Only few studies have shown the efficacy and safety of glucose-control strategies using the quadruple drug combination. Therefore, the aim of the present study was to investigate the usefulness of the quadruple combination therapy with oral hypoglycemic agents (OHAs) in patients with uncontrolled type 2 diabetes mellitus (T2DM).

Only few studies have shown the efficacy and safety of glucose-control strategies using the quadruple drug combination. Therefore, the aim of the present study was to investigate the usefulness of the quadruple combination therapy with oral hypoglycemic agents (OHAs) in patients with uncontrolled type 2 diabetes mellitus (T2DM).

Background: Only few studies have shown the efficacy and safety of glucose-control strategies using the quadruple drug combination. Therefore, the aim of the present study was to investigate the usefulness of the quadruple combination therapy with oral hypoglycemic agents (OHAs) in patients with uncontrolled type 2 diabetes mellitus (T2DM). Methods: From March 2014 to December 2018, data of patients with T2DM, who were treated with quadruple hypoglycemic medications for over 12 months in 11 hospitals in South Korea, were reviewed retrospectively. We compared glycosylated hemoglobin (HbA1c) levels before and 12 months after quadruple treatment with OHAs. The safety, maintenance rate, and therapeutic patterns after failure of the quadruple therapy were also evaluated. Results: In total, 357 patients were enrolled for quadruple OHA therapy, and the baseline HbA1c level was 9.0%±1.3% (74.9± 14.1 mmol/mol). After 12 months, 270 patients (75.6%) adhered to the quadruple therapy and HbA1c was significantly reduced from 8.9%±1.2% to 7.8%±1.3% (mean change, –1.1%±1.2%; P<0.001). The number of patients with HbA1c <7% increased significantly from 5 to 68 (P<0.005). In addition, lipid profiles and liver enzyme levels were also improved whereas no changes in body weight. There was no significant safety issue in patients treated with quadruple OHA therapy. Conclusion This study shows the therapeutic efficacy of the quadruple OHA regimen T2DM and demonstrates that it can be an option for the management of T2DM patients who cannot use insulin or reject injectable therapy.

Classical swine fever (CSF), previously known as hog cholera, remains one of the most important swine-related contagious diseases worldwide. In order to eradicate classical swine fever virus (CSFV), it is commonly used in LOM-850 strain as a live attenuated CSF vaccine. However, there are symptoms of vaccination, such as the depression of feed intake, and difficulty of differentiation between infected and vaccinated hosts is impossible based on the antibodies induced. Nicotiana benthamiana were considered as an alternative to the production of recombinant vaccines on account of higher yields and levels of soluble protein than other models and crops in protein recombinant products. This study was conducted to evaluate histopathological validation of the plant-produced E2 fusion protein (ppE2) in piglets. The piglets were challenged by an injection of YC11WB strain in 7 days, 11 days and 14 days after one shot of the vaccination. The histopathological examination indicated that ppE2 can protect against lethal CSFV challenge at least 11 days of vaccination in piglets. These data suggest that the ppE2 can be an effective vaccine against CSFV in piglets.
Animals ; Antibodies ; Classical swine fever virus ; Classical Swine Fever ; Depression ; Swine ; Tobacco ; Vaccination ; Vaccines, Synthetic

OBJECTIVES: The aim of this research was to determine intra-oral factors that affect halitosis in young women. METHODS: This study was performed between March 2014 to May 2014, and included 35 women in their 20s with good oral health. Correlation and logistic regression analyses were performed to investigate the change in halitosis immediately, and 1 hour after scaling. RESULTS: In both oral gas (OG) and extraoral gas (EG) groups, halitosis was reduced after scaling compared to before scaling. The logistic regression analysis of oral state factors in OG showed that as oral fluid [odds ratio (OR) = 0.792, p = 0.045] and dental plaque (OR = 0.940, p = 0.016) decreased by 1 unit, the OR in the OG group decreased (> 50). In addition, as glucose levels in the oral cavity (OR = 1.245, p = 0.075) and tongue coating index (OR = 2.912, p = 0.064) increased by 1 unit, the OR in the OG group increased (> 50). Furthermore, in the EG group, as oral fluid (OR = 0.66, p = 0.01) and dental plaque (OR = 0.95, p = 0.04) decreased, the OR in the EG group decreased (> 50) significantly. CONCLUSION: To control halitosis, it is necessary to increase oral fluid and decrease the amount of tongue plaque. Furthermore, maintaining a healthy oral environment, aided by regular scaling and removal of dental plaque, may significantly control halitosis.
Dental Plaque ; Female ; Glucose ; Halitosis* ; Humans ; Logistic Models ; Mouth ; Oral Health ; Tongue

N-terminal pro-brain natriuretic peptide (NT-proBNP) is a well-known biomarker for the diagnosis and prognosis of heart failure, and is directly associated with myocardial dysfunction. We evaluated the prognostic value of NT-proBNP for major adverse cardiac events (MACEs) among patients with non-ST-segment elevation myocardial infarction (NSTEMI) from the Korea Acute Myocardial Infarction Registry during their mid-term follow-up period. In this paper, we analyzed NT-proBNP according to various MACE and level of NT-proBNP. We used multivariate logistic regression to determine the risk factors according to MACE type and NT-proBNP levels, and to identify the cutoff value for each MACE by using the receiver operating characteristic (ROC) curve. NT-proBNP was a significant variable among cardiac deaths (p = 0.016), myocardial infarction (p = 0.000), and coronary artery bypass grafting (CABG) (p = 0.000) in patients with MACE compared with those without MACE. Two-vessel coronary artery disease (CAD) (p = 0.037) and the maximum creatinine kinase (max-CK) (p = 0.031) produced significant results in repeat percutaneous coronary intervention. The area under the ROC curve was found to be statistically significant for cardiac death and CABG. NT-proBNP is a useful predictor for 12-month MACEs among patients with NSTEMI and in those with heart failure. We propose that a new index incorporating NT-proBNP, max-CK, and CAD vessel will be useful as a prognostic indicator of MACEs in the future.
Coronary Artery Bypass ; Coronary Artery Disease ; Creatinine ; Death ; Diagnosis ; Follow-Up Studies ; Heart Diseases ; Heart Failure ; Humans ; Korea ; Logistic Models ; Myocardial Infarction* ; Percutaneous Coronary Intervention ; Phosphotransferases ; Prognosis ; Risk Factors ; ROC Curve

Background The clinical significance of complete revascularization for ST segment elevation myocardial infarction (STEMI) pa-tients during admission is still debatable. Methods A total of 1406 STEMI patients from the Korean Myocardial Infarction Registry with multivessel diseases without cardiogenic shock who underwent primary percutaneous coronary intervention (PPCI) were analyzed. We used propensity score matching (PSM) to control differences of baseline characteristics between culprit only intervention (CP) and multivessel percutaneous coronary interventions (MP), and between double vessel disease (DVD) and triple vessel disease (TVD). The major adverse cardiac event (MACE) was analyzed for one year after discharge. Results TVD patients showed higher incidence of MACE (14.2%vs. 8.6%, P=0.01), any cause of revascularization (10.6%vs. 5.9%, P=0.01), and repeated PCI (9.5%vs. 5.7%, P=0.02), as compared to DVD patients during one year after discharge. MP reduced MACE effectively (7.3%vs. 13.8%, P=0.03), as compared to CP for one year, but all cause of death (1.6%vs. 3.2%, P=0.38), MI (0.4%vs. 0.8%, P=1.00), and any cause of revascularization (5.3%vs. 9.7%, P=0.09) were comparable in the two treatment groups. Conclusions STEMI patients with TVD showed higher rate of MACE, as compared to DVD. MP performed during PPCI or ad hoc during admission for STEMI patients without cardiogenic shock showed lower rate of MACE in this large scaled database. Therefore, MP could be considered as an effective treatment option for STEMI patients without cardiogenic shock.

Fine-needle aspiration cytology (FNAC) cannot differentiate follicular adenoma from follicular carcinoma since this distinction can only be based on the presence of capsular or vascular invasion, and this cannot be detected on a cytologic smear. The goal of this study was to define the diagnostic cytologic findings of follicular neoplasm and the possibility of diagnosing follicular neoplasm by performing FNAC. The cases of histologically diagnosed follicular adenoma and follicular carcinoma on the thyroidectomy specimens were retrieved. Among them, the cases with preoperative FNAC that was done within 3 months of the operation were finally selected. Then we reviewed the FNAC and histologic slides of 19 cases: 9 follicular adenomas and 10 follicular carcinomas. Our results suggest that for cases of follicular neoplasm, the aspirates show high or abundant cellularity, frequent follicle formation and occasional cellular atypism of the follicular cells. However, the atypism is more pronounced and more frequently noticed in the cases of follicular carcinoma, which reveals more higher anisocytosis (7/10, 70%), nuclear pleomorphism (9/10, 90%), coarse clumping of chromatin (8/10, 80%) and cellular overlapping (8/10, 80%).
Adenoma ; Biopsy, Fine-Needle ; Chromatin ; Thyroid Gland ; Thyroidectomy

PURPOSE: To analyze the learning objectives and test items for Fundamentals in Nursing which were established between 1999 and 2000 and to develop these items toward a nationwide faculty workshop for national board examination for Korean nurses. RESULTS: 1. According to Bloom's taxonomy, learning objectives established in 1999 mainly consisted of two domains, comprehension (56.1%), and knowledge (27.7%). The learning objectives established in 2000, mainly consisted of comprehension (45.2%) and application (25.4%). 2. According to McGuire's taxonomy, domain of test items established in 1999 consisted of recall (66.7%), interpretation (28.0%) and problem solving (4.9%). Domain of test items established in 2000, consisted of recall (65.1%), interpretation (22.0%) and problem solving (12.9%). 1) Department of Nursing, Chung-Ang University 2) College of Nursing, Yonsei University 3) College of Nursing, Seoul National University 4) Department of Nursing, Kyung-Hee University 5) College of Nursing, Ewha University 6) College of Nursing, The Catholic University of Korea(corresponding author, Email: sky@catholic.ac.kr) 7) National Medical Center Nursing College 8) Red Cross Nursing College 9) Department of Nursing, Gachun Gil College 3. The proportion of learning objectives in the knowledge and comprehension domains established in 200, decreased from 27.7% to 13.5%, and from 56.1% to 45.2% respectively over that of 1999. But the domain of application increased from 5.3% to 25.4% over that of 1999. 4. With regard to McGuire's taxonomy, the proportion for the recall and interpretation domains established in 2000 decreased from 66.7% to 65.1%, and from 28.0% to 22.0% respectively. But the proportion for the problem solving domain increased from 4.9% to 12.9% over that of 1999. For type of test items, the proportion of A type established in 2000 decreased from 47.2% to 37.6%, and K type increased from 52.1% to 60.8% over that of 1999. CONCLUSION: The learning objectives and test items established in 2000 showed remarkable improvement compared to those established in 1999. For better learning objectives and test items in Fundamentals of Nursing, further research is recommended on essential content and standardization of job analysis for national board examination for nurses in Korea.
Classification ; Comprehension ; Education ; Electronic Mail ; Korea* ; Learning* ; Nursing* ; Problem Solving ; Red Cross ; Seoul

PURPOSE: To clarify the morphological patterns of the extensor tendon and juncturae tendinum on the dorsum of the hand. MATERIALS AND METHODS: Fifty eight hands of cadavers were dissected to evaluate the morphological patterns of the extensor tendon and juncturae tendinum. RESULTS: The tendon of extensor indicis proprius and extensor digitorum communis (EDC) to the index finger arose and terminated at a single tendon. The EDC to the long finger arose as a single tendon, divided into two slips and then converged again to form a single tendon. The EDC to the ring finger arose as double tendons, divided into three or four slips and converged again into double tendons. The EDC to the little finger was usually absent (72%). The extensor digiti minimi arose and terminated as double tendons. The juncturae tendinum (JT) between the EDC tendons to the index finger and those to the long finger were of type I (thin filamentous type). The JT between EDC tendon to the long finger and those to the ring finger consisted of 16% in type I, 31% in type II (thick filamentous type) and 53% in type III (tendinous type). There were 14% of type II JT and 86% of type III JT between the ring and small fingers. CONCLUSION: A knowledge of both the usual and possible variations of the extensor tendon and the juncturae tendinum is useful in the identification and repair of these structures.
Cadaver ; Fingers ; Hand* ; Tendons*