Background: Atherogenic dyslipidemia, which is frequently associated with type 2 diabetes (T2D) and insulin resistance, contributes to the development of vascular complications. Statin therapy is the primary approach to dyslipidemia management in T2D, however, the role of non-statin therapy remains unclear. Ezetimibe reduces cholesterol burden by inhibiting intestinal cholesterol absorption. Fibrates lower triglyceride levels and increase high-density lipoprotein cholesterol (HDL-C) levels via peroxisome proliferator- activated receptor alpha agonism. Therefore, when combined, these drugs effectively lower non-HDL-C levels. Despite this, few clinical trials have specifically targeted non-HDL-C, and the efficacy of triple combination therapies, including statins, ezetimibe, and fibrates, has yet to be determined. Methods: This is a multicenter, prospective, randomized, open-label, active-comparator controlled trial involving 3,958 eligible participants with T2D, cardiovascular risk factors, and elevated non-HDL-C (≥100 mg/dL). Participants, already on moderate-intensity statins, will be randomly assigned to either Ezefeno (ezetimibe/fenofibrate) addition or statin dose-escalation. The primary end point is the development of a composite of major adverse cardiovascular and diabetic microvascular events over 48 months. Conclusion This trial aims to assess whether combining statins, ezetimibe, and fenofibrate is as effective as, or possibly superior to, statin monotherapy intensification in lowering cardiovascular and microvascular disease risk for patients with T2D. This could propose a novel therapeutic approach for managing dyslipidemia in T2D.

Purpose: Targeted next-generation sequencing (NGS) panels for solid tumors have been useful in clinical framework for accurate tumor diagnosis and identifying essential molecular aberrations. However, most cancer panels have been designed to address a wide spectrum of pan-cancer models, lacking integral prognostic markers that are highly specific to gliomas. Materials and Methods: To address such challenges, we have developed a glioma-specific NGS panel, termed “GliomaSCAN,” that is capable of capturing single nucleotide variations and insertion/deletion, copy number variation, and selected promoter mutations and structural variations that cover a subset of intron regions in 232 essential glioma-associated genes. We confirmed clinical concordance rate using pairwise comparison of the identified variants from whole exome sequencing (WES), immunohistochemical analysis, and fluorescence in situ hybridization. Results: Our panel demonstrated high sensitivity in detecting potential genomic variants that were present in the standard materials. To ensure the accuracy of our targeted sequencing panel, we compared our targeted panel to WES. The comparison results demonstrated a high correlation. Furthermore, we evaluated clinical utility of our panel in 46 glioma patients to assess the detection capacity of potential actionable mutations. Thirty-two patients harbored at least one recurrent somatic mutation in clinically actionable gene. Conclusion We have established a glioma-specific cancer panel. GliomaSCAN highly excelled in capturing somatic variations in terms of both sensitivity and specificity and provided potential clinical implication in facilitating genome-based clinical trials. Our results could provide conceptual advance towards improving the response of genomically guided molecularly targeted therapy in glioma patients.

OBJECTIVE: Productivity loss was compared by 3-stage of disease activity and associations between higher disease activity and high productivity loss were identified. METHODS: Data were extracted from Rheumatoid Arthritis (RA) Patient-reported Outcomes Research, which enrolled 2,000 RA patients (>20-year) on disease-modifying-antirheumatic-drugs (DMARDs) (≥6-month) from December 2012 to June 2013. This included 1,457 RA patients with the disease activity score (DAS-28-ESR) in their medical charts. Productivity loss in time and indirect cost was estimated using The World Health Organization Health and Work Performance Questionnaire (HPQ). Baseline characteristics and productivity loss outcomes were compared according to DAS-28-ESR groups. RESULTS: 84.4% were females, 54.2% had low DAS-28-ESR ( < 3.2), and 38.2% and 7.6% had moderate (3.2∼5.1) and high DAS-28-ESR (>5.1). Patients with moderate to high DAS-28-ESR had higher lost productivity time (LPT) and monthly costs of LPT than those with low DAS-28-ESR (time in hours: 110.0±58.4 vs. 132.4±57.2 vs. 71.5±52.0, p < 0.0001; monthly costs of LPT in 1,000 Korean won: 1,097±607 vs. 1,302±554 vs. 741±531, p < 0.0001). Multiple regression analyses revealed significant associations with high LPT in high (adjusted odds ratio [OR]=3.87, 95% confidence interval [CI]: 2.18∼6.87) and moderate DAS-28-ESR (adjusted OR=1.88, 95% CI: 1.41∼2.52) compared to low DAS-28-ESR. In addition, positive associations with high monthly costs of LPT were observed in high (adjusted OR=3.45, 95% CI: 1.98∼5.99) and moderate DAS-28-ESR (adjusted OR=1.93, 95% CI: 1.43∼2.54) compared to low DAS-28-ESR. CONCLUSION: Timely therapeutic strategies should be taken into consideration given that the RA patients with moderate to high DAS-28-ESR showed strong associations with high productivity loss for effective management of RA.
Arthritis, Rheumatoid* ; Efficiency* ; Female ; Humans ; Odds Ratio ; Outcome Assessment (Health Care) ; Work Performance ; World Health Organization

Mechanical closing devices were developed to shorten bed rest following percutaneous vascular intervention, and recently, the devices are replacing the conventional manual compression. Among the closing devices, the Perclose suture-mediated closure system (Perclose/Proglide) is known to be a safe and effective method that permits faster hemostasis and earlier ambulation compared with manual compression. However, with increased usage of femoral closure devices, reports of complications have emerged. Most reported complications are local bleedings, hematomas, and wound infections. Herein, we report a rare case: common femoral artery (CFA) stenosis after using Perclose suture-mediated closure system. After failure of secondary ballooning of the CFA stenotic segment, CFA was opened operatively and we found that snared atheroma by Perclose suture material was occupying the CFA lumen. Endarterectomy was performed for the lesion and the CFA stenosis was improved.
Angioplasty ; Bed Rest ; Constriction, Pathologic ; Endarterectomy ; Femoral Artery ; Hematoma ; Hemostasis ; Plaque, Atherosclerotic ; Sutures ; Walking ; Wound Infection

In order to investigate the ecological factors affecting milk intake frequency of adolescents, the questionnaire survey was conducted with 929 middle and high school students living in Chungnam urban area through October and November 2004. The subjects consumed milk 8.6+/-6.7 times per week, other beverages 4.4+/-4.1 times per week and drinking water 3.7+/-2.1 cups per day. Of the students 77.3% took balanced meals, 72.8% ate regularly and 36.2% ate adequate amount. About 61% had breakfast everyday and nearly a half students snacked once a day. Nutritional knowledge scores about milk was 7.2+/-1.7 and milk attitude scores was 28.1+/-6.5. The subjects spent daily 1.8+/-1.1, 1.9+/-1.1, and 1.0+/-0.5 hours for computer use, TV watching and exercise, respectively. Milk intake frequencies were positively correlated with excercise, snack frequency, meal balance and regularity, breakfast frequency, food attitude score and milk preference, while showed negative correlationships with TV watching and computer use. Intake frequency of fruit-tasted and chocolate milk showed inverse correlation with nutritional knowledge. Subjects without either school store or vending machine took milk more frequently than those with one or both did. Of the correlated variables, milk preference was the most important influencing factor to milk intake frequency according to the stepwise linear regression analysis, which presented other 5 important influencing factors as food attitude, school vending facilities, excercise, snacking frequency and watching TV. In conclusion, the improvement of milk preference is the most important and effective way to promote milk consumption in adolescents. The favorite ways of drinking milk, nutritional benefit of milk, healthy beverage and good snacking should be taught in nutrition education. Also physical activities should be recommended to students rather than watching TV, computer use and vending facilities selling soft drinks should be limited to be established inside school.
Adolescent ; Beverages ; Breakfast ; Cacao ; Carbonated Beverages ; Chungcheongnam-do ; Drinking ; Drinking Water ; Education ; Humans ; Linear Models ; Meals ; Milk* ; Motor Activity* ; Questionnaires ; Snacks*

In order to study milk preference and intake pattern of adolescents, the questionnaire survey was conducted with 929 middle and high school students residing in Chungnam cities through October and November 2004. Of the subjects, 56.3% liked milk or liked very much. They preferred chocolate and fruit-tasted milk to plain milk. Reasons for liking milk were for health and its taste, while the reasons of disliking were unpleasant smell and stomach upset. However those who disliked milk did like milk products such as ice-cream, yogurt or cheese. Of the students 35.1% drank milk 2 times or more a day, while 11.8% drank milk less than 2-3 times a month. As a whole they drank milk 8.6+/-6.7 times a week, of which 4.3+/-3.1 times for plain milk. Daily intake amount was estimated as 308+/-315mL. Middle-school students and boys drank more milk than high-school students and girls, respectively. Among the students 64.3% used to drink 1 cup of milk at a time, and 58.3% drank only milk without other foods. It was shown that 51.8% took milk school-serviced and their milk intake frequencies were higher than those of who were not given school milk service. Also milk intake frequencies was higher in students whose mother were housewives than in students whose mother had jobs. Milk preference, intake frequency, and one portion size showed significant and positive correlations each other. In conclusion, milk intake level of the subjects was insufficient and unpleasant smell and stomach upset were the main reasons which decreased milk preference and consumption. Students with low milk preference should be guided with how to drink milk deliciously, how to choose milk type and its products. It is also effective to go into school milk service and to provide milk at home anytime. As students like much fruit-tasted and chocolate milk, the milk processing industries should take their nutritional and health benefits into considerations importantly.
Adolescent* ; Cacao ; Cheese ; Chungcheongnam-do ; Female ; Humans ; Insurance Benefits ; Milk* ; Mothers ; Portion Size ; Questionnaires ; Smell ; Stomach ; Yogurt

OBJECTIVE: The efficacy of two-drug combination treatment may be schedule-dependent. We investigated a simulated in-vitro interaction between taxol and doxorubicin in a Cervical cancer cell line HeLa and the role of peroxiredoxin in cytotoxicity. METHODS: Two contradicting schedules of two drugs (taxol followed by doxorubicin or vice versa) were compared each other in terms of cytotoxicity in parental HeLa cell line and the peroxiredoxin (prx)-overexpressing variant. Cytotoxic activity was determined by MTT assay. Cell cycle pertubation was evaluated by flow cytometric analysis. Protein levels were determined by western blot. RESULTS: The sequential treatment of taxol followed by doxorubicin (T-- Appointments and Schedules ; Blotting, Western ; Cell Cycle ; Cell Line ; Cell Line, Tumor* ; Cyclin D1 ; Doxorubicin ; HeLa Cells ; Humans ; Paclitaxel ; Parents ; Peroxiredoxins* ; Uterine Cervical Neoplasms

In order to investigate the adolescent's beverage drinking pattern and its related ecological factors, a questionnaire survey was conducted with the subjects of 920 middle and high-school students, 450 boys and 470 girls, residing in 4 cities of the Chungnam area. Of the subjects 65% liked, or liked very much, beverages and only 3.7% did not like beverages. They drank beverages 4.3 +/- 4.0 times a week on average, but 10.4% of them drank beverages more than twice a day. Male students drank more frequently than the females. The intake frequency of carbonated drinks was 1.7 +/- 2.3 a week, which was about 40% of the total beverages. However, more students drank mainly ion beverages (33.6%) than carbonated drinks (28.7%). As the students took more balanced food and ate more regularly, their beverage drinking frequency decreased and those taking carbonated drinks also tended to decrease. The more frequent the students took fast food, the more frequent they drank carbonated beverages. The drinking frequencies for beverages or carbonated beverages were also less in students eating cooked rice with sidedishes as breakfast than in students eating others. The drinking frequency for carbonated drinks showed significant correlations with the students' activities such as the time spent using computers and watching TV got longer, the drinking frequency for soft drinks was also higher. When nutritional knowledge was higher, drinking frequency for carbonated drinks got lower. In conclusion, to make the adolescents improve their attitudes toward drinking beverages and to prevent excessive drinking of carbonated drinks, they should be educated not only on the nutritional knowledge and the proper intake of beverages, but also on good dietary habits including balance, regularity, and types of meals. Proper snacking and fast food consumption also should be taught. Since ion beverages were taken more frequently than carbonated drinks among adolescents, further study is recommended on the impact of excessive intake of ion beverages.
Adolescent* ; Beverages* ; Breakfast ; Carbonated Beverages ; Chungcheongnam-do* ; Drinking ; Fast Foods ; Female ; Food Habits ; Humans ; Male ; Meals ; Snacks

BACKGROUND AND OBJECTIVES: Percutaneous mitral balloon valvuloplotomy (PMV) is a safe and effective procedure for the treatment of mitral stenosis (MS); however, its long-term results according to the severity of MS remain unknown. The aim of this study was to compare the long-term results of PMV between moderate and severe MS. SUBJECTS AND METHODS: The immediate and long-term outcomes of 786 patients (198 male, mean age; 43 years) who underwent PMV at a single referral center, between 1988 and 2000, were analyzed. The clinical and echocardiographic data were compared between moderate (n=357) and severe MS (n=429). RESULTS: Optimal results were gained in 618 (79%) patients, including 80 and 76% moderate and severe MS cases, respectively (p=0.13). Acute complications occurred in 85 patients (11%), but without significant difference between the two groups. After a mean follow-up period of 94 months (range, 6 to 210 month), the 5 year event-free survival rate was better in moderate (88%) than in severe MS (79%), but the 10 year event-free survival rates were no different (65% vs. 65%). Independent predictors for better prognosis were a lower echo score (< or =8)(p=0.017, HR=0.67), a larger mitral valve area after the PMV (> or =1.7 cm2)(p=0.002, HR=0.65), less mitral regurgitation ( Atrial Pressure ; Balloon Valvuloplasty ; Disease-Free Survival ; Echocardiography ; Follow-Up Studies ; Humans ; Male ; Mitral Valve ; Mitral Valve Insufficiency ; Mitral Valve Stenosis* ; Prognosis ; Referral and Consultation

The purpose of this study was to examine the effect of nutrition education about the Korean food guide to middle school students on food intake measured by food frequency. Three hundred first graders were sampled from two coeducational middle schools located in the small city of Chungnam area, and divided into 167 (74 boys, 93 girls) education groups of one school and 133 (70 boys, 63 girls) non education groups of the other school. Nutrition education was given to the education group for a total of 16 hours and no education to the non education group during the same period. After education, average nutrition knowledge scores of education group increased from 6.40 +/- 2.17 to 6.81 +/- 1.56 significantly, especially boys with a high range of increase and girls no increase. Dietary habit scores improved significantly from 46.2 +/- 6.5 to 49.1 +/- 6.2 in both boys and girls of education group. Of the knowledge and dietary habits, ability of choosing a balanced meal, biased eating to some food, and taking diverse foods at every meal improved significantly in education group. In non education group no significant increases of either nutrition knowledge scores and dietary habit scores were shown. In addition education group showed significant increases after education, in the intake frequencies of rice noodle loaf bread, kimchi, green and yellow vegetables, and soybean soybean curds by 0.27, 0.23, 0.40 and 0.32 servings per day, compared with non education group. These changes were greater in girls than in boys. According to these results, it can be concluded that nutrition education about the Korean food guide improved effectively not only student's nutrition knowledge and dietary habits, but also healthy food intake ability. It is necessary to prepare long-term and continuous school-based nutrition education programs for the students to get into a habit of healthy food intake.
Adolescent* ; Bias (Epidemiology) ; Bread ; Chungcheongnam-do ; Eating* ; Education* ; Female ; Food Habits ; Humans ; Meals ; Soybeans ; Vegetables