Background: This study aimed to investigate the recent prevalence, management, and comorbidities of diabetes among Korean adults aged ≥30 years by analyzing nationally representative data. Methods: This study used data from the Korea National Health and Nutrition Examination Survey from 2016 to 2018, and the percentage and total number of people ≥30 years of age with diabetes and impaired fasting glucose (IFG) were estimated. Results: In 2018, 13.8% of Korean adults aged ≥30 years had diabetes, and adults aged ≥65 years showed a prevalence rate of 28%. The prevalence of IFG was 26.9% in adults aged ≥30 years. From 2016 to 2018, 35% of the subjects with diabetes were not aware of their condition. Regarding comorbidities, 53.2% and 61.3% were obese and hypertensive, respectively, and 72% had hypercholesterolemia as defined by low-density lipoprotein cholesterol (LDL-C) ≥100 mg/dL in people with diabetes. Of the subjects with diabetes, 43.7% had both hypertension and hypercholesterolemia. With regard to glycemic control, only 28.3% reached the target level of <6.5%. Moreover, only 11.5% of subjects with diabetes met all three targets of glycosylated hemoglobin, blood pressure, and LDL-C. The percentage of energy intake from carbohydrates was higher in diabetes patients than in those without diabetes, while that from protein and fat was lower in subjects with diabetes. Conclusion The high prevalence and low control rate of diabetes and its comorbidities in Korean adults were confirmed. More stringent efforts are needed to improve the comprehensive management of diabetes to reduce diabetes-related morbidity and mortality.

The Committee of Clinical Practice Guidelines of the Korean Diabetes Association (KDA) updated the previous clinical practice guidelines for Korean adults with diabetes and prediabetes and published the seventh edition in May 2021. We performed a comprehensive systematic review of recent clinical trials and evidence that could be applicable in real-world practice and suitable for the Korean population. The guideline is provided for all healthcare providers including physicians, diabetes experts, and certified diabetes educators across the country who manage patients with diabetes or the individuals at the risk of developing diabetes mellitus. The recommendations for screening diabetes and glucose-lowering agents have been revised and updated. New sections for continuous glucose monitoring, insulin pump use, and non-alcoholic fatty liver disease in patients with diabetes mellitus have been added. The KDA recommends active vaccination for coronavirus disease 2019 in patients with diabetes during the pandemic. An abridgement that contains practical information for patient education and systematic management in the clinic was published separately.

The Committee of Clinical Practice Guidelines of the Korean Diabetes Association (KDA) updated the previous clinical practice guidelines for Korean adults with diabetes and prediabetes and published the seventh edition in May 2021. We performed a comprehensive systematic review of recent clinical trials and evidence that could be applicable in real-world practice and suitable for the Korean population. The guideline is provided for all healthcare providers including physicians, diabetes experts, and certified diabetes educators across the country who manage patients with diabetes or the individuals at the risk of developing diabetes mellitus. The recommendations for screening diabetes and glucose-lowering agents have been revised and updated. New sections for continuous glucose monitoring, insulin pump use, and non-alcoholic fatty liver disease in patients with diabetes mellitus have been added. The KDA recommends active vaccination for coronavirus disease 2019 in patients with diabetes during the pandemic. An abridgement that contains practical information for patient education and systematic management in the clinic was published separately.

Purpose: We evaluated the efficacy and safety of pembrolizumab in patients with recurrent gynecologic cancers in real-world practice. Materials and Methods: We conducted a retrospective, single-institution study of patients with recurrent gynecologic malignancies treated with pembrolizumab. The primary endpoints were the objective response rate (ORR) and safety. Results: Thirty-one patients treated with pembrolizumab were included. The primary disease sites were the uterine cervix (n=18), ovaries (n=8), and uterine corpus (n=5). Fifteen of the 31 patients (48%) had an Eastern Cooperative Oncology Group performance status of ≥2. The median number of prior chemotherapy lines was 2 (range, 1–6), and 14 of 31 patients (45%) had received ≥ 3 prior lines of chemotherapy. The overall ORR was 22.6%: specifically, 22.3% (4 of 18 patients), 12.5% (1 of 8 patients), and 40% (2 of 5 patients) for cervical, ovarian, and endometrial cancers, respectively. During a median follow-up of 4.7 months (range, 0.2–35.3), the median time to response was 1.9 months (range, 1.4–5.7). The median duration of response was not reached (range, 8.8-not reached).The median progression-free survival was 2.5 months (95% confidence interval, 1.7-not reached). Adverse events occurred in 20 patients (64.5%), and only 3 (9.7%) were grade ≥3. There was one case of suspicious treatment-related mortality, apart from which most adverse events were manageable. Conclusion In real-world practice, pembrolizumab was feasible and effective in heavily treated recurrent gynecologic cancer patients with poor performance status who may not be eligible for enrollment in clinical trials.

PURPOSE: The purpose of the study is to identify the effects of worker's stair-climbing on blood pressure, lipid profiles, and physical fitness. METHODS: After recruiting 114 healthy adult women aged 20 to 64 years who have had sedentary for more than 3 months, we divided into two groups: the stair group (SG, n=57) and control group (CG, n=57). SG was supposed to do stair-climbing in daily life like workplace and home for 12 weeks. To investigate the effects of the lifestyle changing of stair-climbing, resting blood pressure, heart rate (HR), and lipid profiles were measured before and after 12-week stair-climbing. Also, physical fitness items such as peak oxygen consumption (VO2peak), back muscle strength, sit and reach, isokinetic strength of knee joint, static and dynamic balance were measured. RESULTS: As a result of the 12-week lifestyle changing of stair-climbing, resting systolic blood pressure (SBP; p < 0.05) and HR (p < 0.01) were significantly decreased in SG. Low-density lipoprotein-cholesterol (LDL-C) was significantly reduced in SG (p < 0.05). There was a significant improvement in the VO2peak (p < 0.001). There were a significant improvement in back strength (p < 0.001) and bilateral knee extensor (60°/sec: p < 0.05, p < 0.01, 180°/sec: p < 0.01, p < 0.01) and knee flexor (180°/sec: p < 0.01, p < 0.05) of isokinetic strength. There were significant improvements in static balance of one leg standing eye-closed (p < 0.05) and dynamic balance of left/right velocity (p < 0.01), forward/backward velocity (p < 0.01). CONCLUSION: In this study, 12 weeks of lifestyle changing of stair-climbing improved SBP, resting HR, LDL-C, VO2peak, back and knee strength, static and dynamic balance as well as increased physical activity volume of stair-climbing in the daily living.
Adult ; Back Muscles ; Blood Pressure ; Female ; Heart Rate ; Humans ; Knee ; Knee Joint ; Leg ; Life Style ; Motor Activity ; Oxygen Consumption ; Physical Fitness

BACKGROUND: This study was undertaken to compare the outcome of supervised and home exercises with respect to range of motion (ROM), pain, and Single Assessment Numeric Evaluation (SANE). We further correlated the ROM recovery and pain reduction as well. METHODS: The study included 49 patients who underwent arthroscopic rotator cuff repair. Rehabilitation was initiated after 4 weeks of immobilization. A total of 29 patients performed supervised exercise 3 times a week. Standardized education and brochures for review were provided to the remaining 20 patients who insisted on home rehabilitation. Statistical analysis was performed for comparing pain Numerical Rating Scale (NRS), SANE, and ROM. In addition, we also evaluated the correlation between pain and ROM. RESULTS: Comparison of the two groups revealed no significant differences in forward flexion, internal rotation, abduction, and pain NRS. However, SANE at the 9th week (63.8 vs. 55.0, p=0.038) and improvement of external rotation from the 5th to the 9th week (17.6 vs. 9.3, p=0.018) were significantly higher in the supervised exercise group as compared to the home exercise group. Correlation of pain NRS with forward flexion, external rotation, internal rotation and abduction were statistically not significant (correlation coefficient=0.032 [p=0.828], −0.255 [p=0.077], 0.068 [p=0.642], and −0.188 [p=0.196], respectively). CONCLUSIONS: The supervised rehabilitation after arthroscopic rotator cuff repair showed better improvement in external rotation and higher SANE score after 4 weeks of rehabilitation exercise. However, no statistically significant correlation was observed between the recovery of ROM and short-term pain relief.
Education ; Exercise ; Humans ; Immobilization ; Pamphlets ; Range of Motion, Articular ; Rehabilitation ; Rotator Cuff ; Shoulder

PURPOSE: This study aimed to identify research trends in the Journal of Korean Academy of Nursing Administration from 2013 to 2015. METHODS: For this study, 171 articles were analyzed. Research designs, participants, research settings, sampling, and data analyses methods were reviewed using established analysis criteria. Keyword centrality and clusters were generated by keyword network analysis. RESULTS: Most of studies used quantitative methods (82.5%), and sampling mainly focused on nurses (68.8%). The most commonly used data analyses methods were t-test, ANOVA, correlation, and regression. The most central keywords were turnover and empowerment. Network analysis generated four network groups: 1) burnout; 2) turnover; 3) happiness; and 4) nursing professionalism. CONCLUSION: The results of this study identify current trends and interests in Korean nursing administration research. The findings from this study suggest that future studies include a variety of research methods and maintain appropriate research ethics.
Ethics, Research ; Happiness ; Nursing Administration Research ; Nursing Research ; Nursing* ; Power (Psychology) ; Professionalism ; Research Design ; Statistics as Topic

Compared with biochemical information available about the diseases in the central nervous system, that for peripheral neuropathy is quite limited primarily due to the difficulties in obtaining samples. Characterization of the core pathology is a prerequisite to the development of personalized medicine for genetically heterogeneous diseases, such as hereditary motor and sensory neuropathy (HMSN). Here, we first documented the transcriptome profile of distal sural nerve obtained from HMSN patients. RNA-seq analysis revealed that over 12,000 genes are expressed in distal sural nerve. Among them 4,000 transcripts are novel and 10 fusion genes per sample were observed. Comparing dataset from whole exome sequencing revealed that over 1,500 transcriptional base modifications occur during transcription. These data implicate that dynamic alterations are generated when genetic information are transitioned in distal sural nerve. Although, we could not find significant alterations associated with HMSN, these data might provide crucial information about the pathophysiology of HMSN. Therefore, next step in the development of therapeutic strategy for HMSN might be unveiling biochemical and biophysical abnormalities derived from those potent variation.
Central Nervous System ; Dataset ; Exome ; Gene Expression Profiling* ; Hereditary Sensory and Motor Neuropathy ; Humans ; Pathology ; Peripheral Nervous System Diseases ; Sural Nerve* ; Transcriptome ; Precision Medicine

OBJECTIVE: To investigate whether natural killer (NK) cell and autoimmune antibody acts synergistically, by the action of autoantibodies to increase NK cell number and cytotoxicity, to decrease uterine blood flow during early pregnancy in pregnant women with a history of recurrent spontaneous abortion (RSA). METHODS: Seventy-five pregnant women (between 5 and 7 weeks gestation) with a history of unexplained RSA were included in the study group. Forty-one pregnant women without a history of RSA were included as controls. All women with a history of RSA were tested for autoantibodies and number of peripheral blood natural killer (pbNK) cell by flow cytometry. Study populations were stratified into four groups by existence of autoantibody and degree of increase of pbNK cells. The uterine radial artery resistance index (RI) was measured by color-pulsed Doppler transvaginal ultrasound. RESULTS: The mean RI of the autoimmune antibody-positive (AA+) group (0.63+/-0.09) was significantly higher than that of the normal control group (0.53+/-0.10, P=0.001). The mean RI of the AA+/only-NK elevated (eNK) group (0.63+/-0.09) was significantly higher than those of the only-AA+ group (0.55+/-0.07, P=0.019) and the only-eNK group (0.57+/-0.07, P=0.021). CONCLUSION: Concurrent elevation in NK cells and autoimmunity results in decreased uterine blood flow during early pregnancy. However, the majority of cases of RSA remain unexplained and larger scale studies are needed to confirm our conclusion and to develop diagnostic and therapeutic plans for women with a history of RSA.
Abortion, Spontaneous ; Autoantibodies ; Autoimmunity* ; Female ; Flow Cytometry ; Humans ; Killer Cells, Natural* ; Pregnancy* ; Pregnant Women ; Radial Artery ; Ultrasonography

BACKGROUND: We studied the differences in airway assessment factors among old, middle, and young age groups, and evaluated the frequency and causes of difficult intubation among these groups. METHODS: Patients were divided into young (< 40 yr, n = 75 ), middle (40-59 yr, n = 83), and old (> or = 60 yr, n = 89) group. Airway assessment factors such as head and neck movement, thyromental distance, interincisor gap, dentition, Mallampati score, and Arne score were assessed. After muscle relaxation, cervical joint rigidity and Cormack-Lehane (C-L) grade were assessed. The differences in airway assessment factors between difficult (C-L grade 3, 4) and easy (C-L grade 1, 2) intubation were then examined. Logistic regression analysis was also carried out to identify the extent to which airway assessment factors reflected difficult intubation. RESULTS: As aging, head and neck movement, thyromental distance, and interincisor gap decreased, the grade of dentition, Mallampati score, cervical joint rigidity and the ratio of Arne score > 11 increased. In the old and middle group, the incidence of difficult intubation was increased compared with the young group. Dentition in the young group, Mallampati score and interinsisor gap in the middle group and Mallampati score, cervical joint rigidity in the old group respectively predicted difficult intubation. CONCLUSIONS: Compared to young individuals, middle-aged or elderly adults are likely to experience more difficulty in endotracheal intubation and its predictive factors could vary by age group.
Adult ; Aged ; Aging ; Dentition ; Head ; Humans ; Incidence ; Intubation ; Intubation, Intratracheal ; Joints ; Laryngoscopy ; Logistic Models ; Muscle Relaxation ; Neck