As in other countries, type 2 diabetes is major health concern in Korea. A dramatic increase in the prevalence of type 2 diabetes and its chronic complications has led to an increase in health costs and economic burdens. Early detection of high risk individuals, hidden diabetic patients, and improvement in the quality of care for the disease are the first steps to mitigate the increase in prevalence. The Committee of Clinical Practice Guidelines of the Korean Diabetes Association revised and updated the '3rd Clinical Practice Guidelines' at the end of 2010. In the guidelines, the committee recommended active screening of high risk individuals for early detection and added the hemoglobin A1c level to the diagnostic criteria for type 2 diabetes based on clinical studies performed in Korea. Furthermore, the committee members emphasized that integrating patient education and self-management is an essential part of care. The drug treatment algorithm based on the degree of hyperglycemia and patient characteristics were also updated.
Committee Membership ; Diabetes Mellitus, Type 2 ; Health Care Costs ; Hemoglobins ; Humans ; Hyperglycemia ; Korea ; Mass Screening ; Patient Education as Topic ; Prevalence ; Self Care

As in other countries, type 2 diabetes is major health concern in Korea. A dramatic increase in the prevalence of type 2 diabetes and its chronic complications has led to an increase in health costs and economic burdens. Early detection of high risk individuals, hidden diabetic patients, and improvement in the quality of care for the disease are the first steps to mitigate the increase in prevalence. The Committee of Clinical Practice Guidelines of the Korean Diabetes Association revised and updated the '3rd Clinical Practice Guidelines' at the end of 2010. In the guidelines, the committee recommended active screening of high risk individuals for early detection and added the hemoglobin A1c level to the diagnostic criteria for type 2 diabetes based on clinical studies performed in Korea. Furthermore, the committee members emphasized that integrating patient education and self-management is an essential part of care. The drug treatment algorithm based on the degree of hyperglycemia and patient characteristics were also updated.
Committee Membership ; Diabetes Mellitus, Type 2 ; Health Care Costs ; Hemoglobins ; Humans ; Hyperglycemia ; Korea ; Mass Screening ; Patient Education as Topic ; Prevalence ; Self Care

No abstract available.

The Committee of Clinical Practice Guidelines of the Korean Diabetes Association revised and updated the '3rd Clinical Practice Guidelines' at the end of 2010. In these guidelines, the committee recommends active screening of high risk individuals for early detection and added HbA1c level as a diagnostic criterion of type 2 diabetes to produce a more practical approach based on clinical studies performed in Korea. Furthermore, committee members emphasize that integrated patient education for self-management is an essential part of patient care. The drug treatment algorithm was also updated based on the degree of hyperglycemia and patient characteristics.
Committee Membership ; Diabetes Mellitus, Type 2 ; Humans ; Hyperglycemia ; Korea ; Mass Screening ; Patient Care ; Patient Education as Topic ; Self Care

A 51-year old man presented with vertical and torsional diplopia after reduction of a blowout fracture at another hospital one year ago. He had no anormalies of head position and 14 prism diopters (PD) right hypertropia (RHT) in the primary position. In upgaze no vertical deviation was found, and hyperdeviation on downgaze was 35PD. Bielschowsky head tilt test showed a negative response. Distinct superior oblique (SO) and inferior rectus (IR) underaction of the right eye was noted but IO overaction was mild on the ocular version test. Double Maddox rod test (DMRT) revealed 10-degree extorsion, but fundus extorsion was minimal in the right eye.Thin-section coronal CT scan showed that there was no fracture line on the anterior orbital floor, but a fracture remained on the posterior orbital floor. Also, the anterior part of the right inferior oblique muscle was vertically reoriented and the medial portion of the inferior oblique muscle was not traced on the coronal CT scan. The patient underwent 14 mm right IO recession and 3 mm right IR resection. One month after the surgery, his vertical and torsional diplopia were eliminated in the primary position.
Constriction, Pathologic/complications/etiology/physiopathology/radiography ; Diplopia/etiology ; Humans ; Male ; Middle Aged ; Muscular Diseases/complications/etiology/*physiopathology/*radiography ; Oculomotor Muscles/*physiopathology/*radiography/surgery ; Orbital Fractures/*complications ; *Tomography, X-Ray Computed

Sclerosing mucoepidermoid carcinoma (SMEC) is a very rare tumor of the salivary gland. There have been eight cases of SMEC reported in the medical literature; this is the first reported case in Korea. A 51-year-old woman presented with a right infra-auricular mass that she had for 3 years. We performed superficial parotidectomy. Grossly, the resected parotid gland showed a well-circumscribed firm mass. Histologically, the tumor consisted of central solid or ductal tumor nests within a dense fibrous stroma surrounded by peripheral lymphoid infiltration. The tumor nests were composed of squamous, intermediate and mucin-secreting cells. However, the tumor cells lacked mitosis and nuclear anaplasia. The lymphoid cells were mostly composed of lymphocytes and plasma cells with occasional eosinophils and neutrophils. Immunohistochemically, the tumor cells were positive for high- and low- molecular weight cytokeratins, cytokeratin 7, p16INK4A, Bcl-2 and cyclin D1. The patient also underwent radiation therapy. We report here on a case of SMEC of the parotid gland along with the immunohistochemical characteristics, and we review the relevant literature.
Anaplasia ; Carcinoma, Mucoepidermoid* ; Cyclin D1 ; Eosinophils ; Female ; Humans ; Keratin-7 ; Keratins ; Korea ; Lymphocytes ; Middle Aged ; Mitosis ; Molecular Weight ; Neutrophils ; Parotid Gland* ; Plasma Cells ; Salivary Glands ; Sclerosis

BACKGROUND: The aim of this study was to investigate the prevalence, clinical and laboratory findings of hereditary hemolytic anemia (HHA) in Korea from 1997 to 2006 and to develop the appropriate diagnostic approach for HHA. METHODS: By the use of questionnaires, information on the clinical and laboratory findings ofHHA diagnosed from 1997 to 2006 in Korea was collected and analyzed retrospectively. A total of 431 cases were enrolled in this study from 46 departments of 35 hospitals. RESULTS: The overall frequency of HHA did not change through the 10-year period for pediatrics but did show an increasing tendency for internal medicine. The overall male to female sex ratio did not show sex predominance (1.17:1), but a significant male predominance with a ratio of 1.49:1 was seen for pediatrics while a significant female predominance with a ratio of 1:1.97 was seen forinternal medicine. Of the total cases, 74.2% (282/431) were diagnosed before the age of 15 years. The etiologies of HHA were classified as red cell membrane defects, hemoglobinopathies, red cell enzyme deficiencies and unknown causes. There were 382 cases (88.6%) of red cell membrane defects with 376 cases (87.2%) of hereditary spherocytosis and 6 cases (1.4%) of hereditary elliptocytosis, 20 cases (4.6%) of hemoglobinopathies with 18 cases (4.2%) of beta-thalassemia, a case (0.2%) of alpha-thalassemia and a case (0.2%) of Hemoglobin Madrid, 7 cases (1.6%) of red cell enzyme deficiencies with 5 cases (1.2%) of glucose-6- phosphate dehydrogenase (G-6-PD) deficiency, a case (0.2%) of pyruvate kinase (PK) deficiency and a case (0.2%) of enolase deficiency, and 22 cases (5.1%) of unknown causes. The most common chief complaint in pediatric patients was pallor and that in adult patients was jaundice. In the red cell membrane defect group of patients, the level of hemoglobin was significantly higher than in adult patients. The mean corpuscular volume, mean corpuscular hemoglobin, corrected reticulocyte count, total and indirect bilirubin level and lactate dehydrogenase levels in the hemoglobinopathy group of patients were significantly lower than the values in the red cell membrane defect group of patients. The mean concentration of G-6-PD was 0.8+/-0.7U/1012RBC in the G-6-PD deficient patients, PK was 1.7U/1010 RBC in the PK deficient patient, and the level of enolase was 0.04U/g of Hb in the enolase deficient patient. CONCLUSION: The most prevalent cause of HHA in Korea during 1997 to 2006 was hereditary spherocytosis, but HHA by other causes such as hemoglobinopathy and red cell enzyme deficiency gradually increased with the development of molecular diagnostic methods and increasing general interest. However, the etiologies of HHA need to be pursued further in 5.1% of the patients. An systematic standard diagnostic approach is needed in a nationwide prospective study for correct diagnoses and appropriate management of HHA.
Adult ; alpha-Thalassemia ; Anemia, Hemolytic, Congenital* ; beta-Thalassemia ; Bilirubin ; Cell Membrane ; Diagnosis ; Elliptocytosis, Hereditary ; Erythrocyte Indices ; Female ; Hemoglobinopathies ; Humans ; Internal Medicine ; Jaundice ; Korea* ; L-Lactate Dehydrogenase ; Male ; Oxidoreductases ; Pallor ; Pathology, Molecular ; Pediatrics ; Phosphopyruvate Hydratase ; Prevalence ; Pyruvate Kinase ; Reticulocyte Count ; Retrospective Studies* ; Sex Ratio ; Surveys and Questionnaires

Ruptured dissecting aneurysm of the vertebral artery requires a rapid treatment because of the high rate of fatal early rebleeding. Stent-assisted coil embolization has been introduced as an effective procedure for both aneurysmal occlusion and parent artery preservation. We report a case of successful urgent treatment of ruptured dissecting aneurysm using a self-expandable, intracranial stent (Neuroform(R)) and a coated coil (HydroCoil(R)).
Aneurysm ; Aneurysm, Dissecting* ; Arteries ; Embolization, Therapeutic ; Humans ; Parents ; Stents* ; Vertebral Artery*

We report the case of a 5-month-old infant with a rapidly growing mass on the right nasolabial fold; to our knowledge, this is the youngest infant diagnosed with nodular fasciitis in the literature. Based on the anatomic location, this was a subcutaneous type of nodular fasciitis and it had a mixed cellular and fibrous histologic composition, which is rare in infancy. Here we present periodic ultrasonographic images and MR images, as well as a detailed comparison of the pathologic and radiologic findings.
Fasciitis* ; Humans ; Infant* ; Nasolabial Fold*

PURPOSE: We tried to compare the accuracy of using bony landmarks and inguinal crease landmarks for performing femoral artery puncture and to determine an ideal puncture site. MATERIALS AND METHODS: We studied ninety consecutive patients who underwent femoral arterial puncture for performing angiogram. For the evaluation of bony landmarks, the pelvis and inguinal areas were divided into 8 zones according to 7 lines that were drawn parallel to the line drawn between the anterior superior iliac spine and the pubic tubercle. For evaluation of the inguinal crease as a landmark, the 8 zones above and 4 zones below the inguinal crease were determined. The zones were divided by 11 lines drawn parallel to the inguinal crease, and the interval between each line was 1cm. Locations of the inguinal ligament and femoral bifurcation were recorded for every patient according to the above zones, and an ideal zone for the femoral arterial puncture was decided upon. The ideal zone was considered if the locations of all of inguinal ligaments were above the zone and the least possibility to puncture was below the femoral bifurcation. RESULTS: On the bony landmark, the femoral bifurcations were located at zone 3 in 1 patient (1.1%), at zone 4 in 2 patients (2.2%), at zone 5 in 3 patients (3.3%), at zone 6 in 24 patients (26.7%), and at zone7 in 44 patients (48.9%). Inguinal ligaments were at zone 1 in 2 patients (3.0%), at zone 2 in 34 patients (50.7%), at zone 3 in 25 patients (37.3%), and at zone 4 in 6 patients (8.9%). When the inguinal creases were used as a landmark, the femoral bifurcations were located at zone 4 in 4 patients (4.4%), at zone 3 in 19 patients (21.1%), at zone 2 in 30 patients (33.3%), at zone 1 in 19 patients (21.1%), at zone -1 in 13 patients (14.4%), at zone -2 in 3 patients (3.3%) and at zone-4 in 2 patients (2.2%). Inguinal ligaments were at zone 8 in 7 patients (10.4%), at zone 7 in 11 patients (16.4%), at zone 6 in 19 patients (28.4%), at zone 5 in 20 patients (29.9%), at zone 4 in 7 patients (10.4%), and at zone 3 in 3 patients (4.5%). Therefore, the best zone for femoral arterial puncture was zone 5 with using bony landmarks and zone 2 with using inguinal crease landmarks. In terms of zone 5 on the bony landmark, every locations of inguinal ligaments was above it and 84 patients (93.4%) had their femoral bifurcation below it, excluding the 6 patients who had their femoral bifurcations at zones 3, 4, and 5. Therefore, zone 5 with using the bony landmarks was a good indicator for femoral arterial puncture. In case of zone 2 on the inguinal crease landmark, although every location of the inguinal ligament was above it, 53 patients (58.8%) had their femoral bifurcation above it at zones 4, 3, and 2. So, it was not a good indicator for femoral arterial puncture. CONCLUSION: Bony landmarks are more accurate indicators for performing femoral arterial puncture than the inguinal crease landmark. Zone 5 on the bony landmark is an ideal location for femoral arterial puncture.
Angiography ; Femoral Artery ; Humans ; Ligaments ; Pelvis ; Punctures* ; Spine