No abstract available.
Gram-Positive Bacterial Infections* ; Teicoplanin*

The clinical and pathological features of solitary fibrofolliculoma are presented. Solitary fibrofolliculoma is very rarely encountered and to our knowledge, only 7 cases have been reported in the Western literature and no cases have been published in Korea. We experienced a case of solitary fibrofolliculoma occurring in a 56-year-old female, who had a 1.0 cm-sized and slowly growing nodule on her chin. A brief review of the literature, was made especially in relation to the pathological findings and histogenesis of solitary fibrofolliculoma.
Female ; Humans

Exercise is one of the cornerstones of diabetes management along with diet and medication. Exercise can acutely improve insulin sensitivity for between 2 and 72 hours. Moderate aerobic exercise acutely improves insulin sensitivity and lowers blood glucose while a single bout of intense exercise can transiently increase blood glucose. Combined aerobic and resistance exercise may have more benefits than each exercise alone, although this needs to be confirmed in future studies. Aerobic and resistance training can both improve insulin sensitivity and blood glucose, while, resistance exercise increases muscle mass and may be particularly beneficial in the elderly.
Aged ; Blood Glucose ; Diet ; Exercise ; Glucose ; Humans ; Insulin Resistance ; Muscles ; Resistance Training

Recent studies have shown that bariatric surgery can lead to the remission of diabetes in a large portion of patients with type 2 diabetes and morbid obesity. The effect of bariatric surgery, especially Roux-en-Y gastric bypass, is thought to be caused by mechanisms other than weight loss that contribute to the metabolic improvement. Improvement in hepatic insulin resistance which is thought to be linked to caloric restriction in the initial period after surgery and improved peripheral insulin resistance seen with weight loss are one of the mechanisms leading to improved metabolism. Insulin secretion and altered gut hormone secretion also seem to play a role in this improvement. The mechanisms underlying the beneficial effect of bariatric surgery need to be further studied and this increased understanding will aid in the understanding of the pathophysiology of type 2 diabetes, and may lead to the development of novel therapies.
Bariatric Surgery ; Caloric Restriction ; Diabetes Mellitus ; Gastric Bypass ; Humans ; Insulin ; Insulin Resistance ; Obesity, Morbid ; Weight Loss

Cardiovascular disease is a major cause of morbidity and mortality in people with type 2 diabetes. Therefore, the prevention of cardiovascular diseases is of great importance in these patients. Antidiabetic drugs may have cardiovascular effects independent of their glycemic effects. The highly publicized meta-analysis of rosiglitazone has triggered much concern about the cardiovascular effects of antidiabetic drugs. Since 2008, the US Food and Drug Administration (FDA) has required that all new antidiabetic drugs show proof of an acceptable cardiovascular risk profile. Because there is a lack of well-designed definitive studies, the cardiovascular risk/benefit is not definite in many drugs. Large randomized trials assessing the cardiovascular risk of antidiabetic drugs have been recently completed or are ongoing. The first novel drug class designated after 2008 is the dipeptidyl peptidase-4 (DPP-4) inhibitors. Trials of DPP-4 inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists have shown a neutral effect on cardiovascular disease. Empagliflozin, a sodium-glucose co-transporter 2 inhibitor, significantly decreased the incidence of the primary cardiovascular end point, especially decreasing cardiovascular death and hospital admission for heart failure. Ongoing and future studies will provide better insight about the effects of each class and individual drug on cardiovascular disease.
Cardiovascular Diseases ; Glucagon-Like Peptide 1 ; Heart Failure ; Humans ; Hypoglycemic Agents* ; Incidence ; Mortality ; United States Food and Drug Administration

BACKGROUND: Few studies have investigated the effectiveness of intravenous fluid warmers at low and moderate flow rates below 1,000 ml/h. In this study, we compared the effectiveness of three different fluid warmers at a low flow rate (440 ml/h). METHODS: We experimentally investigated the fluid warming performances of Mega Acer Kit® (Group M, n = 10), Ranger™ (Group R, n = 10), and ThermoSens® (Group T, n = 10) at 440 ml/h for 60 min. All devices were set at a warming temperature of 41℃ with preheating for 10 min. Intravenous fluids were then delivered through them. The fluid temperature (primary endpoint) was measured at 76 cm from the device after infusion for 60 min. The expected decrease in mean body temperature (secondary endpoint) after 5 h infusion for a 70 kg patient (ΔMBT5) was also calculated. RESULTS: The fluid temperature (mean [95% CI]) at 76 cm from the device, 60 minutes after the infusion was higher in group M (36.01 [35.73–36.29]℃), compared to groups T (29.81 [29.38–30.24]℃) and R (29.12 [28.52–29.72]℃) (P < 0.001). The ΔMBT5 (mean [95% CI]) was significantly smaller in group M (−0.04 [−0.04 to −0.03]℃) than that in groups T (−0.27 [−0.28 to −0.29]℃; P < 0.001) and R (−0.30 [−0.32 to −0.27]℃; P < 0.001). However, none of the fluid warmers provided a constant normothermic temperature above 36.5℃. CONCLUSIONS: Mega Acer Kit® was more effective in warming the intravenous fluid with the smallest expected change in the mean body temperature, compared to Ranger™ and ThermoSens®, at a flow rate of 440 ml/h.
Acer* ; Body Temperature ; Humans

An ovarian sex cord tumor with annular tubules(SCTAT) in an 18-year-old woman who had secondary amenorrhea but not Peutz-Jeghers syndrome was studied by light and electron microscopy. Her clinical features were consistent with those of Turner's syndrome, i.e, shortness of stature, webbing of the neck, scanty or absent axillary and pubic hairs, lower hair line with streak gonad. Chromosomal analysis revealed 45, X/46, XX karyotype. The patient has been well and disease free for a period of 2 years after surgical removal of tumor. Histologically, the tumor was composed of nests of cells arranged in simple and complex annular tubules with central acidophilic hyaline bodies. Ultrastructurally, the cells had deeply indented nuclei and the cells were joined by specialized intercellular junctions along their lateral adjacent borders. Central acidophilic hyaline body consisted of concentric lamellae of basal lamina, but Charcot-Boettcher filaments were not observed.
Female ; Humans

PURPOSE: Mucinous cells (MUCs), signet-ring cells (SRCs), and poorly differentiated cells (PDCs) are uncommon histologic types and have been associated with advanced tumor stage and poor prognosis. However, MUCs, SRCs, and PDCs are commonly observed in cancers with high microsatellite instability (MSI), which have favorable outcomes compared with cancers with microsatellite stability (MSS). The purpose of this study was to evaluate the prognostic impact of high-MSI in patients with sporadic colorectal cancer presenting with MUCs, SRCs, and/or PDCs. METHODS: Between January 2006 and December 2012, 176 with proven microsatellite status who also presented with MUCs, SRCs, and PDCs were selected for this study and were divided into 2 groups, high-MSI and MSS; their outcomes were analyzed. RESULTS: Of the 176 patients, 56 and 120, respectively, had high-MSI and MSS cancers. High-MSI cancers had larger tumors, proximal tumor location, and a lower TNM stage. The recurrence rate was lower in the high-MSI group (13.7% vs. 35.4%, P = 0.006). Common patterns of distant metastasis for MUC, SRC, PDC cancers were peritoneal spread (46.9%) and hematogenous metastasis (46.4%). The 5-year CSS rates were 88.2% and 61.2% for patients with high-MSI and MSS cancers, respectively (P < 0.0001). In the multivariate analysis, except for stage-IV cancer, MSI status was an independent risk factor for cancer-specific survival (MSS: hazard ratio, 4.34; 95% confidence interval, 1.68-11.21). CONCLUSION: In patients with colorectal cancer presenting with MUCs, SRCs, and/or PDCs, those with high-MSI cancers had better outcomes.
Colorectal Neoplasms* ; Humans ; Microsatellite Instability* ; Microsatellite Repeats* ; Mucins* ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Risk Factors

Vitamin D deficiency rickets is a metabolic disorder of growing bone, which is still important nutritional problem in developing countries. Recently we had expirienced 2 cases of typical vitamin D deficiency rickets, who were fed with only thin rice gruels and not fed any nutrient diets, breast milk, vitamin D supplements and almostly not to be exposured to sunlight for a long period of time due to poor socio-economic condition. Treatments were consisted of 600,000 units of vitamin D injection, high protein, high calorie diets and frequent exposures to sunlight. All of two were improved in clinical and laboratory findings after above therapy.
Developing Countries ; Diet ; Milk, Human ; Rickets ; Sunlight ; Vitamin D Deficiency* ; Vitamin D* ; Vitamins*

BACKGROUND: The Mega Acer Kit(R) (MAK) is a newly designed heated and humidified breathing circuit that warms fluid passing through the circuit lumen. In this study, we investigated the system's efficacy for the perioperative prevention of hypothermia and fluid warming. METHODS: Ninety patients undergoing spinal surgery were enrolled in this study and randomly assigned to 3 groups based on the fluid warming device used: no fluid warming system (Group C, n = 30), via a Standard Ranger (Group R, n = 30), or via the MAK (Group M, n = 30). Distal esophageal temperatures (Teso) and infusion fluid temperature (TF) were recorded at 15 min intervals for duration of 180 min during surgery. If Teso was < 35.0degrees C, a forced-air convective warming device was used. RESULTS: Final Teso values were 34.8 +/- 0.3degrees C, 35.1 +/- 0.1degrees C, and 35.8 +/- 0.3degrees C in groups C, R, and M, respectively (P < 0.01). Teso was significantly higher in group M when compared with that in groups C and R throughout the study period (P < 0.05). The number of patients requiring a forced-air convective warming device was significantly lower in group M (n = 0) when compared with that in groups R (n = 17) and C (n = 30) (P < 0.05). The final infusion fluid temperature was higher in group M when compared with that in groups C and R throughout the study period (35.4 +/- 1.0 vs. 23.0 +/- 0.3 and 32.8 +/- 0.6degrees C; P < 0.01). CONCLUSIONS: The MAK is more effective for preventing hypothermia and for warming fluid than the Standard Ranger.
Acer ; Esophagus ; Hot Temperature ; Humans ; Hypothermia* ; Respiration