This study compared activity factor, predicted resting metabolic rate (RMR), and nutrient intakes between athletic and non-athletic high school students in Gangwon-do. Fifty soccer players (30 males and 20 females; mean ages 16.7+/-1.0 years and 16.4+/-1.1 years, respectively) and 50 non-athletic (30 males and 20 females; mean ages 17.5+/-0.4 years and 16.4+/-1.1 years respectively) high school students were included. Anthropometric measurements included: weight and height, triceps skinfold, mid-arm circumference, and body fat. Prediction equations consisted of those from the Harris-Benedict, FAO/WHO/UNU, IMNA, Cunningham, Mifflin et al., and Owen et al. A one-day activity diary was collected by interview, and the 24-hour recall method was used to analyze nutrient intakes of subjects. The activity factors of the male and female athletic groups (2.23 and 2.16, respectively) were significantly higher than those (1.52 and 1.46, respectively) of the non-athletic group. There was only a significant difference in RMR by use of the Cunningham's equation between two groups. For the males, almost all nutrient intakes of the athletic group (except carbohydrate, iron, vitamin B1, B6, and niacin) of athletic group were significantly higher than those of the non-athletic group. The female athletic group showed significantly higher nutrient intakes with the exception of most vitamins. These results suggest that assessments of energy balance between energy intake and energy expenditure by employing RMR and activity factors would be useful to prevent and treat obesity in high school athletes. In addition, the Cunningham's equation would be appropriate for predicting their energy needs.
Adipose Tissue ; Athletes ; Energy Intake ; Energy Metabolism ; Female ; Humans ; Iron ; Male ; Obesity ; Soccer ; Sports ; Thiamine ; Vitamins

This study compared activity factor, predicted resting metabolic rate (RMR), and nutrient intakes between athletic and non-athletic high school students in Gangwon-do. Fifty soccer players (30 males and 20 females; mean ages 16.7+/-1.0 years and 16.4+/-1.1 years, respectively) and 50 non-athletic (30 males and 20 females; mean ages 17.5+/-0.4 years and 16.4+/-1.1 years respectively) high school students were included. Anthropometric measurements included: weight and height, triceps skinfold, mid-arm circumference, and body fat. Prediction equations consisted of those from the Harris-Benedict, FAO/WHO/UNU, IMNA, Cunningham, Mifflin et al., and Owen et al. A one-day activity diary was collected by interview, and the 24-hour recall method was used to analyze nutrient intakes of subjects. The activity factors of the male and female athletic groups (2.23 and 2.16, respectively) were significantly higher than those (1.52 and 1.46, respectively) of the non-athletic group. There was only a significant difference in RMR by use of the Cunningham's equation between two groups. For the males, almost all nutrient intakes of the athletic group (except carbohydrate, iron, vitamin B1, B6, and niacin) of athletic group were significantly higher than those of the non-athletic group. The female athletic group showed significantly higher nutrient intakes with the exception of most vitamins. These results suggest that assessments of energy balance between energy intake and energy expenditure by employing RMR and activity factors would be useful to prevent and treat obesity in high school athletes. In addition, the Cunningham's equation would be appropriate for predicting their energy needs.
Adipose Tissue ; Athletes ; Energy Intake ; Energy Metabolism ; Female ; Humans ; Iron ; Male ; Obesity ; Soccer ; Sports ; Thiamine ; Vitamins

One hundred and thirty five patients with carcinoma of the nasopharyx were treated by radiation therapy in the Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University between August 1977 and July 1987. Of the 30 patients omitted: 8 had distant metastases at initial diagnosis or during radiotherapy; 18 patients refused or did not received a full course of radiation therapy, and four had not been confirmed histologically. The remaining 105 patients were analyzed to determine the incidence and patter of distant metastases. Diagnosis of distant metastases was made based on clinical signs and radiography, even though histologic confirmation was not made. Twenty-six patients developed distant metastases after definite irradiation of nasopharyx and neck, an incidence rate of 24.8%. The common sites of distant metastases were, in descending order, bone, lung, liver, and brain. There was a strong correlation between Ho's N stage and distant metastases rate. But sex, age, histologic subtype (squamous cell and undifferentiated cell), AJC T and N stage, treatment modalities (radiotherapy alone and radiotherapy combined with chemotherapy) were not significant. Of those patients who developed distant metastases, 80.8% were discovered within 2 years of their radical radiotherapy. The prognosis for nasopharyngeal carcinoma patients developing distant metastases was poor: median survival was nine months and 80% of those patients died within two years of the initial diagnosis of distant metastasis.
Brain ; Diagnosis ; Humans ; Incidence ; Liver ; Lung ; Neck ; Neoplasm Metastasis* ; Prognosis ; Radiation Oncology ; Radiography ; Radiotherapy

OBJECTIVES: This study was to assess management outcome of patient undergoing decompressive craniectomy for space-occupying cerebral infarction refractory to medical treatment and to identify risk factors associated with unfavorable outcomes. PATIENTS AND METHODS: Between January 1999 and June 2004, total 20 patients were analyzed. The preoperative consciousness was rated using Glasgow Coma Scale (GCS). The clinical outcome was rated using Glasgow Outcome Scale (GOS) at 3 months follow up and divided into 2 groups;favorable outcome group (GOS> or =3) and unfavorable outcome group (GOS<3). The prognostic factors were analyzed multivariately. RESULTS: Fourteen patients were men and six patients were women (mean age, 58.7 yrs). Seventeen patients had right hemispheric infarction, and three patients had left hemispheric infarction. 16 patients had only middle cerebral artery (MCA) infarction, and 2 patients had combined anterior cerebral artery (ACA) or posterior cerebral artery (PCA) infarction respectively. Eleven patients showed anisocoria preoperatively. The mean time interval between symptom onset of infarction and operation was 61.5 hrs. 8 patients showed favorable outcome, and 12 patients showed unfavorable outcome. CONCLUSIONS: The existence of preoperative anisocoria and low preoperative GCS score were statistically significant prognostic factor related to unfavorable outcome.
Anisocoria ; Anterior Cerebral Artery ; Cerebral Infarction* ; Consciousness ; Decompressive Craniectomy* ; Female ; Follow-Up Studies ; Glasgow Coma Scale ; Glasgow Outcome Scale ; Humans ; Infarction ; Male ; Middle Cerebral Artery ; Posterior Cerebral Artery ; Risk Factors

To delineate the clinicopathological features of diffuse axonal injury in patients with diffuse cerebral injury, we reviewed 19 cases from a series of 726 brain autopsies performed during a recent ten-year period. The criteria for inclusion were loss of consciousness for more than 6 hours in closed head injury patients, and no development of a space-occupying lesion within 7 days of injury. The injury was more prevalent in males(70.6%), and in patients aged between 10 and 50 years(82.4%). The main cause was traffic accident(82.4%), and the patients, Glasgow coma scale score on admission after injury was between 3 and 7. CT or MRI performed within the first 7 days of injury disclosed either one or combined focal lesions in the cerebral white matter, corpus callosum and brain stem in 66.7% of cases, and no identifiable lesion in 33.3%. Axonal swellings are the histologic hallmark of diffuse axonal injury in closed head trauma. In this study, careful brain dissection and neuropathologic studies demonstrated these swellings in all autopsy brains. The immunohistochemical stain for neurofilament proteins(68kD, 160/200kD) is the most sensitive marker of axonal swelling, especially when a patient survives more than 12 hours after injury. However, a neurofilament protein(160/200kD) is also expressed in a few normal pyramidal neurons and axial dendrites. Bielschowsky stain also clearly delineates axonal swellings in patients who have survived more than 2 days after injury. Cerebral edema and the appearance of amyloid body are easily identifiable by Luxol fast blue-PAS stain. In patients who survive for 6 months after injury, axonal swellings are hardly identifiable; about 25% of cases are diagnosed by neuropathologic examination only. The above data indicate that for the diagnosis of diffuse axonal injury, careful gross examination and neuropathologic studies are important.
Amyloid ; Autopsy ; Axons ; Brain ; Brain Edema ; Brain Stem ; Corpus Callosum ; Craniocerebral Trauma* ; Dendrites ; Diagnosis ; Diffuse Axonal Injury* ; Glasgow Coma Scale ; Head Injuries, Closed ; Head* ; Humans ; Magnetic Resonance Imaging ; Neurons ; Unconsciousness

BACKGROUND/OBJECTIVES: Athletes generally desire changes in body composition in order to enhance their athletic performance. Often, athletes will practice chronic energy restrictions to attain body composition changes, altering their energy needs. Prediction of resting metabolic rates (RMR) is important in helping to determine an athlete's energy expenditure. This study compared measured RMR of athletic and non-athletic adolescents with predicted RMR from commonly used prediction equations to identify the most accurate equation applicable for adolescent athletes. SUBJECTS/METHODS: A total of 50 athletes (mean age of 16.6 +/- 1.0 years, 30 males and 20 females) and 50 non-athletes (mean age of 16.5 +/- 0.5 years, 30 males and 20 females) were enrolled in the study. The RMR of subjects was measured using indirect calorimetry. The accuracy of 11 RMR prediction equations was evaluated for bias, Pearson's correlation coefficient, and Bland-Altman analysis. RESULTS: Until more accurate prediction equations are developed, our findings recommend using the formulas by Cunningham (-29.8 kcal/day, limits of agreement -318.7 and +259.1 kcal/day) and Park (-0.842 kcal/day, limits of agreement -198.9 and +196.9 kcal/day) for prediction of RMR when studying male adolescent athletes. Among the new prediction formulas reviewed, the formula included in the fat-free mass as a variable [RMR = 730.4 + 15 x fat-free mass] is paramount when examining athletes. CONCLUSIONS: The RMR prediction equation developed in this study is better in assessing the resting metabolic rate of Korean athletic adolescents.
Adolescent* ; Athletes ; Athletic Performance ; Bias (Epidemiology) ; Body Composition ; Calorimetry, Indirect ; Energy Metabolism ; Humans ; Male ; Sports*

PURPOSE: The purpose of this study is to compare the treatment outcomes for locally advanced resectable hypopharyngeal cancer between organ-preserving chemoradiotherapy (CRT) and surgery followed by radiotherapy (SRT). MATERIALS AND METHODS: We reviewed 91 patients with stage III/IV hypopharyngeal squamous cell carcinoma treated with radiotherapy (RT). In the CRT group (n=34), 18 patients were treated with concurrent CRT and 16 patients with induction chemotherapy plus concurrent CRT. In the SRT group (n=57), six patients were treated with total laryngopharyngectomy, 34 patients with total laryngectomy (TL) and partial pharyngectomy (PP), and 17 patients with PP, which were followed by adjuvant radiotherapy (n=41) or CRT (n=16). The median RT dose was 70 Gy for CRT and 59.4 Gy for SRT. RESULTS: Five-year local control (84.1% vs. 90.9%), and disease-free survival (DFS, 51.0% vs. 52.7%) and overall survival (OS, 58.6% vs. 56.6%) showed no significant difference between the CRT and SRT groups. The functional larynx-preservation rate was higher in the CRT group (88.2% vs. 29.8%). Treatment-related toxicity, requiring surgical intervention, occurred more frequently in the SRT group (37% vs. 12%). In the SRT group, TL resulted in a significantly higher DFS than larynx-sparing surgery (63.9% vs. 26.5%, p=0.027). Treatment outcome of the SRT group improved when only patients with TL were considered (n=40); however, 5-year OS (67.1% vs. 58.6%, p=0.830) and DFS (63.9% vs. 51.0%, p=0.490) did not improve significantly when compared to the CRT group. CONCLUSION: Organ preserving CRT provided a treatment outcome that is comparable to SRT for locally advanced hypopharyngeal cancer, while offering an opportunity for functional larynx-preservation and reduced treatment-related toxicity.
Carcinoma, Squamous Cell ; Chemoradiotherapy* ; Disease-Free Survival ; Humans ; Hypopharyngeal Neoplasms* ; Induction Chemotherapy ; Laryngectomy ; Organ Preservation ; Pharyngectomy ; Radiotherapy ; Radiotherapy, Adjuvant* ; Treatment Outcome

PURPOSE: This study aims to abstract the differences of scores between the clinical instructors and standardized patients (SPs) in a clinical performance examination (CPX) using SPs and to correlate the concordance between the evaluation scores and the school records. METHODS: The CPX was administered in 2003 to a total of thirty-six fifth year medical students at Gachon Medical School. The examination consisted of four cases, and four stations were duplicated, each requiring a total of 7.5 minutes per station. Evaluation of the student' s performances was conducted by both clinical instructors and SPs using a formatted checklist. Results were analysed by t-test, agreement rates, and Pearson correlation. RESULT: The mean scores given out by the clinical instructors and the SPs for the newly developed case were significantly different, while those scores for pre-existing cases were not in the old cases. The correlation coefficients between these two evaluation groups were relatively high. And agreements between the two evaluation groups were 0.37~0.72. The mean scores among clinical instructors were not significantly different, but the correlation coefficients and agreement rates were relatively high. The correlation between the evaluation scores and school records did not correlate significantly. CONCLUSION: It is concluded that the CPX is a useful tool to measure the students' essential competences in areas of knowledge, skills and attitude during the subinternship stage. In conducting a successful CPX, it is crucial to reconsider the recycling of cases and the selection and training of SPs aside from the development of an objective checklist.
Checklist ; Clinical Competence ; Humans ; Recycling ; Schools, Medical* ; Students, Medical

PURPOSE: A single institute trial of combination chemotherapy, with paclitaxel and cisplatin, in patients with metastatic breast cancer, having failed previous combination chemotherapy, was performed. MATERIALS AND METHODS: Patients were only eligible for this study if there disease had progressed, following treatment with previous chemotherapy, in either an adjuvant or a metastatic setting. Paclitaxel 175 mg/m2 was administered as a 3-hour continuous infusion on day 1, and cisplatin 80 mg/m2 was administered for 2 hours on day 2, with adequate hydration. This was repeated every 3 weeks, and continued until one of the following events occurred: disease progression, unacceptable adverse effect or treatment refusal by the patient. Intercurrent palliative radiotherapy, or concurrent hormonal therapy, was permitted, depending on each patient's status. All the endpoints were evaluated under the principle of intention to treat analysis. RESULTS: A total of 24 patients entered the study, and 18 had at least one measurable lesion, but 6 did not. The objective response rate of the 18 patients was 50%(9/18). Two were complete responses and seven showed partial responses. The median response duration, progression free and overall survival were 5.3 months (range, 4~18), 6 months (95% CI, 5~7) and 12 months (95% CI, 7~17), respectively. 67% of the planned dose was administered. Out of a total 135 cycles administered, about 20% of cycles showed grade 3 or 4 leukopenia and 7% showed grade 3 thrombocytopenia. Two patients suffered from pneumonia, and one experienced neutropenic fever. Mucositis, greater than grade 3, existed in three cases. No treatment related deaths were reported. CONCLUSION: The combination chemotherapy, with paclitaxel and cisplatin, was active in the treatment of metastatic breast cancer patients having failed previous chemotherapy.
Breast Neoplasms* ; Breast* ; Cisplatin* ; Disease Progression ; Drug Therapy ; Drug Therapy, Combination* ; Fever ; Humans ; Intention to Treat Analysis ; Leukopenia ; Mucositis ; Paclitaxel* ; Pneumonia ; Radiotherapy ; Thrombocytopenia ; Treatment Refusal

We performed a phase II trial to evaluate the efficacy and the safety of gemcitabine monotherapy, a pyrimidine antimetabolite, in patients, who had previously failed anthracycline and taxane-based chemotherapy for the treatment of metastatic breast cancer. MATERIALS AND METHODS: Twenty-one patients with metastatic breast cancer, which was unresponsive to previous chemotherapy, were entered into this study. Gemcitabine was administered at 850 mg/m2, as a 60- minute intravenous infusion on days 1, 8 and 15. This regimen was repeated every 28 days with G-CSF support, but without dose reduction. RESULTS: Objective responses were seen in 6 of the 20 patients who were able to be evaluated (1 complete response and 5 partial responses), with an objective response rate of 30%. The median time to progression was 5 (1~20) months, and the median overall survival duration was 11 (2~21) months. The actual dose intensity was 566.7 mg/m2/wk (range; 340~637.5 mg/m2/wk) and the relative dose intensity was 0.89 (range; 0.40~1.00). Toxicity was mainly hematological. Toxicities included: grade 3 neutropenia in 20% and anemia in 5%. Grades 3 and 4 thrombocytopenia occurred in 15% of the patients. CONCLUSION: Gemcitabine monotherapy is an effective and safe treatment for refractory breast cancer patients heavily treated with the anthracycline and taxane- based regimen.
Anemia ; Breast Neoplasms* ; Breast* ; Drug Therapy ; Granulocyte Colony-Stimulating Factor ; Humans ; Infusions, Intravenous ; Neutropenia ; Thrombocytopenia