BACKGROUND: This study aimed to determine the effect of a multidisciplinary approach on the birth rate of fetuses with prenatally diagnosed congenital heart diseases (CHDs). METHODS: Among the fetuses of 724 gravidas who underwent fetal echocardiography in Samsung Medical Center from January 2013 to June 2017, 463 fetuses with normal cardiac structure, arrhythmia or simple left-to-right shunt were excluded, and the remaining 261 were included in the study. The subjects were subdivided into groups based on whether they were consulted multidisciplinarily, that is, consulted simultaneously by pediatric cardiologists, obstetricians and pediatric cardiac surgeons or not. They were also categorized based on the initial fetal echocardiogram results. RESULTS: Among the fetuses in the multidisciplinary group, 64.5% of the fetuses were given birth to, and the proportion was not different from that in the non-multidisciplinary group (68.6%, P = 0.48). The delivery rate in the multidisciplinary consultation group were 69.2% in the transposition of the great arteries group, 63.6% in the tetralogy of Fallot group, 68.8% in the pulmonary atresia or interrupted aortic arch group, 62.5% in the coarctation of aorta group, 60.0% in the atrioventricular septal defect group, 70.0% in the functional single ventricle group, and 55.6% in the hypoplastic left heart syndrome group; there were no significant differences between the 10 echocardiogram groups. However, when the subjects were categorized into Fontan repair group and biventricular repair group, the Fontan repair group showed a significant increase in the likelihood of delivery when a multidisciplinary approach was taken (P = 0.035). CONCLUSION: When a fetus was diagnosed with a CHD where Fontan repair should be considered, a multidisciplinary approach resulted in increased possibility of delivery.
Aorta, Thoracic ; Aortic Coarctation ; Arrhythmias, Cardiac ; Arteries ; Birth Rate ; Echocardiography ; Fetus ; Heart Defects, Congenital ; Heart Diseases ; Hypoplastic Left Heart Syndrome ; Parturition ; Prenatal Diagnosis ; Pulmonary Atresia ; Surgeons ; Tetralogy of Fallot

PURPOSE: We investigated the prevalence and risk factors of allergic rhinitis (AR), nationwide in random children and adolescents of Korea. METHODS: A modified International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire survey was done in 1,820 children from elementary, middle, and high school nationwide in Korea. The subjects were selected by the stratifying sampling method by school grade and five regions. Current AR was defined as having AR symptoms during the last 12 months with a history of physician-diagnosed AR. Skin prick tests for 18 common allergens were performed. RESULTS: The number of males was 945, and that of females was 875. The mean age of the patients was 12.61+/-3.40 years. The prevalence of current AR and atopic current AR were 29.0% and 18.7%, respectively. Risk factors for current AR were male (adjusted odds ratio [aOR], 1.486; 95% confidence interval [CI], 1.189-1.856), family history of paternal AR (aOR, 3.208; 95% CI, 2.460-4.182), family history of maternal AR (aOR, 3.138; 95% CI, 2.446-4.025), antibiotic use in infancy (aOR, 1.547; 95% CI, 1.228-1.949), mold exposure during infancy (aOR, 1.416; 95% CI, 1.103-1.819), mold exposure during the last 12 months (aOR, 1.285; 95% CI, 1.012-1.630), and sensitization on skin prick tests (aOR, 2.596; 95% CI, 2.055-3.279). Risk factors for atopic current AR were the same as those of current AR, whereas breast-milk feeding (aOR, 0.720; 95% CI, 0.530-0.976) was a protective factor. Sensitized allergens as risk factors for current AR were Dermatophagoides pteronyssinus, Dermatophagoides farina, ragweed, mugwort, oak, alder, birch, Japanese hop, cat, and dog. CONCLUSION: The prevalences of current AR and atopic current AR were 29.0% and 18.7%, respectively. Male, sex parental AR, antibiotic use in infancy, mold exposure during the last 12 months, mold exposure during infancy, and atopic sensitization were risk factors for current AR. Breast-milk feeding was a protective factor for atopic current AR. Aeroallergen sensitization was an important risk factor for AR.
Adolescent ; Allergens ; Alnus ; Ambrosia ; Animals ; Artemisia ; Asian Continental Ancestry Group ; Asthma ; Betula ; Cats ; Child ; Dermatophagoides pteronyssinus ; Dogs ; Female ; Fungi ; Humans ; Humulus ; Hypersensitivity ; Korea ; Male ; Odds Ratio ; Parents ; Prevalence* ; Pyroglyphidae ; Rhinitis* ; Risk Factors* ; Skin

Nicotine addiction is a worldwide problem. However, previous studies characterizing the rewarding and reinforcing effects of nicotine in animal models have reported inconsistent findings. It was observed that the addictive effects are variable on different factors (e.g. route, dose, and age). Here, we evaluated the rewarding and reinforcing effects of nicotine in different routes of administration, across a wide dose range, and in different age groups. Two of the most widely used animal models of drug addiction were employed: the conditioned place preference (CPP) and self-administration (SA) tests. Nicotine CPP was evaluated in different routes [intraperitoneal (i.p.) and subcutaneous (s.c.)], doses (0.05 to 1.0 mg/kg) and age [adolescent and adult rats]. Similarly, intravenous nicotine SA was assessed in different doses (0.01 to 0.06 mg/kg/infusion) and age (adolescent and adult rats). In the CPP test, s.c. nicotine produced greater response than i.p. The 0.2 mg/kg dose produced highest CPP response in adolescent, while 0.6 mg/kg in adult rats; which were also confirmed in 7 days pretreated rats. In the SA test, adolescent rats readily self-administer 0.03 mg/kg/infusion of nicotine. Doses that produced nicotine CPP and SA induced blood nicotine levels that corresponded well with human smokers. In conclusion, we have demonstrated that nicotine produces reliable CPP [0.2 mg/kg dose (s.c.)] in adolescents and [0.6 mg/kg dose (s.c.)] in adults, and SA [0.03 mg/kg/infusion] in adolescent rats. Both tests indicate that adolescent rats are more sensitive to the rewarding and reinforcing effects of nicotine.
Adolescent* ; Adult* ; Animals ; Humans ; Models, Animal ; Nicotine* ; Rats* ; Reward ; Substance-Related Disorders

Introduction: Hypertension is a common co-morbidity in diabetes mellitus (DM) that may lead to serious complications if not adequately controlled. Method: This is a descriptive study based on data from the Audit of Diabetes Control and Management (ADCM) registry. This audit assessed the treatment and standard of control of hypertension in diabetic patients aged 18 years and above. Data were analysed using STATA version 9. Results: From a total of 20 646 cases, about two third of them, 13 417 (65%) were reported to have hypertension. 19 484 (94.4%) had their blood pressure (BP) recorded and out of these, 11 414 (58.5%) were found to have BP >130/80 mmHg. 13 601 cases (65.9%) of the total sample were on antihypertensive drugs. 64.1% of those on antihypertensive drugs were prescribed angiotensin-converting enzyme inhibitors (ACEI) or angiotensin II receptor blockers. 14.2% were on more than two types of antihypertensive drugs. Older patients and those with longer duration of DM were less likely to achieve the target BP of ≤130/80. In general, about 40% of diabetic cases registered in the ADCM project had their hypertension well controlled.

The Eisenmenger's syndrome is presented with an abnormal communication between the systemic and pulmonary circulations and a predominant right to left shunt caused by increased vascular resistance in the pulmonary circulation. The maternal mortality and morbidity rate associated with cesarean section in the presence of Eisenmenger's syndrome is very high. We report a successful anesthetic management of a patient with the Eisenmenger's syndrome who underwent emergency cesarean section under general anesthesia, which is the first case in Korea of using nitric oxide in an attempt to improve pulmonary hypertension and arterial oxygenation. In addition to the basic monitoring devices, arterial and pulmonary catheters were inserted before the anesthesia. A fall in blood pressure was immediately counteracted by the administration of norepinephrine, and loss of blood by transfusion and fluid. After the operation, patient was closely monitored at coronary care unit for 15 days and discharged 18 days after the delivery without complication.
Anesthesia ; Anesthesia, General ; Blood Pressure ; Catheters ; Cesarean Section* ; Coronary Care Units ; Eisenmenger Complex* ; Emergencies ; Female ; Humans ; Hypertension, Pulmonary ; Korea ; Maternal Mortality ; Nitric Oxide ; Norepinephrine ; Oxygen ; Pregnancy ; Pulmonary Circulation ; Vascular Resistance

The purpose of this study was to investigate the regional differences in dietary supplement use and related factors among college students participating in nutritional education programs via the internet. The subjects in this study were 797 college students (male: 518, female: 279). A cross-sectional survey was conducted using a self-administered questionnaire about dietary supplement use, demographic characteristics, health-related lifestyles, nutrient intake, and data were collected via the internet and by mail. Dietary supplements were taken by 82.2% of subjects (males: 76.3%, females: 85.3%). There was a significant regional difference in supplement use (p < 0.01). The supplements, used most frequent by male students in the Seoul and Incheon areas were lactic acid beverages and gagogi, in that order. Male students in the Kyunggi area used gagogi and lactic acid beverages in that order. Lactic acid beverages and Chinese medicine were used most frequently by male students in the Chungcheong area. Male students in the Kyungsang area used lactic acid beverages and water-soluble vitamins, in that order. Male students in Seoul and Kyungsang areas showed significantly higher percentage of keep on taking supplements compared to other areas (p < 0.05). Both male and female students in the Seoul area had more frequent medical examinations, in comparison to students in other areas (p < 0.05). Male students in the Kyungsang and Seoul areas took significantly more calcium (p < 0.05) and iron (p < 0.05), in comparison to students in other areas. Female students in the Kyunsang area took significantly more Vitamin A, phosphorous and iron (p < 0.05), while those in the Seoul area took significantly more Vitamin C (p < 0.01) and calcium (p < 0.05). Male students in the Chungcheong area took significantly less seaweed, in comparison to students in other areas (p < 0.05). Male students in the Seoul area had the highest amount of animal fat and oil, while those in the Incheon area ate the lowest amount of animal oil and fat (p < 0.05). Female students in the Kyunggi area ate the highest amount of fruit, while those in the Incheon area ate the lowest amount of fruit (p < 0.05). Female students in the Incheon area ate the highest amount of seaweed, while those in the Kyunggi area ate the lowest amount of seaweed (p < 0.01). Therefore, it can be concluded that it is necessary to develop dietary supplements to optimize the nutritional status of college students in different areas of Korea.
Animals ; Ascorbic Acid ; Asian Continental Ancestry Group ; Beverages ; Calcium ; Cross-Sectional Studies ; Dietary Supplements* ; Eating ; Education* ; Female ; Fruit ; Gyeonggi-do ; Humans ; Incheon ; Internet* ; Iron ; Korea ; Lactic Acid ; Life Style ; Male ; Nutritional Status ; Postal Service ; Seaweed ; Seoul ; Vitamin A ; Vitamins ; Surveys and Questionnaires

Allogeneic bone marrow or peripheral blood stem cell transplantation traditionally uses myeloablative regimen for conditioning to enable grafting of donor's stem cells. Animal experiments have shown that a milder non-myeloablative conditioning regimen does allow engraftment to occur. Nonmyeloablative conditioning regimens are low-intensity immunosuppressive treatment given to the recipient before infusion of donor's stem cells. It was reported to have decreased immediate procedural mortality, in particular those secondary to acute graft versus host reaction. However, it did give rise to higher risks of graft rejection, tumour tolerance and disease progression. Fortunately, appropriately administered donor lymphocyte infusion has been shown to establish full donor chimerism (complete donor stem cell grafting in the recipient's bone marrow) and potentiate antitumour effect (graft versus tumour reaction). The reduction of immediate transplant mortality allows the procedure to be carried out in older age groups, patients with concomitant diseases that otherwise would have made the patients unfit for the procedure, patients with non-malignant disorders such as congenital immune deficiencies, autoimmune disorders or thalassaemia majors. The regimen also allows transplantation of genetically manipulated haemopoietic stem cells (gene thrapy) to be carried out more readily in the immediate future. Lastly, the regimen may serve as a platform for immunotherapy using specific T cell clones for anti-tumour therapy with or without the knowledge of known tumour antigen.
seconds ; regimen ; Conditioning (Psychology) ; Stem Cells ; Exertional dyspnea

Though the aetiology of transmissible spongiform encephalopathies (TSEs) remains uncertain, proteinase resistant prion protein (PrP-Sc), a converted form of the normal cellular prion protein (PrP-C), accumulates in the lysosome of cells of the nervous systems of animals with TSEs. In this study, clinical and epidemiological examinations of bovine spongiform encephalopathy (BSE) were conducted in Korea. During the investigated period, none of the cattle exhibited typical clinical signs of BSE, such as behavioral disturbances, high sensitivity, and abnormal locomotion. Immunohistochemical analysis and western immunoblotting were established to detect PrP-Sc in the brain tissue using monoclonal antibody (MAb) F89/160.1.5, produced by immunizing mice with a synthetic peptide which corresponds to bovine PrP residues 146-159, NH2-SRPLIHFGSDYEDRC-COOH. Although some BSE-like spongiform changes were observed in bovine brains randomly collected from Korean slaughterhouses from 1996 to 1999, no PrP-Sc was detected in those brains with the established immunohistochemistry and western immunoblotting assay. Also, no positive reaction was observed in bovine brains infected with rabies. These immunohistochemical and western immunoblotting methods using MAbs, specifically reactive with conserved epitopes on ruminant PrP, can be used for postmortem diagnosis of BSE. Further, the method can be applied to antemortem and the preclinical diagnosis of ovine scrapie by detecting PrP-Sc in lymphoid tissues, such as the tonsils, third eyelid or peripheral lymph nodes.
Abattoirs ; Animals ; Blotting, Western ; Brain/*pathology ; Brain Stem/pathology ; Cattle ; Encephalopathy, Bovine Spongiform/*epidemiology/pathology ; Immunohistochemistry ; Korea/epidemiology ; PrPSc Proteins/*analysis ; Sheep ; Sheep Diseases/*epidemiology/pathology

Proteinuria ; Proteins ; Creatinine

Pattern ; Malaysia ; Lupus Nephritis