The definition of the high-risk group for gestational diabetes mellitus (GDM) defined by the American College of Obstetricians and Gynecologists was changed from the criteria composed of five historic/demographic factors (old criteria) to the criteria consisting of 11 factors (new criteria) in 2017. To compare the predictive performances between these two sets of criteria.

PURPOSE: Bowel preparation with sodium phosphate was recently prohibited by the U.S. Food and Drug Administration. Polyethylene glycol (PEG) is safe and effective; however, it is difficult to drink. To identify an easy bowel preparation method for colonoscopy, we evaluated three different bowel preparation regimens regarding their efficacy and patient satisfaction. METHODS: In this randomized, comparative study, 892 patients who visited a secondary referral hospital for a colonoscopy between November 2012 and February 2013 were enrolled. Three regimens were evaluated: three packets of sodium picosulfate/magnesium citrate (PICO, group A), two packets of PICO with 1 L of PEG (PICO + PEG 1 L, group B), and two packets of PICO with 2 L of PEG (PICO + PEG 2 L, group C). A questionnaire survey regarding the patients' preference for the bowel preparation regimen and satisfaction was conducted before the colonoscopies. The quality of bowel cleansing was scored by the colonoscopists who used the Aronchick scoring scale and the Ottawa scale. RESULTS: The patients' satisfaction rate regarding the regimens were 72% in group A, 64% in group B, and 45.9% in group C. Nausea and abdominal bloating caused by the regimens were more frequent in group C than in group A or group B (P < 0.01). Group C showed the lowest preference rate compared to the other groups (P < 0.01). Group C showed better right colon cleansing efficacy than group A or group B. CONCLUSION: Group A exhibited a better result than group B or group C in patient satisfaction and preference. In the cleansing quality, no difference was noted between groups A and C.
Citric Acid* ; Colon ; Colonoscopy* ; Humans ; Nausea ; Patient Satisfaction ; Polyethylene Glycols ; Secondary Care Centers ; Sodium* ; United States Food and Drug Administration ; Surveys and Questionnaires

The incidence of type 2 diabetes is rising rapidly because of an increase in the incidence of being overweight and obesity. Identification of genetic determinants for complex diseases, such as type 2 diabetes, may provide insight into disease pathogenesis. The aim of the study was to investigate the shared genetic factors that predispose individuals to being overweight and developing type 2 diabetes. We conducted genome-wide linkage analyses for type 2 diabetes in 386 affected individuals (269 sibpairs) from 171 Korean families and association analyses with single-nucleotide polymorphisms of candidate genes within linkage regions to identify genetic variants that predispose individuals to being overweight and developing type 2 diabetes. Through fine-mapping analysis of chromosome 4q34-35, we detected a locus potentially linked (nonparametric linkage 2.81, logarithm of odds 2.27, P=6 x 10-4) to type 2 diabetes in overweight or obese individuals (body mass index, BMI> or =23 kg m-2). Multiple regression analysis with type 2 diabetes-related phenotypes revealed a significant association (false discovery rate (FDR) P=0.006 for rs13144140; FDR P=0.002 for rs6830266) between GPM6A (rs13144140) and BMI and waist-hip ratio, and between NEIL3 (rs6830266) and insulin level from 1314 normal individuals. Our systematic search of genome-wide linkage and association studies, demonstrate that a linkage peak for type 2 diabetes on chromosome 4q34-35 contains two type 2 diabetes-related genes, GPM6A and NEIL3.
Body Mass Index ; Chromosomes, Human, Pair 4/*genetics ; Diabetes Mellitus, Type 2/*complications/*genetics ; Female ; Genetic Linkage ; *Genetic Loci ; *Genetic Predisposition to Disease ; Genome-Wide Association Study ; Humans ; Male ; Middle Aged ; Overweight/*complications/*genetics ; Phenotype ; Physical Chromosome Mapping ; Statistics, Nonparametric

Adipsic hypernatremia is a rare disorder of hypothalamic osmoreceptor dysfunction for thirst. It is frequently associated with a deficiency in antidiuretic hormone (ADH) release. We report the first case in Korea of adipsic hypernatremia combined with subnormal ADH response to osmotic stimuli without any demonstrable structural lesion. A 69-year-old woman was admitted to the hospital with general weakness. In a hypernatremic hyperosmolar state, she denied thirst and did not drink spontaneously. Her plasma ADH level was markedly subnormal but she had no large volume of dilute urine. Investigation of osmoregulation by infusion of hypertonic saline revealed adipsia and an absolute deficiency in antidiuretic hormone release, despite a serum osmolarity in excess of 321 mOsmol/kg. There was no structural lesion of the hypothalamus and no abnormal finding in hypothalamic-pituitary function. After diagnosis, she was treated successfully with intentional water intake alone.
Aged ; Female ; Humans ; Hypernatremia ; Hypothalamus ; Korea ; Osmolar Concentration ; Plasma ; Thirst ; Water-Electrolyte Balance

Polymyositis is characterized by symmetrical proximal muscle weakness, nonsuppurative inflammation of skeletal muscle, elevation of muscle enzyme levels, and abnormality of electromyographical change. Its pathogenesis is unclear. Paraneoplastic syndromes are caused by malignant tumors, although not through direct effects of the primary tumor or its metastases. Several paraneoplastic syndromes, including erythrocytosis, hypoglycemia, and hypercholesterolemia, have been reported in patients with hepatocellular carcinoma. A few cases of polymyositis associated with hepatocellular carcinoma and one case of combined hepatocellular-cholangiocarcinoma associated with polymyositis and chronic hepatitis B virus infection have been reported. Skeletal muscle injuries without trauma, including metabolic myopathy, effects of certain drugs and toxins, infection, electrolyte imbalances, and endocrine disorders, may cause rhabdomyolysis. We present here a case of primary liver cancer associated with polymyositis and rhabdomyolysis.
Carcinoma, Hepatocellular ; Hepatitis B, Chronic ; Humans ; Hypercholesterolemia ; Hypoglycemia ; Inflammation ; Liver ; Liver Neoplasms ; Muscle Weakness ; Muscle, Skeletal ; Muscles ; Muscular Diseases ; Neoplasm Metastasis ; Paraneoplastic Syndromes ; Polycythemia ; Polymyositis ; Rhabdomyolysis ; Viruses

Polymyositis is characterized by symmetrical proximal muscle weakness, nonsuppurative inflammation of skeletal muscle, elevation of muscle enzyme levels, and abnormality of electromyographical change. Its pathogenesis is unclear. Paraneoplastic syndromes are caused by malignant tumors, although not through direct effects of the primary tumor or its metastases. Several paraneoplastic syndromes, including erythrocytosis, hypoglycemia, and hypercholesterolemia, have been reported in patients with hepatocellular carcinoma. A few cases of polymyositis associated with hepatocellular carcinoma and one case of combined hepatocellular-cholangiocarcinoma associated with polymyositis and chronic hepatitis B virus infection have been reported. Skeletal muscle injuries without trauma, including metabolic myopathy, effects of certain drugs and toxins, infection, electrolyte imbalances, and endocrine disorders, may cause rhabdomyolysis. We present here a case of primary liver cancer associated with polymyositis and rhabdomyolysis.
Carcinoma, Hepatocellular ; Hepatitis B, Chronic ; Humans ; Hypercholesterolemia ; Hypoglycemia ; Inflammation ; Liver ; Liver Neoplasms ; Muscle Weakness ; Muscle, Skeletal ; Muscles ; Muscular Diseases ; Neoplasm Metastasis ; Paraneoplastic Syndromes ; Polycythemia ; Polymyositis ; Rhabdomyolysis ; Viruses

BACKGROUND/AIMS: P2/MS is known as a simple, accurate, and noninvasive marker for determination of the degree of hepatic fibrosis in patients with viral hepatitis. We aimed to validate P2/MS in patients with HCC. METHODS: Consecutive HCC patients who underwent surgical resection between June 2007 and March 2009 at Seoul National University Hospital were enrolled. Fibrosis stage was reviewed and assessed according to METAVIR scoring. P2/MS values [platelet count (109/L)]2/[monocyte fraction (%)xsegmented neutrophil fraction (%)] and other noninvasive fibrosis scoring systems were calculated. RESULTS: A total of 171 patients were included; seven patients with METAVIR F1, 31 with F2, 41 with F3, and 92 with F4. The area under the receiver-operating characteristic curve of P2/MS was 0.804 [95% confidence interval (CI), 0.681~0.927] for detection of significant fibrosis (F2-F4) and 0.769 (95% CI, 0.698~0.839) for detection of histological cirrhosis (F4). At a value < 62, P2/MS detected significant fibrosis with a specificity of 85.7% (95% CI, 42.0~99.2) and a positive likelihood ratio of 4.268 (95% CI, 0.692~26.309); and at a value > 115, P2/MS ruled out significant fibrosis with a sensitivity of 90.2% (95% CI, 84.4~94.1) and a negative likelihood ratio of 0.34 (95% CI, 0.106~0.095). P2/MS had a superior efficacy for detection of hepatic fibrosis in patients with HCC compared to the other noninvasive panels. CONCLUSIONS: P2/MS can accurately detect fibrosis in patients with HCC. Thus, P2/MS might be utilized as a noninvasive index reflecting the degree of hepatic fibrosis in HCC patients.
Aged ; Area Under Curve ; Carcinoma, Hepatocellular/complications/*diagnosis/pathology ; Cohort Studies ; Female ; Health Status Indicators ; Humans ; Liver Cirrhosis/complications/*diagnosis/pathology ; Liver Neoplasms/complications/*diagnosis/pathology ; Male ; Middle Aged ; Monocytes/cytology ; Neoplasm Staging ; Neutrophils/cytology ; Platelet Count ; ROC Curve ; Reproducibility of Results ; Retrospective Studies ; Severity of Illness Index

BACKGROUND: Molecular tools for tissue profiling generally require collection of fresh frozen tissues (FFT) as sources of high-quality DNA and RNA. Nowadays, researchers carry out large-scale, multi-center studies and they request inter-institutional minimal intrinsic bias, some fundamental similarities, and the same standardized and validated procedures. METHODS: This study reports standardized quality control procedure for fresh frozen tissue of the National Biobank of Korea. RESULTS: The main procedures for quality control for FFT are as follows: records related to sample collection such as labeling of samples, transport temperature, lag time from excision of tissue to freezing, and sample size were reviewed for all fresh frozen samples. The stability of RNA and DNA in fresh frozen tissue was evaluated for 3% of collected samples and purity was assessed (ratio of the absorbance at 260 and 280 nm) as was integrity (agarose gel electrophoresis). Stained hematoxylin and eosin sections were reviewed by a pathologist to confirm the diagnosis and to assess how representative the frozen sample was. CONCLUSIONS: We introduced that the quality-control criteria for fresh frozen tissue of the NBK. We expect that this study contributes to standardization of collection, storage, and quality control of fresh frozen tissue.
Bias (Epidemiology) ; DNA ; Eosine Yellowish-(YS) ; Freezing ; Hematoxylin ; Korea ; Quality Control ; RNA ; Sample Size

BACKGROUND: Hepatocellular carcinoma (HCC) is the most common primary malignant tumor of the human liver. However, the molecular changes and mechanisms that regulate the development and progression of HCC remain unclear. Beta-catenin is known as a multi-functional protein that acts as a regulator of the cadherin-mediated cell-cell adhesion system and also in the Wingless/Wnt signal transduction pathway. The aim of this study was to investigate the expression of beta-catenin and its possible role in HCC. METHODS: We investigated the expression of beta-catenin, Ki-67, TP53, alpha-smooth muscle actin and CD34 by performing immunohistochemical staining for 61 specimens of HCC and their adjacent non-tumorous tissue. We also examined the relationship between the nuclear expression of beta-catenin and the clinicopathologic parameters. RESULTS: The altered expression of beta-catenin was not detected in the nontumorous liver tissue. The nuclear expression of beta-catenin was observed in approximately 16% (10/61) of the HCC specimens. Double immunohistochemical staining for beta-catenin and E-cadherin showed a close relationship between nuclear translocation of beta-catenin and the loss of the membranous E-cadherin expression. Significant correlation was found between the nuclear translocation of beta-catenin and the tumor size, tumor necrosis and the presence of microvessel invasion and intrahepatic metastasis (p<0.05). CONCLUSIONS: This data indicates that nuclear translocation of beta-catenin could play a role in the growth and progression of HCC.
Humans ; Carcinoma, Hepatocellular ; Neoplasm Metastasis

Lipoma is a common benign neoplasm, but lipoma arising from the pleura is rare. Most pleural lipomas are asymptomatic and are discovered incidentally on chest radiographs. Here we report an unusual case of a pedunculated subpleural lipoma with incomplete torsion in a 29-year-old woman who presented with flank pain. On chest radiography, there was a well-defined, ellipsoidal, homogeneous, radioopaque mass in the left lower lobe. An intrathoracic tumor was suspected, and video-assisted thoracic surgery was performed to establish the final diagnosis. The resected tumor was a 10 X 5 cm sized pedunculated pleural mass. The cut surface showed a yellow, well-circumscribed mass with areas of hemorrhage. Histologically, the tumor was composed of mature adipose tissue with fibrous septae composed of fibroblasts. The outer surface of the tumor was covered by mesothelial cells. Some areas were hypercellular, and occasional mitoses were found, but neither lipoblasts nor atypical mitoses were identified.
Adipose Tissue ; Adult ; Benzeneacetamides ; Female ; Fibroblasts ; Flank Pain ; Hemorrhage ; Humans ; Lipoma ; Mitosis ; Piperidones ; Pleura ; Thoracic Surgery, Video-Assisted ; Thorax