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.

Background: Sexual dimorphism is important for sex determination in the field of forensics. However, sexual dimorphism is commonly assessed using cone beam computed tomography (CBCT) rather than three-dimensional (3D) modeling software; therefore, studies using a more accurate measurement approach are necessary. This study assessed the sexual dimorphism of the MS using a 3D modeling program to obtain information that could contribute to the fields of surgery and forensics. Methods: The CBCT data of 60 patients (age, 20∼29 y; 30 males and 30 females) admitted to the Department of Orthodontics at the Dankook University School of Dentistry were provided in Digital Imaging and Communications in Medicine (DICOM) format.The left MS and right MS were modeled based on the DICOM files using the Mimics (version 22; Materialise, Leuven, Belgium) 3D program and converted to stereolithography (STL) files used to measure the width, length, and height of the MS, infraorbital foramen (IOF), right MS, and left MS. The average of three repeated measurements was calculated, and a reliability test was performed to ensure data reliability (Cronbach’s α =0.618). A canonical discriminant analysis was performed using a standard approach (left: Box’s M=0.096; right: Box’s M=0.115). Results: Males had greater values for all parameters (MS width, MS length, MS height, IOF, right MS, left MS) than females. The discriminant analysis identified six independent variables (MS width, MS height, MS length, IOF, right MS, left MS) that could identify sex. The left MS and right MS correctly identified the sex of 81.7% and 71.7% of the patients, respectively, with the left MS having higher accuracy. Conclusion This study confirmed that, for Korean individuals, the left MS has a better ability to identify sex than the right MS. These results may contribute to sex identification in the fields of surgery and forensics.

Background: Psoriasis is a chronic inflammatory skin disease. The etiology of psoriasis is not fully understood, but the genetic background is considered to be the most important factor. To date, many psoriasis-related genes have been discovered, but the role of many important genes has not been well understood. Objective: The purpose of this study is to uncover possible roles of MDA5 in psoriasis. Methods: Expression of MDA5 was investigated using immunohistochemistry. Then, MDA5 was overexpressed in keratinocytes using a recombinant adenovirus. Results: As a result of immunohistochemical staining, the expression of MDA5 was significantly increased in the epidermis of psoriasis compared to normal skin. Similarly, the expression of MDA5 was increased in imiquimod-induced psoriasiform dermatitis model. In cultured keratinocytes, toll-like receptor 3 agonist poly(I:C) induced expression of MDA5 at both mRNA and protein levels. When MDA5 was overexpressed using a recombinant adenovirus, poly(I:C)-induced cytokine expression was significantly increased. Finally, MDA5 overexpression significantly inhibited calcium-induced differentiation of keratinocytes. Conclusion These results suggest that MDA5 increases in psoriasis and negatively regulates keratinocyte differentiation.

Background: Psoriasis is a chronic inflammatory skin disease. The etiology of psoriasis is not fully understood, but the genetic background is considered to be the most important factor. To date, many psoriasis-related genes have been discovered, but the role of many important genes has not been well understood. Objective: The purpose of this study is to uncover possible roles of MDA5 in psoriasis. Methods: Expression of MDA5 was investigated using immunohistochemistry. Then, MDA5 was overexpressed in keratinocytes using a recombinant adenovirus. Results: As a result of immunohistochemical staining, the expression of MDA5 was significantly increased in the epidermis of psoriasis compared to normal skin. Similarly, the expression of MDA5 was increased in imiquimod-induced psoriasiform dermatitis model. In cultured keratinocytes, toll-like receptor 3 agonist poly(I:C) induced expression of MDA5 at both mRNA and protein levels. When MDA5 was overexpressed using a recombinant adenovirus, poly(I:C)-induced cytokine expression was significantly increased. Finally, MDA5 overexpression significantly inhibited calcium-induced differentiation of keratinocytes. Conclusion These results suggest that MDA5 increases in psoriasis and negatively regulates keratinocyte differentiation.

Background: Sebocytes are the main cells involved in the pathogenesis of acne by producing lipids and inflammatory cytokines. Although palmitic acid (PA) has been suggested to induce an inflammatory reaction, its effect on sebocytes remains to be elucidated. Objective: In the present study, we investigated whether PA promotes inflammasome-mediated inflammation of sebocytes both in vivo and in vitro. Methods: We intradermally injected PA into the mice ears. And, we treated cultured human sebocytes with PA. Inflammasome-mediated inflammation was verified by immunohistochemistry, Western blot and ELISA. Results: PA-treated mice developed an inflammatory response associated with increased interleukin (IL)-1β expression in the sebaceous glands. When PA was added to cultured human sebocytes, caspase-1 activation and IL-1β secretion were significantly enhanced. In addition, NLRP3 knockdown attenuated IL-1β production by sebocytes stimulated with PA. PA-mediated inflammasome activation required reactive oxygen species. Conclusion These findings indicate that PA activates the NLRP3 inflammasome before induction of an inflammatory response in sebocytes. Thus, PA may play a role in the inflammation of acne

Background: The fatality rate of patients with coronavirus disease 2019 (COVID-19) varies among countries owing to demographics, patient comorbidities, surge capacity of healthcare systems, and the quality of medical care. We assessed the clinical outcomes of patients with COVID-19 during the first wave of the epidemic in Korea. Methods: Using a modified World Health Organization clinical record form, we obtained clinical data for 3,060 patients with COVID-19 treated at 55 hospitals in Korea. Disease severity scores were defined as: 1) no limitation of daily activities; 2) limitation of daily activities but no need for supplemental oxygen; 3) supplemental oxygen via nasal cannula; 4) supplemental oxygen via facial mask; 5) non-invasive mechanical ventilation; 6) invasive mechanical ventilation; 7) multi-organ failure or extracorporeal membrane oxygenation therapy; and 8) death. Recovery was defined as a severity score of 1 or 2, or discharge and release from isolation. Results: The median age of the patients was 43 years of age; 43.6% were male. The median time from illness onset to admission was 5 days. Of the patients with a disease severity score of 3–4 on admission, 65 (71.5%) of the 91 patients recovered, and 7 (7.7%) died due to illness by day 28. Of the patients with disease severity scores of 5–7, 7 (19.5%) of the 36 patients recovered, and 8 (22.2%) died due to illness by day 28. None of the 1,324 patients who were < 50 years of age died; in contrast, the fatality rate due to illness by day 28 was 0.5% (2/375), 0.9% (2/215), 5.8% (6/104), and 14.0% (7/50) for the patients aged 50–59, 60–69, 70–79, and ≥ 80 years of age, respectively. Conclusion In Korea, almost all patients of < 50 years of age with COVID-19 recovered without supplemental oxygen. In patients of ≥ 50 years of age, the fatality rate increased with age, reaching 14% in patients of ≥ 80 years of age.

BACKGROUND: S100A8 is differentially expressed in various cell types and is associated with a number of malignant disorders. S100A8 may affect tumor biology. However, its role in cutaneous squamous cell carcinoma (SCC) is not well established. OBJECTIVE: This study aims to investigate the relationship between S100A8 and cutaneous SCC development. METHODS: We performed immunohistochemical staining to detect S100A8 expression in facial skin specimens of premalignant actinic keratosis (AK), malignant SCC, and normal tissues. In addition, we utilized postconfluence and high calcium-induced differentiation in a culture system model. Furthermore, we constructed a recombinant adenovirus expressing GFP-tagged S100A8 to investigate the role of S100A8 in SCC cell differentiation. RESULTS: S100A8 was significantly overexpressed in human cutaneous SCC compared to that in normal and AK tissues. S100A8 was gradually upregulated in SCC cells in a post-confluence-induced differentiation model. Overexpression of S100A8 in SCC cells induced by adenoviral transduction led to increased expression levels of differentiation markers, such as loricrin, involucrin, and filaggrin. S100A8 overexpression also increased loricrin and involucrin luciferase activity. CONCLUSION: S100A8 regulates cutaneous SCC differentiation and induces well-differentiated SCC formation in skin.
Adenoviridae ; Antigens, Differentiation ; Biology ; Carcinoma, Squamous Cell* ; Cell Differentiation ; Humans ; Keratosis, Actinic ; Luciferases ; Skin

PURPOSE: This study was conducted in order to determine the current status of duty hours of emergency resident physicians in Korea. METHODS: The training committee of the Korean Society of Emergency Medicine surveyed using a questionnaire on resident training status, which contained the total number of duty hours during four weeks of July (first to 28th day) according to the grades of the resident physician. The proportions of both irregular working hours and independent working hours without supervision of a board certified physician were also evaluated. RESULTS: Responses from 80 hospitals out of 97 training hospitals were analyzed. The average number of duty hours of emergency resident physicians was 63.7+/-10.7 hours/week. The proportion of hospitals for which the average number of duty hours exceeded 80 hours/week was 16.1%. Irregular working hours consisted of 63.9%. Residents in 15(18.7%) hospitals worked 3.7~73.5% of their duty hours without supervision of a board certified physician. The higher grade resident had fewer working hours (p<0.001). No statistical difference was observed in the rate of both irregular work and unsupervised work according to the grade. CONCLUSION: Results of this study showed that nine(11.3%) hospitals had average duty hours above 80 hours/week. In Korea, training hospitals should prepare to minimize the impact of duty hour restriction in the near future, as well as to improve training quality.
Cross-Sectional Studies* ; Emergencies* ; Emergency Medicine ; Emergency Service, Hospital ; Korea ; Organization and Administration ; Surveys and Questionnaires

Leuconostoc species are gram-positive cocci and they are rarely pathogenic in human. Leuconostoc infections are commonly associated with immunocompromised status and indwelling medical devices include intravenous catheter, tracheostomy, endotracheal intubation and percutaneous endoscopic gastrostomy. Clinical isolates of Leuconostoc were frequently misidentified, usually as viridans streptococci, but they possess inherent resistance to vancomycin despite sensitivity to most other antibiotics. We present a case of Leuconostoc peritonitis in patients receiving continuous ambulatory peritoneal dialysis (CAPD). A 48-year-old man with hypertensive nephropathy has been treated with peritoneal dialysis, developed peritonitis due to Leuconostoc species. The peritonitis was poorly responded to empirical antibiotics. He was successfully treated with intraperitoneal administration of ampicillin. The dialysis catheter was left in place, and continued to function. To our knowledge, this is the first case of Leuconostoc peritonitis reported in Korea.
Ampicillin ; Anti-Bacterial Agents ; Catheters ; Dialysis ; Gastrostomy ; Gram-Positive Cocci ; Humans ; Intubation, Intratracheal ; Korea ; Leuconostoc* ; Middle Aged ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis* ; Tracheostomy ; Vancomycin ; Viridans Streptococci

BACKGROUND/OBJECTIVES: This study was performed to investigate the in vitro antioxidant and cytoprotective effects of fermented sesame sauce (FSeS) against hydrogen peroxide (H2O2)-induced oxidative damage in renal proximal tubule LLC-PK1 cells. MATERIALS/METHODS: 1,1-diphenyl-2-picrylhydrazyl (DPPH), hydroxyl radical (*OH), and H2O2 scavenging assay was used to evaluate the in vitro antioxidant activity of FSeS. To investigate the cytoprotective effect of FSeS against H2O2-induced oxidative damage in LLC-PK1 cells, the cellular levels of reactive oxygen species (ROS), lipid peroxidation, and endogenous antioxidant enzymes including catalase (CAT), superoxide dismutase (SOD), and glutathione peroxidase (GSH-px) were measured. RESULTS: The ability of FSeS to scavenge DPPH, *OH and H2O2 was greater than that of FSS and AHSS. FSeS also significantly inhibited H2O2-induced (500 microM) oxidative damage in the LLC-PK1 cells compared to FSS and AHSS (P < 0.05). Following treatment with 100 microg/mL of FSeS and FSS to prevent H2O2-induced oxidation, cell viability increased from 56.7% (control) to 83.7% and 75.6%, respectively. However, AHSS was not able to reduce H2O2-induced cell damage (viability of the AHSS-treated cells was 54.6%). FSeS more effectively suppressed H2O2-induced ROS generation and lipid peroxidation compared to FSS and AHSS (P < 0.05). Compared to the other sauces, FSeS also significantly increased cellular CAT, SOD, and GSH-px activities and mRNA expression (P < 0.05). CONCULUSIONS: These results from the present study suggest that FSeS is an effective radical scavenger and protects against H2O2-induced oxidative damage in LLC-PK1 cells by reducing ROS levels, inhibiting lipid peroxidation, and stimulating antioxidant enzyme activity.
Animals ; Catalase ; Cats ; Cell Survival ; Glutathione Peroxidase ; Hydrogen Peroxide ; Hydrogen* ; Hydroxyl Radical ; Lipid Peroxidation ; LLC-PK1 Cells ; Oxidative Stress ; Reactive Oxygen Species ; RNA, Messenger ; Sesamum* ; Superoxide Dismutase ; Swine