The total energy expenditure (TEE) consists of the basal energy expenditure (BEE), physical activity energy expenditure (PAEE) and the thermic effect of food. The PAEE accounts for a significant portion of the TEE and can be changed according to individual efforts, and the difference between individuals of PAEE is large. Even for the same physical activity, there is a difference in energy expenditure between adults and children. Therefore, a physical activity classification table for youth is needed to classify the physical activity recorded in the physical activity diary prepared to evaluate children's energy expenditure. It is also necessary to calculate the physical activity level required to set the estimated energy requirement in the Dietary Reference Intakes for children and adolescents in Korea. This paper reports a physical activity classification table for Korean youth using the 2017 Youth Compendium of Physical Activities in the United States. This physical activity classification table includes 110 specific activities classified into 14 major categories by four age groups (6–9, 10–12, 13–15, and 16–18 years old) and their metabolic equivalent values. Of these, 87 physical activities were selected from the 2017 Youth Compendium reported in the United States. Nine physical activities such as washing and going to the bathroom, which are daily activities of children and adolescents not included among them, were selected from the another list (2008) of physical activities in America. The remaining 15 physical activities were selected from the research results, which measured the energy expenditure of Korean children and adolescents. Activity categories were divided into 4 areas: daily activity (A), movement (B), school work (C), exercise and sports (D).This physical activity classification table will help standardize the interpretation and scoring process of physical activity of youth in related studies and community health surveys.

To set the estimated energy requirement (EER) in Dietary Reference Intakes for Koreans (KDRI), we need the coefficient by physical activity stage, as determined by the physical activity level(PAL). Thus, there has been demand for a tool to calculate PAL based on the physical activity diary. This study was undertaken to develop a physical activity (PA) classification table for Koreans, using the 2011 Compendium of physical activities in the United States. The PA classification table for Koreans contains 262 codes, and values of the metabolic equivalent of task (MET) for specific activities. Of these, 243 PAs which do not have Korean specific data or information, were selected from the 2011 Compendium of PAs that originated in the United States; another 19 PAs were selected from the previous research data of Koreans. The PA classification table is codified to facilitate the selection of energy values corresponding to each PA. The code for each PA consists of a single letter alphabet (activity category) and four numeric codes that display the activity type (2 digit number), activity intensity (1 digit number), and specific activities (1 digit number). In addition, the intensity (sedentary behavior, low, middle and high) of specific PA and its rate of energy expenditure in MET are presented together. The activity categories are divided into 4 areas: Daily Activity (A), Movement (B), Occupation (C), and Exercise and Sports (D). The developed PA classification table can be applied to quantify the energy cost of PA for adults in research or practice, and to assess energy expenditure and physical activity levels based on self-reported PA.

Purpose: Physical activity (PA) has a beneficial effect on the prevention of arteriosclerosis in healthy adults. The purpose of this study was to analyze the relationship between PA measured using an accelerometer and arterial stiffness in healthy Korean adults. Methods: This study involved 87 subjects (36.8% women) aged 20–64 years. PA was evaluated using an accelerometer (wGT3X-BT, ActiGraph, Florida, USA) for 7 days. Based on the results of the accelerometer measurement, subjects were classified into active and inactive groups according to the World Health Organization (WHO) PA guidelines. The brachial–ankle pulse wave velocity (baPWV) and ankle-brachial index (ABI) to assess arterial stiffness were measured by a non-invasive vascular screening device (VP-1000 Plus, Omron). Results: The average age of the study subjects was 47.7 ± 11.3 years and the WHO PA guideline achievement rate was 29.9%. There was no significant difference in arterial stiffness (baPWV and ABI) between the active and inactive groups. In females, the time spent in light PA were positively correlated with ABI (r = 0.396; p < 0.05) and the number of sedentary bouts over 50 minutes was inversely correlated with ABI (r = −0.402; p < 0.05). However, there was no significant correlation between PA and arterial stiffness in males. Conclusions The results of this study suggest that light PA and sedentary behavior have a positive correlation with arterial stiffness in females.

PURPOSE: Valid determination of HER2 status is a prerequisite to establish an adequate treatment strategy for breast cancer patients, regardless of the disease stage. The goal of this study was to examine the feasibility of the newly developed silver-enhanced in situ hybridization (SISH) technique as an alternative to fluorescence in situ hybridization (FISH) for HER2 assay in primary invasive breast cancer. METHODS: FISH and SISH for HER2 amplification were performed using tissue microarray. Both methods were used in 257 consecutive primary breast cancers. RESULTS: HER2 amplification was observed in 62 (23.1%) of a total of 257 breast cancers based on SISH. Of the 257 breast cancers measured using both methods, the results of the two methods were consistent in 248 (concordance, 96.5%; kappa=0.903). When we compared HER2 amplification in the primary tumor with the metastatic lymph nodes of the same patients, HER2 amplification was observed in nine cases (14.0%) out of 64 cases in which HER2 was not amplified in the primary tumors. In contrast, HER2 status was completely preserved in metastatic lymph nodes showing HER2 amplification in the primary tumor. CONCLUSION: These results indicate that SISH can be a feasible alternative to FISH in the clinical setting. In node-positive breast cancer, confirmation of the HER2 status of the metastatic lymph nodes appears to be mandatory, regardless of the HER2 status of the primary tumors.
Breast ; Breast Neoplasms ; Fluorescence ; Humans ; In Situ Hybridization ; Lymph Nodes

Purpose: The purpose of the first part of this study was to evaluate the validity of the physical activity classification table for youth (Youth-PACT). The second part of this study was aimed at comparing the estimated energy requirement (EER) with the total energy expenditure (TEE) and evaluating the physical activity patterns of Korean children and adolescents. Methods: The subjects of the first part of the study were 17 children aged 10 to 12 years, and their total energy expenditure (TEE DLW ) was measured using the double labeled water (DLW) method. A total of 166 children and adolescents aged 6-18 years participated in the second part of this study. Their resting energy expenditure (REE) was measured using indirect calorimetry and the TEE Youth-PACT and physical activity level were calculated by applying the Youth-PACT to the physical activity diary prepared by the subjects. Results: In the first part of this study, there were no significant differences between theTEE DLW and the TEE Youth-PACT. The TEE Youth-PACT accurately predicted TEE DLW in 37.5% of the subjects. In the second part of the study, the rates at which EER accurately predicted TEE Youth-PACT and overestimated TEE Youth-PACT were 29.6% and 47.3%, respectively. The time spent based on intensity of physical activity and the physical activity categories which were obtained using Youth-PACT showed different patterns according to sex and age group. Age showed significant positive correlations with REE, TEE, and the time spent in sedentary behavior, but age was significantly negatively correlated with REE/body weight, TEE/body weight, and the time spent in low-intensity and high-intensity activities. Conclusion The results of this study showed that the Youth-PACT can be used to evaluate the TEE and PAL of children and adolescents. However, further studies are needed to validate the TEE Youth-PACT and to set the EER for children and adolescents.

We explored the annual risks of mild and severe preeclampsia (PE) among nulliparous women. Using the National Health Information Database of South Korea, 1,317,944 nulliparous women who gave live births were identified. Mild PE increased from 0.9% in 2010 to 1.4% in 2019 (P for trend=0.006), while severe PE decreased from 0.4% in 2010 to 0.3% in 2019 (P=0.049). The incidence of all types of PE (mild and severe) showed no linear change (P=0.514). Adjusted odds ratio (OR) of severe PE decreased in 2013 (0.68; 95% confidence interval [CI]: 0.60, 0.77) and beyond compared to that in 2010, while the OR of mild PE increased in 2017 (1.14; 95% CI: 1.06, 1.22) and beyond. Mild PE was found to be less likely to progress to the severe form since 2010; however, the overall risk of PE among women did not change.

BACKGROUND: Although a personal interview with the patient during the preoperative visit decreases anesthesia-related anxiety, few efforts have been directed at identifying the patients' greatest concerns. The present study was undertaken to assess patients' anxiety regarding anesthetic management and their specific concerns about anesthesia. METHODS: Before any premedication or explanation of proposed anesthetic technique was given, two hundred and ninety five people (family members and patients) scheduled to undergo elective surgical procedures under general or regional anesthesia, were asked the question of what worried them about the anesthesia and what patients really want to know about their anesthesia. RESULTS: The vast majority of patients and their families want to know comprehensive information concerning their general or regional anesthesia including information about all possible complications related to anesthesia. The most common preoperative anxiety and concern regarding the anesthetic procedure relates to complications. In addition, frequent anxiety and curiosity were about recovery time after anesthesia, anesthetic method and pain. Parents and families of children undergoing general anesthesia most worried about brain damage including decline of memory and learning ability. CONCLUSIONS: Reassurance and satisfactory explanations about preanesthetic anxiety and curiosity are required for the patient and their family preoperatively in an attempt to reduce the patient's anxiety.The information from this study could help anesthetists communicate more effectively with the patient and their family during preoperative visits.
Anesthesia* ; Anesthesia, Conduction ; Anesthesia, General ; Anxiety* ; Brain ; Child ; Exploratory Behavior ; Humans ; Learning ; Memory ; Parents ; Premedication ; Surgical Procedures, Elective

PURPOSE: To evaluate the role of magnetic resonance imaging (MRI) in the diagnosis of papillary lesions of the breast. MATERIALS AND METHODS: Among 45 papillary lesions diagnosed at ultrasonography-guided core biopsy (USCB), 27 benign papillary lesions in 22 patients who underwent breast MRI were reviewed. The excsional biopsy was performed in 1-10 days after MRI was done. In MRI findings, lesions were considered suspicious if they show irregular, rim enhancement, or linear enhancement in morphologic evaluation, or washout enhancement pattern of delayed phase in dynamic enhancement characteristics. Diffusion-weighted images were analyzed according to visibility of lesions. MRI findings were correlated with pathologic results at excisional biopsy. RESULTS: At excisional biopsy, two lesions (9%) were diagnosed malignant in 22 benign papillary lesions without atypia by USCB and 4 (80%) were malignant in 5 benign papillary lesions with atypia by USCB. Among 18 lesions detected on MRI, 16 lesions showed suspicious findings on MRI, 11 lesions (69%) were diagnosed as benign and 5 (31%) were malignant. Among 12 lesions detected on diffusion weighted imaging, 10 lesions were diagnosed as benign and 2 were malignant. MRI findings were not significantly correlated with pathologic results at excisional biopsy. CONCLUSION: MRI findings were not useful to predict malignancy in benign papillary lesions diagnosed at USCB, because MRI findings of these were mostly suspicious (88.9%, 16/18). The benign papillary lesion should be included in the false positive lesion on breast MRI.
Biopsy ; Breast ; Breast Neoplasms ; Diffusion ; Humans ; Magnetic Resonance Imaging

PURPOSE: To evaluate the role of magnetic resonance imaging (MRI) in the diagnosis of papillary lesions of the breast. MATERIALS AND METHODS: Among 45 papillary lesions diagnosed at ultrasonography-guided core biopsy (USCB), 27 benign papillary lesions in 22 patients who underwent breast MRI were reviewed. The excsional biopsy was performed in 1-10 days after MRI was done. In MRI findings, lesions were considered suspicious if they show irregular, rim enhancement, or linear enhancement in morphologic evaluation, or washout enhancement pattern of delayed phase in dynamic enhancement characteristics. Diffusion-weighted images were analyzed according to visibility of lesions. MRI findings were correlated with pathologic results at excisional biopsy. RESULTS: At excisional biopsy, two lesions (9%) were diagnosed malignant in 22 benign papillary lesions without atypia by USCB and 4 (80%) were malignant in 5 benign papillary lesions with atypia by USCB. Among 18 lesions detected on MRI, 16 lesions showed suspicious findings on MRI, 11 lesions (69%) were diagnosed as benign and 5 (31%) were malignant. Among 12 lesions detected on diffusion weighted imaging, 10 lesions were diagnosed as benign and 2 were malignant. MRI findings were not significantly correlated with pathologic results at excisional biopsy. CONCLUSION: MRI findings were not useful to predict malignancy in benign papillary lesions diagnosed at USCB, because MRI findings of these were mostly suspicious (88.9%, 16/18). The benign papillary lesion should be included in the false positive lesion on breast MRI.
Biopsy ; Breast ; Breast Neoplasms ; Diffusion ; Humans ; Magnetic Resonance Imaging