Background/Aims: The Gout Impact Scale (GIS), a part of the Gout Assessment Questionnaire 2.0, is used to measure gout-specific health-related quality of life (HRQOL). Although several studies have been conducted on the factors affecting the HRQOL of patients with gout, few have focused on lifestyle factors. This study aimed to investigate the correlation between lifestyle habits and HRQOL using the GIS in patients with gout. Methods: We used data from the Urate-Lowering TheRApy in Gout (ULTRA) registry, a prospective cohort of Korean patients with gout treated at multiple centers nationwide. The patients were aged ≥18 years and met the 2015 American College of Rheumatology/European League Against Rheumatism gout classification criteria. They were asked to complete a GIS and questions regarding their lifestyle habits at enrollment. Results: The study included 232 patients. ‘Gout concern overall’ scores in the GIS were significantly lower in patients who exercised more frequently and consumed soft drinks and meat less, and ‘well-being during attack’ scores were significantly lower in patients who consumed vegetables and exercised more frequently. The frequency of vegetable consumption had a negative linear relationship with the ‘well-being during attack’ and ‘gout concern during attack’ scores (p = 0.01, p = 0.001, respectively). The frequency of exercise had a negative linear relationship with the ‘gout concern overall’ and ‘gout concern during attack’ scores (p = 0.04 and p = 0.002, respectively). Conclusions Patients with gout who frequently consumed vegetables and exercised regularly experienced less impact of gout, exhibiting a better GIS that represented HRQOL.

STUDY DESIGN: Retrospective patient data collection and investigator survey. PURPOSE: To investigate patterns of opioid treatment for pain caused by spinal disorders in Korea. OVERVIEW OF LITERATURE: Opioid analgesic prescription and adequacy of consumption measures in Korea have markedly increased in the past decade, suggesting changing patterns in pain management practice; however, there is lack of integrated data specific to Korean population. METHODS: Patient data were collected from medical records at 34 university hospitals in Korea. Outpatients receiving opioids for pain caused by spinal disorders were included in the study. Treatment patterns, including opioid types, doses, treatment duration, outcomes, and adverse drug reactions (ADRs), were evaluated. Investigators were interviewed on their perceptions of opioid use for spinal disorders. RESULTS: Among 2,468 analyzed cases, spinal stenosis (42.8%) was the most common presentation, followed by disc herniation (24.2%) and vertebral fracture (17.5%). In addition, a greater proportion of patients experienced severe pain (73.9%) rather than moderate (19.9%) or mild (0.7%) pain. Oxycodone (51.9%) and fentanyl (50.8%) were the most frequently prescribed opioids; most patients were prescribed relatively low doses. The median duration of opioid treatment was 84 days. Pain relief was superior in patients with longer treatment duration (≥2 months) or with nociceptive pain than in those with shorter treatment duration or with neuropathic or mixed-type pain. ADRs were observed in 8.6% of cases. According to the investigators' survey, "excellent analgesic effect" was a perceived advantage of opioids, while safety concerns were a disadvantage. CONCLUSIONS: Opioid usage patterns in patients with spinal disorders are in alignment with international guidelines for spinal pain management. Future prospective studies may address the suitability of opioids for spinal pain treatment by using appropriate objective measurement tools.
Analgesics, Opioid ; Chronic Pain ; Data Collection ; Drug-Related Side Effects and Adverse Reactions ; Fentanyl ; Hospitals, University ; Humans ; Korea* ; Medical Records ; Nociceptive Pain ; Outpatients ; Oxycodone ; Pain Management ; Prescriptions ; Prospective Studies ; Research Personnel ; Retrospective Studies* ; Spinal Diseases ; Spinal Stenosis ; Spine

BACKGROUND: We investigated the association between the severity of non-alcoholic fatty liver disease (NAFLD) and the estimated 10-year risk of cardiovascular disease (CVD) calculated by Pooled Cohort Equation (PCE) and Framingham risk score (FRS). METHODS: A total of 15,913 participants (mean age, 46.3 years) in a health screening program were selected for analysis. The presence and severity of fatty liver was assessed by abdominal ultrasonogram. Subjects who drank alcohol more than three times a week were excluded from the study. RESULTS: Among the participants, 57.6% had no NAFLD, 35.4% had grade I, 6.5% had grade II, and 0.5% had grade III NAFLD. Mean estimated 10-year CVD risk was 2.59%, 3.93%, 4.68%, and 5.23% calculated using the PCE (P for trend <0.01) and 4.55%, 6.39%, 7.33%, and 7.13% calculated using FRS, according to NAFLD severity from none to severe (P for trend <0.01). The odds ratio for ≥7.5% estimated CVD risk calculated using the PCE showed a higher correlation with increasing severity of NAFLD even after adjustment for conventional CVD risk factors (1.52, 2.56, 3.35 vs. the no NAFLD group as a reference, P<0.01) compared with calculated risk using FRS (1.65, 1.62, 1.72 vs. no NAFLD group as a reference, P<0.01). CONCLUSION: In our study of apparently healthy Korean adults, increasing severity of NAFLD showed a higher correlation with estimated 10-year CVD risk when calculated using the PCE than when calculated using FRS.
Adult ; Cardiovascular Diseases ; Cohort Studies* ; Fatty Liver* ; Humans ; Mass Screening ; Odds Ratio ; Risk Factors ; Ultrasonography

BACKGROUND: The aim of this study is to compare the risk for future development of nonalcoholic fatty liver disease (NAFLD) according to different status of metabolic health and obesity. METHODS: A total of 3,045 subjects without NAFLD and diabetes at baseline were followed for 4 years. Subjects were categorized into four groups according to the following baseline metabolic health and obesity statuses: metabolically healthy, non-obese (MHNO); metabolically healthy, obese (MHO); metabolically unhealthy, non-obese (MUHNO); and metabolically unhealthy, obese (MUHO). Being metabolically healthy was defined as having fewer than two of the following five components: high blood pressure, high fasting blood glucose, high triglyceride, low high density lipoprotein cholesterol, and being in the highest decile of the homeostasis model assessment-insulin resistance index. Obesity was defined as a body mass index >25 kg/m2. The presence of NAFLD was assessed by ultrasonography. RESULTS: The proportions of subjects included in the MHNO, MHO, MUHNO, and MUHO groups were 71.4%, 9.8%, 13.0%, and 5.8%, respectively. The proportions of subjects who developed NAFLD were 10.5%, 31.4%, 23.2%, and 42% in the MHNO, MHO, MUHNO, and MUHO groups, respectively. The risk for developing NAFLD was highest in subjects who were metabolically unhealthy both at baseline and after 4 years compared with subjects who were consistently metabolically healthy during the follow-up period (odds ratio, 2.862). Using the MHNO group as reference, the odds ratios for the MHO, MUHNO, and MUHO groups were 1.731, 1.877, and 2.501, respectively. CONCLUSION: The risk for NAFLD was lower in MHO subjects than in MUNO subjects.
Blood Glucose ; Body Mass Index ; Cholesterol, HDL ; Fasting ; Fatty Liver* ; Follow-Up Studies ; Homeostasis ; Hypertension ; Obesity* ; Odds Ratio ; Retrospective Studies* ; Triglycerides ; Ultrasonography

Gastric sarcoidosis is a rare disease accounting for 0.1~0.9% of all sarcoidosis cases. It presents either as a systemic disease or as an isolated finding. Diagnosis is established with biopsy of a lesion. It is important to distinguish between sarcoidosis and a sarcoid-like reaction, which can be caused by Crohn's disease, foreign body reaction, fungal infection, tuberculosis, or malignancy. We report a 60-year-old woman with both gastric and pulmonary sarcoidosis.
Biopsy ; Crohn Disease ; Diagnosis ; Female ; Foreign-Body Reaction ; Humans ; Middle Aged ; Rare Diseases ; Sarcoidosis ; Sarcoidosis, Pulmonary* ; Stomach ; Tuberculosis

Neisseria cinerea is an oropharyngeal normal flora known as a non-pathogenic gram-negative diplococcus. Encephalo-meningitis related to N. cinerea is very rare. A 15-year-old healthy male visited emergency room for altered mentality with fever, headache, and vomiting. Physical examination showed abdominal tenderness and neck stiffness but there was no skin rash. Cerebrospinal fluid (CSF) examination revealed opening pressure of 210 mmH2O, red blood cell 200/mm3, white blood cell 8,320/mm3, neutrophil 84%, glucose 34 mg/dL, suggesting acute bacterial meningitis. Empirical antibiotics were administered and N. cinerea was identified in CSF culture. The patient showed complete recovery 10 days after administration of ceftriaxone. We report this case as the first N. cinerea meningitis in Korea.
Adolescent ; Anti-Bacterial Agents ; Ceftriaxone ; Cerebrospinal Fluid ; Emergency Service, Hospital ; Erythrocytes ; Exanthema ; Fever ; Glucose ; Headache ; Humans ; Korea ; Leukocytes ; Male ; Meningitis ; Meningitis, Bacterial* ; Neck ; Neisseria cinerea* ; Neutrophils ; Physical Examination ; Vomiting

Neisseria cinerea is bacteria known as non-pathogenic strain. However, in rare cases, it can cause opportunistic infections. Those diseases caused by N. cinerea include neonatal ophthalmia, proctitis, pneumonia, peritonitis in patients with continuous ambulatory peritoneal dialysis, endocarditis and meningitis. In this report, we describe a patient with septic arthritis and skin abscess of finger joints that was caused by N. cinerea. A 27-year-old man visited the hospital due to swelling, redness and pain of proximal interphalangeal joint of the left second finger. After blood culture test, ceftriaxone was administered on admission and debridement was performed the affected joints. N. cinerea was identified in the blood culture. The patient was improved with ceftriaxone.
Abscess* ; Adult ; Arthritis, Infectious* ; Bacteria ; Ceftriaxone ; Debridement ; Endocarditis ; Endophthalmitis ; Finger Joint ; Fingers ; Humans ; Joints ; Meningitis ; Neisseria cinerea* ; Opportunistic Infections ; Peritoneal Dialysis, Continuous Ambulatory ; Peritonitis ; Pneumonia ; Proctitis ; Skin* ; Soft Tissue Infections

Actinomycosis causes a chronic suppurative, granulomatous disease which is characterized by extensive abscess formation, and sulfur granule formation. Actinomycosis may present different clinical forms: cervicofacial, thoracic, abdominal and cerebral actinomycosis. The diagnosis can only be made after surgery. In general, patients with abdominal actinomycosis have undergone abdominal surgery. We report four cases of primary appendiceal actinomycosis presenting as acute appendicitis without history of abdomen surgery.
Abdomen ; Abscess ; Actinomycosis* ; Appendicitis* ; Diagnosis ; Humans ; Sulfur

Mitochondrial dysfunction in dopaminergic neurons of patients with idiopathic and familial Parkinson's disease (PD) is well known although the underlying mechanism is not clear. We established a homogeneous population of human adipose tissue-derived mesenchymal stromal cells (hAD-MSCs) from human adult patients with early-onset hereditary familial Parkin-defect PD as well as late-onset idiopathic PD by immortalizing cells with the hTERT gene to better understand the underlying mechanism of PD. The hAD-MSCs from patients with idiopathic PD were designated as "PD", from patients with Parkin-defect PD as "Parkin" and from patients with pituitary adenomas as "non-PD" in short. The pGRN145 plasmid containing hTERT was introduced to establish telomerase immortalized cells. The established hTERT-immortalized cell lines showed chromosomal aneuploidy sustained stably over two-years. The morphological study of mitochondria in the primary and immortalized hAD-MSCs showed that the mitochondria of the non-PD were normal; however, those of the PD and Parkin were gradually damaged. A striking decrease in mitochondrial complex I, II, and IV activities was observed in the hTERT-immortalized cells from the patients with idiopathic and Parkin-defect PD. Comparative Western blot analyses were performed to investigate the expressions of PD specific marker proteins in the hTERT-immortalized cell lines. This study suggests that the hTERT-immortalized hAD-MSC cell lines established from patients with idiopathic and familial Parkin-defect PD could be good cellular models to evaluate mitochondrial dysfunction to better understand the pathogenesis of PD and to develop early diagnostic markers and effective therapy targets for the treatment of PD.
Adult ; Aneuploidy ; Blotting, Western ; Cell Line ; Diagnosis ; Dopaminergic Neurons ; Humans* ; Mesenchymal Stromal Cells* ; Mitochondria ; Parkinson Disease* ; Pituitary Neoplasms ; Plasmids ; Strikes, Employee ; Telomerase

BACKGROUND: Obesity is linked to a wide range of respiratory diseases. Several studies have shown that body weight at baseline and weight change were related to pulmonary function. The purpose of this study was to investigate the relationship between change in body mass index (BMI) and pulmonary function in adults. METHODS: Of those aged 40-64 years at baseline who had initially visited the health promotion center at one university-level hospital from January 2000 to December 2002, 499 (men: 309, women: 190) patients revisited the center over a 5-year period up to December 2009 and were enrolled in the study. Subjects were classified into 4 groups- group 1: normal-normal, group 2: normal-obese, group 3: obese-normal, and group 4: obese-obese, based on their BMI at baseline and follow-up. Forced expiratory volume in one second (FEV1), forced vital capacity (FVC) and FEV1/FVC were measured by spirometry. RESULTS: Change in FEV1/FVC was significantly associated with change in BMI for men in all 4 groups. Change in FEV1/FVC was significantly different between group 1 and 3 and between group 1 and 4. Changes in FEV1, FVC and FEV1/FVC were significantly associated with change in BMI for women in all 4 groups. Change in FEV1 was significantly different between group 3 and 4, and change in FVC was significantly different between group 1 and 3. CONCLUSIONS: These results suggest that a change in BMI is negatively associated with change in pulmonary function. Obesity itself can be a risk factor for pulmonary dysfunction, and a decrease in BMI through weight reduction could reduce pulmonary dysfunction or improve pulmonary function in adults.
Adult ; Aged ; Body Mass Index ; Body Weight ; Female ; Follow-Up Studies ; Forced Expiratory Volume ; Health Promotion ; Humans ; Male ; Obesity ; Risk Factors ; Vital Capacity ; Weight Loss