PURPOSE: Leptin and adiponectin are two representative adipocytokines. Leptin increases, but adiponectin decreases, with obesity and insulin resistance. We aimed to study the relationship between the leptin/adiponectin ratio and insulin resistance in healthy children. METHODS: Seventy-seven healthy children (36 boys and 41 girls) were enrolled in this study. Anthropometric measurements were performed, and the percentage of weight for height (%WFH) was calculated in each subject. Fasting plasma levels of glucose, insulin, leptin, adiponectin, testosterone, estradiol, and sex-hormone binding globulin (SHBG) were measured. The free androgen index (FAI) was used as a representative of testosterone bioactivity. The homeostasis model assessment was used to estimate the degree of insulin resistance (HOMA-IR). RESULTS: In the boys, HOMA-IR was significantly correlated with age, pubertal stage, free androgen index (FAI), leptin, and the leptin/adiponectin ratio. HOMA-IR was also significantly related to age, percentage of weight for height (%WFH), pubertal stage, estradiol, leptin, and the leptin/adiponectin ratio in girls. The leptin/adiponectin ratio was independently related to HOMA-IR after adjusting for age, %WFH, and FAI in the boys (P<0.05). The leptin/adiponectin ratio was not independently related to HOMA-IR after adjusting for age, %WFH, and estradiol in girls. CONCLUSION: In non-obese healthy children, the leptin/adiponectin ratio was significantly correlated with insulin resistance. The leptin/adiponectin ratio was independently related to insulin resistance even after adjusting for age, degree of obesity, and androgen levels in healthy boys.
Adipokines ; Adiponectin ; Child ; Estradiol ; Fasting ; Glucose ; Homeostasis ; Humans ; Insulin ; Insulin Resistance ; Leptin ; Obesity ; Plasma ; Testosterone

PURPOSE: Diabetic children should be classified into type 1 or 2 for adequate diabetic control. However, there is a shortage of information of the appropriate criteria in Korea. This study is desinged to discover the clinical types and characteristics of diabetes mellitus(DM) in Korean children. METHODS: We studied the clinical characteristics and laboratory findings of 177 diabetic children. Classification was based on the serum C-peptide levels, presence of ketoacidosis, autoantibodies, and insulin dependence. RESULTS: Among 177 diabetic children, 147(83.1%) were classified as type 1 and 21(11.9%) as type 2, and 12(57.1%) children in type 2 were obese. All patients with age of onset before 9 were type 1. In cases of type 1, initial serum C-peptide levels were < 0.6(50%), 0.6-1.0(44%) and > 1.0ng/mL (6%). All patients with initial serum C-peptide level above 1.5ng/mL were type 2. Four patients initially diagnosed as type 2 DM changed to type 1 during follow-up, and 2 patients of type 1 DM changed to type 2. Only 55.4% of type 1 DM patients had insulin autoantibody, islet cell cytoplasmic antibody or anti-glutamic acid decarboxylase antibodies. CONCLUSION: Most diabetic children in Korea were classified as type 1. Our results suggest that insulin requiring lean patients with positive autoantibody should be classified as type 1 even if their serum C-peptide levels are within normal range, and the clinical types could be changed during follow-up in a small proportion of diabetic children.
Age of Onset ; Antibodies ; Autoantibodies ; C-Peptide ; Child* ; Classification ; Cytoplasm ; Diabetes Mellitus* ; Follow-Up Studies ; Humans ; Insulin ; Islets of Langerhans ; Ketosis ; Korea ; Reference Values

Microcystic adnexal carcinoma is a rare, locally aggressive tumor with a high potential for local recurrence. It usually presents in elderly patients as a solitary, slowly growing, firm, indurated plaque on the face, and particularly on the upper lip or central face. It has occasionally been found in extra-facial locations, including the nipple, axilla and lower extremities, yet scalp involvement has been rarely reported. Histopathologically, it is a poorly circumscribed dermal tumor that shows both follicular and ductal differentiation, and it may extend into the subcutis and skeletal muscle. We report here on a case of microcystic adnexal carcinoma at an unusual site: the scalp. A 42-year-old woman presented with a 6-month history of a painful, solitary, 1 cm-sized, firm, fixed, dome-shaped nodule on the scalp, and this was accompanied by ulceration and oozing. A biopsy specimen demonstrated features of microcystic adnexal carcinoma, with both follicular and ductal differentiation. Immunohistochemical staining for CEA (carcinoembryonic antigen) was positive in the ductal structures, but this was negative in the follicular structures.
Adult ; Aged ; Axilla ; Biopsy ; Female ; Humans ; Lip ; Lower Extremity ; Muscle, Skeletal ; Nipples ; Recurrence ; Scalp ; Ulcer

Microcystic adnexal carcinoma is a rare, locally aggressive tumor with a high potential for local recurrence. It usually presents in elderly patients as a solitary, slowly growing, firm, indurated plaque on the face, and particularly on the upper lip or central face. It has occasionally been found in extra-facial locations, including the nipple, axilla and lower extremities, yet scalp involvement has been rarely reported. Histopathologically, it is a poorly circumscribed dermal tumor that shows both follicular and ductal differentiation, and it may extend into the subcutis and skeletal muscle. We report here on a case of microcystic adnexal carcinoma at an unusual site: the scalp. A 42-year-old woman presented with a 6-month history of a painful, solitary, 1 cm-sized, firm, fixed, dome-shaped nodule on the scalp, and this was accompanied by ulceration and oozing. A biopsy specimen demonstrated features of microcystic adnexal carcinoma, with both follicular and ductal differentiation. Immunohistochemical staining for CEA (carcinoembryonic antigen) was positive in the ductal structures, but this was negative in the follicular structures.
Adult ; Aged ; Axilla ; Biopsy ; Female ; Humans ; Lip ; Lower Extremity ; Muscle, Skeletal ; Nipples ; Recurrence ; Scalp ; Ulcer

Seborrheic keratoses are the most common benign epidermal tumor of the skin and a frequent focus of patient concern because of their variable appearance. Seborrheic keratoses may arise on any non-mucosal surface, including the face, scalp, and trunk. However, it rarely occurs on the ear, especially on the scapha. We report a case of a 42 year-old female patient presenting with 1 cm, brownish pedunculated nodule of seborrheic keratosis on the scapha.
Ear ; Ear Auricle ; Female ; Humans ; Keratosis, Seborrheic ; Scalp ; Skin

PURPOSE: Sentinel lymph node (SLN) dissection is now a widely used and accepted method for staging the axilla in breast cancer patients. The aim of this study was to determine the rate of axillary lymphatic recurrence and metastasis in breast cancer patients who had a negative SLNB. METHODS: A retrospective chart review from August of 2001 to December of 2003 was performed for all patients (n=89) who underwent a SLN biopsy and they had a negative SLN on the intraoperative frozen sections. Any additional axillary lymph node dissection was not performed even when the sentinel lymph node(s) were found to be positive by the permanent pathology. The patients received appropriate adjuvant therapy according to the characteristics of the primary tumor. All the patients who had breast conserving surgery received postoperative radiotherapy to the remaining breast, but not to the axilla. RESULTS: A mean of 4.92 LNs were removed per patient. Among the 89 patients whose sentinel lymph nodes were tumor-free on frozen section, 9 patients had metastatic lymph nodes on the permanent pathology. All the metastases were micrometastasis. Over a mean follow-up period of 53 months, one patient died of liver metastasis and one patient developed n ipsilateral breast recurrence. Only one patient developed an axillary recurrence. CONCLUSION: SLNB provides accurate staging of breast cancer and this might be a good alternative to routine axillary lymph node dissection with incurring less surgical morbidity.
Axilla ; Biopsy ; Breast Neoplasms* ; Breast* ; Follow-Up Studies* ; Frozen Sections ; Humans ; Liver ; Lymph Node Excision ; Lymph Nodes ; Mastectomy, Segmental ; Neoplasm Metastasis ; Neoplasm Micrometastasis ; Pathology ; Radiotherapy ; Recurrence ; Retrospective Studies ; Sentinel Lymph Node Biopsy*

PURPOSE: To investigate the effect of ionizing radiation on high mucin-producing colon cancer cells, we evaluated homotypic cell adhesion, cell-matrix adhesion, and matrix metalloproteinases (MMPs) on HM7 cells. METHODS: After an irradiation of 60 Gy for 48 hours on HM7 cells, we evaluated cellular proliferation, colony-forming ability, homotypic adhesion, cell-matrix binding, and integrin subunit expressions. Also, alterations of MMPs expression were analyzed by using zymography. RESULTS: Cell proliferation of HM7 colon cancer cells was not remarkably affected even after high doses of radiation; however, clonogenic cell growth was significantly affected. Homotypic cell-cell adhesion and cell adhesion to ECM components and basement membrane protein matrigel were significantly increased after irradiation. Radiation induced expressions of cell surface integrin alpha2, alpha3, and beta1 subunits of HM7 cells. The activities of secreted MMPs (MMP-9 and MMP-2) were remarkably inhibited by radiation. CONCLUSIONS: These finding suggest the biologic characteristics of high-mucin-producing colorectal carcinomas. Even though the radiation-associated cellular alterations of HM7 cells with or without matrix proteins were not remarkably different from other cancer cell types studied, the radio-resistant behavior of high mucin producing HM7 cells may explain the aggressive characteristics of mucinous colorectal carcinomas.
Basement Membrane ; Cell Adhesion* ; Cell Proliferation ; Colon* ; Colonic Neoplasms* ; Colorectal Neoplasms ; Integrin alpha2 ; Matrix Metalloproteinases* ; Mucins* ; Population Characteristics ; Radiation, Ionizing*

Background: Micropigmentation is a medical tattooing procedure in which pigments are implanted into the superficial dermis using a manual or electrically driven needle. Objective: We aimed to assess the benefit and risk of micropigmentation in the treatment of acral vitiligo refractory to the conventional treatment. Methods: An open-label study was conducted from December 2018 to March 2019. A total of 12 patients with 20 acral vitiligo lesions were treated with micropigmentation using an electric tattooing machine. The micropigmentation treatment was repeated for a few sessions to achieve optimal pigmentation. Color matching between the lesion and peri-lesional skin was assessed using a 4-point grading scale (poor, fair, good, and excellent). Results: Overall, 85% (17 of 20) showed excellent color matching after a median of 2 (range: 1∼5) treatment sessions. The post-treatment color was darker than the surrounding skin immediately after the procedure, but it gradually faded over time. Pain during the procedure was not mild, but local anesthetic injection was not required. Post-treatment erythema and swelling occurred, but they resolved within a few days. No allergic reaction to the pigment or koebnerization of the vitiligo was noted. Conclusion Micropigmentation could be a promising treatment option for refractory acral vitiligo. A few treatment sessions (i.e., retouch) may be required for desired outcomes. The crucial parts of micropigmentation are pigment selection and implantation depth. It does not require injection of local anesthetics and provides immediate treatment effects after the procedure.

PURPOSE: This study aimed to perform a systematic review of the reports on Mycoplasma pneumoniae pneumonia in the last 30 years (1980-2006) to investigate the intervals between outbreaks, change in the peak incidence age, and diagnostic methods. We also aimed to validate the proper diagnostic criteria for M. pneumoniae pneumonia. METHODS: We reviewed 62 original articles on M. pneumoniae pneumonia in Korean children. We analyzed the annual or seasonal variation, study areas, patient age, journal names, and the date of each report. Further, we checked the methods and criteria used for the diagnosis of M. pneumoniae pneumonia. We also confirmed the proper mycoplasma antibody cutoff using the mycoplasma IgM titer as the gold standard. RESULTS: In the last 30 years, epidemic outbreaks of M. pneumoniae pneumonia occurred every 3 years, except in 1993-1994 and 1996-1997. Seasonal variations were also present and were most prevalent in October and November. The number of preschool children, especially those aged 3 years or younger, with M. pneumoniae pneumonia has increased (P<0.05). The mycoplasma antibody titer of 1:640 or greater was appropriate for diagnosing M. pneumoniae pneumonia, with an acceptable sensitivity and specificity of detection. CONCLUSION: We analyzed the results of studies on M. pneumoniae pneumonia in Korean children during the last 30 years. Infection in younger children is increasing, and further research is required to reveal the major cause of the changing epidemics.
Aged ; Child ; Child, Preschool ; Disease Outbreaks ; Humans ; Immunoglobulin M ; Incidence ; Mycoplasma ; Mycoplasma pneumoniae ; Pneumonia ; Pneumonia, Mycoplasma ; Seasons ; Sensitivity and Specificity