Only few studies have shown the efficacy and safety of glucose-control strategies using the quadruple drug combination. Therefore, the aim of the present study was to investigate the usefulness of the quadruple combination therapy with oral hypoglycemic agents (OHAs) in patients with uncontrolled type 2 diabetes mellitus (T2DM).

Only few studies have shown the efficacy and safety of glucose-control strategies using the quadruple drug combination. Therefore, the aim of the present study was to investigate the usefulness of the quadruple combination therapy with oral hypoglycemic agents (OHAs) in patients with uncontrolled type 2 diabetes mellitus (T2DM).

Purpose: This study was conducted in order to examine the usefulness of osteoconductive bone substitutes with zeta potential control (geneX® ds; Biocomposites, England) by comparing the complications and radiographic evaluation with or without geneX® ds augmentation for internal fixation with proximal femur nail antirotation (PFNA) for treatment of osteoporotic unstable intertrochanteric fractures. Materials and Methods: A retrospective study of 101 patients who underwent fixation with PFNA in osteoporotic unstable intertrochanteric fractures was conducted from December 2015 to August 2020. The radiographic evaluation and complication rates were compared between patients with geneX® ds (Group A: 41 cases) and those without geneX® ds (Group B: 60 cases). Results: In radiological valuation, the degree of blade sliding from the time immediately after surgery to one year after surgery was 1.4±1.2 mm and 5.8±2.7 mm in Group A and Group B, respectively (P<0.001). During the same time frame, a significant difference of 2.3±2.2° and 7.4±3.1° , respectively (P<0.001), in varus collapse, was observed for Group A and Group B. Conclusion Among patients fixed with PFNA for treatment of unstable intertrochanteric fractures, less blade sliding and varus collapse was observed for those with geneX® ds augmentation compared to those without it. In addition, there was no increase in the incidence of complications. The authors believe it can be regarded as a safe and effective additive for intramedullary fixation for treatment of unstable intertrochanteric fractures.

Background: Only few studies have shown the efficacy and safety of glucose-control strategies using the quadruple drug combination. Therefore, the aim of the present study was to investigate the usefulness of the quadruple combination therapy with oral hypoglycemic agents (OHAs) in patients with uncontrolled type 2 diabetes mellitus (T2DM). Methods: From March 2014 to December 2018, data of patients with T2DM, who were treated with quadruple hypoglycemic medications for over 12 months in 11 hospitals in South Korea, were reviewed retrospectively. We compared glycosylated hemoglobin (HbA1c) levels before and 12 months after quadruple treatment with OHAs. The safety, maintenance rate, and therapeutic patterns after failure of the quadruple therapy were also evaluated. Results: In total, 357 patients were enrolled for quadruple OHA therapy, and the baseline HbA1c level was 9.0%±1.3% (74.9± 14.1 mmol/mol). After 12 months, 270 patients (75.6%) adhered to the quadruple therapy and HbA1c was significantly reduced from 8.9%±1.2% to 7.8%±1.3% (mean change, –1.1%±1.2%; P<0.001). The number of patients with HbA1c <7% increased significantly from 5 to 68 (P<0.005). In addition, lipid profiles and liver enzyme levels were also improved whereas no changes in body weight. There was no significant safety issue in patients treated with quadruple OHA therapy. Conclusion This study shows the therapeutic efficacy of the quadruple OHA regimen T2DM and demonstrates that it can be an option for the management of T2DM patients who cannot use insulin or reject injectable therapy.

Objective: Diffusion tensor imaging has been extensively applied to schizophrenia research. In this study, we counted the number ofabnormal brain regions with altered diffusion measures in patients with schizophrenia to enumerate the burden of abnormal diffusivityin the brain. Methods: The public neuroimaging data of the COBRE project from SchizConnect were used for the study. The studied dataset consistedof data from 57 patients with schizophrenia and 71 healthy participants. FreeSurfer and FSL were applied for image processingand analysis. After verifying 161 regions of interest (ROIs), mean diffusion measures in every single ROI in all study participants weremeasured and normalized into Z-scores. Each ROI was then defined as normal or abnormal on the basis of a cutoff absolute Z-score of1.96. The number of abnormal ROIs was obtained by each diffusion measure. Results: The numbers of ROIs with increased radial diffusivity and increased trace were significantly larger in the patient group than inhealthy participants. Conclusion Thus, the patient group showed a significant increase in abnormal ROIs, strongly indicating that schizophrenia is notcaused by the pathology of a single brain region, but is instead attributable to the additive burden of structural alterations within multiplebrain regions. Psychiatry Investig 2020;17(4):341-349

OBJECTIVE: Working memory impairments serve as prognostic factors for patients with schizophrenia. Working memory deficits are mainly associated with gray matter (GM) thickness and volume. We investigated the association between GM diffusivity and working memory in controls and individuals with schizophrenia. METHODS: T1 and diffusion tensor images of the brain, working memory task (letter number sequencing) scores, and the demographic data of 90 individuals with schizophrenia and 97 controls were collected from the SchizConnect database. T1 images were parcellated into the 68 GM Regions of Interest (ROI). Axial Diffusivity (AD), Fractional Anisotropy (FA), Radial Diffusivity (RD), and Trace (TR) were calculated for each of the ROIs. RESULTS: Compared to the controls, schizophrenia group showed significantly increased AD, RD, and TR in specific regions on the frontal, temporal, and anterior cingulate area. Moreover, working memory was negatively correlated with AD, RD, and TR in the lateral orbitofrontal, superior temporal, inferior temporal, and rostral anterior cingulate area on left hemisphere in the individuals with schizophrenia. CONCLUSION: These results demonstrated GM microstructural abnormalities in the frontal, temporal, and anterior cingulate regions of individuals with schizophrenia. Furthermore, these regional GM microstructural abnormalities suggest a neuropathological basis for the working memory deficits observed clinically in individuals with schizophrenia.
Anisotropy ; Brain ; Diffusion ; Diffusion Tensor Imaging ; Gray Matter ; Gyrus Cinguli ; Humans ; Memory, Short-Term ; Schizophrenia

PURPOSE: The purpose of this study is to investigate the functional and radiologic results of treatment of the old with intertrochanteric fractures by implementation of the proximal femoral nail antirotation (PFNA) with Valgus reduction. MATERIALS AND METHODS: A retrospective review of patients (over 65 years old) with intertrochanteric fractures undergoing PFNA, during the period March 2008 to August 2012 at Chungbuk National University Hospital, with follow-up for at least 12 months, was conducted. Fifty-one patients were identified. The mean observation period was 15.6 months and the mean age of patients was 78.6 years old. In this study, AO foundation and Orthopaedic Trauma Association (AO/OTA) classification of initial fractures, post operative neck shaft angle, location of the blade tip (Cleveland index), tip-apex distance (TAD), incidence of complication, Wayne-County reduction, and Koval walking ability were analyzed. RESULTS: Satisfactory reduced status was achieved by significant (p<0.05) valgus reduction in 49 out of 51 cases and the mean period for radiologic bony union was 15.3 weeks. The mean blade sliding distance was 3.5 mm and the mean TAD was 18.7 mm; however, the blade location did not affect the results. No complications, including surgical site infection, delayed union, nonunion, rotational angulation, and cutting out of the blade tip were found. Thirty-one patients out of 42 who maintained their pre-fracture ambulatory ability, 11 patients (out of 42) remained ambulatory but became more dependent on assistive devices. CONCLUSION: It is expected that the Wayne-County reduction followed by internal fixation with PFNA is a useful treatment option for intertrochanteric fractures in elderly patients because it shows few complications with good functional and radiologic results.
Aged ; Chungcheongbuk-do ; Classification ; Femur ; Follow-Up Studies ; Hip Fractures* ; Humans ; Incidence ; Neck ; Retrospective Studies ; Self-Help Devices ; Walking

OBJECTIVES: The aim of this study was to identify the health and environmental risk factors of air contaminants that influence environmental and respiratory diseases in Gyeongju, Pohang and Ulsan in South Korea, with a focus on volatile organic compounds (VOCs). METHODS: Samples were collected by instantaneous negative pressure by opening the injection valve in the canister at a fixed height of 1 to 1.5 m. The sample that was condensed in -150degrees C was heated to 180degrees C in sample pre-concentration trap using a 6-port switching valve and it was injected to a gas chromatography column. The injection quantity of samples was precisely controlled using an electronic flow controller equipped in the gas chromatography-mass spectrometer. RESULTS: The quantity of the VOC emissions in the industrial area was 1.5 to 2 times higher than that in the non-industrial area. With regards to the aromatic hydrocarbons, toluene was detected at the highest level of 22.01 ppb in Ulsan, and chloroform was the halogenated hydrocarbons with the highest level of 10.19 ppb in Pohang. The emission of toluene was shown to be very important, as it accounted for more than 30% of the total aromatic hydrocarbon concentration. CONCLUSIONS: It was considered that benzene in terms of the cancer-causing grade standard, toluene in terms of the emission quantity, and chloroform and styrene in terms of their grades and emission quantities should be selected for priority measurement substances.
Benzene ; Chloroform ; Chromatography, Gas ; Electronics ; Electrons ; Hot Temperature ; Hydrocarbons, Aromatic ; Hydrocarbons, Halogenated ; Republic of Korea ; Risk Factors ; Styrene ; Toluene ; Volatile Organic Compounds

BACKGROUND/AIMS: We aimed to evaluate the efficacy and safety of peginterferon plus ribavirin for chronic hepatitis C (CHC) patients under real life setting in Korea. METHODS: We retrospectively analyzed the medical records of 758 CHC patients treated with peginterferon plus ribavirin between 2000 and 2008 from 14 university hospitals in the Gyeonggi-Incheon area in Korea. RESULTS: Hepatitis C virus (HCV) genotype 1 was detected in 61.2% of patients, while genotype 2 was detected in 35.5%. Baseline HCV RNA level was > or =6x10(5) IU/mL in 51.6% of patients. The sustained virological response (SVR) rate was 59.6% regardless of genotype; 53.6% in genotype 1 and 71.4% in genotype 2/3. On multivariate analysis, male gender (p=0.011), early virological response (p<0.001), genotype 2/3 (p<0.001), HCV RNA <6x10(5) IU/mL (p=0.005) and adherence to the drug >80% of the planned dose (p<0.001) were associated with SVR. The rate of premature discontinuation was 35.7%. The main reason for withdrawal was intolerance to the drug due to common adverse events or cytopenia (48.2%). CONCLUSIONS: Our data suggest that the efficacy of peginterferon and ribavirin therapy in Koreans is better in Koreans than in Caucasians for the treatment of CHC, corroborating previous studies that have shown the superior therapeutic efficacy of this regimen in Asians.
Asian Continental Ancestry Group ; Genotype ; Hepacivirus ; Hepatitis C, Chronic ; Hepatitis, Chronic ; Hospitals, University ; Humans ; Male ; Medical Records ; Multivariate Analysis ; Retrospective Studies ; Ribavirin ; RNA

Primary thyroid lymphoma is a relatively rare thyroid tumor and usually a non-Hodgkin type. Its most common histologic type is the diffuse large B cell lymphoma followed by mucosa-associated lymphoid tissue (MALT). It is known to be frequently associated with autoimmune thyroiditis such as Hashimoto's thyroiditis. We report three cases of thyroid lymphoma at a single institution with a review of the literature.
Lymphoid Tissue ; Lymphoma ; Lymphoma, B-Cell ; Thyroid Gland ; Thyroiditis ; Thyroiditis, Autoimmune