Clinical characteristics of diabetic ketoacidosis in users and non-users of SGLT2 inhibitors.

AIM: This study investigated the clinical characteristics of diabetic ketoacidosis (DKA) and compared the DKA characteristics between patients treated with and without SGLT2 inhibitors. METHODS: Data were collected from patients aged ≥ 18 years admitted for DKA at nine centres in Korea between September 2014 and April 2017. The electronic medical records of these subjects were retrospectively reviewed. Based on their history of medications taken before admission, subjects were classified as either users or non-users of SGLT2 inhibitors and their clinical characteristics of DKA were compared. RESULTS: During the study, the main subtype of DKA episodes (n = 523) was identified as type 2 diabetes (51%). Average hospitalization duration was 11 days, and average intensive care unit (ICU) time was 2.5 days. The in-hospital mortality rate was 3%, but no users of SGLT2 inhibitors died during DKA treatment. In patients taking SGLT2 inhibitors (n = 15), DKA manifested at 124 days, on average, after starting the inhibitors (range: 7-380 days). Also, SGLT2 inhibitors users had significantly lower plasma glucose levels (413 mg/dL) compared with non-users (554 mg/dL), and longer ICU stays (4 vs. 2 days; P = 0.019). CONCLUSION: In this report of recent data on the clinical features of DKA in Korea, patients using SGLT2 inhibitors needed longer treatment in ICUs compared with non-users and had lower levels of blood glucose, whereas DKA associated with SGLT2 inhibitors was rare.

Quantum Transition Properties of Quasi Two Dimensional and Electron-Phonon Interacting System in ZnO and CdS.

We investigated theoretically the quantum optical transition properties of quasi 2-Dimensional Landau splitting system, in ZnO and CdS. We apply the Quantum Transport theory (QTR) to the system in the confinement of electrons by square well confinement potential. We use the projected Liouville equation method with Equilibrium Average Projection Scheme (EAPS). In order to analyze the quantum transition, we compare the temperature and the magnetic field dependencies of the QTLW and the QTLS on two transition processes, namely, the phonon emission transition process and the phonon absorption transition process.

Grading system for migrated lumbar disc herniation on sagittal magnetic resonance imaging: an agreement study.

PURPOSE: Migrated lumbar disc herniations (LDHs) in the sagittal plane are common. Disc migration grading can be applied as a useful measurement tool in the diagnosis, treatment, and outcome evaluation of migrated LDH. No study has evaluated the reliability of migrated LDH grading. We evaluated the reliability and functionality of the current magnetic resonance imaging (MRI) grading system for migrated LDH. METHODS: We assessed a six-level grading system developed based on sagittal MRI and graded according to the direction (rostral and caudal) and degree (low, high, and very high) of disc migration. One-hundred and one migrated LDHs treated with minimally invasive endoscopic discectomy were analyzed independently by two experienced radiologists. Intraobserver and interobserver agreements were assessed by kappa statistics. RESULTS: The most common migrated LDH grade was grade 4 (30.94%; caudal, low-grade migration). Rostral and caudal migrations were more common in the upper and lower lumbar levels, respectively. Interobserver agreement in the grading of migrated LDH was good at both the first (kappa = 0.737) and second assessment (kappa = 0.657). The intraobserver agreement for reader 1 was very good (kappa = 0.827) and for reader 2 was good (kappa = 0.620). CONCLUSIONS: The current grading system for migrated LDH was found to be reliable and functional with good interobserver and intraobserver agreement. It may be useful in the interpretation of disc migration patterns and outcomes of various minimally invasive surgical procedures.

Referred symptom from myofascial pain syndrome: One of the most important causes of sensory disturbance in breast cancer patients using taxanes.

The aim of this retrospective study was to evaluate common causes of upper extremity sensory disturbance in breast cancer patients. Breast cancer patients who received surgery and taxane chemotherapy (CTx) with upper extremity sensory disturbance that began after CTx were included. With comprehensive clinical history, physical examination and electrodiagnostic results, diagnosis for each patient was made. Fifty-two patients were included: 23 (44.2%) were diagnosed with chemotherapy-induced peripheral neuropathy (CIPN), 7 (13.5%) with myofascial pain syndrome (MPS), six (11.5%) with carpal tunnel syndrome (CTS), four (7.7%) with CIPN and MPS, and three (5.8%) with CIPN and CTS. CIPN was more correlated with sensory symptoms at upper and lower extremities, a shorter time from CTx start, and adriamycin and cytoxan (AC) plus paclitaxel, than with AC plus docetaxel and fluorouracil, epirubicin and cyclophosphamide plus taxanes. MPS was correlated with longer duration of CTx and use of hormone therapy. CTS was correlated with wrist trauma history. Patients with CIPN showed similar degrees of pain even after 3 months of treatment, in comparison to the patients with MPS and CTS. When breast cancer patients complain of upper extremity sensory disturbance, various causes, especially referred symptom from MPS, should be considered for effective treatment.

Acute toxicity of organic antifouling biocides to phytoplankton Nitzschia pungens and zooplankton Artemia larvae.

The toxicity of the antifouling biocides Irgarol 1051, Diuron, Chlorothalonil, Dichlofluanid, Sea-nine 211, Copper pyrithione, Zinc pyrithione, Ziram and Zineb were evaluated on Nitzschia pungens and Artemia larvae. Results showed that EC50 for Irgarol 1051 was 0.586µgl-1 was the strongest effect on N. pungens following by Copper pyrithione (4.908µgl-1), Ziram (5.421µgl-1), Zinc pyrithione (5.513µgl-1), Diuron (6.640µgl-1), Zineb (232.249µgl-1), Sea-nine 211(267.368µgl-1), Chlorothalonil (360.963µgl-1) and Dichlofluanid (377.010µgl-1) in 96h. In Artemia larvae, the biocides were evaluated the LC50 for larval survivals at 48h. Sea-nine 211 and Copper pyrithione were 0.318 and 0.319mgl-1. Chlorothalonil, Zinc pyrithione and Ziram were 2.683, 3.147 and 4.778mgl-1. Irgarol 1051, Diuron, Zineb and Dichlofluanid were 9.734, 30.573, 41.170 and 154.944mgl-1. These results provide baseline data concerning the toxicity of antifouling biocides against marine environment.

Control of interior surface materials for speech privacy in high-speed train cabins.

The effect of interior materials with various absorption coefficients on speech privacy was investigated in a 1:10 scale model of one high-speed train cabin geometry. The speech transmission index (STI) and privacy distance (rP ) were measured in the train cabin to quantify speech privacy. Measurement cases were selected for the ceiling, sidewall, and front and back walls and were classified as high-, medium- and low-absorption coefficient cases. Interior materials with high absorption coefficients yielded a low rP , and the ceiling had the largest impact on both the STI and rP among the interior elements. Combinations of the three cases were measured, and the maximum reduction in rP by the absorptive surfaces was 2.4 m, which exceeds the space between two rows of chairs in the high-speed train. Additionally, the contribution of the interior elements to speech privacy was analyzed using recorded impulse responses and a multiple regression model for rP using the equivalent absorption area. The analysis confirmed that the ceiling was the most important interior element for improving speech privacy. These results can be used to find the relative decrease in rP in the acoustic design of interior materials to improve speech privacy in train cabins.

Increase in resting heart rate over 2 years predicts incidence of diabetes: A 10-year prospective study.

OBJECTIVE: The association between resting heart rate (RHR) and the development of diabetes has yet to be fully elucidated, and the relationship between changes in RHR and incidence of diabetes also remains unclear. Our study aimed to investigate the association between changes in RHR over 2 years and the risk of diabetes. METHODS: A total of 7416 adults without diabetes were included. All had participated in the Korean Genome and Epidemiology Study, a community-based, 10-year prospective study in which RHR was measured at baseline and 2 years later. Incident diabetes was defined as fasting blood glucose ≥126mg/dL, 2-h post-load glucose ≥200mg/dL during a 75-g oral glucose tolerance test or current use of diabetes medication. The relative risk of diabetes associated with the 2-year change in RHR was calculated using Cox models. RESULTS: During the 10-year follow-up, 1444 (19.5%) developed diabetes. Compared with RHR increases <5 beats per minute (bpm) over 2 years, increases >10bpm were significantly associated with development of diabetes (adjusted hazard ratio: 1.31, 95% confidence interval: 1.06-1.60), even after adjusting for glycometabolic parameters and baseline RHR. This significant association was attenuated in people who exercised regularly (P=0.650), but remained significant in those not doing any regular exercise (P=0.010). CONCLUSION: An increase in RHR over a 2-year follow-up period is significantly associated with a risk of diabetes, independently of baseline RHR and glycometabolic parameters. Further investigations into ways to control RHR as a potential preventative measure against the development of diabetes are now needed.

Circulating hsa-miR-30e-5p, hsa-miR-92a-3p, and hsa-miR-223-3p may be novel biomarkers in systemic lupus erythematosus.

MicroRNAs (miRNAs) are short, non-coding RNAs that regulate gene expression at the post-transcriptional level, which can be measured in cells, tissues, and body fluids including plasma. Differences in miRNA expression levels suggest an epigenetic mechanism and changed expression levels are emerging as a novel biomarker for various diseases. We attempted to identify circulating miRNAs associated with susceptibility to systemic lupus erythematosus (SLE) in the Korean population and elucidate their significance for clinical phenotype. An expression profiling analysis using miRNA polymerase chain reaction (PCR) array was conducted with pooled miRNA from 10 patients with SLE and 10 healthy controls (HCs). Nine miRNAs were differentially expressed between the SLE and HC. To verify this, we performed quantitative PCR for various miRNA from SLE patients (n = 70) and HCs (n = 40). The hsa-miR-30e-5p, hsa-miR-92a-3p, and hsa-miR-223-3p were significantly up-regulated in plasma of SLE patients (P = 0.048, P = 0.039, and P = 0.046, respectively). Especially, the hsa-miR-223-3p was significantly associated with oral ulcer (P < 0.001) and lupus anticoagulant (P = 0.031). Thus, plasma hsa-miR-30e-5p, hsa-miR-92a-3p, and hsa-miR-223-3p may be promising novel biomarkers in the diagnosis and clinical manifestation of SLE.

Inflammatory Bowel Disease Patients' Participation, Attitude and Preferences Toward Exercise.

The purpose of the study was to investigate the level of exercise participation in patients with inflammatory bowel disease (IBD) and to investigate their intention, attitude and preference toward exercise. The data of 158 IBD patients that participated in a self-administered survey at Severance Hospital between March 2013 and November 2013 were included in this cross sectional and descriptive analysis. Questionnaires included 3 sections to determine the IBD patient's current exercise participation, attitude toward exercise, and exercise preferences. This study investigated IBD patients both collectively, and according to their specific disease: Crohn's disease (CD) (n=62), Ulcerative colitis (UC) (n=73) and intestinal Behçet's disease (BD) (n=23). IBD patients currently participate in 103 min/week of exercise including mild, moderate and strenuous intensity, with BD patients being the least active, followed by CD, and UC being most active. The majority of IBD patients found exercise to be pleasant (57.7%), beneficial (80.5%), sensible (71.8%), uplifting (61%) and good (70.5%), and 44.4% found exercise to be enjoyable. This study shows the IBD patients' participation, attitude and preferences toward exercise and provides much needed information for the development of evidence based exercise programs that are specific to IBD.

Three-dimensional isotropic fast spin-echo MR lymphangiography of T1-weighted and intermediate-weighted pulse sequences in patients with lymphoedema.

AIM: To evaluate the feasibility of magnetic resonance (MR) lymphangiography acquired using three-dimensional (3D) isotropic T1-weighted fast spin-echo (FSE) and 3D isotropic intermediate-weighted FSE sequences, as the new method of MR lymphangiography, and to compare the results of these two methods in patients with lymphoedema. MATERIALS AND METHODS: Thirty-three extremities of 27 patients with primary or secondary lymphoedema and who had undergone radionuclide lymphoscintigraphy and MR lymphangiography with 3D isotropic T1-weighted FSE and 3D isotropic intermediate-weighted FSE were included in the study. The results of both imaging techniques were independently reviewed by two readers in consensus who rated the lymphatic drainage pattern, the quality of the depiction of lymphatic vessels and lymph nodes, and the level of lymph vessel enhancement. The assessment scores of each imaging sequence were compared using the Wilcoxon signed-rank test. The results were expressed as means with standard deviations. RESULTS: More lymphatic vessels were visualised on T1-weighted FSE than on intermediate-weighted FSE (p<0.001). As more lymphatic vessels were detected on T1-weighted FSE, the per-extremity grade of the lymphatic drainage pattern was higher (p=0.046) and the visible levels of lymph-vessel enhancement were also significantly higher (p=0.004) on the T1-weighted FSE sequence, whereas the conspicuity of lymph nodes was superior on intermediate-weighted FSE (p=0.004). CONCLUSION: MR lymphangiography using the 3D FSE pulse sequence is a feasible and noticeable new technique of MR lymphangiography. Between the two applicable protocols used, T1-weighted FSE provided better information regarding lymphatic vessels and their drainage, whereas intermediate-weighted FSE has the advantage of depicting lymph nodes in lymphoedematous extremities.

EFFECTS OF RESISTANCE EXERCISES AND COMPLEX DECONGESTIVE THERAPY ON ARM FUNCTION AND MUSCULAR STRENGTH IN BREAST CANCER RELATED LYMPHEDEMA.

The incorporation of resistance exercises into the lifestyle of patients with lymphedema is understudied and an emerging interest. We investigated the effectiveness and results of adding a moderate intensity resistance exercise program for 8 weeks in conjunction with intensive CDT for 1 or 2 weeks (depending on severity) on arm volume, arm function, QOL, and muscular strength in patients with breast cancer-related lymphedema. This prospective, pilot trial included forty-four patients with a history of breast cancer who were beginning complex decongestive therapy for lymphedema. They were assigned to either the intervention (n = 22) or control (n = 22). groups. The intervention comprised of resis- tance band exercises 5 times a week for 8 weeks. These were initially supervised during the intensive lymphedema treatment, but performed independently during the study period. Limb volume, muscular strength, and the European Organization for Research and Treatment of Cancer QOL Questionnaire C30 (EORTC QLQ-C30), EORTC-Breast Cancer-Specific QOL Questionnaire (EORTC QLQ-BR23), and Disabilities of Arm, Shoulder, and Hand (DASH) questionnaires were assessed at baseline and at 8 weeks. After 8 weeks, the intervention group demonstrated statistically significant differences (p < 0.05) in the DASH score and muscular strength compared to the control group. Our results indicate that upper body resistance exercise demonstrates a positive effect on arm function and muscular strength without increasing arm volume in breast cancer related lymphedema during and shortly post intensive CDT lymphedema treatment.

A combined variation of the musculocutaneous nerve associated with a supernumerary head of the biceps brachii muscle.

Single anatomical variation in the upper limb is common, but the coexistence of neuromuscular anomalies is still rare. We found a combined neuromuscular variation in the upper limb in a 61-year-old Korean male cadaver, whose cause of death was laryngeal carcinoma, during a routine dissection course for medical students. In his left arm, a supernumerary head of the biceps brachii muscle attached to the anteromedial surface of mid-humerus and united distally with the long and short heads of the biceps brachii muscle (BBM). The musculocutaneous nerve, which did not pierce the coracobrachialis muscle but gave 2 muscular branches, had a communicating branch to the median nerve. Since the presence of the supernumerary head of the BBM might affect the course and branching of the musculocutaneous nerve, knowing different patterns of the musculocutaneous variation associated with the BBM variations is essential for anatomists and clinicians.

A six-week motor-driven functional electronic stimulation rowing program improves muscle strength and body composition in people with spinal cord injury: a pilot study.

STUDY DESIGN: Preclinical and postclinical intervention and outcomes measure design. OBJECTIVE: To investigate the efficacy of six weeks of motor-driven functional electronic stimulation (FES) rowing exercise intervention on cardiopulmonary fitness, upper body strength and body composition in people with spinal cord injury (SCI). SETTING: The National Rehabilitation Center in Korea. METHODS: A total of 12 people with SCI (ten males, two females) participated in 42.5-minute training sessions on motor-driven FES rowing machine, 5 days a week for 6 weeks. Peak oxygen consumption, body mass index, percent body fat, waist circumference, shoulder abduction and adduction, shoulder flexion and extension and elbow flexion and extension were measured at baseline and after the intervention. RESULTS: The six weeks of training with a motor-driven FES rowing machine significantly decreased percent body fat (Pre: 23.9±8.5 vs. Post: 20.4±7.9, P=0.028) and increased lean body mass (Pre: 50.4±9.4 vs. Post: 53.3±10.0, P=0.001), muscular strength of the shoulder flexors (Pre: 147.5±68.5 vs. Post: 180.9±71.8, P=0.002), extensors (Pre: 132.7±51.8 vs. Post: 160.6±67.9, P=0.010), abductors (Pre: 126.1±52.6 vs. Post: 163.7±77.8, P=0.002) and adductors (Pre: 172.3±69.0 vs. Post: 215.2±95.7, P=0.003), as well as elbow flexors (Pre: 212.7±66.6 vs. Post: 256.6±76.1, P=0.004) and extensors (Pre: 190.6±65.0 vs. Post: 221.9±63.9, P=0.002). CONCLUSIONS: Exercise using a motor-driven FES rowing machine may be used as a new exercise modality to improve body composition and upper body muscle strength in people with SCI. SPONSORSHIP: This research was supported by a grant (code# 08-B-03, #10-B-01) from the National Rehabilitation Research Institute.

A laboratory study for assessing speech privacy in a simulated open-plan office.

UNLABELLED: The aim of this study is to assess speech privacy in open-plan office using two recently introduced single-number quantities: the spatial decay rate of speech, DL(2,S) [dB], and the A-weighted sound pressure level of speech at a distance of 4 m, L(p,A,S,4) m [dB]. Open-plan offices were modeled using a DL(2,S) of 4, 8, and 12 dB, and L(p,A,S,4) m was changed in three steps, from 43 to 57 dB.Auditory experiments were conducted at three locations with source­receiver distances of 8, 16, and 24 m, while background noise level was fixed at 30 dBA.A total of 20 subjects were asked to rate the speech intelligibility and listening difficulty of 240 Korean sentences in such surroundings. The speech intelligibility scores were not affected by DL(2,S) or L(p,A,S,4) m at a source­receiver distance of 8 m; however, listening difficulty ratings were significantly changed with increasing DL(2,S) and L(p,A,S,4) m values. At other locations, the influences of DL(2,S) and L(p,A,S,4) m on speech intelligibility and listening difficulty ratings were significant. It was also found that the speech intelligibility scores and listening difficulty ratings were considerably changed with increasing the distraction distance (r(D)). Furthermore, listening difficulty is more sensitive to variations in DL(2,S) and L(p,A,S,4) m than intelligibility scores for sound fields with high speech transmission performances. PRACTICAL IMPLICATIONS: The recently introduced single-number quantities in the ISO standard, based on the spatial distribution of sound pressure level, were associated with speech privacy in an open-plan office. The results support single-number quantities being suitable to assess speech privacy, mainly at large distances. This new information can be considered when designing open-plan offices and making acoustic guidelines of open-plan offices.

Use of pericholedochal plexus for portal flow reconstruction in diffuse portal vein thrombosis: case report.

Portal vein thrombosis (PVT) remains a challenging issue for liver transplantation surgeons. Most patients who have PVT undergo eversion thrombectomy. When thrombectomy is not successful due to diffuse PVT, other modalities are adapted, such as the use of a venous jump graft or portal tributaries. Here, we report our successful experience with reconstruction of portal flow using collateral plexus for a patient with grade 4 PVT. Thrombectomy did not restore portal flow. A pericholedochal plexus was found on the lateral wall of common bile duct. Direct end-to-end anastomosis was performed between the donor's portal vein and patient's choledochal plexus. Postoperative color Doppler ultrasound revealed normal portal flow.

The interleukin 6 receptor alpha gene polymorphisms are associated with clinical manifestations of systemic lupus erythematosus in Koreans.

The human interleukin 6 receptor consists of two membrane-bound glycoproteins (IL-6Rα, IL-6RA and gp130/IL-6Rß, IL-6RB) interacting with IL-6, which is a multifunctional cytokine essential to the regulation of the immune response and acute-phase reactions. We have genotyped a single-nucleotide polymorphism (SNP) of the IL-6RA in Korean patients with systemic lupus erythematosus (SLE) (n = 300) and normal controls (NC, n = 299). Three SNPs were identified in the IL-6RA gene; -208 G ≥ A (NM_000565.3:c.-208G ≥ A, rs4845617) in the promoter region, 48841 T ≥ A (NM_000565.3:c.1067-17T ≥ A, rs4845374) in the intron 8 region and 48864 A ≥ C (NM_000565.3:c.1073A ≥ C, rs2228145) in the exon 9 region. There were no differences between the SLE and the NC in the genotype and haplotype frequencies. The 48864 A>C polymorphism was significantly associated with rash (P = 0.008). Also, the frequency of rash (P = 0.037), leucopenia (P = 0.033) and lymphopenia (P = 0.027) was significantly higher in patients with SLE having the haplotype HT2 [ATC]. These data suggest that genetic polymorphisms of IL-6RA gene may be associated with disease phenotypes of SLE in Korean.

Metabolic response of glioblastoma to superselective intra-arterial cerebral infusion of bevacizumab: a proton MR spectroscopic imaging study.

BACKGROUND AND PURPOSE: SIACI of bevacizumab has emerged as a promising novel therapy in the treatment of recurrent GB. This study assessed the potential of (1)H-MRS as an adjunctive technique in detecting metabolic changes reflective of antiproliferative effects of targeted infusion of bevacizumab in the treatment of GB. MATERIALS AND METHODS: Eighteen patients enrolled in a phase I/II study of SIACI of bevacizumab for treatment of recurrent GB were included. Concurrent MR imaging and (1)H-MRS scans were performed before and after treatment. Five distinct morphologic ROIs were evaluated for structural and metabolic changes on MR imaging and (1)H-MRS, which included enhancing, nonenhancing T2 hyperintense signal abnormality, and multiple control regions. Pre- and post-SIACI of bevacizumab peak areas for NAA, tCho, tCr, as well as tCho/tCr and tCho/NAA ratios, were derived for all 5 ROIs and compared using the Wilcoxon signed-rank test. RESULTS: A significant median decrease of 25.99% (range -55.76 to 123.94; P = .006) in tCho/NAA was found post-SIACI of bevacizumab relative to pretreatment values in regions of enhancing disease. A trend-level significant median decrease of 6.45% (range -23.71 to 37.67; P = .06) was noted in tCho/NAA posttreatment in regions of nonenhancing T2-hyperintense signal abnormality. CONCLUSIONS: The results of this (1)H-MRS analysis suggest that GB treatment with SIACI of bevacizumab may be associated with a direct antiproliferative effect, as demonstrated by significant reductions of tCho/NAA after the intervention.

The Dietary Effects of Fermented Chlorella vulgaris (CBT(®)) on Production Performance, Liver Lipids and Intestinal Microflora in Laying Hens.

Fermented Chlorella vulgaris CBT(®) was evaluated for its effects on egg production, egg quality, liver lipids and intestinal microflora in laying hens. One hundred and eight Hy-line Brown layers (n = 108), 80 wk of age, were fed a basal diet supplemented with CBT(®) at the level of 0, 1,000 or 2,000 mg/kg, respectively for 42 d. Egg production was measured daily and egg quality was measured every two weeks. Five eggs from each replicate were collected randomly to determine egg quality. Egg production increased linearly with increasing levels of CBT(®) supplementation (p<0.05), although there was no significant effect of treatment on feed intake. Egg yolk color (p<0.001) and Haugh unit (p<0.01) improved linearly with increasing dietary CBT(®). Hepatic triacylglycerol level was linearly decreased with increasing dietary CBT(®) (p<0.05). The supplemental CBT(®) resulted in linear (p<0.001) and quadratic (p<0.01) response in population of cecal lactic acid bacteria. In conclusion, fermented Chlorella vulgaris supplemented to laying hen diets improved egg production, egg yolk color, Haugh unit and positively affected the contents of hepatic triacylglycerol and the profiles of cecal microflora.

Association between variable number tandem repeats within the 3' flanking region of the interleukin-6 gene and systemic lupus erythematosus in Korean patients.

Variable number tandem repeat (VNTR) polymorphism located in the 3' flanking region of the interleukin-6 (IL-6) gene was examined in Koreans with systemic lupus erythematosus (SLE). We identified 15 VNTR alleles (K1 to K15) in the 3' flanking region by Genescan analysis. The VNTR K8 allele, a 648-base pair (bp) allele, was most commonly found in Koreans, being present in 74.8% of the SLE patients and 70.3% of the normal controls. The VNTR K9 (642 bp) allele was associated with susceptibility to SLE. In addition, the VNTR K9 was significantly associated with leukopenia (p = 0.048), thrombocytopenia (p = 0.020), and elevated C-reactive protein (p = 0.019). These data suggest that the VNTR K9 in the 3' flanking region of the IL-6 gene may be associated with disease susceptibility and the clinical phenotypes of SLE.

Leptin and ghrelin in Korean systemic lupus erythematosus.

Elevated serum leptin levels have been described in patients with systemic lupus erythematosus (SLE), however these studies have provided no information regarding the ghrelin levels. We investigated the clinical significance of serum leptin and ghrelin levels in SLE. The leptin levels of SLE patients were higher than those of normal healthy controls, while the ghrelin levels of the SLE were lower. In addition, the ghrelin levels were significantly lower in SLE patients with arthritis and hematologic disorder. Taken together, these findings suggest that leptin and ghrelin play a role in clinical manifestations observed in SLE.