1.Study Design and Protocol for a Randomized Controlled Trial to Assess Long-Term Efficacy and Safety of a Triple Combination of Ezetimibe, Fenofibrate, and Moderate-Intensity Statin in Patients with Type 2 Diabetes and Modifiable Cardiovascular Risk Factors (ENSEMBLE)
Nam Hoon KIM ; Juneyoung LEE ; Suk CHON ; Jae Myung YU ; In-Kyung JEONG ; Soo LIM ; Won Jun KIM ; Keeho SONG ; Ho Chan CHO ; Hea Min YU ; Kyoung-Ah KIM ; Sang Soo KIM ; Soon Hee LEE ; Chong Hwa KIM ; Soo Heon KWAK ; Yong‐ho LEE ; Choon Hee CHUNG ; Sihoon LEE ; Heung Yong JIN ; Jae Hyuk LEE ; Gwanpyo KOH ; Sang-Yong KIM ; Jaetaek KIM ; Ju Hee LEE ; Tae Nyun KIM ; Hyun Jeong JEON ; Ji Hyun LEE ; Jae-Han JEON ; Hye Jin YOO ; Hee Kyung KIM ; Hyeong-Kyu PARK ; Il Seong NAM-GOONG ; Seongbin HONG ; Chul Woo AHN ; Ji Hee YU ; Jong Heon PARK ; Keun-Gyu PARK ; Chan Ho PARK ; Kyong Hye JOUNG ; Ohk-Hyun RYU ; Keun Yong PARK ; Eun-Gyoung HONG ; Bong-Soo CHA ; Kyu Chang WON ; Yoon-Sok CHUNG ; Sin Gon KIM
Endocrinology and Metabolism 2024;39(5):722-731
Background:
Atherogenic dyslipidemia, which is frequently associated with type 2 diabetes (T2D) and insulin resistance, contributes to the development of vascular complications. Statin therapy is the primary approach to dyslipidemia management in T2D, however, the role of non-statin therapy remains unclear. Ezetimibe reduces cholesterol burden by inhibiting intestinal cholesterol absorption. Fibrates lower triglyceride levels and increase high-density lipoprotein cholesterol (HDL-C) levels via peroxisome proliferator- activated receptor alpha agonism. Therefore, when combined, these drugs effectively lower non-HDL-C levels. Despite this, few clinical trials have specifically targeted non-HDL-C, and the efficacy of triple combination therapies, including statins, ezetimibe, and fibrates, has yet to be determined.
Methods:
This is a multicenter, prospective, randomized, open-label, active-comparator controlled trial involving 3,958 eligible participants with T2D, cardiovascular risk factors, and elevated non-HDL-C (≥100 mg/dL). Participants, already on moderate-intensity statins, will be randomly assigned to either Ezefeno (ezetimibe/fenofibrate) addition or statin dose-escalation. The primary end point is the development of a composite of major adverse cardiovascular and diabetic microvascular events over 48 months.
Conclusion
This trial aims to assess whether combining statins, ezetimibe, and fenofibrate is as effective as, or possibly superior to, statin monotherapy intensification in lowering cardiovascular and microvascular disease risk for patients with T2D. This could propose a novel therapeutic approach for managing dyslipidemia in T2D.
2.Telomerase Activity and the Risk of Lung Cancer.
Hyo Sung JEON ; Jin Eun CHOI ; Deuk Kju JUNG ; Yi Young CHOI ; Hyo Gyoung KANG ; Won Kee LEE ; Seung Soo YOO ; Jeong Ok LIM ; Jae Yong PARK
Journal of Korean Medical Science 2012;27(2):141-145
Telomerase play a key role in the maintenance of telomere length and chromosome integrity. We have evaluated the association between telomerase activity and the risk of lung cancer in peripheral blood. Telomerase activity in peripheral blood mononuclear cells was measured by a PCR-designed telomeric repeat amplification protocol in 63 lung cancer patients and 190 healthy controls that were matched for age, gender, and smoking status. Telomerase activity was significantly lower in the lung cancer patients than in controls (mean +/- standard deviation; 1.32 +/- 1.65 vs 2.60 +/- 3.09, P < 1 x 10(-4)). When telomerase activity was categorized into quartiles based on telomerase activity in the controls, the risk of lung cancer increased as telomerase activity reduced (Ptrend = 1 x 10(-4)). Moreover, when the subjects were categorized based on the median value of telomerase activity, subjects with low telomerase activity were at a significantly increased risk of lung cancer compared to subjects with high telomerase activity (adjusted odds ratio = 3.05, 95% confidence interval = 1.60-5.82, P = 7 x 10-4). These findings suggest that telomerase activity may affect telomere maintenance, thereby contributing to susceptibility to lung cancer.
Age Factors
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Aged
;
Case-Control Studies
;
Female
;
Humans
;
Leukocytes, Mononuclear/enzymology/immunology
;
Lung Neoplasms/*enzymology/*etiology
;
Male
;
Middle Aged
;
Odds Ratio
;
Risk Factors
;
Sex Factors
;
Smoking
;
Telomerase/*blood
3.Polymorphisms in Apoptosis-Related Genes and TP53 Mutations in Non-Small Cell Lung Cancer.
Eun Young BAE ; Eun Jin LEE ; Hyo Gyoung KANG ; Shin Yup LEE ; Gwang JIN ; Won Kee LEE ; Jin Eun CHOI ; Hyo Sung JEON ; Jeong Ok LIM ; Eung Bae LEE ; Jae Yong PARK
Journal of Korean Medical Science 2011;26(11):1527-1530
Apoptosis plays an essential role in the elimination of mutated or transformed cells from the body. Therefore, polymorphisms of apoptosis-related genes may lead to an alteration in apoptotic capacity, thereby affecting the occurrence of TP53 mutations in lung cancer. We investigated the relationship between potentially functional polymorphisms of apoptosis-related genes and TP53 mutations in non-small cell lung cancer (NSCLC). Twenty-seven single nucleotide polymorphisms in 20 apoptosis-related genes were genotyped by a sequenome mass spectrometry-based genotyping assay in 173 NSCLCs and the associations with TP53 mutations in the entire coding exons (exons 2-11), including splicing sites of the gene, were analyzed. None of the 27 polymorphisms was significantly associated with the occurrence of TP53 mutations. This suggests that apoptosis-related genes may not play an important role in the occurrence of TP53 mutations in lung cancer.
Apoptosis/*genetics
;
Carcinoma, Non-Small-Cell Lung/*genetics
;
DNA Mutational Analysis
;
Female
;
*Genes, p53
;
Genetic Predisposition to Disease
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Genotype
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Humans
;
Lung Neoplasms/genetics
;
Male
;
Mutation
;
*Polymorphism, Single Nucleotide
4.A Case of Emetic Toxin Producing Bacillus cereusStrains Isolated from Outbreak.
Jong Hyun KIM ; Eun Gyoung LIM ; Hyun Chul JANG ; Ju Young PARK ; Sun Jin LEE ; Mi Sun PARK ; Gil Bae CHOI ; Bok Kwon LEE
Korean Journal of Clinical Microbiology 2009;12(1):48-52
Bacillus cereus causes two types of gastrointestinal diseases: emesis and diarrhea. It produces one emetic toxin and nine different enterotoxins. In March 2008, eight of a family became sick after eating slices of raw fish. We isolated emetic toxin producing B. cereus from the stools of 6 patients and 2 subclincal humans. In this study, the presence of enterotoxin genes, such as those of haemolysin BL (Hbl), nonhemolytic enterotoxin (Nhe), B. cereus enterotoxin T (BceT), enterotoxin FM (EntFM), cytotoxin K (cytK) and cereulide were assayed by polymerase chain reaction (PCR) methods. Their enterotoxin activities were assayed using the BCET- RPLA, Tecra ELISA kit and Hep-2 vacuole activity. Bacterial isolates were subtyped by pulsed-field gel electrophoresis (PFGE). This study demonstrates the emetic toxin-producing stains of B. cereus in clinical specimens, for the first time in the Republic of Korea.
Bacillus
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Bacillus cereus
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Coloring Agents
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Depsipeptides
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Diarrhea
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Eating
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Electrophoresis, Gel, Pulsed-Field
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Enterotoxins
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Enzyme-Linked Immunosorbent Assay
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Humans
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Polymerase Chain Reaction
;
Republic of Korea
;
Vacuoles
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Vomiting
5.The Effect of Intensive Education on Glycemic Control in Type 2 Diabetic Patients.
Youn Wook LEE ; Won Sun HWANG ; Sun Jung CHOE ; Dong Hun LEE ; Doh Hyun KIM ; Eun Hee LEE ; Eun Gyoung HONG ; Hye Lim NOH ; Yoon Sok CHUNG ; Kwan Woo LEE ; Hyeon Man KIM
Journal of Korean Society of Endocrinology 2003;18(1):63-72
BACKGROUND: To this date, efforts to develop effective methods for the education of diabetic patients have been limited. The important goal of self-management and weight control for diabetic treatment can not be attained without long and intensive period of education. This study was undertaken to assess the effectiveness of an intensive educational program, of behavior and diet control, which was carried out on subjects with type 2 diabetes, on an out-patient basis. We compared the effectiveness of an intensive education programme with that of a conventional education programme for the self-management of type 2 diabetic patients. METHODS: Subjects with type 2 diabetes were randomly selected, and allocated to one of two groups. One group received a conventional education programme of self-management(the CE group), and the second group received an intensive education programmes for three months, after which the effectiveness of the programmes were evaluated. RESULTS: 1) The levels of fasting blood sugar(FBS), postprandial 2 hour blood sugar(PP2h) and HbA1c were significantly lowered in both groups following the intervention(p<0.05). In the IE group, the FBS declined from 12.4nmol/L to 7.7nmol/L, PP2h declined from 20.3nmol/L to 10.9nmol/L, and the HbA1c showed a similar decline from 9.4 to 7.0% after intervention(p<0.05). In the CE group, the FBS declined from 10.9 to 9.4nmol/l, the PP2h decreased from 17.1 to 14.6 nmol/l, and the HbA1c also decreased from 8.5 to 7.3% after intervention(p<0.05). The decrease in the FBS and HbA1c following the educational intervention was more pronounced in the IE group than the CE group (p<0.05). 2) The effectiveness of the education programmes in promoting appropriate dietary behavior in the diabetic subjects was assessed by a scoring system in three parts: a regularity score, a balance score and an attitude score. From a comparative study of the three scores, the patients attitudes were observed to be much improved in both the groups following the intervention compared to before the programmes, but the balance and total scores were significantly higher in the IE group than the CE group(p<0.05). CONCLUSION: We can conclude that the intensive diabetic education programme is more effective than a conventional programme, not only in improving the patients' levels of glucose, HbAlc, and dietary score, but also the diabetic patients self-control abilities, promoting behavioral change, and prompting problem solving capabilities in respect to the everyday problems that they have to face throughout their lives.
Diet
;
Education*
;
Fasting
;
Glucose
;
Humans
;
Outpatients
;
Problem Solving
;
Self Care
6.The Effects of Korean Traditional Medicine Mixture on Cytokine Level, Food Intake and Nutrition Metabolism of the Cachexia Induced-Mice.
Soo Gyoung WANG ; Eun Young YOON ; Jung Min PARK ; Jong Soon LIM ; Seung Hyung KIM
The Korean Journal of Nutrition 2003;36(4):368-375
Cancer cachexia, characterized by weight loss and progressive tissue wasting, has been postulated to be mediated by cytokines. This study was conducted to evaluate the effect of Korean Traditional Medicine (KTM ; mokhyang, jisil, osooyu) mixture on food intake, blood cytokines level and blood nutrients status of the cachexia induced-mice. Thirty male Balb/c mice aged 6-8 weets were blocked into 3 groups that were Normal (no colon26 cells) Control (colon 26 cells) and KTM (colon26 cells + KTM extract mixture) group. In Control and KTM groups, murine adenocarcinoma colon 26 cells were injected subcutaneously to induce cachexia. KTM mice were given 200 ul KTM extract mixture (7%) per day. Half of each groups were sacrificed at the 14 th day to see serum cytokines & nutrients and the others were fed until almost of control group died to see life span. food intake and body weight were decreased significantly in cachexia induced groups. Tumor weight of KTM group was significantly lower than control group. Serum cytokines (IL-1beta and TNF-alpha) level of cachexia induced groups were increased than those of normal group, and those of KTM group were significantly lower than the level of control group. Total serum protein and serum albumin were higher in KTM group than other groups. TG and fatty acid were lower in cachexia induced groups than normal group. HDL-cholesterol in serum was increased in KTM group. Effect of oral administration of KTM extract mixture on survival time of colon26 bearing mice showed extension of the life span. Overall, this study showed that KTM (mokhyang, jisil, osooyu) extract mixture inhibited the growth of cancer cell, changed the secretion of cytokines induced by colon26 adenocarcinoma in mice, and changed nutrition metabolism.
Adenocarcinoma
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Administration, Oral
;
Animals
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Body Weight
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Cachexia*
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Colon
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Cytokines
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Eating*
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Humans
;
Interleukin-1beta
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Male
;
Medicine, East Asian Traditional
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Medicine, Korean Traditional*
;
Metabolism*
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Mice
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Serum Albumin
;
Tumor Burden
;
Tumor Necrosis Factor-alpha
;
Weight Loss
7.Insulin and Glucagon Secretions, and Morphological Change of Pancreatic Islets in OLETF Rats, a Model of Type 2 Diabetes Mellitus.
Eun Gyoung HONG ; Hye Lim NOH ; Seong Kyu LEE ; Yoon Sok CHUNG ; Kwan Woo LEE ; Hyeon Man KIM
Journal of Korean Medical Science 2002;17(1):34-40
This study was performed to observe the changes of glucose-related hormones and the morphological change including ultrastructure of the pancreatic islets in the male Otsuka Long-Evans Tokushima Fatty rat. Area under the curve (AUC) of glucose at the 30th (709 +/- 73 mg.h/dL) and at the 40th week (746 +/- 87 mg.h/ dL) of age were significantly higher than that at the 10th week (360 +/- 25 mg.h/ dL). AUC of insulin of the 10th week was 2.4 +/- 0.9 ng.h/mL, increased gradually to 10.8 +/- 8.3 ng.h/mL at the 30th week, and decreased to 1.8 +/- 1.2 ng.h/mL at the 40th week. The size of islet was increased at 20th week of age and the distribution of peripheral alpha cells and central beta cells at the 10th and 20th weeks was changed to a mixed pattern at the 40th week. On electron microscopic examination, beta cells at the 20th week showed many immature secretory granules, increased mitochondria, and hypertrophied Golgi complex and endoplasmic reticulum. At the 40th week, beta cell contained scanty intracellular organelles and secretory granules and apoptosis of acinar cell was observed. In conclusion, as diabetes progressed, increased secretion of insulin was accompanied by increases in size of islets and number of beta-cells in male OLETF rats showing obese type 2 diabetes. However, these compensatory changes could not overcome the requirement of insulin according to the continuous hyperglycemia after development of diabetes.
Animals
;
Body Weight
;
Diabetes Mellitus, Type 2/*metabolism/pathology
;
Disease Models, Animal
;
Glucagon/*metabolism
;
Insulin/*metabolism
;
Islets of Langerhans/*metabolism/pathology/ultrastructure
;
Male
;
Rats
;
Rats, Inbred OLETF
8.PCNA Expression as a Prognostic Factor in Papillary Thyroid Carcinoma.
Byung Chan LIM ; Jin Suk LEE ; Kwang Gun JUNG ; Sun Tae PARK ; Woo Song HA ; Sang Gyoung CHOI ; Soon Chan HONG ; Soo In KWON ; Young Joon LEE ; Eun Jung JUNG ; Hyun Un JO
Korean Journal of Endocrine Surgery 2001;1(1):61-66
PURPOSE: Assessment of the proliferative ability of cancer cells is necessary not only for the biologic characterization of tumors, but also for the selection of treatment and evaluation of prognosis. Recently, there have been several studies examining the proliferative activity of various malignant tumors using immunohistochemical methods. PCNA is a nuclear protein related to the cell cycle and found with high expression in proliferative tissues, including cancers. METHODS: In our study, to evaluate whether PCNA expression was useful as a prognostic factor in patients with papillary thyroid carcinoma, we quantitated the immunohistochemical expression of PCNA in the formalin-fixed paraffin embedded tissue from 55 patients with papillary thyroid carcinoma and correlated the results with established clinicopathologic parameters. RESULTS: The results were as follows. 1) PCNA expression in papillary thyroid carcinoma did not correlate with the age, sex or metastatic L/N activity of the patient, nor with the size, invasion, or recurrence of the tumor. 2) There was a close relationship between the expression rate of PCNA in thyroid tumor cells and that in metastatic L/N cells (p=0.056, in p<0.1). 3) The expression of PCNA in the metastatic L/N (+) group was higher than in the metastatic L/N (+) group (p=0.045). CONCLUSION: It is suggested that PCNA expression is not an appropriate prognostic factor in papillary thyroid carcinoma.
Cell Cycle
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Humans
;
Nuclear Proteins
;
Paraffin
;
Prognosis
;
Proliferating Cell Nuclear Antigen*
;
Recurrence
;
Thyroid Gland*
;
Thyroid Neoplasms*
9.Detection of Multidrug Resistant Patterns and Associated - genes of Methicillin Resistant Staphylococcus aureus ( MRSA ) Isolated from Clinical Specimens.
Eun Gyoung LIM ; Young Hee KIM ; Ji Yung MUN ; Yung Bu KIM ; Yang Hyo OH
Journal of the Korean Society for Microbiology 2000;35(5):356-356
No Abstract Available.
Methicillin Resistance*
;
Methicillin*
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Methicillin-Resistant Staphylococcus aureus*
;
Staphylococcus aureus*
;
Staphylococcus*
10.Virulence Factors and Genotyping of Vibrio parahaemolyticus.
Eun Gyoung LIM ; Young Hee KIM ; Ji Yung MUN ; Yang Hyo OH ; Yung Bu KIM
Journal of the Korean Society for Microbiology 2000;35(5):355-355
No Abstract Available.
Vibrio parahaemolyticus*
;
Vibrio*
;
Virulence Factors*
;
Virulence*

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