PURPOSE:We performed this study to compare correlation between the indices of insulin resistance using fasting insulin and glucose level and body mass index (BMI), and to determine the clinical usefulness of glucose/insulin ratio (G/I ratio), which is easily available in clinical base. METHODS:Total 119 children with simple obesity, whose BMI is over 95th percentile, were evaluated. We calculated G/I ratio, logInsulin, HOMA-IR, logHOMA-IR, and QUICKI and evaluated their relationship to BMI. RESULTS:Children with high-degree obesity had higher insulin resistance than children with mild to moderate-degree obesity (logInsulin, 1.13+/-.23 vs 1.27+/-.29; logHOMA-IR, 0.46+/-.24 vs 0.61+/-.30; QUICKI, 0.33+/-.03, 0.31+/-.03)(P<0.01), and pubertal children had higher insulin resistance than prepubertal children (G/I ratio, 7.39+/-.07 vs 4.85+/-.29; logInsulin, 1.14+/-.27 vs 1.31+/-.22; logHOMA-IR, 0.47+/-.28 vs 0.65+/-.22; QUICKI, 0.33+/-.03 vs 0.31+/-.02) (P<0.001). BMI had correlation coefficient as -0.436 for QUICKI, -0.432 for G/I ratio, 0.430 for logInsulin, and 0.425 for logHOMA-IR (P=0.000). G/I ratio was well correlated with QUICKI (r=0.901, P=0.000), logHOMA-IR (r=-0.865, P=0.000), and logInsulin (r=0.899, P=0.000). The changes of BMI were correlated with changes of G/I ratio (r=-0.547, P<0.01), QUICKI (r=-0.464, P=0.01), and logHOMA-IR (r=0.429, P<0.05). CONCLUSION: This study revealed that the degree of BMI had statistically significant correlation with insulin resistance, which can be reflected by G/I ratio, logHOMA-IR and QUICKI. G/I ratio was well correlated with logHOMA-IR and QUICKI, which suggests that G/I ratio could be used as an bedside index of insulin resistance. The changes of G/I ratio were more correlated with changes of BMI than those of logHOMA-IR and QUICKI.
Body Mass Index ; Child* ; Fasting ; Glucose ; Humans ; Insulin Resistance* ; Insulin* ; Obesity*

BACKGROUND: Intra-aortic balloon pump (IABP)is well known for its hemodynamic benefit but still has its own complications.Proper use of IABP is the best way t o obt ai n maximum benefit with low complication rate. MATERIALS AND METHOD: Twenty one(men 10,female 11) patients were included in this study among the 100 consecutive adult cardiac surgery patients in our hospital.Eighteen(85.7%)were ischemic heart disease patients.They all received IABP therapy due to postcardiotomy cardiogenic shock according to the well-known indications.Their preoperative conditions,intraoperative factors including hemodynamics, postoperative conditions and IABP-related complications were analyzed. RESULT: Nineteen patients(90.5%)were successfully weaned from IABP.There were 2 patients of operative death and the mortality rate was 9.5%.Duration of IABP use was 40.7+/-24.3 hours.There were 2 cases(9.5%)of IABP-related vascular complications that required surgical intervention. CONCLUSION: We concluded that IABP could be used effectively and safely for postcardiotomy cardiogenic shock patients with low complication rate.
Adult ; Hemodynamics ; Humans ; Mortality ; Myocardial Ischemia ; Shock, Cardiogenic* ; Thoracic Surgery

A case of multiple trichilemmal cysts (TC) is presented. TC is known to be a kind of keratinous cyst with lining cells showing trichilemmal keratiniration. A 63-year-old female patient presented with a 30 year duration of increasing in size and number of twenty five nodular lesions on the scalp. All twenty five TC on the scalp were totally excised and examined microscopically. However, the evidence of proliferation or malignant change like the previous case reports was not found in our case.
Female ; Humans ; Middle Aged ; Scalp

Six cases of lunate dislocation were treated in the departments of orthopaedic surgery, Hangang Sacred Heart Hospital and Kangnam Sacred Heart Hospital, Hallym College during the period from March 1, 1978 to August 31, 1982. The results were as follows; l. Among the total 6 cases, two cases had lunate dislocation only and the other four had associated injuries of the same wrist joints. 2. Marupulative reduction was successful in only one case. Five cases were treated by open reduction, and for four of them internal fixation was tried. 3. Postoperative roentgenograms showed acceptable reductions in all cases except one which redislocation occurred. This case showed lunate dorsiflexion instability and was treated with extensor carpi radialis longus tenodesis. 4. The cases with pure lunate dislocation yielded better functional recovery than those with associated carpal injuries.
Dislocations ; Heart ; Tenodesis ; Wrist Joint

A 55-year-old Korean female patient who presented with longitudinal black pigmentation affecting the right thumbnail is described. Direct microscopic examination of nail tissue in 15% potassium hydroxide and cultures on Sabourauds glucose agar revealed Candida species. Cardida species as a cause of longitudinal melanonychia has, to our knowledge, been described only once in the literature. Our case may be the second one.
Agar ; Candida* ; Female ; Glucose ; Humans ; Middle Aged ; Pigmentation ; Potassium

BACKGROUND: Although the histologic picture of epidermolytic hyperkeratosis is diagnostic for bullous congenital ichthyosiform erythrokerma (BCIE), it is not specific for it. It is found also in several other conditions, that is, linear epidermal nevus, epidermolytic keratisis palmaris et plantaris and epidermolytic acnthoma. Among these, BCIE is caused by mutations of the defferentiation s0pecific keratins K1 and K1-. These mutations produce a weakened cytoskeleton that is prone to collapse resulting I cell fragility and lysis. But the pathogenesis of epidermal nevus showing the similar histologic feature with BCIE is not known. OBJECTIVE: The purpose of our study is to conpare the electron microscopic picture and the immunohistochemical features, and to find the possible pathogenesis of both diseases. METHODS: We evaluated the clinical, histopathologic nd electron microscopic features of 5 BCIE cases and 14 epidermal nevus cases which were histologically diagnosed with epidermolytic hyperkeratosis at the department of dermatology at Wonju Christian Hospital, Shinchon Severance Hospital and Yongdong Severance Hospital, from January 1981 to June 1994. The immunohistochemical staining(PAP method) using monoclonal antibody against cytokeratin was performed on BCIE and epidermal nevus. RESULTS: Light microscopy of both BCIE and epidermal nevus showed the same histologic changes including hyperkeratosis, increased keratohyaline granules, acanthosis and perinuclear vacuolization of upper malpighia layer. Electron mioroscopic findings in both diseases were similar. Aggregation of tonofilaments is noted in the squamous cells, but is not evident in basal cells.In immunohistochemical study of both diseases, 34betaE12 is stained in the whole epidermis and is stuonger ex0ressed in the basal layer tan suprabasal layers. LP34 staining is evident in suprabasal cell layers up to the cornified cell layer. CONCLUSION: Electron microscopy and immunohistochemical study of both diseases showed the same finding. We thind that a defect in the differentiation specific keratins, K1 and K10 is perhaps involved in epidermal nevus histologically showing epidermolytic hyperkeratosis as in BCIE.
Cytoskeleton ; Dermatology ; Epidermis ; Gangwon-do ; Hyperkeratosis, Epidermolytic* ; Intermediate Filaments ; Keratins ; Microscopy ; Microscopy, Electron ; Nevus* ; Triacetoneamine-N-Oxyl

This study was performed to investigate the effects of impression method and design of the retainer on the stress of abutment tooth in distal extension RPD. Three different types of direct retainer such as Akers clasp. RPI clasp, and wrought wire clasp were designed . Stress on the abutment tooth was measured and analyzed with strain gauge method. Impressions were anatomic impression technique and functional impression technique. The following conclusions were drawn from this syudy. 1.The stress at the abutment tooth on all RPD was decreased in functional impression except RPI clasp retained RPD. 2.The stress at the abutment tooth on RPI clasp retained RPD was the most smallest in anatomic impression 3.While load is increase the stress at the abutment tooth was increased, but the change of stress at the buccal side of abutment tooth was not too much in functional impression.
Denture, Partial, Removable* ; Tooth

Localized pulmonary amyloidosis is a rare disease characterized by a deposition of amyloid limited to the lungs. We report a case of primary tracheobronchial amyloidosis which resulted in collapse of left lung and was confirmed by the Congo-red staining.
Amyloid ; Amyloidosis* ; Lung ; Rare Diseases

Localized pulmonary amyloidosis is a rare disease characterized by a deposition of amyloid limited to the lungs. We report a case of primary tracheobronchial amyloidosis which resulted in collapse of left lung and was confirmed by the Congo-red staining.
Amyloid ; Amyloidosis* ; Lung ; Rare Diseases

Supernunmerary nipple is a developmental anomaly occuring alon, the course of the embryological milk lines. This entity has receieved little attention in the dermatologic literature and has been confused with a pigmented nevus in some cases. We have experienced two ease of the more unusual form of supern umerary nipple. According to the Kajavas classification, our caes are classified as polithelia pilosa and complete breast with nipple.
Breast ; Classification ; Milk ; Nevus, Pigmented ; Nipples*