BACKGROUND: Leptin, the product of ob gene, is an important circulating hormone for the regulation of homeostasis of body weight and enegy expenditure. There was a previous reports that thyroid hormone is one of regulating factors of leptin gene expression in vitro. The aim of this study was designed to evaluate the role of thyroid hormone levels in the regulation of circulating leptin concentrations in human. METHODS: A total 16S subjects were studied; 76 patients with Graves disease, 49 patients with Hashimoto disease and 43 control sujjects. The correlation between thryoid hormone and leptin levels were analyzed and serum leptin levels were compared among the groups which was classified by thyroid functional status. Serum leptin concentratios were measured by radioimmunoassay. RESULTS: There were no significant differences in serum leptin levels between the groups of control, Graves disease and Hashimoto disease. The hypothyroid groups of Graves disease which was induced by excessive antithyroid drug treatment showed significant low levels(5.6 +/-2.8 ng/mL) compared to control(9.6 +/- 5.2 ng/ml) and thyrotoxic groups(10.0 +/- 5,0 ng/mL) CONCLUSION: The hypothyroid patients showed low levels of serum leptin concentrations it may indicate that thyroid horrnone play a role in the appropriate secretion of leptin in human.
Body Weight ; Gene Expression ; Graves Disease ; Hashimoto Disease ; Health Expenditures ; Homeostasis ; Humans ; Leptin* ; Radioimmunoassay ; Thyroid Gland*

The Changes of soluble Fas levels in Patients with Autoimmune Thyroid Diseases BACKGROUD: Apoptosis was observed in thyroid tissue from Hashimoto disease but not those from Graves disease. Recently Fas and Fas ligand interactions among thyrocytes were suggested to development of clinical hypothyroidism in Hashimoto disease.Soluble Fas produced as the form lacking the tranmembrane domain due to alternative splicing, is supposed to inhibit Fas-Fas ligand interaction and blocks Fas mediated apoptosis. METHODS: In tbis study, we measured serum soluble Fas to determine the possible involvement of this molecule in the autoimmune thyroid disease by enzyme linked immunosorbant assay in 29 patients with Graves disease, 30 patients with Hashimotos disease and 19 normal controls. RESULTS: Compared with normal subjeets (4.26 +/- 1.00 U/mL), soluble Fas was not increased in patients with Graves disease (4.23 +/- 1.14 U/mL, p>0.05) but it was increased in throtoxic Graves patients (4.70 +/- 1.26 U/mL, p<0.05) compared to euthyroid Graves (3.72 +/- 0.73 U/mL, p<0.05) and normal subjects (4.26 +/- 1.00 U/mL, p<0.05). The euthyroid and hypothyroid patients with Hashimoto disease showed low soluble Fas levels, 2.94 +/- 0.54 U/mL and 2.74 U/mL, respectively compare to the patients with Graves disease and normal subjects. The thyroid hormone levels to (T3 T4 and free T4) showed positive correlation with the serum titers of antithyroid autoantibodies, antithyroglobuin antibodies, antiperoxidase antibodies and thyrotropin binding inhibitor immunoglobulins. CONCLUSION: We found that the patients with thyrotoxic Graves disease had increased level of serum soluble Fas and the patients with Hashimoto disease showed low levels of soluble Fas compared to normal controls. Increased soluble Fas in Graves disease suggests increased expression of alternatively spliced Fas mRNA variant and decreased soluble Fas in Hashimoto disease suggests decreased Fas mRNA variant and increased full length membrane Fas, so these findings are related to the promotion of apoptosis of thyroid cells during autoimmune reaction in Hashimotos disease.
Alternative Splicing ; Antibodies ; Apoptosis ; Autoantibodies ; Fas Ligand Protein ; Graves Disease ; Hashimoto Disease ; Humans ; Hypothyroidism ; Immunoglobulins ; Membranes ; RNA, Messenger ; Thyroid Diseases* ; Thyroid Gland* ; Thyrotropin

Gas within the gastric wall is an alarming finding and a rare condition. Clinically, this condition is divided into two entities; Gastric emphysema and emphysematous gastritis. These two diseases should be differentiated because they are characterized by different clinical symptoms, possible etiology, treatment and prognosis. While emphysematous gastritis is a severe condition with high mortality, gastric emphysema is asymptomatic and usually has benign course. Rarely, anorexia nervosa and bulimia nervosa have been discribed to be associated with acute gastric distension and duodenal obstruction induced by superior mesentery artery syndrome. So, gastric emphysema could be accompanied by acute gastric distension induced by anorexia nervosa. We report a rare case of gastric emphysema in a patient with anorexia nervosa presenting as superior mesenteric artery syndrome with relevant literatures. In this case, the gastric emphysema was improved without surgical intervention after nasogastric tube for decompression and feeding insertion in the fourth portion of the duodenum.
Acute Disease ; Adolescent ; Anorexia Nervosa/complications/*diagnosis ; Emphysema/complications/*diagnosis ; Female ; Gastric Dilatation/complications/*diagnosis/radiography ; Humans ; Intubation, Gastrointestinal ; Superior Mesenteric Artery Syndrome/diagnosis ; Tomography, X-Ray Computed

Intramural hematoma of the gastrointestinal tract is uncommon, with the majority being localized to the esophagus or duodenum. Hematoma of the gastric wall is extremely rare and caused by coagulopathy, peptic ulcer disease or blunt trauma. Recently due to the increase in patients with antiplatelet use, liver cirrhosis, and/or end stage reanal disease, occurrence of gastric submucosal hematomas after endoscopic hemostasis can increase. This is a case of gastric submucosal hematoma which occurred in a patient taking dual antiplatelet therapy after endoscopic hemostasis for gastric peptic ulcer bleeding. We report a case of gastric submucosal hematoma which improved with medical therapy and healed naturally with an ulcer scar.
Cicatrix ; Duodenum ; Esophagus ; Gastrointestinal Tract ; Hematoma ; Hemorrhage ; Hemostasis, Endoscopic ; Humans ; Liver Cirrhosis ; Peptic Ulcer ; Peptic Ulcer Hemorrhage ; Platelet Aggregation Inhibitors ; Ulcer

Damselfish Chromis notata is a small fish less than 15 cm long and it is widespread in the Indo-Pacific Ocean. Of all the cases of fish bone foreign body (FBFB) disease at our hospital, a damselfish FBFB was very common, and a specific part of the bone complex was involved in the majority of cases. This study was performed to evaluate the clinical characteristics of damselfish FBFB in Jeju Island. We retrospectively reviewed the medical records from March 2004 to March 2011 for foreign body diseases. Among 126 cases of foreign body diseases, there were 77 (61.1%) cases of FBFB. The mean age +/- standard deviation was 57.8 +/- 12.7 yr, and this was higher in females 60.9 +/- 14.6 yr vs 54.1 +/- 8.7 yr. Damselfish was the most common origin of a FBFB 36 out of total 77 cases. The anal fin spine-pterygiophore complex of damselfish was most commonly involved and cause more severe clinical features than other fish bone foreign bodies; deep 2.7 +/- 0.8 cm vs 2.3 +/- 0.8 cm; P < 0.01, more common mural penetration 23/36 vs 10/41; P < 0.01, and longer hospital stay 12.6 +/- 20.0 days 4.7 +/- 4.8 days; P = 0.02. We recommend removing the anal fin spine-pterygiophore complex during cleaning the damselfish before cooking.
Adult ; Aged ; Animals ; Bone and Bones/radiography ; Esophagoscopy ; *Esophagus ; Female ; Foreign Bodies/*diagnosis/radiography/surgery ; Humans ; Length of Stay ; Male ; Middle Aged ; Perciformes ; Retrospective Studies ; Tomography, X-Ray Computed

Background: Breast cancer is the second most common cancer and the most common cause of cancer deaths in Korean women. Although tumor-induced mediators and cancer therapy can suppress cell-mediated immunity, the concurrence of herpes zoster in breast cancer patients has not been well-recognized. Objective: This study aimed to delineate the characteristics of herpes zoster in patients with breast cancer, particularly its association with patient age and breast cancer severity, treatment, and clinical course. Methods: We retrospectively reviewed the medical records of breast cancer patients at a tertiary referral center in Korea from January 2003 to June 2018, identified patients with a subsequent diagnosis of herpes zoster, and analyzed their clinical characteristics. Results: Among 8,124 patients with breast cancer, 2.04% further developed zoster during a median 31-month follow-up period. Age at the diagnosis of breast cancer was higher in the zoster group than in the no zoster group.Cytotoxic chemotherapy and radiotherapy significantly increased the risk of zoster. Time from the diagnosis of breast cancer to zoster development was significantly shorter for invasive cancers than for in-situ cancers, with higher risk in the initial 2 years from the cancer diagnosis. Conclusion This study showed that breast cancer patients are at an increased risk of zoster, particularly in the time following cancer diagnosis. Therefore, a recent diagnosis of breast cancer should warrant clinical suspicion of zoster for patients with suggestive symptoms, and active management should be started.

Background: Breast cancer is the second most common cancer and the most common cause of cancer deaths in Korean women. Although tumor-induced mediators and cancer therapy can suppress cell-mediated immunity, the concurrence of herpes zoster in breast cancer patients has not been well-recognized. Objective: This study aimed to delineate the characteristics of herpes zoster in patients with breast cancer, particularly its association with patient age and breast cancer severity, treatment, and clinical course. Methods: We retrospectively reviewed the medical records of breast cancer patients at a tertiary referral center in Korea from January 2003 to June 2018, identified patients with a subsequent diagnosis of herpes zoster, and analyzed their clinical characteristics. Results: Among 8,124 patients with breast cancer, 2.04% further developed zoster during a median 31-month follow-up period. Age at the diagnosis of breast cancer was higher in the zoster group than in the no zoster group.Cytotoxic chemotherapy and radiotherapy significantly increased the risk of zoster. Time from the diagnosis of breast cancer to zoster development was significantly shorter for invasive cancers than for in-situ cancers, with higher risk in the initial 2 years from the cancer diagnosis. Conclusion This study showed that breast cancer patients are at an increased risk of zoster, particularly in the time following cancer diagnosis. Therefore, a recent diagnosis of breast cancer should warrant clinical suspicion of zoster for patients with suggestive symptoms, and active management should be started.

Emergent endoscopy is needed in cases of a fish bone foreign body in the upper gastrointestinal tract. A fish bone foreign body is common in the oral cavity and pharynx and has a high rate of complications because of the characteristic shape. A diagnosis is very difficult when the foreign body penetrates and impacts the surrounding tissue. Computed tomography is useful for the diagnosis; however, direct removal would be impossible if the foreign body was not localized during endoscopy. If the foreign body is anchored to the oral cavity and pharynx, finger palpation is useful to find the impacted fish bone. We report here on a case of an endoscopically missed pharyngeal impacted fish bone foreign body that was finally detected by finger palpation and successfully removed by rescue endoscopy.
Endoscopy ; Fingers ; Foreign Bodies ; Mouth ; Palpation ; Pharynx ; Upper Gastrointestinal Tract

BACKGROUND/AIMS: There have been several studies showing that retroflexion (RF) in the right colon (RC) could reduce the polyp miss rate of proximal colon during colonoscopy. This study was conducted to evaluate the additional benefit of RF technique in the RC. METHODS: Patients who underwent colonoscopy from May 2008 to April 2011 were enrolled in the study. Data were obtained by retrospectively reviewing the medical records. RF was attempted in every patients undergoing colonoscopy since May 2008 except in cases of small RC vault, co-morbidity, severe diverticulosis, failed RF despite two trials, complaints of severe abdominal pain, or time burden. At first, RC was examined under direct vision. It was then examined by RF to detect missed polyps during the initial observation. Finally, the RC was re-examined with direct view. RESULTS: The cumulative RF success rate in the RC was 78.84% (1,805 of 2,319). The RF success rate increased with the number of cases (50% at 160 cases, 70% at 400 cases, and reached near 90% over 1,000 cases). Few polyps (4.88%) were detected only with RF and the additional adenoma detection rate was 3.32%. The additional polyp/adenoma detection rates were higher in the old age group (p<0.01). There were no RF associated perforation or severe complication. CONCLUSIONS: Using RF examination, additional 4.88% of polyps could be detected in the RC. This technique could be a useful and safe method to detect hidden polyp during colonoscopy.
Adenoma/diagnosis/pathology ; Adult ; Aged ; Colon, Descending/pathology ; Colonic Neoplasms/diagnosis/pathology ; Colonic Polyps/*diagnosis ; *Colonoscopy ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies

BACKGROUND: In order to evaluate the effects of the duration of hemodialysis on cell mediated immunity, we studied cellular immune responses in vitro in 12 patients on chronic hemodialysis and in 6 healthy volunteers with normal kidney function. METHODS: The patients on maintenance hemodialysis were divided into two subgroups according to the duration of the hemodialysis: Group 1 (within 5 years, n=6) and Group 2 (>5 yr and < or =10 yr, n=6). Group 3 include the normal control (n=6). The peripheral blood lymphocytes of each group were cultured in RPMI medium 1640 without/or with 3 microgram of phytohemagglutinin (=PHA) for 7 days. RESULTS: CD4 /CD8 ratio at 48hours was totally comparable between the uremic patients (Group 1 and Group 2) and the controls (Group 3). The proportions of CD25 T lymphocytes after 48 hours culture were abnormally high: 7.1+/-0.5% and 7.0+/-1.3% in the uremic patients as compared to 2.5+/-0.6 in the normal controls at the basal state and 66.7+/-2.6% and 68.8+/-1.9% in the uremic patients as compared to 78.3+/-4.6% in the normal controls at the PHA-stimulated condition. The spontaneous production of IL-2 (mean pg SEM) was significantly lower in hemodialized patients (Group 1: 34.5+/-6.0 pg/ml, Group 2: 33.8+/-6.2 pg/ml) as compared to the normal patients (Group 3: 58.8+/-10.4 pg/ml). The PHA stimulated IL-2 production was also significantly reduced in the hemodialized patients (Group 1: 53.2+/- 13.3 pg/ml, Group: 53.0+/-10.3 pg/ml) as compared to the normal patients (Group 3: 150.0+/-24.5 pg/ml). The mean proliferative response to PHA at each point in the hemodialized patients were significantly lower than those of the controls. CONCLUSIONS: These data show that there is no significant correlation between the level of the cell mediated immune response and the duration of hemodialysis. Several defects in the cell mediated immune response associated with uremia might start at an early phase of the hemodialysis.
Healthy Volunteers ; Humans ; Immunity, Cellular* ; Interleukin-2 ; Kidney ; Kidney Failure, Chronic* ; Lymphocytes ; Renal Dialysis* ; T-Lymphocytes ; Uremia