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Changes in Incidence, Survival Rate and Morbidity of Very Low Birth Weight Infants (극소 저출생 체중아의 빈도와 생존율 및 예후 변화)

  • Kim, Young Ok;Kim, Sun Hui;Cho, Chang Yee;Choi, Young Youn;Kook, Jin Hwa;Hwang, Tae Ju
    • Clinical and Experimental Pediatrics
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    • v.46 no.8
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    • pp.769-776
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    • 2003
  • Purpose : The survival rate of very low birth weight infants(VLBWI) has improved by virtue of specialized neonatal care. This study was performed to analyze the changes in incidence, survival rate and morbidity of VLBWI who admitted to Chonnam National University Hospital from 1996 to 2001. Methods : We enrolled 565 VLBWI, and compared the incidence and the survival rate according to the birth weight or gestational weeks between period I(1996 to 1998) and period II(1999 to 2001). The mortality rate according to the postnatal age, cause of death, morbidity and days of hospital stay were also compared. Morbidity is categorized into 'short term' which is curable until discharge, and 'long term' causing any types of sequelae after discharge. Results : Incidence of VLBWI significantly increased in period II over period I(6.0% vs. 11.0%, P< 0.001). The survival rate also increased in period II(71.8% vs. 80.1%, P<0.05), especially in 1,000 to 1,249 gm of birth weight(P<0.001) and in 28 to 30 weeks of gestation(P<0.001). The most common cause of death was respiratory distress syndrome in period I; however it was sepsis in period II. Although overall and short term morbidity rate increased, long term morbidity and days of hospital stay didn't increase in period II. Conclusion : Although the incidence of VLBWI significantly increased and the survival improved in period II compared to period I, especially in 1,000 to 1,249 gm of birth weight and 28 to 30 weeks of gestation, 'long term' morbidity rate and hospital days didn't increase.

Effects of Cigarette Smoking on Clinical Symptoms and Level of Serum Prolactin in Schizophrenic Patients (흡연이 정신분열병 환자의 임상 증상 및 혈청 Prolactin에 미치는 영향)

  • Woo, Haing-Won;Lim, Weon-Jeong;Yun, Kyu-Wol
    • Korean Journal of Psychosomatic Medicine
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    • v.5 no.2
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    • pp.143-150
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    • 1997
  • This study was performed to evaluate the characteristics of smoking behavior and the effects of smoking on clinical symptoms and level of serum prolactin in schizophrenic patients. Methods : 76 male schizophrenic patients answered the questionnaire about the characteristics of smoking patterns. And patients were assessed by brief psychiatric rating scale(BPRS), positive and negative syndrome scle(PANSS), Hamilton rating scale for depression(HAM-D), assessment for involuntary movement scale(AIMS) and symptom checklist 90 R(SCL-90-R). Serum prolactin levels were measured by enzymeimmunoassay. Results: 1) The frequences of drinking coffee were significantly higher in smokers. The reasons for smoking were to relieve tension, to avoid boredom, due to habit and to do with friends. 80.1% of smokers tried quitting, but smoking was relapsed due to craving and withdrawal symptoms. 2) No significant difference was seen in mean neuropeltic doses, scores of PANSS and AIMS. But as for BPRS, scores of anxiety/depression subscale were significanly lower in smokers. Scores of HAM-D and scores of interpersonal sensitivity and phobia among SCL-90-R were significantly lower. 3) Levels of serum prolactin were significanlty lower in smokers. Conclusion : These findings suggest that in schisophrenia smoking relieves anxiety and depression subjectively But decreased prolactin levels may suggest that the possibility of increased dopamine in CNS.

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MMPI and SCL-90-R Profiles in Patients with Sleep-Related Breathing Disorder (수면관련 호흡장애 환자의 MMPI 및 SCL-90-R 반응 특성)

  • Kim, Kyoung-Woo;Yoon, Seok-Joon;Yang, Chang-Kook;Han, Hong-Moo
    • Korean Journal of Psychosomatic Medicine
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    • v.10 no.1
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    • pp.37-47
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    • 2002
  • Objective : Previous studies have suggested an association between sleep-related breathing disorder (SRBD) and several psychological problems, and there were increasing recognition of the link. The purpose of this study is to evaluate the characteristic profiles of MMPI and SCL-90-R in patients with SRBD. Methods : This study consisted of 80 SRBD patients(73 men, 7 women) referred from Sleep Disorder Clinic of Dong-A University Hospital, Busan, Korea. Basic informations including demographic findings and physical examination were collected. Subjects completed the Epworth Sleepiness Scale(ESS), Minnesota Multiphasic Personality Inventory(MMPI), and Symptom Check List-90-Revision (SCL-90-R) prior to standard overnight polysomnography that was performed at hospital sleep laboratory. SRBD was divided into two groups of primary snoring(PS) and obstructive sleep apnea(OSA) according to polysomnographic findings. Results : SRBD showed significant elevation rate of Hs, D, and Hy scales of MMPI and SOM scale of SCL-90-R, which exceeded the rate expected in normal individuals(>5%, 2SD). On comparison of clinical scales of SCL-90-R, OSA group had significantly greater mean score than that of PS group in terms of O-C, DEP, PAR, GSI(p<0.05), SOM and PST(p<0.01). OSA group also showed significantly higher elevation rate in Hs scale of MMPI and SOM scale of SCL-90-R than that of PS. Among OSA group, three scales of MMPI(D, Pt, Si) and three scales of SCL-90-R(ANX, PAR, PSDI) had significant correlation with some PSG variables including total sleep time and sleep efficiency. Among PS group, two scales of MMPI(Hy and Pt), elevation rate of MMPI scales and three scales of SCL-90-R(I-S, PAR, PSDI) had significant correlation with some PSG variables including sleep efficiency, sleep latency and REM sleep percent. Conclusion : The above results suggest that SRBD show neurotic profiles in MMPI and SCL-90-R. This study also clearly indicates that PS group are suffered from clinically meaningful psychiatric symptoms, which are quantitatively lessened but qualitatively similar as compared to that of OSA group.

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Dietary assessment according to intake of Korean soup and stew in Korean adults: Based on the 2011~2014 Korea National Health and Nutrition Examination Survey (한국 성인의 국물 음식류 섭취에 따른 식생활 평가 : 2011~2014 국민건강영양조사 자료를 이용하여)

  • Kwon, Yong-Suk;Han, Gyusang
    • Journal of Nutrition and Health
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    • v.49 no.5
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    • pp.335-346
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    • 2016
  • Purpose: This study was conducted to conduct dietary assessment of Korean adults according to intake of Korean soup and stew. Methods: To accomplish this study, 20,926 adults aged 19 yr or higher who participated in the dietary intake survey (24 h recall method) were analyzed from the data of the 2011~2014 Korea National Health and Nutrition Examination Survey (KNHANES). The items included in the soup and stew were guk, tang, jjigae, jijimi, and jeongol. Results: Intakes of soup and stew of subjects were divided into quartiles; intake range by quartile was Q1: < 22.96 g, Q2: 22.96~98.75 g, Q3: 98.75~212.23 g, and Q4: $${\geq_-}212.24g$$. In the case of the Q4 group, male, married, employed, higher educated, and high income subjects showed increased intakes of soup and stew. In addition, sodium intake among nutrient intakes increased from 3,849.04 mg in Q1 group to 5,363.57 mg in Q4 group. Intakes of cereals/grains, potatoes/starches, legumes, seeds/nuts, vegetables, mushrooms, fruits, meat, fishes/shell fishes, milks/dairy products, oils/fats, and seasonings among all foods significantly increased from Q1 group to Q4 group. Lastly, in the multivariable regression analysis, male, higher age, married, eating breakfast, consumption of snacks, prepared meals from home/institution, average eating-out frequency per week, energy consumption, and sodium intake related parameters increased intake of Korean soup and stew. Conclusion: Excessive intake of sodium was related to high blood pressure and metabolic syndrome. Thus, there are needs to improve dietary guidelines and nutrition education for balanced intake of soup and stew.

Mitochondrial DNA Copy Number in the Patients of Korean Polycystic Ovary Syndrome (PCOS) (한국인 다낭성난소증후군 환자에서 미토콘드리아 DNA Copy 수의 정량적 분석)

  • Park, Ji-Eun;Jang, Min-Hee;Cho, Sung-Won;Kim, Yoo-Shin;Won, Hyung-Jae;Cho, Jung-Hyun;Baek, Kwang-Hyun;Lee, Sook-Hwan
    • Clinical and Experimental Reproductive Medicine
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    • v.33 no.4
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    • pp.245-251
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    • 2006
  • Objective: We analyzed quantification of mitochondria DNA (mtDNA) to investigate the relationship of mitochondria and pathogenesis of PCOS. Materials and Methods: Peripheral blood samples were collected from 28 patients with PCOS who were under the inclusion criteria for PCOS and from 28 healthy controls. Genomic DNA was used to analyze real-time PCR for mtDNA copy number quantification. The mtDNA copy number was compared between the control and PCOS groups. All data was expressed as mean ${\pm}$ SD. Statistical analysis was assessed by t-test. Results: In this study, the mtDNA $C_T$ was $11.67{\pm}0.422$ in PCOS patients and $11.51{\pm}0.722$ in control group, respectively. The mtDNA copy number was $1726410.71{\pm}407858.591$ the patients of in PCOS and $2167887.51{\pm}252459.28$ in control group (p=0.08), respectively. Conclusion: In our study, using real-time PCR, there was a tendency of lower mtDNA copy number in the patients of PCOS when comparing to the control group even though statistical difference was not significant. However, more extensive analysis is required to clarity relationship between mtDNA copy number and pathogenesis of PCOS.

Comparative Study of Perinatal Outcome and the Incidene of Congenital Anomalies of Babies Born after Intracytoplasmic Sperm Injection (ICSI) and Conventional In-vitro Fertilization (IVF) (고식적 체외수정시술과 난자 세포질내 정자주입술에 의해 태어난 아이의 주산기 결과 및 선천성 기형 발생빈도의 비교 연구)

  • Lim, Jeong-Eun;Yoo, Keun-Jai;Lee, Jong-Pyo;Lee, Moon-Seob;Hyun, Woo-Young;Jun, Jin-Hyun;Hong, Soo-Jeong;Song, Ji-Hong;Song, In-Ok;Paik, Eun-Chan;Choi, Bum-Chae;Son, Il-Pyo;Koong, Mi-Kyoung;Kang, In-Soo;Jun, Jong-Young;Park, In-Sou
    • Clinical and Experimental Reproductive Medicine
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    • v.25 no.3
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    • pp.323-329
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    • 1998
  • The safety of ICSI as a novel procedure of assisted fertilization may be assessed by the health of the baby born. In order to evaluate the safety of ICSI, perinatal outcome and congenital anomaly of the babies born after ICSI were compared with those of babies born after IVF (control group). We analysed the clinical data from the obstetric and pediatric records, including the information obtained through telephone. The results are as follows; Mean gestational age $({\pm}SEM)$ and birth weight in singleton pregnancy were $38.8{\pm}1.9$ weeks and $3209.7{\pm}501.9gm$ in IVF group, $39.0{\pm}2.2$ weeks and $3289.9{\pm}479.5gm$ in ICSI group, respectively. Mean gestational age and birth weight in twins were $36.8{\pm}2.1$ weeks and $2512.8{\pm}468.0gm$ in IVF group, $36.5{\pm}2.8$ weeks and $2492.7{\pm}537.1gm$ in ICSI group. In IVF group, perinatal mortality rates were 8.5 in singletons and 56.6 in twins; for the ICSI singletons and ICSI twins, the perinatal mortality rates were 11.6 and 49.0, respectively. The incidence of congenital malformations was 3.6% (8/224) in IVF group and 2.1% (4/188) in ICSI group, there was no statistical difference (p>0.05, Fisher's exact test). The incidence of major congenital anomalies was 0.9% (2/224; pulmonary artery hypoplasia, renal cystic dysplasia) in IVF group and 1.1% (2/188; holoprosencephaly, Cri du chat syndrome) in ICSI groups (p>0.05, Fisher's exact test). Similarly, there was no significant difference in incidence of minor congenital anormalies 2.7% (6/224) in IVF group and 1.1% (2/188) in ICSI group respectively (p>0.05, Fisher's exact test). In conclusion, there was no difference in the perinatal outcome and the incidence of congenital anomalies between the babies born after ICSI and those after conventional IVF.

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Increased Carboxyhemoglobin and Serum Iron Concentration as an Indicator of increased Red Cell Turnover in Preeclampsia (임신성 고혈압 환자에서 적혈구교체의 지표로서 일산화탄소 혈색소와 혈청 철의 임상적 의의)

  • Kim, Sang-Heon;Lee, Kwang-Hee;Kim, Mi-Sook;Lee, Young-Gi;Park, Yoon-Kee;Lee, Tae-Hyung;Lee, Sung-Ho
    • Journal of Yeungnam Medical Science
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    • v.10 no.1
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    • pp.68-76
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    • 1993
  • Pregnancy induced hypertension is multifaceted syndrome with variable involvement of several key organ systems, so sensitive and specific laboratory tests for predicting severity and prognosis, and early diagnosis of this disease are required. Because heme catabolism results in equimolar production of carboxyhemoglobin, iron and bilirubin, a concomittant rise of these parameters would provide confirmation of increased heme catabolism. Microangiopathic hemolytic anemia may occurs in severe preeclampsia, but it is not known whether increased red cell turnover occurs with mild preeclampsia as complication. The purpose of this study was to confirm that increased heme catabolism also occurs in patients with mild preeclampsia. The analysis of data was done on 23 cases with mild preeclampsia and 35 normal pregnant women, who were admitted to Yeungnam University Hospital from October 1992 to March 1993. The results were as follows. 1. The mean antepartum serum iron concentration was significantly higher in the group with mild preeclampsia($86.5{\pm}6.1{\mu}g/dl$) than in the controls($53.2{\pm}5.3{\mu}g/dl$). 2. The mean antepartum and postpartum carboxyhemoglobin concentrations were significantly higher in the group with mild preeclampsia(antepartum : $2.55{\pm}0.42{\mu}g/dl$, postpartum : $1.21{\pm}0.4{\mu}g/dl$) than the controls(antepartum : $0.61{\pm}0.2{\mu}g/dl$, postpartum $0.53{\pm}0.2{\mu}g/dl$) 3. During postpartum, carboxyhemoglobin concentration in preeclampsia reduced significantly from antepartum level, but, there was no difference between antepartum and postpartum carboxyhemoglobin concentrations among controls. 4. Bilirubin concentrations were similar in both groups.

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Efficiency and Side Effects of Sorafenib Therapy for Advanced Hepatocellular Carcinoma: A Retrospective Study by the Anatolian Society of Medical Oncology

  • Berk, Veli;Kaplan, Mehmet Ali;Tonyali, Onder;Buyukberber, Suleyman;Balakan, Ozan;Ozkan, Metin;Demirci, Umut;Ozturk, Turkan;Bilici, Ahmet;Tastekin, Didem;Ozdemir, Nuriye;Unal, Olcun Umit;Oflazoglu, Utku;Turkmen, Esma;Erdogan, Bulent;Uyeturk, Ummugul;Oksuzoglu, Berna;Cinkir, Havva Yesil;Yasar, Nurgul;Gumus, Mahmut
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.12
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    • pp.7367-7369
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    • 2013
  • Background: Inoperable and metastatic hepatocellular carcinoma (HCC) is associated with a poor prognosis and low chemotherapeutic efficiency. Sorafenib is an oral multi-kinase inhibitor exerting its effects via the RAF/MEK/ERK pathway, vascular endothelial growth factor receptor (VEGFR) and platelet derived growth factor receptor beta (PDGFR-${\beta}$) tyrosine kinases. Randomized studies have shown a significant contribution of sorafenib to life expectancy and quality of life of cancer patients. The aim of the present study is to evaluate the efficacy and side effects of sorafenib therapy in Turkey. Materials and Methods: Data for 103 patients (82 males, 21 females) receiving sorafenib therapy in 13 centers from February 2008 to December 2012 were evaluated. Median age was 61 years and median ECOG performance status was 1 (range: 0-2). 60 patients (58%) had hepatitis B, 15 patients (15%) had hepatitis C infection and 12 patients (12%) had a history of alcohol consumption. All of the patients had Child scores meeting the utilization permit of the drug in our country (Child A). Results: A total of 571 cycles of sorafenib therapy were administered with a median of four per patient. Among the evaluable cases, there was partial response in 15 (15%), stable disease in 52 (50%), and progressive disease in 36 (35%). Median progression-free survival was 18 weeks and median overall survival was 48 weeks. The dose was reduced only in 6 patients and discontinued in 2 patients due to grade 3-4 toxicity, 18 patients (17%) suffering hand-foot syndrome, 7 (7%) diarrhea, and 2 (2%) vomiting. Conclusions: This retrospective study demonstrated better efficacy of sorafenib therapy in patients with advanced HCC compared to the literature while progression-free survival and overall survival findings were comparable. The side effect rates indicate that the drug was tolerated well. In conclusion, among the available treatment options, sorafenib is an efficient and tolerable agent in patients with inoperable or metastatic HCC.

Effects of Dry Eye Symptoms on Work Productivity and General Activity in Newly Building (신축건물에서 안구건조증이 작업생산성과 일상활동에 미치는 영향)

  • Kim, Hyojin;Park, Chan-Jung;Lim, Byung-Seo;Kim, Ho-Hyun
    • Journal of Korean Ophthalmic Optics Society
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    • v.19 no.3
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    • pp.389-396
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    • 2014
  • Purpose: The study examined dry eye symptoms of occupants in a newly constructed building and its effects on their work productivity and general activity. Methods: The study subjects were 33 office workers who spent more than eight hours per day on average in a new building constructed in the past three months. The indoor air quality of the new building was evaluated by measuring aldehydes, temperature and humidity. The level of dry eye symptoms was classified into normal, mild, moderate and severe by using the Ocular Surface Disease Index (OSDI). The experience of LASIK surgery, use of eye makeup, daily use time of a computer and smart-phone, and average daily working hours were also examined. The Work Limitation Productivity Questionnaire was used as the questionnaire about work productivity and general activity to measure the impairment level on a ten-point scale. Results: The concentration variation of formaldehyde in the office was $42.42{\pm}6.30{\mu}g/m^3$. The temperature and humidity were $26.2{\pm}0.70^{\circ}C$ and $40{\pm}1%$, respectively. The respondents with normal, mild, moderate and severe dry eye symptoms were 15.2%, 18.2%, 18.2% and 48.5%, respectively. The severity of dry eye symptoms and impairment of work productivity and general activity demonstrated high correlations of 0.599 and 0.655, respectively (p<0.001). Compared to the normal case, severe dry eye symptoms demonstrated significantly high impairment of work productivity and interruption of general activity (p<0.001). The case of serious dry symptoms showed the possibilities of having impairment level of work productivity and interruption of general activity above three points 3.26 times (p=0.032) and 2.25 times (p=0.045), respectively, higher than that of the normal case. Conclusions: It was confirmed that dry eye symptoms among office workers in a newly constructed building affects work productivity and general activity.

Predictive value of cobalt chloride solution for hypohidrosis with topiramate (약물 유발 소한증에서 cobalt chloride solution의 임상적 유용성)

  • Lee, Hyuk;Lee, Seung Hyun;Kim, Sun Jun
    • Clinical and Experimental Pediatrics
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    • v.49 no.11
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    • pp.1180-1185
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    • 2006
  • Purpose : The aims of this study were to verify the incidence of hypohidrosis and to determine the predictive value of noninvasive indicator test ($Neurocheck^{TM}$) for sweating after administration of topiramate in newly diagnosed pediatric epileptic patients. Methods : A total of 46 epileptic patients (22 boys; 24 girls) on topiramate treatment were evaluated in this study at the Department of Pediatrics, Chonbuk National University Hospital, from October 2004 to July 2005. We measured sweating functions using a noninvasive sweating test ($Neurocheck^{TM}$) before topiramate medication, and after 3 months when topiramate reached its target dosage. We performed a direct questionnaire survey for the hypohidrosis related symptoms during topiramate treatment. Results : The mean age was $7.8{\pm}3.2year$. The mean dosage of topiramate was $4.5{\pm}0.8mg/kg/day$. Among the patients, there were 40 complex partial seizures, one simple partial seizure, two partial seizures with secondarily generalization, two generalized seizures, and one Lennox-Gastaut syndrome case. Of the 46 epileptic patients, 17 patients (37.0 percent) experienced hypohidrosis and hypohidrosis related symptoms, 12 (26.1 percent) had facial flushing, four (8.7 percent) had heat intolerance, one (2.2 percent) had lethargy, but no one had anhidrosis. Among the 17 patients, the mild group numbered 12 and the severe group totalled five. Hypohidrosis by $Neurocheck^{TM}$ was diagnosed in 16 patients. The overall measures of agreement between $Neurocheck^{TM}$ and the survey was 76.5 percent. The specificity of this test was 89.7 percent. Patients who showed a time delay after medication, especially over 3 minutes, were seen only in the severe group. Conclusion : $Neurocheck^{TM}$ could be clinically useful to detect and predict topiramate induced hypohidrosis in pediatric epileptic patients. We recommend that patients who show a delay over 3 minutes in $Neurocheck^{TM}$ test after topiramate initiation should be monitored for hypohydrosis.