• Biomolecules & Therapeutics
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• v.24 no.4
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• pp.363-370
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• 2016

Cardiovascular disease is the most common cause of death in diabetic patients. Hyperglycemia is the primary characteristic of diabetes and is associated with many complications. The role of hyperglycemia in the dysfunction of human cardiac progenitor cells that can regenerate damaged cardiac tissue has been investigated, but the exact mechanism underlying this association is not clear. Thus, we examined whether hyperglycemia could regulate mitochondrial dynamics and lead to cardiac progenitor cell dysfunction, and whether blocking glucose uptake could rescue this dysfunction. High glucose in cardiac progenitor cells results in reduced cell viability and decreased expression of cell cycle-related molecules, including CDK2 and cyclin E. A tube formation assay revealed that hyperglycemia led to a significant decrease in the tube-forming ability of cardiac progenitor cells. Fluorescent labeling of cardiac progenitor cell mitochondria revealed that hyperglycemia alters mitochondrial dynamics and increases expression of fission-related proteins, including Fis1 and Drp1. Moreover, we showed that specific blockage of GLUT1 improved cell viability, tube formation, and regulation of mitochondrial dynamics in cardiac progenitor cells. To our knowledge, this study is the first to demonstrate that high glucose leads to cardiac progenitor cell dysfunction through an increase in mitochondrial fission, and that a GLUT1 blocker can rescue cardiac progenitor cell dysfunction and downregulation of mitochondrial fission. Combined therapy with cardiac progenitor cells and a GLUT1 blocker may provide a novel strategy for cardiac progenitor cell therapy in cardiovascular disease patients with diabetes.

• Pediatric Infection and Vaccine
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• v.12 no.2
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• pp.135-139
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• 2005

Purpose : We investigated the clinical manifestations, radiographic and laboratory findings of children with M. pneumoniae pneumonia(MP) according to their age. Methods : A total of 75 children with MP who admitted to The Catholic University, Daejeon St. Mary's Hospital from July 2003 to February 2004, were classified into the three age groups : the ${\leq}2$ years of age(16 children), the children between 3 and 5 years of age(35 children), and the ${\geq}6$ years and older(24 patients). The diagnosis of MP was depended on the titers of anti-mycoplasma antibody that were measured 2 times, at admission and at discharge. Results : The total duration of the fever and the length of hospitalization were not different among the age groups. Although the white blood cell(WBC) value and differential was significantly different between the groups(P<0.01), a similar number in the WBC and reduced lymphocyte proportion was observed in all age groups compared to age-matched references. The patterns of pneumonia were significantly different according to age, i.e. segmental or lobar patterns were observed in 5 cases(31.3%) in the ${\leq}2$ years old group, but 16 cases(66.6%) in the >6 years old group(P<0.01). Conclusion : Although there was no difference in clinical findings according to age in MP, the radiographic finding was more severe in older children.

• Journal of Trauma and Injury
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• v.33 no.1
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• pp.1-12
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• 2020

Purpose: Despite recent developments in the management of trauma patients in South Korea, a standardized system and guideline for trauma treatment are absent. Methods: Five guidelines were assessed using the Appraisal of Guidelines for Research and Evaluation II instrument. Results: Restrictive volume replacement must be used for patients experiencing shock from trauma until hemostasis is achieved (1B). The target systolic pressure for fluid resuscitation should be 80-90 mmHg in hypovolemic shock patients (1C). For patients with head trauma, the target pressure for fluid resuscitation should be 100-110 mmHg (2C). Isotonic crystalloid fluid is recommended for initially treating traumatic hypovolemic shock patients (1A). Hypothermia should be prevented in patients with severe trauma, and if hypothermia occurs, the body temperature should be increased without delay (1B). Acidemia must be corrected with an appropriate means of treatment for hypovolemic trauma patients (1B). When a large amount of transfusion is required for trauma patients in hypovolemic shock, a massive transfusion protocol (MTP) should be used (1B). The decision to implement MTP should be made based on hemodynamic status and initial responses to fluid resuscitation, not only the patient's initial condition (1B). The ratio of plasma to red blood cell concentration should be at least 1:2 for trauma patients requiring massive transfusion (1B). When a trauma patient is in life-threatening hypovolemic shock, vasopressors can be administered in addition to fluids and blood products (1B). Early administration of tranexamic acid is recommended in trauma patients who are actively bleeding or at high risk of hemorrhage (1B). For hypovolemic patients with coagulopathy non-responsive to primary therapy, the use of fibrinogen concentrate, cryoprecipitate, or recombinant factor VIIa can be considered (2C). Conclusions: This research presents Korea's first clinical practice guideline for patients with traumatic shock. This guideline will be revised with updated research every 5 years.

• Radiation Oncology Journal
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• v.35 no.3
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• pp.198-207
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• 2017

Purpose: Whether preoperative chemoradiotherapy (CRT) is better than postoperative CRT in oncologic outcome and toxicity is contentious in prospective randomized clinical trials. We systematically analyze and compare the treatment result, toxicity, and sphincter preservation rate between preoperative CRT and postoperative CRT in stage II-III rectal cancer. Materials and Methods: We searched Medline, Embase, and Cochrane Library from 1990 to 2014 for relevant trials. Only phase III randomized studies performing CRT and curative surgery were selected and the data were extracted. Meta-analysis was used to pool oncologic outcome and toxicity data across studies. Results: Three randomized phase III trials were finally identified. The meta-analysis results showed significantly lower 5-year locoregional recurrence rate in the preoperative-CRT group than in the postoperative-CRT group (hazard ratio, 0.59; 95% confidence interval, 0.41-0.84; p = 0.004). The 5-year distant recurrence rate (p = 0.55), relapse-free survival (p = 0.14), and overall survival (p = 0.22) showed no significant difference between two groups. Acute toxicity was significantly lower in the preoperative-CRT group than in the postoperative-CRT group (p < 0.001). However, there was no significant difference between two groups in perioperative and chronic complications (p = 0.53). The sphincter-saving rate was not significantly different between two groups (p = 0.24). The conversion rate from abdominoperineal resection to low anterior resection in low rectal cancer was significantly higher in the preoperative-CRT group than in the postoperative-CRT group (p < 0.001). Conclusions: As compared to postoperative CRT, preoperative CRT improves only locoregional control, not distant control and survival, with similar chronic toxicity and sphincter preservation rate in rectal cancer patients.

• Radiation Oncology Journal
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• v.36 no.1
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• pp.11-16
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• 2018

Purpose: To investigate interobserver variation in target volume delineations for prostate cancer salvage radiotherapy using planning computed tomography (CT) versus combined planning CT and magnetic resonance imaging (MRI). Materials and Methods: Ten radiation oncologists independently delineated a target volume on the planning CT scans of five cases with different pathological status after radical prostatectomy. Two weeks later, this was repeated with the addition of planning MRI. The volumes obtained with CT only and combined CT and MRI were compared, and the effect of the addition of planning MRI on interobserver variability was assessed. Results: There were large differences in clinical target volume (CTV) delineated by each observer, regardless of the addition of planning MRI ($9.44-139.27cm^3$ in CT only and $7.77-122.83cm^3$ in CT plus MRI) and no significant differences in the mean and standard deviation of CTV. However, there were decreases in mean volume and standard deviation as a result of using the planning MRI. Conclusion: This study showed substantial interobserver variation in target volume delineation for salvage radiotherapy. The combination of planning MRI with CT tended to decrease the target volume and the variation.

• Journal of Chest Surgery
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• v.32 no.5
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• pp.456-460
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• 1999

Background: Thoracic sympathectomy for hyperhidrosis has been recognized as an effective treatment using thoracoscopic devices and operative techniques, but the satisfaction has decreased due to a compensatory hyperhidrosis. Therefore, the postoperative results and compensatory hyperhidrosis were analyzed. We also measured the temperature differences in the hand and foot during the preoperative and postoperative periods and measured the blood flow of upper and lower extremities. Material and Method: From December 1995 to July 1998, total of 47 patients with hyperhidrosis underwent sympathectomy via VATS at the Department of Thoracic and Cardiovascular Surgery, Kangnam St. Mary's Hospital. The patients were evaluated for preoperative and postoperative temperature changes on the finger and toe, and preoperative and postoperative blood flows were measured by the Doppler examination on the digital artery, radial artery and dorsalis pedis artery. Result: There were no operative deaths but some complications existed: 7 pneumothorax, 3 recurrence and 1 Honor syndrome. Ninety-five percent of the patients also had compensatory sweating especially in the trunk. There were 5 patients who regretted recurring the operation because of the compensatory sweating. Sweating decreased in 46% of the sole hyperhidrosis patients. The temperature difference between preoperation and postoperation was 1$^{\circ}C$ on the right hand side and 1.9$^{\circ}C$ on the left hand side(P<0.05). There was no significant temperature difference on the sole. Blood flow increased significantly in the palm, but no difference in the sole. Conclusion: In conclusion, thoracic sympathectomy for hyperhidrosis is a safe and effective treatment but satisfaction has been decreased by the compensatory sweating; therefore, it is important to thoroughly explain the compensatory sweating prior to surgery. Improvement of the plantar hyperhidrosis is not due to a physiological change, but to a psychological stability.

• Nutrition Research and Practice
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• v.4 no.6
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• pp.522-527
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• 2010

Cardiovascular disease is a leading cause of death and disability and remains so in the future. The aim of this study was to detect the impact of a 6-month diet intervention on cardiovascular risk factors in postmenopausal Iranian women. It was a randomized controlled trial that carried out in the East Health Clinic in Ahvaz-Iran. This study started on June 2007 and was completed on May 2008. A total 64 healthy postmenopausal women recruited and randomly assigned to the intervention group (35) and control (29). Over the six months follow-up, the intervention group received five educational sessions (two face to face and three lecture discussion classes with slide demonstration) at the first month. These sessions were about menopause, cardiovascular disease and healthy diet. Every participant in the intervention group received one face to face education session at the $3^{rd}$ month, and also received a telephone call at the end of each month starting with the second month to remain on the diet. Pre-intervention and post-intervention anthropometric measurements, blood pressure, blood lipids and dietary intake were assessed. Data analyzed using the SPSS version 15. Descriptive (means and SD), univariate (paired-t test, Chi-Square and Independent T-test) and multivariate (GLM Repeated Measure) statistics were used. Participants in the diet group had significantly lower weight (-0.9 kg), body mass index (-0.4 $kg/m^2$), and fasting blood sugar (-4.5 mg/dl). The diet group significantly increased their daily intake of fiber (+2.3 g, P=0.05), decreased their intake of sodium (-28 mg, P=0.04), and consumption of fruit and vegetable ${\geq}$ 5 serving a day (80%, P=0.03) compared to the control group. Post menopausal women are at a greater risk for cardiovascular disease. Healthy diet using educational intervention can be an effective means of reducing cardiovascular risk in postmenopausal women.

• Journal of the Korean Dietetic Association
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• v.16 no.4
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• pp.378-396
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• 2010

The objectives of this study were to explore hospital foodservice management and to investigate conditions related to health insurance coverage of inpatient meals. A questionnaire was distributed to the nutrition departments of 44 hospitals in Seoul on July 2009. The average kitchen area was 0.5 $m^2$, and centralized distribution systems were in place. Partition walls from contamination zones, separate work tables to prevent cross-contamination, exclusive areas for preparing tube feeding, and split carts with refrigerated and convection heat settings were largely used in tertiary hospitals. Most dietitians did meal rounds (93.2%) and surveyed for patient satisfaction (86.4%). The major theme of QI (Quality Improvement) was menu management (31.8%). The health insurance fees for meals were (won)4,938.9 for a general diet, (won)5,199.8 for a therapeutic diet, (won)4,067.0 for tube feeding, (won)9,950.0 for sterilized diet, and (won)18,383.4 for diets not covered by health insurance. The prices for general and therapeutic diets were significantly lower in hospitals compared to tertiary or general hospitals (P<0.001). The cost composed of 48.3% food, 44.0% labor and 7.7% overhead for general diets and 47.9%, 44.5% and 7.6% for therapeutic diets. In the case of health insurance coverage for patient meals, the number of items applied to general diets averaged 2.8 out of 4 and for therapeutic diets it averaged 1.9 out of 3. To reform the health insurance coverage system for patient meals, it is urgent that the qualified level of patient meals is presented from a national viewpoint, and monitoring should be performed consistently by developing the evaluation tools.

• Journal of Korean Neurosurgical Society
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• v.50 no.2
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• pp.99-102
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• 2011

Objective : The purpose of this retrospective study was to evaluate the outcome of gamma knife radiosurgery (GKRS) and/or whole brain radiation therapy (WBRT) for the treatment of small cell lung carcinoma (SCLC) metastasis to the brain. Methods : From 2000 to 2010, 50 patients underwent GKRS for metastatic brain lesions originating from SCLC. Among these patients, 11 received prophylactic cranial irradiation (PCI) before the development of metastatic lesions (PCI group), and GKRS was performed as an initial treatment for newly diagnosed lesions in 12 patients who had not received PCI (primary GKRS group). In addition, GKRS was performed as a salvage treatment for progressive lesions after WBRT in 27 patients (salvage GKRS group). The medical records and imaging data of all patients were retrospectively analyzed. Results : The overall survival of the 50 patients was 20.8 months (range 1-53) after the diagnosis of primary tumor and 12.0 months (range 1-47) after the development of cerebral metastasis. Median survival after GKRS was 4.8 months (range 1-15) in the PCI group, 4.6 months (range 0-18) in the primary GKRS group, and 7.6 months (range 0-33) in the salvage GKRS group. Further treatment for progressive lesions after GKRS was necessary in 15 patients, after a mean interval of 3.8 months. Causes of death were systemic organ failure in 15 patients, deterioration of neurological state in 13 patients, and unknown or combined causes in 16 patients. The local control rate of the lesions treated with GKRS was 76.4% (decreased in 13 patients and stable in 16 patients at the final imaging follow-up (mean 5.60 months). Conclusion : GKRS is an effective local treatment for brain metastasis from SCLC both as an initial treatment for newly diagnosed lesions after PCI and as a salvage treatment for recurrent or progressive lesions. However, the survival benefit is not significant because most patients die of systemic multi-organ failure with a short life expectancy.

• Journal of Korean Neurosurgical Society
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• v.56 no.6
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• pp.475-481
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• 2014

Objective : To evaluate the anatomical feasibility of 3.5 mm screw into the cervical spine in the pediatric population and to establish useful guidelines for their placement. Methods : A total of 37 cervical spine computerized tomography scans (24 boys and 13 girls) were included in this study. All patients were younger than 10 years of age at the time of evaluation for the period of 2007-2011. Results : For the C1 screw placement, entry point height (EPH) was the most restrictive factor (47.3% patients were larger than 3.5 mm). All C2 lamina had a height larger than 3.5 mm and 68.8% (51/74) of C2 lamina had a width thicker than 3.5 mm. For C2 pedicle width, 55.4% (41/74) of cases were larger than 3.5 mm, while 58.1% (43/74) of pedicle heights were larger than 3.5 mm. For pedicle width of subaxial spine, 75.7% (C3), 73% (C4), 82.4% (C5), 89.2% (C6), and 98.1% (C7, 1/54) were greater than 3.5 mm. Mean lamina width of subaxial cervical spine was 3.1 (C3), 2.7 (C4), 2.9 (C5), 3.8 (C6), and 4.0 mm (C7), respectively. Only 34.6% (127/370) of subaxial (C3-7) lamina thickness were greater than 3.5 mm. Mean length of lateral mass for the lateral mass screw placement was 9.28 (C3), 9.08 (C4), 8.81 (C5), 8.98 (C6), and 10.38 mm (C7). Conclusion : C1 lateral mass fixation could be limited by the morphometrics of lateral mass height. C2 translamina approach is preferable to C2 pedicle screw fixation. In subaxial spines, pedicle screw placement was preferable to trans-lamina screw placement, except at C7.