BACKGROUND: Atherosclerosis of the coronary artery is related to the obstructive coronary artery disease. The coronary artery calcium score test is a non-invasive and useful indicator of atherosclerosis. The Framingham risk scoring system is a traditional indicator of the cardiovascular risk. This cross-sectional study was performed to evaluate the relation of the coronary artery calcium scores with Framingham risk scores. METHODS: We evaluated 135 patients who visited the Department of Family Medicine in Severance Hospital and had a test of the coronary artery calcium scores from January 5th, 2005, to August 12th, 2006. The Framingham risk scores were calculated. We analyzed the correlation between the coronary artery calcium scores and the Framingham risk scores and tested the difference between the groups divided by categorization of the calcium scores. RESULTS: The coronary artery calcium scores were significantly correlated with the Framingham risk scores (r=0.282, P<0.01). There was a significant correlation in case of women (r=0.349, P<0.01), but not in case of men. There was a significant difference between the group whose calcium score was 0 and the group whose calcium scores were above 0 (P<0.001). CONCLUSION: There was a positive correlation between the coronary artery calcium scores and the Framingham risk scores. The coronary artery calcium score seems to be a significant factor to assess the cardiovascular risk.
Atherosclerosis ; Calcium ; Coronary Artery Disease ; Coronary Vessels ; Cross-Sectional Studies ; Female ; Humans ; Male

OBJECTIVE: To analyze association between urodynamic study (UDS) parameters and renal function in spinal cord injured (SCI) patients with neurogenic detrusor overactivity. METHODS: Patients with a suprasacral SCI, who underwent UDS and radioisotope renogram at least twice between January 1, 2006 and January 31, 2013, were included. UDS (cystometric capacity, reflex volume, compliance, and maximal detrusor pressure) and radioisotope renogram (total effective renal plasma flow [ERPF] of both kidneys) data were collected. The following were conducted to reanalyze any association between reflex volume and ERPF: initial and follow-up results of consecutive evaluations were compared; a mixed-model regression analysis to account for clustered data was conducted to evaluate the association between UDS parameters and ERPF; and finally, a mixed-model analysis type 3 test with data pairs, of which the first evaluation showed involuntary detrusor contraction. RESULTS: A total of 150 patients underwent 390 evaluations which were arranged into 240 pairs of consecutive evaluations, of which 171 had first evaluations with observed involuntary detrusor contraction. The following results were obtained: cystometric capacity was significantly larger and maximal detrusor pressure was significantly lower on follow-up; on univariate analysis, reflex volume and maximal detrusor pressure were significant, and multivariate analysis using these two parameters showed that maximal detrusor pressure is significantly associated with total ERPF; and no significant differences were observed. CONCLUSION: Maximal detrusor pressure should be closely monitored in the urologic management of neurogenic detrusor overactivity in SCI patients. The results also may serve as a reference for regular UDS follow-up.
Compliance ; Follow-Up Studies ; Humans ; Multivariate Analysis ; Reflex ; Renal Plasma Flow ; Renal Plasma Flow, Effective ; Spinal Cord ; Spinal Cord Injuries* ; Urinary Bladder, Neurogenic ; Urodynamics*

OBJECTIVE: To emphasize the need for precise diagnosis of amyotrophic lateral sclerosis (ALS), a progressive and degenerative disease of upper and lower motor neurons that often present initially with weakness at the upper or lower extremities, and frequently misdiagnosed as myelopathy, radiculopathy, peripheral neuropathy or arthropathy that may ultimately lead to unnecessary treatments including surgical procedures. METHOD: We retrospectively reviewed medical records of 331 ALS patients who visited our hospital between 1998 and 2008. Symptoms at onset, progression of disease, radiologic findings, surgeries prior to diagnosis of ALS, outcome after surgery or conservative treatments, and electrodiagnostic study results were reviewed. RESULTS: Among the 331 patients with ALS, 34 (10.3%) had a history of surgical procedure and 37 (11.1%) underwent conservative treatment prior to diagnosis of ALS. 34 patients with a mean disease duration at diagnosis of 20.0+/-14.9 months, had surgery for symptoms that were later attributable to ALS. In 30 of the 34 patients, symptoms did not resolve after the intervention. 37 patients with a mean disease duration at diagnosis of 16.6+/-14.3 months, underwent conservative treatments such as physical therapy prior to diagnosis of ALS. Only in one patient (2.7%), symptoms improved after conservative treatment. CONCLUSION: In the absence of a single confirmatory study for the diagnosis of ALS, clinical findings may be misinterpreted, leading to an erroneous diagnosis. Therefore, closer and more careful follow-up is necessary for patients with limb weakness in the absence of sensory symptoms, or bulbar abnormalities such as dysarthria and dysphagia.
Amyotrophic Lateral Sclerosis ; Deglutition Disorders ; Dysarthria ; Extremities ; Follow-Up Studies ; Humans ; Lower Extremity ; Medical Records ; Motor Neurons ; Peripheral Nervous System Diseases ; Radiculopathy ; Retrospective Studies ; Spinal Cord Diseases

OBJECTIVE: To investigate the drug compliance and factors that have an influence on drug compliance of spinal cord injured patients. METHOD: From January to June in 2009, spinal cord injured patients who visited our hospital for regular prescription were asked to fill out questionnaires about demographic data, comprehension and compliance of medication. RESULTS: Forty-eight patients completed questionnaires. Thirty-three were male and the rest were female. Twenty were tetraplegic and 26 paraplegic. Twenty-two were completely injured and 26 had incomplete injuries. The level of awareness of names, shapes and effects of medication were 70.8%, 87.5% and 77.1%, respectively. The compliant group that had more than 80% of drug compliance was 38 patients. The non-compliant group that had less than 80% compliance had 10 patients. In respect of compliance of medication, the patients tended to miss the time of administration more than the number of administration. Twenty patients didn't tell their doctors that they hadn't been taking their medication properly. There were no statistically significant differences between drug compliance and the following: patient's age, sex, spinal cord injury type, education level, time elapsed since the injury, number of medication per day, and comprehension of name, shapes and effects of medication. CONCLUSION: Drug compliance of spinal cord injured patients was high. Education on necessity, side effects and usage of medication may be needed to maintain high drug compliance. To investigate the drug compliance and factors that have an influence on drug compliance of spinal cord injured patients.
Ambulatory Care Facilities ; Compliance ; Comprehension ; Female ; Humans ; Male ; Outpatients ; Prescriptions ; Questionnaires ; Spinal Cord ; Spinal Cord Injuries

Background: Angiotensin-converting enzyme 2 (ACE2) and transmembrane protease serine subtype 2 (TMPRSS2) are key proteins mediating viral entry of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Although gene expressions of ACE2 and TMPRSS2 have been analyzed in various organs and diseases, their soluble forms have been less studied, particularly in asthma. Therefore, we aimed to measure circulating ACE2 and TMPRSS2 in the serum of asthmatics and examine their relationship with clinical characteristics. Methods: Clinical data and serum samples of 400 participants were obtained from an asthma cohort. The soluble ACE2 (sACE2) and soluble TMPRSS2 (sTMPRSS2) level was measured by enzyme-linked immunosorbent assay, and the values underwent a natural log transformation. Associations between sACE2 and TMPRSS2 levels and various clinical variables were analyzed. Results: The patients younger than 70 years old, those with eosinophilic asthma (eosinophils ≥ 200 cells/µL), and inhaled corticosteroids (ICS) non-users were associated with higher levels of sACE2. Blood eosinophils and fractionated exhaled nitric oxide levels were positively correlated with serum ACE2. In contrast, lower levels of sTMPRSS2 were noted in patients below 70 years and those with eosinophilic asthma, while no association was noted between ICS use and sTMPRSS2. The level of sTMPRSS2 also differed according to sex, smoking history, coexisting hypertension, and forced expiratory volume in 1 second/forced vital capacity (FEV1/FVC) ratio. The proportion of sputum neutrophils was positively correlated with sTMPRSS2, while the FEV1/FVC ratio reported a negative correlation with sTMPRSS2. Conclusion The levels of ACE2 and TMPRSS2 were differently expressed according to age, ICS use, and several inflammatory markers. These findings suggest variable susceptibility and prognosis of SARS-CoV-2 infection among asthmatic patients.