A simple definition of chronic kidney disease (CKD) is necessary to establish clinical practical guidelines. The Kidney Disease Outcomes Quality Initiative (K/DOQI) defined CKD as kidney damage or a glomerular filtration rate (GFR) <60 mL/min/1.73 m2 for 3 months or more, irrespective of cause. In addition, the Kidney Disease: Improving Global Outcome (KDIGO), provided evidence-based understanding of CKD and established global consensus while identifying a collaborative research agenda and plan for the practical definition and classification of CKD. To identify CKD, estimation of the GFR from the serum creatinine and the presence of albuminuria are essential. The GFR estimation needs the application of appropriate equations, such as the Modification of Diet in Renal Disease Study equation or the Cockcroft-Gault formula, and calibration of the serum creatinine. Albuminuria can be detected using an albumin-to-creatinine ratio >30 mg/g in two of three spot urine collections. With the CKD guidelines of K/DOQI and KDIGO, the diagnosis and early detection of CKD, which may need a Korean estimation equation, are improving and should help to reduce the prevalence and incidence of end-stage renal disease in Korea.
Albuminuria ; Calibration ; Consensus ; Creatinine ; Diet ; Glomerular Filtration Rate ; Incidence ; Kidney ; Kidney Diseases ; Kidney Failure, Chronic ; Korea ; Mass Screening ; Prevalence ; Renal Insufficiency, Chronic ; Urine Specimen Collection

No abstract available.
Amniotic Fluid* ; Female ; Meconium*

PURPOSE: This study was done to investigate the factors that influence non-combat soldiers' suicidal ideation. METHODS: The participants of survey were 302 of soldiers in Y and H city. The data were collected from Aug. 5 to 8, 2008 in H city and Oct. 25 to 30, 2009 in Y city. The instruments were the SRI (Stress Response Inventory) developed by Ko, Park, & Kim (2000), SDS (Self-Rating Depression Scale), developed by Zung (1965) and SSI (Scale for Suicidal Ideation) developed by Beck (1979). The data were analyzed using SPSS 12.0. RESULTS: The mean score for the SRI, SDS and SSI were 15.71+/-19.81, 32.02+/-9.67 and 1.34+/-2.74 respectively. There were positive correlations between the SRI and SDS (r=.763), SRI and SSI (r=.583), SDS and SSI (r=.575). Stress, depression, age, and educational level accounted for 41% of the variance in suicidal ideation. CONCLUSION: The results of this study indicates that soldiers' suicidal ideation is related to stress, depression, age, and educational level and that there is a need to develop programs which focus on stress and depression management.
Depression ; Humans ; Military Personnel* ; Suicidal Ideation* ; Suicide

BACKGROUND: Osteoporosis results from bone loss due to menopause [estrogen(E) deficiency] and aging. Initial skeletal effect of menopause is accelerated bone resorption with an increase in seurm calcium(Ca) and compensatory but inadequate bone formation. Secretion of parathyroid hormone(PTH) is suppressed at this time. Postmenopausal osteoporosis results in fractures predominantly of trabecular bone, i.e., vertebra. With aging, secondary hyperparathyroidism by low serum Ca and vitamin D deficiency superim poses. Senile osteoporosis produces hip fractures, area of cortical bone. The aim of this study was to- examine the association of vitamin D[25(OH)D] and intact(i) PTH with bone mineral density(BMD) after controlling for suggested confounding factors, and the possibility of low serum vitamin D and high serum iPTH concentration could impact bone loss in Korean postmenopausal women. METHODS: Data from 188 postmenopausal Korean women aged 42 to 69 were analyzed through BMD, serum 25(OH)D, iPTH, Ca, phosphorus(P), alkaline phosphatase(ALP) and clinical characteristics. Factors affecting BMD was determined by Pearson correlation and the relationship between lumbar and femoral neck BMD and vitamin D[25(OH)D] and iPTH was assessed by multiple regression analysis after adjus- ting for suggested confounding factors. RESULTS: Lumbar and femoral neck BMD, serum Ca, P were decresaed and serum iPTH was increased with aging. In Pearson`s correlation, significant contributing factors to lumbar BMD was age, height, weight, menarche, year since menopause(YSM) and ALP. And significant contributing factors to femoral neck BMD was age, height, weight, menarche, YSM and iPTH. No relationship could be demonstrated between serum vitamin D[25(OH)D] and lumbar and femoral neck BMD. How ever, after controlling for potential confounding factors, a correlation was found between vitamin D[25(OH)D] and both of lumbar (p=0.013) and femoral neck BMD(p=0.077). iPTH was inversely related to femoral neck BMD(p=0.004) only in multiple linear regression. CONCLUSION: Serum vitamin D[25(OH)D] was influencing both of vertebral and femoral neck BMD, which suggests a significant role of vitamin D deficiency in the pathogenesis of postmenopausal osteo- porosis. In age related remodeling and loss of bone, increased serum iPTH might have additive role in cortical bone of femur. These findings suggest that vitamin D is very important for optimal bone health and a deleterious effect of increased iPTH on cortical bone loss. Adequate calcium and vitamin D status have to be maintained to prevent osteoporosis in postmenopausal Korean women.
Aging ; Bone Density* ; Bone Resorption ; Calcium ; Female ; Femur ; Femur Neck ; Hip Fractures ; Humans ; Hyperparathyroidism, Secondary ; Linear Models ; Menarche ; Menopause ; Osteogenesis ; Osteoporosis ; Osteoporosis, Postmenopausal ; Parathyroid Hormone* ; Spine ; Tolnaftate ; Vitamin D Deficiency ; Vitamin D* ; Vitamins*

Dupuytren's contracture is characterized by progressive fibroplasia and contracture of palmar fascia with resultant deformity of hands and fingers. Recently it has been shown that the cellular element, called myofibroblast, contributes significantly in the process of contracture. Among the 6 patients we have seen during the last few years, there was a total of 9 hands with Dupuytren's contracture. Seven of these were treated by a partial fasciectomy or by a dermofascietomy with a full thickness skin graft and the results of these two procedures were compared. Electron microsconic studies were done in 3 of the 6 patients and myofibroblasts were found in 2 of them.
Biopsy ; Clinical Study ; Congenital Abnormalities ; Contracture ; Dupuytren Contracture ; Fascia ; Fingers ; Hand ; Humans ; Myofibroblasts ; Skin ; Transplants

Purpose: We report on the 10-year clinical hip function and radiologic outcomes of patients who underwent hip arthroplasty using a COREN stem. Materials and Methods: A consecutive series of 224 primary cementless hip arthroplasty implantations were performed using a COREN stem between 2009 and 2011; among these, evaluation of 128 hips was performed during a minimum follow-up period of 10 years. The mean age of patients was 65.4 years (range, 40-82 years) and the mean duration of follow-up was 10.8 years (range, 10-12 years). Evaluation of clinical hip function and radiologic implant outcomes was performed according to clinical score, thigh pain, and radiologic analysis. Results: Dramatic improvement of the mean Harris hip score (HHS) from 59.4 preoperatively to 93.5 was observed at the final follow-up (P≤0.01). Stable fixation was demonstrated for all implants with no change in position except for one case of Vancouver type B2 periprosthetic femur fracture. A radiolucent line (RLL) was observed in 16 hips (12.5%). Thigh pain was observed in only two hips (1.6%) at the final follow-up. There were no cases of osteolysis around the stem. The survival rate for the COREN stem was 97.7%. Conclusion Good long-term survival with excellent clinical and radiological outcomes can be achieved using the COREN femoral stem regardless of Dorr type.

OBJECTIVES: Power spectrum analysis decomposes the heart rate signal into its frequency components and facilitates separation of sympathetic (low frequency) and parasympathetic (high frequency) activity. In congestive heart failure, augmented sympathetic tone and decreased parasympathetic tone were found. Autonomic nervous system was normalized 6 months after myocardial infarction. So we compared the autonomic nervous system activity by the heart rate variability in congestive heart failure and old myocardial infarction. METHODS: The protocol involved 20 healthy subjects (Group 1), 5 congestive heart failure patients not caused by myocardial infarction (Group 2), 4 congestive heart failure patients due to myocardial infarction and 11 old myocardial infarction patients without heart failure. We took 24 hour Holter monitoring by Del Mar Avionic tape recorder. All Holter tapes were analyzed with use of Model 563 Stratascan Holter Analysis System. We computed power spectra on each 256 sec segment of each hour during 24 hour recording. So, RR interval, SD of RR interval by time domain, and LF, HF, LF/HF ratio, Total PSD by frequency domain were measured. RESULTS: In congestive heart failure, nocturnal HF peak and diurnal variation of LF/HF ratio was decreased relative to healthy subjects. Nocturnal HF peak in old myocardial infarction was not visualized. All of LF, HF and Total PSD in congestive heart failure and old myocardial infarction patients relative to healthy subjects. CONCLUSION: On heart rate variability analysis using by 24 hour Holter monitoring, abnormal autonomic nervous activity was demonstrated in congestive heart failure and old myocardial infarction patients relative to healthy subjects.
Autonomic Nervous System ; Electrocardiography, Ambulatory* ; Estrogens, Conjugated (USP)* ; Heart Failure* ; Heart Rate* ; Heart* ; Humans ; Myocardial Infarction* ; Spectrum Analysis

BK virus nephropathy has emerged as an important cause of renal allograft dysfunction. Reduction in immunosuppression is the mainstay of BK virus nephropathy treatment. However, decreasing immunosuppressive medications is not sufficient for treatment of BK virus nephropathy. Therefore, there is a need for other treatment strategies such as cidofovir, leflunomide, and intravenous immunoglobulin in combination with immunosuppression reduction. Ciprofloxacin has recently been reported to have antiviral activity and decrease BK viral load in kidney transplant recipients. These findings suggest that the use of ciprofloxacin represents a valuable treatment strategy in patients with BK virus nephropathy. Here, we report on our experience with three patients who developed presumptive BK virus nephropathy after kidney transplantation, who, after 2 months of ciprofloxacin treatment, showed disappearance of BK viremia and improvement in the estimated glomerular filtration rate. Ciprofloxacin may be considered an effective treatment option for BK viremia in kidney transplant recipients.
Allografts ; BK Virus ; Ciprofloxacin ; Glomerular Filtration Rate ; Humans ; Immunoglobulins ; Immunosuppression ; Kidney Transplantation ; Kidney* ; Transplantation* ; Viral Load ; Viremia

Recurrent ectopic pregnancy of cesarean scar is very rare and its therapeutic management is still not established. We reported the first case of recurrent cesarean scar pregnancy that was successfully treated with concomitant intra-gestational sac methotrexate-potassium chloride injection and systemic methotrexate injection. This case study provides physicians with a safe and effective minimally invasive treatment option for recurrent cesarean scar pregnancy.
Cicatrix* ; Female ; Methotrexate* ; Potassium Chloride ; Pregnancy* ; Pregnancy, Ectopic

PURPOSE: Chronic administration of anticonvulsants for children with epilepsy may cause multiple abnormalities in bone metabolism. The aim of this study was to evaluate the effects of anticonvulsants on bone mineral density(BMD) in children with epilepsy. METHODS: Seventy patients with epilepsy were enrolled in this study. All subjects had taken anticonvulsants for at least 1 year or more. Subjects were classified into three groups according to age(5-7 yrs, 8-11 yrs, >12 yrs). BMD was measured by Dual-energy X-ray Absorptiometry(DXA) on the lumbar spine and whole body. Statistical analysis for BMD of anticonvulsants-treated subjects were compared to results with the published data. RESULTS: BMD was significantly decreased in the anticonvulsants-treated group as compared with the control group of all age groups(P<0.05). But BMD among groups according to anticonvulsants was not significantly different(P>0.05). CONCLUSION: Because chronic administration of anticonvulsants for growing children leads to a decrease in BMD, early detection and management of abnormal BMD is important in monitoring of children with epilepsy.
Child ; Male ; Female ; Humans