Geon Ho Lee

Increased insulin resistance and serum resistin in Korean patients with Behçet's disease.

BACKGROUND AND AIMS This study was designed to identify susceptibility to insulin resistance and the association of serum resistin and adiponectin with insulin resistance in patients with Behçets disease (BD). Also, we identify risk determinants for insulin resistance in BD patients. METHODS The study population consisted of 82 BD patients (n = 26 males) and 89 healthy controls (n = 40 males). Clinical data were collected at the time of enrollment, and serum resistin and adiponectin levels were measured using enzyme-linked immunosorbent assays. The homeostasis model assessment of insulin resistance (HOMA-IR) was calculated by measuring fasting plasma glucose and insulin levels. RESULTS BD patients and healthy controls differed significantly in insulin resistance (HOMA-IR) (1.3 +/- 1.1 vs. 0.7 +/- 0.5, p<0.001) and serum resistin level (7901.7 +/- 1314.9 vs. 7444.2 +/- 1841.6, p = 0.001) but not in serum adiponectin level (p = 0.223). No differences in HOMA-IR, serum adiponectin, and serum resistin were found between patients with active and inactive BD. It is determined that plasma glucose, plasma insulin, and serum resistin may be determinant for the HOMA-IR. The number of metabolic syndrome components is closely correlated with HOMA-IR in BD patients (r = 0.245, p = 0.029). CONCLUSION This study demonstrates that there is an increased susceptibility to insulin resistance in patients with BD as compared to healthy controls. Serum resistin level may be an independent determinant for insulin resistance in BD patients.

Radiographic Bone Damage in Chronic Gout Is Negatively Associated with the Inflammatory Cytokines Soluble Interleukin 6 Receptor and Osteoprotegerin

Objective. We investigated the risk factors for radiographic bone damage to foot joints in patients with chronic gout among various patient characteristics and serum inflammatory cytokines such as interleukin 1ß (IL-1ß), IL-6, soluble IL-6 receptor (sIL-6R), osteoprotegerin (OPG), and receptor activator of nuclear factor-κB ligand (RANKL). Methods. Fifty consecutive male patients with gout and 54 age-matched healthy male controls were enrolled. Serum levels of cytokines including IL-1ß, IL-6, sIL-6R, OPG, and RANKL were measured using ELISA. Radiographic damage indices including erosion scores, narrowing scores, and total scores for foot joints were assessed according to a modified Sharp-van der Heijde system. Results. There were significant differences in serum IL-1ß, IL-6, sIL-6R, OPG, and RANKL levels between patients with gout and the controls, after adjustment for confounding factors such as age, body mass index, blood urea nitrogen, creatinine, triglyceride, and fasting blood glucose (p = 0.034 for IL-1ß, p < 0.001 for IL-6, p = 0.040 for sIL-6R, p = 0.002 for OPG, and p = 0.018 for RANKL). Radiographic damage indices (erosion, narrowing, and total scores) were negatively associated with serum sIL-6R and OPG levels in multivariable-adjusted regression analysis. Serum sIL-6R levels in patients without radiographic damage were higher than in those with damage (p = 0.006). Conclusion. Radiographic damage in patients with chronic gouty arthritis was negatively associated with serum sIL-6R and OPG. Further study on the role of inflammatory cytokines in the pathogenesis of radiographic damage in gout is needed.

γδ T cells are increased in the peripheral blood of patients with gastric cancer.

BACKGROUND γδ T cells are implicated in immunoregulation. However, little is known about the characteristics of γδ T cells in gastric cancer. In this study, we assessed the incidence of γδ T cells and lymphocyte subsets in the peripheral blood of gastric cancer patients. METHODS We enrolled 48 patients and 49 healthy controls. The γδ T cells, lymphocyte subsets were analyzed with flow cytometry. RESULTS The mean percentage of γδ T cells in patients with gastric cancer was 5.0±3.4% and for controls 2.3±1.6%. Twenty (41.7%) of the 48 patients with gastric cancer had a high percentage (more than 5%) of peripheral blood γδ T cells, while 4 (8.2%) of the 49 controls did. The percentage of CD3⁺ T cells were elevated in gastric cancer compared to controls (P=0.007). The CD4/CD8 ratio increased in gastric cancer (P=0.311). The percentage of CD3⁺CD4⁻CD8⁻ T cells increased in gastric cancer compared to controls (P=0.004). CONCLUSION The proportion of γδ T cells in the peripheral blood of gastric cancer patients was significantly higher in comparison to that in the healthy controls. Our findings suggest that increased proportion of peripheral γδ T cells may explain anti-tumor immunity against gastric cancer partly.

Dietary Magnesium Intake and Risk of Cancer: A Meta-Analysis of Epidemiologic Studies

The aim of this study was to investigate the association between dietary magnesium and the risk of overall cancer using a meta-analysis. We searched PubMed, SCOPUS, and the Cochrane Review through November 2012. All the articles searched were independently reviewed by 3 authors based on predetermined selection criterion. A total of 13 epidemiologic studies, 6 case-control studies, and 7 prospective cohort studies involving 1,236,004 participants were included in the final analysis. When all studies were pooled, the relative risk (RR) of overall cancer for the highest level of dietary magnesium intake was 0.801 [95% confidence interval (CI): 0.664–0.966) compared with the lowest level of dietary magnesium intake. In subgroup meta-analyses by study design, there was a significant inverse association between dietary magnesium and the risk of cancer in case-control studies (RR = 0.663, 95% CI: 0.475–0.925), whereas there was no significant association in prospective cohort studies (RR = 0.888, 95% CI: 0.745–1.060). Furthermore, there was a significant preventive effect of dietary magnesium for colorectal cancer (RR = 0.775, 95% CI: 0.655–0.919), but not for other cancer. Our meta-analysis showed that higher dietary magnesium intake seems to have a protective effect for cancer, especially colorectal cancer and in females.

Gastric Cancer Detection Using Gastric Juice Pepsinogen and Melanoma-Associated Gene RNA

OBJECTIVES To develop a new method for gastric cancer detection with gastric juice using melanoma-associated gene (MAGE) RNA and pepsinogen (PG). METHODS In total, 183 gastric juice and paired serum specimens were obtained from 134 patients with gastric cancer and 49 healthy individuals. The gastric juice specimens were analyzed with MAGE A1 to A6 nested reverse transcription-polymerase chain reaction. The serum and gastric juice PG were measured with a PG I and II immunoassay. RESULTS The gastric juice PG I and PG I/II ratios were more accurate than those of serum. The combination test using the gastric PG I/II ratio and MAGE was the most accurate, with a sensitivity of 77.6% and a specificity of 87.8%. The sensitivity was 78.8% for stage I gastric cancer and not influenced by cancer location or pathologic type. CONCLUSIONS The combination test is potentially an additional tool for gastric cancer detection.

Enhanced expression of NLRP3 inflammasome-related inflammation in peripheral blood mononuclear cells in Sjögren's syndrome

OBJECTIVE The aim of this study was to identify the association of NLRP3 inflammasome-induced inflammation with disease activity and damage in Sjögrens syndrome. METHODS A total of 33 female patients with Sjögrens syndrome and 34 sex- and age-matched, healthy controls were consecutively enrolled. The mRNA expression levels of NLRP3, ASC, caspase-1, interleukin-1β (IL-1β), and IL-18 in peripheral blood mononuclear cells (PBMCs) were measured, as well as serum IL-1β and IL-18 protein expression levels. Protein levels for mature IL-1β (p17) and caspase-1 (p20) were analyzed by western blotting. The EULAR Sjögrens Syndrome Disease Activity Index (ESSDAI) and Sjögrens Syndrome Disease Damage Index (SSDDI) were also evaluated. RESULTS Patients with Sjögrens syndrome group showed higher expression of mRNA IL-1β and IL-1β at the protein level than controls (p<0.001 of both). Enhanced expression of mature IL-1β (p17) and caspase-1 (p20) proteins in Sjögrens syndrome were noted, compared to controls. The mRNA levels of caspase-1 and ASC were significantly increased in patients with Sjögrens syndrome compared to controls (p=0.001 and p=0.002, respectively). Based on the SSDDI scores, patients with damage (SSDDI≥1) had higher IL-1β mRNA expression compared to patients without damage (SSDDI=0) (p=0.034). SSDDI scores were closely related with IL-18 protein levels (r=0.357, p=0.041). The levels of IL-1β mRNA and IL-1β protein were correlated with the mRNA level of NLRP3 (r=0.597, p<0.001 and r=0.502, p=0.003, respectively). IL-1β mRNA expression was responsible for the presence of damage for Sjögrens syndrome (p=0.034). CONCLUSION This study confirmed that NLRP3 inflammasome-mediated inflammation might be implicated in the pathogenesis of Sjögrens syndrome.

Disappearance of an adnexal mass with Saam acupuncture: a case report

We report the case of a 30-year-old woman with a right adnexal mass resembling an ovarian cyst who declined diagnostic laparoscopy and requested treatment with acupuncture. The patient was treated with Saam acupuncture for 14 weeks. After treatment, transvaginal sonography revealed disappearance of the right adnexal mass. No adverse effects of the Saam acupuncture treatment were reported.