BACKGROUND: Cardiovascular disease (CVD) is the major cause of death in type 2 diabetic patients. The purpose of this study was to investigate the characteristics of Korean type 2 diabetes mellitus (DM) patients according to plasma high density lipoprotein (HDL) cholesterol level and to document the effect of diet on HDL-cholesterol. METHODS: The subjects were 252 (male: 134, female: 118) Korean type 2 DM patients recruited from a general hospital's DM clinic and divided into low HDL-cholesterol group (male < 40 mg/dL, female < 50 mg/dL) and control group (male > or = 40 mg/dL, female > or = 50 mg/dL). Anthropometric and hematological variables and dietary intake were assessed by the groups. RESULTS: The subject's mean age was 60.2 +/- 1.1 years and duration of diabetes was 9.5 +/- 1.0 years. Anthropometric measurements (body fat mass, % body fat, WHR, fat free mass, and muscle mass) and BMI were not significantly different between two groups. The male subjects with low HDL-cholesterolemia showed higher Atherogenic Index (AI, P < 0.001) and higher % carbohydrate from energy than control group (P < 0.01). The female subjects with low HDL-cholesterolemia showed higher AI (P < 0.001) and a tendency of higher triglyceride level and lower intake of energy, protein, lipid, vitamin B1 and vitamin E (P < 0.05) than control group. CONCLUSION: The subject with low HDL-cholesterolemia showed significantly higher AI. Male subject with low HDL-cholesterolemia consumed higher carbohydrate and female subject with low HDL-cholesterolemia showed lower intakes of many nutrients. This result suggests the importance of an adequate and balanced diet to manage type 2 DM patients to prevent CVD complications.
Adipose Tissue ; Cardiovascular Diseases ; Cause of Death ; Cholesterol ; Diabetes Mellitus, Type 2 ; Diet ; Female ; Humans ; Lipoproteins ; Male ; Muscles ; Plasma ; Thiamine ; Vitamin E ; Vitamins

Spontaneous fistula formation between the kidney and the colon is uncommon. The underlying cause is usually a pyonephrotic kidney which becomes adherent to a portion of the colon and then ruptures spontaneously, thus creating a fistula. Herein we present a case of renocolonic fistula which occurred in a 36-year old man with review of the literature.
Adult ; Colon ; Fistula* ; Humans ; Kidney ; Rupture

The sacral area is the most frequent site of pressure sore. Because bony prominence is broad and flat along with little soft tissue padding. Between many muscle flaps, the gluteus maximus myocutaneous flap is the most reliable one for surgery of sacral pressure sores. After complete resection of ulcer, the gluteus maximus muscle detached from its original site including posterior iliac crest. After adequate dissection proceeded and bony prominence removed, flap repair is done at the central line. When performing this flap, most surgeon use elliptical design and incision. In the past, we also used elliptical incision and sometimes experienced some drawbacks especially when wound extended close to anus. There are difficulties on repair of perianal skin, central tension of long vertical scar, perianal skin adhesion and natal cleft distortion and resulting asymmetry of gluteal contour and contamination of operation site by defication. After review of the photographs in the references dealing with pressure sores, we had an impression that there are skin adhesion near the anus in some cases and actually experienced such cases in other surgeon's operations. This time, we applicate new design called the "Bomb-shape" design when performing this flap to patients who have a broad wound extent close to anus or perianal skin. The "Bomb-shape" design is a concept of adding bilateral subcutaneous incisions to lower part of classic elliptical incision and we named as such because it resembles the military bomb in shape. We expect the effect of preserving the perianal skin and preventing the skin adhesion or natal cleft distortion and performed this procedure in 15 patients whose defect close to anus. Consequently, benefits of this method are spreading tension of vertical scar, decreased contamination in wound care, earn skin stability without perianal skin adhesion or natal cleft distortion, so maintain the symmetry of gluteal contour and get better cosmetic result. There is no significant increase in operation time in that no need of handling the "dog-ear", and all 15 patients have good results and are satisfied, so we introduce this flap design carefully with concurrent review of literature.
Anal Canal ; Bombs ; Cicatrix ; Concurrent Review ; Humans ; Military Personnel ; Myocutaneous Flap ; Pressure Ulcer* ; Skin ; Ulcer ; Wounds and Injuries

Solitary plasmacytoma of bone is a rare disease that accounts for only about 3~5% of all plasma cell tumors. Especially, no case of solitary plasmacytoma of a rib origin has been described in the Korean literature. A 54 year old Korean man was referred to our hospital for further evaluation of a lung mass that had been detected on a screening chest radiograph. A tumor with a left 6th rib origin was revealed by the computed tomography (CT) and positive emission tomography (PET-CT); therefore, surgical resection was performed. The histopathological findings of the tumor revealed plasmacytoma of a rib origin. The postoperative screening test revealed no evidence of multiple myeloma. Postoperative radiation therapy was not performed, and no new lesion has been noted during the 2 years of follow up.
Lung ; Mass Screening ; Multiple Myeloma ; Plasmacytoma ; Rare Diseases ; Ribs ; Thorax

BACKGROUND: Goal of the initial treatment of primary spontaneous pneumothorax is re-expansion of the lung by evacuation of air from pleural space. Authors thought small caliber catheter could reach to this goal instead of conventional large bore chest tube. This retrospective study was undertaken to assess the effectiveness of 7-French (Fr) catheter for the initial treatment of primary spontaneous pneumothorax. MATERIAL AND METHOD: Between May 2003 and April 2005, 111 patients with primary spontaneous pneumothorax were managed with tube drainage; 7 Fr catheter for 86 patients and 24-French chest tube for 25 patients. We analyzed catheter indwelling time, use of analgesics, re-expansion of the lung, and catheter related problems by medical records. RESULT: Mean catheter indwelling time was 2.4+/-1.1 days in 7 Fr group and 2.3+/-1.3 days in chest tube group (p>0.05). All patients with 24 Fr catheter needed analgesics injection but never in 7Fr group. Complete re-expansion of the lung based on plane chest radiograph was obtained in 77% of 7 Fr group. The problem related with 7 Fr catheter was kinking, which showed in 5.6%. CONCLUSION: Application of the 7 Fr catheter for initial management of primary spontaneous pneumothorax was as effective as 24 Fr catheter.
Analgesics ; Catheters* ; Chest Tubes ; Drainage ; Humans ; Lung ; Medical Records ; Pneumothorax* ; Radiography, Thoracic ; Retrospective Studies

The purpose of this study was to investigate the impact DM duration on cardiovascular disease risk factors in Korean Type 2 diabetes mellitus patients. The subject were 250 (male: 134, female: 118) Korean Type 2 DM patients recruited from a general hospital's DM clinic. Anthropometric and hematological variables and dietary intake were assessed. The subject's mean age was 60.2 years and duration of diabetes was 9.5 years. As far as DM duration was concerned, male subjects with long duration (> or = 5 years and longer) showed significantly lower weight, fat free mass, skeletal muscle mass, BMI (p < 0.05) and higher 2hrs-postprandial plasma glucose (p < 0.05) and concentration of Hemoglobin A1c (p < 0.01) compared to those with less 5years of duration. In female subjects, same trend was found. Female subjects with long duration (> or = 5 years and longer) showed significantly higher fat free mass (p < 0.05) and skeletal muscle mass (p < 0.05), Hemoglobin A1c (p < 0.01), HDL-cholesterol (p < 0.01) and triglyceride (p < 0.05), dietary intakes of protein (p < 0.05) and fat (p < 0.05) compared to those with less 5years of duration. In conclusion, Type II DM patients of long duration had higher blood lipid concentrations and higher carbohydrates intakes. Subjects followed diet prescription strictly showed lower blood lipid concentration, suggesting the effectiveness of diet to manage Type 2 DM patients.
Blood Glucose ; Carbohydrates ; Cardiovascular Diseases* ; Diabetes Mellitus, Type 2 ; Diet ; Female ; Humans ; Korea* ; Male ; Muscle, Skeletal ; Prescriptions ; Risk Factors* ; Triglycerides

Background: This retrospective observational matched cohort study assessed the differences in critical infections caused by severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) during the omicron-predominant period of the coronavirus disease 2019 (COVID-19) pandemic. We evaluated the vaccine effectiveness of bivalent mRNA vaccine compared to unvaccinated individuals. Methods: We collected COVID-19 case data from the Korean COVID-19 vaccine effectiveness cohort. We calculated the probability of critical COVID-19 cases by comparing the vaccinated and unvaccinated groups. Results: The risk of being critically infected due to SAR-CoV-2 infection was 5.96 times higher (95% confidence interval, 5.63–6.38) among older individuals who were unvaccinated compared to those who received the bivalent COVID-19 vaccine. Conclusion Our findings indicate that the bivalent vaccine reduces the disease burden of the SARS-CoV-2 omicron variant, particularly among the older population. Further studies are warranted to determine the effectiveness of booster doses of vaccines for SARS-CoV-2 infection.

Gliosarcoma is a rare central nervous system tumor usually located in the supratentorial area. Here we report a rare case of a gliosarcoma that developed in the cerebellar hemisphere in a 70-year-old woman. Computed tomography (CT) and magnetic resonance imaging (MRI) of the brain revealed an infratentorial mass of which radiological features were similar to those of glioblastoma. The tumor was diagnosed by pathology as a gliosarcoma. Though rare, gliosarcoma should be considered in the differential diagnosis of infratentorial tumors with radiological features of glioblastoma or metastasis in elderly patients.
Aged ; Cerebellar Neoplasms/*diagnosis/pathology/surgery ; Contrast Media/diagnostic use ; Female ; Gliosarcoma/*diagnosis/pathology/surgery ; Humans ; Magnetic Resonance Imaging ; Tomography, X-Ray Computed

A 37 year old female presented with epigastric pain and weight loss over a period of 3 months. Her abdominal CT finding showed a 4.5 cm size hepatic mass and 4.3 cm size pancreatic head mass with multiple macronodules in the liver. At the same time, her chest CT revealed a 5 cm size necrotic mass in the left lower lobe of the lung with multiple bilateral pulmonary nodules. We diagnosed these lesions as tuberculosis through multiple biopsies. She was treated with anti-tuberculous medication. After taking the medications, her symptoms were improved. Twelve months later, imaging studies indicated an improvement in the patient's health. Here we report a case report of multi-organ macronodular tuberculosis in lung, liver and pancreas.
Biopsy ; Female ; Head ; Humans ; Liver ; Lung ; Multiple Pulmonary Nodules ; Pancreas ; Thorax ; Tuberculoma ; Tuberculosis ; Tuberculosis, Hepatic ; Weight Loss

BACKGROUND: beta-catenin plays a pivotal role in hair follicle development and hair growth cycle. OBJECTIVE: The aim of this study was to identify beta-catenin-regulated genes in cultured human hair outer root sheath (ORS) cells. METHODS: Primary cultured ORS cells were transduced with recombinant adenovirus expressing N-terminal truncated beta-catenin (constitutive active form), and beta-catenin-regulated genes were identified. RESULTS: Overexpression of the constitutively active form of beta-catenin led to induction of Sox9 expression at both mRNA and protein levels. To investigate the potential role of Sox9, we made the recombinant adenovirus expressing green fluorescent protein-tagged Sox9, and then transduced into cultured ORS cells. Interestingly, Sox9 induced the expression of keratin 15, increased the proliferation of ORS cells in vitro, and enhanced colony-forming activity. CONCLUSION: Our results suggest that Sox9 is a beta-catenin-regulated gene in ORS cells, and has potential importance in the regulation of hair follicle homeostasis.
Adenoviridae ; beta Catenin ; Electrolytes ; Hair ; Hair Follicle ; Homeostasis ; Humans ; Keratin-15 ; RNA, Messenger