Appropriate Timing of the Screening Test of Gestational Diabetes / 대한주산의학회잡지

OBJECTIVE: Screening tests for Gestational diabetes (GDM) are performed during the 24~28 weeks of pregnancy. Therefore, in many cases, GDM is not detected during the first trimester of pregnancy while most of important organs are developed during this period. In this review, we performed a retrospective study by dividing GDM mothers into 3 groups: diabetic, impaired glucose tolerance (IGT) and normal. The medical records of mothers and neonates from these three groups were compared. METHODS: 136 out of 536 GDM patients in Holy Family Hospital from 1995 to 2005 took a 75 g OGTT 6 weeks after delivery. As a result, 28 were diagnosed as diabetes, 18 had impaired glucose tolerance, and 90 were normal. The antenatal and perinatal history of above groups were retrospetively compared. RESULTS: In the diabetic group, 46.4% of mothers had a positive family history of diabetes, where as 38% of IGT group, 31.8% of normal group had the history. Secondly, the abortion history rate for each group was 21.4%, 16.6%, 13.3%, and each group had an average HbA1C of 7.20, 5.82 and 5.69. Also, the rate of preterm labor for each group was 17.9%, 11.1%, and 4.45%. The Apgar score (1 min/ 5min) was 7.29/8.54, 7.75/8.75 and 7.89/8.97. Lastly the rate of preeclampsia for each group was 14.3%, 11.1% and 6.8%. CONCLUSION: Three groups had distinctive differences in their perinatal morbidity both before and after delivery. Therefore, in order to reduce the perinatal morbidity and mortality rate, the present frequency or timing of GDM screening test, should be reconsidered.

Effects of Corticosteroids on RANTES Production in Human Bronchial Epithelial Cell with Respiratory Syncytial Virus Infection / 소아알레르기및호흡기학회지

PURPOSE: Respiratory syncytial virus (RSV) which is the most common cause of bronchiolitis in infants is an important triggering factor of asthma exacerbation in children. This virus stimulates chemokine such as regulated on activation normal T-cell expressed and secreted (RANTES) production by human airway epithelial cells in vitro. Corticosteroids are effective medications for prevention of asthma exacerbation. We examined whether the inhibitory effect of corticosteroid on RANTES production in human bronchial epithelial cells (BEAS-2B) infected with RSV varies according to the kinds of corticosteroids and the timing of corticosteroid treatment in vitro. METHODS: In the pretreatment group, BEAS-2B cells were pretreated with budesonide (BUD), fluticasone propionate (FP), or methylprednisolone (MP), and then the cells were infected with RSV. The supernatants of the cell culture were collected after virus infection. In the posttreatment group, BEAS-2B cells were infected with RSV, and then treated with corticosteroid, and the supernatants of the cell culture were collected. RANTES levels in each of the collected supernatant were determined. RESULTS: In the pretreatment group, the strength of each corticosteroid's inhibitory effect on RANTES product was not significantly different. In the posttreatment group, the strength of the inhibitory effect on the production of RANTES was in the order of BUD> MP=FP. BUD have more inhibitory effect on RANTES production at posttreatment group. CONCLUSION: The inhibitory effect of corticosteroid on the production of RANTES in BEAS-2B cells infected with RSV varied widely according to the kinds of corticosteroids and the timing of the corticosteroid treatment.

A Case of Antithyroid Drug-Induced Agranulocytosis Treated with Granulocyte Colony-Stimulating Factor (G-CSF) and Methylprednisolone / 대한소아내분비학회지

Although rare, agranulocytosis is the most serious, potentially fatal side effect of antithyroid drug. We experienced a 13-year-old girl who developed methimazole-induced agranulocytosis at 1 month after the initiation of treatment. Her granulocyte count recovered after discontinuation of methimazole and treatment with broad spectrum-antibiotics, G-CSF, and methylprednisolone. After recovery from agranulocytosis she was treated with radioiodine ablation therapy. Early detection and proper management of antithyroid drug-induced agranulocytosis is very important.