BACKGROUND: The regular meal pattern with consistent day-to-day calorie and carbohydrate intake is one of the most important determinants of good glycemic control in diabetes. This study was aimed to investigate the meal pattern and their relationships with total energy intake, nutrients intake and glycemic and lipid profile in type 2 diabetes. METHODS: 1,084 subjects were divided according to glycemic status into three groups: the diabetes (DM), dysglycemia (DG) and normal (N). The meal frequency (MF), meal interval (MI) and daily intake of total energy, macronutrient and micronutrient were estimated with the 24 hours dietary recall from the Korean National Health and Nutrition Examination Survey (KNHANES) in 2001 and Eulji hospital. For analysis of meal pattern and it's relations with the nutrients intake, we regrouped into meal skipper (G1), non-meal skipper with unreasonable MI (G2), and non-meal skipper with reasonable MI (G3). RESULTS: 17.5% of DM, 21.8% of DG, 23.3% of N skipped at least one meal a day without significant difference across the groups. 55.9% of non-meal skipper had unreasonable MI. Meal was more regular in older age, lower educated person, employee, and female. G1 took higher fat, and more calories form snack and less micronutrient density, compared with G3 (P < 0.05). HbA1c, total cholesterol and triglyceride values were higher in G1 compared with other two groups (P < 0.05). CONCLUSION: Many type 2 diabetics had the irregular meal patterns, which was associated with poor glycemic control, lipid profiles and less micronutrient density. This suggested that another treatment strategy might be required for those who had irregular lifestyle.
Cholesterol ; Energy Intake ; Female ; Humans ; Life Style ; Meals ; Micronutrients ; Nutrition Surveys ; Snacks

Naringenin (NAR) as one of the flavonoids observed in grapefruit has been reported to exhibit an anti-cancer activity. However, more detailed mechanism by which NAR exerts anti-cancer properties still remains unanswered. Thus, in this study, we have shown that NAR down-regulates the level of cyclin D1 in human colorectal cancer cell lines, HCT116 and SW480. NAR inhibited the cell proliferation in HCT116 and SW480 cells and decreased the level of cyclin D1 protein. Inhibition of proteasomal degradation by MG132 blocked NAR-mediated cyclin D1 downregulation and the half-life of cyclin D1 was decreased in the cells treated with NAR. In addition, NAR increased the phosphorylation of cyclin D1 at threonine-286 and a point mutation of threonine-286 to alanine blocked cyclin D1 downregulation by NAR. p38 inactivation attenuated cyclin D1 downregulation by NAR. From these results, we suggest that NAR-mediated cyclin D1 downregulation may result from proteasomal degradation through p38 activation. The current study provides new mechanistic link between NAR, cyclin D1 downregulation and cell growth in human colorectal cancer cells.
Alanine ; Cell Line ; Cell Proliferation ; Citrus paradisi ; Colorectal Neoplasms* ; Cyclin D1* ; Down-Regulation* ; Flavonoids ; Half-Life ; Humans ; Phosphorylation ; Point Mutation

No abstract available.
Chitosan* ; Osteoblasts* ; Peptides* ; Transplants*

A case of primary adenosquamous carcinoma of the liver is reported. A large cystic mass with irregular enhancing wall was seen in the left lobe of the liver; multiple hepatic cysts and metastatic nodules were scattered in both lobes. Sonoguided needle biopsy was performed and on histopathology, adenosquamous carcinoma was diagnosed. The radiologic and pathologic relationships of this unusual neoplasm are discussed.
Biopsy, Needle ; Carcinoma, Adenosquamous* ; Liver*

PURPOSE: We wanted to investigate the accuracy of axillary ultrasonography for detecting axillary nodal metastasis in patients with T1-2 breast cancer and we also wanted to determine the factors affecting the sensitivity. MATERIALS AND METHODS: Two radiologists performed axillary ultrasonography in 119 consecutive patients with T1-2 breast cancer and clinically uninvolved axillae. We analyzed the accuracy of ultrasonography for detecting axillary nodal metastasis with the histologic results being used as a reference standard. We evaluated the number of involved lymph nodes, T staging and the histologic grade of the tumors. RESULTS: Axillary nodes were involved in 39% of total patients (46/119); 30% of the patients with T1 cancer and 55% of the patients with T2 cancer. The sensitivity, specificity, positive predictive value and negative predictive value were for 52%, 92%, 80% and 75%, respectively. The sensitivity was significantly lower for the cases with one to two lymph nodes metastasis and T1 cancer than in those cases with 3 or more lymph nodes metastasis and T2 cancer (35% and 75% in the cases with 1-2 cancer and the cases with > 3 lymph nodes metastasis, respectively, p = 0.009; 38% and 68% in the cases with T1 and the cases with T2 cancer, respectively, p = 0.045). CONCLUSIONS: The ultrasonographic sensitivity for detecting axillary lymph node metastasis is low, especially in the cases with one to two lymph nodes metastasis and the cases with T1 cancer. Detailed analysis and adoption of cytologic examination of the axillary lymph nodes are necessary to improue the accuracy of ultrasonography.
Adoption ; Axilla ; Breast ; Breast Neoplasms ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Sensitivity and Specificity

Background/Aims: The prevalence of simple renal cysts increases with age; however, they are occasionally found in adults aged < 40 years. This cross-sectional study evaluated the clinical significance of simple cysts in young adults, focusing on their associations with hematuria and albuminuria. Methods: Adults aged < 40 years who underwent comprehensive medical examination between January 2005 and December 2013 were included. Simple renal cysts were identified by ultrasonography. Results: Renal cysts were found in 276 of the 5,832 subjects (4.7%). Subjects with medullary sponge kidney (n = 1) or polycystic kidney disease (n = 5) were excluded. A single cyst and multiple cysts were found in 234 (4.0%) and 42 (0.7%) subjects, respectively. Age, high systolic blood pressure, and history of hypertension were independent risk factors for the presence of simple cysts. Simple cysts were not associated with an increased prevalence of hematuria. However, subjects with cysts showed a higher prevalence of albuminuria than those without (11.3% vs. 4.5%, p < 0.001). Multivariate analysis revealed that the existence of simple renal cysts was associated with a 2.30-fold increased prevalence of albuminuria (95% confidence interval, 1.512 to 3.519; p < 0.001) independent of other risk factors. Conclusions In young adults, the presence of simple renal cysts was independently associated with an increased prevalence of albuminuria. The causal relationship needs to be elucidated in further studies.

BACKGROUND/AIMS: The increasing trend of antibiotic resistance emphasizes the need for the assessment of eradication rate of first and second-line therapy for Helicobacter pylori (H. pylori) infection. The reinfection rate depends on the geographical, national, or socioeconomic status of the patients. The aim of this study was to evaluate the recent 5-year changes of eradication rates and the reinfection rates after the successful eradication of Helicobacter pylori infection for 3-years follow-up in Bucheon, Korea. METHODS: From February 2001 to August 2006, 3,267 patients with H. pylori-positive peptic ulcer disease received the first-line therapy for 7 days. The 317 patients who failed to the first-line therapy received the second-line therapy for 7 days. The 167 patients with 3-years follow-up after the successful eradication were included. (13)C-urea breath tests or rapid urease tests and histologies were assessed to determine the H. pylori status after the eradication. RESULTS: The eradication rate of first-line therapy was 83.7% in 2001, 83.4% in 2002, 83.7% in 2003, 85.9% in 2004, 87.2% in 2005, and 81.8% in 2006 by per protocol analysis (PP), respectively. The eradication rate of second-line therapy was 80.0% in 2002, 86.8% in 2003, 89.7% in 2004, 98.0% in 2005, and 78.8% in 2006 by PP. The cumulative reinfection rate was 6.0%. The annual reinfection rate was 2.0%. The recurrence rate of peptic ulcer was 17.2% in the patients without reinfection and 50% with reinfection. CONCLUSIONS: The eradication rate for H. pylori have not changed in the recent 5-years. The annual reinfection rate was low. The successful eradication of H. pylori was effective for preventing the recurrence of peptic ulcers.
Adult ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents/therapeutic use ; Demography ; Female ; Follow-Up Studies ; Helicobacter Infections/*drug therapy/prevention & control ; Helicobacter pylori/*drug effects ; Humans ; Male ; Middle Aged ; Peptic Ulcer/microbiology/therapy ; Recurrence ; Remission Induction ; Time Factors ; Treatment Outcome

Colonic lipomas represent mesenchymal origin tumors that are second most common benign colonic tumor after hyperplastic polyps and adenomatous polyps. The patho-genesis of them is not clear. Most patients are asymptomatic and the lesion is often detected incidentally at colonoscopy, operation, and autopsy. According to the size and the location of lipoma, it may cause intestinal obstruction, perforation, intussusception, and life-threatening bleeding. There have been many reports of small colonic lipomas removed by endoscopic resection. Giant lipoma which is greater than 2 cm in size has been associated with higher risk of perforation, thus it has been removed by surgery until now. We report a case of colonic giant lipoma inducing intussusception which could be removed by endoscopic resection.
Adenomatous Polyps ; Autopsy ; Colon* ; Colonoscopy ; Hemorrhage ; Humans ; Intestinal Obstruction ; Intussusception ; Lipoma* ; Polyps

BACKGROUND/AIMS: The removal of esophageal and gastric submucosal tumors is difficult using conventional endoscopic mucosal resection methods. This study examined the usefulness of an endoscopic subtumoral dissection for an en-bloc resection of submucosal tumors. METHODS: An endoscopic subtumoral dissection was attempted for an en-bloc resection in 15 submucosal tumors (M: F=10 : 5, 13 stomach, 2 esophagus). Before the procedures, endoscopic ultrasonography was performed in all cases. The procedure was carried out using various electrosurgical knives, such as an endoscopic submucosal dissection. RESULTS: Pathological and immunohistochemical studies confirmed a gastrointestinal stromal tumor in 6 cases. Other pathological diagnoses were made in 9 patients with submucosal lesions: leiomyoma (4), ectopic pancreas (3), lipoma (1), and hemangioma (1). An en-bloc resection was performed in 13 of the 15 tumors (86.7%). The mean specimen size was 29.5x21.1 mm. The mean procedure time was 49.4 minutes (range: 8~103 minutes). Gastric perforation was a complication in 2 cases with GIST. However, the two perforated cases were treated with endoscopic closure using endoclips and recovered without the need for surgery. CONCLUSIONS: An endoscopic subtumoral dissection technique is useful for an en-bloc resection of esophageal and gastric submucosal tumors. However, sufficient attention should be paid to the detection of perforations in the case of tumors with a proper muscle origin.
Endosonography ; Gastrointestinal Stromal Tumors ; Hemangioma ; Humans ; Leiomyoma ; Lipoma ; Muscles ; Pancreas ; Stomach

BACKGROUND/AIMS: Propofol is widely used for sedation during endoscopy. Because propofol may cause hepatic encephalopathy, hemodynamic compromise, and respiratory depression, cautious use is required in patients with liver cirrhosis. We evaluated the safety and efficacy of propofol in compensated cirrhosis during endoscopic examination. METHODS: Thirty-nine cirrhotic patients (19 and 20 cases of Child Pugh classes A and B, respectively) and 56 control subjects were included. The initial dose of propofol (40 mg) was increased by 20-mg increments until moderate sedation was achieved. The number connection test, flapping tremor test, blood pressure, heart rate, oxygen saturation, liver enzymes, and prothrombin time were evaluated before and after endoscopy. RESULTS: No significant change was observed in any parameter compared to baseline in either group. The mean dose of propofol was significantly lower in cirrhotic versus control subjects (49.7+/-15.8 versus 65.0+/-17.9 mg, respectively; p<0.001). Scores based on a visual analog scale evaluating patient satisfaction did not differ between groups (72+/-27 versus 64+/-26, respectively; p=0.196), nor did mean recovery time (16.4+/-9.8 versus 14.2+/-6.7 min, respectively; p=0.186). CONCLUSION: Propofol is safe and effective for moderate sedation in compensated liver cirrhosis.
Child ; Conscious Sedation ; Endoscopy ; Fibrosis ; Heart Rate ; Hematologic Tests ; Hemodynamics ; Hepatic Encephalopathy ; Humans ; Liver ; Liver Cirrhosis ; Oxygen ; Patient Satisfaction ; Propofol ; Prothrombin Time ; Respiratory Insufficiency ; Tremor