Background: It is well known that a large number of patients with diabetes also have dyslipidemia, which significantly increases the risk of cardiovascular disease (CVD). This study aimed to evaluate the efficacy and safety of combination drugs consisting of metformin and atorvastatin, widely used as therapeutic agents for diabetes and dyslipidemia. Methods: This randomized, double-blind, placebo-controlled, parallel-group and phase III multicenter study included adults with glycosylated hemoglobin (HbA1c) levels >7.0% and <10.0%, low-density lipoprotein cholesterol (LDL-C) >100 and <250 mg/dL. One hundred eighty-five eligible subjects were randomized to the combination group (metformin+atorvastatin), metformin group (metformin+atorvastatin placebo), and atorvastatin group (atorvastatin+metformin placebo). The primary efficacy endpoints were the percent changes in HbA1c and LDL-C levels from baseline at the end of the treatment. Results: After 16 weeks of treatment compared to baseline, HbA1c showed a significant difference of 0.94% compared to the atorvastatin group in the combination group (0.35% vs. −0.58%, respectively; P<0.0001), whereas the proportion of patients with increased HbA1c was also 62% and 15%, respectively, showing a significant difference (P<0.001). The combination group also showed a significant decrease in LDL-C levels compared to the metformin group (−55.20% vs. −7.69%, P<0.001) without previously unknown adverse drug events. Conclusion The addition of atorvastatin to metformin improved HbA1c and LDL-C levels to a significant extent compared to metformin or atorvastatin alone in diabetes and dyslipidemia patients. This study also suggested metformin’s preventive effect on the glucose-elevating potential of atorvastatin in patients with type 2 diabetes mellitus and dyslipidemia, insufficiently controlled with exercise and diet. Metformin and atorvastatin combination might be an effective treatment in reducing the CVD risk in patients with both diabetes and dyslipidemia because of its lowering effect on LDL-C and glucose.

Inflammaging in male reproductive organs covers a wide variety of problems, including sexual dysfunction and infertility. In this study, the beneficial effects of cordycepin (COR), isolated from potential medicinal fungi Cordyceps militaris, in aging-associated testicular inflammation and serum biochemical changes in naturally aged rats were investigated. Male Sprague Dawley rats were divided into young control (YC), aged control (AC), and COR (5, 10, and 20 mg/kg) treated aged rat groups. Aging-associated serum biochemical changes and inflammatory parameters were analyzed by biochemical assay kits, Western blotting, and real-time RT-PCR. Results showed a significant (p < 0.05) alteration in the total blood cell count, lipid metabolism, and liver functional parameters in AC group when compared with YC group. However, COR-treated aged rats ameliorated the altered biochemical parameters significantly (p < 0.05 and p < 0.01 at 5, 10, and 20 mg/kg, respectively). Furthermore, the increase in the expression of inflammatory mediators (COX-2, interleukin (IL)-6, IL-1b, and tissue necrosis factor-alpha) in aged rat testis was significant (p < 0.05) when compared with YC group. Treatment with COR at 20 mg/kg to aged rats attenuated the increased expression of inflammatory mediators significantly (p < 0.05). Mechanistic studies revealed that the potential attenuating effects exhibited by COR in aged rats was mediated by regulation of NF-jB activation and MAPKs (c-Jun N-terminal kinase, extracellular signal-regulated kinase 1/ 2, and p38) signaling. In conclusion, COR restored the altered serum biochemical parameters in aged rats and ameliorated the aging-associated testicular inflammation proving the therapeutic benefits of COR targeting inflammaging-associated male sexual dysfunctions.

PURPOSE: The purpose of this study was to determine the results of mobile bearing unicompartmental knee arthroplasty (UKA) with an intentionally increased flexion angle of the femoral component in patients requiring high flexion. MATERIALS AND METHODS: We investigated 45 knees treated by UKA. Clinically, we measured the range of motion (ROM) and the American Knee Society (AKS) score preoperatively and at final follow-up and investigated complications. Radiologically, we measured the flexion angle of the femoral component, the posterior slope angle of the tibial component, the femorotibial angle and mechanical axis of the limb postoperatively. RESULTS: The ROM was increased from 123° preoperatively to 139° at the final follow-up. The AKS knee and function scores increased from 59 and 68, respectively, preoperatively to 94 and 96, respectively, at the final follow-up. The flexion angle of the femoral component was 9.1°, and the posterior slope angle of the tibial component was 8.6°. There was one case of bearing dislocation in the largest femoral flexion angle case. CONCLUSIONS: The results might reflect the positive effect of an increased flexion angle of the femoral component up to 10° on ROM in mobile bearing UKA, which would contribute to better quality of life after UKA especially in populations requiring deep knee flexion.
Arthroplasty ; Arthroplasty, Replacement, Knee ; Dislocations ; Extremities ; Follow-Up Studies ; Humans ; Intention ; Knee ; Quality of Life ; Range of Motion, Articular

PURPOSE: The goal of this study was to evaluate changes in nocturia and other lower urinary tract symptoms (LUTS) after laparoscopic radical prostatectomy (LRP) and robot-assisted laparoscopic radical prostatectomy (RALP). MATERIALS AND METHODS: We reviewed the medical records of 96 patients who underwent LRP or RALP for clinically localized prostate cancer and completed the International Prostate Symptom Score (IPSS) questionnaire, which provided a basis for assessing their symptoms. We also evaluated maximal flow rate and post-void residual urine volume over a follow-up period of at least 24 months. We divided the patients into three groups according to postoperative changes in the frequency of nocturia. RESULTS: Voiding symptoms significantly improved over the course of 24 months in patients who underwent LRP or RALP. However, most patients showed persistent or increased nocturia after LRP or RALP. Moreover, more than one third of the patients (33/96) presented with exacerbated nocturia (1.0+/-0.9 episodes of preoperative nocturia vs. 3.0+/-1.3 episodes of postoperative nocturia). Multiple regression analysis showed that preoperative IPSS storage sub-score had negative association with the nocturia after radical prostatectomy (p=0.005). However, patients' age, body mass index, preoperative prostate specific antigen, Gleason score, T-stage, and prostate volume had no association. CONCLUSIONS: The present study showed that nocturia was influenced by a range of factors, including other storage LUTS and the relief of bladder outlet obstruction after radical prostatectomy. Moreover, the preoperative storage symptoms are regarded as an important factor which influences the changes of nocturia after radical prostatectomy.
Body Mass Index ; Follow-Up Studies ; Humans ; Laparoscopy ; Lower Urinary Tract Symptoms* ; Medical Records ; Neoplasm Grading ; Nocturia* ; Prostate ; Prostate-Specific Antigen ; Prostatectomy* ; Prostatic Neoplasms ; Urinary Bladder Neck Obstruction

Transglutaminase 2 (TG2), a cross-linking enzyme, is involved in drug resistance and in the constitutive activation of nuclear factor kappa B (NF-kappaB). We investigated the association of non-small cell lung cancer (NSCLC) treatment efficacy with TG2 and NF-kappaB expression in 120 patients: 102 with adenocarcinoma and 18 with other histologic types. All patients underwent surgery; 88 received adjuvant chemotherapy, with 28 receiving platinum-based doublet chemotherapy as first-line treatment and 29 receiving epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI) therapy. Patients' TG2 and NF-kappaB expression values were calculated semiquantitatively. The median TG2 value was 50 (range, 0-300) and the median NF-kappaB value was 20 (range, 0-240). Disease-free survival did not differ between the low- and high-TG2 groups. Among patients who received palliative platinum-based doublet chemotherapy, progression free survival (PFS) was longer in the low-TG2 group than in the high-TG2 group (11.0 vs. 7.0 months; P=0.330). Among those who received EGFR-TKI therapy, PFS was also longer in the low-TG2 group than in the high-TG 2 group (11.0 vs. 2.0 months; P=0.013). Similarly, in EGFR wild-type patients treated with EGFR-TKI, PFS was longer in patients with low TG2 expression (9.0 vs. 2.0 months; P=0.013). TG2 expression levels can predict PFS in patients with NSCLC treated with EGFR-TKI.
Adenocarcinoma/*drug therapy/mortality/surgery ; Adult ; Aged ; Aged, 80 and over ; Antineoplastic Agents/therapeutic use ; Carcinoma, Non-Small-Cell Lung/*drug therapy/mortality/surgery ; Disease-Free Survival ; Female ; GTP-Binding Proteins/*biosynthesis ; Humans ; Lung Neoplasms/*drug therapy/mortality/surgery ; Male ; Middle Aged ; NF-kappa B/biosynthesis ; Protein Kinase Inhibitors/therapeutic use ; Receptor, Epidermal Growth Factor/*antagonists & inhibitors/genetics ; Transglutaminases/*biosynthesis ; Treatment Outcome

OBJECTIVE: A single balloon extrapedicular kyphoplasty has been introduced as one of the unilateral approaches for thoracic compression fractures; however, the unilateral extrapedicular technique in the lumbar area needs a further understanding of structures in the lumbar area. The purpose of the present study is to describe methods and pitfalls of this procedure based on the anatomy of the lumbar area and to analyze clinical outcome and complications. METHODS: Anatomical evaluation was performed with 2 human cadavers. A retrospective review of unilateral extrapedicular approaches yielded 74 vertebral levels in 55 patients that were treated with unilateral extrapedicular vertebroplasty and kyphoplasty. Radiographic assessment included the restoration rate of vertebral height and correction of kyphosis. RESULTS: Anatomical evaluation indicates that the safe needle entry zone of bone for the extrapedicular approach was located in the supero-lateral aspect of the junction between the pedicle and vertebral body. The unilateral extrapedicular procedure achieved adequate pain relief with a mean decreases in pain severity of 7.25+/-1.5 and 2.0+/-1.4, respectively. Complications were 1 retroperitoneal hematoma, 6 unilateral fillings and 3 epidural leak of the polymethylmethacrylate. CONCLUSION: The method of a unilateral extrapedicular approach in kyphoplasty and vertebroplasty in the lumbar area might be similar to that in thoracic approach using a route via the extrapedicular space. However, different anatomical characteristics of the lumbar area should be considered.
Cadaver ; Fractures, Compression ; Hematoma ; Humans ; Kyphoplasty ; Needles ; Retrospective Studies ; Vertebroplasty

BACKGROUND/AIMS: Fabry disease is an X-linked recessive and progressive disease caused by alpha-galactosidase A (alpha-GaL A) deficiency. We sought to assess the prevalence of unrecognized Fabry disease in dialysis-dependent patients and the efficacy of serum globotriaosylceramide (GL3) screening. METHODS: A total of 480 patients of 1,230 patients among 17 clinics were enrolled. Serum GL3 levels were measured by tandem mass spectrometry. Additionally, we studied the association between increased GL3 levels and cardiovascular disease, cerebrovascular disease, or left ventricular hypertrophy. RESULTS: Twenty-nine patients had elevated serum GL3 levels. The alpha-GaL A activity was determined for the 26 patients with high GL3 levels. The mean alpha-GaL A activity was 64.6 nmol/hr/mg (reference range, 45 to 85), and no patient was identified with decreased alpha-GaL A activity. Among the group with high GL3 levels, 15 women had a alpha-GaL A genetics analysis. No point mutations were discovered among the women with high GL3 levels. No correlation was observed between serum GL3 levels and alpha-GaL A activity; the Pearson correlation coefficient was 0.01352 (p = 0.9478). No significant correlation was observed between increased GL3 levels and the frequency of cardiovascular disease or cerebrovascular disease. CONCLUSIONS: Fabry disease is very rare disease in patients with end-stage renal disease. Serum GL3 measurements as a screening method for Fabry disease showed a high false-positive rate. Thus, serum GL3 levels determined by tandem mass spectrometry may not be useful as a screening method for Fabry disease in patients with end stage renal disease.
Adult ; Aged ; Fabry Disease/blood/*diagnosis ; Female ; Humans ; Kidney Failure, Chronic/blood/*therapy ; Male ; Middle Aged ; *Renal Dialysis ; Trihexosylceramides/*blood ; alpha-Galactosidase/genetics/metabolism

BACKGROUND: Constipation is one of the most common digestive complaints. Although, there are increased interest on the socioeconomic effect of constipation and studies associated with quality of life on constipation, there is no study about the influence of constipation onto quality of life (QOL) in Korea. We studied the impact of functional constipation on QOL. METHODS: Between March to June 2008, person to person survey with 844 elderly aged over 60 years was performed at two senior care centers, a public health center, and secondary hospital in Seoul metrocity and Chung-ju city. The diagnosis of functional constipation was based on the Rome III criteria and QOL was measured by the Medical Outcomes Study (MOS) 36-Item Short-Form Health Survey (SF-36). RESULTS: The average age was 73.6 years and the prevalence rate of constipation was 20.3%. The average SF-36 score was 63.5 in total population, 57.9 in constipation group, and 64.9 in normal group. CONCLUSION: These results suggest that the constipation lowers QOL in adults aged over 60 years old. Further study will be necessary to explore if QOL changes according to the severity of constipation and its treatment and to assess QOL using a disease-specific measurement tool that can be used for Korean environment.
Adult ; Aged ; Constipation ; Health Surveys ; Humans ; Korea ; Prevalence ; Public Health ; Quality of Life ; Rome

BACKGROUND: Constipation is one of the most common digestive complaints. Although, there are increased interest on the socioeconomic effect of constipation and studies associated with quality of life on constipation, there is no study about the influence of constipation onto quality of life (QOL) in Korea. We studied the impact of functional constipation on QOL. METHODS: Between March to June 2008, person to person survey with 844 elderly aged over 60 years was performed at two senior care centers, a public health center, and secondary hospital in Seoul metrocity and Chung-ju city. The diagnosis of functional constipation was based on the Rome III criteria and QOL was measured by the Medical Outcomes Study (MOS) 36-Item Short-Form Health Survey (SF-36). RESULTS: The average age was 73.6 years and the prevalence rate of constipation was 20.3%. The average SF-36 score was 63.5 in total population, 57.9 in constipation group, and 64.9 in normal group. CONCLUSION: These results suggest that the constipation lowers QOL in adults aged over 60 years old. Further study will be necessary to explore if QOL changes according to the severity of constipation and its treatment and to assess QOL using a disease-specific measurement tool that can be used for Korean environment.
Adult ; Aged ; Constipation ; Health Surveys ; Humans ; Korea ; Prevalence ; Public Health ; Quality of Life ; Rome

BACKGROUND: Recently, the mass media serves a major role in the public health education, but have not been proven whether they are being appropriately utilized in the elderly. The aim of this study was to identify the elderly person's concern in the mass media health information and utilization behavior. METHODS: Between March to June 2008, one to one survey with the elderly people over 60 years was performed in two elderly welfare centers, one public health center, and two secondary hospitals outpatients and inpatients in Seoul and Chungju. RESULTS: A total of 999 subjects were included. By multivariate analysis, factors significantly associated with low concern in the mass media health information were low educational level, non-exercise group, and low concern in own health (P = 0.001, 0.009, < 0.001, respectively). The most frequently utilized health information source was the mass media. By comparing the frequency of health information utilization, women, low educational level, low income, non-exercise group, underweight, low level of self-evaluated health status, and low concern in health information were significantly associated with the lowest quintile of utilization (P value: < 0.001, 0.005, 0.05, < 0.001, 0.002, 0.03, 0.005, respectively). However, the presence of chronic diseases, such as hypertension, diabetes, had no association. CONCLUSION: In community-dwelling elderly, important factors associated with concern in and utilization of the mass media health information were concern in health, self-evaluated health status, exercise status and socioeconomic factors such as education or income level, rather than comorbid chronic disease.
Aged ; Chronic Disease ; Female ; Humans ; Hypertension ; Inpatients ; Mass Media ; Multivariate Analysis ; Outpatients ; Public Health ; Socioeconomic Factors ; Thinness