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Biomedical subjects

Ji Sun Nam

Publications and source records attributed to Ji Sun Nam.

4 recordsLinked to original sources

Bilateral peripheral facial palsy in a patient with Human Immunodeficiency Virus (HIV) infection.

Neurological complications are important causes of morbidity and mortality in patients with human immunodeficiency virus (HIV) infection. They can occur at any stage of the disease and can affect any level of the central or peripheral nervous systems. In the literature, several cases of HIV-associated facial paralysis have been reported; however, bilateral facial palsy is rarely reported. In this paper, we present the first case in Korea, of a bilateral facial palsy occurring as the first clinical manifestation of HIV infection.

Adult↗

Clinical and biochemical characteristics of nonobese type 2 diabetic patients with glutamic acid decarboxylase antibody in Korea.

We evaluated the prevalence of glutamic acid decarboxylase autoantibody (GADA) in nonobese patients with type 2 diabetes mellitus in Korea and investigated the characteristics of GADA-positive and GADA-negative patients. Two years later, we assessed the progression of beta-cell function in these patients. Of the 647 nonobese patients with type 2 diabetes mellitus enrolled in the study, 10.1% was positive for GADA. Glutamic acid decarboxylase antibody-positive patients had lower fasting and stimulated C-peptide levels compared with GADA-negative patients (1.70 +/- 0.72 vs 1.24 +/- 0.59 microg/L, P < .001; 2.59 +/- 1.51 vs 1.99 +/- 0.82 microg/L, P < .001). Patients treated with insulin had lower fasting and stimulated C-peptide levels than those not treated (1.13 +/- 0.52 vs 1.66 +/- 0.73 microg/L, P = .002; 1.85 +/- 0.69 vs 2.49 +/- 0.91 microg/L, P = .004) and had higher titers of GADA (30.5 +/- 7.3 vs 6.0 +/- 4.8 U/mL, P < .001). In terms of progression of beta-cell function, fasting and stimulated C-peptide levels were significantly lower in GADA-positive patients after 2 years (from 1.24 +/- 0.59 to 0.95 +/- 0.54 microg/L, P = .004; from 1.99 +/- 0.82 to 1.61 +/- 0.77 microg/L, P = .007), whereas no such difference was observed in the GADA-negative patients. We demonstrate that a significant proportion of Korean patients may be positive for GADA; this is consistent with studies of white subjects, although disagrees with previous reports on Korean subjects. By assessing the presence of GADA in Korean type 2 diabetic patients, we are able to predict their course of beta-cell function and identify in advance those who are likely to require insulin treatment.

Adult↗

Does birthweight predict adolescent adiponectin levels?

OBJECTIVE: Low birthweight is associated with insulin resistance later in life, and adiponectin is known to play an important role in insulin resistance. We have investigated whether birthweight has a relationship with adiponectin levels in adolescence. PATIENTS: An at-home questionnaire survey was completed by 660 middle-school students (aged 12-15 years) in Seoul, Korea, and 152 participants were selected randomly based on their birthweight. MEASUREMENTS Subjects were separated into three groups according to birthweight. We recorded the birthweight and measured anthropometric factors including blood pressure, lipid profile, homeostasis model assessment of insulin resistance (HOMA-IR) and beta-cell function (HOMA-beta), and adiponectin levels of the subjects. These parameters were compared among the groups. The relationship between birthweight and physiological characteristics in adolescence was examined. RESULTS: Systolic blood pressure, lipid profiles and fasting plasma glucose were not significantly different among the groups, but diastolic blood pressure was lower in the third tertile. Insulin, C-peptide and HOMA-IR were higher in the low birthweight tertile. After adjustment for confounding factors, birthweight was inversely related to diastolic blood pressure, insulin, C-peptide and HOMA-IR. Adiponectin level had a significant relationship with current body mass index (BMI) (r=-0.291; P< 0.001) but not with birthweight (r = 0.117; P = 0.166). CONCLUSIONSP: Although birthweight is closely related to insulin resistance during adolescence, adiponectin levels during adolescence had no significant relationship with birthweight. This result implies that low birthweight may not permanently affect adiponectin levels, but current body size is more closely associated with a decreased adiponectin level. However, the limited importance of birthweight as a determining factor on the adiponectin level later in life needs to be further evaluated.

Adiponectin↗

Effects of growth hormone on insulin resistance and atherosclerotic risk factors in obese type 2 diabetic patients with poor glycaemic control.

OBJECTIVE: We aimed to evaluate the combined effects of GH treatment and diet restriction on lipolysis and anabolism, insulin resistance and atherosclerotic risk factors in obese patients with type 2 diabetes mellitus (T2DM). SUBJECTS: This randomized, double-blind, placebo-controlled study included 24 obese T2DM patients (male : female = 12 : 12, mean age 53.7 +/- 7.2 years) with poor glycaemic control (fasting plasma glucose 10.673 +/- 1.121 mmol/l, HbA(1C) 9.9 +/- 2.3%). Sixteen of these patients were treated with recombinant human GH (1-1.5 units/day, 5 days/week) while undergoing diet restriction and exercise for 12 weeks. METHODS: Anthropometric and bioelectrical impedance measurements were undertaken to determine the lean body mass and total body fat. Computed tomography (CT) was performed to estimate visceral and subcutaneous fat distribution at the umbilicus level and the muscle area of the midthigh. Insulin resistance was measured by the insulin tolerance test (ITT) and by the homeostasis model assessment of insulin resistance (HOMA-IR). RESULTS: The ratios VSR (visceral fat area/subcutaneous fat area) and VMR (visceral fat area/thigh muscle area) were significantly decreased in the GH-treated group compared to the control group. An increase in lean body mass was observed in the GH-treated group. Levels of total cholesterol, triglyceride, free fatty acid (FFA), fibrinogen, and plasminogen activator inhibitor-1 (PAI-1) were significantly decreased after GH treatment. Fasting glucose levels decreased similarly (P < 0.05 anova) in both groups during the treatment period. Fasting C-peptide levels significantly increased, whereas insulin levels significantly decreased, in the GH-treated group, but no changes were observed in the control group. The insulin sensitivity index (ISI) was significantly increased in the GH-treated group (1.3 +/- 1.4 vs. 1.9 +/- 1.0%/min, P < 0.05). CONCLUSIONS: GH treatment in obese T2DM patients with poor glycaemic control is beneficial in decreasing the amount of visceral fats, and may therefore result in improvements in insulin resistance, atherosclerotic risk factors and dyslipidaemia.

Analysis of Variance↗