Association between Nutrient Intake and Obesity in Type 2 Diabetic Patients from the Korean National Diabetes Program: A Cross-Sectional Study

The aim of the study was to assess the association between usual dietary nutrient intake and obesity in Korean type 2 diabetic patients. We examined 2,832 type 2 diabetic patients from the Korean National Diabetes Program cohort who completed dietary assessment and clinical evaluation in this cross-sectional study. In men, higher dietary fiber intake was associated with a lower odds of being obese (Ptrend = 0.003) and in women, higher protein intake was associated with a lower odds of being obese (Ptrend = 0.03) after adjustment for age, diabetes duration, HbA1c, alcohol drinking, income, education level, and calorie intake. In men, higher fiber intake was associated with lower odds of obesity after further adjustment for diastolic blood pressure, physical activity, and possible confounding nutritional intake and medication. The multivariable adjusted odds ratio for the highest quintile of fiber intake was 0.37 (Ptrend < 0.001). In women, protein intake was not associated with obesity after further adjustment. In conclusion, higher intake of dietary fiber is associated with lower odds of being obese in type 2 diabetic men, suggesting a role for dietary fiber in the management and prevention of obesity in type 2 diabetes (ClinicalTrials.gov: NCT 01212198).

Characteristics of Radial Tears in the Posterior Horn of the Medial Meniscus Compared to Horizontal Tears

BACKGROUND: The clinical and radiologic features of radial tears of the medial meniscus posterior horn were compared with those of horizontal tears. METHODS: From January 2007 to December 2008, 387 consecutive cases of medial meniscal tears were treated arthroscopically. Among these, 91 were radial tears in the medial meniscus posterior horn, and 95 were horizontal tears in the posterior segment of the medial meniscus. The patients' data (age, gender, duration of symptom, body mass index, and injury history), radiographic findings (Kellgren and Lawrence score, posterior tibial slope, and femorotibial angle), and chondral lesions were recorded. RESULTS: The patient factors of age, gender, and body mass index were related to radial tears of the medial meniscus posterior horn. Radial tears were significantly correlated with Kellgren and Lawrence score, varus alignment, posterior tibial slope, and severity of the chondral lesion. CONCLUSIONS: Radial tears of the medial meniscus posterior horn are a unique clinical entity that are associated with older age, females and obesity, and are strongly associated with an increased incidence and severity of cartilage degeneration compared to horizontal tears.

Medial Meniscal Tears in Anterior Cruciate Ligament-Deficient Knees: Effects of Posterior Tibial Slope on Medial Meniscal Tear

PURPOSE: To evaluate the incidence of meniscal tears in patients with chronic anterior cruciate ligament (ACL)-deficient knees, and to determine the influence of posterior tibial slope (PTS) on medial meniscal tears in ACL-deficient knees. MATERIALS AND METHODS: We reviewed 174 patients (174 knees) with a mean age of 30.7 years who underwent ACL reconstruction for chronic ACL tears. We divided the patients into two groups: low group (135 knees with a PTS or =13degrees). RESULTS: The incidence of medial meniscus tears was 44% (77/174), and that of lateral meniscus tears was 35% (61/174). The mean PTS in patients with medial meniscal tears was 11.4degrees+/-3.0degrees, whereas that in patients without medial meniscal tears was 9.8degrees+/-2.4degrees. The incidence of meniscal tears was 57.8% (78/135) in the low group and 89.7% (35/39) in the high group (p or =13degrees is a risk factor for secondary medial meniscal tears in ACL-deficient knees. So, we suggest that PTS is one of the considerations for determining early ACL reconstruction to prevent secondary meniscal tears.

Factors influencing on perinatal outcomes in pregnancy with IgA nephropathy / 대한산부인과학회지

OBJECTIVE: The aim of this study is to evaluate factors influencing on perinatal outcomes of pregnancy with IgA nephropathy and the effect of pregnancy on the prognosis of IgA nephropathy. METHODS: We retrospectively reviewed clinical and laboratory findings of 28 pregnancies in 25 pregnant women with biopsy-proven IgA nephropathy at six hospitals of Catholic Medical Center throughout the period of January 1999 to December 2009. They are divided into two groups by presence or absence of perinatal complications such as preeclampsia and preterm labor and then compared. The prognosis of IgA nephropathy was determined by serum creatinine level and diagnosis of end stage renal disease (ESRD) until 3 years after delivery. Fisher exact test and Mann-Witney U test were used for statistical analysis. RESULTS: The factors that related perinatal complications included high blood pressure (P=0.019), low glomerular filtration rate (less than 50 mL/min) (P=0.029), and high creatinine level (more than 2.0 mg/dL) (P=0.005). Especially, hypertension and high creatinine level (more than 2.0 mg/dL) increased risk of not only preterm birth (P=0.017, P=0.026, respectively) but also preeclampsia (P=0.008, P=0.001, respectively). The factors that increased risk of ESRD within 2 years after delivery included high creatinine level (more than 2.0 mg/dL) (P=0.018) and preeclampsia (P=0.018). CONCLUSION: Our results indicate that hypertension and poor renal function could be predictors of poor perinatal outcomes, and when pregnancies with IgA nephropathy are complicated by preeclampsia or high creatinine level (more than 2.0 mg/dL), the prognosis of IgA nephropathy might be poor.

The Effects of Intra synovial Ropivacaine and Morphine Injection on Postoperative Pain After Total Knee Arthroplasty

PURPOSE: Pain control after total knee arthroplasty reduces total admission days and is important in improving post operative range of motion. This study evaluates the efficacy of intrasynovial injection of morphine and ropivacaine after total knee arthroplasty. MATERIALS AND METHODS: A prospective, double blinded and randomized study was performed in thirty two patients with American society of anesthesiology stage I or II who underwent one staged total knee arthroplasty for both knees simultaneously under spinal anesthesia. Demographic data (age, height, weight, gender distribution, Hospital for Special Surgery knee score, Knee society score, visual analogue scores (VAS) and range of motion were evaluated in all patients preoperatively. Before closure of the joint capsule, a local injective analgesia of 50mL including 0.5 ml 5 mg of HCL morphine, 40 mL 0.6% 300 mg ropivacaine and 0.25 mL of 1:200,000 epinephrine was injected into the synovium of one knee and 50 mL of normal saline was injected into the synovium of the opposite knee. Analgesic efficacy was evaluated by visual analogue scores (VAS) at intervals of 2, 4, 6, 12, 24, 32, 40 and 48 hours after operation. During this period, the amount of postoperative bleeding and range of motion were compared between both knees in the same patient. RESULTS: There were no statistically significant differences among both knees in regard to VAS at intervals of 2, 4, 6, 12, 24, 32, 40 and 48 hours after surgery (p>0.05). There were no statistically significant differences between the range of motion among both knees (p>0.05). CONCLUSION: On the basis of the results of this study, we do not recommend the routine use of postoperative intrasy-novial ropivacaine and morphine injection for the purpose of reducing pain in patients undergoing knee arthroplasty under spinal anesthesia with epidural patient controlled anesthesia.

Tissue Engineered Intervertebral Disc by Atelocollagen Scaffolds and Growth Factors / 대한척추외과학회지

STUDY DESIGN: In vitro experimental study. OBJECTIVES: To examine the cellular proliferation, synthetic activity and phenotypical expression of intervertebral disc (IVD) cells seeded on types I and II atelocollagen scaffolds, with the stimulation of TGF-beta1 and BMP-2. SUMMARY OF LITERATURE REVIEW: Recently, tissue engineering is regarded as a new experimental technique for the biological treatment of degenerative IVD diseases, and has been highlighted as a promising technique for the regeneration of tissues and organs in the human body. Research on cell transplantation in artificial scaffolds has provided that the conditions for tissue engineering have to be equilibrated, including the cell viability and proliferation, maintenance of characteristic phenotype, suitable scaffolds in organisms and biologically stimulated growth factor. MATERIAL AND METHOD: Lumbar IVD cells were harvested from 10 New Zealand white rabbits, with the nucleus pulposus cells isolated by sequential enzymatic digestion. Each of 1% types I and II atelocollagen dispersions were poured into a 96-well plate (diameter 5 mm), frozen at -70 degrees C, and then lyophilized at -50 degrees C. Fabricated porous collagen matrices were made using the cross-linking method. Cell suspensions were imbibed by surface tension into a scaffold consisting of atelocollagen. The cell cultured scaffolds were then treated with TGF-beta1 (10 ng/ml) or BMP-2 (100 ng/ml) or both. After 1 and 2 week culture periods, the DNA synthesis was measured by [3H] thymidine incorporation, and newly synthesized proteoglycan by incorporation of [35S] sulphate. Reverse transcription-polymerase chain reactions for the mRNA expressions of type I and II collagen, aggrecan and osteocalcin were performed. The inner morphology of the scaffolds was determined by scanning electron microscopy (SEM). RESULTS: The IVD cultures in collagen type II with TGF-beta1 demonstrated an increase in proteoglycan synthesis and up regulation of aggrecan and types I and II collagen mRNA expressions compared to the control. IVD cultures in the type I atelocollagen scaffold with growth factors exhibited an increase in DNA synthesis and up regulation of the type II atelocollagen mRNA expression. With all combinations of growth factor, the IVD cultures in types I and II atelocollagen scaffolds showed no up regulation of the osteocalcin mRNA expression. Furthermore, there was no synergistic effect of TGF-beta1 and BMP-2 in the matrix synthesis or for the mRNA expression of the matrix components. CONCLUSIONS: Nucleus pulposus cells from rabbit were viable in atelocollagen types I and II atelocollagen scaffolds. The type I atelocollagen scaffold was suitable for cell proliferation, but the type II atelocollagen scaffold was more suitable for extracellular matrix synthesis. The IVD cells in both scaffolds were biologically responsive to growth factors. Taken together, nucleus pulposus cells in atelocollagen scaffolds, with anabolic growth factors, provide a mechanism for tissue engineering of IVD cells.

Tissue Engineered Intervertebral Disc by Atelocollagen Scaffolds and Growth Factors / 대한척추외과학회지

STUDY DESIGN: In vitro experimental study. OBJECTIVES: To examine the cellular proliferation, synthetic activity and phenotypical expression of intervertebral disc (IVD) cells seeded on types I and II atelocollagen scaffolds, with the stimulation of TGF-beta1 and BMP-2. SUMMARY OF LITERATURE REVIEW: Recently, tissue engineering is regarded as a new experimental technique for the biological treatment of degenerative IVD diseases, and has been highlighted as a promising technique for the regeneration of tissues and organs in the human body. Research on cell transplantation in artificial scaffolds has provided that the conditions for tissue engineering have to be equilibrated, including the cell viability and proliferation, maintenance of characteristic phenotype, suitable scaffolds in organisms and biologically stimulated growth factor. MATERIAL AND METHOD: Lumbar IVD cells were harvested from 10 New Zealand white rabbits, with the nucleus pulposus cells isolated by sequential enzymatic digestion. Each of 1% types I and II atelocollagen dispersions were poured into a 96-well plate (diameter 5 mm), frozen at -70 degrees C, and then lyophilized at -50 degrees C. Fabricated porous collagen matrices were made using the cross-linking method. Cell suspensions were imbibed by surface tension into a scaffold consisting of atelocollagen. The cell cultured scaffolds were then treated with TGF-beta1 (10 ng/ml) or BMP-2 (100 ng/ml) or both. After 1 and 2 week culture periods, the DNA synthesis was measured by [3H] thymidine incorporation, and newly synthesized proteoglycan by incorporation of [35S] sulphate. Reverse transcription-polymerase chain reactions for the mRNA expressions of type I and II collagen, aggrecan and osteocalcin were performed. The inner morphology of the scaffolds was determined by scanning electron microscopy (SEM). RESULTS: The IVD cultures in collagen type II with TGF-beta1 demonstrated an increase in proteoglycan synthesis and up regulation of aggrecan and types I and II collagen mRNA expressions compared to the control. IVD cultures in the type I atelocollagen scaffold with growth factors exhibited an increase in DNA synthesis and up regulation of the type II atelocollagen mRNA expression. With all combinations of growth factor, the IVD cultures in types I and II atelocollagen scaffolds showed no up regulation of the osteocalcin mRNA expression. Furthermore, there was no synergistic effect of TGF-beta1 and BMP-2 in the matrix synthesis or for the mRNA expression of the matrix components. CONCLUSIONS: Nucleus pulposus cells from rabbit were viable in atelocollagen types I and II atelocollagen scaffolds. The type I atelocollagen scaffold was suitable for cell proliferation, but the type II atelocollagen scaffold was more suitable for extracellular matrix synthesis. The IVD cells in both scaffolds were biologically responsive to growth factors. Taken together, nucleus pulposus cells in atelocollagen scaffolds, with anabolic growth factors, provide a mechanism for tissue engineering of IVD cells.

Treatment of Brachymetatarsia by Distraction Osteogenesis / 대한족부족관절학회지

PURPOSE: To evaluate the efficacy of distraction osteogenesis for fourth brachymetatarsia. MATERIALS AND METHODS: Seven patients (10 cases) who were treated by distraction osteogenesis for fourth brachymetatarsia from March 2000 to December 2003 were reviewed retrospectively. RESULTS: The average length gain of fourth metatarsus was 16.6 mm (37%) and the average healing index was 50 days/cm. The final results according to AOFAS functional scale were excellent in 8 cases and good in 2 cases. CONCLUSION: Distraction osteogenesis is an effective treatment for fourth brachymetatarsia in spite of some minor complications.

Treatment of Brachymetatarsia by Distraction Osteogenesis / 대한족부족관절학회지

PURPOSE: To evaluate the efficacy of distraction osteogenesis for fourth brachymetatarsia. MATERIALS AND METHODS: Seven patients (10 cases) who were treated by distraction osteogenesis for fourth brachymetatarsia from March 2000 to December 2003 were reviewed retrospectively. RESULTS: The average length gain of fourth metatarsus was 16.6 mm (37%) and the average healing index was 50 days/cm. The final results according to AOFAS functional scale were excellent in 8 cases and good in 2 cases. CONCLUSION: Distraction osteogenesis is an effective treatment for fourth brachymetatarsia in spite of some minor complications.

A Study on Prevalence of Obesity, Eating Habits and Life Styles of 5th Grade Students in Inchon / 대한지역사회영양학회지

The purpose of this survey was to investigate the prevalence of obesity, eating habits and life styles of children. This survey was carried out anthropometry and questionnaires in 180 male and 141 female students of fifth-grade at Dongmak elementary school. The results are summarized as follows : 1)18.2% of the male and 19.3% of female students were obese. Underweight group was 10.5% of the male and 15.0% of the female students. 2) Average height of male and female students were 142.0 cm, 144.0 cm and weight of those were 35.8 kg and 37.1 kg respectively. The height and skinfold thickness of the triceps in female students were significantly higher than those of male students and body fat content in female students was significantly lower than that of male students. There was no difference in BMI, RW and RI between male and female students. The average BMI, RW, RI were 17.7, 25.4, 124.0, respectively. 3) The student's height was positively related to parent's height and moth's weight. There were significantly positive correlation between mother's and subject's weight. BMI, RW and RI were positively related to parent's BMI. 4) 78.3% of male and 51.8% of female students had prejudice for special food, and 45.5% of male and 34.5% of female students had an overeating habit. Male students had significanthy higher rate than female in both cases. Average eating time per meal was 18.9 minutes for male and 21.0 minutes for female students. Experience for taking nutrient supplement in male student was more than that in female. Obese group had prejudice for special food, overeating habit and rapid eating rate more than any other groups. The prevalence of obesity among the children is gradually increasing. Therefore, in order to prevent progress into adulthood obesity, nutrition education including the right perception for obesity and eating behavior modification was needed.