Correlations between metabolic syndrome, serologic factors, and gallstones.

[Purpose] This study investigated the serologic factors associated with metabolic syndrome and gallstones. [Subjects and Methods] The study evaluated subjects who visited a health promotion center in Seoul from March 2, 2013 to February 28, 2014, and had undergone abdominal ultrasonography. Height, weight, and blood pressure were measured. Blood sampling was performed for high-density lipoprotein cholesterol, triglyceride, fasting blood glucose, total bilirubin, direct bilirubin, indirect bilirubin, aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, uric acid, total cholesterol, low-density lipoprotein cholesterol, thyroid stimulating hormone, and red and white blood cell counts. We conducted logistic regression analysis to assess the risk factors associated with metabolic syndrome. [Results] The risk factors for metabolic syndrome in men, in order of decreasing weight, were red blood cell count, body mass index, maximum size of gallstones, white blood cell count, waist circumference, and uric acid level. The factors in women, in order of decreasing weight, were red blood cell count, presence/absence of gallstones, uric acid level, body mass index, fasting blood glucose, and waist circumference. [Conclusion] Most serum biochemical factors and gallstone occurrence could be used to indicate the presence or absence of metabolic syndrome, independent of gender.

Risk factors for fatigue and stress among Korean police officers.

[Purpose] This study investigated factors that affect the health of police officers by analyzing job stress, psychosocial stress, and fatigue faced by police officers in order to provide basic data for the efficient management of police officers and future comparative research. [Subjects and Methods] Police officers admitted to the National Police Hospital from March to May 2013 were surveyed to investigate their degree of stress. The questionnaire consisted of 4 areas related to patient characteristics: general and demographic characteristics factors, job stress, psychosocial stress, and fatigue. [Results] The analysis of the relationships among job stress, psychosocial health, and fatigue showed the 0%, 44.7%, and 82% of those with healthy, potential, and high risks of stress had high job stress, respectively. Meanwhile, 40.8% and 77.9% of subjects with normal and high risks of fatigue had high job stress. [Conclusion] The studies can be used as basic and comparative data for the prevention and early control of job-related diseases for police officers.

Blood levels related to the Z-score of bone mineral density in young males and females.

[Purpose] The purpose of this study was to investigate the blood levels related to the bone mineral density by using the dual energy X-ray absorption for females before menopause and males younger than 50 years old. [Subjects and Methods] Between August 1, and September 15, 2013, the Z-score was measured in females before menopause and males younger than 50 years old using a bone mineral density measuring instrument. After the measurement, the subjects were classified into two groups, that is, the below expectations and within expectations groups. Next, we analyzed and compared the differences in age, body mass index, and blood levels between the 2 groups. [Results] The results showed a correlation of 0.212 for total protein, -0.317 for alanine aminotransferase, -0.199 for gamma-glutamyl transferase, -0.358 for alkaline phosphatase, 0.266 for uric acid, -0.313 for lactate dehydrogenase, 0.244 for creatinine, -0.234 for the red blood cell count, and -0.230 for the red cell distribution width in patients with less than expected level for their age. [Conclusion] In conclusion, osteoporosis may occur in females before menopause and males younger than 50 years old, and aggressive attention is required for prevention and treatment.

Risk factors for musculoskeletal symptoms among Korean radiation workers.

The first aim of this study was to determine the prevalence of musculoskeletal symptoms. The second aim was to study the association between musculoskeletal symptoms and factors in radiation workers from the active lists of clinics and hospitals and then to provide basic data for a systematic and effective resource management of radiation workers' musculoskeletal problems in the future. A questionnaire survey was conducted on radiation workers in clinics, general hospitals, and Dong-A university hospitals around the Korean city Buscan from July 10 to 31, 2011. The results showed that the rate of musculoskeletal symptoms was higher in the shoulder, waist, neck, leg/foot, hand/wrist/finger than arm/elbow. The probability of neck pain was 2 times higher in patients with a disease.

Measurement of T2 value by using 3.0T MRI for patient with ankle arthritis.

This study intended to evaluate shape of ankle joint cartilage and damage to the ankle joint cartilage by measuring changes in T2 value of cartilage of healthy people without ankle arthritis and patients with ankle arthritis. The multi-echo technique was used for 20 healthy persons who had no ankle arthritis in the past or in the present clinically and 20 patients who were examined to have ankle arthritis in order to obtain T2 map image of knee joint cartilage. We divided the talotibial joint into medial position, middle position and lateral position to calculate the mean values of T2 in 18 spots that included anterior part, middle part and posterior part of cartilage of neck bone and ankle bone. Mean T2 values were measured in the healthy people group and the ankle arthritis patient group. According to the measurement results, the mean T2 value of the ankle arthritis patient group was measured to be higher than that of the healthy people group.

Exiting root injury in transforaminal endoscopic discectomy: preoperative image considerations for safety.

PURPOSE: To evaluate the clinical and radiological risk factors for exiting root injuries during transforaminal endoscopic discectomy. METHODS: We retrospectively examined cohort data from 233 patients who underwent percutaneous endoscopic lumbar discectomy for lumbar disc herniation between January 1st, 2010 and December 31st, 2011. We divided the patients into the two groups: those who presented a postoperative exiting root injury, such as postoperative dysesthesia or motor weakness (Group A, n = 20), and those who did not suffer from a root injury (Group B, n = 213). We examined the clinical and radiological factors relating exiting root injuries. We measured the active working zone with the exiting root to the upper facet distance (Distance A), the exiting root to disc surface distance at the lower facet line (Distance B) and the exiting root to the lower facet distance (Distance C) in magnetic resonance imaging (MRI). RESULTS: Group A exhibited a shorter Distance C (6.4 ± 1.5 versus 4.4 ± 0.8 mm, p < 0.001) and a longer operation time (67.9 ± 21.8 versus 80.3 ± 23.7 min, p = 0.017) relative to Group B. The complication rate decreased by 23% per each 1-mm increase in Distance C (p = 0.000). In addition, the complication rate increased 1.027-fold per each 1-min increase in the operation time (p = 0.027). CONCLUSION: We recommend measuring the distance from the exiting root to the facet at the lower disc level according to a preoperative MRI scan. If the distance is narrow, an alternative surgical method, such as microdiscectomy or conventional open discectomy, should be considered.

Associations between sympathetic activity, plasma concentrations of renin, aldosterone, and parathyroid hormone, and the degree of intractability of blood pressure control in modialysis patients.

This study was designed to examine how such factors as hemodialysis parameters, body mass index, renin and aldosterone concentrations, sympathetic nervous activity, and parathyroid hormone concentrations are associated with the control of hypertension in hemodialysis patients. Hemodialysis patients (n=114) were grouped into four categories. Group 1 had normal BP without antihypertensive medication. Group 2 needed one antihypertensive drug, Group 3 needed combination of two or three categories of antihypertensive drugs without minoxidil. Group 4 needed more than three categories of antihypertensive drugs including minoxidil. Parathyroid hormone, beta2-microglobulin, renin and aldosterone, epinephrine, norepinephrine, and hemodialysis parameters were measured. The fractional clearance of urea as Kt/V urea was significantly lower in Group 3 and Group 4 than in Group 2 (p<0.01). Concentrations of parathyroid hormone were significantly higher in Group 4 than the other groups (p<0.01). Pre-hemodialysis norepinephrine concentrations were significantly higher in Group 4 than the other groups (p<0.05). Traditional factors associated with hypertension did not seem to be relevant to the degree of hypertension in hemodialysis patients in the present study. In conclusion, poor Kt/V urea, elevated parathyroid hormone concentrations, and elevated concentrations of plasma norepinephrine seemed to be the factors that might be associated with control of hypertension in hemodialysis patients.

Relationship between serum prostate-specific antigen levels and body mass index in healthy younger men.

OBJECTIVES: To understand further the physiologic characteristics of serum prostate-specific antigen (PSA) concentrations in healthy younger men. METHODS: A total of 2032 men, 20 to 39 years old, who visited our hospital for a routine health checkup were entered into the study. Pearson correlation coefficients were determined to evaluate the association between serum PSA and clinical parameters. Because of the log-normal distribution, the serum PSA levels were log-transformed for analysis. RESULTS: Although the relationships were weak, significant negative correlations were noted between serum PSA and body weight (r = -0.107, P <0.001), body mass index (BMI; r = -0.131, P <0.001), aspartate aminotransferase (AST; r = -0.076, P = 0.001), alanine aminotransferase (ALT; r = -0.079, P = 0.001), gamma-glutamyltransferase (r = -0.046, P = 0.046), and creatinine clearance (r = -0.113, P <0.001). A positive correlation was found between serum PSA and creatinine (r = 0.053, P = 0.024). Age did not correlate with serum PSA level. The influence of clinical parameters on serum PSA was explored using multiple linear regression analysis. Using the stepwise method, all other explanatory variables, except BMI, AST, and creatinine were eliminated (log10[PSA] = -0.124[BMI] + 0.063[creatinine] - 0.053[AST] + 0.097; r = 0.152, P <0.001). CONCLUSIONS: BMI, creatinine, and AST may influence the serum PSA level in this population. However, because it was not clear that this group should be considered at high risk of prostate cancer in the future, additional longitudinal research is needed.

Computerized physician order entry and electronic medical record systems in Korean teaching and general hospitals: results of a 2004 survey.

OBJECTIVE: To determine the availability of computerized physician order entry (CPOE) and electronic medical record (EMR) systems in teaching and general hospitals in the Republic of Korea. DESIGN: A combined mail and telephone survey of 283 hospitals. MEASUREMENTS: The surveys assessed the availability of CPOE and EMRs in the hospitals, as well as inducement, participation, and saturation regarding CPOE use by physicians. RESULTS: A total of 122 (43.1%) hospitals responded to the survey. The complete form of CPOE was available in 98 (80.3%) hospitals. The use of CPOE was mandatory in 92 (86.0%) of the 107 hospitals that responded to the questions regarding the requirement of CPOE use. In 85 (79.4%) of the hospitals in which CPOE was in use, more than 90% of physicians used the system. In addition, physicians entered more than 90% of their total orders through CPOE in 87 (81.3%) hospitals. In contrast, a complete EMR system was available in only 11 (9.0%) of the hospitals. CONCLUSION: Of the teaching and general hospitals in the Republic of Korea that responded to the survey, the majority (80.3%) have CPOE systems, and a complete EMR system is available in only 9%.

Influence of age, anthropometry, and hepatic and renal function on serum prostate-specific antigen levels in healthy middle-age men.

OBJECTIVES: To test the hypothesis of a causal relationship between clinical parameters, including age, anthropometry, and hepatic or renal function tests and serum prostate-specific antigen (PSA) levels and to determine the predictors of high serum PSA concentrations in healthy middle-age men. METHODS: Between January 1999 and December 2000, 6005 healthy men 40 to 59 years old who visited our hospital for a routine health checkup were entered into the study. The association between the clinical parameters and a high serum PSA level (greater than 2.5, 3.0, 3.5, or 4.0 ng/mL) was studied in three groups: the 10% with low clinical parameters, the 10% with high clinical parameters, and the remainder as a reference group. RESULTS: The univariate logistic regression analysis indicated that high or low age, body weight, body mass index, creatinine, and creatinine clearance were significant factors in relation to serum PSA concentration compared with the reference group. In the multivariate model used, only older age was positively related to the serum PSA concentration. CONCLUSIONS: The results of anthropometry and hepatic and renal function tests do not influence the serum PSA level in this population. Our findings suggest that serum PSA may be a reliable marker in middle-age men without severe hepatic or renal disease.

Distribution of serum prostate-specific antigen in healthy Korean men: influence of ethnicity.

OBJECTIVES: To evaluate the normal distribution of serum prostate-specific antigen (PSA) levels in healthy Korean men. The subjects included men younger than 40 years of age, because information on serum PSA levels in younger men is scarce. METHODS: Between January 1997 and December 1998, the serum PSA levels of the subjects who visited our hospital for a routine health checkup were determined. All men who were older than 50 years with abnormal digital rectal examination findings and/or an abnormal serum PSA level (greater than 4.0 ng/mL) underwent transrectal ultrasound-guided sextant biopsy. Two men who were found to have cancer were excluded from the analysis. The detection rate of prostate cancer for men with abnormal digital rectal examination findings and/or an abnormal serum PSA level was 2.0% for men 50 to 59 years old; 0.0% for men 60 to 69 years old; and 11.1% for men 70 to 79 years old. A total of 8297 men (aged 20 to 79 years) were included in the study. RESULTS: The median serum PSA level (5th to 95th percentile range) was 0.90 ng/mL (0.33 to 2.25) for men 20 to 29 years old; 0.89 ng/mL (0.30 to 2.35) for men 30 to 39 years old; 0.89 ng/mL (0.30 to 2.36) for men 40 to 49 years old; 0.96 ng/mL (0.32 to 2.96) for men 50 to 59 years old; 1.22 ng/mL (0.33 to 3.78) for men 60 to 69 years old; and 1.25 ng/mL (0.30 to 7.49) for men 70 to 79 years old. The median and 95th percentile serum PSA levels of Korean men younger than 50 years were higher, but those for men 50 years old or older were lower than in other races. In our study cohort, the serum PSA level weakly correlated with age (r = 0.088, P <0.001). The serum PSA level weakly correlated with age in men 50 years old or older (r = 0.116, P <0.001) but in men younger than 50 years, it did not correlate (r = 0.000, P = 0.987). CONCLUSIONS: These results suggest that the distribution and cutoff value of the serum PSA level in Korean men differ from those in other races. In addition, our findings raise the question of whether lowering the PSA cutoff may enhance the detection of cancer in this population with low prostate cancer rates.