PURPOSE:Ghrelin is an endogenous ligand of the growth hormone secretagogue receptor, and stomach is the major site of ghrelin secretion. The purpose of this study is to compare the serum ghrelin concentrations between patients with type 2 diabetes mellitus (DM) and normal adults. We studied also whether serum ghrelin levels in the patients with type 2 DM are correlated with body mass index (BMI), serum insulin, lipid profiles, and creatinine levels. METHODS:Forty patients with type 2 DM and forty normal adults were included in this study. We measured heights and weights of the subjects and calculated their BMIs. Blood samples were obtained to measure the ghrelin concentration and their sera were stored at -20degreeC until used. In all subjects, serum ghrelin levels were measured using the commercially available Ghrelin(human) EIA kit. RESULTS:No differences of mean values were detected between the control group and the type 2 diabetic group for age, body weight, BMI, and the levels of serum total cholesterol, triglyceride, HDL cholesterol, and creatinine. But ghrelin level of the type 2 diabetic group (71.1+/-30.5 ng/L) was significantly lower than the control group (139.7+/-36.9 ng/L). In the control group, the ghrelin level showed positive correlation with HDL cholesterol (Pearson's correlation coefficient=0.37, P<0.05). In the diabetic group, the ghrelin level showed weakly positive correlation with insulin concentration. However, there was no significant relationship between serum ghrelin and various parameters in the diabetic patients group. CONCLUSION: In this study, ghrelin concentration in type 2 diabetic patients was lower than that in the control group. In the control group, serum ghrelin concentrations were positively correlated with HDL cholesterol. In the type 2 diabetic group, there was no significant correlation between insulin and ghrelin concentrations.
Adult ; Body Mass Index ; Body Weight ; Cholesterol ; Cholesterol, HDL ; Creatinine ; Diabetes Mellitus ; Diabetes Mellitus, Type 2* ; Ghrelin* ; Humans ; Insulin ; Receptors, Ghrelin ; Stomach ; Triglycerides ; Weights and Measures

PURPOSE: The purpose of this study is to identify the changes to nursing activities of nurses on patients with DNR (Do-Not-Resuscitate) order and factors associated to the changes. METHODS: Data were collected using a structured questionnaire for 173 nurses at general hospitals. Logistic regression analysis was performed on the data using SAS 9.4. RESULTS: With 39 nursing activities, an average of 60.4 (34.9%) nurses reported an increase in the activities, 102.4 (59.2%) no change and 10.1 (5.9%) a drop. The activity increase was the greatest in the social area, and the physical area was where the activities decreased the most. The activity increase was associated knowledge competency (9 items), attitudes (2 items), practical competency (4 items) and work load (14 items were). CONCLUSION: To offer systematical care for DNR patients, it is necessary to expand nurses' knowledge through end-of-life education and adjust their workload and provide a support system at the department level.
Education ; Hospitals, General ; Humans ; Logistic Models ; Nursing Care ; Nursing* ; Resuscitation Orders ; Terminal Care

An important error in the result of Table 3 was confirmed in the article.

Purpose: Attending physicians in Korea are aware of the existence of the Nutrition Support Team (NST), but even when the NST are consulted, compliance with their recommendations may be low. This study was performed to identify physicians’ compliance with the NST advice and how this affected the outcome of treatment for critically ill patients. Methods: This study was a retrospective observational study. Critically ill patients who were older than 18 years, younger than 90 years, and had been admitted and managed in the intensive care unit were selected for this study. Patients were assigned to either the compliance group or the non-compliance group according to physician compliance with the NST advice. Each group were compared using variables such as calorie supply, protein supply, laboratory findings, hospital stay, 30-day mortality, and survival rate. Results: The compliance group (81% of cases) was supplied with a significantly higher energy (1,146.36 ± 473.45 kcal vs. 832.45 ± 364.28 kcal, p < 0.01) and a significantly higher protein (55.00 ± 22.30 g/day vs. 42.98 ± 24.46 g/day, p = 0.04) compared with the non-compliance group. There was no significant difference in the basic demographics between groups, although the compliance group had a better outcome in the 30-day mortality rate (8% vs. 26%, p = 0.02), and in survival beyond 1 year (Crude model, hazard ratio: 2.42, CI: 1.11-5.29). Conclusion Critically ill patients whose attending physician complied with the NST advice, received an increased energy intake and supply of protein which was positively associated with survival.

PURPOSE: Bone morphogenetic proteins (BMPs) are members of the transforming growth factor-beta family and play an important role in cellular growth. Recent reports suggest that exogenous bone morphogenetic protein-2 (BMP-2) acts as an antiproliferative agent in a variety of cell lines. We will study whether BMP-2 is altered in human colorectal cancer. METHODS: We analyzed 40 colorectal cancer cases and 6 colorectal cancer cell lines by using reverse transcription-polymerase chain reaction (RT-PCR) to determine the expression of BMP-2. RESULTS: Thirteen of 40 colorectal cancers (33%) and 3 of 6 colorectal cancer cell lines (50%) revealed decreased expression of BMP-2. The rates of decreased expression were 0% (0/7), 42.1% (8/19), 28.6% (2/7), 33.3% (2/6), and 100% (1/1) in stages I, II, III, and IV, respectively. Histologically, the rates were 33.3% (2/6), 32.2% (10/21), 50% (1/2), and 0% (0/1) in well-differentiated, moderately-differentiated, poorly-differentiated and mucinous cancers, respectively. As for location, the rates for colon and rectal cancers were 27.8% (5/18) and 36.4% (8/22), respectively. We identified methylation in the CpG island of the BMP-2 gene in 60% of colorectal cancer cells and in 50% of colorectal cancer cell lines. The 13 cases without BMP-2 gene expression showed no significant correlation with clinicopathological factors. Epigenetic silencing through DNA methylation is one of the key steps during carcinogenesis. CONCLUSION: We found, through an analysis using the methylation-specific polymerase chain reaction technique, CpG island methylation of the BMP-2 promoter region in colorectal cancer. Thus, aberrant BMP-2 methylation and the resultant loss of BMP-2 expression may be related to colorectal carcinogenesis.
Bone Morphogenetic Proteins ; Cell Line ; Colon ; Colorectal Neoplasms ; CpG Islands ; DNA Methylation ; Epigenomics ; Gene Expression ; Humans ; Methylation ; Mucins ; Polymerase Chain Reaction ; Promoter Regions, Genetic ; Rectal Neoplasms

Spark’s nevus is a compound word composed of Spitz nevus and Clark’s nevus. It is one of the combined melanocytic nevi which is more common in female and usually presents as a sharp circumscribed hyperpigmented macule on the lower extremities. On histopathologic findings, both cytologic features of Spitz nevus characterized as large spindle or epithelioid melanocytes containing large nuclei with abundant cytoplasm, and architecture of Clark’s nevus characterized as elongation of rete ridges, bridging of the nests, concentric and lamellar fibrosis can be seen. A 24-year-old female presented with an asymptomatic, solitary, dark-brown-colored papule surrounded by brownish patch that looked similar to dysplastic nevus or malignant melanoma on the buttock. On dermoscopic examination, it showed brown-to-black globules, diffuse homogenous pigmentation with blue-white structures, and a surrounding brownish reticular pattern that faded away. On histopathologic findings, overall asymmetrical structure, epithelioid large melanocytes containing large nuclei with abundant cytoplasm, and Kamino body were seen in the central portion. Also, lentiginous hyperplasia, bridging of the nests composed of melanocytes containing foamy cytoplasm, concentric and lamellar fibrosis along with the elongation of rete ridge, and perivascular lymphocytic infiltration were seen in the peripheral portion. The diagnosis of Spark’s nevus was made. Following its definition, this combined nevus is diagnosed histopathologically, but the clinicodermoscopic features have not been well described. Herein, we report a case of Spark’s nevus in which dermoscopy was helpful for differentiating it from malignant melanoma.

BACKGROUND: Health illiteracy is a problem often unrecognized by health care providers. It influences medical costs and the health status of adults. The purposes of this study were to determine the level of health literacy in community-dwelling adults and to identify the factors influencing it. METHODS: A cross-sectional survey was conducted in Seoul, Gyeonggi and Chungcheong province. A total of 420 adults aged 18 or older were interviewed by trained nursing students between November 1 to December 30, 2011. Health literacy was measured using the Short Test of Functional Health Literacy in Adults. Data were analyzed using the PASW 18.0 program. RESULTS: The mean score of health literacy was 50.64+/-19.18. In the multiple linear regression analysis, health literacy was significantly associated with education (beta=0.17, P=0.001), alcohol use (beta=-0.12, P=0.010), and perceived health status (beta=0.11, P=0.029). These factors accounted for about 7% of health literacy. CONCLUSIONS: Health literacy is a very important public health issue. Our findings showed that educational level, alcohol use and perceived health status should be considered when assessing this issue in patients. Furthermore, the development of a standardized Korean assessment tool for health literacy and specified interventions for enhancing health literacy are needed to improve health outcomes.
Adult* ; Cross-Sectional Studies ; Education ; Gyeonggi-do ; Health Literacy* ; Health Personnel ; Health Status ; Humans ; Linear Models ; Literacy ; Primary Prevention ; Public Health ; Seoul ; Students, Nursing

Weber-Christian disease is a rare inflammatory disease of subcutaneous fat necrosis that may or may not involve systemic disease. We report the results of a breast sonograph of a case diagnosed as a form of an acute lobular panniculitis affecting the breasts and upper limbs.
Breast* ; Necrosis ; Panniculitis ; Panniculitis, Nodular Nonsuppurative* ; Subcutaneous Fat ; Ultrasonography ; Upper Extremity

PURPOSE: This in vitro study was performed to assess the adherence of Porphyromonas gingivalis to a resorbable blast media (RBM) titanium surface pretreated with an ultrasonic scaler or toothbrush and to evaluate the effects of the treatment of the RBM titanium discs on the bacterial removal efficiency of brushing by crystal violet assay and scanning electron microscopy. METHODS: RBM titanium discs were pretreated with one of several ultrasonic scaler tips or cleaned with a toothbrush. Then the titanium discs were incubated with P. gingivalis and the quantity of adherent bacteria was compared. The disc surfaces incubated with bacteria were brushed with a toothbrush with dentifrice. Bacteria remaining on the disc surfaces were quantified. RESULTS: A change in morphology of the surface of the RBM titanium discs after different treatments was noted. There were no significant differences in the adherence of bacteria on the pretreated discs according to the treatment modality. Pretreatment with various instruments did not produce significant differences in the bacterial removal efficiency of brushing with dentifrice. CONCLUSIONS: Within the limits of this study, various types of mechanical instrumentation were shown to cause mechanical changes on the RBM titanium surface but did not show a significant influence on the adherence of bacteria and removal efficiency of brushing.
Bacteria ; Dental Scaling ; Dentifrices ; Gentian Violet ; Microscopy, Electron, Scanning ; Porphyromonas gingivalis ; Surface Properties ; Titanium* ; Toothbrushing ; Ultrasonics*

BACKGROUND: Cryopreservation of hematopoietic stem cells has become an important process due to the therapeutic protocol, which includes stem cell transplantation after chemotherapy, for many hematological malignancies. The conventional medium contains 10% dimethyl sulfoxide (DMSO) as a cryoprotectant, but this has been reported to be related with many complications. We analyzed the usefulness of trehalose, catalase and zVAD-fmk for cryopreservation along with using a reduced concentration of DMSO to 5%. METHODS: Peripheral blood stem cells were frozen in 10% DMSO as a control and also in 5% DMSO with trehalose and catalase. After 3 weeks of storage in a liquid nitrogen tank, the viability of the thawed hematopoietic stem cells was measured using Trypan blue staining and 7-AAD analysis via conducting flow cytometry. The colony forming potential was assessed using methylcellulose culture. We measured the viability of cells in 5% DMSO medium with or without addition of 30 uM zVAD-fmk right after thawing, and we also did this 6 and 24 hours after incubation. RESULTS: Cryopreserved cells in 5% DMSO with trehalose and catalase showed similar survival (50.42%) compared with the control (49.78%). The viability of cells that were also treated with added zVAD-fmk showed a better result (13.12%) than without it (5.5%) after 24 hours of incubation. Colony forming assay showed similar colony formation in 5% DMSO with the natural cryoprotectants. CONCLUSION: According to the results, lowering the DMSO concentration to 5% is significant and we can expect better cell viability and prevent many side effects of high dose DMSO when adding natural cryprotectants in the cryopreservation medium or by adding caspase-inhibitor right after thawing.
Amino Acid Chloromethyl Ketones ; Catalase ; Cell Survival ; Cryopreservation ; Dimethyl Sulfoxide ; Diminazene ; Flow Cytometry ; Hematologic Neoplasms ; Hematopoietic Stem Cells ; Methylcellulose ; Nitrogen ; Safrole ; Stem Cell Transplantation ; Stem Cells ; Trehalose ; Trypan Blue