The physical activity has an important physiological and psychological benefit for all people, and the exercise program has a key role in the management of diabetes. This article presents exercise recommendations for people with diabetes. Though the patients with diabetes may give many benefits from regular physical exercise, there may be several hazards from exercise as well. We assessed 30 patients with type 2 Diabetes Mellitus and 15 normal control subjects with sedentary life-style for their workload, heart rate on maximal performance and maximal oxygen uptake, change of blood glucose level after exercise using bicycle ergometer and Astrand nomogram. The workload, heart rate on maximal performance and maximal oxygen uptake were lower in diabetic patient than control subjects. Blood glucose decreased in diabetic patient than control subjects, after exercise and the lowered value was maintained until 60 minutes after exercise. The maximal oxygen uptake was lower in diabetic patients than control subjects. The blood glucose decreased in both diabetic patients and normal control after exercise.
Blood Glucose ; Diabetes Mellitus* ; Diabetes Mellitus, Type 2 ; Exercise ; Heart Rate ; Humans ; Motor Activity ; Nomograms ; Oxygen

URPOSE: To evalvate the role of double-phase spiral CT for T staging of gastric cancers with radiologic-pathologic correlation. MATERIALS AND METHODS: Double-phase spiral CT images of 44 patients of gastriccancers proved by pathologic examination were retrospectively evaluated. We retrospectively classified spiral CTimages of gastric cancers ; classification was from S 0 to S 4 and was based on the degree of change in three multilayered patterns shown in normal gastric wall and whether or not tumor cells had invaded perigastric fattissue. Pathologic classification was based on the T staging of TNM classification for gastric cancers, and wethen correlated these results. RESULTS: In group S1, all of three cases(100%) were proved to be T1 and in groupS2, five(45.5%) of 11 cases were T2. Of five cases with S3 CT findings, three(60%) were proved to be T3s andtwo(40%) were T2. Of 22 cases with S4 CT findings, 19(86.4%) were T3p. Overall sensitivity, specificity, and accuracy were 60.3%, 88. 5%, and 86.9%, respectively. In 35 (79.5%) of the total of 44 cases, the lesions were more enhanced on venous than on arterial phase. CONCLUSION: The accuracy of double-phase spiral CT for T staging of gastric cancers was 86.9%, and in contrast to previous results for conventional or dynamic CT, this level of accuracy was thought to be relatively high. In conclusion, double-phase spiral CT images of gastric cancers were helpful in the diagnosis of T staging.
Classification ; Diagnosis ; Humans ; Retrospective Studies ; Sensitivity and Specificity ; Stomach Neoplasms* ; Tomography, Spiral Computed*

PURPOSE: The prevalence of atopic diseases has been increasing remarkably. The less frequent opportunities for infection early in life, especially mycobacteria exposure, parallel this higher prevalence of atopic diseases. Bacille Calmette-Gu rin (BCG), a potent inducer of Th1 immune response, has been suggested to suppress Th2 response which is known to mediate IgE-mediated atopic disorders. This study was done to investigate whether there is any relation between the number of BCG scars and the prevalence of atopic disorders in early childhood. METHODS: We surveyed 393 parents with a children who were given percutaneous multi- puncture BCG vaccination within four weeks after birth. The main questions concerned the past history and present illness of physician-diagnosed atopic diseases (atopic dermatitis, bronchial asthma, and allergic rhinitis), the number of BCG scars (range; 0-18), and potential confounders such as gender, parental atopy, maternal smoking and environmental cofactors. The prevalence rate of each atopic disease was measured and analysed according to the number of BCG scars. RESULTS: Each prevalence rate was 18.1% for atopic dermatitis, 9.4% for bronchial asthma, 14.6% for allergic rhinitis, and 32.3% for any of them. All of them had received BCG vaccination during the first four weeks of life. The children with 15 or more BCG scars had a significantly lower prevalence of any atopic disease (22/99, 22.2%) as compared to those with four scars or less (51/125, 40.8%) by simple regression analysis. (P value=0.02) But this association was not significant after controlling for potential confounders. (P value= 0.26) CONCLUSION: This survey demonstrated a weak relation between a larger number of BCG scars and less atopy development at early childhood. But the relation was not so significant. Further studies are needed.
Asthma ; Child ; Cicatrix* ; Dermatitis ; Dermatitis, Atopic ; Humans ; Mycobacterium bovis* ; Parents ; Parturition ; Prevalence ; Punctures ; Rhinitis ; Smoke ; Smoking ; Vaccination

BACKGROUND AND OBJECTIVES: Mucosal melanoma comprises 1.3% of all malignant melanomas and mainly occurs at the oropharynx and the sinonasal cavity in the head and neck area. Five year survival rate is about 10-46%. We aimed to investigate the clinical features and treatment outcomes of 38 patients with sinonasal malignant melanoma (SNMM). SUBJECTS AND METHOD: A retrospective review of medical records was carried out on 38 patients who were diagnosed as SNMM between August 1995 and December 2012. Clinical features were evaluated and tumors were staged according to the TNM staging system. The Kaplan-Meier method was used to assess survival in the cohort. RESULTS: The 38 patients consisted of 18 males and 20 females, ranging in age from 36 to 91 years, with a median age of 59 years at diagnosis. Common symptoms were nasal obstruction and epistaxis, and mean symptom duration to diagnosis was 2.0 months. The main treatment modalities were surgery only (n=18) or surgery plus adjuvant radiotherapy (n=9). Distant metastases were detected in 15 patients (39.5%) at 8 months after initial therapy. Overall 5-year survival rate was 45.6%. There was no significant difference in survival rate between patients who underwent surgery only and those who had surgery with postoperative radiation (p=0.359). CONCLUSION: Sinonasal mucosal melanoma is a highly recurrent tumor (80% recurrence rate) with poor prognosis (5-year survival rate; 46%). As radiation treatment and/or chemotherapy are not so effective for the recurrent tumor, early detection and surgical resection are mandatory at present. New treatment modality should be developed to improve the survival rate.
Cohort Studies ; Diagnosis ; Drug Therapy ; Epistaxis ; Female ; Head ; Humans ; Male ; Medical Records ; Melanoma* ; Nasal Obstruction ; Neck ; Neoplasm Metastasis ; Neoplasm Staging ; Oropharynx ; Prognosis ; Radiotherapy, Adjuvant ; Recurrence ; Retrospective Studies* ; Survival Rate

Maternal serum alpha-fetoprotein (AFP) has been used for a long time for the prenatal diagnosis of neural tube defects in women at midtrimester of gestation. But AFP is elevated not only in cases of neural tube defects, but also in fetus with congenital nephrosis, abdominal wall defects, fetal demise, low birth weight or simply erroneously calculated gestational age. So, when maternal serum AFP is increased, gestational age of the fetus must be re-evaluated and targeted ultrasonographic evaluation is indicated to rule out neural tube defects. If NTDs are suspected or ultrasound is non-diagnostic, amniotic fluid AFP are measured and when AF-AFP is elevated, the presence or absence of acetylcholinesterase should be evaluated. The detection rate of open neural tube defects using amniotic acetylcholiesterase is reported to be as high as 96 to 99% with a 0.06% and 0.14% of false positive rate in amniotic fluids non-contaminated and contaminated by blood, respectively. We report a case with elevated mid-trimester MS-AFP, AF-AFP and positive amniotic acetylcholin-esterase, but in which repeated sonographic findings were normal, and result in delivery of a heathy baby without anomalies.
Abdominal Wall ; Acetylcholinesterase* ; alpha-Fetoproteins ; Amniotic Fluid ; Female ; Fetus ; Gestational Age ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Nephrosis ; Neural Tube Defects ; Pregnancy Trimester, Second ; Pregnancy* ; Prenatal Diagnosis ; Ultrasonography

Maternal serum alpha-fetoprotein (AFP) has been used for a long time for the prenatal diagnosis of neural tube defects in women at midtrimester of gestation. But AFP is elevated not only in cases of neural tube defects, but also in fetus with congenital nephrosis, abdominal wall defects, fetal demise, low birth weight or simply erroneously calculated gestational age. So, when maternal serum AFP is increased, gestational age of the fetus must be re-evaluated and targeted ultrasonographic evaluation is indicated to rule out neural tube defects. If NTDs are suspected or ultrasound is non-diagnostic, amniotic fluid AFP are measured and when AF-AFP is elevated, the presence or absence of acetylcholinesterase should be evaluated. The detection rate of open neural tube defects using amniotic acetylcholiesterase is reported to be as high as 96 to 99% with a 0.06% and 0.14% of false positive rate in amniotic fluids non-contaminated and contaminated by blood, respectively. We report a case with elevated mid-trimester MS-AFP, AF-AFP and positive amniotic acetylcholin-esterase, but in which repeated sonographic findings were normal, and result in delivery of a heathy baby without anomalies.
Abdominal Wall ; Acetylcholinesterase* ; alpha-Fetoproteins ; Amniotic Fluid ; Female ; Fetus ; Gestational Age ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Nephrosis ; Neural Tube Defects ; Pregnancy Trimester, Second ; Pregnancy* ; Prenatal Diagnosis ; Ultrasonography

Neuroendocrine cells are distributed throughout the body and they are found in the gastrointestinal tract, pancreas, lung, thyroid, adrenal gland and many other organs, and especially the gastrointestinal tract. As a consequence, neuroendocrine tumors of the colon and rectum are common neoplasm. Several cases of the benign carcinoid tumor and a few cases of the malignant carcinoid tumor of the colon and rectum have been reported. Yet there have been no reports on concurrent malignant carcinoid tumor and benign carcinoid tumor at the same site of the colon. A 60-year-old man presented with an asymptomatic rectal mass. After the mass was evaluated and operated on, it was confirmed to be a concurrent malignant carcinoid tumor and benign carcinoid tumor of the rectum, and metastasis to the liver was also found.
Adrenal Glands ; Carcinoid Tumor ; Colon ; Gastrointestinal Tract ; Humans ; Liver ; Lung ; Middle Aged ; Neoplasm Metastasis ; Neuroendocrine Cells ; Neuroendocrine Tumors ; Pancreas ; Rectum ; Thyroid Gland

We report a case of ring chromosome 13 with a distal deletion of 13q32.2-->qter observed in a fetus who was referred to our institution at term due to severe growth restriction and multiple congenital malformations on ultrasonographic examination.This boy was born by vaginal delivery at 39 weeks in gestation. His weight, head circumference and height were less than the 3 percentile of gestational age. Apgar score was 7 at 1 minute and 9 at 5 minutes. He showed microcephaly, large forehead, low set ears, hypertelorism, flat nasal bridge, and micrognathia. The genitalia was ambiguous, showing severe hypoplasia of the penis. The anus was ectopic, displaced anteriorly from its normal position but with a normal opening and function. Neurologic examination was normal. Echocardiogram done at 2 weeks of life showed a persistent foramen ovale and a ventriculoseptal defect (type II) with increased pulmonary hypertension. MRI examination of the brain showed poorly demarcating corpus callosum suspecting agenesis of corpus callosum. Also, cerebellar vermis was small and hypoplastic, mimicking a variant form of Dandy-Walker malformation. MRI of the pelvis showed a tubular structure in pelvic cavity, suspicious of uterine remnant, between urinary bladder and rectum, and a inguinal hernia was noted in the left side. In the abdominal cavity enlarged adrenal glands were noted, and hormonal study showed elevated 17-alpha-OH-progesterone (168.9 ng/ml) with normal 17-KS and 17-OHCS levels. Gastrointestinal and urogenital system were otherwise normal. Cytogenetic analysis of the parents were both normal but the newborn showed 46, XY, r (13), de novo, with deletion points q32.2-->qter. Our findings are in line with previous reports about chromosome 13 deletions, in which loss of the "critical point" leads to major malformations like brain anomalies and ambiguous genitalia.
Abdominal Cavity ; Adrenal Glands ; Agenesis of Corpus Callosum ; Anal Canal ; Apgar Score ; Brain ; Chromosomes, Human, Pair 13 ; Corpus Callosum ; Cytogenetic Analysis ; Dandy-Walker Syndrome ; Disorders of Sex Development ; Ear ; Fetus ; Foramen Ovale ; Forehead ; Genitalia ; Gestational Age ; Head ; Hernia, Inguinal ; Humans ; Hypertelorism ; Hypertension, Pulmonary ; Infant, Newborn ; Magnetic Resonance Imaging ; Male ; Microcephaly ; Neurologic Examination ; Parents ; Pelvis ; Penis ; Pregnancy ; Rectum ; Ring Chromosomes ; Urinary Bladder ; Urogenital System

BACKGROUND: Worldwide stomach cancer death rates have been steadily declining in most countries since World War II, but in Korea the incidence of stomach cancer is still high and is a major concern for public health. Surgical resection is the best method of treatment and offers a chance for cure, but the overall results of surgical treatment have been dismal. METHODS: The authors performed a retrospective study of 958 patients treated for adenocarcinomas of the stomach with curative intent over the period from March 1986 through December 1994 at Kyung Hee University Hospital. The study examined the prognostic influence of 2 host factors (age and sex of the patients), 7 tumor factors (location of tumor, number of lesions, size of tumor, depth of invasion, extent of lymph-node involvement, number of metastatic lymph nodes, and TNM stage), and 4 treatment factors (type of gastrectomy, combined resection, extent of lymph-node dissection, and adjuvant chemotherapy) by univariate and multivariate analysis. RESULTS: In univariate analysis, 9 prognostic factors - the age of the patients, the size of lesions, the depth of invasion, the extent of lymph-node involvement, the number of metastatic lymph nodes, the TNM stage, the type of gastrectomy, the extent of lymph-node dissection, and combined resection - were significantly correlated with survival. In multivariate analysis using the Cox proportional hazard model, 5 independent prognostic factors significantly correlated with survival: the age of the patients (RR = 1.480), the depth of invasion (RR = 1.287), the number of metastatic lymph nodes (RR = 2.700), the TNM stage (RR = 1.592), and the extent of lymph-node dissection (RR = 1.390). CONCLUSIONS: The authors can make a prognosis for stomach cancer more precisely on the basis of these independent prognostic factors, and an extended D2 operation (D2 alpha operation) may be a valuable means to treat gastric cancer.
Adenocarcinoma ; Gastrectomy ; Humans ; Incidence ; Korea ; Lymph Nodes ; Mortality ; Multivariate Analysis* ; Prognosis ; Proportional Hazards Models ; Public Health ; Retrospective Studies ; Stomach ; Stomach Neoplasms* ; World War II

With the increased use of cell therapy in the veterinary sector, there is a growing demand for the development of cell-based medicinal products and the determination of their safety. Currently, the Korean Animal and Plant Quarantine Agency has established a guideline for evaluating the safety of cell-based medicinal products for animal use. The guideline includes items related to definition, classification, management, manufacturing procedure and quality control (standard and test method), stability testing, toxicity testing, pharmacological testing, and performance of clinical trials. In addition, testing protocols related to safety assessment of animal cell-based products such as chromosome karyotyping, tumorigenicity testing, confirmatory testing of biodistribution and kinetics, and target animal safety testing are described in detail. Moreover, because cell-based medicinal products are novel therapies, deviations from traditional designs may be justified in order to obtain relevant safety information on the treatment. Additionally, this guideline can be amended on the basis of new scientific findings.
Animals ; Carcinogenicity Tests ; Cell- and Tissue-Based Therapy ; Classification ; Karyotyping ; Kinetics ; Plants ; Quality Control ; Quarantine ; Toxicity Tests