1.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
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Radiopharmaceuticals/diagnostic use
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Sodium Pertechnetate Tc 99m/diagnostic use
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Thyroid Dysgenesis/blood/*diagnosis/drug therapy
;
Thyroid Function Tests
;
*Thyroid Gland/drug effects/metabolism/radiography/radionuclide imaging/ultrasonography
;
Thyrotropin/blood
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Thyroxine/blood/therapeutic use
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Tomography, X-Ray Computed
2.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
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Insulin/blood
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Insulinoma/blood/*blood supply/pathology/surgery
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Middle Aged
;
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
3.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
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Coronary Vessels/*chemistry/radiography
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Cross-Sectional Studies
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Female
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Humans
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Male
;
Metabolic Syndrome X/blood/diagnosis/*epidemiology
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Middle Aged
;
Multidetector Computed Tomography
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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
4.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
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Humans
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Hypoglycemia/blood/chemically induced/epidemiology/physiopathology/*prevention & control
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Hypoglycemic Agents/*adverse effects
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Incidence
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Patient Education as Topic
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Prevalence
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Prognosis
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Risk Assessment
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Risk Factors
5.IL28B Is Associated with Outcomes of Chronic HBV Infection.
Xiaodong SHI ; Xiumei CHI ; Yu PAN ; Yanhang GAO ; Wanyu LI ; Chen YANG ; Jin ZHONG ; Damo XU ; Manna ZHANG ; Gerald MINUK ; Jing JIANG ; Junqi NIU
Yonsei Medical Journal 2015;56(3):625-633
PURPOSE: The role of IL28B gene variants and expression in hepatitis B virus (HBV) infections are not well understood. Here, we evaluated whether IL28B gene expression and rs12979860 variations are associated with HBV outcomes. MATERIALS AND METHODS: IL28B genetic variations (rs12979860) were genotyped by pyrosequencing of DNA samples from 137 individuals with chronic HBV infection [50 inactive carriers (IC), 34 chronic hepatitis B (CHB), 27 cirrhosis, 26 hepatocellular carcinoma (HCC)], and 19 healthy controls. IL28A/B mRNA expression in peripheral blood mononuclear cells was determined by qRT-PCR, and serum IL28B protein was measured by ELISA. RESULTS: Patients with IL28B C/C genotype had greater IL28A/B mRNA expression and higher IL28B protein levels than C/T patients. Within the various disease stages, compared to IC and healthy controls, IL28B expression was reduced in the CHB, cirrhosis, and HCC cohorts (CHB vs. IC, p=0.02; cirrhosis vs. IC, p=0.01; HCC vs. IC, p=0.001; CHB vs. controls, p<0.01; cirrhosis vs. controls, p<0.01; HCC vs. controls, p<0.01). When stratified with respect to serum HBV markers in the IC and CHB cohorts, IL28B mRNA and protein levels were higher in HBeAg-positive than negative individuals (p=0.01). Logistic regression analysis revealed that factors associated with high IL28B protein levels were C/C versus C/T genotype [p=0.016, odds ratio (OR)=0.25, 95% confidence interval (CI)=0.08-0.78], high alanine aminotransferase values (p<0.001, OR=8.02, 95% CI=2.64-24.4), and the IC stage of HBV infection (p<0.001). CONCLUSION: Our data suggest that IL28B genetic variations may play an important role in long-term development of disease in chronic HBV infections.
Adult
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Aged
;
Alanine Transaminase/blood
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Asian Continental Ancestry Group/*genetics
;
Biological Markers/blood
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Carcinoma, Hepatocellular/genetics
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Case-Control Studies
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China
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DNA, Viral/blood
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Enzyme-Linked Immunosorbent Assay
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Female
;
Genotype
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Hepatitis B virus/genetics
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Hepatitis B, Chronic/ethnology/*genetics/immunology/*virology
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Humans
;
Interleukins/blood/*genetics/metabolism
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Leukocytes, Mononuclear
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Liver Cirrhosis/blood
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Liver Neoplasms/genetics
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Male
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Middle Aged
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RNA, Messenger/*genetics
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Reverse Transcriptase Polymerase Chain Reaction
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.Measurement of antioxidant capacity using the biological antioxidant potential test and its role as a predictive marker of metabolic syndrome.
Jung Hee KIM ; Hyun Wook BAIK ; Yeong Sook YOON ; Hyo Jee JOUNG ; Ju Sang PARK ; Sang Jong PARK ; Eun Jeong JANG ; Sang Woon PARK ; Sang Jung KIM ; Mi Jeoung KIM ; Dong Ok JEON ; Hyo Jin CHO ; Sang Jin LEE ; Sung Gyu IM ; Sun Kyung JANG
The Korean Journal of Internal Medicine 2014;29(1):31-39
BACKGROUND/AIMS: Oxidative stress increases the risk of cardiovascular complications of metabolic syndrome (MetS). This study was conducted to examine the difference in antioxidant capacity according to the presence of MetS, and to characterize the association between antioxidant capacity and MetS-related factors. METHODS: We used the biological antioxidant potential (BAP) test to estimate antioxidant capacity. The BAP test has recently been used as an indicator of antioxidant capacity. We measured BAP levels in 45 patients with MetS (mean age, 44.6 +/- 1.1 years) and 47 age- and sex-matched controls (mean age, 42.7 +/- 1.1 years). To evaluate the association between antioxidant capacity and MetS, adiponectin, high-sensitivity C-reactive protein (hs-CRP), interleukin-6, tumor necrosis factor-alpha, and homeostatic model assessment for insulin resistance (HOMA-IR), linear regression and logistic analyses were performed. RESULTS: The mean BAP of the MetS group (1,937.3 +/- 36.5 micromol/L) was significantly lower than that of the non-MetS group (2,101.7 +/- 29.5 micromol/L). Also, the mean BAP was low in persons having low high density lipoprotein and high triglyceride. Reduced antioxidant capacity was significantly associated with adiponectin, HOMA-IR and hs-CRP after adjusting for age and sex. The odds ratios for MetS with BAP, log adiponectin, log HOMA-IR, and log hs-CRP were 0.63 (95% confidence interval [CI], 0.49 to 0.82), 0.22 (0.10 to 0.51), 14.24 (4.35 to 46.58), and 1.93 (1.36 to 2.75), respectively. CONCLUSIONS: Persons with MetS showed reduced antioxidant capacity. We identified relationships between antioxidant capacity measured by BAP test and MetS, as well as MetS-related factors, such as insulin resistance, hs-CRP, and adiponectin.
Adipokines/blood
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Adult
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Antioxidants/*metabolism
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Biological Markers/blood
;
C-Reactive Protein/metabolism
;
Case-Control Studies
;
Female
;
Humans
;
Insulin Resistance
;
Interleukin-6/blood
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Male
;
Metabolic Syndrome X/*blood
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Middle Aged
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Predictive Value of Tests
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Tumor Necrosis Factor-alpha/blood
8.S100A8/A9 as a biomarker for synovial inflammation and joint damage in patients with rheumatoid arthritis.
Kwi Young KANG ; Jung Won WOO ; Sung Hwan PARK
The Korean Journal of Internal Medicine 2014;29(1):12-19
S100A8 and S100A9 are major leukocyte proteins, known as damage-associated molecular patterns, found at high concentrations in the synovial fluid of patients with rheumatoid arthritis (RA). A heterodimeric complex of S100A8/A9 is secreted by activated leukocytes and binds to Toll-like receptor 4, which mediates downstream signaling and promotes inflammation and autoimmunity. Serum and synovial fluid levels of S100A8/A9 are markedly higher in patients with RA than in patients with osteoarthritis or miscellaneous inflammatory arthritis. Serum levels of S100A8/A9 are significantly correlated with clinical and laboratory markers of inflammation, such as C-reactive protein, erythrocyte sedimentation rate, rheumatoid factor, and the Disease Activity Score for 28 joints. Significant correlations have also been found between S100A8/A9 and radiographic and clinical assessments of joint damage, such as hand radiographs and the Rheumatoid Arthritis Articular Damage score. In addition, among known inflammatory markers, S100A8/A9 has the strongest correlation with total sum scores of ultrasonography assessment. Furthermore, baseline levels of S100A8/A9 are independently associated with progression of joint destruction in longitudinal studies and are responsive to change during conventional and biologic treatments. These findings suggest S100A8/A9 to be a valuable diagnostic and prognostic biomarker for RA.
Arthritis, Rheumatoid/*blood/pathology/radiography
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Arthrography
;
Biological Markers/blood
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Calgranulin A/*blood
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Calgranulin B/*blood
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Humans
;
Joints/pathology
;
Synovial Fluid/metabolism
9.Correlation between Soluble Triggering Receptor Expressed on Myeloid Cells-1 and Endoscopic Activity in Intestinal Behcet's Disease.
Hyun Jung LEE ; Hye Sun SHIN ; Hui Won JANG ; Seung Won KIM ; Soo Jung PARK ; Sung Pil HONG ; Tae Il KIM ; Won Ho KIM ; Jae Hee CHEON
Yonsei Medical Journal 2014;55(4):960-966
PURPOSE: The serum levels of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) have recently been shown to be correlated highly with disease activity in patients with intestinal Behcet's disease (BD). However, it remains unclear whether sTREM-1 levels reflect endoscopic activity in intestinal BD. This study aimed to evaluate the correlation of sTREM-1 levels with endoscopic activity in intestinal BD. MATERIALS AND METHODS: A total of 84 patients with intestinal BD were enrolled. Endoscopic activity was compared with sTREM-1 levels as well as other laboratory findings, including erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). RESULTS: sTREM-1 levels were significantly increased in intestinal BD patients compared with controls (37.98+/-27.09 pg/mL vs. 16.65+/-7.76 pg/mL, p=0.002), however, there was no difference between endoscopically quiescent and active diseases (43.53+/-24.95 pg/mL vs. 42.22+/-32.68 pg/mL, p=0.819). Moreover, serum sTREM-1 levels did not differ in terms of number, shape, depth, size, margin, or type of ulcer in patients with intestinal BD. However, mean ESR and CRP levels in patients with active disease were significantly higher than those in patients with quiescent disease (p=0.001, p<0.001, respectively). In addition, endoscopic activity scores for intestinal BD were correlated significantly with both CRP levels (gamma=0.329) and ESR (gamma=0.298), but not with sTREM-1 levels (gamma=0.166). CONCLUSION: Unlike CRP levels and ESR, serum sTREM-1 levels were not correlated with endoscopic activity in patients with intestinal BD.
Adult
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Behcet Syndrome/*blood/*pathology
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Biological Markers/blood
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Blood Sedimentation
;
C-Reactive Protein/metabolism
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Female
;
Humans
;
Intestinal Diseases/*blood/*pathology
;
Male
;
Membrane Glycoproteins/*blood
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Receptors, Immunologic/*blood
10.Resting energy expenditure is not associated with disease activity in women with rheumatoid arthritis: cross-sectional study.
Jung Yoon CHOE ; Sung Hoon PARK ; Hwajeong LEE ; Hyun Hee KWON ; Seong Kyu KIM
The Korean Journal of Internal Medicine 2014;29(4):516-524
BACKGROUND/AIMS: Increased resting energy expenditure (REE) in rheumatoid arthritis (RA) patients is thought to be caused by hypermetabolism associated with production of proinflammatory cytokines. Our aim in the present study was to explore the possible association between REE and disease activity in females with RA. METHODS: A total of 499 female RA patients were recruited to this cross-sectional study assessing REE scores on disease activity indices (the routine assessment of patient index data 3 [RAPID3], the disease activity score 28, and the clinical/simplified disease activity index [CDAI/SDAI]) and the levels of RA-associated autoantibodies (rheumatoid factor and anticyclic citrullinated peptide [anti-CCP] antibodies). Age-matched healthy female controls (n = 131) were also enrolled. RESULTS: REE did not differ between RA patients (all patients, and those in remission or not) and controls, or between RA patients in remission or not (p > 0.05 for all comparisons). Increased REE in total RA patients was associated with younger age and a higher body mass index (BMI) (p < 0.001 and p < 0.001, respectively), but not with disease activity index scores on any of RAPID3, CDAI, or SDAI. BMI was the only clinical parameter exhibiting a significant relationship with REE quartiles (Q1 to Q4; p < 0.001); none of disease duration, functional status, or anti-CCP antibody titer in RA patients was significantly related to REE, based on analysis of covariance. CONCLUSIONS: We found no association between REE and disease activity in RA patients, implying that energy metabolism in RA patients might be independent of RA-associated systemic inflammation.
Adult
;
Age Factors
;
Aged
;
Arthritis, Rheumatoid/blood/diagnosis/*metabolism/physiopathology
;
Biological Markers/blood
;
Body Mass Index
;
Case-Control Studies
;
Cross-Sectional Studies
;
*Energy Metabolism
;
Female
;
Humans
;
Inflammation Mediators/blood
;
Middle Aged
;
Peptides, Cyclic/immunology
;
Predictive Value of Tests
;
*Rest
;
Rheumatoid Factor/blood
;
Severity of Illness Index

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