New distribution of Reticulitermes speratus speratus (Blattodea: Rhinotermitidae) in Korea.

Reticulitermes speratus (Kolbe) is economically important pest in East Asia including Korea, Japan, and China where they infest wooden structures in urban areas. Previously, it has been reported that R. speratus consists of 5 subspecies, R. speratus kyushuensis Morimoto, R. speratus speratus Kolbe, R. speratus leptolabralis Morimoto, R. speratus okinawanus Morimoto, R. speratus yaeyamanus Morimoto, while only R. speratus kyushuensis was recorded in Korea in the past. However, it remains elusive if different subspecies of R. speratus other than R. speratus kyushuensis are present in Korea. In this study, we report the first record of R. speratus speratus from Korea, which was verified using soldier morphology and molecular characteristics obtained from a mitochondrial gene. R. speratus speratus Kolbe, 1885 (Blattodea: Rhinotermitidae) are found in several provinces, mainly southern regions in Korea, whereas R. speratus kyushuensis are distributed throughout the country. Our morphological comparison showed that R. speratus speratus can be distinguishable from R. speratus kyushuensis by the ratio of the posterior postmentum width to length. In the molecular comparison, R. speratus speratus revealed genetic differences of 3.06% (range 2.60-4.10%) from R. speratus kyushuensis using cytochrome oxidase subunit II gene sequences.

AI-Driven Segmentation and Automated Analysis of the Whole Sagittal Spine from X-ray Images for Spinopelvic Parameter Evaluation.

Spinal-pelvic parameters are utilized in orthopedics for assessing patients' curvature and body alignment in diagnosing, treating, and planning surgeries for spinal and pelvic disorders. Segmenting and autodetecting the whole spine from lateral radiographs is challenging. Recent efforts have employed deep learning techniques to automate the segmentation and analysis of whole-spine lateral radiographs. This study aims to develop an artificial intelligence (AI)-based deep learning approach for the automated segmentation, alignment, and measurement of spinal-pelvic parameters through whole-spine lateral radiographs. We conducted the study on 932 annotated images from various spinal pathologies. Using a deep learning (DL) model, anatomical landmarks of the cervical, thoracic, lumbar vertebrae, sacrum, and femoral head were automatically distinguished. The algorithm was designed to measure 13 radiographic alignment and spinal-pelvic parameters from the whole-spine lateral radiographs. Training data comprised 748 digital radiographic (DR) X-ray images, while 90 X-ray images were used for validation. Another set of 90 X-ray images served as the test set. Inter-rater reliability between orthopedic spine specialists, orthopedic residents, and the DL model was evaluated using the intraclass correlation coefficient (ICC). The segmentation accuracy for anatomical landmarks was within an acceptable range (median error: 1.7-4.1 mm). The inter-rater reliability between the proposed DL model and individual experts was fair to good for measurements of spinal curvature characteristics (all ICC values > 0.62). The developed DL model in this study demonstrated good levels of inter-rater reliability for predicting anatomical landmark positions and measuring radiographic alignment and spinal-pelvic parameters. Automated segmentation and analysis of whole-spine lateral radiographs using deep learning offers a promising tool to enhance accuracy and efficiency in orthopedic diagnostics and treatments.

Effectiveness of Weekly Teriparatide Injection in Postmenopausal Patients with Hip Fractures.

Background: Teriparatide is an effective anabolic agent used in the treatment of severe osteoporosis. In addition, it is also used to promote fracture healing. The purpose of this double-blind randomized controlled trial was to evaluate the influence of weekly teriparatide administration on bone formation in hip fracture patients. Methods: The control group (n = 41) was composed of patients treated with normal saline other than teriparatide, and the teriparatide group (n = 51) consisted of patients who received weekly teriparatide. Bone turnover markers, C-terminal telopeptide (CTx) and osteocalcin (OC), were assessed through blood tests at the initial hospital visit and 3-month, 6-month, and 1-year follow-ups. Dual-energy X-ray absorptiometry was performed 5 days postoperatively and at 1-year postoperative follow-up. The degree of fracture union was evaluated by comparing the radiographic union scoring system for hips using Radiographic Union Score for Hip (RUSH) scores between the two groups at 3 months, 6 months, and 1 year after surgery. Results: Evaluation of the rate of change in bone mineral density over 1 year showed that the lumber bone mineral density increased by more than 7% in the experimental group. The control group did not show a difference between the CTx and OC at 6 months, but the difference between the CTx and OC values was large at 6 months in the experimental group. The mean RUSH score was significantly different between the control group and the experimental group: 12.105 and 15.476, respectively (p = 0.004), at 3 months and 18.571 and 22.389, respectively, at 6 months (p = 0.006). Conclusions: Weekly use of teriparatide improved fracture healing, bone formation, and clinical outcomes at 1 year after hip fracture surgery by the anabolic window effect.

The influence of different hinge position on PTS during HTO: comparison between open-wedge and closed-wedge HTO.

PURPOSE: The purpose of this study was to determine the significance of hinge position through comparison between open-wedge and closed-wedge high tibial osteotomy (HTO) and to determine the ideal hinge position to minimize the effect of HTO on the posterior tibial slope (PTS) and medial proximal tibial angle (MPTA). METHODS: Procedures were performed on 32 cadaveric knees using open-wedge HTO with the standard hinge position or a low hinge position or closed-wedge HTO with the standard hinge position or a low hinge position. To define the standard hinge position in open wedge HTO, we drew a line 3-cm inferior to the medial tibial plateau toward the fibular head and located the intersection of this line with a longitudinal line 1-cm medial to fibular shaft. The low hinge position was then defined as the point 1-cm inferior to the standard position. For the standard hinge position for closed-wedge HTO, we drew a line parallel with joint line from 2-cm inferior to the lateral tibial plateau. The low hinge position was then defined as the point 1-cm inferior to the standard position. RESULTS: For the open-wedge procedure, osteotomy through the low hinge position resulted in a significantly greater PTS compared to osteotomy through the standard hinge position. MPTA was also significantly greater for the low hinge position compared to standard hinge position. In the closed-wedge HTO, neither the PTS nor MPTA was significantly different for the low and standard hinge positions. CONCLUSIONS: Hinge position significantly affects changes in the PTS and MPTA following open-wedge but not closed-wedge HTO. Understanding how to hinge position affects the PTS and MPTA is critical for surgeons performing open-wedge HTO procedures. Adopting an accurate hinge position is crucial for preventing complications, especially in open-wedge osteotomy, due to postoperative changes in the PTS and MPTA.

Integrative analyses of genes about venous thromboembolism: An umbrella review of systematic reviews and meta-analyses.

BACKGROUND: In recent years, many studies have found possible links between gene polymorphisms and venous thromboembolism (VTE). By identifying genetic risk factors before facing environmental risk factors such as surgical interventions and COVID-19 vaccination, we could rapidly respond to the risk of VTE. The aim of this study was to perform an umbrella review of genetic variants related to VTE. Integrative gene analysis of VTE was performed to identify critical genetic variations. METHODS: This study conducted an umbrella review of systematic reviews and meta-analyses. All included studies were selected from the PubMed/MEDLINE database. To select eligible studies, the following variables were extracted: first author name; effect size of each study genetic variant; year of publication; the number of studies included in each article; ethnicity, sample size, P values, and heterogeneity estimates. To assess cumulative evidence in genetic epidemiology about effects of gene polymorphisms on VTE, Human Genome Epidemiology Network's Venice criteria were used. Methodological quality assessment was conducted with JBI Critical Appraisal Checklist for Systematic Reviews and Research Syntheses. RESULTS: Genes provided in the present study with genetic variants associated with VTE were FVL (G1691A), Prothrombin (G20210A), MTHFR (C677T, A1298C), PAI-1 (4G/5G), factor VII activating protease (1601G > A), and endothelial protein C receptor (g.6936A_G, c.4600A_G). Among them, variants in FVL, Prothrombin, MTHFR, and PAI-1 showed high significance. Particularly, variants in Prothrombin (G20210A), MTHFR (C677T), and PAI-1 (4G/5G) had more than 2 types of model significance. CONCLUSION: The present study performed a systematic review of genetic variants associated with VTE. Our results could lead to a more comprehensive understanding of VTE etiology. These results could give a strategy of prediagnosis about evaluating individual risks of VTE who might be exposed to environmental risk factors.

Can the cortical bone trajectory screw technique be an alternative method to the pedicle screw in posterior lumbar fusion? A systematic review and metaanalysis.

OBJECTIVE: The aim of this study was to verify the practicability of the cortical bone trajectory (CBT) method by comparing the clinical outcomes including the complications between the CBT method and pedicle screws (PSs). METHODS: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), web of Science, and SCOPUS electronic databases were searched for relevant articles published through March 2021 that compared the outcomes of the CBT and PSs. The data search, extraction, analysis, and quality assessment were performed according to the Cochrane Collaboration guidelines. The clinical and radiological outcomes of both techniques were evaluated using various outcome measures. RESULTS: Sixteen studies with a total of 1173 patients were included in the study. The outcomes in the meta-analysis indicated that the use of CBT fixation showed better results for overall complications (P < 0.0001), symptomatic adjacent segment disease (sASD) (P = 0.007), superior facet joint violation (SFJV) rate (P = 0.007), operating time (P = 0.007), intraoperative blood loss (P < 0.00001), incision length (P = 0.002), length of hospital stay (P = 0.0006), and revision rates (P = 0.02). However, there were no statistically significant differences in fusion rates or detailed complications including hardware complications, wound infections (all P > 0.05) between the CBT method and PS fixation groups. CONCLUSIONS: The present study revealed that the CBT method was associated with higher functional recovery, lower surgical morbidity rates, lower revision rates, and lower overall complication rates including sASD and SFJV rates. However, both the CBT method and PSs had similar fusion rates, complications including hardware complications (screw malposition, screw loosening, and screw pullout) and wound infections. Thus, the CBT method did not outperform the PSs in all aspects. Therefore, it is recommended to select a surgical method in consideration of the patient's bone mineral density, the condition of the pars interarticularis, or the skill level of the surgeon. Prognostic evaluation through long-term follow-up is required, and more high-quality randomized controlled trials are required to verify and strengthen our results. LEVEL OF EVIDENCE: Level III, Therapeutic Study.

Anterior cruciate ligament femoral-tunnel drilling through an anteromedial portal: 3-dimensional plane drilling angle affects tunnel length relative to notchplasty.

BACKGROUND: Notchplasty is a surgical technique often performed during anterior cruciate ligament reconstruction (ACLR) with widening of the intercondylar notch of the lateral distal femur to avoid graft impingement. The purpose of this study was to correlate femoral-tunnel length with 3-dimensional (3D) drilling angle through the anteromedial (AM) portal with and without notchplasty. MATERIALS AND METHODS: Computer data were collected from an anatomical study using 16 cadaveric knees. The anterior cruciate ligament (ACL) femoral insertion was dissected and outlined for gross anatomical observation. The dissected cadaveric knees were scanned by computed tomography (CT). Three-dimensional measurements were calculated using software (Geomagic, Inc., Research Triangle Park, NC, USA) and included the center of the ACL footprint and the size of the ACL femoral footprint. The femoral-tunnel aperture centers were measured in the anatomical posterior-to-anterior and proximal-to-distal directions using Bernard's quadrant method. The ACL tunnel was created 3-demensionally in the anatomical center of femoral foot print of ACL using software (SolidWorks®, Corp., Waltham, MA, USA). The 8-mm cylinder shaped ACL tunnel was rested upon the anatomical center of the ACL footprint and placed in three different positions: the coronal plane, the sagittal plane, and the axial plane. Finally, the effect of notchplasty on the femoral-tunnel length and center of the ACL footprint were measured. All the above-mentioned studies performed ACLR using the AM portal. RESULTS: The length of the femoral tunnels produced using the low coronal and high axial angles with 5-mm notchplasty became significantly shorter as the femoral starting position became more horizontal. The result was 30.38 ± 2.11 mm on average at 20° in the coronal plane/70° in the axial plane/45° in the sagittal plane and 31.26 ± 2.08 mm at 30° in the coronal plane/60° in the axial plane/45° in the sagittal plane, respectively, comparing the standard technique of 45° in the coronal/45° in the axial/45° in the sagittal plane of 32.98 ± 3.04 mm (P < 0.001). The tunnels made using the high coronal and low axial angles with notchplasty became longer than those made using the standard technique: 40.31 ± 3.36 mm at 60° in the coronal plane/30° in the axial plane/45° in the sagittal plane and 50.46 ± 3.13 mm at 75° in the coronal plane/15° in the axial plane/45° in the sagittal plane (P < 0.001). CONCLUSIONS: Our results show that excessive notchplasty causes the femoral tunnel to be located in the non-anatomical center of the ACL footprint and reduces the femoral-tunnel length. Therefore, care should be taken to avoid excessive notchplasty when performing this operation.

Association between height and sleep duration in Korean adults.

The relationship between height and sleep duration is poorly understood in adults. We analysed the data from 32 698 adults collected by the 2007-2016 Korean National Health and Nutrition Examination Survey. A total of 44.4% and 9.1% participants reported short (≤6 h) and long (≥9 h) sleep duration, respectively. A shorter height was significantly associated with increased likelihood of both short and long sleep. A sex-stratified analysis revealed that the relationship between height and sleep duration was only significant in males. In conclusion, height was independently related to sleep duration in Korean men.

An Updated Meta-analysis on the Risk of Urologic Cancer in Patients with Systemic Lupus Erythematosus.

BACKGROUND: The risk of urologic cancers in patients with systemic lupus erythematosus (SLE) remains uncertain. We investigated the association between SLE and incident urologic cancers through a systematic review and meta-analysis. METHODS: We searched the PubMed, EMBASE, and the Cochrane Library to identify articles that recorded prostate, bladder, or kidney cancers in SLE patients from inception to August 31, 2018. We included observational, case-control, or cohort studies with no language restriction. Two investigators screened and extracted the data independently. RESULTS: Fourteen cohort studies with 83,860 SLE patients were finally analyzed. Overall, SLE patients were at increased risk of bladder cancer (hazard ratio [HR], 1.92; 95% confidence interval [CI], 1.15-3.21) but not of prostate or kidney cancer. However, subgroup analyses showed a reduced risk of prostate cancer in <10-year follow-up studies (HR, 0.68; 95% CI, 0.51-0.89) and an elevated risk of kidney cancer in patients with SLE in Western studies (HR, 2.00; 95% CI, 1.02-3.92), community-based studies (HR, 4.54; 95% CI, 2.17-9.52), prospective studies (HR, 6.84; 95% CI, 2.71-17.26), <10-year follow-up studies (HR, 1.88; 95% CI, 1.38-2.57), and low-quality studies (HR, 2.05; 95% CI, 1.50-2.80). CONCLUSION: This study indicates that SLE increases the risk of bladder cancer but not prostate or kidney cancer. Well-designed long-term studies are required to confirm these associations.

Adult height is not associated with the risk of stomach cancer in a meta-analysis.

BACKGROUND: Adult height has been suggested as a biomarker for a wide range of diseases. However, there are epidemiologic inconsistencies regarding the association between adult height and stomach cancer risk. METHODS: We retrieved PubMed, EMBASE and Cochrane library databases to identify relevant studies assessing the relationship between height and risk of stomach cancer, published from inception to June 4, 2019. We pooled effect sizes for 5-cm height increments using a random-effect model and obtained the cumulative relative risk (RR) and 95% confidence interval (CI). Additionally, we performed subgroup investigation with sensitivity analysis and tested for publication bias using the Begg rank correlation test. RESULTS: We analyzed 11 studies involving 137,451 cases. The summary of effect size (95% CI) of stomach cancer for a 5-cm-increase in adult height was 0.99 (0.95-1.02). A "leave-one-out" sensitivity analysis indicated that the heterogeneity decreased by a half and the result showed significance (RR, 0.972; 95% CI, 0.948-0.997). Subgroup analyses found no significant associations, with one exception. The exception also depended entirely on one study. We found no significant publication bias (P=0.276). CONCLUSIONS: Height is not associated with increased stomach cancer risk. Epidemiologic studies of potential confounders are needed to clarify the association.

Hypernatremia at admission predicts poor survival in patients with terminal cancer: a retrospective cohort study.

BACKGROUND: Although palliative care providers, patients, and their families rely heavily on accurate prognostication, the prognostic value of electrolyte imbalance has received little attention. METHODS: As a retrospective review, we screened inpatients with terminal cancer admitted between January 2017 and May 2019 to a single hospice-palliative care unit. Clinical characteristics and laboratory results were obtained from medical records for multivariable Cox regression analysis of independent prognostic factors. RESULTS: Of the 487 patients who qualified, 15 (3%) were hypernatremic upon admission. The median survival time was 26 days. Parameters associated with shortened survival included male sex, advanced age (> 70 years), lung cancer, poor performance status, elevated inflammatory markers, azotemia, impaired liver function, and hypernatremia. In a multivariable Cox proportional hazards model, male sex (hazard ratio [HR] = 1.53, 95% confidence interval [CI]: 1.15-2.04), poor performance status (HR = 1.45, 95% CI: 1.09-1.94), leukocytosis (HR = 1.98, 95% CI: 1.47-2.66), hypoalbuminemia (HR = 2.06, 95% CI: 1.49-2.73), and hypernatremia (HR = 1.55, 95% CI: 1.18-2.03) emerged as significant predictors of poor prognosis. CONCLUSION: Hypernatremia may be a useful gauge of prognosis in patients with terminal cancer. Further large-scale prospective studies are needed to corroborate this finding.

Association between serum carcinoembryonic antigen (CEA) levels and leukoaraiosis in middle-aged and older adults: A cross-sectional study.

BACKGROUND: Leukoaraiosis refers to lesions of high signal intensities in periventricular and subcortical white matter, which result from chronic microvascular ischemic damage of the brain. Emerging evidence suggests that serum carcinoembryonic antigen (CEA) is elevated in cardiometabolic diseases, which are closely related with microangiopathy. Thus, we hypothesized that serum CEA levels could be associated with leukoaraiosis and aimed to examine this association among middle-aged and older adults. METHODS: This cross-sectional study included 2164 Korean adults aged ≥ 45 years who underwent a health examination program at a single hospital between 2010 and 2015. Serum CEA levels were quantified by chemiluminescence immunoassay and categorized as quartiles: Q1: ≤ 1.1, Q2: 1.2-1.6, Q2: 1.7-2.4, and Q4: ≥ 2.5 µg/L. The odds ratios (ORs) and 95% confidence intervals (95% CIs) for leukoaraiosis based on brain MRI scans were calculated across serum CEA quartiles using multiple logistic regression analysis after adjusting for age, sex, body mass index, smoking status, fasting plasma glucose, triglyceride, HDL-cholesterol, hypertension, type 2 diabetes, and leukocyte count. RESULTS: The overall prevalence of leukoaraiosis was 5.4% and increased with serum CEA quartiles: 3.3% for Q1, 5.0% for Q2, 5.8% for Q3, and 7.6% for Q4 (P < 0.001). The OR (95% CI) of the highest CEA quartile, compared to the lowest quartile, for leukoaraiosis was 2.164 (1.169-4.006) after adjusting for confounding variables. CONCLUSIONS: Serum CEA levels were positively and independently associated with leukoaraiosis. Our findings indicate that serum CEA level might be useful additional measure in assessing leukoaraiosis in clinical settings.

Risk of pancreatic cancer in patients with systemic lupus erythematosus: a meta-analysis.

OBJECT: Accumulating evidences suggest that the incidence of several cancers is higher in systemic lupus erythematosus (SLE) than in general population. However, the finding on pancreatic cancer risk is inconsistent. This meta-analysis aimed to determine whether SLE patients are at risk for pancreatic cancer. METHODS: We searched PubMed, Embase, and the Cochrane database to screen the studies meeting our criteria. The hazard ratios (HRs) and its 95% confidence interval (CIs) were calculated from a meta-analysis. RESULTS: Eleven cohort studies were included in the final analysis. Overall, patients with SLE had an increased risk of pancreatic cancer (HR = 1.42, CI = 1.32-1.53). In subgroup analysis, hospital-based (HR = 1.43, CI = 1.32-1.54), retrospective (HR = 1.42, CI = 1.32-1.54), over 10 years followed (HR = 1.44, CI = 1.33-1.55), and low-quality studies (HR = 1.42, CI = 1.31-1.53) remained robust. Significant publication bias was not observed among the studies (p = 0.533). CONCLUSIONS: The synthesized evidence from our meta-analysis demonstrated that SLE was associated with increased risk for pancreatic cancer. A well-designed, long-period followed study is needed to confirm this association. Key Points • Cancer incidence in SLE patients is increasing, but the data concerning pancreatic cancer remains inconclusive. • Our meta-analysis indicated that the risk of pancreatic cancer was significantly increased in SLE patients. • A well-designed, long-period followed study is needed to confirm the association.

Relationship between serum alkaline phosphatase level, C-reactive protein and leukocyte counts in adults aged 60 years or older.

Serum alkaline phosphatase (ALP), a useful marker of hepatobiliary or bone disorders, has been known to be associated with cardiovascular disease (CVD), which is increasingly being viewed as an inflammatory disease. C-reactive protein level and leukocyte count have also been highlighted as independent risk markers of CVD. Thus, the mechanism underlying the link between elevated ALP and CVD could be subclinical low-grade inflammation. This study aimed to examine associations of serum ALP level with inflammatory markers. This cross-sectional study included 2403 participants (1324 men and 1079 women) aged ≥60 years who participated in a health examination program. Serum ALP quartiles were categorized as follows: Q1: ≤51, Q2: 52-61, Q3: 62-74 and Q4: ≥75 U/L. The odds ratios (ORs) and 95% confidence intervals (CIs) for high CRP and leukocyte count (≥75th percentiles) were calculated after adjusting for confounding variables across serum ALP quartiles using multiple logistic regression analysis. Median CRP level and mean leukocyte count increased in accordance with serum ALP quartiles. Compared to the lowest quartile, the ORs (95% CI) of the highest quartile for high CRP and leukocyte count were 2.03 (1.50-2.76) and 1.54 (1.13-2.10) after adjusting for age, sex, body mass index, smoking status, alcohol intake, fasting plasma glucose, log-transformed triglyceride and HDL-cholesterol levels. Serum ALP level was positively and independently associated with inflammatory markers in adults aged 60 years or older.

Decision feedback equalizer for holographic data storage.

Holographic data storage (HDS) has attracted much attention as a next-generation storage medium. Because HDS suffers from two-dimensional (2D) inter-symbol interference (ISI), the partial-response maximum-likelihood (PRML) method has been studied to reduce 2D ISI. However, the PRML method has various drawbacks. To solve the problems, we propose a modified decision feedback equalizer (DFE) for HDS. To prevent the error propagation problem, which is a typical problem in DFEs, we also propose a reliability factor for HDS. Various simulations were executed to analyze the performance of the proposed methods. The proposed methods showed fast processing speed after training, superior bit error rate performance, and consistency.

The relationship between pulmonary function and suicidal ideation in Korean adults: a nationwide survey.

Controversy surrounds the association between lung function and mental health in the general population, and previous reported results were confounded by the effect of other chronic illnesses. This study aimed to investigate whether reduced lung function was related to mental health issues, taking into consideration the relevant potential confounders. We used data from the 2008-2013 Korean National Health and Nutrition Examination Survey to examine the relationship between lung function and three mental issues (recognized stress, depressive mood, and suicidal ideation) among 22,068 Korean adults. A multiple logistic regression with adjustment for potential covariates including chronic illnesses revealed that a .5-L decrement of forced vital capacity increased the risk for suicidal ideation in both genders, but there was no significant association with recognized stress or depressive mood. We found an inverse relationship between lung function and suicidal ideation in the Korean general population.

Practice Patterns in Distinguishing Between Background Pain and Breakthrough Pain During Patient Education: a Korean Physician Survey.

This study sought to explore the association between physician practice patterns and patient education, with a focus on breakthrough cancer pain (BTcP). A nationwide online survey was conducted by 92 Korean physicians. Thirteen questions on Korean physician's assessment, prescription, patient education practices, and knowledge regarding BTcP were administered. Based on their responses, physicians were divided using two methods: (1) by their patient education practices, where the "education group" always explained the distinction between background pain and BTcP and the "less education group" which explained it less frequently; and (2) by their definition of BTcP, as occurring "after control of background pain" or "regardless of background pain." We compared practice patterns using Fisher's exact test or Student's t test and performed multiple logistic regression analysis. The "education group" (65 physicians, 70.7 %) was more likely than the "less education group" to assess BTcP meticulously (odds ratio [OR] 17.13, 95 % confidence interval [CI] 4.98-58.94), prepare rescue medications in advance (OR 3.67, 95 % CI 1.36-9.90), and give explicit instructions regarding medications (OR 36.68, 95 % CI 5.63-239.15). Physicians who defined BTcP as occurring "after control of background pain" were more likely to explain how to take rescue medication (P < 0.05) than physicians who defined BTcP as occurring "regardless of background pain." Korean physicians' BTcP practice patterns may be affected by whether they consistently educate patients on the distinction between background pain and BTcP, regardless of their knowledge of the definition of BTcP.

Inverse relationship between vitamin D levels and platelet indices in Korean adults.

BACKGROUND AND AIMS: Vitamin D deficiency and increased platelet indices are associated with increased rate or risk of several diseases such as cardiovascular disease and metabolic syndrome, respectively. We investigated whether vitamin D deficiency is associated with increased platelet count (PC) and mean platelet volume (MPV). METHODS AND RESULTS: The study included 3190 subjects older than 20 years. Subjects were divided into three groups based on their vitamin D levels: vitamin D deficiency (<10.0 ng/ml); insufficiency (10-20 ng/ml); and sufficiency (>20.0 ng/ml). The associations between platelet indices and various parameters were analyzed by Pearson's correlation analysis and t-tests. Then, multivariate linear regression analyses were done correcting for associated parameters. PC and MPV showed a negative correlation with vitamin D groups by ANOVA and multiple linear regression. PC was inversely related with vitamin D group after adjusting for sex, age, regular exercise, white blood cell count, total cholesterol, hemoglobin, and creatinine levels (ß ± SE = -3.461 ± 1.512, P = 0.022). MPV was also inversely related with vitamin D group after adjusting for regular exercise, hemoglobin level, and total cholesterol level (ß ± SE = -0.080 ± 0.026, P = 0.002), and this relationship remained statistically significant after adjusting for regular exercise, hemoglobin level, total cholesterol level, diabetes, hypertension, and body mass index (ß ± SE=-0.082 ± 0.026, P = 0.002). CONCLUSION: PC and MPV are inversely associated with vitamin D levels in adults.