BACKGROUND: Combination of metformin to reduce the fasting plasma glucose level and an α-glucosidase inhibitor to decrease the postprandial glucose level is expected to generate a complementary effect. We compared the efficacy and safety of a fixed-dose combination of voglibose plus metformin (vogmet) with metformin monotherapy in drug-naïve newly-diagnosed type 2 diabetes mellitus. METHODS: A total of 187 eligible patients aged 20 to 70 years, with a glycosylated hemoglobin (HbA1c) level of 7.0% to 11.0%, were randomized into either vogmet or metformin treatments for 24 weeks. A change in the HbA1c level from baseline was measured at week 24. RESULTS: The reduction in the levels of HbA1c was −1.62%±0.07% in the vogmet group and −1.31%±0.07% in the metformin group (P=0.003), and significantly more vogmet-treated patients achieved the target HbA1c levels of <6.5% (P=0.002) or <7% (P=0.039). Glycemic variability was also significantly improved with vogmet treatment, estimated by M-values (P=0.004). Gastrointestinal adverse events and hypoglycemia (%) were numerically lower in the vogmet-treated group. Moreover, a significant weight loss was observed with vogmet treatment compared with metformin (−1.63 kg vs. −0.86 kg, P=0.039). CONCLUSION: Vogmet is a safe antihyperglycemic agent that controls blood glucose level effectively, yields weight loss, and is superior to metformin in terms of various key glycemic parameters without increasing the risk of hypoglycemia.
Blood Glucose ; Diabetes Mellitus, Type 2 ; Fasting ; Glucose ; Hemoglobin A, Glycosylated ; Humans ; Hypoglycemia ; Metformin ; Weight Loss

OBJECTIVES: This study developed an information and communication technology (ICT)-based comprehensive health and social-needs assessment (CHSNA) system based on the International Classification of Functioning, Disability, and Health (ICF) with the aim of enhancing person-centered community care for community residents and supporting healthcare professionals and social workers who provide healthcare and social services in the community. METHODS: Items related to a CHSNA tool were developed and mapped with ICF codes. Experts validated the CHSNA system design and process using the Delphi method, and a pilot test of the initial version of the system was conducted. RESULTS: The following three steps of CHSNA were embedded in the system, which had a user-friendly screen and images: basic health assessment, life and activity assessment, and in-depth health assessment. The assessment results for the community residents were presented with visualized health profiles, including images, graphs, and an ICF model. CONCLUSIONS: The developed CHSNA system can be used by healthcare professionals, social workers, and community residents to evaluate the reasoning underlying health and social needs, to facilitate the identification of more appropriate healthcare plans, and to guide community residents to receive the best healthcare services. A CHSNA system can improve the implementation of standardized terminology utilizing the ICF and the accuracy of needs assessments of community residents.
Classification ; Community Health Services ; Decision Support Techniques ; Delivery of Health Care ; Methods ; Needs Assessment ; Patient-Centered Care ; Social Work ; Social Workers

A statistical analysis was performed on national forensic autopsy data collected in the Republic of Korea during 2016 to overcome regional limitations and limitations from the number of unusual deaths as reported in the literature over the previous year. A total of 8,335 cases were categorized based on the region, based on requests by the Police Agency and the Coast Guard, gender, age, manner of death, and cause of death. Analysis of the manner of death revealed that 4,028 cases (48.3%) were of unnatural death, 3,447 cases (41.4%) were of natural death, and 860 cases (10.3%) were of unknown death. Among the unnatural deaths, the majority of the manner of deaths (1,584 cases, 39.3%) was accidents, 1,378 cases (34.2%) were suicides, 428 cases (10.6%) were homicides, and 638 cases (15.8%) were undetermined deaths. Among the unnatural deaths, the majority of the cause of deaths (1,518 cases, 37.7%) was due to trauma, followed by 827 cases (20.5%) of poisoning and 732 cases (18.2%) of asphyxia. Falling was the major cause of death by trauma (668 cases, 44.0%). Based on a previous study about asphyxia, strangulation was the major cause, with 569 cases (77.7%). Among the natural deaths, heart disease was the major cause (1,727 cases, 50.1%), followed by vascular disease (587 cases, 17.0%).
Accidental Falls ; Asphyxia ; Autopsy ; Cause of Death ; Data Interpretation, Statistical ; Heart Diseases ; Homicide ; Humans ; Korea ; Military Personnel ; Poisoning ; Police ; Republic of Korea ; Suicide ; Vascular Diseases

Aspergillus infection is the most common cause of death due to fungi in immunocompromised hosts. Aspergillus tracheobronchitis is an uncommon but severe form of invasive pulmonary aspergillosis, which is limited entirely or mainly to the tracheobronchial tree and can often be life-threatening. We report a case of a 54-year-old man who died from Aspergillus tracheobronchitis without an underlying disease. Autopsy revealed an extensive yellowish plaque adhering to the trachea and bronchial wall. The microscopic examination of the trachea and bronchus revealed septate branching hyphae of Aspergillus.
Aspergillus ; Autopsy ; Bronchi ; Bronchitis ; Cause of Death ; Fungi ; Humans ; Hyphae ; Immunocompromised Host ; Invasive Pulmonary Aspergillosis ; Middle Aged ; Trachea ; Tracheitis ; Trees

Statistical analysis was performed on national forensic autopsy data collected in the Republic of Korea, with the exception of Ulsan, during 2017. A total of 8,777 cases were categorized based on the region; information was provided by the Police Agency and the Coast Guard regarding sex, age, manner of death, and cause of death. Analysis of the manner of death revealed that 3,971 cases (45.2%) were unnatural deaths, 3,679 cases (41.9%) were natural deaths, and 1,127 cases (12.8%) were unknown deaths. Among the unnatural deaths, the majority of the cases (1,740 cases, 43.8%) were accidents, 1,316 cases (33.1%) were suicide, 385 cases (9.7%) were homicide, and 530 cases (13.3%) were undetermined deaths. Among the unnatural deaths, the majority of the cases (1,575 cases, 39.7%) were trauma, followed by 793 cases (20.0%) of poisoning and 689 cases (17.4%) of asphyxia. Falling down was the major cause of death by trauma (737 cases, 46.8%). As a result of the classification of asphyxia based on previous study, strangulation was the major cause, with 538 cases (78.1%). Among the natural deaths, heart disease was the major cause (1,790 cases, 48.7%), followed by vascular disease (697 cases, 18.9%).
Accidental Falls ; Asphyxia ; Autopsy ; Cause of Death ; Classification ; Data Interpretation, Statistical ; Heart Diseases ; Homicide ; Humans ; Korea ; Military Personnel ; Poisoning ; Police ; Republic of Korea ; Suicide ; Ulsan ; Vascular Diseases

A statistical analysis was performed on national forensic autopsy data collected in the Republic of Korea during 2016 to overcome regional limitations and limitations from the number of unusual deaths as reported in the literature over the previous year. A total of 8,335 cases were categorized based on the region, based on requests by the Police Agency and the Coast Guard, gender, age, manner of death, and cause of death. Analysis of the manner of death revealed that 4,028 cases (48.3%) were of unnatural death, 3,447 cases (41.4%) were of natural death, and 860 cases (10.3%) were of unknown death. Among the unnatural deaths, the majority of the manner of deaths (1,584 cases, 39.3%) was accidents, 1,378 cases (34.2%) were suicides, 428 cases (10.6%) were homicides, and 638 cases (15.8%) were undetermined deaths. Among the unnatural deaths, the majority of the cause of deaths (1,518 cases, 37.7%) was due to trauma, followed by 827 cases (20.5%) of poisoning and 732 cases (18.2%) of asphyxia. Falling was the major cause of death by trauma (668 cases, 44.0%). Based on a previous study about asphyxia, strangulation was the major cause, with 569 cases (77.7%). Among the natural deaths, heart disease was the major cause (1,727 cases, 50.1%), followed by vascular disease (587 cases, 17.0%).

Aspergillus infection is the most common cause of death due to fungi in immunocompromised hosts. Aspergillus tracheobronchitis is an uncommon but severe form of invasive pulmonary aspergillosis, which is limited entirely or mainly to the tracheobronchial tree and can often be life-threatening. We report a case of a 54-year-old man who died from Aspergillus tracheobronchitis without an underlying disease. Autopsy revealed an extensive yellowish plaque adhering to the trachea and bronchial wall. The microscopic examination of the trachea and bronchus revealed septate branching hyphae of Aspergillus.

Statistical analysis was performed on national forensic autopsy data collected in the Republic of Korea, with the exception of Ulsan, during 2017. A total of 8,777 cases were categorized based on the region; information was provided by the Police Agency and the Coast Guard regarding sex, age, manner of death, and cause of death. Analysis of the manner of death revealed that 3,971 cases (45.2%) were unnatural deaths, 3,679 cases (41.9%) were natural deaths, and 1,127 cases (12.8%) were unknown deaths. Among the unnatural deaths, the majority of the cases (1,740 cases, 43.8%) were accidents, 1,316 cases (33.1%) were suicide, 385 cases (9.7%) were homicide, and 530 cases (13.3%) were undetermined deaths. Among the unnatural deaths, the majority of the cases (1,575 cases, 39.7%) were trauma, followed by 793 cases (20.0%) of poisoning and 689 cases (17.4%) of asphyxia. Falling down was the major cause of death by trauma (737 cases, 46.8%). As a result of the classification of asphyxia based on previous study, strangulation was the major cause, with 538 cases (78.1%). Among the natural deaths, heart disease was the major cause (1,790 cases, 48.7%), followed by vascular disease (697 cases, 18.9%).

Forensic autopsies were performed on 1,821 cases in 2014 and 2,024 cases in 2015 at the National Forensic Service Seoul Institute. Based on the autopsy reports, 103 cases (5.7%) in 2014 and 130 cases (6.4%) in 2015 were selected as unnatural deaths caused by fatal intoxication. The cases were divided into five groups. The first group had ethanol intoxication, the second had drug intoxication, the third had agrochemical intoxication, the fourth had cyanide intoxication, and the fifth had miscellaneous intoxications. Of the 233 cases, 202 had death certificates. Of these 202 cases, 169 (83.7%) had an undetermined manner of death (MOD); 17 (8.4%) had an unnatrual MOD and intoxication was the cause of death (COD); nine (4.5%) had an unnatural MOD, but the COD was not intoxication; seven (3.5%) had a natural MOD and disease as a COD. The predictive ratios of intoxication as a COD were compared with the death certificates and the police death scene investigation results. The death certificates and the police investigation results showed predictive ratios of 8.4% and 55.2%, respectively, for intoxication as a COD. The discrepance in these predictive ratios and relatively low predictive ratio of police investigation results mean that intoxicated deaths have been underevaluated; thus, some homicides or intentional deaths were probably missed under South Korea's death investigation system. Doctors who specialize in forensic medicine need to supervise the entire postmortem examination process and emergency blood toxicological analysis should be performed in South Korea.
Autopsy ; Cause of Death ; Death Certificates* ; Emergencies ; Ethanol ; Forensic Medicine ; Homicide ; Humans ; Korea* ; Police ; Seoul

The statistical analysis of forensic autopsies provides basic data for the postmortem investigation system and is the foundation of the statistics used in the analysis of the causes of death. A statistical analysis was performed on national forensic autopsy data collected in the Republic of Korea during 2015 to overcome regional limitations and limitations from the number of unusual deaths in the current forensic autopsy research. A total of 6,610 cases were categorized based on the region, requested Police Agency or Coast Guard, gender, age, manner of death, and cause of death. Analysis of the manner of death revealed that 3,326 cases (50.3%) were unnatural death, 2,754 cases (41.7%) were natural death, and 530 cases (8.0%) were of unknown. Of the 3,326 cases of unnatural death, the majority (1,275 cases, 38.3%) were accidents, 1,040 cases (31.3%) were suicide, 481 cases (14.5%) were homicide, and 530 cases (15.9%) were undetermined death. Among the unnatural death, the majority (1,330 cases, 40.0%) were trauma, followed by 588 cases (17.7%) of asphyxia and 566 cases (17.0%) of poisoning. Fall down were the major cause of death by trauma (538 cases, 40.5%). On the basis of a previous study, there were 588 cases of asphyxia; strangulation was the major cause, with 472 cases (80.3%). Of the 2,754 cases of natural death, heart disease was the major cause (1,417 cases, 51.5%), followed by vascular disease (503 cases, 18.3%).
Asphyxia ; Autopsy* ; Cause of Death ; Data Interpretation, Statistical ; Heart Diseases ; Homicide ; Humans ; Korea* ; Military Personnel ; Poisoning ; Police ; Republic of Korea ; Suicide ; Vascular Diseases