In May 2023, the Committee of Clinical Practice Guidelines of the Korean Diabetes Association published the revised clinical practice guidelines for Korean adults with diabetes and prediabetes. We incorporated the latest clinical research findings through a comprehensive systematic literature review and applied them in a manner suitable for the Korean population. These guidelines are designed for all healthcare providers nationwide, including physicians, diabetes experts, and certified diabetes educators who manage patients with diabetes or individuals at risk of developing diabetes. Based on recent changes in international guidelines and the results of a Korean epidemiological study, the recommended age for diabetes screening has been lowered. In collaboration with the relevant Korean medical societies, recently revised guidelines for managing hypertension and dyslipidemia in patients with diabetes have been incorporated into this guideline. An abridgment containing practical information on patient education and systematic management in the clinic was published separately.

Purpose: The survival benefit of neoadjuvant chemotherapy (NAC) prior to surgical resection in colorectal cancer with liver metastases (CRCLM) patients remains controversial. The aim of this study was to compare overall outcome of CRCLM patients who underwent NAC followed by surgical resection versus surgical treatment first. Methods: We retrospectively analyzed 429 patients with stage IV colorectal cancer with synchronous liver metastases who underwent simultaneous liver resection between January 2008 and December 2016. Using propensity score matching, overall outcome between 60 patients who underwent NAC before surgical treatment and 60 patients who underwent surgical treatment first was compared. Results: Before propensity score matching, metastatic cancer tended to involve a larger number of liver segments and the primary tumor size was bigger in the NAC group than in the primary resection group, so that a larger percentage of patients in the NAC group underwent major hepatectomy (P<0.001). After propensity score matching, demographic features and pathologic outcomes showed no significant differences between the 2 groups. In addition, there was no significant difference in short-term recovery outcomes such as postoperative morbidity (P=0.603) and oncologic outcome, including 3-year overall survival rate (P=0.285) and disease-free survival rate (P=0.730), between the 2 groups. Conclusion NAC prior to surgical treatment in CRCLM is considered a safe treatment that does not increase postoperative morbidity, and its impact on oncologic outcome was not inferior.

Objectives: The purpose of this study was to evaluate and report the antibacterial efficacy in relation to oral disease-causing bacteria using a mouthwash containing 0.05% CPC in an in vitro test. Methods: The sterilization test and susceptibility assay of mouthwash containing 0.05% CPC were investigated against Streptococcus mutans, Streptococcus sobrinus, and Lactobacillus acidophilus;Streptococcus sanguinis as oral bacteria related to dental caries; Enterococcus faecalis as apical periodontitis-related bacteria; and Actinomyces israelii, Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, Prevotella intermedia, Prevotella nigrescence, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, and Filifactor alocis as periodontal disease-related bacteria. Results: In the sterilization test, most of the bacteria had more than 99.99% sterilizing power for all samples but compared to other bacteria, the sterilizing power of these samples was not successful for L. acidophilus and E. faecalis bacteria. When comparing the sterilization power between the samples, sample 3 (0.05% CPC+20% ethanol) was the strongest. Conclusions In the antimicrobial activity test, sample 3 inhibited growth at the lowest concentration overall.

Purpose: The survival benefit of neoadjuvant chemotherapy (NAC) prior to surgical resection in colorectal cancer with liver metastases (CRCLM) patients remains controversial. The aim of this study was to compare overall outcome of CRCLM patients who underwent NAC followed by surgical resection versus surgical treatment first. Methods: We retrospectively analyzed 429 patients with stage IV colorectal cancer with synchronous liver metastases who underwent simultaneous liver resection between January 2008 and December 2016. Using propensity score matching, overall outcome between 60 patients who underwent NAC before surgical treatment and 60 patients who underwent surgical treatment first was compared. Results: Before propensity score matching, metastatic cancer tended to involve a larger number of liver segments and the primary tumor size was bigger in the NAC group than in the primary resection group, so that a larger percentage of patients in the NAC group underwent major hepatectomy (P<0.001). After propensity score matching, demographic features and pathologic outcomes showed no significant differences between the 2 groups. In addition, there was no significant difference in short-term recovery outcomes such as postoperative morbidity (P=0.603) and oncologic outcome, including 3-year overall survival rate (P=0.285) and disease-free survival rate (P=0.730), between the 2 groups. Conclusion NAC prior to surgical treatment in CRCLM is considered a safe treatment that does not increase postoperative morbidity, and its impact on oncologic outcome was not inferior.

Objectives: The purpose of this study was to evaluate and report the antibacterial efficacy in relation to oral disease-causing bacteria using a mouthwash containing 0.05% CPC in an in vitro test. Methods: The sterilization test and susceptibility assay of mouthwash containing 0.05% CPC were investigated against Streptococcus mutans, Streptococcus sobrinus, and Lactobacillus acidophilus;Streptococcus sanguinis as oral bacteria related to dental caries; Enterococcus faecalis as apical periodontitis-related bacteria; and Actinomyces israelii, Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, Prevotella intermedia, Prevotella nigrescence, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, and Filifactor alocis as periodontal disease-related bacteria. Results: In the sterilization test, most of the bacteria had more than 99.99% sterilizing power for all samples but compared to other bacteria, the sterilizing power of these samples was not successful for L. acidophilus and E. faecalis bacteria. When comparing the sterilization power between the samples, sample 3 (0.05% CPC+20% ethanol) was the strongest. Conclusions In the antimicrobial activity test, sample 3 inhibited growth at the lowest concentration overall.

Objectives: ：Community managements for elderly are changing due to increased social and economic burdens.The purpose of this study was to find out if there is an effect on depression, anxiety, quality of life, and life management by using a care robot, which is a future technology. Methods: ：For 100 elderly patients who visited the hospital with cognitive impairment or type 2 diabetes, we install a care robot between August 20 and November 14, 2019. The self-report questionnaire was used to measure changes in depression, sleep quality, quality of life, and life management among patients. In this study, 77 patients completed the survey were compared before and after the use of a care robot. Results: ：It was confirmed that the elderly patients using the care robot improved in terms of depression, sleep quality, anxiety, and life management. When the mean values of the scores before and after the care robot intervention were compared, there was a significant decrease (p≤0.001) in depression scale. In the sleep quality category, there was a significant positive effect (p≤0.001). In quality of life category, anxiety/depression showed a significant decrease (p≤0.001). In the life management category, there was a significant improvement (p=0.004) in the cognitive impairment group, and especially in the drug compliance, patients with the cognitive impairment group had a positive effect (p=0.01). Conclusion ：For elderly patients, the use of care robots as a non- pharmacological intervention can help improve depression, anxiety and sleep quality. In particular, in the cognitive impairment group, it is effective in improving life management.

PURPOSE: The purpose of the study was to determine effect of incivility, resilience, and social support experienced by nursing students on burnout in clinical practice. METHODS: Subjects were 140 nursing students who agreed to participate in this study. Collected data were analyzed using descriptive statistics, t-test, analysis of variance, Pearson's correlation and stepwise multiple regression with SPSS WIN 23.0 program. RESULTS: Burnout showed significantly positive correlation with incivility but significantly negative correlations with resilience and social support. Factors affecting burnout were satisfaction with major-dissatisfaction, satisfaction with major-average, social support, grade, and relationship with peers. Satisfaction with major (dissatisfaction) had the greatest effect on burnout, explaining 41% of the total variance. CONCLUSION: According to this study, dissatisfaction with major was identified as the most significant factor influencing burnout of nursing students in clinical practice. Therefore, it is important to develop and implement programs that can reduce dissatisfaction with major and increase social support and relationship with peers in order to lower burnout of nursing students. In addition, a systemic management of fourth-grade students with a high level of clinical practice is necessary to reduce the level of clinical practice. The authors declared no conflict of interest.
Conflict of Interest ; Humans ; Nursing ; Resilience, Psychological ; Students, Nursing

Ceramide metabolism is known to be an essential etiology for various diseases, such as atopic dermatitis and Gaucher disease. Glucosylceramide synthase (GCS) is a key enzyme for the synthesis of glucosylceramide (GlcCer), which is a main ceramide metabolism pathway in mammalian cells. In this article, we developed a liquid chromatography-tandem mass spectrometry (LC-MS/MS) method to determine GCS activity using synthetic non-natural sphingolipid C8-ceramide as a substrate. The reaction products, C8-GlcCer for GCS, could be separated on a C18 column by reverse-phase high-performance liquid chromatography (HPLC). Quantification was conducted using the multiple reaction monitoring (MRM) mode to monitor the precursor-to-product ion transitions of m/z 588.6 → 264.4 for C8-GlcCer at positive ionization mode. The calibration curve was established over the range of 0.625–160 ng/mL, and the correlation coefficient was larger than 0.999. This method was successfully applied to detect GCS in the human hepatocellular carcinoma cell line (HepG2 cells) and mouse peripheral blood mononuclear cells. We also evaluated the inhibition degree of a known GCS inhibitor 1-phenyl-2-decanoylamino-3-morpholino-1-propanol (PDMP) on GCS enzymatic activity and proved that this method could be successfully applied to GCS inhibitor screening of preventive and therapeutic drugs for ceramide metabolism diseases, such as atopic dermatitis and Gaucher disease.
Animals ; Calibration ; Carcinoma, Hepatocellular ; Cell Line ; Chromatography, Liquid ; Dermatitis, Atopic ; Gaucher Disease ; Humans ; Mass Screening ; Mass Spectrometry ; Metabolism ; Methods ; Mice

PURPOSE: We investigated whether irinotecan plus capecitabine improved progression-free survival (PFS) compared with capecitabine alone in patients with human epidermal growth factor 2 (HER2) negative and anthracycline and taxane pretreated metastatic breast cancer (MBC). MATERIALS AND METHODS: A total of 221 patients were randomly assigned to irinotecan (80 mg/m2, days 1 and 8) and capecitabine (1,000 mg/m2 twice a day, days 1-14) or capecitabine alone (1,250 mg/m2 twice a day, days 1-14) every 3 weeks. The primary endpoint was PFS. RESULTS: There was no significant difference in PFS between the combination and monotherapy arm (median, 6.4 months vs. 4.7 months; hazard ratio [HR], 0.84; 95% confidence interval [CI], 0.63 to 1.11; p=0.84). In patients with triple-negative breast cancer (TNBC, n=90), the combination significantly improved PFS (median, 4.7 months vs. 2.5 months; HR, 0.58; 95% CI, 0.37 to 0.91; p=0.02). Objective response rate was numerically higher in the combination arm, though it failed to reach statistical significance (44.4% vs. 33.3%, p=0.30). Overall survival did not differ between arms (median, 20.4 months vs. 24.0 months; p=0.63). While grade 3 or 4 neutropenia was more common in the combination arm (39.6% vs. 9.0%), hand-foot syndrome was more often observed in capecitabine arm. Quality of life measurements in global health status was similar. However, patients in the combination arm showed significantly worse symptom scales especially in nausea/vomiting and diarrhea. CONCLUSION: Irinotecan plus capecitabine did not prove clinically superior to single-agent capecitabine in anthracycline- and taxane-pretreated HER2 negative MBC patients. Toxicity profiles of the two groups differed but were manageable. The role of added irinotecan in patients with TNBC remains to be elucidated.
Arm ; Breast Neoplasms* ; Breast* ; Capecitabine* ; Diarrhea ; Disease-Free Survival ; Epidermal Growth Factor ; Global Health ; Hand-Foot Syndrome ; Humans ; Neutropenia ; Quality of Life ; Triple Negative Breast Neoplasms ; Weights and Measures