1.Rhupus syndrome.
Jae Ki MIN ; Kyoung Ann LEE ; Hae Rim KIM ; Ho Youn KIM ; Sang Heon LEE
The Korean Journal of Internal Medicine 2015;30(1):131-131
No abstract available.
Antirheumatic Agents/therapeutic use
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Arthritis, Rheumatoid/blood/*complications/diagnosis/drug therapy/physiopathology
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Biological Markers/blood
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Drug Therapy, Combination
;
Facial Dermatoses/complications/diagnosis
;
Female
;
Hand Joints/physiopathology/radiography
;
Humans
;
Immunosuppressive Agents/therapeutic use
;
Inflammation Mediators/blood
;
Knee Joint/physiopathology/radiography
;
Lupus Erythematosus, Systemic/blood/*complications/diagnosis/drug therapy
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Middle Aged
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Syndrome
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Treatment Outcome
2.Dual ectopic thyroid presenting with an anterior neck mass.
Hannah SEOK ; Su Jin OH ; Won Chul HA ; Hyun Shik SON ; Tae Seo SOHN
The Korean Journal of Internal Medicine 2015;30(1):129-130
No abstract available.
Adult
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Biological Markers/blood
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Female
;
Humans
;
Mouth Floor
;
*Neck/radiography/radionuclide imaging/ultrasonography
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Predictive Value of Tests
;
Radiopharmaceuticals/diagnostic use
;
Sodium Pertechnetate Tc 99m/diagnostic use
;
Thyroid Dysgenesis/blood/*diagnosis/drug therapy
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Thyroid Function Tests
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*Thyroid Gland/drug effects/metabolism/radiography/radionuclide imaging/ultrasonography
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Thyrotropin/blood
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Thyroxine/blood/therapeutic use
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Tomography, X-Ray Computed
3.An insulinoma with an aberrant feeder from the splenic artery detected by super-selective arterial calcium stimulation with venous sampling.
Joon Ho MOON ; Eun Ky KIM ; Ah Reum KHANG ; Hyo Cheol KIM ; Jin Young JANG ; Young Min CHO
The Korean Journal of Internal Medicine 2015;30(1):118-121
No abstract available.
Biopsy
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Blood Glucose/metabolism
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C-Peptide/blood
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Calcium Gluconate/administration & dosage/*diagnostic use
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Female
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Humans
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Immunohistochemistry
;
Injections, Intra-Arterial
;
Insulin/blood
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Insulinoma/blood/*blood supply/pathology/surgery
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Middle Aged
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Pancreatic Neoplasms/blood/*blood supply/pathology/surgery
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Pancreaticoduodenectomy
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Splenic Artery/*radiography
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*Tomography, X-Ray Computed
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Treatment Outcome
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Tumor Markers, Biological/blood
4.Exponential Rise in Prostate-Specific Antigen (PSA) during Anti-Androgen Withdrawal Predicts PSA Flare after Docetaxel Chemotherapy in Patients with Castration-Resistant Prostate Cancer.
Kyung Seok HAN ; Sung Joon HONG
Yonsei Medical Journal 2015;56(2):368-374
PURPOSE: To investigate the relationship between rising patterns of prostate-specific antigen (PSA) before chemotherapy and PSA flare during the early phase of chemotherapy in patients with castration-resistant prostate cancer (CRPC). MATERIALS AND METHODS: This study included 55 patients with CRPC who received chemotherapy and in whom pre-treatment or post-treatment PSA levels could be serially obtained. The baseline parameters included age, performance, Gleason score, PSA level, and disease extent. PSA doubling time was calculated using the different intervals: the conventional interval from the second hormone manipulation following the nadir until anti-androgen withdrawal (PSADT1), the interval from the initial rise after anti-androgen withdrawal to the start of chemotherapy (PSADT2), and the interval from the nadir until the start of chemotherapy (PSADT3). The PSA growth patterns were analyzed using the ratio of PSADT2 to PSADT1. RESULTS: There were two growth patterns of PSA doubling time: 22 patients (40.0%) had a steady pattern with a more prolonged PSADT2 than PSADT1, while 33 (60.0%) had an accelerating pattern with a shorter PSADT2 than PSADT1. During three cycles of chemotherapy, PSA flare occurred in 11 patients (20.0%); of these patients, 3 were among 33 (9.1%) patients with an accelerating PSA growth pattern and 8 were among 22 patients (36.4%) with a steady PSA growth pattern (p=0.019). Multivariate analysis showed that only PSA growth pattern was an independent predictor of PSA flare (p=0.034). CONCLUSION: An exponential rise in PSA during anti-androgen withdrawal is a significant predictor for PSA flare during chemotherapy in CRPC patients.
Aged
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Aged, 80 and over
;
Androgen Antagonists
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Antineoplastic Agents/*therapeutic use
;
Follow-Up Studies
;
Humans
;
Karnofsky Performance Status
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Male
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Middle Aged
;
Neoplasm Grading
;
Predictive Value of Tests
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Prostate-Specific Antigen/*blood
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Prostatic Neoplasms, Castration-Resistant/*blood/*drug therapy/pathology
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Taxoids/*therapeutic use
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Tumor Markers, Biological/blood
5.Usefulness of C-Reactive Protein as a Disease Activity Marker in Crohn's Disease according to the Location of Disease.
Dong Hoon YANG ; Suk Kyun YANG ; Sang Hyoung PARK ; Ho Su LEE ; Sun Jin BOO ; Jae Ho PARK ; Soo Young NA ; Kee Wook JUNG ; Kyung Jo KIM ; Byong Duk YE ; Jeong Sik BYEON ; Seung Jae MYUNG ; Jin Ho KIM
Gut and Liver 2015;9(1):80-86
BACKGROUND/AIMS: C-reactive protein (CRP) is a serologic activity marker in Crohn's disease (CD), but it may be less useful in evaluating CD activity in ileal CD patients. We aimed to investigate the usefulness of CRP as a disease activity marker in CD according to disease location. METHODS: Korean CD patients in a single hospital were evaluated. Factors associated with elevated CRP concentration at the time of diagnosis of CD and the association between the physician's prediction regarding upcoming surgery and the sites of the lesions directly related to surgery were analyzed. RESULTS: Of 435 CD patients, 25.7%, 6.9%, and 67.4% had ileal, colonic, and ileocolonic CD, respectively. Multivariate analysis revealed that an elevated erythrocyte sedimentation rate, reduced serum albumin, CD activity index (CDAI) >220, and ileocolonic/colonic location were associated with an elevated CRP level and that the CRP level was significantly correlated with the CDAI in all CD patients (gamma=0.466, p<0.01). However, the correlation coefficient was dependent on the location, with values of 0.395, 0.456, and 0.527 in patients with an ileal, ileocolonic, and colonic disease location, respectively. Surgery for ileal lesions was less predictable than surgery for ileocolonic or colonic lesions during follow-up. CONCLUSIONS: CRP is less useful as a disease activity marker in patients with ileal CD than those with ileocolonic or colonic CD.
Adolescent
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Adult
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Aged
;
Biological Markers/blood
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Blood Sedimentation
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C-Reactive Protein/*analysis
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Child
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Colon/pathology
;
Crohn Disease/blood/*diagnosis/pathology
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Female
;
Humans
;
Ileum/pathology
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Male
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Middle Aged
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Serum Albumin/analysis
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Severity of Illness Index
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Young Adult
6.The Difference of Lymphocyte Subsets Including Regulatory T-Cells in Umbilical Cord Blood between AGA Neonates and SGA Neonates.
Sang Hee YOON ; Mina HUR ; Han Sung HWANG ; Han Sung KWON ; In Sook SOHN
Yonsei Medical Journal 2015;56(3):798-804
PURPOSE: This study aimed to compare the regulatory T cells in cord blood of appropriate for gestational age (AGA) neonates with those of small for gestational age (SGA) neonates. MATERIALS AND METHODS: Umbilical cord blood was collected upon labor in 108 healthy full-term (between 37 and 41 gestational weeks) neonates, who were born between November 2010 and April 2012. Among them, 77 samples were obtained from AGA neonates, and 31 samples were obtained from SGA neonates. Regulatory T cells and lymphocyte subsets were determined using a flow cytometer. Student's t-test for independent samples was used to compare differences between AGA and SGA neonates. RESULTS: Regulatory T cells in cord blood were increased in the SGA group compared with normal controls (p=0.041). However, cytotoxic T cells in cord blood were significantly decreased in the SGA group compared with normal controls (p=0.007). CONCLUSION: This is the first study to compare the distribution of lymphocyte subsets including regulatory T cells in cord blood between AGA neonates and SGA neonates.
Biological Markers/metabolism
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Female
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Fetal Blood/*immunology
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Gestational Age
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Humans
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Infant, Newborn/*blood
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Infant, Small for Gestational Age/*blood
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Lymphocyte Count
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T-Lymphocytes, Cytotoxic/metabolism
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T-Lymphocytes, Regulatory/*metabolism
7.Triglyceride Is a Useful Surrogate Marker for Insulin Resistance in Korean Women with Polycystic Ovary Syndrome.
So Yun PARK ; Yeon Jean CHO ; Sa Ra LEE ; Hyewon CHUNG ; Kyungah JEONG
Yonsei Medical Journal 2015;56(3):785-792
PURPOSE: To evaluate lipid profiles and liver enzymes as surrogate markers used for recognizing insulin resistance in Korean women with polycystic ovary syndrome (PCOS). MATERIALS AND METHODS: 458 women with PCOS were divided into two groups: non-obese with a body mass index (BMI)<25.0 kg/m2 and obese with a BMI> or =25.0 kg/m2. Anthropometric measures and blood sampling for hormone assay, liver enzymes, lipid profiles and 75 g oral glucose tolerance test were performed. Insulin resistance was defined as homeostasis model assessment of insulin resistance (HOMA-IR)> or =2.5. Areas under the receiver operating characteristic (ROC) curves were used to compare the power of serum markers. Multiple linear regression analysis was used to evaluate the contribution of each confounding factor for HOMA-IR. RESULTS: In non-obese and obese groups, the ROC curve analyses demonstrated that the best marker for insulin resistance was triglyceride (TG), with the areas under the ROC curve of 0.617 and 0.837, respectively. Low-density lipoprotein cholesterol (LDL-C) was the significant marker for insulin resistance with areas under the ROC curve of 0.698 in obese group, but not significant in non-obese group. TG and LDL-C were significantly associated with HOMA-IR in both non-obese and obese PCOS women by multiple linear regression analysis. The optimal cut-off points of TG> or =68.5 was a marker for predicting insulin resistance in non-obese PCOS patients and TG> or =100.5 in obese group. CONCLUSION: TG can be used as a useful marker for insulin resistance in Korean women with PCOS, especially for obese patients.
Adult
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Asian Continental Ancestry Group/ethnology
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Biological Markers/blood
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Body Mass Index
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Cholesterol, LDL/blood
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Female
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Glucose Tolerance Test
;
Humans
;
Insulin/blood
;
Insulin Resistance/ethnology/*physiology
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Lipids/blood
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Obesity/*blood/ethnology
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Polycystic Ovary Syndrome/*blood/ethnology
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ROC Curve
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Regression Analysis
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Republic of Korea/epidemiology
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Triglycerides/*blood
8.Metabolic syndrome criteria as predictors of subclinical atherosclerosis based on the coronary calcium score.
Mi Hae SEO ; Eun Jung RHEE ; Se Eun PARK ; Cheol Young PARK ; Ki Won OH ; Sung Woo PARK ; Won Young LEE
The Korean Journal of Internal Medicine 2015;30(1):73-81
BACKGROUND/AIMS: The aim was to determine which of three sets of metabolic syndrome (MetS) criteria (International Diabetes Federation [IDF], National Cholesterol Education Program Adult Treatment Panel III [ATP III], and European Group for the Study of Insulin Resistance [EGIR]) best predicts the coronary artery calcification (CAC) score in a cross-sectional study. This has not been evaluated in previous studies. METHODS: A total of 24,060 subjects were screened for CAC by multi-detector computed tomography. The presence of CAC was defined as a CAC score > 0. The odds ratio for the presence of CAC was analyzed for three different sets of MetS criteria and according to number of MetS components. RESULTS: CAC was observed in 12.6% (3,037) of the subjects. Patients with MetS, as defined by the IDF, ATP III, and EGIR criteria, had a CAC rate of 23.0%, 25.1%, and 29.5%, respectively (p < 0.001). Comparisons of C statistics for multivariate regression models revealed no significant difference among the three sets of criteria. After adjustment for risk factors, the ATP III criteria produced a slightly higher odds ratio for CAC compared with the other criteria, but this difference was not significant. The risk factor-adjusted odds ratio for the presence of CAC increased from 1 to 1.679 as the number of MetS components defined by ATP III increased from 0 to > or = 3 (p for trend < 0.001). CONCLUSIONS: The presence of MetS was associated with the presence of CAC. There was no significant difference among the three sets of MetS criteria in terms of the ability to predict CAC. An increase in the number of MetS components was associated with an increased odds of CAC.
Adult
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Asymptomatic Diseases
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Biological Markers/blood
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Calcium/*analysis
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Coronary Angiography/methods
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Coronary Artery Disease/blood/*epidemiology/radiography
;
Coronary Vessels/*chemistry/radiography
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Cross-Sectional Studies
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Female
;
Humans
;
Male
;
Metabolic Syndrome X/blood/diagnosis/*epidemiology
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Middle Aged
;
Multidetector Computed Tomography
;
Multivariate Analysis
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Odds Ratio
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Predictive Value of Tests
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Prevalence
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Republic of Korea/epidemiology
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Risk Assessment
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Risk Factors
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Vascular Calcification/blood/*epidemiology/metabolism/radiography
9.Long-term efficacy of tenofovir disoproxil fumarate therapy after multiple nucleos(t)ide analogue failure in chronic hepatitis B patients.
Hyo Jin KIM ; Ju Yeon CHO ; Yu Jin KIM ; Geum Youn GWAK ; Yong Han PAIK ; Moon Seok CHOI ; Kwang Cheol KOH ; Seung Woon PAIK ; Byung Chul YOO ; Joon Hyeok LEE
The Korean Journal of Internal Medicine 2015;30(1):32-41
BACKGROUND/AIMS: The efficacy of tenofovir disoproxil fumarate (TDF) for the treatment of chronic hepatitis B (CHB) patients following prior treatment failure with multiple nucleos(t)ide analogues (NAs) is not well defined, especially in Asian populations. In this study we investigated the efficacy and safety of TDF rescue therapy in CHB patients after multiple NA treatment failure. METHODS: The study retrospectively analyzed 52 CHB patients who experienced failure with two or more NAs and who were switched to regimens containing TDF. The efficacy and safety assessments included hepatitis B virus (HBV) DNA undetectability, hepatitis B envelop antigen (HBeAg) seroclearance, alanine transaminase (ALT) normalization and changes in serum creatinine and phosphorus levels. RESULTS: The mean HBV DNA level at baseline was 5.4 +/- 1.76 log10 IU/mL. At a median duration of 34.5 months of TDF treatment, the cumulative probabilities of achieving complete virological response (CVR) were 25.0%, 51.8%, 74.2%, and 96.7% at 6, 12, 24, and 48 months, respectively. HBeAg seroclearance occurred in seven of 48 patients (14.6%). ALT levels were normalized in 27 of 31 patients (87.1%) with elevated ALT at baseline. Lower levels of HBV DNA at baseline were significantly associated with increased CVR rates (p < 0.001). However, CVR rates did not differ between TDF monotherapy or combination therapy with other NAs, and were not affected by mutations associated with resistance to NAs. No significant adverse events were observed. CONCLUSIONS: TDF is an efficient and safe rescue therapy for CHB patients after treatment failure with multiple NAs.
Adenine/adverse effects/*analogs & derivatives/therapeutic use
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Adult
;
Aged
;
Alanine Transaminase/blood
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Antiviral Agents/adverse effects/*therapeutic use
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Biological Markers/blood
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Creatinine/blood
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DNA, Viral/blood
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Drug Resistance, Viral/genetics
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Drug Substitution
;
Female
;
Genotype
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Hepatitis B e Antigens/blood
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Hepatitis B virus/*drug effects/genetics/immunology/pathogenicity
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Hepatitis B, Chronic/blood/diagnosis/*drug therapy
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Humans
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Kaplan-Meier Estimate
;
Male
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Middle Aged
;
Mutation
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Phosphorous Acids/adverse effects/*therapeutic use
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Phosphorus/blood
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Retrospective Studies
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Time Factors
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Treatment Failure
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Viral Load
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Young Adult
10.Avoiding or coping with severe hypoglycemia in patients with type 2 diabetes.
The Korean Journal of Internal Medicine 2015;30(1):6-16
Hypoglycemia is a major barrier to achieving the glycemic goal in patients with type 2 diabetes. In particular, severe hypoglycemia, which is defined as an event that requires the assistance of another person to actively administer carbohydrates, glucagon, or take other corrective actions, is a serious clinical concern in patients with diabetes. If severe hypoglycemia is not managed promptly, it can be life threatening. Hypoglycemia-associated autonomic failure (HAAF) is the main pathogenic mechanism behind severe hypoglycemia. Defective glucose counter-regulation (altered insulin secretion, glucagon secretion, and an attenuated increase in epinephrine during hypoglycemia) and a lack of awareness regarding hypoglycemia (attenuated sympathoadrenal activity) are common components of HAAF in patients with diabetes. There is considerable evidence that hypoglycemia is an independent risk factor for cardiovascular disease. In addition, hypoglycemia has a significant influence on the quality of life of patients with diabetes. To prevent hypoglycemic events, the setting of glycemic goals should be individualized, particularly in elderly individuals or patients with complicated or advanced type 2 diabetes. Patients at high-risk for the future development of severe hypoglycemia should be selected carefully, and intensive education with reinforcement should be implemented.
Autonomic Nervous System/physiopathology
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Biological Markers/blood
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Blood Glucose/*drug effects/metabolism
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Diabetes Mellitus, Type 2/blood/complications/diagnosis/*drug therapy/physiopathology
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Health Knowledge, Attitudes, Practice
;
Humans
;
Hypoglycemia/blood/chemically induced/epidemiology/physiopathology/*prevention & control
;
Hypoglycemic Agents/*adverse effects
;
Incidence
;
Patient Education as Topic
;
Prevalence
;
Prognosis
;
Risk Assessment
;
Risk Factors

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