PURPOSE: IL-6 is one of the cytokines which is important mediators of host response to stress and infection. But, little is known about the activities of IL-6 in neonates with complicated course. So, We measured Il-6 levels in cord blood serum and which were compared neonates with perinatal complication with healthy neonats. METHOD: In a prospective study, level of IL-6 were measured in cord blood serum from 29 neonates (38.8+/-2.66wks, 3075.52+/-669.37gm) by specific immunoassay (Quantikine Human IL-6 immunoassay, RandD systems Inc., D6050), who delivered in Wonkwang University Hospital from May 1995 to July 1995. Statistical significance was analyzed with Mann-Whitney U test. RESULT: 1) IL-6 serum level in cord blood did not differ in neonates born by varying type of delivery. 2) IL-6 serum levels in cord blood were not related to perinatal complications. 3) IL-6 serum levels in cord blood were significantly higher in the neonates with infectious complication(128.0+/-29.74pg/ml) than non-infecatious complication(54.63+/-11.63pg/ml, p<0.05) and in healthy neonates (49.46+/-20.89pg/ml, p<0.02) CONCLUSION: Levels of IL-6 in cord blood serum were elevated in neonates with infectious complication. So, prospective measurement of IL-6 in cord blood may be useful in infection of perinatal period.
Cytokines ; Fetal Blood* ; Humans ; Immunoassay ; Infant, Newborn* ; Interleukin-6* ; Prospective Studies

PURPOSE: To investigate the postoperative patterns of weight-gain in early infants with ventricular septal defects (VSDs), we analyze 48 patients who received primary surgical closure of the symptomatic VSDs during 6 months of age in the period of 1993 through 1995. METHODS: Forty-sixt infants met criteria for inclusion in the study. The mean follow up period was 14 months (3 to 36 months). Weight percentile was extrapolarated from data of the Korean boys and girls measured in 1985. The data was compared by one-group paired student t-test. RESULTS: The overall mortality rate of this study was 4% (2/48). No surviving patients required a second ventricular septal defect operation, and the majority no longer received anticongestive therapies. The mean percentile of the preoperative weight was 3.53. In postoperative follow up period, they grew steadily. But, the mean weight percentile was only 5.46 in age under 6 months. Mean 12 percentile was achieved in age of 6 to 8 months, hence 25.4 percentile in 9 to 12 months, 33.5 percentile over 12 months, 64.8 percentile over 24 months of age. The weighing pattern of the patients with smaller defect was similar in 24 patients (52%) with large VSD, which size were same or larger than diameter of the aortic root. CONCLUSIONS: This study indicated that the patients under 6 months who have undergone primary surgical closure of the symptomatic large ventricular septal defects could gain the weight normally in postoperative period. Although the weight-gain was not sufficient when the age was under 12 months, It became normal pattern of weighing in age over 12 months.
Female ; Follow-Up Studies ; Heart Septal Defects, Ventricular* ; Humans ; Infant* ; Mortality ; Postoperative Period

PURPOSE: To investigate the postoperative patterns of weight-gain in early infants with ventricular septal defects (VSDs), we analyze 48 patients who received primary surgical closure of the symptomatic VSDs during 6 months of age in the period of 1993 through 1995. METHODS: Forty-sixt infants met criteria for inclusion in the study. The mean follow up period was 14 months (3 to 36 months). Weight percentile was extrapolarated from data of the Korean boys and girls measured in 1985. The data was compared by one-group paired student t-test. RESULTS: The overall mortality rate of this study was 4% (2/48). No surviving patients required a second ventricular septal defect operation, and the majority no longer received anticongestive therapies. The mean percentile of the preoperative weight was 3.53. In postoperative follow up period, they grew steadily. But, the mean weight percentile was only 5.46 in age under 6 months. Mean 12 percentile was achieved in age of 6 to 8 months, hence 25.4 percentile in 9 to 12 months, 33.5 percentile over 12 months, 64.8 percentile over 24 months of age. The weighing pattern of the patients with smaller defect was similar in 24 patients (52%) with large VSD, which size were same or larger than diameter of the aortic root. CONCLUSIONS: This study indicated that the patients under 6 months who have undergone primary surgical closure of the symptomatic large ventricular septal defects could gain the weight normally in postoperative period. Although the weight-gain was not sufficient when the age was under 12 months, It became normal pattern of weighing in age over 12 months.
Female ; Follow-Up Studies ; Heart Septal Defects, Ventricular* ; Humans ; Infant* ; Mortality ; Postoperative Period

PURPOSE: Serum level of the aminotransferase is the most common test in use to assess hepatocellular injury and are sensitive test of hepatocyte necrosis, but both AST and ALT level in serum rise in a variety of hepatic disorders. Some clinical study reports that AST/ALT ratio was possible to predict prognostic outcome of infants with liver disease. We have tried to assess whether AST/ALT ratio is valuable or not for predict prognosis of hepatitis and differentiate cause of it. METHODS: Serum AST, ALT, and AST/ALT ratio were evaluated in the infants with acute hepatitis. They were grouped into 12 patients with Hepatitis B surface antigen positive only(group I), 23 patients with Hepatitis B surface antibody positive only(group II), and 12 patients with not-known cause of hepatitis(group III). The 24 patients were able to follow-up of AST and ALT for 2 months. They are grouped into 12 patients with normalized AST and ALT within 2 months(group A) and 12 patients not normalized within 2 months(group B). RESULTS: 1)There were no statistical difference of mean serum level of AST and ALT that were tested on admission day, one week and 2 week of admission respectively among the group I, II, and III. 2)The value of AST/ALT ratio were increased from 0.6 on admission day to 0.9 after 2 week of admission in group I(p<0.05), decreased from 1.1 to 0.8 in group II. It were not changed in group III. 3)The mean values of AST/ALT ratio were not statistically different in group A and B. 4)The mean values of serum alkaline phosphatase, total bilirubin, and prothrombin time were not statistically different among these groups, if we exclude two cases of cholestatic jaudice, one case of acute fulminant hepatitis, and one case of hepatitis C from these groups. CONCLUSIONS: On the basis of this study, we concluded that progression of hepatitis and damage of hepatic cell was different according to the cause of hepatitis. AST/ALT ratio of the acute phase hepatitis were not able to reflect the time duration of normalization of AST and ALT and it was not related to etiology of hepatitis. For predict prognosis of infant with acute hepatitis, long term follow up is needed in many more cases of infants with acute hepatitis.
Alkaline Phosphatase ; Bilirubin ; Follow-Up Studies ; Hepatitis B ; Hepatitis B Surface Antigens ; Hepatitis C ; Hepatitis* ; Hepatocytes ; Humans ; Infant ; Liver Diseases ; Necrosis ; Prognosis ; Prothrombin Time

Carcinosarcoma is a rare malignant neoplasm consisting of both epithelial and nonepithelial components, that is, carcinoma and sarcoma in the same tumor. Since Queckenstedt reported the case of carcinosarcoma of the stomach in 1904, only 30 cases have been reported. We present a case of carcinosarcoma and adenocarcinoma of the stomach in 63-year-old man with the review of the literature.
Adenocarcinoma* ; Carcinosarcoma* ; Humans ; Middle Aged ; Sarcoma ; Stomach*

PURPOSE: In the present study, the volume of hard exudates (HEs) was quantitatively measured using optical coherence tomography (OCT) and the agreement and correlation with area of HEs in fundus photography were analyzed. METHODS: The medical records of patients with diabetic macular edema who underwent focal laser treatment and were followed up more than 3 months were retrospectively evaluated. An automated customized program designed for measuring HE volume was used. The HEs in each OCT B-scan binary image were measured using 512 × 128 pixels, 6 mm × 6 mm OCT cube scans. The volume was measured by summing the segmented HEs in each 128 B-scan image. The area was measured in 6 mm x 6 mm fundus photography. The volume and area were measured before and 3 months after the treatment. The agreement of increase and decrease in HEs, and the correlation of volume and area of HEs were analyzed. RESULTS: A total of 35 patients (39 eyes) were included in the study. The volume was significantly reduced from 0.07978 to 0.02565 mm³ at 3 months (p < 0.001). The area was also significantly reduced from 15.35 to 8.60 mm² at 3 months (p < 0.001). The volume was decreased in 34 eyes and increased in 5 eyes. The area was decreased in 37 eyes and increased in 2 eyes. A significant correlation between volume and area was found (p < 0.001) as well as agreement between increase and decrease in volume and area. CONCLUSIONS: In the 3-dimensional quantitative volumetric analysis, the volume and area of HEs were correlated and the direction of increase and decrease was concordant. Considering the distribution of HEs in multiple layers of the retina, volumetric analysis could be considered a substitute for the analysis of HE area.
Exudates and Transudates ; Humans ; Macular Edema ; Medical Records ; Methods ; Photography ; Retina ; Retrospective Studies ; Tomography, Optical Coherence

PURPOSE: A completion thyroidectomy after less than total thyroidectomy is needed for the treatment of recurrent papillary thyroid carcinoma (PTC). The aim of this study is to evaluate the clinicopathological features and the postoperative complications of completion thyroidectomy for patients with recurrent PTC. METHODS: A total 94 PTC patients who had undergone prior less than total thyroidectomy underwent completion thyroidectomy for recurrence from March 1986 to June 2009. We retrospectively analyzed the clinicopathological features and postoperative complications. RESULTS: At the initial operation, the patients' mean age was 38.2 years old. Central node metastasis was found in 37 cases and extrathyroidal invasion was found in 12 cases. The mean interval time between the initial operation to the completion thyroidectomy was 76.6 months. Fifty six patients underwent completion thyroidectomy only and 38 underwent a completion thyroidectomy combined with a modified radical neck dissection. In the combined group, central neck node metastasis and extrathyroidal invasion at the time of the initial operation were significantly more frequent than those in the completion thyroidectomy only group. The postoperative complications were 14 cases of transient hypocalcemia and 8 cases of permanent hypocalcemia and there were no significant differences between the two groups. CONCLUSION: When performing completion thyroidectomy, it is important to check the lateral neck nodes for metastasis when central neck node metastasis or extrathyroidal invasion were present at the initial operation, and this can be done safely without severe complications even though it is combined with modified radical neck dissection.
Humans ; Hypocalcemia ; Neck ; Neck Dissection ; Neoplasm Metastasis ; Postoperative Complications* ; Recurrence ; Retrospective Studies ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy*

PURPOSE: A large bowel obstruction as a result of primary colorectal cancer has a poor outcome. A retrospective study was designed to verify the recurrence patterns and to determine the prognostic factors after a curative resection in patients with a completely obstructing colorectal cancer. METHODS: Eight hundred patients with stage II and III colorectal adenocarcinomas (37 patients with a complete obstruction and 763 patients without an obstruction) underwent curative surgery between 1989 and 1996 at the Asan Medical Center. The median follow-up period was 55 (3~107) months. RESULTS: Clinicopathologic variables, i.e. sex, serum carcinoembryonic antigen (CEA), Borrmann type, differentiation, and tumor stage in the two groups were similar. Patients with obstructing colorectal cancer were significantly older than those without an obstruction (61+/-14 vs. 56+/-12 years, P=0.02). Rectal cancers were more frequent in the non-obstructing cancers than in the obstructing cancers (P=0.02). The recurrence rate in the two groups was similar (obstructing vs. non-obstructing cancer, 27.0% vs. 28.0%). Ten patients with 12 recurrences were identified in 37 obstructing colorectal cancer patients, three with local recurrences (8.1%) and nine with distant metastasis (24.3%). The 5-year survival rate between the same stages was not different between the two groups (77.8% vs. 85.3% in stage II, 65.1% vs. 60.4% in stage III). Among the various clinicopathologic variables, neural invasion was strongly associated with a poor prognosis in obstructing colorectal cancer on multivariate analysis (P<0.05). CONCLUSION: Because the obstructing cancers and the non-obstructing colorectal cancers had a similar outcome, curative surgery appears to offer the best chance of a cure in stage II and III obstructing colorectal cancer.
Adenocarcinoma ; Carcinoembryonic Antigen ; Chungcheongnam-do ; Colorectal Neoplasms* ; Follow-Up Studies ; Humans ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis ; Rectal Neoplasms ; Recurrence ; Retrospective Studies ; Survival Rate

BACKGROUND/OBJECTIVES: Excessive sugar consumption may increase the risk for development of several diseases. Although average dietary sugar intake of Koreans is within the recommended level, an increasing trend has been found in all age groups. This study aimed to evaluate the population attributable fractions (PAF) to dietary sugar for disease and death in Korea, and to estimate the socioeconomic effects of a reduction in dietary sugar. MATERIALS/METHODS: The prevalence of sugar-sweetened beverages (SSB) overconsumption (≥ 20 g of sugar from beverages) was analyzed using the Korean National Health and Nutrition Examination Survey 2015. Disease-specific relative risks of excessive SSB consumption were obtained through reviewing previous studies. Using the prevalence of SSB overconsumption and each relative risk, PAFs for morbidity and mortality were calculated. Socioeconomic costs of diseases and death attributable to SSB overconsumption were estimated by using representative data on national medical expenditures, health insurance statistics, employment information, and previous reports. RESULTS: Disease-specific PAF to SSB consumption ranged from 3.11% for stroke to 9.05% for obesity and dental caries, respectively. Costs from disease caused by SSB overconsumption was estimated at 594 billion won in 2015. About 39 billion won was estimated to be from SSB consumption-related deaths, and a total of 633 billion won was predicted to have been saved through preventing SSB overconsumption. CONCLUSIONS: Sugars overconsumption causes considerable public burdens, although the cost estimates do not include any informal expenditure. Information on these socioeconomic effects helps both health professionals and policy makers to create and to implement programs for reducing sugar consumption.
Administrative Personnel ; Beverages ; Carbohydrates ; Dental Caries ; Dietary Sucrose ; Employment ; Health Expenditures ; Health Occupations ; Humans ; Insurance ; Korea ; Mortality ; Nutrition Surveys ; Obesity ; Prevalence ; Public Health ; Stroke

BACKGROUND/AIMS: Transient lower esophageal sphincter relaxation (tLESR) is the main cause of gastroesophageal reflux (GER) in both healthy subjects and patients with GER disease. Unfortunately, we have no data on tLESR and its relationship with GER in Korea. Therefore, this study was performed to evaluate the characteristics of tLESR in Korean subjects and the mechanisms of GER after Korean meals. METHODS: Eight healthy volunteers (8 men, 23 to 25 yrs) received a Korean meal (laver-rolled rice, fried egg, sweet rice juice, 640 Kcal). A mylohyoid electromyogram, LES pressure using a Dent sleeve and esophageal pH were simultaneously recorded for 1 hour while fasting and 3 hours after the meal. We compared the manometric profile of swallow-induced LES relaxation (sLESR) with the manometric profile of tLESR and evaluated the frequency of tLESR and reflux episodes, and their relationship. RESULTS: Compared with sLESR, tLESR showed longer time onset to completion, slower relaxation rate, longer duration of relaxation, and a lower nadir pressure. Incidence of tLESR increased after the meal, which was mostly accompanied by GER. Also, the frequency of GER increased after the meal, which mostly occurred during tLESR. CONCLUSIONS: Our results suggest that tLESR is a main cause of GER in healthy Korean adults, which is a similar result to studies of Westerners.
Adult* ; Esophageal Sphincter, Lower* ; Fasting ; Gastroesophageal Reflux ; Healthy Volunteers ; Humans ; Hydrogen-Ion Concentration ; Incidence ; Korea ; Male ; Meals ; Ovum ; Relaxation*