Rare Disease Entity of Dorsolateral Foot Pain:Lateral Branch of Deep Peroneal Nerve Entrapment Syndrome

When a patient represents pain in foot, physician can easily overlook compression neuropathy of peripheral nerve as it is uncommon. Among nerve entrapment syndrome encountered in the foot, selective compression in lateral branch of deep peroneal nerve (DPN) is rare. We report a case of a patient with pain and dysesthesia in dorsolateral foot which turned out as lateral branch of deep peroneal nerve entrapment syndrome caused by talonavicular joint effusion. We would like to share diagnostic work up flow and conservative treatment courses. This case manifests the importance of the deep peroneal nerve and its branches in clinical setting of pain and ankle instability.

The Korean Version of the Fugl-Meyer Assessment: Reliability and Validity Evaluation

Objective@#To systematically translate the Fugl-Meyer Assessment (FMA) into a Korean version of the FMA (K-FMA). @*Methods@#We translated the original FMA into the Korean version with three translators and a translation committee, which included physiatrists, physical therapists, and occupational therapists. Based on a test-retest method, each of 31 patients with stroke was assessed by two evaluators twice, once on recruitment, and again after a week. Analysis of intra- and inter-rater reliabilities was performed using the intra-class correlation coefficient, whereas validity was analysed using Pearson correlation test along with the Motricity Index (MI), Motor Assessment Scale (MAS), and Berg Balance Scale (BBS). @*Results@#The intra- and inter-rater reliabilities were significant for the total score, and good to excellent reliability was noted in all domains except for the joint range of motion of the lower extremity domain of the K-FMA. The MI and MAS scores were significantly correlated with all domains, all with p<0.01. The results for the MI ranged from r=0.639 to r=0.891 and those for the MAS from r=0.339 to r=0.555. However, the BBS was not significantly correlated with any domain, as the K-FMA lacks balance evaluation items. @*Conclusion@#The K-FMA was found to have high reliability and validity. Additionally, the newly developed manual for the K-FMA may help minimise errors that can occur during evaluation and improve the reliability of motor function evaluation.

The Korean Version of the Fugl-Meyer Assessment: Reliability and Validity Evaluation

Objective@#To systematically translate the Fugl-Meyer Assessment (FMA) into a Korean version of the FMA (K-FMA). @*Methods@#We translated the original FMA into the Korean version with three translators and a translation committee, which included physiatrists, physical therapists, and occupational therapists. Based on a test-retest method, each of 31 patients with stroke was assessed by two evaluators twice, once on recruitment, and again after a week. Analysis of intra- and inter-rater reliabilities was performed using the intra-class correlation coefficient, whereas validity was analysed using Pearson correlation test along with the Motricity Index (MI), Motor Assessment Scale (MAS), and Berg Balance Scale (BBS). @*Results@#The intra- and inter-rater reliabilities were significant for the total score, and good to excellent reliability was noted in all domains except for the joint range of motion of the lower extremity domain of the K-FMA. The MI and MAS scores were significantly correlated with all domains, all with p<0.01. The results for the MI ranged from r=0.639 to r=0.891 and those for the MAS from r=0.339 to r=0.555. However, the BBS was not significantly correlated with any domain, as the K-FMA lacks balance evaluation items. @*Conclusion@#The K-FMA was found to have high reliability and validity. Additionally, the newly developed manual for the K-FMA may help minimise errors that can occur during evaluation and improve the reliability of motor function evaluation.

Radiation Recall Myositis during Gemcitabine Chemotherapy

Radiation recall is an uncommon phenomenon in which administration of a chemotherapy or another systemic agent induces an acute inflammatory reaction in previously irradiated tissues, often weeks to years after completion of radiotherapy.Gemcitabine can induce an inflammatory reaction within an area of prior radiation. Radiation recall is known to medical oncologists, however only few cases have been reported in Korean journals, therefore physiatrist who diagnose and treat the treatment-related physical impairments of cancer patients must know about it. We emphasize the importance of knowledge of this phenomenon when considering the differential diagnosis of painful limb edema in a patient who has received cancer treatment.

The study of glucose-6-phosphate dehydrogenase deficiency from persons affected by Hansen's disease in Korea / 나학회지

Background@#Glucose-6-phosphate dehydrogenase deficiency is the most common enzyme deficiency disease. Drugs that cause deficiency-related hemolytic responses include dapsone, which is taken as a therapeutic drug for Hansen's disease. Due to the hemolytic adverse effects, the deficiency test should be performed before the dapsone administration, but it is not conducted on the basis of low incidence in Korea. Thus, the monitoring of deficiency in patients with Hansen's disease was needed and the study was undertaken. @*Objective@#The aims of this study were to determine the prevalence of deficiency and gene mutations from persons affected by Hansen's disease in Korea. @*Methods@#Hemanalysis and activity test by venipuncture were performed against the 339 persons affected by Hansen's disease. All subjects were tested for detection of mutations by the polymerase chain reaction. @*Results@#The prevalence of anemia was 45.5% and the prevalence of deficiency was 1.2% from persons affected by Hansen's disease. 2 gene mutations, Mahidol and Mediterranean, were detected in foreign participants (Myanmar and Nepal). @*Conclusion@#In this study, we detected that the prevalence of deficiency and gene mutation was low, thus inferred that anemia was relatively less relevant to deficiency in persons affected by Hansen's disease. However, the number of participant in our study is small, and many studies reported that deficiency test should be performed before the dapsone administration, therefore, we suggest that continuous monitoring of patients with Hansen's disease is necessary.

The Study of Association between Leprosy's Type and Apolipoprotein E Gene in Korean Persons Affected by Leprosy / 나학회지

Background@#Apolipoprotein E protein is a family of apolipoproteins that play an important role in lipid metabolism. Apolipoprotein E genotype and single-nucleotide polymorphisms of genes are known to induce neurodegenerative diseases and cardiovascular diseases. Recently, it has been reported that apolipoprotein E is related to Hansen's disease by regulating genes related to lipid metabolism. @*Objective@#In this study, we investigated that relationship of apolipoprotein E genotype with leprosy type and single-nucleotide polymorphism in korean persons affected by leprosy. @*Methods@#The Apolipoprotein E genotype was confirmed using the polymerase chain reaction from korean persons affected by leprosy. Real-time polymerase chain reaction using probes confirmed the rs405509 and rs439401 of Apolipoprotein E. The identified genotype was cross-analyzed with each single-nucleotide polymorphism results and leprosy type by chi-squared test. @*Results@#The distribution of apolipoprotein E genotypes was E3/E3 76.7%, E3/E4 17.4%, E2/E2 2.3%, E2/E3 2.3%, E2/E4 1.2% were in order. The frequencies of the apolipoprotein E allele were identified in the order of ε2 4.1%, ε3 86.6%, and ε4 9.3%. By type of leprosy, ε2 allele increased 2.2 times in multibacillary than pauacibacillary(4.8% vs 2.2%), and ε4 allele decreased 2.8 times in multibacillary than pauacibacillary(6.3% vs 17.4%). ApoE genotype was cross-analyzed with rs405509·rs439401, and there was a statistically significant association. @*Conclusion@#Apolipoprotein E genotype is associated with leprosy types in korean persons affected by leprosy. The research for apolipoprotein E gene is thought to be helpful in basic research on the pathogenesis of leprosy.who underwent surgery.

Approach Using Multiple Biomarkers for Diagnosis of Hansen's Disease / 나학회지

Background@#The prevalence of leprosy has almost reached the goal of World Health Organization. Accordingly, attention to leprosy and the number of skilled doctors who can diagnosis the leprosy upon clinical manifestations were decreased which caused the delayed diagnosis of leprosy. @*Objective@#Serum C-reactive protein, interferon gamma-induced protein 10, anti-phenolic-glycolipid-1 IgM are biomarkers associated with multi-bacillary leprosy. Therefore, we investigated whether the use of multiple biomarkers has diagnostic value. @*Methods@#The samples were collected from August 2012 to December 2019 at our institute. Through various statistic methods, multiple biomarkers and equation were compared in multi-bacillary patients, pauci-bacillary patients, contacts and different skin disease. @*Results@#Samples were collected from 21patients (17 multi-bacillary, 4 pauci-bacillary) and 17 from non-patients (7 from contacts, 10 from other skin disease). Serum level of C-reactive protein, interferon gamma-induced protein 10, anti-phenolic-glycolipid-1 IgM and equation showed statistical significance compared from patients to non-patients. Comparing multi-bacillary patients to pauci-bacillary patients, only anti-phenolic-glycolipid-1 IgM showed statistical significance. Each area under receiver operating characteristic curve of those biomarkers and equation was ≥0.70 and p≤0.05. The results of Equation using 3 indicators showed higher area under receiver operating characteristic curve and lower P value compared when each indicator was used. Also sensitivity and specificity of them presented meaningful data. @*Conclusion@#We confirmed that using integrated analysis of three biomarkers is more significant than the single indicator in the diagnosis of leprosy. In addition, the use of multiple biomarkers is thought to contribute to the management of leprosy in the community.

Radiation Recall Myositis during Gemcitabine Chemotherapy

Radiation recall is an uncommon phenomenon in which administration of a chemotherapy or another systemic agent induces an acute inflammatory reaction in previously irradiated tissues, often weeks to years after completion of radiotherapy.Gemcitabine can induce an inflammatory reaction within an area of prior radiation. Radiation recall is known to medical oncologists, however only few cases have been reported in Korean journals, therefore physiatrist who diagnose and treat the treatment-related physical impairments of cancer patients must know about it. We emphasize the importance of knowledge of this phenomenon when considering the differential diagnosis of painful limb edema in a patient who has received cancer treatment.

Prevalence of Toxocariasis and Its Risk Factors in Patients with Eosinophilia in Korea

Eosinophilia occurs commonly in many diseases including allergic diseases and helminthic infections. Toxocariasis has been suggested as one cause of eosinophilia. The present study was undertaken to examine the prevalence of toxocariasis in patients with eosinophilia and to identify the risk factors for toxocariasis. This prospective cohort study recruited a total of 81 patients with eosinophilia (34 males and 47 females) who visited the outpatient clinic at Seoul National University Hospital from January 2017 to February 2018 and agreed to participate in this study. The prevalence of toxocariasis was examined by T. canis-specific ELISA, and the various risk factors for toxocariasis were evaluated by a questionnaire survey. Among 81 patients with eosinophilia, 18 were positive for anti-T. canis antibodies (22.2%); 88.9% were male (16/18) and 11.1% were female (2/18). Multivariate statistical analysis revealed that males (OR 21.876, 95% CI: 1.667-287.144) with a history of consuming the raw meat or livers of animals (OR 5.899, 95% CI: 1.004-34.669) and a heavy alcohol-drinking habit (OR 8.767, 95% CI: 1.018-75.497) were at higher risk of toxocariasis in patients with eosinophilia. Toxocariasis should be considered a potential cause of eosinophilia when the patient has a history of eating the raw meat or livers of animals in Korea. A single course of albendazole is recommended to reduce the migration of Toxocara larvae in serologically positive cases with eosinophilia.

The study of glucose-6-phosphate dehydrogenase deficiency from persons affected by Hansen's disease in Korea / 나학회지

Background@#Glucose-6-phosphate dehydrogenase deficiency is the most common enzyme deficiency disease. Drugs that cause deficiency-related hemolytic responses include dapsone, which is taken as a therapeutic drug for Hansen's disease. Due to the hemolytic adverse effects, the deficiency test should be performed before the dapsone administration, but it is not conducted on the basis of low incidence in Korea. Thus, the monitoring of deficiency in patients with Hansen's disease was needed and the study was undertaken. @*Objective@#The aims of this study were to determine the prevalence of deficiency and gene mutations from persons affected by Hansen's disease in Korea. @*Methods@#Hemanalysis and activity test by venipuncture were performed against the 339 persons affected by Hansen's disease. All subjects were tested for detection of mutations by the polymerase chain reaction. @*Results@#The prevalence of anemia was 45.5% and the prevalence of deficiency was 1.2% from persons affected by Hansen's disease. 2 gene mutations, Mahidol and Mediterranean, were detected in foreign participants (Myanmar and Nepal). @*Conclusion@#In this study, we detected that the prevalence of deficiency and gene mutation was low, thus inferred that anemia was relatively less relevant to deficiency in persons affected by Hansen's disease. However, the number of participant in our study is small, and many studies reported that deficiency test should be performed before the dapsone administration, therefore, we suggest that continuous monitoring of patients with Hansen's disease is necessary.

The Study of Association between Leprosy's Type and Apolipoprotein E Gene in Korean Persons Affected by Leprosy / 나학회지

Background@#Apolipoprotein E protein is a family of apolipoproteins that play an important role in lipid metabolism. Apolipoprotein E genotype and single-nucleotide polymorphisms of genes are known to induce neurodegenerative diseases and cardiovascular diseases. Recently, it has been reported that apolipoprotein E is related to Hansen's disease by regulating genes related to lipid metabolism. @*Objective@#In this study, we investigated that relationship of apolipoprotein E genotype with leprosy type and single-nucleotide polymorphism in korean persons affected by leprosy. @*Methods@#The Apolipoprotein E genotype was confirmed using the polymerase chain reaction from korean persons affected by leprosy. Real-time polymerase chain reaction using probes confirmed the rs405509 and rs439401 of Apolipoprotein E. The identified genotype was cross-analyzed with each single-nucleotide polymorphism results and leprosy type by chi-squared test. @*Results@#The distribution of apolipoprotein E genotypes was E3/E3 76.7%, E3/E4 17.4%, E2/E2 2.3%, E2/E3 2.3%, E2/E4 1.2% were in order. The frequencies of the apolipoprotein E allele were identified in the order of ε2 4.1%, ε3 86.6%, and ε4 9.3%. By type of leprosy, ε2 allele increased 2.2 times in multibacillary than pauacibacillary(4.8% vs 2.2%), and ε4 allele decreased 2.8 times in multibacillary than pauacibacillary(6.3% vs 17.4%). ApoE genotype was cross-analyzed with rs405509·rs439401, and there was a statistically significant association. @*Conclusion@#Apolipoprotein E genotype is associated with leprosy types in korean persons affected by leprosy. The research for apolipoprotein E gene is thought to be helpful in basic research on the pathogenesis of leprosy.who underwent surgery.

Approach Using Multiple Biomarkers for Diagnosis of Hansen's Disease / 나학회지

Background@#The prevalence of leprosy has almost reached the goal of World Health Organization. Accordingly, attention to leprosy and the number of skilled doctors who can diagnosis the leprosy upon clinical manifestations were decreased which caused the delayed diagnosis of leprosy. @*Objective@#Serum C-reactive protein, interferon gamma-induced protein 10, anti-phenolic-glycolipid-1 IgM are biomarkers associated with multi-bacillary leprosy. Therefore, we investigated whether the use of multiple biomarkers has diagnostic value. @*Methods@#The samples were collected from August 2012 to December 2019 at our institute. Through various statistic methods, multiple biomarkers and equation were compared in multi-bacillary patients, pauci-bacillary patients, contacts and different skin disease. @*Results@#Samples were collected from 21patients (17 multi-bacillary, 4 pauci-bacillary) and 17 from non-patients (7 from contacts, 10 from other skin disease). Serum level of C-reactive protein, interferon gamma-induced protein 10, anti-phenolic-glycolipid-1 IgM and equation showed statistical significance compared from patients to non-patients. Comparing multi-bacillary patients to pauci-bacillary patients, only anti-phenolic-glycolipid-1 IgM showed statistical significance. Each area under receiver operating characteristic curve of those biomarkers and equation was ≥0.70 and p≤0.05. The results of Equation using 3 indicators showed higher area under receiver operating characteristic curve and lower P value compared when each indicator was used. Also sensitivity and specificity of them presented meaningful data. @*Conclusion@#We confirmed that using integrated analysis of three biomarkers is more significant than the single indicator in the diagnosis of leprosy. In addition, the use of multiple biomarkers is thought to contribute to the management of leprosy in the community.

Clinical Factors Associated with Videofluoroscopic Swallowing Study Findings in Stroke Patients / 대한연하장애학회지

OBJECTIVE: To examine the clinical factors and brain lesion locations related to the patterns of dysphagia in stroke patients in a rehabilitation hospital. METHODS: The medical records of 116 stroke patients who underwent a videofluoroscopic swallowing study (VFSS) between January 2010 and January 2015 in a rehabilitation hospital were reviewed retrospectively. The swallowing-related parameters were assessed using a VFSS. The brain lesion locations were classified as the cortex, basal ganglia, thalamus, midbrain, pons, medulla, cerebellum, and others (subarachnoid or intraventricular hemorrhage). The ambulation ability was assessed using functional ambulation categories (FACs). The independence in the activities of daily living and the degree of cognitive impairment were assessed using the Korean versions of the modified Barthel index (K-MBI) and Mini-Mental State Examination (K-MMSE), respectively. After adjusting for the potential confounding factors in multivariate analysis, the odds ratios and confidence intervals of the stroke brain lesions were calculated and the clinical factors for predicting the VFSS findings were determined. RESULTS: Among the 116 patients, 35 (27%) had an impaired oral stage and 58 (50%) had aspiration. The impaired oral stage was associated significantly with the onset time, basal ganglia stroke, dietary and fluid intake methods at the time of the VFSS, symptoms of dysphagia, FACs, K-MBI, and K-MMSE. Aspiration was correlated with a pontine stroke, methods of dietary and fluid intakes at the time of the VFSS, symptoms of dysphagia, FACs, and K-MBI. Multivariate analysis showed that the pontine stroke and methods of dietary and fluid intake at the time of VFSS predicted aspiration after adjusting for the potential confounding factors. In subgroup analysis of the diet type, the liquid and semisolid aspirations were correlated with the dietary and fluid intake methods and pontine stroke, respectively. CONCLUSION: Patients with a pons lesion stroke, who are on a modified diet (fluid thickening and tube feeding), have higher risks of aspiration. This provides evidence for precise clinical reasoning in this specific patient group.

Comparison of Effective DNA Extraction method for Molecular biological study of Mycobacterium leprae / 나학회지

BACKGROUND@#Leprosy is an important health problem in many geographical areas yet. It is caused through a cough or contact with fluid from the nose of a person infected by Mycobacterium leprae. Study of DNA from M. leprae is important to understand essentiality for leprosy. However, there is no standard in many parts, so various studies are needed.OBJECTS: In this study, DNA extraction method were confirmed for the effective detection of M. leprae. And restriction enzyme fragment length polymorphism typing and high resolution melt (HRM) analysis were performed for comparison with sequencing analysis.@*METHODS@#Compared with three DNA extraction methods (BB, SM and SP) with real-time polymerase chain reaction (PCR). Analysis single nucleotide polymorphism (SNP) genotype and tandem repeats by PCR amplification, and then compare with sequence.@*RESULTS@#BB method was effective when measuring the concentration and threshold cycle (Ct) compared with SM and SP methods. When compared with restriction fragment length polymorphism typing method and sequence analysis, all methods were suitable for SNP1 and 3 type classification. Tandem repeats values of BB method were correspond to sequence analysis than SM and SP methods in HRM analysis.@*CONCLUSIONS@#The DNA extraction method by bead is useful approach for studying of M. leprae.

Effect of temperature and medium on the viability of Mycobacterium leprae during long term-storage / 나학회지

BACKGROUND@#Mycobacterium leprae (M. leprae) is pathogenic bacterium with polymorphic, acid-fast properties and causes leprosy that it is called Hansen's disease. Leprosy can be completely cured using multidrug therapy (MDT), but it is not easy to eradicate leprosy and M. leprae on the planet.OBJECT: We still do not understand the exact pathogenesis mechanism of leprosy. The main reason is that we cannot grow bacteria in vitro. Therefore, quantitative measurement and damage-free storage of live M. leprae are very important.@*METHODS@#Here, we generated bacteria stocks of M. leprae using HBSS with 0.05% tween 80 or freezing solution 11 months ago and evaluated conditional survival of bacteria by Propidium monoazide (PMA) staining, real-time PCR.@*RESULTS@#There were assessed for bacteria viability under the conditions of each temperature or medium by delta-Ct level of real-time PCR. We also observed that frozen-stored M. leprae (2.14) compare to refrigerated-stored M. leprae (1.03) was significant decreased delta-Ct in HBSS (P<0.05). However, frozen-stored M. leprae (1.14) was not difference refrigerated-stored M. leprae (0.84) in freezing solution (P=NS). Real-time PCR with SYBR green method was reliable for results and statistical significance, but data for real-time PCR with probe method were unreliable.@*CONCLUSIONS@#Taken together, these results indicated that freezing solution regardless of temperature increase much more bacterial survival. In addition, if use not freezing solution, M. leprae must be stored frozen.

Uterine Leiomyoma Is Associated with Female Sexual Dysfunction in Postmenopausal Women

PURPOSE: To determine the relationship between uterine leiomyoma and female sexual dysfunction (FSD) among premenopausal and postmenopausal women. MATERIALS AND METHODS: The study population consisted of consecutive women who underwent gynecologic screening tests, including transvaginal ultrasound, and completed the questionnaires on FSD. A total of 841 women were included from January 2010 to December 2011. FSD was defined as Female Sexual Function Index (FSFI) ≤26.55. The relationship between uterine leiomyoma and FSD were compared according to menopausal status. RESULTS: In premenopausal group (n=564), there were no differences in the frequency of FSD (55.0% vs. 58.8%, p=0.387) and total FSFI score. However, in postmenopausal group (n=277), women with uterine leiomyoma had a lower frequency of FSD than those without uterine leiomyoma (71.3% vs. 86.4%, p=0.003). This relationship between uterine leiomyoma and lower frequency of FSD in postmenopausal women remained significant after adjusting for confounding variables. CONCLUSION: The relationship between uterine leiomyoma and FSD is different depending on the menopausal status.

Is Vitamin D an Independent Risk Factor of Nonalcoholic Fatty Liver Disease?: a Cross-Sectional Study of the Healthy Population

The association between vitamin D levels and nonalcoholic fatty liver disease (NAFLD) has been recognized. However, few studies showed independent associations between vitamin D deficiency and NAFLD after a sex-related adjustment for metabolic factors. We aimed to study whether vitamin D deficiency is an independent risk factor of NAFLD even after controlling for metabolic syndrome and visceral fat in both sexes. In this cross-sectional study, 7,514 Korean adults (5,278 men, 2,236 women) participated in a health check-up program. They underwent blood tests, abdominal computed tomography (CT) of the visceral fat area, and ultrasonography for NAFLD screening. Multiple logistic regression analysis was used to investigate the association of vitamin D deficiency with NAFLD according to the sex differences. Vitamin D deficiency is associated with NAFLD. The adjusted odds ratio (aOR) for NAFLD increased sequentially with decreasing vitamin D level, even after adjusting for metabolic syndrome and visceral fat. The subjects in the vitamin D sufficiency group (20–30 ng/mL) had an aOR for NAFLD of 1.18 (95% CI, 1.00–1.39), whereas the deficiency group (< 20 ng/mL) had an aOR of 1.29 (95% CI, 1.10–1.52). However, we have detected a significant sex-related interaction when analyzing the results. A significant relationship between vitamin D deficiency and NAFLD was found in men (aOR, 1.33; 95% CI, 1.11–1.60) but not in women.

Prevalence of severe fever with thrombocytopenia syndrome virus among ticks surveyed at Mt. Gwanak, Korea

This study was performed to investigate the distribution of ticks and the rate of infection with severe fever with thrombocytopenia syndrome (SFTS) virus in ticks collected at Mt. Gwanak and the Seoul National University campus, Korea. Ticks (n = 273) were collected from May to October and included 76 Haemaphysalis longicornis (4 adult females, 72 nymphs), 49 Haemaphysalis flava (9 adult females, 3 adult males, 37 nymphs), and 148 Haemaphysalis spp. larvae. SFTS virus detection was performed by using one-step RT PCR and nested PCR. The SFTS virus was detected in 7 samples (1 Haemaphysalis longicornis nymph, 3 Haemaphysalis flava nymphs, and 3 Haemaphysalis spp. larva). The overall minimum field infection rate was 2.6%, whereas the minimum field infection rates of adult, nymphal, and larval ticks were 0%, 3.2%, and 2.0%, respectively. For a more accurate indication of the prevalence of SFTS virus in Korea, further in-depth investigations of tick species and SFTS virus occurrence over a larger area and longer period are needed.

Genome-Wide Association Study of Bone Mineral Density in Korean Men

Osteoporosis is a medical condition of global concern, with increasing incidence in both sexes. Bone mineral density (BMD), a highly heritable trait, has been proven a useful diagnostic factor in predicting fracture. Because medical information is lacking about male osteoporotic genetics, we conducted a genome-wide association study of BMD in Korean men. With 1,176 participants, we analyzed 4,414,664 single nucleotide polymorphisms (SNPs) after genomic imputation, and identified five SNPs and three loci correlated with bone density and strength. Multivariate linear regression models were applied to adjust for age and body mass index interference. Rs17124500 (p = 6.42 × 10⁻⁷), rs34594869 (p = 6.53 × 10⁻⁷) and rs17124504 (p = 6.53 × 10⁻⁷) in 14q31.3 and rs140155614 (p = 8.64 × 10⁻⁷) in 15q25.1 were significantly associated with lumbar spine BMD (LS-BMD), while rs111822233 (p = 6.35 × 10⁻⁷) was linked with the femur total BMD (FT-BMD). Additionally, we analyzed the relationship between BMD and five genes previously identified in Korean men. Rs61382873 (p = 0.0009) in LRP5, rs9567003 (p = 0.0033) in TNFSF11 and rs9935828 (p = 0.0248) in FOXL1 were observed for LS-BMD. Furthermore, rs33997547 (p = 0.0057) in ZBTB and rs1664496 (p = 0.0012) in MEF2C were found to influence FT-BMD and rs61769193 (p = 0.0114) in ZBTB to influence femur neck BMD. We identified five SNPs and three genomic regions, associated with BMD. The significance of our results lies in the discovery of new loci, while also affirming a previously significant locus, as potential osteoporotic factors in the Korean male population.

Depression and Its Severity Are Strongly Associated with Both Storage and Voiding Lower Urinary Tract Symptoms Independently of Prostate Volume

Depression is related to various functional medical conditions. Its association with lower urinary tract symptoms (LUTS) is also expected. We evaluated whether depression and its severity are associated with LUTS when LUTS risk factors including prostate volume (PV) are taken into account in a large population of Korean men. Study subjects included 10,275 men who underwent routine health check-ups at the Healthcare System Gangnam Center of Seoul National University Hospital. Depression was assessed using Beck Depression Inventory-II and LUTS using international prostate symptom score. PV was measured using transrectal ultrasonography by a radiologist. Effect sizes of depression severity on total, storage, and voiding symptoms were assessed. In multivariate logistic regression analysis, mild, moderate and severe depression were associated with total (adjusted odds ratio: aOR = 2.99, 3.86 and 8.99; all P < 0.001), voiding (aOR = 3.04, 3.28 and 5.58; all P < 0.001) and storage symptoms (aOR = 2.43, 3.43 and 2.89; all P < 0.05) showing dose response relationships (all P trend < 0.001). In a subgroup analysis for participants with PV data (n = 1,925), mild and moderate-severe depression were also associated with LUTS (aOR = 3.29, 2.84; P < 0.001 and 0.018, respectively). In conclusion, depression and its severity are strongly associated with total, voiding, and storage symptoms independently of PV state.