BACKGROUND: We aimed to identify the postpartum metabolic factors that were associated with the development of diabetes in women with a history of gestational diabetes mellitus (GDM). In addition, we examined the role of the oral glucose tolerance test (OGTT) in the prediction of future diabetes. METHODS: We conducted a prospective study of 179 subjects who previously had GDM but did not have diabetes at 2 months postpartum. The initial postpartum examination including a 75-g OGTT and the frequently sampled intravenous glucose tolerance test (FSIVGTT) was performed 12 months after delivery, and annual follow-up visits were made thereafter. RESULTS: The insulinogenic index (IGI30) obtained from the OGTT was significantly correlated with the acute insulin response to glucose (AIRg) obtained from the FSIVGTT. The disposition indices obtained from the OGTT and FSIVGTT were also significantly correlated. Women who progressed to diabetes had a lower insulin secretory capacity including IGI30, AIRg, and disposition indices obtained from the FSIVGTT and OGTT compared with those who did not. However, the insulin sensitivity indices obtained from the OGTT and FSIVGTT did not differ between the two groups. Multivariate logistic regression analysis showed that the 2-hour glucose and disposition index obtained from the FSIVGTT were significant postpartum metabolic risk factors for the development of diabetes. CONCLUSION: We identified a crucial role of β-cell dysfunction in the development of diabetes in Korean women with previous GDM. The 2-hour glucose result from the OGTT is an independent predictor of future diabetes. Therefore, the OGTT is crucial for better prediction of future diabetes in Korean women with previous GDM.
Diabetes Mellitus, Type 2 ; Diabetes, Gestational ; Female ; Follow-Up Studies ; Glucose ; Glucose Tolerance Test ; Humans ; Insulin ; Insulin Resistance ; Logistic Models ; Postpartum Period ; Pregnancy ; Prospective Studies ; Risk Factors

PURPOSE: The aim of this study was to establish a simple formula to predict renal length in children using a Technesium-99m dimercaptosuccinic acid (DMSA) scan data, and to compare it with the formula derived from ultrasonography, which is widely accepted. METHODS: Children who underwent a DMSA scan and ultrasonography were reviewed retrospectively, and those who had anatomical urinary tract abnormalities or urinary tract infections were excluded. RESULTS: A total of 230 children (84 males and 146 females; age, 1 month to 16 years; mean age, 16.8 +/- 27.4 months). Mean renal length measured by DMSA scan was longer than that by ultrasonography (6.38 +/- 1.16 vs. 6.02 +/- 1.14 cm; P < 0.001). Renal length was correlated with age, weight, height, and body surface area on the DMSA scan and ultrasonography, and showed the strongest positive correlation with height. The following formulae were established to predict renal length: mean renal length (cm) = 5.433 x height (m) + 2.330 (R2, 0.833) using the DMSA scan data, and mean renal length (cm) = 5.367 x height (m) + 2.027 (R2, 0.853) using ultrasonography data. CONCLUSION: We propose a simple height-based formula to predict renal length in children using a DMSA scan data, and validate it by comparing with ultrasonography formula.
Body Surface Area ; Child* ; Female ; Humans ; Kidney ; Male ; Organ Size ; Retrospective Studies ; Succimer* ; Ultrasonography ; Urinary Tract ; Urinary Tract Infections

The purpose of the study was to assess the effects of a 12 weeks aged garlic extract (AGE) regimen with regular exercise on cardiovascular disease (CVD) risk in postmenopausal women. A total of 30 postmenopausal women (54.4 +/- 5.4 years) were randomly divided into the following four groups: Placebo (Placebo; n = 6), AGE intake (AGEI; n = 8), exercise and placebo (Ex + Placebo; n = 8), exercise and AGE (Ex + AGE; n = 8) groups. The AGE group consume 80 mg per day, and exercise groups performed moderate exercise (aerobic and resistance) three times per week. After 12 weeks of treatment, body composition, lipid profile, and CVD risk factors were analyzed. Body weight was significantly decreased in AGEI, Ex + Placebo, and Ex + AGE groups compared to baseline. Body fat % was significantly decreased in the AGEI and Ex + Placebo groups. Body mass index (BMI) was significantly decreased in the AGEI, Ex + Placebo, and Ex + AGE groups. Fat-free mass was significantly decreased in the AGEI group. Total cholesterol (TC) was significantly lower in the Ex + Placebo compared to the Placebo group. AGE supplementation or exercise effectively reduced low-density lipoprotein (LDL-C). Triglyceride (TG) was significantly increased in the AGEI group. Malondialdehyde (MDA) levels were significantly decreased in the AGEI, Ex + Placebo, and Ex + AGE compared to the placebo group. AGE supplementation reduced homocysteine levels regardless of whether the women also exercised. The present results suggest that AGE supplementation reduces cardiovascular risk factors independently of exercise in postmenopausal women.
Adipose Tissue ; Aged ; Body Composition ; Body Mass Index ; Body Weight ; Cardiovascular Diseases ; Cholesterol ; Female ; Garlic ; Homocysteine ; Humans ; Lipoproteins ; Malondialdehyde ; Risk Factors

Aged garlic extract (AGE) is known to have a protective effect against immune system, endothelial function, oxidative stress and inflammation. We examined the effects of exercise with and without aged garlic extract administration on body weight, lipid profiles, inflammatory cytokines, and oxidative stress marker in high-fat diet (HFD)-induced obese rats. Forty-five Sprague-Dawley rats were fed either a HFD (HFD, n = 40) or a normal diet (ND, n = 5) for 6 weeks and thereafter randomized into ND (n = 5), HFD (n = 10), HFD with AGE (n = 10), HFD with Exercise (n = 10), or HFD with Exercise+AGE (n = 10) for 4 weeks. AGE groups were administered at a dose of 2.86 g/kg.body weight, orally. Exercise consisted of running 15-60 min 5 days/week with gradually increasing intensity. AGE (P < 0.01), Exercise, and Exercise+AGE (P < 0.001) attenuated body weight gain and food efficiency ratio compared to HFD. Visceral fat and liver weight gain were attenuated (P < 0.05) with all three interventions with a greater effect on visceral fat in the Exercise+AGE than AGE (P < 0.001). In reducing visceral fat (P < 0.001), epididymal fat (P < 0.01) and liver weight (P < 0.001), Exercise+AGE was effective, but exercise showed a stronger suppressive effect than AGE. Exercise+AGE showed further additive effects on reducing visceral fat and liver weight (P < 0.001). AGE significantly attenuated the increase in total cholesterol and low-density lipoprotein-cholesterol compared with HFD (P < 0.05). Exercise+AGE attenuated the increase in triglycerides compared with HFD (P < 0.05). Exercise group significantly decrease in C-reactive protein (P < 0.001). These results suggest that AGE supplementation and exercise alone have anti-obesity, cholesterol lowering, and anti-inflammatory effects, but the combined intervention is more effective in reducing weight gain and triglycerides levels than either intervention alone.
Aged ; Animals ; Body Weight ; C-Reactive Protein ; Cholesterol ; Cytokines ; Diet ; Diet, High-Fat ; Garlic ; Humans ; Immune System ; Inflammation ; Intra-Abdominal Fat ; Liver ; Obesity ; Oxidative Stress ; Rats ; Rats, Sprague-Dawley ; Running ; Triglycerides ; Weight Gain

Systemic lupus erythematosus (SLE) is an autoimmune disease with various manifestations, while its autoantibodies and immune reactions involve multiple organs. Neuropsychiatric involvement in SLE is known to be common, however, peripheral neuropathy is relatively rare. Guillain-Barre syndrome is clinically defined as an acute demyelinating peripheral neuropathy causing weakness and numbness in the legs and arms. We describe a case of Guillain-Barre syndrome with antiphospholipid syndrome and lupus nephritis. The patient was admitted with fever and diarrhea. He developed progressive weakness of the upper and lower extremities and dysarthria with characteristic nerve conduction patterns compatible with Guillain-Barre syndrome. He also had proteinuria and gangrene of the hand and toe with antiphospholipid antibody. He received intravenous immunoglobulin and plasmapheresis for progressive neuropathy, intravenous high dose steroid to control activity of SLE, and anticoagulation for antiphospholipid syndrome. Neuropsychiatric manifestation of SLE is related to lupus activity closely, so it is important to control lupus activity.
Antibodies, Antiphospholipid ; Antiphospholipid Syndrome ; Arm ; Autoantibodies ; Autoimmune Diseases ; Diarrhea ; Dysarthria ; Fever ; Gangrene ; Guillain-Barre Syndrome ; Hand ; Humans ; Hypesthesia ; Immunoglobulins ; Leg ; Lower Extremity ; Lupus Erythematosus, Systemic ; Lupus Nephritis ; Neural Conduction ; Peripheral Nervous System Diseases ; Plasmapheresis ; Proteinuria ; Toes

Yoga has been known to have stimulatory or inhibitory effects on the metabolic parameters and to be uncomplicated therapy for obesity. The purpose of the present study was to test the effect of an 8-week of yoga-asana training on body composition, lipid profile, and insulin resistance (IR) in obese adolescent boys. Twenty volunteers with body mass index (BMI) greater than the 95th percentile were randomly assigned to yoga (age 14.7+/-0.5 years, n=10) and control groups (age 14.6+/-1.0 years, n=10). The yoga group performed exercises three times per week at 40~60% of heart-rate reserve (HRR) for 8 weeks. IR was determined with the homeostasis model assessment of insulin resistance (HOMA-IR). After yoga training, body weight, BMI, fat mass (FM), and body fat % (BF %) were significantly decreased, and fat-free mass and basal metabolic rate were significantly increased than baseline values. FM and BF % were significantly improved in the yoga group compared with the control group (p<0.05). Total cholesterol (TC) was significantly decreased in the yoga group (p<0.01). HDL-cholesterol was decreased in both groups (p<0.05). No significant changes were observed between or within groups for triglycerides, LDL-cholesterol, glucose, insulin, and HOMA-IR. Our findings show that an 8-week of yoga training improves body composition and TC levels in obese adolescent boys, suggesting that yoga training may be effective in controlling some metabolic syndrome factors in obese adolescent boys.
Adipose Tissue ; Adolescent ; Basal Metabolism ; Body Composition ; Body Mass Index ; Body Weight ; Cholesterol ; Exercise ; Glucose ; Homeostasis ; Humans ; Insulin ; Insulin Resistance ; Obesity ; Triglycerides ; Yoga

Nontuberculous mycobacterial infection is rarely accompanied by pleural involvement. We report a very rare case of Mycobacterium intracellulare pulmonary disease accompanied with pleural effusion. A 76-year-old man was admitted to our hospital because of dyspnea. A chest radiograph and CT showed bilateral bronchiectasis and bronchopneumonia accompanied with right pleural effusion. The fluid was lymphocyte-dominant exudative effusion, and microbiological examinations of the effusion, including staining and culturing, proved negative. However, one month after admission, subsequent cultures of bronchial washing fluid revealed the presence of M. intracellulare. The patient's effusion was gradually resolved with antibiotic treatment, including clarithromycin.
Aged ; Bronchiectasis ; Bronchopneumonia ; Dyspnea ; Humans ; Lung Diseases ; Mycobacterium ; Mycobacterium avium Complex ; Mycobacterium avium-intracellulare Infection ; Pleural Effusion ; Thorax

We report a case of nephrotic syndrome and factor X deficiency secondary to primary amyloidosis. A 58-year-old man was referred to our hospital for evaluation of nephrotic syndrome and bleeding tendency. He was confirmed to have primary amyloidosis by renal biopsy, immunofixation electrophoresis and bone marrow findings. His bleeding tendency was due to prothrombin time prolongation caused by isolated factor X deficiency. If any patient with nephrotic syndrome has bleeding tendency due to coagulation abnormalities, that patient should be considered to have factor X deficiency secondary to primary amyloidosis.
Amyloidosis ; Biopsy ; Bone Marrow ; Electrophoresis ; Factor X ; Factor X Deficiency ; Hemorrhage ; Humans ; Middle Aged ; Nephrotic Syndrome ; Prothrombin Time

A 46-year-old woman was found to have a huge liver mass that was detected by abdominal ultrasonography. Abdominal CT and MRI showed a 10 cm-sized, encapsulated mass occupying the anterior segment of the right hepatic lobe. Extended right hemihepatectomy was performed and pathological examination revealed fibroblast-like spindle cells within dense deposits of collagen. On immunohistochemical staining, these spindle tumor cells showed an intense CD34 immunoreactivity. The patient is alive without evidence of tumor recurrence 7 months after the resection. Solitary fibrous tumor is a very rare neoplasm found in the liver parenchyma, and it has been reported in less than 30 patients in the English literature. We present here the first such case in Korea.
Antigens, CD34/analysis/immunology ; Female ; Humans ; Liver Neoplasms/*diagnosis/pathology/surgery ; Magnetic Resonance Imaging ; Middle Aged ; Solitary Fibrous Tumors/*diagnosis/pathology/surgery ; Tomography, X-Ray Computed ; Tumor Markers, Biological/analysis/immunology

Intramural pregnancy on a cesarean section scar is one of the rarest forms of ectopic pregnancy that may cause serious complications such as uterine rupture and massive bleeding. The common treatment in the past was laparotomy, but today early diagnosis is available thanks to the development of image diagnostic technology and, as a consequence, cases of less invasive conservative management are reported. Using vaginal ultrasonography and MRI, we made an early diagnosis on a case of intramural pregnancy on the scar of a previous cesarean section. We injected methotrexate locally into the gestational sac, and the intramural pregnancy was completely cured. Thus, here we report this case with a brief review of relevant literature.
Cesarean Section ; Cicatrix* ; Early Diagnosis ; Female ; Gestational Sac ; Hemorrhage ; Laparotomy ; Magnetic Resonance Imaging ; Methotrexate* ; Pregnancy* ; Pregnancy, Ectopic ; Ultrasonography ; Uterine Rupture