Sacroiliac (SI) joint pain can result from degeneration, infection, malignancy, and trauma. Patients with metastatic bone pain who do not respond to conventional treatment may need more aggressive neuroinvasive approaches. Recently, pulsed radiofrequency (PRF) neuromodulation has emerged as a promising treatment alternative for refractory cases of SI joint pain. Nevertheless, there is no report on the treatment of pain arising from SI joint metastases with PRF. We are reporting about a 63-year-old woman suffering from buttock pain due to breast cancer metastases in the SI joint. We treated this patient with PRF neuromodulation of the L4-S3 primary dorsal rami and lateral branches using a rotating curved needle technique. The patient tolerated the procedures well, without any complications. She experienced about 70% reduction in pain, and pain relief was sustained for 10 months. This result suggests that PRF neuromodulation is a safe, effective treatment for pain from SI joint metastases.
Arthralgia ; Breast Neoplasms ; Buttocks ; Female ; Humans ; Joints ; Middle Aged ; Needles ; Neoplasm Metastasis* ; Sacroiliac Joint*

BACKGROUND: Malnutrition-inflammation complex syndrome (MICS) is common in maintenance hemodialysis (MHD) patients and may be related to a poor outcome. However, there is little evidence showing MICS to be a risk factor for atherosclerosis. The aim of this study was to determine if MICS is associated with the atherosclerotic markers such as abdominal aortic calcification (AAC) and pulse wave velocity (PWV) in MHD patients. METHODS: Eighty MHD patients were selected in Kangbuk Samsung Hospital (male: female=50:30, age 58+/-14 years). The nutritional status was assessed by the Subjective Global Assessment (SGA), biochemical measurement and the normalized protein equivalent of the total nitrogen appearance (nPNA). The presence of inflammatory reaction was assessed by the C-reactive protein (CRP). The malnutrition-Inflammation Score (MIS) was used to assess MICS. A lateral lumbar radiogram was used to evaluate the AAC index. Brachial-ankle (ba) PWV using automatic device was performed. RESULTS: Malnourished patients had a higher MIS than the well nourished patients (8.7+/-3.6 vs. 4.0+/-1.8, p<0.001). Patients with inflammation (CRP3 mg/L) showed a higher MIS than patients without inflammation (7.6+/-4.6 vs. 5.7+/-3.3, p=0.045). There was no correlation between the MIS and the AAC index (r=0.157, p=0.191) and baPWV (r= 0.144, p=0.323). CONCLUSION: These results suggest that the MIS is a useful marker of MICS in MHD patients. However, the MIS was not directly related to the AAC index and baPWV. This report highlights the importance of assessing the MICS and atherosclerosis in MHD patients.
Atherosclerosis* ; C-Reactive Protein ; Humans ; Inflammation ; Malnutrition ; Nitrogen ; Nutritional Status ; Pulse Wave Analysis ; Renal Dialysis* ; Risk Factors

Autosomal dominant polycystic kidney disease (ADPKD) is one of most common hereditary disorders that is potentially fatal. To elucidate clinical and genetic characteristics of ADPKD in Korea, 166 patients were analyzed retrospectively. The results were as follows ; 1) The male-to-female ratio was 83: 83, and age of patients was 4813(meanSD) years. 6496 of patients have a family history of the ADPKD. 2) Most common symptom was flank and ab- dominal pain. In urinalysis, proteinuria(42%), hematuria(18%) were found. Other organ involvement included hepatic cysts(58%), pancreatic cysts(8%) and splenic cyst(296). 3) The age at diagnosis was 44% 12 years. Hypertension was observed in 65%, the age of detection was 45% 11 years. Azotemia was observed in 36%, the age of detection was 52 +/- 11 years. 4) Echocardiography showed left ventricular hypertrophy 5896(19/33), valve regurgitation 1596(5/33) and mitral valve prolapse 3%(1/33). Cerebrovascular events occurred in 14 patients(8.4%), and 6 patients confirmed cerebral aneurysm rupture. 5) 29 patients(17%) reached end stage renal fail- ure(ESRD), the age was 53 +/- 10 years. The provability of being alive and not having ESRD was 88% by age 50, 76% by age 58, and 48% by age 65. Sex and hepatic cyst were not associated significantly with the course of renal function(p>0.05). 6) 15 patients(9%) died, the age of death was 55 +/- 12 years. 6 patients died after reaching ESRD. The cause of death were was cancer(4), cerebrovascular event(3), cessation of dialysis(2), sudden death (2), liver cirrhosis(1), sepsis(1), suicide(1) and unknown(1). Results of our study revealed the complications of ADPKD in Korea, hypertension 6596, ESRD 17% and cerebrovascular event 8%. Functional survival was 88M by age 50, 76% by age 58, and 48M by age 65. The extrarenal manifestations are more important contributors to mortality than renal manifestations of ADPKD.
Azotemia ; Cause of Death ; Death, Sudden ; Diagnosis ; Echocardiography ; Humans ; Hypertension ; Hypertrophy, Left Ventricular ; Intracranial Aneurysm ; Kidney Failure, Chronic ; Korea* ; Liver ; Mitral Valve Prolapse ; Mortality ; Polycystic Kidney, Autosomal Dominant ; Retrospective Studies ; Rupture ; Urinalysis

No abstract available.

As in other countries, type 2 diabetes is major health concern in Korea. A dramatic increase in the prevalence of type 2 diabetes and its chronic complications has led to an increase in health costs and economic burdens. Early detection of high risk individuals, hidden diabetic patients, and improvement in the quality of care for the disease are the first steps to mitigate the increase in prevalence. The Committee of Clinical Practice Guidelines of the Korean Diabetes Association revised and updated the '3rd Clinical Practice Guidelines' at the end of 2010. In the guidelines, the committee recommended active screening of high risk individuals for early detection and added the hemoglobin A1c level to the diagnostic criteria for type 2 diabetes based on clinical studies performed in Korea. Furthermore, the committee members emphasized that integrating patient education and self-management is an essential part of care. The drug treatment algorithm based on the degree of hyperglycemia and patient characteristics were also updated.
Committee Membership ; Diabetes Mellitus, Type 2 ; Health Care Costs ; Hemoglobins ; Humans ; Hyperglycemia ; Korea ; Mass Screening ; Patient Education as Topic ; Prevalence ; Self Care

As in other countries, type 2 diabetes is major health concern in Korea. A dramatic increase in the prevalence of type 2 diabetes and its chronic complications has led to an increase in health costs and economic burdens. Early detection of high risk individuals, hidden diabetic patients, and improvement in the quality of care for the disease are the first steps to mitigate the increase in prevalence. The Committee of Clinical Practice Guidelines of the Korean Diabetes Association revised and updated the '3rd Clinical Practice Guidelines' at the end of 2010. In the guidelines, the committee recommended active screening of high risk individuals for early detection and added the hemoglobin A1c level to the diagnostic criteria for type 2 diabetes based on clinical studies performed in Korea. Furthermore, the committee members emphasized that integrating patient education and self-management is an essential part of care. The drug treatment algorithm based on the degree of hyperglycemia and patient characteristics were also updated.
Committee Membership ; Diabetes Mellitus, Type 2 ; Health Care Costs ; Hemoglobins ; Humans ; Hyperglycemia ; Korea ; Mass Screening ; Patient Education as Topic ; Prevalence ; Self Care

The Committee of Clinical Practice Guidelines of the Korean Diabetes Association revised and updated the '3rd Clinical Practice Guidelines' at the end of 2010. In these guidelines, the committee recommends active screening of high risk individuals for early detection and added HbA1c level as a diagnostic criterion of type 2 diabetes to produce a more practical approach based on clinical studies performed in Korea. Furthermore, committee members emphasize that integrated patient education for self-management is an essential part of patient care. The drug treatment algorithm was also updated based on the degree of hyperglycemia and patient characteristics.
Committee Membership ; Diabetes Mellitus, Type 2 ; Humans ; Hyperglycemia ; Korea ; Mass Screening ; Patient Care ; Patient Education as Topic ; Self Care