PURPOSE: Cardiovascular adverse events (AEs) after use of dipeptidyl peptidase-4 (DPP4) inhibitors have been reported and suspected since the launch of DPP-4 inhibitors in 2006. However, few studies have investigated the association between cardiovascular AEs and DPP-4 inhibitors. The objective of this study is to detect the signals of cardiovascular AEs after use of DPP-4 inhibitors by analyzing the Korea Institute of Drug Safety & Risk Management-Korea Adverse Event Reporting System Database (KIDS-KD). MATERIALS AND METHODS: Data on the use of oral antidiabetic drugs from 2008 to 2016 were extracted from KIDS-KD, and analyzed descriptively. Data mining was conducted by calculating three indices, which were proportional reporting ratios, reporting odds ratios, and information components, to detect signals from use of all oral antidiabetic drugs including DPP-4 inhibitors. Then, the suspected adverse drug reactions (ADRs) were confirmed by signal detection, and drug label information between the Korea Ministry of Food and Drug Safety and the U.S. Food and Drug Administration were compared. RESULTS: Cardiovascular AEs after taking DPP-4 inhibitors were detected in only three (1.0%) out of a total of 307 AE reports. Two of the three cardiovascular AEs were reported after using sitagliptin and one using gemiglipitin, but these were not statistically significant. CONCLUSION: Analysis of spontaneous ADR reports data on the use of DPP-4 inhibitors could not showed the association between DPP-4 inhibitors and cardiovascular AEs, due to a small number of cardiovascular AEs reports.
Cardiovascular Diseases ; Data Mining ; Drug-Related Side Effects and Adverse Reactions ; Hypoglycemic Agents ; Korea ; Odds Ratio ; Pharmacovigilance ; Sitagliptin Phosphate ; United States Food and Drug Administration

In addition to Helicobacter pylori, the acute bacterial causes of infectious gastritis, include phlegmonous gastritis, gastric tuberculosis, and gastric syphilis. Bacterial gastritis often improves with appropriate broad-spectrum antibiotics, emphasizing the need for prompt diagnosis and treatment based on the clinical and endoscopic findings. Among viral gastritis, cytomegalovirus gastritis, primarily occurring in immunocompromised patients, necessitates antiviral intervention, while immunocompetent individuals typically achieve amelioration by administering proton pump inhibitors. In contrast, most gastric infections caused by the Epstein-Barr virus (EBV) are asymptomatic, but an EBV infection is a cause of stomach cancer. EBV-associated gastric cancer exhibits distinct clinical, pathological, genetic, and post-genetic mutation features, making it clinically significant. The colonization of Candida albicans in the stomach is uncommon, and typical antifungal treatment is unnecessary. Candida infections in gastric ulcers can be treated with anti-ulcer treatment alone. Lastly, anisakidosis in the stomach, which occurs when consuming raw seafood, can manifest in various clinical presentations and is typically treated through endoscopic removal of the nematode. This article aims to contribute to the rapid diagnosis and treatment of rare stomach infections beyond Helicobacter pylori in real clinical situations.

Purpose: Depression is a prevalent mental health concern globally including South Korea.Given the growing interest in the relationship between diet and mental health, this study aimed to investigate the association between seafood consumption and depression among Korean adults. Methods: A cross-sectional analysis was conducted using data from the Korea National Health and Nutrition Examination Survey (KNHANES, 2014–2020). The study included 18,149 participants (7,541 men and 10,608 women) aged 19 years and older who completed the Patient Health Questionnaire (PHQ-9). Seafood intake levels were assessed using a oneday 24-hour dietary recall, and participants were categorized into three tertiles by gender.Depression status was determined using the PHQ-9 scores and the self-report of the doctor’s diagnosis and treatment. Multivariable logistic regression analysis was performed to assess the association between seafood consumption and depression in both genders. Results: Participants with a higher seafood intake had a significantly lower nutritional density of total fat, while the nutritional density of omega-3 polyunsaturated fatty acids was significantly higher. The prevalence of depression was significantly lower in the highest tertile of seafood consumption compared to the lowest tertile in both men (p < 0.001) and women (p < 0.001). After adjusting for confounding factors, the highest tertile of seafood consumption demonstrated a decreased risk of depression compared to the lowest tertile in men (odds ratio [OR], 0.71; 95% confidence interval [CI], 0.51–0.99; p-trend = 0.020) and women (OR, 0.73; 95% CI, 0.59–0.91; p-trend = 0.004). Conclusion The findings of this study suggest that consuming seafood rich in omega-3 fatty acids may potentially reduce the risk of depression in the adult population.

When cerebral cortical hyperintensities on diffusion-weighted image are seen in patients with suspected acute stroke accompanying seizure, it is necessary to differentiate whether they are caused by infarction or seizure-related change. We report a case of seizure-related cortical hypertensities in a patient with suspected acute infarction. With perfusion MR imaging, we could differentiate from acute infarction.
Humans ; Infarction ; Magnetic Resonance Imaging* ; Perfusion* ; Seizures ; Stroke

Objective: Decreases in the hemoglobin level compared to the pre-injury lab results are often observed in patients with elderly hip fractures visiting the emergency department (ED). This decrease could be the outcome of the fracture itself or a complication caused by comorbidities. This study examined whether significant hemoglobin decreases, as detected in the ED, are related to other-than-hip-fracture bleeding focus or clinical outcomes. Methods: The electronic medical records were reviewed retrospectively at a single university ED from January 2012 to March 2019. ED diagnoses of hip fractures were screened and enrolled if the patient was 60 years or older and had hemoglobin levels recorded within the previous 6 months. A significant decrease in the hemoglobin level is defined as more than 2 g/dL. Results: Three hundred patients were enrolled in this study. Significant hemoglobin decreases were apparent in 43 patients (14.3%). Only four patients (1.3%) had an other-than-hip-fracture bleeding focus. One of those had a significant hemoglobin decrease. In a “significant decrease” versus “non-significant decrease” intergroup comparison, length of hospital stays (median and interquartile range: 17.0 [15.0-21.5] vs. 17.0 [12.0-21.0], P=0.55), survival discharge (4.7% vs. 2.3%, P=0.72), and other-than-hip-fracture bleeding focus (2.3% vs. 1.2%, P>0.99) did not differ significantly. Conclusion A decrease in hemoglobin level is common among elderly hip fracture patients. On the other hand, the incidence of other-than-hip-fracture bleeding focus was rare and unrelated to a decrease in significant hemoglobin levels. Similarly, neither the hospital length of stay nor survival discharge was unrelated to the hemoglobin level decrease.

PURPOSE: The purpose of this study was to evaluate the associated brain parenchymal abnormalities of developmental venous anomalies (DVA) with susceptibility-weighted image (SWI). MATERIALS AND METHODS: Between January 2012 and June 2013, 2356 patients underwent brain MR examinations with contrast enhancement. We retrospectively reviewed their MR examinations and data were collected as per the following criteria: incidence, locations, and associated parenchymal signal abnormalities of DVAs on T2-weighted image, fluid-attenuated inversion recovery (FLAIR), and SWI. Contrast enhanced T1-weighted image was used to diagnose DVA. RESULTS: Of the 2356 patients examined, 57 DVAs were detected in 57 patients (2.4%); 47 (82.4%) were in either lobe of the supratentorial brain, 9 (15.7%) were in the cerebellum, and 1 (1.7%) was in the pons. Of the 57 DVAs identified, 20 (35.1%) had associated parenchymal abnormalities in the drainage area. Among the 20 DVAs which had associated parenchymal abnormalities, 13 showed hemorrhagic foci on SWI, and 7 demonstrated only increased parenchymal signal abnormalities on T2-weighted and FLAIR images. In 5 of the 13 patients (38.5%) who had hemorrhagic foci, the hemorrhagic lesions were demonstrated only on SWI. CONCLUSION: The overall incidence of DVAs was 2.4%. Parenchymal abnormalities were associated with DVAs in 35.1% of the cases. On SWI, hemorrhage was detected in 22.8% of DVAs. Thus, we conclude that SWI might give a potential for understanding of the pathophysiology of parenchymal abnormalities in DVAs.
Brain* ; Cerebellum ; Drainage ; Hemorrhage ; Humans ; Incidence ; Magnetic Resonance Imaging* ; Pons ; Retrospective Studies

PURPOSE: To investigate the value of image post-processing software (FreeSurfer, IBASPM [individual brain atlases using statistical parametric mapping software]) and inversion time (TI) in volumetric analyses of the hippocampus and to identify differences in comparison with manual tracing. MATERIALS AND METHODS: Brain images from 12 normal adults were acquired using magnetization prepared rapid acquisition gradient echo (MPRAGE) with a slice thickness of 1.3 mm and TI of 800, 900, 1000, and 1100 ms. Hippocampal volumes were measured using FreeSurfer, IBASPM and manual tracing. Statistical differences were examined using correlation analyses accounting for spatial interpretations percent volume overlap and percent volume difference. RESULTS: FreeSurfer revealed a maximum percent volume overlap and maximum percent volume difference at TI = 800 ms (77.1 +/- 2.9%) and TI = 1100 ms (13.1 +/- 2.1%), respectively. The respective values for IBASPM were TI = 1100 ms (55.3 +/- 9.1%) and TI = 800 ms (43.1 +/- 10.7%). FreeSurfer presented a higher correlation than IBASPM but it was not statistically significant. CONCLUSIONS: FreeSurfer performed better in volumetric determination than IBASPM. Given the subjective nature of manual tracing, automated image acquisition and analysis image is accurate and preferable.
Adult* ; Brain ; Hippocampus ; Humans

BACKGROUND: Although effective care for type 2 diabetes (T2DM) is well known, considerable inadequate care has been still existed. Variations in achievement of the recommended quality indicators inT2DM care among small areas are not well known in Korea. This study examined the quality of care T2DM care and its geographical variations. METHODS: We used the national health insurance database and national health screening database. Seven quality indicators were used to evaluate continuity of care (medication possession ratio), process of care (hemoglobin A1c test, lipid profile, microalbuminuria test, and eye examination), and intermediate outcome (blood pressure control, and low-density lipoprotein control). Crude and age-standardized proportions were calculated for each 252 districts in Korea. RESULTS: All quality indicators failed to achieve the recommended level. Only about 3% and 15% of the patients underwent eye examination and microalbuminuria test, respectively. Other indicators ranged from 48% to 68%. Wide variation in the quality existed among districts and indicators. Eye examination and microalbuminuria test varied the most showing tenfold (0.9%–9.2%) and fourfold (6.3%–28.9%) variation by districts, respectively. There were 32.4 and 42.7 percentage point gap between the best and the worst districts in hemoglobin A1c test and blood pressure control, respectively. CONCLUSION: Considerable proportion of T2DM patients were not adequately managed and quality of care varied substantially district to district. To improve the quality of diabetes care, it is necessary to identify the poor performance areas and establish a well-coordinated care system tailored to the need of the district.
Blood Pressure ; Continuity of Patient Care ; Diabetes Mellitus ; Humans ; Korea ; Lipoproteins ; Mass Screening ; National Health Programs ; Quality of Health Care ; Small-Area Analysis

Recent amendments to regulatory frameworks have placed a greater emphasis on the utilization of in vitro testing platforms for preclinical drug evaluations and toxicity assessments. This requires advanced tissue models capable of accurately replicating liver functions for drug efficacy and toxicity predictions. Liver organoids, derived from human cell sources, offer promise as a reliable platform for drug evaluation. However, there is a lack of standardized quality evaluation methods, which hinders their regulatory acceptance. This paper proposes comprehensive quality standards tailored for liver organoids, addressing cell source validation, organoid generation, and functional assessment. These guidelines aim to enhance reproducibility and accuracy in toxicity testing, thereby accelerating the adoption of organoids as a reliable alternative or complementary tool to animal testing in drug development. The quality standards include criteria for size, cellular composition, gene expression, and functional assays, thus ensuring a robust hepatotoxicity testing platform.

Background: and Purpose: Dementia subtypes, including Alzheimer’s dementia (AD), dementia with Lewy bodies (DLB), and frontotemporal dementia (FTD), pose diagnostic challenges. This review examines the effectiveness of 18 F-Fluorodeoxyglucose Positron Emission Tomography ( 18 F-FDG PET) in differentiating these subtypes for precise treatment and management. Methods: A systematic review following Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines was conducted using databases like PubMed and Embase to identify studies on the diagnostic utility of 18 F-FDG PET in dementia. The search included studies up to November 16, 2022, focusing on peer-reviewed journals and applying the goldstandard clinical diagnosis for dementia subtypes. Results: From 12,815 articles, 14 were selected for final analysis. For AD versus FTD, the sensitivity was 0.96 (95% confidence interval [CI], 0.88–0.98) and specificity was 0.84 (95% CI, 0.70–0.92). In the case of AD versus DLB, 18F-FDG PET showed a sensitivity of 0.93 (95% CI 0.88-0.98) and specificity of 0.92 (95% CI, 0.70–0.92). Lastly, when differentiating AD from non-AD dementias, the sensitivity was 0.86 (95% CI, 0.80–0.91) and the specificity was 0.88 (95% CI, 0.80–0.91). The studies mostly used case-control designs with visual and quantitative assessments. Conclusions 18 F-FDG PET exhibits high sensitivity and specificity in differentiating dementia subtypes, particularly AD, FTD, and DLB. This method, while not a standalone diagnostic tool, significantly enhances diagnostic accuracy in uncertain cases, complementing clinical assessments and structural imaging.