The original version of this article contained wrong informations of some authors which should be changed.

BACKGROUND AND PURPOSE: Nonmotor symptoms (NMS) in Parkinson's disease (PD) have multisystem origins with heterogeneous manifestations that develop throughout the course of PD. NMS are increasingly recognized as having a significant impact on the health-related quality of life (HrQoL). We aimed to determine the NMS presentation according to PD status, and the associations of NMS with other clinical variables and the HrQoL of Korean PD patients. METHODS: We surveyed patients in 37 movement-disorders clinics throughout Korea. In total, 323 PD patients were recruited for assessment of disease severity and duration, NMS, HrQoL, and other clinical variables including demographics, cognition, sleep scale, fatigability, and symptoms. RESULTS: In total, 98.1% of enrolled PD subjects suffered from various kinds of NMS. The prevalence of NMS and scores in each NMS domain were significantly higher in the PD group, and the NMS worsened as the disease progressed. Among clinical variables, disease duration and depressive mood showed significant correlations with all NMS domains (p<0.001). NMS status impacted HrQoL in PD (rS=0.329, p<0.01), and the association patterns differed with the disease stage. CONCLUSIONS: The results of our survey suggest that NMS in PD are not simply isolated symptoms of degenerative disease, but rather exert significant influences throughout the disease course. A novel clinical approach focused on NMS to develop tailored management strategies is warranted to improve the HrQoL in PD patients.
Cognition ; Demography ; Humans ; Korea ; Movement Disorders* ; Parkinson Disease* ; Prevalence ; Quality of Life*

BACKGROUND AND PURPOSE: Charcot-Marie-Tooth disease (CMT) type 1A (CMT1A) is the demyelinating form of CMT that is significantly associated with PMP22 duplication. Some studies have found that the disease-related disabilities of these patients are correlated with their compound muscle action potentials (CMAPs), while others have suggested that they are related to the nerve conduction velocities. In the present study, we investigated the correlations between the disease-related disabilities and the electrophysiological values in a large cohort of Korean CMT1A patients. METHODS: We analyzed 167 CMT1A patients of Korean origin with PMP22 duplication using clinical and electrophysiological assessments, including the CMT neuropathy score and the functional disability scale. RESULTS: Clinical motor disabilities were significantly correlated with the CMAPs but not the motor nerve conduction velocities (MNCVs). Moreover, the observed sensory impairments matched the corresponding reductions in the sensory nerve action potentials (SNAPs) but not with slowing of the sensory nerve conduction velocities (SNCVs). In addition, CMAPs were strongly correlated with the disease duration but not with the age at onset. The terminal latency index did not differ between CMT1A patients and healthy controls. CONCLUSIONS: In CMT1A patients, disease-related disabilities such as muscle wasting and sensory impairment were strongly correlated with CMAPs and SNAPs but not with the MNCVs or SNCVs. Therefore, we suggest that the clinical disabilities of CMT patients are determined by the extent of axonal dysfunction.
Action Potentials ; Axons ; Charcot-Marie-Tooth Disease ; Cohort Studies ; Humans ; Muscles ; Neural Conduction

The publisher wishes to apologize for incorrectly displaying the author (Seok Beom Gwon) name. We correct his name from Seok Beom Gwon to Seok Beom Kwon.

PURPOSE: This study was performed in order to determine the changes over time in preventable and potentially preventable traumatic death rates, and to assess the factors that affected the deaths of trauma patients which occurred in Korean pre-hospital and hospital settings. METHODS: All trauma deaths occurring either in the emergency department (ED) or after admission at twenty Korean hospitals between August 2009 and July 2010 were retrospectively analyzed. The deaths were initially reviewed by a team of multidisciplinary specialists and classified into non-preventable, potentially preventable, and preventable deaths. Only preventable and potentially preventable deaths were the subject of our analysis. Structured data extraction included patient demographics, vital signs, injury severity, probability of survival, preventability of mortality, reported errors in the evaluation and management of the patient, and classification of error types (system, judgment, knowledge). RESULTS: During the study period, 446 trauma victims died in the ED or within 7 days after admission. The mean age was 52 years, 74.1% were men and the mean time from injury to death was 35.6 hours. The most common cause of death was head injury (44.7%) followed by hemorrhage (30.8%) and multi-organ failure (8.0%). The rates of preventable/potentially preventable deaths were 35.2% overall and 29.8% when limited to patients surviving to admission. Of all death classifications, 31.2% were potentially preventable and 4.0% were preventable. Errors leading to preventable death occurred in the emergency department (51.2%), pre-hospital setting (30.3%) and during inter-hospital transfer (60.8%). Most errors were related to clinical management (48.4%) and structural problems in the emergency medical system (36.5%). CONCLUSION: The preventable death rates for Korean trauma victims were higher than those found in other developed countries, possibly due to poorly established emergency medical systems for trauma victims in pre-hospital and hospital settings. A system wide approach based on the emergency medical system and well-developed in-hospital trauma teams should be adopted in order to improve the quality of care of trauma victims in Korea.
Cause of Death ; Craniocerebral Trauma ; Demography ; Developed Countries ; Emergencies ; Emergency Medical Services ; Hemorrhage ; Humans ; Judgment ; Korea ; Male ; Retrospective Studies ; Specialization ; Vital Signs

OBJECTIVE: Occupational medicine specialists in the Busan, Ulsan and Kyung-Nam areas established an area-based occupational disease surveillance system and used this system to collected case information for the purpose of preventing occupational diseases METHODS: 11 hospitals participated in this system. The authors selected five main diseases, which were hand-arm vibration syndrome (HAVS), work-related musculoskeletal disorder (WRMSD), occupational asthma, occupational skin disease and occupational lung cancer and established their case definitions. All cases were reported on the web, and real time analysis was conducted. RESULTS: Between Apri1 2001 and April 2003, 192 cases of HAVS, 118 cases of WRMSD, 33 cases of occupational asthma, 17 cases of occupational skin disease and 17 cases of occupational lung cancer (for a total of 377 cases of these five main diseases) were reported. Most of the HAVS cases came from shipbuilding, and 172 of them (92.7 %) were associated with grinding. Of the four main types of WRMSD, carpal tunnel syndrome (CTS) was the most prevalent with 46 cases and shipbuilding was also the main industry involved (83.9 %). The ergonomic risk factors involved mainly associated with the hand. In 19 (57.6 %) and 4 (12.1 %) cases of occupational asthma, the agents included isocyanate and welding fume, respectively. 64.7 % of the cases of occupational skin diseases were contact dermatitis, and organic solvents and welding fume were the main agents involved. The causative agents of occupational lung cancer included Cr, welding fume, PAH, Ni, etc. 10 (58.8 %) of the cases were diagnosed as squamous cell carcinoma and 5 (29.4 %) as adenoma. CONCLUSION: This result showed that an area-based occupational disease surveillance system might provide an effective method of evaluating the prevalence of such diseases, however the Busan, Ulsan and Kyung-Nam provinces are too large to be treated as individual areas. Therefore, the authors suggest that each province should establish its own surveillance system.
Adenoma ; Asthma, Occupational ; Busan* ; Carcinoma, Squamous Cell ; Carpal Tunnel Syndrome ; Dermatitis, Contact ; Hand ; Hand-Arm Vibration Syndrome ; Lung Neoplasms ; Occupational Diseases* ; Occupational Medicine ; Prevalence ; Risk Factors ; Skin Diseases ; Solvents ; Specialization ; Ulsan* ; Welding

OBJECTIVE: Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by increased production of cytokines, proliferation of fibroblast-like synoviocytes (FLS) and joint destruction. It is well known that the involved joints in RA are hypoxic. Hypoxia may play a role in the pathogenesis of RA. We thought that hypoxia might alter the production of cytokines by FLS and these changes could affect the biologic behaviors of FLS. Based on that, we investigated whether hypoxia affects the production of cytokines in FLS and the effect of these changes on matrix metalloproteinases (MMPs) expression. METHODS: Fibroblast-like synoviocytes from human rheumatoid synovial tissue obtained duringjoint replacement surgery were cultured in vitro. Hypoxic culture was performed by incubating cells in BBL? Gaspak pouchTM anaerobic system. After incubation under hypoxic condition for 24 hr, the concentrations of various cytokines in culture supernatants were determined by ELISA. To determine the effect of highly expressed cytokines on MMP expression, we performed ELISA of MMP-1, MMP-2 and MMP-3 in cultured FLS, after stimulation with respective cytokines. RESULTS: In hypoxic state, IL-6, IL-8 and vascular endothelial growth factor (VEGF) concentrations were significantly increased compared to those in normoxic condition. However, there were little differences in IL-1, IL-2, IL-4, TNF-alpha and TGF-beta. Stimulation of FLS with IL-6 and IL-8 showed the increased concentrations of MMP-1, MMP-2 and MMP-3. CONCLUSION: Hypoxic environment of rheumatoid synovium might affect FLS to produce proinflammatory and proangiogenic cytokine such as IL-6 and IL-8. These cytokines again could stimulate MMPs production in FLS leading to joint destruction.
Anoxia* ; Arthritis, Rheumatoid ; Cytokines ; Enzyme-Linked Immunosorbent Assay ; Humans ; Interleukin-1 ; Interleukin-2 ; Interleukin-4 ; Interleukin-6 ; Interleukin-8 ; Joints ; Matrix Metalloproteinases ; Synovial Membrane ; Transforming Growth Factor beta ; Tumor Necrosis Factor-alpha ; Vascular Endothelial Growth Factor A

An 51-year-old woman presented with microscopic hematuria without protenuria for long time. Laboratory studies demonstrated the presence of red blood cells in urine, a normal serum IgM level, the absence of antinuclear antibodies, and a normal complement level. Renal biopsy revealed that some glomeruli are enlarged with endocapillary cell proliferation and a few glomeruli exhibit prominent vascular pole of the tufts and segmental increase in mesangial cell and matrix. Immunofluorescence studies demonstrated segmental granular deposits for IgM. Electron microscopy showed well-preserved foot process associated with focal effacement. Biopsy findings were consistent with IgM nephropathy. We present this case to promote understanding of the pathogenesis of IgM nephropathy.
Antibodies, Antinuclear ; Biopsy ; Cell Proliferation ; Complement System Proteins ; Erythrocytes ; Female ; Fluorescent Antibody Technique ; Foot ; Hematuria ; Humans ; Immunoglobulin M* ; Mesangial Cells ; Microscopy, Electron ; Middle Aged ; Proteinuria*

A renin- or angiotensin-II responsive aldosterone producing tumor is a rare cause of primary hyperaldosteronism. This tumor can be identified by tests that show that the aldosterone producing adrenal tumor is not fully autonomous. In other words partially it is responsible for the stimulation of aldosterone secretion that results aldosterone levels in an increase in serum in response to the upright posture and spironolactone treatment. Furthermore, the urinary 18-hydroxycortisol level is within the normal range. Because of different responses to surgical removal, the differential diagnosis of the causes of primary aldosteronism can't be overemphasized even for rare causes of primary aldosteronism such as unilateral nodular hyperplasia or a renin-responsible aldosterone producing tumor. We should consider renin or angiotensin-II responsive adrenal adenoma in the differential diagnosis of primary aldosteronism when biochemical data shows atypical results. Here we present the first case in Korea of a renin-responsive aldosterone producing adrenal adenoma which was fully accessible and was successfully treated by surgical removal. Also, sampling for aldosterone secretion just above the insertion site in the left renal vein before surgery showed a suspiciously abberant left adrenal vein drainage into the IVC, This was very helpful information during adrenal vein ligation in laparoscopic adrenalectomy.
Adenoma ; Adrenalectomy* ; Aldosterone ; Cushing Syndrome* ; Diagnosis, Differential ; Drainage ; Female ; Humans ; Hyperaldosteronism ; Hyperplasia ; Korea ; Ligation ; Posture ; Pregnancy ; Pregnancy Trimester, Third* ; Pregnant Women* ; Reference Values ; Renal Veins ; Renin ; Spironolactone ; Veins

The hemodynamic effects of thyroid hormones which is well established, affect myocardial contractility, heart rate, and myocardial oxygen consumption. The alterations in thyroid function test are frequently seen in patients with nonthyroidal illness and often correlate with the severity of the illness and the prognosis. In this study, thyroid hormone changes were investigated in 20 patients who received cardiopulmonary bypass(CPB). All patients showed a state of biochemical euthyroidism preoperatively. The results were as follows : 1. Serum triiodothyronine(T3) reached to its nadir(30.05+/-17.5ng/dl, p<0.001) at 10 minutes after the start of CPB and remained low(p<0.05) throughout the study period. 2. Serum thyroxine(T4) concentration slightly decreased after CPB, but maintained within normal range. 3. Serum free thyroxine(fT4) concentration slightly increased after CPB, but maintained within normal range. 4. Serum thyroid stimulating hormone(TSH) concentration increased 10 minute after CPB, reached to its nadir(3.37+/-0.81uIU/ml, p<0.001) at 2 hours after CPB. After then, serum TSH concentration decreased and reached its normal levels at 24 hours after CPB. 5. The patients whose postoperative recovery was uneventful(Group 1) had higher serum T3 levels than those who had postoperative complications(Group 2)(p<0.05). Group 1 showed elevating patterns of serum T3 in the fourth day after operation, whereas group 2 did not show such an elevating pattern. These findings are similar to the euthyroid sick syndrome seen in severely ill patients and indicate that patients undergoing open heart surgery have suppression of the pituitary-thyroid axis.
Axis, Cervical Vertebra ; Euthyroid Sick Syndromes ; Heart* ; Hemodynamics ; Humans ; Myocardial Contraction ; Oxygen Consumption ; Prognosis ; Reference Values ; Thoracic Surgery* ; Thyroid Function Tests ; Thyroid Gland* ; Thyroid Hormones