No abstract available.
Gallbladder* ; Lithotripsy*

BACKGROUND: Although insulin resistance and decreased insulin secretion are characteristics of established type 2 DM, which of these metabolic abnormalities is the primary determinant of type 2 DM is controversial. It is also not well known how insulin resistance and beta cell dysfunction influence serum insulin, proinsulin, proinsulin/insulin ratio in type 2 DM. METHODS: We compared serum insulin, proinsulin and proinsulin/insulin ratio in type 2 diabetic patients and control subjects. We also investigated the relationship between serum insulin, proinsulin and proinsulin/insulin ratio and several biochemical markers which represent insulin resistance or beta cell function. RESULTS: Insulin, proinsulin and proinsulin/insulin ratio were significantly higher in type 2 DM than control(p < 0.001). In diabetic patients, total insulin level was correlated with urinary albumin excretion rates(r = 0.224, p = 0.025) and body mass index(r = 0.269, p = 0.014). Proinsulin level was correlated with fasting C-peptide(r = 0.43, p = 0.002), postprandial 2 hour blood glucose(r = 0.213, p = 0.05) and triglyceride(r = 0.28, p = 0.022). Proinsulin/insulin ratio was positively correlated with fasting C-peptide(r = 0.236, p = 0.031), fasting blood glucose (r = 0.264, p = 0.015), postprandial 2 hour blood glucose(r = 0.277, p = 0.001) and triglyceride(r = 0.428, p < 0.001). In control subjects, insulin level was correlated with triglyceride(r = 0.366, p = 0.002). Proinsulin/insulin ratio was correlated with age(r = 0.241, p = 0.044). CONCLUSION: The serum levels of insulin and proinsulin seem to be associated with several markers of insulin resistance. Whereas proinsulin/insulin ratio might represent beta cell function rather than insulin resistance. But more studies are needed to clarify the mechanisms of elevated proinsulin/insulin ratio in type 2 DM.
Aged ; Diabetes Mellitus, Non-Insulin-Dependent/etiology ; Diabetes Mellitus, Non-Insulin-Dependent/blood* ; Female ; Human ; Insulin/blood* ; Insulin Resistance* ; Islets of Langerhans/physiopathology* ; Male ; Middle Age ; Proinsulin/blood* ; Sulfonylurea Compounds/pharmacology

An anomalous left coronary artery from the pulmonary artery(Bland-White-Garland syndrome) is a rare congenital malformation and sometimes fatal. It is caused by an abberant endothelial budding from or an anomalous division of the truncus arteriosus. Echocardiography (transthoracic and transesophageal) and angiographical imaging are essential for the diagnosis of this anomaly. Corrective Surgery is recommended due to its fatal natural course. A case was diagnosed in a 45-year-old man who presented with intermittent palpitation. This patient was successfully treated with closure of anomalous left coronary artery orifice combined with right saphenous vein graft anastomosis.
Bland White Garland Syndrome ; Coronary Vessels* ; Diagnosis ; Echocardiography ; Humans ; Middle Aged ; Pulmonary Artery* ; Saphenous Vein ; Transplants ; Truncus Arteriosus

OBJECTIVE: Miniscrew-assisted rapid palatal expansion (MARPE) is a means for expanding the basal bone without surgical intervention in young adults. Here, we assessed the differences in dental, alveolar, and skeletal measurements taken before (T0), immediately after (T1), and 1 year after (T2) MARPE. METHODS: Twenty-four patients (mean age, 21.6 years) who had undergone MARPE and cone-beam computed tomography at T0, T1, and T2 were included. Changes in the following parameters were compared using paired t-tests: intercusp, interapex, alveolar, nasal floor, and nasal cavity widths; inclination of the first molar (M1) and its alveolus; and thickness and height of the alveolar bone. A linear mixed-effects model was used to determine variables that affected periodontal changes in the M1. RESULTS: MARPE produced significant increases in most measurements during T0–T2, despite relapse of some measurements during T1–T2. The alveolar thickness decreased on the buccal side, but increased on the palatal side. The alveolar crest level at the first premolar moved apically. Changes in the thickness and height of the alveolar bone were affected by the corresponding initial values. CONCLUSIONS: MARPE can be used as an effective tool for correcting maxillomandibular transverse discrepancy, showing stable outcomes 1 year after expansion.
Bicuspid ; Cone-Beam Computed Tomography ; Humans ; Molar ; Nasal Cavity ; Recurrence ; Young Adult

Objective: Recently, microRNA (miRNA) has been identified both as a powerful regulator involved in various biological processes through the regulation of numerous genes and as an effective biomarker for the prediction and diagnosis of various disease states. The objective of this study was to identify and validate miRNAs and their target genes involved in inflammation in placental tissue. Methods: Microarrays were utilized to obtain miRNA and gene expression profiles from placentas with or without inflammation obtained from nine normal pregnant women and 10 preterm labor patients. Quantitative real-time polymerase chain reaction and Western blots were performed to validate the miRNAs and differentially-expressed genes in the placentas with inflammation. Correlations between miRNA and target gene expression were confirmed by luciferase assays in HTR-8/SVneo cells. Results: We identified and validated miRNAs and their target genes that were differentially expressed in placentas with inflammation. We also demonstrated that several miRNAs (miR-371a-5p, miR-3065-3p, miR-519b-3p, and miR-373-3p) directly targeted their target genes (LEF1, LOX, ITGB4, and CD44). However, some miRNAs and their direct target genes showed no correlation in tissue samples. Interestingly, miR-373-3p and miR-3065-3p were markedly regulated by lipopolysaccharide (LPS) treatment, although the expression of their direct targets CD44 and LOX was not altered by LPS treatment. Conclusion These results provide candidate miRNAs and their target genes that could be used as placental biomarkers of inflammation. These candidates may be useful for further miRNA-based biomarker development.

BACKGROUND: Metabolic syndrome (MS) is characterized by insulin resistance accompanied by one or more of the following: obesity, hypertension, impaired glucose tolerance, low HDL cholesterol levels, and/or hypertriglyceridemia. However, the precise underlying pathogenic mechanism of MS is not known. Several recent reports have suggested a positive association between components of MS and markers of the acute-phase response, including C-reactive protein (CRP). These results imply that MS is accompanied by an ongoing inflammatory process. The purpose of our study was to evaluate the association between circulating levels of C-reactive protein, a sensitive systemic marker of inflammation, with components of metabolic syndrome in Korean adults. METHODS: A total of 1,461 subjects aged between 20 and 81 years, who visited the Health Management Center at Korea university between November 2000 and February 2001 were studied. We investigated the correlation between CRP levels and components of MS. The components of MS were categorized, and age-sex adjusted mean values of CRP calculated for the categorized components. The BMI was categorized into 5 classes, and the CRP levels examined according to their BMI class. In addition, subjects with a different number of the MS components were grouped as follows: group 1 for 0 components, group 2 for 1 components, group 3 for 2 components and group 4 for > or = 3 components, and the CRP levels calculated for each group. RESULTS: There were significant positive correlations of CRP levels with age, BMI, TG, systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBS), uric acid, insulin,and homeostasis model assessment IR (HOMAIR). A significant inverse correlation was observed between CRP levels and serum HDL. From the multivariate analysis, age and BMI were significantly correlated with CRP levels. The means of the CRP for the categorized components of MS were significantly higher in the BMI categories: > or =25 for female/27 for male, TG > or =200 mg/dL, fasting plasma glucose > or =126 mg/dL and blood pressure > or =140/90 mmHg, and the CRP levels by BMI class were: 1.19 (BMI <18.5), 1.54 (BMI 18.5~22.9), 1.59 (BMI 23.0~24.9), 1.77 (BMI 25.0~29.9) and 2.07 (BMI >30.0) mg/L. Furthermore, the increase in the CRP levels in relation to the numbers of MS were 1.46 (group 1), 1.70 (group 2), 1.95 (group 3) and 2.11 mg/L (group 4) with statistical significance. CONCLUSION: The above data showed associations between the CRP levels and the different components of MS. This might suggest that MS in Koreans could be accompanied by a systemic inflammation response
Acute-Phase Reaction ; Adult* ; Blood Glucose ; Blood Pressure ; C-Reactive Protein ; Cholesterol, HDL ; Fasting ; Glucose ; Homeostasis ; Humans ; Hypertension ; Hypertriglyceridemia ; Inflammation ; Insulin Resistance ; Korea ; Male ; Multivariate Analysis ; Obesity ; Uric Acid

OBJECTIVE: Our purpose was to review patients undergoing radical hysterectmy and pelvic lymphadenectomy, comparing Pfannenstiel and Vertical midline incisions for operative feasibility and perioperative outcome. METHODS: Between January 2001 and February 2003, 123 patients underwent radical hysterectomy and pelvic lymphadenectomy for cervical cancer at Busan Paik hospital. All procedures were performed by a gynecologic oncologist. Prospectively, all data were collected from review of each patient's medical record, including age, body mass index (BMI), stage, histology, nodal counts, operative time, estimated blood loss, surgical pathologic margin positivity, complications, and length of hospital stay. Associations between variables were studied using X2 test, t-test, and Fisher Exact test. RESULTS: Radical hysterectomy was performed through a Vertical midline (n=62) and Pfannenstiel (n=61) incision. There were no significant differences in age, BMI, stage, histology, nodal counts, estimated blood loss, surgical pathologic margin positivity, complications, and length of hospital stay. But, patients with a Pfannenstiel incision had shorter operative time than those with Vertical midline incision (169 min vs 197 min, P<0.0001). CONCLUSION: Radical hysterectomy and pelvic lymphadenectomy can be safely performed through a Pfannenstiel incision without increased operative morbidity and equal nodal removal as compared with Vertical midline incision. Pfannenstiel incision may offer the benefits of improved cosmesis and shorter operative time without compromising surgical exposure or increasing the risk of surgical complications.
Blood Loss, Surgical ; Body Mass Index ; Busan ; Humans ; Hysterectomy* ; Length of Stay ; Lymph Node Excision* ; Medical Records ; Operative Time ; Prospective Studies ; Uterine Cervical Neoplasms

PURPOSE: PTEN is a novel tumor suppressor gene located on chromosomal band 10q23.3. The detection of PTEN mutations in Cowden disease and in breast carcinoma cell lines suggests that PTEN may be involved in mammary carcinogenesis. Among several series of breast carcinomas, the frequency of loss of flanking markers around PTEN is approximately 30 to 40% and the somatic intragenic PTEN mutation frequency is less than 5%. METHODS: The expression of PTEN was stuided immunohistochemically studied in 41 invasive ductal carcinomas of the breast. We examined the correlation between PTEN expression and clinicopathologic factors such as age, tumor size, lymph node metastasis, histologic grade, nuclear grade, stage, as well as estrogen and progesteron receptors. RESULTS: Among the 41 infiltrating ductal carcinomas, studied 7 (17.1%) were immunohistochemically negative, and 19 (46.3%) demonstrated reduced expression. Among the clinicopathologic factors, tumor size, lymph node metastasis, high stage, and negative progesteron receptor displayed a significant relationship with the decrease of PTEN expression, however age, nuclear grade, and estrogen receptor had less of a relationship with PTEN expression. CONCLUSION: These results suggest that PTEN does play some role as a prognostic factor for carcinogenesis, but this hypothesis requires further study.
Breast Neoplasms ; Breast* ; Carcinogenesis ; Carcinoma, Ductal* ; Cell Line ; Estrogens ; Genes, Tumor Suppressor ; Hamartoma Syndrome, Multiple ; Lymph Nodes ; Mutation Rate ; Neoplasm Metastasis

PURPOSE: Angiogenesis plays an important role in the growth, progression and metastasis of solid tumors. Vascular endothelial growth factor (VEGF) was thought to be one such angiogenic factor and was also thought to be a selective mitogen for endothelial cells. The purpose of this retrospective study was to evaluate for prognostic significance of VEGF in stomach cancer. MATERIALS AND METHODS: The sections of formalin-fixed, paraffin embedded from 55 stomach cancer were stained immunohistochemically for VEGF. The rate of VEGF expression and correlation between expression of VEGF and other prognostic factor of stomach cancer were studied. RESULTS: There were 20 cases (36.4%) of VEGF-positive and 35 cases (63.6%) of VEGF- negative. There were no significant difference between VEGF expression and the histologic type, differentiation, depth of invasion of histologic stage, lymph node involvement. The frequency of hepatic recurrence was higher in patients with VEGF-positive tumor than that af patient with negative tumor (p=0.007). The prognosis of the patients with VEGF positive tumor was worse than that of patients with VEGF negative tumor (p=0.0214). CONCLUSION: There was a closely significant between positive expression of VEGF and a high incidence of hepatic metastasis, low survival rate. The expression of VEGF could be considered to be one of useful prognostic factor in human gastric carcinoma
Angiogenesis Inducing Agents ; Endothelial Cells ; Humans* ; Incidence ; Lymph Nodes ; Neoplasm Metastasis ; Paraffin ; Prognosis ; Recurrence ; Retrospective Studies ; Stomach Neoplasms* ; Stomach* ; Survival Rate ; Vascular Endothelial Growth Factor A*

This paper presents a family with sick sinus syndrome, spanning three generations and with an autosomal dominant trait. The proband was affected by atrial fibrillation with a slow ventricular rhythm that required a permanent pacemaker. Her three sons were affected with a sinus node dysfunction and one daughter died suddenly at the age of 32 years. A pacemaker was implanted in the proband and her two sons with symptoms related to bradycardia. One of her sons with the pacemaker died of a cerebrovascular accident several months later. We report a family with sick sinus syndrome requiring the implantation of a pacemaker with a review of the literature.
Atrial Fibrillation ; Bradycardia ; Family Characteristics ; Humans ; Nuclear Family ; Sick Sinus Syndrome* ; Stroke