Cheek ; Fascia ; Head ; Humans ; Mouth ; Neck ; Neoplasm Metastasis ; Skin ; Tissue Donors ; Tongue ; Wounds and Injuries

OBJECTIVE: To determine the effect of lowering the cutoff values of 3-hour oral glucose tolerance test (OGTT) for gestational diabetes mellitus (GDM). METHODS: Patients with an abnormal 50 gm glucose challenge test (GCT) of more than 130 mg/dL at 24-28 weeks of gestation underwent a 3-hour OGTT at 28-32 weeks of gestation. Patients were divided into four groups according to the criteria recommended by Carpenter-Coustan or National Diabetes Data Group (NDDG) (Control: 50 gm GCT negative [n=268], Borderline: 2 or more abnormal values met or exceeded Carpenter-Coustan criteria but not the NDDG criteria [n=100], NDDG I: 2 or more abnormal values met or exceeded NDDG criteria, [treated, n=70], NDDG II: [not treated, n=42]). Obstetric and perinatal outcomes were analyzed retrospectively. RESULTS: Of 5,827 pregnant women screened for GDM, 112 (1.9%) met the NDDG criteria, whereas 212 (3.6%) met the Carpenter-Coustan criteria. The incidences of poor maternal outcomes were 20.1%, 28.0%, 47.1%, 21.4%, and the incidences of poor neonatal outcomes were 3.7%, 6.0%, 14.3%, 16.7% in the four groups (p<0.05). Multivariable logistic regression analysis showed that 1) NDDG I showed an independent risk factor for poor maternal outcome (OR, 3.37), but the borderline group did not, 2) NDDG I showed an independent risk factor for poor neonatal outcome (OR, 3.87), but the borderline group did not, 3) the borderline group showed an independent risk factor for preterm delivery (OR, 2.67). CONCLUSION: Lowering the cutoff values would increase the number of pregnant women with GDM, while only minimally affecting the perinatal outcomes. Further large-scale prospective studies for Korean pregnant women may be needed.
Diabetes, Gestational* ; Female ; Glucose ; Glucose Tolerance Test ; Humans ; Incidence ; Logistic Models ; Pregnancy ; Pregnant Women ; Retrospective Studies ; Risk Factors

PURPOSE: This study evaluated the efficacy of a water-soluble contrast enema (WCE) in predicting anastomotic healing after a low anterior resection (LAR). METHODS: Between January 2000 and March 2012, 682 consecutive patients underwent a LAR or an ultra-low anterior resection (uLAR) and were followed up for leakage. Clinical leakage was established by using physical and laboratory findings. Radiologic leakage was identified by using retrograde WCE imaging. Abnormal radiologic features on WCE were categorized into four types based on morphology: namely, dendritic, horny, saccular, and serpentine. RESULTS: Of the 126 patients who received a concurrent diverting stoma, only two (1.6%) suffered clinical leakage due to pelvic abscess. However, 37 patients (6.7%) in the other group suffered clinical leakage following fecal diversion (P = 0.027). Among the 163 patients who received a fecal diversion, 20 showed radiologic leakage on the first WCE (eight with and 12 without a concurrent diversion); 16 had abnormal features continuously until the final WCE while four patients healed spontaneously. Eleven of the 16 patients (69%), by their surgeon's decision, underwent a stoma restoration based on clinical findings (2/3 dendritic, 3/4 horny, 5/7 saccular, 1/2 serpentine). After stoma reversal, only 2 of the 11 (19%) complained of complications related to the rectal anastomosis. CONCLUSION: WCE is helpful for detecting radiologic leakage before stoma restoration, especially in patients suffering clinical leakage after an uLAR. However, surgeons appear to opt for stoma restoration despite the persistent existence of radiologic leakage in cases with particular features on the WCE.
Abscess ; Anastomotic Leak ; Colorectal Surgery ; Enema* ; Humans ; Rectal Neoplasms*

BACKGROUND: Scid.adh is a recently developed murine thymic lymphoma cell line, which has been used as in vitro model for the study of double negative stage III thymocytes. In this study, we compared the expression profile of a number of genes and proteins, which are tightly related to T cell development and apoptosis, in thymic lymphoma cell lines, R1.1, EL-4, and Scid.adh for the developmental staging. METHODS: We examined the expression of development marker genes and proteins in three lymphoma cell lines by flow cytometry and RT-PCR. In addition, the expression of apoptosis-related molecules including bcl-2, bax and Fas was also investigated. RESULTS: As previously reported, Scid.adh cell line expressed CD8 and CD25 but not TCR alpha chain, while R1.1 cells expressed TCR alpha chain and both CD4 and CD8 transcripts. These suggest that R1.1 might be in double positive stage, and low level of CD44 expression and the absence of CD25 support this suggestion. In contrast, EL-4 cells showed high level of TCR alpha chain transcript, and low-level of CD4 expression, suggesting that EL-4 is in more mature stage than R1.1. Further, this suggestion was supported by the lack of mT-20 in EL-4 cells, which is expressed in the immature thymocytes, and Scid.adh and R1.1 cell lines, but not in the terminally differentiated thymocytes and peripheral T cells. Among the apoptosis-related gene, transcripts of bcl-2 gene were detected in both R1.1 and EL-4 but not in Scid.adh cells, while bax was expressed in all cell lines. Fas expression was the highest in EL-4 cells and low in Scid.adh cell line. CONCLUSION: R1.1 cell may represent double positive stage, and EL-4 is more differentiated cell line. In addition, Scid.adh and EL-4 cell lines are suspected to be useful for the study of function of bcl-2 family and Fas during the thymocyte development, respectively.
Apoptosis ; Cell Line* ; Flow Cytometry ; Genes, bcl-2 ; Humans ; Lymphoma* ; T-Lymphocytes ; Thymocytes

BACKGROUND: There is a clinical need for a simpler measurement of global cardiac function incorporating elements of both systole and diastole. Doppler time index is theoretically regarded as a sensitive index of global left ventricular perfomance and defined as the sum of isovolumetric contraction time (IVCT) and isovolumetric relaxation time (IVRT) divided by ejection time (ET). This study was designed to determine the clinical usefulness of the Doppler time index in patients with left ventricular diastolic dysfunction as well as systolic dysfunction. METHODS: The study population consisted of 23 patients with hypertension as a diastolic dysfunction group, 16 patients with low ejection fraction as a systolic dysfunction group and 31 subjects with normal LV function. The ejection fraction (EF) was measured using M-mode echocardiography. Doppler profiles such as IVCT, IVRT and ET were obtained from Doppler echocardiography. The Doppler time index [ (IVCT+RT)/ET] was calculated from each Doppler velocity profiles. RESULTS: IVRT, IVRT/ET and (IVCT+VRT)/ET were significantly increased in the diastolic dysfunction group (120.5+/-19.5 msec, 0.45+/-0.1, 0.64+/-0.2, respectively:p<0.001, p<0.001, p<0.001, respectively) compared with normal subjects (66.1+/-17.4 msec, 0.25+/-0.0, 0.41+/-0.1). IVCT and IVRT were significantly increased and ET was significantly shortened in systolic dysfunction group (75.4+/-25.7, 144.0+/-39.5 msec, 242.7+/-46.5 msec respectively:p<0.001, p<0.05, p<0.05, respectively) compared with diastolic dysfunction group (50.4+/-23.0 msec, 120.5+/-19.5 msec, 276.8+/-44.6 msec, respectively). IVCT/ET, IVRT/ET and (IVCT+IVRT)/ET also were increased in patients with systolic dysfunction group (0.32+/-0.1, 0.61+/-0.2, 0.93+/-0.2 respectively:p<0.01, p<0.01, p<0.001, res-pectively) compared with diastolic dysfunction group (0.19+/-0.1, 0.45+/-0.1, 0.64+/-0.2). Ejection fraction calculated by M-mode parameters was significantly correlated with (IVCT+IVRT)/ET (correlation coefficient - 0.605, p<0.001). CONCLUSION: The Doppler time index was significantly difficient from normal subjects in patients with isolated LV diastolic dysfunction as well as in those with systolic dysfunction. Thus, this index can be used as a sensitive indicator of myocardial performance.
Diastole ; Echocardiography ; Echocardiography, Doppler ; Humans ; Hypertension ; Relaxation ; Systole ; Ventricular Dysfunction, Left

This study was conducted to identify the factors for serum cholesterol level among Korean Air Force pilots. We obtained risk factors for 408 pilots examined during period from January 1996 through March 1997. The associations between total cholesterol, LDL-cholesterol, triglyceride, HDL-cholesterol and age, body mass Index(BMI), smoking, drinking, blood pressure, flight time and fat intake were analyzed. The mean serum total cholesterol, HDL-cholesterol, LDL-cholesterol, and triglyceride levels were 161.8+/-31.0 mg/dl, 475+/-11.0 mg/dl, 93.1+/-30.2 mg/dl, and 106.5+/-61.3 mg/dl respectively. Possible risk factors were total flight time, BMI, smoking, drinking, exercise, flight, and fighter or not. Total flight time and BMI were statistically significant factors In serum cholesterol level while controlling for the effect of the remaining factors. The longer the total flight time, the higher the level of serum total cholesterol. Total flight time, BMI, and drinking amount were statistically significant factors in serum HDL-cholesterol while controlling for the effect of the remaining factors. The higher the BIM, the lower the level of HDL-cholesterol. BMI was a statistically significant factor in seurm LDL-cholesterol while controlling for the effect of remaining factors. Total flight time, BIM, and flight were statistically significant factors in serum triglyceride while controlling for the effect of the remaining factors. Conclusively, BIM was a only significant factor in all four lipid levels, and total flight time took an affect to total cholesterol, HDL-cholesterol, and triglyceride levels.
Blood Pressure ; Cholesterol ; Drinking ; Risk Factors ; Smoke ; Smoking ; Triglycerides

PURPOSE: The aim of this study was to assess the size and extrusion of the meniscus in young and non-traumatic knees, especially in Korean males. MATERIALS AND METHODS: The participants (n=91 knees, 77 patients) were consecutive patients observed at an orthopedic outpatient clinic who had another problem unrelated to the knee joint. The patients were excluded from the study if they had a history of trauma and pain on the knee joint. The patients received a magnetic resonance imaging (MRI) scan on the knee joint. The size, extrusion, and extrusion ratio of the meniscus on an MRI scan were evaluated. RESULTS: The mean age of the participants was 21.6±1.1 years (range, 19–24 years). The mean size of the medial meniscus on the coronal plane was 9.0±1.1 mm (range, 7.1–11.9 mm). The extent of extrusion on the coronal plane was 2.0±1.0 mm (range, 0–4.4 mm). The extrusion ratio (extruded size/total size×100) of the medial meniscus on the coronal plane was 22.7%±11.5% (range, 0%–53.7%). The extent of extrusion on the sagittal plane was 1.6±1.1 mm (range, 0–4.0 mm). The extrusion ratio (extruded size/total×100) of the medial meniscus on the sagittal plane was 18.0%±11.9% (range, 0%–40.7%). The incidence of medial meniscal extrusion on the coronal and sagittal plane are 92.3% and 80.2%, respectively. The mean size of lateral meniscus on the coronal plane was 11.1±3.4 mm (range, 7.3–22.9 mm). The extent of extrusion on the sagittal plane was 0.5±0.7 mm (range, 0–2.5 mm). The extrusion ratio of the lateral meniscus on the sagittal plane was 4.0%±6.7% (range, 0%–26.3%). The incidence of lateral meniscal extrusion on the coronal plane was 34.1%. No extrusion of the lateral meniscus was observed on the sagittal plane. CONCLUSION: In young and non-traumatic knees, the extrusion of meniscus was common, especially medial meniscus than lateral meniscus.
Ambulatory Care Facilities ; Humans ; Incidence ; Knee Joint ; Knee* ; Magnetic Resonance Imaging* ; Male ; Menisci, Tibial ; Orthopedics

Paracentesis is a diagnostic, therapeutic procedure performed in patients with ascites. It is generally thought to be a safe procedure and transfusion of platelet concentrate or fresh frozen plasma is not recommended before the procedure, because the incidence of clinically significant bleeding is very low. We report a case of lateral abdominal wall hematoma due to the injury of the deep circumflex iliac artery after paracentesis in patient with alcoholic liver cirrhosis who was treated with transcatheter arterial embolization.
Abdominal Wall/*blood supply ; Embolization, Therapeutic ; Hematoma/etiology/*therapy ; Humans ; Iliac Artery/injuries ; Liver Cirrhosis, Alcoholic/diagnosis ; Male ; Middle Aged ; Paracentesis/adverse effects

A subepithelial tumor-like esophageal carcinoma is rare. We report a case of an esophageal squamous cell carcinoma with lymph node metastasis presenting as a small subepithelial tumor. A 68-year-old man presented to our hospital complaining of hoarseness since last three months. Endoscopic examination revealed a 1 cm hard and fixed subepithelial tumor with surface erosion in the lower esophagus. A biopsy specimen was obtained using conventional forceps, and histopathological evaluation revealed few atypical squamous epithelial cells. Subsequent EUS demonstrated a homogeneous hypoechoic lesion in the deep mucosal layer. A CT scan of the chest showed a 3 cm mass in the right upper paratracheal area. EUS-guided fine needle biopsy of the lesion led to the diagnosis of squamous cell carcinoma with lymph node metastasis.
Aged ; Biopsy ; Biopsy, Fine-Needle ; Carcinoma, Squamous Cell ; Diagnosis ; Endosonography ; Epithelial Cells ; Esophageal Neoplasms ; Esophagus ; Hoarseness ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Surgical Instruments ; Thorax ; Tomography, X-Ray Computed

We report a case of a 58 year-old male with polysplenia and left inferior vena cava draining into the right atrium via hemiazygous vein; the left superior vena cava and the coronary sinus in order. He presented dyspnea on exertion and atrial fibrillation. Originally, through findings of mediastinal widening in chest X-ray and the double lumen of the descending aorta in transesophageal echocardiography, he was erroneously diagnosed with aortic dissection. The anomalous venous connection was discovered via spiral CT and venography. We also found three to five small spleens via CT. We emphasize that normal left superior vena cava mimic aortic dissection on chest X-rays and transesophageal echocardiographys.
Aorta, Thoracic ; Atrial Fibrillation ; Coronary Sinus ; Dyspnea ; Echocardiography, Transesophageal ; Heart Atria* ; Heterotaxy Syndrome* ; Humans ; Male ; Middle Aged ; Phlebography ; Spleen ; Thorax ; Tomography, Spiral Computed ; Veins ; Vena Cava, Inferior* ; Vena Cava, Superior*