The Committee of Clinical Practice Guidelines of the Korean Diabetes Association revised and updated the 6th Clinical Practice Guidelines in 2019. Targets of glycemic, blood pressure, and lipid control in type 2 diabetes mellitus (T2DM) were updated. The obese and overweight population is increasing steadily in Korea, and half of the Koreans with diabetes are obese. Evidence-based recommendations for weight-loss therapy for obesity management as treatment for hyperglycemia in T2DM were provided. In addition, evidence from large clinical studies assessing cardiovascular outcomes following the use of sodium-glucose cotransporter-2 inhibitors and glucagon-like peptide 1 receptor agonists in patients with T2DM were incorporated into the recommendations.
Blood Pressure ; Diabetes Mellitus, Type 2 ; Diagnosis ; Glucagon-Like Peptide 1 ; Humans ; Hyperglycemia ; Korea ; Obesity ; Overweight

OBJECTIVE: Bilateral cavernous sinus dural arteriovenous fistula (CSdAVF) is very rare, even in Asian countries. The research intended to present clinical and radiologic outcomes of treating such fistulas through endovascular embolization. MATERIALS AND METHODS: Data was obtained from 220 consecutive patients, with CSdAVF, who were treated from January 2004 to December 2015. Bilateral CSdAVF was identified in 17 patients (7.7%). The clinical and radiologic outcomes of the fistulas were assessed with an emphasis on the technical aspects of treatment. RESULTS: At the time of treatment, 7 and 10 patients presented with bilateral and unilateral symptoms, respectively. In the former cases, 4 patients had progressed from unilateral to bilateral symptoms. Bilateral fistulas were treated with a single-stage transvenous embolization (TVE) in 15 patients, via bilateral inferior petrosal sinuses (IPS) (n = 9) and unilateral IPS (n = 6). In the other 2 patients with one-sided dominance of shunting, only dominant fistula was treated. Two untreated lesions were found on follow-up to have spontaneously resolved after treatment of the dominant contralateral fistula. Of the 34 CSdAVF lesions, complete occlusion was achieved in 32 lesions after TVE. Seven patients (41.2%) developed worsening of cranial nerve palsy after TVE. During the follow-up period, 4 patients obtained complete recovery, whereas the other 3 remained with deficits. CONCLUSION: With adjustments of endovascular procedures to accommodate distinct anatomical configurations, endovascular treatment for bilateral CSdAVF can achieve excellent angiographic occlusion results. However, aggravation of symptoms after TVE may occur frequently in bilateral CSdAVF. In the patients with one-sided dominance of shunt, treatment of only dominant fistula might be an alternative option.
Arteriovenous Fistula ; Asian Continental Ancestry Group ; Cavernous Sinus* ; Central Nervous System Vascular Malformations* ; Cranial Nerve Diseases ; Endovascular Procedures ; Fistula ; Follow-Up Studies* ; Humans

OBJECTIVE: Outcomes of stent-assisted coil embolization (SACE) have not been well established in the setting of vertebrobasilar dissecting aneurysms (VBDAs) due to the low percentage of cases that need treatment and the array of available therapeutic options. Herein, we presented clinical and radiographic results of SACE in patients with VBDAs. MATERIALS AND METHODS: A total of 47 patients (M:F, 30:17; mean age ± SD, 53.7 ± 12.6 years), with a VBDA who underwent SACE between 2008 and 2014 at two institutions were evaluated retrospectively. Medical records and radiologic data were analyzed to assess the outcome of SACE procedures. Cox proportional hazards regression analysis was conducted to determine the factors that were associated with aneurysmal recanalization after SACE. RESULTS: Stent-assisted coil embolization technically succeeded in all patients. Three cerebellar infarctions occurred on postembolization day 1, week 2, and month 2, but no other procedure-related complications developed. Immediately following SACE, 25 aneurysms (53.2%) showed no contrast filling into the aneurysmal sac. During a mean follow-up of 20.2 months, 37 lesions (78.7%) appeared completely occluded, whereas 10 lesions showed recanalization, 5 of which required additional embolization. Overall recanalization rate was 12.64% per lesion-year, and mean postoperative time to recanalization was 18 months (range, 3-36 months). In multivariable analysis, major branch involvement (hazard ratio [HR]: 7.28; p = 0.013) and the presence of residual sac filling (HR: 8.49, p = 0.044) were identified as statistically significant independent predictors of recanalization. No bleeding was encountered in follow-up monitoring. CONCLUSION: Stent-assisted coil embolization appears feasible and safe for treatment of VBDAs. Long-term results were acceptable in a majority of patients studied, despite a relatively high rate of incomplete occlusion immediately after SACE. Major branch involvement and coiled aneurysms with residual sac filling may predispose to recanalization.
Aneurysm ; Aneurysm, Dissecting* ; Embolization, Therapeutic* ; Follow-Up Studies ; Hemorrhage ; Humans ; Infarction ; Medical Records ; Retrospective Studies ; Stents

PURPOSE: The mortality of motorcycle accidents in old age is very high in Korea compared with other countries. The aim of this study is to compare the differences in injury patterns and severity between younger and older riders in motorcycle accidents. METHODS: Cross sectional data from Konkuk University Chung-ju Hospital were used to evaluate patients who visited the emergency department as a result of a motorcycle accident from June 2012 to May 2014. We separated the patients into younger rider group from 16 to 64 and older rider group over 65 years of age. Injury sustained, the types of severe injuries and injury severity between two groups were compared using Abbreviated Injury Scale (AIS) and Injury Severity Score (ISS). RESULTS: The younger and older rider group included 310 and 111 patients, respectively. Injuries in head, face, chest, and lumbar spine were higher in the older rider group (p<0.05). In the comparison of severe injury sustained over AIS 2, the older rider group had a four-fold odds increased rate of head injury (OR 3.718, 95% CI: 2.317-5.965, p<0.001) and a two-fold odds increased rate of chest injury (OR 2.306, 95% CI: 1.199-4.437, p=0.016) compared with the younger rider group. In addition, the older rider group had a nearly seven fold increased odds of severe injury over ISS 15 (OR 7.108, 95% CI: 3.579-14.119, p<0.001). CONCLUSION: In a motorcycle accident, the frequency of head, facial, chest, and lumbar injuries was higher in the older rider group. In addition, the older rider group had a higher injury severity, particularly a higher risk of head and chest injury.
Abbreviated Injury Scale ; Chungcheongbuk-do ; Craniocerebral Trauma ; Emergency Service, Hospital ; Head ; Humans ; Injury Severity Score ; Korea ; Mortality ; Motorcycles* ; Spine ; Thoracic Injuries ; Thorax

Laccase activity of Pleurotus ostreatus is significantly increased by the addition of apple pomace. Among various conditions, the best concentration of apple pomace and cultivation time for the production of laccase by P. ostreatus was 2.5% and 9 days, respectively. Reverse transcription polymerase chain reaction analyses of laccase isoenzyme genes, including pox1, pox3, pox4, poxc, poxa3, and poxa1b, revealed a clear effect of apple pomace on transcription induction. Our findings reveal that the use of apple pomace can be a model for the valuable addition of similar wastes and for the development of a solid-state fermenter and commercial production of oyster mushroom P. ostreatus.
Fungi* ; Laccase* ; Pleurotus* ; Polymerase Chain Reaction ; Reverse Transcription

Since the release of first Korean Clinical Practice Guideline of Stroke in 2009, many important new evidences have emerged in the field of thrombolytic therapy. Among the recent developments are the extended therapeutic time window of intravenous (IV) tissue plasminogen activator (tPA) up to 4.5 hours after onset, and the efforts for the wider application of IV thrombolysis to patients with minor stroke and elderly patients over 80 years old. Debates about the optimal dose of IV tPA according to the ethnic population is still ongoing. Further evidences for the efficacy of intra-arterial thrombolysis have also accumulated, including the application of various novel mechanical devices with promising results. Thus update of guideline became necessary and we revise the acute stroke management guideline, focusing on the thrombolytic therapy.
Aged ; Humans ; Stroke ; Thrombolytic Therapy ; Tissue Plasminogen Activator

In the present study, a phylogenetic analysis was undertaken based on the internal transcribed spacer (ITS) rDNA and partial beta-tubulin gene sequence of the Ganoderma species. The size of the ITS rDNA regions from different Ganoderma species varied from 625 to 673 bp, and those of the partial beta-tubulin gene sequence were 419 bp. Based on the results, a phylogenetic tree was prepared which revealed that Korean Ganoderma lucidum strains belong in a single group along with a G. lucidum strain from Bangladesh.
Bangladesh ; DNA, Ribosomal ; Ganoderma ; Korea ; Reishi ; Sequence Analysis ; Sprains and Strains ; Tubulin

Carotid Arteries ; Deglutition Disorders ; Earache ; Foreign Bodies ; Humans ; Ligaments ; Orientation ; Ossification, Heterotopic ; Palatine Tonsil ; Palpation ; Pharynx ; Physical Examination ; Sensation ; Stroke ; Temporal Bone ; Tinnitus

Humans ; Malocclusion ; Mandible ; Osteotomy, Sagittal Split Ramus ; Prognathism ; Recurrence ; Retrospective Studies

PURPOSE: Continuous renal replacement therapy (CRRT) has been used widely for treating critically ill patients with acute renal failure (ARF). We performed this study to identify predictors of mortality in critically ill ARF patients treated with CRRT. METHODS: We analyzed the data of 128 patients who were treated with continuous veno-venous hemofiltration (CVVH) or continuous veno-venous hemodiafiltration (CVVHDF) from May, 2002 to March, 2008. We compared the clinical data of survivors with non-survivors. RESULTS: On univariate analyses of prognostic factors of patients treated with CVVHDF, APACHE II scores (p=0.004), prothrombin time (INR) (p=0.033) and the number of inotropics used (p=0.005) were significantly lower in survivors than those of non-survivors. MAP (p=0.027), diastolic BP (p=0.015) and fibrinogen level (p=0.007) were significantly higher in survivors than those of non-survivors. Multivariate analysis revealed that APACHE II scores and fibrinogen level were the independent factors for the prediction of mortality. And on univariate analyses of prognostic factors of patients treated with CVVH, APACHE II scores (p=0.002) and the number of inotropics used (p=0.006) were significantly lower in survivors than in non-survivors. MAP (p=0.03), systolic BP (p=0.02) and diastolic BP (p=0.03) were significantly higher in survivors than in non-survivors. Multivariate analysis also revealed that APACHE II scores was the only independent factor for the prediction of mortality. CONCLUSION: This study showed that the independent prognostic factor for mortality in ARF patients treated with CRRT was the APACHE II score.
Acute Kidney Injury ; APACHE ; Critical Illness ; Fibrinogen ; Hemodiafiltration ; Hemofiltration ; Humans ; Multivariate Analysis ; Prognosis ; Prothrombin Time ; Renal Replacement Therapy ; Survivors