Purpose: Gait evaluation in patients with dizziness is essential during both initial evaluation and vestibular rehabilitation. Inertial measurement unit (IMU)-based gait analysis systems are clinically applicable in patients with dizziness. Since dizzy patients can utilize visual inputs to compensate for vestibular deficits, it is more difficult for them to walk with their eyes closed (EC). In this study, we compared gait characteristics during forward walking with both eyes open (EO) and EC between healthy subjects and dizzy patients. Materials and Methods: Forty-nine healthy controls (mean age 37.18±10.71 years) and 23 patients with dizziness (mean age 49.25± 15.16 years) were subjected to vestibular and gait analyses. Medical histories, physical examinations, and vestibular function tests ruled out possible vestibular deficits in the controls. Subjects were instructed to walk at a comfortable pace for 10 m under two conditions (EO or EC). Spatiotemporal parameters, kinematics, and simulated kinetics of each gait recording were recorded using a shoe-type IMU system and analyzed. Results: Although gait speeds were slower, stride lengths were smaller, and double support times were increased under the EC, compared to the EO condition, in both healthy subjects and dizzy patients, the difference was more prominent in dizzy patients.Phase coordination index values did not differ significantly in either group. Gait asymmetry (GA) increased significantly under the EC condition, compared to the EO condition, in dizzy patients. Conclusion GA during forward walking was greater in dizzy patients under an EC condition than under an EO condition.

Several epidemiological studies have reported an association between environmental pollution and various health conditions in individuals residing in industrial complexes. To evaluate the effects of pollution from industrial complex on human health, we performed a pooled analysis of environmental epidemiologic monitoring data for residents living near national industrial complexes in Korea. The respiratory and allergic symptoms and the prevalence of acute and chronic diseases, including cancer, were used as the outcome variables for health effects. Multiple logistic regression analysis was used to analyze the relationship between exposure to pollution from industrial complexes and health conditions. After adjusting for age, sex, smoking status, occupational exposure, level of education, and body mass index, the residents near the industrial complexes were found to have more respiratory symptoms, such as cough (odds ratio [OR], 1.18; 95% confidence interval [CI], 1.06 to 1.31) and sputum production (OR, 1.13; 95% CI, 1.03 to 1.24), and symptoms of atopic dermatitis (OR, 1.10; 95% CI, 1.01 to 1.20). Among residents of the industrial complexes, the prevalence of acute eye disorders was approximately 40% higher (OR, 1.39; 95% CI, 1.04 to 1.84) and the prevalence of lung and uterine cancer was 3.45 times and 1.88 times higher, respectively, than those among residents of the control area. This study showed that residents living in the vicinity of industrial complexes have a high risk of acute and chronic diseases including respiratory and allergic conditions. These results can be used as basic objective data for developing health management measures for individuals residing near industrial complexes.
Body Mass Index ; Chronic Disease ; Cough ; Dermatitis, Atopic ; Education ; Employment ; Environmental Pollution ; Epidemiologic Studies ; Epidemiological Monitoring ; Humans ; Korea ; Logistic Models ; Lung ; Prevalence ; Smoke ; Smoking ; Sputum ; Uterine Neoplasms

Several epidemiological studies have reported an association between environmental pollution and various health conditions in individuals residing in industrial complexes. To evaluate the effects of pollution from industrial complex on human health, we performed a pooled analysis of environmental epidemiologic monitoring data for residents living near national industrial complexes in Korea. The respiratory and allergic symptoms and the prevalence of acute and chronic diseases, including cancer, were used as the outcome variables for health effects. Multiple logistic regression analysis was used to analyze the relationship between exposure to pollution from industrial complexes and health conditions. After adjusting for age, sex, smoking status, occupational exposure, level of education, and body mass index, the residents near the industrial complexes were found to have more respiratory symptoms, such as cough (odds ratio [OR], 1.18; 95% confidence interval [CI], 1.06 to 1.31) and sputum production (OR, 1.13; 95% CI, 1.03 to 1.24), and symptoms of atopic dermatitis (OR, 1.10; 95% CI, 1.01 to 1.20). Among residents of the industrial complexes, the prevalence of acute eye disorders was approximately 40% higher (OR, 1.39; 95% CI, 1.04 to 1.84) and the prevalence of lung and uterine cancer was 3.45 times and 1.88 times higher, respectively, than those among residents of the control area. This study showed that residents living in the vicinity of industrial complexes have a high risk of acute and chronic diseases including respiratory and allergic conditions. These results can be used as basic objective data for developing health management measures for individuals residing near industrial complexes.
Body Mass Index ; Chronic Disease ; Cough ; Dermatitis, Atopic ; Education ; Employment ; Environmental Pollution* ; Epidemiologic Studies ; Epidemiological Monitoring ; Humans ; Korea* ; Logistic Models ; Lung ; Prevalence ; Smoke ; Smoking ; Sputum ; Uterine Neoplasms

PURPOSE: The aim was to evaluate the effect of curing mode and different dentin surface pretreatment on microtensile bond strength (microTBS) of self-adhesive resin cements. MATERIALS AND METHODS: Thirty-six extracted human permanent molars were sectioned horizontally exposing flat dentin surface. The teeth were divided into 12 groups (3 teeth/group) according to the dentin surface pretreatment methods (control, 18% EDTA, 10% Polyacrylic acid) and curing mode (self-curing vs. light-curing) of cement. After pretreatment, composite resin blocks were cemented with the following: (a) G-CEM LinkAce; (b) RelyX U200, followed by either self-curing or light-curing. After storage, the teeth were sectioned and microTBS test was performed using a microtensile testing machine. The data was statistically analyzed using one-way ANOVA, Student T-test and Scheffe's post-hoc test at P<.05 level. RESULTS: For G-CEM LinkAce cement groups, polyacrylic acid pretreatment showed the highest microTBS in the self-cured group. In the light-cured group, no significant improvements were observed according to the dentin surface pretreatment. There were no significant differences between curing modes. Both dentin surface pretreatment methods helped to increase the microTBS of RelyX U200 resin cement significantly and degree of pretreatment effect was similar. No significant differences were found regarding curing modes except control groups. In the comparisons of two self-adhesive resin cements, all groups within the same pretreatment and curing mode were significantly different excluding self-cured control groups. CONCLUSION: Selecting RelyX U200 used in this study and application of dentin surface pretreatment with EDTA and polyacrylic acid might be recommended to enhance the bond strength of cement to dentin.
Dentin* ; Edetic Acid ; Humans ; Molar ; Resin Cements* ; Tooth

BACKGROUND: In the early stages of non-Hodgkin lymphoma (NHL), it can be difficult to recognize minimal morphological changes in the bone marrow (BM). In particular, when the quality of the BM biopsy is poor, determining BM involvement is limited to microscopic findings on BM aspiration. In this study, we compared the results of clonal immunoglobulin (IG) gene rearrangements with BM morphology results in B-cell NHL patients who underwent BM analysis as a staging workup and evaluated the usefulness of the clonal IG gene rearrangements for staging. METHODS: Forty two B-cell NHL patients were analyzed. Clonal rearrangements of the IG heavy chain (IGH), kappa light chain (IGK) and lambda light chain (IGL) genes were detected using the IdentiClone(TM) Clonality assay (InVivoScribe Technologies, USA). Clinical characteristics and outcomes were evaluated based on the detection of monoclonal IG gene rearrangements. RESULTS: Monoclonal IG gene rearrangements were found in 9 of 42 patients (21.4%). Microscopic BM involvement was found in only 2 of 42 patients (4.8%). The monoclonality rate of IG genes in BM was correlated with clinical stage and the international prognostic index (P<0.01). Patients with monoclonal IG gene rearrangements in BM had a significantly higher relapse rate (P=0.014) and poorer overall survival at 2 yr (P<0.01). CONCLUSIONS: Clonality analysis of BM in B-cell NHL can contribute to identification of patients with occult BM involvement with a significantly poorer overall survival despite normal BM histology.
B-Lymphocytes* ; Biopsy ; Bone Marrow* ; Gene Rearrangement ; Genes, Immunoglobulin* ; Humans ; Immunoglobulins ; Lymphoma, Non-Hodgkin* ; Recurrence

BACKGROUND: It is known that chronic sustained hyperglycemia and its consequent oxidative stress causes diabetic complication in type 2 diabetes. It has been further proven that glycemic variability causes oxidative stress. The aim of this study is to measure the average daily risk range (ADDR)-index of glycemic variability, and to evaluate relevant variables. METHODS: We measured the blood glucose level of type 2 diabetic patients who were treated with multiple daily injections from January to July, 2008. The blood glucose levels were checked four times a day for 14 days and were conversed according to the ADRR formula. The degree of glycemic variability was categorized into non-fluctuation and fluctuation groups. We collected patient data on age, sex, duration of diabetes, body mass index, HOMA(IR), HOMA(betacell) and HbA1c. RESULTS: A total of 97 patients were enrolled in this study. The mean age, duration of diabetes, HbA1c and mean ADRR were 57.6 +/- 13.4, 11.5 +/- 8.5 years, 10.7 +/- 2.5%, and 26.6 +/- 9.8, respectively. We classified 18.5% of the patients to the non-fluctuation group, and 81.5% to the fluctuation group. ADRR was significantly correlated with duration of diabetes, fasting and postprandial glucose, fructosamine, HbA1c and BMI and HOMAbetacell. In addition, this study confirmed that BMI, HOMAbetacell and HbA1c were ADRR-related independent variables. CONCLUSION: ADRR can be used as an index for blood glucose fluctuation in type 2 diabetic patients. Measuring ADRR in patients with low BMI and a long duration of diabetes is helpful to improve the effectiveness of their care.
Blood Glucose ; Body Mass Index ; Diabetes Complications ; Diabetes Mellitus, Type 2 ; Fasting ; Fructosamine ; Glucose ; Humans ; Hyperglycemia ; Inpatients ; Oxidative Stress

BACKGROUND: The frequency of lower extremity amputation due to diabetic foot has been increasing in type 2 diabetic patients. The aim of this study was to observe the incidence, clinical aspects and associated risk factors for diabetic foot. METHODS: We evaluated the incidence of diabetic foot through a five-year observation of type 2 diabetic patients who presented to St. vincent's Hospital between January and December 2003. To identify the risk factors for diabetic foot, we evaluated mean glycosylated hemoglobin A1c (HbA1c) every six months and assessed renal function based on the existence of proteinuria and estimated glomerular filtration rate (GFR) using the Modification of Diet in Renal Disease (MDRD) equation. Patients were also evaluated for retinopathy, peripheral neuropathy and autonomic neuropathy using Ewing's method. RESULTS: From an initial pool of 613 patients, the observational study of 508 patients (82.9%) was completed. The mean age, duration of diabetes and HbA1c were 50.3 +/- 10.6 yrs, 7.2 +/- 6.5 yrs and 8.8 +/- 2.1%, respectively. Diabetic foot occurred in 32 patients (6.3%). The incidence of diabetic foot increased when diabetic retinopathy (OR = 6.707, 2.314~19.439), peripheral neuropathy (OR = 2.949, 1.075~8.090), and autonomic neuropathy (OR = 3.967, 1.476~10.660) were present and when the MDRD GFR (OR = 5.089, 1.712~15.130) decreased. Mean HbA1c (OR = 12.013, 1.470~98.179) was found to be an independent risk factor for diabetic foot. CONCLUSION: The present study confirmed the importance of intensive glycemic control and the role of autonomic dysfunction in the development of diabetic foot. In addition, diabetic retinopathy and impaired renal function proved to be factors associated with the occurrence of diabetic foot. Therefore, intensive glycemic control, as well as periodic examination of renal function, are essential for the prevention of diabetic foot.
Amputation ; Diabetic Foot ; Diabetic Neuropathies ; Diabetic Retinopathy ; Diet ; Glomerular Filtration Rate ; Hemoglobin A, Glycosylated ; Humans ; Incidence ; Lower Extremity ; Peripheral Nervous System Diseases ; Proteinuria ; Risk Factors

BACKGROUND: Recent studies suggest that serum Cystatin C is both a sensitive marker for renal dysfunction and a predictive marker for cardiovascular diseases. We aimed to evaluate the association between Cystatin C and various biomarkers and to find out its utility in estimating risk for cardiovascular diseases in type 2 diabetic patients. METHODS: From June 2006 to March 2008, anthropometric measurements and biochemical studies including biomarkers for risk factors of cardiovascular diseases were done in 520 type 2 diabetic patients. A 10-year risk for coronary heart diseases and stroke was estimated using Framingham risk score and UKPDS risk engine. RESULTS: The independent variables showing statistically significant associations with Cystatin C were age (beta = 0.009, P < 0.0001), hemoglobin (beta = -0.038, P = 0.0006), serum creatinine (beta = 0.719, beta < 0.0001), uric acid (beta = 0.048, P = 0.0004), log hsCRP (beta = 0.035, P = 0.0021) and homocysteine (beta = 0.005, P = 0.0228). The levels of microalbuminuria, carotid intima-media thickness, fibrinogen and lipoprotein (a) also correlated with Cystatin C, although the significance was lost after multivariate adjustment. Calculated risk for coronary heart diseases increased in proportion to Cystatin C quartiles: 3.3 +/- 0.4, 6.2 +/- 0.6, 7.6 +/- 0.7, 8.4 +/- 0.7% from Framingham risk score (P < 0.0001); 13.1 +/- 0.9, 21.2 +/- 1.6, 26.1 +/- 1.7, 35.4 +/- 2.0% from UKPDS risk engine (P < 0.0001) (means +/- SE). CONCLUSIONS: Cystatin C is significantly correlated with various emerging biomarkers for cardiovascular diseases. It was also in accordance with the calculated risk for cardiovascular diseases. These findings verify Cystatin C as a valuable and useful marker for predicting future cardiovascular diseases in type 2 diabetic patients.
Biomarkers ; Cardiovascular Diseases ; Carotid Intima-Media Thickness ; Coronary Disease ; Creatinine ; Cystatin C ; Fibrinogen ; Hemoglobins ; Homocysteine ; Humans ; Lipoprotein(a) ; Risk Factors ; Stroke ; Uric Acid

Acute renal failure is the most common complication of rhabdomyolysis. However, hyperosmolar hyperglycemic state (HHS) induced-rhabdomyolysis rarely causes acute renal failure (ARF) because HHS induces osmotic diuresis and prevents tubular necrosis. Here we report a case of acute renal failure caused by HHS-induced rhabdomyolysis in a patient with poorly controlled diabetes mellitus. A 59-year-old male was admitted with comatose mentality. He had been diagnosed with diabetes mellitus 6 months ago but had not been treated. Physical examination showed severe dehydration of oral mucosa. His laboratory findings demonstrated severe HHS, rhabdomyolysis and acute renal failure (plasam glucose 1,543 mg/dL, osmolarity 329 mOsm/L, creatine phophokinase 15,395 IU/L, lactate dehydrogenase 1,046 IU/L, creatinine 2.4 mg/dL). With adequate hydration and insulin therapy, HHS improved but rhabdomyolysis and ARF were more aggravated. With early hemodialysis treatment, he finally improved without sequale.
Acute Kidney Injury* ; Coma ; Creatine ; Creatinine ; Dehydration ; Diabetes Mellitus ; Diuresis ; Glucose ; Humans ; Insulin ; L-Lactate Dehydrogenase ; Male ; Middle Aged ; Mouth Mucosa ; Necrosis ; Osmolar Concentration ; Physical Examination ; Renal Dialysis ; Rhabdomyolysis

PURPOSE: p63 is a recently described as p53 homologue. Despite their structural homologies, they have different activities. p63 is a specific myoepithelial cell marker in normal breast tissue and it is expressed in a minority of breast cancers. The aim of this study was to evaluate the prognostic significance of the p63 expression in breast cancer. METHODS: The expression of p63 in breast cancer was determined by performing immunohistochemistry on 350 patients who underwent mastectomy at the Department of Surgery at Korea University Medical Center between January 1992 and September 2004. A retrospective analysis was conducted using the medical records. A tissue microarray was constructed, and immunohistochemical analysis for p63 was performed according to the usual methods. RESULTS: Among 350 patients, 40 (11.4%) showed a p63 expression. There was a significant correlation between p63 and the histologic grade. There were significant correlations of p63 with p53 and HER2/neu, respectively. In the basal type of breast cancer, the p63 expression was significantly higher than in the luminal type of breast cancer. The 5 year disease free survival rates were 69% in the patients with a p63 expression and 76% in the patients without a p63 expression, but there was no statistical difference. CONCLUSION: The present results indicate that a p63 expression is associated with a high grade tumor, a p53 expression and a HER2/neu expression in breast cancer, which are the known poor prognostic factors of breast cancer. Immunohistochemical subtyping shows that the p63 expression is a useful predictor for the basal type of breast cancer. In addition, this study suggests that the p63 expression in the basal type of breast cancer is associated with a poor prognosis.
Academic Medical Centers ; Breast Neoplasms* ; Breast* ; Disease-Free Survival ; Humans ; Immunohistochemistry ; Korea ; Mastectomy ; Medical Records ; Phenobarbital ; Prognosis ; Retrospective Studies