Mutation Screening of HNF-1alpha Gene in Korean Women with Gestational Diabetes Mellitus / 당뇨병

BACKGROUNDS: Gestational diabetes mellitus (GDM) is defined as glucose intolerance with onset or first detection during pregnancy and mostly caused by insulin resistance and beta-cell dysfunction like type 2 diabetes. However, autoimmune or monogenic diabetes can contribute to GDM. Maturity-onset diabetes of the young (MODY) is a monogenic form of diabetes characterized by an early age of onset and an autosomal dominant pattern of inheritance. Most MODY cases are attributable to mutations in HNF-1alpha gene, also known as MODY3. We investigated whether mutations in HNF-1alpha gene are present in Korean women with GDM. METHODS: A total of 96 Korean women with GDM who have a family history of DM were screened for mutations in the HNF-1alpha gene. We evaluated the clinical characteristics of GDM women with HNF-1alpha gene mutations. RESULTS: Five of 96 patients (5.2%) were found to have a mutation in HNF-1alpha gene. Four of those (-23C > G, 833G > A (Arg278Gln), 923C > T, IVS5 + 106A > G) were novel and one (-124G > C) in promoter region was reported in previous study. The mean age of GDM women with mutations of HNF-1alpha gene was 34 years. Four women with MODY3 gene mutations required insulin therapy during pregnancy. GDM women with MODY3 gene mutations appeared to be decreased insulin secretion (HOMA-%B) than those without mutations. CONCLUSIONS: We have found the existence of MODY3 as well as novel HNF-1alpha gene mutations in Korean women with GDM.

The Effect of Paroxetine on the Reduction of Migraine Frequency is Independent of Its Anxiolytic Effect

BACKGROUND AND PURPOSE: Anxiety is the most important precipitating factor of migraine attacks, and more than half of migraineurs have coexisting anxiety disorders. Paroxetine, an antidepressant, is one of the selective serotonin reuptake inhibitors (SSRIs) that has an anxiolytic effect, and is also known to be effective for migraine prophylaxis. The aim of this study was to determine the role of the anxiolytic effect of paroxetine on the prevention of migraine. METHODS: This study investigated migraineurs with a general anxiety disorder who visited the neurological clinic. The following efficacy variables were assessed at baseline and after taking paroxetine (20 for 12 weeks: headache frequency, Hamilton Anxiety Rating Scale (HAM-A), Headache Management Self-Efficacy Scale (HMSE), and Headache Disability Inventory (HDI). The correlation between the headache responsiveness to paroxetine and improvement in anxiety levels was analyzed. RESULTS: Twenty-four patients (aged 54.96+/-12.09 years, mean+/-SD) were included in this study. Paroxetine reduced headache frequency by 49.1% within 12 weeks (p<0.05 vs baseline). HAM-A and HMSE scores also showed an improvement, whereas there was no significant change in HDI score. The baseline HAM-A scores did not differ between paroxetine responders and nonresponders. In addition, the improvement in HAM-A score was not correlated with the reduction in headache frequency. CONCLUSIONS: Paroxetine decreased the headache frequency and reduced anxiety levels. However, the anxiolytic effect of paroxetine was not correlated with the migraine prevention effect. These observation indicate that the anxiolytic effect of paroxetine does not contribute strongly to its prophylactic effect on migraine frequency in migraineurs with anxiety disorder.

Estimation of Kidney Size by Ultrasonography in Normal Korean Adults / 대한신장학회잡지

BACKGROUND: The kidney size is important in differentiating many renal diseases. Some studies have been reported about the normal kidney size in the foreign countries. However, no studies were performed by using ultrasonography in Korea. Therefore, we investigated the normal kidney length, the factors affecting the kidney length and the relationship of each other. METHODS: One thousand three hundred eighty eight healthy Koreans were scanned for the kidney length by ultrasonography and were measured for their body index(height, weight, body surface area, total body water, and fat free mass). We analyzed the association between kidney length and body index. RESULTS: Eight hundred four male and five hundred eighty four female were involved in this study and their mean age was 47.8+/-10.3 in male, 48.1+/-9.5 in female. 1) The average value of left and right kidney was 10.65+/-0.80cm, 10.50+/-0.78cm respectively, and the left kidney was greater than right one(P<0.01). 2) The difference between male and female was 10.77+/-0.79cm, 10.49+/-0.78cm respectively in the left kidney and 10.66+/-0.76cm, 10.27+/-0.75cm in the right kidney(P<0.01). 3) The aging process nearly does not affects the kidney size from 4th decade to 7th decade. However, the kidney size is getting smaller after 8th decade. 4) The correlation coefficient between the kidney size and height, weight, body surface area, total body water, fat free mass was 0.37, 0.41, 0.43, 0.37, 0.38(P<0.01) respectively. CONCLUSION: The kidney length showed normal distribution in normal Korean adult and the length greater than 12.36cm, smaller than 8.76cm means out of its range of normal(+/-2SD) irrespective of sex and position. The body surface area has the largest correlation with kidney size in both sex(r=0.38/0.44; left/right, P<0.01).

Body-Shape Satisfaction and Adjustment Functions in Obese Adolescent School Girls / 신경정신의학

OBJECTIVES: This study was designed to explore body-shape satisfaction and adjustment functions in 410 adolescent school girls. METHODS: After underweight, normal-weight and overweight groups were identified among 410 high school girls according to BMI(body mass index), we compared current weight & height, ideal weight & height, subtracted value of ideal weight from current weight, subtracted value of ideal height from current height, subtracted value of ideal BMI from current BMI, weight dissatisfaction, height dissatisfaction,body-shape dissatisfaction,and EAT-26(Eating attitude Test-26),OSIQ(Offer Self-Image Questionnaire for Adolescents), STAI(State-Trait Anxiety Inventory),BDI(Beck Depression Inventory),BITE(Bulimic Investigatory Test Edinburgh) among the three group. RESULTS: 1) The subjects consisted with overweight group(BMI > 25,N=27,6.6%), normal-weight group(19< or = BMI < or =25,N=278,67.8%),and underweight group(BMI<19, N=105, 25.6%). 2) In comparison to other groups, overweight group was significantly different in subtracted value of ideal weight from current weight and subtracted value of ideal height from current height. These results suggest that overweight group wants greater body-shape change than other groups. Overweight group was significantly shorter in height than underweight group there were no significant differences in ideal height among the groups. 3) Overweight group and normal-weight group showed significantly highter weight dissatisfaction than underweight group. There were no significant differences in height dissatisfaction and body-shape dissatisfaction among the three groups. All groups showed higher weight, height dissatisfaction and body-shape dissatisfaction except higher weight dissatisfaction in underweight group. 4) In comparison of overweignt group with other groups by mean difference of each scale, there was significant difference in superior adjustment subscale of the OSIQ and symptom subscale of the BITE between overweight group and other groups. There was also significant difference in symptom severity subscale of the BITE between overweight and underweight groups. There was no significant difference in EAT-26,STAI,BDI,other subscales of OSIQ among the groups. CONCLUSIONS: 1) The distribution rate of overweight group was lower than in western studies. 2) These results suggest that overweight group wants greater body-shape change than other groups, and overweight group may have binge-eating behavior and poor coping system.

Thoracic emphyemas neccessitating surgical management: CT criteria

No abstract available.