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Significance of Inflammatory Markers in Diabetic Patients with Stable Coronary Artery Disease
( Hyo Jin Lee ),( Sung Ho Her ),( Yun Sun Im ),( Kang Yeon Won ),( Sun Hong Yoo ),( Dong Bin Kim ),( Dong Il Shin ),( Pum Joon Kim ),( Ki Bae Seung ),( Jae Hyung Kim ),( Keon Yeop Kim ) 대한내과학회 2009 The Korean Journal of Internal Medicine Vol.24 No.3
Background/Aims: Patients with diabetes are prone to coronary artery disease (CAD); however, the majority of diabetic patients show normal coronary arteries. We examined differences in the clinical aspects of diabetic patients with insignificant and with significant stenosis of the coronary artery. Methods: A total of 418 consecutive diabetic patients with stable angina who had undergone coronary angiography from January 2004 to March 2007 were included in this study. Patients were subdivided into control and CAD groups and then clinical characteristics and CAD-associated factors were evaluated. Results: A total of 92 (22%) patients were assigned to the control group and 326 (78%) patients were assigned to the CAD group. Using univariate regression analysis, we found that patients with CAD were significantly older (control vs. CAD; 59±21 vs. 64.7±33.7, years, p<0.001), had a longer duration of diabetes (8.2±21.8 vs. 10.2±29.8, years, p=0.027), higher titers of high sensitivity C-reactive protein (hsCRP; 0.3±6.79 vs. 0.9±12.6, mg/dL, p=0.015), and increased hemoglobin A1c (HbA1c) levels (7.1±3.8 vs. 7.5±4.8, %, p=0.007) compared to control patients. Multivariate regression analysis showed that only differences in age, hsCRP, and HbA1c were statistically significant. When patients were subdivided into groups based on hsCRP levels (208 patients in the low group [49.8%], 210 patients in the high group [50.2%]), we found that patients with higher hsCRP levels showed more frequent multivessel disease. Conclusions: In diabetic patients, age, hsCRP, and HbA1c were associated with stable CAD. Among these factors, hsCRP levels were significantly correlated with multivessel involvement in diabetic CAD. Therefore, high hsCRP levels may be a strong predictor for atherosclerotic progression of the coronary arteries in diabetic patients, suggesting that regular screening tests should be performed. (Korean J Intern Med 2009;24:212-219)
Hyo Young Jung,Woosuk Kim,Kyu Ri Hahn,Min Soo Kang,Hyun Jung Kwon,Jung Hoon Choi,Yeo Sung Yoon,Dae Won Kim,Dae Young Yoo,In Koo Hwang 한국실험동물학회 2021 한국실험동물학회 학술발표대회 논문집 Vol.2021 No.7
We investigated the effects of pyridoxine deficiency on ischemic neuronal death in the hippocampus of gerbil (n = 5 per group). Serum pyridoxal 5’-phosphate levels were significantly decreased in Pyridoxine deficient diet (PDD)-fed gerbils, while homocysteine levels were significantly increased in sham- and ischemia-operated gerbils. PDD-fed gerbil showed reduction in NeuN-immunoreactive neurons in the medial part of the CA1 region three days after. Reactive astrocytosis and microgliosis were found in PDD-fed gerbils, and transient ischemia caused the aggregation of activated microglia in the stratum pyramidale three days after ischemia. Lipid peroxidation was prominently increased in the hippocampus and was significantly higher in PDD-fed gerbils than in CD-fed gerbils after ischemia. In contrast, pyridoxine deficiency decreased the proliferating cells and neuroblasts in the dentate gyrus in sham- and ischemia-operated gerbils. Nuclear factor erythroid 2-related factor 2 (Nrf2) and brain-derived neurotrophic factor (BDNF) levels also significantly decreased in PDD-fed gerbils sham 24 h after ischemia. These results suggest that pyridoxine deficiency accelerates the neuronal death by increasing serum homocysteine levels and lipid peroxidation, and by decreasing Nrf2 levels in the hippocampus. Additionally, it reduces the regenerated potentials in hippocampus by decreasing BDNF levels. Collectively, pyridoxine is an essential element in modulating cell death and hippocampal neurogenesis after ischemia.
Hyo Jung Cho,Soon Sun Kim,So Young Kang,Min Jae Yang,Choong Kyun Noh,Jae Chul Hwang,Sun Gyo Lim,Sung Jae Shin,Kee Myung Lee,Byung Moo Yoo,Kwang Jae Lee,Jin Hong Kim,Sung Won Cho,Jae Youn Cheong, 거트앤리버 소화기연관학회협의회 2019 Gut and Liver Vol.13 No.5
Background/Aims: Barcelona Clinic Liver Cancer (BCLC) C stage demonstrates considerable heterogeneity because it includes patients with either symptomatic tumors (performance status [PS], 1–2) or with an invasive tumoral pattern reflected by the presence of vascular invasion (VI) or extrahepatic spread (EHS). This study aimed to derive a more relevant staging system by modification of the BCLC system considering the prognostic implication of PS. Methods: A total of 7,501 subjects who were registered in the Korean multicenter hepatocellular carcinoma (HCC) registry database from 2008 to 2013 were analyzed. The relative goodness-of-fit between staging systems was compared using the Akaike information criterion (AIC) and integrated area under the curve (IAUC). Three modified BCLC (m-BCLC) systems (#1, #2, and #3) were devised by reducing the role of PS. Results: As a result, the BCLC C stage, which includes patients with PS 1-2 without VI/EHS, was reassigned to stage 0, A, or B according to their tumor burden in the m-BCLC #2 model. This model was identified as the most explanatory and desirable model for HCC staging by demonstrating the smallest AIC (AIC=70,088.01) and the largest IAUC (IAUC=0.722), while the original BCLC showed the largest AIC (AIC=70,697.17) and the smallest IAUC (IAUC=0.705). The m-BCLC #2 stage C was further subclassified into C1, C2, C3, and C4 according to the Child-Pugh score, PS, presence of EHS, and tumor extent. The C1 to C4 subgroups showed significantly different overall survival distribution between groups (p<0.001). Conclusions: An accurate and relevant staging system for patients with HCC was derived though modification of the BCLC system based on PS.