OBJECTIVES: We estimated the population prevalence of antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), including unreported infections, through a Korea Seroprevalence Study of Monitoring of SARS-CoV-2 Antibody Retention and Transmission (K-SEROSMART) in 258 communities throughout Korea. METHODS: In August 2022, a survey was conducted among 10,000 household members aged 5 years and older, in households selected through two stage probability random sampling. During face-to-face household interviews, participants self-reported their health status, COVID-19 diagnosis and vaccination history, and general characteristics. Subsequently, participants visited a community health center or medical clinic for blood sampling. Blood samples were analyzed for the presence of antibodies to spike proteins (anti-S) and antibodies to nucleocapsid proteins (anti-N) SARS-CoV-2 proteins using an electrochemiluminescence immunoassay. To estimate the population prevalence, the PROC SURVEYMEANS statistical procedure was employed, with weighting to reflect demographic data from July 2022. RESULTS: In total, 9,945 individuals from 5,041 households were surveyed across 258 communities, representing all basic local governments in Korea. The overall population-adjusted prevalence rates of anti-S and anti-N were 97.6% and 57.1%, respectively. Since the Korea Disease Control and Prevention Agency has reported a cumulative incidence of confirmed cases of 37.8% through July 31, 2022, the proportion of unreported infections among all COVID-19 infection was suggested to be 33.9%. CONCLUSIONS The K-SEROSMART represents the first nationwide, community-based seroepidemiologic survey of COVID-19, confirming that most individuals possess antibodies to SARS-CoV-2 and that a significant number of unreported cases existed. Furthermore, this study lays the foundation for a surveillance system to continuously monitor transmission at the community level and the response to COVID-19.

BACKGROUND: The patency of arteriovenous access is important for stable and effective hemodialysis, and long-term technical survival is best achieved with a native arteriovenous fistula (AVF). However, maintaining AVF patency remains a challenge. This study was designed to determine the independent prognostic factors for AVF patency according to hemodialysis duration. METHODS: The primary study end point was unassisted patency of the AVF, which was defined as the time from the first fistula surgery to the first AVF failure. AVF failure was defined as an event that required percutaneous intervention or surgery to revise or replace the fistula, which occurred at least 2 months after fistula formation. RESULTS: We enrolled 478 patients with a mean age of 55.5+/-14.0 years, and mean duration of dialysis was 2.5+/-2.1 years. There were 109 cases (22.8%) of AVF failure. The factors related to AVF patency differed according to hemodialysis duration. Using a Cox-adjusted model, we observed a significant correlation between the incidence of AVF failure and diabetes within the initial 12 months of hemodialysis. Uncontrolled hyperphosphatemia (mean serum phosphorus>5.5 mg/dL during hemodialysis) was associated with patency loss of AVF after 1 year of hemodialysis. CONCLUSION: Various factors were associated with the development of patency loss of AVF as hemodialysis duration differed, and a preventive role of hyperphosphatemia control in AVF survival needs further clinical study.
Arteriovenous Fistula* ; Dialysis ; Fistula ; Humans ; Hyperphosphatemia* ; Incidence ; Renal Dialysis*

Polycystic ovary syndrome is characterized by symptoms of oligomenorrhea, amenorrhea, infertility, hirsutism and obesity. It is known that the women with such diseases would have higher risks to coronary heart diseases, hypertension, DM and endometrial cancer later on, Known risk factors of endometrial cancer are nullipara, late menopause, obesity, DM, unopposed estrogen, tamoxifen treatment, and atypical endometrial hyperplasia ect. 75% of endometrial cancer occurs in age over 50 and 4% of endometrial cancer occurs in age under 40. Particulary endometrial cancer concurrent polycystic ovary syndrome occurs usually in people under age 40 and is commonly well differentiated cell type and is related to good prognosis. We experienced a case of endometrial cancer with polycystic ovary syndrome, who was early dignosed, presented with infertility and got an operation in our hospital, and report this case with a brief review of literature.
Amenorrhea ; Coronary Disease ; Endometrial Hyperplasia ; Endometrial Neoplasms* ; Estrogens ; Female ; Hirsutism ; Humans ; Hypertension ; Infertility ; Menopause ; Obesity ; Oligomenorrhea ; Polycystic Ovary Syndrome* ; Prognosis ; Risk Factors ; Tamoxifen

There are opinions that microalbuminuria acts as an independent risk factor for cardiovascular diseases, related to other risk factors such as endothelial cell dysfunction, hypertension, insulin resistance, obesity, hyperlipidemia and platelet aggregation dysfunction in diabetic and non-diabetic patients. We examined the prevalence of microalbuminuria and macroalbuminuria and the relationship of microalbuminuria and macroalbuminuria to coronary heart disease in type 2 diabetic patients. Out of 798 type 2 diabetic patients who were hospitalized at Yonsei medical center from Oct. 1997 to Feb. 1999, we studied 181 patients who had normal renal function and were examined 24 hour urine albumin excretion. According to the amount of urine albumin excretion, 181 patients were categorized into three groups; normoalbuminuria(less than 30mg/24hour), microalbuminuria(30-300mg/24hour) and macroalbuminuria (more than 300mg/24hour). Patients were tested using treadmill test, stress thallium scan, echocardiography, and coronary angiography for the evaluation of coronary heart disease. The freguency of normoalbuminuria, microalbuminuria, and macroalbuminuria in our patients were 50.3%(91/181), 30.9%(56/181), and 18.3%(34/181), respectively. In each group, the prevalence of hypertension were 42.5%, 78.5%, and 82.3%, respectively and the prevalence of cardiovascular disease were 24.7%, 50.0%, and 46.0%, respectively. Microalbuminuria and macroalbuminuria groups showed statistically significant differences in the prevalence of hypertension and coronary heart disease compared with normoalbuminuria group(p<0.05). In addition, the prevalence of diabetic retinopathy were 37.3%, 58.9%, and 55.8%, respectively and microalbuminuria and macroalbuminuria groups showed statistically significant differences in the prevalence of diabetic retinopathy compared with normoalbuminuria group(p<0.05). We conclude that microalbuminuria and macroalbuminuria is a strong predictor of coronary heart disease in patients with type 2 diabetes.
Albuminuria* ; Cardiovascular Diseases ; Coronary Angiography ; Coronary Disease* ; Diabetic Nephropathies ; Diabetic Retinopathy ; Echocardiography ; Endothelial Cells ; Exercise Test ; Humans ; Hyperlipidemias ; Hypertension ; Insulin Resistance ; Obesity ; Platelet Aggregation ; Prevalence* ; Risk Factors ; Thallium

Calcitriol therapy is an important treatment for the prevention and control of secondary hyperparathyroidism in continuous ambulatory peritoneal dialysis (CAPD) patients. However, this often has been limited by the associated hypercalcemia and hyperphosphatemia due to increase in intestinal calcium and phosphorus absorption. Many studies reported that these limitations could be avoided by changing routes, frequency and dose of calcitriol treatment. But, there are still controversy about each methods and the results on the PTH response to conventional calcitriol treatment in CAPD patients. This study was performed to evaluate the factors affecting the response to oral calcitriol in CAPD patients. A retrospective study was done in 92 CAPD patients with secondary hyperparathyroidism(intact PTH level >200pg/ml) on oral calcitriol treatment. After baseline study of serum calcium, phosphorus, alkaline phosphatase, BUN, creatinine and intact PTH, calcitriol therapy was begun via oral rou- te, daily. Serum calcium, phosphorus, alkaline phosphatase, BUN, creatinine, intact FI'H and other bio- chemical markers were checked at 3 month, 6 month after treatment. Parathyroid gland ultrasonography was performed to detect parathyroid hypertrophy and nodule and to measure the diameter of parathymid gland. All the patients were divided into two groups according to percent reduetion of i-PTH(initial PTH PTH after 3, 6 months)X100/initial PTH(%),deltaPTH during oral calcitriol therapy for 3 and 6 months(group I ; delta PTH >30%, group II ; delta PTH <30%). RESULT: 1) All 92 patients(mean age 46.5 11.3yr, M: F 45: 47, mean CAPD duration 51.3 39.4 months) were administered oral calcitriol, daily. Mean calcitriol dose during 3 month was 0.43 0.22Mg and during 6month 0.43 0.24Mg. 2) After 3-month treament, there were significant differences in initial i-PTH, the diameter of parathyroid gland, initial phosphorus, intial total alkaline phosphatase and duration of CAPD between group I and II(406.7+/-196.5 vs. 871.0+/-478Apglml, 6.2+/-2.6 vs. 13.1+/-5.2mm, 5.0+/-1.3 vs. 5.7+/-1.3mg/dl, 93.7+/-4L1 vs. 171.9+/-137.6IU/L, 40.1+/-34.9 vs. 73.5+/-37.8months, p< 0.05, respectively). 4) After 6-month treament, there were significant differences in initial i-PTH, the diameter of parathyroid gland, intial total alkaline phosphatase and duration of CAPD between group I and II(474.1+/-266.6 vs. 889.7+/-485.4pg/ml, 6.4+/-2.7 vs. 14.5+/-5.1mm, 107.9+/-80.1 vs. 180.7+/-121.5IU/L, 40.5+/- 32.9 vs. 81.8+/-35.3months, p<0.05, respectively). 5) The significant negative correlation was shown between deltaPTH and the duration of peritoneal dialysis, the diameter of parathyroid gland, initial PTH level and PTH response during 3-month and 6-month oral calcitriol treatment. The response to oral calcitriol was poor when i-PTH level more than 500pg/ml(kappa 0.429, p value <0.01), the diameter of parathyroid gland more than 10.0mm(kappa 0.641, p value<0.01), the duration of CAPD more than 55months(kappa 0.524, p value< 0.01). These data suggested that initial i-PTH level, the diameter of parathyroid gland size and the duration of CAPD were independent risk factors of the poor response to oral calcitriol therapy in CAPD patients with secondary hyperparathyroidism.
Absorption ; Alkaline Phosphatase ; Calcitriol* ; Calcium ; Creatinine ; Humans ; Hypercalcemia ; Hyperparathyroidism, Secondary* ; Hyperphosphatemia ; Hypertrophy ; Parathyroid Glands ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory* ; Phosphorus ; Retrospective Studies ; Risk Factors ; Ultrasonography

It's well known that protein/creatinine ratio(P/C ratio) in random urine samples reflects 24-hour urine protein. However, the factors affecting accurate quantitation of proteinuria using random urine P/C ratio are not fully evaluated. The aim of this study is to evaluate factors affecting accurate quantitaion of proteinuria using random urine P/C ratio. 118 patients admitted in Yonsei university medical center during June 1998 and Dec. 1998 were assessed for the measurement of random urine protein/creatinine ratio from second voided urine. 118 patients(mean age 41.5year, male: female 2.36: 1) had mean creati-nine level 1.83+/-1.78mg/dL, 24-hour pmteinuria 6.06+/-7.64g/day and P/C ratio 4.80+/-4.48, All the patiient.s were divided into A, B, C, I, II, K, IV according to serum creatinine level and 24-hour proteinurim amount. The correlation coefficient(R value) between proteinuria and P/C ratio are shown that in all pa- tients is 0.875, group A(Cr* Academic Medical Centers ; Creatinine ; Female ; Humans ; Male ; Proteinuria* ; Sensitivity and Specificity

The most widely used method for treatment of secondary hyperparathyroidism(SH) in CAPD patients has been the administration of calcitriol by oral route. In this study, we compared the efficacy and safety of daily low dose calcitriol therapy with those of intermittent high dose pulse therapy. The study group consisted of 38 patients undergoing CAPD with serum intact PTH level of more than 200pg/ mL. Twenty patients were randomly administered daily low dose calcitriol(0.25 microgram/day for 1 month followed by 0.5 microgram daily dose for the next 3 mon-ths) while 18 patients were given intermittent pulse therapy (0.5 microgram-0.5 microgram-0.75 microgram 3 times a week for 1 month, increased to 1.0 microgram-1.25 microgram-1.25 microgram 3 times a week for the next 3 months). Thirty five patients completed the study : 17 on daily oral calcitriol (M: F=0.7:1, mean age=47.3+/-10.6 years, mean duration of CAPD=48.9+/-41.1 months), and 18 on oral pulse calcitriol (M:F=1.6:1, mean age=41.5+/-12.7 years, mean duration of CAPD=49.2+/-41.6 months). The baseline serum levels of calcium, phosphorus, i-PTH, alkaline phosphatase, and total CO2 were not different between daily and pulse group(9.5+/-0.8 vs 9.3+/-0.9mg/dL, 5.8+/-1.3 vs 5.1+/-1.2mg/dL, 443.1+/-162.5 vs 546+/-385.9pg/mL, 91.8+/-47.7 vs 108.9+/-66.5IU/L, 23.7+/-1.9 vs 25.5+/-2.0mEq/L, p>0.05, respectively). The i-PTH level decreased significantly in daily calcitriol group after 1 month (332.8+/-214.8pg/mL, p<0.01), and at final evaluation (180.4+/-254.8pg/mL, p<0.01). In pulse calcitriol group, i-PTH level also decreased significantly to 400,4+/-225.8pg/mL(p<0.05), 89.4+/-122.6 pg/mL(p<0.01), respectively. The rate of decline in i-PTH level from baseline were similar(daily=25.4+/-22.7 vs pulse=19.5+/-12.6%decline/month, p>0.05). The serum calcium increased similarly in both groups after treatment (daily=10.6+/-0.8 vs pulse=l0.1+/-1.0mg/dL, p>0.05). Hypercalcemia(>11.0mg/dL) was rarely observed in all patients (daily=5, pulse=8 episodes). In conclusion, both daily and pulse calcitriol therapy were similarly effective and safe in control of SH.
Alkaline Phosphatase ; Calcitriol* ; Calcium ; Humans ; Hyperparathyroidism, Secondary* ; Peritoneal Dialysis* ; Peritoneal Dialysis, Continuous Ambulatory ; Phosphorus

BACKGROUND: To predict the therapeutic efficacy of osteoporosis, one or two years is needed to evaluate the therapeutic effect by the measurement of bone mineral density(BMD), whereas three to six months is sufficient with bone markers. Using this information, we can change therapeutic plan or modulate drug dosage if necessary. This approach would provide appropriate therapy for osteoporosis. The purpose of this study is to evaluate the association between the percentage change of BMD which was measured by peripheral quantitative computed tomography(pQCT), and bone markers after 1 year of hormone replacement therapy(HRT) in healthy postmenopausal women. METHODS: Bone mineral density of nondominant distal forearm in 89 postmenopausal women was measured by pQCT. We measured serum alkaline phosphatase(ALP) and intact osteocalcin(iOC, Novocalcin) as bone formation markers, urinary deoxypyridinoline(dPyr, PyriLinks-D(TM)) as bone resorption marker by using enzyme immunoassay. After 1 year of HRT, 54 subjects dropped out and 33 subjects were reevaluated. RESULTS: After 1 year of HRT, the drop-out rate was 61%. There was no significant difference in age, age of menopause, years since menopause, initial BMD, initial bone markers between remained and drop out groups. But osteocalcin level was significantly high in remained group(p=0.02). ALP(-27.6 %), iOC(-29.9%), dPyr(-25.2%) were significantly decreased after 1 year of HRT(p<0.001). Trabecular BMD was increased by 2.4%(p=0.003), but the percentage change of total and cortical BMD was not significant(p>0.05). The levels of BMD and bone markers between before and after was significantly correlated, demonstrating the homogeneity of response to HRT. The percentage change of trabecular BMD was negatively correhted with the percentage change of dPyr after HRT(r=-0.45, p=0.01). The variance of the percentage change of dPyr contributed to the percentage change of trabecular BMD by 20%. There was no correlation between the percentage change of total BMD or cortical BMD and the change of ALP, iOC, or dPyr after HRT. CONCLUSIONS: After 1 year of HRT in postmenopausal women, all biochemical bone markers were decreased significantly, whereas only trabecular BMD measured by pQCT was increased significantly. This result suggests that bone markers was more sensitive than BMD to monitor the therapeutic efficacy of HRT. The percentage change of trabecular BMD was correlated with the change of dPyr after HRT only. dPyr might be the most sensitive marker among bone markers tested. Therefore, we can predict the change of BMD after HRT through monitoring the levels of dPyr.
Bone Density* ; Bone Resorption ; Female ; Forearm ; Hormone Replacement Therapy* ; Humans ; Immunoenzyme Techniques ; Menopause ; Osteocalcin ; Osteogenesis ; Osteoporosis

The hemangiopericytoma originated from the greater omentum is a very rare vascular tumor and grows to a large mass without symptoms for a long period. The diagnosis can be made on ultrasonogram, CT or MRI and angiogram with the findings of well circumscribed, solitary mass with hypervascularity in the abdominal cavity especially retroperitoneal cavity. The surgical treatment is recommended due to its possibility of malignant potential and metastasis on diagnosis. The evaluation of differential diagnosis to rule out this tumor is obligatory if a large solitary movable mass being palpated in abdomen. We experienced a case of hemangiopericytoma of greater omentum which was diagnosed as a left ovarian tumor preparatively, and we report the case with brief review of the literatures.
Abdomen ; Abdominal Cavity ; Diagnosis ; Diagnosis, Differential ; Hemangiopericytoma* ; Magnetic Resonance Imaging ; Neoplasm Metastasis ; Omentum* ; Ultrasonography

The hemangiopericytoma originated from the greater omentum is a very rare vascular tumor and grows to a large mass without symptoms for a long period. The diagnosis can be made on ultrasonogram, CT or MRI and angiogram with the findings of well circumscribed, solitary mass with hypervascularity in the abdominal cavity especially retroperitoneal cavity. The surgical treatment is recommended due to its possibility of malignant potential and metastasis on diagnosis. The evaluation of differential diagnosis to rule out this tumor is obligatory if a large solitary movable mass being palpated in abdomen. We experienced a case of hemangiopericytoma of greater omentum which was diagnosed as a left ovarian tumor preparatively, and we report the case with brief review of the literatures.
Abdomen ; Abdominal Cavity ; Diagnosis ; Diagnosis, Differential ; Hemangiopericytoma* ; Magnetic Resonance Imaging ; Neoplasm Metastasis ; Omentum* ; Ultrasonography