BACKGROUND: Metabolic syndrome (MetS) is a known predictor of diabetes mellitus (DM), but whether longitudinal changes in MetS status modify the risk for DM remains unclear. We investigated whether changes in MetS status over 2 years modify the 10-year risk of incident DM. METHODS: We analyzed data from 7,317 participants aged 40 to 70 years without DM at baseline, who took part in 2001 to 2011 Korean Genome Epidemiology Study. Subjects were categorized into four groups based on repeated longitudinal assessment of MetS status over 2 years: non-MetS, resolved MetS, incident MetS, and persistent MetS. The hazard ratio (HR) of new-onset DM during 10 years was calculated in each group using Cox models. RESULTS: During the 10-year follow-up, 1,099 participants (15.0%) developed DM. Compared to the non-MetS group, the fully adjusted HRs for new-onset DM were 1.28 (95% confidence interval [CI], 0.92 to 1.79) in the resolved MetS group, 1.75 (95% CI, 1.30 to 2.37) in the incident MetS group, and 1.98 (95% CI, 1.50 to 2.61) in the persistent MetS group (P for trend <0.001). The risk of DM in subjects with resolved MetS was significantly attenuated compared to those with persistent MetS over 2 years. In addition, the adjusted HR for 10-year developing DM gradually increased as the number of MetS components increased 2 years later. CONCLUSION: We found that discrete longitudinal changes pattern in MetS status over 2 years associated with 10-year risk of DM. These findings suggest that monitoring change of MetS status and controlling it in individuals may be important for risk prediction of DM.
Diabetes Mellitus ; Epidemiology ; Follow-Up Studies ; Genome ; Life Style ; Proportional Hazards Models

BACKGROUND AND OBJECTIVES: We compared the efficacy and safety of valsartan and rosuvastatin combination therapy with each treatment alone in hypercholesterolemic hypertensive patients. SUBJECTS AND METHODS: Patients who met inclusion criteria were randomized to receive 1 of the following 2-month drug regimens: valsartan 160 mg plus rosuvastatin 20 mg, valsartan 160 mg plus placebo, or rosuvastatin 20 mg plus placebo. The primary efficacy variables were change in sitting diastolic blood pressure (sitDBP) and sitting systolic blood pressure (sitSBP), and percentage change in low-density lipoprotein-cholesterol (LDL-C) in the combination, valsartan, and rosuvastatin groups. Adverse events (AEs) during the study were analyzed. RESULTS: A total of 354 patients were screened and 123 of them were finally randomized. Changes of sitDBP by least squares mean (LSM) were -11.1, -7.2, and -3.6 mm Hg, respectively, and was greater in the combination, as compared to both valsartan (p=0.02) and rosuvastatin (p<0.001). Changes of sitSBP by LSM were -13.2, -10.8, and -4.9 mm Hg, and was greater in the combination, as compared to rosuvastatin (p=0.006) and not valsartan (p=0.42). Percentage changes of LDL-C by LSM were -52, -4, and -47% in each group, and was greater in the combination, as compared to valsartan (p<0.001), similar to rosuvastatin (p=0.16). Most AEs were mild and resolved by the end of the study. CONCLUSION: Combination treatment with valsartan and rosuvastatin exhibited an additive blood pressure-lowering effect with acceptable tolerability, as compared to valsartan monotherapy. Its lipid lowering effect was similar to rosuvatatin monotherapy.
Blood Pressure ; Drug Therapy, Combination ; Humans ; Least-Squares Analysis ; Rosuvastatin Calcium ; Valsartan

In this article, on page 230, Fig. 2A needs to be corrected.

PURPOSE: Malignant lymphoma arising from mucosa-associated lymphoid tissue (MALT) accounts for a large proportion of a extranodal lymphomas. The stomach is the preferential site of MALT lymphoma, and the pathogenesis of a gastric MALT lymphoma is known to be closely related to Helicobacter pylori infection. Epigenetic silencing of tumor- related genes due to CpG island methylation, has recently been reported in B cell lymphomas, but its role in gastric lymphomas is unclear. METHODS: We analyzed the methylation status of cell cycle control (p16), apoptosis regulation (Death-associated protein kinase, DAPK) and DNA mismatch repair (MGMT, hMLH1, and hMSH3) genes using a methylation-specific polymerase chain reaction in 46 low- and high-grade gastric lymphomas, pathologically documented at Chonnam National University Hospital, between January 1999 and August 2004. RESULTS: Methylation of p16, DAPK, and MGMT was more frequent in the high- than in the low-grade lymphomas (80, 80 and 93 vs. 71, 74 and 84%, respectively). Methylation of hMLH1 and hMSH3 was rare or absent. There was no difference in frequencies of CIMP between the low- and high-grade gastric lymphomas. Of the 46 gastric lymphoma cases, compared with matched normal gastric mucosa, five had an MSI-low phenotype, with two and three in the low- and high-grade lymphomas, respectively. CONCLUSION: Methylation of p16, DAPK, and MGMT may represent a major pathogenetic event in gastric lymphomas, which may contribute to the early tumorigenesis and have clinical applications in the management and follow-up of low and high grade gastric lymphomas.
Apoptosis ; Carcinogenesis ; Cell Cycle Checkpoints ; CpG Islands ; DNA Mismatch Repair ; Epigenomics ; Gastric Mucosa ; Helicobacter pylori ; Jeollanam-do ; Lymphoid Tissue ; Lymphoma* ; Lymphoma, B-Cell ; Lymphoma, B-Cell, Marginal Zone ; Lymphoma, Non-Hodgkin ; Methylation* ; Phenotype ; Polymerase Chain Reaction ; Protein Kinases ; Stomach

PURPOSE: To determine the incidence, characteristics and outcomes of newborns with congenital heart disease (CHD) developed necrotizing enterocolitis (NEC), and to find various risk factors leading into NEC among newborns with CHD. METHODS: Cardiac diagnosis, age at admission were analyzed for NEC among 508 patients with CHD during January 1997 to December 2002 at Asan Medical Center. Retrospective case control study was undertaken by comparing various demographic variables between those newborns developed NEC and control newborns with CHD did not develop NEC during hospitalization. RESULTS: The incidence of all stages of NEC among newborns with CHD was 6.3%. 25% of those newborns who developed NEC had CHD. The mean gestational age, birth weight for NEC and control groups were 37.7+/-3.5 weeks, 2, 560+/-700 g and 37.6+/-2.3 weeks, 2600+/-1200 g respectively. The severity of NEC, in order, according to Modified Bell's Criteria revealed stage IB (35%) followed by stage 1A (26%), stage IIB (18%), stage IIA (9%), IIIA (9%), and IIIB (3%). The mortality in NEC group was 5/23 (21.7 %). Potential risk factors associated with developement of NEC among newborns with CHD included failure to make prenatal diagnosis of CHD, perinatal complications, requirement of Prostaglandin E1, anemia, sepsis and increased incidence of hemodynamic instability as evidenced by low cardiac output and increased desaturations. Of 23 newborns who developed NEC, excluding 9 premature infants with PDA, 55% had acynotic CHD compared to 45% cyanotic heart disease. CONCLUSION: Awareness of increased risk of NEC among newborns with CHD especially those with potential risk factors is essential to improve their outcomes.
Alprostadil ; Anemia ; Birth Weight ; Cardiac Output, Low ; Case-Control Studies ; Chungcheongnam-do ; Diagnosis ; Enterocolitis, Necrotizing* ; Gestational Age ; Heart Defects, Congenital* ; Heart Diseases ; Hemodynamics ; Hospitalization ; Humans ; Incidence ; Infant, Newborn* ; Infant, Premature ; Mortality ; Prenatal Diagnosis ; Retrospective Studies ; Risk Factors ; Sepsis

Cardiac surgery in the neonate with congenital heart disease has progressed dramatically in the past three decades. However, low-birth-weight premie with congenital heart disease continue to challenge the intellectual and technical skills of those who care for them. We report a case of successful arterial switch operation in 1140 g premie with TGA, IVS after 4 week care 1317 gm.
Heart Defects, Congenital ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Thoracic Surgery ; Transposition of Great Vessels

While endovascular aneurysm repair (EVAR) is prevailing for the treatment of abdominal aortic aneurysm (AAA) in modern vascular practice, PURPOSE: we conducted nationwide questionnaire survey to investigate the current status of AAA treatment and their results in Korea. METHOD: We reviewed the replies from 28 hospitals (33 departments) to the questionnaire inquiring annual number, clinical features, mode of treatment and results of AAA patients during the period from Jan. 2000 to Jul. 2004. Results: 980 AAA patients were reported including 292 ruptured AAA (29.8%) and 688 non-ruptured AAA (70.2%). For treatment of AAA, 834 (85.1%) surgical repairs (SRs) and 111 (11.3%) endovascualr aneurysm repairs (EVARs) were performed while 35 patients (3.6%) died of AAA rupture before operation. The locations of AAA were infrarenal in 889 (90.7%), juxtarenal in 62 (6.3%), and suprarenal in 29 patients (3.0%). Among 834 patients undergoing SR, 577 patients (69.2%) had non-ruptured AAAs and 257 patients (30.8%) had ruptured AAAs. Mean operative mortality rate was 4.1% after elective SRs, 30.7% after SR for ruptured AAAs, and 2.3% after EVARs. The reported brand name of stent graft devices were various including domestic custom-made in 56 (50.5%), imported brand in 18 (16.2%) while 37 (33.3%) stent grafts were not reported their brand name. The frequencies of type I and III endoleaks after EVAR were reported 5.8% and 5.8% respectively in 86 patients with an available data. CONCLUSION: SR has been used as a major treatment option in Korea for the treatment of AAA patients while EVAR is increasing. The mortality rate of SR of AAA was comparable to western multi-center trial reports but mortality or morbidity rates of EVAR were unable to know in this questionnaire survey.
Aneurysm ; Aortic Aneurysm ; Aortic Aneurysm, Abdominal* ; Blood Vessel Prosthesis ; Endoleak ; Humans ; Korea* ; Mortality ; Questionnaires* ; Rupture ; Treatment Outcome

Anomalous left pulmonary artery(pulmonary artery sling) is a congenital anomaly in which the vascular structure arises either from the posterior surface of the right pulmonary artery, or from the main pulmonary artery and courses to the left lung between the posterior surface of the trachea and the anterior surface of the esophagus. It may compress on the tracheobronchial tree causing significant symptoms on the part of the respiratory system such as dyspnea, stridor, or cyanosis. It is a rare condition leading to death in the first months of life, if it is not corrected. We present a case of pulmonary sling who was suffering from recurrent lower respiratory tract diseases, expiratory wheezing, and intermittent dyspnea since birth, thus she was treated for bronchial asthma. We confirmed the diagnosis with computerized tomography, especially with three dimensional reconstruction, which provided information regarding the spatial relationship between the anomalous pulmonary artery branch and the trachea and bronchi.
Arteries ; Asthma* ; Bronchi ; Cyanosis ; Diagnosis ; Dyspnea ; Esophagus ; Lung ; Parturition ; Pulmonary Artery* ; Respiratory Sounds ; Respiratory System ; Respiratory Tract Diseases ; Trachea

OBJECTIVE: To assess the clinical efficacy and safety of meloxicam 7.5mg versus diclofenac 100mg slow release (SR) in the Korean patients with osteoarthritis of the knee. METHODS: Ninety-one patients of four university hospitals in 1999 were randomized to receive once daily oral meloxicam 7.5mg (N=45) or diclofenac 100mg SR (N=46) for 8 weeks. Clinical efficacy was evaluated using 100mm Visual Analogue Scale (VAS) for pain, Lequesne index after 4, 8 weeks of treatment as well as the physician? and patient? global assessment at the end of treatment. Evaluations for clinical safety were performed using the incidence of adverse events, physical examinations, laboratory finding and total ingestion of antacid during the treatment. RESULTS: After 8 weeks of therapy, both groups had significant improvement in 100mm VAS and Lequesne index than baseline although the difference between two groups did not reach statistical significance. The physician? and patient's global assessment were similar in two groups. The incidence of gastrointestinal adverse events was significantly lower in meloxicam group (24.4%) than diclofenac group (50.0%)(p<0.05). CONCLUSION: Meloxicam 7.5mg is comparable to diclofenac 100mg SR in the treatment of Korean patients with osteoarthritis of the knee. Furthermore meloxicam 7.5mg was well tolerated for 8 weeks and has safe advantage of a significantly lower incidence of gastrointestinal adverse events.
Diclofenac* ; Eating ; Hospitals, University ; Humans ; Incidence ; Knee* ; Osteoarthritis* ; Physical Examination

OBJECTIVE: To assess the clinical efficacy and safety of meloxicam 7.5mg versus diclofenac 100mg slow release (SR) in the Korean patients with osteoarthritis of the knee. METHODS: Ninety-one patients of four university hospitals in 1999 were randomized to receive once daily oral meloxicam 7.5mg (N=45) or diclofenac 100mg SR (N=46) for 8 weeks. Clinical efficacy was evaluated using 100mm Visual Analogue Scale (VAS) for pain, Lequesne index after 4, 8 weeks of treatment as well as the physician? and patient? global assessment at the end of treatment. Evaluations for clinical safety were performed using the incidence of adverse events, physical examinations, laboratory finding and total ingestion of antacid during the treatment. RESULTS: After 8 weeks of therapy, both groups had significant improvement in 100mm VAS and Lequesne index than baseline although the difference between two groups did not reach statistical significance. The physician? and patient's global assessment were similar in two groups. The incidence of gastrointestinal adverse events was significantly lower in meloxicam group (24.4%) than diclofenac group (50.0%)(p<0.05). CONCLUSION: Meloxicam 7.5mg is comparable to diclofenac 100mg SR in the treatment of Korean patients with osteoarthritis of the knee. Furthermore meloxicam 7.5mg was well tolerated for 8 weeks and has safe advantage of a significantly lower incidence of gastrointestinal adverse events.
Diclofenac* ; Eating ; Hospitals, University ; Humans ; Incidence ; Knee* ; Osteoarthritis* ; Physical Examination