Background and Objectives: Sjögren’s syndrome (SS) is an autoimmune inflammatory disorder of exocrine glands characterized by dry mouth and eye. Recently, ultrasonography has become a valuable tool for the assessment of salivary gland involvement in SS although studies on the usefulness of salivary gland CT is rare. In this regard, we evaluated the diagnostic accuracy of parotid gland CT for SS.Subjects and Method A total of 91 patients with sicca symptoms took a parotid CT, a serology test, an ophthalmologic examination and a minor salivary gland biopsy. At the end, as a standard, we diagnosed the primary SS according to the new 2016 American College of Rheumatology/ European League Against Rheumatism classification criteria. The diagnostic value of parotid CT was compared by the McNemar test. Results: Of the total of 91 patients with parotid CT, 37 (40.7%) patients met the SS classification criteria. On the parotid CT, heterogeneity of the parotid gland has the sensitivity of 74.1%, specificity of 70.3%, and accuracy of 71.4%. The abnormal fat tissue deposition showed the sensitivity of 74.1%, specificity of 81.3%, and accuracy of 79.1%. Diffuse calcification was seen in 1/91 SS patients (sensitivity 3.7%, specificity 100%, accuracy 71.4%). Conclusion Parotid CT is helpful for the diagnosis of SS. The presence of heterogeneity and fat tissue deposition are highly sensitive for the accuracy of SS. Diffuse calcification in bilateral parotid glands is highly specific for SS.

BACKGROUND/AIMS: Functional dyspepsia (FD) is one of the most common gastrointestinal disorders, and FD imposes social and economic burden worldwide. The aim of this study is to identify the prevalence and risk factors of FD in health check-up population in tertiary centers in Korea. METHODS: A nationwide multicenter prospective study was performed at 9 tertiary healthcare centers in Korea between September 2016 and June 2017. A total of 2525 subjects were investigated based on endoscopic findings and questionnaires with the Rome III criteria, and Helicobacter pylori serology (IgG). RESULTS: A total of 1714 subjects without organic disease were enrolled. The mean (± SD) age was 51.5 (± 12.7) years, and 917 patients (53.5%) were female. The proportion of H. pylori seropositivity was 51.0% (874/1714). The prevalence of FD was 10.3% (176/1714), and the subtypes of postprandial distress syndrome alone, epigastric pain syndrome alone, and postprandial distress syndrome-epigastric pain syndrome overlap were 4.8%, 3.0%, and 2.5%, respectively. Multivariate analysis showed that female gender (OR, 1.58; 95% CI, 1.14–2.21) and education below college level (OR, 1.45; 95% CI, 1.01–2.07) were related to FD. Multivariate analysis based on age 60 showed female gender as a significant (OR, 2.90; 95% CI, 1.06–7.94) factor in the group ≥60 years. CONCLUSIONS: The prevalence of FD was 10.3% in the health check-up population in Korea. Female sex and education below college level were risk factors for FD. Female sex is a risk factor for FD in old age, underscoring the need for close attention in this age group.
Dyspepsia ; Education ; Female ; Helicobacter pylori ; Humans ; Korea ; Multivariate Analysis ; Prevalence ; Prospective Studies ; Risk Factors ; Tertiary Healthcare

OBJECTIVE: The purpose of the current study was to compare the circulating levels of visfatin between women with polycystic ovary syndrome (PCOS) and those without PCOS and to assess the correlations between visfatin levels and various parameters. METHODS: This case-control study recruited 74 PCOS patients and 74 age- and body mass index (BMI)-matched controls. Serum visfatin levels were evaluated using the enzyme-linked immunosorbent assay. Women with PCOS were divided into 2 subgroups based on the presence of clinical or biochemical hyperandrogenism. The possible differences in serum visfatin levels between the hyperandrogenic and non-hyperandrogenic groups were also assessed. RESULTS: Visfatin levels in PCOS patients were similar to those in the controls. However, hyperandrogenic patients had significantly higher mean serum visfatin levels than those in non-hyperandrogenic patients (3.87 ng/mL; 95% confidence intervals [CIs], 3.09–4.85 in hyperandrogenic group vs. 2.69 ng/mL; 95% CIs, 2.06–3.52 in non-hyperandrogenic group; P=0.038). In women with PCOS, visfatin levels positively correlated with BMI (r=0.23; P=0.047) and the log free androgen index (FAI) (r=0.27; P=0.021) and negatively correlated with high-density lipoprotein (HDL) cholesterol levels (r=−0.37; P=0.025). Except for HDL cholesterol levels, these correlations were also observed in controls. CONCLUSION: Visfatin levels in PCOS patients were similar to those in the controls. However, hyperandrogenic patients showed significantly higher serum visfatin levels than those of non-hyperandrogenic patients, and visfatin had a positive linear correlation with FAI in both PCOS patients and controls.
Body Mass Index ; Case-Control Studies ; Cholesterol ; Cholesterol, HDL ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Hyperandrogenism ; Lipoproteins ; Nicotinamide Phosphoribosyltransferase* ; Polycystic Ovary Syndrome*

OBJECTIVE: To determine the impact of the changes in the amount of abdominal fat, directly measured by computed tomography, body composition, and the metabolic syndrome (MetS) risk factors on the bone mineral density (BMD) of Korean women. METHODS: A retrospective cohort study involving 534 Korean women aged 29 to 78 years, who had undergone both dual-energy X-ray absorptiometry and abdominal adipose tissue analysis by computed tomography scan more than twice between January 2004 and December 2010. The changes in the BMD values were examined in association with the changes in fat amount, body composition parameters, and risk factors of MetS. RESULTS: On cross sectional analysis, there was a significant positive correlation between femoral BMD and total abdominal fat amount at the initial visit. However, the correlation disappeared when the impact of change of the fat amount on the change in BMD was analyzed over the study period. When the MetS and body composition parameters were analyzed, a significantly positive correlation was found between skeletal muscle mass and BMD. There was no significant relationship between the MetS risk factors or other body composition parameters and BMD throughout the study period after adjusting for age (time interval). CONCLUSION: Among body composition parameters, only increased skeletal muscle mass had a positive correlation with increased BMD over the study period of 2.7 years.
Abdominal Fat ; Absorptiometry, Photon ; Body Composition ; Bone Density* ; Cohort Studies* ; Cross-Sectional Studies ; Female ; Humans ; Muscle, Skeletal* ; Retrospective Studies* ; Risk Factors

Although it is difficult to reach a diagnosis in patients who complain of pain or sensitivity to cold in their hands, Raynaud's phenomenon is most often suspected in such cases. Symptoms of Raynaud's phenomenon include pallor, cyanosis, and redness following cold exposure. Glomus tumors can also increase patients' sensitivity to cold. In this case, our patient complained of symptoms indicative of Raynaud's phenomenon. Although treatment of Raynaud's phenomenon improved the symptoms, pain persisted in the fourth finger of the left hand. We diagnosed the patient with a glomus tumor and, after surgical treatment, the patient's symptoms improved. Here, we have also reviewed and discussed a number of reports of glomus tumors associated with Raynaud's disease. Diagnosing a glomus tumor in the hand may take some time, and the diagnosis could be further delayed if accompanied by Raynaud's phenomenon. Although glomus tumors are rare, we suggest that clinical awareness is important for early diagnosis and treatment.
Cyanosis ; Diagnosis ; Early Diagnosis ; Fingers ; Glomus Tumor* ; Hand* ; Humans ; Pallor ; Raynaud Disease*

OBJECTIVE: To investigate: the prevalence of vitamin D deficiency in Korean women with polycystic ovary syndrome (PCOS), and the relationship between vitamin D status and clinical or metabolic features in this group. METHODS: We recruited 38 women with PCOS using the Rotterdam criteria. A total of 109 premenopausal control women were matched with patients based on age and body mass index. Serum 25-hydroxy vitamin D concentrations less than 20 ng/mL were classified as frank vitamin D deficiency. Since vitamin D may play a significant role in metabolic disturbances in women with PCOS, correlations between clinical or metabolic parameters and vitamin D status were analyzed separately in patients and controls. RESULTS: Women with PCOS showed no differences in the level of 25-hydroxy vitamin D (19.6+/-6.6 ng/mL in patients vs. 20.1+/-7.4 ng/mL in controls, respectively, p=0.696) or prevalence of vitamin D deficiency (57.9% in patients vs. 56.5% in controls, respectively, p=0.880). In addition, we did not find any correlations between serum vitamin D level and clinical or metabolic profiles in either PCOS patients or controls. CONCLUSION: Our study found no differences in the absolute level of serum vitamin D between PCOS patients and matched controls. Prevalence of vitamin D deficiency was equally common among both patients and controls. Additionally, we did not find any correlations between serum vitamin D level and clinical or metabolic profiles, suggesting that the role of vitamin D in the pathogenesis of PCOS is not yet clear.
Body Mass Index ; Female ; Humans ; Insulin Resistance ; Metabolome ; Polycystic Ovary Syndrome* ; Prevalence ; Vitamin D ; Vitamin D Deficiency*

OBJECTIVE: Metabolic disturbances are well-recognized clinical features of polycystic ovary syndrome (PCOS). Carotid intima-media thickness (CIMT) has been widely used as a surrogate marker of atherosclerosis and cardiovascular disease (CVD). CIMT in women with PCOS has been investigated in many studies, but there has been only one report in the Korean population. The aim of the present study was to compare the presence of subclinical atherosclerosis in young untreated Korean women with PCOS and age-matched controls, specifically by measuring their CIMT. METHODS: CIMT was measured by one radiologist in 56 PCOS patients and 56 controls. To compare the CIMT according to PCOS phenotypes, women with PCOS were divided into two subgroups according to the presence of hyperandrogenism. RESULTS: Although PCOS patients were more obese and had higher blood pressure and insulin resistance index than the age-matched controls, the CIMT was not different between the two groups (0.49 +/- 0.09 mm in PCOS patients vs. 0.50 +/- 0.11 mm in controls, respectively, p = 0.562). When the CIMT in the control group was compared with hyperandrogenic and non-hyperandrogenic PCOS groups, also no significant differences were found. CONCLUSION: Despite the significant differences in some vascular risk factors between women with PCOS and controls, PCOS patients did not have a significantly higher CIMT (even in the hyperandrogenic subgroups). Although our study did not show the increased risk of subclinical atherosclerosis in PCOS patients, the role of CIMT continues to be investigated considering the importance of screening and monitoring CVD risk factors in women with PCOS.
Atherosclerosis ; Biomarkers ; Blood Pressure ; Cardiovascular Diseases ; Carotid Intima-Media Thickness ; Female ; Humans ; Insulin Resistance ; Mass Screening ; Phenotype ; Polycystic Ovary Syndrome ; Risk Factors

Polymyalgia rheumatica is an inflammatory disease affecting elderly and involving the shoulder and pelvic girdles. No epidemiological study of polymyalgia rheumatica was conducted in Korea. We retrospectively evaluated patients with polymyalgia rheumatica followed up at the rheumatology clinics of 10 tertiary hospitals. In total 51 patients, 36 patients (70.6%) were female. Age at disease onset was 67.4 yr. Twenty-three patients (45.1%) developed polymyalgia rheumatica in winter. Shoulder girdle ache was observed in 45 patients (90%) and elevated erythrocyte sedimentation rate (> 40 mm/h) in 49 patients (96.1%). Initial steroid dose was 23.3 mg/d prednisolone equivalent. Time to normal erythrocyte sedimentation rate was 4.1 months. Only 8 patients (15.7%) achieved remission. Among 41 patients followed up, 28 patients (68.3%) had flare at least once. Number of flares was 1.5 +/- 1.6. The frequency of flare was significantly lower in patients with remission (P = 0.02). In Korea, polymyalgia rheumatica commonly develops during winter. Initial response to steroid is fairly good, but the prognosis is not benign because remission is rare with frequent relapse requiring long-term steroid treatment.
Aged ; Aged, 80 and over ; Anti-Inflammatory Agents/administration & dosage/*therapeutic use ; Blood Sedimentation ; Cohort Studies ; Female ; Humans ; Male ; Middle Aged ; Polymyalgia Rheumatica/*drug therapy/epidemiology ; Prognosis ; Recurrence ; Republic of Korea/epidemiology ; Retrospective Studies ; Seasons ; Steroids/administration & dosage/*therapeutic use

Left ventricular hypertrabeculation/noncompaction (LVHT) is an uncommon type of genetic cardiomyopathy characterized by trabeculations and recesses within the ventricular myocardium. LVHT is associated with diastolic or systolic dysfunction, thromboembolic complications, and arrhythmias, including atrial fibrillation, ventricular arrhythmias, atrioventricular block and Wolff-Parkinson-White syndrome. Herein, we describe a patient who presented with heart failure and wide-complex tachycardia. Echocardiography showed LVHT accompanied with severe mitral regurgitation. The electrophysiologic study revealed a fasciculo-ventricular accessory pathway and atrial flutter (AFL). The AFL was successfully treated with catheter ablation.
Arrhythmias, Cardiac ; Atrial Fibrillation ; Atrial Flutter ; Atrioventricular Block ; Cardiomyopathies ; Catheter Ablation ; Echocardiography ; Heart Failure ; Humans ; Isolated Noncompaction of the Ventricular Myocardium ; Mitral Valve Insufficiency ; Myocardium ; Pre-Excitation, Mahaim-Type ; Tachycardia ; Wolff-Parkinson-White Syndrome

External compression of the right ventricle (RV) due to a depressed sternum in patients with pectus excavatum is uncommon. Moreover, mid-RV obstruction-induced cachexia rarely occurs in patients with pectus excavatum. We report a case of cardiac cachexia caused by significant RV compression in a patient with pectus excavatum.
Cachexia ; Funnel Chest ; Heart Ventricles ; Humans ; Sternum ; Ventricular Dysfunction, Right