PURPOSE: Helicobacter pylori infection induces phenotype-stabilizing methylation and promotes gastric mucosal atrophy that can inhibit CpG-island methylation. Relationship between the progression of gastric mucosal atrophy and the initiation of CpG-island methylation was analyzed to delineate epigenetic period for neoplastic transformation. MATERIALS AND METHODS: Normal-appearing gastric mucosa was biopsied from 110 H. pylori–positive controls, 95 H. pylori–negative controls, 99 gastric cancer patients, and 118 gastric dysplasia patients. Gastric atrophy was assessed using endoscopic-atrophic-border score. Methylation-variable sites of eight CpG-island genes adjacent to Alu (CDH1, ARRDC4, PPARG, and TRAPPC2L) or LTR (MMP2, CDKN2A, RUNX2, and RUNX3) retroelements and stomach-specific TFF3 gene were analyzed using radioisotope-labeled methylation-specific polymerase chain reaction. RESULTS: Mean ages of H. pylori–positive controls with mild, moderate, and severe atrophy were 51, 54, and 65 years and those of H. pylori–associated TFF3 overmethylation at the three atrophic levels (51, 58, and 63 years) tended to be periodic. Alu-adjacent overmethylation (50 years) was earlier than TFF3 overmethylation (58 years) in H. pylori–positive controls with moderate atrophy. Cancer patients with moderate atrophy showed late Alu-adjacent (58 years) overmethylation and frequent LTR-adjacent overmethylation. LTR-adjacent overmethylation was frequent in cancer (66 years) and dysplasia (68 years) patients with severe atrophy. CONCLUSION: Atrophic progression is associated with gastric cancer at moderate level by impeding the initiation of Alu-adjacent methylation. LTR-adjacent methylation is increased in cancer patients and subsequently in dysplasia patients.
Atrophy* ; DNA Methylation ; Epigenomics ; Gastric Mucosa ; Gastritis, Atrophic ; Genes, Essential* ; Helicobacter pylori ; Housekeeping* ; Humans ; Methylation* ; Polymerase Chain Reaction ; Retroelements ; Stomach Neoplasms*

Purpose: We examined the effects of the 8-week moderate-intensity Pilates exercise program on body composition, balance ability, metabolic parameters, arterial condition, and eating habits among overweight and obese women. Methods: From the general sample of overweight or obese Korean women (body mass index ≥ 23 kg/m2 ), those who had not been diagnosed with any chronic degenerative diseases were enrolled in the study (n = 39). After 8 weeks of the Pilates exercise program, the participants were subdivided into adherence and non-adherence groups. Among the study participants, 24 women were matched for age and menopausal status to reduce the bias, and then finally included for the comparison (Pilates-adherence, n = 12; Pilates-non-adherence, n = 12). Results: The body balance measured by the Y-balance test, body mass index, and subcutaneous fat areas were significantly improved in both groups. However, the Pilatesadherence group showed more positive changes in body balance and had significant improvement in body composition parameters such as waist size, visceral fat area, systolic blood pressure, arterial aging index, fasting blood glucose, and glycated hemoglobin than the Pilates-non-adherence group. In addition, the nutrition quotient for Korean adults (balance,moderation, and behavior except diversity) were significantly improved in both groups after dietary education. However, the participants did not show dramatic improvement in the metabolic parameters, because all the study subjects were in relatively good health and did not have any diagnosed diseases. Conclusion This study demonstrated that higher adherence to the Pilates exercise program together with a modification of eating habits may effectively improve body balance, body composition, and obesity-related parameters among overweight and obese women.

Purpose: We aimed to identify factors influencing smoking cessation success among cancer patients registered in an inpatient smoking cessation program at a single cancer center. Materials and Methods: The electronic medical records of enrolled patients with solid cancer were retrospectively reviewed. We evaluated factors associated with 6-month smoking cessation. Results: A total of 458 patients with cancer were included in this study. Their mean age was 62.9±10.3 years, and 56.3% of the participants had lung cancer. 193 (42.1%) had not yet begun their main treatment. The mean number of counseling sessions for the participants was 8.4±3.5, and 46 (10.0%) patients were prescribed smoking cessation medications. The 6-month smoking cessation success rate was 48.0%. Multivariate analysis showed that younger age (<65 years), cohabited status, early stage, and the number of counseling sessions were statistically significant factors affecting 6-month smoking cessation success (p<0.05). Initiation of a cessation program before cancer treatment was significantly associated with cessation success (odds ratio, 1.66; 95% confidence interval, 1.02–2.70; p=0.040). Conclusion Smoking cessation intervention must be considered when establishing a treatment plan immediately after a cancer diagnosis among smokers.

Systemic lupus erythematosus (SLE) is a multisystem inflammatory disorder mediated by autoantibodies and immune complexes that exhibit a range of symptoms. Although thirty-five to forty percent of patients with SLE show signs or symptoms of gastrointestinal involvement, acute pancreatitis is an uncommon complication of SLE, and SLE presenting with acute pancreatitis is extremely rare. We report a case of a 28-year-old female SLE patient who initially presented with acute abdominal pain and elevated pancreatic enzyme levels. The patient was diagnosed clinically with acute pancreatitis and then with SLE after further investigations. Her condition improved after high dose steroid therapy.
Abdominal Pain ; Adult ; Antigen-Antibody Complex ; Autoantibodies ; Female ; Humans ; Lupus Erythematosus, Systemic ; Pancreatitis

Malignant fibrous histiocytoma, a type of sarcoma, is a malignant neoplasm with uncertain origin that arises in both the soft tissues and the bone. The occurrence of primary malignant fibrous histiocytoma of the pleura is extremely rare. We report a case of a 65-year-old Korean man who is being diagnosed with primary malignant fibrous histiocytoma of the pleura.
Histiocytoma, Malignant Fibrous ; Pleura ; Sarcoma

Systemic lupus erythematosus (SLE) is a multisystemic inflammatory autoimmune disease mediated by autoantibodies and immune complexes. In SLE, a splenectomy to control the thrombocytopenia does not increase the total risk of thrombosis, but tends to increase arterial events. We experienced a patient with lupus- anticoagulant positive SLE who developed a venous thrombosis after a splenectomy for the control of thrombocytopenia, which was a very rare case.
Antigen-Antibody Complex ; Autoantibodies ; Autoimmune Diseases ; Humans ; Lupus Erythematosus, Systemic ; Splenectomy ; Thrombocytopenia ; Thrombosis ; Venous Thrombosis

PURPOSE: Asthma is one of the most common chronic childhood disease. Education of asthmatic children and their families about asthma and its management may improve disease control, reduce symptoms, and improve school performance. The aim of the study was to evaluate the effects of an intensive asthma education program in asthmatic children and their families on outcome measure of asthma management behavior scale, knowledge about asthma, self efficacy scale and quality of life. METHODS: Fifteen asthmatic children and their families were invited the intensive asthma education program which including allergen avoidance, management of asthma, correct use of the inhalation devices and control of exercise-induced asthma (study group). Fifteen asthmatic children and their families those who did not participate this program were served as control group. Participants were asked to complete a written questionnaire before and 3-month after the program. RESULTS: After completing the intensive education program, significant improvement of the childrens asthma management behavior scale (27.1 vs. 32.2, P=0.011), belief and knowledge about asthma (14.2 vs. 17.9, P<0.001), self efficacy (47.9 vs. 49.7, P=0.091) and quality of life (79.6 vs. 88.6, P<0.001) was noted in the study group by measuring questionnaires. There are increasing tendencies in parental asthma management behavior scale and knowledge about asthma. CONCLUSION: This intensive asthma education program is effective in improving asthma control, self efficacy and quality of life of asthmatic children. This should serve as a national model for family-based programs for asthmatic children and their families.
Asthma ; Asthma, Exercise-Induced ; Caregivers ; Child ; Disease Management ; Humans ; Nebulizers and Vaporizers ; Outcome Assessment (Health Care) ; Parents ; Patient Education as Topic ; Quality of Life ; Surveys and Questionnaires ; Self Efficacy

BACKGROUND: The purpose of this study was to compare the outcome of carbapenem versus non-carbapenem antimicrobial therapy for pediatric urinary tract infections (UTIs) caused by extended-spectrum beta-lactamase (ESBL) producing Enterobacteriaceae. MATERIALS AND METHODS: From 2006 to 2011, 42 episodes of UTI caused by ESBL-producing Enterobacteriaceae were diagnosed at Seoul National University Children's Hospital. Patients were grouped according to the antimicrobials they received into a carbapenem group and a non-carbapenem group. Medical records were retrospectively reviewed to assess treatment outcome, time to defervescence after initiation of treatment, and relapse rate. RESULTS: There were 36 children with 42 episodes of UTI caused by ESBL-producing Enterobacteriaceae. Twenty-seven cases (64%) had an underlying urologic disease, 28 (67%) cases were caused by Escherichia coli, and 14 (33%) cases were caused by Klebsiella pneumoniae. Four (10%) cases were treated with carbapenem, 23 cases (55%) were treated with non-carbapenem, and 15 (36%) cases were treated by switching from a carbapenem to a non-carbapenem and vice versa. There was no treatment failure at the time of antimicrobial discontinuation. Between the carbapenem and the non-carbapenem treatment groups, there were no significant differences in bacterial etiology (P = 0.59), time to defervescence after the initiation of antimicrobials (P = 0.28), and relapse rate (P = 0.50). In vitro susceptibility to non-carbapenem antimicrobials did not affect the time to defervescence after the initiation of antimicrobial treatment, and the relapse rate in the non-carbapenem group. CONCLUSIONS: This study found no significant difference in the treatment outcome between pediatric patients treated with carbapenem and those treated with non-carbapenem antimicrobials for UTI caused by ESBL-producing Enterobacteriaceae. Therefore, the initially administered non-carbapenem can be maintained in UTI patients showing clinical improvement.
beta-Lactamases ; Child ; Enterobacteriaceae* ; Escherichia coli ; Humans ; Klebsiella pneumoniae ; Medical Records ; Recurrence ; Retrospective Studies ; Seoul ; Treatment Failure ; Treatment Outcome ; Urinary Tract Infections* ; Urinary Tract* ; Urologic Diseases

Transcatheter arterial chemoembolization (TACE) has become an effective alternative treatment strategy for patients with inoperable hepatocellular carcinoma (HCC). Although TACE is relatively safe, acute respiratory distress syndrome associated with pulmonary lipiodol embolism is a rare and potentially fatal complication. We report a rare case of acute respiratory distress syndrome after TACE for inoperable HCC. A 75-year-old man, with huge HCC in right lobe, was treated by TACE for the first time. Seven hours after uneventful TACE procedure, he felt dyspneic and his oxygen saturation recorded by pulse oximetry (SpO2) fell to 80% despite of applying non-rebreathing mask. He underwent mechanical ventilation with a protective ventilatory strategy. We experienced a case of acute respiratory distress syndrome after TACE for HCC.
Carcinoma, Hepatocellular ; Embolism ; Ethiodized Oil ; Humans ; Masks ; Oximetry ; Oxygen ; Respiration, Artificial ; Respiratory Distress Syndrome, Adult

We present the case of a 34-year-old man with acute biphenotype leukemia that co-expressed B-lymphoid and myeloid antigen after the diagnosis of pulmonary alveolar proteinosis (PAP). The diagnosis of PAP was established by Periodic Acid-Schiff reaction staining on the Video Associated Thoracoscope guided lung biopsy and biphenotype leukemia was revealed by immunohistochemical stains of the blasts harvested from the bone marrow biopsy. Supposedly, PAP follows a hematologic malignancy, yet this case shows the reverse sequence.
Adult ; Biopsy ; Bone Marrow ; Coloring Agents ; Hematologic Neoplasms ; Humans ; Leukemia ; Lung ; Periodic Acid-Schiff Reaction ; Pulmonary Alveolar Proteinosis ; Thoracoscopes