PURPOSE: As the importance of breastfeeding has been reinforced, human milk is often stored for practical reasons. Therefore, we evaluated optimal storage and processing methods for human milk from a nutritional standpoint. METHODS: Human milk samples were collected between June 2017 and February 2018. Also, data about maternal information were collected. Human milk was analyzed for macronutrients and caloric content. The samples were subdivided into groups for nutrient analysis. The control group (fresh milk) was not stored or processed. The other groups (9 groups) consisted of samples analyzed based on different storage temperatures (room temperature, refrigerated, frozen), defrosting methods (bottle warmer, room temperature thawing, microwave oven), and storage period (1 week, 1 month, 2 months) and compared with the control group. RESULTS: There was no statistically significant difference in the nutrient content of human milk among the collected samples. A significant change in the content of macronutrients in milk samples was observed under storage condition at different temperatures for 1 week with subsequent thawing with bottle warmer compared to fresh milk. Under storage at −20°C for 1 week with subsequent thawing with different defrosting methods, a significant change in the content of macronutrients in milk samples was observed compared to fresh milk. After storage at −20°C for different periods and thawing with a bottle warmer, a significant change in macronutrient content in milk samples was observed compared to fresh milk regardless of the storage period. CONCLUSION: Unlike previous guidelines, changes in macronutrient content in milk samples were observed regardless of the method of storing and thawing. Apparently, it is proposed that mothers should feed fresh human milk to their babies without storing.
Breast Feeding ; Humans ; Infant Formula ; Methods ; Microwaves ; Milk ; Milk, Human ; Mothers

PURPOSE: Lung Cancer Subcommittee of Korean Radiation Oncology Group (KROG) has recently launched a prospective clinical trial (KROG 17-06) of hippocampus-sparing whole brain radiotherapy (HS-WBRT) with simultaneous integrated boost (SIB) in treating multiple brain metastases from non-small cell lung cancer. In order to improve trial quality, dummy run studies among the participating institutions were designed. This work reported the results of two-step dummy run procedures of the KROG 17-06 study. MATERIALS AND METHODS: Two steps tested hippocampus contouring variability and radiation therapy planning compliance. In the first step, the variation of the hippocampus delineation was investigated for two representative cases using the Dice similarity coefficients. In the second step, the participating institutions were requested to generate a HS-WBRT with SIB treatment plan for another representative case. The compliance of the treatment plans to the planning protocol was evaluated. RESULTS: In the first step, the median Dice similarity coefficients of the hippocampus contours for two other dummy run cases changed from 0.669 (range, 0.073 to 0.712) to 0.690 (range, 0.522 to 0.750) and from 0.291 (range, 0.219 to 0.522) to 0.412 (range, 0.264 to 0.598) after providing the hippocampus contouring feedback. In the second step, with providing additional plan priority and extended dose constraints to the target volumes and normal structures, we observed the improved compliance of the treatment plans to the planning protocol. CONCLUSION: The dummy run studies demonstrated the notable inter-institutional variability in delineating the hippocampus and treatment plan generation, which could be decreased through feedback from the trial center.
Brain ; Carcinoma, Non-Small-Cell Lung ; Compliance ; Hippocampus ; Lung Neoplasms ; Neoplasm Metastasis ; Prospective Studies ; Radiation Oncology ; Radiotherapy

PURPOSE: Secondary primary cancers (SPCs) commonly arise in patients with renal cell carcinoma (RCC). We designed the present study to estimate the SPC incidence in Korean patients with RCC. MATERIALS AND METHODS: The study cohort was population-based and consisted of 40,347 individuals from the Korean Central Cancer Registry who were diagnosed with primary renal cancer between 1993 and 2013. Standardized incidence ratios (SIRs) for SPCs were estimated for different ages at diagnosis, latencies, diagnostic periods, and treatments. RESULTS: For patients with primary RCC, the risk of developing a SPC was higher than the risk of developing cancer in the general population (SIR, 1.13; 95% confidence interval, 1.08 to 1.18). Most cancer types showed higher incidences in patients with RCC than in the general population. However, the relative incidence of gastric cancer as an SPC varied by age. Gastric cancer incidence was elevated in young patients (< 30 years) with RCC, but reduced in older (≥ 30) patients with RCC. Patients with advanced RCC died prematurely, regardless of SPC development. In contrast, those with early-stage RCC survived for longer periods, although SPC development affected their post-RCC survival. After SPC development, women had better survival than men. CONCLUSION: In Korean patients with primary RCC, the incidence of SPC was 13% higher than the incidence of cancer in the general population. These findings may play important roles in the conduct of follow-up evaluations and education for patients with RCC.
Carcinoma, Renal Cell ; Cohort Studies ; Diagnosis ; Education ; Female ; Follow-Up Studies ; Humans ; Incidence ; Kidney Neoplasms ; Kidney ; Korea ; Male ; Neoplasms, Second Primary ; Prognosis ; Stomach Neoplasms

PURPOSE: This descriptive study assessed the current trends in the incidence of urological cancers and patient survival in Korea. MATERIALS AND METHODS: In this nationwide retrospective observational study based on the data from the Korea National Cancer Incidence Database (KNCIDB), this study analyzed the age-standardized incidence rates (ASRs) and annual percentage changes (APCs) of kidney, bladder, prostate, testicular, and penile cancers as well as cancer of the renal pelvis and ureter between 1999 and 2012. The relative survival rates (RSRs) were calculated for urological cancer patients diagnosed between 1993 and 2012 from the KNCIDB data. RESULTS: Prostate cancer was diagnosed in 66,812 individuals followed by bladder (41,549) and kidney (36,836) cancers. The overall ASR (18.26 per 100,000) increased with age because of the higher ASRs of bladder and prostate cancers in the elderly. The ASR for kidney cancer was highest in the 40-59-year-old group, whereas testicular cancer occurred most frequently before the age of 40. The incidence of most urological cancers increased (overall APC, 6.39%; p < 0.001), except for penile (APC, –2.01%; p=0.05) and bladder (APC, –0.40%; p=0.25) cancers. The overall survival increased steadily (5-year RSR, 66.4% in 1993-1995 vs. 84.2% in 2008-2012; p < 0.001), particularly for prostate (by 34.10%) and kidney (by 16.30%) cancers, but not for renal pelvis and ureter cancers (–7.20%). CONCLUSION: The most common urological cancer in Korea was prostate cancer followed by bladder and kidney cancers. The incidence of most urological cancers, except for penile and bladder cancers, increased. Survival also increased, particularly for prostate and kidney cancers.
Aged ; Humans ; Incidence* ; Kidney ; Kidney Neoplasms ; Kidney Pelvis ; Korea* ; Male ; Observational Study ; Penile Neoplasms ; Prostate ; Prostatic Neoplasms ; Retrospective Studies ; Survival Rate* ; Testicular Neoplasms ; Ureter ; Ureteral Neoplasms ; Urinary Bladder ; Urinary Bladder Neoplasms ; Urologic Neoplasms*

Primary rectal mucosa-associated lymphoid tissue (MALT) lymphoma is a particularly rare disease, comprising <1% of gastrointestinal lymphomas. Although antibiotic therapy has been demonstrated effective for gastric MALT lymphoma, the optimal treatment for MALT lymphoma of the rectum is unknown. Radiotherapy or surgery is often used to treat limited stage MALT lymphoma of the rectum. Here, we describe a case of a 44-year-old-man, who was diagnosed with primary MALT lymphoma of the rectum through colonoscopy. Other staging evaluations, including upper gastrointestinal endoscopy, abdomino-pelvic CT, chest CT, 18F fludeoxyglucose-positron emission tomography, and a bone marrow examination showed no other abnormalities, except stage IA para-rectal lymphadenopathy. The patient received 2 months of radiotherapy without major toxicity. A follow-up abdomino-pelvic CT scan revealed marked improvement in the volume of rectal lymphoma and adjacent lymph nodes. Mucosal nodularity of the lower rectum had completely regressed at the follow-up endoscopy and complete remission was confirmed with a biopsy.
Biopsy ; Bone Marrow Examination ; Colonoscopy ; Endoscopy ; Endoscopy, Gastrointestinal ; Follow-Up Studies ; Humans ; Lymph Nodes ; Lymphatic Diseases ; Lymphoid Tissue ; Lymphoma ; Lymphoma, B-Cell, Marginal Zone ; Rare Diseases ; Rectum ; Thorax

Tumor migration/invasion is the main cause of tumor progression and STAT3 is needed to enhance tumor migration/invasion by up-regulating MMP-9. Thus, agents that inhibit STAT3 activation may be used as an anticancer drug. We present herein that 6-methyl-2-propylimino-6, 7-dihydro-5H-benzo [1, 3]-oxathiol- 4-one (LYR71) , a derivative of trimeric resveratrol, has an anticancer activity through inhibition of STAT3 activation. We found that LYR71 suppressed STAT3 activation and inhibited the expression and activity of MMP-9 in RANTES-stimulated breast cancer cells. In addition, LYR71 reduced RANTES-induced MMP-9 transcripts by blocking STAT3 recruitment, dissociating p300 and deacetylating histone H3 and H4 on the MMP-9 promoter. Furthermore, LYR71 inhibited tumor migration/invasion in RANTES-treated breast cancer cells and consequently blocked tumor progression in tumor-bearing mice. Taken together, the results of this study suggest that LYR71 can be therapeutically useful due to the inhibition effect of STAT3-mediated MMP-9 expression in breast cancer cells.
Animals ; Antineoplastic Agents/chemistry/*pharmacology ; Bicyclo Compounds, Heterocyclic/chemistry/*pharmacology ; Blotting, Western ; Breast Neoplasms/genetics/metabolism/pathology ; Cell Line, Tumor ; Cell Movement/drug effects ; Cell Survival/drug effects ; Chromatin Immunoprecipitation ; Female ; Gene Expression/drug effects ; Humans ; Imines/chemistry/*pharmacology ; Immunohistochemistry ; Mammary Neoplasms, Experimental/pathology/prevention & control ; Matrix Metalloproteinase 9/genetics/*metabolism ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Molecular Structure ; Phosphorylation/drug effects ; Reverse Transcriptase Polymerase Chain Reaction ; STAT3 Transcription Factor/genetics/*metabolism ; Stilbenes/chemistry ; Xenograft Model Antitumor Assays/methods

The general anesthesia combined with epidural anesthesia have many advantages, which are including early recovery, postoperative analgesia, and less requirement of inhalation anesthetic. But the complications of epidural anesthesia such as total spinal anesthesia, respiratory depression, myocardial ischemia, and local anesthetic toxicity can lead to cardiac arrest. We report a case of acute myocardial infarction in a 74-year-old female patient receiving general anesthesia combined with epidural anesthesia. The profound hypotension without bradycardia and ST-segment elevation in lead II occurred 1 hour after local anesthetic injection and cardiac arrest followed. After the injection of atropine, epinephrine and dopamine, and external cardiac massage, sinus rhythm was restored. Postoperative serial examinations of ECG showed ST-segment elevation in leads II, III, aVF and serum enzymes such as CPK, CK-MB, and Troponin T were elevated. Emergency percutaneous transluminal coronary angioplasty was performed and the patient recovered uneventfully.
Aged ; Analgesia ; Anesthesia, Epidural ; Anesthesia, General ; Anesthesia, Spinal ; Angioplasty, Balloon, Coronary ; Atropine ; Bradycardia ; Dopamine ; Electrocardiography ; Emergencies ; Epinephrine ; Female ; Heart Arrest ; Heart Massage ; Humans ; Hypotension ; Inhalation ; Myocardial Infarction ; Myocardial Ischemia ; Respiratory Insufficiency ; Troponin T

A 6-year-old-man with a severe pectus excavatum and marfanoid feature was admitted for the correction of pectus excavatum. Nuss procedure was recently introduced, because of its excellent effect from the cosmetic point of view. This method is that convex steel bar is inserted under the sternum through small bilateral thoracic incisions, and when it is in position, the bar is turn over, thereby correction the deformity. We experienced a case of the cardiac arrest during the rotation of a stainless steel bar. After the injection of atropine, epinephrine and the closed cardiac massage, sinus rhythm was restored. A vasovagal reflex due to the operation could be considered the possible etiology.
Atropine ; Congenital Abnormalities ; Epinephrine ; Funnel Chest* ; Heart Arrest* ; Heart Massage ; Humans ; Reflex ; Stainless Steel* ; Steel ; Sternum

Nuss procedure offers excellent outcome effect in the cosmetic point of view, but the complications such as cardiac perforation, pericardial effusion, constrictive pericarditis, hemothorax, pneumothorax and bar displacement sometimes occur. We experienced a 13-year-old-male, who showed the profound hypotension with bradycardia due to the cardiac perforation and the lung laceration during the pericardiectomy and the removal of pectus bar. Emergent partial cardiopulmonary bypass was initiated and then, ruptured right atrium and lung laceration were repaired without the remarkable complications. In anesthetic management of the pectus excavatum. This case reveals that special attention should be paid to those with cardiac perforation and lung laceration.
Bradycardia ; Cardiopulmonary Bypass ; Funnel Chest* ; Heart Atria ; Hemothorax* ; Humans ; Hypotension ; Lacerations ; Lung ; Pericardial Effusion ; Pericardiectomy* ; Pericarditis, Constrictive* ; Pneumothorax

The authors report a rare case of retroperitoneal leiomyosarcoma in a 49 year-old woman, with a palpable mass in the left lower abdomen. There is a large neoplasm which was soft and movable, looking a pelvic mass. Abdominal and pelvic CT scan showed a 11.0x9.2x7.5 cm-sized lobulated heterogenous enhancing mass with multifocal necrotic portion near the left ovary. Laparotomy and resection of the mass was performed. Microscopic examination revealed 15 mitoses per 10 high power fields. She was diagnosed as primary leiomyosarcoma originated from the left common iliac vein, stage I (IB). The best treatment of these neoplasms is complete surgical excision, and no therapeutic benefit has been derived from chemotherapy or radiotherapy. Though metastases are occasional, local recurrences can be taken into consideration and, after a careful tumoral re-staging, they can be resected once more. Therefore, careful follow-up is necessary on the basis of neoplastic grading, extension and involvement of the adjacent structures.
Abdomen ; Drug Therapy ; Female ; Humans ; Iliac Vein ; Laparotomy ; Leiomyosarcoma* ; Middle Aged ; Mitosis ; Neoplasm Metastasis ; Ovary ; Radiotherapy ; Recurrence ; Retroperitoneal Space ; Tomography, X-Ray Computed