PURPOSE:Recent studies proposed that polyunsaturated fatty acids (PUFA) of the omega6 series (linoleic acid, LA) compared to the omega 3 series (linolenic acid, LNA) may be a potent promoters of adipogenesis during the gestation/lactation period. Increased ratio of LA/LNA may stimulate adipose tissue development during gestation/lactation period and may subsequently lead to chilhood obesity. The purpose of this study is to evaluate fatty acids composition of the breast milk in Korean lactating women and to analyze the relationship between LA/LNA and the body weight gain of the infants. METHODS:Fifty eight healthy postpartum lactating women and their healthy 58 breast feeding infants were studied. At 11.3+/-3.9 days of postpartum, breast milk were taken and analyzed by gas-liquid chromatography with one-step methylation method. RESULTS:The total fat contents in breast milk were 3.2+/-1.3%. The total fat contents in breast milk were not related to maternal BMI or Kaup index of infants. The percentage of PUFA was 24.9+/-6.0%. Among these PUFA, the percentage of LA and LNA was 20.3+/-5.8% and 2.2+/-0.8%, respectively. LA/ LNA ratio was 10.2+/-2.5. There were no significant correlations between LA/LNA ratio and infant weight gain during the first 2 months of life. CONCLUSION: Short term weight gain of infant was not related to the LA/LNA ratio in the breast milk. Further studies on the long term effects on fat percent and body weight of infants would be needed.
Adipogenesis ; Adipose Tissue ; alpha-Linolenic Acid ; Body Weight* ; Breast Feeding ; Breast* ; Chromatography, Gas ; Fatty Acids* ; Fatty Acids, Unsaturated ; Female ; Humans ; Infant* ; Linoleic Acid ; Methylation ; Milk, Human* ; Obesity ; Postpartum Period ; Weight Gain

PURPOSE: The purpose of this study is to verify the effect of basic psychological needs of learners on student engagement in medical school. METHODS: A total of 91 first-year and second-year medical students participated in this study. Their basic psychological needs were determined. Student engagement scales were utilized to determine their engagement. Correlation and multiple regression analyses were conducted. RESULTS: Basic psychological needs showed a total explanatory power of 13% for student engagement (F=5.27, p < 0.01). Competence (β=0.295, p < 0.01) had statistically significant effect on student engagement. CONCLUSION: Results of the present study verified that student engagement could be determined by learner's traits. Among psychological traits of learners, student engagement was significantly affected by competence. Thus, medical school should provide various experiences to satisfy competence as a basic psychological need of learners.
Humans ; Mental Competency ; Schools, Medical* ; Students, Medical ; Weights and Measures

3-Methylcrotonyl-CoA carboxylase(MCC) is a biotin-dependent enzyme involved in the leucine metabolism. We describe a patient with MCC deficiency who manifested with Reye syndrome-like illness with status epilepticus, metabolic acidosis, hypoglycemia, hyperammonemia, elevated liver enzymes and neurologic impairments after a viral gastroenteritis and then suffered from Lennox-Gastaut syndrome. Urinary organic acid analysis revealed increased excretions of 3-hydroxyisovaleric acid and 3-methylcrotonylglycine. This patient was managed with a leucine restriction diet and supplementation of biotin and carnitine, which was not so effective. He suffered from neurologic sequelae such as Lennox-Gastaut syndrome, motor and cognitive impairements.
Acidosis ; Biotin ; Carnitine ; Diet ; Gastroenteritis ; Humans ; Hyperammonemia ; Hypoglycemia ; Leucine ; Liver ; Metabolism ; Status Epilepticus

t (8;21)(q22;q22) is the most frequently detected cytogenetic abnormality in patients with acute myeloid leukemia (AML) and accounts for 8-21% of de novo AML. The translocation involves two genes, RUNX1 (formerly AML1) on 21q22 and RUNX1T1 (ETO) on 8q22. RUNX1/RUNX1T1 translocation confers a favorable prognosis, but a subset of patients has a precipitous course with a high incidence of relapse. This patient subset is associated with the presence of a c-kit mutation. c-kit is a proto-oncogene, which encodes a type III transmembrane tyrosine kinase, which elicits a variety of cellular responses essential for the development of bone marrow stem cells. The expression of the c-kit mutation in AML is < 2%, whereas AML with RUNX1/RUNX1T1 shows higher rates of c-kit mutation and is associated with extramedullary leukemia and poor clinical outcome. We report cases of myeloid sarcoma in patients with RUNX1/RUNX1T1-positive AML and a c-kit mutation.
Bone Marrow ; Chromosome Aberrations ; Core Binding Factor Alpha 2 Subunit ; Humans ; Incidence ; Leukemia ; Leukemia, Myeloid, Acute ; Oncogene Proteins, Fusion ; Prognosis ; Protein-Tyrosine Kinases ; Proto-Oncogenes ; Recurrence ; Sarcoma, Myeloid ; Stem Cells

We observed a very rare case of primary lung cancer producing alpha-fetoprotein (AFP). A 70-year-old male with a history of smoking 50 packs per year was diagnosed with large cell carcinoma of the lung. The clinical stage was T2bN3M0 (IIIB), and serum AFP was 23,247 ng/mL. There was no evidence of metastasis to the liver, scrotum or other organs. While undergoing chemotherapy for 1 year, as the cancer progressed the AFP value steadily increased. The patient died of respiratory failure due to pneumonia 12 months after being diagnosed with lung cancer.
Aged ; alpha-Fetoproteins ; Carcinoma, Large Cell ; Humans ; Liver ; Lung ; Lung Neoplasms ; Male ; Neoplasm Metastasis ; Pneumonia ; Respiratory Insufficiency ; Scrotum ; Smoke ; Smoking

Paragonimiasis is an infectious disease caused by consumption of raw or improperly cooked freshwater crab or crayfish contaminated with Paragonimus metacercariae. The incidence of the disease has markedly decreased, but it is still a lung disease that requires a differential diagnosis in endemic areas such as Korea and Japan. It is commonly found in the lung but has also been found as extrapulmonary infestations, such as cerebral, spinal, subcutaneous, abdominal, urinary, and gynecological infestations. We report a rare case of ectopic paragonimiasis involving the breast with pleural effusion that was initially misdiagnosed as tuberculous pleurisy and a breast abscess.
Abscess ; Astacoidea ; Breast ; Communicable Diseases ; Diagnosis, Differential ; Fresh Water ; Incidence ; Japan ; Korea ; Lung ; Lung Diseases ; Metacercariae ; Paragonimiasis ; Paragonimus ; Pleural Effusion ; Tuberculosis, Pleural

Situs ambiguous is rare congenital anomaly in adults. In 2 adult patients who admitted for different cardiac problems, situs ambiguous with polysplenia was detected. A 42-year-old male admitted for radio frequent catheter ablation of atrial fibrillation, and he had left-sided inferior vena cava (IVC), hepatic segment of IVC interruption with hemiazygos continuation, multiple spleens and intestinal malrotation. And in a 52-year-old female case who was hospitalized due to infective endocarditis after implanting pacemaker for sick sinus syndrome, multiple spleens, left-sided stomach, bilateral liver with midline gallbladder, and left-sided IVC were found. Those findings were consistent with situs ambiguous with polysplenia, but their features were distinctive.
Adult ; Atrial Fibrillation ; Catheter Ablation ; Endocarditis ; Female ; Gallbladder ; Heterotaxy Syndrome ; Humans ; Liver ; Male ; Middle Aged ; Sick Sinus Syndrome ; Spleen ; Stomach ; Vena Cava, Inferior

Early repolarization is a common electrocardiographic (ECG) feature found in young adults, men and athletes, and has been considered to be a benign feature for the last several decades. But recent studies suggest that early repolarization may be related to idiopathic ventricular fibrillation and sudden cardiac death. We report a young man, 35 years old, who had life threatening ventricular fibrillation and sudden cardiac arrest. He was evaluated for cardiac causes of ventricular fibrillation. There was no explanation other than that his ECG showed an early repolarization pattern so we treated him with implantable cardioverter defibrillator. Thus, we suggest that early repolarization may be related with life threatening ventricular arrhythmia.
Arrhythmias, Cardiac ; Athletes ; Death, Sudden, Cardiac ; Defibrillators ; Electrocardiography ; Humans ; Male ; Ventricular Fibrillation* ; Young Adult

Isolated hypoparathyroidism (IH) shows heterogeneous phenotypes and can be caused by defects in a variety of genes. The goal of our study was to determine the clinical features and to analyze gene mutations in a large cohort of Korean patients with sporadic or familial IH. We recruited 23 patients. They showed a broad range of onset age and various values of biochemical data. Whole exome sequencing was performed on two affected cases and one unaffected individual in a family. All coding exons and exon-intron borders of GCMB, CASR, and prepro-PTH were sequenced using PCR-amplified DNA. In one family who underwent the whole exome sequencing analysis, approximately 300 single nucleotide changes emerged as candidates for genetic alteration. Among them, we identified a functional mutation in exon 2 of GCMB (C106R) in two affected cases. Besides, heterozygous gain-of-function mutations in the CASR gene were found in other subjects; D410E and P221L. We also found one single nucleotide polymorphism (SNP) in the prepro-PTH gene, five SNPs in the CASR gene, and four SNPs in the GCMB gene. The current study represents a variety of biochemical phenotypes in IH patients with the molecular genetic diagnosis of IH.
Adult ; Aged ; Asian Continental Ancestry Group/*genetics ; Cohort Studies ; Heterozygote ; Humans ; Hypoparathyroidism/diagnosis/*genetics/pathology ; Middle Aged ; Nuclear Proteins/*genetics ; Parathyroid Hormone/*genetics ; Phenotype ; Polymorphism, Single Nucleotide ; Receptors, Calcium-Sensing/*genetics ; Registries ; Republic of Korea ; Transcription Factors/*genetics ; Young Adult

Invasive aspergillosis (IA) is a major cause of morbidity and mortality in patients with hematological malignancies. While the development of new effective antifungals and advancement of diagnostic techniques have lead to improved outcomes, relapse of IA in patients with subsequent immunosuppression is emerging as a major issue. The primary IA site is the most common relapse site, but disseminated infection from the lung to multiple organs, including the brain, thyroid, liver, spleen, kidney, bone, heart valve, and skin, can often occur in patients with severe immunosuppression. Furthermore, relapsing or disseminated IA have very poor outcomes. We report a case of disseminated IA presenting as multiple cutaneous lesions without involvement of any other organs in an acute leukemia patient. The patient had suffered from prior invasive pulmonary aspergillosis, which was treated successfully. The multiple skin lesions were fully resolved after antifungal therapy for 6 weeks.
Aspergillosis ; Brain ; Heart Valves ; Hematologic Neoplasms ; Humans ; Immunosuppression ; Invasive Pulmonary Aspergillosis ; Kidney ; Leukemia ; Leukemia, Myeloid, Acute ; Liver ; Lung ; Recurrence ; Skin ; Spleen ; Thyroid Gland