Comparative study on long-term stability in mandibular sagittal split ramus osteotomy: hydroxyapatite/poly-l-lactide mesh versus titanium miniplate.

BACKGROUND: Resorbable devices have recently been adopted in the field of orthognathic surgery with controversies about their postoperative skeletal stability. Hence, we determined the long-term skeletal stability of unsintered hydroxyapatite/poly-l-lactic acid (HA/PLLA) mesh for osteofixation of mandibular sagittal split ramus osteotomy (SSRO), and compared it with that of titanium miniplate. METHODS: Patients were divided into resorbable mesh and titanium miniplate fixation groups. A comparative study of the change in the mandibular position was performed with preoperative, 1-day, 6-month, and 2-year postoperative lateral cephalograms. RESULTS: At postoperative 6 months-compared with postoperative 1 day, point B (supra-mentale) was significantly displaced anteriorly in the titanium-fixation group. Moreover, at postoperative 2 years-compared with postoperative 6 months, point B was significantly displaced inferiorly in the titanium-fixation. However, the HA/PLLA mesh-fixation group did not show any significant change with respect to point B postoperatively. CONCLUSIONS: The HA/PLLA mesh-fixation group demonstrated superior long-term skeletal stability with respect to the position of mandible, when compared with the titanium-fixation group.

The effect of physical activity on serum IL-6 and vaspin levels in late elementary school children.

PURPOSE: This study investigates the effects of physical activity on serum IL-6 and vaspin in late elementary school children. METHODS: Those who (n = 220) completed the 7-day physical activity monitoring underwent a second round of measurements including body fat, serum glucose and insulin, and serum IL-6 and vaspin. One way ANOVAs followed by LSD post hoc tests were used to test for significant differences in dependent variables across incremental physical activity levels at p=0.05. Multivariate stepwise linear regression analyses were used to determine significant predictors for serum IL-6 and vaspin levels at p=0.05. RESULTS: The results showed significant inverse linear trends for body fat parameters across incremental physical activity levels (from low to high); the lower the body fat, the higher the physical activity levels. On the other hand, there were no significant linear trends for insulin resistance markers or dietary intake across incremental physical activity levels. Multiple stepwise linear regression analyses were used to determine significant predictors for individual variations in serum IL-6 and vaspin in the study population. We found that body mass index (p=0.002) and low- and moderate-intensity physical activities (p=0.002 and p=0.0045, respectively) were significant determinants of serum IL-6. In addition, low- and moderate-intensity physical activities (p=0.01 & p=0.022, respectively) were significant determinants of serum vaspin levels in this study population. CONCLUSION: In summary, the findings of the current study suggest that promotion of physical activity along with a healthy diet should be key components of lifestyle interventions to improve serum cytokine profiles associated with insulin resistance syndrome in late elementary school children.

Single Cavernous Hemangioma of the Small Bowel Diagnosed by Using Capsule Endoscopy in a Child with Chronic Iron-Deficiency Anemia.

Cavernous hemangiomas of the gastrointestinal tract are extremely rare. In particular, the diagnosis of small bowel hemangiomas is very difficult in children. A 13-year-old boy presented at the outpatient clinic with dizziness and fatigue. The patient was previously diagnosed with iron-deficiency anemia at 3 years of age and had been treated with iron supplements continuously and pure red cell transfusion intermittently. Laboratory tests indicated that the patient currently had iron-deficiency anemia. There was no evidence of gross bleeding, such as hematemesis or bloody stool. Laboratory findings indicated no bleeding tendency. Gastroduodenoscopy and colonoscopy results were negative. To obtain a definitive diagnosis, the patient underwent capsule endoscopy. A purplish stalked mass was found in the jejunum, and the mass was excised successfully. We report of a 13-year-old boy who presented with severe and recurrent iron-deficiency anemia caused by a cavernous hemangioma in the small bowel without symptoms of gastrointestinal bleeding.

Long-term outcome of patients with p22 (phox) -deficient chronic granulomatous disease on Jeju Island, Korea.

PURPOSE: This study investigated the long-term clinical outcomes of patients with p22 (phox) -deficient chronic granulomatous disease (CGD) on Jeju Island and retrospectively evaluated the effects of interferon-gamma (IFN-γ) prophylaxis. METHODS: The medical records of 15 patients with CGD were retrospectively reviewed. The efficacy of IFN-γ prophylaxis was evaluated by comparing the frequency of severe infections before and after starting continuous prophylaxis with IFN-γ. RESULTS: At the time of the analysis, 14 patients were alive, with a median age of 14.3 years. The diagnosis of CGD was made at a median age of 2.4 years, and the median age at onset of severe infection was 0.3 years. Thirteen of the 15 patients had their first severe infection within the first year of life. The overall incidence of severe infection was 1.36 infections per patient-year; pneumonia, suppurative lymphadenitis, and skin and subcutaneous abscesses were the most common infections. Aspergillus species were the most frequently isolated microorganisms, present in 15.8% of isolates. IFN-γ did not significantly change the rate of severe infection. The survival rate for patients after 2 years of age was 93%; there was a prolonged survival plateau beyond the age of 2. CONCLUSION: Compared with cases of X-linked CGD reported in other studies, patients with CGD on Jeju Island did not show obviously different clinical manifestations, but they had a significantly higher survival rate. Further studies with a substantially longer period of observation, and with more patients under intensive surveillance are necessary to elucidate the prophylactic efficiency of IFN-γ.

High-dose methylprednisolone pulse therapy for treatment of refractory intestinal involvement caused by Henoch-Schönlein purpura: a case report.

INTRODUCTION: Henoch-Schönlein purpura is an immunoglobulin A-mediated, small vascular inflammatory disease that can be associated with palpable purpura, arthralgia, abdominal pain, or nephritis. The presence of purpura facilitates the diagnosis of Henoch-Schönlein purpura at the onset of associated symptoms, whereas the absence of purpura makes the diagnosis challenging. It is important to diagnose Henoch-Schönlein purpura with delayed-onset skin purpura to avoid unnecessary surgery for acute abdomen. Most cases of Henoch-Schönlein purpura with severe abdominal pain are treated with low-dose steroids and intravenous immunoglobulin. CASE PRESENTATION: A 15-year-old Korean girl complained of severe abdominal pain and delayed-onset purpura on admission. Henoch-Schönlein purpura was diagnosed based on endoscopic findings of hemorrhagic duodenitis and duodenal vasculitis and abdominal computed tomography findings of edematous bowels. Two common initial treatments, a low-dose steroid and intravenous immunoglobulin, were administered, but there was no improvement for 1 month. Subsequently, we used high-dose intravenous methylprednisolone pulse therapy (30 mg/kg/day, with a maximum of 1g/day), which dramatically alleviated her abdominal symptoms. CONCLUSIONS: High-dose intravenous methylprednisolone pulse therapy can be used as the ultimate treatment for delayed-onset Henoch-Schönlein purpura with severe abdominal pain when symptoms do not improve after low-dose steroid and intravenous immunoglobulin treatments.

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.

Roles of physical activity and cardiorespiratory fitness on sex difference in insulin resistance in late elementary years.

PURPOSE: Little is known about the potential role of lifestyle factors in sex differences in insulin resistance in late elementary school children. METHODS: In this cross-sectional study, we compared sex differences in Tanner scales, body fat, physical activity (PA) and fitness, and insulin resistance markers in elementary school children (boys, n = 69 and girls, n = 81) aged 12-13 years. Body composition was assessed with a standardized protocol. Cardiorespiratory fitness was measured as oxygen consumption during an incremental treadmill exercise. Fasting blood samples were collected for blood chemistry assays including lipids, glucose, insulin and homeostasis model assessment for insulin resistance (HOMA-IR), leptin, and adiponectin. Daily PA was measured with an accelerometer for 7 consecutive days, and they were classified as low-, moderate-, and vigorous-PA. Independent t-tests were used to compare mean differences in the measured variables between boys and girls. There were significant sex differences in Tanner scales, body mass index, percent body fat, and waist circumference (WC). RESULTS: Girls had significantly higher values in Tanner scales (p < 0.001) and percent body fat (p < 0.001) than boys. Boys had significantly higher values in body mass index (p = 0.019) and waist circumference (p < 0.001) than girls. Boys also had significantly higher values in VO2max (p < 0.001) and low (p < 0.001), moderate (p < 0.001), and vigorous (p < 0.001) PAs. With respect to metabolic risk factors, girls had significantly higher serum levels of triglycerides (p = 0.005), insulin (p < 0.001), and HOMA-IR (p < 0.001) and significantly lower high-density lipoprotein cholesterol (p = 0.015) than boys. CONCLUSION: In summary, the current findings of the study showed that the increased risk for insulin resistance in girls over boys is associated with higher Tanner scale and percent body fat in conjunction with poor cardiorespiratory fitness and physical inactivity, suggesting that exercise intervention to promote physical activity and fitness is imperative for general health promotion of school children, with a special focus on girls.

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.

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.

Low cardio/respiratory fitness as an independent predictor of metabolic syndrome in Korean young men.

Little information is available regarding the relationship between cardio/respiratory fitness (CRF) and metabolic risk factors in South Korea. The purpose of this study was to compare metabolic risk factors and the prevalence of metabolic syndrome (MS) across CRF levels in young Korean men. In a cross-sectional study, we examined 909 Korean young men (mean age 24.0 +/- 2 years) who were apparently healthy, free of any diagnosed chronic diseases, not taking any medications, and who had completed all the requested measurements. Body composition, resting blood pressures, and fasting blood levels of lipids, glucose, and insulin were measured with our standardized laboratory protocols. CRF was quantified as the maximum volume of minute oxygen uptake measured during a graded treadmill test. Group analyses showed that men with moderate to high CRF levels had more favorable profiles in terms of body composition, resting blood pressures, mean values in fasting lipids, glucose, and insulin as well as the homeostasis model of assessment-insulin resistance than men with a low CRF level. After adjusting for age, smoking, and percent body fat, the low and moderate CRF groups had odds of 4.64 (95% CI 2.00-10.79) and 2.57 (95% CI 1.04-6.34) respectively for having the MS compared to the high CRF group. These findings suggest that low CRF is positively and independently associated with the MS in Korean young men.

Apolipoprotein C-III SstI genotypes modulate exercise-induced hypotriglyceridemia.

PURPOSE: To investigate whether the efficacy of exercise as an antitriglyceridemic treatment was dependent on the apolipoprotein (apo) C-III SstI gene polymorphism. METHODS: A subgroup of 100 Korean men, who were prescreened by genotypes (S1S1 = 40, S1S2 = 40, S2S2 = 20), participated in a 6-d moderate-exercise intervention using either a motor-driven treadmill or a cycle ergometer. Height and weight for body mass index and waist circumference were measured. Fasting total cholesterol, triglycerides (TG), high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, glucose, and insulin were measured. Univariate analysis of variance and ANCOVA followed by Bonferroni post hoc tests were used to compare the preintervention values and the pre- to postexercise change (delta) scores in the measured variables across the genotypes, respectively. Multivariate linear regressions were carried out with age, smoking, waist circumference, body mass index, and genotype as independent variables and lipids, glucose, and insulin as dependent variables. RESULTS: Subjects with the S2S2 genotype had a significantly higher preintervention TG concentration than subjects with the S1S1 genotype (P = 0.022). Waist circumference and genotype were the only significant predictors for the preintervention TG (P < 0.001). With respect to the delta scores, the subjects with the S2S2 genotype had a greater reduction in TG than the subjects with the S1S1 genotype, adjusted for the preintervention difference (P = 0.047). CONCLUSION: This study suggests that the apo C-III SstI gene polymorphism might be useful for determining who is most susceptible to intervention by exercise in lowering fasting TG concentration.