CSII in type 1 diabetes is associated with improved glycemic control with no increase in hypoglycemia. HbA1c improvement declined over time, suggesting a need for re-education after CSII commencement. The iMDI program did not have significant glycemic benefits.
S: Concurrent FP chemoradiotherapy was effective as a definitive therapy for patients with esophageal cancer. The major toxicity was mucositis. Although the treatment was relatively feasible, a randomized trial of reduced courses of chemotherapy is warranted.
Background: Increased body fat, abdominal obesity and insulin resistance are important clinical features in hypogonadal men. Several studies have demonstrated that a low testosterone concentration in men is associated with coronary heart disease, visceral obesity and insulin resistance. In this study, the effects of testosterone replacement therapy on the abdominal visceral fat and cardiovascular risk factors in hypogonadal men were investigated.Methods: We selected 26 men with secondary hypogonadism (mean serum testosterone ± SD 0.39 ± 0.57 ng/mL), who were then treated with testosterone for 12 months. We measured the body composition, including the abdominal visceral fat area by abdominal CT at the L4 level, both before and 12 months after treatment, and the lipid profile, fasting plasma insulin, HOMA-IR and the serum homocysteine, CRP and IL-6 before and 6, 12 months after treatment.Results: With respect to the body composition, the lean body mass had significantly increased 12 months after treatment (P = 0.002), but there were no significant changes in the body fat mass and abdominal visceral fat area. There was a trend toward a decreased fasting plasma insulin and HOMA-IR, but this did not reach statistical significance. The total cholesterol had decreased significantly at 12 months (P = 0.04) and the HDL cholesterol decreased significantly over the course of study (P = 0.02). There were no significant changes in the serum homocysteine, CRP and IL-6 after treatment.Conclusions: After 12 months testosterone replacement therapy in the 26 men with hypogonadism, the lean body mass had increased significantly, but there was no significant change on the abdominal visceral fat during the treatment period. Testosterone replacement had deleterious effect on HDL cholesterol, but not significant effects on insulin resistance and the serum homocysteine, CRP and IL-6. These results suggest that testosterone replacement therapy may have a few adverse effects on cardiovascular diseases in hypogonadal men. However, it will be necessary to examine the long-term effects of testosterone replacement on the incidence of cardiovascular events as well as the cardiovascular risk factors in men with hypogonadism (J Kor Soc Endocrinol 20:252~260, 2005). ꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏ
Background and Objectives:The presence of leukocytosis in patients with acute myocardial infarction (AMI) has been reported to be related to the extent of MI and with the prognosis. However, whether the leukocytosis itself is a cause or result of the myocardial injury has not been determined. The relationship between the leukocyte count and the extent of myocardial injury was investigated in patients with AMI that had undergone reperfusion therapy. Subjects and Methods:Patients with AMI that had undergone thrombolysis (n=60) or primary PCI (n=36) were included. The initial leukocyte counts were analyzed with regard to the peak and initial CK-MB levels. The relationship between leukocytosis and the time elapsed from the onset of symptoms, infarct related coronary arteries and the proximity of the lesions were also investigated. Results:In both groups, the initial leukocyte count did not show a significant relationship with the initial CK-MB level or the time elapsed from symptoms onset, which could be an indication of the extent of early myocardial injury. Furthermore, no significant relationship was shown with the infarct related coronary artery or proximity of the lesion. However, a relationship was shown with the maximum CK-MB level, which could be an indication of the extent of myocardial injury following reperfusion therapy in both groups (p<0.01). Conclusion:This study suggests that the initial leukocyte count in patients with AMI might is an important prognostic factor that determines the extent of myocardial injury following reperfusion therapy, rather than being a simple indicator of the extent of early myocardial injury. (Korean Circulation J 2004;34(8):735-742)
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