BACKGROUND/OBJECTIVES: Breast milk is the best available food for optimum growth and development of infants and the breastfeeding rate is increasing in Korea. The purpose of this study is to measure the concentrations of macronutrients and to evaluate their changes according to lactation period in breast milk from lactating Korean women. SUBJECTS/METHODS: Milk samples were obtained from 2,632 healthy lactating women (mean age; 32.0 +/- 3.3 years), where the lactating period was up to a period of 8 months, who also volunteered to participate in the Human Milk Macronutrient Analysis Research. Lactose, protein, fat and water content in the breast milk samples were analyzed with infrared spectrometry using MilkoScan FT-2. RESULTS: The mean macronutrient composition per 100 mL of mature breast milk was 7.1 g for lactose, 1.4 g for protein and 3.0 g for fat, and energy content was 61.1 kcal. The protein concentration was significantly lower in milk samples at 1-2 weeks (2.0 g/dL) to 2-3 months (1.4 g/dL) than those at 0-1 week (2.2 g/dL), but it was similar among samples from 3-4 months to 7-8 months (1.3 g/dL). Mean lipid levels varied among different lactational period groups (2.7-3.2 g/dL), but presented no significant difference. Lactose concentration in the milk samples did not differ with lactation period. Maternal body mass index was positively related to protein and lipid breast milk contents, but was negatively related to lactose content. General linear models examining the associations between maternal variables and milk macronutrient content revealed that lactation period had a major impact on protein and lipid, but not on lactose content in breast milk. CONCLUSIONS: These results warrant future studies to explore factors that may be associated with changes in macronutrient content in human milk.
Body Mass Index ; Breast Feeding ; Female ; Growth and Development ; Humans ; Infant* ; Korea ; Lactation ; Lactose ; Linear Models ; Milk ; Milk, Human* ; Mothers* ; Spectrum Analysis ; Water

Anomalous union of the pancreaticobiliary duct (AUPBD) is a congenital anomaly that is defined as a junction of the bile duct and pancreatic duct outside the duodenal wall. This anomaly results in a loss of normal sphincteric mechanisms at the pancreaticobiliary junction. As a result, regurgitation of pancreatic juice into the biliary system develops and causes choledochal cysts, choledocholithiasis, cholangitis, pancreatitis and malignancy of the biliary tract. Gallbladder cancer or common bile duct cancer associated with AUPBD and choledochal cysts have been frequently reported. But, intrahepatic cholangiocarcinoma associated with this condition has been only rarely reported. Here, we report a case of intrahepatic cholangiocarcinoma associated with AUPBD and choledochal cyst.
Adult ; Bile Duct Neoplasms/*diagnosis/etiology/pathology ; *Bile Ducts, Intrahepatic ; Cholangiocarcinoma/*diagnosis/etiology/pathology ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangiopancreatography, Magnetic Resonance ; Choledochal Cyst/complications/*diagnosis ; Female ; Humans ; Positron-Emission Tomography and Computed Tomography ; Tomography, X-Ray Computed

This study was performed to investigate the effect of insight on the readiness to change in alcoholism. The subjects were 131 Korean male patients with alcohol dependence who were being hospitalized in a community-based alcohol treatment center. The patients' readiness to change was classified into precontemplation, contemplation, and action stage through the readiness to change questionnaire. The state of the patients' insight was measured through the Hanil alcohol insight scale. Fourteen patients (10.7%) were in the stage of precontemplation, 65 (49.6%) in contemplation and 52 (39.7%) in action stage. The insight score of the patients in precontemplation stage was significantly lower (p<0.001) than that of others. On the basis of the precontemplation stage, multinomial logistic regression analysis for the control of the differences in the patients' characteristics among each stage of the readiness to change showed that the possibility of contemplation and action stage went up 1.231 (p<0.01) and 1.249 (p<0.01) times higher as the insight score increased.
Adaptation, Psychological ; Adult ; Alcohol Drinking ; Alcoholism/*psychology/*therapy ; Awareness ; Health Behavior ; Humans ; Korea ; Male ; Middle Aged ; Motivation ; Psychometrics ; Questionnaires ; Regression Analysis ; Self Care

A volvulus of the colon is a twisting of a redundant segment of the colon at its narrow mesentery. A sigmoid volvulus is the most common type. This disorder may spontaneously reduce and recur as a chronic problem. However, it more frequently becomes acute as a result of an obstruction, which can lead to strangulation and gangrene with a high mortality if not treated promptly. Colonoscopic reduction and decompression is the preferred initial treatment for patients with a sigmoid volvulus who show no signs of bowel strangulation, which may be the cause of the high mortality associated with emergency surgery. We experienced 2 cases of a sigmoid volvulus in a 44-year-old female and a 51-year-old male. The sigmoid volvulus was diagnosed by simple abdominal film and treated successfully by an emergency colonoscopic reduction. We report our experience on the use of colonoscopy to treat sigmoid volvulus with a reviews of the relevant literlature.
Female ; Humans ; Mortality

PURPOSE: There are several reports suggested the usefulness of serum tumor markers, AFP, CEA and CA19-9 as prognostic factors or indicators for recurrence in gastric cancer. This clinical study was performed to evaluate positive rate of tumor markers according to site of recurrence in gastric cancer. MATERIALS AND METHODS: From the database of patients who underwent radical gastrectomy for gastric cancer between January 1999 and January 2004, 52 patients who showed recurrence were included in this retrospective study. Serum levels of tumor markers were measured at the time of preoperative diagnosis of the gastric cancer and at the time of postoperative recurrence during follow up, respectively. RESULTS: The overall positivity of tumor markers at the time of recurrence was found to be significantly higher than that of prior to surgery in the recurred group for the single test as well as the combination tests. For the peritoneum, the most common recurrent site, the positivity of CA19-9 was higher at the time of recurrence. And the significant positivity of CEA at the time of recurrence was detected in the liver cases. CONCLUSION: Having a preoperative positive tumor marker may identify the patient as having an increased chance of a recurrence. Although tumor markers continue to have limited diagnostic significance in gastric cancer, CA19-9 may be useful as a predictor for peritoneal recurrence of the gastric cancer, and CEA for recurrence to liver.
Diagnosis ; Follow-Up Studies ; Gastrectomy ; Humans ; Liver ; Peritoneum ; Recurrence* ; Retrospective Studies ; Stomach Neoplasms* ; Biomarkers, Tumor

Typhoid fever often manifests hepatic involvement but pleural involvement has rarely been reported to occur as a complication of typhoid fever. One case of typhoid pleurisy, in which Salmonella was isolated from the blood, is presented with the brief review of the literature. A 44 year old female was admitted to the hospital because of high fever, abdominal pain. Typhoid fever was diagnosed by blood culture, Widal test, and liver function test. Chest X-ray and pleural effusion examination demonstrated pleurisy. With the administration of ceftriaxone and pleural aspiration, she became afebrile with subsidence of pleural effusion.
Abdominal Pain ; Adult ; Ceftriaxone ; Female ; Fever ; Hepatitis* ; Humans ; Liver Function Tests ; Pleural Effusion ; Pleurisy* ; Salmonella ; Thorax ; Typhoid Fever*

Typhoid fever often manifests hepatic involvement but pleural involvement has rarely been reported to occur as a complication of typhoid fever. One case of typhoid pleurisy, in which Salmonella was isolated from the blood, is presented with the brief review of the literature. A 44 year old female was admitted to the hospital because of high fever, abdominal pain. Typhoid fever was diagnosed by blood culture, Widal test, and liver function test. Chest X-ray and pleural effusion examination demonstrated pleurisy. With the administration of ceftriaxone and pleural aspiration, she became afebrile with subsidence of pleural effusion.
Abdominal Pain ; Adult ; Ceftriaxone ; Female ; Fever ; Hepatitis* ; Humans ; Liver Function Tests ; Pleural Effusion ; Pleurisy* ; Salmonella ; Thorax ; Typhoid Fever*

We experienced a case of primary gastric tuberculosis presented with melena. A 61-year-old male was admitted with epigastric pain and melena. Upper endoscopy revealed an irregular shaped gastric ulcer on the posterior wall of the body. Histological examination of endoscopic specimen revealed chronic inflammation with fibrosis, granulomas and acid-fast bacilli. Cultures for acid-fast bacilli subsequently grew Mycobacterium tuberculosis. There was no evidence of the tuberculous lesion anywhere else. Primary gastric tuberculosis remains an extremely uncommon clinical entity; the definitive diagnosis is made by biopsy and positive culture for the organism. We report a case of primary gastric tuberculosis with review of the literature.
Biopsy ; Diagnosis ; Endoscopy ; Fibrosis ; Granuloma ; Humans ; Inflammation ; Male ; Melena* ; Middle Aged ; Mycobacterium tuberculosis ; Stomach Ulcer ; Tuberculosis*

We report a case of a 27-year-old male showing Becker's nevus on his trunk and lower extremities. It represented symmetrically bilateral and extensive(about 50% of body surface) involvement. In addition to the usual clinical findings of Becker's nevus, grouped small darker spots were noted on the lesion of the buttock featuring agminated lentigine. Histologic findings of the brownish pigmented lesion consisted of mild acanthosis, hyperkeratosis, elongation of rete ridges, increase of basal layer pigmentation, and numerous terminal hair follicles. A dark macule in agminated lesions on the buttock showed more dense basal layer pigmentation and more regular elongation and fusion of rete ridges consistent with the histologic findings of lentigo simplex. This report describes a rare case of a giant Becker's nevus involving 50% of body surface in a bilateral and symmetrical distribution with associated agminated lentigine.
Adult ; Buttocks ; Hair Follicle ; Humans ; Lentigo ; Lower Extremity ; Male ; Nevus* ; Pigmentation

We report a case of a 27-year-old male showing Becker's nevus on his trunk and lower extremities. It represented symmetrically bilateral and extensive(about 50% of body surface) involvement. In addition to the usual clinical findings of Becker's nevus, grouped small darker spots were noted on the lesion of the buttock featuring agminated lentigine. Histologic findings of the brownish pigmented lesion consisted of mild acanthosis, hyperkeratosis, elongation of rete ridges, increase of basal layer pigmentation, and numerous terminal hair follicles. A dark macule in agminated lesions on the buttock showed more dense basal layer pigmentation and more regular elongation and fusion of rete ridges consistent with the histologic findings of lentigo simplex. This report describes a rare case of a giant Becker's nevus involving 50% of body surface in a bilateral and symmetrical distribution with associated agminated lentigine.
Adult ; Buttocks ; Hair Follicle ; Humans ; Lentigo ; Lower Extremity ; Male ; Nevus* ; Pigmentation