• Clinical and Experimental Pediatrics
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• v.48 no.9
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• pp.939-945
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• 2005

Purpose : The purpose of this study was to report outcome of fetal infants with birth weight below 500 g known as lower limit of viability and to evaluate treatment characteristics and short-term morbidity of their survivors. Methods : We retrospectively analyzed the medical records of all fetal infants with birth weight below 500 g who were delivered at Samsung Medical Center(SMC), or transferred to neonatal intensive care unit(NICU) of SMC within 24 hrs after birth between 1994 and 2004. Data for all interventions and morbidity outcome were analyzed for infants who were admitted to the NICU and were compared between NICU survivors and deaths. Results : Among 53 infants with birth weights of 400 to 499 g who were born in SMC during the study period, 8(15.1%) infants were admitted to the NICU and one was transferred to NICU from other hospital. Overall, 4(44%) of 9 survived and were discharged from the NICU. The smallest infant who survived weighed 439 grams. The least gestational age was $23^{+3}$ among the survivors. Compared with NICU deaths, NICU survivors had larger gestational age($24^{+2}{\pm}1^{+3}$ vs. $25^{+4}{\pm}2^{+3}$) and birth weight($424{\pm}17$ vs. $453{\pm}19$)(P<0.05). Median survival duration of NICU deaths was 15 days. None of NICU survivors had severe IVH, but 3(75%) had laser therapy for retinopathy of prematurity and bronchopulmonary dysplasia, respectively. Conclusion : Fetal infants with birth weight below 500 g known as lower limit of viability survived successfully. Study for their long-term follow-up will be needed to define our limit of viability and indication for their active resuscitation.

• Clinical and Experimental Pediatrics
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• v.50 no.9
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• pp.905-911
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• 2007

Purpose : Ghrelin, being secreted from the stomach, stimulates growth hormone secretion and controls energy homeostasis by increasing appetite. Leptin, being secreted from the adipocytes, controls weight and energy homeostasis by decreasing appetite. Leptin concentration is reported to increase after childhood cancer therapy. This study was aimed to compare ghrelin and leptin concentrations in normal children and children who received cancer therapy. Methods : We enrolled forty-three patients who were diagnosed with cancer and received radiotherapy or chemotherapy during Dec. 2004 through Dec. 2005 in St. Marys hospital and Kangnam St. Marys hospital. Forty-five healthy children were selected as a control group whose age, gender, weight and height were similar to those of cancer group. The serum leptin and ghrelin concentrations were also measured by radioimmunoassay. Results : The cancer group showed higher BMI and leptin concentrations. The control group showed higher concentrations of ghrelin. Both control and cancer groups revealed positive correlations between leptin concentrations and BMI. Ghrelin concentrations in the control group showed negative correlations with age, height, weight and BMI but no significant correlation was found in the cancer group. All the parameters in the group treated with chemotherapy only were not different from those in the group treated with chemotherapy and irradiation. But the level of ghrelin in the acute myeloid leukemia group was much higher than those in the acute lymphoblastic leukemia group. Conclusion : Patients with pediatric cancer treatment have presented higher BMI and leptin concentrations but lower ghrelin concentrations than those in healthy children. Because of the relatively short duration and cross sectional method of the study, however, further long term and prospective study will be required in the future.

• Clinical and Experimental Pediatrics
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• v.50 no.9
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• pp.912-918
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• 2007

Purpose : Breast milk contains several components that provide specific immunity and affect the maturation of the infant's immune system. Allergic disease (AD), including atopic eczema, asthma, allergic rhinitis, and food allergy is characterized by an imbalance between cytokines produced by distinct T-helper cell subtypes. The aim of the study was to investigate the concentrations of cytokines and chemokines that were involved in allergic reactions in breast milk from allergic and nonallergic mothers and then analyse the effect of breastfeeding duration on the prevalence of allergic disease in the age of two. Methods : The breast milk samples were collected from mothers with AD (n=88) and without AD (n=47). Breast milk was collected at the second day (colostrum) and four weeks later (mature milk).The level of Interlukine (IL)-4, IL-5, IL-6, IL-8, IL-10, IL-13, $TGF-{\beta}1$, $TGF-{\beta}2$, RANTES in breast milk were determined by commercially available enzyme-linked immunosorbent assay (ELISA) kits according to the manufacturer's instructions. Results : Mothers with AD had a higher concentration of IL-8 in colostrum compared with those without AD (P=0.021). But, $TGF-{\beta}1$ and $TGF-{\beta}2$ were higher concentrated in colostrum of mother without AD (P=0.013, P=0.001). Whereas concentrations of other cytokines were not significantly different between the two groups. There was no association between levels of cytokines and chemokines in the breast milk and allergic development during the first 2 years of life in the infants. Conclusion : The higher concentration of $TGF-{\beta}1$ and $TGF-{\beta}2$ in colostrum from non-allergic mothers may explain the protective effect. But, the higher concentrations of IL-8 in colostrum from allergic mothers may in part explain the controversial results on the protective effect of breastfeeding against allergic diseases. We conclude that there is no convincing evidence form a relation between cytokines in breast milk and allergic diseases in infants. Longer follow-up are necessary to evaluate the effects of breast milk components on AD.

• Journal of Nutrition and Health
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• v.31 no.5
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• pp.897-905
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• 1998

Docosahexaenoic acid(DHA), a $\omega$3 series fatty acid and arachidonic acid(AA). a $\omega$6 series fatty acid were found in relatively high concentrations in the phospholipids(PLs) of cell membranes of nerve tissues, and they can be affected by various factors. The present study examined the effects of dietary $\omega$6 and $\omega$3 fatty acid composition on P/M/S and on $\omega$3/$\omega$6 fatty acid ratios in brain PLs of 2nd generation rats. The expeimental diets consisted of 10% fat(by wt), which were computer- searched mixed oil('M') with P/M/S ratio, 1 : 1.4 : 1 and $\omega$6/$\omega$3 ratio, 6 : 1 and safflower oil('S') poor in $\omega$3 fatty acids. The experimental diets were started 3-4 wks prior to conception. During the lactation period, the feeding mothers were switched 1 wk after birth and provided the pups for 2 wks with milk which had compositions different from that of their natural mother. The same diet as their mothers was provided from weaning to 9 wks of age. The 'M'and 'S' rats were again subdivided into MM, MS, SS, SM rats according to diet which their lactating mothers were fed from the begining of the experiment. The relative percentage of P/M/S fatty acids in brain PLs in all experimental groups converged to a very similar value at 9 wks of age, indicating the existence of a control mechanism for the degree of fatty acids, unsaturation. The $\omega$3/$\omega$6 fatty acid ratios of brain PLs converged to about 1.0 in MM & SM groups and to 0.7 in SS & MS groups, suggesting also the existence of some balance between $\omega$3 and $\omega$6 fatty acids in developing rat brain. The concentrations of $\omega$3 fatty acids, especially DHA, in the SM group were increased and became similar to those in MM group at 9 wks of age. The increase in DHA of brain PLs was counterbalanced b)r a decrease in 22 5$\omega$6. Therefore, the ratios of 22 : 6$\omega$6/22 : 5$\omega$6 were higher in both MM & SM groups than those of SS & MS groups at 9 wak of age. Although dietary $\omega$3 and $\omega$6 fatty acids affected 22 : 6$\omega$S and 22 : 5$\omega$6 contained in rat brain PLs reciprocally, the relative percentage of AA did not appear to be significantly influenced by the diet in all groups at 9 wks of age, suggesting that a mechanism for the maintenance of a certain level of AA in brain PLs exists. In conclusion, the $\omega$3/$\omega$6 fatty acid and 22 : 6$\omega$3/22 : 5$\omega$6 ratios, but not P/M/S ratio, of rat brain PLs were affected by the postnatal dietary changes. Futher studies are required to clarify the mechanism(S) of ensuring a certain level of DHA and of maintaining a similar level of AA in rat brain PLs after. weaning(9 wk) regardless of prenatal and postnatal dietary changes. (Korean J Nutrition 31(5) : 897-905, 1998)

• Radiation Oncology Journal
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• v.5 no.1
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• pp.31-36
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• 1987

Radiobiological and clinical evidences indicate that hyperthermia combined with ionizing radiation produces a significant improvement in therapeutic effect of cancer. In general, malignant cells are more sensitive to heat than normal cells in the heat range of $41\~45^{\circ}C$. We report the experiences obtained from 42 patients with advanced malignant neoplasms managed with 2,450MHz microwave-induced local hyperthermia and ionizing radiation at the Department of Radiology, Kangnam St. Mary's Hospital, Catholic University Medical College. A clinical analysis of 42 thermoirradiated patients showed result of 11(26\%),\;15(36\%),\;11(26\%)\;and\;5(12\%)$ patients with complete response (CR), partial response (PR), minor response (MR) and no response (NR), respectively. Histologically there were $17(40.2\%)$ squamous cell carcinomas, $12(28.6\%)$ adenocarcinomas and $6(14.3\%)$ miscellaneous cancers. Eleven patients with CR consisted of five squamous cell carcinomas, five adenocarcinomas, and one chloroma. Among 15 patients with PR were five squamous cell carcinomas, five adenocarcinomas, three unknown primary tumors, and one poorly differentiated, and miscellaneous tumor each.

• Tuberculosis and Respiratory Diseases
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• v.67 no.2
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• pp.105-112
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• 2009

Background: Solitary pulmonary nodules (SPN) are encountered incidentally in 0.2% of patients who undergo chest X-ray or chest CT. Although SPN has malignant potential, it cannot be treated surgically by biopsy in all patients. The first stage is to determine if patients with SPN require periodic observation and biopsy or resection. An important early step in the management of patients with SPN is to estimate the clinical pretest probability of a malignancy. In every patient with SPN, it is recommended that clinicians estimate the pretest probability of a malignancy either qualitatively using clinical judgment or quantitatively using a validated model. This study examined whether Bayesian analysis or multiple logistic regression analysis is more predictive of the probability of a malignancy in SPN. Methods: From January 2005 to December 2008, this study enrolled 63 participants with SPN at the Kangnam Sacred Hospital. The accuracy of Bayesian analysis and Bayesian analysis with a FDG-PET scan, and Multiple logistic regression analysis was compared retrospectively. The accurate probability of a malignancy in a patient was compared by taking the chest CT and pathology of SPN patients with <30 mm at CXR incidentally. Results: From those participated in study, 27 people (42.9%) were classified as having a malignancy, and 36 people were benign. The result of the malignant estimation by Bayesian analysis was 0.779 (95% confidence interval [CI], 0.657 to 0.874). Using Multiple logistic regression analysis, the result was 0.684 (95% CI, 0.555 to 0.796). This suggests that Bayesian analysis provides a more accurate examination than multiple logistic regression analysis. Conclusion: Bayesian analysis is better than multiple logistic regression analysis in predicting the probability of a malignancy in solitary pulmonary nodules but the difference was not statistically significant.

• Tuberculosis and Respiratory Diseases
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• v.80 no.3
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• pp.277-283
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• 2017

Background: Smoking cessation is the most powerful intervention to modify progress of chronic obstructive pulmonary disease (COPD), and nicotine dependence is one of the most important determinants of success or failure in smoking cessation. We evaluated nicotine dependence status and investigated factors associated with moderate to high nicotine dependence in patients with COPD. Methods: We included 53 current smokers with COPD in the Korean Obstructive Lung Disease II cohort enrolled between January 2014 and March 2016. Nicotine dependence was measured by using Fagerstrom test for nicotine dependence (FTND). Cognitive function was assessed by Korean version of Montreal Cognitive Assessment. Results: The median FTND score was 3, and 32 patients (60%) had moderate to high nicotine dependence. The median smoking amount was 44 pack-years, which was not related to nicotine dependence. Multiple logistic regression analysis revealed that high education status (odds ratio, 1.286; 95% confidence interval, 1.036-1.596; p=0.023), age <70 (odds ratio, 6.407; 95% confidence interval, 1.376-29.830; p=0.018), and mild to moderate airflow obstruction (odds ratio, 6.969; 95% confidence interval, 1.388-34.998; p=0.018) were related to moderate to high nicotine dependence. Conclusion: Nicotine dependence does not correlate with smoking amount, but with education level, age, and severity of airflow obstruction. Physicians should provide different strategies of smoking cessation intervention for current smokers with COPD according to their education levels, age, and severity of airflow obstruction.

• The Journal of the Korean bone and joint tumor society
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• v.7 no.2
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• pp.51-58
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• 2001

Purpose : In patients having malignant and aggressive bone tumors around knee joint requiring amputation, segmental resection and rotationplasty were performed and the clinical results were analyzed. Materials and Methods : Twenty-six patients underwent segmental resection and rotationplasty between February 1988 and June 1994, because limb salvage with tumor prosthesis after removal of tumor was impossible. The mean follow-up of malignant tumors was 57(6~120) months and the average age of patients was 21.4(5~37) years old. Out of 26 patients, there were 18 osteosarcoma(${\geq}$stage IIB), 2 synovial sarcoma, and 6 giant cell tumor. Results : Clinical results were evaluated by the Shriner's rating system. Four patients were excluded due to death or amputation and remaining 22 patients were included for assessment. Eighteen patients had excellent result, 3 good, and 1 fair. Range of motion of ankle joint was -11(dorsiflexion)~80(plantarflexion) degrees and daily walking activity with prosthesis was possible. Local recurrence developed in 2 patients and distant metastasis in 10. Early complications had 3 thrombosis and 1 sepsis, and late complications had 6 nonunion, 2 malrotation and 1 stiffness of ankle joint. Conclusion : Rotationplasty which is functionally excellent may serve as an effective partial limb salvage procedure, especially in patients less than 10 years old that lower extremity discrepancy or loosening tumor prosthesis due to enlargement of medullary cavity are anticipated or amputation is inevitable for wide resection margin.

• Journal of the Korean Society of Food Science and Nutrition
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• v.37 no.5
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• pp.578-588
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• 2008

The objective of this study was to evaluate associations of dietary sodium (Na) intake with salt-related dietary behaviors of 218 university students (95 men; 123 women) living in Gyeonggi area. Dish frequency questionnaire (DFQ) was used to identify salt-related dietary behaviors and to determine Na intakes. In men, systolic & diastolic blood pressures, Na intakes and DFQ-15 scores were significantly higher than in women. High-salt intake group (HS), classified by DFQ-15, had higher scores of high-salt dietary attitude and more Na intakes than low-salt intake group (LS). HS took protein foods and had balanced diets less frequently than LS (p<0.05). HS had fried dishes & fatty meats, and added salt to dishes more frequently (p<0.05). HS and LS had differences in preference of soy-boiled and Chinese or Japanese foods, in intake frequency of bean-paste soup, in use of soy sauce with fried food or raw fish, and in salt addition to dishes at the table (p<0.05). HS, classified by Na intakes, had high-salt dietary attitudes such as preference of seasoned rice & soy-boiled foods and habitual addition of soy sauce or salt to dishes at the table. The subjects using food labels when purchasing had better salt-related attitudes & behaviors, and lower DFQ-15 scores & Na intakes than the non-users (p<0.01). Self-assessed HS (SHS) had worse salt-related attitudes and behaviors (p<0.05). Male self-assessed LS (SLS) had higher Na intakes, which indicated that self-assessment of salt preference did not actually reflect Na intake. In summary, male university students belonged to a high-risk group of salt intakes, and HS preferred soy-boiled foods or fatty dishes, frequently added salt to dishes and rarely had balanced diets. These results suggest that nutrition education programs for university students should include fundamental dietetics and a balanced diet, in addition to a low-Na diet.

• Journal of Gastric Cancer
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• v.13 no.3
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• pp.164-171
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• 2013

Purpose: Laparoscopy-assisted distal gastrectomy for early gastric cancer has gained acceptance and popularity worldwide. However, laparoscopy-assisted distal gastrectomy for advanced gastric cancer is still controversial. Therefore, we propose this prospective randomized controlled multi-center trial in order to evaluate the safety and feasibility of laparoscopy assisted D2-gastrectomy for advanced stage gastric cancer. Materials and Methods: Patients undergoing distal gastrectomy for advanced gastric cancer staged cT2/3/4 cN0/1/2/3a cM0 by endoscopy and computed tomography are eligible for enrollment after giving their informed consent. Patients will be randomized either to laparoscopyassisted distal gastrectomy or open distal gastrectomy. Sample size calculation revealed that 102 patients are to be included per treatment arm. The primary endpoint is the non-compliance rate of D2 dissection; relevant secondary endpoints are three-year disease free survival, surgical and postoperative complications, hospital stay and unanimity rate of D2 dissection evaluated by reviewing the intraoperative video documentation. Discussion: Oncologic safety is the major concern regarding laparoscopy-assisted distal gastrectomy for advanced gastric cancer. Therefore, the non-compliance rate of clearing the N2 area was chosen as the most important parameter for the technical feasibility of the laparoscopic procedure. Furthermore, surgical quality will be carefully reviewed, that is, three independent experts will review the video records and score with a check list. For a long-term result, disease free survival is considered a secondary endpoint for this trial. This study will offer promising evidence of the feasibility and safety of Laparoscopy-assisted distal gastrectomy for advanced gastric cancer. Trial Registration: NCT01088204 (international), NCCCTS-09-448 (Korea).