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Purpose: Infants in the neonatal intensive care unit (NICU) often show cardiorespiratory deterioration during gavage feeding. We aimed to determine whether slow infusion intermittent feeding (SIIF) can reduce respiratory deterioration during gavage feeding in preterm infants in the NICU.Methods: Data on preterm infants whose gavage feeding method was changed to SIIF (1-­­hour infusion with an infusion pump and 2-­hour rest within a 3­-hour interval) from bolus gravity feeding (2-­ or 3-­hour interval) due to feeding­-associated cardiorespiratory deterioration were retrospectively reviewed. A significant cardiorespiratory event was defined as a saturation level below 80% or heart rate below 80 bpm. We compared the frequency of cardiorespiratory events and the level of respiratory support 24 hours before and after the application of SIIF.Results: A total of 34 infants were enrolled and analyzed. The total frequency of desaturation or bradycardia significantly decreased after SIIF application (8.94 vs. 5.03, P=0.001). The frequency of feeding­related bradycardia and desaturation also significantly decreased (4.15 vs. 1.68, P=0.008). Out of 34 patients, 11 (32.4%) had a decreased level of ventilator support within 1 day after SIIF. The respiratory severity scores of the 10 patients who received invasive ventilator support decreased significantly after SIIF (5.24 vs. 4.59, P=0.032).Conclusion: SIIF significantly decreased gavage feeding­associated cardiorespiratory events and reduced respiratory support in approximately one­third of subjects. Therefore, SIIF may be a therapeutic option for gavage feed­associated respiratory deterioration in preterm infants in the NICU.

Neonatal tension pneumothorax is life-threatening. A tension pneumothorax on the right side was detected on a newborn boy weighing 2,380 g, who was born at 35 weeks of gestation. Given the unavailability of an on-duty thoracic surgeon and appropriately sized chest tubes in the neonatal intensive care unit, an emergency physician performed closed thoracostomy using two 7-French latex catheters. Immediately after the re-expansion of the right lung, left tension pneumothorax was newly detected. Two more 7-French latex catheters were inserted, relieving the left lesion. We consider that the right pneumothorax occurred due to the mixture of spontaneous rupture of the subpleural blebs and barotrauma during the initial positive pressure ventilation, while the left lesion did due to the high-flow oscillatory ventilation. Despite the limited availability of devices in the present case, a favorable outcome was achieved by the use of alternative catheters, which were chosen by the emergency physician.

Background: South Korea has no official geriatric specialties or subspecialties. Moreover, studies on the unmet needs related to geriatric health problems in older Korean adults are scarce. Therefore, we investigated the unmet needs regarding geriatric health problems among older Korean adults. Methods: This cross-sectional study included 411 Korean adults aged ≥70 years. We constructed a questionnaire for a field survey that comprised 21 items to understand the geriatric challenges related to the participants’ physicians and the necessity for geriatric physicians to resolve participants’ health problems. We used unweighted numbers (weighted percentages) or mean±standard deviation to describe the characteristics of the study participants for categorical and continuous variables, respectively.Results: This study included a total of 411 men and women. The mean age was 77.6±5.9 years. Among the participants, 88.6% had one or more chronic diseases (mean number of chronic diseases, 2.0±1.3). Of the participants, 32.8% said that their physicians did not spend enough time addressing their problems and only 24.3% felt that their physicians understood geriatric problems well. Of these, 76.2% (n=313) said that geriatricians were required to fulfill their unmet healthcare needs.Conclusions: The participants reported the need for help from a geriatrician, although most of the participants consulted regular physicians about their health problems. The study results support that geriatricians are needed to improve health services for older adults.

With aging, loss of skeletal muscle mass and muscle function increases, resulting in an increased risk of falls, fractures, long-term institutional care, cardiovascular and metabolic diseases, and even death. Sarcopenia, which is derived from the Greek words “sarx” or flesh+“penia” or loss, is defined as a condition characterized by low muscle mass and low muscle strength and performance. In 2019, the Asian Working Group for Sarcopenia (AWGS) published a consensus paper on the diagnosis and treatment of sarcopenia. The AWGS 2019 guideline, specifically, presented strategies for case-finding and assessment to help diagnose “possible sarcopenia” in primary care settings. For case finding, the AWGS 2019 guideline proposed an algorithm that recommends calf circumference measurement (cut-off

Hydrogen radio recombination lines (RRLs) are one of the major diagnostics of the physical properties of H ii regions. We use RRL H40α, He40α, and 3 mm continuum emission to investigate the properties of a large sample of resolved UC H ii regions identified in the ATOMS survey. In total, we identify 94 UC H ii regions from H40α emission. The basic parameters for these UC H ii regions, such as electron density, emission measure, electron temperature, ionic abundance ratio (n$_{\rm He^+}$/n$_{\rm H^+}$), and line width are derived. The median electron density and the median n$_{\rm He^+}$/n$_{\rm H^+}$ ratio of these UC H ii regions derived from RRLs are ∼9000 cm−3 and 0.11, respectively. Within UC H ii regions, the n$_{\rm He^+}$/n$_{\rm H^+}$ ratios derived from the intensity ratio of the He40α and H40α lines seems to be higher in the boundary region than in the centre. The H40α line width is mainly broadened by thermal motion and microturbulence. The electron temperature of these UC H ii regions has a median value of ∼6700 K, and its dependence on galactocentric distance is weak.

Background: To evaluate the safety and effectiveness of empagliflozin in routine clinical settings, we collected and assessed the clinical profiles of Korean patients with type 2 diabetes mellitus.Methods: This was a post-marketing surveillance study of empagliflozin 10 and 25 mg. Information on adverse events and adverse drug reactions (ADRs) was collected as safety data sets. Available effectiveness outcomes, including glycosylated hemoglobin (HbA1c) level, fasting plasma glucose, body weight, and blood pressure, were assessed.Results: The incidence rate of ADRs was 5.14% in the safety dataset (n=3,231). Pollakiuria, pruritis genital, and weight loss were the most common ADRs. ADRs of special interest accounted for only 1.18%, and there were no serious events that led to mortality or hospitalization. In the effectiveness data set (n=2,567), empagliflozin significantly reduced the mean HbA1c level and body weight during the study period by –0.68%±1.39% and –1.91±3.37 kg (both P

Diabetes mellitus is a major risk factor for the development of heart failure. Furthermore, the prognosis of heart failure is worse in patients with diabetes mellitus than in those without it. Therefore, early diagnosis and proper management of heart failure in patients with diabetes mellitus are important. This review discusses the current criteria for diagnosis and screening tools for heart failure and the currently recommended pharmacological therapies for heart failure. We also highlight the effects of anti-diabetic medications on heart failure.

Determine whether the twice daily (BID) regimen is superior to the once daily (QD) regimen for managing glycemic variability by comparing the effects of anagliptin 100 mg BID versus sitagliptin 100 mg QD.A double-blinded, randomized, multicenter study was performed in 89 patients with type 2 diabetes treated with metformin alone (6.5%HbA1c 8.5%). Subjects were randomly assigned to anagliptin 100 mg BID or sitagliptin 100 mg QD in a 1:1 ratio for 12 weeks. Continuous glucose monitoring (CGM) was used to measure the mean amplitude of glycemic excursion (MAGE) and postprandial time in range (TIR) before and after DPP-4 inhibitor treatment to compare glycemic variability.The decrease from baseline in MAGE at 12 weeks after DPP-4 inhibitor treatment was significantly greater in the anagliptin BID group than in the sitagliptin QD group (p0.05); -30.4 ± 25.6 mg/dL (p0.001) in the anagliptin group versus -9.5 ± 38.0 mg/dL (p=0.215) in the sitagliptin group. The TIR after dinner increased by 33.0 ± 22.0% (p0.001) in the anagliptin group and by 14.6 ± 28.2% (p=0.014) in the sitagliptin group, with a statistically significant difference (p=0.009). No statistically significant differences were observed between the groups in the changes in HbA1c and fasting plasma glucose (FPG).The anagliptin BID regimen for the treatment of type 2 diabetes was superior in blood glucose control after dinner to improve glycemic variability, as indicated by MAGE and TIR but equivalent to the QD regimen in terms of HbA1c and FPG. This article is protected by copyright. All rights reserved.

Objective Acute gallbladder disease (AGD) is frequent in the emergency department (ED) and usually requires emergency surgery. However, only a few studies have reported the impact of COVID-19 on AGD. The goal of this study was to evaluate the time between symptom onset and surgery and the perioperative severity of AGD during the COVID-19 pandemic compared to before the era of COVID-19.Methods This retrospective, single-center cohort study included patients who presented to the ED with suspected AGD and who underwent emergency cholecystectomy. We designed a before-after comparative study, and the intervention was the COVID-19 outbreak. The 6-month period after the COVID-19 outbreak was defined as the post-COVID group, whereas the pre-COVID group consisted of the same period in the previous year. The primary outcome was the time from symptoms to surgery. We evaluated the time intervals between symptom onset and ED arrival and between ED arrival and surgery. The secondary outcomes were preoperative and postoperative severity indexes.Results A total of 316 patients was analyzed. The post-COVID group showed longer duration from symptom onset to ED arrival (34.0 hours vs. 15.0 hours, P

Active B5-sites on Ru catalysts can be exploited for various catalytic applications; the epitaxial formation of Ru NPs with hexagonal planar morphologies on hexagonal boron nitride sheets increases the number of active B5-sites along the nanoparticle edges.

Techno-economic, carbon footprint, and scenario analyses of an ammonia-to-hydrogen-to-power system with different catalysts and fuels are conducted to evaluate its feasibility.

Purpose: To report a case of optic disc pigmentation in a nevus of Ota patient.Case summary: A 56-year-old female was referred to our clinic with suspected glaucoma in the left eye. She had no previous history of ocular surgery or treatment. The best corrected visual acuity and intraocular pressure were 0.7 and 15 mmHg in both eyes, respectively. Slit lamp microscopy demonstrated nevus of Ota in the right sclera and increased iris pigmentation. Gonioscopy demonstrated increased trabecular meshwork pigmentation in the right eye. Fundus examination showed pigmentation of the choroid and optic disc in the right eye; choroidal thickness of the right eye was greater than that of the left eye on optical coherence tomography. However, there were no glaucomatous changes in the right eye. There were no specific findings in the left eye.Conclusions: To the best of our knowledge, this was the first reported case of optic disc pigmentation in a Korean nevus of Ota patient.

We present BISTRO Survey 850 {\mu}m dust emission polarisation observations of the L1495A-B10 region of the Taurus molecular cloud, taken at the JCMT. We observe a roughly triangular network of dense filaments. We detect 9 of the dense starless cores embedded within these filaments in polarisation, finding that the plane-of-sky orientation of the core-scale magnetic field lies roughly perpendicular to the filaments in almost all cases. We also find that the large-scale magnetic field orientation measured by Planck is not correlated with any of the core or filament structures, except in the case of the lowest-density core. We propose a scenario for early prestellar evolution that is both an extension to, and consistent with, previous models, introducing an additional evolutionary transitional stage between field-dominated and matter-dominated evolution, observed here for the first time. In this scenario, the cloud collapses first to a sheet-like structure. Uniquely, we appear to be seeing this sheet almost face-on. The sheet fragments into filaments, which in turn form cores. However, the material must reach a certain critical density before the evolution changes from being field-dominated to being matter-dominated. We measure the sheet surface density and the magnetic field strength at that transition for the first time and show consistency with an analytical prediction that had previously gone untested for over 50 years (Mestel 1965)., Comment: 14 pages, 5 figures. ApJ accepted

Lethal neonatal rigidity and multifocal seizure syndrome (RMFSL) is a severe autosomal recessive epileptic encephalopathy characterized by rigidity, intractable multifocal seizures, microcephaly, apnea, and bradycardia immediately after birth. RMFSL is related to a mutation in breast cancer 1-associated ataxia telangiectasia mutated activation-1 protein (BRAT1). We report a case of a female infant born to non-consanguineous Korean parents who developed hypertonia, dysmorphic features, progressive encephalopathy with refractory seizures at birth, and worsening intermittent apnea, leading to intubation and death at 137 days of age. The initial repeated electroencephalographic findings were normal; however, a pattern of focal seizures emerged at 35 days of life. Rapid trio whole-exome sequencing revealed heterozygous mutations c.1313_1314delAG p.(Gln438Argfs*51) and c.1276C>T p. (Gln426*) in BRAT1. After genetic counseling for pregnancy planning, a preimplantation genetic diagnosis for targeted BRAT1 mutations was successfully performed, and a healthy baby was born. To our knowledge, this is the first reported case of a Korean patient with compound heterozygous mutations in BRAT1. An early and accurate genetic diagnosis can help provide timely treatment to patients and indicate the need for reproductive counseling for parents for family planning.

Background: Self-harm is an important public health problem with increasing incidences among adolescents for over a decade. This study aimed to identify factors associated with self-harm in adolescent psychiatric inpatients in Korea. We also investigated clinical characteristics associated with nonsuicidal self-injury disorder (NSSI-D) and suicidal behavior disorder (SBD) according to the Diagnostic and Statistical Manual of Mental Disorders 5 criteria.Methods: This retrospective study included 215 adolescents aged between 12 to 18 years, who were admitted to the psychiatric ward of Samsung Medical Center, Seoul, Korea, from January 2014 to February 2021. Participants were divided into three groups according to NSSI-D and SBD diagnostic criteria. Collected data were analyzed using chi-square test and analysis of variance test.Results: Overall, 57.7% of the participants (n=124) reported self-harm at least once in their lives. Patients with self-harm were more likely to have experienced parental conflict, parent-child relational problems, and verbal, physical, or sexual abuse. Among the three groups divided according to NSSI-D and SBD diagnostic criteria, patients with both NSSI-D and SBD were more likely to have experienced parent-child relational problems than those with either NSSI-D only or SBD only.Conclusion: This study shows that parent-child relational problem is associated with high incidences of selfharm. Especially, the parent-child relational problem seemed to be a risk factor for SBD among patients with NSSI-D. These are important findings that provide an understanding of the self-harm characteristics and therefore improve prevention and treatment strategies in psychiatric adolescent patients.

Background: Sarcopenia, a progressive and generalized skeletal muscle disorder involving an accelerated loss of muscle mass and muscle function, is a common condition in older individuals. This study aimed to determine whether sleep latency and duration were independently associated with incident sarcopenia and to explore sex differences in these associations. Methods: This 2-year longitudinal analysis of cohort study data included community-dwelling participants of the 2016–2017 Korea Frailty and Aging Cohort Study aged 70–84 years at baseline survey who completed the 2-year follow-up survey. Logistic regression was used to calculate the odds ratios (ORs) for sarcopenia and sarcopenia components. Sarcopenia was defined using the 2019 Asian Working Group for Sarcopenia guidelines. Results: Among 1,353 non-sarcopenic participants in the baseline survey, 1,160 (85.8%) and 193 (14.2%) were classified as non-sarcopenic and sarcopenic, respectively, after 2 years. Long sleep duration (>8 hours per night) was associated with incident sarcopenia in male—OR=2.41 (95% confidence interval [CI], 1.13–5.17) after adjusting for confounding factors. Long sleep duration was specifically associated with the development of low skeletal muscle mass and low muscle strength in male—adjusted OR=2.16 (95% CI, 1.02–4.61) and adjusted OR=2.70 (95% CI, 1.13–6.43), respectively. In female, compared to normal sleep duration, the adjusted ORs for long and short sleep duration for sarcopenia were 2.093 (95% CI, 0.753–5.812; p=0.157) and 0.852 (95% CI, 0.520–1.393; p=0.522), respectively, which were not significant.Conclusion: In male, long sleep duration was associated with incident sarcopenia, specifically the development of low muscle mass and low muscle strength, but not with low physical performance.

Despite widespread concern about energy imbalance due to tumor and chemotherapy-related side effects, little is known about detailed variations in energy input, metabolic rate, and physical activity. This study explored changes in energy balance components and serum biomarkers of patients with hematologic malignancies undergoing chemotherapy. Our prospective study included 40 patients with hematologic malignancies hospitalized for chemotherapy. We measured energy balance components, physical function, and serum biomarkers at baseline and weekly after chemotherapy for 3 weeks. Significant weight loss, representing negative energy balance, occurred at 2 (p = 0.002) and 3 weeks (p 0.001) post-chemotherapy. Statistically reduced oral intake was observed at 3 weeks post-chemotherapy (p = 0.040), and resting energy expenditure statistically decreased according to Harris-Benedict equation, but not to Penn State University equation. Physical function according to DEMMI score decreased significantly at 3 weeks post-chemotherapy (p = 0.002). Serum biomarker analysis demonstrated significant changes in albumin, total protein, CXCL13, and GDF15, with exception of leptin. Although conventional serum biomarkers (total protein and albumin) did not reach pathological states despite their statistical differences, subgroup analysis showed CXCL13 in weight loss group and GDF15 in reduced oral intake group were significantly changed. Over half of patients (65.0%, n = 26) suffered from energy imbalance associated with weight loss and reduced oral intake during chemotherapy. Serial laboratory results suggested that novel biomarkers (CXCL13, GDF15) could be correlated with cachexic state and reduced food intake. Monitoring clinical and serum biomarkers associated with energy balance together can help identify needs for nutritional support in patients with hematologic malignancies undergoing chemotherapy.

Objective To compare the biomechanical properties of the glenohumeral joint capsule between adhesive capsulitis (AC) after breast cancer surgery and idiopathic AC and demonstrate the effects of hydrodilatation (HD) with corticosteroid injection for AC after breast cancer surgery.Methods Twenty-three prospective patients with AC after breast cancer surgery (BC group) and 44 retrospective patients with idiopathic AC without breast cancer (CON group) underwent HD with corticosteroid injection and home exercise training. We compared their biomechanical characteristics (capsular capacity, maximal pressure, and capsular stiffness). In the BC group, the passive range of motion (ROM) of the affected shoulder and a questionnaire (Shoulder Pain and Disability Index [SPADI]) were evaluated at baseline and 2 and 4 weeks after treatment.Results The BC group showed higher biomechanical characteristics (maximal pressure and capsular stiffness) than did the CON group. The mean maximal pressure and capsular stiffness were 519.67±120.90 mmHg and 19.69±10.58 mmHg/mL in the BC group and 424.78±104.42 mmHg and 11.55±7.77 mmHg/mL in the CON group (p=0.002 and p=0.001, respectively). And, the BC group showed significant improvements in all ROMs (abduction, flexion, and external rotation) and the SPADI pain and disability sub-scores following the treatment.Conclusion The glenohumeral joint capsular stiffness was greater in the patients with AC after breast cancer surgery than in those with idiopathic AC. HD with corticosteroid injection was effective in treating AC after breast cancer surgery.

Chlorosilane is a hazardous chemical compound which is used as a raw material in the production of silicone. Despite strict restrictions, accidental spillage of chlorosilane is often reported. However, human exposure was rarely reported in the past decades and the effect on humans is barely known. We report cases of human exposure to an accidental trichlorosilane spill. Three middle aged male industrial workers visited our emergency department after exposure to trichlorosilane. They presented with shortness of breath and burns on multiple sites. Chest radiograph and laboratory studies were performed. None of the reports showed serious results and were discharged after conservative management.

Severe bacterial infections are frequently accompanied by depressed neutrophil functions. Thus, agents that increase the microbicidal activity of neutrophils could add to a direct antimicrobial therapy. Lysophosphatidylcholine augments neutrophil bactericidal activity

We investigate the presence of hub-filament systems in a large sample of 146 active proto-clusters, using H$^{13}$CO$^{+}$ J=1-0 molecular line data obtained from the ATOMS survey. We find that filaments are ubiquitous in proto-clusters, and hub-filament systems are very common from dense core scales ($\sim$0.1 pc) to clump/cloud scales ($\sim$1-10 pc). The proportion of proto-clusters containing hub-filament systems decreases with increasing dust temperature ($T_d$) and luminosity-to-mass ratios ($L/M$) of clumps, indicating that stellar feedback from H{\sc ii} regions gradually destroys the hub-filament systems as proto-clusters evolve. Clear velocity gradients are seen along the longest filaments with a mean velocity gradient of 8.71 km s$^{-1}$pc$^{-1}$ and a median velocity gradient of 5.54 km s$^{-1}$pc$^{-1}$. We find that velocity gradients are small for filament lengths larger than $\sim$1~pc, probably hinting at the existence of inertial inflows, although we cannot determine whether the latter are driven by large-scale turbulence or large-scale gravitational contraction. In contrast, velocity gradients below $\sim$1~pc dramatically increase as filament lengths decrease, indicating that the gravity of the hubs or cores starts to dominate gas infall at small scales. We suggest that self-similar hub-filament systems and filamentary accretion at all scales may play a key role in high-mass star formation., 16 pages

Sarcopenic obesity is defined as the presence of high fat mass and low muscle mass combined with low physical function, and it is closely related with the onset of cardiovasular diseases (CVD). The existing anthropometric indices, which are being utilised in clinical practice as predictors of CVD, may also be used to screen sarcopenic obesity, but their feasibility remained unknown. Using cross-sectional data of 2031 participants aged 70–84 years (mean age, 75·9 ± 3·9 years; 49·2 % women) from the Korean Frailty and Aging Cohort Study, we analysed the association of anthropometric indices, including body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR) and weight-adjusted waist index (WWI) with sarcopenic obesity. Body composition was measured using dual-energy X-ray absorptiometry. Higher WWI, WHtR and WC quartiles were associated with higher risk of sarcopenic obesity; the odds ratio (OR) of sarcopenic obesity were highest in the fourth quartile of the WWI (OR: 10·99, 95 % CI: 4·92–24·85, Pfor trend < 0·001). WWI provided the best diagnostic power for sarcopenic obesity in men (area under the receiver operating characteristic curve: 0·781, 95 % CI: 0·751–0·837). No anthropometric indices were significantly associated with sarcopenic obesity in women. WWI was the only index that was negatively correlated with physical function in both men and women. WWI showed the strongest association with sarcopenic obesity, defined by high fat mass and low muscle mass combined with low physical function only in older men. No anthropometric indices were associated with sarcopenic obesity in older women.

Although the loss of skeletal limb muscle mass and muscle strength in the elderly have been demonstrated, the aging process of the back muscles to maintain core stability is not well known. This 1-year prospective observational study aimed to investigate the natural aging course of the lumbar extensor muscles (LEMs) compared with the extremity muscles and determine whether muscle strength or mass decreases more in community-dwelling older women.Twenty-four older urban-dwelling women aged 70 years or older were initially enrolled. Their demographic variables, conventional and spinal sarcopenia indices, and functional outcome parameters were evaluated. We also measured back extensor strength, radiological parameters for spinal sagittal balance on whole-spine radiography, and volumetric parameters of the LEM on computed tomography.After the exclusion of 6 subjects, 18 older women were finally analyzed. All variables related to extremity muscle mass, muscle strength, physical performance, and LEM volume declined over the study period, but the changes were insignificant. However, back extensor strength decreased significantly (median, first, and third quartile: 35.20 [30.80, 44.00] N to 31.40 [29.25, 37.90] N, P = 0.026). Among spinal sagittal balance-related parameters, lumbar lordosis (44.25 [39.30, 47.35]° to 43.15 [31.43, 45.75]°, P = 0.043) and sagittal vertical axis (33.85 [3.57, 58.75] mm to 45.15 [25.35, 58.68] mm, P = 0.004) showed significant changes during the study.When the natural aging course of LEM in women aged 70 years or older was observed for 1 year, muscle mass decreased less than back extensor strength and spinal sagittal balance. Measurements of back extensor strength and spinal sagittal balance are necessary for the clinical evaluation of spinal aging.

To compare the neurodevelopmental outcomes at 18-24 months of corrected age between preterm (32 weeks of gestational age) infants with very low birth weight (VLBW) conceived with and without the assistance of in vitro fertilization (IVF).Prospective cohort study.Not applicable.In total, 4,940 infants with VLBW were born before 32 weeks of gestational age from January 2013 to December 2015.In vitro fertilization.Neuromotor or sensory disability (primary outcome) and developmental delay assessed using the Bayley Scales of Infant and Toddler Development (secondary outcome) at 18-24 months of corrected age.Of the 4,940 infants with VLBW enrolled, 2,818 surviving infants who were followed up for neurodevelopmental assessment at 18-24 months of corrected age were included in the study. Of these 2,818 infants, 630 (22.4%) were conceived with the assistance of IVF, and 2,188 (77.6%) were not. After adjustment for potential confounders, no statistically significant differences were found in the rate of neuromotor or sensory disability at 18-24 months of corrected age between infants conceived with and without the assistance of IVF. After excluding infants with neuromotor or sensory disability, the rate of developmental delay was also comparable between those conceived with and without the assistance of IVF.This study showed comparable neurodevelopmental outcomes at 18-24 months of corrected age between preterm infants with VLBW conceived with and without the assistance of IVF.

Background Only few studies have shown the efficacy and safety of glucose-control strategies using the quadruple drug combination. Therefore, the aim of the present study was to investigate the usefulness of the quadruple combination therapy with oral hypoglycemic agents (OHAs) in patients with uncontrolled type 2 diabetes mellitus (T2DM). Methods From March 2014 to December 2018, data of patients with T2DM, who were treated with quadruple hypoglycemic medications for over 12 months in 11 hospitals in South Korea, were reviewed retrospectively. We compared glycosylated hemoglobin (HbA1c) levels before and 12 months after quadruple treatment with OHAs. The safety, maintenance rate, and therapeutic patterns after failure of the quadruple therapy were also evaluated. Results In total, 357 patients were enrolled for quadruple OHA therapy, and the baseline HbA1c level was 9.0%±1.3% (74.9±14.1 mmol/mol). After 12 months, 270 patients (75.6%) adhered to the quadruple therapy and HbA1c was significantly reduced from 8.9%±1.2% to 7.8%±1.3% (mean change, −1.1%±1.2%; P