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Purpose@#We report a patient with refractory scleritis effectively treated with rituximab after ineffective, initial, conventional immunosuppressive therapy.Case summary: A 58-year-old woman with no specific medical history presented with recurrent scleritis of the right eye. Her uncorrected visual acuities in both eyes were 20/20, and a blood test for cytoplasmic antineutrophil cytoplasmic antibody (C-ANCA) was positive. Systemic and subconjunctival steroid treatments were not effective, and the scleritis recurred even after further treatment with oral cyclosporin A and mycophenolate mofetil. After intravenous administration of infliximab (5 mg/kg), slight improvement was noted, but the recurrence continued. Thereafter, the visual acuity of the right eye decreased markedly because of choroidal and serous retinal detachment caused by posterior scleritis. Immunohistochemically, the inflamed scleral tissue showed considerable B-cell infiltration. Accordingly, intravenous rituximab (1 g) was administered twice at a 2-week interval. The scleral vessel engorgement and inflammation dramatically improved, and the scleritis became well-controlled without recurrence for more than 8 months. @*Conclusions@#Intravenous rituximab may be helpful when encountering scleritis refractory to conventional immunomodulation therapy.
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Background@#Mesenchymal stem cells (MSCs) have been investigated as therapeutic agents for inflammatory bowel disease (IBD). Stimulation of MSCs with pro-inflammatory cytokines is an approach to enhance their immunomodulatory effects. However, further investigation is required to support their application in immune-mediated disorders and companion animals. @*Objectives@#This study aimed to assess the therapeutic effect of tumor necrosis factor (TNF)-α-stimulated feline adipose tissue-derived MSCs (fAT-MSCs) in a dextran sulfate sodium (DSS)-induced colitis mouse model. @*Methods@#Colitis mice was made by drinking water with 3% DSS and fAT-MSCs were injected intraperitoneally. Colons were collected on day 10. The severity of the disease was evaluated and compared. Raw 264.7 cells were cultured with the conditioned medium to determine the mechanism, using quantitative real-time polymerase chain reaction and enzyme-linked immunosorbent assay. @*Results@#TNF-α-stimulated fAT-MSCs more improved severity of DSS-induced colitis in disease activity, colon length, histologic score, and inflammatory cytokine. In sectionized colon tissues, the group comprising TNF-α-stimulated fAT-MSCs had higher proportion of CD11b + CD206 + macrophages than in the other groups. In vitro, TNF-α-stimulation increased cyclooxygenase-2 (COX-2) expression and prostaglandin E2 (PGE2 ) secretion from fAT-MSCs. The conditioned medium from TNF-α-stimulated fAT-MSCs enhanced the expression of interleukin-10 and arginase-1 in LPS-activated Raw 264.7 cells. @*Conclusions@#These results represent that TNF-α-stimulated fat-mscs ameliorate the inflamed colon more effectively. Furthermore, we demonstrated that the effectiveness was interlinked with the COX-2/PGE2 pathway.
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Background@#This longitudinal study examined risk factors for future suicidality among North Korean defectors (NKDs) living in South Korea. @*Methods@#The subjects were 300 NKDs registered with a regional adaptation center (the Hana Center) in South Korea. Face-to-face interviews were conducted using the North Korean version of the World Health Organization’s Composite International Diagnostic Interview to diagnose mental disorders according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Subjects were also asked about sociodemographic and clinical factors at baseline. At follow-up after three years, the NKDs (n = 172 respondents) were asked to participate in an online survey, responding to self-questionnaires about suicidality. Logistic regression analyses were used to explore associations between baseline variables and future suicidality among NKDs. @*Results@#Thirty (17.4%) of the 172 survey respondents reported suicidality at follow-up. The presence of health problems over the past year, any prior suicidality at baseline, a higher score on a trauma-related scale, and a lower score on a resilience scale at baseline were associated with greater odds of suicidality at follow-up after adjusting for age, sex, and educational level. Of all mental disorder categories, major depressive disorder, dysthymia, agoraphobia, and social phobia were also associated with significantly increased odds of suicidality at follow-up after adjusting for age, sex, educational level, and prior suicidality at baseline. @*Conclusion@#Resilience, a previous history of suicidality, and the presence of lifetime depressive disorder and anxiety disorder should be given consideration in mental health support and suicide prevention in NKDs.
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Purpose@#The aim of this study was to assess the feasibility and efficacy of an ultrasound needle guidance system (NGS) based on standard needle magnetization in a phantom study of thyroid nodule (TN)-targeting punctures. @*Methods@#Six trainees and a staff radiologist performed TN-targeting punctures with or without the NGS in phantom models (group 1, experience <50 cases; group 2, experience ≥50 cases and <100 cases; group 3, experience ≥100 cases of TN-targeting punctures). The feasibility, technical success rate, number of punctures, and procedure time were recorded. @*Results@#The feasibility of NGS was 98.6% (138/140). In group 1, the technical success rate increased from 60.0%±8.2% to 80.0%±8.2% when the NGS was used (P=0.046), with a reduction in the number of punctures from 2.2 to 1.2 (P=0.005). In group 2, the rate changed from 95.0%±5.8% to 100.0%±0.0% with the NGS (P=0.157), with a minimal decrease in the number of punctures from 1.1 to 1.0 (P=0.157). The procedure time significantly decreased in both groups (P=0.041 and P=0.010, respectively) when the NGS was used. In group 3, there were no significant differences in the technical success rate and the number of punctures according to whether the NGS was used (P=0.317 and P=0.317, respectively). @*Conclusion@#NGS using standard needle magnetization is technically feasible and has potential to improve the efficacy of TN-targeting punctures for less-experienced operators, especially beginners, according to the findings of this phantom study.
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Purpose@#Systemic inflammation is associated with various malignancies, including colorectal cancer, as possible prognostic predictors. We aimed to evaluate the correlation of pretreatment the platelet-to-lymphocyte (PLR) and the neutrophil-to-lymphocyte (NLR) ratio with long-term oncologic outcomes and pathologic complete response (pCR) in locally ad vanced rectal cancer patients who received neoadjuvant concurrent chemoradiotherapy (CRT) followed by curative resection. @*Methods@#Between October 1996 and December 2015, 168 rectal cancer patients treated with preoperative CRT followed by surgery were enrolled. The set cut-off/mean PLR and NLR were 170 and 2.8. We analyzed the relationship between PLR, NLR, and the 5-year overall survival (OS), disease-free survival (DFS), and pCR rate. @*Results@#The 5-year OS rates were 75.9% and 59.8% in the highand low-PLR groups. The 5-year DFS rates were 62.9% and 50.8% in the high- and low-PLR groups, with no significant difference. In addition, the 5-year OS rates were 75.7% and 58.4%, and the 5-year DFS rates were 62.5% and 50.0% in the high- and low-NLR groups, respectively, both without any significant difference. Multivariate analysis showed only pretreatment PLR as an independent prognostic factor for OS (hazard ratio, 1.850; 95% confidence interval, 1.041–3.287; P=0.036), and both serologic markers were not independent prognostic factors for 5-year DFS. @*Conclusion@#Neither PLR nor NLR was associated with 5-year DFS nor pCR to neoadjuvant CRT. Only pretreatment PLR can be used in predicting OS in locally advanced rectal cancer patients who received neoadjuvant CRT followed by curative resection.
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Objectives@#This study examined the stigma against social withdrawal syndrome (hikikomori) among mental health practitioners, and compared levels of stigma against social withdrawal syndrome versus mental illness. @*Methods@#The participants were 133 mental health practitioners (28 males, 105 females) with experience of social withdrawal syndrome that self-reported levels of stigma against social withdrawal syndrome and mental illness. @*Results@#Stigma against social withdrawal syndrome was generally significantly lower than stigma against mental illness. However, mental health practitioners tended to agree they would be reluctant to become personally involved with a person that had experienced social withdrawal syndrome (e.g., dating, hiring). Levels of stigma also differed across mental health occupations. @*Conclusion@#This study suggests although mental health practitioners may generally have less negative attitudes toward social withdrawal syndrome in the context of mental illness, that they may also have some reservations about personal interactions with individuals with social withdrawal syndrome.
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Objectives@#To develop a Loneliness and Social Isolation scale (LSIS) that can measure both social isolation and loneliness in order to understand the degree of social isolation in Korea. Exploratory and confirmatory factor analysis was used to examine the factorial validity of the scale. @*Methods@#The subjects of the study were 300 adults aged 19 or older who visited Samsung Medical Center and voluntarily expressed their willingness to participate in this research. Exploratory factor analysis (n=150) and confirmatory factor analysis (n=150) were conducted to construct the factorial structure model and to determine the model fit. @*Results@#Exploratory factor analysis showed a three-factor structure with a total variance of 65.8%; factor 1 consisted of social support, factor 2 of social networks, and factor 3 of items representing loneliness. After conducting confirmatory factor analysis on the three-factor models, a three-factor model consisting of 8 items (LSIS-8) and a three-factor model consisting of 6 items (LSIS-6) showed significant goodness-of-fit. Internal consistency for all items was good (Cronbach’s α=0.774), and correlations with existing social isolation and loneliness measures were significant. @*Conclusion@#This study is meaningful as provides a tool that comprehensively measures social support, social networks, and loneliness. We believe that the application of such tools that are relatively easy to apply in communities will aid understanding of the current state of social isolation and loneliness in Korea.
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Objective@#This study aims to investigate the prevalence and psychological impact of social isolation and loneliness in South Korea. Loneliness and social isolation have been regarded as a risk to both physical and mental health. However, most studies have focused on the elderly; hence, there are limited studies on the characteristics of socially isolated or lonely people considering age. @*Methods@#A sample of 1,700 participants was selected from three major cities in South Korea. In-person interviews were conducted to evaluate loneliness, social isolation and mental health status. @*Results@#Among the participants, the prevalence of social isolation and loneliness was 17.8% and 4.1%, respectively. Males decreased the odds of loneliness (AOR 0.49, 95% CI=0.28–0.87), while increasing the odds of social isolation (AOR 1.44, 95% CI=1.12–1.86) after adjusting for age and sex. Greater depressive and social phobic symptoms were associated with increased odds of loneliness and social isolation. @*Conclusion@#Social isolation and loneliness are prevalent among Koreans and associated with depression, social phobic symptoms, and suicidality. This study provides a foundation for further research to investigate nationwide prevalence and a more in-depth analysis of loneliness and social isolation.
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Background@#Malignant lymphoma is the most common hematopoietic malignancy in dogs, and relapse is frequently seen despite aggressive initial treatment. In order for the treatment of these recurrent lymphomas in dogs to be effective, it is important to choose a personalized and sensitive anticancer agent. To provide a reliable tool for drug development and for personalized cancer therapy, it is critical to maintain key characteristics of the original tumor. @*Objectives@#In this study, we established a model of hybrid tumor/stromal spheroids and investigated the association between canine lymphoma cell line (GL-1) and canine lymph node (LN)-derived stromal cells (SCs). @*Methods@#A hybrid spheroid model consisting of GL-1 cells and LN-derived SC was created using ultra low attachment plate. The relationship between SCs and tumor cells (TCs) was investigated using a coculture system. @*Results@#TCs cocultured with SCs were found to have significantly upregulated multidrug resistance genes, such as P-qp, MRP1, and BCRP, compared with TC monocultures.Additionally, it was revealed that coculture with SCs reduced doxorubicin-induced apoptosis and G2/M cell cycle arrest of GL-1 cells. @*Conclusions@#SCs upregulated multidrug resistance genes in TCs and influenced apoptosis and the cell cycle of TCs in the presence of anticancer drugs. This study revealed that understanding the interaction between the tumor microenvironment and TCs is essential in designing experimental approaches to personalized medicine and to predict the effect of drugs.
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Background@#Preconditioning with inflammatory stimuli is used to improve the secretion of anti-inflammatory agents in stem cells from variant species such as mouse, human, and dog. However, there are only few studies on feline stem cells. @*Objectives@#This study aimed to evaluate the immune regulatory capacity of feline adipose tissue-derived (fAT) mesenchymal stem cells (MSCs) pretreated with interferon-gamma (IFN-γ). @*Methods@#To assess the interaction of lymphocytes and macrophages with IFN-γ-pretreated fAT-MSCs, mouse splenocytes and RAW 264.7 cells were cultured with the conditioned media from IFN-γ-pretreated MSCs. @*Results@#Pretreatment with IFN-γ increased the gene expression levels of cyclooxygenase-2, indoleamine 2,3-dioxygenase, hepatocyte growth factor, and transforming growth factorbeta 1 in the MSCs. The conditioned media from IFN-γ-pretreated MSCs increased the expression levels of M2 macrophage markers and regulatory T-cell markers compared to those in the conditioned media from naive MSCs. Further, prostaglandin E 2 (PGE 2 ) inhibitor NS-398 attenuated the immunoregulatory potential of MSCs, suggesting that the increased PGE 2 levels induced by IFN-γ stimulation is a crucial factor in the immune regulatory capacity of MSCs pretreated with IFN-γ. @*Conclusions@#IFN-γ pretreatment improves the immune regulatory profile of fAT-MSCs mainly via the secretion of PGE 2 , which induces macrophage polarization and increases regulatory T-cell numbers.
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Background@#Malignant lymphoma is the most common hematopoietic malignancy in dogs, and relapse is frequently seen despite aggressive initial treatment. In order for the treatment of these recurrent lymphomas in dogs to be effective, it is important to choose a personalized and sensitive anticancer agent. To provide a reliable tool for drug development and for personalized cancer therapy, it is critical to maintain key characteristics of the original tumor. @*Objectives@#In this study, we established a model of hybrid tumor/stromal spheroids and investigated the association between canine lymphoma cell line (GL-1) and canine lymph node (LN)-derived stromal cells (SCs). @*Methods@#A hybrid spheroid model consisting of GL-1 cells and LN-derived SC was created using ultra low attachment plate. The relationship between SCs and tumor cells (TCs) was investigated using a coculture system. @*Results@#TCs cocultured with SCs were found to have significantly upregulated multidrug resistance genes, such as P-qp, MRP1, and BCRP, compared with TC monocultures.Additionally, it was revealed that coculture with SCs reduced doxorubicin-induced apoptosis and G2/M cell cycle arrest of GL-1 cells. @*Conclusions@#SCs upregulated multidrug resistance genes in TCs and influenced apoptosis and the cell cycle of TCs in the presence of anticancer drugs. This study revealed that understanding the interaction between the tumor microenvironment and TCs is essential in designing experimental approaches to personalized medicine and to predict the effect of drugs.
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Background@#Preconditioning with inflammatory stimuli is used to improve the secretion of anti-inflammatory agents in stem cells from variant species such as mouse, human, and dog. However, there are only few studies on feline stem cells. @*Objectives@#This study aimed to evaluate the immune regulatory capacity of feline adipose tissue-derived (fAT) mesenchymal stem cells (MSCs) pretreated with interferon-gamma (IFN-γ). @*Methods@#To assess the interaction of lymphocytes and macrophages with IFN-γ-pretreated fAT-MSCs, mouse splenocytes and RAW 264.7 cells were cultured with the conditioned media from IFN-γ-pretreated MSCs. @*Results@#Pretreatment with IFN-γ increased the gene expression levels of cyclooxygenase-2, indoleamine 2,3-dioxygenase, hepatocyte growth factor, and transforming growth factorbeta 1 in the MSCs. The conditioned media from IFN-γ-pretreated MSCs increased the expression levels of M2 macrophage markers and regulatory T-cell markers compared to those in the conditioned media from naive MSCs. Further, prostaglandin E 2 (PGE 2 ) inhibitor NS-398 attenuated the immunoregulatory potential of MSCs, suggesting that the increased PGE 2 levels induced by IFN-γ stimulation is a crucial factor in the immune regulatory capacity of MSCs pretreated with IFN-γ. @*Conclusions@#IFN-γ pretreatment improves the immune regulatory profile of fAT-MSCs mainly via the secretion of PGE 2 , which induces macrophage polarization and increases regulatory T-cell numbers.
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Objective@#This study aims to investigate the prevalence and psychological impact of social isolation and loneliness in South Korea. Loneliness and social isolation have been regarded as a risk to both physical and mental health. However, most studies have focused on the elderly; hence, there are limited studies on the characteristics of socially isolated or lonely people considering age. @*Methods@#A sample of 1,700 participants was selected from three major cities in South Korea. In-person interviews were conducted to evaluate loneliness, social isolation and mental health status. @*Results@#Among the participants, the prevalence of social isolation and loneliness was 17.8% and 4.1%, respectively. Males decreased the odds of loneliness (AOR 0.49, 95% CI=0.28–0.87), while increasing the odds of social isolation (AOR 1.44, 95% CI=1.12–1.86) after adjusting for age and sex. Greater depressive and social phobic symptoms were associated with increased odds of loneliness and social isolation. @*Conclusion@#Social isolation and loneliness are prevalent among Koreans and associated with depression, social phobic symptoms, and suicidality. This study provides a foundation for further research to investigate nationwide prevalence and a more in-depth analysis of loneliness and social isolation.
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Purpose@#To determine the usefulness of measuring the tortuosity of retinal arteries using smartphone fundus photographs to quantify plus disease in retinopathy of prematurity (ROP) patients. @*Methods@#Digital fundus photographs were taken with a smartphone of 116 eyes involving 58 premature infants. The tortuosity of retinal arteries named as the tortuosity index (TI) was measured with Image J software. Patients were classified into the treated and control groups and the TIs of the two groups were compared. A receiver operating characteristic curve was constructed and areas under the curve (AUC) were calculated to quantify the diagnostic utility of TI. @*Results@#Fundus photographs of 98 eyes of 50 premature infants were analyzed; 38 eyes of 20 infants were the treated group and 60 eyes of 30 infants were the control group. The TI was 1.231 ± 0.156 in the treated group before treatment, which was significantly larger than 1.062 ± 0.019 in the control group. After treatment of the treated group, the TI was 1.100 ± 0.093, which was significantly smaller than before treatment. The AUC was 0.926, and using a cut-off value of 1.095, the sensitivity and specificity of TIs for requiring treatment were 85.1% and 95.5%, respectively. @*Conclusions@#The tortuosity of retinal arteries was measured by analyzing smartphone fundus photographs to quantify plus disease in ROP patients. This method may be helpful for screening, follow-up, and treatment decisions for ROP patients.
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Objective@#The aim of this study was to estimate the prevalence of major psychiatric disorders among North Korean defectors (NKD) settled in South Korea. @*Methods@#The study population consisted of 294 North Korean defectors, aged 18 to 64 years settled in South Korea for 3 years or less. Between June 1, 2016 and October 31, 2016, face-to-face interviews were conducted using the North Korean version of the WHO-Composite International Diagnostic Interview (NK-CIDI) to diagnose DSM-IV psychiatric disorders. @*Results@#The lifetime prevalence of any DSM-IV psychiatric disorders was 62.2% in NKD and 25.0% in the general Korean population. The prevalence of specific disorders in NKD and general Korean population was as follows: 22.3% and 4.9% for major depressive disorder (MDD), 12.2% and 1.4% for post-traumatic stress disorder (PTSD), 18.0% and 4.8% for nicotine dependence, and 14.5% and 11.2% for alcohol abuse. The incidence of every single psychiatric disorder varied in each country. For instance, the generalized anxiety disorder, specific phobia, and alcohol use disorder occurred more frequently in North Korea whereas PTSD was more prevalent in other countries. @*Conclusion@#The prevalence of psychiatric disorders among NKD was quite higher than in the general population of South Korea.
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Purpose@#To compare the hospital length of stay (LOS), duration of antibiotic use, medical costs, and incidence of surgical site infection (SSI) between laparoscopic colorectal surgery (Lap-CRS) and open CRS (Open-CRS). @*Methods@#We retrospectively reviewed data of the Health Insurance Review and Assessment Service Surgical Antibiotic Prophylaxis assessment (7th assessment, 2015); the nationwide data were collected from patients who underwent CRS from September to November 2015 in low volume hospital to the tertiary hospital level in Korea. @*Results@#All 2,751 patients who underwent elective CRS were assessed. The mean hospital LOS (12.18 days vs. 14.16 days, P < 0.001) and mean postoperative LOS (8.21 days vs. 9.46 days, P < 0.001) were shorter in the Lap-CRS group than in the Open-CRS group. The mean duration of antibiotic use was shorter in the Lap-CRS group (2.91 days vs. 3.64 days, P = 0.033). The rate of SSI was lower in the Lap-CRS group, but there was no significant difference between the groups (3.57% vs. 5.01%, P = 0.133). Among the SSI group, the mean LOS (19.5 days vs. 24.9 days, P = 0.081), duration of antibiotic use (12.62 days vs. 15.46 days, P = 0.097), and medical costs showed no significant difference between the 2 groups. @*Conclusion@#Lap-CRS is significantly associated with reduced hospital LOS and the duration of antibiotic use in this study. However, we could not identify significant differences in the incidence of SSI according to the type of surgery. To assess the overall benefits of Lap-CRS, studies including the rate of SSI up to 30 days postoperatively will be needed in the future.
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Purpose@#To compare the hospital length of stay (LOS), duration of antibiotic use, medical costs, and incidence of surgical site infection (SSI) between laparoscopic colorectal surgery (Lap-CRS) and open CRS (Open-CRS). @*Methods@#We retrospectively reviewed data of the Health Insurance Review and Assessment Service Surgical Antibiotic Prophylaxis assessment (7th assessment, 2015); the nationwide data were collected from patients who underwent CRS from September to November 2015 in low volume hospital to the tertiary hospital level in Korea. @*Results@#All 2,751 patients who underwent elective CRS were assessed. The mean hospital LOS (12.18 days vs. 14.16 days, P < 0.001) and mean postoperative LOS (8.21 days vs. 9.46 days, P < 0.001) were shorter in the Lap-CRS group than in the Open-CRS group. The mean duration of antibiotic use was shorter in the Lap-CRS group (2.91 days vs. 3.64 days, P = 0.033). The rate of SSI was lower in the Lap-CRS group, but there was no significant difference between the groups (3.57% vs. 5.01%, P = 0.133). Among the SSI group, the mean LOS (19.5 days vs. 24.9 days, P = 0.081), duration of antibiotic use (12.62 days vs. 15.46 days, P = 0.097), and medical costs showed no significant difference between the 2 groups. @*Conclusion@#Lap-CRS is significantly associated with reduced hospital LOS and the duration of antibiotic use in this study. However, we could not identify significant differences in the incidence of SSI according to the type of surgery. To assess the overall benefits of Lap-CRS, studies including the rate of SSI up to 30 days postoperatively will be needed in the future.
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BACKGROUND AND OBJECTIVES: Proficient differentiation of human pluripotent stem cells (hPSCs) into specific lineages is required for applications in regenerative medicine. A growing amount of evidences had implicated hormones and hormone-like molecules as critical regulators of proliferation and lineage specification during in vivo development. Therefore, a deeper understanding of the hormones and hormone-like molecules involved in cell fate decisions is critical for efficient and controlled differentiation of hPSCs into specific lineages. Thus, we functionally and quantitatively compared the effects of diverse hormones (estradiol 17-β (E2), progesterone (P4), and dexamethasone (DM)) and a hormone-like molecule (retinoic acid (RA)) on the regulation of hematopoietic and neural lineage specification. METHODS AND RESULTS: We used 10 nM E2, 3 μM P4, 10 nM DM, and 10 nM RA based on their functional in vivo developmental potential. The sex hormone E2 enhanced functional activity of hematopoietic progenitors compared to P4 and DM, whereas RA impaired hematopoietic differentiation. In addition, E2 increased CD34⁺CD45⁺ cells with progenitor functions, even in the CD43⁻ population, a well-known hemogenic marker. RA exhibited lineage-biased potential, preferentially committing hPSCs toward the neural lineage while restricting the hematopoietic fate decision. CONCLUSIONS: Our findings reveal unique cell fate potentials of E2 and RA treatment and provide valuable differentiation information that is essential for hPSC applications.
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Humans , Dexamethasone , Induced Pluripotent Stem Cells , Pluripotent Stem Cells , Progesterone , Regenerative Medicine , TretinoinABSTRACT
BACKGROUND: Elevated levels of cortisol and growth hormone are critical counterregulatory responses to severe hypoglycemia. However, the proportion and clinical characteristics of patients with type 2 diabetes mellitus (DM) who fail to show appropriate cortisol and/or growth hormone secretion in response to severe hypoglycemia have not been investigated. METHODS: We measured plasma cortisol and growth hormone levels in type 2 DM patients with severe hypoglycemia who visited the emergency department between 2006 and 2015. RESULTS: Of 112 hypoglycemic patients, 23 (20.5%) had an impaired cortisol response (<18 µg/dL) and 82 patients (73.2%) had an impaired growth hormone response (<5 ng/mL). Nineteen patients (17.0%) had impaired responses to both cortisol and growth hormone. The patients with impaired responses of cortisol, growth hormone, and both hormones were significantly older and more likely to be female, and had higher admission rates, lower growth hormone levels, and lower adrenocorticotropic hormone levels than the patients with a normal hormonal response. Multivariate logistic regression analysis indicated that an impaired growth hormone response was significantly associated with advanced age, shorter DM duration, a higher admission rate, and a higher body mass index (BMI). An impaired cortisol response was significantly associated with growth hormone levels. Patients with an impaired growth hormone response had higher admission rates than patients with a normal response. CONCLUSION: A considerable number of type 2 DM patients had impaired cortisol and/or growth hormone responses to severe hypoglycemia. Advanced age, shorter DM duration, and higher BMI were independently associated with an abnormal growth hormone response.
Subject(s)
Female , Humans , Adrenocorticotropic Hormone , Body Mass Index , Diabetes Mellitus, Type 2 , Emergency Service, Hospital , Growth Hormone , Hydrocortisone , Hypoglycemia , Logistic Models , PlasmaABSTRACT
The authors regret that there were errors in funding section.