Due to poor nutrition and abnormal energy metabolism, cancer patients typically experience the loss of muscle mass. Although the diabetic conditions or dyslipidemia have been reported as a causal link of cancer but the consequence of such conditions in relation to gain or loss of skeletal muscle mass in cancer patients has not been well documented. The purpose of this study was to investigate the relationship of lean body mass and systemic parameters related to lipid metabolism in non-diabetic cancer patients using data from the Korean National Health and Nutrition Examination Survey (KNHANES) 2008-2011. As results the level of serum total cholesterol (total-C) was negatively associated with both total lean body mass and appendicular lean body mass in cancer patients after adjustment for sex, physical activity, energy intake and comorbidity. The associations between consumption of dietary factors (energy, carbohydrate, protein and fat) and lean body mass were disappeared after adjusting comorbidities of cancer patients. Multivariate-adjusted linear regression analysis by quartiles of serum total-C showed that higher quartile group of total-C had significantly lower percent of lean body mass than reference group in cancer patients. The data indicate that serum lipid status can be the potential estimate of loss of skeletal muscle mass in cancer patients and be referenced in nutrition care of cancer patients under the onset of cachexia or parenteral/enteral nutrition. This data need to be confirmed with large pool of subjects and should be specified by stage of cancer or the site of cancer in future studies.
Cachexia ; Cholesterol* ; Comorbidity ; Dyslipidemias ; Energy Intake ; Energy Metabolism ; Humans ; Linear Models ; Lipid Metabolism ; Motor Activity ; Muscle, Skeletal ; Nutrition Surveys

Carcinoid tumors are the most common endocrine tumors of gastrointestinal tract. Argentaffin cells are the origin of carcinoids. These cells belong to the amino precursor uptake and decarboxylation (APUD) system. These cells give the tumor its most distinguishing feature: the ability to produce biogenic amines and polypeptide hormones that, in turn, give rise to the dramatic carcinoid syndrome. We treated a case of multi-centric carcinoid tumor of the duodenum in a 63-year-old male patient. He was admitted to the hospital because of epigastric pain. On the gastrofiberscopic examination, 1.0 x1.5 cm and 0.7 x0.8 cm sized two polyps (Yamada type II, I) were noticed on the duodenal bulb. The biopsy specimen showed carcinoid tumors of different histologic types. The level of 24-hour urine 5-HIAA of this case was normal. He was treated with subtotal gastrectomy with Billroth-II anastomosis. We report this case with literature review.
Biogenic Amines ; Biopsy ; Carcinoid Tumor* ; Decarboxylation ; Duodenum ; Enterochromaffin Cells ; Gastrectomy ; Gastrointestinal Tract ; Humans ; Hydroxyindoleacetic Acid ; Male ; Middle Aged ; Peptide Hormones ; Polyps

PURPOSE: Chronic upper airway obstruction causes hypoxemic pulmonary vasoconstriction, which may lead to right ventricle (RV) dysfunction. Adenotonsillar hypertrophy (ATH) is the most common cause of upper airway obstruction in children. Therefore, we aimed to evaluate RV function in children with ATH. METHODS: Twenty-one children (male/female, 15/6; mean age, 92.3~39.0 months; age range, 4-15 years) with ATH and 21 healthy age- and gender-matched controls were included in this study. Tricuspid annular plane systolic excursion and RV myocardial performance index were measured by transthoracic echocardiography. Further, the plasma level of N-terminal of probrain natriuretic peptide (NT-proBNP), an indicator of RV function, was determined. RESULTS: The snoring-tiredness during daytime-observed apnea-high blood pressure (STOP) questionnaire was completed by the patients' parents, and loud snoring was noted in the ATH group. The plasma NT-proBNP level was significantly higher in the ATH group than that in the controls (66.44+/-37.63 pg/mL vs. 27.85+/-8.89 pg/mL, P=0.001). The echocardiographic parameters were not significantly different between the groups. CONCLUSION: We were unable to confirm the significance of echocardiographic evidence of RV dysfunction in the management of children with ATH. However, the plasma NT-proBNP level was significantly higher in the ATH group than that in the control, suggesting that chronic airway obstruction in children may carry a risk for cardiac dysfunction. Therefore, more patients should be examined using transthoracic echocardiography. In addition, pediatricians and otolaryngologists should consider cardiologic aspects during the management of children with severe ATH.
Airway Obstruction ; Blood Pressure ; Child* ; Echocardiography ; Heart Ventricles* ; Humans ; Hypertrophy* ; Parents ; Plasma ; Surveys and Questionnaires ; Sleep Apnea, Obstructive ; Snoring ; Vasoconstriction

Hypoxia-induced cell damage is known to be mediated by increase in intracellular calcium. In the present study, the effect of calcium channel blockers on the hypoxia-induced cell damage was investigated in iat pheochromocytoma cells line, PC12 cells. The cultured cells were exposed to hypoxia under 95% N2 plus 5% C02 gas phase and incubated in the media devoid of fetal bovine seruril The cell demage was assessed by measuring the release of lactate dehydrogenase (LDH) from the cells into the incubation media. Exposure of the cells to hypoxia for 2 hours caused a 28% of the total LDH to be released from cells -into media. The pretreatment of the cells with 1 mM each of diltiazem, nifedipine, and verapamil depressed the LDH release to the extent of 52%, 42%, and 30% inhibition, respectively. The inhibitory effects of diltiazem and verapamil were more marked at 1 mM than at 10 mM. The influx of 45 Ca2+ into the cells was rapidly increased within 2 minutes after exposure of the cells to hypoxia. Diltiazem at 1 mM almost completely inhibited Ca2+ influx, while nifedipine and verapamil exhibited only, 30% inhibition of Ca2- influx. The results lend support to the notion that mcreased intracellular calcium triggers a series of cascade reactions leadmg to cell death. It is suggested that the inhibitory effects of various calcium antagonists on hypoxia-induced cell damage differ from each other in their potency.
Animals ; Anoxia* ; Calcium Channel Blockers ; Calcium* ; Cell Death ; Cells, Cultured ; Diltiazem ; L-Lactate Dehydrogenase ; Nifedipine ; PC12 Cells* ; Pheochromocytoma ; Verapamil

Acardiac twin is a rare complication of multifetal pregnancy. The literatures report an incidence of 1% among monochorionic twin pregnancies, i. e. 1 of 35,000 pregnancies. The absence of identifiable fetal heart structures in one twin and reduction anomalies in many organ systems suggest the diagnosis. It has been hypothesized that in the presence of artery-to-artery and vein-to-vein anastomoses in a monozygotic placenta, blood is perfused by hemodynamically advantaged pump-twin to the recipient twin by retrograde flow. The principal perinatal problems associated with acardiac twinning are congestive heart failure of pump-twin, maternal polyhydramnios, preterm delivery and intrauterine death. The outcome is invariably fatal for the acardiac twin and 50-75% of the normal twin. Management options include observation, medical therapy, and selective termination of acardiac twin. The most appropriate intervention for the various clinical presentations of this disorder is undetermined, and conservative nonintervention is often appropriate. Long-term follow-up data on surviving pump twins are lacking. We experienced a case of acardiac twin gestation which showed satisfactory outcome with conservative management, so we present the case with a brief review of the literature.
Diagnosis ; Fetal Heart ; Follow-Up Studies ; Heart Failure ; Humans ; Incidence ; Placenta ; Polyhydramnios ; Pregnancy ; Pregnancy, Twin

OBJECTIVE: We undertook this study to find out clinical characteristics and prognostic factors of neonatal survival in nonimmune hydrops fetalis (NIHF). METHODS: From Oct. 1988 to Feb. 2001, 54 cases of nonimmune hydrops fetalis diagnosed at Seoul National University Hospital (SNUH) were included in our study. The incidence and perinatal mortality were investigated. The diagnostic work-up for associated conditions (or etiology) included detailed ultrasonography, karyotyping, fetal echocardiography, infection work-up (TORCH, parvovirus), and autopsy (if fetus was dead). Among 54 cases, 20 cases of liveborns were divided into two groups. Group I survived beyond neonatal period (survived>28 days) and group II did not (expired3 (OR=21, CI 1.77, 248.1; p<0.05), and 5-min AS>3 (p<0.01). CONCLUSION: Over 3 of 1-min and 5-min AS were meaningful factors for neonatal survival in NIHF.
Apgar Score ; Autopsy ; Echocardiography ; Female ; Fetofetal Transfusion ; Fetus ; Gestational Age ; Hydrops Fetalis* ; Incidence ; Karyotyping ; Parturition ; Perinatal Mortality ; Pleural Effusion ; Polyhydramnios ; Pregnancy ; Seoul ; Ultrasonography

BACKGROUND/AIMS: This study was designed to compare the survival rates between patients with localized esophgeal cancer who were treated with concurrent chemoradiation therapy without surgery and patients who were treated with concurrent chemoradiation therapy including surgery. METHODS: Eighty-eight patients from January 1997 to December 2005 with locally advaned resectable esophageal cancer were selected and retrospectively analyzed. Survival period was defined as the time to death from the date of diagnosis or mid-monitor period of December 2005. Sixty-one patients were treated with chemoradiation therapy alone while twenty-seven patients were treated with chemoradiation therapy in addition to surgery as for curative intention. As for radiation therapy, 5,000-5,500 cGY was used. 5-Fluouracil and cisplatin were used for chemotherapy. The primary end point was overall survival time. The secondary end point was overall progression free survival time. RESULTS: There was no significant difference in tissue type, location and clinical staging, but the median age was significantly younger in the group treated with surgery (63.4 years) than the group treated without surgery (68.8 years). Median period analyzed was 17.3 months. Five year survival rate for the group with chemoradiation alone was 7.4% and 4% for the group with surgery. The median survival rate was 11+/-3 months for the group with chemoradiation alone and 10+/-6 months for the group with surgery, in which there was no statistical difference (p=0.697). CONCLUSIONS: There was no significant increase in survival rate in patients who were treated by chemoradiation with surgery compared with chemoradiation alone. Further analysis in terms of prospective study is needed.
Aged ; Aged, 80 and over ; Antineoplastic Agents/therapeutic use ; Combined Modality Therapy ; Data Interpretation, Statistical ; Esophageal Neoplasms/radiotherapy/surgery/*therapy ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Survival Rate