Chungnam National University Hospital Research Articles

Drinking Amount Associated with Abnormal Gamma-Glutamyl Transpeptidase Expression in Women.

BackgroundThis study investigated whether there is any difference in drinking amount associated with abnormal expression of gamma-glutamyl transpeptidase (GGT), one of the biological markers of excessive drinking, between flushing and non-flushing women after drinkingMethodsThe subjects were 797 women aged 20–59 years old who visited health promotion center of Chungnam National University Hospital between January, 2013 and July, 2014. Facial flushing status after drinking, amount of alcohol consumed per drinking episode, and the number of drinking days per week were assessed using a questionnaire. Age, abnormal GGT expression, smoking status, menopauase status, and body mass index (BMI) were obtained from the health screening data. The weekly drinking amount were categorized into <4 drinks; ≥4, <8 drinks; and ≥8 drinks. The association of abnormal GGT expression with weekly drinking amount was analyzed using multivariate logistic regression after controlling for confounding variables including age, smoking status, menopauase status, and BMI.ResultsCompared to nondrinkers, the abnormal GGT expression in the non-flushing group was significantly increased when the weekly drinking amount was ≥4 drinks (≥4, <8 drinks: adjusted odds ratio [aOR], 37.568; 95% confidence interval [CI], 9.793–144.116; ≥8 drinks: aOR, 20.350; 95% CI, 20.350–305.138). On the other hand, the abnormal GGT expression in the flushing group was significantly increased in every weekly drinking amount range (<4 drinks: aOR, 4.120; 95% CI, 1.603–10.585; ≥4, <8 drinks: aOR, 79.206; 95% CI, 24.034–261.031; ≥8 drinks: aOR, 111.342; 95% CI, 30.987–400.079). For each weekly drinking amount range, the flushing group showed significantly higher abnormal GGT expression than the non-flushing group (<4 drinks: aOR, 3.867; 95% CI, 1.786–8.374; ≥4, <8 drinks: aOR, 57.277; 95% CI, 24.430–134.285; ≥8 drinks: aOR, 104.871; 95% CI, 42.945–256.091).ConclusionThis study showed that abnormal GGT expression in the flushing female drinkers was induced by smaller amounts of alcohol than in the non-flushing female drinkers.

Modification of nutrition strategy for improvement of postnatal growth in very low birth weight infants.

PurposeTo identify the effects of modified parenteral nutrition (PN) and enteral nutrition (EN) regimens on the growth of very low birth weight (VLBW) infants.MethodsThe study included VLBW infants weighing <1,500 g, admitted to Chungnam National University Hospital between October 2010 and April 2014, who were alive at the time of discharge. Subjects were divided according to 3 periods: period 1 (n=37); prior to the PN and EN regimen being modified, period 2 (n=50); following the PN-only regimen modification, period 3 (n=37); following both PN and EN regimen modification. The modified PN regimen provided 3 g/kg/day of protein and 1 g/kg/day of lipid on the first day of life. The modified EN regimen provided 3.5-4.5 g/kg/day of protein and 150 kcal/kg/day of energy. We investigated growth rate, anthropometric measurements at 40 weeks postconceptional age (PCA) and the incidence of extrauterine growth restriction (EUGR) at 40 weeks PCA.ResultsAcross the 3 periods, clinical characteristics, including gestational age, anthropometric measurements at birth, multiple births, sex, Apgar score, surfactant use and PDA treatment, were similar. Growth rates for weight and height, from time of full enteral feeding to 40 weeks PCA, were higher in period 3. Anthropometric measurements at 40 weeks PCA were greatest in period 3. Incidence of weight, height and head circumference EUGR at 40 weeks PCA decreased in period 3.ConclusionBeginning PN earlier, with a greater supply of protein and energy during PN and EN, is advantageous for postnatal growth in VLBW infants.

Prognostic Implications of Abdominal Computed Tomography at Diagnosis in Patients with Polycythemia Vera or Essential Thrombocythemia

Background: To our knowledge, no reports have examined the clinical significance of splenomegaly measured using computed tomography (CT) in patients with polycythemia vera (PV) or essential thrombocythemia (ET). This study retrospectively analyzed abdominal CT in PV and ET patients to determine the prognostic role of splenomegaly on CT at diagnosis.Methods: This study enrolled patients who were newly diagnosed with PV or ET between 2005 and 2014 at Chungnam National University Hospital. Spleen volume was estimated by measuring the caudocranial dimension and maximum size and thickness in the axial plane on cross-sectional images (Prassopoulos et al. Eur Radiol 1997;7(2):246-8).Results: In total, 46 patients were diagnosed with PV and 73 with ET; abdominal CT was performed at diagnosis in 38 (82.6%) PV patients and 45 (61.6%) ET patients. The International Working Group for Myeloproliferative Neorplams Research and Treament (IWG-MRT) risk score and International Prognostic Score for ET (IPSET) were well applied to these patients group. In the PV group, there were no significant differences in clinical features or laboratory findings between patients who did or did not undergo CT. In the ET group, patients who underwent abdominal CT had lower hemoglobin and hematocrit levels, and were less likely to have a history of thrombosis than those who did not. Splenomegaly was observed in 29 (73.7%) patients with PV and 18 (40.0%) patients with ET. Splenomegaly greater than twice the normal value was observed in 11 (28.9%) PV patients and 4 (8.9%) ET patients. In the PV group, patients with splenomegaly on CT had significantly higher leukocyte and lactate dehydrogenase (LDH) levels than patients without splenomegaly. Splenomegaly more than twice the normal value were not observed in PV patients over 67 years old; in younger patients, PV patients with splenomegaly greater than twice the normal value had lower overall survival than those with smaller spleens (p = 0.02). In the ET group, patients with splenomegaly on CT had higher hemoglobin, hematocrit, leukocyte, and LDH levels than did patients without splenomegaly, but there was no difference in their overall survival (p = 0.643).Conclusion: These results indicate that splenomegaly measured by abdominal CT might be useful for predicting prognosis in patients with PV. DisclosuresJo:Alexion Pharmaceuticals: Research Funding.

Effects of nutritional status and cognitive ability on olfactory function in geriatric patients.

The aim of this study was to investigate the prevalence of olfactory dysfunction and evaluate the relationship between olfactory function and nutritional status, comorbidity, and the results of a neurocognitive test in geriatric patients who do not suffer from neurodegenerative disease. A total of 45 patients who visited the Geriatric Health Center of Chungnam National University Hospital were enrolled in this study. Olfactory function was assessed using a Korean Version of Sniffin' Stick Test II. Cognitive status of all participants was assessed with the MMSE-K (Korean version of the Mini-Mental State Examination). Nutritional status was assessed with body mass index, Mini-Nutritional Assessment (MNA), and serum total protein and albumin. A total of 45 participants were enrolled in this study. Of these subjects, 28 were men and 17 were women, with a mean age of 71.7±5.16 years. Nine (20%) were normosmia, 13 (28.9%) were hyposmia, and 23 (51.1%) were anosmia. Thirty-six patients (80%) suffered from olfactory dysfunction (anosmia or hyposmia). MMSE score showed significant correlation with MNA score. There were significant negative correlations between age and total TDI (threshold, discrimination, and identification) score, discrimination score, identification score, and MMSE score. MMSE score showed significant correlation with discrimination score and identification score. However, MNA score did not show any significant correlation with olfactory function test results. Although olfactory function was not influenced by nutritional status, abilities of discrimination and identification of odors were associated with cognitive function in geriatric patients.

Septic Knee Arthritis Caused by Staphylococcus lugdunensis After Intraarticular Injection Therapy

Copyright©2015 Korean Geriatric Society This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/). ▸Received: April 6, 2015 ▸Revised: April 27, 2015 ▸Accepted: May 8, 2015 Address for correspondence: Kyung Mok Sohn, MD Division of Infectious Diseases, Department of Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon 301-721, Korea Tel: +82-42-280-7126, Fax: +82-42-280-8125 E-mail: medone@cnuh.co.kr 관절 내 주사 치료 후 발생한 Staphylococcus lugdunensis에 의한 화농성 슬관절염

위암 환자의 진단 경로에 따른 병기 및 관련요인의 차이

본 연구는 위암 진단 당시 진단 경로에 따라 병기 및 관련요인의 차이가 있는지 비교하기 위해 시행되었다. 조사대상 은 충남대학교 병원에서 위암에 대해 진단 받은 뒤 수술하기 위해 내원한 환자 375명으로 하였으며, 자료 수집은 2010년 8월 1일부터 2013년 3월 31일까지 표준화된 자기기입식 설문지를 사용하여 수집하였다. 증상군과 검진군간에 영향을 미치 는 요인의 위험도를 측정하기 위해 로지스틱회귀분석을 사용 하였다. 연구결과, 검진군에서의 조기위암의 비율이 증상군에 서 보다 유의하게 높아(p=0.001) 조기검진의 중요성을 시사해 주었다. 또한 증상군은 검진군에 비해 병기가 상대적으로 높았 다.(p=0.001). 앞으로 위암 선별검사가 널리 시행되고 대규모의 전향적인 연구가 뒷받침 되면 우리나라에 가장 적절한 검사 및 간격에 대한 추정까지도 가능할 것이다.

Abstract 148: The Optimal Duration Of Asa Treatment After Acute Phase Of Kawasaki Disease Based On Inflammatory Markers

Purpose: Outcomes of Kawasaki disease (KD) are determined by the development of cardiovascular complications. Low dose aspirin(ASA) treatment is used as antithrombotic effect after acute phase of KD for 6-8 weeks.There are no standardized inflammatory markers used as guidance for completing low dose ASA treatment. The optimal duration of low dose ASA treatment is not determined. The aim of this study is to decide the duration of low dose ASA treatment based on inflammatory markers. Methods : We enrolled 80 KD children admitted to the Chungnam National University Hospital,South Korea between Sep 2012 and May 2014. We reviewed the medical records for clinical characteristics, duration of fever, cardiovascular complications and laboratory data on admission. Inflammatory markers were measured every 7-14 days at OPD after immunoglobulin(IVIG) and high dose ASA treatment in acute phase. Low dose ASA was stopped when the level of inflammatory markers were down to the normal without any cardiovascular complications. Echocardiograms were performed at admission, discharge and prior to completion of ASA treatment when the inflammatory marker turned to normal. Results : 80 KD patients,(Complete, n=44; Incomplete, n=36). The incidence of cardiovascular complications was similar both two groups. No significant differences in the laboratory studies either complete or incomplete KD. The levels of inflammatory marker were normalize after the acute phase as 13.0±13.6 days for platelets, 13.8± 8.3 days for CRP, 14.4±9.6 days for d-dimer, and 24.1 ± 10.5 days for ESR. The levels of platelets and CRP were first normalized within 2 weeks, and that of ESR was last within 3-4 weeks. The duration of raised CRP levels showed significantly shorter in incomplete group compared to complete groups (p=0.02). No new coronary lesions were developed among patients who didn’t have the coronary lesions at subacute phase. Conclusion: The majority of the inflammatory marker levels were normalized within 2-3 weeks after acute phase of KD. There were no new cardiovascular complications when the duration of low dose ASA treatment was guided by level of the inflammatory markers. So, the optimal duration of low dose ASA treatment can be reduced to 3-4 weeks without development of coronary lesions.

The Efficacy and Safety of Platinum/Vinorelbine as More Than Second-Line Chemotherapy for Advanced Non-small Cell Lung Cancer.

PurposeThere is no regimen that is strongly recommended for more than second-line treatment. We investigated the efficacy and safety of platinum/vinorelbine as more than second-line treatment.Materials and MethodsWe selected patients with advanced non-small cell lung cancer (NSCLC) who received treatment with platinum/vinorelbine at Chungnam National University Hospital from August 2001 to December 2013. The primary end point was the response rate, and secondary end points were progression-free survival (PFS), overall survival (OS), and toxicity.ResultsThirty-five patients were enrolled. Response rate was 22.9% (complete response, 0 patients [0%]; partial response, eight patients [22.9%]; stable disease, 10 patients [28.6%]; progressive disease, 14 patients [40.0%]). A significantly higher response rate was observed for patients who had responded to previous chemotherapy than for those who did not (34.8% [8/23] vs. 0% [0/12], p=0.020). The median PFS was 4 months (range, 1 to 21 months). Patients with adenocarcinoma and non-smokers had a significantly longer PFS than patients with non-adenocarcinoma and smokers (5 months vs. 2 months, p=0.007; 4.5 months vs. 2 months, p=0.046, respectively). The median OS was 10 months (range, 1 to 41 months). Patients with good performance status and non-smokers had a significantly longer OS than patients with poor performance status and smokers (14 months vs. 4 months, p=0.02; 18.5 months vs. 6 months, p=0.049, respectively). The main serious adverse event (grade 3 or 4) was neutropenia (15 events, 13.3%) in a total of 113 cycles.ConclusionPlatinum/vinorelbine was effective as more than second-line chemotherapy, and the toxicity was tolerable, in patients with advanced NSCLC.

Comparison of Ocular Adnexal Mantle Cell Lymphoma and MALT Lymphoma

Purpose: Mantle cell lymphoma (MCL) is known to have systemic dissemination with poor prognosis, but very few cases have been reported in Korea. Therefore, we analyzed clinical features and prognosis of MCL by comparing 3 cases of ocular adnexal MCL and mucosa-associated lymphoid tissue (MALT) lymphoma. Methods: The medical records of patients with ocular adnexal MALT lymphoma and MCL from Chungnam National University Hospital and Pusan National University Hospital from January 1999 to April 2014 were retrospectively reviewed. Immunohistochemical examination was selectively used to diagnose lymphoma subtypes. Systemic dissemination, treatment response, and recurrence were identified using radiological testing and bone marrow aspiration. Results: This study included 39 patients with ocular and ocular adnexal MALT lymphoma and 1 patient with MCL from Chungnam National University Hospital and 53 patients with MALT lymphoma and 2 patients with MCL from Pusan National University Hospital. All 3 (100%) patients diagnosed with ocular adnexal MCL were over 60 years of age. However, 28 of 92 (30.4%) patients diagnosed with MALT lymphoma were over 60 years of age. In MALT lymphoma, 3 of 92 patients presented with systemic dissemination and most patients recovered with radiotherapy. Conversely, all 3 patients with MCL showed systemic dissemination and recurrence after radiotherapy or chemotherapy, therefore, additional chemotherapy was required. Conclusions: Contrary to MALT lymphoma, ocular and ocular adnexal MCL usually presented with systemic dissemination and complete remission was difficult even though many regimens of chemotherapy were attempted. Because MCL can be misdiagnosed as MALT lymphoma, careful evaluation should be performed. J Korean Ophthalmol Soc 2015;56(6):815-822

The Relationship between Uric Acid and Homocysteine Levels based on Alcohol-related Facial Flushing

Eo Chin Kim, Jong Sung Kim, Won Chul Uh, Soo Young Choi, Sun Kyung Lee, Bog Seon Jeong Health Promotion Center, Daejeon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea Department of Family Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea Department of Family Medicine, Chungnam National University School of Medicine, Daejeon, Korea Department of Family Medicine, Daejeon Veterans Hospital, Daejeon, Korea

Vertebral Osteomyelitis caused byBurkholderia cepaciain an Immunocompetent Elderly Patient After Acupuncture

Vertebral Osteomyelitis caused by Burkholderia cepacia in an Immunocompetent Elderly Patient After Acupuncture Ki Dae Kim, MD, Kyung Mok Sohn, MD, Yeon-Sook Kim, MD, Shinhye Cheon, MD, Chang Hun Song, MD, Jin-Young Youm, MD, Sun Hoe Koo, MD Division of Infectious Diseases, Departments of Neurosurgery, and Laboratory Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea

Restoration of Overexpressed Variable Heavy Chain 2 Transcripts with Tumor Necrosis Factor Inhibitors in Ankylosing Spondylitis

To the Editor: Ankylosing spondylitis (AS) is a chronic inflammatory disorder characterized by progressive and destructive arthritis of the spine and pelvis1. B cells are involved in the pathogenesis of autoimmune diseases through antibody production, cytokine release, and antibody presentation to auto-reactive T cells. In AS, the role of B cells in the pathogenesis is still incompletely understood2. It has been hypothesized that the production of high affinity monoreactive autoantibodies in autoimmune disease could arise from intrinsic abnormalities in the generation of immunoglobulin genes3. Immunoglobulin gene usage can be regarded as an important factor of pathogenesis of autoimmune diseases. Investigation of variable heavy chain (VH) gene usage is important for determining whether usage of particular gene families is distorted. Several studies have investigated the VH gene usage in various autoimmune diseases, including systemic lupus erythematosus4, myasthenia gravis5, rheumatoid arthritis (RA)6, Sjogren syndrome7, and AS8 … Address correspondence to Dr. S-C. Shim, Division of Rheumatology, Department of Medicine, Daejeon Rheumatoid and Degenerative Arthritis Center, Chungnam National University Hospital, 6 munwha-ro Jung-gu, Daejeon, South Korea. E-mail: shimsc{at}cnuh.co.kr

Evolution of torsional-upbeat into hemi-seesaw nystagmus in medial medullary infarction

Department of Neurology, Ajou University School of Medicine, Ajou University Hospital, Suwon, South Korea Department of Neurology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea Department of Neurology, Chungnam National University Hospital, Daejon, South Korea Kangwon National University College of Medicine, Biomedical Research Institute, Seoul National University Bundang Hospital, Seongnam, South Korea

Laparoscopic assisted adenomyomectomy using double flap method

ObjectiveThe purpose of this study was to evaluate postoperative prognosis and progression in patients who received laparoscopic-assisted adenomyomectomy using the double flap method.MethodsThe pelvic cavity was explored by the conventional laparoscopic method, and drainage was achieved through a 5-mm trocar. After a small incision in the abdomen, the uterus was incised from the fundus to the upper cervical margin until exposing the endometrial cavity. Adenomyotic tissue was removed using a scalpel, scissors, or monopolar electrical bovie. The endometrial cavity was repaired with interrupted sutures using 2-0 vicryl. One side of the serosal flap was used to cover the endometrial side of the uterus. The second serosal flap covered the first flap after removal of the serosal surface of the first flap.ResultsFrom January 2008 to March 2012, there were 11 cases of laparoscopic-assisted adenomyomectomy at Chungnam National University Hospital. Nine cases were analyzed, excluding two cases with less than one year of follow-up. The average patient age was 37.0 years and average follow-up duration was 32.8 months. All patients showed improvement in dysmenorrhea (P < 0.001) and hypermenorrhea (P = 0.001) after surgery and were evaluated by visual analogue scale score. However, symptoms of adenomyosis were aggravated in three patients. Adenomyosis was progressed in the side opposite the site of operation. One patient required a total laparoscopic hysterectomy 27 months after surgery.ConclusionLaparoscopic-assisted adenomyomectomy using the double flap method is effective for uterine reduction and relief of dysmenorrhea and hypermenorrhea. Conservative management and careful follow-up are needed because adenomyosis can recur or progress in some patients.

Two-port access versus four-port access laparoscopic ovarian cystectomy.

ObjectiveThis study was conducted to compare the surgical outcomes between two-port access and four-port access laparoscopic ovarian cystectomy.MethodsFour hundred and eighty nine patients who had received two-port access laparoscopic ovarian cystectomy (n=175) and four-port access laparoscopic ovarian cystectomy (n=314) in Chungnam National University Hospital from January 2009 to August 2012 were analyzed retrospectively. The data were compared between the bilaterality of the cysts and cyst diameter of less than 6 cm and 6 cm or more.ResultsThere were no significant differences in patient's age, parity, body weight, body mass index and history of previous surgery between the two-port and four-port access laparoscopy group. Bilaterality of ovarian cysts was more in fourport access laparoscopy group (13.7% vs. 32.5%, P=0.000). There were no significant differences in operation time, hemoglobin change, hospital stay, adhesiolysis, transfusion, and insertion of hemo-vac between the two-port and four-port access laparoscopy group for size matched compare. However additional analgesics were more in four-port access laparoscopy group for unilateral ovarian cystectomy.ConclusionTwo-port access laparoscopic surgery was feasible and safe for unilateral and bilateral ovarian cystectomy compare with four-port access laparoscopic surgery.

Extramedullary Plasmacytoma of the Head and Neck

Background and ObjectivesZZHead and neck solitary extramedullary plasmacytomas (EMP) are rare neoplasms of plasma cell origin. Literature review reveals only small numbers of reports. The objective was to review our experience of treating patients of this neoplasm and to compare with the analysis of EMP cases reported in Korean literature. Subjects and MethodZZA retrospective review of all patients treated for EMP of the head and neck at the Chungnam National University Hospital between 1985 and 2012 was performed. Eleven patients with head and neck EMP were identified and included in this study. ResultsZZThe mean age of our cases diagnosed was 51.6 years, with the range of 25 to 69 years. There was a strong male preponderance (M:F=10:1). The sinonasal tract was the most common site (six patients) of the disease, followed by the pharynx and larynx in frequency. Four patients were treated by surgery, four by surgery and radiation, two by chemoradiation, and one by radiation. The mean follow-up was 80 months. Local recurrence developed in one patient. The time from diagnosis to local recurrence was 60 months. Two patients developed multiple myeloma, and the time took to develop multiple myeloma from the date of diagnosis of EMP was 9 and 177 months, respectively. Korean literature review (19 cases) showed similar aspects in terms of prevalent age, origin site, and treatment modalities, but equal sex ratio and low recurrence rate. ConclusionZZWe described 11 Korean cases of EMP. Long-term follow-up is essential because local recurrence and disseminated disease can occur many years after treatment. � Korean J Otorhinolaryngol-Head Neck Surg 2014;57:103-7

A Korean boy with atypical X-linked adrenoleukodystrophy confirmed by an unpublished mutation of ABCD1.

X-linked adrenoleukodystrophy (X-ALD) is a rare peroxisomal disorder, that is rapidly progressive, neurodegenerative, and recessive, and characteristically primary affects the central nervous system white matter and the adrenal cortex. X-ALD is diagnosed basaed on clinical, radiological, and serological parameters, including elevated plasma levels of very long chain fatty acids (VLCFA), such as C24:0 and C26:0, and high C24:0/C22:0 and C26:0/C22:0 ratios. These tests are complemented with genetic analyses. A 7.5-year-old boy was admitted to Department of Pediatrics, Chungnam National University Hospital with progressive weakness of the bilateral lower extremities. Brain magnetic resonance imaging confirmed clinically suspected ALD. A low dose adrenocorticotropic hormone stimulation test revealed parital adrenal insufficiency. His fasting plasma levels of VLCFA showed that his C24:0/C22:0 and C26:0/C22:0 ratios were significantly elevated to 1.609 (normal, 0-1.390) and 0.075 (normal, 0-0.023), respectively. Genomic DNA was extracted from peripheral whole blood samples collected from the patient and his family. All exons of ABCD1 gene were amplified by polymerase chain reaction (PCR) using specific primers. Amplified PCR products were sequenced using the same primer pairs according to the manufacturer's instructions. We identified a missense mutation (p.Arg163Leu) in the ABCD1 gene of the proband caused by the nucleotide change 488G>T in exon 1. His asymptomatic mother carried the same mutation. We have reported an unpublished mutation in the ABCD1 gene in a patient with X-ALD, who showed increased ratio of C24:0/C22:0 and C26:0/C22:0, despite a normal VLCFA concentrations.

Reliability and Validity of Alcohol Use Disorder dentification Test-Korean Revised Version for Screening At-risk Drinking and Alcohol Use Disorders

BackgroundThere needs to be an amendment to the Korean version of the Alcohol Use Disorder Identification Test (AUDIT) with regards to the recent change in percent alcohol by volume (ABV) Korean liquor. This study was performed to suggest a cutoff value, reliability and validity of AUDIT-Korean revised version (AUDIT-KR), which reflect the change of the ABV of Korean alcohol.MethodsThe subjects were 435 peoples (210 males and 225 females), who visited the Chungnam National University Hospital for a comprehensive medical examination. The respondents completed the AUDIT-KR. At-risk drinking and alcohol use disorders had been evaluated by diagnostic interview. The Cronbach's alpha value, the receiver operating characteristic curve, the appropriate cutoff value, sensitivity and specificity of the AUDIT-KR were evaluated.ResultsThere were 190 at-risk drinkers (111 males and 79 females), and 66 people with alcohol use disorders (48 males and 18 females). The cutoff value of the AUDIT-KR for at-risk drinking was 3 points (sensitivity 93.69% and specificity 78.79%) for males and 3 points (sensitivity 92.40% and specificity 78.08%) for females. The cutoff value for alcohol use disorders was 10 points (sensitivity 100.00% and specificity 89.51%) for males and 8 points (sensitivity 100.00% and specificity 93.71%) for females. Cronbach's alpha of the AUDIT-KR was 0.885.ConclusionThe above results suggest that the AUDIT-KR shows a high reliability and validity in identifying at-risk drinking and alcohol use disorders.

Influence of the Flushing Response in the Relationship between Alcohol Consumption and Cardiovascular Disease Risk.

BackgroundThe purpose of this study was to examine the relationship between cardiovascular disease risk and alcohol consumption according to facial flushing after drinking among Korean men.MethodsThe subjects were 1,817 Korean men (non-drinker group, 283 men; drinking-related facial flushing group, 662 men; non-flushing group, 872 men) >30 years who had undergone comprehensive health examinations at the health promotion center of a Chungnam National University Hospital between 2007 and 2009. Alcohol consumption and alcohol-related facial flushing were assessed through a questionnaire. Cardiovascular disease risk was investigated based on the 2008 Framingham Heart Study. With the non-drinker group as reference, logistic regression was used to analyze the relationship between weekly alcohol intake and cardiovascular disease risk within 10 years for the flushing and non-flushing groups, with adjustment for confounding factors such as body mass index, diastolic blood pressure, low density lipoprotein cholesterol, triglycerides, and exercise patterns.ResultsIndividuals in the non-flushing group with alcohol consumption of ≤4 standard drinks (1 standard drink = 14 g of alcohol) per week had significantly lower moderate or high cardiovascular disease risk than individuals in the nondrinker group (adjusted odds ratio, 0.51; 95% confidence interval, 0.37 to 0.71). However, no significant relationship between the drinking amount and cardiovascular disease risk was observed in the flushing group.ConclusionCardiovascular disease risk is likely lowered by alcohol consumption among non-flushers, and the relationship between the drinking amount and cardiovascular disease risk may differ according to facial flushing after drinking, representing an individual's vulnerability.

Treatment of segmental lichen aureus with a pulsed-dye laser: new treatment options for lichen aureus

ejd.2013.2166 Auteur(s) : Dong-kyun Hong, In-kyu Chang, Young Lee, Young-joon Seo, Chang-deok Kim, Jeung-hoon Lee, Myung Im im1177@hanmail.net Department of Dermatology, Chungnam National University Hospital, 33 Munhwa-ro, Daejeon, 301-747, Korea Lichen aureus is a localized variant of pigmented purpuric dermatosis (PPD) and is characterized by discrete or confluent lichenoid macules and papules that are very persistent. The underlying cause of lichen aureus remains unknown and consequently there [...]