Relationship of PGC-1α gene polymorphism with insulin resistance syndrome in Korean children.

This study aimed to investigate the associations between peroxisome proliferator-activated receptor γ coactivator-1α (PGC-1α) gene Gly482Ser polymorphism (rs8192678) and parameters of insulin resistance in a sample of Korean children. A total of 286 children aged 10 to 12 years old were recruited from local elementary schools. Measured variables included body fat, blood pressures, blood lipids, glucose, insulin, homeostasis model assessment of insulin resistance (HOMA-IR), and accelerometer-based physical activity (PA). Significant differences in percentage body fat (P = .016), insulin (P = .013), and HOMA-IR (P = .007) were found according to Gly482Ser genotype, with no significant genotype differences in the other measured variables. The genotype-specific differences in insulin (P = .136) and HOMA-IR (P = .067) were significantly attenuated when adjusted for age, sex, Tanner stage, body fat, and PA. The findings of the study suggest that the genetic effects of the PGC-1α genotypes on parameters of insulin resistance might be modulated by lifestyle factors, including PA and body fatness.

Palmar crease release and secondary full-thickness skin grafts for contractures in primary full-thickness skin grafts during growth spurts in pediatric palmar hand burns.

Pediatric palmar hand burns are a difficult problem because of the serious hand deformity, with functional impairment resulting from rapid growth. In cases of severe pediatric palmar hand burns, a secondary full-thickness skin graft after a primary full-thickness skin graft offers a reliable way of obtaining the required functional and aesthetic outcomes.This study retrospectively evaluated 28 children who required palmar crease releases and secondary full-thickness skin grafts during the past 12 years. The case records were reviewed for sex and age distributions, injury mechanism, and time interval between the primary and secondary full-thickness skin grafts. Surgical procedures included secondary full-thickness skin grafts and incisional releases of grafted skin on the involved creases. There were 19 men and 9 women. The mean age at the time of the burn injury was 10.1 months (range, 5-19 months). The mean age at the time of the secondary full-thickness skin graft was 8.3 years (range, 3-17 years). The most common mechanism of burn injury was steam (n = 24). The median time interval from the primary to the secondary full-thickness skin graft was 67 months (range, 8-156 months). The number of released creases was 81. The number of palmar web contractures in 23 patients was 52. A secondary full-thickness skin graft was more frequently necessary in patients with a primary full-thickness skin graft in the proximal digital crease and palmar web areas. All patients achieved adequate digital length and palmar web contour after surgery. Our patients should be observed until the rapid pubertal growth period.

A Case of Severe HIV-Associated Psoriasis Successfully Treated with Acitretin Therapy.

Psoriasis is a chronic inflammatory skin disease that involves immune-mediated cutaneous inflammation and keratinocyte hyperproliferation. Psoriasis in patients with HIV responds poorly to treatment and has a high morbidity rate, thus posing a challenge to clinicians. Until now, there have been no documented cases of acitretin therapy for HIV-associated psoriasis in Korea. Here, we report a case of safe and successful therapy with acitretin in a 52-year-old man with HIV-associated psoriasis that responded poorly to previous treatments including steroids and ultraviolet B phototherapy. We also review the relevant literature.

Association between serum vitamin D status and metabolic syndrome in Korean young men.

PURPOSE: This study examined the relations of serum vitamin D levels to body fatness, cardiorespiratory fitness (CRF), and metabolic risk factors in young adults in Korea. METHODS: Between 2007 and 2009, 799 young men completed a health examination. Body fatness, CRF based on a maximal treadmill exercise test, and measurements of metabolic risk factors were measured in study participants. Participants were classified by serum vitamin D levels as deficient (<12.5 ng·mL), insufficient (≥12.5 to <20 ng·mL), and sufficient (>20 ng·mL) and by CRF as unfit (lowest 20%) and fit (remaining 80%) based on age-standardized distribution of V˙O2max values in this study population. Body fatness, CRF, and metabolic risk factors were evaluated according to serum vitamin D classification. A clustered metabolic risk score was computed by summing standardized scores for waist circumference, resting blood pressures, triacylglycerols, the inverse of high-density lipoprotein cholesterol, glucose, and insulin. RESULTS: Linear decreases in body fatness and metabolic risk factors were observed, as was a linear increase for CRF across incremental vitamin D categories. A linear decrease was found in the clustered metabolic risk score across incremental vitamin D categories. Compared to the fit group (reference), the unfit group had significantly higher risks for serum vitamin D inadequacy before and after adjusting for age, smoking, and body fatness parameters. CONCLUSIONS: The findings of the study suggest that increasing vitamin D intake, eating a healthy diet, and getting enough outdoor physical activity should be promoted as nonpharmacologic means to improve CRF and prevent a clustering of metabolic risk factors in young adults.

Serum vitamin D, physical activity, and metabolic risk factors in Korean children.

PURPOSE: The purpose of this study was to investigate the relationship of serum vitamin D levels with lifestyle factors, including body fatness and physical activity (PA) parameters, and the clustering of metabolic risk factors in the Korean pediatric population. METHODS: Serum 25-hydroxyvitamin D levels, accelerometer-based PA, and body fatness and metabolic syndrome parameters were assessed in a sample of children of Korean descent (N = 310). Correlation and multivariate linear regression were used to explore the relationships among serum vitamin D levels, lifestyle factors, and the clustering of metabolic risk factors in the study sample. RESULTS: Serum vitamin D levels were negatively associated with body fatness parameters, including body mass index, percent body fat, and waist circumference, but positively associated with accelerometer-based PA including low, moderate, and vigorous levels. In addition, serum vitamin D levels were inversely related to total cholesterol, triglycerides, fasting glucose, and insulin. A stepwise linear regression model showed that both low serum vitamin D levels and decreased vigorous PA were independent predictors for individual variation in the clustering of metabolic risk factors in this study sample. CONCLUSION: The results of this study suggest that an increase in vigorous PA and vitamin D intake should be two major targets of public health inventions against the clustering of metabolic risk factors in the Korean pediatric population.

The impact of laser Doppler imaging on the early decision-making process for surgical intervention in adults with indeterminate burns.

OBJECTIVE: We aimed to analyze whether laser Doppler imaging (LDI) can lead to earlier decision-making regarding the need for surgery in adults with indeterminate burns. METHODS: In a retrospective cohort study, we developed a prediction model for surgery in adults with indeterminate burns. Patient data (n=101) from January 2007 to December 2009 were used for model development, and those (n=40) from January 2010 to October 2010 for external validation. RESULTS: Between non-surgical and surgical groups, there were significant differences for mean age (p=0.009), % total body surface area burn (p=0.016), site of burn wound (p=0.033), and mean perfusion units (PU) (p<0.001). Multiple logistic regression showed that only the mean PU differed significantly between the groups. The area under the curve (AUC) of the equation derived from multiple logistic regression was 0.938, which did not differ from that of the mean PU alone (0.931; p=0.453). Using a cut-off point of 154.7PU, the sensitivity of LDI was 78.3% and the specificity was 92.7%. This cut-off point also yielded a sensitivity of 77.8% and specificity of 95.5% in the external validation dataset. CONCLUSION: LDI can help make a decision for surgery in the early stages of care for adults with indeterminate burns.

Genetic effects of adiponectin single nucleotide polymorphisms on the clustering of metabolic risk factors in young Korean adults.

Little is known if lifestyle-related risk factors modulate the adiponectin genetic effects on its outcome phenotypes. The aims of the study were to investigate whether the association between the adiponectin gene two SNPs (+45T>G, rs2241766 and +276G>T, rs1501299) and a clustering of metabolic risk factors is modified by both cardiorespiratory fitness (CRF) and insulin resistance in a study sample of 1,622 young Korean adults (941 men and 681 women, mean age 22.9 ± 2.4 years). The clustering of metabolic risk factors was defined as a sum of Z scores for waist circumference (WC), blood pressure (BP), triacylglycerols (TAG), high-density lipoprotein cholesterol, and fasting glucose. With respect to SNP +45T>G, the TT genotype had significantly higher values for BMI, WC, systolic BP, TAG, insulin, and a clustered risk score than did the TG+GG genotype. The genetic effect of SNP +45 on the clustered risk score remained significant even after controlling for age, sex, and smoking (P = 0.019). However, the genetic impact was no longer significant when additionally controlling for CRF (P = 0.097) and fasting insulin (P = 0.181), respectively. With respect to SNP +276G>T, the GT+TT genotypes had significantly higher values for BMI and TAG than did the TT genotype. In summary, the present findings suggest that the SNPs at position +45 and +276 are associated with several of metabolic risk factors; however, the genetic effect of SNP +45T/G variant on the clustered risk score is modulated by both CRF and insulin resistance.

Clustering of metabolic syndrome risk factors associated with lifestyle factors and serum leptin in Korean children.

The present study investigated the relationships among metabolic risk factors, major lifestyle factors, and serum cytokines in a sample of Korean children. In a cross-sectional design, we studied a total of 275 children (130 boys and 145 girls) aged 12-13 years. Measured variables included anthropometrics, blood pressures (BP), VO2max, physical activity (PA), dietary intakes, lipids, glucose, and insulin. We explored the extent to which dietary intakes, VO2max, PA, and serum cytokines explained variance in a clustered risk score, which is a sum of Z scores for waist circumference, BP, TG, HDLC, and HOMA-IR, using a stepwise linear regression by blocks. VO2max, vigorous PA (VPA), and leptin were independent predictors for the clustered risk score while adjusting for age and Tanner stage. Our findings suggest that the clustered risk score is associated not only with low levels of VO2max and VPA, but also with elevated serum leptin in Korean children.

Combined effects of body mass index and cardio/respiratory fitness on serum vaspin concentrations in Korean young men.

Little information is available regarding how body fatness and cardio/respiratory fitness (CRF) are associated with serum vaspin. The purpose of the study was to investigate the combined effect of body mass index (BMI) and CRF on serum vaspin in Korean young men. In a cross-sectional study, we examined 490 Korean young men (mean age 23.8 +/- 2.5 years) who were voluntarily recruited. Body fatness and fasting levels of serum insulin, adiponectin, and vaspin were measured. CRF was quantified as the minute volume of oxygen consumption (VO(2)) measured during a graded treadmill test. We assigned individuals to either low or middle or high third CRF tertiles based on age-adjusted VO(2max). We also assigned individuals to either a lean weight (LN) or obese (OB) group based on body fatness levels, in which a BMI value >/=25 kg/m(2) was used as an indicator of Pacific-Asian obesity. Group analyses showed significant interaction effects between fatness and CRF on fasting insulin and serum vaspin such that the OB group with low CRF levels had significantly higher insulin and vaspin concentrations than the OB counterparts with moderate to high CRF levels, and no such CRF-based sub-group differences in insulin and vaspin were found in the LN groups. Regression analyses show that BMI, waist circumference, VO(2), and fasting insulin explain approximately 18% of the individual variations in serum vaspin concentration in this study population. This is the first study to show that high body fatness along with low CRF might contribute to increased vaspin concentrations in Korean young men.

Relationship between healing time and mean perfusion units of laser Doppler imaging (LDI) in pediatric burns.

BACKGROUND: Laser Doppler imaging (LDI) is a noninvasive technique used to assess burn depth. However, there have been no studies regarding the use of LDI in predicting burn healing time. OBJECTIVES: The aims of this study are to evaluate the relationship between healing time and the amount of perfusion seen on LDI and to determine a cut-off value for LDI that predicts if a burn will heal within 14 days. STUDY DESIGN: Consecutive patients younger than 15 years old with partial-thickness burns were recruited from May to November 2006 for this prospective observational study. The mean number of perfusion units (PU) as determined by LDI (Periscan PIM 3 system) was obtained within 2-3 days following injury. Healing time was estimated clinically by two physicians and marked by the observation of reepithelization. The mean PU was compared between the early (healed with 14 days) and late healing groups (healed later than 14 days). The usefulness of the mean PU in predicting healing time within 14 days was estimated by receiver operating characteristic curve analysis. RESULTS: A total of 103 patients with 181 partial-thickness burn wounds were enrolled in this study. The mean PU from LDI was higher in the early healing group compared to the late healing group (380.2+/-157.8 vs. 185.8+/-115.8, p<0.001). When using 250 PUs as a cut-off value to predict early healing, the sensitivity and specificity were 80.6% and 76.9%, respectively. The area under the ROC curve was 0.844 (p<0.001, 95% CI=0.780-0.908). CONCLUSIONS: This study suggests the mean PU as determined by LDI can be used as a valuable tool in predicting the healing time of burn wounds.

Polymorphism of haptoglobin in patients with premature rupture of membrane.

PURPOSE: To investigate whether allelic polymorphism of haptoglobin (Hp) is associated with premature rupture of membrane (PROM), the Hp phenotypes of pregnant women with PROM were analyzed. PATIENTS AND METHODS: The Hp phenotypes of 221 pregnant Korean women (187 control and 34 PROM patients) were determined by benzidine/hydrogen peroxide staining, following native polyacrylamide gel electrophoresis of hemoglobin-mixed sera. The Hp allele frequencies were calculated from the data of Hp phenotypes, and overall association with PROM was evaluated using Pearson Chi-Square test. RESULTS: The polymorphic distribution of the patients cohort who underwent a normal delivery (control group) was similar to that of healthy Koreans. In contrast, however, patients with PROM showed significantly higher occurrence of the Hp 1-1 phenotype than control group (23.5% vs 8.0%). Hp 2-2 phenotype was lower in PROM cohort (38.2%) than in the control group (48.7%). The Hp(1) allele frequency in PROM group was significantly higher than that in the control group (0.426 vs 0.297, p = 0.034) with odds ratio of 1.762 (95% CI: 1.038 - 2.991). CONCLUSION: These findings suggest that pregnant Korean women who possess Hp(1) allele (expressed as Hp 1-1 phenotype) have higher incidence of PROM than women with Hp(2) allele (expressed as Hp 2-2 phenotype). This is the first study that evaluated the significance of Hp polymorphism with respect to the development of PROM.