Hospital-Based Korean Diabetes Prevention Study: A Prospective, Multi-Center, Randomized, Open-Label Controlled Study

이상열,전숙,안규정,우정택,the Korean Diabetes Prevention Study Investigators 대한당뇨병학회 2019 Diabetes and Metabolism Journal Vol.43 No.1

Background: The prevalence of diabetes mellitus (DM) continues to increase, and the disease burden is the highest of any medical condition in Korea. However, large-scale clinical studies have not yet conducted to establish the basis for diabetes prevention in Korea. Methods: The hospital-based Korean Diabetes Prevention Study (H-KDPS) is a prospective, multi-center, randomized, open-label controlled study conducted at university hospitals for the purpose of gathering data to help in efforts to prevent type 2 DM. Ten university hospitals are participating, and 744 subjects will be recruited. The subjects are randomly assigned to the standard care group, lifestyle modification group, or metformin group, and their clinical course will be observed for 36 months. Results: All intervention methodologies were developed, validated, and approved by Korean Diabetes Association (KDA) multidisciplinary team members. The standard control group will engage in individual education based on the current KDA guidelines, and the lifestyle modification group will participate in a professionally guided healthcare intervention aiming for ≥5% weight loss. The metformin group will begin dosing at 250 mg/day, increasing to a maximum of 1,000 mg/day. The primary endpoint of this study is the cumulative incidence of DM during the 3 years after randomization. Conclusion: The H-KDPS study is the first large-scale clinical study to establish evidence-based interventions for the prevention of type 2 DM in Koreans. The evidence gathered by this study will be useful for enhancing the health of Koreans and improving the stability of the Korean healthcare system (Trial registration: CRIS KCT0002260, NCT02981121).

Association between Bone Mineral Density and Clinical Consequences: Cross-Sectional Study of Korean Postmenopausal Women in an Orthopaedic Outpatient Clinic

이재협,이예현,문성환,TOP Study 대한의학회 2014 Journal of Korean medical science Vol.29 No.8

This study is to identify the characteristics of BMD and the related clinical consequencesthrough a nationwide, consecutive, cross-sectional study. A total of 1,281 postmenopausalwomen was enrolled nationwide and underwent measurement for BMD using dual energyx-ray absorptiometry. Following the T-spine and L-spine plane radiography, they wereevaluated for vertebral fracture by a semi-quantitative method using the Genant’s method. Relationship between BMD and osteoporotic fracture and a degree of deformity invertebral fracture, treatment history in osteoporosis and the EQ-5D was analyzed. Thedistribution of the normal, osteopenia and osteoporosis group was 25.9%, 37.0%, and37.2% in lumbar spine, and 31.4%, 45.3%, and 23.3% in femur neck, respectively. BMDin subjects with symptomatic or asymptomatic vertebral fracture was significantly lowerthan those without fracture. The femur neck and total hip BMDs were significantly lowerin hip fracture group (0.646 g/cm2 and 0.643 g/cm2, respectively) and wrist fracture group(0.661 g/cm2 and 0.712 g/cm2, respectively) than in subjects without fracture (0.721 g/cm2and 0.712 g/cm2, respectively). The BMD was significantly lower with more severe degreeof deformity in vertebral fracture and lower scores in mobility, usual activities and pain/discomfort of the EQ-5D. In Korean postmenopausal women, the prevalence of osteoporosisand vertebral, hip and wrist fracture increase and quality of life decreases with lower BMD.

The Korean Academy of Tuberculosis and Respiratory Diseases : Slide Session ; OS-051 : Miscellaneous ; The Association of Cigarette Smoking and Mental Health in Korean

( Jae Woo Jung ),( Jae Chol Choi ),( Jong Wook Shin ),( In Won Park ),( Byoung Whui Choi ),( Jae Yeol Kim ),( Korean Smoking Cessation Study Group ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: Many studies investigated that smoking is the major cause of various physical illnesses, but the relationship between smoking status and mental health including suicidal ideation and suicidal attempts was not studied. This study was conducted to evaluate whether cigarette smoking status was related with mental health including suicidal ideation and suicidal attempts in Korean adult population. Methods: We used data from the fourth and fifth annual South Korean National Health and Nutrition Examination Survey (Korean NHANES IV) conducted in 2008,2009, 2010, 2011 and 2012. From a total of 45,811 subjects, 32,184 adult subjects who were at least 19 years of age were included in the study population. The correlation between smoking status and mental health using questionnaires about mental health, cigarette smoking and diagnosis of major depressive disorder were analyzed. They were adjusted by age, income, education and marital state. Results: In male, current smoker was 42.4%, former smoker 38.9% and non smoker18.7% and in female, 5.9%, 5.6% and 88.4%. Age, quartile of income, education state and marital state were different according to smoking status (P<0.001). In male and female, perceived stress was higher and EQ-VAS in current smoker was lower than those in non smoker (P<0.001). The incidence of major depressive disorder in current smoker female was higher than that in non smoker female (8.4% vs. 4.5%, OR=1.945, 95% CI: 1.536-2.463). In female, current smoker had higher prevalence of suicidal ideation and suicidal attempts in last year compared with non smoker (OR=1.912, 95% CI: 1.659-2.203, OR=3.930, 95% CI: 2.701-5.719, respectively).Conclusion: In the current study, current smoking was signifi cantly related with major depressive disorder, depression symptom and suicidal ideation and attempts in Korean females.

A prospective multicentre phase II study of cisplatin and weekly docetaxel as first-line treatment for recurrent or metastatic nasopharyngeal cancer (KCSG HN07-01)

Korean Cancer Study Group,Ji, J.H.,Yun, T.,Kim, S.B.,Kang, J.H.,Park, J.C.,Cho, I.S.,Sohn, C.H.,Heo, D.S.,Jang, J.S.,Shin, S.W.,Hwang, D.W.,Sun, J.M.,Park, K.,Ahn, M.J. Pergamon Press 2012 European journal of cancer Vol.48 No.17

Background: The purpose of this phase II study was to determine the efficacy and toxicity of cisplatin and weekly docetaxel combination chemotherapy as a first-line treatment in patients with recurrent or metastatic nasopharyngeal cancer. Patients and Methods: Recurrent or metastatic nasopharyngeal cancer patients were enrolled and received a combination of weekly docetaxel (35mg/m<SUP>2</SUP> on Day1 and Day8) and cisplatin (70mg/m<SUP>2</SUP> D1) every 21days, for up to a maximum of 6 cycles. The primary endpoint was objective response rate, and the secondary endpoints included toxicity of combination chemotherapy, progression-free survival, overall survival and 1-year survival rate. Results: In total, 47 patients were enrolled and analysed, and 46 patients (97.9%) completed the planned protocol. In an intent-to-treat analysis, 6 patients (12.8%) achieved complete response (CR) and 27 patients (57.4%) showed partial response (PR), with an objective response rate of 70.2%. The median progression-free survival and overall survival were 9.6months (95% C.I. 5.7-13.5months) and 28.5months (95% C.I. 16.9-40.1months), respectively, and the 1-year survival rate was 89.9%. The common grade 3 adverse events were stomatitis (1.2%), neutropenia (0.8%), anaemia (0.8%), infection (0.8%) and diarrhoea (0.8%). Grade 4 adverse events were not observed in this study. Conclusions: The combination chemotherapy of cisplatin and weekly docetaxel is highly effective and shows favourable toxicity as a first-line chemotherapy in patients with recurrent or metastatic nasopharyngeal cancer.

Trend of CD4+ Cell Counts at Diagnosis and Initiation of Highly Active Antiretroviral Therapy (HAART): Korea HIV/AIDS Cohort Study, 1992-2015

김민정,장현하,김상일,김윤정,박대원,강춘,기미경,최주연,김수민,최보율,김우주,김준명,최준용,최영화,이진수,김신우,Korea HIV/AIDS Cohort Study 대한감염학회 2017 Infection and Chemotherapy Vol.49 No.2

Background: CD4+ cell counts reflect immunologic status of human immunodeficiency virus (HIV) patients. Recommended CD4+ cell counts for the initiation of highly active antiretroviral therapy (HAART) has increased over the past several years in various HIV treatment guidelines. We investigated the trend of CD4+ cell counts at diagnosis and treatment start using data from the Korea HIV/acquired immune deficiency syndrome (AIDS) Cohort Study. Materials and Methods: The Korea HIV/AIDS Cohort Study started in 2006 and enrolled HIV patients from 21 tertiary and secondary hospitals in South Korea. The data for CD4+ cell counts at diagnosis and HAART initiation from these HIV patients were analyzed by three-year time intervals and presented by number of CD4+ cells (≤100, 101-200, 201-350, 351-500 and >500 cells/mm3). The HIV-RNA titer at diagnosis and HAART initiation were presented by 3-year intervals by groups ≤50,000, 50,001-100,000, 100,001- 200,000, 200,001-1,000,000, and >1,000,000 copies/mL. Results: Median values of CD4+ cell count and HIV-RNA titer at initial HIV diagnosis were 247 cells/mm3 and 394,955 copies/mL, respectively. At time of initiating HAART, median values of CD4+ cell count and HIV-RNA were 181 cells/mm3 and 83,500 copies/ mL, respectively. Patients with low CD4+ cell count (CD4+ cell count ≤200 cells/mm3) at diagnosis (31-51%) and initiation of HAART accounted for the largest proportion (30-65%) over the three-year time intervals. This proportion increased until 2010-2012. Conclusion: CD4+ cell count at initiation of HAART was found to be very low, and the increase in late initiation of HAART in recent years is of concern. We think that this increase is primarily due to an increasing proportion of late presenters. We recommend early detection of HIV patients and earlier start of HAART in order to treat and prevent spread of HIV infection.

Intraperitoneal Paclitaxel Combined with S-1 Plus Oxaliplatin for Advanced Gastric Cancer with Peritoneal Metastasis: a Phase I Study

김동욱,서원준,Sang Il Youn,Ye Seob Jee,장유진,김종한,Perioperative Intra-Peritoneal & Systemic Chemotherapy for Gastric Cancer (PIPS-GC) study group 대한위암학회 2021 Journal of gastric cancer Vol.21 No.4

Purpose: We designed a new regimen by combining intraperitoneal (IP) paclitaxel (PTX) with systemic S-1 plus oxaliplatin (SOX) for the treatment of advanced gastric cancer with peritoneal metastasis. This dose-escalation study aimed to determine the maximum tolerated dose (MTD) and recommended dose (RD) of IP PTX administered weekly to patients. Materials and Methods: Eight cycles of IP PTX plus SOX regimen were administered to the patients. S-1 was administered orally twice daily at a dose of 80 mg/m2/day for 14 consecutive days, followed by 7 days of rest. Intravenous oxaliplatin was administered at a fixed dose of 100 mg/m2 on day 1, while IP PTX was administered on days 1 and 8. The initial dose of IP PTX was 40 mg/m2, and the dose escalation was set in units of 20 mg/m2 up to 80 mg/m2. Dose-limiting toxicities (DLTs) were defined as grade 3 non-hematologic toxicities, grade 4 leukopenia, grade 3 febrile neutropenia, and grade 3 thrombocytopenia. Results: Nine patients were included in the study. No DLTs were observed in any of the enrolled patients. Therefore, the MTD was not reached, and the RD of IP PTX was determined to be 80 mg/m2. Four patients (44%) showed a decreased peritoneal cancer index score on second-look laparoscopic examination. Conclusions: The present study determined the dose for further clinical trials of IP PTX to be 80 mg/m2, when combined with a systemic SOX regimen.

Is Sacral Extension a Risk Factor for Early Proximal Junctional Kyphosis in Adult Spinal Deformity Surgery?

Sebastian Decker,Renaud Lafage,Christian Krettek,Robert Hart,Christopher Ames,Justin S. Smith,Douglas Burton,Eric Klineberg,Shay Bess,Frank J. Schwab,Virginie Lafage,International Spine Study Group 대한척추외과학회 2020 Asian Spine Journal Vol.14 No.2

Study Design: Retrospective cohort study. Purpose: To investigate the role of sacral extension (SE) for the development of proximal junctional kyphosis (PJK) in adult spinal deformity (ASD) surgery. Overview of Literature: The development of PJK is multifactorial and different risk factors have been identified. Of these, there is some evidence that SE also affects the development of PJK, but data are insufficient. Methods: Using a combined database comprising two propensity-matched groups of fusions following ASD surgery, one with fixation to S1 or S1 and the ilium (SE) and one without SE but with a lower instrumented vertebra of L5 or higher (lumbar fixation, LF), PJK and the role of further parameters were analyzed. The propensity-matched variables included age, the upper-most instrumented vertebra (UIV), preoperative sagittal alignment, and the baseline to 1 year change of the sagittal alignment. Results: Propensity matching led to two groups of 89 patients each. The UIV, pelvic incidence minus lumbar lordosis, sagittal vertical axis, pelvic tilt, age, and body mass index were similar in both groups (p>0.05). The incidence of PJK at postoperative 1 year was similar for SE (30.3%) and LF (22.5%) groups (p=0.207). The PJK angle was comparable (p=0.963) with a change of −8.2° (SE) and −8.3° (LF) from the preoperative measures (p=0.954). A higher rate of PJK after SE (p=0.026) was found only in the subgroup of patients with UIV levels between T9 and T12. Conclusions: Instrumentation to the sacrum with or without iliac extension did not increase the overall risk of PJK. However, an increased risk for PJK was found after SE with UIV levels between T9 and T12.

韓國人의 臨床檢體에 따른 抗酸菌 陽性率에 對한 考察

金永權 김천대학교 1985 김천대학교 논문집 Vol.6 No.-

Author practiced total 14,993 cases of AFB stain for five years from Jan 1, 1979 to Dec 31, 1983 at clinical laboratory Seoul Paik Hospital, Inje medical College. Author obtained 14,74 cases of AFB positive among a total 14,993 clinical specimens. Author have studied (1)Numbers of AFB stain from various specimen sources (2)AFB positive rate by different specimen sources (3)Age and sex distribution of AFB patients The results are summarized as follows: 1.Numbers of specimen sources requested for AFB stain are; sputum 12,498 cases(83.7%), urine 1,051 cases(7.0%), CSF 457 cases(3.0%) etc, among total 14,993 cases. 2.AFB positive rate is 9.9%(1474/14,993 cases) AFB positive rate in different specimen sources are; Pus 12.8%, sputum 11.1%, stool 4.0%, others 3.4% respectively. 3.AFB positivity in sexes are; 61.1% in male, 38.9% in female 4.Age distribution of AFB positivity are; 25-29 age groups 2.10% 30-34 age groups 0.82, 20-24 age groups 1.93% etc.

When is LABA/LAMA Better than LAMA in GOLD Group B or D Patients for Reducing Acute Exacerbations of COPD?

신홍준,김유일,김유림,이창열,라승원,문지용,정기석,유광하,신경철,임성철,KOCOSS Cohort Study Group 전남대학교 의과학연구소 2023 전남의대학술지 Vol.59 No.3

Long-acting b2-agonist (LABA)/long-acting muscarinic-antagonist (LAMA) dual therapy has been found to be more effective than LAMA monotherapy in the treatment of chronic obstructive pulmonary disease (COPD). However, among patients with group B or D COPD, the characteristics of patients for whom LABA/LAMA dual therapy is superior to LAMA monotherapy in minimizing acute exacerbations remain unknown. With data from a prospective COPD cohort, subgroup analyses were conducted to determine whether LABA/LAMA dual therapy was superior to LAMA monotherapy in reducing the rate of acute exacerbations in group B and D COPD patients. Group B and D COPD patients taking LAMA or LABA/LAMA were enrolled according to the 2022 Global initiative for Chronic Obstructive Pulmonary Disease guidelines. A total of 737 patients were included in this study: 600 with group B COPD and 137 with group D COPD. Compared with patients taking LAMA monotherapy, those taking LABA/ LAMA had a significantly lower incidence of acute exacerbations over 1 year. In the subgroup of patients ≥70 years old, there was a significantly lower risk of severe COPD exacerbations among group B patients taking LABA/LAMA than among those taking LAMA monotherapy (odds ratio [OR], 0.258; 95% confidence interval [CI], 0.095–0.703). In contrast, in the subgroup of group D patients with COPD Assessment Test scores ≥25, compared with LAMA monotherapy, LABA/LAMA treatment was associated with lower risk of severe COPD exacerbations (OR, 0.115; 95% CI, 0.018-0.749). The combination of LABA and LAMA was found to be superior to LAMA monotherapy, especially for treating older adults with group B COPD, as well as for group D patients with severe symptoms.

Causes of HIV Drug Non-Adherence in Korea: Korea HIV/AIDS Cohort Study, 2006-2015

김민정,이상아,장현하,김민자,우준희,김상일,강춘,기미경,최주연,최윤수,최보율,김준명,최준용,김효열,송준영,김신우,Korea HIV/AIDS Cohort Study 대한감염학회 2017 Infection and Chemotherapy Vol.49 No.3

We aimed to determine the initial adherence of HIV cohort patients to ART (antiretroviral therapy), and reasons for non-adherence. Patients who received ART at the time of enrollment in the Korea HIV/AIDS Cohort were included in this study. Treatment adherence was determined at the baseline interview by self-reported questionnaire. Eight-hundred thirty two HIV-infected patients received ART. Of these, 253 (30.4%) patients skipped ART more than once a month. The most common reason of skipping medication was “simply forgot” (60.4%).