Purpose: The purpose of this study was to evaluate the validity and reliability of the Korean version of the Apathy Evaluation Scale Short Form (K AES-10) for people with dementia. Methods: Participants in this study were 198 patients with dementia resident in two hospitals in the Republic of Korea. The AES-10 was translated into Korean through the translation and adaptation of instruments process developed by the World Health Organization. This process was carried out by three bilingual nursing professionals. Validity and reliability, such as construct validity, convergent validity, Cronbach's ⍺, inter-rater reliability, and test-retest reliability, were evaluated. IBM SPSS Statistics 25.0 and AMOS 26.0 programs were used for the data analysis. Results: A uni-dimensional model was proposed in the explanatory factor analysis; a single factor accounted for 68.0% of total variances. The confirmatory factor analysis supported the validity of the Korean version of the AES-10. The scale had a Cronbach's ⍺ of .95, inter-rater reliability of .66 (p<.001), and a test-retest reliability of .81 (p<.001). Conclusion The findings show that the Korean version of the AES-10 is both valid and reliable for measuring apathy among people diagnosed with dementia in the Republic of Korea.

PURPOSE: There are several reports that the risk of development of leukemias is much higher in Down syndrome (DS) children than in non DS children. But there are a few reports about the clinical features of leukemia in Down syndrome and the prognosis in Korea. The object of this study is to evaluate clinical features, treatment results and the prognosis of leukemia of Down syndrome patients. METHODS: We conducted retrospective reviews in 10 children with leukemia of Down syndrome who were admitted to the Department of Pediatrics in Yonsei University Hospital between March 1986 and December 2000. We analyzed the clinical features, laboratory findings and survival rates. RESULTS: A male to female ratio was 1:1.25. Median age at diagnosis was 2 years 8 months. Initial symptoms were hepatosplenomegaly, petechiae, fever and upper respiratory infection symptoms. The number of patients by the type was as followed:acute myeloid leukemia (AML) 7 (70%), acute lymphocytic leukemia 2 (20%), acute mixed lineage leukemia 1 (10%). There were 4 cases of M7 subtype in AML. The median peripheral blood cell counts were as followed; leukocyte was 41,000/muL, hemoglobin was 8.7 g/dL, the platelet was 103,000/muL. The five years event free survival rate after diagnosis was 87.5% (7/8). The one patient relapsed and another one patient died of cardiac anomaly. CONCLUSION: There seemed to be several differences of clinical features between DS leukemia and non DS leukemia, especially prognosis. Multi-centered well organized study should be done to confirm our observation.
Blood Cell Count ; Blood Platelets ; Child ; Chromosomes, Human, Pair 21 ; Diagnosis ; Disease-Free Survival ; Down Syndrome* ; Female ; Fever ; Humans ; Korea ; Leukemia* ; Leukemia, Myeloid ; Leukemia, Myeloid, Acute ; Leukocytes ; Male ; Pediatrics ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Prognosis* ; Purpura ; Retrospective Studies ; Survival Rate

BACKGROUND: Early detection of vascular change may improve prediction of subclinical stage of cardiovascular disease, allowing intervention to prevent overt vascular damage. High heart rate is known to increase cardiovascular morbidity and mortality rate in the general population and in individuals with cardiovascular disease. We aimed to investigate the association between resting heart rate (RHR) measured using electrocardiogram (ECG) and arterial stiffness measured using the cardio-ankle vascular index (CAVI) in men. METHODS: Data were collected from 5,629 men aged between 20 and 78 years who visited a single-site health promotion center. RHR was measured in a supine posture after resting for 10 minutes using an ECG. Arterial stiffness was measured using the CAVI. The cutoff value for high CAVI was ≥9.0. RESULTS: RHR was one of the major determinants of high CAVI after adjusting for age, waist circumference, mean arterial pressure, glycosylated hemoglobin level, triglyceride level, white blood cell count, and lifestyle factors. When RHR groups were defined according to the RHR quartiles, the odds ratio of group with RHR ≥70 bpm, for high CAVI was 3.62 (95% confidence interval [CI], 2.21–5.91) after adjusting for age and lifestyle factors. This association was not changed after adjusting for all other covariates (odds ratio, 2.39; 95% CI, 1.36–4.19). CONCLUSIONS: RHR measured using ECG is significantly associated with arterial stiffness in men not taking medications for hypertension, dyslipidemia, or diabetes. These findings suggest that RHR may be useful in assessing cardiovascular risk in men.
Arterial Pressure ; Arteriosclerosis ; Cardiovascular Diseases ; Dyslipidemias ; Electrocardiography ; Health Promotion ; Heart Rate ; Heart ; Hemoglobin A, Glycosylated ; Humans ; Hypertension ; Leukocyte Count ; Life Style ; Male ; Mortality ; Odds Ratio ; Posture ; Risk Assessment ; Triglycerides ; Vascular Stiffness ; Waist Circumference

Background: Non-alcoholic fatty liver disease fibrosis score (NFS) is a scoring system applied in clinical practice to predict advanced fibrosis in patients with non-alcoholic fatty liver disease (NAFLD). Evidence shows that progression of steatohepatitis and liver fibrosis reduces the production of verylow- density lipoprotein. The aim of this study was to identify the association of NFS and serum low-density lipoprotein cholesterol (LDL-C) levels and in adults with NAFLD. Methods: Data were gathered from 24,889 subjects who had visited a health promotion center. NFS was calculated to assess the severity of fibrosis in all the subjects. Serum LDL-C levels were measured using a direct method. Results: Serum LDL-C levels tended to decrease with increasing NFS quartiles (P for trend<0.01). NFS was one of the major determinants of serum LDL-C level after adjusting for age, sex, lifestyle-related factors, and other covariates. The estimated mean serum LDL-C level was significantly lower in the highest quartile of NFS than in the lowest quartile of NFS. Conclusion NFS had a negative association with serum LDL-C levels in adults with NAFLD. Elevated LDL-C level is not only a risk factor of cardiovascular disease but also a predictive indicator of NAFLD severity.

Background: In general, women tend to increase serum low-density lipoprotein cholesterol levels after menopause. Hypercholesterolemia is a risk factor that causes atherosclerosis and increases the risk of cardiovascular disease. Additionally, low-density lipoprotein cholesterol increases even when attempting to modify lifestyles in menopausal women. Therefore, we wanted to find out what risk factors are associated with low-density lipoprotein cholesterol in menopausal women. Methods: Data were gathered from 4,943 subjects who had visited a Health Promotion Center. Variables are measured in body metering and blood tests. Partial correlation analysis was performed to identify the variables that are related to low-density lipoprotein cholesterol, and multiple regression analysis was performed to find the variables that can predict low-density lipoprotein cholesterol. Results: The mean age of the subjects was 57.3±6.6 years old, the average low density lipoprotein cholesterol concentration was 124.6±33.3 mg/dL, the average body mass index was 23.6±3.2 kg/m 2 , and the average waist circumference was 78.4±8.3 cm, and 21.5 percent of subjects was abdominal obesity. Serum low-density lipoprotein cholesterol level showed a positive correlation with obesity, oxidative stress-related indices, and inflammatory markers such as ESR, CRP. ESR, body fat mass, total bilirubin, uric acid, fasting plasma glucose, and WBC count showed positive correlation with serum low-density lipoprotein cholesterol levels, and age showed negative correlation. Conclusion This study identified several factors, such as inflammatory markers, obesity and oxidative stress related indices were associated with elevated serum low-density lipoprotein cholesterol levels in postmenopausal women.

Purpose: To evaluate the effectiveness of the transradial artery approach (TRA) for treating malfunctioning arteriovenous fistulas (AVFs) in patients on hemodialysis. Materials and Methods: A retrospective analysis was conducted in this single-center study of TRA endovascular procedures in 73 patients (43 male and 30 female; mean age of 67.4 years (range, 42–92 years) with malfunctioning AVFs, between January 2008 and April 2019. Patients’ baseline and lesion characteristics, technical and clinical success, and complications were evaluated, and functional patency was analyzed using the Kaplan-Meier method. Results: Radial artery approaches were successful in all patients. Angioplasty performed using the TRA achieved technical and clinical success rates of 98.6%(72/73) and 91.7%(67/73), respectively. The median primary patency time was 18.8 ± 15.9 months. The primary functional patency rates at 3, 6, and 12 months were 82.1%, 68.6%, and 63.9%, respectively. There were no major complications or adverse events, such as hand ischemia, related to the radial artery approach. Conclusion In selected cases, the TRA can be used complementary to the transvenous approach to treat malfunctioning AVFs.

BACKGROUND: Early detection of vascular change may improve prediction of subclinical stage of cardiovascular disease, allowing intervention to prevent overt vascular damage. High heart rate is known to increase cardiovascular morbidity and mortality rate in the general population and in individuals with cardiovascular disease. We aimed to investigate the association between resting heart rate (RHR) measured using electrocardiogram (ECG) and arterial stiffness measured using the cardio-ankle vascular index (CAVI) in men. METHODS: Data were collected from 5,629 men aged between 20 and 78 years who visited a single-site health promotion center. RHR was measured in a supine posture after resting for 10 minutes using an ECG. Arterial stiffness was measured using the CAVI. The cutoff value for high CAVI was ≥9.0. RESULTS: RHR was one of the major determinants of high CAVI after adjusting for age, waist circumference, mean arterial pressure, glycosylated hemoglobin level, triglyceride level, white blood cell count, and lifestyle factors. When RHR groups were defined according to the RHR quartiles, the odds ratio of group with RHR ≥70 bpm, for high CAVI was 3.62 (95% confidence interval [CI], 2.21–5.91) after adjusting for age and lifestyle factors. This association was not changed after adjusting for all other covariates (odds ratio, 2.39; 95% CI, 1.36–4.19). CONCLUSIONS RHR measured using ECG is significantly associated with arterial stiffness in men not taking medications for hypertension, dyslipidemia, or diabetes. These findings suggest that RHR may be useful in assessing cardiovascular risk in men.

PURPOSE: Infant leukemia is rare and accounts for 5% of leukemia in children. It differs from childhood leukemia in biologic and clinical features and has a poor prognosis. Research on infant leukemia is difficult due to the scarcity of cases. We studied the clinical progress and prognosis of infant leukemia diagnosed in our hospital, in order to contribute to the treatment and prognosis of infant leukemia. METHODS: The patients who were diagnosed with leukemia in the first 12 months of life were analysed between January 1991 and December 2000 in Yonsei Medical Center. We analysed the sex, age, clinical features, treatment outcome, prognostic factor, and survival rate. RESULTS: Among a total of 41 cases, 19 cases were diagnosed with acute lymphoblastic leukemia (ALL), 15 cases with acute myelogenous leukemia (AML), 2 cases with chronic myelogenous leukemia (CML), and 5 cases were unclassifed. Twenty-two were males and 19 females; age at diagnosis was 4 months in ALL, 8 months in AML, and 4 months in CML. Common clinical features at diagnosis were pale appearance and fever, others were poor oral intake, abdominal distension, and irritability. Hyperleukocytosis with average over 20,000/mm3, anemia, and thrombocytopenia were seen. By immunologic surface marker analysis, 8 of 15 B-lineage ALL were CALLA negative, early pre-B ALL. The remission induction rate was 79% in ALL and 60% in AML. The 5 year-survival rate of 41 patients was 29.2%. Sex, age at diagnosis, white blood cell count > 50 109/L, hepatomegaly, and CNS involvement were not prognostic factors. CONCLUSION: Infant leukemia differs from childhood leukemia in biological and clinical features and has a poor prognosis. Therefore, further clinical research is needed to improve the outcome of infant leukemia.
Anemia ; Child ; Diagnosis ; Female ; Fever ; Hepatomegaly ; Humans ; Infant* ; Leukemia* ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Leukemia, Myeloid, Acute ; Leukocyte Count ; Male ; Precursor B-Cell Lymphoblastic Leukemia-Lymphoma ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Prognosis ; Remission Induction ; Survival Rate ; Thrombocytopenia ; Treatment Outcome

PURPOSE: This study was conducted to identify risk factors for new onset diabetes after transplantation (NODAT) among renal transplant recipients treated with tacrolimus-based immunosuppressant. METHODS: We selected renal transplant recipients who underwent surgery at Samsung Seoul Hospital between May 2001 and July 2009. Exclusion criteria were as follows: recipients <18 years old, history of diabetes mellitus (DM) or impaired glucose tolerance. Analysis of possible risk factors for NODAT included age, gender, body mass index, co-morbid diseases, family history of DM, infection of hepatitis B or polyomavirus, type of donors (cadaver or living) and acute rejection. Overall incidence and median value of NODAT onset day were analyzed with Kaplan-Meier curve. We calculated crude incidence rate and relative risk (RR) and 95% confidence interval (CI) for independent risk factors of NODAT using Cox proportional hazard analysis. RESULTS: A total of 278 patients were included and the incidence of NODAT was 13.3% (5.6/100 person-year) and the median duration of NODAT onset was 28 days. In Cox analysis, risk factors for NODAT were age (45-59 years: RR=1.41, 95% CI 1.09-1.83, 60> years: RR=4.36, 95% CI 2.00-9.49), family history of DM (RR=1.62, 95% CI 1.12-2.34) and polyomavirus infection (RR=1.40, 95% CI 1.08-1.81). CONCLUSION: The risk factors for NODAT among renal transplant recipients treated with tacrolimus-based regimen were age (>45 years old), family history of DM and polyomavirus infection.
Body Mass Index ; Diabetes Mellitus ; Glucose ; Hepatitis B ; Humans ; Incidence ; Kidney Transplantation ; Polyomavirus ; Polyomavirus Infections ; Rejection (Psychology) ; Risk Factors ; Tacrolimus ; Tissue Donors ; Transplants

PURPOSE: We evaluated the utility of magnetic resonance imaging (MRI) and 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) for the preoperative staging of invasive lobular carcinoma (ILC) of the breast and compared the results with those of invasive ductal carcinoma (IDC). METHODS: The study included pathologically proven 32 ILCs and 73 IDCs. We compared clinical and histopathological characteristics and the diagnostic performances of MRI and 18F-FDG PET/CT for the primary mass, additional ipsilateral and/or contralateral lesion(s), and axillary lymph node metastasis between the ILC and IDC groups. RESULTS: Primary ILCs were greater in size, but demonstrated lower maximum standardized uptake values than IDCs. All primary masses were detected on MRI. The detection rate for ILCs (75.0%) was lower than that for IDCs (83.6%) on 18F-FDG PET/CT, but the difference was not significant. For additional ipsilateral lesion(s), the sensitivities and specificities of MRI were 87.5% and 58.3% for ILC and 100.0% and 66.7% for IDC, respectively; whereas the sensitivities and specificities of 18F-FDG PET/CT were 0% and 91.7% for ILC and 37.5% and 94.7% for IDC, respectively. The sensitivity of 18F-FDG PET/CT for ipsilateral lesion(s) was significantly lower in the ILC group than the IDC group. The sensitivity for ipsilateral lesion(s) was significantly higher with MRI; however, specificity was higher with 18F-FDG PET/CT in both tumor groups. There was no significant difference in the diagnostic performance for additional contralateral lesion(s) or axillary lymph node metastasis on MRI or 18F-FDG PET/CT for ILC versus IDC. CONCLUSION: The MRI and 18F-FDG PET/CT detection rates for the primary cancer do not differ between the ILC and IDC groups. Although 18F-FDG PET/CT demonstrates lower sensitivity for primary and additional ipsilateral lesions, it shows higher specificity for additional ipsilateral lesions, and could play a complementary role in the staging of ILC as well as IDC.
Breast* ; Carcinoma, Ductal* ; Carcinoma, Lobular* ; Electrons ; Fluorodeoxyglucose F18* ; Lymph Nodes ; Magnetic Resonance Imaging* ; Neoplasm Metastasis ; Positron-Emission Tomography and Computed Tomography* ; Sensitivity and Specificity