Association of High-Density Lipoprotein Cholesterol Phenotypes with the Risk of Cardiovascular Diseases and Mortality: A Cohort Study in Korea

Background@#We investigated whether low high-density lipoprotein cholesterol (HDL-C) and isolated and non-isolated low HDL-C levels are associated with the risk of cardiovascular diseases and all-cause mortality among Korean adults. @*Methods@#We included 8,665,841 individuals aged ≥20 years who had undergone a health examination provided by the Korean National Health Insurance Service (NHIS) in 2009 and were followed up until the end of 2018. The hazard ratios (HRs) and 95% confidence intervals (CIs) for study outcomes were calculated using multivariable Cox proportional hazard regression analysis. @*Results@#During the 8.2 years of mean follow-up, myocardial infarction (MI), stroke, and all-cause mortality occurred in 81,431, 110,996, and 244,309 individuals, respectively. After adjusting for confounding variables (model 3), individuals with low HDL-C and lower HDL quartiles were associated with significantly increased risks of all three outcomes, compared to those with normal HDL-C and highest HDL-C quartile (all P<0.001), respectively. HRs for incident MI (1.28; 95% CI, 1.26 to 1.30), stroke (1.13; 95% CI, 1.11 to 1.15), and all-cause mortality (1.07; 95% CI, 1.05 to 1.08) increased in the non-isolated low HDL-C group compared to the normal HDL-C group. Isolated low HDL-C also showed an increase in the HRs of incident stroke (1.06; 95% CI, 1.04 to 1.08) and all-cause mortality (1.30; 95% CI, 1.28 to 1.32). @*Conclusion@#Low HDL-C and non-isolated low HDL-C were associated with increased risk of MI, stroke, and all-cause mortality, and isolated low HDL-C was associated with incident stroke and all-cause mortality risk.

Analysis of the Time Interval between the Physician Order for Life-Sustaining Treatment Completion and Death / 가정의학회지

Background@#This study aimed to explore the time interval distribution pattern between the Physicians Order for Life-Sustaining Treatment (POLST) form completion and death at a tertiary hospital in South Korea. It also examined the association between various independent parameters and POLST form completion timing. @*Methods@#A total of 150 critically ill patients admitted to Korea University Guro Hospital between June 1, 2018 and December 31, 2018 who completed the POLST form were retrospectively analyzed and included in this study. Data were analyzed with descriptive statistics, and group comparisons were performed using the chi-square test for categorical variables. Fisher’s exact test was also used to compare cancer versus non-cancer groups. @*Results@#More than half the decedents (54.7%) completed their POLST within 15 days of death and 73.4% within 30 days. The non-cancer group had the highest percentage of patients (77.8%) who died within 15 days of POLST form completion while the colorectal (39.1%) and other cancer (37.5%) groups had the lowest (P=0.336). @*Conclusion@#Our findings demonstrated a current need for more explicit guidance to assist physicians with initiating more timely, proactive end-of-life discussions.

Incidence and Risk Factors for Dementia in Type 2 Diabetes Mellitus: A Nationwide Population-Based Study in Korea

BACKGROUND: Diabetes mellitus is associated with an increased risk of dementia. We aimed to comprehensively analyze the incidence and risk factors for dementia and young-onset dementia (YOD) in diabetic patients in Korea using the National Health Insurance Service data.METHODS: Between January 1, 2009 and December 31, 2012, a total of 1,917,702 participants with diabetes were included and followed until the date of dementia diagnosis or until December 31, 2015. We evaluated the incidence and risk factors for all dementia, Alzheimer's disease (AD), and vascular dementia (VaD) by Cox proportional hazards analyses. We also compared the impact of risk factors on the occurrence of YOD and late-onset dementia (LOD).RESULTS: During an average of 5.1 years of follow-up, the incidence of all types of dementia, AD, or VaD was 9.5, 6.8, and 1.3/1,000 person-years, respectively, in participants with diabetes. YOD comprised 4.8% of all dementia occurrence, and the ratio of AD/VaD was 2.1 for YOD compared with 5.5 for LOD. Current smokers and subjects with lower income, plasma glucose levels, body mass index (BMI), and subjects with hypertension, dyslipidemia, vascular complications, depression, and insulin treatment developed dementia more frequently. Vascular risk factors such as smoking, hypertension, and previous cardiovascular diseases were more strongly associated with the development of VaD than AD. Low BMI and a history of stroke or depression had a stronger influence on the development of YOD than LOD.CONCLUSION: The optimal management of modifiable risk factors may be important for preventing dementia in subjects with diabetes mellitus.

A Randomized, Double-Blind, Placebo-Controlled, Multi-Centered Clinical Study to Evaluate the Efficacy and Safety of Artemisia annua L. Extract for Improvement of Liver Function

Non-alcoholic fatty liver disease (NAFLD) has the potential to develop into hepatic steatosis and progress to terminal liver diseases such as cirrhosis and hepatocellular carcinoma. This human clinical study was aimed to demonstrate that SPB-201 (powdered-water extract of Artemisia annua) can improve liver function in subjects with non-alcoholic liver dysfunction at mild to moderate levels. A decrease of 271% in aspartate aminotransferase (AST) level and a significant decrease of 334% in alanine aminotransferase (ALT) level was observed in the test group as compared to the control group at the 4 weeks follow-up. In addition, after 8 weeks, decreases of 199% in AST level and 216% in ALT level were reported in the test group as compared to the control group. These results confirmed that SPB-201 intake significantly enhanced liver function and health. Moreover, the Multidimensional Fatigue Scale score of the test group decreased but that of the control group increased, implicating that SPB-201 also eliminated overall fatigue. No significant adverse events were observed among all subjects during the study. Taken together, our clinical study confirmed the excellent efficacy and safety of SPB-201 in liver function improvement, showing the possibility of SPB-201 as a functional food to restore liver dysfunction and treat liver diseases.

A Randomized, Double-Blind, Placebo-Controlled, Multi-Centered Clinical Study to Evaluate the Efficacy and Safety of Artemisia annua L. Extract for Improvement of Liver Function

Non-alcoholic fatty liver disease (NAFLD) has the potential to develop into hepatic steatosis and progress to terminal liver diseases such as cirrhosis and hepatocellular carcinoma. This human clinical study was aimed to demonstrate that SPB-201 (powdered-water extract of Artemisia annua) can improve liver function in subjects with non-alcoholic liver dysfunction at mild to moderate levels. A decrease of 271% in aspartate aminotransferase (AST) level and a significant decrease of 334% in alanine aminotransferase (ALT) level was observed in the test group as compared to the control group at the 4 weeks follow-up. In addition, after 8 weeks, decreases of 199% in AST level and 216% in ALT level were reported in the test group as compared to the control group. These results confirmed that SPB-201 intake significantly enhanced liver function and health. Moreover, the Multidimensional Fatigue Scale score of the test group decreased but that of the control group increased, implicating that SPB-201 also eliminated overall fatigue. No significant adverse events were observed among all subjects during the study. Taken together, our clinical study confirmed the excellent efficacy and safety of SPB-201 in liver function improvement, showing the possibility of SPB-201 as a functional food to restore liver dysfunction and treat liver diseases.

Associated Factors for Target Blood Pressure Achievement after Triple Combination Therapy in Hypertensive Patients

BACKGROUND@#The prevalence of hypertension reaches 29% in adults over 30 years of age in the Korean population; however, the control rate is merely 44%. The aim of this study was to investigate the associated factors for target blood pressure achievement after triple combination therapy in hypertensive patients.@*METHODS@#From February 2016 to May 2018, 10 family physicians recruited 348 patients, who newly started a triple combination antihypertensive medication. Target blood pressure was defined as a systolic blood pressure (SBP) <140 mmHg and diastolic blood pressure (DBP) <90 mmHg after 6 months of triple combination therapy. Multivariate logistic regression analyses were performed to analyze the associated factors for target blood pressure achievement.@*RESULTS@#Among the 348 study participants, 317 completed 6 months of treatment. The target achievement rate was 76.3% (242/317). The mean absolute difference and 95% confidence interval (CI) for the SBP and DBP were 10.8 mmHg (8.8 to 12.7) and 6.4 mmHg (5.1 to 7.8), respectively (P<0.05). The odds ratio (OR) for the target blood pressure achievement increased in those with college education or higher (OR, 2.69; 95% CI, 1.22–5.92), those with dyslipidemia (OR, 1.74; 95% CI, 1.01–2.99), and those who were satisfied with the medication (OR, 29.91; 95% CI, 3.70–241.92).@*CONCLUSIONS@#The presence of dyslipidemia and patient's satisfaction with the medication were associated with target blood pressure achievement in our analyses. Our findings suggest the importance of patient's factor in the control of blood pressure.

Impact of the Dynamic Change of Metabolic Health Status on the Incident Type 2 Diabetes: A Nationwide Population-Based Cohort Study

BACKGROUND: Metabolically healthy obese (MHO) is regarded as a transient concept. We examined the effect of the dynamic change of metabolic health status on the incidence of type 2 diabetes mellitus (T2DM) both in obese and normal weight individuals.METHODS: We analyzed 3,479,514 metabolically healthy subjects aged over 20 years from the Korean National Health Screening Program, who underwent health examination between 2009 and 2010, with a follow-up after 4 years. The relative risk for T2DM incidence until the December 2017 was compared among the four groups: stable metabolically healthy normal weight (MHNW), unstable MHNW, stable MHO, and unstable MHO.RESULTS: During the 4 years, 11.1% of subjects in the MHNW group, and 31.5% in the MHO group converted to a metabolically unhealthy phenotype. In the multivariate adjusted model, the unstable MHO group showed the highest risk of T2DM (hazard ratio [HR], 4.67; 95% confidence interval [CI], 4.58 to 4.77). The unstable MHNW group had a higher risk of T2DM than stable MHO group ([HR, 3.23; 95% CI, 3.16 to 3.30] vs. [HR, 1.81; 95% CI, 1.76 to 1.85]). The stable MHO group showed a higher risk of T2DM than the stable MHNW group. The influence of the transition into a metabolically unhealthy phenotype on T2DM incidence was greater in subjects with aged <65 years, women, and those with weight gain.CONCLUSION: Metabolically healthy phenotype was transient both in normal weight and obese individuals. Maintaining metabolic health was critical for the prevention of T2DM, irrespective of their baseline body mass index.

Associated Factors for Target Blood Pressure Achievement after Triple Combination Therapy in Hypertensive Patients

BACKGROUND: The prevalence of hypertension reaches 29% in adults over 30 years of age in the Korean population; however, the control rate is merely 44%. The aim of this study was to investigate the associated factors for target blood pressure achievement after triple combination therapy in hypertensive patients. METHODS: From February 2016 to May 2018, 10 family physicians recruited 348 patients, who newly started a triple combination antihypertensive medication. Target blood pressure was defined as a systolic blood pressure (SBP) <140 mmHg and diastolic blood pressure (DBP) <90 mmHg after 6 months of triple combination therapy. Multivariate logistic regression analyses were performed to analyze the associated factors for target blood pressure achievement. RESULTS: Among the 348 study participants, 317 completed 6 months of treatment. The target achievement rate was 76.3% (242/317). The mean absolute difference and 95% confidence interval (CI) for the SBP and DBP were 10.8 mmHg (8.8 to 12.7) and 6.4 mmHg (5.1 to 7.8), respectively (P<0.05). The odds ratio (OR) for the target blood pressure achievement increased in those with college education or higher (OR, 2.69; 95% CI, 1.22–5.92), those with dyslipidemia (OR, 1.74; 95% CI, 1.01–2.99), and those who were satisfied with the medication (OR, 29.91; 95% CI, 3.70–241.92). CONCLUSIONS: The presence of dyslipidemia and patient's satisfaction with the medication were associated with target blood pressure achievement in our analyses. Our findings suggest the importance of patient's factor in the control of blood pressure.

Association between electronic cigarette smoking and allergic rhinitis – The Korea National Health and Nutrition Examination Survey (2015)

PURPOSE: Allergic rhinitis (AR) is one of the common chronic diseases. Although it is not a life-threatening disease, its persistent symptoms may cause fatigue, mood change, discomfort at work, and academic disability as well as the decrease of quality of life. The prevalence of AR has been increasing steadily due to the Westernized lifestyle and environmental change. In previous studies, it has been found that AR has a clear relationship with smoking. However, there is no relationship study between AR and electronic cigarettes smoking (ECS). METHODS: The study was conducted on >19-year-old adults who participated in the 2015 Korea National Health and Nutrition Examination Survey. Sex, age, residence status, tobacco smoking, alcohol drinking, stress level, economic status, and diagnosis of AR were analyzed by using univariate and multivariate logistic regression analyses. RESULTS: AR tended to be associated with ECS in the Korean adult population in univariate analysis, but ECS was not statistically significant in multivariate analysis. By multivariate analysis, AR was significantly related with younger age, male sex, alcohol consumption, and stress. Moreover, the prevalence of AR was linearly decreased as age increased from 19 to 69 years. CONCLUSION: A diagnosis of AR was not significantly associated with ECS. Instead, AR showed an increased prevalence in adults at younger age, of male sex, and with alcohol consumption and high stress. To derive statistically significant results of relationship between AR and ECS, more well-designed studies focusing on the temporal causal are needed.

The Relationship between Opioids Use, Cortisol and DHEAS / 한국호스피스완화의료학회지

PURPOSE: Fatigue, energy loss, feeling of helplessness, poor appetite, pain besides general weakness are major symptoms presented to terminally ill cancer patients. These symptoms are similar to those that appeared with adrenal insufficiency. Also, for terminally ill cancer patients who are hospitalized for palliative care, opioid agents are prescribed to control moderate to severe pain. We studied the relationship of opioid agents and adrenal insufficiency. METHODS: From November 2013 through June 2014, we monitored the serum level of cortisol and dehydroepiandrosterone sulfate (DHEAS, serum) in 55 cancer patients who were over 18 years old and were treated at a hospice center. We also checked the treatment period and dosage of opioid agents. RESULTS: The DHEAS level, treatment period and dosage of opioid agents did not have significant correlation. Correlation between the serum cortisol level and the opioid agent treatment period was not significant either, but the serum cortisol level was positively correlated with the dosage of opioid agents (P value 0.0322). CONCLUSION: This study did not identify a novel link between treatment period, dosage of opioid agents and adrenal insufficiency. But, the DHEAS level was mostly below the normal level in patients who were treated with opioid agents.

2014 Clinical Practice Guidelines for Overweight and Obesity in Korea

The dramatic increase in the prevalence of obesity and its accompanying comorbidities are major health concerns in Korea. Obesity is defined as a body mass index > or =25 kg/m2 in Korea. Current estimates are that 32.8% of adults are obese: 36.1% of men and 29.7% of women. The prevalence of being overweight and obese in national surveys is increasing steadily. Early detection and the proper management of obesity are urgently needed. Weight loss of 5% to 10% is the standard goal. In obese patients, control of cardiovascular risk factors deserves the same emphasis as weight-loss therapy. Since obesity is multifactorial, proper care of obesity requires a coordinated multidisciplinary treatment team, as a single intervention is unlikely to modify the incidence or natural history of obesity.

Gender specific effect of major dietary patterns on the metabolic syndrome risk in Korean pre-pubertal children

There is a lack of data on metabolic risk factors during pre-puberty, which is important for identifying the subgroups of youth, at whom early interventions should be targeted. In this study, we evaluated the prevalence of metabolic risk factors and its subsequent relations with dietary patterns in Korean pre-pubertal children through a cross-sectional sample (n = 1,008; boys = 513) of pre-pubertal children (aged 8-9 years) from a sub-study of the Korea Metabolic Syndrome Research Initiatives (KMSRI) in Seoul, Korea. Measures of anthropometry and blood pressure as well as fasting blood samples were used in the analysis. A three-day food records were collected. The metabolic syndrome was defined according to the age-adjusted National Cholesterol Education Program Adult Treatment Panel III guidelines. An added metabolic risk score was calculated for each subject by summing the quintile values of the five individual risk factors. Among the 5 risk components of metabolic syndrome, high waist circumference (WC) was the major factor (P < 0.001). A significant increasing trend of the added metabolic syndrome risk score was observed with the increase of WC (P (trend) < 0.001) among both genders. The cutoff point for high WC for pre-pubertal children was 61.3 cm for boys and 59.9 cm for girls. The prevalence of high triglyceride (TG) values was significantly higher in girls than it was in boys (P < 0.01). Girls in the highest quintile of balanced dietary pattern scores had lower TG values (P (trend) = 0.032) than did those in the lowest quintile. Moreover, girls in the highest quintile of western dietary pattern scores showed increasing trend for the added metabolic risk score (P (trend) = 0.026) compared with those in the lowest quintile. Adverse associations exist between western dietary patterns and the accumulation of metabolic risks among girls, not in boys, even during pre-puberty.

The Educational Effect of Pre-medical Curriculum for a Service Learning Program

BACKGROUND: A curriculum in medical school should help doctors achieve professional attitude, ethics and values by socialization process. However, existing knowledge-based curriculum has lots of shortcomings to reach these ideal goals. This study was operated to investigate the effect of a 'service-learning program' for premedical students in medical college of Korea University. METHODS: The survey was conducted from July 3 2006 to 5 at Chungbuk Eumsung Kkottongnae. A total of 99 students completed surveys; before and after the intervention. The questionnaire was consisting of necessity and goal of the program and it also include assessment of students' attitude and contents of the program. Each item was assessed by using 5-Likert scale. For comparing the items, we practiced paired t-test. RESULTS: 97 (response rate 97.9%) students completed survey. 53 students (54.6%) agreed 'the program is really needed.' About the questions: 'self-development from program', 'the program will be helpful for medical activity in the future.' students gave positive answers. The participants' attitude, interest was significantly increased. Also 'the motivation', 'appropriation of the program and time allocation', 'general satisfaction' were all increased. CONCLUSION: 54.6% of participants thought a service-learning program was necessary for a medical curriculum and this program would be helpful to get self-development and professionalism. Active attending for a service-learning program increased interest and motivation. It will be needed further study about the long-term effect of a service-learning program.

Association Study between Tic Disorder and Dopamine D2 Receptor Gene Polymorphism in Korean Population

OBJECTIVES: The purpose of the present study was to investigate whether the Taq I A polymorphism of dopamine receptor D2 gene(DRD2) is associated with Tourette syndrome(TS) and chronic motor tic disorder(CMT) in Korean population. METHODS: DRD2 Taq I A RFLP genotyping was carried out with DNA extracted from blood samples of 75 patients with tic disorders(47 with TS and 28 with CMT) and 90 healthy subjects. Genotype and allelic frequencies for the DRD2 gene polymorphisms of the tic disorder group as a whole were compared to those of the control group. Separating the TS group, thereafter, the frequency of genotypes and alleles were compared to those of the controls. RESULTS: The results demonstrated that genotype and allele distributions for the DRD2 gene polymorphism in the tic disorder as a whole, TS, and control groups were not significantly different. CONCLUSION: No association was found for DRD2 gene, TS and CMT. The data suggest that DRD2 gene may not be a useful marker for the prediction of the susceptibility of tic disorder.

Relationship between Percent Body Fat and Cardiovascular Risk Factors for Normal Weight Adults

BACKGROUND: To investigate the relationship between adiposity and risk factors for cardiovascular disease (CVD) in normal weight individuals. METHODS: The study subjects were those over 19 years old, less than 23 kg/m2 of body mass index (BMI). They were examined in a health promotion center of a general hospital from June to November, 2001 (309 men and 369 women). Height, weight, BMI, blood pressure (BP), serum lipids and fasting blood glucose (FBS) were checked. Percent body percent (%BF) was obtained by bioelectrical method. Normal weight subjects were divided into two groups according to their %BF; then, the groups were evaluated for the presence of CVD risk factors. RESULTS: The average age of the study subjects was 43.66+/-11.26 years old in men and 41.11+/-10.90 years old in women. The average BMI was 21.15+/-1.47 kg/m2 in men and 20.68+/-1.53 kg/m2 in women. High %BF group showed significantly increased frequency of higher BP, FBS, total cholesterol (TC), triglyceride (TG) and LDL-cholesterol (LDL-C) compared with low %BF group in both sexes. In men, odds ratios (ORs) of the high %BF group with respect to the low %BF group were significantly high for BP and TG elevation. ORs of the high %BF group were significantly high for FBS, TC, LDL-C and TG elevation in women. ORs for more than one CVD risk factor was 2.46 (1.38~4.38) in men and 1.50 (0.95~2.36) in women. CONCLUSION: Increased %BF was related to cardiovascular risk factors in normal weight subjects. The result was more significant for normal weight men than normal weight women.

Prevalence of the Metabolic Syndrome in Korean Children and Adolescents: Korea National Health and Nutrition Survey 2001

BACKGROUND: As the metabolic syndrome represents a constellation of cardiovascular risk factors,its prevention is very important. Especially, child and adolescent obesity and metabolic abnormalities track into adulthood and it may promote the development of the metabolic syndrome in adults. however, in Korea there are only few studies about the metabolic syndrome of children and adolescents. Therefore, the objective of this study was to determine the prevalence and distribution of the metabolic syndrome in Korean children and adolescents. METHODS: The Korean National Health and Nutrition Survey (KNHNS) 2001 was a nation representative survey with a stratified multistage sampling design. Data from a comprehensive questionnaire, physical examination, and blood sample were obtained from 1,090 Korean children and adolescents (567 boys, 523 girls), aged 10 to 19 years. The metabolic syndrome was determined by using the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATPIII) definition modified for age. RESULTS: The prevalence of the metabolic syndrome in Korean children and adolescents was 7.1% (9.2% in boys, 4.8% in girls). The syndrome was present in 36.6% of overweight children and adolescents (body mass index [BMI] > or = 95th percentile) compared with 11.2% of at-risk children and adolescents (BMI 85th to <95th percentile) and 2.5% of those with a BMI below the 85th percentile (P<0.001). A multivariate logistic regression model showed a significant increase in risk of the metabolic syndrome in association with gender and BMI. CONCLUSION: Overall, 7.1% of children and adolescents and 36.6% of overweight children and adolescents in Korea met the criteria for the metabolic syndrome. These findings emphasize the need for both public health and clinical interventions to improve the detection, prevention, and treatment of the metabolic syndrome, especially in obese children and adolescents.

Hypoadiponectinemia and Insulin Resistance are Associated with Nonalcoholic Fatty Liver Disease

We investigated the association between nonalcoholic fatty liver disease (NAFLD) and plasma adiponectin levels and insulin resistance. We recruited study subjects among one hundred and eighty one persons who were examined abdominal ultrasound at routine screening tests. A standard interview (consumption of alcohol and medical history), physical examination (height, weight, waist circumference, and blood pressure), and biochemical study (lipid parameters, aminotransferases, fasting plasma glucose, fasting insulin, and plasma adiponectin) were performed. Subjects who consumed alcohol more than moderate, evidence of viral hepatitis, toxic hepatitis, and serious cardiac, renal, or hepatic disease were excluded. Thirty-eight NAFLD patients and 53 control subjects diagnosed by ultrasound were finally analyzed. The plasma adiponectin level was significantly correlated with HDL-cholesterol (r=0. 38, p<0.001), triglycerides (r=-0.22, p=0.04), fasting insulin (r=-0.37, p<0.01), and insulin resistance by homeostasis model of assessment-insulin resistance (HOMAIR) (r=-0.39, p<0.01), after adjusting for age, sex, and adiposity. Multiple logistic regression analysis indicated that HOMA-IR was a significant predictor of having NAFLD (odds ratio [OR]=2.38; 95% confidence interval [CI]: 1.52-5.74), while adiponectin had a protective effect against NAFLD (OR=0.22; 95% CI: 0.09-0.55). We demonstrated that hypoadiponectinemia and insulin resistance are associated with NAFLD independent of obesity.

Usefullness of Thermography in Migraine Diagnosis

Background : The reports from researchers present new imaging diagnosis, which makes it possible to observe the vascular change(temperature change) of face in migraine. However, we do not have enough study for thermography to find out migraine in Korea. thus, this study was performed in order to apply thermography to migraine patients. Methods : From November in 1989 to July in 1999, patients with headache who visited to Korea University Hospital Family Medicine were undertaken. Among them, 6 patients who were appropriated for the International Headache Society criteria for migraine were performed facial thermography. Results : Six patients who were appropriate for IHS criteria for migraine were undertaken in this study. When they had headache attack, we tested thermography. Asymmetry of heat loss on supraorbital and frontotemporal areas was not significantly different in three of them. The others showed the difference of heat loss more than 0.5 degrees C in supraorbital and frontotemporal areas. It was in headache side that heat loss was showed. Two of patients who showed heat loss were enable to follow up and one of them showed the disappearance of asymmetrical heat loss. Conclusions : As a result, facial thermograms demonstrated the significant differences in heat loss from the temple and orbits in migraine patients. We concluded thermography in migraine patients is suitable for clinical use

Usefulness of Thermography in Diabetic Neuropathy

Background : diabetic neuropathy is one of the serious complication of diabetes mellitus and it can cause serious foot problems. These foot problems could be preventable if early detection method of diabetic neuropathy is established. Therefore, essential diagnostic tool is needed. The changes on electrophysiologic studies(EPS) may to be necessarily correlated with clinical neuropathy. Theater has attempted to confirm the thermography as an useful tool for detecting diabetic peripheral neuropathy. Methods : Author has studied 20 patients with diabetes visiting to department of family medicine of Korea University Hospital between December 1, 1998 and June, 30, 1999. All cases were evaluated on clinical criteria. Furthermore, the EPS and thermography have been taken. The author investigated the results of thermograpy and the relation of the clinical diagnosis and EPS. Results : among 20 cases, 12(60.0%) cases have shown abnormality on EPS and 6(30.0%) cases of them was also abnormal on clinical criteria, the other 8(40.0%) cases were normal on EPS. Results of EPS were moderately related to clinical diagnosis. 10(50.0%) cases have shown abnormality on thermography and 6(30.0%) cases of them were also abnormal on clinical criteria, the other 10(50.0%) cases were normal on thermography. Results of thermography were related to clinical diagnosis. Among 12(60.0%) cases were abnormal on EPS, 9(45%) cases also have shown abnormality on thermography. Among 8(40.0%) cases were normal on EPS, 7(35.0%) cases were also normal on thermography. Results of thermography were highly related to EPS. Conclusion : Thermography is a useful diagnostic tool in diabetic peripheral neuropathy.

Practicality of thermography in evaluation of osteoarthritis of knee joint

BACKGROUND: About 80 percent of the Korean population over 55 years old show radiographic signs of osteoarthritis. Hence, osteoarthritis has become one of the most important public health problem among the old age. Despite the importance of this disease, proper methods for evaluation and diagnosis of osteoarthritis have not been developed. Authors have investigated the sensitivity and specificity of thermography in diagnosing osteoarthritis. METHODS: Twenty patients who had visited the department of family medicine, Korea University Hospital, with non-traumatic knee pain during the period from April 1 to May 30, 1999, were included in the study. Patients had gone through series of careful history taking, physical examination and laboratory evaluations for clinical evaluation of osteoarthritis of the knee joints. Furthermore, the radiographic and thermographic examination of both knee joints were assessed. RESULTS: Among the twenty patients who have been examined, 15 patients were to have shown radiographic abnormality; on the other hand, 14 patients showed thermographic abnormality. Seventeen patients showed clinical manifestations of osteoarthritis. Twelve patients, among those who had clinical osteoarthritis, were shown to have osteoarthritis in both image studies, i.e. radiographic and thermographic abnormalities. All patients who had not shown clinical osteoarthritis, were normal on both image studies. The sensitivity and specificity of thermography in diagnosing osteoarthritis were 80% and 80%, respectively (P<0.05). CONCLUSIONS: Hot spots or asymmetric distribution in the knee joint area of osteoarthritis patients were in thermographic examination. Thermography has shown efficacy in the evaluation of osteoarthritis.