Background: This study aimed to evaluate the co-administration effect of atelocollagen combined with hyaluronic acid (HA) injections fortreatment of full-thickness rotator cuff tear (RCT). Methods: Eighty patients who underwent arthroscopic rotator cuff repair for full-thickness RCT from March 2018 to November 2019 wereenrolled. The patients were randomly allocated to the following groups: combined atelocollagen and HA injection (group I, n=28), only HAinjection (group II, n=26), and no injection (group III, n=26). Clinical outcomes were assessed at 3, 6, and 12 months after surgery usingthe American Shoulder and Elbow Surgeons score, visual analog scale pain score, functional scores (pain visual analog scale, function visualanalog score), and range of motion. Magnetic resonance imaging was performed 12 months after surgery to evaluate rotator cuff integrity. Results: Preoperative demographic data and postoperative clinical outcomes did not differ significantly among the three groups (p>0.05).However, in group I, the number of steroid injections after surgery was significantly lower than that in the other groups (p=0.011). The retear rate on follow-up magnetic resonance imaging was significantly higher in group II (9.5%, n=2) and group III (13.6%, n=3) than ingroup I (0%, p=0.021). Conclusions Co-administration of atelocollagen and HA improves healing of the rotator cuff and increases the integrity of the rotator cuffrepair site. This study provides encouraging evidence for use of combined atelocollagen-HA injections to treat patients with full-thicknessRCT.

Background: This study aimed to evaluate the co-administration effect of atelocollagen combined with hyaluronic acid (HA) injections fortreatment of full-thickness rotator cuff tear (RCT). Methods: Eighty patients who underwent arthroscopic rotator cuff repair for full-thickness RCT from March 2018 to November 2019 wereenrolled. The patients were randomly allocated to the following groups: combined atelocollagen and HA injection (group I, n=28), only HAinjection (group II, n=26), and no injection (group III, n=26). Clinical outcomes were assessed at 3, 6, and 12 months after surgery usingthe American Shoulder and Elbow Surgeons score, visual analog scale pain score, functional scores (pain visual analog scale, function visualanalog score), and range of motion. Magnetic resonance imaging was performed 12 months after surgery to evaluate rotator cuff integrity. Results: Preoperative demographic data and postoperative clinical outcomes did not differ significantly among the three groups (p>0.05).However, in group I, the number of steroid injections after surgery was significantly lower than that in the other groups (p=0.011). The retear rate on follow-up magnetic resonance imaging was significantly higher in group II (9.5%, n=2) and group III (13.6%, n=3) than ingroup I (0%, p=0.021). Conclusions Co-administration of atelocollagen and HA improves healing of the rotator cuff and increases the integrity of the rotator cuffrepair site. This study provides encouraging evidence for use of combined atelocollagen-HA injections to treat patients with full-thicknessRCT.

BACKGROUND: A1chieve(R) was a noninterventional study evaluating the clinical safety and efficacy of biphasic insulin aspart 30, insulin detemir, and insulin aspart. METHODS: Korean type 2 diabetes patients who have not been treated with the study insulin or have started it within 4 weeks before enrollment were eligible for the study. The patient selection and the choice of regimen were at the discretion of the physician. The safety and efficacy information was collected from the subjects at baseline, week 12, and week 24. The number of serious adverse drug reactions (SADRs) was the primary endpoint. The changes of clinical diabetic markers at week 12 and/or at week 24 compared to baseline were the secondary endpoints. RESULTS: Out of 4,058 exposed patients, 3,003 completed the study. During the study period, three SADRs were reported in three patients (0.1%). No major hypoglycemic episodes were observed and the rate of minor hypoglycemic episodes marginally decreased during 24 weeks (from 2.77 to 2.42 events per patient-year). The overall quality of life score improved (from 66.7+/-15.9 to 72.5+/-13.5) while the mean body weight was slightly increased (0.6+/-3.0 kg). The 24-week reductions in glycated hemoglobin, fasting plasma glucose and postprandial plasma glucose were 1.6%+/-2.2%, 2.5+/-4.7 mmol/L, and 4.0+/-6.4 mmol/L, respectively. CONCLUSION: The studied regimens showed improvements in glycemic control with low incidence of SADRs, including no incidence of major hypoglycemic episodes in Korean patients with type 2 diabetes.
Biphasic Insulins ; Body Weight ; Diabetes Mellitus, Type 2 ; Drug Toxicity ; Fasting ; Glucose ; Hemoglobins ; Humans ; Incidence ; Insulin ; Insulin Aspart ; Insulin, Isophane ; Insulin, Long-Acting ; Patient Selection ; Plasma ; Quality of Life ; Republic of Korea ; Treatment Outcome ; Insulin Detemir

We analyzed the direct medical costs for Korean patients with type 2 diabetes according to the type of complications and the number of microvascular complications. We analyzed costs for type 2 diabetes and associated complications in 3,125 patients. These data were obtained from the Korean National Diabetes Program (KNDP), a large, ongoing, prospective cohort study that began in 2005. The cost data were prospectively collected, using an electronic database, for the KNDP cohort at six hospitals. The costs were analyzed according to complications for 1 yr from enrollment in the study. Among 3,125 patients, 918 patients had no vascular complications; 1,883 had microvascular complications only; 51 had macrovascular complications only; and 273 had both complications. The annual direct medical costs for a patient with only macrovascular, only microvascular, or both macrovascular and microvascular complications were 2.7, 1.5, and 2.0 times higher than the medical costs of patients without complications. Annual direct medical costs per patient increased with the number of microvascular complications in patients without macrovascular complications. The economic costs for type 2 diabetes are attributable largely to the management of microvascular and macrovascular complications. Proper management of diabetes and prevention of related complications are important for reducing medical costs.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; Cohort Studies ; Costs and Cost Analysis ; Databases, Factual ; Diabetes Mellitus, Type 2/complications/*economics ; Female ; Health Care Costs ; Humans ; Male ; Middle Aged ; Prospective Studies ; Republic of Korea ; Vascular Diseases/complications ; Young Adult

BACKGROUND: The aim of this study was to analyze the dynamics of blood glucose during therapeutic hypothermia (TH) and the association between in-hospital mortality and blood glucose in out-of-hospital cardiac arrest survivors (OHCA) treated with TH. METHODS: The OHCA treated with TH between 2008 and 2011 were identified and analyzed. Blood glucose values were measured every hour during TH and collected. Mean blood glucose and standard deviation (SD) were calculated using blood glucose values during the entire TH period and during each phase of TH. The primary outcome was in-hospital mortality. RESULTS: One hundred twenty patients were analyzed. The non-shockable rhythm (OR = 8.263, 95% CI 1.622-42.094, p = 0.011) and mean glucose value during induction (OR = 1.010, 95% CI 1.003-1.016, p = 0.003) were independent predictors of in-hospital mortality. The blood glucose values decreased with time, and median glucose values were 161.0 (116.0-228.0) mg/dl, 128.0 (102.0-165.0) mg/dl, and 105.0 (87.5-129.3) mg/dl during the induction, maintenance, and rewarming phase, respectively. The 241 (180-309) mg/dl of the median blood glucose value before TH was significantly lower than 183 (133-242) mg/dl of the maximal median blood glucose value during the cooling phase (p < 0.001). CONCLUSIONS: High blood glucose was associated with in-hospital mortality in OHCA treated with TH. Therefore, hyperglycaemia during TH should be monitored and managed. The blood glucose decreased by time during TH. However, it is unclear whether TH itself, insulin treatment or fluid resuscitation with glucose-free solutions affects hypoglycaemia.
Blood Glucose ; Glucose ; Heart Arrest ; Hospital Mortality ; Humans ; Hypothermia ; Hypothermia, Induced ; Insulin ; Out-of-Hospital Cardiac Arrest ; Resuscitation ; Rewarming ; Survivors

BACKGROUND/AIMS: The aim of this study was to quantitatively measure changes in lipids and lipoproteins during perimenopause and to identify variables related to these changes. METHODS: Among women who had three regular health evaluations over a span of 2-4 years, 34 women remained in the premenopausal state, 34 premenopausal women transitioned to the postmenopausal state, and 36 postmenopausal women were enrolled. The menopausal state was determined not only by a history of amenorrhea but also by levels of female sex hormones. Yearly changes in lipids were calculated using a linear regression of the three measurements. RESULTS: The transition from premenopause to postmenopause was associated with increased total cholesterol and low-density lipoprotein (LDL) cholesterol levels by 7.4 +/- 8.0 mg/dL (4.2 +/- 4.9%) and 6.9 +/- 6.5 mg/dL (6.8 +/- 7.0%) over one year, resulting in an elevation of 19.6 +/- 22.6 mg/dL (10.9 +/- 13.0%) and 18.9 +/- 19.5 mg/dL (18.6 +/- 20.3%), respectively, during perimenopause. There were no changes observed in premenopausal and postmenopausal women. Body weight, blood pressure, high-density lipoprotein (HDL) cholesterol, and triglycerides did not change in any of the three groups. In all women, changes in both total cholesterol and LDL cholesterol were associated with changes in follicle stimulating hormone (r = 0.40, p < 0.001 and r = 0.38, p < 0.001, respectively). Changes in triglycerides were associated with changes in body weight (r = 0.28, p = 0.005). CONCLUSIONS: During perimenopause, total and LDL cholesterol levels increase and these changes in cholesterol are mainly dependent on changes in female sex hormones.
Adult ; Cholesterol, HDL/blood ; Cholesterol, LDL/blood ; Female ; Follicle Stimulating Hormone/blood ; Humans ; Lipids/*blood ; Lipoproteins/*blood ; Middle Aged ; Postmenopause/*blood ; Premenopause/*blood

BACKGROUND: Although many anti-diabetic drugs have been used to control hyperglycemia for decades, the efficacy of commonly-used oral glucose-lowering agents in Korean type 2 diabetic patients has yet to be clearly demonstrated. METHODS: We evaluated the efficacy of glimepiride, metformin, and rosiglitazone as initial treatment for drug-naive type 2 diabetes mellitus patients in a 48-week, double-blind, randomized controlled study that included 349 Korean patients. Our primary goal was to determine the change in HbA1c levels from baseline to end point. Our secondary goal was to evaluate changes in fasting plasma glucose (FPG) levels, body weight, frequency of adverse events, and the proportion of participants achieving target HbA1c levels. RESULTS: HbA1c levels decreased from 7.8% to 6.9% in the glimepiride group (P<0.001), from 7.9% to 7.0% in the metformin group (P<0.001), and from 7.8% to 7.0% (P<0.001) in the rosiglitazone group. Glimepiride and rosiglitazone significantly increased body weight and metformin reduced body weight during the study period. Symptomatic hypoglycemia was more frequent in the glimepiride group and diarrhea was more frequent in the metformin group. CONCLUSION: The efficacy of glimepiride, metformin, and rosiglitazone as antidiabetic monotherapies in drug-naive Korean type 2 diabetic patients was similar in the three groups, with no statistical difference. This study is the first randomized controlled trial to evaluate the efficacy of commonly-used oral hypoglycemic agents in Korean type 2 diabetic patients. An additional subgroup analysis is recommended to obtain more detailed information.
Body Weight ; Diabetes Mellitus, Type 2 ; Diarrhea ; Fasting ; Glucose ; Humans ; Hyperglycemia ; Hypoglycemia ; Hypoglycemic Agents ; Metformin ; Plasma ; Sulfonylurea Compounds ; Thiazolidinediones

BACKGROUND: Alveolar soft part sarcomas (ASPSs) are rare, histologically distinctive soft tissue sarcomas of unknown origin. Although ASPSs are characterized by a specific alteration, der(17)t(X;17)(p11;q25), the entire spectrum of genetic events underlying the pathogenesis of ASPS is unclear. Using array-based comparative genomic hybridization (array-CGH), we examined the DNA copy number changes in ASPS. METHODS: Array-CGH, composed of 4,030 clones, was performed in two samples of fresh frozen tumor tissues from a 29-year-old male and a 16-year-old female. RESULTS: We identified 16 commonly altered chromosomal regions involving 25 genes. Eleven altered regions were located on chromosome Xp (Xp22.33, Xp22.11, Xp11.3, Xp11.3-Xp11.23, Xp22.2, Xp22.12, Xp22.31, Xp22.32, Xp21.1, Xp21.3, and Xp11.4). Additional regions with an increased copy number were observed at 1q25.1, 7q35, 12p12.1, and 17p11.2. Loss was found in only one region of chromosome 22q11.23. Several genes located within the amplified region of Xp included GYG2, ARSD, ARSE, ARSH, UBE1, USP11, PCTK1, ARAF, SYN1, TIMP1, XK, PDK3, PCYT1B, PHEX, ARX, RPS6KA3, TMSB4X, TMEM27, BMX, and KAL1. CONCLUSIONS: This was the first application report of genome-wide copy number changes by BAC array-CGH in ASPSs. Our study showed unique genomic regions and new candidate genes that suggest a neural origin and are associated with tumor pathogenesis in ASPSs.
Adolescent ; Adult ; Clone Cells ; Coat Protein Complex I ; Comparative Genomic Hybridization ; DNA Copy Number Variations ; Female ; Humans ; Male ; Nucleic Acid Hybridization ; Sarcoma ; Sarcoma, Alveolar Soft Part ; Viperidae

Infected aneurysms are uncommon, frequently fatal lesions. "True" fungus-infected aneurysms are even rarer. Fungal infections have high morbidity and mortality. However, diagnosis is frequently difficult, since the symptoms are non-specific and standard diagnostic procedures are often insensitive. We experienced a patient with persistent fever and negative blood cultures. The patient was immunocompetent and had no risk factors, and was diagnosed with a fungus-infected aneurysm based on computed tomography and vascular surgery. The vascular tissue revealed some narrow-based budding yeast within the thrombus, suggesting Candida infection. Seventeen cases of infected aneurysm of the abdomen were reported in Korea from 1988 to 2007, although none were "true" fungus-infected aneurysms, making this the first fungus-infected aneurysm of the abdomen in Korea. Prompt diagnostic procedures and aggressive treatment modalities are necessary for patients with occult infection and negative blood cultures, regardless of their immunocompetence, because of the high morbidity and mortality of this condition.
Abdomen ; Aneurysm ; Aneurysm, Infected ; Aorta, Abdominal ; Candida ; Fever ; Fungi ; Humans ; Immunocompetence ; Korea ; Risk Factors ; Saccharomycetales ; Thrombosis

Infected aneurysms are uncommon, frequently fatal lesions. "True" fungus-infected aneurysms are even rarer. Fungal infections have high morbidity and mortality. However, diagnosis is frequently difficult, since the symptoms are non-specific and standard diagnostic procedures are often insensitive. We experienced a patient with persistent fever and negative blood cultures. The patient was immunocompetent and had no risk factors, and was diagnosed with a fungus-infected aneurysm based on computed tomography and vascular surgery. The vascular tissue revealed some narrow-based budding yeast within the thrombus, suggesting Candida infection. Seventeen cases of infected aneurysm of the abdomen were reported in Korea from 1988 to 2007, although none were "true" fungus-infected aneurysms, making this the first fungus-infected aneurysm of the abdomen in Korea. Prompt diagnostic procedures and aggressive treatment modalities are necessary for patients with occult infection and negative blood cultures, regardless of their immunocompetence, because of the high morbidity and mortality of this condition.
Abdomen ; Aneurysm ; Aneurysm, Infected ; Aorta, Abdominal ; Candida ; Fever ; Fungi ; Humans ; Immunocompetence ; Korea ; Risk Factors ; Saccharomycetales ; Thrombosis