BACKGROUND: Currently, several definitions for metabolic syndrome are in use. For epidemiological and clinical purposes, universally accepted definition would be needed. International Diabetes Federation (IDF) has introduced a new diagnostic criteria for the metabolic syndrome (MS). We analyzed the association between insulin resistance and MS using both the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) definition and new IDF definition, in order to compare the clinical utility of these two different definitions. METHODS: The subjects of this study included 206 men, aged 29~65 years, who visited a health promotion center located in Seoul. Among the subjects, we excluded hypertensive or diabetic patients. We measured their waist circumference, blood pressure, fasting glucose, insulin and lipid profiles. The metabolic syndrome was diagnosed using both ATP III and IDF definitions. We used the multiple logistic regression method to estimate odds ratio for MS according to the level insulin resistance measured by HOMA-IR. RESULTS: The prevalence of metabolic syndrome was 14.1% according to the NCEP-ATP III defintion, and 12.6% according to the IDF definition. After adjusting for age, alcohol, smoking and exercise, the odds ratios for insulin resistance of metabolic syndrome group defined by NCEP-ATP III criteria and IDF criteria were 3.04 (95%CI 1.28~7.22) and 2.33 (0.95~5.76) respectively. CONCLUSION: New IDF definition does not seem to be as sensitive as ATP III definition with respect to insulin resistance. Studies using the new IDF definition for metabolic syndrome are still scarce and therefore further investigations will be required.
Adenosine Triphosphate ; Adult* ; Blood Pressure ; Cardiovascular Diseases ; Cholesterol ; Education ; Fasting ; Glucose ; Health Promotion ; Humans ; Insulin ; Insulin Resistance* ; Logistic Models ; Male ; Odds Ratio ; Prevalence ; Seoul ; Smoke ; Smoking ; Waist Circumference

PURPOSE: Rush immunotherapy (RIT) with house dust mite may be effective to treat house dust mite allergic disease, but the mechanisms are not clear. Considerable attention has been devoted to the IgG subclass in relation to clinical outcome. Usually, conventional immunotherapy with D.f and D.p is followed early on by a rise in allergen-specific IgG1 with a gradual decline over time and slow rise in allergen-specific IgG4. Some investigators have implicated that IgG4 is a more important blocking antibody than IgG1 in RIT. But there is no consistent data on the early changes of allergen-specific IgG1 or IgG4. To inves- tigate the alteration of humoral immunity in the mechanism of early phase of RIT, the D.f -specific IgE, IgG1, and IgG4 levels of the RIT group were compared with that of the con- trol group with asthma. METHOD: The RIT group included 17 D.f and D.p-sensitized asthmatic children, who had received RIT with D.f and D.p, and the control group included 15 D.f and D.p-sensitized asthmatic children who had not received RIT. They received RIT to mite for just over 8 weeks until maintenance was achieved. The symptom scores of asthma, skin reactivity to D.f (allergen/histamine ratio), RIT changes of D.f-specific IgE, IgG1, and IgG4 levels were compared before and 8 weeks after for the two groups. D.f-specific IgE, IgG1, and IgG4 levels were measured by ELISA. RESULTS: The symptom scores and the skin reactivity to D.f decreased significantly 8 weeks after RIT. D.f-specific IgG1 levels increased significantly 8 weeks after RIT in the RIT group but not in the control group. But D.f-specific IgE and D.f- specific IgG4 levels did not change 8 weeks after RIT in either of the two groups. CONCLUSION: D.f-specific IgG1 production was increased in the early phase of RIT. These findings suggest that the early clinical changes after RIT may be linked to the early increase of IgG1 blocking antibody.
Asthma ; Child* ; Dermatophagoides farinae* ; Dermatophagoides pteronyssinus* ; Dust* ; Enzyme-Linked Immunosorbent Assay ; Humans ; Immunity, Humoral* ; Immunoglobulin E ; Immunoglobulin G ; Immunotherapy* ; Mites ; Pyroglyphidae* ; Research Personnel ; Skin

Retroperitoneal fibrosis (RPF) is a rare disease characterized by marked fibro-inflammatory tissue in the retroperitoneum. Approximately 70% of cases of RPF are idiopathic, while the rest can be secondary to several other causes. The diagnosis is mainly obtained by imaging modalities such as computed tomography (CT). However, histological examination should be considered when the clinical manifestations and imaging studies suggest malignancy. In particular, in malignant diseases with retroperitoneal metastases, abnormal collagen plaques are formed from an exuberant desmoplastic response, which may not be distinguishable from RPF on CT scans. Therefore, even if CT suggests RPF, biopsy is essential to identify malignant disease because it typically results in a fatal prognosis. Here, we report a case of metastatic adenocarcinoma of unknown primary site that developed only in the retroperitoneum and was initially diagnosed as RPF based on CT findings.
Adenocarcinoma ; Biopsy ; Collagen ; Diagnosis ; Neoplasm Metastasis ; Neoplasms, Unknown Primary ; Prognosis ; Rare Diseases ; Retroperitoneal Fibrosis* ; Tomography, X-Ray Computed

OBJECTIVE: To investigate the correlation between magnetic resonance imaging (MRI) findings for children with cerebral palsy (CP) and the severity of their developmental disability. METHOD: MRI and M nchener Funktionelle Entwicklungs Diagnostik (MFED) were used for the evaluation of 52 children with CP. MFED quotient (MFED age/corrected age 100) was compared to the MRI findings. RESULTS: Of the 52 MRIs, no abnormalities were found in 7 cases (13%), periventricular leukomalacias (PVLs) in 37 cases (71.2%), corpus callosum abnormalities in 33 cases (63.5%), delayed myelinations in 8 cases (15.4%), congenital brain abnormalities in 6 cases (11.5%), and central sulcus abnormalities in 3 cases (5.8%). Among 27 patients who were born preterm, the major MRI finding was PVL (100%), indicative of a hypoxic brain injury. All patients with a normal MRI were born at term. There were significant correlations between the MFED quotient and the severity of PVL. The ratio of corpus callosum length/brain anteroposterior diameter was correlated with a developmental disability. CONCLUSION: MRI findings for the patients with CP are well correlated with the developmental disabilities and the timing of brain insult.
Brain ; Brain Injuries ; Cerebral Palsy* ; Child ; Corpus Callosum ; Developmental Disabilities* ; Humans ; Infant, Newborn ; Leukomalacia, Periventricular ; Magnetic Resonance Imaging ; Myelin Sheath

Dermatomyositis (DM) is an autoimmune disease characterized by subacute-onset proximal symmetric muscle weakness, skin abnormalities, and muscle inflammation. Descriptions of DM as a complication of chronic graft-versus-host disease (cGVHD) are very rare. We report a 50-year-old woman who developed DM associated with cGVHD after allogeneic stem cell transplantation.
Autoimmune Diseases ; Dermatomyositis* ; Female ; Graft vs Host Disease* ; Humans ; Inflammation ; Middle Aged ; Muscle Weakness ; Skin Abnormalities ; Stem Cell Transplantation ; Stem Cells* ; Transplantation*

A 79-year-old woman was admitted to our hospital for shoulder pain. A physical examination revealed a tender right shoulder with limitation of active, and preservation of passive, motion. She had undergone a cerebral angiography with coil embolization two months prior to admission. After the procedure, she was presented with pain in the right upper arm and shoulder. Due to persistent shoulder pain, an MRI of the shoulder was performed, and osteonecrosis of the humeral head was detected. We present a case of osteonecrosis of the humeral head after cerebral angiography.
Aged ; Arm ; Cerebral Angiography* ; Embolization, Therapeutic ; Female ; Humans ; Humeral Head* ; Magnetic Resonance Imaging ; Osteonecrosis* ; Physical Examination ; Shoulder ; Shoulder Pain

A percutaneous transthoracic needle biopsy is a common procedure in the practice of pulmonology. An air embolism is a rare but potentially fatal complication of a percutaneous transthoracic needle biopsy. We report four cases of a cerebral air embolism that developed after a percutaneous transthoracic needle biopsy. Early diagnosis and the rapid application of hyperbaric oxygen therapy is the mainstay of therapy for an embolism. Prevention is the best course and it is essential that possible risk factors be avoided.
Adult ; Aged ; Biopsy, Needle/*adverse effects/methods ; Embolism, Air/*etiology/therapy ; Female ; Humans ; Hyperbaric Oxygenation ; Intracranial Embolism/*etiology/therapy ; Lung/*pathology ; Male ; Radiography, Interventional

Polymyalgia rheumatica (PMR) is an uncommon disorder characterized by bilateral pain and stiffness in the shoulder and pelvic girdles. Polymyalgia rheumatica and giant cell arteritis (GCA) occur in the same patient population and share a common pathogenesis. Giant cell arteritis predominantly affects the cranial arteries and rarely involves the gastrointestinal tract. Moreover, giant cell arteritis has rarely been reported in Asians. Here, we present a case with 62-year-old Asian woman who developed polymyalgia rheumatica with localized vasculitis in the mesenteric arteries.
Arteries ; Asian Continental Ancestry Group ; Female ; Gastrointestinal Tract ; Giant Cell Arteritis ; Humans ; Mesenteric Arteries ; Middle Aged ; Polymyalgia Rheumatica* ; Shoulder ; Vasculitis*

Hypertrophic osteoarthropathy is a syndrome characterized by periosteal new bone formation, arthritis, and clubbing of the fingers and toes. The majority of cases occur secondarily to the conditions associated with pulmonary, cardiac, gastrointestinal disorders or other systemic diseases. There are many cases with malignancy worldwide. We report the first patient who had hypertrophic osteoarthropathy due to metastatic cancer after surgical removal for mucoepidermoid carcinoma of the parotid gland.
Arthritis ; Carcinoma, Mucoepidermoid* ; Fingers ; Humans ; Lung* ; Neoplasm Metastasis* ; Osteogenesis ; Parotid Gland* ; Toes

Mycobacterium avium complex (MAC) comprises M. intracellulare and M. avium. MAC usually causes pulmonary diseases in individuals with intact immunity, disseminated disease in patients with acquired immunodeficiency syndrome, and cervical lymphadenitis. It can also cause cutaneous disease, but musculoskeletal infection is rare. Herein, we present a case of vertebral osteomyelitis due to M. intracellulare in an elderly immunocompetent patient who underwent vertebroplasty. The patient was successfully treated with antimycobacterial drugs without surgical intervention. MAC should be considered as a causative pathogen of vertebral osteomyelitis when the patient has a history of vertebroplasty.
Acquired Immunodeficiency Syndrome ; Aged* ; Humans ; Lung Diseases ; Lymphadenitis ; Mycobacterium avium Complex* ; Mycobacterium avium-intracellulare Infection ; Mycobacterium* ; Nontuberculous Mycobacteria ; Osteomyelitis* ; Vertebroplasty*