Background: This study aimed to investigate real-world data of C-terminal telopeptide (CTX), propeptide of type I collagen (P1NP), and osteocalcin through present multicenter clinical study, and retrospectively analyze the usefulness of bone turnover markers (BTMs) in Koreans. Methods: The study focused on pre- and post-menopausal patients diagnosed with osteoporosis and excluded patients without certain test results or with test intervals of over 1 year. The demographic data and 3 BTMs (CTX, P1NP, and osteocalcin) were collected. The patients were classified by demographic characteristics and the BTM concentrations were analyzed by the group. Results: Among women with no history of fractures, the levels of P1NP (N=2,100) were 43.544±36.902, CTX (N=1,855) were 0.373 ±0.927, and osteocalcin (N=219) were 10.81 ±20.631. Among men with no history of fractures, the levels of P1NP (N=221) were 48.498±52.892, CTX (N=201) were 0.370±0.351, and osteocalcin (N=15) were 7.868 ±10.674. Treatment with teriparatide increased the P1NP levels after 3 months in both men and women, with a 50% increase observed in women. Similarly, treatment with denosumab decreased the CTX levels after 3 months in both men and women, with a reduction of 50% observed in women. Conclusions The results of this study can contribute to the accurate assessment of bone replacement status in Koreans. We also provide the P1NP level in the Korean population for future comparative studies with other populations.

Background: Several studies have reported associations between obesity and autonomic dysfunction. However, little research has investigated the effect of bariatric surgery on heart rate recovery (HRR) in the treadmill test and heart rate variability (HRV) in 24-hour Holter monitoring. We investigated the effects of bariatric surgery on HRR and HRV, which are parameters related to autonomic dysfunction. Methods: We retrospectively investigated patients who underwent bariatric surgery in 2019. The treadmill test, 24-hour Holter monitoring, and echocardiography were performed before and 6 months after surgery. We compared the changes in HRR in the treadmill test and HRV parameters such as the time domain and spectral domain in 24-hour Holter monitoring before and after surgery. Results: Of the 40 patients who underwent bariatric surgery, 25 patients had the treadmill test or 24-hour Holter monitoring both before and after surgery. Body weight and body mass index significantly decreased after surgery (112.86±24.37 kg vs. 89.10±20.26 kg, p<0.001; 39.22±5.69 kg/m2 vs. 31.00±5.09 kg/m2, p<0.001, respectively). HRR significantly increased (n=23; 43.00±20.97 vs. 64.29±18.49, p=0.001). The time domain of HRV parameters increased (n=21; standard deviation of the N-N interval 123.57±28.05 vs. 152.57±39.49, p=0.002 and mean N-N interval 791.57±88.84 vs. 869.05±126.31, p=0.002). Conclusions Our data showed that HRR after exercise and HRV during 24-hour Holter monitoring improved after weight reduction with bariatric surgery through improved cardiac autonomic function.

Background: We aimed to evaluate the clinicopathological features and biological behaviors of Korean thyroid cancer patients with rare variants of papillary thyroid carcinoma (PTC) to address the ambiguity regarding the prognostic consequences of these variants. Methods: We retrospectively reviewed the medical records of 5,496 patients who underwent thyroid surgery for PTC, between January and December 2012, in nine tertiary hospitals. Rare PTC variants included tall cell (TCV), columnar cell (CCV), diffuse sclerosing (DSV), cribriform-morular (CMV), solid (SV), hobnail, and Warthin-like variants. Recurrence-free survival (RFS) was defined as the time from the date of thyroidectomy until recurrence. Results: Rare variants accounted for 1.1% (n=63) of the PTC patients; with 0.9% TCV, 0.02% CCV, 0.1% DSV, 0.1% CMV, and 0.1% SV. The mean age of patients and primary tumor size were 42.1±13.1 years and 1.3±0.9 cm, respectively. Extrathyroidal extension and cervical lymph node metastasis were observed in 38 (60.3%) and 37 (58.7%) patients, respectively. Ultrasonographic findings revealed typical malignant features in most cases. During a median follow-up of 7 years, 6.3% of patients experienced a locoregional recurrence. The 5-year RFS rates were 71.4% in patients with DSV or SV, 95.9% for TCV, or CCV, and 100% for other variants. DSV emerged an independent risk factor associated with shorter RFS. Conclusion In this multicenter Korean cohort, rare variants accounted for 1.1% of all PTC cases, with TCV being the most frequent subtype. DSV emerged as a significant prognostic factor for RFS.

Background: We aimed to evaluate the clinicopathological features and biological behaviors of Korean thyroid cancer patients with rare variants of papillary thyroid carcinoma (PTC) to address the ambiguity regarding the prognostic consequences of these variants. Methods: We retrospectively reviewed the medical records of 5,496 patients who underwent thyroid surgery for PTC, between January and December 2012, in nine tertiary hospitals. Rare PTC variants included tall cell (TCV), columnar cell (CCV), diffuse sclerosing (DSV), cribriform-morular (CMV), solid (SV), hobnail, and Warthin-like variants. Recurrence-free survival (RFS) was defined as the time from the date of thyroidectomy until recurrence. Results: Rare variants accounted for 1.1% (n=63) of the PTC patients; with 0.9% TCV, 0.02% CCV, 0.1% DSV, 0.1% CMV, and 0.1% SV. The mean age of patients and primary tumor size were 42.1±13.1 years and 1.3±0.9 cm, respectively. Extrathyroidal extension and cervical lymph node metastasis were observed in 38 (60.3%) and 37 (58.7%) patients, respectively. Ultrasonographic findings revealed typical malignant features in most cases. During a median follow-up of 7 years, 6.3% of patients experienced a locoregional recurrence. The 5-year RFS rates were 71.4% in patients with DSV or SV, 95.9% for TCV, or CCV, and 100% for other variants. DSV emerged an independent risk factor associated with shorter RFS. Conclusion In this multicenter Korean cohort, rare variants accounted for 1.1% of all PTC cases, with TCV being the most frequent subtype. DSV emerged as a significant prognostic factor for RFS.

BACKGROUND: AND PURPOSE: The aim of this study was to determine the diagnostic performance and safety of a new ¹⁸F-labeled amyloid tracer, ¹⁸F-FC119S. METHODS: This study prospectively recruited 105 participants, comprising 53 with Alzheimer's disease (AD) patients, 16 patients with dementia other than AD (non-AD), and 36 healthy controls (HCs). In the first screening visit, the Seoul Neuropsychological Screening Battery cognitive function test was given to the dementia group, while HC subjects completed the Korean version of the Mini Mental State Examination. Individuals underwent ¹⁸F-FC119S PET, ¹⁸F-fluorodeoxyglucose (FDG) PET, and brain MRI. The diagnostic performance of ¹⁸F-FC119S PET for AD was compared to a historical control (comprising previously reported and currently used amyloid-beta PET agents), ¹⁸F-FDG PET, and MRI. The standardized uptake value (SUV) ratio (ratio of the cerebral cortical SUV to the cerebellar SUV) was measured for each PET data set to provide semiquantitative analysis. All adverse effects during the clinical trial periods were monitored. RESULTS: Visual assessments of the ¹⁸F-FC119S PET data revealed a sensitivity of 92% and a specificity of 84% in detecting AD. ¹⁸F-FC119S PET demonstrated equivalent or better diagnostic performance for AD detection than the historical control, ¹⁸F-FDG PET (sensitivity of 80.0% and specificity of 76.0%), and MRI (sensitivity of 98.0% and specificity of 50.0%). The SUV ratios differed significantly between AD patients and the other groups, at 1.44±0.17 (mean±SD) for AD, 1.24±0.09 for non-AD, and 1.21±0.08 for HC. No clinically significant adverse effects occurred during the trial periods. CONCLUSIONS ¹⁸F-FC119S PET provides high sensitivity and specificity in detecting AD and therefore may be considered a useful diagnostic tool for AD.

OBJECTIVE: Focused assessment with sonography for trauma (FAST) is used routinely for evaluating patients with major trauma. After a primary survey, the existence of hemoperitoneum or hemopericardium must be searched using FAST. Traditionally, hemopericardium can be assessed through the subcostal approach with the curved probe for the abdomen. On the other hand, satisfactory images (four chamber view) are difficult to obtain with this approach. METHODS: This was a prospective, single-center pilot study of an academic tertiary medical center. When FAST is performed on the patients, traditional FAST (subcostal approach with the curved probe) is generally conducted. During a FAST examination, the time consumed, numeric rating scale (NRS) for pain, and success rate of satisfactory images are recorded. After the traditional FAST was used, we used the curved probe like echo probe. The curved probe was positioned beside the left nipple with the probe marker opposite-sided (modified FAST) like the parasternal long-axis view of echocardiography. Finally, the existence of hemopericardium is confirmed using an echo probe. In this study, the consumed time, NRS, and success rate of satisfactory images were compared. RESULTS: The consumed time was shorter (57.4 vs. 71.2 seconds, P<0.001) and the pain score was lower (0.1 vs. 1.8, P<0.001) with the modified FAST compared to the traditional FAST. Satisfactory images were obtained in 23 cases (51%) with traditional FAST, whereas satisfactory images were obtained in 37 cases (82%) using modified FAST. CONCLUSION: Mvodified FAST is more accurate for the detection of hemopericardium than traditional FAST. The pain is less severe and the time consumed is shorter.
Abdomen ; Advanced Trauma Life Support Care ; Echocardiography ; Hand ; Hemoperitoneum ; Humans ; Nipples ; Pericardial Effusion ; Pilot Projects ; Prospective Studies ; Ultrasonography

BACKGROUND: The objective of this study was to compare differences in lifestyle diseases, musculoskeletal pain, psychosocial stress, and self-health awareness according to gender in Korean farmers. METHODS: The study population comprised 436 farmers residing in rural areas in Korea. A self-administered questionnaire was used to survey demographic characteristics, health-related behaviors, and musculoskeletal pain. The psychosocial well-being index short form (PWI-SF) was used to survey psychosocial stress, and the 12-item short form health survey (SF-12) was used to survey self-health awareness. In addition, a clinical examination was performed for each participant, and lifestyle diseases were identified through a health checkup. RESULTS: Among lifestyle diseases, females showed a significantly higher proportion than males for metabolic syndrome (OR: 4.57 [95% CI, 1.67–12.51]). For musculoskeletal pain, females again showed significantly higher proportion than males for hand pain (OR: 16.79 [95% CI, 3.09–91.30]), and pain in at least one body part (OR: 2.34 [95% CI, 1.16–4.70]). For psychosocial stress, females showed a significantly higher proportion than males for high-risk stress (OR: 3.10 [95% CI, 1.17–8.24]). Among the items in self-health awareness, females showed significantly higher proportion than males for mental component score (MCS) (OR: 3.10 [95% CI, 1.52–6.31]) and total score (OR: 2.34 [95% CI, 1.11–4.90]). CONCLUSIONS: For all items that showed significant differences, females showed higher proportion than males, which indicates that female farmers tended to have poorer overall health than male farmers. Therefore, specialized programs will have to be developed to improve the health of female farmers.
Farmers ; Female ; Hand ; Health Surveys ; Humans ; Korea ; Life Style ; Male ; Musculoskeletal Diseases ; Musculoskeletal Pain

BACKGROUND: This study was conducted to identify the sleep status of daytime workers who do not work in shifts. This study analyzed factors affecting sleep duration and sleep quality. METHODS: This study was conducted on 1171 daytime workers at a manufacturing workshop. We used a self-administered questionnaire to investigate demographic variables, work type, working period, musculoskeletal symptoms and the Pittsburgh Sleep Quality Index to assess sleep. Regular health checkup was conducted for the worker’s clinical examination. RESULTS: The mean sleep duration was 6.36 h and the mean score on the Pittsburgh Sleep Quality Index was 4.46. Work type and obesity were related to sleep duration. Age, obesity and musculoskeletal pain were significantly related to sleep quality. The prevalence ratio of researcher group for short sleep duration was 1.27 (95% confidence interval: 1.02–1.58). The prevalence ratio of those aged 50 years and over was 0.47 (0.25–0.91) and of those in their 40s was 0.56 (0.35–0.91) for poor sleep quality compared to those in their 20s. The prevalence ratio of the obesity group for poor sleep quality was 1.53 (1.10–2.12). The prevalence ratio of musculoskeletal pain group for poor sleep quality was 1.92 (1.29–2.84). CONCLUSIONS: Age, obesity and musculoskeletal pain were factors affecting the poor quality on sleep of daytime workers. In addition, work type related to short sleep duration.
Education ; Musculoskeletal Pain ; Obesity ; Prevalence

PURPOSE: A morphologic contour method for assessing an exophytic renal mass as benign versus malignant on the basis of the shape of the interface with the renal parenchyma was recently developed. We investigated the usefulness of this morphologic contour method for predicting angiomyolipoma (AML) in patients who underwent partial nephrectomy for small renal masses (SRMs). MATERIALS AND METHODS: From January 2004 to March 2013, among 197 patients who underwent partial nephrectomy for suspicious renal cell carcinoma (RCC), the medical records of 153 patients with tumors (AML or RCC) < or =3 cm in diameter were retrospectively reviewed. Patient characteristics including age, gender, type of surgery, size and location of tumor, pathologic results, and specific findings of the imaging study ("ice-cream cone" shape) were compared between the AML and RCC groups. RESULTS: AML was diagnosed in 18 patients and RCC was diagnosed in 135 patients. Gender (p=0.001), tumor size (p=0.032), and presence of the ice-cream cone shape (p=0.001) showed statistically significant differences between the AML group and the RCC group. In the multivariate logistic regression analysis, female gender (odds ratio [OR], 5.20; 95% confidence interval [CI], 1.45 to 18.57; p=0.011), tumor size (OR, 0.34; 95% CI, 0.12 to 0.92; p=0.034), and presence of the ice-cream cone shape (OR, 18.12; 95% CI, 4.97 to 66.06; p=0.001) were predictors of AML. CONCLUSIONS: This study confirmed a high incidence of AML in females. Also, the ice-cream cone shape and small tumor size were significant predictors of AML in SRMs. These finding could be beneficial for counseling patients with SRMs.
Angiomyolipoma ; Carcinoma, Renal Cell ; Counseling ; Diagnostic Imaging ; Female ; Humans ; Incidence ; Kidney ; Logistic Models ; Medical Records ; Nephrectomy ; Retrospective Studies

Bloodstain pattern analysis is a forensic discipline that reconstruct events of a crime scene by analyzing sizes, shapes, distributions, positions of bloodstains. Bloodstain pattern can be classified into the low velocity, medium velocity, and high velocity system. Velocities in this system represent the velocity of the wounding agent (the force applied) and not to the velocity of the blood in flight. Thus there is no reference system about the velocity of the blood in flight in the existing bloodstain classification system. Applying bloodstain pattern analysis to the real crime case, we needed to have the reference system of velocities of impact spatter, cast-off spatter, and expectorate spatter. Therefore we measured the velocities of these spatters using high speed camera and we analyzed the results. In this experiments the average velocity of impact spatter that generated by swinging a hammer with all experimenter's strength at the pool of blood is about 4.7 times faster than that of swing cast-off spatter that generated by swinging a red-wat hammer with all experimenter's strength, and about 3.9 times faster than that of expectorate spatter that generated by emitting blood from the mouth with all experimenter's strength. The velocities of cast-off spatter and expectorate spatter, however, showed similar distributions. Our experiments that measure the velocities of droplets of blood spatters in flight under the specific conditions that generated at fastest speed can give some reference to the classification system of velocities of bloodstains which is not distinct up to now, as well as some real bloodshed crime cases.
Crime ; Enzyme Multiplied Immunoassay Technique ; Mouth