Purpose: We investigated whether response classification after total thyroidectomy and radioactive iodine (RAI) therapy could be affected by serum levels of recombinant human thyrotropin (rhTSH)-stimulated thyroglobulin (Tg) measured at different time points in a follow-up of patients with papillary thyroid carcinoma (PTC). Methods: A total of 147 PTC patients underwent serum Tg measurement for response assessment 6 to 24 months after the first RAI therapy. Serum Tg levels were measured at 24 h (D1Tg) and 48–72 h (D2-3Tg) after the 2nd injection of rhTSH. Responses were classified into three categories based on serum Tg corresponding to the excellent response (ER-Tg), indeterminate response (IR-Tg), and biochemical incomplete response (BIR-Tg). The distribution pattern of response classification based on serum Tg at different time points (D1Tg vs. D2-3Tg) was compared. Results: Serum D2-3Tg level was higher than D1Tg level (0.339 ng/mL vs. 0.239 ng/mL, P < 0.001). The distribution of response categories was not significantly different between D1Tg-based and D2-3Tg-based classification. However, 8 of 103 (7.8%) patients and 3 of 40 (7.5%) patients initially categorized as ER-Tg and IR-Tg based on D1Tg, respectively, were reclassified to IR-Tg and BIR-Tg based on D2-3Tg, respectively. The optimal cutoff values of D1Tg for the change of response categories were 0.557 ng/mL (from ER-Tg to IR-Tg) and 6.845 ng/mL (from IR-Tg to BIR-Tg). Conclusion D1Tg measurement was sufficient to assess the therapeutic response in most patients with low level of D1Tg. Nevertheless, D2-3Tg measurement was still necessary in the patients with D1Tg higher than a certain level as response classification based on D2-3Tg could change.

BACKGROUND: Incontinence and muscle loss are important senior health issues. Nevertheless, there are no available domestic or international studies on the association between urinary incontinence and muscle loss. The aim of this study was to investigate the association between muscle loss and urinary incontinence in elderly Korean woman. METHODS: Korean women (1,313) > or =65 years of age whose complete body composition data were collected using dual X-ray absorptiometry were analyzed from the Fourth Korean National Health and Nutritional Examination Surveys. Class I and II losses of the appendicular, truncal, and total muscle mass were defined using adjustments for weight and height. Each participant's incontinence status was collected using constructed questionnaires. Multiple logistic regression was performed to examine the association between muscle loss and incontinence. RESULTS: On the basis of physician-diagnosed incontinence, weight- and height-adjusted muscle loss showed no association with urinary incontinence (weight-adjusted muscle loss: class I adjusted odds ratio [aOR], 0.77; 95% confidence interval [CI], 0.34 to 1.73; class II aOR, 1.37; 95% CI, 0.59 to 3.18; height-adjusted muscle loss: class I aOR, 0.51; 95% CI, 0.18 to 1.51; class II aOR, 1.86; 95% CI, 0.22 to 15.79). Similar results were observed for truncal muscle and total muscle mass as well as self-reported urinary incontinence. CONCLUSION: Our study found no association between urinary incontinence and appendicular, truncal, and total muscle loss in elderly Korean women.
Absorptiometry, Photon ; Aged* ; Body Composition ; Female ; Humans ; Logistic Models ; Muscle, Skeletal ; Muscular Atrophy ; Odds Ratio ; Surveys and Questionnaires ; Urinary Incontinence*

BACKGROUND/AIMS: beta2-microglobulin (beta2-MG) is freely filtered at the glomerulus and subsequently reabsorbed and catabolized by proximal renal tubular cells. Urinary beta2-MG is an early and sensitive biomarker of acute kidney injury; however, its utility as a biomarker of immunoglobulin A nephropathy (IgAN) is unclear. METHODS: We included urinary beta2-MG levels in the routine laboratory examination of all inpatients with biopsy-proven IgAN at our hospital from 2006 to 2010. We retrospectively analyzed the correlation between beta2-MG levels and clinical parameters as a prognostic biomarker of IgAN. RESULTS: A total of 51 patients (30 males, 21 females; mean age, 33.01 +/- 12.73 years) with IgAN were included in this study. Initial demographic, clinical, and laboratory data for all patients are listed. The mean initial estimated glomerular filtration rate and 24-hour urine protein levels were 94.69 +/- 34.78 mL/min/1.73 m2 and 1.28 +/- 1.75 g/day, respectively. The mean level of urinary beta2-MG was 1.92 +/- 7.38 microg/mg creatinine. There was a significant correlation between initial serum creatinine (iSCr), urine protein creatinine ratio (UPCR), and the level of beta2-MG (r = 0.744, r = 0.667, p < 0.01). There was also a significant correlation between renal function tests and the level of urinary beta2-MG (p < 0.01). Cox regression analysis showed that albumin, beta2-MG, iSCr, and UPCR were significant predictors of disease progression in IgAN. CONCLUSIONS: Urinary beta2-MG levels showed a significant correlation with renal function and proteinuria in IgAN. Thus, we propose that urinary beta2-MG may be an additional prognostic factor in patients with IgAN.
Adult ; Biological Markers/blood/urine ; Biopsy ; Creatinine/blood/urine ; Disease Progression ; Female ; Glomerular Filtration Rate ; Glomerulonephritis, IGA/blood/diagnosis/physiopathology/*urine ; Humans ; Inpatients ; Linear Models ; Male ; Middle Aged ; Multivariate Analysis ; Predictive Value of Tests ; Prognosis ; Proportional Hazards Models ; Proteinuria/blood/diagnosis/physiopathology/*urine ; Risk Factors ; Young Adult ; beta 2-Microglobulin/*urine

BACKGROUND/AIMS: It is unknown whether pulmonary rehabilitation (PR) is an effective intervention to manage coal-worker pneumoconiosis (CWP). We evaluated the efficacy and safety of an individualized PR program in 53 patients with CWP hospitalized in two medical institutions. METHODS: The PR program consisted of upper and lower extremity exercises to improve exercise endurance and skeletal musculoskeletal strength. All subjects performed treadmill and ergometer exercise with steady loading weights three times/week for 12 weeks. The following tests were performed before and after the study to investigate the efficacy of the PR program: modified Borg scale, pulmonary function test, mid-thigh circumference, maximum muscular strength, 6-min walk distance (6MWD), and the St. George's Respiratory Questionnaire (SGRQ), Korean version. RESULTS: Forty patients (75.5%) completed their PR programs. They improved significantly on the modified Borg scale, mid-thigh circumference, maximum muscular strength, 6MWD (all p < 0.000), and SGRQ (p = 0.007); however, no significant improvement was observed on the pulmonary function test. A significant improvement in dyspnea (p = 0.004) and 6MWD (p = 0.002) was observed in 12 patients with forced expiratory volume in 1 sec < 60%. The PR program with smoking cessation resulted in significantly more improvement on the 6MWD (p < 0.0001) and the SGRQ score (p = 0.002), as compared to those of patients who did not quit smoking. CONCLUSIONS: Our results show that an individualized 12-week PR program improves exercise capacity and quality of life for patients with CWP.
Dyspnea ; Exercise ; Exercise Therapy ; Forced Expiratory Volume ; Humans ; Lower Extremity ; Pneumoconiosis* ; Quality of Life ; Surveys and Questionnaires ; Rehabilitation* ; Respiratory Function Tests ; Smoke ; Smoking ; Smoking Cessation ; Weights and Measures

BACKGROUND/AIMS: The prevalence of occult HBV infection (OBI) in patients with chronic hepatitis C (CHC) in Korea has not been reported. Additionally, it is unclear whether OBI influences treatment outcome in CHC patients. We investigated the prevalence of OBI and its impact on treatment outcome in patients with CHC. METHODS: Seventy-six patients with CHC were enrolled and treated with pegylated or conventional interferon and ribavirin. Hepatitis B virus (HBV) DNA was detected by nested polymerase chain reaction. RESULTS: Among the 68 patients who completed treatment and follow-up, HBV DNA was detected in serum from nine (13.2%) patients, liver tissue from 10 (14.7%), and serum or liver tissue from 15 (22.1%). OBI was diagnosed in nine (12.7%) control subjects. No difference in the prevalence of OBI between patients with CHC and controls was observed (13.2 vs. 12.0%; p = 0.92). No significant differences in age, sex, genotype 1 frequency, amount of hepatitis C virus RNA, anti-hepatitis B surface antigen/anti-hepatitis B core-IgG seropositivity, staging, or histology grading were observed in patients with or without HBV DNA. Sustained virological response was achieved in 73.3% of patients with OBI and 83.0% without OBI (p = 0.46). CONCLUSIONS: These results demonstrate that a significant proportion of patients with CHC have occult HBV infection and that OBI does not affect treatment outcome in patients with CHC.
DNA ; Follow-Up Studies ; Genotype ; Hepacivirus ; Hepatitis B virus ; Hepatitis C, Chronic ; Hepatitis, Chronic ; Humans ; Interferons ; Korea ; Liver ; Prevalence ; Ribavirin ; RNA ; Treatment Outcome

BACKGROUND: The value of metabolic syndrome (MetS) evaluation in predicting cardiovascular disease is recently criticized. We investigated, in hypertensive patients without diabetes mellitus, the influence of MetS on the target organ damage. METHODS: Data from the fourth Korean National Health and Nutrition Examination Survey performed in 2008 were analyzed. Metabolic syndrome is defined by the 2001 National Cholesterol Education Program-Third Adult Treatment Panel guideline. The category of hypertension is defined following the seventh report of the Joint National Commitee-7 guideline. RESULTS: The prevalence of target organ damage (TOD), defined as history of myocardial infarction/angina/stroke/chronic renal disease as well as the presence of macroalbuminuria, was increased according to blood pressure; 8.5% in the population of normal blood pressure, 12.5% in those of prehypertensive range, and 20.5% in hypertensive population. Hypertensive population associated with MetS showed greater prevalence of TOD than those without MetS even excluding diabetic population. The presence of MetS in hypertensive population showed 2.2 fold increased risk for TOD. Any single parameter of MetS diagnostic criteria as well as obesity did not show the comparable range of risk prediction as MetS. CONCLUSIONS: These results indicate a strong relationship of Mets with TOD in hypertensive population. Evaluating the metabolic components in hypertensive population is necessary in establishing management strategies for overall risk.
Adult ; Blood Pressure ; Cardiovascular Diseases ; Cholesterol ; Diabetes Mellitus ; Humans ; Hypertension ; Joints ; Nutrition Surveys ; Obesity ; Prevalence

PURPOSE: To evaluate the incidence and clinical features of age-related macular degeneration (AMD) in Korea. METHODS: Web-based (www.armd-nova.or.kr) registration was conducted for AMD patients aged 50 or more who were newly diagnosed by retinal specialists in Korea from August 20, 2005 to August 20, 2006. Patient data including ophthalmologic examination, fundus photography, fluorescein angiogram and/or indocyanin green angiogram (ICG), past medical history, behavioral habit, combined systemic diseases were up-loaded. RESULTS: Among finally enrolled 1,141 newly diagnosed AMD patients, 690 patients (60.5%) were male and 451 patients (39.5%) were female. The average age of AMD patients was 69.7+/-8.0. Early AMD was observed in 190 patients and 951 patients had late AMD. Classic choroidal neovascular membrane (CNVM) was observed in 18.6% of exudative AMD patients and 63.4 % had occult CNVM. Subfoveal CNVM was observed in 80.4% of the patients with CNVM. Among the 580 exudative AMD eyes that performed indocyanin green angiography (ICG), 184 eyes (31.7%) had polypoidal choroidal vasculopathy (PCV) and 36 eyes (6.2%) showed retinal angiomatous proliferation (RAP). Age, male gender, smoking, diabetes and hypertension significantly increased the risk of the AMD among Koreans. CONCLUSIONS: Because of the low rate of participation by retinal specialists, definite incidence of AMD was not obtainable. However, the estimated 1-year AMD incidence in the Pusan area of Korea is at least 0.4%. In contrast to Western people, 31.7% of exudative AMD cases were revealed to be PCV and 6.2% were revealed to be RAP. This discrepancy between ethnic groups should be considered in the diagnosis and treatment modality selection of Korean AMD patients.
Aged ; Angiography ; Choroid ; Ethnic Groups ; Eye ; Female ; Fluorescein ; Humans ; Hypertension ; Incidence ; Korea ; Macular Degeneration ; Male ; Membranes ; Photography ; Retinaldehyde ; Smoke ; Smoking ; Specialization

Early reduction and stabilization of the pelvic bone after traumatic unstable pelvic bone fracture is the most effective method to control life-threatening bleeding and reduce late complication. In this study, we compared the effect of the non-invasive pelvic belt on various positions, and studied the effects of weight bearing and shifting during walking on pelvic belt position. Case 1) separation of symphysis pubis; Case 2) fracture of the superior and inferior ramus of the right pubis; Case 3) fractures of the superior and inferior ramus of both pubis and separation of symphysis pubis. Pelvic belt was prescribed in all three cases. Pelvic belt reduction reduced the distance between fracture line by 40~60% at all levels. Therefore, pelvic belt reduction is recommended as a non-invasive, safe and effective rehabilitative treatment for pelvic bone fracture patients to restore function without pain or secondary injury.
Hemorrhage ; Humans ; Pelvic Bones ; Walking ; Weight-Bearing

PURPOSE: To investigate the effects of repeated photodynamic therapy (PDT) for subfoveal choroidal neovascularization secondary to age-related macular degeneration (AMD) in Korean patients. METHODS: Clinical data of patients who were treated with repeated (3 times or more) PDT for subfoveal choroidal neovascularization secondary to AMD and followed up for more than 6 months were collected from 17 hospitals around the country. Visual outcomes at 12 and 24 months, follow-up were compared between subtypes of choroidal neovascularization. The factors related to final visual prognosis and PDT-related adverse effects were evaluated. RESULTS: 244 patients (244 eyes) were recruited (male: 60%, age: 67.7+/-9.1 years). The portion of patients with predominantly classic, minimally classic, and occult without classic choroidal neovascularization was 57%, 13%, and 24%, respectively and that of patients with visual improvements or less than moderate visual loss at 24 months follow-up were 28%, 38%, 30% and 47%, 56%, and 65%, respectively. Baseline visual acuity and age were significantly related to the final visual prognosis (p<0.05). PDT-related adverse events developed in 15 (6.1%) patients, but most were mild and transient. CONCLUSIONS: Repeated PDT for subfoveal choroidal neovascularization secondary to AMD has effects comparable to those of previous prospective, controlled trials without any significant safety concerns in Korea.
Choroid* ; Choroidal Neovascularization* ; Follow-Up Studies ; Humans ; Korea ; Macular Degeneration* ; Photochemotherapy* ; Prognosis ; Visual Acuity

OBJECTIVE: The purpose of this study was to examine the long-term effects of Hospital Information System(HIS) on nurses' job pattern and satisfaction, and attitudes toward electronic medical record system. METHODS: Prospective survey using repeated measures design was performed to compare the changes between 2 years and 4 years after introduction of HIS in a tertiary hospital. Participants were 374 nurses working in the target hospital. Questionnaire was developed by researchers based on Walker, Eyman, Krall, Prophet, and Flanagan(1996)'s study and consisted of 21 questions about job pattern, job satisfaction, and attitudes toward computerization and paper record system. RESULTS: Overall time for documentation, shift reporting, communication with other departments were reduced. Otherwise, direct nursing time was not increased after HIS. Nurses showed positive responses on changes of job pattern after HIS while job satisfaction has been decreased. In addition, nurses' attitudes toward hospital information system and paper medical record system showed they were accepting computerized information system. CONCLUSION: This study identified the long-term positive effects of HIS and the need for nursing sensitive hospital information system.
Electronic Health Records ; Hospital Information Systems* ; Information Systems ; Job Satisfaction ; Medical Records ; Nursing ; Prospective Studies ; Surveys and Questionnaires ; Tertiary Care Centers