Purpose: Tumors of the foot and ankle account for approximately 3%~5% of all musculoskeletal tumors, and accurate diagnosis is often delayed due to their rare prevalence. Therefore, the authors aimed to analyze the incidence, treatment methods, and prognostic factors of foot and ankle tumors treated at the authors’ hospital. Materials and Methods: A retrospective single-center study examined 342 patients treated for foot and ankle tumors at the authors’ hospital from January 2011 to February 2022. Data were collected from the electronic medical records (EMR) and picture archiving and communication systems (PACS). The information analyzed included gender, age, follow-up period, diagnosis, tumor occurrence and recurrence, treatment, and clinical outcomes. Results: Most cases (93.3%) were benign, but 6.7% were malignant. The main treatment for malignant tumors was surgical resection (91.3%). Approximately 53.1% of benign tumors and 91.3% of malignant tumors were treated with surgery, and two of the malignant tumors that did not undergo surgery had metastatic cancer. After surgery, 8.2% of benign lesions and 19.0% of malignant lesions recurred, and 9.5% of the patients with malignant tumors died after surgery. Conclusion Most foot and ankle tumors are benign tumors, and the prognosis is not poor if treated properly, but most malignant tumors often require amputation. In some cases, however, amputation can be avoided with a combination of chemotherapy and radiation therapy.

OBJECTIVES: We estimated the population prevalence of antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), including unreported infections, through a Korea Seroprevalence Study of Monitoring of SARS-CoV-2 Antibody Retention and Transmission (K-SEROSMART) in 258 communities throughout Korea. METHODS: In August 2022, a survey was conducted among 10,000 household members aged 5 years and older, in households selected through two stage probability random sampling. During face-to-face household interviews, participants self-reported their health status, COVID-19 diagnosis and vaccination history, and general characteristics. Subsequently, participants visited a community health center or medical clinic for blood sampling. Blood samples were analyzed for the presence of antibodies to spike proteins (anti-S) and antibodies to nucleocapsid proteins (anti-N) SARS-CoV-2 proteins using an electrochemiluminescence immunoassay. To estimate the population prevalence, the PROC SURVEYMEANS statistical procedure was employed, with weighting to reflect demographic data from July 2022. RESULTS: In total, 9,945 individuals from 5,041 households were surveyed across 258 communities, representing all basic local governments in Korea. The overall population-adjusted prevalence rates of anti-S and anti-N were 97.6% and 57.1%, respectively. Since the Korea Disease Control and Prevention Agency has reported a cumulative incidence of confirmed cases of 37.8% through July 31, 2022, the proportion of unreported infections among all COVID-19 infection was suggested to be 33.9%. CONCLUSIONS The K-SEROSMART represents the first nationwide, community-based seroepidemiologic survey of COVID-19, confirming that most individuals possess antibodies to SARS-CoV-2 and that a significant number of unreported cases existed. Furthermore, this study lays the foundation for a surveillance system to continuously monitor transmission at the community level and the response to COVID-19.

Objectives: The purpose of this manuscript was to propose the policy and perspectives of prevention and management for hypertension and diabetes in Korea. Methods: Authors reviewed the chronic disease prevention and management projects and models were executed in Korea until now, and analyzed and evaluated their performances. Results: In the circumstances of Korea, the following several requisites should be improved ; Specific Korean strategy for development and pursuing of national level policy agenda for chronic disease management must be established. There are a need to establish several means of supplementing the weaknesses of the current chronic disease management policies and programs. Firstly, development and distribution of contents of guidelines on the systematic project execution regime (regarding systematization of local community, subjects and contents of the projects) with guarantee for the quality of chronic disease prevention and management are necessary. Secondly, there is a need for development of information system that can lead the chronic disease management programs currently being implemented. Thirdly, there is urgent need to develop resources such as cultivation of manpower and facilities for provision of education and consultation for the patients and holders of risk factors of chronic disease. Fourthly, there is a need for means of securing management system and financial resources for operation of policies and programs. Conclusions The results can be able to use as a road map, models, and direction and strategies of policies for chronic disease prevention and management of Korea.

Objective: To investigate the effects of a herb complex extract (HCE) prepared from Cornus officinalis Sieb. Et Zucc., Eriobotrya japonica Lindley, and olive leaves on immune response of mouse spleen NK cells in vitro and in vivo analysis. Methods: The activity of natural killer (NK) cells was measured in splenocytes and YAC-1 cells. Mice were immunosuppressed using cyclophosphamide (5 mg/kg body weight). Three different doses of HCE (200, 400, and 800 mg/kg body weight) and red ginseng extract (800 mg/kg body weight) which was used as standard immunomodulatory herb were administered orally for 4 weeks. The body weight, dietary, water intake, organs (liver, thymus, and spleen) weight, completed blood count, and cytokines (tumor necrosis factor alpha, interferon gamma, and interleukin-2) production was measured. Results: At the maximum concentration of HCE, the activity of NK cells was increased by 48.5%. HCE increased liver, spleen, and thymus weights without altering numbers of white blood cells, lymphocytes, and neutrophils in a cyclophosphamide-induced immunosuppression rat model. However, HCE recovered the inhibited cytokine expression; HCE (800 mg/kg) increased cytokines levels. The results indicate the immune enhancement potential of this HCE. Conclusion: The HCE enhances immunity by increasing NK cell activity, regulating cytokine levels, and maintaining spleen weight. Therefore, it may be used as a potential immunity enhancer.

STUDY DESIGN: A prospective study. PURPOSE: To evaluate the reliability and validity of the adapted Korean version of the Neck Pain and Disability Scale (NPDS). OVERVIEW OF LITERATURE: The validity of Korean version of NPDS has not been completely demonstrated yet. METHODS: Translation/retranslation of the English version of NPDS was conducted, and all steps of the cross-cultural adaptation process were performed. The Korean version of the visual analog scale (VAS) measure of pain, NPDS and the previously validated Short Form-36 (SF-36) were mailed to 91 patients, who had been surgically treated for degenerative cervical disease. Eighty-one patients responded to the first mailing of questionnaires and 69 of the first time responder returned their second survey. Factor analysis and reliability assessment by kappa statistics of agreement for each item, the intraclass correlation coefficient and Cronbach's alpha were conducted. Concurrent and construct validity were also evaluated by comparing the responses of NPDS with the results of VAS and responses of SF-36. RESULTS: Factor analysis extracted 3 factors. All items had a kappa statistics of agreement greater than 0.6. The NPDS showed excellent test/re-test reliability. Internal consistency of Cronbach's alpha was found to be very good. The NPDS was correlated with the VAS. The Korean version of NPDS showed good significant correlation with SF-36 total score and with single SF-36 domains scores. CONCLUSIONS: The adapted Korean version of the NPDS was successfully translated and is considered suitable for outcome assessments in the Korean-speaking patients with neck pain.
Humans ; Neck ; Neck Pain ; Prospective Studies ; Reproducibility of Results ; Surveys and Questionnaires

BACKGROUND: A1chieve(R) was a noninterventional study evaluating the clinical safety and efficacy of biphasic insulin aspart 30, insulin detemir, and insulin aspart. METHODS: Korean type 2 diabetes patients who have not been treated with the study insulin or have started it within 4 weeks before enrollment were eligible for the study. The patient selection and the choice of regimen were at the discretion of the physician. The safety and efficacy information was collected from the subjects at baseline, week 12, and week 24. The number of serious adverse drug reactions (SADRs) was the primary endpoint. The changes of clinical diabetic markers at week 12 and/or at week 24 compared to baseline were the secondary endpoints. RESULTS: Out of 4,058 exposed patients, 3,003 completed the study. During the study period, three SADRs were reported in three patients (0.1%). No major hypoglycemic episodes were observed and the rate of minor hypoglycemic episodes marginally decreased during 24 weeks (from 2.77 to 2.42 events per patient-year). The overall quality of life score improved (from 66.7+/-15.9 to 72.5+/-13.5) while the mean body weight was slightly increased (0.6+/-3.0 kg). The 24-week reductions in glycated hemoglobin, fasting plasma glucose and postprandial plasma glucose were 1.6%+/-2.2%, 2.5+/-4.7 mmol/L, and 4.0+/-6.4 mmol/L, respectively. CONCLUSION: The studied regimens showed improvements in glycemic control with low incidence of SADRs, including no incidence of major hypoglycemic episodes in Korean patients with type 2 diabetes.
Biphasic Insulins ; Body Weight ; Diabetes Mellitus, Type 2 ; Drug Toxicity ; Fasting ; Glucose ; Hemoglobins ; Humans ; Incidence ; Insulin ; Insulin Aspart ; Insulin, Isophane ; Insulin, Long-Acting ; Patient Selection ; Plasma ; Quality of Life ; Republic of Korea ; Treatment Outcome ; Insulin Detemir

In several previously reported studies, metabolic syndrome (MS) was found to be associated with colorectal adenomas. While the incidence of colorectal adenoma is growing in Korean population, there are only few studies that examined the association between MS and colorectal adenoma in Korea. The aim of this study was to investigate relationships between prevalence of colorectal adenoma and MS components. We conducted a cross sectional study using data from individuals who had undergone complete colonoscopy for health examinations at the Health Promotion Center of Korea University Medical Center from July 1, 2004 to July 31, 2010. A total of 7481 subjects (4459 males and 3022 females) were included; 1733 subjects with pathologically proven adenoma were assigned to the case group, and other 5748 subjects were assigned to the non-case group. All the participants underwent colonoscopy and received blood biochemical tests (fasting blood sugar [FBS], insulin, lipid profile, hemoglobin, blood urea nitrogen [BUN], creatinine). Univariate analysis showed that the prevalence of colorectal adenoma was higher in individuals with higher blood pressure, body mass index (BMI), total cholesterol (TC), triglyceride (TG), FBS and lower high-density lipoprotein cholesterols (HDL-C) levels, compared to those with low levels. Multiple logistic regression analysis revealed that high levels of BMI (OR 1.17, 95% CI 1.01-1.34, P trend = 0.01), TG (OR 1.27, 95% CI 1.07-1.51, P trend = 0.006), and FBS (OR 1.19 95% CI 1.01-1.40, P trend = 0.05) were significantly associated with prevalence of colorectal adenoma. Subjects with high levels of BMI, TG and FBS have increased prevalence of developing colorectal adenoma in Korea.
Academic Medical Centers ; Adenoma* ; Blood Glucose* ; Blood Pressure ; Blood Urea Nitrogen ; Body Mass Index ; Cholesterol ; Colonoscopy* ; Fasting* ; Health Promotion ; Humans ; Incidence ; Insulin ; Korea ; Lipoproteins ; Logistic Models ; Male ; Mass Screening* ; Prevalence ; Risk Factors* ; Triglycerides*

OBJECTIVE: The purpose of this study was to investigate the possible association of estrogen receptor alpha (ERalpha) gene polymorphisms in a cohort of degenerative spondylolisthesis (DS) patients. METHODS: Accordingly, the authors examined the association between DS and ERalpha gene polymorphisms in 174 patients diagnosed with DS. The Pvu II and Xba I polymorphisms, bone mineral density at the lumbar spine and femoral neck, and biochemical markers were analyzed and compared in the 174 patients with DS and 214 patients with spinal stenosis (SS). RESULTS: A comparison of genotype frequencies in DS and SS patients revealed a significant difference for the Pvu II polymorphism only (p=0.0452). No significant difference was found between these two groups with respect to the Xba I polymorphism, BMD or biochemical markers. No significant association was found between the Pvu II polymorphism of ERalpha and BMD, vertebral slip or biochemical markers in patients with DS. CONCLUSION: These results suggest that the ERalpha gene polymorphism using Pvu II restriction enzyme influences the prevalence of DS.
Biomarkers ; Bone Density ; Cohort Studies ; Estrogen Receptor alpha ; Estrogens ; Femur Neck ; Genotype ; Humans ; Prevalence ; Spinal Stenosis ; Spine ; Spondylolisthesis

STUDY DESIGN: A prospective study. PURPOSE: To assess postoperative changes in cerebral glucose metabolism in anxiety patients with lumbar spinal stenosis (SS). OVERVIEW OF LITERATURE: Although an association between preoperative anxiety and abnormal cerebral glucose metabolism may exist, only a limited number of studies using F-18 fluorodeoxyglucose positron emission tomography (FDG PET) have evaluated preoperative to postoperative changes in cerebral glucose metabolism in SS patients in detail. METHODS: The present study was designed to assess preoperative to postoperative changes in cerebral glucose metabolism in anxiety patients with SS. F-18 FDG PET with statistical parametric mapping analyses was used to compare preoperative and postoperative regional brain glucose metabolism in 18 SS patients. RESULTS: F-18 FDG PET scans showed postoperative activation of several brain clusters in gray matter. These included left parahippocampus, left cerebellar tonsil, left inferior semi-lunar lobule, and right cerebellar tonsil. Areas that were deactivated postoperatively were the right insula, left fusiform gyrus, left orbitofrontal cortex, left inferior frontal gyrus, left middle frontal gyrus, left precuneus, and left inferior frontal gyrus. CONCLUSIONS: SS patients with preoperative anxiety showed altered cerebral glucose metabolism at postoperative follow-up.
Anxiety ; Brain ; Follow-Up Studies ; Glucose ; Humans ; Palatine Tonsil ; Positron-Emission Tomography ; Prospective Studies ; Spinal Stenosis

STUDY DESIGN: This is a prospective study. PURPOSE: We compared the outcomes of segmental decompression and wide decompression in patients who had multilevel lumbar foraminal stenosis with back pain. OVERVIEW OF LITERATURE: Wide decompression and fusion in patients with multilevel lumbar foraminal stenosis may increase the risk of perioperative complications. METHODS: From March 2005 to December 2007, this study prospectively examined 87 patients with multilevel lumbar foraminal stenosis and who were treated by segmental or wide decompression along with posterior fusion using pedicle screw fixation, and these patients could be followed-up for a minimum of 2 years. Of the 87 patients, 45 and 42 patients were assigned to the segmental decompression group (group 1) and the wide decompression group (group 2), respectively. We compared the clinical and radiological outcomes of the patients in these two groups. RESULTS: There were no significant differences between groups 1 and 2 in terms of the levels of postoperative pain based on the visual analogue scale, the Oswestry Disability Score, the clinical results based on the Kirkaldy-Willis Criteria, the complication rate or the posterior fusion rate. On the other hand, the mean operating times in groups 1 and 2 were 153 +/- 32 minutes and 187 +/- 36 minutes, respectively (p < 0.05). The amount of blood loss during surgery and on the first postoperative day was 840 +/- 236 ml and 1,040 +/- 301 ml in groups 1 and 2, respectively (p < 0.05). CONCLUSIONS: These results suggest that segmental decompression offers promising and reproducible clinical and radiological results for patients suffering from multilevel lumbar foraminal stenosis.
Constriction, Pathologic ; Decompression ; Hand ; Humans ; Pain, Postoperative ; Prospective Studies ; Stress, Psychological