Objective: Primary frozen shoulder causes significant pain and progressively restricts shoulder movements. Diagnosis is made clinically based on patient history and physical examination. Management is mainly non-invasive owing to its self-limiting clinical course. However, clinical practice guidelines for frozen shoulder have not yet been developed in Korea. The developed guidelines aim to provide evidence-based recommendations for the diagnosis and treatment of frozen shoulder. Methods: A guideline development committee reviewed the literature from four databases (PubMed, Embase, Cochrane Library, and KMbase). Using the Population, Intervention, Comparator, and Outcome (PICO) framework, the committee formulated two backgrounds and 16 key questions to address common clinical concerns. Recommendations were made using the Grading of Recommendations, Assessment, Development, and Evaluation framework. Results: Diabetes, thyroid disease, and dyslipidemia significantly increase the risk of developing a frozen shoulder. Although frozen shoulder is often self-limiting, some patients may experience long-term functional disabilities. Ultrasound and magnetic resonance imaging should be used as adjunctive tools alongside clinical diagnosis, and rather than as independent diagnostic methods. Noninvasive approaches, such as medications, physical modalities, exercises, electrical stimulation, and manual therapy, may reduce pain and improve shoulder function. Other noninvasive interventions have limited evidence, and their application should be based on clinical judgment. Intra-articular steroid injections are recommended for treatment, and physiotherapy or hydrodilation with steroid injections can also be beneficial. Conclusion These guidelines provide evidence-based recommendations for diagnosing and treating primary frozen shoulder.

Objectives: . The relationships among positional obstructive sleep apnea (POSA), obstructive sleep apnea (OSA), and periodic limb movements during sleep (PLMS) remain unclear. We investigated these relationships with respect to the severity of OSA and explored the underlying mechanisms. Methods: . We retrospectively reviewed 6,140 eligible participants who underwent full-night diagnostic polysomnography at four clinical centers over a 5-year period, utilizing event-synchronized analysis. We evaluated the periodic limb movement index (PLMI) and the periodic limb movement with arousal index (PLMAI). The impacts of POSA on the PLMI, PLMAI, and PLMS were analyzed in relation to the severity of OSA. Results: . The mean PLMI, the mean PLMAI, and the prevalence of PLMS were significantly lower in participants with severe OSA compared to the mild and moderate OSA groups. The mean PLMI among those with mild OSA exceeded that of control participants. Furthermore, the mean PLMI (4.8±12.7 vs. 2.6±9.8 events/hr, P<0.001), the mean PLMAI (0.9±3.7 vs. 0.5±3.3 events/hr, P<0.001), and the prevalence of PLMS (11% vs. 5.3%, P<0.001) were higher in patients with POSA than in those with non-positional OSA. This PLMS finding was particularly pronounced among those with severe OSA (odds ratio [OR], 1.554; 95% confidence interval [CI], 1.065–2.267) and was less evident in the mild (OR, 0.559; 95% CI, 0.303–1.030) and moderate (OR, 1.822; 95% CI, 0.995–3.339) groups. Conclusion . Patients with POSA, especially those with severe OSA, exhibit a comparatively high prevalence of PLMS. In cases involving prominent PLMS, the diagnosis and treatment of POSA and OSA should be considered.

Background/Aims: The risk for colonoscopic postpolypec-tomy bleeding (PPB) in patients with chronic liver disease (CLD) remains unclear. We determined the incidence and risk factors for colonoscopic PPB in patients with CLD, espe-cially those with liver cirrhosis. Methods: We retrospectively reviewed the medical records of patients with CLD who un-derwent colonoscopic polypectomy at Seoul National Univer-sity Hospital between 2011 and 2014. The study endpoints were immediate and delayed PPB. Results: A total of 1,267 consecutive patients with CLD were included in the study. Im-mediate PPB occurred significantly more often in the ChildPugh (CP) B or C cirrhosis group (17.5%) than in the CP-A (6.3%) and chronic hepatitis (4.6%) groups (p<0.001). More-over, the incidence of delayed PPB in the CP-B or C cirrhosis group (4.4%) was significantly higher than that in the CP-A (0.7%) and chronic hepatitis (0.2%) groups (p<0.001). The independent risk factors for immediate PPB were CP-B or C cirrhosis (p=0.011), a platelet count <50,000/μL (p<0.001), 3 or more polyps (p=0.017), endoscopic mucosal resection or submucosal dissection (p<0.001), and polypectomy per-formed by trainees (p<0.001). The independent risk factors for delayed PPB were CP-B or C cirrhosis (p=0.009), and pol-yps >10 mm in size (p=0.010). Conclusions Patients with CP-B or C cirrhosis had an increased risk for bleeding fol-lowing colonoscopic polypectomy.

PURPOSE: This study examined dietary and health characteristics of the young-old and the old-old by food security status. METHODS: The study used data from the 6th (2013 ~ 2015) Korea National Health and Nutrition Examination Survey. The study subjects consisted of 3,948 subjects, of whom 2,445 were the young-old (aged 65 to 74 years) and 1,503 were the old-old (aged 75 years and over). Food security status was evaluated using an 18-item questionnaire. Energy intake, nutrient densities, and prevalence of insufficient nutrient intake were assessed. Food intake was evaluated in terms of the number of food group servings. Dietary behaviors and health status were also assessed. RESULTS: The prevalence of food insecurity among the young-old and the old-old was 10.0% and 11.6%, respectively. Among the young-old, the food insecure group had a significantly higher level of prevalence of insufficient intake for all the nutrients (protein, vitamin A, thiamin, riboflavin, niacin, vitamin C, calcium, phosphorous, and iron) assessed in this study compared with the food secure group. In case of the old-old, significant differences were found only for four nutrients (protein, riboflavin, niacin, and phosphorus) in the prevalence of insufficient nutrient intake between the food secure and the food insecure groups. Kinds of food groups with significantly different numbers of servings by food security status were dissimilar between the two age groups. In both the age groups, the food insecure group consumed a significantly lower number of servings in meat·fish·eggs·legumes and fruits than the food secure group; grains and vegetables intake in the young-old and oils·sweets intake in the old-old differed in the number of servings by food security status. Among the young-old, the prevalence of chewing difficulties in the food insecure group was significantly higher than that of the food secure group, while among the old-old, no significant differences were found by food security status. CONCLUSION: Dietary and health characteristics of the young-old and the old-old differed by food security status. Such differences were more apparent in the young-old than the old-old. Therefore, it is suggested that food and nutrition assistant programs should be designed with consideration of the differences.
Ascorbic Acid ; Calcium ; Diet ; Eating ; Energy Intake ; Food Supply ; Fruit ; Humans ; Korea ; Mastication ; Niacin ; Nutrition Surveys ; Prevalence ; Riboflavin ; Vegetables ; Vitamin A

OBJECTIVES: This study compared the nutritional status of child-bearing age women between the Democratic People's Republic of Korea (North Korea) and the Republic of Korea (South Korea). METHODS: The data presented in the DPRK Final Report of the National Nutrition Survey 2012 was utilized for the nutritional status and food intake of North Korean women. To produce the South Korean women's data comparable to those of North Korean women, the data from the 2012 National Health and Nutrition Survey were analyzed and the data presented in the 2010 Report of the Korean Agency for Technology and Standards were utilized. RESULTS: The prevalence of maternal anemia (blood hemoglobin < 12.0 g/dL) was over 30% in all the age groups of North Korean women and 8.9%, 14.2%, 16.4% in 20-29, 30-39, 40-49 year old South Korean women, respectively. The prevalence of maternal protein-energy malnutrition (Mid-Upper Arm Circumference < 22.5 cm) was 25.2%, 21.4%, 21.8% in 20-29, 30-39, 40-49 year old North Korean women, respectively and less than 10% in all the age groups of South Korean women. Result of dietary diversity comparison showed that North Korean women consumed less food than South Korean women at all food groups: grains, fruits, vegetables, meat, and dairy. Percentage of North Korean women having consumed protein rich foods-meat and fish, eggs or dairy products-were much lower than those of South Korean women. CONCLUSIONS: The striking disparity of nutritional status between South and North Korean women indicates that nutrition support for North Korean women is essential in the process of preparation for a unified nation.
Anemia ; Arm ; Democratic People's Republic of Korea* ; Eating ; Eggs ; Female ; Fruit ; Humans ; Meat ; Nutrition Surveys ; Nutritional Status ; Ovum ; Prevalence ; Protein-Energy Malnutrition ; Republic of Korea ; Strikes, Employee ; Vegetables

Retroperitoneal tumors are rare. They are asymptomatic, and are often found incidentally on abdominal computed tomograms (CTs). The patient reported here visited our hospital complaining of right flank pain. On abdominal CTs, a left-side retroperitoneal mass and a right ureteral stone were found. The hormonal study was normal. After surgical excision, the tumor was confirmed to be a bronchogenic cyst histologically, a very rare cause of retroperitoneal tumor. Our medical center has seen 15 cases with a soft tissue mass in retroperitoneal space over the past 5 years. Benign tumors were incidentally, while malignant tumors were often diagnosed after the patient complained of a palpable mass. In many of these cases, the radiologic impressions and pathologic diagnosis were inconsistent.
Bronchogenic Cyst* ; Diagnosis ; Flank Pain ; Humans ; Retroperitoneal Neoplasms ; Retroperitoneal Space ; Tomography, X-Ray Computed ; Ureter

OBJECTIVES: To investigate the association between BMI and Mortality. METHODS: This study was based on the analysis and assembly of the 'Kangwha Cohort Study', previously conducted by the Department of Preventive Medicine, Yonsei University. A total of 2,696 males and 3,595 females were followed for almost ten years and ten months from March 1985 to January 1996, a total of whom 2,420 died during this period. The Cox's proportional hazards regression model was used to analyze this data. RESULTS: We found a U-shaped relationship between BMI and mortality among the aged men in the Kangwha cohort. The hazard ratio of dying was adjusted for age, marital status, occupation, self cognitive health level, chronic disease, smoking, and alcohol frequency, then sorted by body mass index into the following groups; less than 18.5, 18.5 to less than 21.0, 21.0 to less than 23.5, 23.5 to less than 26.0 and greater than or equal to 26. The corresponding ratios for men were 1.81(1.50-2.19, 95%CI), 1.31(1.14-1.51, 95%CI), 1.0(referent), 1.05(0.87-1.26, 95%CI) and 1.39(1.09-1.76, 95%CI), respectively. And for women, 1.46(1.19-1.78), 1.12(0.95-1.31, 95%CI), 1.0(referent), 1.00(0.84-1.20, 95%CI) and 1.09(0.89-1.34, 95%CI), respectively. CONCLUSIONS: The risk of death among aged men in Kangwha increased in the under and overweight groups. The relationship between BMI and mortality has been well studied in Western populations, but little is known about the association between BMI and mortality in our country. So, on the basis of this study, it is apparent that more studies of the relationship between BMI and mortality will be needed for future work.
Body Mass Index ; Chronic Disease ; Cohort Studies* ; Female ; Health Status ; Humans ; Male ; Marital Status ; Mortality* ; Occupations ; Overweight ; Preventive Medicine ; Smoke ; Smoking