PURPOSE: Ghrelin, a 28-amino-acid peptide predominantly produced by the stomach, is endogenous ligand of growth hormone secretagogue receptor and potent stimulator of growth hormone. Ghrelin is also proposed to be orexigenic peptide that induce weight gain by increasing food intake. In general, ghrelin level increase preprandially and decrease after meals and ghrelin is reduced in obese, insulin resistance adults. There is a few available data of ghrelin level in obese children. The aim of this study was to determine whether there was difference of serum ghrelin level between obese and lean children and to evaluate the relationship between ghrelin and insulin resistance. METHODS: The study population consisted of 104 Children (65 males and 39 females) aged 8.0 to 15.0 years. We measured serum glucose and lipid profiles after 8 hr of fasting. Serum insulin and ghrelin were measured by radioimmunoassay. We compared serum ghrelin level between 52 obese children whose body mass index (BMI) greater than the 95th percentile for age and sex and 31 lean children and evaluated the relationship of ghrelin with BMI, fasting glucose, lipid profile and insulin resistance. We also compared serum ghrelin level of fasting and two-hour postprandial state by oral glucose tolerance test in 23 obese children. RESULTS: Mean serum ghrelin concentrations were 445.4 pg/mL in obese children, 504.9 pg/mL in lean children, but not different significantly. The decrease in serum ghrelin with advancing pubertal stage was significantly marked between prepuberty and overt puberty group (P<0.05). The fasting serum ghrelin concentration were negatively associated with height (r=-0.25, P<0.05), weight (r=-0.28, P<0.01), BMI (r=-0.21, P<0.05), fasting insulin concentration (r=-0.27, P<0.01) and HOMA-IR (r=-0.24, P<0.05). After two-hour postprandial state in obese children group, serum ghrelin level were decreased than fasting state (P<0.01). CONCLUSION: Serum ghrelin had no significant difference between obese and lean children but negatively correlated with body mass index and ghrelin were associated with fasting insulin concentration and HOMA-IR. This findings suggest that ghrelin is regulated by feeding state and also modulated by insulin secretion.
Adolescent* ; Adult ; Blood Glucose ; Body Mass Index ; Child* ; Eating ; Fasting ; Ghrelin* ; Glucose ; Glucose Tolerance Test ; Growth Hormone ; Humans ; Insulin Resistance* ; Insulin* ; Male ; Meals ; Obesity ; Puberty ; Radioimmunoassay ; Receptors, Ghrelin ; Stomach ; Weight Gain

BACKGROUND: To ensure safety of blood transfusion, accuracy in performance of blood grouping tests (BGT) is essential. External proficiency testing (PT) for BGT has not been conducted in Korea. The first PT for BGT in domestic blood centers was conducted in order to evaluate the domestic status of accuracy of BGT in blood centers and to aid in improving the quality of blood centers. METHODS: Whole blood survey specimens consisting of three panels for ABO grouping and two panels for Rh typing were sent to 81 blood centers. Evaluation criteria for BGT were as follows: 'Good' for answers with 100% referee consensus, 'Acceptable' for correct answers other than those of the referee, and 'Unacceptable' for answers other than those of 'Good+acceptable' as correct answers. RESULTS: Rates of correct answers on three panels for ABO grouping were all 100%; however, that of cell typing for the panel with BW was 61.7%, and 31 blood centers incorrectly reported normal 'B' type as an answer. The rate of correct answers for the Rh negative panel was 100%; however, that for the weak D panel was 84%, and 13 blood centers incorrectly reported Rh negative type as an answer. CONCLUSION: Findings from this study demonstrated that some hospital blood centers were not able to correctly detect blood groups with weak antigens. Therefore, to improve the quality of blood centers, intensive education for blood center staff and continued PT for BGT should be required.
Blood Group Antigens ; Blood Grouping and Crossmatching ; Blood Transfusion ; Consensus ; Dietary Sucrose ; Korea

PURPOSE: Obesity has become a pandemic and especially the prevalence of childhood obesity has increased remarkably over the past years. Childhood obesity is often accompanied by the expected morbidities such as hyperlipidemia, fatty liver and glucose intolerance. We evaluated the pattern of alteration in the body mass index (BMI), serum adiponectin concentration, insulin resistance (HOMA-IR), and complication rates after one year follow-up. METHODS: Forty two obese children (age: 8-15 years, 95th percentile of BMI for age and sex) were examined twice annually on June, 2004 and July, 2005. The body mass index (BMI) and sexual maturity rating (SMR) were determined annually by the same examiner and serum fasting glucose, liver enzyme, lipid profiles, adiponectin, insulin and HOMA-IR were measured and annual results were compared. Upper abdominal sonography was performed to detect fatty liver. RESULTS: BMI (25.3+/-2.9 kg/m2 vs. 26.0+/-2.9 kg/m2) and HOMA-IR (3.6+/-1.8 vs. 4.7+/-1.9) have increased significantly after one-year follow-up. The serum adiponectin concentration (17.2+/-5.2 g/mL vs. 12.6+/-5.2 g/mL) has decreased after one year. The prevalence of hyperlipidemia and fatty liver were not changed significantly but that of hyperinsulinemia increased after one-year. HOMA-IR showed a positive correlation with BMI and SMR, but was negatively correlated with serum adiponectin concentration. CONCLUSION: Obese children in our study showed significant increment of insulin resistance during one year. These results suggest that well-organized and continuous obesity control is required especially for obese adolescent to prevent complication of obesity.
Adiponectin* ; Adolescent* ; Body Mass Index ; Child* ; Fasting ; Fatty Liver ; Follow-Up Studies* ; Glucose ; Glucose Intolerance ; Humans ; Hyperinsulinism ; Hyperlipidemias ; Insulin Resistance* ; Insulin* ; Liver ; Obesity ; Pandemics ; Pediatric Obesity ; Prevalence

Meningioangiomatosis is a rare, benign, focal lesion of the leptomeninges and underlying cerebral cortex, characterized by leptomeningeal and meningovascular proliferation. It may be presented as isolated, sporadic form and rarely associated with neurofibromatosis type II. Medically refractory, localization-related epilepsy is the most common presentation in sporadic cases. We report a 49-year-old man presented with intractable complex partial seizures was diagnosed with sporadic form of meningioangiomatosis. The anterior temporal lobectomy with amygdalo-hippocampectomy was performed and he was seizure-free for one year.
Anterior Temporal Lobectomy ; Cerebral Cortex ; Epilepsies, Partial ; Epilepsy, Temporal Lobe* ; Humans ; Middle Aged ; Neurofibromatosis 2 ; Seizures ; Temporal Lobe*

Pulmonary thromboembolism is one of the most important causes of morbidity and mortality in patients undergoing lower extremity orthopedic surgery. Early diagnosis and appropriate management are important clinical challenges. In this case, massive pulmonary embolism causing sudden cardiac arrest was attributed to use of tourniquet inflation during lower extremity orthopedic surgery. Resuscitation procedures were initiated and transesophageal echocardiography revealed pulmonary thromboembolism. Patients with high suspicion for the presence of deep vein thrombus must be monitored thoroughly during limb exsanguinations.
Anesthesia, Spinal ; Death, Sudden, Cardiac ; Early Diagnosis ; Echocardiography, Transesophageal ; Extremities ; Heart Arrest ; Humans ; Inflation, Economic ; Lower Extremity ; Orthopedics ; Pulmonary Embolism ; Resuscitation ; Thrombosis ; Tourniquets ; Veins

OBJECTIVES: The purpose of this study was to compare the marginal and internal fit of nano-composite CAD-CAM restorations. MATERIALS AND METHODS: A full veneer crown and an mesio-occluso-distal (MOD) inlay cavity, which were prepared on extracted human molars, were used as templates of epoxy resin replicas. The prepared teeth were scanned and CAD-CAM restorations were milled using Lava Ultimate (LU) and experimental nano-composite CAD/CAM blocks (EB) under the same milling parameters. To assess the marginal and internal fit, the restorations were cemented to replicas and were embedded in an acrylic mold for sectioning at 0.5 mm intervals. The measured gap data were pooled according to the block types and measuring points for statistical analysis. RESULTS: Both the block type and measuring point significantly affected gap values, and their interaction was significant (p = 0.000). In crowns and inlays made from the two blocks, gap values were significantly larger in the occlusal area than in the axial area, while gap values in the marginal area were smallest (p < 0.001). Among the blocks, the restorations milled from EB had a significantly larger gap at all measuring points than those milled from LU (p = 0.000). CONCLUSIONS: The marginal and internal gaps of the two nano-composite CAD/CAM blocks differed according to the measuring points. Among the internal area of the two nano-composite CAD/CAM restorations, occlusal gap data were significantly larger than axial gap data. The EB crowns and inlays had significantly larger gaps than LU restorations.
Computer-Aided Design ; Crowns ; Fungi ; Humans ; Inlays ; Molar ; Tooth

OBJECTIVES: The purpose of this study was to compare the marginal and internal fit of nano-composite CAD-CAM restorations. MATERIALS AND METHODS: A full veneer crown and an mesio-occluso-distal (MOD) inlay cavity, which were prepared on extracted human molars, were used as templates of epoxy resin replicas. The prepared teeth were scanned and CAD-CAM restorations were milled using Lava Ultimate (LU) and experimental nano-composite CAD/CAM blocks (EB) under the same milling parameters. To assess the marginal and internal fit, the restorations were cemented to replicas and were embedded in an acrylic mold for sectioning at 0.5 mm intervals. The measured gap data were pooled according to the block types and measuring points for statistical analysis. RESULTS: Both the block type and measuring point significantly affected gap values, and their interaction was significant (p = 0.000). In crowns and inlays made from the two blocks, gap values were significantly larger in the occlusal area than in the axial area, while gap values in the marginal area were smallest (p < 0.001). Among the blocks, the restorations milled from EB had a significantly larger gap at all measuring points than those milled from LU (p = 0.000). CONCLUSIONS: The marginal and internal gaps of the two nano-composite CAD/CAM blocks differed according to the measuring points. Among the internal area of the two nano-composite CAD/CAM restorations, occlusal gap data were significantly larger than axial gap data. The EB crowns and inlays had significantly larger gaps than LU restorations.
Computer-Aided Design ; Crowns ; Fungi ; Humans ; Inlays ; Molar ; Tooth

PURPOSE: The purpose of this study was to compare the grade of fatty degeneration and atrophy of rotator cuffs on immediate postoperative MRI to those on preoperative MRI in patients with rotator cuff tears. MATERIALS AND METHODS: Seventy patients were included in this study, who received arthroscopic rotator-cuff repair and underwent both preoperative magnetic resonance imaging (MRI) and immediate postoperative MRI in our institution. Fatty degeneration of rotator cuffs and the atrophy of supraspinatus muscles were evaluated with T1 oblique sagittal images in the Y-shaped view. Fatty degeneration was evaluated using a Goutallier classification system, and the atrophy of supraspinatus muscles was evaluated using a modified tangent sign and a visual occupation ratio. RESULTS: From 70 patients, a total of 100 tendons were repaired: 18, 69, and 13 tendons were treated for subscapularis, supraspinatus, and infraspinatus, respectively. The Goutallier grades (P = 0.012), modified tangent signs (P = 0.000), and visual occupation ratios (P = 0.000) of supraspinatus muscles were significantly decreased in immediate postoperative MRIs when compared to preoperative MRIs. In immediate postoperative MRIs, the Goutallier grades of supraspinatus muscles were decreased by one grade in 18.8% (n = 13) of the patients, and the atrophy of supraspinatus muscles was improved by one grade in 26.1% (n = 18) for modified tangent signs and 21.7% (n = 15) for visual occupation ratios. However, fatty infiltration by the Goutallier grades of subscapularis (P = 1.000) and infraspinatus (P = 0.157) muscles were not significantly changed after arthroscopic surgery. CONCLUSION: Immediate postoperative MRIs showed a significant improvement of fatty degeneration and muscle atrophy in supraspinatus muscles when compared to preoperative MRIs.
Arthroscopy ; Atrophy* ; Classification ; Humans ; Magnetic Resonance Imaging* ; Muscles ; Muscular Atrophy ; Occupations ; Rotator Cuff* ; Tears ; Tendons

INTRODUCTION: Eliminating the residual debris and bacteria in the root canal system is one of the main purposes of the endodontic treatment. However, the complexity on the anatomy of the root canal system makes it difficult to eliminate the bacterial biofilm existing along the root canal surface and necrotic pulp tissue by mechanical instrumentation and chemical irrigation. Recently, more effective irrigant delivery systems for root canal irrigation have been developed. The purpose of this review was to present an overview of root canal irrigant delivery techniques and devices available in endodontics. REVIEW: The contents of this paper include as follows; - syringe-needle irrigation, manual dynamic irrigation, brushes - sonic and ultrasonic irrigation, passive ultrasonic irrigation, rotary brush, RinsEndo, EndoVac, Laser CONCLUSION: Though technological advances during the last decade have brought to fruition new agitation devices that rely on various mechanisms, there are few evidence based study to correlate the clinical efficacy of these devices with improved outcomes except syringe irrigation with needle and ultrasonic irrigation. The clinicians should try their best efforts to deliver antimicrobial and tissue solvent solutions in predictable volumes safely to working length.
Bacteria ; Biofilms ; Dental Pulp Cavity ; Dihydroergotamine ; Needles ; Syringes ; Ultrasonics

No abstract available.
Paramyxoviridae Infections* ; Polymerase Chain Reaction* ; Reverse Transcription*