The effect of persistant mild hyperglycemic hyperinsulinemia on the development of the insulin resistance in rats was studied in vivo. Also, the characteristics of the insulin resistance compared with the insulin resistance of STZ diabetic rats. Persistant mild hyperglycemic hyperinsulinemic rat model was produced by ingestion of glucose polymer for 8 days. The glucose disappearance and infusion rate was measured by hyperinsulinemic euglycemic clamp to"Imique at steady state of blood glucose and insulin levels. The clamped level of blood glucose was 100 mg/dl, and the clamped levels of insulin were 70 pU/ml (physiologic condition) and 3000 pU/ml (supramaximal condition). Hepatic glucose producticon rate was calculated using measured data. And the glycogen synthetic capacity of skeletal muscle(soleus) and liver was measured after 2 hours of hyperinsulinemic euglycemic clamp study. The glucose disappearance and glucose infusion rate in glucose polymer group was decreased in the both physiological and supramaximal insulin level compared to the rate of the normal control group. The rate of STZ diabetic group wase lowest at supramaximal insulin level among two another experimental groups. The hepatic glucose production rate of glucose polymer group was decreased compared to normal control but increased in STZ diabetic group.
Animals ; Blood Glucose ; Eating ; Glucans ; Glucose ; Glucose Clamp Technique ; Glycogen ; Hyperinsulinism* ; Insulin Resistance* ; Insulin* ; Liver ; Models, Animal ; Rats*

The influence of normal late pregnancy on insulin action and insulin secretion was studied in the Sprague-Dawley female rats. On 20th day after mating, intravenous glucose tolerance test(IVGTI) was performed in non pregnant control and pregnant rats. As results of IVGTT, glucose disappearance rate was not significantly different in both groups, but secretory response of insulin was significantly(p<0.05) increased in pregnant rat. And the ratio of insulin/ .glucose was significantly higher in pregnant rats, which means existence of insulin resistance. These insulin resistance was overcomed by increased secretory response of pancreatic insulin. Insulinogenic index( A insulin/glucose - 5 min) was highly significantly (r=0.62, p<0.01) correlated with progesterone concentration. Glycogen level and amounts of "C-glucose incorporated into glycogen after IVGTT were significantly(p<0. 05) decreased in the liver, but were not changed significantly in soleus. Glycogen synthase activity of soleus and liver was not differ significantly in the both groups. Insulin binding at varying concentrations of insulin to crude membrane of pregnant liver was not significantly different from control. In conclusions, although these pregnant rats were normal glucose tolerance due to increased secretory response of insulin, that was correlated with progesterone concentration, pregnant rat had insulin resistance. The mechanisms of insulin resistance were not related to defect of insulin binding phase and glycogen synthase, but suggest pre-receptor and/or postreceptor phase.
Animals ; Female ; Glucose ; Glucose Tolerance Test ; Glycogen ; Glycogen Synthase ; Humans ; Insulin Resistance* ; Insulin* ; Liver ; Membranes ; Pregnancy ; Progesterone ; Rats* ; Rats, Sprague-Dawley ; Receptor, Insulin

BACKGROUND: This study was undertaken to evaluate the analgesic effect of a self administered surgical wound infusion of local anesthetic alone compared to combination of local anesthetic and morphine or ketorolac. METHOD: Forty eight patients undergoing minor surgery were randomly classified into four groups: Group 1 (saline, n = 10), Group 2 (bupivacaine only, n = 11), Group 3 (bupivacaine with morphine, n = 14), and Group 4 (bupivacaine with ketorolac, n = 13). A two-hole 19 G epidural catheter was tunneled subcutaneously into the surgical wound and was connected to 100 ml elastometric balloon pump filled with either 0.5% bupivacaine only, 0.5% bupivacaine and morphine 40 mg, or 0.5% bupivacaine and ketorolac 80 mg. We assessed the postoperative visual analogue scale (VAS) pain scores at postoperative 0.5, 1, 2, 6, 12, 24, 36, and 48 hours, and the side effects, sedation score and total amount of infused bupivacaine were recorded. RESULTS: VAS pain score were significantly decreased until 36 hours in groups 2, 3, and 4 compared to group 1, and significantly lower at 1, 2, 12, and 24 hrs in groups 3, 4 than in group 2 (P < 0.05). The total requirement of infused bupivacaine in groups 3, 4 is significantly decreased compared to that of group 2. Side effects like nausea, vomiting, urinary retension, pruiritis, respiratory difficulty, sedation, and dizziness did not occur in the four groups but seroma did in one case. CONCLUSION: Patient-controlled surgical wound infusion of bupivacaine reduced postoperative pain after minor surgery without any side effects. The combination of bupivacaine with morphine or ketorolac gave rise to a significant additive effect to local analgesia.
Analgesia ; Analgesia, Patient-Controlled* ; Bupivacaine ; Catheters ; Dizziness ; Humans ; Ketorolac ; Morphine ; Nausea ; Pain, Postoperative ; Seroma ; Surgical Procedures, Minor ; Vomiting ; Wounds and Injuries*

We describe a 27-year-old man who developed gait disturbance and dysarthria 2 years after the onset of cardinal symptoms of Behcet's disease. Positron emission tomography with 18F-fluorodeoxyglucose revealed severe hypometabolism in the cerebellum, in accordance wih cerebellar symptoms and sign of the patient. However, single-photon emission tomography with Tc-99m-HMPAO and Tc-99m-ECD did not disclose significant perfusion abnormalities in the brain. Routine brain magnetic resonance imaging did not show signal abnormalities. The findings of imaging studies compared with neurological manifestations of the patient are discussed.
Adult ; Brain ; Cerebellum ; Dysarthria ; Gait ; Humans ; Magnetic Resonance Imaging* ; Neurologic Manifestations ; Perfusion ; Positron-Emission Tomography ; Tomography, Emission-Computed, Single-Photon*

Purpose: The purpose of this pilot study is to identify the problems and stability of a study to investigate “Effects of Squat Exercise according to Weight Support on Balance and Gait in Patients after Total Hip Replacement.” before proceeding with the study. Methods: Twenty-two rehabilitation patients after THR surgery who met the selection criteria participated. The study subjects were randomly assigned to a squat group using a slider or a squat group using a reformer. The interventions were applied for two weeks. The patients were assessed using Berg balance scale (BBS), Timed up and go test (TUG), and 10-meter walking test (10MW). Results: Although twenty-two study subjects participated in this study, eight study subjects participated dropouts occurred during the study period. There was a significant difference within the group in BBS and TUG in two groups (p < 0.05). The difference between the two groups was not significant in all outcome measures (p > 0.05). The largest effect size was 1.21 and the smallest effect size was 0.39, all from the BBS. Conclusion This pilot study suggest that it is feasible with minor adjustment to conduct a larger scale, powered RCT to examine the efficacy of squat exercise according to weight support with patients after THR.

No abstract available.
Heel* ; Melanoma, Amelanotic* ; Ulcer*

The incidence of malignant adrenal tumors, including primary adrenal lymphoma (PAL) and adrenocortical carcinoma (ACC), is rather low. Early differentiation between ACC and PAL is necessary because the therapeutic strategies for the two differ and the prognosis of each disease is poor. Unfortunately, there is no pathognomonic characteristic of PAL, so radiologists have difficulty in differentiating it from ACC. To our knowledge, there have been only two case reports on ACC that was evaluated and followed up using F-18 FDG PET/CT. The previously reported cases were simple, involving only the bilateral adrenal glands. Here, we report on a 52-year-old man diagnosed with PAL that radiologically mimicked ACC. He had findings of heterogeneous enhancement on CT, several adjacent lymphadenopathies with internal necrosis, and abutting hepatic and bilateral crural invasion. After pathological confirmation, we monitored his prognosis using F-18 FDG PET/CT after three cycles of rituximab-CHOP and again after six cycles of treatment.
Adrenal Glands ; Adrenocortical Carcinoma* ; Follow-Up Studies* ; Humans ; Incidence ; Lymphoma ; Lymphoma, B-Cell* ; Lymphoma, Non-Hodgkin ; Middle Aged ; Necrosis ; Positron-Emission Tomography and Computed Tomography* ; Prognosis

Obesity is a major public health issue worldwide and is frequently associated with erectile dysfunction (ED). Both conditions may share an internal pathologic environment, also known as common soil. Their main pathophysiologic processes are oxidative stress, inflammation, and resultant insulin and leptin resistance. Moreover, the severity of ED is correlated with comorbid medical conditions, including obesity. Therefore, amelioration of these comorbidities may increase the efficacy of ED treatment with phosphodiesterase 5 inhibitors, the first-line medication for patients with ED. Although metformin was originally developed as an insulin sensitizer six decades ago, it has also been shown to improve leptin resistance. In addition, metformin has been reported to reduce oxidative stress, inflammatory response, and body weight, as well as improve ED, in animal and human studies. Moreover, administration of a combination of metformin and phosphodiesterase 5 inhibitors improves erectile function in patients with ED who have a poor response to sildenafil and are insulin resistant. Thus, concomitant treatment of metabolic derangements associated with obesity in patients with ED who are obese would improve the efficacy and reduce the refractory response to penile vasodilators. In this review, we discuss the connecting factors between obesity and ED and the possible combined treatment modalities.
Animals ; Body Weight ; Comorbidity ; Erectile Dysfunction ; Humans ; Inflammation ; Insulin ; Leptin ; Male ; Metformin ; Obesity ; Oxidative Stress ; Phosphodiesterase 5 Inhibitors ; Public Health ; Sildenafil Citrate ; Soil ; Vasodilator Agents

In the spring of 2011, a cluster of lung injuries caused by humidifier disinfectant (HD) usage were reported in Korea. Many patients required mechanical ventilation, extracorporeal membrane oxygenation, and even lung transplantation (LTPL). However, the long-term course of HD-associated lung injury remains unclear because the majority of survivors recovered normal lung function. Here we report a 33-year-old woman who underwent LTPL approximately four years after severe HD-associated lung injury. The patient was initially admitted to the intensive care unit and was supported by a high-flow nasal cannula. Although she had been discharged, she was recurrently admitted to our hospital due to progressive lung fibrosis and a persistent decline in lung function. Finally, sequential double LTPL was successfully performed, and the patient's clinical and radiological findings showed significant improvement. Therefore, we conclude that LTPL can be a therapeutic option for patients with chronic inhalation injury.
Adult ; Catheters ; Disinfectants ; Extracorporeal Membrane Oxygenation ; Female ; Fibrosis ; Humans ; Humidifiers* ; Inhalation ; Inhalation Exposure ; Intensive Care Units ; Korea ; Lung Injury* ; Lung Transplantation* ; Lung* ; Oxygen Inhalation Therapy ; Respiration, Artificial ; Survivors

The purpose of the present study was to determine the preventive effects of combined interventional trial of fish oil treatment and exercise training on insulin resistance of skeletal muscle in high-fat fed rats. Male Wistar rats were randomly divided into chow diet (CD), high-fat diet (HF), high-fat diet with fish oil (FO), high-fat diet with exercise training (EX), and FO+EX groups. The rats in control group were fed chow diet containing, as percents of calories, 58.9% carbohydrate, 12.4% fat, and 28.7% protein. High-fat diet provided 32% energy as lard, 18% as corn oil, 27% as carbohydrate and 23% as casein. The fish oil diet had the same composition as the high fat diet except that 100 g menhaden oil was substituted for corn oil. Insulin sensitivity was assessed by in vitro glucose transport in the soleus muscle after diet treatment and treadmill running for 4 weeks. While the FO or EX only partially prevented insulin resistance on glucose transport and visceral obesity induced by high-fat diet, these interventions completely corrected hyperinsulinemia and hyperglycemia from the high-fat diet. The rats in the FO+EX showed normalized insulin action on glucose transport, plasma chemicals and visceral fat mass. Insulin-mediated glucose transport was negatively associated with total visceral fat mass (r=-0.734; p<0.000), plasma triglyceride (r=-0.403; p<0.05) and lepin (r=-0.583; p<0.001) concentrations with significance. Multiple stepwise regression analysis showed that only total visceral fat mass was independently associated with insulin-mediated glucose transport (r=-0.668; p<0.000). In conclusion, combined interventional trial of FO+EX recovered insulin resistance on glucose transport of skeletal muscle induced by high-fat diet. Visceral fat mass might be more important factor than plasma TG and leptin to induce insulin resistance on glucose transport of skeletal muscle in high-fat fed rats.
Animals ; Caseins ; Corn Oil ; Diet ; Diet, High-Fat* ; Glucose* ; Humans ; Hyperglycemia ; Hyperinsulinism ; Insulin Resistance ; Insulin* ; Intra-Abdominal Fat ; Leptin ; Male ; Muscle, Skeletal* ; Obesity, Abdominal ; Plasma ; Rats* ; Rats, Wistar ; Running ; Triglycerides