Journal of Korean medical science
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J. Korean Med. Sci. · Aug 2009
Comparative StudyComparison of the prevalence of chronic obstructive pulmonary disease diagnosed by lower limit of normal and fixed ratio criteria.
The Global Initiative of Chronic Obstructive Lung Disease (GOLD) guidelines define chronic obstructive pulmonary disease (COPD) in subjects with FEV(1)/FVC <0.7. However, the use of this fixed ratio may result in over-diagnosis of COPD in the elderly, especially with mild degree of COPD. The lower limit of normal (LLN) can be used to minimize the potential misclassification. ⋯ The difference of prevalence between LLN and fixed ratio of FEV(1)/FVC was even higher among subjects with age >/=65, 14.9% and 31.1%, respectively. In conclusion, the prevalence of COPD by LLN criterion was significantly lower in elderly compared to fixed ratio of FEV(1)/FVC. Implementing LLN criterion instead of fixed ratio of FEV(1)/FVC may reduce the risk of over-diagnosis of COPD in elderly people.
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J. Korean Med. Sci. · Aug 2009
A prospective study on the incidence and predictive factors of relative adrenal insufficiency in Korean critically-ill patients.
This study was undertaken to evaluate the incidence and risk factors associated with relative adrenal insufficiency (RAI) in Korean critically-ill patients. All patients who were admitted to the Medical Intensive Care Unit (MICU) of Samsung Medical Center between January 1, 2006 and April 30, 2007 were prospectively evaluated using a short corticotropin stimulation test on the day of admission. RAI was defined as an increase in the serum cortisol level of <9 microg/dL from the baseline after administration of 250 microg of corticotropin. ⋯ The presence of septic shock (P=0.001), the Simplified Acute Physiology Score (SAPS) II (P=0.003), the Sequential Organ Failure Assessment (SOFA) score (P=0.001), the mean heart rate (P=0.040), lactate levels (P=0.001), arterial pH (P=0.047), treatment with vasopressors at ICU admission (P=0.004), and the 28-day mortality (P=0.041) were significantly different between patients with and without RAI. The multivariate analysis showed that the SOFA score was an independent predictor of RAI in critically-ill patients (odd ratio=1.235, P=0.032). Our data suggest that RAI is frequently found in Korean critically-ill patients and that a high SOFA score is an independent predictor of RAI in these patients.
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J. Korean Med. Sci. · Aug 2009
Randomized Controlled TrialComparison between open procedure and tubular retractor assisted procedure for cervical radiculopathy: results of a randomized controlled study.
Posterior cervical foraminotomy is an effective surgical technique for the treatment of radicular pain caused by foraminal stenosis or posterolateral herniated discs. The present study was performed to compare the clinical parameters and surgical outcomes of open foraminotomy/discectomy (OF/OFD) and tubular retractor assisted foraminotomy/discectomy (TAF/TAFD) in the treatment of cervical radiculopathy. ⋯ Surgical outcomes were not different between the two groups. In conclusion, TAF/TAFD should increase patient's compliance and is as clinically effective as much as the OF/OFD.
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Paraoxonase (PON) has anti-atherogenic activity. Considering the important role of polymorphism in the genetic susceptibility to cardiovascular disease and the variability of its allele frequencies in different ethnic groups, the distribution of genotypes and allele frequencies of PON1M55L, PON1Q192R, PON2A148G, and PON2S311C polymorphisms was analyzed in a total 988 South-western Koreans and determined their effects on lipid parameters. The genotype distribution of PON1 at position 55 was LL=0.886, LM=0.114; and at position 192 was QQ=0.406, QR=0.594. ⋯ The concentrations of LDL and ApoB were significantly different between the PON2A148G (P<0.05) and PON2 S311C polymorphisms (P<0.01). PON polymorphisms and allele frequencies were described in Koreans living south-western part of Korea. These ethnic variations are considered important in the interpretation of diseases associated with PON polymorphisms.
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J. Korean Med. Sci. · Aug 2009
Case ReportsA case of Wernicke's encephalopathy following fluorouracil-based chemotherapy.
The pyrimidine antimetabolite 5-fluorouracil (5-FU) is a chemotherapeutic agent used widely for various tumors. Common side effects of 5-FU are related to its effects on the bone marrow and gastrointestinal epithelium. ⋯ Central nervous system neurotoxicity such as Wernicke's encephalopathy following chemotherapy with 5-FU has been reported rarely, although it has been suggested that 5-FU can produce adverse neurological effects by causing thiamine deficiency. We report a patient with Wernicke's encephalopathy, reversible with thiamine therapy, associated with 5-FU-based chemotherapy.