PURPOSE:Ghrelin is an endogenous ligand of the growth hormone secretagogue receptor, and stomach is the major site of ghrelin secretion. The purpose of this study is to compare the serum ghrelin concentrations between patients with type 2 diabetes mellitus (DM) and normal adults. We studied also whether serum ghrelin levels in the patients with type 2 DM are correlated with body mass index (BMI), serum insulin, lipid profiles, and creatinine levels. METHODS:Forty patients with type 2 DM and forty normal adults were included in this study. We measured heights and weights of the subjects and calculated their BMIs. Blood samples were obtained to measure the ghrelin concentration and their sera were stored at -20degreeC until used. In all subjects, serum ghrelin levels were measured using the commercially available Ghrelin(human) EIA kit. RESULTS:No differences of mean values were detected between the control group and the type 2 diabetic group for age, body weight, BMI, and the levels of serum total cholesterol, triglyceride, HDL cholesterol, and creatinine. But ghrelin level of the type 2 diabetic group (71.1+/-30.5 ng/L) was significantly lower than the control group (139.7+/-36.9 ng/L). In the control group, the ghrelin level showed positive correlation with HDL cholesterol (Pearson's correlation coefficient=0.37, P<0.05). In the diabetic group, the ghrelin level showed weakly positive correlation with insulin concentration. However, there was no significant relationship between serum ghrelin and various parameters in the diabetic patients group. CONCLUSION: In this study, ghrelin concentration in type 2 diabetic patients was lower than that in the control group. In the control group, serum ghrelin concentrations were positively correlated with HDL cholesterol. In the type 2 diabetic group, there was no significant correlation between insulin and ghrelin concentrations.
Adult ; Body Mass Index ; Body Weight ; Cholesterol ; Cholesterol, HDL ; Creatinine ; Diabetes Mellitus ; Diabetes Mellitus, Type 2* ; Ghrelin* ; Humans ; Insulin ; Receptors, Ghrelin ; Stomach ; Triglycerides ; Weights and Measures

PURPOSE: Axillary osmidrosis is a distressing disorder characterized by unpleasant odor from axillary area and it is mainly associated with apocrine glands but also associated with eccrine glands. For surgical treatment of osmidrosis, recently ultrasound assisted liposuction(UAL) had been performed for many patients. According to the recent studies about ultrasound assisted liposuction for the treatment of osmidrosis, histologic studies about apocrine gland had been applied for 35 cases, but there were rare mention about eccrine gland and the relationship between two glands. The purpose of this article is to evaluate the effect of ultrasound assisted liposuction for the treatment of axillary osmidrosis on apocrine and eccrine glands. METHODS: From January 2004 to January 2007, 35 patients underwent ultrasound assisted liposuction for the treatment of osmidrosis and 5 patients underwent histologic studies. Histologic examinations were performed before and after ultrasound assisted liposuction and each biopsy was performed in central axillary area. The volume ratio of both glands, presence of degeneration were examined. And in aspirates, distribution and density of both glands and their morphological changes were examined. RESULTS: Preoperative biopsy results showed average volume ratio of apocrine glands to eccrine glands was 65:35. According to the postoperative biopsy results, the volume of apocrine glands in dermis were significantly reduced and glands were degenerated, but the volume of eccrine glands were slightly reduced and glands were mildly damaged. And the average volume ratio of two glands was 20:80. According to biopsy results of aspirates, the volume ratio of two glands was 85:15 and apocrine glands had significantly greater proportion. CONCLUSION: By comparison of each biopsy result, apocrine glands were more significantly reduced and degenerated than eccrine glands in all 5 cases. However, further studies with large sample sizes and close examinations are required.
Apocrine Glands ; Biopsy ; Dermis ; Eccrine Glands ; Humans ; Lipectomy ; Odors ; Sample Size

BACKGROUND: The authors report the results of femoroacetabular impingement (FAI) treated with a surgical dislocation. METHODS: From April 2005 to May 2007, 15 FAI hips were treated with a surgical dislocation. The male/female ratio, mean age and mean symptom duration was 12/2, 35.8 years and 2.3 years, respectively. Radiographs and MR arthrograms were taken. The clinical evaluation involved changes in the pre- and postoperative Harris hip score (HHS). RESULTS: There were 12 hips (80%) with at least one structural abnormality in the radiographs, with 11 (79%) labral tears and 8 (73%) abnormally high angles in the MR arthrograms. We performed 15 osteochondroplasties, 12 labral repairs, 12 acetabuloplasty, and 3 debridements. The mean HHS improved from 76 to 93 points. Three non-unions of the trochanteric osteotomy sites were encountered as complications. CONCLUSIONS: Radiographs and MR arthrograms are important for making a proper diagnosis of FAI and planning treatment. A surgical dislocation can be used to treat FAI but further technical improvements will be needed for fixation of the greater trochanteric osteotomy sites.
Acetabulum/surgery ; Adult ; Female ; Femoracetabular Impingement/radiography/*surgery ; Femur Head/surgery ; Humans ; Ligaments, Articular/surgery ; Male ; Middle Aged ; Orthopedic Procedures/methods ; Osteotomy ; Treatment Outcome ; Young Adult

PURPOSE: The 2005 resuscitation guidelines stipulate the need for monitoring CPR (cardiopulmonary resuscitation) quality. Recently, several clinical investigations have shown that a real time monitoring and feedback system is effective for improving the quality of chest compressions during resuscitation. However little data exists regarding the accuracy of the monitoring system using an accelerometer sensor and a pressure sensor for the measuring of compression rate and depth. Our goal for this study was to investigate how well chest compression rate and depth can be estimated using the monitoring system. METHODS: Thirty seconds of continuous chest compressions were delivered on a standard skillmeter manikin lying on the floor with the monitoring system. The chest compressions were delivered with variations in compression rate (67~142 /min) and with variations in compression depth (22~61 mm). A total of 120 sets of compressions were delivered for validation of rate and depth. RESULTS: The correlation coefficient for compression rate between the monitoring system and the standard method was 0.999 (p<0.001), and Bland-Altman analysis showed a mean bias of -0.10+/-0.77/min, with limits of agreement ranging from -1.60 to 1.40 /min. The correlation coefficient for compression depth between two methods was 0.983 (p<0.001), and Bland-Altman analysis showed a mean bias of 4.2+/-2.0 mm, with limits of agreement ranging from 0.24 to 8.10 mm. CONCLUSION: Compared with a skillmeter manikin, a monitoring system for the quality of CPR estimates chest compression rate precisely, but overestimates chest compression depth by an average of 10.3%.
Bias (Epidemiology) ; Cardiopulmonary Resuscitation ; Deception ; Delivery of Health Care ; Floors and Floorcoverings ; Manikins ; Monitoring, Physiologic ; Resuscitation ; Thorax

The numb chin syndrome (NCS) is characterized by chin or lower lip numbness restricted to the distribution of the mental nerve (the distal trigeminal nerve). The authors report a patient whose initial symptom of tumor recurrence was unilateral numbness of the chin. A 65-year-old male was admitted because of paresthesia around the left chin and left lower lip. Neurologic examination revealed hypesthesia on the left side of chin, lower lip and buccal mucous mem-brane. Bone scan (Tc-99m MDP) showed focal hot uptakes on the left mandible and left first rib. Brain CT with bone window setting showed a focal osteolytic lesion in the bone marrow of the left mandibular canal without destruction of bone cortex. Both coronal T1 weighted image and axial T2 weighted image showed focal low signal intensities on the left ramus. The pathophysiologic mechanism could be understood by identification of the pathologic focus.
Aged ; Bone Marrow ; Brain ; Chin ; Hodgkin Disease* ; Humans ; Hypesthesia ; Lip ; Male ; Mandible ; Neurologic Examination ; Paresthesia ; Recurrence ; Ribs

PURPOSE: Nasal bone fracture is the most common type of facial bone fracture and most of nasal bone fracture is combined with septal fracture frequently. Nasal septum is important to support the distal nose and to maintain the nasal airway. But nasal septal fractures are usually unrecognized and untreated at the time of operation. Recently, various materials were using for nasal packing after closed reduction, however these materials are not focused on the correction of nasal bone and nasal septal fracture and many patients are suffered from nasal packing materials. Thus, the purpose of this study is to compare routine packing materials and rolled silastic sheet with respect to postoperative effect of correction of nasal bone fracture and discomfort of nasal packing materials. METHODS: We examined 320 patients treated nasal bone fracture from January 2008 to December 2010. For Group I(n=92), Merocel(R) was used for nasal packing, for Group II(n=152) vaseline gauze was used, and Rolled silastic sheet(RSS) with vaseline gauze packing(VGP) was used for Group III(n=76). Under the general anesthesia, all patients were operated by closed reduction and nasal packing was done using three kinds of packing materials. At the time of postoperative 7 days, packing material was removed and studied for pt's satisfaction and postop. complications. RESULTS: In patients with RSS with VGP, the complaints (nasal obstruction, foreign compressive sensation and discomfort during food ingestion) of keeping the nasal packing were decreased(p<0.05) and the postoperative complication(deviation) were decreased comparing to vaseline gauze packing and Merocel(R) packing, however, these differences were not statistically significant(p>0.05). CONCLUSION: Postoperative nasal packing with RSS with VGP was more comfortable to the patients and it was more effective method to correct the nasal bone fracture and nasal septal fracture.
Anesthesia, General ; Dimethylpolysiloxanes ; Facial Bones ; Humans ; Nasal Bone ; Nasal Septum ; Nose ; Petrolatum ; Sensation

Cervical pregnancy is one of most rare form of ectopic pregancy in which the blastocyst implants within the cervical canal below the internal os of uterine cervix. Most cervical pregnancy result in early spontaneous abortion, complicated by severe hemorrhage frm the eroded blood vessels within the cervix. Because of fear of rofuse hemorrhage, abdominal hysterectomy has been historically considered the standard therapy. However, a number of new therapies have been aimed at uterine preservation, conservative treatment is highly desirable for young women who want to be pregnancy in the future. Methotrexate has been utilized recently for the successful management of tubal, interstitial, and cervical ectopic gestations. We report a case of a cervical preganncy that was successfully managed with methotrexate and leucovorine.
Abortion, Spontaneous ; Blastocyst ; Blood Vessels ; Cervix Uteri ; Cytochrome P-450 CYP1A1 ; Female ; Hemorrhage ; Humans ; Hysterectomy ; Leucovorin ; Methotrexate* ; Pregnancy*

OBJECTIVE: The authors conducted a retrospective study of patients with degenerative lumbar spinal disorders who received a posterior lumbar interbody fusion (PLIF) with the IS(R) cage. METHODS: We assessed 105 patients who underwent on a PLIF with or without pedicle screws using the IS(R) cage in our institute from November 2007 to December 2008. Clinical outcomes were analyzed with a Visual Analog Scale (VAS) for back and leg pain. Radiographs were obtained before and after the surgery. In some cases, a lumbar spinal computed tomography scan was obtained. Radiological outcomes of intercage distance, fusion rate, and intervertebral disc height were assessed. In scoliosis or lateral translation, the extent of correction was examined. RESULTS: The mean VAS score for back pain improved from 6.86 preoperatively to 2.66 at postoperative month 12, and the score for leg pain decreased from 7.92 to 1.78. The mean intervertebral disc height was 8.71+/-2.35mm before the surgery, and it increased to 11.67+/-1.77mm at 7 days postoperative and decreased to 9.57+/-1.90mm at 6 months postoperative. The fusion rate was 95.65%. For scoliosis or lateral translation, thesegmental angle of scoliosis decreased from 11.10+/-5.82degrees before the surgery to 5.61+/-3.71degrees by month 6 postoperative. The extent of the lateral translation changed from 6.04+/-1.73mm before the surgery to 3.56+/-4.99mm at month 6 postoperative. CONCLUSION: There have been low complication rates with the IS(R) cage during the follow-up period, and the results of this study demonstrates a wide fusion area, partial reduction of lateral translation and scoliosis, good clinical success, and a high fusion rate.
Back Pain ; Follow-Up Studies ; Humans ; Intervertebral Disc ; Leg ; Retrospective Studies ; Scoliosis ; Spinal Fusion

PURPOSE: Blow out fracture resulting from facial trauma is of high frequency among facial bone fractures, and can cause severe complications. So, proper post-operative management and close observation are needed. So far, Computed tomography has been the best method in evaluating following orbit wall reconstruction. However, cost-effectiveness, accessibility to patients and hazard of radiation exposure of computed tomography require supplementary measure for the evaluation following orbit wall reconstruction. This study was performed to describe the effectiveness of ultrasonography in the evaluation following orbit wall reconstruction. METHODS: A retrospective study was performed on 40 patients who underwent orbit wall reconstruction from June, 2008 to July, 2008. The patients' ages ranged from 13 to 65 years with the mean of 27.5 years. The patient group was composed of 27 males and 13 females. The follow up period ranged from 2 weeks to 28 weeks with the mean of 11 weeks. Preoperatively, all fractures were diagnosed using computed tomography. Ultrasonography for all cases, and computed tomography for 2 cases were performed for evaluation following orbit wall reconstruction. RESULTS: Reduction of herniated orbital soft tissue and orbit implant was identified by using ultrasonography in 38 cases out of 40 cases. In other cases which we could not identify the orbit implant, computed tomography was performed. CONCLUSION: Compared to computed tomography, ultrasonography is a simple, inexpensive and convenient method. Ultrasonography can be used as supplementary measure to computed tomography in the evaluation following orbit wall reconstruction for elective patients.
Facial Bones ; Female ; Follow-Up Studies ; Humans ; Male ; Orbit ; Retrospective Studies

Castleman's disease is a rare lymphoproliferative disorder of uncertain etiology which most commonly occurs in the mediastinum. We describe a case of a benign Castleman 's disease of the hyaline vascular type affecting the upper extremity, an extremely rare site of the disease.
Giant Lymph Node Hyperplasia* ; Hamartoma ; Hyalin ; Lymphoproliferative Disorders ; Mediastinum ; Upper Extremity*