No abstract available.

PURPOSE: Not only regionalization of neonatal care for high risk newborn, but also safe neonatal transport system of newborn were not completely established in Korea. The aim of this study was to compare the clinical outcomes of preterm infants less than 35 week gestational age with regard to inborn and outborn status, to understand the problems of regionalization of neonatal care and neonatal transport system and to provide the basis to solve the potential problems. METHODS: This retrospective study included 40 outborn and 40 inborn preterm infants less than 35 week gestational age admitted to the neonatal intensive care unit of Korea University Ansan Hospital during the period between January 2006 and June 2013. RESULTS: Compared with those in the inborn group, the incidences of hypoglycemia and respiratory distress were significantly more frequent in the outborn group at admission. The uses of surfactant, ventilator, and inotrope were significantly more frequent in the outborn during hospitalization. Mortality occurred only in the outborn group. Most of infants were transferred by a nurse alone, not a team with doctor. CONCLUSION: Transferred preterm infants may not be sufficiently stabilized before transport, according to the result of more frequent hypoglycemia and respiratory distress in the outborn group. In order to reduce mortality and morbidity of transferred newborn from level I, the national policy about neonatal intensive care unit level guideline (manpower, equipment, and facility), regionalization of neonatal intensive care, and neonatal transport system are needed in Korea.
Gestational Age ; Gyeonggi-do* ; Hospitalization ; Humans ; Hypoglycemia ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature* ; Intensive Care, Neonatal* ; Korea ; Mortality ; Perinatal Care ; Regional Medical Programs ; Resuscitation ; Retrospective Studies ; Transportation of Patients ; Ventilators, Mechanical

OBJECTIVE: With improvement in the social and economic states of Korea, most of the pregnancies have been appropriately examined but there are a few mothers and newborns who have not received proper prenatal care. The aim of this study was to investigate obstetrical and neonatal complications resulting from inadequate prenatal care. METHODS: The medical records of 107 neonates who had received prenatal care lesser than 3 visits and admitted to the neonatal intensive care units of Korea University Ansan Hospital from January 2004 to December 2009 were retrospectively reviewed. Obstetrical complications, neonatal gestational age, birth weight, neonatal complications were analyzed. We compared neonatal complications of the inadequate prenatal care group and those of the adequate prenatal care group lesser than 34 weeks' gestational age neonates. RESULTS: In obstetrical complications, there were twenty women with anemia, fifteen cases with premature rupture of membranes, and fourteen chorioamnionitis. In neonatal complications, there were forth-four premature infants, and forty-four low birth weight infants. Respiratory distress syndrome, small for gestational age, severe intraventricular hemorrhage were more common in the inadequate prenatal care group than the adequate prenatal care group. Thirty-seven infants (34.5%) were sent to the adoption agency. Fifty infants (46.6%) received medical expense support by the social service. CONCLUSIONS: Obstetrical and neonatal complications and social burden were increasing when the pregnancies had not received adequate prenatal care. To reduce perinatal complications of mothers and neonates in low socioeconomic classes, practical nation's policies and social supports for adequate prenatal care should be provided.
Adoption ; Anemia ; Birth Weight ; Chorioamnionitis ; Female ; Gestational Age ; Hemorrhage ; Humans ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Intensive Care Units, Neonatal ; Korea ; Medical Records ; Membranes ; Mothers ; Pregnancy ; Prenatal Care ; Retrospective Studies ; Rupture

BACKGROUND: Known as a kind of complication or a specific form of pulmonary tuberculosis, endobronchial tuberculosis caused several kinds of problems in diagnosis and managements. But the frequency of this disease are is widely variable, generally reported from as low as 10 - 20% to as high as 40 - 50%. We prospectively performed bronchoscopy in patients diagnosed as pulmonary tuberculosis to evaluate the frequency of endobronchial tuberculosis and its related findings. METHOD: From March, 1995 to February, 1996, we prospectively performed bronchoscopy in patients newly diagnosed as pulmonary tuberculosis and evaluated the frequency of endobronchial tuberculosis, its clinical features and laboratory findings including raiologic, microbiologic and physiologic aspects. RESULTS: Number of patients diagnosed as pulmonary tuberculosis was 103 and 55 patients(53.4%) were found to have endobronchial tuberculosis. But the frequency were 43.8% in male and 76.7% in female, respectively. Frequently noted symtoms were nonspecific including cough, sputum, fever, weight loss in the order of frequency but cough was more frequent than in pulmonary tuberculosis. Physical examination showed rale,decreased breathing sound and wheezing and wheezing was more frequent than in pulmonary tuberculosis. All 7 subtypes were noted bronchoscopically and edema-hyperemia (stenotic without fibrosis) type was most frequently(32.7%) noted, and followed by chronic nonspecific bronchitis type stenotic with fibrosis type and actively caseating type in the order of frequency. The relationship between subtypes of endobronchial tuberculosis and radiologic findings was insignificant. Right lung was involved more frequently than left lung and left upper lobe was most commonly involved site, and followed by right upper lobe and trachea. Acid-fast bacilli(AFB) positivity in sputum and / or bronchial washing fluid was 73% and suggested high risk of infectivity. CONCLUSION: The frequency of endobronchial tuberculosis in patients with pulmonary tuberculosis was higher than known and also suggested bronchoscopic examination to detect endobronchial involvement should be recommanded and careful management is also needed to prevent complications.
Bronchitis ; Bronchoscopy ; Cough ; Diagnosis ; Female ; Fever ; Fibrosis ; Humans ; Lung ; Male ; Physical Examination ; Prospective Studies ; Respiratory Sounds ; Sputum ; Trachea ; Tuberculosis* ; Tuberculosis, Pulmonary* ; Weight Loss

BACKGROUND: One quarter to one third of patients with NSCLC present with primary tumors that although confined to the thorax are too extensive for surgical resection. Until resently standard treatment for these patients had been thoracic radiation, which produces tumor regression in most patients but few cures and dismal 5-year survival rate. The fact that death for most patients with stage III tumors is caused by distant metastases has promped a reevaluation of combined modality treatment approaches that include systemic chemotherapy. Therefore, we report the results observed in a study to evaluate the effect of multimodality treatment in locally advanced non-small cell lung cancer from 1/91 to 8/93 in CNUH. METHOD: We grouped the patients according to the treatment modalities and evaluated response rate, median survival and the effect of prognostic variables. Among 67 patients evaluated, twenty seven patients classified with group A, received cisplatin and etoposide containing combination chemotherapy alone, eighteen patients, classified with group B, received chemotherapy and radiotherapy, fifteen patients, group C, received neoadjuvant or adjuvant chemotherapy and surgery with/without radiation therapy, seven patients, group D, received only supportive care. RESULT: The major response rate for group A and B was 37% and 61% respectively. There was no statistically significant difference in response rate between A and B groups(p=0.97). The analysis of prognostic factors showed that differences of age, sex, pathology, blood type, smoking year, stage and ECOG performance did not related to improvement in survival. Median survival time was 8.6 months for group A, 13.4 months for group B, 19.2 months for group C, and 5.4 months for group D, respectively and there was statistically significant difference(p=0.003), suggesting that multimodality therapy was associated with signigicant improvement in survival. Subset survival analysis showed a significant therapeutic effect for earlier stage and good performance state(p=0.007, 0.009, respectively). A possible survival advantages were observed for major response groups. CONCLUSION: It was suggested that multimodality therapy for the management of patients who had stage III disease, has yielded good median survival and long survival for seleted patients. But, it is necessory to validate above result with further investigation in large scale and in prospective randomized trials.
Carcinoma, Non-Small-Cell Lung* ; Chemotherapy, Adjuvant ; Cisplatin ; Drug Therapy ; Drug Therapy, Combination ; Etoposide ; Humans ; Neoplasm Metastasis ; Pathology ; Prospective Studies ; Radiotherapy ; Smoke ; Smoking ; Survival Rate ; Thorax

OBJECTIVES: To estimate the resistance rate and to correlate the clinical characteristics of resistant tuberculosis with the patients of pulmonary tuberculosis who were referred to the university hospital. METHODS: We prospectively performed sensitivity tests for all patients who were diagnosed as active tuberculosis by sputum smear or sputum culture from January, 1995 to June, 1996. Patients profile, previous treatment history, patterns of drug resistance, initial chest films and other clinical findings were analysed. RESULTS: Overall, 24(26.0%) of the 92 patients had resistance to at least one drug and 8(8.6%) had resistance to isoniazid(INH) and rifampin(RFP). Among the 66 patients without previous tuberculosis therapy, 11(16.6%) were drug-resistant and 2(3.0%) were multi-drug resistant. Among the 26 patients with previous therapy, 13(50.0%) were drug-resistant and 6(23.0%) were multi-drug resistant. For all 92, resistance to INH was most common (19.5%), followed by RFP (9.7%) and ethambutol (9.7%). Drug resistance was significantly high in previously treated patients and in cavity-positive patients. Treatment failure was also high in previously treated patients with resistant tuberculosis. In patients with primary resistance, treatment failure was not observed. CONCLUSION: Sensitivity tests are strongly recommended in all culture positive patients with previous therapy but, in patients with primary resistance, sensitivity tests are not required. Proper combination chemotherapy should be given under careful surveillance.
Adolescence ; Adult ; Aged ; Antitubercular Agents/pharmacology ; Female ; Hospitals, University ; Human ; Korea/epidemiology ; Male ; Middle Age ; Prospective Studies ; Tuberculosis, Multidrug-Resistant/epidemiology* ; Tuberculosis, Multidrug-Resistant/drug therapy ; Tuberculosis, Pulmonary/epidemiology* ; Tuberculosis, Pulmonary/drug therapy

Molecular mechanism of lung carcinogenesis and its aggressive nature is still largely elusive. To uncover the biomarkers related with tumorigenesis and behavior of lung cancer, we screened novel differentially expressed genes (DEG) in A549 lung cancer cell line by comparison with CCD-25Lu, normal pulmonary epithelial cell line, using annealing control primer(ACP)- based GeneFishing system. Of the DEGs, over-expression of leucyl-tRNA synthetase 1 (LARS1) was prominent and this up-regulation was confirmed by immunoblotting and real-time quantitative RT-PCR analysis. In addition to A549 cell line, primary lung cancer tissues also expressed higher level of LARS1 mRNA than their normal counter tissues. To explore the oncogenic potential of LARS1 over-expression in lung cancer, we knocked-down LARS1 by treating siRNA and observed the tumor behavior. LARS1 knock-down cells showed reduced ability to migrate through transwell membrane and to form colonies in both soft agar and culture plate. Taken together, these findings suggest that LARS1 may play roles in migration and growth of lung cancer cells, which suggest its potential implication in lung tumorigenesis.
Base Sequence ; Blotting, Western ; Cell Line, Tumor ; *Cell Movement ; DNA Primers ; Humans ; Leucine-tRNA Ligase/genetics/*metabolism ; Lung Neoplasms/*enzymology/pathology ; *RNA, Small Interfering ; Reverse Transcriptase Polymerase Chain Reaction

The borderline tumor is not benign but has low malignant potential, which accounts for 10-15% of all ovarian tumors. The mucinous borderline tumors make up approximately 40% of all borderline tumors. About 5% of mature cystic teratomas of ovary include some with mucinous cystadenoma. The malignant transformation is occurred in about 1-3% of patients who have a mature cystic teratoma. There has been reported frequently about the malignant transformation of a mature cystic teratoma. After the first description of a patient with mucinous borderline tumor associated with a mature cystic teratoma in 1988, the borderline tumorous change of a mature cystic teratoma has been reported rarely. This report presents a patient with atypical proliferating mucinous tumor arising in a mature cystic teratoma.
Cystadenoma, Mucinous ; Female ; Humans ; Mucins ; Ovary ; Teratoma*

Precise and reliable identification of CNV is still important to fully understand the effect of CNV on genetic diversity and background of complex diseases. SNP marker has been used frequently to detect CNVs, but the analysis of SNP chip data for identifying CNV has not been well established. We compared various normalization methods for CNV analysis and suggest optimal normalization procedure for reliable CNV call. Four normal Koreans and NA10851 HapMap male samples were genotyped using Affymetrix Genome-Wide Human SNP array 5.0. We evaluated the effect of median and quantile normalization to find the optimal normalization for CNV detection based on SNP array data. We also explored the effect of Robust Multichip Average (RMA) background correction for each normalization process. In total, the following 4 combinations of normalization were tried: 1) Median normalization without RMA background correction, 2) Quantile normalization without RMA background correction, 3) Median normalization with RMA background correction, and 4) Quantile ormalization with RMA background correction. CNV was called using SW-ARRAY algorithm. We applied 4 different combinations of normalization and compared the effect using intensity ratio profile, box plot, and MA plot. When we applied median and quantile normalizations without RMA background correction, both methods showed similar normalization effect and the final CNV calls were also similar in terms of number and size. In both median and quantile normalizations, RMA background correction resulted in widening the range of intensity ratio distribution, which may suggest that RMA background correction may help to detect more CNVs compared to no correction.
Coat Protein Complex I ; Genetic Variation ; HapMap Project ; Humans ; Male

BACKGROUND: Left ventricular hypertrophy (LVH) is closely related with a high death rate, rhythmia, ischemic heart disease, stroke and sudden death. It is known that the prognosis becomes better as LVH regresses. Therefore, it is important to diagnose it correctly with ease in primary care. The authors evaluated the most standard cardio-thoracic ratio (CTR) with respect to LVH oriented towards elderly people whose body habitus changed over time as they had become older, and evaluated the factors which affect the rate of diagnosis including sensitivity and specificity. METHODS: A total of 231 subjects over 60 years of age who visited a general hospital health promotion center from March 1997 to August 2003, underwent echocardiography and identified not to have heart disease were selected. LV (left vetricular) mass was measured through echocardiography. LV mass was divided by 2.7 times of height (m) by Deveruex's method, and 49.1 g/m2.7 for men and 46.7 g/m2.7 for women were set to be standards of LVH. CTR was obtained by dividing the maximum transverse diameter of the heart by maximum transverse diameter of thorax on chest PA. RESULTS: CTR was observed on the basis of 0.45, 0.5, 0.55, and the agreement was highest of 0.5 for men and 0.45 for women. However, considering the sensitivity, the specificity, and the positive predictive value, it was thought to be most proper to be set at 0.5 was be standard for both men and women. When diagnosing LVH through chest PA, if 0.5 was set to be standard, false positive become high in women, false negative became high as height increased, and false negative became high as body mass index (BMI) increased. The smoking group showed higher false negative compared to the non- smoking group, and the false negative was higher as the level of hemoglobin increased. CONCLUSION: When diagnosing LVH through CTR in elderly people, it was appropriate to set 0.5 as a standard, but it is necessary to consider sex, body habitus, BMI, smoking and the level of hemoglobin.
Aged* ; Body Mass Index ; Death, Sudden ; Diagnosis ; Echocardiography ; Female ; Health Promotion ; Heart ; Heart Diseases ; Hospitals, General ; Humans ; Hypertrophy, Left Ventricular* ; Male ; Mortality ; Myocardial Ischemia ; Primary Health Care ; Prognosis ; Sensitivity and Specificity ; Smoke ; Smoking ; Stroke ; Thorax