equation: calculated GFR = 186 X Scr(-1.154) X age(-0.203) X (0.742 if female). We evaluated the change of calculated GFR with aging and compared the change of calculated GFR after 5 years follow-up according to smoking and obesity. RESULTS: The decreased GFR in adults was associated with aging. The mean calculated GFR (mean +/- SD) was 82.2 +/- 9.7 mL/min/1.73 m2 at 1997, 76.2 +/- 9.1 mL/min/1.73 m2 at 2002, respectively, so decrease is 6.0 mL/min/1.73 m2/yr (1.2 mL/min/1.73 m2/yr). The change of calculated GFR was more decreased in smoking group (5.2 vs 5.0 mL/min/1.73 m2) and obesity group (6.4 vs 5.7 mL/min/1.73 m2), but not statistically significant(p>0.05). CONCLUSION: Aging is an important factor of decrease in renal function. The mean decrease in calculated GFR was 1.2 mL/min/1.73 m2/yr. We suggest that smoking and obesity had some effects on decrease in renal function. These changes in renal function should be confirmed by a prospective study for a long period and in a large number of subject.
Adult ; Aging* ; Diet ; Follow-Up Studies ; Glomerular Filtration Rate* ; Humans ; Hypertension, Renal ; Kidney ; Male ; Mass Screening ; Obesity* ; Renal Insufficiency, Chronic ; Risk Factors ; Smoke* ; Smoking*

BACKGROUND: The glomerular filtration rate (GFR) is considered the best overall index for the level of renal function and is estimated commonly by the creatinine-based, Cockcroft-Gault (CG) equation or the Modification of Diet Disease Study (MDRD) equation indirectly. Recently, cystatin C has been reported as a new endogenous marker of GFR. To predict the decrease of renal function in the elderly, we measured standard GFR (EDTA-GFR) by (51)Cr- EDTA and attempted to compare the result with CG, MDRD, and cystatin C equation for accuracy. METHODS: Sixty-three elderly persons (28 men, 35 women:mean age 70, range 65-78) who underwent health screening, were measured for plasma creatinine, cystatin C and EDTA-GFR. RESULTS: The CG and MDRD equations performed better than the cystatin C equation with an accuracy of within 30% (68 and 67%, respectively, versus 37%) and 50% (98 and 94%, respectively, versus 72%) of EDTA-GFR. The coefficient of determination (R2) of each estimated equation was 0.08 (p=0.03) in CG, 0.06 (p=0.04) in MDRD, and 0.07 (p=0.04) in cystatin C equation. Analysis of ROC curves with EDTA-GFR 60 mL/min/1.73m2 showed that each estimated equation was inadequate for the diagnosis of chronic kidney disease (sensitivity and specificity, 73% and 65% in CG, and 68% and 65% in MDRD, respectively). CONCLUSION: In the elderly, CG or MDRD equation was more accurate than cystatin C equation. Nevertheless, problems remain in the assessment of GFR using these equations and caution is particularly necessary in the diagnosis of chronic kidney disease with calculated estimates of GFR<60 mL/ min/1.73m2 in the elderly.
Female ; Male ; Humans ; Sensitivity and Specificity

BACKGROUND: The glomerular filtration rate (GFR) is considered the best overall index for the level of renal function and is estimated commonly by the creatinine-based, Cockcroft-Gault (CG) equation or the Modification of Diet Disease Study (MDRD) equation indirectly. Recently, cystatin C has been reported as a new endogenous marker of GFR. To predict the decrease of renal function in the elderly, we measured standard GFR (EDTA-GFR) by (51)Cr- EDTA and attempted to compare the result with CG, MDRD, and cystatin C equation for accuracy. METHODS: Sixty-three elderly persons (28 men, 35 women:mean age 70, range 65-78) who underwent health screening, were measured for plasma creatinine, cystatin C and EDTA-GFR. RESULTS: The CG and MDRD equations performed better than the cystatin C equation with an accuracy of within 30% (68 and 67%, respectively, versus 37%) and 50% (98 and 94%, respectively, versus 72%) of EDTA-GFR. The coefficient of determination (R2) of each estimated equation was 0.08 (p=0.03) in CG, 0.06 (p=0.04) in MDRD, and 0.07 (p=0.04) in cystatin C equation. Analysis of ROC curves with EDTA-GFR 60 mL/min/1.73m2 showed that each estimated equation was inadequate for the diagnosis of chronic kidney disease (sensitivity and specificity, 73% and 65% in CG, and 68% and 65% in MDRD, respectively). CONCLUSION: In the elderly, CG or MDRD equation was more accurate than cystatin C equation. Nevertheless, problems remain in the assessment of GFR using these equations and caution is particularly necessary in the diagnosis of chronic kidney disease with calculated estimates of GFR<60 mL/ min/1.73m2 in the elderly.
Female ; Male ; Humans ; Sensitivity and Specificity

BACKGROUND AND OBJECTIVES: There is growing evidence that inflammation plays an important role in atherosclerosis and in the elevation of cardiac troponin I (cTnI) after coronary intervention. The aim of this study was to evaluate the relationship between inflammatory markers and the elevation of cTnI after coronary intervention in patients with stable angina. SUBJECTS AND METHODS: Twenty-three patients who underwent successful percutaneous transluminal coronary angioplasty with stent were examined as the subjects. Serial blood samples were obtained for High Sensitivity C-reactive protein (hs-CRP), which served as markers of systemic inflammation, and cTnI. The difference of cTnI before and 24 hours after coronary intervention was defined as the gradient of cTnI. RESULTS: The mean gradient of cTnI was 1.77+/-3.4 ng/mL. The concentrations of baseline and post-procedural hs-CRP were 1.57+/-1.3 mg/L and 6.31+/-3.8 mg/L, respectively (p=0.001). There were no significant differences in the gradient of cTnI with hypertention, diabetes, smoking, and hypercholesterolemia. The variable that significantly correlated with the gradient of cTnI was the baseline hs-CRP (R2=0.374, p=0.048). CONCLUSION: Systemic inflammation correlated with periprocedural elevation of cTnI in stable angina patients. These results suggest that inflammation plays a pivotal role in the predictive value of myocardial injury after coronary intervention.
Angina Pectoris ; Angina, Stable* ; Angioplasty, Balloon, Coronary* ; Atherosclerosis ; C-Reactive Protein ; Humans ; Hypercholesterolemia ; Inflammation* ; Smoke ; Smoking ; Stents* ; Troponin I* ; Troponin*

BACKGROUND AND OBJECTIVES: This study was performed to, 1) evaluate the diagnostic value of the Brain Natriuretic Peptide (BNP), which is known to be present in the heart ventricle, for patients with dyspnea for the assessing its causes;diastolic or systolic heart failure or pulmonary disease, and 2) find if the BNP is correlated with the distance walked in 6 minutes, which is known to be a prognostic indicator for heart failure. SUBJECTS AND METHODS: Fifty-seven patients who admitted to the Kangbuk Samsung Medical Center, with the chief complaint of dyspnea, were enrolled in the study. The subjects were classified into three groups according to the causes of their dyspnea, which were systolic heart failure, diastolic heart failure and chronic obstructive pulmonary disease. The plasma BNP levels were measured by a radioimmunoassay, both at admission and discharge. The BNP levels at admission were compared among the three groups. The presence of a correlation between the distance walked in 6 minutes and the BNP at discharge were also evaluated. RESULTS: The patients group with systolic heart failure had the highest mean BNP concentration of 934.6+/-386.7 pg/mL. The other two groups had significantly lower levels of BNP. The patients group with chronic obstructive pulmonary disease had significantly lower level than the group with diastolic heart failure (33.2+/-25.6 vs. 181.8+/-222.2 pg/mL). The BNP concentrations at discharge, and the distance walked in 6 minutes, between the three groups showed no statistical significance (p=0.69). CONCLUSION: This study showed that the mean plasma BNP level was highest in the group with systolic heart failure, followed by diastolic heart failure and lastly chronic obstructive pulmonary disease. These findings suggest that diagnostic value of the plasma BNP concentration in the assessment of the causes of dyspnea. Although this study has failed to show a correlation between the plasma BNP concentration at discharge and the distance walked in 6 minutes, prospective cohort studies, with larger sample sizes, need to be performed to establish the relationship, if any.
Cohort Studies ; Diagnosis ; Diagnosis, Differential* ; Dyspnea* ; Heart Failure ; Heart Failure, Diastolic ; Heart Failure, Systolic ; Heart Ventricles ; Humans ; Lung Diseases ; Natriuretic Peptide, Brain* ; Plasma ; Pulmonary Disease, Chronic Obstructive ; Radioimmunoassay ; Sample Size

BACKGROUND AND OBJECTIVE: The relationship between serum uric acid and metabolic syndrome variables has not been reported in Korea. Therefore, whether the circulating levels of serum uric acid are independently related to hypertension, insulin resistance and the variables of metabolic syndrome were assessed. SUCJECTS AND METHODS: A total of 53,477 health screen examinees were enrolled and divided into four groups (Quartile 1:<4.2 mg/dL, Quartile 2:4.2-5.29 mg/dL, Quartile 3:5.3-6.29 mg/dL, Quartile 4:>6.29 mg/dL) according to their serum uric acid level. The blood pressure, lipid profiles, fasting plasma glucose, waist circumference, HOMA, high sensitivity CRP and apolipoprotein were compared between the four groups. RESULTS: There was a positive association between blood pressure and the serum uric acid level (p<0.001). After adjustment for covariates the prevalence of hypertension due to uric acid was 1.192 (95% CI, 1.038-1.368 p=0.013), and 1.408 (95% CI, 1.221-1.623 p<0.001) times higher in subjects in the third and fourth uric acid level quartiles, respectively, compared to the subjects in the first quartile. Insulin resistance and metabolic syndrome variables were positively correlated with the serum uric acid level. The number of metabolic syndrome variables was also increased with an elevated serum uric acid level. CONCLUSION: Our study suggests that serum uric acid levels were independently associated with hypertension, insulin resistance and the variables of metabolic syndrome in the Korean population. Although the serum uric acid level was normal value, the risk of metabolic syndrome was increased with an elevated serum uric acid level. However, because of the cross-sectional nature of our study, these findings should be confirmed in prospective cohort studies.
Apolipoproteins ; Blood Glucose ; Blood Pressure ; Cohort Studies ; Fasting ; Hypertension* ; Insulin Resistance* ; Insulin* ; Korea ; Prevalence ; Reference Values ; Uric Acid* ; Waist Circumference

BACKGROUND: It is getting more difficult to involve appropriate investigators in clinical trials. Knowing what investigators want from sponsor initiated clinical trials would help industry cooperate with investigators more efficiently. This study aims to describe the incentives for investigators choosing to participate or not and perform well in sponsored clinical trials. METHODS: Investigators who have participated in GSK sponsored clinical trials were interviewed face-to-face or through e-mail using the standardized questionnaire. Investigators were asked to choose five items and determine the ranking or those five items. RESULTS: Questionnaires answered by 122 investigators were collected. The top three incentives were "Academic merit" (108, 88.5 %), "Expectation of treatment potentially helpful to patient" (101, 82.8 %), and "Access to new treatments" (92, 75.4 %). The disincentives and the factors affecting an investigator's performance were analyzed separately because of the different questionnaire between investigators for medicine and vaccine. Investigators for medicine choose as disincentives "Insufficient time" (43, 61.4 %), "Difficult protocol" (41, 58.6 %), and "Adverse event concerns" (41, 58.6 %). Vaccine investigators pointed out "Limited support staff" (41, 78.8 %), "Insufficient time" (40, 76.9 %), and "Difficult blood sampling" (333, 63.5 %) as disincentives. Factors adversely affecting an investigator's performance showed similar results to those of disincentives. CONCLUSION: Investigators focused on academic curiosity and patients and insufficient time mostly inhibits them from participating and performing clinical trials. Our results would help industry cooperate with investigators more efficiently, finally making companies perform clinical trials more effectively.
Electronic Mail ; Exploratory Behavior ; Humans ; Motivation ; Surveys and Questionnaires ; Research Personnel

BACKGROUND: Many epidemiological studies have reported that hyperuricemia was related to cardiovascular diseases, insulin resistance and the metabolic syndrome. However, there are few studies on the relationship between serum uric acid concentration and the metabolic syndrome among Korean adults. We performed this study to assess the relationship between serum uric acid level and the factors of the metabolic syndrome among healthy Korean men. METHODS: We consecutively selected 206 male subjects who underwent health screening examination from February 2005 to April 2005 at the Health Promotion Center of Seoul Paik Hospital. Insulin resistance measured by HOMA-IR and the metabolic syndrome factors were assessed by the quartiles of serum uric acid level. RESULTS: Body mass index (P<0.001), systolic blood pressure (P=0.015), diastolic blood pressure (P=0.015), fasting insulin (P=0.038), and triglyceride (P=0.005) level increased and high density lipoprotein cholesterol (P=0.008) decreased significantly from the lowest quartile to the highest quartile of seum uric acid level. The proportions of the metabolic syndrome in each quartile were 13.7%, 15.7%, 18.9%, and 36.0%, respectively (P=0.007). However, insulin resistance measured by HOMA-IR was not associated with serum uric acid. When compared with the lowest quartile group, the odds ratio for the metabolic syndrome of the second, the third, and the highest quartile groups were 1.42 (0.39-5.14), 1.14 (0.33-3.92), and 4.00 (1.15-13.89), respectively. CONCLUSION: We found that high uric acid level was significantly related to the factors of the metabolic syndrome and increased the risk of the metabolic syndrome. Further prospective studies with large sample size are necessary to establish whether uric acid level can pose as a risk factor for the development of the metabolic syndrome.
Adult ; Blood Pressure ; Body Mass Index ; Cardiovascular Diseases ; Cholesterol, HDL ; Fasting ; Health Promotion ; Humans ; Hyperuricemia ; Insulin ; Insulin Resistance ; Male ; Mass Screening ; Odds Ratio ; Risk Factors ; Sample Size ; Seoul ; Triglycerides ; Uric Acid*

P-ANCA small vessel vasculitis is multisystemic disease, especially frequently involving the kidney. Diagnosis is delayed because it's non-specific clinical manifestation. Recently ANCA becomes available tools for diagnosis of vasculitis. Infection and gastrointestinal complications are relatively common in vasculitis. But spontaneous rupture of gastrointestinal artery is a rare complication. A 61-year-old housewife was admitted due to poor oral intake, weight loss and microscopic hematuria. Renal biopsy showed an extensive necrotizing glomerulonephritis, consistent with Wegener's granulomatosis or microscopic polyangitis. Serum test showed positive for P-ANCA. Despite steroid therapy, she expired due to spontaneous rupture of right gastroepiploic artery.
Antibodies, Antineutrophil Cytoplasmic* ; Arteries ; Biopsy ; Diagnosis ; Gastroepiploic Artery ; Glomerulonephritis ; Hematuria ; Hemorrhage* ; Humans ; Kidney ; Middle Aged ; Rupture, Spontaneous ; Vasculitis* ; Wegener Granulomatosis ; Weight Loss