Patients with acromegaly have a reduced life expectancy rnainly due to cardiovascular, respiratory or cerebrovascular diseas-. Malignancy also seems to occur with greater than the expected incidence. In particular, the published retrospective or prospective studies have suggested a strong association of colonic neoplasia with acromegaly. But, there were a few reports of thyroid cancer in acrornegaly. We report a case of thyroid papillary cancer derived from diffuse goiter in acromegaly, sugge- sting the possible carcinogenic role of growth hormone.
Acromegaly ; Bites and Stings ; Colon ; Goiter ; Growth Hormone ; Humans ; Incidence ; Life Expectancy ; Prospective Studies ; Retrospective Studies ; Thyroid Gland ; Thyroid Neoplasms

Objective: This study aimed to provide basic data for preventing and managing sarcopenia by identifying the relationship between sarcopenia, malnutrition, and psychosocial factors among the elderly in the community. Methods: The study included 1,019 subjects aged 60 and over. “Possible sarcopenia” was defined by low handgrip strength with or without reduced physical performance. Nutrition was evaluated according to the mini nutrition assessment (MNA), and the psychosocial factors examined were self-efficacy, social isolation, fear of falling, and social capital (trust and participation). A logistic regression analysis was also performed on the relationship between risk of malnutrition, psychosocial factors, and sarcopenia. Results: MNA was significantly associated with social participation (OR = 1.747, p <0.001), fear of falling (OR = 2.905, p <0.001), and self-efficacy (high/low, OR = 0.654, p = 0.011). In model 3, which included both MNA and psychosocial factors, sarcopenia was significantly associated with MNA (OR = 2.529, p <0.001) and fear of falling (OR = 1.544, p = 0.045). Compared with the low self-efficacy group, the high group (OR = 0.589, p = 0.009) was significant. The factors related to possible sarcopenia include risk of malnutrition, fear of falls, and low self-efficacy. Conclusion It will be necessary to improve self-efficacy so that individuals feel they can do activities of daily living themselves and to reduce their fear of falling through muscle strength and balance exercises.Finally, it is also necessary to increase regular participation in community social activities.

Teriparatide (TPTD) is a bone-forming agent used to treat postmenopausal osteoporosis. Since hip fractures are related to higher morbidity and mortality rates than other fractures, efficacious osteoporosis drugs for the hip are critical. We reviewed research articles reporting the efficacy of TPTD in terms of bone mineral density (BMD), fractures prevention, changes in the outer diameter, cortical thickness and porosity, post-operative periprosthetic BMD loss, and healing of typical and atypical fractures of the hip. Data meta-analyses indicated that TPTD not only increased the BMD of the proximal femur but also decreased the risk of hip fractures. Even though TPTD increases the cortical bone porosity of the proximal femur, the bone strength does not decrease as the majority of the porosity is located at the endocortex; further, it increases the outer diameter and thickens the cortical bone.TPTD stimulates bone remodeling and facilitates callus maturity and fracture healing. There have been many reports on improving the effect of TPTD on the healing of atypical fractures; therefore it is advisable to use TPTD considering the increase benefit compared to the risk.

Objective: There is currently no structured interview tool developed that comprehensively evaluates self-injurious thoughts and behaviors (SITB) in Korea. The Self-injurious Thoughts and Behaviors Interview (SITBI) collectively measures suicidal ideation, plans, gestures, attempts, and non-suicidal self-injuries (NSSI). The SITBI’s reliability and validity have been established with it being widely used in English speaking countries. This study evaluated the psychometric validity of the Korean version of the SITBI (SITBI-K). Methods: The SITBI’s validity as a diagnostic assessment tool for NSSI and suicidal behavior disorder (SBD), as defined by the Diagnostic and Statistical Manual of Mental Disorders-5th edition, was examined. Analyses were performed on 108 university students reporting experiences of suicidal thoughts and behaviors (female 84.26%, mean age=22.10, ±SD 3.33). Results: The SITBI-K displayed excellent interrater reliability, with a credible test-retest reliability at two months. Construct validity examined the correlation between the SITBI-K’s modules and approved the self-report results. Appropriate convergent and discriminant validities were obtained for suicidal ideation, plans, gestures, attempts, and NSSI. Conclusion The SITBI-K showed excellent psychometric validity at a level comparable to the original. Its clinical utility for both NSSI and SBD diagnoses was confirmed.

Purpose: This study analyzed the relationship between degree of disability and edema index [extracellular water/total body water (ECW/TBW) ratio] values in a rural population of older adult patients with osteopenia, sarcopenia, or osteosarcopenia (OS). Materials and Methods: This study used data from the Namgaram-2 cohort. The degree of disability was measured using the World Health Organization Disability Assessment Schedule (WHODAS) 12, and ECW/TBW ratio was calculated using bioelectrical impedance analysis. Based on ECW/TBW ratio, the participants were stratified into normal (<0.391) and abnormal (≥0.391) groups, and the mean WHODAS 12 scores were compared between the two groups. Multiple regression analysis corrected for demographic factors, smoking history, hypertension, diabetes, and serological test results was also conducted. Results: Significant differences in mean WHODAS 12 scores were observed in the healthy group (5.8±7.4 vs. 9.2±9.7, p=0.008), the osteopenia only group (7.4±8.7 vs. 12.9±12.0, p<0.001), and the OS group (16.0±13.2 vs. 23.1±17.1, p=0.004). However, no significant difference in mean WHODAS 12 score was observed in the sarcopenia only group (14.9±13.4 vs. 20.7±14.8, p= 0.051). There were significant differences in ECW/TBW ratio values between the abnormal and normal groups in the osteopenia only group (B=4.646 and p=0.001), the sarcopenia only group (B=5.097 and p=0.016), and the OS group (B=5.653 and p=0.043). Conclusion This study found that the degree of disability is related to the edema index in older patients with osteopenia, sarcopenia, or OS. Since the edema index indicates the nutritional status of an individual, proper nutrition and fluid intake are important to reduce disability.

OBJECTIVES: To analyze the adherence of once-yearly intravenous zolendronic acid for osteoporosis. MATERIALS AND METHODS: The subjects were 322 osteoporotic patients who received more than single infusion of zolendronic acid. On clinical assessment, we assessed adherence. The changes of bone mineral density (BMD) and bone turnover marker were measured before and after infusion. RESULTS: Reinfusion rate was 48.4% (109/225) at second infusion, and 51.3% (41/80) at third infusion. Adverse event at each time was 161 (42.1%) cases, 30 (27.5%) cases, and 8 (19.5%) cases, respectively. The measured mean BMD change was significantly increased (P-value<0.001). CONCLUSIONS: In this study, once-yearly intravenous zolendronic acid for 2 years was safe and efficacious in terms of BMD and bone turnover marker. The adherence was higher than most published studies of adherence to oral bisphosphonates, but lower than optimal. Physicians should fully explain to patients about medications and educate to improve their adherence.
Bone Density ; Diphosphonates ; Humans ; Osteoporosis

PURPOSE: This study was conducted to identify and analyze the trends of theory-based research published in Asian Oncology Nursing (AON) from 2011 to 2017. METHODS: We analyzed 22 theory-based studies taken from among the 232 studies published in AON for 7years. We analyzed the framework developed by researchers, descriptive summaries of theory, keyword classification of nursing meta-paradigms, the generic character of the studies, and the type of research designs. RESULTS: A total of 23 theories were applied in the 22 (9.5%) studies. ‘Nursing’ was the most prevalent field of study (34.8%). In the field of study of theory, nursing theory was the largest with eight (34.8%), and in the method of theory utilization, all 22 studies were theoretical applications 3 middle-range theories were most prevalent. In the keyword classification using meta-paradigm in nursing, we found 83 key words. Among them, ‘Health’ related key words were most frequent (53), followed by ‘Cancer’ keywords (13). CONCLUSION: AON has a high ratio of theoretical study compared to other journals, but the ratio is still less than 10%, which is still weak. Therefore, it is believed that the attention to, utilization of, application, and institutional establishment of nursing theory should be necessary.
Asian Continental Ancestry Group ; Classification ; Humans ; Methods ; Models, Theoretical ; Nursing ; Nursing Theory ; Oncology Nursing ; Research Design

STUDY DESIGN: Retrospective study. OBJECTIVES: To compare serum vitamin D levels in elderly patients with or without osteoporotic spinal compression fractures (OSCFs) and to identify relationships between the serum vitamin D level and other variables, such as age, bone mineral density (BMD), and bone turnover markers (osteocalcin and C-telopeptide). SUMMARY OF LITERATURE REVIEW: Vitamin D plays a key role in calcium metabolism in the bone tissue. Vitamin D deficiency can lead to decreased BMD and an increased risk of falls and of osteoporotic fractures. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 95 elderly patients (≥60 years) with OSCFs (fracture group) and 118 subjects who had been diagnosed with osteoporosis without OSCFs (control group). Serum vitamin D levels were contrasted between the two groups taking into account other factors such as patient age, sex, and seasonal variations. For all the patients, we also evaluated the correlation between the vitamin D level and the patient age, BMD, and bone turnover markers. RESULTS: The mean of the serum 25(OH) vitamin D3 levels was significantly lower in the fracture group than in the control group. There were significant differences in the 25(OH) vitamin D3 levels in autumn. In all patients, the mean serum 25(OH) vitamin D3 levels were the highest in autumn and the lowest in spring. Furthermore, the mean serum 25(OH) vitamin D3 levels were significantly correlated with patient age and BMD. CONCLUSIONS: A low serum vitamin D level might be a risk factor of OSCFs in elderly patients.
Aged ; Bone and Bones ; Bone Density ; Calcitriol ; Calcium ; Case-Control Studies* ; Cholecalciferol ; Fractures, Compression ; Humans ; Medical Records ; Metabolism ; Osteoporosis ; Osteoporotic Fractures ; Retrospective Studies ; Risk Factors ; Seasons ; Spinal Fractures ; Spine* ; Vitamin D Deficiency ; Vitamin D* ; Vitamins*

STUDY DESIGN: A case report. OBJECTIVES: To report a rare case of intradural disc herniation (IDH) around conus medullaris. SUMMARY OF LITERATURE REVIEW: IDH is rare with an incidence of less than 1% of all lumbar disc herniations. It is important to differentiate IDH from other condition with accurate diagnosis and subsequent surgical treatment. IDH has a higher risk of neurologic deficit, like conus medullaris syndrome and cauda equina syndrome. MATERIALS AND METHODS: A 62 year-old male was affected by lumbar back pain radiating to the anterolateral aspect of the right thigh for 5 days. MRI showed a mass that existed on the anterior portion of the conus medullaris. We performed partial laminectomy at the L1-L2level. The mass located anteriorly in the intradural space was eliminated after durotomy by a posterior approach. RESULTS: We confirmed the IDH for histopathology. CONCLUSIONS: IDH usually needs accurate differential diagnosis. Preoperative MRI scans are necessary to differentiate IDH from other intradural lesions. The confirmative diagnosis can be done only in the operative field.
Back Pain ; Conus Snail ; Diagnosis ; Diagnosis, Differential ; Humans ; Incidence ; Laminectomy ; Magnetic Resonance Imaging ; Male ; Neurologic Manifestations ; Polyradiculopathy ; Spinal Cord Compression ; Thigh

We report a case of a 74-year-old woman who was incidentally found to have a single thyroid nodule. Laboratory evaluation showed undetectable serum thyroid stimulating hormone and elevated free thyroxine levels. (99m)Tc thyroid scan showed a hyperfunctioning autonomous nodule in a right lobe of the thyroid. Thyroid ultrasonography showed a 2.2 cm sized nonhomogeneous spiculated nodule with microcalcification, and which was identical with the hyperfunctioning nodule confirmed in thyroid scan by (99m)Tc single photon emission computed tomography/computed tomography. Fine needle aspiration was done, and cytology reported as suspicious of malignancy. The patient underwent total thyroidectomy with central neck dissection, and pathology was consistent with papillary thyroid carcinoma. This case report demonstrates that diagnosis of a hyperfunctioning autonomous thyroid nodule does not preclude the possibility of thyroid cancer. Clinicians should consider further evaluation such as ultrasonography and fine needle aspiration in patients with hyperfunctioning autonomous nodules.
Aged ; Biopsy, Fine-Needle ; Diagnosis ; Female ; Humans ; Hyperthyroidism* ; Neck Dissection ; Pathology ; Radionuclide Imaging ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroid Nodule ; Thyroidectomy ; Thyrotropin ; Thyroxine ; Ultrasonography