BACKGROUND: Carotid artery intima medial thickness (IMT), brachial-ankle pulse wave velocity (baPWV), and ankle-brachial index (ABI) are commonly used surrogate markers of subclinical atherosclerosis in patients with type 2 diabetes mellitus (T2DM). The cardio-ankle vascular index (CAVI) is a complement to the baPWV, which is affected by blood pressure. However, it is unclear which marker is the most sensitive predictor of atherosclerotic cardiovascular disease (ASCVD). METHODS: This was a retrospective non-interventional study that enrolled 219 patients with T2DM. The correlations among IMT, ABI, and CAVI as well as the relationship of these tests to the 10-year ASCVD risk were also analyzed. RESULTS: Among the 219 patients, 39 (17.8%) had ASCVD. In the non-ASCVD group, CAVI correlated significantly with IMT after adjusting for confounding variables, but ABI was not associated with CAVI or IMT. The analyses after dividing the non-ASCVD group into three subgroups according to the CAVI score ( < 8, ≥8 and < 9, and ≥9) demonstrated the significant increase in the mean IMT, 10-year ASCVD risk and number of metabolic syndrome risk factors, and decrease in the mean ABI in the high-CAVI group. A high CAVI was an independent risk factor in the non-ASCVD group for both a high 10-year ASCVD risk (≥7.5%; odds ratio [OR], 2.42; P < 0.001) and atherosclerosis (mean IMT ≥1 mm; OR, 1.53; P=0.007). CONCLUSION: In Korean patients with T2DM without ASCVD, CAVI was the most sensitive of several surrogate markers for the detection of subclinical atherosclerosis.
Ankle Brachial Index ; Atherosclerosis ; Biomarkers* ; Blood Pressure ; Cardiovascular Diseases* ; Carotid Arteries ; Complement System Proteins ; Confounding Factors (Epidemiology) ; Diabetes Mellitus, Type 2* ; Humans ; Korea ; Odds Ratio ; Pulse Wave Analysis ; Retrospective Studies ; Risk Factors

Immunoglobulin A (IgA) vasculitis is the most common leukocytoclastic small-vessel vasculitis in children and mainly involves the small vessels in the skin, joints, digestive tract, and kidneys. Its pathogenesis is still unclear. Currently, it is believed that environmental factors can cause autoimmune dysfunction and lead to the deposition of IgA-containing immune complexes on the wall of arterioles on the basis of genetic factors. This article reviews the research advances in the role of immune factors in the pathogenesis of IgA vasculitis.
Autoantibodies ; analysis ; Complement System Proteins ; physiology ; Cytokines ; physiology ; Glycosylation ; Humans ; Immunoglobulin A ; analysis ; Immunoglobulin E ; metabolism ; Vasculitis ; etiology ; immunology

Near-infrared spectroscopy (NIRS), a noninvasive optical method, utilizes the characteristic absorption spectra of hemoglobin in the near-infrared range to provide information on cerebral hemodynamic changes in various clinical situations. NIRS monitoring have been used mainly to detect reduced perfusion of the brain during orthostatic stress for three common forms of orthostatic intolerance (OI); orthostatic hypotension, neurally mediated syncope, and postural orthostatic tachycardia syndrome. Autonomic function testing is an important diagnostic test to assess their autonomic nervous systems for patients with symptom of OI. However, these techniques cannot measure dynamic changes in cerebral blood flow. There are many experimentations about study of NIRS to reveal the pathophysiology of patients with OI. Research using NIRS in other neurologic diseases (stroke, epilepsy and migraine) are ongoing. NIRS have been experimentally used in all stages of stroke and may complement the established diagnostic and monitoring tools. NIRS also provide pathophysiological approach during rehabilitation and secondary prevention of stroke. The hemodynamic response to seizure has long been a topic for discussion in association with the neuronal damage resulting from convulsion. One critical issue when unpredictable events are to be detected is how continuous NIRS data are analyzed. Besides, NIRS studies targeting pathophysiological aspects of migraine may contribute to a deeper understanding of mechanisms relating to aura of migraine. NIRS monitoring may play an important role to trend regional hemodynamic distribution of flow in real time and also highlights the pathophysiology and management of not only patients with OI symptoms but also those with various neurologic diseases.
Absorption ; Autonomic Nervous System ; Brain ; Cerebrovascular Circulation ; Complement System Proteins ; Diagnostic Tests, Routine ; Epilepsy ; Hemodynamics ; Humans ; Hypotension, Orthostatic ; Methods ; Migraine Disorders ; Nervous System Diseases* ; Neurons ; Orthostatic Intolerance* ; Perfusion ; Postural Orthostatic Tachycardia Syndrome ; Rehabilitation ; Secondary Prevention ; Seizures ; Spectroscopy, Near-Infrared* ; Spectrum Analysis ; Stroke ; Syncope

BACKGROUND: Despite considerable efforts made in recent years, the industrial accident rate and the fatality rate in the Republic of Korea are much higher than those in most developed countries in Europe and North America. Industrial safety policies and safety regulations are also known to be ineffective and inefficient in some cases. METHODS: This study focuses on the quantitative evaluation of the effectiveness of direct safety regulations such as safety certification, self-declaration of conformity, and safety inspection of industrial machines in the Republic of Korea. Implications on safety policies to restructure the industrial safety system associated with industrial machines are also explored. RESULTS: Analysis of causes in industrial accidents associated with industrial machines confirms that technical causes need to be resolved to reduce both the frequency and the severity of such industrial accidents. Statistical analysis also confirms that the indirect effects of safety device regulation on users are limited for a variety of reasons. Safety device regulation needs to be shifted to complement safety certification and self-declaration of conformity for more balanced direct regulations on manufacturers and users. An example of cost-benefit analysis on conveyor justifies such a transition. CONCLUSION: Industrial safety policies and regulations associated with industrial machines must be directed towards eliminating the sources of danger at the stage of danger creation, thereby securing the safe industrial machines. Safety inspection further secures the safety of workers at the stage of danger use. The overall balance between such safety regulations is achieved by proper distribution of industrial machines subject to such regulations and the intensity of each regulation. Rearrangement of industrial machines subject to safety certification and self-declaration of conformity to include more movable industrial machines and other industrial machines with a high level of danger is also suggested.
Accidents, Occupational ; Certification ; Complement System Proteins ; Cost-Benefit Analysis ; Developed Countries ; Europe ; Evaluation Studies as Topic ; North America ; Protective Devices ; Republic of Korea* ; Social Control, Formal*

BACKGROUND AND OBJECTIVES: Ancillary tests such as BRAF(V600E) mutation or immunohistochemical (IHC) assays have been utilized as complements to morphological criteria in diagnosing subsets of papillary thyroid carcinoma (PTC). Utilizing results from analysis by The Cancer Genome Atlas (TCGA), we evaluated the diagnostic value and feasibility of these ancillary tests in diagnosing follicular variant PTC (FVPTC). MATERIALS AND METHODS: Clinical data and tissue samples were analyzed from 370 PTC patients, who had undergone thyroidectomy between December 2003 and July 2014. PTC was limited to conventional PTC (CVPTC), tall cell variant PTC (TCPTC), and FVPTC. Using multivariate analyses, FVPTC cases were compared to CVPTC and TCPTC cases. Surgical specimens were pyrosequenced for BRAF(V600E) mutation or stained for IHC markers such as CD56, galectin-3, cytokeratin 19 (CK19), or CD31. For the validation, a comprehensive analysis was performed for BRAF(V600E) mutation and quantitative mRNA expressional difference in TCGA. RESULTS: Demographic differences were not observed between 159 CVPTC, 103 TCPTC, and 108 FVPTC cases. BRAF(V600E) mutation predominated in CVPTC+TCPTC group, but not in FVPTC group (78.4% vs. 18.7%, p<0.001), as suggested by TCGA (57.4% vs. 12.1%, p<0.0001). IHC markers significantly distinguished FVPTC cases from CVPTC+TCPTC cases. CD56 exhibited more intense staining in FVPTC cases (21.1% vs. 72.0%, p<0.001). Galectin-3 and CK19 yielded limited values. CD31 correlated with lymphovascular invasion (r=0.847, p<0.001). In analysis of TCGA, mRNA differential expression of these genes revealed their corresponding upregulation or downregulation. CONCLUSION: BRAF(V600E) mutation or TCGA-validated IHC assay could be recommended as ancillary tests for classifying PTC.
Complement System Proteins ; Down-Regulation ; Galectin 3 ; Genome* ; Humans ; Keratin-19 ; Multivariate Analysis ; RNA, Messenger ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy ; Up-Regulation

OBJECTIVETo investigate the action of Shen-Fu Injection (SFI) in regulating the expression of the serum complements and inflammatory cytokines synthesized and released in response to the stress of global ischemia accompanying cardiac arrest (CA) and resuscitation.

METHODSThirty pigs were randomly divided into the sham (n=6) and 3 returns of spontaneous circulation (ROSC) groups (n=24). After 8-min untreated ventricular fibrillation and 2-min basic life support, 24 pigs of the ROSC groups were randomized into three groups (n=8 per group), which received central venous injection of SFI (SFI group), epinephrine (EP group), or saline (SA group). Hemodynamic status and blood samples were obtained at 0, 0.5, 1, 2, 4, 6, 12, and 24 h after ROSC.

RESULTSSerum concentrations of specific activation markers of the complement system C3, C4 and C5b-9 were increased during cardiopulmonary resuscitation through 24 h after ROSC. There were intense changes of various pro-inflammatory cytokines and anti-inflammatory cytokines as early as 0.5 h after CA. Compared with the EP and SA groups, SFI treatment reduced the proinflammatory cytokines levels of interleukin (IL)-6, IL-8 and tumor necrosis factor α (TNF-α, P<0.05), and increased the anti-inflammatory cytokine levels of IL-4 and IL-10 (P<0.05). Further, SFI treatment decreased the values of C3, C4 and C5b-9 compared with the EP and SA groups.

CONCLUSIONSSFI, derived from the ancient Chinese medicine, has significant effects in attenuating post-resuscitation immune dysfunction by modulating the expression of complements and cytokines levels. The current study provided an experimental basis for the clinical application of a potential pharmacologic target for post resuscitation immune dysfunction.

Aconitine ; chemistry ; pharmacology ; Animals ; Cardiopulmonary Resuscitation ; Complement Activation ; drug effects ; Complement System Proteins ; metabolism ; Cytokines ; blood ; Drugs, Chinese Herbal ; administration & dosage ; pharmacology ; Ginsenosides ; chemistry ; pharmacology ; Hemodynamics ; drug effects ; Inflammation Mediators ; metabolism ; Injections ; Male ; Models, Animal ; Oxygen ; metabolism ; Survival Analysis ; Sus scrofa

OBJECTIVETo detect the variations in peripheral blood levels of autoantibodies, immunoglobulilns and complements in patients with non-lactational mastitis and investigate whether non-lactational mastitis is an autoimmune disease with immune dysfunction.

METHODSSeven-eight patients with non-lactational mastitis treated in our hospital between September 2013 and May 2015 and 88 healthy women (control) were examined for peripheral blood levels of antinuclear antibody (ANA), anti-histone antibody (AHA), immunoglobulins (IgA, IgM, and IgG) and complements (C3, C4, and total complements).

RESULTSs Of the 78 patients with non-lactational mastitis, 50 (64.10%) were positive of ANA showing mainly the granular and cytoplasmic granular fluorescence patterns, and the positivity rate was significantly higher than that in the control group (P<0.000). Twenty-eight (36.00%) of the patients were positive of AHA, a rate significantly higher than that in the control group (P<0.000). The levels of IgA, IgM, C4, and total complements levels were all significantly elevated in the patients compared with those in the control group (P<0.05).

CONCLUSIONPatients with non-lactational mastitis have abnormal changes in peripheral blood levels of immunoglobulins and complements with high positivity rates for ANA and AHA, indicating that non-lactational mastitis is an autoimmune disease with immune dysfunction.

Antibodies, Antinuclear ; blood ; Autoantibodies ; blood ; Autoimmune Diseases ; blood ; diagnosis ; Case-Control Studies ; Complement System Proteins ; analysis ; Female ; Humans ; Mastitis ; blood ; diagnosis

BACKGROUND AND OBJECTIVES: According to the correlation between hearing injury and McBride disability rating presented by previous studies, there are over/underestimated cases particularly in the 40 dB hearing range compared to other ranges. In this study, we reviewed the overestimated and underestimated data and propose a complementation scheme for a disability rating system by using the linear regression analysis. SUBJECTS AND METHOD: For the past 14 years, we have provided legal advisory for 121 cases of hearing injury, for which disability had to be rated. We reviewed all but excluded 11 cases for the aggravation of disability. A regression equation was produced from a linear regression analysis that used the percent of hearing handicap (AAO-HNS/AMA-1979 formula) as an independent variable (x) and McBride disability rating (%) as a dependent variable (y), following the Pearson correlation test. Iterative calculation was performed for overestimated (18) and underestimated (8) cases. RESULTS: Appropriate disability ratings were 14% for the cases overestimated to 20% and 11% for those underestimated to 5%. Appropriate disability ratings for the 20% of overestimated cases were changed to 14%, and for the 5% of the underestimated cases, the disability ratinb 11%. Iterative calculation showed that the Pearson correlation index was improved from 0.8866 to 0.9065 and the determination coefficient of regression analysis (adjusted R-square) was improved from 0.784 to 0.8202. CONCLUSION: The common range of hearing injury, which falls between 30-40 dB corresponds to the percentage of hearing handicap of 7.5-22.5%. A fairer assessment of ability rating would be possible by complementing some parts of this hearing range.
Complement System Proteins* ; Disability Evaluation ; Hearing Loss ; Hearing* ; Jurisprudence ; Linear Models* ; Regression Analysis*

OBJECTIVETo explore the effects of postoperative enteral immunonutrition on inflammatory response and immunologic function in patients with gastrointestinal tumor.

METHODSClinical data of 106 gastrointestinal malignant tumor patients with malnutrition who were treated in the Department of General Surgery, the People's Hospital of Cangzhou in Hebei province from January 2008 to June 2010 were prospectively collected. Patients were randomized into two groups, including enteral immunonutrition group(n=53) and common enteral nutrition group(n=53). Related immunological indices and C-reaction protein were measured on preoperative day 5 and postoperative day 1 and 9.

RESULTSThe general information and preoperative immunological indices were comparable between the two groups(P>0.05). On postoperative day 9, levels of CD4, CD4/CD8, IgG, lymphocyte, NK cells, and complement C3, C4, and CH50 in the enteral immunonutrition group were higher than those in common enteral nutrition group. Serum C-reaction protein level was lower than that in control group, and the difference was statistically significant (P<0.05). Postoperative infection rate was 3.8%(2/53) in enteral immunonutrition group, significantly lower than that in control group with an infection rate of 15.1%(8/53)(P<0.05). The mean postoperative hospital stay of the two groups were (8.1±1.1) d and (9.2±2.1) d, respectively, and the difference was statistically significant(P<0.05).

CONCLUSIONFor gastrointestinal malignant tumor patients with malnutrition, the use of enteral immunonutrition can alleviate the postoperative trauma and inflammatory response, improve the immune function, thus can reduce the occurrence of postoperative infection, and accelerate patient recovery.

Adolescent ; Adult ; Aged ; C-Reactive Protein ; analysis ; CD4-CD8 Ratio ; Complement System Proteins ; immunology ; Enteral Nutrition ; Female ; Gastrointestinal Neoplasms ; complications ; immunology ; therapy ; Humans ; Inflammation ; immunology ; Killer Cells, Natural ; immunology ; Male ; Malnutrition ; complications ; therapy ; Middle Aged ; Postoperative Period ; Prospective Studies ; Treatment Outcome ; Young Adult

Adolescent ; Child ; Child, Preschool ; Complement System Proteins ; analysis ; Female ; Humans ; Immunoglobulins ; analysis ; Infant ; Male ; Pneumonia, Mycoplasma ; immunology