• Clinical and Experimental Reproductive Medicine
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• v.51 no.1
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• pp.28-41
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• 2024

Objective: Chronic scrotal hyperthermia (SHT) can lead to serious disorders of the male reproductive system, with oxidative stress playing a key role in the onset of these dysfunctions. Thus, we evaluated the impact of caffeine, a potent antioxidant, on cellular and tissue disorders in mice with chronic SHT. Methods: In this experimental study, 56 adult male NMRI mice were allocated into seven equal groups. Apart from the non-treated control group, all were exposed to heat stress. Two groups, termed "preventive" and "curative," were orally administered caffeine. The preventive mice began receiving caffeine immediately prior to heat exposure, while for the curative group, a caffeine regimen was initiated 15 consecutive days following cessation of heat exposure. Each treated group was subdivided based on pairing with a positive control (Pre/ curative [Cur]+PC) or a vehicle (Pre/Cur+vehicle). Upon conclusion of the study, we assessed sperm characteristics, testosterone levels, stereological parameters, apoptosis, antioxidant and oxidant levels, and molecular markers. Results: Sperm parameters, testosterone levels, stereological parameters, biochemical factors (excluding malondialdehyde [MDA]), and c-kit gene expression were significantly elevated in the preventive and curative groups, especially the former, relative to the other groups. Conversely, expression levels of the heat shock protein 72 (HSP72) and nuclear factor kappa beta (NF-κβ) genes, MDA levels, and apoptotic cell density were markedly lower in both caffeine-treated groups relative to the other groups, with more pronounced differences observed in the preventive group. Conclusion: Overall, caffeine attenuated cellular and molecular abnormalities induced by heat stress in the testis, particularly in the mice treated under the preventive condition.

• Clinical Endoscopy
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• v.55 no.3
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• pp.372-380
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• 2022

Background/Aims: Endoscopic resection has become the preferred treatment approach for select early esophageal adenocarcinoma (EAC); however, the epidemiology of early stage disease has not been well defined. Methods: Surveillance Epidemiology and End Results (SEER) data were analyzed to determine age-adjusted incidence rates among major epithelial carcinomas, including EAC, from 1973 to 2017. The percent change in incidence over time was compared according to tumor subtype. Early T-stage, node-negative EAC without metastasis was examined from 2004 to 2017 when precise T-stage data were available. Results: The percent change in annual incidence from 1973 to 2017 was 767% for EAC. Joinpoint analysis showed that the average annual percent change in EAC from 1973 to 2017 was 5.11% (95% confidence interval, 4.66%-5.56%). The annual percent change appeared to plateau between 2004 and 2017; however, early EAC decreased from 2010 to 2017, with an annual percent change of -5.78%. Conclusions: There has been a 7-fold increase in the incidence of EAC, which was significantly greater than that of the other major epithelial malignancies examined. More recently, the incidence of early EAC has been decreasing. Approximately one in five patients has node negative, potentially resectable early stage disease.

• Journal of Nutrition and Health
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• v.51 no.5
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• pp.386-399
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• 2018

Purpose: This study examined whether the supply of healthy Korean diets for 12 weeks is effective in improving the risk factors related to serum GGT and cardiovascular diseases in patients with hypertension and diabetes. Methods: This study selected 41 patients, who were treated with hypertension and diabetes. The Korean diet was composed of cooked-rice, soup, kimchi, and various banchan with one serving called bapsang, which emphasize proportionally high consumption of vegetables and fermented foods, moderate to high consumption of legumes and fish, and low consumption of animal foods. The control group was instead instructed to "eat and exercise as usual" while following the Korean Diabetes Association's dietary guidelines with an intake that can assist in glycemic control, maintain adequate weight, and meet the nutritional requirements. The Korean diet group (21 patients) were served three healthy Korean meals a day for 12 weeks, and the control group (20 patients, who trained in the diet guideline of diabetes) maintained their usual diabetic diet. The serum GGT, blood pressure, heart rate, glycemic control data, cardiovascular risk indicators, and changes in diet measured at the four visits (week 0, 4, 8, and 12) during the course of 12 weeks were compared and evaluated. Results: The serum GGT (p < 0.001), HbA1c (p = 0.004), heart rate (p = 0.007), weight (p = 0.002), Body Mass Index (p = 0.002), body fat mass (p < 0.001), body fat (%) (p < 0.001), and free fatty acid (p = 0.007) in the Korean diet group decreased significantly after the dietary intervention compared to the control group. The amount of intake of rice, whole grains, green vegetables, Kimchi, and soybean fermented food were increased significantly compared to the control group (p < 0.001). The Korean diet group showed significant decreases (p < 0.001) in the intake of animal protein, lipid, and cholesterol derived from animal foods compared to the control group but significant increases (p < 0.001) in the intake of total calories, folic acid, dietary fiber, sodium, potassium, and vitamins A, E, and C. Conclusion: In patients with hypertension and diabetes, it was confirmed that regular eating of a healthy Korean diet helps improve the risk factors for GGT and cardiovascular diseases.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.1 no.1
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• pp.107-114
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• 1998

Purpose: The purpose of our study is to provide useful information for me-asurement methods of childhood obesity and to provide clinical significance of bioelectrical impedance analysis. Methods: We measured height, weight, waist to hip ratio, skinfold thickness and bioelectrical impedance from 206 elementary students in Kwangju from May to July 1997. Results: In males; 1) There were statistically high correlations between tri-ceps skinfold thickness and body mass index (BMI), percentage of body fat (%BF), weight, Rohler index (RI), total fat weight (TFW), waist to hip (W/H) ratio, height, lean body mass (LBM) (all, p<0.001). 2) There were statistically high correlations between subscapular skinfold thickness and BMI, RI, weig-ht, %BF, TBW (all, p<0.001). 3) There were statistically high correlations between %BF and BMI, triceps skinfold thickness, RI, TFW, subscapular skinfold thickness, weight (all, p<0.001). In females; 4) There were statistically high correlations between triceps skinfold thickness and BMI, weight, LBM, height, %BF (all, p<0.001). 5) There were statistically significant correlations between subscapular skinfold thickness and BMI, weight, LBM, RI, height. 6) There were statistically high correlations between percentage of body fat and BMI, RI, triceps skinfold thickness. The percentage of body fat according to the bioelectrical impedance analysis highly correlated with that calculated by skinfold thickness in males (r＝0.57, p<0.01) and in females (r＝0.30, p<0.01). Conclusion: The results of our study suggests that bioelectrical impedance analysis is a useful method of estimating body fat in the childhood obesity.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.13 no.2
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• pp.146-153
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• 2010

Purpose: Recent studies have reported an increase in the incidence of community-acquired Clostridium difficile-associated disease (CA-CDAD) among children. There is an overall lack of information on CA-CDAD in the pediatric population. The aim of our study was to compare the epidemiologic and clinical features between CA-CDAD and hospital-acquired C. difficile-associated disease (HA-CDAD) in children. Methods: We retrospectively reviewed the medical records of all patients who were diagnosed with C. difficile-associated disease (CDAD) at Gil Hospital between April 2008 and March 2009. The diagnosis of CDAD was made when patients with gastrointestinal symptoms had positive results for C. difficile toxins A and B assay or stool culture. Results: Sixty-one (male, 32 and female, 29) patients were included. The mean age was 3.79${\pm}$4.54 years. Of the 61 patients, 22 (36.1%) were <1 year of age. Twenty-three patients (37.7%) had a history of antibiotic exposure in the previous 3 months. Forty-one patients (67.2%) were diagnosed with CA-CDAD. There were no significant differences in age, gender, symptoms, laboratory findings, recovery period, complications, and recurrence between the CA-CDAD and HA-CDAD groups. On the other hand, exposure to antibiotics was significantly more frequent among patients in the HA-CDAD group (p=0.005). Conclusion: This study suggests that the occurrence of CA-CDAD is increasing in the pediatric population, especially in younger children with no history of exposure to antibiotics and in outpatients. Awareness of the increasing incidence of CA-CDAD and prompt investigation of C. difficile in susceptible patients is needed to avoid misdiagnosis and for appropriate therapy.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.8 no.2
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• pp.157-163
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• 2005

Purpose: Dietary protein induced proctocolitis (DPIPC) can be considered as a cause of rectal bleeding or blood streaked stool in otherwise healthy-looking infants in the first several months of life. Failure to appreciate this entity may lead to inappropriate diagnostic or therapeutic intervention. This study aimed to ascertain the clinical features, treatment and prognosis of DPIPC. Methods: We reviewed 13 infants retrospectively, presented with bloody stool in early infancy. They were diagnosed as DPIPC clinically in Pusan National University Hospital from May 2002 to June 2004. Results: Seven males and six females were included. The mean age at onset of bleeding was $96.8{\pm}58.8days$. The mean frequency of hematochezia was $2.6{\pm}2.5$ times a day. Duration from onset of symptom to diagnosis was $35.5{\pm}55.0days$ and duration from onset of symptom to resolution of bleeding was $58.7{\pm}67.0days$. Nine (69.2%) were exclusively breast-fed infants and two (15.4%) were formula-fed infants. All but one infant did not have family history of other allergic diseases. A dietary history of ingestion of cow's milk, nut or shellfish was present in three mothers. Peripheral eosinophil count was normal to slightly elevated (total WBC count $10,555{\pm}3,145/mm^3$, relative eosinophil count $6.3{\pm}3.0%$, absolute eosinophil count $659.0{\pm}532.2/mm^3$). Sigmoidoscopy revealed lymphonodular hyperplasia with surrounding hemorrhagic spots in the rectosigmoid colon in 6 infants. Histopathologic finding of colonic biopsies in 5 infants showed chronic inflammation with lymphoid follicular hyperplasia (5 infants), crypt abscess (3 infants), or mild infiltration of eosinophils (less than 20/high power field) in the lamina propria. Spontaneous resolution of rectal bleeding occurred in all infants without dietary change or medicine. Conclusion: Most infants with DPIPC experience a very benign course and have spontaneous resolution of rectal bleeding without changes in the mother's diet. In the case of strong evidence for DPIPC we suggest deferring further invasive investigation and continuing breast feeding.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.8 no.2
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• pp.130-136
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• 2005

Purpose: The aim of this study was to evaluate the correlation among descriptions regarding one's stool, Bristol stool form scale and colon transit time (CTT) in children with gastrointestinal symptoms, along with the clinical significance of Bristol stool form scale. Methods: 489 patients treated in the pediatric department of Severance hospital with gastrointestinal symptoms between May 2002 to May 2004 were included. We analyzed their age, sex, verbal descriptions of stool, Bristol stool form types, and CTT measured by Metcalf's method. Results: 116 children were under 5 years of age, 202 children between 5.1~10, and 171 children 10 years of age or older. Their mean age was $8.2{\pm}3.9years$. Stools were described as loose in 65 children (13.3%), normal in 221 (45.2%), hard in 188 (38.4%), and mixed (loose+hard) in 15 (3.1%). According to Bristol stool form scale, 57 children(11.7%) were classified as type 1, 66 (13.5%) as type 2, 203 (41.5%) as type 3, 109 (22.3%) as type 4, 36 (7.4%) as type 5, 18 (3.7%) as type 6, and 1 (0.2%) as type 7. Their mean CTT was checked $35.9{\pm}19.5hours$. Though no significant relationship was observed between age and CTT (p=0.4), a significant relationship was noted among patient's stool description, Bristol stool form scale and CTT (p<0.001). However, concordance between stool description and Bristol stool form was relatively low in the loose stool group (29%) and normal stool group (37%) while high in the hard stool group (87%). Conclusion: Bristol stool form scale could be used in the estimation of CTT in clinical practice.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.8 no.2
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• pp.117-121
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• 2005

Purpose: Elevated AST/ALT level in rotavirus gastroenteritis have been reported. We found elevated creatine kinase (CK) in those children. This study was carried out to define the relationship of major clinical presentation, laboratory findings, and level of creatine kinase. Methods: A retrospective analysis was made for thirty patients who were diagnosed rotavirus gastroenteritis from Jan 2001 to Mar 2005 in Department of Pediatrics, Gyeongsang National University Hospital. Serum creatine kinase was checked for the evaluation of high aminotransferase level among the patients. Results: Fourteen patients (8 males, 6 females) with high creatine kinase activity were included in this study. The mean age was $1.46{\pm}1.24year$ of age. The mean level of AST, ALT and CK were $127.5{\pm}136.2IU/L$, $126.1{\pm}154.3IU/L$, and $542.8{\pm}624.6IU/L$, respectively. Electrophoresis of CK isoenzyme was performed in four of them and the results revealed elevated CK-MM fraction (96~100%). Three of them revealed high serum creatine kinase acitivity (>1,000 IU/L) without acute renal failure and other symptom. However, none of them had muscular pain or trauma history. Elevated creatine kinase activity did not correlate with clinical implications (age, sex, vomiting, diarrhea, fever, symptom of URI, degree of dehydration or seizure) or laboratory findings. Conclusion: In this study, we found that serum creatine kinase acitivity also was elevated in infants with rotavirus gastroenteritis. This data support muscular damage due to rotavirus, but could not prove the mechanism of increased serum creatine kinase activity.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.3 no.1
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• pp.1-8
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• 2000

Purpose: This study was undertaken to evaluate the clinical features and complication such as esophageal stricture in children with corrosive esophagitis. Methods: We retrospectively reviewed medical records of 31 children who accidentally ingested corrosive materials and visited to emergency room of Chonnam National University Hospital from Jan. 1992 to Dec. 1999. Twenty-one children were examined by upper gastrointestinal (UGI) endoscopy to evaluate location and severity of caustic injury. Results: 1) Among 31 patients, there were 20 males and 11 females and the ratio of male to female was 2:1. Average age at diagnosis was 2.3 years (12 months to 9.8 years). Twenty-seven (87.1%) patients were accidentally ingested vinegar. 2) Initial presenting symptoms were dysphagia (54.8%), vomiting (48.3%), chemical burn on lips and skin (45.2%), excessive salivation (45.2%), coughing and respiratory grunting (32.3%) and aspiration pneumonia (9.8%). 3) UGI endoscopic examination showed caustic injury in 17 children: grade I in 8, grade II in 7 and grade III in 2. The region of caustic injury was proximal esophagus in 5, distal esophagus in 3, entire esophagus in 9 and stomach in 6. 4) Corrosive esophageal strictures developed in 6 children (19.4%) and gastric outlet stricture in 1 (3.2%). All of them showed grade II or III caustic injury on endoscopic examination. Conclusion: The development of esophageal stricture was related to the severity of the caustic injury. Early UGI endoscopic examination in caustic ingestion seems to be useful for prediction of development of caustic stricture.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.6 no.2
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• pp.129-139
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• 2003

Purpose: The aim of the study was to evaluate the long-term outcome of glycogen storage disease (GSD) type 1 with particular reference to hepatic adenoma and hepatocellular carcinoma, and to analyze risk factors affecting the development of hepatic adenoma in GSD type 1. Methods: Forty-three GSD type 1 patients (31 males and 12 females, mean age $13.9{\pm}6.4$ years) were analyzed retrospectively. Hepatic adenoma was detected on abdominal USG and diagnosed on histologic examination. Clinical profiles were compared between patients with hepatic adenoma (n=16) and age-matched controls without hepatic adenoma (n=16). Results: 1) Of 43 GSD type 1 patients, 16 (37.2%) had hepatic adeoma. Hepatic adenoma was detected at the age of mean $14.2{\pm}4.1$ years (range: 7.9~25.7 years). Fourteen (87.5%) adenomas were multiple at detection. 2) Comparison of the clinical profiles between adenoma group and non-adenoma group revealed that age at first introduction of uncooked cornstarch treatment was significantly late in adenoma group compared with non-adenoma group ($9.1{\pm}5.2$ years vs. $3.0{\pm}1.8$ years, p=0.003). Portocaval shunt surgery was performed in 11 (68.8%) patients in adenoma group and 3 (18.8%) in non-adenoma group (p=0.004). Hepatic adenoma developed mean $5.8{\pm}4.2$ years after shunt operation. 3) One patient was diagnosed as hepatocellular carcinoma at the age of 25.7 years. Conclusion: Hepatic adenoma is an important late complication of GSD type 1 with the risk of malignant transformation. Early introduction of cornstarch therapy with strict metabolic control is needed to prevent the development of hepatic adenoma in GSD type 1.