BACKGROUND: Adiponectin is a fat cell-secreted cytokine, which has been reported to improve insulin sensitivity and have antiatherogenic properties. However, it is still unclear whether resistin plays a significant role in the development of insulin resistance in humans. The aim of this study was to investigate the relationship of the adiponectin and resistin concentrations with insulin resistance, metabolic markers and adiposity in healthy and type 2 diabetic subjects. METHODS: Eighty-three type 2 diabetic and 139 healthy subjects were studied. Blood samples were drawn after fasting to determine the fasting plasma glucose, insulin, resistin, adiponectin, total cholesterol, triglyceride and HDL-cholesterol levels. The subcutaneous and visceral fat areas were measured at the umbilical level using computed tomography. RESULTS: The serum adiponectin concentrations were significantly lower in the diabetic(6.7+/-2.3microgram/mL) than in the obese(8.2+/-2.4microgram/mL, P<0.01) and non-obese subjects(9.9+/-4.5microgram/mL, P<0.01). The serum resistin concentrations were Similar between the non-obese, obese and type 2 diabetic subjects. From a multiple regression analysis, the fasting glucose, HDL-cholesterol and HOMA-IR were found to be independent determinants of the log of the adiponectin level in the diabetes group. In healthy subjects, the gender, BMI, HOMA-IR, visceral fat area and HDL-cholesterol were associated with the log of the adiponectin level. However, the log of the resistin level was not associated with the markers of insulin resistance and obesity. CONCLUSION: This study showed that the serum adiponectin concentration was closely related to the insulin resistance marker in both healthy and type 2 diabetic subjects. However, the resistin concentration was not associated with the markers of insulin resistance and/or obesity.
Adiponectin* ; Adiposity ; Blood Glucose ; Cholesterol ; Diabetes Mellitus, Type 2 ; Fasting ; Glucose ; Humans ; Insulin ; Insulin Resistance ; Intra-Abdominal Fat ; Obesity ; Resistin* ; Risk Factors* ; Triglycerides

OBJECTIVE: To correlate CT parameters on detector-based dual-energy CT enterography (DECTE) with Crohn's disease activity index (CDAI) and externally validate quantitative CT parameters. MATERIALS AND METHODS: Thirty-nine patients with CD were retrospectively enrolled. Two radiologists reviewed DECTE images by consensus for qualitative and quantitative CT features. CT attenuation and iodine concentration for the diseased bowel were also measured. Univariate statistical tests were used to evaluate whether there was a significant difference in CTE features between remission and active groups, on the basis of the CDAI score. Pearson's correlation test and multiple linear regression analyses were used to assess the correlation between quantitative CT parameters and CDAI. For external validation, an additional 33 consecutive patients were recruited. The correlation and concordance rate were calculated between real and estimated CDAI. RESULTS: There were significant differences between remission and active groups in the bowel enhancement pattern, subjective degree of enhancement, mesenteric fat infiltration, comb sign, and obstruction (p < 0.05). Significant correlations were found between CDAI and quantitative CT parameters, including number of lesions (correlation coefficient, r = 0.573), bowel wall thickness (r = 0.477), iodine concentration (r = 0.744), and relative degree of enhancement (r = 0.541; p < 0.05). Iodine concentration remained the sole independent variable associated with CDAI in multivariate analysis (p = 0.001). The linear regression equation for CDAI (y) and iodine concentration (x) was y = 53.549x + 55.111. For validation patients, a significant correlation (r = 0.925; p < 0.001) and high concordance rate (87.9%, 29/33) were observed between real and estimated CDAIs. CONCLUSION: Iodine concentration, measured on detector-based DECTE, represents a convenient and reproducible biomarker to monitor disease activity in CD.
Consensus ; Crohn Disease* ; Humans ; Iodine* ; Linear Models ; Multivariate Analysis ; Retrospective Studies

Hypertrophic osteoarthropathy (HOA) is a rare clinical condition including an abnormal periosteal reaction in the long bones that causes painful swelling and tenderness of the extremities, digital clubbing, arthritis, synovitis, and joint effusions. Most cases are associated with tumorous conditions and most commonly with lung cancer. HOA has been rarely reported in association with other cancers. A patient with a history of recurrent renal cell carcinoma was referred to our clinic with bilateral leg pain, knee joint effusion, and arthritis. Simple radiography and bone scintigraphy confirmed a diagnosis of HOA. Oral non-steroidal anti-inflammatory drugs, joint fluid aspiration, and intra-articular injection of pain medications were found to be effective in the management of HOA pain. HOA prognosis depends on the underlying disease, therefore, cancer treatment is critical. This case demonstrates the need to consider HOA in patients with various malignancies who present with bone or joint pain of the extremities.

Multiple gestation accounts for 1 percent of all pregnancies. But, the morbidity of congenital anomaly is more than 2 times in contrast to singleton gestation. The major congenital anomaly was developed about 2 percent in the multiple gestation. Hydrocephalus and anencephaly, known central nervous system anomaly, were seen about 0.1% each other in singleton gestation. We have experienced a case of prenatally detected concomitant hydrocephalus and anencephaly in twin pregnancy which was diagnosed by ultrasonography at 16 weeks gestation. Thus, we report a case with brief review of the literature.
Anencephaly* ; Central Nervous System ; Humans ; Hydrocephalus* ; Pregnancy ; Pregnancy, Twin* ; Ultrasonography

BACKGROUND: The tuberculin skin test (TST) is the standard tool to diagnose latent tuberculosis infection (LTBI) in mass screening. The aim of this study is to find an optimal cut-off point of the TST+ rate within tuberculosis (TB) contacts to predict the active TB development among adolescents in school TB outbreaks. METHODS: The Korean National Health Insurance Review and Assessment database was used to identify active TB development in relation to the initial TST (cut-off, 10 mm). The 7,475 contacts in 89 schools were divided into two groups: Incident TB group (43 schools) and no incident TB group (46 schools). LTBI treatment was initiated in 607 of the 1,761 TST+ contacts. The association with active TB progression was examined at different cut-off points of the TST+ rate. RESULTS: The mean duration of follow-up was 3.9+/-0.9 years. Thirty-three contacts developed active TB during the 4,504 person-years among the TST+ contacts without LTBI treatment (n=1,154). The average TST+ rate for the incident TB group (n=43) and no incident TB group (n=46) were 31.0% and 15.5%, respectively. The TST+ rate per group was related with TB progression (odds ratio [OR], 1.025; 95% confidence interval [CI], 1.001-1.050; p=0.037). Based on the TST+ rate per group, active TB was best predicted at TST+ > or = 16% (OR, 3.11; 95% CI, 1.29-7.51; area under curve, 0.64). CONCLUSION: Sixteen percent of the TST+ rate per group within the same grade students can be suggested as an optimal cut-off to predict active TB development in middle and high schools TB outbreaks.
Adolescent ; Area Under Curve ; Disease Outbreaks* ; Follow-Up Studies ; Humans ; Latent Tuberculosis ; Mass Screening ; National Health Programs ; Prevalence* ; Skin Tests* ; Skin* ; Tuberculin Test ; Tuberculin* ; Tuberculosis*

BACKGROUND: Non-erosive reflux disorder, which represents more than 60% of gastro-esophageal reflux disorders, lacks objective parameters for diagnosis. The purpose of this study was to evaluate the correlation between non-erosive minimal lesions at the lower esophagus and gastro-esophageal reflux disorder. METHODS: Patients were asked to answer a symptom questionnaire. The endoscopic findings were either graded by LA classification or recorded as non-erosive minimal lesions. Patients with minimal lesions were treated with rabeprazole or a placebo and responses were evaluated at weeks 1 and 4. RESULTS: In 8 centers, 3454 patients were screened. In patients with heartburn or acid regurgitation as the most bothersome symptom, 23.7% had endoscopy negative reflux disorder, 40.1% showed minimal lesions, and 36.2% had mucosal break esophagitis. Thirty-four percent of patients with minimal lesions and 39.1% of patients with LA 'grade A' mild esophagitis reported typical reflux symptoms as their main symptom. In patients with minimal lesions, medication with rabeprazole reduced symptoms significantly at weeks 1 and 4, but not with the placebo. CONCLUSION: Patients with non-erosive minimal esophageal lesions had similar reflux symptoms comparable to those with mild erosive reflux esophagitis, and reflux symptoms were improved with a short-term proton pump inhibitor. Thus, non-erosive minimal esophageal lesion constitutes a great part of gastro-esophageal reflux disorder.
2-Pyridinylmethylsulfinylbenzimidazoles ; Adult ; Aged ; Aged, 80 and over ; Anti-Ulcer Agents/*therapeutic use ; Benzimidazoles/*therapeutic use ; Enzyme Inhibitors/*therapeutic use ; Esophageal Diseases/*pathology ; Female ; Follow-Up Studies ; Gastroesophageal Reflux/drug therapy/epidemiology/*pathology ; Humans ; Korea/epidemiology ; Male ; Middle Aged ; Omeprazole/*analogs & derivatives/therapeutic use ; Prospective Studies ; Proton-Translocating ATPases/*antagonists & inhibitors ; Treatment Outcome

Bacillus (B.) anthracis, the etiological agent of anthrax, is one of the most genetically monomorphic bacteria species in the world. Due to the very limited genetic diversity of this species, classification of isolates of this bacterium requires methods with high discriminatory power. Single nucleotide repeat (SNR) analysis is a type of variable-number tandem repeat assay that evaluates regions with very high mutation rates. To subtype a collection of 21 isolates that were obtained during a B. anthracis outbreak in Korea, we analyzed four SNR marker loci using nucleotide sequencing analysis. These isolates were obtained from soil samples and the Korean Center for Disease Control and Prevention. The SNR analysis was able to detect 13 subgenotypes, which allowed a detailed evaluation of the Korean isolates. Our study demonstrated that the SNR analysis was able to discriminate between strains with the same multiple-locus variable-number tandem repeat analysis genotypes. In summary, we obtained SNR results for four SNR marker loci of newly acquired strains from Korea. Our findings will be helpful for creating marker systems and help identify markers that could be used for future forensic studies.
Bacillus anthracis/*classification/*genetics/isolation & purification ; *Genetic Variation ; *Minisatellite Repeats ; Polymerase Chain Reaction/veterinary ; Republic of Korea ; Sequence Analysis, DNA/*methods/veterinary ; *Soil Microbiology

BACKGROUND: Diffuse panbronchiolitis(DPB) is a chronic inflammatory lung disease that presents as coughing, copious sputum, exertional dyspnea, which progresses to bronchiectasis. The pathogenesis of bronchiectasis is controlled by inflammatory mediators, which are closely related to mucus hypersecretion, goblet cell dysplasia. In recent studies, the epidermal growth factor receptor(EGFR) system was reported to be associated with this process. It was hypothesized that a relationship exists between goblet cell dysplasia, EGFR expression, and inflammatory mediators produced by neutrophil. METHOD: Alcian blue/periodic acid -Schiff(AB/PAS) stain, MUC5AC, EGFR, CD16 immunohistochemical stain were examined to investigate a role for the EGFR system in a mucus hypersecretion in DPB using the lung biopsy specimens from 13 DPB patients and 6 controls. RESULTS: In the DPB group, the AB/PAS- and MUC5AC-stained areas were 8.31+/-3.36%, 11.46+/-4.68%, respectively. In the control group, the AB/PAS- and MUC5AC-stained areas were 50.5+/-5.77%, 53.3%+/-6.67%, which was significantly larger than in the DPB group (each comparison, p<0.05). The percentage of EGFR expression was 9.54+/-4.95% in the DPB group, but zero in of the control group. The extent of neutrophilic infiltration was 71.92+/-3.71/5HPF in the DPB group and 45.0+/-5.73/5HPF in the control group, which was statistically significant(p=0.002). CONCLUSION: The EGFR system is highly related to goblet cell dysplasia, mucus hypersecretion and neutrophilic inflammation in DPB.
Biopsy ; Bronchiectasis ; Cough ; Dyspnea ; Epidermal Growth Factor* ; Goblet Cells* ; Humans ; Inflammation ; Lung ; Lung Diseases ; Mucus ; Neutrophils ; Receptor, Epidermal Growth Factor* ; Sputum

Paraneoplastic limbic encephalitis (PLE) is a rare syndrome characterized by memory impairment, affective and behavioral disturbances and seizures. Among many different neoplasms known to cause PLE, small cell lung cancer (SCLC) is the most frequently reported. The pathogenesis is not fully understood but is believed to be autoimmune-related. We experienced a patient with typical clinical features of PLE. A 67-year-old man presented with seizure and disorientation. Brain magnetic resonance imaging demonstrated high signal intensity in the bilateral amygdala and hippocampus in flair and T2-weighted images suggestive of limbic encephalitis. Cerebrospinal fluid tapping revealed no evidence of malignant cells or infection. Positron emission tomography/computed tomography showed a lung mass with pleural effusion and a consequent biopsy confirmed the diagnosis of PLE associated with SCLC. The patient was subsequently treated with chemotherapy and neurologic symptoms gradually improved.
Aged ; Amygdala ; Biopsy ; Brain ; Electrons ; Hippocampus ; Humans ; Limbic Encephalitis ; Lung ; Lung Neoplasms ; Magnetic Resonance Imaging ; Memory ; Neurologic Manifestations ; Paraneoplastic Syndromes ; Pleural Effusion ; Seizures ; Small Cell Lung Carcinoma

The detrimental effects of environmental pollutants on the health of the individual are generally accepted, although the mechanisms of these effects remain to be incompletely understood. In the present study, we examined the effects of B[a]P, 2-BP, phenol and TCDD on proinflammatory cytokine gene expression in mice spleen cells which were stimulated with anti-CD3. 10-9M TCDD increased IFN gammar and TNF alpha gene expression, but suppressed IL-1 gene expression. 10-6M phenol inhibited IL-1, IL-6 and TNF alpha gene expression, and 10-6M of 2-BP downregulated TNF alpha gene expression. However, 10-6M of B[a]P did not influence on IL-1, IL-6, IFN gammar and TNF alpha gene expression. These findings suggest that TCDD may impair the immune functions of mice by enhancing proinflammatory cytokines production, whereas phenol and 2-BP may impair the functions by inhibiting the production of these cytokines.
Animals ; Antigens, CD3/immunology ; Apoptosis/drug effects ; Benzo(a)pyrene/*toxicity ; Cells, Cultured ; Cytokines/*biosynthesis/genetics ; Environmental Pollutants/*toxicity ; Gene Expression/drug effects ; Hydrocarbons, Brominated/*toxicity ; Male ; Mice ; Mice, Inbred C3H ; Phenol/*toxicity ; RNA/chemistry/genetics ; Reverse Transcriptase Polymerase Chain Reaction ; Spleen/*drug effects/metabolism ; Tetrachlorodibenzodioxin/*toxicity