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*

BACKGROUND: Nosocomial urinary tract infection (UTI) accounts for 35% of the nosocomial infection and 80-90% of them are associated with urethral catheters. Recently, we experienced an outbreak of nosocomial UTI caused by multidrug-resistant Pseudomonas aeruginosa in neurosurgical intensive care unit (NSICU). METHODS: We investigated clinical records of the patients and observed the methods of care of urethral catheters in NSICU. Identification of P. aeruginose was done by API NE (API system; bioMerieux, France) and antibiotic susceptibility tests were done by disk diffusion method. Random Amplification of Polymorphic DNA (RAPD) assay was used as a genotyping method. RESULTS: Between November 1997 and January 1998, 11 P. aeruginosa strains were isolated from the urine of 11 patients hospitalized in NSICU of Kangnam St. Mary's Hospital. Routine regular bladder irrigation, and emptying urine with common urinal had been done falsely. Antibiogram of the isolates showed resistance to multiple antibiotics including imipenem, gentamicin. amikacin, piperacillin, ciprofloxacin, ceftazidime, and cefoperazone/sulbactam. RAPD of the outbreak strains showed clonal relatedness, which was different from those of other clinical strains, We instructed all the health care workers to stop bladder Irrigation, and to use the separate urinals for each patient. Thereafter, no further case of P. aeruginosa UTI has occurred. CONCLUSION: An outbreak of UTI, caused by a single clone of P. aeruginosa, was confirmed by RAPD and was eradicated after correction of false practice on care-of urinary catheter.
Amikacin ; Anti-Bacterial Agents ; Ceftazidime ; Ciprofloxacin ; Clone Cells ; Cross Infection ; Delivery of Health Care ; Diffusion ; DNA ; Drug Resistance, Multiple ; Gentamicins ; Humans ; Imipenem ; Intensive Care Units ; Microbial Sensitivity Tests ; Piperacillin ; Pseudomonas aeruginosa* ; Pseudomonas* ; Urinary Bladder ; Urinary Catheters ; Urinary Tract Infections* ; Urinary Tract*

Granulomatous(lobular) mastitis is a distinct disease entity of unknown etiology which is characterized by noncaseating granulomatous lobulocentric inflammation. We describe a rare case of granulomatous(lobular) mastitis of a 36 year-old pregnant woman a review of the literature. The mass which was discovered in the third month of her pregnancy, began as a localized, nontender mass on the left breast and persisted during her entire pregnancy. It decreased slightly in size when she began taking post-partum bromocriptine. Clinically and mammographically, the mass was highly suspected as a carcinoma with axillary lymph node metastasis. Fine needle aspiration smears revealed numerous aggregates of granulomas composed of epithelioid histiocytes admixed with multinucleated giant cells of Langhans' and foreign body type, and collections of polymorphonuclear leukocytes. Ziehl-Neelsen, silver methenamine and PAS stain were negative for acid-fast bacilli, fungus, and bacilli on the smear respectively. Histologically, granulomatous inflammation was centered on the breast lobules. Caseation necrosis was absent, instead, numerous microabscesses were formed in the center of the granulomas. Cultures of the fresh tissue for the AFB, aerobic and anaerobic bacteria, and fungus were all negative. Excision of the mass was performed without further treatment and there was no recurrence of the mass 6 months postoperatively. An autoimmune mechanism, infection, and some association with oral contraceptives have been suggested as etiologic factors in the literature.
Pregnancy ; Female ; Humans

McCune-Albright syndrome, which consists of cafe-au lait spots, multiple fibrous dysplasia, sexual precocity and endocrinal dysfunction such as pituitary, thyroid and adrenal aberrations, has been increasingly recognized recently. The etiology is now suggested that activating mutations on the gene that encodes the alpha subunit of stimulatory G protein cause McCune-Albright syndrome. The child presented with sexual precocity and elevated estrogen level was still persisted after left oophorectomy and right partial oophorectomy due to misdiagnosed as ovarian granulosa-theca cell tumor. Whole body bone scan revealed abnormal radiotracer uptake on left facial bone and left proximal femur. Facial bone MRI showed marked thickening of facial bone from fibrous dysplasia. And the patient had cafe-au-lait pigmentations on neck and buttock area. Other endocrine function was normal. Pathologic finding of ovary was finally confirmed with cystic follicles. Skull biopsy revealed fibrous dysplasia. And she was finally diagnosed McCune-Albright syndrome.
Biopsy ; Buttocks ; Cafe-au-Lait Spots ; Child ; Estrogens ; Facial Bones ; Female ; Femur ; Fibrous Dysplasia, Polyostotic* ; GTP-Binding Proteins ; Humans ; Magnetic Resonance Imaging ; Neck ; Ovariectomy ; Ovary ; Pigmentation ; Skull ; Thyroid Gland

The human oral mucosa has noncornified lining epithelium, cornified masticatory epithelium, and complex epithelium. The epithelium of human tongue shows diverse morphological variations from one site to another, and conflicting reports exist in the literature concerning the type of lingual epithelium. Cytokeratin[CK] have been shown to characterize different type of epithelia. In the present study to clarify intermediate filament patterns of tongue mucosa and lingual gland in human fetus from second trimester of pregnancy and adult, cytokeratin expression was investigated immunohistochemically using antibodies for cytokeratins in the dorsal surface of tongue, taste bud, and lingual gland, and comparison with the expression between fetus and adult was made. The epithelium of the fetal lingual papillae consisted of 4 to 6 layered stratified cells, and that of the inferior surface of tongue consisted of 6-8 layered stratified cells in PAS-hematoxylin stain. The lingual gland was well differentiated and the alveolus was strongly positive to PAS reaction. The dorsal surface of the adult tongue was composed of lingual papillae. The papillae was covered by keratinized stratified squamous epithelium and interpapillary area by nokeratinized epithelium in hematoxylin-eosin stain. The taste bud was present in the fungiform papilla. The lingual gland appeared among the muscle layers near the inferior surtace and was composed of mucous and serous cells. By immunohistochemical stain, the epithelium of the lingual papillae exhibited various staining-intensities for cytokeratin antibodies, and showed same staining patterns bosh epithelium in tip of papilla and interpapillary area in fetus. However, the dorsal epithelium of the adult tongue showed different staining patterns between tip of the papilla and interpapillary area. In fetal lingual papilla CK7 and CK8 were expressed in superficial cells, AE8 in intermediate and superficial cells, CKl4 in basal cells. MNFI116 and AE3 showed a strong reaction in basal and suprabasal cells. The epithelium of the inferior lingual surface reacted positively with AE8 and CK14, MNF116, and AE3. CK7 and CK8, however, were not reacted. In adult lingual papilla CK10 was expressed in superficial cells of the tip of the papilla, AE8 in suprabasal cells of interpapillary epithelium, CKl4 in basal cells of papillary and interpapillary epithelium, CKl9 in superficial cells of interpapillary epithelium, MNFI116 and AE3 in suprabasal cells of papillary and interpapillary epithelium. However, CK7, CK8, CK18, and 5D3 were not expressed in the epithelium of the dorsal tongue. The cells of taste bud in fetus showed positive reactions for CK7, CK8, MNF116, and AE3, but negative reactions with CK10 and AE8. The cells of taste bud in adult were stained with CK7, CK8, CK18, and MNF116, but not stained with CK10 and AE8. In lingual gland of fetus, CK7, CK8, CKl8, 5D3, MNF116, and AE3 were expressed in alveolar cells. Only CK10 gave a negative staining in ductal cells. The mucous cells of the adult lingual gland were reacted with CK7, CK10, CK18, CK19, and MNF116, and the serous cell with CK7, CK19, and MNF116. The ductal cells of the adult lingual gland were stained with CK7, AE8, CK18, CKl9, 5D3, MNF116, and AE3. CK14 was expressed in the cells of intralubular ductule, not in the ductal cells. By electron microscopy, the epithelia of both dorsal and inferior lingual surfaces in fetus consisted of nonkeratinized stratified squamous epithelium. A cell with clear cytoplasm and some dense granules was noted among the basal cells. These results indicate that the epithelium of fetal lingual papillae is non-keratinized type and the epithelium of the papillary tip is keratinized type and interpapillary epithelium is nonkeratinized type in adult, and suggest that the superficial cell containing cytokeratins 7 and 8 in dorsal lingual epithelium of fetus has a similar role to the periderm of fatal skin.
Adult ; Antibodies ; Cytoplasm ; Epithelium* ; Female ; Fetus* ; Humans* ; Immunohistochemistry ; Intermediate Filaments ; Keratins ; Microscopy, Electron ; Mouth Mucosa ; Mucous Membrane ; Negative Staining ; Periodic Acid-Schiff Reaction ; Pregnancy ; Pregnancy Trimester, Second ; Skin ; Taste Buds ; Tongue

PURPOSE: Leptin has been considered a link between metabolic state and reproductive activity. Defective reproductive function can occur in leptin-deficient and leptin-excessive conditions. The aim of this study was to examine the effects of centrally injected leptin on the hypothalamic KiSS-1 system in relation to gonadotropin-releasing hormone (GnRH) action in the initial stage of puberty. METHODS: Leptin (1 microg) was injected directly into the ventricle of pubertal female mice. The resultant gene expressions of hypothalamic GnRH and KiSS-1 and pituitary LH, 2 and 4 hours after injection, were compared with those of saline-injected control mice. The changes in the gene expressions after blocking the GnRH action were also analyzed. RESULTS: The basal expression levels of KiSS-1, GnRH, and LH were significantly higher in the pubertal mice than in the prepubertal mice. The 1-microg leptin dose significantly decreased the mRNA expression levels of KiSS-1, GnRH, and LH in the pubertal mice. A GnRH antagonist significantly increased the KiSS-1 and GnRH mRNA expression levels, and the additional leptin injection decreased the gene expression levels compared with those in the control group. CONCLUSION: The excess leptin might have suppressed the central reproductive axis in the pubertal mice by inhibiting the KiSS-1 expression, and this mechanism is independent of the GnRH-LH-estradiol feedback loop.
Aluminum Hydroxide ; Animals ; Axis, Cervical Vertebra ; Carbonates ; Female ; Gene Expression ; Gonadotropin-Releasing Hormone ; Humans ; Leptin ; Luteinizing Hormone ; Mice ; Puberty ; RNA, Messenger

Interferons(IFNs) exhibit an antiproliferative effect on many normal and transformed cells and have in vivo antitumor activity in a variety of cancers. Recent clinical studies have suggested major activity with IFNs, especially in advanced squamous cell carcinoma of the skin and cervix. With the objective of exploring how the IFNs might work in squamous carcinoma cell line, we studied the effect of IFN-a on cervical cancer cell lines. The effect of IFNs on apoptosis and cell cycle of cervical cancer cell lines(C33A, CaSki, SiHa, HeLa, ME-180) was analysed by flow cytometry in time dependent manner. Results were as follows: (1) According to cell count of studied cancer cell lines treated with 2,000 IU/ml IFN-a for 7 days exposure, IFN-a had the antiproliferative effect on all five tested cervical cancer cell lines. Also this antiproliferative effect was confirmed by WST-1 assay. (2) The effect of IFN-a on apoptosis of each cultute was analysed by flow cytometry after 3 days and 7 days exposure with 2,000 IU/ml IFN-a, Apoptosis was not induced by IFN-a treatment. (3) The effect of IFN-a on the cell cycle of each culture was analysed by flow cytometry after 3 days exposure with 2,000 IU/ml IFN-a. As compared to control cells, treatment with IFN-a resulted in a higher proportion of cells in S phase with lower portion of cells with G2/M phase. (4) Time course of IFN-a effect on HPV 16 and HPV 18 E6 mRNA levels was evaluated by northern blot analysis. In CaSki cell line, HPV 16 E6 mRNA expression induced by IFN-a was not inhibited. But in HeLa cell line, HPV 18 E6 inRNA expression was inhibited. IFN-a appears to have the antiproliferative effect on all five tested cervical cancer cell lines and the antiproliferative effect of IFN-a seemed to be induced not by apoptosis but by disruption on specific cell cycle. Also regulation of HPV E6 mRNA expression induced by IFN-a is not directly related to the mechanisms of the antiproliferative effect of IFN-a in cancer cell lines.
Apoptosis ; Blotting, Northern ; Carcinoma, Squamous Cell ; Cell Count ; Cell Cycle ; Cell Line* ; Cervix Uteri ; Female ; Flow Cytometry ; HeLa Cells ; Human papillomavirus 16 ; Human papillomavirus 18 ; Humans ; RNA, Messenger ; S Phase ; Skin ; Uterine Cervical Neoplasms*

Myasthenia gravis is an autoimmune disorder, caused by the presence of anti-ac- etylcholine receptor antibody or acetylcholine-receptor deficiency and involved neuro- muscular endplate. The clinical course and outcome of myasthenia gravis are variable during pregnancy. The special caution and adequate management for myasthenic mother and myasthenia gravis occurred newborn of myasthenic mother are essential for good perinatal outcomes. We experienced a case of myasthenia gravis associated with pregnancy who underwent cesarean section. We present this case with a brief review of literatures.
Cesarean Section ; Female ; Humans ; Infant, Newborn ; Mothers ; Myasthenia Gravis* ; Myasthenia Gravis, Neonatal ; Pregnancy*

PURPOSE: Noonan syndrome (NS), congenital malformation syndrome characterized by distinct facial anomalies, short stature and variable congenital heart defects, is thought to be caused by mutations of the gene for PTPN11 (protein-tyrosine phosphatase, nonreceptor type 11). The aim of this study is to know the type and detection rate of mutations of PTPN11 in NS. METHODS: This study consisted of 17 NS patients (11 males and 6 females). All of the NS patients met the diagnostic criteria proposed by van der Burgt et al. The leukocyte genomic DNA of each patients was amplified by PCR for 7 exons, where the mutations had been reported so far, out of 15 exons of PTPN11 gene. And the PCR products were subjected to direct sequencing from both directions. RESULTS: All 17 NS patients were sporadic cases. Heterozygous PTPN11 mutations were identified in 3 of the 17 patients (17.6%, all males). All mutations were known missense mutations. They consist of two D61N in exon 3 and one S502T in exon 13. CONCLUSION: This study showed 17.6% (3/17) of detection rate of PTPN11 gene mutation in NS. This is smaller than that of previous reports. The further study with larger number of cases will be needed to analyse type of mutation and genotype-phenotype correlation.
DNA ; Exons ; Genetic Association Studies ; Heart Defects, Congenital ; Humans ; Leukocytes ; Male ; Mutation, Missense ; Noonan Syndrome* ; Polymerase Chain Reaction

No abstract available.
Paragonimiasis*