BACKGROUND: Insulin resistance is related to central obesity and the amount of skeletal muscle. A simple and practical anthropometric marker for muscle mass is not known, although waist circumference (WC) is used as an indicator of abdominal obesity. The aims of this study were to investigate whether arm (AC) and thigh circumferences (TC) can be used as an indicator of muscle mass and if they are related to muscle strength. METHODS: A total of 110 obese (body mass index [BMI]> or =25 kg/m2) women with type 2 diabetes were enrolled, and WC, AC, and TC were measured. Abdominal visceral fat (AVF), subcutaneous fat (ASF), and total fat (ATF) were assessed by computed tomography, regional muscle (MM), and fat mass by dual-energy X-ray absorptiometry, muscle strength by one repetition maximum (1RM) of both extremities (chest and leg press) and insulin resistance by KITT. RESULTS: The mean age was 56.2+/-7.3 years, duration of diabetes was 4.2+/-4.4 years, and BMI was 27.2+/-2.8 kg/m2. WC was correlated with ATF, AVF, and ASF (r=0.728, P<0.001; r=0.515, P<0.001; r=0.608, P<0.001, respectively). Arm MM was correlated with AC (r=0.500, P<0.001), and leg MM with TC (r=0.291, P=0.002). Upper 1RM was related to AC/WC ratio (r=0.359, P<0.001), and lower 1RM was to TC/WC ratio (r=0.286, P=0.003). Insulin resistance had significant relations with AVF, WC, and total MM (r=-0.262, P=0.008; r=-0.217, P=0.029; r=0.160, P=0.031, respectively). CONCLUSION: The muscle mass was related to extremity circumferences, and muscle strength was to extremity/waist circumference ratio in obese women with type 2 diabetes.
Absorptiometry, Photon ; Arm ; Diabetes Mellitus, Type 2 ; Extremities ; Female ; Humans ; Insulin Resistance ; Intra-Abdominal Fat ; Leg ; Muscle Strength ; Muscle, Skeletal ; Muscles ; Obesity, Abdominal ; Subcutaneous Fat ; Thigh ; Waist Circumference

BACKGROUND: There is controversy over whether aerobic or resistance exercise is more effective for improving endothelial function in type 2 diabetes mellitus (T2DM). This study was aimed to investigate the effects of an aerobic and resistance training program on endothelial function, and the influences of glycemic control, body weight changes, and aerobic capacity in T2DM. METHODS: Total 40 overweight women with T2DM were assigned into 3 groups: an aerobic exercise group (AEG, n=13), resistance exercise group (REG, n=12), and control group (CG, n=15), and followed either brisk walking for the AEG or resistance band training for the REG, 60 minutes per day, 5 days per week for 12 weeks with monitoring daily activity using accelerometers. We assessed endothelial function by flow-mediated dilation (FMD), and aerobic capacity by oxygen uptake at anaerobic threshold (AT_VO2) at baseline and following training program. RESULTS: The mean participants' age was 57.0+/-6.8 years, and body mass index (BMI) was 27.0+/-2.3 kg/m2. After intervention, FMD increased by 2.2+/-1.9% in AEG, which differed from REG and CG (P=0.002), despite of decreased body weight (BW) in both AG and RG (2.8+/-2.5%, P=0.002; 1.6+/-2.0%, P=0.017, respectively). A significant increased AT_VO2 and decreased HbA1c were found only in AEG. In all participants, FMD was changed with the significant relations to the AT_VO2 (r=0.348, P=0.035), but not to HbA1c levels or BW. CONCLUSION: Aerobic exercise appears to be more beneficial than resistance exercise for improving endothelial function in T2DM. In addition, aerobic capacity could be a better predictor of changes in FMD than BW and glycemic control.
Anaerobic Threshold ; Body Mass Index ; Body Weight ; Body Weight Changes ; Diabetes Mellitus, Type 2 ; Exercise ; Female ; Humans ; Overweight ; Oxygen ; Resistance Training ; Walking

Dermatofibroma (DF) is one of the most common benign soft tissue tumors. Various histological variants of DF have been described, and it is important to discern the different variants to evaluate the prognosis. A 43-year-old female patient with no specific medical history presented with multiple brown-colored nodules on the right arm for 5 years. Biopsy specimens showed a predominance of collagen and fibroblasts in a whorled arrangement with moderate cellularity, findings that were consistent with fibrocollagenous DF. The patient underwent excision of the largest lesion and revisited our department 3 months after surgery with local recurrence at the excision site. We report a rare case of multiple fibrocollagenous DF with local recurrence at the excision site.

Nemaline myopathies, originally reported as a type of congenital myopathy, are clinically and genetically heterogenous diseases. Clinically, nemalin myopathies can be divided into infantile, juvenile and adult forms, and genetically, into autosomal dominant and recessive. There are several reports on nemalin myopathy in Korea, all juvenile forms, but not adult or infant form. In contrast to juvenile form, the adult congential nemalin myopathy is characterized by rather selective acute or subacute respiratory dysfunction in adult age with sporadic or autosomal recessive inheritance. Here, we report the first case of an adult form of nemalin myopathy, whose symptoms were rapidly developed at the age of 32. Therefore, nemalin myopathy can be included in the differential diagnosis for the unexplainable respiratory failure in adult age.
Adult* ; Diagnosis, Differential ; Humans ; Infant ; Korea ; Muscular Diseases ; Myopathies, Nemaline* ; Respiratory Insufficiency ; Respiratory Muscles* ; Wills

Colonic pseudo-obstruction, which is characterized by repetitive episodes or continuous symptoms and signs of a bowel obstruction, is a rare disease that results in colorectal dilatation without any obstructing lesions. Cases with neuropathic chronic colonic pseudo-obstruction have rarely been reported in Korea. We report a case of neuropathic colonic pseudo-obstruction, which results in decreased number of interstitial cells of Cajal and hypoganglionosis, in a 50-year-old man with chronic constipation accompanied by megacolon.
Colon ; Colonic Pseudo-Obstruction ; Constipation ; Dilatation ; Humans ; Interstitial Cells of Cajal ; Korea ; Megacolon ; Middle Aged ; Rare Diseases

A serrated adenoma is a precursor lesion for some cases of microsatellite unstable colorectal carcinoma (CRC). The serrated neoplasia pathway has been associated with carcinogenesis of serrated adenoma, which is different from the traditional adenoma-carcinoma sequence. The serrated neoplasia pathway accounts for 10~15% of CRCs, and these tumors typically demonstrate microsatellite instability. Cases of a CRC arising from a serrated adenoma have been rarely identified with the recent recognition of the serrated neoplasia pathway. However, these cases are not frequently reported in Korea, because this concept has only been recently emphasized. We report a case of an early adenocarcinoma arising from a traditional serrated adenoma of the colon, which was diagnosed and treated by a colonoscopic polypectomy.
Adenocarcinoma ; Adenoma ; Calcium Hydroxide ; Colon ; Colorectal Neoplasms ; Korea ; Microsatellite Instability ; Microsatellite Repeats ; Zinc Oxide

Colonic phytobezoars are defined as conglomerate masses of fruit or vegetable matter in the colon, and these have rarely reported as a cause of colon obstruction. Because it is extremely rare, its correct diagnosis might be delayed even with the aid of abdominal computed tomography. We report here on a case of diagnosed colonic obstruction due to colonic phytobezoars in a 67-year-old female with diabetic end stage renal disease and chronic constipation. Although abdomino-pelvic computed tomography did not demonstrate the presence of phytobezoars, multiple phytobezoars impacted in the colon were found and these were removed by colonoscopy. This is a rare case in that colonic obstruction due to phytobezoar was diagnosed early and it was treated by colonoscopy.
Aged ; Colon ; Colonoscopy ; Constipation ; Female ; Fruit ; Humans ; Kidney Failure, Chronic ; Vegetables

A 36-year-old female patient had suffered from left sided decreasing visual acuity, ocular pain and headache since 6 months before admission. We performed enucleation of the left eyeball under the clinical diagnosis of the secondary glaucoma and obtained the histopathological diagnosis of malignant melanoma of the choroid(epitheloid type).
Adult ; Choroid* ; Diagnosis ; Female ; Glaucoma ; Headache ; Humans ; Melanoma* ; Visual Acuity

A 50-year-old male presented with acutely progressed paraplegia. His magnetic resonance imaging demonstrated two well-demarcated components with opposite signals in one cystic lesion between the T1- and T2-weighted images at the T1 spine level. The patient showed immediately improved neurological symptoms after surgical intervention and the histopathological exam was compatible with a neurenteric cyst. On operation, two different viscous drainages from the cyst were confirmed. A unique similarity of image findings was found from a review of the pertinent literature. The common findings of spinal neurenteric cyst include an isointense or mildly hyperintense signal relative to cerebrospinal fluid for both T1- and T2-weighted images. However, albeit rarer, the signals of some part of the cyst could change into brightly hyperintensity on T1-weighted images and hypointensity on T2-weighted images due to the differing sedimentation of the more viscous contents in the cyst.
Diagnosis, Differential ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; *Neural Tube Defects/diagnosis/physiopathology/surgery ; *Spinal Cord/pathology/surgery ; *Spinal Cord Diseases/diagnosis/physiopathology/surgery