PURPOSE:We performed this study to compare correlation between the indices of insulin resistance using fasting insulin and glucose level and body mass index (BMI), and to determine the clinical usefulness of glucose/insulin ratio (G/I ratio), which is easily available in clinical base. METHODS:Total 119 children with simple obesity, whose BMI is over 95th percentile, were evaluated. We calculated G/I ratio, logInsulin, HOMA-IR, logHOMA-IR, and QUICKI and evaluated their relationship to BMI. RESULTS:Children with high-degree obesity had higher insulin resistance than children with mild to moderate-degree obesity (logInsulin, 1.13+/-.23 vs 1.27+/-.29; logHOMA-IR, 0.46+/-.24 vs 0.61+/-.30; QUICKI, 0.33+/-.03, 0.31+/-.03)(P<0.01), and pubertal children had higher insulin resistance than prepubertal children (G/I ratio, 7.39+/-.07 vs 4.85+/-.29; logInsulin, 1.14+/-.27 vs 1.31+/-.22; logHOMA-IR, 0.47+/-.28 vs 0.65+/-.22; QUICKI, 0.33+/-.03 vs 0.31+/-.02) (P<0.001). BMI had correlation coefficient as -0.436 for QUICKI, -0.432 for G/I ratio, 0.430 for logInsulin, and 0.425 for logHOMA-IR (P=0.000). G/I ratio was well correlated with QUICKI (r=0.901, P=0.000), logHOMA-IR (r=-0.865, P=0.000), and logInsulin (r=0.899, P=0.000). The changes of BMI were correlated with changes of G/I ratio (r=-0.547, P<0.01), QUICKI (r=-0.464, P=0.01), and logHOMA-IR (r=0.429, P<0.05). CONCLUSION: This study revealed that the degree of BMI had statistically significant correlation with insulin resistance, which can be reflected by G/I ratio, logHOMA-IR and QUICKI. G/I ratio was well correlated with logHOMA-IR and QUICKI, which suggests that G/I ratio could be used as an bedside index of insulin resistance. The changes of G/I ratio were more correlated with changes of BMI than those of logHOMA-IR and QUICKI.
Body Mass Index ; Child* ; Fasting ; Glucose ; Humans ; Insulin Resistance* ; Insulin* ; Obesity*

No abstract available.
Posterior Cruciate Ligament*

A case of multiple trichilemmal cysts (TC) is presented. TC is known to be a kind of keratinous cyst with lining cells showing trichilemmal keratiniration. A 63-year-old female patient presented with a 30 year duration of increasing in size and number of twenty five nodular lesions on the scalp. All twenty five TC on the scalp were totally excised and examined microscopically. However, the evidence of proliferation or malignant change like the previous case reports was not found in our case.
Female ; Humans ; Middle Aged ; Scalp

Acute tubular necrosis has been rarely reported as a complication of typhoid fever in the literature. We experienced four cases of acute tubular necrosis associated with typhoid fever in children. Patients showed significant titer of widal reaction associated with acute renal failure and one of them rised in 2 months after onset of clinical symptoms. Renal biopsy findings were compatible with acute tubular necrosis and immune complexes were not deposited in the glomeruli. Clinical and urinary findings were normalized by hemodialysis and antibiotic therapies. In conclusion, close longterm follow up of widal titer is mandatory in acute tubular necrosis, especially when associated with high fever.
Acute Kidney Injury ; Antigen-Antibody Complex ; Biopsy ; Child ; Fever ; Follow-Up Studies ; Humans ; Necrosis* ; Renal Dialysis ; Typhoid Fever*

Owing to the advancement of imaging techniques which include the CT scan, it became easier to evaluate fracture patterns of calcaneal fractures accurately. Moreover, it is possible to obtain good results with operative treatment as a consequence of the development of good operative equipment and new operative technique. In 1988, Regazzoni and Benirschke in 1990, recommended L-shaped extensive lateral approach for calcaneus which provide extensive exposure of calcaneus and so allow easier reduction and fixation. We carried out L-shaped extensive lateral approach in 11 cases from June, 1993 to April, 1994. This approach did not produce any skin problems and allowed excellent anatomical reduction and fixation. But we experienced some severe causalgia on the heel region in several cases. We tried to analyse the cause of pain and concluded that it was the damage to the lateral calcaneal branch of the sural nerve. We are reporting the problems of tbis approach.
Calcaneus ; Causalgia ; Heel ; Skin ; Sural Nerve ; Tomography, X-Ray Computed

BACKGROUND: Handgrip and cold pressor test may increase the afterload of the heart. And in left ventricular hypertrophy, it is known that mitral flow pattern is affected by decreased left ventricular compliance. We investigated the effects of handgrip and cold pressor test on mitral flow pattern in patients with left ventricular hypertrophy. METHODS: Handgrip and cold pressor test were performed in 12 subjects with left ventricular hypertrophy and in 14 healthy normal subjects. In supine position, blood pressure, heart rate and Doppler echocardiographic parameters(early peak flow velocity : E, atrial peak flow velocity : A) were obtained at rest, 1 and 3 minutes after the onset of tests respectively. RESULTS: In both groups, handgrip and cold pressor test increased blood pressure slightly without a statistical significance. In left ventricular hypertrophy group, there were significant increments in heart rates at 1 minute of handgrip (78+/-12min-1, p<0.001) and cold pressor test(77+/-7min-1, p<0.05) as compared to that at rest (73+/-12min-1). Mitral flow velocities did not show significant change after the tests in control group. A waves after 1 minute of handgrip(85.2+/-18.4cm/sec, p<0.05) and cold pressor test (87.3+/-17.8cm/sec, p<0.001) showed significant increases as compared to that at rest (79.1+/-14.9cm/sec) in left ventricular hypertrophy group whereas E waves did not. CONCLUSION: Although handgrip and cold pressor tests did not affect the mitral flow significantly in control group, each test raised A waves in left ventricular hypertrophy group. These results suggest that increased A waves may be due to a rise in afterload and decreased left ventricular compliance caused by handgrip and cold pressor test in left ventricular hypertrophy group.
Blood Pressure ; Compliance ; Echocardiography ; Heart ; Heart Rate ; Humans ; Hypertrophy, Left Ventricular* ; Supine Position

We examined several kinds of immunocompromied patients for onyr,homycosis. The incidence of onychomycosis in the patients with connective tissue disease treated with corticosteroid was significantly higher than the incidences in the patients with solid tumors trcated with chemotherapeutic agents, in the patients with leukernia (WBC<1, 000/cm3), and in the control patients. Although conventional corticosteroid trcatment do not disseminate the superficial fungal infection, it may perpetuate the low grade dermatophytosis.
Connective Tissue Diseases* ; Connective Tissue* ; Humans ; Immunocompromised Host ; Incidence ; Onychomycosis* ; Tinea

Two cases of neurofibromatosis are presented. In the first case, mainly the occipito-parietal area and in the other case, lumbosacral area were involved.
Neurofibromatoses*

No abstract available.
Anemia, Hemolytic* ; Cholelithiasis* ; Hepatolenticular Degeneration*

No abstract available.
Child* ; Drug Therapy ; Humans ; Radiotherapy