OBJECTIVE: To investigate whether there is a significant effect of growth hormone(GH) treatment with diet and exercise over the diet and exercise alone in obese non-insulin dependent diabetes mellitus(NIDDM). METHOD: Twenty obese NIDDM adults were studied. We measured the body weight, body composition and exercise capacity before and after 12 weeks of treatment program. The subjects were assigned in a double-blind manner either to the diet, aerobic exercise with placebo treatment group(group A) or to the diet, aerobic exercise with GH treatment group(group B) for twenty-week period. Two groups were compared for the demographic data. RESULTS: After 12-weeks of treatment program, each group showed a significant weight loss (group A: 8.54+/-2.29 kg vs group B: 7.14+/-2.99 kg) than before the treatment, however there was no significant weight loss between two groups. After 12-weeks, the fat fraction of body weight loss was significantly higher in group B than group A(0.80+/-0.40%kg versus 0.55+/-0.30%kg). After 12-weeks, the maximal oxygen consumption was similarly increased in both groups(23.75% in the group A versus 29.2% in the group B). After 12-weeks, the peak torque was similarly increased in both groups(9.7% in the group A versus 17.3% in the group B). After 12-weeks, the endurance was similarly increased in both groups(10.1% in the group A versus 8.1% in the group B). CONCLUSION: Both group A and B showed a significant weight loss and resulted in a comparable gain in the muscle strength, endurance, and maximal oxygen consumption. The addition of GH in a low dose to a the calorie-restricted diet and aerobic exercise resulted in a significant fat loss especially around the visceral area.
Adult ; Body Composition ; Body Weight ; Diabetes Mellitus, Type 2 ; Diet* ; Exercise ; Growth Hormone* ; Humans ; Muscle Strength ; Obesity ; Oxygen Consumption ; Torque ; Weight Loss

Runx2 and Osterix, the transcription factors for osteoblast differentiation, are known as fundamental factors to regulate the development of calcified tissues. However, the biological functions of these factors in the development of the periodontal tissues remain unclear. In this study, we investigated the distribution of Runx2 and Osterix during periodontal tissue development of the mice. Mandibles from 14-day-old mice were prepared for paraffin section. Serial sections of the mandible containing 1st molar tooth germs were obtained as a thickness of 7 microm. Some sections were stained with hematoxylin and eosin. Others were used for immunohistochemistry for PCNA, Runx2, and Osterix. Epithelial cells in growing end of Hertwig's epithelial root sheath (HERS) and mesenchymal cells adjacent to the growing end of HERS expressed PCNA. Undifferentiated mesenchymal cells and hard tissue forming cells like cementoblasts and osteoblasts in early stage of differentiation expressed Runx2. Fully differentiated cementoblasts and osteoblasts secreting matrix proteins expressed Osterix. However, the cells terminated the matrix formation did not express Osterix. Periodontal ligament cells expressed Runx2 and Osterix. Pulp cells expressed Runx2 only.These results suggest that Runx2 and Osterix might regulate the differentiation of cementoblasts in the same manner as osteoblasts. Runx2 might participate in the process of cementoblast differentiation in early stage, whether Osterix might regulate the maturation and matrix synthesis of the cells.
Animals ; Dental Cementum ; Eosine Yellowish-(YS) ; Epithelial Cells ; Hematoxylin ; Immunohistochemistry ; Mandible ; Mice ; Molar ; Osteoblasts ; Paraffin ; Periodontal Ligament ; Proliferating Cell Nuclear Antigen ; Proteins ; Tooth Germ ; Transcription Factors

Recently, many natural medicines, whose advantages are less side effects and possibility of long-term use, have been studied for their capacity, their anti-bacterial and anti-inflammatory effects and regenerative potential of periodontal tissues. Cervi Parvum Cornu(CPC) have been traditionally used as an hale, growth, hematogenous, anti-aging, back pain in Eastern medicine. The purpose of present study was to investigate the effects of CPC extract on cell cycle progression and its molecular mechanism in human fetal osteoblasts. CPC extracts (10 microgram/ml) increased cell proliferation in the human fetal osteoblasts as compared to non-supplemented control. There was no significant change in the G1 and S phase, but a increase in the G2/M phase in 10 microgram/ml and 100 microgram/ml of CPC extracts group as compared to non-supplemented control. The protein expression of cyclin E, cdk 2, cyclin D, cdk 4, and cdk 6 was higher than that of control group. The level of p21 was lower than that of control. But that of pRb and p16 was not distinguished from control. These results indicate that the increase of cell proliferation by CPC extracts may be due to the increased expression of cyclin E , cdk 2, cyclin D, cdk 4 and cdk 6, and the decreased expression of p21 in human fetal osteoblasts .
Back Pain ; Cell Cycle* ; Cell Proliferation ; Cyclin D ; Cyclin E ; Cyclins ; Humans* ; Osteoblasts* ; S Phase

BACKGROUND: Success of transplantation is critically dependent upon the quality of the donor organ and optimal management. Recently, hormonal replacement therapy has been reported to result in rapid recovery of cardiac function and enable significantly more organs to be transplanted, while some other studies show conflicting results. The aim of this study is to comprehensively evaluate changes in basal circulating hormonal levels of the brain-dead organ donors. METHODS: We reviewed the records of all brain-dead patients between January, 2004, and June, 2007. Hemodynamic variables, plasma hormone levels were recorded at following time points: admission to the ICU (T1, baseline), 30 minutes (min) after first apnea test (T2), 30 min after second apnea test (T3), before operation for harvesting (T4). Hormonal measurements included cortisol, adrenocorticotrophic hormone, triiodothyronine (T(3)), thyroxine, free thyroxine, thyroid-stimulating hormone, growth hormone, and testosterone. RESULTS: Nineteen patients were included in this study. Comparisons of hemodynamic parameters and hormonal levels to baseline values revealed no significant changes throughout the study period. When the patients were divided into 2 groups according to the requirement of norepinephrine (either>0.05 or < or =0.05microgram/kg/min), patients requiring >0.05microgram/kg/min of norepinephrine had T(3) level below the normal range at significantly more time points of measurement (7 vs. 0). CONCLUSION: In this comprehensive assessment of hormonal levels in brain-dead organ donors, we could not observe any significant changes during the ICU stay. Replacement therapy of T(3) may be considered in patients requiring >0.05microgram/kg/min of norepinephrine.
Adrenocorticotropic Hormone ; Apnea ; Growth Hormone ; Hemodynamics ; Humans ; Hydrocortisone ; Norepinephrine ; Plasma ; Reference Values ; Testosterone ; Thyrotropin ; Thyroxine ; Tissue Donors ; Transplants ; Triiodothyronine

Central nervous system involvement by tuberculosis is rare, and intramedullary involvement is even more rare. A patient that developed intermittent amnesia during anti-tuberculous therapy underwent brain CT and MRI and spine MRI. The latter showed multiple small enhancing nodules in the brain and spinal cord. The patient was treated with anti-tuberculous medication and steroids under the suspected diagnosis of miliary tuberculosis. Follow-up CT showed decreased nodule size and number. We report a case of miliary tuberculosis in the brain and spinal cord and present a review of the literature related to similar cases.
Amnesia ; Brain ; Brain Diseases ; Central Nervous System ; Follow-Up Studies ; Humans ; Spinal Cord ; Spinal Cord Diseases ; Spine ; Steroids ; Tuberculosis ; Tuberculosis, Central Nervous System ; Tuberculosis, Miliary

PURPOSE: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumor of the gastrointestinal tract. Recent studies have revealed much of the biological and genetics underpinning GISTs. METHODS: KIT, PDGFRA, NF2 and GPHN mutations were examined by PCR-SSCP and DNA sequencing. Immunohistochemical analyses of CD117, CD34, SMA, S-100 and desmin were performed in 11 GISTs cases, and each tumor classified as being either very low, low, intermediate or high risk. RESULTS: Mutation in exon 11 of KIT was identified in 6 of the 11 GISTs, but mutations in exon 9, 13 and 17 of KIT were not detected. Three cases lacking KIT mutations showed PDGFRA mutations. No NF2 mutations were detected. GPHN gene mutation in exon 1 was identified in one case, which showed a simple point mutation in exon 11 of KIT. In a correlation between the mutation types and risk of aggressive behavior, four tumors involved multiple ( >2 codons) KIT mutations and one showed a point mutation of KIT plus a GPHN mutation were high risk, but one tumor with a point mutation of KIT showed a low risk. Three tumors having a PDGFRA mutation were of intermediate or very low risk. CONCLUSION: Mutations at exon 9, 13 or 17 of KIT and a NF2 mutation are considered rare in sporadic GIST. KIT and PDGFRA mutations appeared to be alternatives. A GPHN mutation occurring with a KIT mutation may be a secondary change in the pathogenesis of GIST, as the KIT mutation is a major event in GIST. KIT mutant GIST may have a poorer prognosis than PDGFRA mutant GIST.
Desmin ; Exons ; Gastrointestinal Stromal Tumors* ; Gastrointestinal Tract ; Genetics ; Point Mutation ; Prognosis ; Sequence Analysis, DNA

BACKGROUNDS: Malnutrition is common in patients with chronic renal failure(CRF) and various signs of malnutrition are strong predictors of increased morbidity and mortality. Monitoring of protein intake and nutritional status is therefore important in the clinical management of CRF patients. Few studies have demonstrated direct correlations among renal function, protein intake, and nutritional status in a prospective study although clinical experiences suggest such relationship. The aim of this study was to prospectively evaluate correlations between renal function, protein intake, and nutritional status during progressive renal failure. METHODS: A total of 431 studies on renal function, protein intake, and nutritional status was carried out in 282 patients with normal renal function and varying degrees of renal failure before beginning dialysis. Renal functional indices included weekly Kt/Vurea, total weekly creatinine clearance(Ccr, L/week/1.73m2), creatinine clearance(Ccr, mL/min/1.73m2), urea clearance(Curea, mL/min) and residual renal function(RRF, mL/min). Protein intake was assessed from the protein equivalent of total nitrogen appearance normalized by standard weight(nPNA, g/kg/day) by DOQI formula[nPNA(D)], Bergstr m formula 1[nPNA(B1)] and Bergstr m formula 2[nPNA(B2)]. Nutritional indices were fat free edema free body mass(FFEFBM, kg) by creatinine kinetics, %lean body mass(LBM, %) and serum albumin(g/dL). We evaluated correlations between renal function, protein intake and nutritional status by linear regression analysis. In a separate analysis, 237 studies from 94 patients with follow-up studies were analyzed for correlations among renal function, protein intake, and nutritional status. RESULTS: There was a highly significant correlation among weekly Kt/Vurea, weekly creatinine clearance, and residual renal function, among nPNA(D), nPNA (B1), nPNA(B2), and between FFEFBM and %LBM. Significant correlation was also observed between weekly Kt/Vurea and nPNA, between weekly Kt/ Vurea and FFEFBM, between weekly Kt/Vurea and %LBM, between nPNA and FFEFBM, and between nPNA and %LBM. The results were the same in patients with follow-up studies. CONCLUSION: These results clearly demonstrate that renal urea and creatinine clearance is closely correlated with protein intake and nutritional status in predialysis patients. With declining small solute clearances, protein intake decreased and nutritional status became worse. Starting dialysis before malnutrition becomes apparent may improve patient morbidity and mortality after dialysis.
Creatinine ; Dialysis ; Edema ; Follow-Up Studies ; Humans ; Kinetics ; Linear Models ; Malnutrition ; Mortality ; Nitrogen ; Nutrition Assessment ; Nutritional Status* ; Prospective Studies ; Renal Insufficiency* ; Urea

OBJECTIVE: The study was undertaken to evaluate clinical safety and usefulness of laparoscopic myomectomy with analyzing clinical course and postoperative complications of 93 patients underwent laparoscopic myomectomy at Yosu Chon-nam Hospital and to introduce operative methods executed in this hospital. METHODS: Total number of patients underwent laparoscopic myomectomy at Yosu Chon-nam Hospital from May 2001 to December 2002 was 93. With ward chart and admission recordings, Age, parity, symtom, size of myoma, number of myoma, location operation time and hemoglobin change were recorded. Data were analyzed with Microsoft Excel. RESULTS: The mean age of patients was 42.68 ( +/- 6.05) years. The mean parity was 2.02 ( +/- 0.96). The mean number of myoma was 1.70 ( +/- 1.27). The mean weight of myoma was 71.7 ( +/- 56.4) gm. The most common symtom was hypermenorrhea. The location of myoma was submucosal, intramural, subserosal in large order. The mean operation time was 101.1 ( +/- 30.2) minutes. The mean hemoglobin change after operation was 1.40 ( +/- 0.81) g/dL. Mean hospital stay was 3.90 ( +/- 1.20) days. The operative complication was trocar site bleeding (2 cases), surgical emphysema (2 cases). In 2 cases, Laparoscopic procedure was converted to laparotomic method. CONCLUSION: Indication of operation was extended in almost all age (including reproductive age) and 93 Laparoscopic myomectomy was done safely and effectively without severe complications. However, to obtain more safety and usefulness of laparoscopic myomectomy, adequate laparoscopic instrument and expertized operative technic should be demanded. In near future, laparoscopic myomectomy will be more popular and effective by variable technical development and ordered discipline.
Emphysema ; Female ; Hemorrhage ; Humans ; Jeollanam-do ; Length of Stay ; Menorrhagia ; Myoma ; Parity ; Postoperative Complications ; Surgical Instruments

Echocardiographic parameters can predict cardiovascular events in several clinical settings. However, which echocardiographic parameter is most predictive of each cardiovascular or non-cardiovascular event in patients starting hemodialysis remains unresolved. Echocardiography was used in 189 patients at the time of starting hemodialysis. We established primary outcomes as follows: cardiovascular events (ischemic heart disease, cerebrovascular disease, peripheral artery disease, and acute heart failure), fatal non-cardiovascular events, all-cause mortality, and all combined events. The most predictable echocardiographic parameter was determined in the Cox hazard ratio model with a backward selection after the adjustment of multiple covariates. Among several echocardiographic parameters, the E/e' ratio and the left ventricular end-diastolic volume (LVEDV) were the strongest predictors of cardiovascular and non-cardiovascular events, respectively. After the adjustment of clinical and biochemical covariates, the predictability of E/e' remained consistent, but LVEDV did not. When clinical events were further analyzed, the significant echocardiographic parameters were as follows: s' for ischemic heart disease and peripheral artery disease, LVEDV and E/e' for acute heart failure, and E/e' for all-cause mortality and all combined events. However, no echocardiographic parameter independently predicted cerebrovascular disease or non-cardiovascular events. In conclusion, E/e', s', and LVEDV have independent predictive values for several cardiovascular and mortality events.
*Echocardiography ; Female ; Heart Failure/*diagnosis/mortality ; Humans ; Kidney Failure, Chronic/mortality/*therapy ; Male ; Middle Aged ; Predictive Value of Tests ; Prognosis ; *Renal Dialysis ; Risk Factors ; Ventricular Function, Left/*physiology