OBJECTIVE: To investigate whether there is a significant effect of growth hormone(GH) treatment with diet and exercise over the diet and exercise alone in obese non-insulin dependent diabetes mellitus(NIDDM). METHOD: Twenty obese NIDDM adults were studied. We measured the body weight, body composition and exercise capacity before and after 12 weeks of treatment program. The subjects were assigned in a double-blind manner either to the diet, aerobic exercise with placebo treatment group(group A) or to the diet, aerobic exercise with GH treatment group(group B) for twenty-week period. Two groups were compared for the demographic data. RESULTS: After 12-weeks of treatment program, each group showed a significant weight loss (group A: 8.54+/-2.29 kg vs group B: 7.14+/-2.99 kg) than before the treatment, however there was no significant weight loss between two groups. After 12-weeks, the fat fraction of body weight loss was significantly higher in group B than group A(0.80+/-0.40%kg versus 0.55+/-0.30%kg). After 12-weeks, the maximal oxygen consumption was similarly increased in both groups(23.75% in the group A versus 29.2% in the group B). After 12-weeks, the peak torque was similarly increased in both groups(9.7% in the group A versus 17.3% in the group B). After 12-weeks, the endurance was similarly increased in both groups(10.1% in the group A versus 8.1% in the group B). CONCLUSION: Both group A and B showed a significant weight loss and resulted in a comparable gain in the muscle strength, endurance, and maximal oxygen consumption. The addition of GH in a low dose to a the calorie-restricted diet and aerobic exercise resulted in a significant fat loss especially around the visceral area.
Adult ; Body Composition ; Body Weight ; Diabetes Mellitus, Type 2 ; Diet* ; Exercise ; Growth Hormone* ; Humans ; Muscle Strength ; Obesity ; Oxygen Consumption ; Torque ; Weight Loss

BACKGROUND/AIMS: Although intravenous proton pump inhibitor (PPI) has been used for the prevention of post endoscopic submucosal dissection (ESD) bleeding, the route of administration has not been confirmed. The aim of the present study was to compare the efficacy of intravenous and oral PPI administration for the prevention of delayed post ESD bleeding. METHODS: Total 166 consecutive patients were randomly assigned to 30 mg lansoprazol twice a day (PO group) and 120 mg pantoprazole intravenous injection (IV group) for 48 hours. Finally, 65 patients in PO group and 87 patients in IV group were analyzed. After ESD, all patients underwent follow up endoscopy after 24 hours and were observed the symptoms of bleeding up to 60 days after ESD. RESULTS: Age, sex and use of anticoagulants were not different between groups. At follow up endoscopy after 24 hours, oozing and exposed vessel was noted in 4.6% of PO group and 8.0% of IV group and there was no significant difference. Delayed bleeding occurred in 4 of 65 patients (6.2%) in the PO group and 8 of 87 patients (9.2%) in the IV group (p>0.999). By multivariate analysis, oozing or exposed vessels at follow up endoscopy were risk factors for delayed bleeding (OR=17.5, p=0.022). CONCLUSIONS: There was no significant difference in the delayed bleeding, length of hospital stay according to the administration route. Bleeding stigmata at follow up endoscopy was risk factor of delayed bleeding. Oral PPI administration can cost-effectively replace IV PPI for prevention of post ESD bleeding.
2-Pyridinylmethylsulfinylbenzimidazoles/therapeutic use ; *Administration, Oral ; Aged ; Anticoagulants/therapeutic use ; Endoscopic Mucosal Resection/*adverse effects ; Female ; Gastroscopy ; Humans ; *Injections, Intravenous ; Lansoprazole/therapeutic use ; Male ; Middle Aged ; Odds Ratio ; Postoperative Hemorrhage/etiology/*prevention & control ; Prospective Studies ; Proton Pump Inhibitors/*therapeutic use ; Risk Factors ; Stomach Neoplasms/surgery

Takayasu's arteritis is generally recognized as a chronic, idiopathic, inflammatory disease, which affects the aorta and the proximal portions of its major branches. We experienced a patient with Takayasu's arteritis who was presented with main pulmonary artery stenosis and right coronary ostial occlusion without involvement of aorta nor its major branches. She was managed with pulmonary arterioplasty and coronary artery bypass graft. This case emphasize that the disease cannot affect the aorta.
Aorta ; Constriction, Pathologic* ; Coronary Artery Bypass ; Coronary Vessels* ; Humans ; Pulmonary Artery* ; Takayasu Arteritis* ; Transplants

OBJECTIVES: To evaluate the compatability of high school students' desks and chairs to the fittness of their physique, to examine the factors related the posture and pain while they use the classroom desks and chairs, and to analyze the curvature of spine in sitting position. METHOD: Measurements of the dimensions of desks and chairs and a written survey to question students' habits regarding to the usage of classroom desks and chairs along with the physical examinations of spine including the analysis of spine curvature in sitting position with an electrogoniometer. RESULTS: Seven hundred forty nine among 831 male students, and 1,017 among 1,074 female students, complained of discomforts associated with the usage of classroom desks and chiairs. An examination of spine in sitting position using an electrogoniometer showed that both male and female subjects displayed the spine curvatures in the order of thoracic kyphosis, lumbar lordosis, and scoliosis. All subjects displayed pain in the order of low back(38.8%), posterior neck(23.9%), shoulder and elbow joints(15.8%), and buttock(15.7%). CONCLUSION: The study revealed an urgent need for the adaptation of classroom desks and chairs according to the growing physique of the adolescents. A majority of the teenaged subjects experienced the discomfort from the use of improper funiture and a poor posture. Authors highly recommend a formal education to the students regarding the importance of proper posture and the usage of adjustable desks and chairs.
Adolescent* ; Animals ; Education ; Elbow ; Female ; Humans ; Kyphosis ; Lordosis ; Male ; Physical Examination ; Posture ; Scoliosis ; Shoulder ; Spine

BACKGROUND/AIMS: Several studies have reported an association between antiphospholipid antibodies (APA) and major adverse cardiovascular events (MACE) following acute myocardial infarction (AMI). However, the relationship between APA and the prognosis after drug-eluting stent (DES) implantation in patients with AMI is not known. METHODS: Thus, we investigated the relationship between the incidence of MACE and APA levels in patients with AMI who underwent successful DES implantation. RESULTS: Of 182 patients, 78 (42.9%) tested positive for APA. Lupus anticoagulant was positive in 37.6% (68 of 181) patients, anticardiolipin antibody IgM was positive in 8.3% (15 of 180), and anticardiolipin antibody IgG was positive in 1.7% (3 of 180) patients. At follow up, a MACE had occurred in 11 (14.1%) patients in the APA-positive group and in seven (6.7%) patients in the APA-negative group (p = 0.099). CONCLUSIONS: No significant association was found between the incidence of MACE and the presence of APA in patients with AMI who underwent successful DES implantation.
Antibodies, Anticardiolipin ; Antibodies, Antiphospholipid ; Drug-Eluting Stents ; Follow-Up Studies ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Incidence ; Lupus Coagulation Inhibitor ; Myocardial Infarction ; Prognosis

Platelets play an important role in the development of acute coronary syndrome. Platelet-inhibiting drugs, such as glycoprotein IIb/IIIa inhibitors, can be beneficial when they are administered at the time of primary percutaneous coronary intervention for acute coronary syndrome. Although an increased risk for bleeding complications is well recognized, the risk associated with diffuse alveolar hemorrhage is much less reported. We report a case of diffuse alveolar hemorrhage after using abciximab.
Acute Coronary Syndrome ; Antibodies, Monoclonal ; Blood Platelets ; Glycoproteins ; Hemoptysis ; Hemorrhage ; Immunoglobulin Fab Fragments ; Percutaneous Coronary Intervention

BACKGROUND AND OBJECTIVES: Left ventricular (LV) dyssynchrony has been commonly detected among hypertensive patients with normal LV systolic function and no evidence of congestive heart failure. The purpose of our study was to assess the changes in LV systolic dyssynchrony (SDSLV) among hypertensive patients after antihypertensive treatment, and to determine the relationship between SDSLV and other conventional echocardiographic parameters. SUBJECTS AND METHODS: Forty one hypertensive patients with normal LV ejection fraction were enrolled. By performing a conventional echocardiographic study, the SDSLV was measured as the time difference between the shortest and longest time of the peak myocardial systolic velocities among 12 segments of the basal and mid-levels of the 3 apical views, and radial dyssynchrony of the basal (RDSbase) and mid-levels (RDSmid) measured as the time difference between the earliest and latest peak values on the radial strain curves of each level of the parasternal short-axis views. RESULTS: Compared to baseline after six months of antihypertensive treatment, the SDSLV improved significantly (48.7+/-37.9 ms vs. 29.5+/-34.1 ms, p=0.020). Also the RDSbase and RDSmid improved significantly in respect to the baseline values (129.9+/-136.3 ms vs. 38.8+/-45.4 ms, p=0.002 and 75.2+/-63.8 ms vs. 28.2+/-37.7 ms, respectively, p<0.001). CONCLUSION: The severity of SDSLV improved with antihypertensive treatment, and was associated with the regression of LV mass. Furthermore, it might precede improvement in the mitral inflow pattern, as assessed by conventional echocardiography, so that early detection of the benefit of antihypertensive treatment may be possible.
Echocardiography ; Heart Failure ; Humans ; Hypertension ; Sprains and Strains

Ethylene glycol is commonly incorporated into automotive antifreeze agents and a variety of other commercial products. Ethylene glycol poisoning can cause life-threatening metabolic acidosis, cardiopulmonary failure, and renal failure that may be fatal. We present an unusual case of a patient who ingested a large amount of ethylene glycol for the purpose of suicide and developed multiorgan damage, including acute renal failure followed by uremic pericarditis and cardiac tamponade. This unusual complication was effectively managed with echocardiography-guided percutaneous pericardiocentesis and continuous catheter drainage for 3 days. After intensive hemodialysis and supportive care, the patient made a good recovery with near normal cardiac and renal function. Physicians should be aware of the possibility of acute pericarditis and cardiac tamponade in cases of acute renal failure caused by ethylene glycol poisoning.
Acidosis ; Acute Kidney Injury ; Cardiac Tamponade ; Catheters ; Drainage ; Ethylene Glycol ; Ethylenes ; Humans ; Pericardiocentesis ; Pericarditis ; Renal Dialysis ; Renal Insufficiency ; Suicide

Brucellosis is usually transmitted to human by direct contact with infected animals or by ingestion of unpasteurized dairy products. Because of the wide spectrum of its clinical manifestations, brucellosis may appear as other infections and asymptomatic conditions and, therefore, the diagnosis of the disease is frequently missed or delayed. A 41-years-old livestock worker was attended at a local clinic with headache, undulating fever, fatigue, weight loss presentations but the symptoms were not improved in spite of symptomatic therapy of the disease for 6 weeks. Epidemiological background showed that the patient had often ingested unpasteurized cow milk. We confirmed Brucella abortus infection by STA, ELISA and PCR methods. Symptomatic therapy of the disease with appropriate antibiotics (streptomycin, doxicyclin), had favourable outcome. It's the first case report of human brucellosis caused by direct contact of brucella infected milk cow or ingestion of raw milk in Korea, since its original identification in 1939.
Animals ; Anti-Bacterial Agents ; Asymptomatic Diseases ; Brucella ; Brucella abortus ; Brucellosis* ; Dairy Products ; Diagnosis ; Eating ; Enzyme-Linked Immunosorbent Assay ; Fatigue ; Fever ; Headache ; Humans* ; Korea* ; Livestock ; Milk ; Polymerase Chain Reaction ; Weight Loss

Brucellosis is usually transmitted to human by direct contact with infected animals or by ingestion of unpasteurized dairy products. Because of the wide spectrum of its clinical manifestations, brucellosis may appear as other infections and asymptomatic conditions and, therefore, the diagnosis of the disease is frequently missed or delayed. A 41-years-old livestock worker was attended at a local clinic with headache, undulating fever, fatigue, weight loss presentations but the symptoms were not improved in spite of symptomatic therapy of the disease for 6 weeks. Epidemiological background showed that the patient had often ingested unpasteurized cow milk. We confirmed Brucella abortus infection by STA, ELISA and PCR methods. Symptomatic therapy of the disease with appropriate antibiotics (streptomycin, doxicyclin), had favourable outcome. It's the first case report of human brucellosis caused by direct contact of brucella infected milk cow or ingestion of raw milk in Korea, since its original identification in 1939.
Animals ; Anti-Bacterial Agents ; Asymptomatic Diseases ; Brucella ; Brucella abortus ; Brucellosis* ; Dairy Products ; Diagnosis ; Eating ; Enzyme-Linked Immunosorbent Assay ; Fatigue ; Fever ; Headache ; Humans* ; Korea* ; Livestock ; Milk ; Polymerase Chain Reaction ; Weight Loss