BACKGROUND: Insulin resistance syndrome shows extreme insulin resistance and is associated with acanthosis nigricans. We can differentiate it into type A insulin resistance that has insulin receptor defect, and type B insulin resistance due to insulin receptor autoantibody. Type B insulin resistance was firstly described by Kahn in 1976. It was often found in adult female and showed autoimmune characteristics. As clinical characteristics, there are hyperglycemia, hypoglycemia, hyperinsulinemia, extreme insulin resistance and acanthosis nigricans. METHODS: We investigated 17 insulin receptor autoantibody positive cases and 8 cases of normal control who had visited Wonju Christian Hospital from October 1994 to December 1995. Among insulin receptor autoantibody positive subject, male was 4 cases and female 13 cases. Their mean age was 42.2. We compared patients who had insulin receptor antibody positive acanthosis nigricans(IRA) with normal controls. IRA patients were 6 cases(35.3%) of nomal glucose tolerance, 11 cases(64.7%) of abnormal glucose tolerance including overt diabetes mellitus. RESULTS: The 11 cases(64.7%) among IRA patrents were obese and 13 cases(76.5%) had hyperininsulinemia. In IRA patients, mean serum insulin concentration during oral glucose tolerance test was 202.1mU/mL and it was greater than 46.3 of normal controls. Insulin sensitivity in 1.79mg/L * mM * xmU * min normal controls was higher than 0.74mg/L * mM * min of IRA patients. CONCLUSION: IRA patients showed abnormal glucose tolerance including overt diabetes millitus, severe insulin resistance, hyperinsulinemia and obesity.
Acanthosis Nigricans* ; Adult ; Diabetes Mellitus ; Female ; Gangwon-do ; Glucose ; Glucose Tolerance Test ; Humans ; Hyperglycemia ; Hyperinsulinism ; Hypoglycemia ; Insulin Resistance ; Insulin* ; Male ; Obesity ; Receptor, Insulin*

Primary hypothyroidism can result in reactive enlargement of the pituitary gland which is indistinguishable from primary pituitary lesions in clinical presentation and on magnetic resonance imaging. A 17-year-old girl came to the hospital due to short stature, general weakness and galac-torrhea. The magnetic resonance imaging (MRI) study showed pitutary enlargement. The hormone study showed hyperprolactinemia, decreased basal growth hormone level and primary hypothyroi-dism. By thyroid replacement therapy only, mass was successfully regressed on follow up MRI after 4 months, and growth acceleration could be achieved.
Acceleration ; Adolescent ; Female ; Follow-Up Studies ; Growth Hormone ; Humans ; Hyperplasia* ; Hyperprolactinemia ; Hypothyroidism* ; Magnetic Resonance Imaging ; Pituitary Gland ; Thyroid Gland

The incidence of primary lung cancer is increasing in our country. This presentation is an attempt to correlate a useful diagnosis with radiological findings of primary lung cancer. Histologically proved 210 cases of primary lung cancer are as follow: Epidermoid Ca. 65%, Adeno Ca. 18%, Small cell Ca. 9.5%, Large cell Ca. 2%, Unclassified Ca. 3.3%, Mucoepidermoid Ca. 2.4%, Mixed Ca. 0.5%. 3. In smoking history; 91% of epidermoid Ca, 17%of small cell Ca. 30% of adeno Ca. has smoking history. 4. In mass size; Average diameter of mass was most was5.3cm. Hilar mass was seen in 48 cases. Hilar mass was most frequent finding in small cell Ca. and the peripheral mass in adeno Ca. 5. Cavitary lung Ca. was 26 cases (12.4%) and most cases had relative thick wall and its mean thickness was 3.6mm. 6. Coexistence of pulmonary tuberculosis and lung cancer was 22 cases (10.5%), and most common in epidermoid cell Ca. as 16 cases. 7. Other findings include metastasis to lymph node, bone and other organ, and pleural effusion.
Diagnosis ; Incidence ; Lung Neoplasms ; Lung ; Lymph Nodes ; Neoplasm Metastasis ; Pleural Effusion ; Smoke ; Smoking ; Tuberculosis, Pulmonary

Autophagy is a life-sustaining process by which cytoplasmic constituents are segregated in double-lipid bilayer membrane vesicles and undergo degradation into lysosomes. In recent studies, the basal autophagy is an indispensable process mediating proper vascular function in the body. Moreover, autophagy activated by many stress-related stimuli in the arterial wall protects endothelial cells and smooth muscle cells against cell death and the progression of vascular disease including atherosclerosis. Autophagy is protective to atherosclerosis during early stage but becomes dysfunctional in advanced atherosclerotic lesions. Following this finding, the need is emphasized which pharmacological development with compounds that activate the protective effects of autophagy in the vascular disease. Autophagy stimulated by oral or vascular delivery of rapamycin or derivatives effectively suppressed the atherosclerotic plaque growth and plaque destabilization. In this review, the recent finding is summarized on the role of autophagy in atherosclerosis and find out whether the activation or rescue of autophagy could provide a breakthrough in the treatment of atherosclerosis.
Atherosclerosis* ; Autophagy* ; Cell Death ; Cytoplasm ; Endothelial Cells ; Lysosomes ; Membranes ; Myocytes, Smooth Muscle ; Negotiating ; Plaque, Atherosclerotic ; Sirolimus ; Vascular Diseases

No abstract available.
Thyroiditis, Autoimmune ; Turner Syndrome

Thyroid tuberculosis is rare. We experienced case of a 50-year-old woman with tuberculosis of the thyroid associated with miliary tuberculosis. She complained of chronic cough and weight loss. She was clinically and biochemically euthyroid. Thyroid sonogram demonstrated 3 2 cm sized heterogenous echogenic mass on upper pole of the left lobe of thyroid with calcification. Fine needle aspiration biopsy showed epithelioid granuloma in the caseous necrosis and acid-fast bacilli. She took antituberculous agents. One month later, radiologic finding improved and thyroid mass decreased also.
Biopsy ; Biopsy, Fine-Needle ; Cough ; Diagnosis* ; Female ; Granuloma ; Humans ; Middle Aged ; Necrosis ; Thyroid Gland* ; Tuberculosis* ; Tuberculosis, Miliary* ; Weight Loss

Thyroid tuberculosis is rare. We experienced case of a 50-year-old woman with tuberculosis of the thyroid associated with miliary tuberculosis. She complained of chronic cough and weight loss. She was clinically and biochemically euthyroid. Thyroid sonogram demonstrated 3 2 cm sized heterogenous echogenic mass on upper pole of the left lobe of thyroid with calcification. Fine needle aspiration biopsy showed epithelioid granuloma in the caseous necrosis and acid-fast bacilli. She took antituberculous agents. One month later, radiologic finding improved and thyroid mass decreased also.
Biopsy ; Biopsy, Fine-Needle ; Cough ; Diagnosis* ; Female ; Granuloma ; Humans ; Middle Aged ; Necrosis ; Thyroid Gland* ; Tuberculosis* ; Tuberculosis, Miliary* ; Weight Loss

The intrauterine fetal death(IUFD) is the death of the fetus prior to complete expulsion or extraction from its mother when the fetus is over 20 weeks gestation or weights more than 500 gm. This is a clinical study of 262 cases of IUFD and 262 control cases among 18542 deli-veries at Chung Goo Sung Sim Hospital during 10 years from 1987 to 1996. The results obtain-ed were as follows: 1. The incidence of IUFD was 1.41%. 2. The risk of IUFD was high in women older. 3. The risk of IUFD was high in women with parity of three or more, there was a previous history of IUFD in 11.2% of the IUFD cases and in 6.3% of the control cases, but there was no difference between the two groups of women in history of spontaneous abortion. 4. The sex ratio of male versus female was 1.24:1 in the IUFD cases, 1.11:1 in the control cases. 5. The low birth weight and preterm infants were much more frequent in the IUFD cases. 6. The mode of delivery IUFD was induced labor(77.5%), laparotomy(12.2%), spontaneo- us delivery(10.3%). The indications for laparotomy were placental abruption, placenta previa, transverse lie, previous cesarean section status, cephalopelvic disproportion and uterine rupture. 7. The most common cause of IUFD was unexplained causes(45.1%). 8. There were 67 cases(25.6%) of maternal complication, and the most common complica- tion was fever(35.8%). 9. In the incidence of abnormal coagulation test, the low platelet count(<100,000/mm3) was 8.0%, the prolonged prothrombin time(>14 seconds) was 7.2%, the prolonged partial thr- omboplastin time was 1.0%, the hypofibrinogenemia(<150mg/dl) was 7.2% and the elevated fibrinogen degradation products(>40 ug/ml) was 8.4%. 10. The risk of IUFD was lowered as the number of antenatal care was increased.
Abortion, Spontaneous ; Abruptio Placentae ; Blood Platelets ; Cephalopelvic Disproportion ; Cesarean Section ; Female ; Fetal Death* ; Fetus ; Fibrinogen ; Humans ; Incidence ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Laparotomy ; Male ; Mothers ; Parity ; Placenta Previa ; Pregnancy ; Prothrombin ; Sex Ratio ; Uterine Rupture ; Weights and Measures

The institutional review board is crucial to ensure the scientific and ethical quality of human participant research. This paper analyzes a survey on the current constitution and operation of institutional review boards (IRBs) in Korea, conducted by the Korean Association of Institutional Review Boards in April 2002. Out of 74 IRBs, 63 responded to the survey (85.1% response rate). IRB membership has a male-to-female ratio of approximately 80:20, a predominance of male clinicians (60%) and an underrepresentation of community people unaffiliated to the institutions (less than 10%). Most IRBs (around 80%) confine the scope of their reviews to the clinical evaluation of drugs or devices, leaving the remaining areas of research involving human participants untouched. As their role is limited, the majority of IRBs do not operate actively: 72% of responding IRBs reviewed less than one protocol per month in 2001. Sixty two percent of institutions have never discussed the need for insuring research participants' risks or making indemnity arrangements. This survey reveals many shortcomings and points for improvement by the institutional support bodies, including the need to establish regular education programs for IRB members and investigators.
Appointments and Schedules ; Clinical Trials/legislation & jurisprudence ; Clinical Trials/standards ; Data Collection ; Epidemiologic Studies ; Ethics Committees, Research*/legislation & jurisprudence ; Ethics Committees, Research*/standards ; Ethics Committees, Research*/statistics & numerical data ; Female ; Human ; Human Experimentation/legislation & jurisprudence ; Human Experimentation/standards ; Korea ; Male ; Politics ; Public Policy ; Research Design/standards

We used an animal model of laser-induced retinal artery occlusion to study the temporal and spatial patterns of tissue injury and to identify apoptosis-like morphologic changes.We performed fundus exam and fluorescein angiography for 2 weeks.Rats were sacrificed at 6 hours, 12 hours, 1 day, 2 days, 3 days, 7 days, and 14 days after arterial occlusion.The arterial reperfusion was seen from 6 hours to 4 days.We could observe vascular tortuosity and retinal hemorrhage in the fundus.Six hours after retinal arterial occlusion, there were a lot of cells which had chromatin condensation.One to three days membrane budding and apoptotic body were identifed after occlusion.Most of inner retinal layers were destroyed following 7days.These data demonstrated that retinal artery occlusion induces apoptotic cell death in the retinal ganglion cell and inner nuclear layer.
Apoptosis ; Cell Death ; Chromatin ; Fluorescein Angiography ; Membranes ; Models, Animal ; Reperfusion ; Retinal Artery Occlusion* ; Retinal Artery* ; Retinal Ganglion Cells ; Retinal Hemorrhage ; Retinaldehyde*