BACKGROUND: In Korea, the prevalence, complications, and mortality rate of diabetes are rapidly increasing. However, investigations on the actual condition of diabetes management are very limited due to lack of nation-wide research or multicenter study. Hence, we have minutely inquired the current status of diabetes management and achievement of glucose target goal in general hospital offering education program. That way, we are able to furnish data for policy making of diabetes education and draw up guideline which may allow us to reduce the morbidity and mortality of diabetes. METHODS: The subjects consisted of 2,610 patients with type 2 diabetes who visited the 13 general hospital in Seoul or Gyeonggi region from March 19 to May 29, 2013. General characteristics, associated diseases, complications, and management status were investigated. RESULTS: The mean age was 61.0+/-11.6 years, body mass index was 25.0+/-3.3 kg/m2, and family history of diabetes was 50.5%. The mean duration of diabetes was 10.7+/-7.9 years and 53% received education about diabetes. The prevalence of hypertension and dyslipidemia were 59.2% and 65.5%, respectively, and 18.3% of the subjects were accompanied by liver disease. Diabetic retinopathy appeared in 31.6%, nephropathy in 28.1%, and neuropathy in 19.9% of the subjects. The mean glycosylated hemoglobin (HbA1c) level was 7.3%+/-1.3% and the achieving rate based on Korean Diabetes Association guideline (HbA1c <6.5%) was 24.8%, blood pressure (130/80 mm Hg or less) was 49.4%, and low density lipoprotein cholesterol (<100 mg/dL) was 63.6%. The reaching rate to the target level in four parameters (blood glucose, blood pressure, lipids, and body weight) was 7.8%. CONCLUSION: The blood glucose control rate was lower than other parameters, and the implementation rate of diabetes education was only 53%. Thus more appropriate glucose control and systematic diabetes education are imperative.
Blood Glucose ; Blood Pressure ; Body Mass Index ; Cholesterol, LDL ; Diabetes Mellitus, Type 2* ; Diabetic Retinopathy ; Dyslipidemias ; Education ; Glucose ; Gyeonggi-do ; Hemoglobin A, Glycosylated ; Hospitals, General* ; Humans ; Hypertension ; Korea* ; Liver Diseases ; Mortality ; Policy Making ; Prevalence ; Seoul

PURPOSE: Recent studies have shown that cyclooxygenase (COX)-2 may be involved in colorectal carcinogenesis. In this study, we evaluate the differences of COX-2 expression in patients with synchronous and metachronous hepatic metastasis of colorectal cancer. In addition, the expression of COX-1 and E-cadherin were also evaluated. METHODS: Paraffin embedded blocks were obtained from 41 patients who underwent surgery for colorectal cancer with hepatic metastasis. Samples from primary colorectal cancer, synchronous and metachronous hepatic lesions were stained by immunohistochemistry for monoclonal antibody against COX-1, COX-2, and E-cadherin. RESULTS: In colonic COX-1 expression, there was no significant difference in the degree of COX-1 expression between primary colorectal cancer with synchronous hepatic metastasis and that of metachronous hepatic metastasis (P=0.507). In colonic COX-2 and E-cadherin expression, the degree of COX-2 expression was not different between the two groups. But, the patient survival rate in the positive group of COX-1 and COX-2 expression was lower than in the negative group, respectively (P=0.023, P=0.006). CONCLUSION: The degree of colonic COX-1 and COX-2 expression has an impact on prognosis in synchronous and metachronous hepatic metastasis. Further large-scale study is necessary to determine the meaning of COX-2 expression in colorectal cancer.
Cadherins ; Colon ; Colorectal Neoplasms ; Humans ; Immunohistochemistry ; Neoplasm Metastasis ; Paraffin ; Prognosis ; Prostaglandin-Endoperoxide Synthases ; Survival Rate

The Beijing family of Mycobacterium tuberculosis has been emerging in the world. However, there are few nationwide data of genotypic distribution in Korea. This study aimed to identify the genotypic diversity of clinical isolates of M. tuberculosis and to demonstrate the population of Beijing family in Korea. We collected 96 clinical M. tuberculosis isolates from 11 university hospitals nationwide in Korea from 2008 to 2009. We observed 24 clusters in IS6110-RFLP analysis and 19 patterns in spoligotyping. Seventy-five isolates were confirmed to be Beijing family. Two isolates of the K strain and 12 isolates of the K family strain were also found. We found that drug resistance phenotypes were more strongly associated with Beijing family than non-Beijing family (P=0.003). This study gives an overview of the distribution of genotypes of M. tuberculosis in Korea. These findings indicate that we have to pay more attention to control of M. tuberculosis strains associated with the Beijing family.
Drug Resistance, Bacterial ; Genotype ; Humans ; Microbial Sensitivity Tests ; Mycobacterium tuberculosis/*classification/genetics/isolation & purification ; Phenotype ; Polymorphism, Restriction Fragment Length ; Republic of Korea ; Tuberculosis/*epidemiology/genetics/microbiology

PURPOSE: The p21(Waf1/Cip1) protein inhibits the cell cycle by inhibiting the phosphorylation at the G1-->S check point, and the p27(Kip1) protein similarly performs the suppressor function by controlling the p27-mediated G1 arrest. In this study, we analysed the clinical status and survival rates in correlations with p21 and p27 expression patterns in gastric cancer. MATERIALS AND METHODS: Between 1993 and 1997, 192 patients who underwent surgeries in Catholic Medical Center were analysed retrospectively in this study. Immunohistochemical staining was performed and if the nuclei of the tumor cells were stained, we assumed those as positive results. Statistical analysis was based on clinicopathological findings and differences in survival rates. RESULTS: The expression rate of p27 was 28.1% and 15.6% in p21 each. The ratio of T1-2(80.0%) was significantly high in p21 (+), but the ratio of T3-4 (50.6%) was slightly high in p21 (-). There was no statistical significance regarding other factors. The results in p27 was not much different from expression rate of p21 in T-stage. In addition, p27 expression in diffuse type (91.3%) was higher than in intestinal type (62.7%) by Lauren's classification (P <0.05). Also, there was no statistical significance in other factors. In the correlation of p21 and p27, p27 was positive when p21 was positive (53.5%). Conversely, p27 was negative when p21 was negative (76.5%, p <0.05). In the p21 and p27 combination test, there was higher rate of T1-2 (87.5%) in p21 (+)/p27 (+), and higher rate of T3-4 (58.1%) in p21 (-)/p27 (-) (P <0.05). Results showed higher rate of intestinal type (100%) in p21 (+)/p27 (+), and diffuse type (87.0%) was dominant in p21 (-)/p27 (-) (P <0.05) by Lauren's classification. Moreover, there was no statistical significance in the 5-year survival rate in the expression of p21 and p27, and the 5-year survival rate was highest in the case of p21 (+)/p27 (+) without statistical significance. CONCLUSION: In our study, p21(Waf1/Cip1) and p27(Kip1) expressed similar patterns. The expression of p21(Waf1/Cip1) and p27(Kip1) affected the degree of invasiveness of the tumor, and. Combined examination result revealed the correlation of p21(Waf1/Cip1) and p27(Kip1) with Lauren's classification and depth of invasion of the tumor. However, we assumed that little difference between the survival rates depending on expression of p21(Waf1/Cip1) and p27(Kip1) has limited their value as predictable prognostic indicators.
Cell Cycle ; Classification ; Humans ; Phosphorylation ; Retrospective Studies ; Stomach Neoplasms* ; Survival Rate

BACKGROUND: Clinical isolates of Escherichia coli were evaluated to determine the prevalence and genotypes of Ambler class A extended-spectrum beta -lactamases (ESBLs). METHODS: Clinical isolates of E. coli were collected from 12 hospitals from February through July, 2004. Antimicrobial susceptibility was tested by disk diffusion and agar dilution methods, and ESBLproduction was determined by double-disk synergy test. TEM, SHV, CTX-M, PER-1, VEB, IBC, GES, and TLA type ESBL genes were detected by PCR amplifications, and the PCR products were subjected to direct sequencing. RESULTS: The double-disk synergy test was positive in 90.9% (149 in 164) of the ceftazidime- or cefotaxime-resistant E. coli isolates. The most prevalent types of Ambler class A ESBLs in E. coliisolates were CTX-M-15 (n=53). CTX-M-14 (n=24), CTX-M-3 (n=9), CTX-M-9 (n=3), CTX-M-12 (n=3), SHV-2a (n=1), SHV-12 (n=5) and TEM-52 (n=3) were also found. CTX-M-12 ESBL had never been reported before in Korea. CONCLUSIONS: CTX-M type ESBL-producing E. coli isolates are spreading and CTX-M-12 is emerging in Korea.
Agar ; beta-Lactamases* ; Diffusion ; Escherichia coli* ; Genotype ; Korea ; Polymerase Chain Reaction ; Prevalence

Primary thyroid lymphomas constitute of up to 5% of all thyroid malignancies. Recently, mucosa-associated lymphoid tissue (MALT) lymphoma are relatively recognized as a B cell subset of non-Hodgkin's lymphoma. MALT-lymphomas are thought to develop from acquired lymphocytic tissue during the course of a chronic inflammatory or autoimmune process. In the thyroid , which is normally devoid of lymphocytic tissue, chronic autoimmune thyroiditis (Hashimoto's disease) has been associated with an increased risk of lymphoma, including MALT type. The clinical presentations include the enlarging of the neck mass, dysphagia, hoarsenes and choking or cold thyroid nodule. We report a case of MALToma of the thyroid accompanied by Hashimoto's thyroiditis with a review of the literature.
Airway Obstruction ; Deglutition Disorders ; Lymphoid Tissue ; Lymphoma ; Lymphoma, B-Cell, Marginal Zone* ; Lymphoma, Non-Hodgkin ; Neck ; Thyroid Gland* ; Thyroid Nodule ; Thyroiditis* ; Thyroiditis, Autoimmune

We report a case of mucinous adenocarcinoma in the ascending colon. A 55-year-old woman was admitted to Asan Medical Center due to right lower quadrant abdominal pain. On physical examination, an approximately 5X5 cm sized tender mass was palpated in the right lower quadrant. Colonoscopy revealed a fungating mass covered with gelatinous, yellow-whitish mucoid material in the ascending colon. Abdominal computed tomography showed irregular wall thickening from ileocecal valve to mid ascending colon with pericolic fat thickening. She underwent right hemicolectomy and surgical specimen revealed well differentiated tubulopapillary adenocarcinoma with mucinous background consistent with mucinous adenocarcinoma.
Abdominal Pain ; Adenocarcinoma ; Adenocarcinoma, Mucinous* ; Chungcheongnam-do ; Colon, Ascending ; Colonic Neoplasms ; Colonoscopy ; Female ; Gelatin ; Humans ; Ileocecal Valve ; Middle Aged ; Mucins* ; Physical Examination

Mucin-producing tumors of the pancreas were first reported by Ohhashi and Takagi in 1980. Since then, many cases of intraductal papillary mucinous tumor (IPMT) of the pancreas, which is almost homonymous to mucin-producing tumors of the pancreas, have been reported. IPMTs are generally regarded as tumors with a favorable prognosis. Some IPMTs have invasiveness and this is always associated with a poor prognosis. Most IPMTs arise from the main pancreatic duct and IPMTs arising from the accessory pancreatic duct are relatively rare. Only 6 cases have been reported in the literature so far. Our patient was a 43-year old man who was admitted to the hospital due to recurrent pancreatitis. An endoscopic retrograde pancreatography revealed a patulous minor papilla orifice extruding mucin and a cystic lesion in a branch of the accessory duct. A pancreaticoduodenectomy was performed and a pathologic examination of the resected specimen showed intraductal papaillary mucinous neoplasm, low grade malignancy, in the accessory pancreatic duct and its branch. We herein report this interesting case with a review of the literature.
Adult ; Humans ; Mucins* ; Pancreas ; Pancreatic Ducts* ; Pancreaticoduodenectomy ; Pancreatitis ; Prognosis

BACKGROUND AND OBJECTIVES: To evaluate the association between chronic infection with Chlamydia pneumoniae, as measured by Immunoglobulin G and A, and acute myocardial infarction (AMI) in Korea. MATERIALS AND METHODS: A total of 136 patients [normal control 65 cases (male:female 27:8, mean age 55.1+/-11.7 years), AMI 71 cases (male:female 54:17, mean age 58.9+/-12.7 years)] had immunoglobulin G, A, and M antibody titers measured against Chlamydia pneumoniae by microimmunoflorescence assay and had coronary angiography performed. We investigated the incidence of major adverse cardiac events (MACE) at 6 month follow-up. Controls were defined as patients with no significant stenosis on coronary angiography. RESULTS: 1) AMI patients were more likely to be male (76.1: 41.5%) and smokers (67.6: 16.9%) compared with the controls. >2) In AMI patients, there was a weak correlation with IgG and IgA antibody titers (r=0.39, p=0.001).> 3) After adjusting for gender and smoking status, IgG and IgA antibody titers were similar between two groups.> 4) Increased IgG and IgA titers did not affect the MACE during follow-up. CONCLUSION: Chronic Chlamydia pneumoniae infection detected by immunoglobulin assay is not significantly associated with AMI. Further studies, such as polymerase chain reaction, immunocytochemistry, or culture of the atheromatous plaques, are needed to better define the association.
Chlamydia* ; Chlamydophila pneumoniae* ; Constriction, Pathologic ; Coronary Angiography ; Follow-Up Studies ; Humans ; Immunoglobulin A ; Immunoglobulin G ; Immunoglobulins ; Immunohistochemistry ; Incidence ; Korea* ; Male ; Myocardial Infarction* ; Plaque, Atherosclerotic ; Polymerase Chain Reaction ; Risk Factors* ; Smoke ; Smoking

To evaluate the feasibility and usefulness of transthoracic Doppler echocardiography (TTDE) as a non-invasive method in recording distal anterior descending (LAD) coronary flow velocity, we compared coronary flow reserve (CFR) measured by TTDE with measurements by intracoronary Doppler wire (ICDW). Twenty-one patients without LAD stenosis were studied. ICDW performed at baseline and after intracoronary injection of 18 microg adenosine. TTDE was performed at baseline and after intravenous adenosine (140 microg/kgmin for 2 min). Adequate Doppler recordings of coronary flow velocities during systole were obtained in 14 of 21 study patients (67%) and during diastole in 17 (81%) patients. Baseline and hyperemic peak diastolic flow velocities measured by TTDE were significantly smaller than those obtained by ICDW (p<0.05). However, diminishing trends of diastolic and systolic velocity ratio after hyperemia were similarly observed in both methods. CFR obtained by TTDE (3.0+/-0.5), was higher than the value calculated by ICDW (2.5+/-0.4). There were significant correlations between the values obtained by the two methods (r=0.72, p<0.01). It is concluded that TTDE is a feasible method in measuring coronary flow velocity and appears to be a promising non-invasive method in evaluating CFR.
Adult ; Aged ; Blood Flow Velocity ; Comparative Study ; Coronary Angiography ; Coronary Circulation* ; Coronary Disease/ultrasonography* ; Echocardiography, Doppler/standards ; Echocardiography, Doppler/methods* ; Female ; Heart Rate ; Human ; Hyperemia/ultrasonography ; Linear Models ; Male ; Middle Age ; Prospective Studies ; Reproducibility of Results