The Cut-off Values of Surrogate Measures for Insulin Sensitivity in a Healthy Population in Korea according to the Korean National Health and Nutrition Examination Survey (KNHANES) 2007–2010

BACKGROUND: This study aimed to identify the gender-specific characteristics of the surrogate measures of insulin resistance and to establish valid cut-off values for metabolic abnormalities in a representative sample in Korea. METHODS: Data were collected from the datasets of the Korean National Health and Nutrition Examination Survey between 2007 and 2010. The total number of eligible participants was 10,997. We used three measures of insulin resistance: the homeostasis model assessment-insulin resistance (HOMA-IR), McAuley index, and triglyceride and glucose (TyG) index. The estimated cut-off values were determined using the highest score of the Youden index. RESULTS: The area under the curve (AUC) of the HOMA-IR, McAuley index, and TyG index were 0.737 (95% confidence interval [CI], 0.725–0.750), 0.861 (95% CI, 0.853–0.870), and 0.877 (95% CI, 0.868–0.885), respectively. The cut-off values of the HOMA-IR were 2.20 in men, 2.55 in premenopausal women, and 2.03 in postmenopausal women, and those of the McAuley index were 6.4 in men and 6.6 in premenopausal and postmenopausal women. For the TyG index, the cut-off values were 4.76 in men and 4.71 in premenopausal and postmenopausal women. CONCLUSION: In conclusion, the present study provides the valid cut-off values of the indirect surrogate measures of insulin sensitivity. These values may be used as reference for insulin sensitivity in a clinical setting and may provide a simple and supplementary method for identifying populations at risk of insulin resistance.

The Cut-off Values of Triglycerides and Glucose Index for Metabolic Syndrome in American and Korean Adolescents

The aim of this study was to establish ethnic- and gender-specific cut-off values of triglycerides and glucose index (TyG index) for clinical usefulness in a representative sample of Mexican American, Non-Hispanic White, Non-Hispanic Black, and Korean adolescents. The data were collected from datasets of the National Health and Nutrition Examination Survey between 1999 and 2012, and the Korean National Health and Nutrition Examination Survey between 2005 and 2013. Receiver operating characteristic curve analysis was used to find valid cut-off values of the TyG index for metabolic syndrome. The total number of eligible participants was 3,164 in the US and 4,873 in Korea. The optimal cut-off value with the Cook et al. definition revealed 8.55 in Mexican American, 8.55 in Non-Hispanic White, 8.35 in Non-Hispanic Black, and 8.45 in Korean, respectively. The cut-off value with the de Ferranti et al. definition was 8.45, 8.45, 8.15, and 8.35, and the cut-off value with the International Diabetes Federation definition was 8.65, 8.65, 8.15, and 8.55, respectively. These findings may be clinically useful for evaluating insulin resistance for determining metabolic abnormalities in adolescents.

Pharmacologic Treatment Strategies of Type 2 Diabetes / 한양의대학술지

Type 2 diabetes has become epidemic in the past several decades owing to advancing age, a substantially increased prevalence of obesity and decreased physical activities etc. Achieving & maintaning glycemic level as close to the nondiabetic range as possible through intensive diabetes therapy has been demonstrated to have a powerful beneficial effect on diabetesspecific microvascular complications in type 1 & type 2 diabetes. However, diabetes is associated with a reduced lifespan, largely as a consequence of cardiovascular disease. Unlike type 1 diabetes, current studies have failed to demonstrate a beneficial effect of intensive diabetes therapy on cardiovascular disease in type 2 diabetes. Accordingly, special consideration may now need to be given to high-risk patients with multiple risk factors & heart disease. Therefore, comprehensive approach to the treatment of type 2 diabetes that include the treatment of all of the coexisting risk factors for cardiovascular disease has to be implemented and achieved

Chlamydia trachomatis Antibody in Fitz-Hugh-Curtis Syndrome / 대한진단검사의학회지

BACKGROUND: Fitz-Hugh-Curtis (FHC) syndrome is inflammation of the liver capsule associated with pelvic inflammatory disease. We measured Chlamydia trachomatis antibodies in 30 female patients with acute abdominal pain for diagnosis of FHC-syndrome, and the results were compared with other tests. METHODS: A dual-polymerase chain reaction was used for the detection of C. trachomatis in the cervix, and a micro-immunofluorescence test was performed to measure the antibody to C. trachomatis in serum. Cervical specimens were stained with Gram stain and cultured on chocolate agar for detection of Neisseria gonorrhoeae, and abdominal computed tomography (CT) and pelvic examinations were performed. RESULTS: Of the 30 patients examined, 19 were diagnosed as having FHC-syndromes and 11 abdominal pains without FHC-syndrome. C. trachomatis was detected from one of the five patients studied, and no N. gonorrhoeae was isolated from the patients with FHC-syndrome. High titers of IgG antibody (1:512-1:1,024) to C. trachomatis were demonstrated in all patients with FHC-syndrome. The CT scan revealed perihepatitis in 14 patients with FHC-syndrome. CONCLUSIONS: All patients with FHC-syndrome are associated with C. trachomatis infections, and a high titer of C. trachomatis antibody (IgG) is a very useful marker for FHC-syndrome.

Detection of Cytomegalovirus by Dual-PCR / 대한임상미생물학회지

BACKGROUND: Cytomegalovirus (CMV) infection is a major cause of morbidity and mortality in transplant recipients and immunocompromised patients. We compared the results of a dual polymerase chain reaction (dual-PCR) and an antigenemia (Ag) test for detection of CMV from blood samples. METHODS: Between February 2002 and May 2005, we analyzed 175 blood samples submitted for CMV tests at Hanyang University Hospital. The late antigen (LA) and major immediate early (MIE) genes of CMV were concurrently amplified in the dual-PCR. The lower matrix protein pp65 of CMV was detected for the Ag test (Chemicon, Temecula, CA, USA). RESULTS: The positive rate of the dual-PCR was 14.3% (25/175) and that of the Ag test was 13.1% (23/175). The concordance rate of the dual-PCR and Ag test was 85.1% (149/175), while the discordance rate was 14.9% (26/175). CONCLUSION: The dual-PCR is a useful method for the early detection of CMV, but we recommend using both the dual-PCR and Ag test for detection of CMV due to a high discordance rate of the two methods.

Prevalence and Molecular Genetic Characteristics of Vibrio parahaemolyticus New 03:K6 and 04:K68 / 병원감염관리

BACKGROUND: Vibrio parahaemolyticus belonged to the new 03:K6 serotype was demonstrated an unusual potential to spread and an enhanced propensity to cause infection in the worldwide. Recently, increased numbers of V. parahaemolyticus 03:K6 had been isolated in Korea, and we analyzed the prevalence and molecular genetic characteristics of V. parahaemolyticus 03:K6 isolates. METHODS: V. parahaemolyticus were isolated from clinical specimens of patients with diarrhea in Hanyang University Hospital, Seoul, Korea, from 1998 to 2005. The serovars of isolates were determined by slide agglutination test with specific antisera. All isolates were examined for the presence of tdh/trh genes. AGS-PCR method detecting the new 03:K6 clone was used in this study. We analyzed clonality of these isolates by infrequent restriction site-polymerase chain reaction (IRS-PCR). RESULTS: Thirty-six strains were isolated from 1998 to 2005. The main serotype of isolates were 03:K6 (24/36: 67%), All of them have tdh gene but not trh gene and an unique toxRS gene of the new 03:K6. The morphotypes of 03:K6 isolates show a same pattern of IRS-PCR, but can easily be differentiated from non-03:K6 and 04:K68 isolates. CONCLUSION: The 03:K6 was a main serotype of V. parahaemolyticus isolated from 1998 to 2005 and they show same molecular characteristics.

A Comparison of Nested Multiplex-Polymerase Chain Reaction with Indirect Immunofluorescence for Detection and Typing of Herpes Simplex Virus / 대한진단검사의학회지

BACKGROUND: Herpes simplex virus type 1 (HSV-1) is linked specifically to oral and lip infections while HSV-2 is involved in genital infections. We evaluated a recently reported nested-multiplex ploymerase chain reaction (NM-PCR) for the detection and typing of HSV and compared the results with indirect immunofluorescence (IF) after cell culture. METHODS: One hundred thirty three specimens were received from patients suspected of having clinical HSV infections. HSV was cultured by the shell vial method and stained with type specific monoclonal antibodies. NM-PCR was performed using crude samples. RESULTS: HSV was detected in 45 (33.8%) and 46 (34.6%) of the 133 specimens by IF and NMPCR, respectively. All of the HSV IF positive specimens were also positive by NM-PCR. Typing by the two methods concurred in all but two of the 45 specimens; the two specimens were typed as HSV-1 and HSN-2, respectivey, by IF, and both as HSV-1 and HSV-2 by NM-PCR. CONCLUSIONS: Our results suggest that NM-PCR is a rapid and sensitive method for the detection and typing of HSV.

Calcium & Bone Metabolism during Space Flight / 항공우주의학회지

No abstract available.

The influence of gastrectomy on the change of bone metabolism and bone density

OBJECTIVES: Abnormalities of bone metabolism could be followed in gastrectomized patients as a late complication. Nowadays, many biochemical and radiologic measurements are applied to detect these abnormalities. The aim of our study is to determine the valuable parameter as an appropriate screening test during long-term follow-up periods and define the usefulness of new biochemical markers for bone metabolism by comparing with traditional markers. METHODS: Fifteen patients who had undergone partial gastrectomy were chosen randomly and fifteen healthy controls were compared. Then, several biochemical and radiologic tests were measured. We excluded subjects who proved to have other causes of bone metabolism abnormalities. Ten patients and 10 controls were finally selected. RESULTS: Comparing the data with those of a corresponding control group, the lumbar bone density measured by quantitative computed tomography (QCT) was statistically significantly lower in the patient group (p +ADw- 0.01). The urinary deoxypyridinoline, a biochemical marker for bone resorption, was statistically higher in the patient group (p +ADw- 0.025). Osteocalcin, Procollagen I C-terminal peptide (PICP) and Type I collagen C-terminal telopeptide (ICTP) were slightly but not significantly higher in the patient group. The serum parathyroid hormone (PTH) and 25-hydroxy vitamin D levels were similar in both groups. CONCLUSION: We could suggest that urinary deoxypyridinoline and QCT are appropriate parameters as screening tests for the detection of bone metabolism abnormalities in gastrectomized patients during long-term follow-up. Urinary deoxypyridinoline may be a simple and rapid test which could replace cumbersome 24-hour urinary hydroxyproline.