The Association Between Lung Function and Type 2 Diabetes in Koreans

ObjectivesThis study was performed to test the association between lung function and type 2 diabetes mellitus (T2DM) in Korean patients.MethodsData from the 6th Korea National Health and Nutrition Examination Survey (2013 to 2015) was used in this study. There were 3,466 individuals aged between 40 and 80 years, with T2DM, who had a smoking and alcohol status listed, and blood analysis (including blood pressure), were included in this study. Lung function, measured by spirometer ventilatory dysfunction was categorized into 3 patterns: normal, restrictive ventilatory dysfunction, and obstructive ventilatory dysfunction (OVD).ResultsBased on multivariate logistic regression analysis, individuals with restrictive ventilatory dysfunction had an increased odds ratio (OR 1.615, 95% CI 1.137–2.294) for T2DM compared with individuals with normal ventilatory function, whereas OVD had no increase in the odds ratio (OR 1.169, 95 % CI 0.857–1.594). Model 1, which adjusted for age and gender, showed that the probability of having restrictive disorder was 1.559 times (95% CI 1.617–2.082) higher for prediabetes patients, and 2.320 times (95% CI 1.611–3.343) higher for T2DM patients, compared to normal individuals. For Model 4, which was fully adjusted for variables, the probability of having a restrictive disorder was 1.837 times higher for T2DM patients (95% CI 1.260–2.679).ConclusionRestrictive ventilatory dysfunction, but not OVD, was associated independently with T2DM.

The Association between Health-related Quality of Life and Depression on Activity Restriction in Osteoarthritis: A Cross-sectional Study

Purpose@#The purpose of this study is to provide basic evidence on the need to approach osteoarthritis patients through a psychological factors-considering rehabilitation program by understanding how activity restrictions in osteoarthritis affect health-related quality of life and depression. @*Methods@#This study assessed 3,761 osteoarthritis patients from the Korea National Health and Nutrition Examination Survey. The subjects were divided into two categories: with and without activity restriction. @*Results@#The prevalence of osteoarthritis in women was higher than that of men (men: 19.7%; women: 80.3%), and high BMI increased the prevalence of osteoarthritis. The EQ-5D index of subjects with activity restriction was 0.84±0.18 (points), while in those without activity restriction was 0.93±0.12, and the diagnosis of depression was 15.8%, 8.2%. There was a statistically significant difference in the odds ratio for each item in the EQ-5D. Moreover, the odds ratio for depression with activity restriction was 2.098 compared with no activity restriction. @*Conclusion@#Activity restriction of osteoarthritis patients significantly decreases the health-related quality of life and increase the probability of depression. Therefore, early diagnosis of depression symptoms to prevent deterioration of symptoms in patients with osteoarthritis and to increase compliance with rehabilitation treatment, and to provide arbitration, including treatment that can alleviate depression.

The Association between Health-related Quality of Life and Depression on Activity Restriction in Osteoarthritis: A Cross-sectional Study

Purpose@#The purpose of this study is to provide basic evidence on the need to approach osteoarthritis patients through a psychological factors-considering rehabilitation program by understanding how activity restrictions in osteoarthritis affect health-related quality of life and depression. @*Methods@#This study assessed 3,761 osteoarthritis patients from the Korea National Health and Nutrition Examination Survey. The subjects were divided into two categories: with and without activity restriction. @*Results@#The prevalence of osteoarthritis in women was higher than that of men (men: 19.7%; women: 80.3%), and high BMI increased the prevalence of osteoarthritis. The EQ-5D index of subjects with activity restriction was 0.84±0.18 (points), while in those without activity restriction was 0.93±0.12, and the diagnosis of depression was 15.8%, 8.2%. There was a statistically significant difference in the odds ratio for each item in the EQ-5D. Moreover, the odds ratio for depression with activity restriction was 2.098 compared with no activity restriction. @*Conclusion@#Activity restriction of osteoarthritis patients significantly decreases the health-related quality of life and increase the probability of depression. Therefore, early diagnosis of depression symptoms to prevent deterioration of symptoms in patients with osteoarthritis and to increase compliance with rehabilitation treatment, and to provide arbitration, including treatment that can alleviate depression.

Effects of Exercise on Cervical Angle and Respiratory Function in Smartphone Users

OBJECTIVES: The aim of this study was to determine whether exercises can change the cervical angle and respiratory function in smartphone users. METHODS: Thirty healthy volunteers were recruited. The subjects were randomly divided into an exercise group and a control group. All participants used a smartphone for 1 hour while maintaining a sitting posture. Then, each group performed their assigned activity. The exercise group performed two types of exercises and the control group maintained routine activities for 20 minutes. To investigate the changes in cervical angle and respiratory function, we measured the craniovertebral angle by using a spirometer. RESULTS: Statistically significant differences were noted in the craniovertebral angle, forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/FVC ratio, peak expiratory flow, maximal inspiratory pressure, and maximal expiratory pressure of the two groups (p < 0.05). CONCLUSION: Our findings showed that proper exercise could be a good method of improving the cervical angle and respiratory function in smartphone users.

Endovascular Treatment of Isolated Common Iliac Artery Aneurysms With Short Necks Using Bifurcated Stent-Grafts

Elective surgical repair has traditionally been considered to be the treatment of choice for the exclusion of isolated iliac artery aneurysms (IAAs). Recently, endovascular repair has evolved as an alternative to surgical repair, especially in patients at high surgical risk. However, in the absence of sufficient proximal necks, iliac artery aneurysms are not suitable for direct deployment of a tubular-shaped endograft. Here we report two cases of IAAs with short proximal necks that were excluded using an endovascular bifurcated stent-graft. The bifurcated stent-graft was successfully deployed with complete exclusion of the aneurysm. In neither case was there evidence of procedural failures. There were no signs of significant complications. We conclude that endovascular repair of IAAs with short proximal necks is feasible and efficient using an endovascular bifurcated stent-graft.

Hypoglycemia-induced Dementia and MR Image-irreversible Restricted Diffusion in Splenium of Corpus Callosum: A case report

The clinical impact of severe hypoglycemic brain insult is ranged from alterations of mental status to profound coma and death. However, the exact mechanism of hypoglycemic brain insult is not well known yet. We report a case of a 75-year-old female with diabetes, who developed dementia after a severe hypoglycemic event. Diffusion-weighted magnetic resonance imaging detected an increased signal intensity in the splenium of corpus callosum. After 6 days, follow-up MRI (T2 weighted imaging) revealed irreversible signal abnormalities in the splenium of corpus callosum. Also, SPECT (Single Positron Emission Computed Tomography) and PET (Positron Emission Tomography) revealed decreased cerebral functions in left parietal, temporal and occipital lobes. This case brings up better understanding for the extent and mechanism of hypoglycemic brain insult.

Overexpression of alpha-protease Inhibitor and Galectin-1 in Radiation-induced Early Phase of Pulmonary Fibrosis / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: Radiation-induced pulmonary fibrosis (RIF) is a significant complication of radiotherapy for lung cancer. Despite the large number of studies, the molecular mechanisms of RIF are poorly understood. Therefore, the complex protein expression pattern in RIF was characterized by identifying the proteins with an altered expression level after thorax irradiation using two-dimensional electrophoresis (2-DE) and mass spectrometry. MATERIALS AND METHODS: A mouse model of RIF was used to examine the alteration of the lung proteome because of availability of murine data related to human cases and the abundance of murine fibrotic lung samples. A mouse model of RIF was induced in radiosensitive C57BL/6 mice. Twenty-one weeks after 25 Gy irradiation, hematoxylin-eosin staining and hydroxyproline assay confirmed the early-phase pulmonary fibrosis. RESULTS: Lung samples from the irradiated and age-matched control mice were used to generate 16 high quality 2-DE gels containing approximately 1,000 spots. Of the 31 significantly up- or down-regulated protein spots, 17 were identified by MALDI-TOF/MS. CONCLUSIONS: Two important upregulated proteins were found, the alpha-protease inhibitor and galectin-1, which might be used as potential markers for the early phase of RIF.

Immediate and Mid-Term Outcomes of the Endovascular Stent-Graft Treatment of Abdominal Aortic Aneurysm

BACKGROUND AND OBJECTIVES: Although the standard management of an abdominal aortic aneurysm (AAA) is surgery, endovascular stent-graft treatment is more attractive for patients with significant co-morbid conditions. We evaluated the immediate and mid-term outcomes for the endovascular treatment of AAA. SUBJECTS AND METHODS: Between November 1996 and August 2004, 59 patients with an AAA (53 males, mean age 68.0+/-9.6 years, 3 cases with ruptured AAA) underwent an endovascular stent-graft repair at our institute. All patients were evaluated by an angiography, taken just after the completion of the procedure and at followed up with computed tomography (CT) at 1, 3, 6 and 12 months, and yearly thereafter. RESULTS: Technical success was achieved in 54 of the 59 patients (91.5%). The periprocedural mortality rate was 3.4% (2 of the 59 patients). A primary endoleak was found in 12 patients (20.3%)(type I; 9 patients, type II; 2 patients, type III; 1 patient), 2 of which required subsequent surgical conversion. Spontaneous resolution of an endoleak was seen in 4 patients (33.3%). The average follow-up period of 57 patients was 27.5 months (range from 72 days to 2581 days). In 8 patients (14.0%), a newly developed secondary endoleak was documented. A total 14 patients (23.7%) died during the follow-up period (rupture; 3, operation-related sepsis; 3, unrelated causes; 3, cardiac arrest; 1, unknown causes; 4). The cumulative survival rates at 30 days and at 1 and 2 years were found to be 93.0, and 85.7 and 76.3%, respectively, using Kaplan-Meier methods. Secondary intervention was required in 12 patients (21.8%), and surgical conversion in 4 (6.8%), with 2 (3.4%) requiring conversion to open surgery immediately after the intervention. In those with technical success, without endoleaks and graft failure, the survival rate during follow-up was higher (97.1%; rate with the exception of unrelated cause of death) than that of all the patients. CONCLUSION: The immediate and mid-term results suggest that the endovascular treatment of an AAA is technically feasible and effective. There was higher mortality and morbidity in primary and newly developed endoleak cases; therefore, proper selection of cases, according to the anatomical and clinical criteria, is essential, with meticulous regular follow-ups being critical for the optimal endovascular treatment of an AAA.

Favorable Late Outcome of Endovascular Abdominal Aortic Aneurysm Repair

BACKGROUND AND OBJECTIVE: Although the endovascular method of treating abdominal aortic aneurysms (AAA) shows good early results and benefits, the late outcome of this treatment remains uncertain. This study evaluated the late outcome following an endovascular AAA repair. SUBJECTS AND METHODS: Thirty-three patients that had undergone an endovascular AAA repair at our institute were evaluated. The results of the treatment were evaluated by an angiography, taken just after the completion of the procedure, and by contrast-enhanced CT scans at 1, 3, 6 and 12 months, and annually thereafter. RESULTS: The patient's characteristics were as follows: 29 (88%) were male, 19 (58%) had coronary artery disease and 7 (21%) had renal insufficiency. A technical success was achieved in 31 patients (94%), with primary endoleaks in two. Two patients (6.1%) died within 1 month of the procedure, both at an elderly age, with high risk. There was 1 (3%) incidence of early complications that required treatment. During the 28 month follow-up period, 6 patients (20%) needed a secondary procedure. Endoleaks remained in 4 patients, and the size of aneurysm increased in 3 patients. Four patients died during follow-up, and two had an endoleak. The cause of death was not related to cardiovascular diseases in the other two patients. The event free survival at 24 months was 72%. CONCLUSION: The late outcome after an endovascular AAA repair was favorable. However, a secondary procedure was needed, and endoleaks observed, in half of the patients that died during follow-up. Therefore, regular evaluation of aneurysms and the management of endoleaks are very important for a favorable late outcome in endovascular AAA repair patients.