Socioeconomic and Employment Status of Patients with Rheumatoid Arthritis in Korea / 한국역학회지

OBJECTIVES: This study investigates the prevalence of rheumatoid arthritis (RA) by gender and socio-economic characteristics. It also explores the differences in the employment status between RA patients and the general population without RA in Korea. METHODS: We analyzed data from the Fourth Korea National Health and Nutrition Examination Survey (KNHANES IV) conducted from 2007 to 2009. Prevalence rates were estimated for female and male patients with RA in terms of age, residence, education, income level, and occupation type. The female respondents aged 45 to 64 were divided into the RA population and the non-RA population in order to compare the employment status between the two groups. RESULTS: The annual physician-diagnosed RA prevalence rate was 1.45%. The prevalence rate was 2.27% for women and 0.62% for men. Individuals with RA had a significantly lower employment rate than individuals without RA (41.7 vs. 68.1%). The main reason for non-employment among RA patients was health-related problems (47.1%). There was statistically significant difference in employment type among the two groups. The experience rates for sick leave and sick-in-bed due to RA were 1.7 and 3.9%, respectively. CONCLUSION: Middle- and old-aged women accounted for the majority of the Korean RA population, which had a significant lower employment rate compared to the population without RA for both sexes. RA resulted in considerable productivity loss in Korea.

Respiratory Distress Synd rome: Comparison between Radiographic Finding after Surfactant Replacement Thera py and Prognosis

PURPOSE: To evaluate the relationship between radiographic findings after surfactant replacement therapy and prognosis in newborns with respiratory distress syndrome (RDS). MATERIALS AND METHODS: The chest radiographs and medical records of 78 infants [body weight 840-3600g, mean 1682g, gestational age 20 -38 (mean, 31) weeks] who had been treated with surfactant were retrospectively analysed. Surfactant was applied 1 -12 (mean, 5) hours after birth. By comparing pre-and post-surfactant radiographs, radiographi changes were graded as either uniform bilateral improvement (grade 1), asymmetrical unilateral improvement (grade 2), or no improvement (grade 3). Complications such as barotrauma, bilateral diffuse consolidation, or intracranial hemorrhage were tabulated. We correlated the prognosis with (a) the radiographic improvement pattern, (b) the time of surfactant application, and (c) the incidence of pulmonary complications, respectively. RESULTS: Forty-six (59%) of 78 infants survived, and 32 (41%) died. The survivors comprised 38 infants in group 1 (67%, n=57), six in group 2 (46%, n=13), and two in group 3 (25%, n=8) (p 0.05). Infants with barotrauma had a lower survival rate (42%, 10/24) than those not suffering from this condition (67%, 36/54) (p<0.05). The condition oc-curred in 12 (21%) of 57 infants in group 1, six (46%) of 13 in group 2, and six (75%) of eight in group 3 (p <0.05). Eleven(92%) of 12 infants with pulmonary hemorrhage, seven (100%) of seven with intracranial hemorrhage above grade 3, and seven (41%) of 17 with sepsis died. CONCLUSION: The radiographic changes occurring after surfactant replacement therapy correlated closely with the incidence of barotrauma and the prognosis of newborns with respiratory distress syndrome. Close observation of follow-up radiographic findings plays an important role in therapy and prognosis.

Gastric Emptying Time in Preterm Infents: Comparison between Breast Milk and Formula Milk

PURPOSE: Failure of adequate gastric emptying frequently interferes with successful enteral nutrition in infants. Study of gastric emptying in preterm infants has been hampered by the absence of a suitable and, valid technique, but ultrasonic assessment is well tolerated by infants. The aim of this study is to compare gastric emptying rates of breast milk and formula within preterm infants using an ultrasonic technique. METHODS: Ten infants(6 males, 4 females) were studied on 20 occasions. Median gestation of the group was 33 wks(29-38 wks), birthweight was 1506gms(850-1870gms). Each infant was receiving a minimum of 150 ml/kg/day of breast milk. We conducted the study with breast milk first and with formula milk 2 days later. With the infant in the right lateral position, ultrasonic images of the gastric antrum were obtained using the aorta bifurcational branch of superior mesenteric artery as constant landmarks. Measurements of antral cross sectional area(ACSA) were made before the feed and then sequentially, following its completion until ACSA returned to its pre-feeding state. Half-emptying time(t1/2) was calculated as the time taken for the ACSA to fall to half the maximal increment. The test was well tolerated by all subjects. RESULTS: There was a strong linear relationship between gastric volume and ACSA. The half-emptying time for breast milk was less than formula : t1/2 breast milk 32.0+/-9.8 min; t1/2 formula 45.0+/-11.6 min, P=0.0004. CONCLUSION: The data demonstrate that human milk increases gastric emptying compared to formula. This has important implications for the management of preterm infants who have feeding intolerances.

A Case of Hydranencephaly Caused by Internal Carotid Artery Stenosis: Diagnosis with Doppler Sonogram

Hydranencephaly is congenital absence of the cerebral hemispheres which are replaced by a large fluid-filled cavity. The brain stem and basal ganglia are well formed and rudiments of frontal k occipital cortex may be present. We experienced a case of hydranencephaly caused by both internal carotid artery stenosis. We diagnosed it through the brain CT sonogram and doppler sonogram. A brief review of the related literatures was made.

The Usefulness of Whole Body Bone Mineral Densitometry in the Osteopenia of Preterm Infants: Comparison with the Wrist Radiography and Biochemical Parameters

PURPOSE: To evaluate the usefulness of whole body bone mineral densitometry in the diagnosis of frequent osteopenia of preterm infants by comparison with the wrist radiographs and biochemical parameters. MATERIALS AND METHODS: From January 1995 to January 1996, we obtained whole body bone mineral density(BMD) studies using dual energy X-ray absorptiometry(DXA) and wrist radiographs of 39 preterm infants. They were divided into three groups according to birth weight, under 1500g, 1501g to 2000g and above 2000g, and four grades of skeletal change, as seen on wrist radiography, according to the scoring method of Koo et al. Groups of birth weight and grades of skeletal change were then correlated with whole body BMD and biochemical parameters. For comparison, normal data were obtained from 13 infants born at full term. Data were analyzed by one way analysis of variation(ANOVA) and correlation and regression analysis. A p-value of less than 0.05 was considered significant. RESUTLS: Whole body BMDs were significantly lower in the more premature and smaller birth weight infants(r=0.77, p=0.0000), and in the higher grade of skeletal change (r=-0.5276, p=0.0000). Aggravated skeletal changes were found in infants with lower birth weight(r=-0.3822, p=0.01). Interobserver variation in grading skeletal change was 42.9%, and intraobserver variation was 18.4%. Biochemical parameters such as serum calcium, phosphate, alkaline phosphatase, parathromone, calcitonin and 25-hydroxy-vitamine D did not vary significantly according to either birth weight or skeletal change (p>0.05). CONCLUSION: Premature osteopenia is more effectively diagnosed by measuring whole body BMD using DXA than by grading radiographical skeletal change or by biochemical parameters.

Value of infusion-DSA(digital subtraction angiography) in diagnosis of primary hepatocellular carcinoma

No abstract available.