Association between the Eating Family Meal and the Prevalence of Metabolic Syndrome Using Data from Korea National Health and Nutrition Examination Survey (2007–2012) / 가정의학회지

BACKGROUND: Several studies have shown that family meals promote a well-balanced and healthier diet and weight status. Metabolic syndrome is related to eating behavior. This study investigated the association between eating family meals and the prevalence of metabolic syndrome. METHODS: This cross-sectional study included 4,529 subjects who participated in the Korea National Health and Nutrition Examination Survey IV and V (2007–2012). A self-reported questionnaire was used to assess dietary status. Metabolic syndrome was defined according to the guidelines of the modified version of the National Cholesterol Education Program Adult Treatment Panel III. We compared the overall quality of dietary intake in family meal. RESULTS: Nutritional adequacy ratios for energy, protein, calcium, vitamin A, vitamin B₁, vitamin B₂, vitamin C, niacin, and potassium, and the mean adequacy ratio were significantly higher in the family meal group (P<0.05). The prevalence of metabolic syndrome was lower in the family meal group (P<0.05). However, we observed no significant association between eating family meals and the prevalence of metabolic syndrome. CONCLUSION: This study demonstrated that eating family meals appeared to be associated with nutrient adequacy. However, we observed no significant differences in prevalence of metabolic syndrome between the 2 groups.

Efficacy of horse chestnut leaf extract ALH-L1005 as a matrix metalloproteinase inhibitor in ligature-induced periodontitis in canine model

Matrix metalloproteinases (MMPs) are the main proteinases associated with periodontal tissue destruction and remodeling. Therefore, inhibition of host-derived MMPs has a key role in the prevention and reduction of periodontitis progression. Horse chestnut (Aesculus hippocastanum L.) extracts have been used as treatments for inflammatory disease, traditionally. This study assessed the clinical effect as a MMP inhibitor of horse chestnut leaf extract ALH-L1005 on periodontitis. ALH-L1005 was obtained from horse chestnut leaf and its MMP inhibitory activities estimated. Periodontitis was induced in beagles assigned to 4 groups and medicated for 6 weeks: low dose test (LT; ALH-L1005, 100 mg/kg/day), high dose test (HT; ALH-L1005, 200 mg/kg/day), positive control (PC; doxycycline, 10 mg/kg/day), or negative control (NC; placebo). Before and after administration, clinical indices of the teeth and MMP quantity in gingival tissues using zymography were measured. Clinical conditions of the LT, HT, and PC groups were significantly improved after 6 weeks. In zymographic evaluations, gelatinolytic and caseinolytic activities were suppressed in LT, HT, and PC groups but not in the NC group. The results suggest that ALH-L1005 could be an effective agent for clinical prevention and treatment of periodontitis by inhibiting the gelatinase and collagenase activities, which can detach periodontal ligaments from alveolar bone.

Current status of human papillomavirus vaccines

Cervical cancer is a malignant neoplasm arising from cells that originate in the cervix uteri. It is the second most prevalent cancer among women. It can have several causes; an infection with some type of human papillomavirus (HPV) is the greatest risk factor for cervical cancer. Over 100 types of HPVs have been identified, and more than 40 types of HPVs are typically transmitted through sexual contact and infect the anogenital region. Among these, a number of HPVs types, containing types 16 and 18, are classified as "high-risk" HPVs that can cause cervical cancer. The HPVs vaccine prevents infection with certain species of HPVs associated with the development of cervical cancer, genital warts, and some less common cancers. Two HPVs vaccines are currently on the global market: quadrivalent HPVs vaccine and bivalent HPV vaccine that use virus-like particles as a vaccine antigen. This review discusses the current status of HPVs vaccines on the global market, clinical trials, and the future of HPVs vaccine development.

A Case of Incidentally Diagnosed Adrenal Paragonimiasis

We report here on a rare case of adrenal paragonimiasis that presented with an adrenal incidentaloma. A 52-year-old male presented with fatigue and weight loss. The laboratory findings revealed eosinophilia (8.5%) and an increased eosinophil count (910/microL). The computed tomography scan showed 6.5 x 5 cm sized multilocular cystic mass in the right adrenal gland, which was non-functioning, and cystic lesions with variable sizes were also noted in the abdominal cavity. On the surgical field, whitish patches were spread out in the peritoneum, the omentum, the dome of the liver and the diaphragm. The right adrenal gland was replaced by a cystic mass filled with mucopurulent creamy materials. The pathologic findings revealed numerous eggs of Paragonimus spp. Also, the ELISA was positive for IgG paragonimus antibody. The adrenal gland can become infected by various microbial pathogens, including parasites, although it is relatively uncommon. However, in the case of a cystic adrenal mass with accompanying eosinophilia in an endemic area, clinicians should consider the possibility of parasitic infection.

Incidence of Diabetic Foot and Associated Risk Factors in Type 2 Diabetic Patients: A Five-year Observational Study / 당뇨병

BACKGROUND: The frequency of lower extremity amputation due to diabetic foot has been increasing in type 2 diabetic patients. The aim of this study was to observe the incidence, clinical aspects and associated risk factors for diabetic foot. METHODS: We evaluated the incidence of diabetic foot through a five-year observation of type 2 diabetic patients who presented to St. vincent's Hospital between January and December 2003. To identify the risk factors for diabetic foot, we evaluated mean glycosylated hemoglobin A1c (HbA1c) every six months and assessed renal function based on the existence of proteinuria and estimated glomerular filtration rate (GFR) using the Modification of Diet in Renal Disease (MDRD) equation. Patients were also evaluated for retinopathy, peripheral neuropathy and autonomic neuropathy using Ewing's method. RESULTS: From an initial pool of 613 patients, the observational study of 508 patients (82.9%) was completed. The mean age, duration of diabetes and HbA1c were 50.3 +/- 10.6 yrs, 7.2 +/- 6.5 yrs and 8.8 +/- 2.1%, respectively. Diabetic foot occurred in 32 patients (6.3%). The incidence of diabetic foot increased when diabetic retinopathy (OR = 6.707, 2.314~19.439), peripheral neuropathy (OR = 2.949, 1.075~8.090), and autonomic neuropathy (OR = 3.967, 1.476~10.660) were present and when the MDRD GFR (OR = 5.089, 1.712~15.130) decreased. Mean HbA1c (OR = 12.013, 1.470~98.179) was found to be an independent risk factor for diabetic foot. CONCLUSION: The present study confirmed the importance of intensive glycemic control and the role of autonomic dysfunction in the development of diabetic foot. In addition, diabetic retinopathy and impaired renal function proved to be factors associated with the occurrence of diabetic foot. Therefore, intensive glycemic control, as well as periodic examination of renal function, are essential for the prevention of diabetic foot.

Average Daily Risk Range-Index of Glycemic Variability-Related Factor in Type 2 Diabetic Inpatients / 당뇨병

BACKGROUND: It is known that chronic sustained hyperglycemia and its consequent oxidative stress causes diabetic complication in type 2 diabetes. It has been further proven that glycemic variability causes oxidative stress. The aim of this study is to measure the average daily risk range (ADDR)-index of glycemic variability, and to evaluate relevant variables. METHODS: We measured the blood glucose level of type 2 diabetic patients who were treated with multiple daily injections from January to July, 2008. The blood glucose levels were checked four times a day for 14 days and were conversed according to the ADRR formula. The degree of glycemic variability was categorized into non-fluctuation and fluctuation groups. We collected patient data on age, sex, duration of diabetes, body mass index, HOMA(IR), HOMA(betacell) and HbA1c. RESULTS: A total of 97 patients were enrolled in this study. The mean age, duration of diabetes, HbA1c and mean ADRR were 57.6 +/- 13.4, 11.5 +/- 8.5 years, 10.7 +/- 2.5%, and 26.6 +/- 9.8, respectively. We classified 18.5% of the patients to the non-fluctuation group, and 81.5% to the fluctuation group. ADRR was significantly correlated with duration of diabetes, fasting and postprandial glucose, fructosamine, HbA1c and BMI and HOMAbetacell. In addition, this study confirmed that BMI, HOMAbetacell and HbA1c were ADRR-related independent variables. CONCLUSION: ADRR can be used as an index for blood glucose fluctuation in type 2 diabetic patients. Measuring ADRR in patients with low BMI and a long duration of diabetes is helpful to improve the effectiveness of their care.

Utility of CT colonography in detecting colon polyps as a colon cancer screen / 대한내과학회지

BACKGROUND/AIMS: CT colonography is a rapid and safe imaging method for detecting polyps in the colon and rectum. We assessed the efficacy of CT colonography in colorectal polyp detection. METHODS: We prospectively studied 84 subjects (mean age 55.7+/-11.1 years; 52 men, 32 women) undergoing CT colonography followed by colonoscopy. Based on the results of CT colonography, all polyps were classified by size (any size, and those larger than 5, 7, and 10 mm) and were checked for location, morphology, and histological characteristics. We determined the sensitivity and specificity of CT colonography using colonoscopy as a reference standard with a segmental unblinding method. RESULTS: A total of 56 lesions were identified in 26 of 79 subjects undergoing both CT colonography and conventional colonoscopy. The sensitivities of CT colonography for polyps of any size, and larger than 5, 7, and 10 mm were 60.7%, 70.5%, 75.9%, and 81.8%, respectively. The per-subject sensitivities of CT colonography for the polyps of any size, and larger than 5, 7, and 10 mm, were 80.7%, 95.0%, 93.3%, and 90.9%, respectively. The per-subject specificities of CT colonography for polyps were 86.8%, 89.8%, 95.3%, and 100.0%, respectively. The sensitivities of CT colonography for flat, sessile, and pedunculated polyps were 30.8%, 85.0%, and 90.0%, respectively. CONCLUSIONS: CT colonography is a useful diagnostic method for screening colorectal neoplasias larger than 7 mm diameter, showing 75.9% sensitivity and 71.0% positive predictive value.

Cystatin C is a Valuable Marker for Predicting Future Cardiovascular Diseases in Type 2 Diabetic Patients / 당뇨병

BACKGROUND: Recent studies suggest that serum Cystatin C is both a sensitive marker for renal dysfunction and a predictive marker for cardiovascular diseases. We aimed to evaluate the association between Cystatin C and various biomarkers and to find out its utility in estimating risk for cardiovascular diseases in type 2 diabetic patients. METHODS: From June 2006 to March 2008, anthropometric measurements and biochemical studies including biomarkers for risk factors of cardiovascular diseases were done in 520 type 2 diabetic patients. A 10-year risk for coronary heart diseases and stroke was estimated using Framingham risk score and UKPDS risk engine. RESULTS: The independent variables showing statistically significant associations with Cystatin C were age (beta = 0.009, P < 0.0001), hemoglobin (beta = -0.038, P = 0.0006), serum creatinine (beta = 0.719, beta < 0.0001), uric acid (beta = 0.048, P = 0.0004), log hsCRP (beta = 0.035, P = 0.0021) and homocysteine (beta = 0.005, P = 0.0228). The levels of microalbuminuria, carotid intima-media thickness, fibrinogen and lipoprotein (a) also correlated with Cystatin C, although the significance was lost after multivariate adjustment. Calculated risk for coronary heart diseases increased in proportion to Cystatin C quartiles: 3.3 +/- 0.4, 6.2 +/- 0.6, 7.6 +/- 0.7, 8.4 +/- 0.7% from Framingham risk score (P < 0.0001); 13.1 +/- 0.9, 21.2 +/- 1.6, 26.1 +/- 1.7, 35.4 +/- 2.0% from UKPDS risk engine (P < 0.0001) (means +/- SE). CONCLUSIONS: Cystatin C is significantly correlated with various emerging biomarkers for cardiovascular diseases. It was also in accordance with the calculated risk for cardiovascular diseases. These findings verify Cystatin C as a valuable and useful marker for predicting future cardiovascular diseases in type 2 diabetic patients.

The Effect of Oriental Self-help Group Program for the Living Alone-Aged Inhabiting Rural Region

PURPOSE: The purpose of this study was to evaluate the effect of an Oriental self-help group program on living-alone elders in rural areas. METHOD: A one-group pretest-post test design was used. The subjects of the experimental group participated in the oriental self-help program, health education, feet bathing in hot water, cupping therapy, and foot-reflexology. The obtained data were analyzed using the Wilcoxon signed rank test and Pearson correlation coefficients of SPSS. RESULTS: 1) The level of blood triglyceride, SGOT and glucose decreased significantly in the experimental group compared to the control group. 2) The scores of depression and stress decreased significantly in the experimental group compared to the control group. 3) The score of Yangsaeng increased significantly in the experimental group compared to the control group. 4) Depression was higher when the score of stress was high, and the score of depression and stress were lower when the score of Yangsaeng was high. CONCLUSION: Considering the results of this research, the program is effective in improving physiological indexes partially, emotional indexes and Yangsaeng. Therefore this program can be implemented as a community-based self-help group program for living-alone elders in rural areas.

A case of suprasellar germinoma misdiagnosed as lymphocytic hypophysitis / 대한내과학회지

We report here on a case of a 22-year-old girl with a suprasellar mass that was originally diagnosed as lymphocytic hypophysitis, but it eventually turned out to be a germinoma. She initially underwent partial tumor removal and the tissue diagnosis was suggestive of lymphocytic hypophysitis. 46 months later, she presented with a lateral visual field defect and decreased visual acuity of her right eye. The serum and cerebrospinal beta-hCG and alpha-fetoprotein levels were measured. The beta-hCG level was elevated in both, whereas the alpha-fetoprotein level was detectable in neither. The serum anti-pituitary antibody-1 level was negative. She was reoperated and the permanent section biopsies were compatible with pure germinoma. There was no evidence of meningeal metastasis on her whole spine MRI. She was treated with chemotherapy.