• Journal of Environmental Health Sciences
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• v.42 no.3
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• pp.196-204
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• 2016

Objectives: Aluminum is well known as a potent neurotoxicant. There are many reports that aluminum can be toxic to humans and to animals. However, there are only few studies on the assessment of aluminum exposure among humans in Korea. Therefore, the aim of this study was to evaluate current aluminum concentrations among the adult population in regions of Korea. Methods: We selected 439 adults aged 20-89 years from the Busan-Ulsan-Gyeongnam region and certain other sites. Blood aluminum concentrations were analyzed using inductively-coupled plasma mass spectrometry (ICP/MS). The geometric means (GM) and 95% confidence intervals (CI) of aluminum concentrations were calculated, and we also confirmed the proportion of excess of the aluminum reference value. Results: Total GM (95% CI) of aluminum levels was 14.26 (13.43-15.14) ppb. Levels among males (15.58 [14.09-17.22] ppb) were higher compared to among females (13.51 [12.54-14.55] ppb), and levels increased with subject age from 40 years and over. Three point one nine percent of the subjects exceed the reference value of 50 ppb. Lastly, aluminum concentration has a log-normal distribution with lnN (x; 2.89, 0.642), x>0. Conclusion: In the present study, we evaluated the distribution of blood aluminum concentrations among the normal population in Korea, and we found some adults exceeding the reference levels. However, in order to compare the results with other studies, an extended study including measurement of serum aluminum level is required. In addition, further research on various population groups, including occupational exposure of workers, is required.

• Journal of Korean Neurosurgical Society
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• v.30 no.4
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• pp.430-436
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• 2001

Objective : The proliferative potential of intracranial glioma affects the histological malignancy and prognosis of patients with these tumors. In this study, we present the relationship between MIB-1 labeling index(LI) and clinical variables which might play the major role in determining the prognosis of patient with astrocytic tumors. Patients and Methods : Excised tumor specimens from a total of 52 patients were stained to detect monoclonal MIB-1-Ki-67 antibody by avidin-biotin complex immunohistochemistry. The MIB-1 LI was evaluated with histological grades, demograpghic data, and survival time. The statistical significance of their correlation was analyzed by Pearson correlation test. Results : The 52 patients included 30 male patients and 22 female patients. The tumors according to the criteria of the World Health Organization(WHO) classification were verified as pleomorphic xanthoastrocytoma in one, pilocytic astrocytomas 4, astrocytomas 1, anaplastic astrocytomas 3, and glioblastomas 31. MIB-1 LI in astrocytic ttumors showed no correlation with age and gender. However, the patients under 10 years had the longest survival time, whereas short survival time was observed in the older patients. The mean MIB-1 LI of different tumor grades were as follows : pleomorphic xanthoastrocytoma, $4.40{\pm}0.00$ ; pilocytic astrocytoma, $4.53{\pm}3.09$ ; astrocytoma, $5.50{\pm}6.03$ ; anaplastic astrocytoma, $12.68{\pm}12.50$ ; Glioblastoma, $21.31{\pm}19.63$. Although the levels of MIB-1 LI were varied in individual tumors, the MIB-1 LI was increased in parallel with the histological grades. Glioblstomas showed significantly higher MIB-1 LI compared with that of anaplastic astrocytomas and low grade astrocytomas (p = 0.001). The mean survival time of entire group of patients was also well correlated with MIB-1 LI in astrocytic tumors(p = 0.015). Moreover, the mean survival time of the entire group of patients with Lis < 10 was $125.33{\pm}113.57weeks$, and the mean survival of those with $Lis{\geq}10$ was $60.71{\pm}62.58weeks$. This difference was also statistically significant(p = 0.004). Conclusion : The results of this study suggest that MIB-1 LI correlates with histological grades and might play a significant role in predicting the survival of patients with astrocytic tumors.

• Journal of Korean Neurosurgical Society
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• v.29 no.2
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• pp.180-187
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• 2000

Objective : A number of evidence have suggested a pivotal role of matrix metalloproteinases(MMP) on the degeneration of intervertebral disc. Proteins of intervertebral disc mainly consist of collagen and proteoglycan. These proteins can be destructed by MMP, resulting in changes of main collagen type and degeneration of matrix proteins. The present study was to determine the different effects of MMP-1 and MMP-2 on the degenerative spinal diseases, resulting from aging process. Clinical Materials & Methods : Thirty-one patients were randomly selected among 350 patients whose discs were resected during operation from March 1997 to February 1999. Patients were divided into two groups: group I with spinal stenosis and group II with herniated intervertebral disc. Group II was subdivided into the ruptured(Group Iia) and unruptured(Group Iib). Increases in MMP-1 immunopositive cells were observed in both groups, as evidenced by immunocytochemical staining. However, in marked contrast, the number of MMP-2 immunopositive cells were only seen in group II. There was no significant difference between Group IIa and Group IIb. The MMP-2 immunopositive cells were increased in the anulus fibrosus of ruptured(Group Iia) more than unruptured(Group Iib), but statistically it was not significant. In addition, the immunopositivity of MMP-1 and MMP-2 was proportional to patients's age. Conclusion : These results strongly suggests the possible involvement of MMP-2, but not MMP-1 in progressive herniated intervertevral disc.

• Journal of Korean Neurosurgical Society
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• v.29 no.7
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• pp.910-917
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• 2000

Introduction : The management of chordomas and chondrosarcomas in the skull base is difficult due to the critical location, locally aggressive nature, and high recurrence rate. The authors present the effectiveness of surgical removal and radiation therapy on survival and tumor recurrence. Material and Methods : Thirty cranial base chordomas and chondrosarcomas from 23 patients(14 patients with chordomas and 9 patients with chondrosarcomas) were operated in our institution between 1985 and 1998. There were 15 men and 8 women, with a mean age of 40.7 years. The largest diameter of tumors ranged from 15 to 70mm (mean 41.5). The extent of surgical removal was subtotal or total in a half(15 operations). In nineteen operations, tumors were removed by conventional approaches and skull base approaches were applied in 11 operations. Postoperative radiation therapy was performed in 16(70%) patients. The mean duration of follow up is 50 months(1- 156 months). Results : The 3- and 5-year survival rates(YSR) of overall patient are 75% and 67%, respectively. The analysis showed that 1) skull base approach to chordomas and chondrosarcomas showed a tendency to remove more portion of the tumors(p＝0.058) but leave more frequent incidence of new deficits(p＝0.047) : 2) larger tumor diameter af-fected the extent of removal(p＝0.028) : 3) the extent of removal seemed to be the determining factor for overall survival and recurrence-free survival(the 5-YSR and RFSR of subtotal or total removal group are 92% and 80% vs. 40% of partial removal or biopsy group) : 4) conventional radiation therapy improved patient survival(5-YSR of patients who received RT is 76% whereas 5-YSR of those who didn't receive RT is 43%) but failed to prolong long-term recurrence-free survival. Conclusion : The extent of removal and postoperative radiation therapy are determining factors of patients' survival in skull base chordomas and chondrosarcomas. However, none of these factors significantly influenced the survival in multivariate analysis. Aggressive surgical removal of more than subtotal resection combined with postoperative radiation therapy seems to be the choice of therapy in the management of these tumors.

• Journal of Korean Neurosurgical Society
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• v.61 no.4
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• pp.450-457
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• 2018

Objective : Very large (20-25 mm) and giant (${\geq}25mm$) intracranial aneurysms have an extremely poor natural course, and treatment of these aneurysms remains a challenge for endovascular and surgical strategies. This study was undertaken to describe our experiences of endosaccular treatment of very large and giant intracranial aneurysms with parent artery preservation. Methods : From January 2005 to October 2016, twenty-four very large or giant aneurysms in 24 patients were treated by endosaccular coil embolization with parent artery preservation. Nine (37.5%) aneurysms were ruptured and 15 were unruptured, and of these 15, 11 were symptomatic cases and 4 were incidentally discovered. The cohort comprised 17 women and 7 men of mean age 58.5 years (range, 26-82). Mean aneurysm size was 26.0 mm (range, 20-39) and 13 of the 24 aneurysms were giant. Results : Immediate angiographic results were complete occlusion in nine (37.5%) cases, remnant neck in six (25.0%), and remnant sac in nine (37.5%). Overall procedural related morbidity and mortality rates were 12.5% and 4.2%, respectively. Angiographic follow-up was available in 16 patients (66.7%). Mean and median follow-up periods were 27.2 (range, 2-77) and 10.5 months, respectively. In 12 cases (12/16, 75%) stable occlusion was achieved, four cases (4/16, 25%) had recanalized, and two of these were retreated with additional coiling. At clinical follow-up of the nine ruptured cases, three patients (33.3%) achieved a good clinical outcome (Glasgow outcome scale [GOS] score of 4 or 5), two (22.2%) a poor outcome (GOS score of 2 or 3), and four patients (44.4%) expired (GOS 1). On the other hand, of the 15 unruptured cases, 13 patients (86.7%) achieved a good clinical outcome (GOS 4 or 5), one patient a poor outcome (GOS score of 2 or 3), and one patient expired (GOS 1). Conclusion : The present study shows endosaccular treatment of very large or giant intracranial aneurysms with parent artery preservation is both feasible and effective with acceptable morbidity and mortality.

• Clinical and Experimental Pediatrics
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• v.49 no.6
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• pp.648-652
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• 2006

Objective : $^{99m}Tc$-dimercaptosuccinic acid(DMSA) scan is considered to be the most sensitive examination for detection of renal scars. However, because of its high radiation exposure to the kidney and its limited usefulness for patients with low grade vesicoureteral reflux(VUR), some authors have suggested that DMSA scans should be reserved primarily for children with VUR grade 3 and above. The aim of this study was to reevaluate the necessity of DMSA scans as a screening test in infants without reflux or with low grade reflux. Methods : In this retrospective study, 189 infants(mean age : 6.2 months) diagnosed as UTI were enrolled. Voiding cystourethrogram(VCUG), DMSA scan and renal ultrasonography were performed within 1 month of UTI. VUR grade was classified into three subgroups; low grade(grade 1-2), moderate grade(grade 3), and high grade(grade 4-5), respectively. Results : Renal defects were present in 67 of 189 infants, and 82 of the 378 renal units. The incidence of renal defects was significantly correlated with VUR grade(P<0.01); 28 percent without reflux, 38 percent with low grade, 53 percent with moderate grade, 100 percent with high grade, respectively. However, there was no significant differences in incidence of renal defects between the low grade and moderate grade group. Conclusion : In this study, renal defects were found in quite high percentages; 28 percent patients without reflux and 38 percent patients with low grade VUR, respectively. Moreover, there was no significant difference in the incidence of renal defects between the low grade and moderate grade groups. Therefore, DMSA scan should be performed for infants with UTI as a screening test regardless of the presence of VUR.

• Archives of Plastic Surgery
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• v.38 no.6
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• pp.791-797
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• 2011

Purpose: Angiosarcoma is a rare and aggressive malignant soft tissue tumor. Due to a lack of the established optimal treatment modalities, however, an extensive resection followed by an early detection has been reported to be the best treatment of choice. We analyzed the clinical course of six patients, hence attempted to contribute to making a treatment plan for patients with angiosarcoma. Methods: Six patients who have been surgically treated between 2005 and 2010 are included. Through a retrospective analysis of the medical records, we evaluated the pattern of disease detection, a past history, time span between the detection and the primary surgery, surgical treatment modalities, time span between the primary surgery and the recurrence/metastasis, the sites of metastasis and the secondary treatment modalities. Results: The mean age of patients was 70.5 years; all male; and the sites were the scalp. Four patients underwent the reconstruction using a local flap with a skin graft and two patients using a free flap. The mean period elapsed until the primary operation since the identification was 7.3 months and until a recurrence or a metastasis occurred following the primary operation was 12 months. Four patients had pulmonary metastasis. As a secondary therapy, four patients underwent the radiotherapy and one was treated with the chemotherapy. At the present, five patients died and one undergoes a monitoring of the clinical course. Conclusion: It would be mandatory to shorten the length of hospital stay and to return patients to their daily lives as the earliest as possible using relatively simpler surgical methods, thus attempting to give them opportunity to resume their previous normal life.

• Archives of Plastic Surgery
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• v.47 no.5
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• pp.460-466
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• 2020

Background Sternoclavicular joint (SCJ) osteomyelitis is a rare pathology requiring urgent intervention. Several operative approaches have been described with conflicting reports. Here, we present a multi-institutional study utilizing multiple surgical pathways for SCJ reconstruction. Methods A multi-institutional retrospective cohort study was conducted to identify patients who underwent surgical repair for sternoclavicular osteomyelitis between 2008 and 2019. Patients were stratified according to reconstruction approach: single-stage reconstruction with advancement flap and delayed-reconstruction with flap following initial debridement. Demographics, operative approach, type of reconstruction, and postoperative outcomes were analyzed. Results Thirty-two patients were identified. Mean patient age was 56.2±13.8 years and 68.8% were male. The average body mass index (BMI) was 30.0±8.8 kg/㎡. The most common infection etiologies were intravenous drug use and bacteremia (both 25%). Fourteen patients (43.8%) underwent one-stage reconstruction and 18 (56.2%) underwent delayed two-staged reconstruction. Both single and delayed-stage groups had comparable rates of reinfection (7.1% vs. 11.1%, respectively), surgical site complications (21.4% vs. 27.8%), readmissions (7.1% vs. 16.6%), and reoperations (7.1% vs. 5.6%; all P>0.05). The single-stage reconstruction group had a significantly lower BMI (26.2±5.7 kg/㎡ vs. 32.9±9.1 kg/㎡; P<0.05) and trended towards shorter hospital length of stay (11.3 days vs. 17.9 days; P=0.01). Conclusions Both single and delayed-stage approaches are appropriate methods with comparable outcomes for reconstruction for SCJ osteomyelitis. When clinically indicated, a single-stage reconstruction approach may be preferable in order to avoid a second operation as associated with the delayed phase, and possibly shortening total hospital length of stay.

• Korean Journal of Poultry Science
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• v.40 no.2
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• pp.147-155
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• 2013

This study was conducted to evaluate the effects of dietary supplementation of vitamin C or E on the expressions of endoplasmic reticulum (ER) stress, lipid and glucose metabolism associated genes in broiler chickens. A total of 216 one-day-old male broilers was randomly alloted to 4 treatments with 6 replicate pens per treatment and 9 broilers per pen for 35 days. The dietary treatments were control, vitamin C (control diet + ascorbic acid 200 mg/kg diet), vitamin E (control diet + ${\alpha}$-tocopherol 100 mg/kg diet), vitamin C + E (control diet + vitamin C 200 mg/kg + vitamin E 100 mg/kg), respectively. To evaluate gene expressions by quantitative real-time polymerase chain reaction, total RNA was extracted from the liver of the chicken at 35 days of age. Dietary supplementation of vitamins was significantly down-regulated the expression of stress marker genes including HSP70, HSP90, and HMGCR, as compared to the control (p<0.05). The expressions of ER stress associated genes also inhibited by supplementation of vitamins as well (p<0.05). Vitamin C supplementation suppressed the expression of lipid associated genes such as FASN, FATP1 and ACSL1. Vitamin supplementation did not affect the glucose transporters, GLUT2 and GLUT8, in the liver. The results of the present study indicated that dietary supplementation of vitamin C or E could be beneficial for the alleviating physiological stress in broiler chickens.

• Proceedings of the Korean Society for Bioinformatics Conference
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• 2003.10a
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• pp.26-51
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• 2003

Large scale protein interaction maps provide a new, global perspective with which to analyse protein function. PSIMAP, the Protein Structural Interactome Map, is a database of all the structurally observed interactions between superfamilies of protein domains with known three-dimensional structure in thePDB. PSIMAP incorporates both functional and evolutionary information into a single network. It makes it possible to age protein domains in terms of taxonomic diversity, interaction and function. One consequence of it is to predict the most important protein domain structure in evolution. We present a global analysis of PSIMAP using several distinct network measures relating to centrality, interactivity, fault-tolerance, and taxonomic diversity. We found the following results: ${\bullet}$ Centrality: we show that the center and barycenter of PSIMAP do not coincide, and that the superfamilies forming the barycenter relate to very general functions, while those constituting the center relate to enzymatic activity. ${\bullet}$ Interactivity: we identify the P-loop and immunoglobulin superfamilies as the most highly interactive. We successfully use connectivity and cluster index, which characterise the connectivity of a superfamily's neighbourhood, to discover superfamilies of complex I and II. This is particularly significant as the structure of complex I is not yet solved. ${\bullet}$ Taxonomic diversity: we found that highly interactive superfamilies are in general taxonomically very diverse and are thus amongst the oldest. This led to the prediction of the oldest and most important protein domain in evolution of lift. ${\bullet}$ Fault-tolerance: we found that the network is very robust as for the majority of superfamilies removal from the network will not break up the network. Overall, we can single out the P-loop containing nucleotide triphosphate hydrolases superfamily as it is the most highly connected and has the highest taxonomic diversity. In addition, this superfamily has the highest interaction rank, is the barycenter of the network (it has the shortest average path to every other superfamily in the network), and is an articulation vertex, whose removal will disconnect the network. More generally, we conclude that the graph-theoretic and taxonomic analysis of PSIMAP is an important step towards the understanding of protein function and could be an important tool for tracing the evolution of life at the molecular level.