Background/Aims: Elevated gamma-glutamyl transferase (GGT) levels indicate hepatic dysfunction and have been linked to an increased risk of pancreatobiliary cancers. However, this association, particularly in individuals with diabetes mellitus (DM), requires elucidation. We aimed to examine the association between elevated serum GGT levels and pancreatobiliary cancer risk in patients with diabetes. Methods: Our study included data from the National Health Insurance Service (NHIS) database for 2,459,966 adults aged >20 years diagnosed with DM between 2009 and 2012. We examined the association between serum GGT levels and pancreatobiliary cancer risk, considering DMrelated factors. Serum GGT levels were categorized into quartiles, and Cox proportional hazards analysis was performed to evaluate the association between serum GGT levels and pancreatobiliary cancer risk. Results: Over a median follow-up period of 7.2 years, 21,795 patients (0.89%) were newly diagnosed with pancreatobiliary cancer. The adjusted hazard ratio for pancreatobiliary cancer in quartiles 2–4 compared with that in quartile 1 was 1.091, 1.223, and 1.554, respectively, demonstrating a significant upward trend (p<0.001). This association remained consistent across all cancer types and was independent of the DM duration or treatment regimen. Conclusions Elevated serum GGT levels were independently associated with an increased risk of pancreatobiliary cancer, regardless of the duration of DM or the use of oral hypoglycemic agents and insulin. While these findings suggest the potential utility of serum GGT as a biomarker for identifying individuals at higher risk of pancreatobiliary cancer within the diabetic population, further research is needed to validate its clinical applicability.

Background/Aims: Elevated gamma-glutamyl transferase (GGT) levels indicate hepatic dysfunction and have been linked to an increased risk of pancreatobiliary cancers. However, this association, particularly in individuals with diabetes mellitus (DM), requires elucidation. We aimed to examine the association between elevated serum GGT levels and pancreatobiliary cancer risk in patients with diabetes. Methods: Our study included data from the National Health Insurance Service (NHIS) database for 2,459,966 adults aged >20 years diagnosed with DM between 2009 and 2012. We examined the association between serum GGT levels and pancreatobiliary cancer risk, considering DMrelated factors. Serum GGT levels were categorized into quartiles, and Cox proportional hazards analysis was performed to evaluate the association between serum GGT levels and pancreatobiliary cancer risk. Results: Over a median follow-up period of 7.2 years, 21,795 patients (0.89%) were newly diagnosed with pancreatobiliary cancer. The adjusted hazard ratio for pancreatobiliary cancer in quartiles 2–4 compared with that in quartile 1 was 1.091, 1.223, and 1.554, respectively, demonstrating a significant upward trend (p<0.001). This association remained consistent across all cancer types and was independent of the DM duration or treatment regimen. Conclusions Elevated serum GGT levels were independently associated with an increased risk of pancreatobiliary cancer, regardless of the duration of DM or the use of oral hypoglycemic agents and insulin. While these findings suggest the potential utility of serum GGT as a biomarker for identifying individuals at higher risk of pancreatobiliary cancer within the diabetic population, further research is needed to validate its clinical applicability.

Background/Aims: Elevated gamma-glutamyl transferase (GGT) levels indicate hepatic dysfunction and have been linked to an increased risk of pancreatobiliary cancers. However, this association, particularly in individuals with diabetes mellitus (DM), requires elucidation. We aimed to examine the association between elevated serum GGT levels and pancreatobiliary cancer risk in patients with diabetes. Methods: Our study included data from the National Health Insurance Service (NHIS) database for 2,459,966 adults aged >20 years diagnosed with DM between 2009 and 2012. We examined the association between serum GGT levels and pancreatobiliary cancer risk, considering DMrelated factors. Serum GGT levels were categorized into quartiles, and Cox proportional hazards analysis was performed to evaluate the association between serum GGT levels and pancreatobiliary cancer risk. Results: Over a median follow-up period of 7.2 years, 21,795 patients (0.89%) were newly diagnosed with pancreatobiliary cancer. The adjusted hazard ratio for pancreatobiliary cancer in quartiles 2–4 compared with that in quartile 1 was 1.091, 1.223, and 1.554, respectively, demonstrating a significant upward trend (p<0.001). This association remained consistent across all cancer types and was independent of the DM duration or treatment regimen. Conclusions Elevated serum GGT levels were independently associated with an increased risk of pancreatobiliary cancer, regardless of the duration of DM or the use of oral hypoglycemic agents and insulin. While these findings suggest the potential utility of serum GGT as a biomarker for identifying individuals at higher risk of pancreatobiliary cancer within the diabetic population, further research is needed to validate its clinical applicability.

Background/Aims: Elevated gamma-glutamyl transferase (GGT) levels indicate hepatic dysfunction and have been linked to an increased risk of pancreatobiliary cancers. However, this association, particularly in individuals with diabetes mellitus (DM), requires elucidation. We aimed to examine the association between elevated serum GGT levels and pancreatobiliary cancer risk in patients with diabetes. Methods: Our study included data from the National Health Insurance Service (NHIS) database for 2,459,966 adults aged >20 years diagnosed with DM between 2009 and 2012. We examined the association between serum GGT levels and pancreatobiliary cancer risk, considering DMrelated factors. Serum GGT levels were categorized into quartiles, and Cox proportional hazards analysis was performed to evaluate the association between serum GGT levels and pancreatobiliary cancer risk. Results: Over a median follow-up period of 7.2 years, 21,795 patients (0.89%) were newly diagnosed with pancreatobiliary cancer. The adjusted hazard ratio for pancreatobiliary cancer in quartiles 2–4 compared with that in quartile 1 was 1.091, 1.223, and 1.554, respectively, demonstrating a significant upward trend (p<0.001). This association remained consistent across all cancer types and was independent of the DM duration or treatment regimen. Conclusions Elevated serum GGT levels were independently associated with an increased risk of pancreatobiliary cancer, regardless of the duration of DM or the use of oral hypoglycemic agents and insulin. While these findings suggest the potential utility of serum GGT as a biomarker for identifying individuals at higher risk of pancreatobiliary cancer within the diabetic population, further research is needed to validate its clinical applicability.

Ovarian Pregnacy is a rare form of ectopic pregnacy. Its estimated overall incidence is highly variable, but improved diagnosis of acute hemoperitoneum of ovarian pregnancy may reveal a high incidence than reported earlier. Ovarian pregnancy occurs in the corpus luteum, and is usually accompanied with the rupture of the ovary and massive hemoperitoneum. It presents as a hemorragic ovary and frequently misdiagnosed as a ruptured corpus luteum. Risk facters to ovarian pregnacy include a history of pelvic inflammatory disease(PID), prior pelvic surgery, and use of an intrauterine contraceptive device(IUD). We have experienced two cases of ovarian pregnancy and reviewed it briefly.
Corpus Luteum ; Diagnosis ; Female ; Hemoperitoneum ; Incidence ; Ovary ; Pregnancy ; Pregnancy, Ectopic* ; Rupture

Although antithrombotic drug therapy is not a substitute for precise surgical technique, it has become an important adjunct for the microsurgeon performing replantation and elective free-tissue transfers. Systemic anticoagulant use in 60 free flap procedures performed from January 2001 to February 2004 was reviewed to determine the flap loss rate, associated risk of hematoma formation and heparin-induced thrombocytopenia. Patients were divided into two groups: a single intraoperative bolus of 1250 units of heparin(20 flaps, Group 1), 2500 units(40 flaps, Group 2) respectively. Partial and complete flap loss rate was higher in Group 1(35 percent) than in Group 2(10 percent). Neither the difference in hematoma incidence nor the difference in thrombocytopenia incidence between two groups was significant and there was no case presenting heparin- induced thrombocytopenia. We have encountered unusually high flap loss rate in the group who received a single intraoperative bolus of 1250 units of heparin. Although a cause-and-effect relationship between the use of systemic heparin and flap loss or prevention of thrombosis could not be established, it seems to be beneficial that a single bolus of 2500 units of heparin is given intraoperatively without significantly increasing the risk of hematoma or heparin-induced thrombocytopenia.
Drug Therapy ; Free Tissue Flaps* ; Hematoma ; Heparin* ; Humans ; Incidence ; Replantation ; Thrombocytopenia ; Thrombosis

PURPOSE: The purpose of this study was to investigate satisfaction with and perception of the school meal service according to middle school students and dieticians/dietetic teachers in Gwangju area who experienced change to the free meal service and the main contents were as follows. METHODS: The research subjects were 197 students (99 boys and 98 girls) and 42 dieticians/dietetic teachers were recruited. RESULTS: Compared to the free meal service before, satisfaction of students was high (53.8%), and 69.9% of students said there was no change in the school meals, however a significant difference was observed between gender. Overall 80.2% of middle school students said that there was no change in menu, 70.6% were no change in the frequency of food with high preference, and 64.0% were no change in leftover of meals. 85.7% of dieticians/dietetic teachers said that there was no change in the student's satisfaction according to the conversion of free meal services; 59.5% of dieticians/dietetic teachers said that there was no change in the frequency of foods with high preference, the variety of vegetables was increased in the qualitative change item of food materials, and 95% of them were not aware of change in the amount of students' leftover foods. Dieticians/dietetic teachers had limitations in selecting menus with purchase and costs of food materials (26.2%) by conversion of the free meal service and their priority considered was the food cost (45.2%) when they selected menus. Change in feeding affairs was office work management (26.2%) and recipe research and development (19.0%). CONCLUSION: With the results of this study, the satisfaction with the school meal service was not changed in the awareness of students and dieticians/dietetic teachers. Therefore further study is needed to determine the middle school's satisfaction with school meals based on a variety of factors including the environmental food meal services.
Gwangju ; Humans ; Meals* ; Research Subjects ; Vegetables

PURPOSE: Increased level mitogen-activated protein kinase (MAPK) and activation of MAPK have been reported in human breast cancers, especially in breast cancers with HER2/neu overexpression. To understand the relationship between the MAPK protein expressions and other clinico-pathological parameters, we examined the status of MAPKs in 20 breast cancers compared to those of paired normals. METHODS: A total of 20 breast cancers and paired normal breast tissues were included in this study. Tissues were obtained at the operation room and stored at -80degrees C. Tissue proteins were extracted and the concentration was determined by Bio-Rad protein assay method. Western blot analysis were performed to determine the level of MAPKs expressions using 100 ug of tissue protein in 8%, 10%, or 12% sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE). MAPK assays were carried out by a non-radioactive method developed by Cell Signaling Tech. as recommened by the manufacturer. Clinico-pathological information was provided from the Breast Cancer Registry of Department of Surgery, Yonsei University College of Medicine. RESULTS: The levels of MAPKs were higher in 95% of breast cancers compared to those of paired normals. The levels of ERK1/2 were significantly higher in cancer tissues compared to paired normals but the activated forms were not. The levels of JNK, p38, and MKP1 proteins were significantly increased in the cancer tissue compared to the paired normals. The levels of ERK1/2 and activated ERK1/2 proteins were not different between tumor stages. There were no significant differences of the levels of ERK1/2 and activated ERK1/2 proteins between HER2-negative and HER2- positive cancers. There were significantly higher levels of activated ERK1/2 proteins in ER-positive cancers than those in ER-negative cancers (P<0.05). CONCLUSION: The levels of MAPKs, but not the activated forms, seem to be increased in breast cancer tissues compared to those of paired normals. The levels of activated MAPKs seem to be associated with estrogen receptor expression in cancer tissues.
Blotting, Western ; Breast Neoplasms* ; Breast* ; Carcinogenesis* ; Electrophoresis, Polyacrylamide Gel ; Estrogens ; Humans ; Mitogen-Activated Protein Kinases* ; Protein Kinases ; Sodium

PURPOSE: Estrogen signal transduction plays very important roles in both normal mammary development and neoplastic progression. Since the discovery of estrogen receptor-beta (ER-beta) there have been many controversial reports on the role of ER-beta in breast carcinogenesis and progression, and prognostic implications. ER-beta mRNA levels were investigated in various mammary tissues in order to verify the role of ER-beta expression in breast carcinogenesis. METHODS: Using messenger RNA (mRNA) in situ hybridization, we examined ER-beta expression in 60 paired normal and cancer tissues, 11 paired normal and benign breast tumor tissues, and 10 metastatic lymph nodes. We determined the intensity and extent (proportion of cells with positive hybridization) of the mRNA hybridization signals and gave scores 0 to 3; no hybridization (0), minimal (1), moderate (2), and strong (3) by the hybridization intensity and no hybridization (0), hybridization in less than 10% of cells (1), 10~50% (2), and more than 50% of cells (3) by the proportion of positively hybridized cells. Chi-square test, independent t-test or one-way ANOVA test was used for the statistical analysis and differences were considered to be significant with a p-value of less than 0.05. RESULTS: There was no statistically difference in ER-beta expression between normal and benign mammary tissues. ERbeta expression was significantly decreased in breast cancer and metastatic lymph node tissues compared with normal mammary and benign breast tumor tissues (P<0.01). The intensity and extent of ER beta expression were also significantly lower in breast cancer and metastatic lymph node tissues than in the normal mammary and benign breast tumor tissues (P<0.01). In cases of positive hybridization, the sum of scores of intensity and area were also significantly higher in normal and fibroadenoma tissues than in cancer or metastatic lymph nodes (P<0.01). CONCLUSION: ER beta transcription decreases in the process of breast cancer development, which suggests a protective role of ER beta in breast carcinogenesis.
Breast ; Breast Neoplasms ; Carcinogenesis ; Estrogen Receptor beta ; Estrogens* ; Fibroadenoma ; In Situ Hybridization ; Lymph Nodes ; RNA, Messenger* ; Signal Transduction

Mitochondnal encephalomyopathies are multisysternic diseases affecting predominantly the CNS and skeletal muscLes by mitochondrial dysfunction. Mitochondrial diseases include three distinct syndromes: mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS): myoclonus epilepsy associated with ragged-red fibers (MERRF):and chronic progressive external ophthalmoplegia(CPEO). A characteristic abnormality called "ragged-red fibers" is usually seen on histochemical evaluation of muscle biopsy specimens in these diseases. The characteristic clinical presentations of MELAS are short stature, recurrent stroke like episodes, migraine-like headache, sensorineural hearmg loss, glucose intolerance and neuropathy. We now report a case of MELAS syndrome confirmed by demonstrating "ragged-red fibers" and abnormal mitochondria in muscle biopsy.
Biopsy ; Epilepsies, Myoclonic ; Glucose Intolerance ; Headache ; MELAS Syndrome* ; Mitochondria ; Mitochondrial Diseases ; Muscle, Skeletal ; Stroke