PURPOSE:The prevalence of childhood obesity has been increased rapidly, associated with high morbidity of dyslipidemia, cardiovascular risk factors and insulin resistance/hyperinsulinemia. Hyperinsulinemia in obese children may depend on either increased insulin secretion or decreased insulin clearance. We investigate whether insulin secretion and clearance are different between obese and normal weight children. METHODS:The body mass index(BMI), fasting serum glucose, insulin and C-peptide levels were measured in 101 children(52 obese children and 49 non-obese controls) in Ansan area, from 6 to 14 years old. Fasting serum C-peptide/insulin ratio, insulin/glucose ratio, homeostasis model assessment(HOMA) were calculated and compared between obese and control group. RESULTS:The fasting serum insulin and C-peptide levels were significantly higher in obese group than in controls. The C-peptide/insulin ratio was significantly lower and insulin/glucose ratio was significantly higher in obese group than in controls. There were positive correlations between BMI and fasting serum insulin level, fasting insulin/glucose ratio and HOMA. The prevalence of hyperinsulinemia is higher in obese adolescents than in controls. CONCLUSION: Our findings suggest that increased insulin secretion and decreased insulin clearance may contribute to hyperinsulinemia in obese children.
Adolescent ; Blood Glucose* ; C-Peptide* ; Child* ; Dyslipidemias ; Fasting* ; Gyeonggi-do ; Homeostasis ; Humans ; Hyperinsulinism ; Insulin* ; Obesity* ; Pediatric Obesity ; Prevalence ; Risk Factors

No abstract available.
Arthrogryposis* ; Pyloric Stenosis*

Cystathionine is well-known intermediate in the metabolism of methionine. It is cleaved to cysteine and homoserine by gamma-cystathionase. This enzyme utilize pyridoxal 5'-phosphate as coenzyme. gamma-cystathionase deficiency leads to persistent excretion of large amount of cystathionine in urine, as well as to accumulation of cystathionine in body tissues and fluids. It is inherited as an autosomal recessive trait and shows wide variety of clinical manifestations. No clinical abnormality seems to be specifically associated with gamma-cystathionase deficiency. The majority of patients responded to high dose administration of pyridoxine. We report the first case of cystathioninuric patient in Korea, 19 months of female with developmental delay. In brain MRI, there was generalized mild brain atrophy. There were several times of brief paroxysmal generalized polyspike and wave discharges in electroencephalography(EEG). In amino acid analysis of urine, there was elevated level of cystathionine. She was treated with high dose of pyridoxine. In follow up analysis of urinary amino acid, the cystathionine level was markedly decreased to normal range, and EEG was normalized. Her development shows improvement.
Atrophy ; Brain ; Cystathionine ; Cystathionine gamma-Lyase ; Cysteine ; Electroencephalography ; Female ; Follow-Up Studies ; Homoserine ; Humans ; Korea ; Magnetic Resonance Imaging ; Metabolism ; Methionine ; Pyridoxal ; Pyridoxine ; Reference Values

PURPOSE: To assess the clinical characteristics of the 2000-2001 measles outbreak in the Seoul metropolitan area, Korea, the clinical data of measles inpatients were analyzed. METHODS: Three hundred and five children diagnosed with measles by clinical manifestation from July, 2000 to February, 2001, in Seoul, Ilsan and Ansan City were grouped according to their age and investigated for clinical manifestations, vaccination history and measles-specific IgM/IgG antibody positivity. RESULTS: Thirty eight point seven percent of the subjects were less than 12 months of age, 27.5 % were 12-47 months of age and 33.8% were 48 months of age or older. There was no significant sexual difference(male : female=1.2 : 1). This epidemic started in June, 2000 and the number of patients increased abruptly in October, peaked in December and finally decreased after February, 2001. It started from the older age group and moved to the younger. Sixty five point two percent had a history of more than 1-dose vaccination and 13.6% of the patients equal or more than 48 months of age had a history of 2-dose vaccination. Primary vaccine failure rate was 59.4%(107/ 180) and secondary vaccine failure rate was 3.9%(7/180) in 1 dose vaccinees. Sixty one point six percent showed more than one complication and 38.4% had no complication. The most common complication was pneumonia(31.8 %), followed by bronchitis(11.5%) and acute otitis media(4.6%). Vaccination and dose were not related significantly with the occurrence of complications. CONCLUSION: Compared with previous outbreaks in Korea, clinical features showed no specific change in the 2000-2001 measles epidemic. However, primary vaccine failure rate was so high that the second vaccination at four to six years of age must be emphasized in Korea.
Child ; Disease Outbreaks ; Gyeonggi-do ; Humans ; Inpatients ; Korea ; Measles* ; Otitis ; Seoul* ; Vaccination

Polyarteritis nodosa is a systemic necrotizing vasculitis that affects mainly small and medium-sized arteries that involve multiple organs. In addition to the systemic involvement of classical vasculitis, localized vasculitis involves blood vessels within a confined vascular distribution or single organ without clinical evidence of generalized inflammation. Localized vasculitis of the gastrointestinal tract is a rare entity. In particular, a limited involvement of the small bowel is an unusual manifestation of polyarteritis nodosa. In this report, we describe a case of biopsy-proven polyarteritis nodosa presenting as small bowel bleeding without other systemic manifestations.
Arteries ; Blood Vessels ; Gastrointestinal Tract ; Hemorrhage ; Inflammation ; Polyarteritis Nodosa ; Vasculitis

Lymphoid polyp is a very rare disease that commonly occurs in the rectum. It is a benign, focal or diffuse lesion that typically occurs where clusters of lymphoid follicles are present. The polyp is composed of well differentiated lymphoid tissue. It can generally be differentiated from malignant lymphoma by the proliferation of normal lymphoid tissue, which has a prominent follicular pattern and a clearly defined germinal center. There have been only a few reports of lymphoid polyps of the rectum, and there have been no reports of lymphoid polyp in the ampulla of Vater. We experienced a case of lymphoid polyp in the ampulla of Vater associated with tubulopapillary adenoma, and the patient first presented with jaundice, weight loss and general weakness.
Adenoma ; Ampulla of Vater ; Germinal Center ; Humans ; Jaundice ; Lymphoid Tissue ; Lymphoma ; Polyps ; Rare Diseases ; Rectum ; Weight Loss

BACKGROUND/AIMS: Recently, variable gastrointestinal track tumors including early stage malignancies are treated by endoscopic procedure. However, the discrepancy of histologic diagnosis may sometimes exist between the pretreatment forceps biopsy results and those of post treatment specimen. So the prediction of malignant lesion is important in the aspect of treatment selection. In this study, we investigated the predictable factors of the histologic discrepancy through the clinical, endoscopic features of the lesion diagnosed as adenocarcinoma in the post-endoscopic treatment specimen after the adenoma was diagnosed by the endoscopic forceps biopsy. METHODS: From March 2005 to April 2009, 129 gastric tumor lesions (129 patients) which were not diagnosed as malignancy and treated with endoscopic procedure were enrolled retrospectively. We compared the pretreatment endoscopic forceps biopsy results and post-treatment specimen biopsy results, then, analyzed the tumor characteristics. RESULTS: Twenty-one cases (16.3%) were diagnosed as malignancy after endoscopic treatment. Especially, discrepancy occurred more frequently in depressed lesions than in flat or elevated lesions (41.7% vs. 13.7%, p=0.012), and in lesions diagnosed as high grade adenomas than low or moderate grade adenomas (33.3% vs. 11.1%. p=0.004). CONCLUSIONS: In cases of depressed type lesions in the pretreatment endoscopy or those diagnosed as high grade adenoma in the pretreatment forceps biopsy, we should consider combined malignant lesion. Therefore, treatment modalities ensuring accurate diagnosis and potentially curative resection, should be carefully selected and performed in cases which have these features.
Adenoma/pathology/surgery ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Biopsy ; Female ; Gastroscopy ; Humans ; Male ; Middle Aged ; *Predictive Value of Tests ; Sex Factors ; Stomach Neoplasms/*pathology/surgery

A choledochal cyst is relatively rare lesion in the biliary system, and a carcinoma arising from such a cyst is rarely reported. Until now, a case of a hepatocellular carcinoma combined with a choledochal cyst had not been reported. A 45-year-old woman was recently admitted due to abdominal pain. An abdominal computed tomography revealed a 5 cm-sized low attenuative mass involving the right anterior and left medial segment of the liver and gallbladder fossa. An endoscopic retrograde cholangiopancreatogram showed fusiform dilatation of the common bile duct, but anomalous union of pancreaticobiliary duct was not observed. Fine-needle aspiration of the liver was conducted and yielded a hepatocellular carcinoma. On celiac arteriography, a hypervascular hepatic mass was also found. Transarterial chemoembolization was performed. It is believed this may be the first case of a choledochal cyst combined with a hepatocellular carcinoma in the literature. Hence, this case is herein reported with a review of related literatures.
Abdominal Pain ; Angiography ; Biliary Tract ; Biopsy, Fine-Needle ; Carcinoma, Hepatocellular* ; Choledochal Cyst* ; Common Bile Duct ; Dilatation ; Female ; Gallbladder ; Humans ; Liver ; Middle Aged

No abstract available.
Alcoholics* ; Aldehyde Dehydrogenase* ; Humans ; Liver Diseases, Alcoholic*

Primary cardiac sarcomas are an extremely rare disease, which are usually diagnosed late, as they seldom display symptoms until they obstruct the cardiac outflow or spread to distant organs. We report the case of a 57-year-old female presenting symptoms of a brain tumor, such as dizziness and visual disturbance. Further evaluations revealed multiple brain metastatic tumors, and a cardiac tumor as the primary lesion. Histological examination of the resected cardiac tumor showed cells of a poorly differentiated sarcoma. The current literature regarding incidences, diagnosing techniques, treatment strategies and prognosis of primary cardiac sarcomas are briefly reviewed with our case report.
Brain Neoplasms ; Brain* ; Dizziness ; Female ; Heart Neoplasms ; Humans ; Incidence ; Middle Aged ; Neoplasm Metastasis* ; Prognosis ; Rare Diseases ; Sarcoma*