Purpose : The main genetic contribution to type 1 diabetes susceptibility is the human leukocyte antigen (HLA) class II gene. Several non-HLA chromosomal regions are also known to be involved. We studied the association of HLA class II and non-HLA candidate genes, which are cytotoxic T lymphocyte antigen-4 (CTLA4), tumor necrosis factor (TNF), lymphotoxin-alpha(LT-alpha, and vitamin D receptor (VDR) gene, polymorphisms with disease susceptibility in Korean children with type 1 diabetes.Methods : Fifty Korean children with type 1 diabetes (29 girls and 21 boys) and 166 healthy Koreans were investigated in this study. HLA class II alleles were determined by PCR-SSP (sequence-specific primer) and PCR-SSOP (sequence specific oliogonucleotide probe) method. CTLA4 exon 1 polymor phism was analyzed by PCR-SSCP (single strand conformation polymorphism), and TNF promotor and LT-alphagene polymorphism by PCR-RFLP (restriction fragment length polymorphism), respectively. VDR gene polymorphisms were analyzed by PCR-RFLP using restriction enzyme FokI, ApaI, TaqI, and BsmI. Results : The frequencies of HLA-DRB1*04, DRB1*09, and DQB1*04 were significantly increased and those of HLA-DRB1*14, DRB1*15, DQB1*05 and DQB1*06 were significantly decreased in the patients with type 1 diabetes compared with the control subjects. No significant differences in the distribution of CTLA4 exon 1, TNF promotor, LT-alpha and VDR gene polymorphisms were observed between the patients with type 1 diabetes and the control subjects. Conclusion : These data suggest that HLA-DRB1*04, DRB1*09, and DQB1*04 are susceptible genes for type 1 diabetes, whereas HLA-DRB1*14, DRB1*15, DQB1*05, and DQB1*06 are protective genes in Korean children. CTLA4 exon 1, TNF promotor, LT-alpha and VDR gene polymorphisms are not associated with susceptibility to type 1 diabetes in Korean children.
Alleles ; Child* ; Diabetes Mellitus, Type 1* ; Disease Susceptibility* ; Exons ; Female ; Genes, MHC Class II ; Humans ; Leukocytes ; Lymphocytes ; Receptors, Calcitriol ; Tumor Necrosis Factor-alpha

No abstract available.

High tibial osteotomy is a useful procedure in the treatment of early stage osteoarthritis of the knee which is confined to the medial compartment. But long term follow-up study of high tibial osteotomy has not been provided yet and its prerequisite for a successful result still remains unrevealed. Since the osteoarthritis can progress after the osteotomy, it may result in the loss of correction and recurrence of pain and require conversion to total knee replacement arthroplasty. We studied clinically and radiologically the long term result of high tibial osteotomy in 11 patients(16 knees) who had been treated at the Department of Orthopaedic surgery of Seoul Paik Hospital during the period from January, 1978 to May, 1989, and follow-up for longer than 4 years. Preoperative mean varus angle was 6.4 degrees and immediate postoperative mean valgus angle was 8.6 degrees and final mean valgus angle was 4.7 degrees. The average loss of correction angle was 3.9 degrees. At 2-year follow-up, the results of 16 knees were as follows; excellent in six knees, good in seven knees. The final results at average 7.2-year follow-up were excellent in four knees, good in six knees and one knee was converted to total knee replacement arthroplasty. The results showed deterioration of clinical results and loss of correction with time after osteotomy. However, in more than half of the cases the results were good or excellent at the final follow-up, We, therefore, conclude that high tibial osteotomy is still a useful procedure in osteoarthritis of the knee if performed with a precise surgical technique and an adequate overcorrection more than 10 degrees.
Arthroplasty ; Arthroplasty, Replacement, Knee ; Follow-Up Studies ; Knee ; Osteoarthritis ; Osteotomy ; Recurrence ; Seoul

PURPOSE: Growth hormone (GH) has multiple beneficial effects in addition to its promotion of linear growth. Therefore adults with GH deficiency (GHD) have abnormal body composition, altered lipid metabolism, increased cardiovascular disease, and decreased bone mineral density (BMD). We evaluated the effect of GH therapy on BMD in young adults with childhood-onset GHD. METHODS: 17 childhood-onset GHD adults (10 male, 7 female, mean age 24.5+/-5.5 yr) with or without continuous GH treatment after final height were studied. All subjects divided two groups; GH-treated group (n=6) and GH-untreated group (n=11). BMD in lumbar spine and proximal femur was measured by dual energy X-ray absorptiometry. RESULTS: The mean serum level of IGF-I concentration in the GH-untreated group was lower than in the GH-treated group (88.4+/-55.9 ng/mL vs. 358.7+/-196.8 ng/mL, P<0.05). The BMD of lumbar spine in the GH-treated group and GH-untreated group was 1.02+/-0.13 g/cm2 and 0.82+/-0.09 g/cm2 and the BMD of femur was 1.15+/-0.14 g/cm2 and 0.82+/-0.10 g/cm2 respectively. The BMD of the GH-treated group was significantly higher than the GH-untreated group (P<0.05). CONCLUSION: These findings support the need of continuous GH treatment after completion of growth and careful evaluation of BMD in adult patients with childhood-onset GHD.
Absorptiometry, Photon ; Adult ; Body Composition ; Bone Density ; Cardiovascular Diseases ; Female ; Femur ; Growth Hormone ; Humans ; Insulin-Like Growth Factor I ; Lipid Metabolism ; Male ; Spine ; Young Adult

PURPOSE: Recently, it was reported that tumor necrosis factor (TNF) and lymphotoxin-alpha (LT-alpha) gene regions might be a susceptible loci to type 1 diabetes in Japanese. The purpose of this study was to investigate the association of TNF and LT-alpha gene polymorphisms with disease susceptibility in Korean children with type 1 diabetes. METHODS: Forty-nine Korean children with type 1 diabetes (29 girls and 20 boys) and 94 healthy Koreans were investigated in this study. Genotyping for -857T/C polymorphism in the TNF promoter region and LT-alpha gene polymorphism were performed by PCR-RFLP (restriction fragment length polymorphism). TNF promoter -1031C/T polymorphism was detected by allele-specific PCR. RESULTS: The distribution of the -857T/C and -1031C/T genotype in the TNF promoter region was not different between diabetic children and the controls. The frequency of TT genotype in the distribution of TNF -1031C/T polymorphism in diabetic children with diabetic ketoacidosis (DKA) at diagnosis was significantly lower than those without DKA (P< 0.05). No significant difference in the distribution of LT-alpha gene polymorphism was observed between diabetic children and the controls. There was no association between clinical characteristics of type 1 diabetes and LT-alpha gene polymorphisms. CONCLUSION: These results suggest that TNF promoter -857T/C and LT-alpha gene polymorphisms are not associated with susceptibility to type 1 diabetes in Korean children. TNF promoter -1031C/T polymorphism might be related to clinical manifestations (DKA) of type 1 diabetes.
Asian Continental Ancestry Group ; Child* ; Diabetic Ketoacidosis ; Diagnosis ; Disease Susceptibility ; Female ; Genotype ; Humans ; Lymphotoxin-alpha* ; Polymerase Chain Reaction ; Promoter Regions, Genetic ; Tumor Necrosis Factor-alpha*

PURPOSE: Contrast-enhanced 3-D ultrafast MR angiography is a widely accepted MR imaging technique for theevaluation of the carotid artery, aorta, renal artery, mesenteric artery and portal venous system. To esti-mateitsclinical usefulness, single -and double- dose contrast-enhanced 3-D ultrafast pulmonary MR angiography wasassessed after a timing examination was performed. MATERIALS AND METHODS: Twenty volunteers underwentgadolinium-enhanced ultrafast pulmonary MR angiog-raphy( 3-D FISP, TR[msec]/TE[msec]=5.0/2.0, with 25 degrees flipangle). In ten volunteers(single-dose injection group) pulmonary MR angiography was performed after theadminstration of 0.1 mmol/kg(single dose injec-tion group), while the other ten(double-dose injection group) eachreceived, prior to angiography, 0.2 m m o l / kg. In all cases, a timing examination was performed during axialturbo-FLASH imaging(TR/TE/TI=8.5/4.0/100, 1 0 degree flip angle) after injection of the same dose as that used forsubsequent contrast-enhanced pulmonary MR angiography. In both groups, overall image quality, pulmonary arteryvisibility and contrast-to-noise ratio of the pulmonary artery were assessed on the basis of images obtained.RESULTS: With regard to overall image quality, there was no significant statistical difference between the twogroups (P>0.05), and in both, depiction of the central and lobar pulmonary artery was excellent. As regardsdepiction of the segmental artery, the average grading of the single dose injection group was 2.83 +/- 0.32, that ofthe double dose injection group was 2.85 +/-0.3, with no statistical significance(P>0.05). With respect tocon-trast-to-noise ratio of the central, lobar, and segmental arteries, the best results were obtained by thedouble dose injection group(P<0.05). CONCLUSION: Although the contrast-to-noise ratio in the double-dose injectiongroup was better than that in the single-dose group, differences in overall image quality and pulmoanry arterydepiction were not statistically significant. Thus, single-dose, contrast-enhanced 3-D ultrafast pulmonary MRangiography can provide useful images in clinical trials.
Angiography* ; Aorta ; Arteries ; Carotid Arteries ; Magnetic Resonance Imaging ; Mesenteric Arteries ; Pulmonary Artery ; Renal Artery ; Volunteers

PURPOSE: To evaluate the clinical results between interlocking intramedullary nail with fibular fixation and nail only for treating distal tibiofibular diaphyseal fractures. MATERIALS AND METHODS: From March 2003 to September 2006, 19 distal tibiofibular fractures were antegrade nailed after anatomical reduction and fixation of fibular fractures, and another 37 fractures fixed with nails only. Average age of patients was 48.6 years. These two groups were compared by VAS (visual analogue scale)&ankle ROM according to degree of comminution and fracture configuration. The statistical analysis was evaluated by t-test. RESULTS: There was no statistical difference between fibular fixation group and non-fixation group in VAS score according to fracture comminution and configuration (p>0.05). However, compared according to fracture configuration, mean ankle eversion of fibular fixation group in oblique fractures was 18.3 degrees, and that of non-fixation group was 12.5 degrees (p<0.05). In addition, mean ankle plantar flexion, dorsiflexion, inversion and total ankle ROM of fibular fixation group in spiral fractures was 40.0, 20.0, 30.0 and 108.3 degrees of each and that of non-fixation group was 38.3, 18.5, 27.0 and 101.7 degrees (p<0.05). CONCLUSIONS: In oblique and spiral fractures of distal tibiofibular diaphysis, interlocking intramedullary nail with fibular fixation had the advantage in postoperative ankle ROM. So, it can be a worthy method for the treatment of distal tibiofibular diaphyseal fractures.
Animals ; Ankle ; Diaphyses ; Fracture Fixation, Intramedullary ; Humans ; Imidazoles ; Nails ; Nitro Compounds

PURPOSE: Suppression of the relatively high signal intensity of fat leads to more efficient use of thedynamic range for display of tissue contrast. In order to evaluate meniscal tears, we compared a fat-suppressedturbo spin-echo(FSTSE) sequence with turbo SE(TSE). MATERIALS AND METHODS: One hundred and seven knees in 103consecutive patients referred for MR study of the knee were imaged using both FSTSE and TSE sequence. The turbo SEsequence provided proton density-weighted and T2-weighted images (dual echo technique) with an effectiveecho-train length of five. For fat-suppression, a frequency-selective chemical presaturation pulse was applied.Forty-two knees (84 menisci) were studied arthroscopically and the findings were taken as the reference standard.FSTSE and TSE images were reviewed retrospectively by two radiologists. Next, for each patient, the quality ofFSTSE and TSE images was compared;the former were scored by each reviewer as either superior to, equal to, orinferior to TSE images. RESULTS: Among the 214 menisci evaluated, the results of FSTSE and TSE imaging were verysimilar (kappa index 0.87). Twenty four tears were found during arthroscopy in 84 menisci. FSTSE imaging was moresensitive than TSE (96% versus 83%), though specificity was equal(98%). Among the 107 cases, FSTSE images wererated by both observers as superior to TSE images for overall quality and visualization of the meniscus itself.CONCLUSION: For the evaluation of meniscal tears, FSTSE sequences were more sensitive than those obtained withTSE, and their image quality was superior. For the study of meniscus tears among a large population, FSTSE istherefore more useful than TSE.
Arthroscopy ; Humans ; Knee ; Magnetic Resonance Imaging* ; Protons ; Retrospective Studies ; Sensitivity and Specificity

BACKGROUND AND OBJECTIVES: This research investigated the association between HLA (human leukocyte antigen) class II alleles and the susceptibility to sudden sensorineural hearing loss, and between HLA class Il alleles and the results of treatment with steroid in the Korean population. MATERIALS AND METHOD: We carried out HLA-DRR1, -DQA1, -DQR1 and -DPRl genotyping in 41 patients with sudden sensorineural hearing loss and in 206 healthy controls. We examined the initial hearing levels at the onset of hearing loss and the final hearing levels after the treatment, and then evaluated for the association with HLA class II alleles. HLA-DRB1, DQA1, BQB1 and DPB1 genotypings were performed by employing the sequence specific oligonucleotide probes (SSOP) method. RESULTS: The frequencies of HLA-DRB1, DQA1, DQB1, and DP31 alleles were not significantly different between the patients and controls. When the association between the results of treatment and HLA alleles was increased, the frequencies of HLA-DRB1X14 (RR= 3.5, p<0.02), -DQA1X03 (RR=4.2, p<0.02) and -DQA1X05 (RR=3.1, p(0.03) significantly increased, but the frequencies of HIA-DQA1X01 (RR=0.2, p<0.004) and -DQB1X06 (RR =0.2, p<0.009) significantly decreased in patients who did not respond to the steroid treatment, compared with the controls. The frequencies of HLA-DQA1X01 (p<0.04) and -DQB1X06 (p<0.02) significantly increased while the frequency of HLA- DQA1X03 (p<0.003) significantly decreased in patients who responded well to steroid, compared with patients who did not. CONCLUSION: These results suggest that the presence of HLA-DRB1X14, DQA1X03 and DQA1X05 might be an useful marker that implys poor prognoses whereas the presence of HLA-DQA101 and DQB1X06 might be a marker implying good prognoses in Korean patients with sudden sensorineural hearing loss.
Alleles* ; Hearing ; Hearing Loss ; Hearing Loss, Sensorineural* ; HLA-DRB1 Chains ; Humans ; Leukocytes ; Oligonucleotide Probes ; Prognosis

No abstract available.
Carcinoma, Squamous Cell* ; Head* ; Humans ; Interleukin-2* ; Neck*