BACKGROUND: It is known that hyperglycemia increase oxidative stress. Korean type 2 diabetic patients usually appear to be insulin deficient and insulin resistant. The blood glucose control can be normalized by the intensive insulin therapy. It has been reported that hyperinsulinemia have harmful effects on oxidative stress. The purpose of this study was to determine whether continuous subcutaneous insulin infusion (CSII) therapy by insulin pump affects the defense mechanism of oxidative stress in Korean type 2 diabetic patients. METHODS: Fasting blood from eighty three subjects was collected prior to starting CSII therapy using portable insulin pump and after hospitalization for 2 weeks. Serum and red blood cell lipid peroxide concentrations were analyzed by Yagi's methods. Serum tocopherol and vitamin C concentrations were measured by HPLC. Red blood cell glutathione peroxidase, superoxide dismutase and catalase activities were also measured. RESULTS: The mean age of subjects were 50.0+/-10.9 years, and they had diabetes for 8.4+/-5.8 years. Their average body mass index was 23.4+2.7 kg/m2. Their blood glucose levels were not controlled by oral hypoglycemic agents, diet and exercise treatment. Patients were divided into two categories according to blood glucose levels prior to CSII treatment. One category consists of patients with less than 11.1 mmol/L of average daily blood glucose levels prior to CSII treatment (the controlled group). The other category consists of patients with more than 11.1 mmol/L of average daily blood glucose levels (the uncontrolled group). Patients in the uncontrolled group had higher serum lipid peroxide levels than those in the controlled group before CSII therapy. After 2 weeks of CSII therapy, oxidative stress was not changed in controlled and uncontrolled groups. Serum insulin levels of all patients were increased after CSII treatment, but the levels before and after treatments were in the normal range, not hyperinsulinemic. Also, serum insulin levels did not correlate with serum lipid peroxide levels regardless of CSII treatment. Average serum vitamin C levels were remarkably increased after the therapy in all patients, but average serum total tocopherol levels was not altered. Also, activities of antioxidant enzymes such as glutathione peroxidase, superoxide dismutase, and catalase were not significantly changed. CONCLUSION: The blood glucose levels were normalized with the normal ranges of serum insulin levels after two weeks of CSII treatment. However, serum lipid peroxide levels were not changed even though serum vitamin C levels were increased. It is concluded that the oxidative stress of Korean type 2 diabetic patients are not changed after two weeks of CSII treatment, but there may be possibility the longer duation of CSII therapy may gradually improve oxidative stress.
Antioxidants ; Ascorbic Acid ; Blood Glucose ; Body Mass Index ; Catalase ; Chromatography, High Pressure Liquid ; Diet ; Erythrocytes ; Fasting ; Glutathione Peroxidase ; Hospitalization ; Humans ; Hyperglycemia ; Hyperinsulinism ; Hypoglycemic Agents ; Insulin* ; Oxidative Stress* ; Reference Values ; Superoxide Dismutase ; Tocopherols

Genetically engineered mouse models are used in high-throughput phenotyping screens to understand genotype-phenotype associations and their relevance to human diseases. However, not all mutant mouse lines with detectable phenotypes are associated with human diseases. Here, we propose the “Target gene selection system for Genetically engineered mouse models” (TarGo). Using a combination of human disease descriptions, network topology, and genotype-phenotype correlations, novel genes that are potentially related to human diseases are suggested. We constructed a gene interaction network using protein-protein interactions, molecular pathways, and co-expression data. Several repositories for human disease signatures were used to obtain information on human disease-related genes. We calculated disease- or phenotype-specific gene ranks using network topology and disease signatures. In conclusion, TarGo provides many novel features for gene function prediction.
Animals ; Computational Biology ; Genes, vif ; Genetic Association Studies ; Humans ; Mice ; Phenotype ; Systems Biology

Microinvasive carcinoma of the uterine cervix(FIGO stage IA) has been reported as highly curable disease even with conservative surgery such as conization and simple hysterectomy. Nevertheless, the surgical management for microinvasive carcinomas has been proposed varying from conservative surgery to radical hysterectomy with pelvic nodes dissection according to different diagnostic criterias for microinvasive carcinoma. We reviewed 512 patients who had been diagnosed as microinvasive carcinoma of the uterine cervix at the Department of Obstetrics and Gynecology, Samsung Cheil Hospital and Women's Healthcare Center from Jan. 1988 to Dec. 1995. Among them, 376 patients were included in this study satisfying guided criterias such as proper management and follow up more than at least one year, and they were analyzed retrospectively based on the clinicopathologic characteristics, pattern of surgical management and postoperative status. (continue)
Cervix Uteri* ; Conization ; Delivery of Health Care ; Diagnosis* ; Female ; Follow-Up Studies ; Gynecology ; Humans ; Hysterectomy ; Obstetrics ; Retrospective Studies

OBJECTIVE: The aim of this study was to compare vitrification optimization of mouse embryos using electron microscopy (EM) grid, cryotop, and thin plastic strip (TPS) containers by evaluating developmental competence and apoptosis rates. METHODS: Mouse embryos were obtained from superovulated mice. Mouse cleavage-stage, expanded, hatching-stage, and hatched-stage embryos were cryopreserved in EM grid, cryotop, and TPS containers by vitrification in 15% ethylene glycol, 15% dimethylsulfoxide, 10 microg/mL Ficoll, and 0.65 M sucrose, and 20% serum substitute supplement (SSS) with basal medium, respectively. For the three groups in which the embryos were thawed in the EM grid, cryotop, and TPS containers, the thawing solution consisted of 0.25 M sucrose, 0.125 M sucrose, and 20% SSS with basal medium, respectively. Rates of survival, re-expansion, reaching the hatched stage, and apoptosis after thawing were compared among the three groups. RESULTS: Developmental competence after thawing of vitrified expanded and hatching-stage blastocysts using cryotop and TPS methods were significantly higher than survival using the EM grid (p<0.05). Also, apoptosis positive nuclei rates after thawing of vitrified expanded blastocysts using cryotop and TPS were significantly lower than when using the EM grid (p<0.05). CONCLUSION: The TPS vitrification method has the advantages of achieving a high developmental ability and effective preservation.
Animals ; Apoptosis ; Blastocyst ; Dimethyl Sulfoxide ; Embryonic Structures ; Ethylene Glycol ; Ethylenes ; Ficoll ; Mental Competency ; Mice ; Microscopy, Electron ; Plastics ; Sucrose ; Vitrification

Overtube provides a conduit for the passage of endoscope into the digestive tract. Esophageal perforation with mediastinitis is a rare overtube-related complication. Until now, no reports have been published regarding the esophageal perforation which developed many months after the original procedure using the overtube. A 56-year-old female visited our hospital complaining of chest pain and back pain that began 14 days ago. The patient underwent esophageal variceal ligation using the overtube 12 months earlier. She was diagnosed with esophageal perforation with mediastinitis which extended to intervertebral and epidural space. The cause of this condition was considered to have been related to the use of overtube. Management of delayed perforation remains controversial. Although surgical management might be the preferred mode of treatment, she underwent local N-butyl 2-cyanoacrylate injection therapy and temporary stent therapy with antibiotics due to high operative risk. Herein, we report a case of overtube-related delayed esophageal perforation with mediastinitis that was successfully treated by nonoperative management.
Anti-Bacterial Agents ; Back Pain ; Chest Pain ; Endoscopes ; Epidural Space ; Esophageal Perforation* ; Female ; Gastrointestinal Tract ; Humans ; Ligation ; Mediastinitis* ; Middle Aged ; Stents

We sought to determine whether early amniocentesis is a safe and acceptable method of genetic evaluation in early pregnancy. During the 20-month period from February 1994 to September 1995, 80 consecutive early amniocentesis were performed transabdominally at 12(+3)-14(+6) weeks of gestation and 305 consecutive mid-second-trimester transabdominal amniocenteses were performed at 16(+0)-18(+0) weeks of gestation. All amniotic fluid samples were cultured using flask method. There were no significant differences between the early and mid-second-trimester amniocenteses in failed sampling, ambiguous results, pregnancy loss within 4 weeks after the procedure, pregnancy loss from 4 weeks after procedure to 28 weeks of gestation, preterm birth, and perinatal death. We may conclude that early amniocentesis is a safe and acceptable method for prenatal diagnosis.
Amniocentesis* ; Amniotic Fluid ; Female ; Pregnancy ; Premature Birth ; Prenatal Diagnosis

BACKGROUND AND OBJECTIVES: Some patients with Kawasaki disease (KD) present with fever and cervical lymphadenopathy alone. The purpose of this study was to characterize the clinical features of these unusual KD patients and determine whether this is a severe form of KD associated with increased risks of intravenous immunoglobulin (IVIG) resistance and coronary artery lesions (CALs). SUBJECTS AND METHODS: A total of 146 children with KD were reviewed retrospectively, and classified into two groups according to initial clinical features. Those presenting with only fever and cervical lymphadenopathy (LKD) were classified as LKD patients. Other-KD patients included all except the LKD patients. RESULTS: Among 146 KD patients, 13 (8.9%) were classified as LKD patients. The LKD patients were significantly older and admitted earlier. The duration between fever onset and KD diagnosis was significantly longer in the LKD patients (5.9 days vs. 4.9 days, p=0.023). The frequency of IVIG resistance was not different between the two groups., In the LKD patients, the incidence of CALs was significantly higher in the acute phase, and without significant difference in the convalescent phase. The percentage of neutrophils and C-reactive protein, albumin, and total bilirubin levels were significantly higher in LKD patients. CONCLUSION: Even though LKD patients were older, admitted earlier, and had higher inflammatory marker levels, they did not have a greater risk of CALs or IVIG resistance. However, echocardiography may be helpful in the acute stage if patients have only fever and cervical lymphadenopathy and are unresponsive to empirical antibiotics.
Anti-Bacterial Agents ; Bilirubin ; C-Reactive Protein ; Child ; Coronary Vessels ; Diagnosis ; Echocardiography ; Fever* ; Humans ; Immunoglobulins ; Immunoglobulins, Intravenous ; Incidence ; Lymphatic Diseases* ; Mucocutaneous Lymph Node Syndrome* ; Neck ; Neutrophils ; Retrospective Studies

Objective: To compare the utility and diagnostic performance of automated breast ultrasound system (ABUS) with that of handheld ultrasound (HHUS) in evaluating pure non-mass enhancement (NME) lesions on breast magnetic resonance imaging (MRI). Materials and Methods: One hundred twenty-six consecutive MRI-visible pure NME lesions of 122 patients with breast cancer were assessed from April 2016 to March 2017. Two radiologists reviewed the preoperative breast MRI, ABUS, and HHUS images along with mammography (MG) findings. The NME correlation rate and diagnostic performance of ABUS were compared with that of HHUS, and the imaging features associated with ABUS visibility were analyzed. Results: Among 126 pure NME lesions, 100 (79.4%) were malignant and 26 (20.6%) were benign. The overall correlation rate was 87.3% (110/126) in ABUS and 92.9% (117/126) in HHUS. The sensitivity and specificity were 87% and 50% for ABUS and 92% and 42.3% for HHUS, respectively, with no significant differences (p = 0.180 and 0.727, respectively). Malignant NME was more frequently visualized than benign NME lesions on ABUS (93% vs. 65.4%, p = 0.001). Significant factors associated with the visibility of ABUS were the size of NME lesions on MRI (p < 0.001), their distribution pattern (p < 0.001), and microcalcifications on MG (p = 0.027). Conclusion ABUS evaluation of pure NME lesions on MRI in patients with breast cancer is a useful technique with high visibility, especially in malignant lesions. The diagnostic performance of ABUS was comparable with that of conventional HHUS in evaluating NME lesions.

Objective: To compare the performance of simulated abbreviated breast MRI (AB-MRI) and full diagnostic (FD)-MRI in distinguishing between benign and malignant lesions detected by MRI and investigate the features of discrepant lesions of the two protocols. Materials and Methods: An AB-MRI set with single first postcontrast images was retrospectively obtained from an FD-MRI cohort of 111 lesions (34 malignant, 77 benign) detected by contralateral breast MRI in 111 women (mean age, 49.8. ± 9.8;range, 28–75 years) with recently diagnosed breast cancer. Five blinded readers independently classified the likelihood of malignancy using Breast Imaging Reporting and Data System assessments. McNemar tests and area under the receiver operating characteristic curve (AUC) analyses were performed. The imaging and pathologic features of the discrepant lesions of the two protocols were analyzed. Results: The sensitivity of AB-MRI for lesion characterization tended to be lower than that of FD-MRI for all readers (58.8– 82.4% vs. 79.4–100%), although the findings of only two readers were significantly different (p < 0.05). The specificity of AB-MRI for lesion characterization was higher than that of FD-MRI for 80% of readers (39.0–74.0% vs. 19.5–45.5%, p ≤ 0.001). The AUC of AB-MRI was comparable to that of FD-MRI for all readers (p > 0.05). Fifteen percent (5/34) of the cancers were false-negatives on AB-MRI. More suspicious margins or internal enhancement on the delayed phase images were related to the discrepancies. Conclusion The overall performance of AB-MRI was similar to that of FD-MRI in distinguishing between benign and malignant lesions. AB-MRI showed lower sensitivity and higher specificity than FD-MRI, as 15% of the cancers were misclassified compared to FD-MRI.

BACKGROUND: The differences in clinical features are important when differentiating between Alzheimer's disease (AD) and vascular dementia (VD). There have been many studies comparing the severity of progression in both diseases. They have assessed individual symptoms but have not explained the differences and global change of progression comprehensively. We have evaluated the cognitive and non-cognitive functions at the same time and evaluated the differences between AD and VD. METHODS: One hundred and thirty-eight dementia patients from Busan?Gyeongnam Dementia Association outpatient clinics were analyzed. All of the patients underwent the Korean version of the Mini-Mental State Examination (K-MMSE), the expanded version of the Korean Clinical Dementia Rating Scale (CDR), the Korean version of the Neuropsychiatric Inventory (K-NPI), the scales for activity of daily living, and the Short form of the Samsung Dementia Questionnaire (S-SDQ). RESULTS: There were 93 patients with AD and 45 with VD. VD patients revealed more severe Barthel Index of Activity of Daily Living (B-ADL) deficits. AD patients had more severe memory and orientation deficiency in CDR 1 and CDR 2. VD patients revealed much faster decline of K-MMSE score between CDR 2 and CDR 3. CONCLUSIONS: These results suggest that VD patients display more severe B-ADL difficulty, while AD patients display more severe memory difficulty and disorientation. B-ADL progresses in the earlier stages in VD and in the later stages in AD. Global cognitive dysfunction progression is the opposite: in the earlier stages in AD and in the later stages in VD.
Alzheimer Disease* ; Ambulatory Care Facilities ; Dementia ; Dementia, Vascular* ; Humans ; Memory ; Surveys and Questionnaires ; Weights and Measures