Pan C.,Chinese PLA General Hospital |
Yoo H.J.,Hangang Sacred Heart Hospital |
Ho L.-T.,Taipei Veterans General Hospital |
Ho L.-T.,National Yang Ming University
Journal of Obesity | Year: 2011
Rimonabant, a selective cannabinoid-1 (CB1) receptor antagonist, has been shown to reduce weight and enhance improvements in cardiometabolic risk parameters in Western populations. This study assessed these effects of rimonabant in Asian population. A total of 643 patients (BMI 25 kg / m 2 or greater without diabetes) from China, Republic of Korea, and Taiwan were prescribed a hypocaloric diet (600 kcal/day deficit) and randomized to rimonabant 20 mg (n = 318) or placebo (n = 325) for 9months. The primary efficacy variable was weight change from baseline after 9 months of treatment. Results showed that rimonabant group lost more weight than placebo, (LSM ± SEM of -4.7 ± 0.3 kg vs. -1.7 ± 0.3 kg, P <.0001). The 5% and 10% responders were 2 or 3 folds more in the rimonabant group (53.0% vs. 20.0% and 21.5% vs. 5.7%, resp.) (P <.0001). Rimonabant also significantly increased HDL-cholesterol, decreased triglycerides and waist circumference,by 7.1%, 10.6%, and 2.8 cm, respectively (P <.0001). This study confirmed the comparable efficacy and safety profile of rimonabant in Asian population to Caucasians. Owing to the recent suspension of all the CB1 antagonists off the pharmaceutical market for weight reduction in Europe and USA, a perspective in drug discovery for intervening peripheral CB1 receptor in the management of obesity is discussed. © 2011 Changyu Pan et al.
Lim S.,Seoul National University |
Kang S.M.,Seoul National University |
Lee H.J.,Seoul National University |
Yoon J.W.,Seoul National University |
And 7 more authors.
Diabetes Care | Year: 2011
OBJECTIVE - To improve quality and efficiency of care for elderly patients with type 2 diabetes, we introduced elderly-friendly strategies to the clinical decision support system (CDSS)-based ubiquitous healthcare (u-healthcare) service, which is an individualized health management system using advanced medical information technology. RESEARCH DESIGN AND METHODS - We conducted a 6-month randomized, controlled clinical trial involving 144 patients aged >60 years. Participants were randomly assigned to receive routine care (control, n = 48), to the self-monitored blood glucose (SMBG, n = 47) group, or to the u-healthcare group (n = 49). The primary end point was the proportion of patients achieving A1C <7% without hypoglycemia at 6 months. U-healthcare system refers to an individualized medical service in which medical instructions are given through the patient's mobile phone. Patients receive a glucometer with a public switched telephone network-connected cradle that automatically transfers test results to a hospital-based server.Once the data are transferred to the server, an automated system, the CDSS rule engine, generates and sends patient-specific messages by mobile phone. RESULTS - After 6 months of follow-up, the mean A1C level was significantly decreased from 7.8 ±1.3% to 7.4 ± 1.0% (P< 0.001) in the u-healthcare group and from 7.9 ±1.0% to 7.7 ± 1.0%(P = 0.020) in the SMBG group, compared with 7.9±0.8% to 7.861.0% (P=0.274) in the control group. The proportion of patients with A1C <7% without hypoglycemia was 30.6% in the u-healthcare group, 23.4% in the SMBG group (23.4%), and 14.0%in the control group (P< 0.05). CONCLUSIONS - The CDSS-based u-healthcare service achieved better glycemic control with less hypoglycemia than SMBG and routine care and may provide effective and safe diabetes management in the elderly diabetic patients. © 2011 by the American Diabetes Association.
Choi Y.-H.,Anesthesiology and Pain Medicine |
Kim K.-M.,Hallym University |
Kim H.-O.,Hangang Sacred Heart Hospital |
Kwak I.-S.,Hallym University
Annals of Dermatology | Year: 2013
Background: Hypertrophic scar following a burn is caused by the excessive deposit of collagen resulting in an exaggerated wound healing response. The burn patient complains of pain and itching over the scar, which can give rise to cosmetic and functional problems. Objective: The aim of this study was to investigate the clinical and histological correlation of a hypertrophic burn scar for itching and pain sensations. Methods: Thirty- eight patients underwent a scar release and skin graft. the modified Vancouver scar scale and the verbal numerical rating scale were recorded. All biopsies were taken from scar tissue (scar) and normal tissue (normal). Histologically, tissues were observed in the epidermis, the monocytes around the vessels, the collagen fiber, elastic fiber, and the mast cells. Results: The mean total score of MVSS was 8.4±2.7 (pliability 2.0±0.9; thickness 1.8±0.9; vascularity 2.0± 0.9; and pigmentation 2.1±0.9). Pain and itching were 2.4±2.0 and 2.9±3.0. Epidermis were 7.9±2.8 layers (scar) and 4.0±0.8 layers (normal). The collagen fibers were thin and dense (scar) and thicker and loose (normal). The elastic fibers were thin and nonexistent (scar) and thin and loose (normal). Mast cells were 11.2±5.8/high power field (scar) and 7.4±4.1 (normal). Conclusion: As the scar tissue thickens, the itching becomes more severe. The stiffness of the scar with the pain appeared to be associated with the condition of the tissue. The correlation between clinical and histological post-burn hypertrophic scars will help further studies on the scar. This helped with the development of the base material for therapeutic strategies. (Ann Dermatol 25(4) 428~433, 2013).
A randomized, double-blind, multicenter comparison study of triple antiplatelet therapy with dual antiplatelet therapy to reduce restenosis after drug-eluting stent implantation in long coronary lesions: Results from the DECLARE-LONG II (Drug-eluting stenting followed by cilostazol treatment reduces late restenosis in patients with long coronary lesions) trial
Lee S.-W.,University of Ulsan |
Park S.-W.,University of Ulsan |
Kim Y.-H.,University of Ulsan |
Yun S.-C.,University of Ulsan |
And 24 more authors.
Journal of the American College of Cardiology | Year: 2011
Objectives: The purpose of this study was to determine whether cilostazol reduces intimal hyperplasia in patients undergoing long zotarolimus-eluting stent implantation (stent length: <30 mm) for native long coronary lesions (length: <25 mm). Background: Restenosis after drug-eluting stent implantation remains a significant clinical problem in long coronary lesions. Methods: Patients (n = 499) were assigned randomly to triple (aspirin, clopidogrel, and cilostazol, triple group: n = 250) or dual antiplatelet therapy (aspirin and clopidogrel and placebo, dual group: n = 249) for 8 months after long zotarolimus-eluting stent implantation. The primary end point was in-stent late loss at the 8-month angiography according to the intention-to-treat principle. Results: The 2 groups had similar baseline characteristics. The in-stent (0.56 ± 0.55 mm vs. 0.68 ± 0.59 mm, p = 0.045) and in-segment (0.32 ± 0.54 mm vs. 0.47 ± 0.54 mm, p = 0.006) late loss were significantly lower in the triple versus dual group, as were 8-month in-stent restenosis (10.8% vs. 19.1%, p = 0.016), in-segment restenosis (12.2% vs. 20.0%, p = 0.028), and 12-month ischemic-driven target lesion revascularization (5.2% vs. 10.0%, p = 0.042) rates. At 12 months, major adverse cardiac events including death, myocardial infarction, and ischemic-driven target lesion revascularization tended to be lower in the triple group than the dual group (7.2% vs. 12.0%, p = 0.07). Percent intimal hyperplasia volume by volumetric intravascular ultrasound analysis was reduced from 27.1 ± 13.2% for the dual group to 22.1 ± 9.9% for the triple group (p = 0.017). Conclusions: Patients receiving triple antiplatelet therapy after long zotarolimus-eluting stent implantation had decreased extent of late luminal loss, percent intimal hyperplasia volume, and angiographic restenosis, resulting in a reduced risk of 12-month target lesion revascularization compared with patients receiving dual antiplatelet therapy. © 2011 American College of Cardiology Foundation.
Shin W.G.,Kangdong Sacred Heart Hospital |
Kim S.J.,Chuncheon Sacred Heart Hospital |
Choi M.H.,Hangang Sacred Heart Hospital |
Kim K.O.,Hallym University |
And 8 more authors.
Gastrointestinal Endoscopy | Year: 2012
Background: There has been no consensus regarding the optimal treatment durations and drug regimens in patients with endoscopic submucosal dissection (ESD)induced ulcers. Objective: To assess the efficacy of proton pump inhibitor (PPI) and rebamipide combination therapy compared with PPI monotherapy for ESD-induced ulcer healing. Design: Randomized, prospective, controlled study; clinical trial. Setting: Five hospitals in a University Medical Center group in Korea. Patients: This study involved 290 adults (309 lesions) who underwent ESD for gastric adenoma or early gastric cancer. Intervention: PPI and rebamipide combination therapy. Main Outcome Measurements: The ulcer healing rate at 4 weeks after ESD. Results: The ulcer healing rates at 4 weeks after ESD in the PPI and rebamipide combination therapy group were significantly higher than those in the PPI alone group, both in the full analysis (94.9% vs 89.9%; P <.0001) and in the per-protocol analysis (94.5% vs 91.2%; P =.020). This combination therapy was an independent predictive factor for a high ulcer healing rate (adjusted odds ratio [OR] 5.572; 95% confidence interval [CI], 2.615-11.876; P =.014). Additionally, the combination therapy group exhibited a higher quality of ulcer healing than the PPI monotherapy group (reviewer 1: P =.027; OR 1.949; 95% CI, 1.077-3.527; reviewer 2: P =.027; OR 1.933; 95% CI, 1.074-3.481). Limitations: Open-label study. Conclusion: PPI and rebamipide combination therapy had a superior 4-week ESD-induced ulcer healing rate and quality of ulcer healing compared with PPI monotherapy. (Clinical trial registration number: NCT01167101.) © 2012 American Society for Gastrointestinal Endoscopy.
Oh S.J.,Hallym University |
Koh S.H.,Hallym University |
Lee J.W.,Hangang Sacred Heart Hospital |
Jang Y.C.,Hangang Sacred Heart Hospital
Journal of Craniofacial Surgery | Year: 2010
The advent of tissue expansion started a new era of aesthetically reconstructed scalp alopecia by providing a large hair-bearing scalp area with acceptable hair density. However, residual scalp alopecia and wide visible scars still raised aesthetic problems. The hair follicle transplantation carries the possibility of producing a more natural scalp because both the desired hair density and the natural direction of the hair can be reproduced using this procedure.Our study group consisted of 62 patients (41 males and 21 females) with a mean age of 26.3 years. The median age of suffering a burn to the scalp was 3 years. The causes of burn resulting to scalp alopecia were flame (n = 28), scald (n = 18), contact (n = 7), and electrical (n = 9) injuries. The first reconstruction for all patients was the expanded flap coverage. Three patients used 2-stage expanded flaps. Five patients underwent hair follicle transplantation after they had undergone the expanded flap coverage.Expanders (n = 86) were placed in 62 patients with a total of 9 major (9.3%) and 3 minor (3.5%) complications. The overall results after expanded flap reconstruction and hair follicle transplantation were excellent (43 patients, 69.4%), good (18 patients, 29%), and bad (1 patient, 1.6%).Postburn scalp alopecia can be reconstructed by 1-stage or multiple-stage expanded flap procedures. The visible remaining alopecia and marginal scar after the procedure, especially on the anterior hairline of the forehead and the sideburns, can be refined by hair follicle transplantation. This report also suggests the possibility that cicatrical scalp alopecia with intact deep tissue can be restored by hair follicle transplantations using hair transplanter. Copyright © 2010 by Mutaz B. Habal, MD.
Comparison between on-demand dosing of dapoxetine alone and dapoxetine plus mirodenafil in patients with lifelong premature ejaculation: Prospective, randomized, double-blind, placebo-controlled, multicenter study
Lee W.K.,Hallym University |
Lee S.H.,Hallym University |
Cho S.T.,Kangnam Sacred Heart Hospital |
Lee Y.S.,Hangang Sacred Heart Hospital |
And 5 more authors.
Journal of Sexual Medicine | Year: 2013
Introduction: There is partial evidence to support the use of phophodiesterase-5 inhibitor (PDE5-I) for the treatment of premature ejaculation (PE). Aim: We compared on-demand dosing of dapoxetine alone and combined with mirodenafil in subjects with lifelong PE and without erectile dysfunction (ED). Methods: Our prospective, randomized, double-blind, placebo-controlled, multicenter trial enrolled 118 subjects with lifelong PE without ED. PE was diagnosed using Diagnostic andStatisticalManual ofMentalDisorders, fourth edition, text revision. Patients were divided into two groups: dapoxetine 30mg plus placebo (group A, n=56) and dapoxetine 30mg plus mirodenafil 50mg (group B, n=62). Main Outcome Measures: During 12 weeks, intravaginal ejaculatory latency time (IELT) and the time from foreplay to beginning intercourse (FTIT) with a stopwatch, and Premature Ejaculation Profile (PEP) were measured. Overall sexual act time (OSAT; sum of FTIT and IELT) was calculated. Any treatment-emergent adverse events (TEAEs) were also recorded. Results: Over 12 weeks, IELT, OSAT, and PEP index score significantly improved in group B compared with group A (increased geometric mean IELT in group A and B=3.6 and 6.1 minutes, P=0.026; increased geometric mean OSAT in group A and B=5.5 and 9.9 minutes, P=0.012; increased median PEP index score in group A and B=1.0 and 1.3, P=0.046). However, there was no significant difference between two groups with respect to improvement of FTIT (P=0.147). TEAEs did not differ between groups (all P>0.05), and there was no serious adverse event in any subjects. Conclusions: Low dose of dapoxetine combined with mirodenafil showed better results in terms of IELT, OSAT, and PEP index score, and similar TEAEs, compared with that of dapoxetine only. Our results support the suggestion that the PDE5-Is have a potential role in the treatment of PE without ED. © 2013 International Society for Sexual Medicine.
Shin C.S.,Seoul National University |
Choi H.J.,Seoul National University |
Kim M.J.,Seoul National University |
Kim J.T.,Eulji General Hospital |
And 9 more authors.
Bone | Year: 2010
Purpose: To investigate bone mineral density (BMD) profiles, osteoporosis prevalence and risk factors in a community-based cohort in Korea. Methods: The present study is a cross-sectional study. The study population consisted of 1,547 men and 1991 women aged 40. years and older with BMD measurements using central dual energy X-ray absorptiometry from a prospective community-based cohort. The data were compared with other ethnic groups. Risk factors related to osteoporosis were analyzed. Results: Crude prevalence of osteoporosis in the whole subjects (40-79. years old) was 13.1% for men and 24.3% for women by WHO criteria, at any site among lumbar spine, femoral neck or total hip. Standardized prevalence of osteoporosis between age of 50 and 79 at lumbar spine, femoral neck and total hip was 12.9%, 1.3% and 0.7% in men and 24.0%, 5.7% and 5.6% in women, respectively. The mean BMD of studied female subjects after age of 50 was not significantly different from that of Chinese but significantly lower than that of Japanese, non-Hispanic whites, non-Hispanic blacks and Mexican Americans. Risk of osteoporosis was significantly associated with the presence of past fracture history (OR, 1.45; 95% CI, 1.08-1.94), smoking. 1 pack/day (OR, 1.63; 95% CI, 1.01-2.62), menarche after age of 16 (OR, 1.46; 95% CI, 1.14-1.87), last delivery after age of 30 (OR, 1.58; 95% CI, 1.20-2.09), more than three offspring (OR, 1.42; 95% CI, 1.07-1.89), post-menopause status (OR, 7.32; 95% CI, 3.05-17.6), more than 17. years since menopause (OR, 1.53; 95% CI, 1.10-2.14), regular exercise of two to three times per week (OR, 0.40; 95% CI, 0.18-0.89), monthly income above 500,000. won per household (OR, 0.64; 95% CI, 0.45-0.92), college graduate (OR, 0.29; 95% CI, 0.13-0.63) and calcium intake. 627.5. mg/day (OR, 0.65; 95% CI, 0.43-0.98) after adjusting for age and BMI. Conclusion: The BMD and osteoporosis prevalence of Koreans are presented. Risk of osteoporosis was significantly associated with fracture history, smoking, reproductive history, regular exercise, income level, education background and calcium intake. © 2010 Elsevier Inc.
Lim J.W.,Chuncheon Sacred Heart Hospital |
Han J.R.,Hangang Sacred Heart Hospital
Clinical and Experimental Ophthalmology | Year: 2011
Background: To determine the aqueous humour levels of vascular endothelial growth factor (VEGF) and erythropoietin (EPO) in eyes with diabetic macular oedema before and after intravitreal EPO injection. Design: Prospective interventional case series. Participants: Eleven eyes of 11 patients with diabetic macular oedema, and 10 eyes of 10 patients with cataract surgery as controls. Main Outcomes Measures: EPO and VEGF levels in aqueous humour before and after intravitreal EPO injection in patients and compared with controls. Methods: Eyes with diabetic macular oedema received an intravitreal injection of EPO (1000IU/0.05mL), followed by various intraocular procedures at different intervals (1-54days) after injection. An aqueous humour sample was obtained and aqueous humour levels of EPO and VEGF were measured using enzyme-linked immunosorbent assay. Results: The aqueous levels of EPO and VEGF were significantly elevated in diabetic macular oedema eyes compared to control eyes (P<0.05). EPO levels in patients correlated with VEGF levels (r=0.816, P=0.002) and central macular thickness at baseline (r=0.618, P=0.043). After intravitreal EPO injection, aqueous EPO levels were significantly elevated, whereas aqueous VEGF levels were varied according to the time interval since injection. Visual acuity and central macular thickness were not different after injection, compared to before injection. Aqueous EPO levels did not correlate with serum EPO levels(r=0.299, P=0.371). Conclusions: EPO is locally expressed and is correlated with VEGF in eyes with diabetic macular oedema. The role of EPO and the effect of intravitreal EPO in patients with diabetic macular oedema need to be further defined. © 2011 The Authors. Clinical and Experimental Ophthalmology © 2011 Royal Australian and New Zealand College of Ophthalmologists.
Im H.-J.,Hallym University |
Oh D.-G.,Gachon University |
Ju Y.-S.,Hallym University |
Kwon Y.-J.,Hangang Sacred Heart Hospital |
And 2 more authors.
American Journal of Industrial Medicine | Year: 2012
Background: The number of workers who died due to occupational injury in Korea as of 2007 was 1,383. The aim of this study was to identify whether there were any differences in the risk of occupational injury between nonstandard workers (temporary workers and/or subcontract workers) and regular workers. Methods: 1,576 injured workers, selected from National Health Insurance and National Workers' Compensation Insurance, were interviewed via telephone survey using standardized questionnaires in 2007. The control group was 1,500 workers matched for age, gender, and severity of injury. A multivariate logistic regression model was used to analyze the association between the type of nonstandard work and occupational injury. Results: Nonstandard temporary workers were more likely to be injured than regular workers even if other related factors of occupational injury were statistically adjusted (adjusted odds ratio, OR 2.87, 95% confidence interval 2.37-3.49). Conclusions: The reason why the risks of nonstandard workers are higher than those of regular workers is that nonstandard workers are placed in poor working conditions. © 2012 Wiley Periodicals, Inc.