OBJECTIVE: To investigate serum 25-hydroxyl vitamin D (25(OH)D) and vitamin D-binding protein (VDBP) concentrations in women with endometriosis according to the severity of disease. METHODS: Women with mild endometriosis (n = 9) and advanced endometriosis (n = 7), as well as healthy controls (n = 16), were enrolled in this observational study. Serum total 25(OH)D concentrations were analyzed using the Elecsys vitamin D total kit with the Cobas e602 module. Concentrations of bioavailable and free 25(OH)D were calculated. Concentrations of VDBP were measured using the Human Vitamin D BP Quantikine ELISA kit. Variables were tested for normality and homoscedasticity using the Shapiro-Wilk test and Leven F test, respectively. Correlation analysis was used to identify the variables related to total 25(OH)D and VDBP levels. To assess the effects of total 25(OH)D and VDBP levels in the three groups, multivariate generalized additive modeling (GAM) was performed. RESULTS: Gravidity and parity were significantly different across the three groups. Erythrocyte sedimentation rate (ESR) and CA-125 levels increased as a function of endometriosis severity, respectively (p= 0.051, p= 0.004). The correlation analysis showed that total 25(OH)D levels were positively correlated with gravidity (r = 0.59, p< 0.001) and parity (r = 0.51, p< 0.003). Multivariate GAM showed no significant relationship of total 25(OH)D levels with EMT severity after adjusting for gravidity and ESR. However, the coefficient of total 25(OH)D levels with gravidity was significant (1.87; 95% confidence interval, 0.12–3.63; p= 0.040). CONCLUSION: These results indicate that vitamin D and VDBP levels were not associated with the severity of endometriosis.
Blood Sedimentation ; Endometriosis ; Enzyme-Linked Immunosorbent Assay ; Female ; Gravidity ; Humans ; Observational Study ; Parity ; Vitamin D ; Vitamin D-Binding Protein ; Vitamins

Iatrogenic parasitic myomas are rare. The condition is defined by the presence of multiple smooth-muscle tumorous nodules in the peritoneal cavity. This may be attributable to seeding of myoma particles during uterine surgery. The clinical course is usually indolent. The disease is often asymptomatic and is usually discovered only incidentally. A 38-year-old woman who had undergone abdominal myomectomy 7 months prior presented with acute abdominal pain and a huge pelvic mass. We performed exploratory laparotomy. A parasitic mass 17 cm in diameter with a twisted omental pedicle was identified. En bloc excision of the mass and omentum was performed, followed by total abdominal hysterectomy. Histopathological examination of multiple sections revealed features compatible with an infarcted leiomyoma. Thus, we present a very rare case of an iatrogenic, rapidly growing parasitic myoma complicated by omental torsion (which caused the acute abdominal pain). We also offer a literature review.
Abdominal Pain ; Adult ; Female ; Humans ; Hysterectomy ; Laparotomy ; Leiomyoma ; Myoma* ; Omentum ; Peritoneal Cavity

OBJECTIVE: We evaluated the effects of tooth displacement on frictional force when conventional ligating lingual brackets (CL-LBs), CL-LBs with a narrow bracket width, and self-ligating lingual brackets (SL-LBs) were used with initial leveling and alignment wires. METHODS: CL-LBs (7th Generation), CL-LBs with a narrow bracket width (STb), and SL-LBs (In-Ovation L) were tested under three tooth displacement conditions: no displacement (control); a 2-mm palatal displacement (PD) of the maxillary right lateral incisor (MXLI); and a 2-mm gingival displacement (GD) of the maxillary right canine (MXC) (nine groups, n = 7 per group). A stereolithographic typodont system and artificial saliva were used. Static and kinetic frictional forces (SFF and KFF, respectively) were measured while drawing a 0.013-inch copper-nickel-titanium archwire through brackets at 0.5 mm/min for 5 minutes at 36.5℃. RESULTS: The In-Ovation L exhibited lower SFF under control conditions and lower KFF under all displacement conditions than the 7th Generation and STb (all p < 0.001). No significant difference in SFF existed between the In-Ovation L and STb for a 2-mm GD of the MXC and 2-mm PD of the MXLI. A 2-mm GD of the MXC produced higher SFF and KFF than a 2-mm PD of the MXLI in all brackets (all p < 0.001). CONCLUSIONS: CL-LBs with narrow bracket widths exhibited higher KFF than SL-LBs under tooth displacement conditions. CL-LBs and ligation methods should be developed to produce SFF and KFF as low as those in SL-LBs during the initial and leveling stage.
Friction* ; Incisor ; Ligation ; Saliva, Artificial ; Tooth*

Distal limb deformities are congenital malformations with phenotypic variability and high genetic heterogeneity. Split hand/foot malformation, also known as ectrodactyly, is a congenital limb malformation characterized by a defect of the central rays of the hands and/or feet. Split hand/foot malformation with long-bone deficiency (SHFLD) is a rare condition related to a 17p13.3 duplication. Recently, genomic duplications encompassing BHLHA9 have been associated with SHFLD. We report a case of SHFLD presenting with campomelia of the right femur, bilateral agenesis of fibulae, bilateral club feet, and oligosyndactyly of the hands and feet, that was associated with a 17p13.3 duplication, as determined prenatally using array comparative genomic hybridization.
Comparative Genomic Hybridization ; Congenital Abnormalities ; Extremities ; Femur ; Fibula ; Foot ; Genetic Heterogeneity ; Hand ; Prenatal Diagnosis*

PURPOSE: To assess the outcomes of increased fetal nuchal translucency (NT), to aid in prenatal counseling and management in our practice. MATERIALS AND METHODS: We retrospectively reviewed the medical records of patients who underwent first trimester fetal karyotyping using chorionic villi sampling (CVS) and second trimester level II sonography for a fetal NT thickness > or =3.0 mm between 11 weeks and 13 weeks 6 days' gestation, at Gyeongsang National University Hospital. Pediatric medical records and a telephone interview were used to follow-up live-born children. Exclusion criteria included incomplete data and CVS for other indications. RESULTS: Seventy cases met the inclusion criteria (median NT thickness, 4.7 mm; range, 3.0-16.1 mm). Twenty-nine cases (41.4%) were aneuploid. The prevalence of chromosomal defects increased with NT thickness: NT 3.0-3.4 mm, 16.7%; NT 3.5-4.4 mm, 27.3%; NT 4.5-5.4 mm, 66.7%; NT 5.5-6.4 mm, 37.5%; NT > or =6.5 mm, 62.5%. The most common karyotype abnormality was trisomy 18 (n=12), followed by trisomy 21 (n=9). In chromosomally normal fetuses (n=41), fetal death occurred in 2 cases (4.9%), and structural malformations were found in 11 cases (26.8%). In chromosomally and anatomically normal fetuses (n=28), one child had neurodevelopmental delay (3.6%). Twenty-eight infants who had a prenatal increased NT were alive and well at follow-up (40%). CONCLUSION: Outcomes of increased fetal NT might help inform prenatal counseling and management. The high prevalence of chromosomal defects associated with increased fetal NT implies that CVS should be performed in the first trimester, particularly considering the stress associated with an uncertain diagnosis.
Aneuploidy ; Child ; Chorionic Villi Sampling* ; Counseling ; Diagnosis ; Down Syndrome ; Female ; Fetal Death ; Fetus ; Follow-Up Studies ; Humans ; Infant ; Interviews as Topic ; Karyotype ; Karyotyping ; Medical Records ; Nuchal Translucency Measurement* ; Pregnancy ; Pregnancy Trimester, First ; Pregnancy Trimester, Second ; Prevalence ; Retrospective Studies ; Trisomy

BACKGROUND: Studies on factors which may predict the risk of diabetes are scarce. This prospective cohort study was conducted to determine the association between adiponectin and type 2 diabetes among Korean men and women. METHODS: A total of 42,845 participants who visited one of seven health examination centers located in Seoul and Gyeonggi province, Republic of Korea between 2004 and 2008 were included in this study. The incidence rates of diabetes were determined through December 2011. To evaluate the effects of adiponectin on type 2 diabetes, the Cox proportional hazard model was used. RESULTS: Of the 40,005 participants, 959 developed type 2 diabetes during a 6-year follow-up. After the adjustment for age, body mass index (BMI), and waist circumference, the risks for type 2 diabetes in participants with normoglycemia had a 1.70-fold (95% confidence interval [CI], 1.21 to 2.38) increase in men and a 1.83-fold (95% CI, 1.17 to 2.86) increase in women with the lowest tertile of adiponectin when compared to the highest tertile of adiponectin. For participants with impaired fasting glucose (IFG), the risk for type 2 diabetes had a 1.46-fold (95% CI, 1.17 to 1.83) increase in men and a 2.52-fold (95% CI, 1.57 to 4.06) increase in women with the lowest tertile of adiponectin. Except for female participants with normoglycemia, all the risks remained significant after the adjustment for fasting glucose and other confounding variables. Surprisingly, BMI and waist circumference were not predictors of type 2 diabetes in men or women with IFG after adjustment for fasting glucose and other confounders. CONCLUSION: A strong association between adiponectin and diabetes was observed. The use of adiponectin as a predictor of type 2 diabetes is considered to be useful.
Adiponectin ; Body Mass Index ; Cohort Studies ; Confounding Factors (Epidemiology) ; Diabetes Mellitus ; Fasting ; Female ; Follow-Up Studies ; Glucose ; Humans ; Incidence ; Male ; Proportional Hazards Models ; Prospective Studies ; Republic of Korea ; Waist Circumference

PURPOSE: Hepatobiliary surgery has changed dramatically in recent decades with the advent of laparoscopic techniques. The aim of this retrospective study was to compare survival rates according to stages, adjusting for important prognostic factors. METHODS: A retrospective study of a 17-year period from January 1994 to April 2011 was carried out. The cases studied were divided into two time period cohorts, those treated in the first 9-years (n = 109) and those treated in the last 7-years (n = 109). RESULTS: An operation with curative intent was performed on 218 patients. The 5-year survival rates according to the depth of invasion were 86% (T1), 56% (T2), 45% (T3), and 5% (T4). The number of cases of incidental gallbladder cancer found during 3,919 laparoscopic cholecystectomies was 96 (2.4%). Incidental gallbladder cancer revealed a better survival rate (P = 0.003). Iatrogenic bile spillage was found in 20 perforations of the gallbladder during laparoscopic cholecystectomies, 16 preoperative percutaneous transhepatic gallbladder drainages and 16 percutaneous transhepatic biliary drainages; only percutaneous transhepatic biliary drainage patients showed a significantly lower survival rate than patients without iatrogenic bile spillage (P < 0.034). Chemoradiation appeared to improve overall survival (P < 0.001). Multivariate analysis also revealed that time period, type of surgery, surgical margin, lymphovascular invasion, lymph node involvement, and chemoradiation therapy had significant effects. CONCLUSION: This study found that the prognosis of gallbladder cancer is still determined by the stage at presentation due to the aggressive biology of this tumor. Early diagnosis, radical resection and appropriate adjuvant therapy can increase overall survival.
Bile ; Biology ; Cholecystectomy, Laparoscopic ; Cohort Studies ; Drainage ; Early Diagnosis ; Gallbladder ; Gallbladder Neoplasms ; Humans ; Laparoscopy ; Lymph Nodes ; Multivariate Analysis ; Prognosis ; Retrospective Studies ; Survival Rate

OBJECTIVES: The purpose of this study was to compare the differences in bone mineral density (BMD), T-scores, and the prevalence of osteopenia and osteoporosis between mountain villagers and seaside villagers. MATERIALS & METHODS: Four hundred fifty-one postmenopausal women (138 women in mountain villagers and 313 women in seaside villagers) were examined, including women > 50 years of age. The study subjects were recruited from the women who had received care at the health examination center of our hospital between January 2005 and September 2009. The BMD was measured at lumbar 1-4 by dual-energy X-ray absorptiometry.
Absorptiometry, Photon ; Aged ; Bone Density ; Bone Diseases, Metabolic ; Female ; Humans ; Osteoporosis ; Prevalence ; Spine

OBJECTIVE: The aim of this research was to evaluate the mechanical properties (MP) and degree of the phase transformation (PT) of martensitic (M-NiTi), austenitic (A-NiTi) and thermodynamic nickel-titanium wire (T-NiTi). METHODS: The samples consisted of 0.016 x 0.022 inch M-NiTi (Nitinol Classic, NC), A-NiTi (Optimalloy, OPTI) and T-NiTi (Neo-Sentalloy, NEO). Differential scanning calorimetry (DSC), three-point bending test, X-ray diffraction (XRD), and microstructure examination were used. Statistical evaluation was undertaken using ANOVA test. RESULTS: In DSC analysis, OPTI and NEO showed two peaks in the heating curves and one peak in the cooling curves. However, NC revealed one single broad and weak peak in the heating and cooling curves. Austenite finishing (Af) temperatures were 19.7degrees C for OPTI, 24.6degrees C for NEO and 52.4degrees C for NC. In the three-point bending test, residual deflection was observed for NC, OPTI and NEO. The load ranges of NC and OPTI were broader and higher than NEO. XRD and microstructure analyses showed that OPTI and NEO had a mixture of martensite and austenite at temperatures below Martensite finishing (Mf). NEO and OPTI showed improved MP and PT behavior than NC. CONCLUSIONS: The mechanical and thermal behaviors of NiTi wire cannot be completely explained by the expected degree of PT because of complicated martensite variants and independent PT induced by heat and stress.
Calorimetry, Differential Scanning ; Dental Alloys ; Heating ; Hot Temperature ; Thermodynamics ; Transition Temperature ; X-Ray Diffraction