From January l, l990 to June 30, l992, tota1 1,067 epidural anesthesia were evaluated retrospectively for physical status, level of anesthesia, agents of 1ocal anesthetics, complication and poatoperative pain control. The reaults were as follows: 1) Annual numbers of epidural aneathesia were 272 cases in 1990. 392 cases in 1991 and 403 cases in 1992 respectively. The number of epidural anesthesia was increaeing with years. 2) The most common site of epidural puncture level wae L(3-4) intervertebral space and mean depth from skin to epidural space was 4.88 cm. 3) The local anesthetics that used during epidural anesthesia were lidocaine(1%, 1.5%, 2%) and bupivacaine(0.25%, 0.375%. 0.5%). 4) The most common sensory level which were blocked by epidural anesthesia waa T(10) and most common complication was hypotension. 5) Postoperative pain control with epidural anestheaia was managed with continuous drug infusor after 1991, and it was managed with single bolus injection before 1991. In conclusion, epidural anesthesia is a safe regional anesthesia that will reduce the incidence of hypotension provided that careful control of the aensory level to be anesthetiaed is taken under consideration along with the age, physical status, site of operation, volume of local anesthetics and it is effective for the postoperative pain control with continuous infusion of morphine sulfate and local anesthetic through catheter.
Anesthesia ; Anesthesia, Conduction ; Anesthesia, Epidural* ; Anesthetics ; Anesthetics, Local ; Catheters ; Epidural Space ; Hypotension ; Incidence ; Infusion Pumps ; Morphine ; Pain, Postoperative ; Punctures ; Retrospective Studies ; Skin

This study investigated the effects of soyoligosaccharide consumption on lipid profile of plasma, liver and feces and immune responses in Sprague-Dawley male rats. Sixty male Sprague-Dawley rats 4-wk-old were provided the soyoligosaccharide containing diets for 4 weeks (0, 100 g/kg diet); each of these diets was supplemented with either 70 or 200 g fat/kg diet, giving a total of 4 experimental groups. The effect of weight reduction was most significantly observed in the group fed low fat and soyoligosacchairde diet. The plasma total lipid and cholesterol contents were not changed by either fat proportion or soyoligosaccharide supplementation in the diets. Also the plasma triglyceride lowering effect by soyoligosaccharide was not observed in rats fed either low fat or high fat diet. However, the significant decrease in TG contents was found with rats fed high fat diets compared to the control/no soyoligosaccharide diet. Elevation of plasma LDL-cholesterol and reduction of HDL-cholesterol by feeding high fat diet was not altered by supplementing soyoligosaccharide. This was also applied to the liver lipid profiles. The significant increases in liver total lipid, triglycerides and cholesterol by high fat diet was not abolished by feeding soyoligosaccharide. However, the desirable effects of feeding soyoligosaccharide were found with total lipid and cholesterol excretion through feces in rats fed high fat diets. Immune organ weights and spleen cell proliferations did not affected by experimental diets. These results demonstrated that soyoligosaccharide intakes increased the lipid output via feces, especially in rats fed the high fat diet, but more researches are needed on immune responses.
Animals ; Cholesterol ; Diet* ; Diet, High-Fat ; Feces ; Humans ; Lipid Metabolism* ; Liver ; Male ; Organ Size ; Plasma ; Rats* ; Rats, Sprague-Dawley ; Spleen ; Triglycerides ; Weight Loss

The objective of this study is to develop a nutrition policy on food and nutrition labeling and education systems for fast food and carbonated soft drinks in Korea by identifying the fast food and soft drink use and by examining nutrition policies and labeling in Korea and other countries. Fast food is defined as food dispensed quickly at a restaurant generally offering a limited menu of inexpensive items, which may be mostly not nutritious. It is a growing component of the Korean diet, especially on children and adolescent population. Low nutrient dense beverages such as carbonated drinks are also increasing in the children and adolescent's diet in Korea and concern has been raised that these beverages may replace more nutritious beverage and provide empty calories. According to 2001 Korean national health and nutrition survey, fast food and carbonated soft drinks were most popular among 13 - 19 years old adolescents. Thirty six and 72 percent of adolescents consumed hamburger and carbonated beverage equal to or more than once a week, respectively. In United States, all processed food including soft drinks should disclose full nutrition information by nutrition labeling requirement. Restaurant foods are not required to provide nutrition information currently, but legislation on mandatory nutrition labeling of fast foods with other restaurant foods has been proposed currently in US. The sales of foods of minimal nutritional value, such as soft drinks, in the nation's schools is regulated by the United States Department of Agriculture. Nutrition information about fast food in US has been provided by fast food companies, non-profit organizations, hospitals and government through internet, booklet and brochure, etc, but the information is available from only a few resources in Korea. This study suggests a nutrition policy on fast food and soft drink use which includes establishing mandatory nutrition labeling and developing nutrition education materials and programs by web-site, booklet and government and school programs in Korea.
Adolescent ; Beverages ; Carbon* ; Carbonated Beverages* ; Child ; Commerce ; Diet ; Education* ; Fast Foods* ; Food Labeling* ; Humans ; Internet ; Korea* ; Nutrition Policy* ; Nutrition Surveys ; Nutritive Value ; Organizations, Nonprofit ; Pamphlets ; Restaurants ; United States ; United States Department of Agriculture ; Young Adult

Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) represents an important acquired condition characterized by progressive, symmetrical, proximal and distal weakness. CIDP is characterized by sensory loss and weakness, areflexia, elevated CSF protein and electrodiagnostic evidence of multifocal demyelination with or without superimposed axonal degeneration. Some reports are made that an antecedent illness in the weeks preceding the onset of symptoms such as upper respiratory syndrome or flu-like illness, gastrointestinal syndrome etc., but intestinal pseudoobstruction as the main clinical feature in CIDP is an uncommon finding. The clinical course is variable. The condition is responsive to immunosuppressive therapy, especially prednisone and plasma exchange. We report a case of intestinal pseudoobstruction secondary to CIDP diagnosed by clinical features, electrodiagnostic study and nerve biopsy pathology.
Axons ; Biopsy ; Demyelinating Diseases ; Intestinal Pseudo-Obstruction* ; Pathology ; Plasma Exchange ; Polyradiculoneuropathy, Chronic Inflammatory Demyelinating* ; Prednisone

This study investigated elementary, middle, and high school teachers' satisfaction, nutrition education, workload changes, and demands in school foodservice programs (SFPs). The subjects were 630 teachers at 12 elementary, 9 middle, and 9 high school within the nation. Ninety five percent of the teachers felt that there was a necessity for SFPs. Middle school teachers (MTs) and high school teachers (HTs) thought that it was necessary in order to reduce the students'burden of carrying lunch boxes. The teachers were relatively satisfied with their school's foodservice management types, food distribution types, meal quality, and sanitation. Elementary teachers (ETs) and HTs had a higher satisfaction than MTs. Teachers thought that SFPs had positive effects on their students' nutrition and health, enhancing desirable eating habits, and socialization. ETs had more positive opinions than MTs or HTs. ETs and MTs thought that their workload had been increased by SFPs more than HTs, but they had relatively positive opinions on the workload change. ETs taught nutrition and health through SFPs more frequently than MTs or HTs. Many teachers thought that there was a lack of appropriate teaching materials. Some teachers thought that the problems in the present SFPs were: a lack of cafeteria facilities, poor quality of meals, and management of leftovers. Their demands for SFPs were a improvement of meal quality and the establishment of cafeterias. In conclusion, MTs had more negative opinions than ETs or HTs. ETs perceived that SFPs had a function as an important educational activity as well as the supply of nutritional meals. MTs or HTs tended to consider only a meal. It is suggested that teachers, especially MTs and HTs, should modify their attitudes and recognize the educational functions of SFPs. Training programs should be developed under government auspices.
Eating ; Education ; Humans ; Lunch ; Meals ; Sanitation ; Socialization ; Teaching Materials

This study on satisfaction with school food service (FS) programs was conducted with 485 middle school students and 515 high school students based on FS management type. There were four types of FS management: independent-conventional (IC), independent-commissary (ICM), contract-conventional (CC), and contract-delivery (CD). About seventy percent of the students expressed satisfaction with the food quantity of the school lunches. But one third of the students, who felt the quantity was insufficient, cited the small size of the rice serving. Many high school students cited the small size of the side dishes as well as the rice serving. It is suggested that the meal quantity should be determined in consideration of the students' physical development. The satisfaction with FS sanitation was lower than that with the meal quality, eating environment, and environment of dining room with respect to all four types of FS management, and was lowest in the CD. It is suggested that FS sanitation should be managed more thoroughly for the students' safety, and that the school FS Committee should carefully monitor the sanitary management of the contract FS companies by means of a well-designed and monitored management system. Most of middle and high school students expected good taste and a diversity of foods in their school lunches. Food taste should be improved, and various food materials and cooking methods should be used for balanced nutrition and greater student satisfaction, particularly in contract FS types (CC and CD).
Cooking ; Eating ; Food Services* ; Humans ; Lunch ; Meals ; Sanitation

Vulvar squamous cell carcinoma (SCC) consists of two different etiologic categories: human papilloma virus (HPV)-associated (HPV (+)) and HPV-non-associated (HPV (−)). There have been no genome-wide studies on the genetic alterations of vulvar SCCs or on the differences between HPV (+) and HPV (−) vulvar SCCs. In this study, we performed whole-exome sequencing and copy number profiling of 6 HPV (+) and 9 HPV (−) vulvar SCCs and found known mutations (TP53, CDKN2A and HRAS) and copy number alterations (CNAs) (7p and 8q gains and 2q loss) in HPV (−) SCCs. In HPV (+), we found novel mutations in PIK3CA, BRCA2 and FBXW7 that had not been reported in vulvar SCCs. HPV (−) SCCs exhibited more mutational loads (numbers of nonsilent mutations and driver mutations) than HPV (+) SCCs, but the CNA loads and mutation signatures between HPV (+) and HPV (−) SCCs did not differ. Of note, 40% and 40% of the 15 vulvar SCCs harbored PIK3CA and FAT1 alterations, respectively. In addition, we found that the SCCs harbored kataegis (a localized hypermutation) in 2 HPV (+) SCCs and copy-neutral losses of heterozygosity in 4 (one HPV (+) and 3 HPV (−)) SCCs. Our data indicate that HPV (+) and HPV (−) vulvar SCCs may have different mutation and CNA profiles but that there are genomic features common to SCCs. Our data provide useful information for both HPV (+) and HPV (−) vulvar SCCs and may aid in the development of clinical treatment strategies.

BACKGROUND: Several factors had been suggested to contribute to the development of hypertension in chronic glomerulonephritis (GN). This study was conducted to find the association of baseline blood pressure (BP) with pathophysiologic findings and later renal progression in chronic GN. METHODS: Clinico-pathological findings including serum creatinine (Cr), proteinuria, pathological findings, and urinary Na excretion were analyzed in a total of 233 patients with IgA nephropathy from The Kyung-Hee Cohort of GN. Glomerular surface area (GSA) was measured by imaging analysis and urine angiotensinogen (AGT) concentrations by human ELISA kits. RESULTS: Systolic BP was ≥130mmHg in 124 patients (53%). Systolic BP was negatively correlated with follow-up eGFR (r=−0.32, p<0.0001) and positively serum uric acid concentrations, while it had no significant relationships with initial serum Cr and eGFR. As compared with patients with systolic BP<130 mmHg, those with ≥130 mmHg were older and showed higher serum Cr, proteinuria, 24 hr urinary Na excretion, mean GSA, and T-I fibrosis, lower follow-up eGFR, and steeper decline in slope of eGFR. The results in patients with normal serum Cr concentrations were comparable to those in whole group. Systolic BP was positively correlated with age, baseline and follow-up proteinuria, serum uric acid concentrations and IgM deposit and negatively with follow-up eGFR. In subgroup analysis, systolic BP was also positively correlated with mean GSA and urinary AGT concentrations. CONCLUSION This study showed that baseline systolic BP is related to urinary Na excretion, glomerulomegaly, T-I fibrosis and later renal progression in patients with IgA nephropathy.

Endostatin is released during extracellular matrix remodeling and is involved in the development of vascular pathology and cardiovascular (CV) disease. However, the role of circulating endostatin as a biomarker of vascular calcification and CV events in patients undergoing hemodialysis (HD) remains unclear. Methods: A total of 372 patients undergoing HD were prospectively recruited. Plasma endostatin levels were measured at baseline, and their associations with circulating mineral bone disease (MBD) biomarkers and abdominal aortic vascular calcification scores were analyzed. The primary endpoint was defined as a composite of CV and cardiac events. Results: Plasma levels of patients in endostatin tertile 3 were significantly associated with low-density lipoprotein cholesterol levels and predialysis systolic blood pressure in multivariate analysis. However, endostatin levels did not correlate with circulating MBD biomarkers or vascular calcification scores. Patients in endostatin tertile 3 had a significantly higher cumulative event rate for the composite of CV events (p = 0.006). Endostatin tertile 3 was also associated with an increased cumulative rate of cardiac events (p = 0.04). In multivariate Cox regression analyses, endostatin tertile 3 was associated with a 4.37-fold risk for composite CV events and a 3.88-fold risk for cardiac events after adjusting for multiple variables. Conclusion: Higher circulating endostatin levels were independently associated with atherosclerotic risk factors but did not correlate with MBD markers or vascular calcification. Higher circulating endostatin levels were associated with a greater risk of composite CV events in patients undergoing HD, and endostatin is a biomarker that helps to determine the high risk of CV events.

The most widely used method for treatment of secondary hyperparathyroidism(SH) in CAPD patients has been the administration of calcitriol by oral route. In this study, we compared the efficacy and safety of daily low dose calcitriol therapy with those of intermittent high dose pulse therapy. The study group consisted of 38 patients undergoing CAPD with serum intact PTH level of more than 200pg/ mL. Twenty patients were randomly administered daily low dose calcitriol(0.25 microgram/day for 1 month followed by 0.5 microgram daily dose for the next 3 mon-ths) while 18 patients were given intermittent pulse therapy (0.5 microgram-0.5 microgram-0.75 microgram 3 times a week for 1 month, increased to 1.0 microgram-1.25 microgram-1.25 microgram 3 times a week for the next 3 months). Thirty five patients completed the study : 17 on daily oral calcitriol (M: F=0.7:1, mean age=47.3+/-10.6 years, mean duration of CAPD=48.9+/-41.1 months), and 18 on oral pulse calcitriol (M:F=1.6:1, mean age=41.5+/-12.7 years, mean duration of CAPD=49.2+/-41.6 months). The baseline serum levels of calcium, phosphorus, i-PTH, alkaline phosphatase, and total CO2 were not different between daily and pulse group(9.5+/-0.8 vs 9.3+/-0.9mg/dL, 5.8+/-1.3 vs 5.1+/-1.2mg/dL, 443.1+/-162.5 vs 546+/-385.9pg/mL, 91.8+/-47.7 vs 108.9+/-66.5IU/L, 23.7+/-1.9 vs 25.5+/-2.0mEq/L, p>0.05, respectively). The i-PTH level decreased significantly in daily calcitriol group after 1 month (332.8+/-214.8pg/mL, p<0.01), and at final evaluation (180.4+/-254.8pg/mL, p<0.01). In pulse calcitriol group, i-PTH level also decreased significantly to 400,4+/-225.8pg/mL(p<0.05), 89.4+/-122.6 pg/mL(p<0.01), respectively. The rate of decline in i-PTH level from baseline were similar(daily=25.4+/-22.7 vs pulse=19.5+/-12.6%decline/month, p>0.05). The serum calcium increased similarly in both groups after treatment (daily=10.6+/-0.8 vs pulse=l0.1+/-1.0mg/dL, p>0.05). Hypercalcemia(>11.0mg/dL) was rarely observed in all patients (daily=5, pulse=8 episodes). In conclusion, both daily and pulse calcitriol therapy were similarly effective and safe in control of SH.
Alkaline Phosphatase ; Calcitriol* ; Calcium ; Humans ; Hyperparathyroidism, Secondary* ; Peritoneal Dialysis* ; Peritoneal Dialysis, Continuous Ambulatory ; Phosphorus