Development of Protocol for Korean Lung Cancer Screening Project (K-LUCAS) to Evaluate Effectiveness and Feasibility to Implement National Cancer Screening Program / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: To reduce lung cancer mortality, lung cancer screening was recommended using low-dose computed tomography (LDCT) to high-risk population. A protocol for multicenter lung cancer screening pilot project was developed to evaluate the effectiveness and feasibility of lung cancer screening to implement National Cancer Screening Program in Korea. MATERIALS AND METHODS: Multidisciplinary expert committee was comprised to develop a standardized protocol for Korean Lung Cancer Screening Project (K-LUCAS). K-LUCAS is a population-based single arm trial that targets high-risk population aged 55-74 years with at least 30 pack-year smoking history. LDCT results are reported by Lung-RADS suggested by American Radiology Society. Network-based system using computer-aided detection program is prepared to assist reducing diagnostic errors. Smoking cessation counselling is provided to all currently smoking participants. A small pilot test was conducted to check the feasibility and compliance of the protocols for K-LUCAS. RESULTS: In pilot test, 256 were participated. The average age of participants was 63.2 years and only three participants (1.2%) were female. The participants had a smoking history of 40.5 pack-year on average and 53.9% were current smokers. Among them, 86.3% had willing to participate in lung cancer screening again. The average willingness to quit smoking among current smokers was 12.7% higher than before screening. In Lung-RADS reports, 10 (3.9%) were grade 3 and nine (3.5%) were grade 4. One participant was diagnosed as lung cancer. CONCLUSION: The protocol developed by this study is assessed to be feasible to perform K-LUCAS in multicenter nationwide scale.

A Possible Case of Statin-Induced Ichthyosis in an Elderly Woman / 가정의학회지

Ichthyosis is a heterogeneous group of hereditary or acquired skin disorders, characterized by increased stratum corneum production. Several systemic diseases and many drugs can occasionally cause acquired ichthyosis. We report a case of statin-induced ichthyosis in which the causality between statin and ichthyosis was found possible by using the Naranjo scale. A 79-year-old woman presented with pruritic skin lesions on both legs that appeared erythematous, scaly, and cracked. A clinical diagnosis of acquired ichthyosis was made and the statin was suspected as the cause. The skin lesions improved after 6 weeks of dose reduction of the statin.

Link between Short Sleep Duration and Hypertension / 가정의학회지

No abstract available.

Subclinical Thyroid Dysfunction in the Elderly

Subclinical thyroid dysfunction, including both subclinical hyperthyroidism and subclinical hypothyroidism is biochemically defined as an abnormal thyroid-stimulating hormone (TSH) level and thyroid hormone level within its reference range. The prevalence of this condition varies according to the reference range for TSH and geographic or demographic factors, but is common in the elderly and in women. Subclinical thyroid dysfunction has various causes. Thus, careful clinical assessment is needed. Subclinical thyroid dysfunction can be likely to progress to overt thyroid disease and be associated with various health outcomes. However, to date, supporting data are lacking and levels of evidence for the associations are different. Although the management of subclinical thyroid dysfunction is controversial, recommendations are based on the degree to which TSH levels have deviated from normal, age, symptoms, and underlying comorbidities. Further studies are needed to inform how to best care for the elderly with subclinical thyroid dysfunction.

Association of Arterial Stiffness and Osteoporosis in Healthy Men Undergoing Screening Medical Examination

BACKGROUND: Association of arterial stiffness and osteoporosis has been previously reported in women. However, this association is still controversial for men. Therefore, we investigated correlation of arterial stiffness and osteoporosis by measuring brachial-ankle (ba) pulse wave velocity (PWV) and bone mineral density (BMD). METHODS: We reviewed medical charts of 239 people (women: 128, men: 111) who visited the Health Promotion Center, retrospectively. ba-PWV was measured by automatic wave analyzer. Lumbar spine (L1-L4) BMD and femur BMD were measured by dual energy X-ray absorptiometry. Metabolic syndrome was based on the National Cholesterol Education Program (NCEP)-Adult Treatment Panel (ATPIII) definition. Body mass index (BMI)>25 kg/m2 was used instead of waist circumference. RESULTS: In Pearson's correlation analysis, PWV and femur BMD (Neck, total) had a significant inverse relationship in men (r=-0.254, P=0.007; r=-0.202, P=0.034). In women, PWV and the L-spine, femur (Neck, total) had a significant inverse relationship. (r=-0.321, P<0.001; r=-0.189, P=0.032; r=-0.177, P=0.046) Age and PWV showed the greatest association in both men and women (r=0.46 P<0.001; r=0.525, P<0.001) In multiple regression analysis, the L-spine BMD and PWV had an independent relationship in women after adjusting for age, metabolic syndrome, BMI, smoking, drinking and exercise. (r=-0.229, P=0.015). No independent association was found between PWV and BMD in men. CONCLUSIONS: The association between arterial stiffness and BMD was confirmed in women. However, this association was not statistically significant for men.

Association of Health Risk Behaviors with Mental Health among Elderly Koreans

BACKGROUND: Korea is currently experiencing a rapid aging of its population. With regards to healthy aging, a mental health status is an important factor in the elderly. The purpose of our study was to investigate the prevalence of mental health problems (depression symptoms, anxiety symptoms, poor quality of life) and to examine the relationships between health behaviors and mental health status. METHODS: The data were collected from the Korean Longitudinal Study on Aging, which was designed to compile information on several aspects of aging for use, as a basic statistical data in interdisciplinary research. A total of 5,548 elderly aged 60 years or older were included in this descriptive cross-sectional study. The results were examined with multiple logistic regression analysis. RESULTS: The prevalence of depression, anxiety experience, and poor quality of life was 40.8%, 29.9%, and 54.6%, respectively. Current smoking was significantly associated with the risk of anxiety symptoms and poor quality of life (adjusted prevalence odds ratio [POR], 1.24; 95% confidence interval [CI], 1.02 to 1.52 and adjusted POR, 1.34; 95% CI, 1.12 to 1.60, respectively). Also, not exercising regularly was significantly associated with all of the mental health problems (depression and anxiety symptoms, and poor quality of life), which were measured in this study (adjusted POR, 1.31; 95% CI, 1.14 to 1.51 and adjusted POR, 1.39; 95% CI, 1.19 to 1.62 and adjusted POR, 1.45; 95% CI, 1.27 to 1.65, respectively). CONCLUSION: Elderly Koreans with health risk behaviors are likely to be vulnerable to mental health concerns. This finding underscores the continued needs to design and implement mental health policies at the community or the country level, especially in elderly Koreans with health risk behaviors.

Risedronate-related Localized Amnesia in an Elderly Patient with Osteoporosis

Osteoporosis is the most common metabolic bone disease that results in an increased risk of fragility fractures. Bisphosphonates are commonly used in the treatment of osteoporosis. Concerns about their association with several possible adverse effects have been raised. Here, we experienced a rare case regarding a 63-year-old female patient who had localized amnesia related to once-monthly oral risedronate. A clear cause-and-effect relationship between the treatment of risedronate and this event has not been established and the mechanism behind the adverse effect is unknown. As clinical uses of bisphosphonates continue to expand, clinicians should be aware of the rare but potential adverse effects associated with bisphosphonates including neuropsychiatric problems.

Factors Associated with the Use of Uterine Cervical Cancer Screening Services in Korean Elderly Women / 가정의학회지

BACKGROUND: The Papanicolaou (Pap) smear test is an effective screening test for the early detection of uterine cervical cancer. The Pap test still plays an important role in Korean elderly women, as uterine cervical cancer remains a frequent form of cancer and an important cause of death. However, the participation rate and other factors related to the Pap test in Korean elderly women have been studied insufficiently. METHODS: This study included 654 individuals aged 65 and over who completed a cervical cancer screening questionnaire from the Third Korean National Health and Nutrition Examination Survey 2005. Using multiple logistic regression, odds ratios and confidence intervals for the association between attendance of the Pap test and sociodemographic or health-related factors were calculated. RESULTS: One hundred and eleven individuals (17.0%) of the study population showed compliance with Pap testing within the previous 2 years. We recognized that the most elderly women (75 years and over) or those with lower levels of education were less likely to have had the test. CONCLUSION: Primary health care providers need to make efforts to improve attendance rates of Pap smear screening in Korean elderly women, individually taking into account previous Pap results, life expectancy, risk factors for cervical cancer, and preferences. More attention will especially be needed among the eldest elderly or less educated elderly women.