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.

BACKGROUND: Individual attitudes toward suicide are known to markedly influence suicidal ideation and suicidal behavior. Therefore, this study aimed to determine the factors associated with attitudes toward suicide.METHODS: This study was conducted on 3,213 adult men and women living in a province of Korea. After excluding 281 participants because of unreliable responses, the remaining 2,932 were included in the data analysis. Demographic factors were investigated, and psychological factors were evaluated. Attitudes toward suicide were evaluated using the Attitudes Towards Suicide-20, physical symptoms were evaluated using the Patient Health Questionnaire-15 (PHQ-15), self-compassion was evaluated using the Korean Self-Compassion Scale, and stress was evaluated using the Global Assessment of Recent Stress (GARS) scale. One-way analysis of variance was used to examine the psychological characteristics of attitudes toward suicide.RESULTS: Differences in various factors based on demographic characteristics were observed regarding attitudes toward suicide. Significant differences in attitudes toward suicide were observed based on severity of suicide, acceptability (F=20.332, p<0.001), prevention of suicide (F=7.700, p<0.001), and universality (F=13.741, p<0.001). The duration of suicidal ideation, self-kindness, self-judgment, common humanity, isolation, and over-identification showed differences, as did the GARS and PHQ-15 scores.CONCLUSION: This study explored the demographic and psychological factors affecting attitudes toward suicide. Adequate mediation of these factors is needed to prevent suicidal ideation and behavior.
Adult ; Demography ; Empathy ; Female ; Humans ; Korea ; Male ; Negotiating ; Psychology ; Statistics as Topic ; Stress, Psychological ; Suicidal Ideation ; Suicide

OBJECTIVES: This study aimed to investigate the psychosocial characteristics of functional gastrointestinal disorder (FGID) in patients with psychiatric disorders. METHODS: This study was conducted with 144 outpatients visiting the psychiatric clinic at a university hospital. FGIDs were screened according to the Rome III questionnaire-Korean version. Demographic factors were investigated, and psychosocial factors were evaluated using the Hospital Anxiety Depression Scale, Patient Health Questionnaire-15, Childhood Trauma Questionnaire-Korean, and State-Trait Anger Expression Inventory. Chi-squared test and student's t-test were used as statistical analysis methods. RESULTS: There were differences in education level between two groups divided according to FGID status (χ²=10.139, p=0.017). Comparing the psychiatric disorder by FGID group, irritable bowel syndrome (IBS) group showed significant differences (χ²=11.408, p=0.022). According to FGID status, IBS group showed significant differences for anxiety (t=−3.106, p=0.002), depressive symptom (t=−2.105, p=0.037), somatic symptom (t=−3.565, p < 0.001), trait anger (t=−3.683, p < 0.001), anger-in (t=−2.463, p=0.015), and anger-out (t=− 2.355, p=0.020). Functional dyspepsia group showed significant differences for anxiety (t=−4.893, p < 0.001), depressive symptom (t=−3.459, p < 0.001), somatic symptom (t=−7.906, p < 0.001), trait-anger (t=−4.148, p < 0.001), state-anger (t=−2.181, p=0.031), anger-in (t=−2.684, p=0.008), and anger-out (t=−3.005, p=0.003). Nonerosive reflux disease group showed significant differences for anxiety (t=−4.286, p < 0.001), depressive symptom (t=−3.402, p < 0.001), somatic symptom (t=−7.162, p < 0.001), trait anger (t=−2.994, p=0.003), state anger (t=−2.259, p=0.025), anger-in (t=−2.772, p=0.006), and anger-out (t=−2.958, p=0.004). CONCLUSIONS: Patients with psychiatric disorders had a high prevalence of FGID, and various psychosocial factors contributed to such differences. Therefore, the psychiatric approach can offer better understandings and treatments to patients with FGID.
Anger ; Anxiety ; Demography ; Depression ; Dyspepsia ; Education ; Gastrointestinal Diseases ; Humans ; Irritable Bowel Syndrome ; Outpatients ; Prevalence ; Psychology

PURPOSE: Visceral fat (VF) is closely associated with many metabolic risk factors and is also known to be a strong predictive factor for severe metabolic complications in adults. But there are only a few studies concerning the association of VF and risk factors for metabolic syndrome (MS) in children and adolescents. In our study, we emphasized the association of VF [measured by VF computed tomography (VFCT)] and risk factors for metabolic syndrome in children and adolescents. MATERIALS AND METHODS: The subjects were outpatients aged 6 to 18 years who underwent VFCT in the family medicine of The Catholic University of Korea from January 2005 to August 2009. There were 82 patients in total (42 children, 40 adolescents). Height, weight, blood pressure (BP), blood tests, body composition analysis and VF were measured. The three groups were also classified by metabolic score. RESULTS: In children, only high density lipoprotein cholesterol (HDL-C) showed a statistically significant difference, while in adolescents, triglyceride, HDL-C, BP, body mass index (BMI), waist circumference (WC) and VFA showed statistically significant differences. In terms of VFA, fasting glucose, BP, BMI, basal metabolic rate (BMR) and WC showed statistically significant differences. BMI showed a statistically significant difference in terms of BP, BMR, WC, VFA and HDL-C. CONCLUSION: There is a need to acknowledge the statistically significant associations of VF and risk factors for MS in children and adolescents. Screening tests for BP, cholesterol, fasting glucose and WC should be given in clinics for children and adolescents so that MS can be detected and its risk factors treated early.
Adolescent ; Body Mass Index ; Child ; Female ; Humans ; Intra-Abdominal Fat/*physiology ; Male ; Metabolic Syndrome X/*epidemiology/metabolism/physiopathology ; Risk Factors ; Waist Circumference/physiology

PURPOSE: The purpose of this study was to evaluate efficacy and toxicity of irinotecan, leucovorin and 5-fluorouracil (FOLFIRI) as second-line treatment after failure of oxaliplatin, leucovorin and 5-fluorouracil (FOLFOX) for advanced gastric cancer. MATERIALS AND METHODS: Patients who received modified FOLFOX-4 as first-line treatment and then received sequential modified FOLFIRI for disease progression were included in this study. The modified FOLFIRI regimen consisted of irinotecan 150 mg/m2 in a 90-minute intravenous infusion on day 1, leucovorin (LV) 20 mg/m2 and 5-fluorouracil (5-FU) 400 mg/m2 as a bolus followed by 600 mg/m2 as a 22-hour infusion on days 1 and 2 with the same dose of 5-FU/LV of modified FOLFOX-4 every 2 weeks. RESULTS: A total of 32 patients received 126 courses of FOLFIRI chemotherapy. No complete response was achieved. Three patients (9.4%; 95% confidence interval [CI], 0 to 20.1%) achieved partial response, whereas 11 (34.4%; 95% CI, 17.0 to 51.8%) patients showed stable disease. Disease control rate (complete response, partial responses and stable diseases) was 43.8% (95% CI, 25.6 to 61.9%) and median follow up duration was 11.3 months (range, 2.23 to 37.9 months). Median time to progression was 2 months (95% CI, 1.49 to 2.51 months), and median overall survival from the start of FOLFIRI was 5.84 months (95% CI, 4.34 to 7.34 months). Toxicities were tolerable. CONCLUSION: Modified FOLFIRI as second-line chemotherapy after failure of the modified FOLFOX-4 in advanced gastric cancer was tolerable but showed a lower response rate. Further study about retrying 5-FU/LV with irinotecan after failure of the 5-FU/LV combined regimen is necessary in advanced gastric cancer.
Camptothecin ; Disease Progression ; Fluorouracil ; Follow-Up Studies ; Humans ; Infusions, Intravenous ; Leucovorin ; Organoplatinum Compounds ; Stomach Neoplasms

PURPOSE: The purpose of this study was to evaluate efficacy and toxicity of irinotecan, leucovorin and 5-fluorouracil (FOLFIRI) as second-line treatment after failure of oxaliplatin, leucovorin and 5-fluorouracil (FOLFOX) for advanced gastric cancer. MATERIALS AND METHODS: Patients who received modified FOLFOX-4 as first-line treatment and then received sequential modified FOLFIRI for disease progression were included in this study. The modified FOLFIRI regimen consisted of irinotecan 150 mg/m2 in a 90-minute intravenous infusion on day 1, leucovorin (LV) 20 mg/m2 and 5-fluorouracil (5-FU) 400 mg/m2 as a bolus followed by 600 mg/m2 as a 22-hour infusion on days 1 and 2 with the same dose of 5-FU/LV of modified FOLFOX-4 every 2 weeks. RESULTS: A total of 32 patients received 126 courses of FOLFIRI chemotherapy. No complete response was achieved. Three patients (9.4%; 95% confidence interval [CI], 0 to 20.1%) achieved partial response, whereas 11 (34.4%; 95% CI, 17.0 to 51.8%) patients showed stable disease. Disease control rate (complete response, partial responses and stable diseases) was 43.8% (95% CI, 25.6 to 61.9%) and median follow up duration was 11.3 months (range, 2.23 to 37.9 months). Median time to progression was 2 months (95% CI, 1.49 to 2.51 months), and median overall survival from the start of FOLFIRI was 5.84 months (95% CI, 4.34 to 7.34 months). Toxicities were tolerable. CONCLUSION: Modified FOLFIRI as second-line chemotherapy after failure of the modified FOLFOX-4 in advanced gastric cancer was tolerable but showed a lower response rate. Further study about retrying 5-FU/LV with irinotecan after failure of the 5-FU/LV combined regimen is necessary in advanced gastric cancer.
Camptothecin ; Disease Progression ; Fluorouracil ; Follow-Up Studies ; Humans ; Infusions, Intravenous ; Leucovorin ; Organoplatinum Compounds ; Stomach Neoplasms

PURPOSE: The purpose of this study was to evaluate the clinical benefits of preoperative percutaneous transhepatic drainage (PTGBD), especially regarding morbidity and mortality, in patients aged 60 or older with acute cholecystitis. METHODS: A retrospective study was done on a series of elderly patients (>60 years old; n=132) who had been diagnosed between January 2007 and December 2009 as having acute cholecystitis. The patients were divided into 4 groups; cases in which only laparoscopic cholecystectomy (LC) was done (Group 1, n=84), cases in which LC was done after preoperative PTGBD (Group 2, n=15), cases in which only open cholecystectomy was done (Group 3, n=23), and cases in which open cholecystectomy was done after preoperative PTGBD (Group 4, n=10). We analyzed between group differences in surgical outcomes including periods of postoperative fast and postoperative hospital stay, OP. morbidity, and open conversion rate. RESULTS: Patients in Group 1 had fewer underlying medical problems and lower ASA scores than patients in groups 2, 3, or 4 (p<0.05). Mean operating time in Group 2 (113.66+/-107.5 min) was significantly longer than in group 1 (72.02.9+/-34.2 min) (p<0.05) and the open conversion rate was higher (8.33% vs 26.67%). But, blood loss (ml) and OP time in Group 2 were lower than in Group 3 or 4 (p<0.001). Postoperative recovery progression (periods of postoperative fasting and length of postoperative hospital stay) of Group 2 were better than in groups 3 or 4 (p<0.001). CONCLUSION: Pre-operative PTGBD procedures in elderly patients with acute cholecystitis is a good clinical option as a pretreatment to a cholecystitis operation.
Aged ; Cholecystectomy ; Cholecystectomy, Laparoscopic ; Cholecystitis ; Cholecystitis, Acute ; Drainage ; Fasting ; Gallbladder ; Humans ; Length of Stay ; Retrospective Studies

BACKGROUND: The pathophysiologic mechanisms of radiation-induced lung injury should be elucidated to enhance the therapeutic efficacy of radiotherapy and to manage patients exposed to serious radiation by accident. It has been suggested that pro-inflammatory cytokines play an important role in radiation-induced effect on the lung. This study was aimed to investigate changes in pro-inflammatory cytokines such as TNF-alpha, MIP-2, IL-1beta and HMGB1, a newly recognized inflammatory mediator. METHODS: The chests of BALB/c mice were selectively irradiated with single fraction of 20 Gy and then sacrificed at indicated times. Pathologic changes in the lung were examined after H&E staining. The expression level of pro-inflammatory cytokines was evaluated by ELISA kits in lung homogenate and in serum. RESULTS: Radiation induced inflammatory changes and mild fibrosis in lung. Biphasic increase of TNF-alpha and IL-1beta was found in lung homogenate at 4 hours and at 3 weeks after radiation. The elevation in the second phase tended to be more intense. However, there was no similar change in serum. MIP-2 level was slightly increased in lung homogenate at 4 hours, but not at 3 weeks. HMGB1 was increased at 3 weeks in serum while there was no significant change in lung homogenate. CONCLUSION: Radiation induced a biphasic increase in TNF-alpha and IL-1beta. The effective control of second phase cytokine elevation should contribute to preventing severe lung fibrosis caused by radiation.
Animals ; Cytokines ; Enzyme-Linked Immunosorbent Assay ; Fibrosis ; HMGB1 Protein ; Humans ; Lung ; Lung Injury ; Mice ; Thorax ; Tumor Necrosis Factor-alpha

An 1-month old female newborn was admitted to our hospital because of jaundice which occurred at 2 days after birth. Plain chest X-ray and chest CT revealed a collapsed right middle lobe and lobar emphysema was suspected. Right upper lobectomy of the lung was done and pathologic findings showed an infantile lobar emphysema. After the operation, the newborn was discharged without complication and was followed up through the out patient clinic. Infantile lobar emphysema is rare and male dominant. Left upper lobe of the lung is the most prevalent site. Patients with infantile lobar emphysema complain of respiratory symptoms. We report one case of infantile lobar emphysema on right upper lobe of lung, in a female with no respiratory symptoms.
Emphysema* ; Female ; Humans ; Infant ; Infant, Newborn ; Jaundice ; Lung ; Male ; Parturition ; Thorax ; Tomography, X-Ray Computed

Unilateral or, particularly, bilateral congenital agenesis of the internal carotid artery is a rare anomaly. We report an occurrence of the condition, arising bilaterally, and report the findings of magnetic resonance imaging and magnetic resonance angiography.
Carotid Artery, Internal* ; Magnetic Resonance Angiography ; Magnetic Resonance Imaging