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
;
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
;
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
;
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
;
Coronary Vessels/*chemistry/radiography
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Cross-Sectional Studies
;
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
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
;
Diabetes Mellitus, Type 2/blood/complications/diagnosis/*drug therapy/physiopathology
;
Health Knowledge, Attitudes, Practice
;
Humans
;
Hypoglycemia/blood/chemically induced/epidemiology/physiopathology/*prevention & control
;
Hypoglycemic Agents/*adverse effects
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Incidence
;
Patient Education as Topic
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Prevalence
;
Prognosis
;
Risk Assessment
;
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
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Biological Markers/blood
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Carcinoma, Hepatocellular/genetics
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Case-Control Studies
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China
;
DNA, Viral/blood
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Enzyme-Linked Immunosorbent Assay
;
Female
;
Genotype
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Hepatitis B virus/genetics
;
Hepatitis B, Chronic/ethnology/*genetics/immunology/*virology
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Humans
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Interleukins/blood/*genetics/metabolism
;
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.Regulatory B Cells Are Inversely Associated with Disease Activity in Rheumatoid Arthritis.
Jinhyun KIM ; Hyun Ji LEE ; In Seol YOO ; Seong Wook KANG ; Jae Ho LEE
Yonsei Medical Journal 2014;55(5):1354-1358
PURPOSE: The function of regulatory B lymphocytes is known to be abnormal in inflammatory diseases. However, a recent study indicates that IL-10+ B cells seem to be expanded in rheumatoid arthritis (RA). Therefore, the state of IL-10+ B cells in the peripheral blood from RA patients and healthy controls were investigated. MATERIALS AND METHODS: CD19+ cells in peripheral blood mononuclear cells were purified from blood samples of RA patients and age and gender-matched healthy controls, and stimulated with CD40 ligand and CpG for 48 hours. Then, intracellular IL-10 in CD19+ cells was analyzed using flow cytometry. RESULTS: There was no significant difference in the proportion of IL-10+ B cells between 10 RA patients and 10 healthy controls (RA, 0.300+/-0.07 vs. healthy control 0.459+/-0.07, p=0.114). The proportion of induced IL-10+ B cells to total B cells in RA patients was significantly higher than those in controls (RA, 4.44+/-3.44% vs. healthy control 2.44+/-1.64%, p=0.033). However, the proportion of IL-10+ B cells to total B cells correlated negatively with disease activity in RA patients (r=-0.398, p=0.040). Erythrocyte sedimentation rate or C-reactive protein or medication was not associated with the proportion of IL-10+ B cells. CONCLUSION: The proportion of induced IL-10+ B cell increased in RA patients compared to healthy control, however, negatively correlated with disease activity in RA.
Adult
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Aged
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Antigens, CD19/metabolism
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Arthritis, Rheumatoid/blood/*immunology/pathology
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B-Lymphocytes, Regulatory/metabolism/*physiology
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Biological Markers/blood
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Female
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Humans
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Interleukin-10/metabolism
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Male
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Middle Aged
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Severity of Illness Index
8.Lipoprotein-Associated Phospholipase A2 Is Related to Plaque Stability and Is a Potential Biomarker for Acute Coronary Syndrome.
Hyemoon CHUNG ; Hyuck Moon KWON ; Jong Youn KIM ; Young Won YOON ; Jihyuk RHEE ; Eui Young CHOI ; Pil Ki MIN ; Bum Kee HONG ; Se Joong RIM ; Ji Hyun YOON ; Sung Joo LEE ; Jong Kwan PARK ; Myung Hyun KIM ; Minhee JO ; Jeong Hee YANG ; Byoung Kwon LEE
Yonsei Medical Journal 2014;55(6):1507-1515
PURPOSE: Plasma lipoprotein-associated phospholipase A2 (Lp-PLA2) binds to low-density lipoprotein. The levels of Lp-PLA2 reflect the plaque burden, and are upregulated in acute coronary syndrome (ACS). We investigated the diagnostic value of Lp-PLA2 levels and found that it might be a potential biomarker for ACS. MATERIALS AND METHODS: We classified 226 study participants into three groups: patients without significant stenosis (control group), patients with significant stenosis with stable angina (SA group), and patients with ACS (ACS group). RESULTS: Lp-PLA2 and high-sensitivity C-reactive protein (hs-CRP) levels were significantly greater in the ACS group than in the SA group (p=0.044 and p=0.029, respectively). Multivariate logistic regression analysis revealed that Lp-PLA2 levels are significantly associated with ACS (odds ratio=1.047, p=0.013). The addition of Lp-PLA2 to the ACS model significantly increased the global chi2 value over traditional risk factors (28.14 to 35.602, p=0.006). The area under the receiver operating characteristic curve for Lp-PLA2 was 0.624 (p=0.004). The addition of Lp-PLA2 level to serum hs-CRP concentration yielded an integrated discrimination improvement of 0.0368 (p=0.0093, standard error: 0.0142) and improved the ability to diagnose ACS. CONCLUSION: Lp-PLA2 levels are related to plaque stability and might be a diagnostic biomarker for ACS.
1-Alkyl-2-acetylglycerophosphocholine Esterase/*blood
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Acute Coronary Syndrome/*blood/physiopathology
;
Aged
;
Aged, 80 and over
;
Angina Pectoris
;
Biological Markers/blood
;
C-Reactive Protein/*metabolism
;
Coronary Angiography
;
Female
;
Humans
;
Lipoproteins, LDL/*blood
;
Logistic Models
;
Male
;
Middle Aged
;
Multivariate Analysis
;
Plaque, Atherosclerotic/blood
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ROC Curve
;
Risk Factors
9.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
;
Adult
;
Antioxidants/*metabolism
;
Biological Markers/blood
;
C-Reactive Protein/metabolism
;
Case-Control Studies
;
Female
;
Humans
;
Insulin Resistance
;
Interleukin-6/blood
;
Male
;
Metabolic Syndrome X/*blood
;
Middle Aged
;
Predictive Value of Tests
;
Tumor Necrosis Factor-alpha/blood
10.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
;
Calgranulin A/*blood
;
Calgranulin B/*blood
;
Humans
;
Joints/pathology
;
Synovial Fluid/metabolism

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