Although rheumatoid arthritis (RA) is the most common chronic inflammatory autoimmune disease, diagnosis of RA is currently based on clinical manifestations, and there is no simple, practical assessment tool in the clinical field to assess disease activity and severity. Recently, there has been increasing interest in the discovery of new diagnostic RA biomarkers that can assist in evaluating disease activity, severity, and treatment response. Proteomics, the large-scale study of the proteome, has emerged as a powerful technique for protein identification and characterization. For the past 10 years, proteomic techniques have been applied to different biological samples (synovial tissue/fluid, blood, and urine) from RA patients and experimental animal models. In this review, we summarize the current state of the application of proteomics in RA and its importance in identifying biomarkers and treatment targets.
Arthritis, Rheumatoid* ; Autoimmune Diseases ; Biomarkers ; Diagnosis ; Humans ; Models, Animal ; Proteome ; Proteomics*

Primary aortoenteric fistula (PAEF) is a rare but catastrophic cause of massive gastrointestinal bleeding. Diagnosis of PAEF is difficult to make and is frequently delayed without strong clinical suspicion. Timely surgical intervention is essential for patient's survival. We report on a case of an 86-year-old woman with no history of abdominal surgery, who presented with abdominal pain. Initially, computed tomography scan showed an intra-abdominal abscess, located anterior to the aortic bifurcation. However, she was discharged without treatment because of spontaneous improvement on a follow-up computed tomography scan, which showed a newly developed right common iliac artery aneurysm. One week later, she was readmitted due to recurrent abdominal pain. On the second day of admission, sudden onset of gastrointestinal bleeding occurred for the first time. After several endoscopic examinations, an aortoenteric fistula bleeding site was found in the sigmoid colon, and aortography showed progression of a right common iliac artery aneurysm. We finally concluded that intra-abdominal abscess induced an infected aortic aneurysm and enteric fistula to the sigmoid colon. This case demonstrated an extremely rare type of PAEF to the sigmoid colon caused by an infected abdominal aortic aneurysm, which has rarely been reported.
Abdominal Abscess/*diagnosis/microbiology ; Aged, 80 and over ; Aorta, Abdominal/radiography ; Aortic Aneurysm, Abdominal/*diagnosis/etiology ; Bacteroides/isolation & purification ; Bacteroides fragilis/isolation & purification ; Colon, Sigmoid/radiography ; Colonoscopy ; Enterococcus/isolation & purification ; Female ; Fistula/*diagnosis ; Humans ; Tomography, X-Ray Computed

OBJECTIVE: The purpose of this paper is to analyze the effects of precarious employment status on the level of self-rated health, based on various criteria, by participants in the Korean Labor and Income Panel Survey. METHODS: Data were obtained from 3,268 subjects(2,057 men and 1,211 women), who participated in the 2005-2006 Korean Labor and Income Panel Survey. Group A was classified as Non-precarious employment by both the Ministry of Labor (MoLab) and the Korea Labor and Society Institute (KLSI). The group B was classified as Non-precarious employment by the MoLab and as precarious employment by the KLSI. The group C is classified as Non-precarious employment by both MoLab and KLSI. Outcome variables were self-rated health and a panel logistic regression analysis was performed on the data. RESULTS: The level of self-rated health was worse among group B males (OR: 1.45, C.I:1.00~2.11) and group C males (OR: 1.69, C.I:1.35~2.10) compared to group A males. A substantial difference(57.8%) in the level of self-rated health between groups A and B was attributed to the sociodemographic characteristics of the populations. The difference in self-rated health between groups A and C was explained by work environments(15.7%), as well as by sociodemographic characteristics(26.1%). For female workers, the level of self-rated health in group B and C was worse than in group A, but this finding was not statistically significant. CONCLUSIONS: These findings suggested that the policy to improve the working environment, as well as a more comprehensive effort to reduce the disparity, is needed for the precarious employment worker.
Employment ; Female ; Health Status ; Humans ; Korea ; Logistic Models ; Longitudinal Studies ; Male

OBJECTIVES: The present study was designed to determine the characteristics of shift work and the relationship between shift work and the level of self-rated health using the Korean Labor and Income Panel Study (KLIPS) data, which represents urban households in Korea. METHODS: Using the 9th wave of KLIPS, this study analyzed 2,087 male workers aged 25 to 64 years; participants missing data were excluded from analysis. To determine the impact of shift work on the level of self-rated health, logistic regression analysis was applied that controlled for socio-demographic characteristics, labor environment, and health-related behaviors. RESULTS: Shift workers comprised 13.4% of study subjects overall. The majority(69.2%) of participants were in 2-teams and in 2-shifts. Week 1 shift cycle changes were the highest, 56.3%. The risk of poor self-rated health was not significantly higher among shift workers compared to non-shift workers (OR=1.08, 95% CI=0.79~1.48). When divided by tenure, shift workers with more than 10-years experience (OR=1.79, 95% CI=0.91~3.50) tended to show greater risk than non-shift workers at marginal significance. CONCLUSIONS: In the present study, a significantly higher risk of self-rated poor health among shift workers was not observed. However, shift workers with more than 10-years experience tended to show increased health risk compared to non-shift workers. Further studies are required to determine time-series data and to consider both healthy worker effect and information bias.
Aged ; Bias (Epidemiology) ; Family Characteristics ; Healthy Worker Effect ; Humans ; Korea ; Logistic Models ; Male

Due to the aging population and tremendous changes in life style over the past decades, cancer has been the leading cause of death in Korea. The incidence rate of breast cancer is the second highest in Korea, and it has shown an annual increase of 6.8% for the past 6 years. The major risk factors of breast cancer in Korean women are as follows: Early menarche, late menopause, late full-term pregnancy (FTP), and low numbers of FTP. Height and body mass index increased the risk of breast cancer in postmenopausal women only. There are ethnic variations in breast cancer due to the differences in genetic susceptibility or exposure to etiologic agent. With the epidemiological evidences on the possibility of further increase of breast cancer in Korea, the Korean Government began implementing the National Cancer Screening Program against breast cancer in 2002. Five-year survival rates for female breast cancer have improved significantly from 78.0% in early 1993-1995 to 90.0% in 2004-2008. This data indicate that improvement of the survival rate may be partially due to the early diagnosis of breast cancer as well as the increased public awareness about the significance of early detection and organized cancer screening program. The current primary prevention programs are geared towards strengthening national prevention campaigns. In accordance with the improvement in 5-year survival rate, the overall cancer mortality has started to decrease. However, breast cancer death rate and incidence rates are still increasing, which need further organized effort by the Korean Government.
Aging ; Body Mass Index ; Breast ; Breast Neoplasms ; Cause of Death ; Early Detection of Cancer ; Early Diagnosis ; Female ; Formycins ; Genetic Predisposition to Disease ; Humans ; Incidence ; Korea ; Life Style ; Menarche ; Menopause ; Pregnancy ; Primary Prevention ; Ribonucleotides ; Risk Factors ; Survival Rate

BACKGROUND: Graft-versus-host disease (GVHD) is initiated when alloreactive donor T cells are primed by host APCs to undergo clonal expansion and maturation. Since there is a controversy regarding the role of nonhematopoietic cells in GVHD, we wanted to investigate the influence of MHC disparity on nonhematopoietic cells on the pathogenesis of GVHD in the MHC-haplomismatched C57BL/6 (H-2(b)) or DBA/2 (H-2(d))-->unirradiated (C57BL/6xDBA/2) F(1)(BDF(1); H-2(b/d)) murine model of acute GVHD (aGVHD) or chronic GVHD (cGVHD). METHODS: We generated (BDF(1)-->C57BL/6), (BDF(1)-->DBA/2), and (BDF(1)-->BDF(1)) chimeras and examined GVHD-related parameters and donor cell engraftment in those chimeras. RESULTS: Using this experimental system, we found that 1) severe aGVHD across MHC Ag barrier depends on the expression of nonhematopoietically rather than hematopoietically derived alloAgs for maximal GVHD manifestations; 2) host APCs were sufficient to break B cell tolerance to self molecules in cGVHD, whereas host APCs were insufficient to induce autoimmunity in aGVHD; 3) donor cell engraftment was greatly enhanced in the host with MHC-matched nonhematopoietic cells. CONCLUSION: Taken together, our results provide an insight into how MHC disparity on GVHD target organs contribute to the pathogenesis of GVHD.
Autoimmunity ; Chimera ; Graft vs Host Disease ; Humans ; Immune Tolerance ; T-Lymphocytes ; Tissue Donors

PURPOSE: To evaluate the usefulness of transcatheter arterial chemoembolization (TACE) in the management of gastrointestinal leiomyosarcoma metastatic to the liver. MATERIALS AND METHODS: Ten patients with gastrointestinal leiomyosarcoma and hepatic metastasis underwent TACE after surgical resection of the primary tumor. All of the leiomyosarcomas originated from the stomach (n=5), duodenum (n=1) or jejunum(n=4), and the interval between primary tumor resection and hepatic metastasis was 1-120 (mean 26) months. Using an emulsion of 3-20 mL of Lipiodol and 15-60 mg of doxorubicin. TACE was performed, and in five patients, gelfoam embolization was added. Therapeutic response was evaluated by follow-up CT, and nine patients underwent repeated TACE (range :2-9 times ; interval : 1-9 months). RESULTS: On celiac arteriography, all cases showed hypervascular tumor staining. As an initial therapeutic response based on CT assessment, more than 50% regression of the tumor (partial remission) was achieved in seven patients, and in the remaining three, regression was 20-30% (stable disease) ; neither complete remission nor progression was seen. With regard to long-term survival, five patients died at 5, 8, 14, 20 and 49 (median, 19) months after initial TACE. The remaining five, in whom follow-up has extended for 13-54 months, are still alive. Overall, survival time ranged from 5-54 (median, 19) months, and except for postembolization syndrome, there was no specific complication. The period of durable tumor regression before progression ranged from 6 to 54 (median, 17) months. CONCLUSION: TACE can be a safe and effective method for the palliation of gastrointestinal leiomyosarcoma metastatic to the liver.
Angiography ; Doxorubicin ; Duodenum ; Ethiodized Oil ; Follow-Up Studies ; Gelatin Sponge, Absorbable ; Humans ; Leiomyosarcoma* ; Liver* ; Neoplasm Metastasis* ; Stomach

OBJECTIVES: To estimate the effect of medical conditions in the population of Korea on breast cancer risk in a case-control study. METHODS: The cases were 3242 women with incident, histologically confirmed breast cancer in two major hospitals interviewed between 2001 and 2007. The controls were 1818 women each admitted to either of those two hospitals for a variety of non-neoplastic conditions. Information on each disease was obtained from a standardized questionnaire by trained personnel. Odds ratios (ORs) for each disease were derived from multiple logistic regression adjusted for age, age of menarche, pregnancy, age of first pregnancy, and family history of breast cancer. RESULTS: Among all of the incident breast cancer patients, pre-existing diabetes (OR, 1.33; 95% confidence interval [CI], 0.99 to 1.78), hypertension (OR, 1.46; 95% CI, 1.18 to 1.83), thyroid diseases (OR, 1.26; 95% CI, 1.00 to 1.58), and ovarian diseases (OR, 1.70; 95% CI, 1.23 to 2.35) were associated with an increased risk of breast cancer when other factors were adjusted for. In a stratified analysis by menopausal status, pre-existing hypertension (pre-menopause OR, 0.80; 95% CI, 0.48 to 1.34 vs. post-menopause OR, 1.87; 95% CI, 1.44 to 2.43; p-heterogeneity <0.01) and ovarian disease (pre-menopause OR, 4.20; 95% CI, 1.91 to 9.24 vs. post-menopause OR, 1.39; 95% CI, 1.02 to 1.91; p-heterogeneity 0.01) showed significantly different risks of breast cancer. CONCLUSIONS: Our results suggest the possibility that medical conditions such as hypertension affect breast cancer development, and that this can differ by menopausal status. Our study also indicates a possible correlation between ovarian diseases and breast cancer risk.
Age Factors ; Breast Neoplasms/complications/*epidemiology ; Case-Control Studies ; Diabetes Complications ; Female ; Humans ; Hypertension/complications ; Interviews as Topic ; Menarche ; Middle Aged ; Odds Ratio ; Ovarian Diseases/complications ; Postmenopause ; Pregnancy ; Premenopause ; Republic of Korea ; Risk Factors

To optimize treatment for rheumatoid arthritis (RA), it is ideal to monitor the disease activity on a daily basis because RA activity fluctuates over time. Urine can be collected routinely at home by patients. Recently, we identified four urinary biomarker candidates—gelsolin (GSN), orosomucoid (ORM)1, ORM2 and soluble CD14 (sCD14)—in RA patients through transcriptomic and proteomic studies. Here, we investigated the clinical significance of the aforementioned urinary biomarker candidates in a prospective manner. For the first time, we found that urinary ORM1, ORM2 and sCD14 levels, but not GSN, were elevated in RA patients and had a positive correlation with the status of the disease activity. In particular, urine tests for ORM 1, ORM 2 and sCD14 efficiently represented the presence of high RA activity without the need for measuring blood markers. In a parallel study, a more rapid radiographic progression over 3 years was observed in patients with higher ORM2 levels. Combined measurements of urinary ORM2 and serum C-reactive protein synergistically increased the predictability of the radiographic progression of RA (odds ratio: 46.5). Collectively, our data provide evidence that blood-free, urinary biomarkers are promising surrogates for assessing disease activity and prognosis of RA. We anticipate that our urinary biomarkers will provide novel candidates for patient-driven measurements of RA activity at home and can shift the paradigm from blood to urine testing in the assessment of RA activity and prognosis in hospitals.
Arthritis, Rheumatoid* ; Biomarkers* ; C-Reactive Protein ; Humans ; Orosomucoid ; Prognosis* ; Prospective Studies

Breast cancer is the second leading cancer for Korean women and its incidence rate has been increasing annually. If early diagnosis were implemented with epidemiologic data, the women could easily assess breast cancer risk using internet. National Cancer Institute in the United States has released a Web-based Breast Cancer Risk Assessment Tool based on Gail model. However, it is inapplicable directly to Korean women since breast cancer risk is dependent on race. Also, it shows low accuracy (58%-59%). In this study, breast cancer discrimination models for Korean women are developed using only epidemiological case-control data (n = 4,574). The models are configured by different classification techniques: support vector machine, artificial neural network, and Bayesian network. A 1,000-time repeated random sub-sampling validation is performed for diverse parameter conditions, respectively. The performance is evaluated and compared as an area under the receiver operating characteristic curve (AUC). According to age group and classification techniques, AUC, accuracy, sensitivity, specificity, and calculation time of all models were calculated and compared. Although the support vector machine took the longest calculation time, the highest classification performance has been achieved in the case of women older than 50 yr (AUC = 64%). The proposed model is dependent on demographic characteristics, reproductive factors, and lifestyle habits without using any clinical or genetic test. It is expected that the model could be implemented as a web-based discrimination tool for breast cancer. This tool can encourage potential breast cancer prone women to go the hospital for diagnostic tests.
Adult ; Aged ; Aged, 80 and over ; Breast Neoplasms/*diagnosis/*epidemiology ; Diagnosis, Computer-Assisted/*methods ; Early Detection of Cancer/*methods ; Female ; Humans ; *Machine Learning ; Middle Aged ; Pattern Recognition, Automated/methods ; Prevalence ; Reproducibility of Results ; Republic of Korea/epidemiology ; Risk Assessment/methods ; Risk Factors ; Sensitivity and Specificity ; Women's Health/*statistics & numerical data