BACKGROUND: Metabolic health is an emerging concept that is highly correlated with various metabolic complications, and adipocytokines have been causally linked to a wide range of metabolic diseases. Thus, this study compared serum adipocytokine levels according to metabolic health and obesity status. METHODS: Four hundred and fifty-six nondiabetic subjects (mean age, 40.5 years) were categorized into four groups according to metabolic health and obesity status: metabolically healthy nonobese (MHNO), metabolically healthy obese (MHO), metabolically unhealthy nonobese (MUHNO), and metabolically unhealthy obese (MUHO). Being metabolically healthy was defined as the presence of fewer than two of the following five metabolic abnormalities: high blood pressure, high fasting blood glucose, high triglyceride, low high density lipoprotein cholesterol, and being in the highest decile of the homeostatic model assessment of insulin resistance index. Obesity status was assessed using body mass index (BMI), with obesity defined as a BMI higher than 25 kg/m2. Levels of serum interleukin-6 (IL-6), monocyte chemoattractant protein-1 (MCP-1), tumor necrosis factor alpha (TNF-alpha), and adipocyte fatty acid binding protein (A-FABP) were also evaluated. RESULTS: Of the 456 subjects, 247 (54.2%) were in the MHNO group, 66 (14.5%) were in the MHO group, 66 (14.5%) were in the MUHNO group, and 77 (16.9%) were in the MUHO group. There were no significant differences in IL-6 or MCP-1 levels among the groups, but levels of TNF-alpha and A-FABP were significantly higher in the MUHNO group compared to the MHNO group. CONCLUSION: High TNF-alpha and A-FABP levels are significantly associated with metabolically unhealthiness in nonobese Korean individuals.
Adipocytes ; Adipokines ; Blood Glucose ; Body Mass Index ; Carrier Proteins ; Chemokine CCL2 ; Cholesterol, HDL ; Fasting ; Hypertension ; Insulin Resistance ; Interleukin-6 ; Metabolic Diseases ; Obesity* ; Triglycerides ; Tumor Necrosis Factor-alpha

Sweet's syndrome is an uncommon reactive dermatoses characterized by fever, polymorphonuclear leukocytosis, painful erythematous plaques, and dense dermal infiltrate of neutrophils. Sweet's syndrome can be associated with several diseases, including infectious diseases, malignant tumors, and autoimmune diseases. However, no case of Sweet's syndrome associated with Sjogren's syndrome (SjS) has been reported in Korea. A 44-year-old woman presented with acute pustular rashes and fever. The patient had multiple papulopustular skin rashes, and complained of fever, chills, and headache. Our patient had the characteristic clinical and histopathological features of Sweet's syndrome, in association with SjS, diagnosed by salivary gland scan, positive anti-SS-A/SS-B antibody, and sicca symptoms simultaneously. Thus, we report on a case of a patient with Sweet's syndrome with concomitant diagnosis of SjS.
Adult ; Autoimmune Diseases ; Chills ; Communicable Diseases ; Diagnosis ; Exanthema ; Female ; Fever ; Headache ; Humans ; Korea ; Leukocytosis ; Neutrophils ; Salivary Glands ; Sjogren's Syndrome* ; Skin Diseases ; Sweet Syndrome*

BACKGROUND/AIMS: Adenoma detection rate (ADR) is widely used as an index of colonoscopy quality management. Although advanced adenomas can be found less frequently than non-advanced adenomas, advanced adenomas have a higher clinical significance during screening for colorectal cancer. The aim of this study was to investigate the correlation between advanced and non-advanced ADR among colonoscopists. METHODS: This study is an observational study of a cohort of patients undergoing screening colonoscopy between 2009 and 2010. We collected the data on patients' characteristics and colonoscopic findings. The detection rates of adenoma and advanced adenoma were calculated. Logistic regression was used to determine the effects of variables on advanced adenoma detection, and spearman's rank-order correlation was used to evaluate the relationship between advanced ADR and ADR. RESULTS: A total of 561 patients underwent screening colonoscopy by 18 experienced colonoscopists. Most colonoscopists had adequate (>20%) ADRs. Logistic regression showed that increased patient age (OR 1.07 per 1 year increase, 95% CI 1.009-1.133, p=0.023) and male gender (OR 1.860, 95% CI 0.764-4.529, p=0.171) were associated with advanced ADR. When colonoscopists were divided into two groups on the basis of advanced ADR of 5%, ADR was also significantly higher in the group having higher level of advanced ADR. However, there was no correlation between advanced ADR and ADR among colonoscopists as an individual. CONCLUSIONS: Colonoscopists' advanced ADRs were independent of their ADRs, indicating that advanced ADR could be quite low even among colonoscopists with acceptable ADRs. Thus, there seems to be a limitation in using ADR as an adequate index of colonoscopy quality management.
Adenoma/*diagnosis ; Adult ; Aged ; Cohort Studies ; Colonoscopy ; Colorectal Neoplasms/*diagnosis ; Early Detection of Cancer ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Neoplasm Staging ; Odds Ratio

BACKGROUND: Chronic kidney disease (CKD) is considered one of the most common risk factors for cardiovascular disease. Coronary artery calcification (CAC) is a potential mechanism that explains the association between renal function and cardiovascular mortality. We aimed to evaluate the association between renal function and CAC in apparently healthy Korean subjects. METHODS: A total of 23,617 participants in a health-screening program at Kangbuk Samsung Hospital were included in the study. Estimated glomerular filtration rate (eGFR) was assessed using the Cockcroft-Gault equation. Coronary artery calcium score (CACS) was measured via multidetector computed tomography. Subjects were divided into three groups according to the CKD Staging system with eGFR grade: stage 1, eGFR > or =90 mL/min/1.73 m2; stage 2, eGFR 60 to 89 mL/min/1.73 m2; and stage 3, eGFR 30 to 59 mL/min/1.73 m2. RESULTS: The mean age of the participants was 41.4 years and the mean eGFR was 103.6+/-21.7 mL/min/1.73 m2. Hypertension and diabetes were noted in 43.7% and 5.5% of the participants, respectively. eGFR showed a weakly negative but significant association with CACS in bivariate correlation analysis (r=-0.076, P<0.01). Mean CACS significantly increased from CKD stage 1 to 3. The proportion of subjects who had CAC significantly increased from CKD stage 1 to 3. Although the odds ratio for CAC significantly increased from stage 1 to 3 after adjustment for confounding factors, this significance was reversed when age was included in the model. CONCLUSION: In early CKD, renal function negatively correlated with the degree of CAC in Korean subjects. Age was the strongest effector for this association.
Adult* ; Calcium ; Cardiovascular Diseases ; Coronary Vessels* ; Glomerular Filtration Rate* ; Humans ; Hypertension ; Mortality ; Multidetector Computed Tomography ; Odds Ratio ; Renal Insufficiency, Chronic ; Risk Factors

BACKGROUND: The hypertriglyceridemic waist (HTGW) phenotype is a simple and inexpensive screening parameter to identify people at increased risk of cardiovascular disease. We evaluated whether the HTGW phenotype predicts diabetes in urban Korean adults. METHODS: A total of 2,900 nondiabetic subjects (mean age 44.3 years), comprising 2,078 males (71.7%) and 822 females (28.3%) who underwent annual medical check-ups at our center between January 2005 and December 2009, were recruited. The subjects were divided into four groups according to baseline serum triglyceride (TG) level and waist circumference (WC): normal WC-normal TG (NWNT) level, normal WC-high TG level, enlarged WC-normal TG level, and enlarged WC-high TG (EWHT) level. High serum TG level was defined as > or =150 mg/dL and enlarged WC was defined as > or =90 cm for men and > or =85 cm for women. New cases of diabetes were determined according to questionnaires filled in by participants and the diagnostic criteria of the American Diabetes Association. Cox proportional hazards model analysis was used to assess the association of HTGW phenotype with the incidence of diabetes. RESULTS: A total of 101 (3.5%) new diabetes cases were diagnosed during the study period. The EWHT group had a higher incidence of diabetes (8.3%) compared with the NWNT group (2.2%). The adjusted hazard ratio for diabetes for subjects with the EWHT phenotype at baseline was 4.113 (95% confidence interval [CI], 2.397 to 7.059) after adjustment for age, and 2.429 (95% CI, 1.370 to 4.307) after adjustment for age, sex, total cholesterol, systolic blood pressure, and alcohol drinking history. It was attenuated by inclusion of baseline fasting glucose level in the model. CONCLUSION: Subjects with the HTGW phenotype showed the highest risk of incident diabetes. This tool could be useful for identifying individuals at high risk of diabetes.
Adult ; Alcohol Drinking ; Blood Pressure ; Cardiovascular Diseases ; Cholesterol ; Fasting ; Female ; Glucose ; Humans ; Hypertriglyceridemia ; Hypertriglyceridemic Waist* ; Incidence ; Longitudinal Studies* ; Male ; Mass Screening ; Phenotype* ; Proportional Hazards Models ; Triglycerides ; Waist Circumference ; Surveys and Questionnaires

OBJECTIVE: This study aimed to investigate the adolescent brain activation patterns in response to performance feedback (PF), social reward (SR) and monetary reward (MR) and their association with psychological factors. METHODS: Functional magnetic resonance imaging (fMRI) was performed while middle school boys (n=15) performed tests pertained to PF, SR and MR. The brain activation pattern in each condition was investigated, and the extent of brain activation in each of the three conditions was compared at once. RESULTS: The caudate and the dorsal prefrontal area were activated in all three conditions. Furthermore, the cuneus showed significantly greater activation in the PF condition than the SR or MR condition. And the self - related areas, such as the right precentral gyrus and paracenral lobule, were more activated in the SR condition than the PF or MR condition. The left middle frontal gyrus was more activated in the MR condition than the PF or SR condition. CONCLUSION: Not only various reward stimuli but also feedback stimulus might commonly activate dorsal prefrontal and subcortical area in adolescents. Moreover, several different brain activation patterns were also observed in each condition. The results of this study could be applied to planning of learning and teaching strategy for adolescents in various ways.
Adolescent ; Brain ; Humans ; Learning ; Magnetic Resonance Imaging ; Reward

BACKGROUND: Smoking is a major risk factor of stroke, but not all smokers develop stroke. This individual difference could be explained by the variation of detoxification capacity. We investigated the relationship of smoking with the genetic polymorphism of a detoxification enzyme (glutathione S-transferase: GST). METHODS: This study was conducted as a case-control study. Conventional risk factors for stroke and 3 genetic polymorphisms of GST (GSTM1, GSTT1, and GSTP1) were studied in both 290 acute ischemic stroke patients and 290 age and sex matched controls. Smoking status was determined by urinary cotinine level. The effect of interaction of GST polymorphisms and smoking on stroke risk was investigated. RESULTS: Stroke patients had higher cotinine level compared to that of control (P<0.01). There was little difference between the patient group and control group with regard to the GST polymorphism alone, but significant interaction was noticed between the GST polymorphism and the smoking status. When we stratified the group according to the smoking status by cotinine level, stroke was significantly more frequent in GSTM1 null type and GSTT1, GSTP1 wild type of the high cotinine level group (OR and 95% CI: 2.115, 1.219-3.670; 2.620, 1.480-4.638; 2.212, 1.343-3.644 respectively). CONCLUSION: GST polymorphisms interact with the smoking and confer an increased risk of ischemic stroke, indicating that genetic polymorphism of GST might reveal smokers who are more susceptible to the ischemic stroke.
Case-Control Studies ; Cotinine ; Glutathione ; Glutathione Transferase ; Humans ; Individuality ; Polymorphism, Genetic ; Risk Factors ; Smoke ; Smoking ; Stroke

OBJECTIVES: This study compared covert narcissistic propensity in adolescents with internet addiction tendency to normal adolescents. Further, we investigated the correlation between such propensities and anonymity in cyberspace, presence feeling and interactivity in internet gaming, and achievement motivation in adolescents with internet addiction tendencies. METHODS: Male middle school students with internet addiction tendencies (Addiction Tendency Group, N=27) and normal students (Control Group, N=29) were recruited. The scale of internet use, Covert Narcissism Scale, scale of achievement motivation, scale of anonymity in cyberspace, scale of presence feeling in internet games, and the scale of interactivity in internet games were administered. A comparison of the average scores and correlation analyses were performed. RESULTS: 1) Compared with Control Group, the Addiction Tendency Group showed significantly higher scores on all subscales of the Covert Narcissism Scale, and both the scale of presence feeling and that of interactivity in internet games. Further, the score on the scale of achievement motivation for the Addiction Tendency Group was significantly lower than that of the Control Group. 2) In the Addiction Tendency Group, the scores on several subscales of the Covert Narcissism Scale were significantly positively correlated with the scores on the scale of presence feeling in internet games, anonymity in cyberspace, and interactivity in internet games. However, in the Control Group, the scores of several subscales on the Covert Narcissism Scale were significantly negatively correlated with the score on the scale of achievement motivation, and was significantly positively correlated with the score on the scale of interactivity in internet games. There were no other significant correlations between the scores on the subscales of the Covert Narcissism Scale and the scores of either presence feeling in internet games or anonymity in cyberspace. CONCLUSION: These results suggested that adolescents with a tendency to be addicted to the internet exhibited higher covert narcissistic propensities than normal adolescents and that the covert narcissistic tendencies were related with presence feeling in cyber games as well as with anonymity in cyberspace.
Achievement ; Adolescent ; Anonyms and Pseudonyms ; Humans ; Internet ; Male ; Motivation ; Narcissism