Objectives: This study compared the nutritional intakes of early and late preterm infants in a neonatal intensive care unit (NICU) and at home. The dietary problems and the need for community care services for premature infants were further investigated. Methods: This is a cross-sectional and descriptive study on 125 preterm infants and their parents (Early preterm n = 70, Late preterm n = 55). The data were collected by surveying the parents of preterm infants and from hospital medical records. Results: No significant differences were obtained between the early and late preterm infant groups when considering the proportion of feeding types in the NICU and at home. Early preterm infants were fed with a greater amount of additional calories at home and had more hours of tube feeding (P = 0.022). Most preterm infants had feeding problems. However, there was no significant difference between early and late preterm infants in the mental pain of parents, sleeping, feeding, and weaning problems at home. Many parents of preterm babies had no external support, and more than half the parents required community care to take care of their preterm babies. Conclusions Regardless of the gestational age, most preterm infants have several problems with dietary intake. Our study indicates the need to establish community care services for preterm infants.

PURPOSE: To investigate the correlations between parameters of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and prognostic factors in rectal cancer. MATERIALS AND METHODS: We studied 29 patients with rectal cancer who underwent gadolinium contrast-enhanced, T1-weighted DCE-MRI with a three Tesla scanner prior to surgery. Signal intensity on DCE-MRI was independently measured by two observers to examine reproducibility. A time-signal intensity curve was generated, from which four semiquantitative parameters were calculated: steepest slope (SLP), time to peak (Tp), relative enhancement during a rapid rise (Erise), and maximal enhancement (Emax). Morphologic prognostic factors including T stage, N stage, and histologic grade were identified. Tumor angiogenesis was evaluated in terms of microvessel count (MVC) and microvessel area (MVA) by morphometric study. As molecular factors, the mutation status of the K-ras oncogene and microsatellite instability were assessed. DCE-MRI parameters were correlated with each prognostic factor using bivariate correlation analysis. A p-value of <0.05 was considered significant. RESULTS: Erise was significantly correlated with N stage (r=-0.387 and -0.393, respectively, for two independent data), and Tp was significantly correlated with histologic grade (r=0.466 and 0.489, respectively). MVA was significantly correlated with SLP (r=-0.532 and -0.535, respectively) and Erise (r=-0.511 and -0.446, respectively). MVC was significantly correlated with Emax (r=-0.435 and -0.386, respectively). No significant correlations were found between DCE-MRI parameters and T stage, K-ras mutation, or microsatellite instability. CONCLUSION: DCE-MRI may provide useful prognostic information in terms of histologic differentiation and angiogenesis in rectal cancer.
Adult ; Aged ; Aged, 80 and over ; Cell Differentiation ; Contrast Media/*pharmacology ; DNA Mutational Analysis ; Female ; Gadolinium/pharmacology ; Genes, ras ; Humans ; Magnetic Resonance Imaging/*methods ; Male ; Microcirculation ; Microsatellite Instability ; Middle Aged ; Neoplasm Staging ; Neovascularization, Pathologic ; Prognosis ; Rectal Neoplasms/*diagnosis/genetics/*pathology ; Retrospective Studies ; Time Factors

Although the incidence of bleeding complications during extracorporeal membrane oxygenator (ECMO) support has decreased in various trials, bleeding is still the most fatal complication. We investigated the ideal dosage and efficacy of nafamostat mesilate for use with ECMO in patients with acute cardiac or respiratory failure. We assessed 73 consecutive patients who received ECMO due to acute cardiac or respiratory failure between January 2006 and December 2009. To evaluate the efficacy of nafamostat mesilate, we divided the patients into 2 groups according to the anticoagulants used during ECMO support. All patients of nafamostat mesilate group were male with a mean age of 49.2 yr. Six, 3, 5, and 3 patients were diagnosed with acute myocardial infarction, cardiac arrest, septic shock, and acute respiratory distress syndrome, respectively. The mean dosage of nafamostat mesilate was 0.64 mg/kg/hr, and the mean duration of ECMO was 270.7 hr. The daily volume of transfused packed red blood cells, fresh frozen plasma, and cryoprecipitate and the number of complications related to hemorrhage and thrombosis was lower in the nafamostat mesilate group than in the heparin group. Nafamostat mesilate should be considered as an alternative anticoagulant to heparin to reduce bleeding complications during ECMO.
Acute Disease ; Anticoagulants/*administration & dosage ; Dose-Response Relationship, Drug ; *Extracorporeal Membrane Oxygenation ; Female ; Guanidines/*administration & dosage ; Heart Failure/diagnosis/mortality/therapy ; Heparin/administration & dosage ; Humans ; Male ; Middle Aged ; Myocardial Infarction/diagnosis/mortality/therapy ; Respiratory Distress Syndrome, Adult/diagnosis/mortality/therapy ; Retrospective Studies ; Shock, Septic/diagnosis/mortality/therapy ; Survival Analysis

PURPOSE: Serine-threonine kinase11 (STK11) was originally identified in 1997 as the causative mutation that's responsible for Peutz-Jeghers Syndrome (PJS). Several recent studies have reported that the STK11 gene is an important human tumor suppressor gene in lung cancer. We evaluated the associations between the polymorphisms of the STK11 promoter region and the risk of lung cancer in 901 Koreans. MATERIALS AND METHODS: By direct sequencing, we first discovered three novel polymorphisms (-1,795 T>C, -981 C>T and -160 G>T) and four known polymorphisms (-1,580 C>T, -1,494 A>C, -881 A>G and -458 G>C) of the STK11 promoter region in 24 blood samples of 24 Korean lung cancer patients. Further genotype analyses were then performed on 443 lung cancer patients and 458 controls. RESULTS: We discovered three novel polymorphisms and we identified four known polymorphisms of the STK11 promoter region in a Korean population. Statistical analyses revealed that the genotypes and haplotypes in the STK11 gene were not significantly associated with the risk of lung cancer in a Korean population. CONCLUSION: This is the first study that's focused on the association of STK11 promoter polymorphisms and the risk of lung cancer in a Korean population. To evaluate the role of the STK11 gene for the risk of lung cancer, the genotypes of the STK11 promoter region (-1,795 T>C, -1,494 A>C and -160 G>T) were determined in 901 Koreans, yet the result revealed no significant difference between the lung cancer patients and the controls. These results suggest that the three promoter polymorphisms we studied are not important risk factors for the susceptibility to lung cancer in Koreans.
Genes, Tumor Suppressor ; Genotype ; Haplotypes ; Humans ; Lung ; Lung Neoplasms ; Peutz-Jeghers Syndrome ; Promoter Regions, Genetic ; Risk Factors

A metastatic melanoma to the gastrointestinal tract is observed in 1.5~4.4% of all melanoma patients. However, colonic and rectal involvement is less common. A 72-year-old woman was admitted due to abdominal pain and poor oral intake for 20 days. She had a 3 x 4 cm-sized mass on her right inguinal area 4 month ago, which was diagnosed as a malignant melanoma of the inguinal lymph node on excision biopsy. A large exophytic mass with an irregular ulcerlated, whitish patch, erythematous surface was observed in the hepatic flexure during colonoscopy. A histology diagnosis of a metastatic melanoma was made by an optical microscopy examination of the biopsies obtained during the colonscopy, and palliative right hemicolectomy was performed on account of a potential intestinal obstruction. We report a case of a metastatic melanoma of the colon with a review of the relevant literature.
Abdominal Pain ; Aged ; Biopsy ; Colon* ; Colonoscopy ; Diagnosis ; Female ; Gastrointestinal Tract ; Humans ; Intestinal Obstruction ; Lymph Nodes ; Melanoma* ; Microscopy

Macroglobulinemia is the result of an uncontrolled proliferation of lymphocytes and plasma cells in which a large IgM M protein is produced. IgM monoclonal gammopathy is recognized in a variety of lymphoproliferative diseases and Waldenstr?m's macroglobulinemia (WM) is the most frequent disease in this group. We report a case of nodal marginal zone B-cell lymphoma (Nodal MZBCL) accompanied by monoclonal macroglobulinemia. A 58-year-old man was admitted to the hospital with chronic fatigue and dyspnea. Physical examination revealed cervical, subaxillary, and inguinal lymphadenopathy. Histopathologically, monocytoid B cells with abundant pale cytoplasm and small nuclei infiltrated the cervical lymph node. The neoplastic cells were positive for CD 20, bcl-2, and IgM. The serum and urine electrophoresis showed monoclonal spike in the globulin region and immunoelectrophoresis demonstrated immunoglobulin of IgM, kappa type. Immunohistochemically, this monoclonal gammaglobulinemia (IgM, Kappa) was produced and secreted from the nodal MZBCL. This is the first report of nodal MZBCL accompanying macroglobulinemia in Korea.
B-Lymphocytes ; Cytoplasm ; Dyspnea ; Electrophoresis ; Fatigue ; Humans ; Immunoelectrophoresis ; Immunoglobulin M ; Immunoglobulins ; Korea ; Lymph Nodes ; Lymphatic Diseases ; Lymphocytes ; Lymphoma, B-Cell, Marginal Zone* ; Middle Aged ; Paraproteinemias ; Physical Examination ; Plasma Cells ; Waldenstrom Macroglobulinemia*

PURPOSE: To assess the preliminary findings of Mn-enhanced T1-weighted MR cholangiography for the evaluation of intrahepatic choledocholithiasis. MATERIALS AND METHODS: Seven patients with recurrent pyogenic cholangitis underwent conventional heavily T2-weighted and manganese-enhanced T1-weighted MR cholangiography. For the former, the two reviewers focused on intrahepatic ductal dilatation, calculi, and stricture; and for the latter, ductal enhancement. RESULTS: In seven patients, 13 diseased segments were depicted and intrahepatic bile ductal dilatation was present in all 13 of these in all seven patients. Calculi were present in eight segments in six patients, and stricture in four segments in three patients. Of the 13 diseased segmental ducts, six were seen at manganese-enhanced imaging to be filled with contrast material, suggesting a functioning bile duct. CONCLUSION: Combined T2-weighted and mangafodipir trisodium-enhanced T1-weighted MR cholangiography provides both anatomic detail and functional detail of the biliary system. Combined MR cholangiography is useful for the evaluation of intrahepatic choledocholithiasis, demonstrating the stricture and function of the segmental ducts involved.
Bile Ducts ; Bile Ducts, Intrahepatic ; Biliary Tract ; Calculi ; Cholangiography* ; Cholangitis ; Choledocholithiasis* ; Constriction, Pathologic ; Diagnosis* ; Dilatation ; Humans

Heterotopic pregnancy, simultaneous intrauterine and extrauterine pregnancy, classically was considered a exceedingly rare obstetrical phenomenon. But nowadays the natural incidence is increasing and especially in association with assisted reproductive technologies, such as use of variable methods for ovulation inductions, in-vitro fertilization and embryo transfer, and gamate intrafallopian transfer. In spite of the difficult early diagnosis, which is potentially dangerous to the mother and fetus, the maternal mortality, morbidity and fetal loss is low when the diagnosis is made in timely fashion and proper management is achieved. The presence of a intrauterine pregnancy dose not exclude the possibility of a extrauterine pregnancy, and in women associated with assisted reproductive technologies, the possibility of a heterotopic pregnancy should be considered. We report a case of a heterotopic pregnancy following ovulation induction and intrauterine insemination with brief review of literature.
Diagnosis ; Early Diagnosis ; Embryo Transfer ; Female ; Fertilization ; Fetus ; Humans ; Incidence ; Insemination ; Maternal Mortality ; Mothers ; Ovulation Induction* ; Ovulation* ; Pregnancy ; Pregnancy, Heterotopic* ; Reproductive Techniques, Assisted

BACKGROUND: The Lewis and secretor gene determine the Lewis phenoytpe. Conventional Lewis blood grouping is difficult because of the presence of nongenuine Lewis negative individuals. Recently, the Lewis gene (FUT3), the secretor gene (FUT2), and several mutations that cause the Lewis negative and the nonsecretor phenotypes were identified. The purpose of this study was to compare Lewis phenotypes determined by commercially available three pairs of monoclonal antibodies with the Lewis and secretor genotypes. METHODS: RBCs for phenotyping and peripheral blood leukocytes for genotyping of FUT3 and FUT2 gene were obtained from 184 apparently healthy volunteers. Lewis phenotypes were determined on K3EDTA-stablized fresh blood samples using three pairs of commercially available monoclonal antibodies, one of which was the column agglutination method and the others were the tube agglutination methods. Lewis blood group genotyping was performed by the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method to detect T59G, G428A, C357T, and A385T mutations. RESULTS: The frequencies of the Lewis blood group phenotype were Le(a+b-) 15.0%, Le(a-b+) 65.8%, Le(a-b-) 14.8%, and Le(a+b+) 4.3%, respectively. The Lewis blood group phenotypes determined by three pairs of monoclonal antibodies were 93.5%, 93.5% and 89.1% in accordance with the genotypes. The frequencies of Le, le, Se and se alleles were 64.4%, 35.6%, 48.6%, and 51.4% and we have newly detected 4 cases with only one A385T mutation. All of the Le(a+b+) phenotype cases have both C357T, and A385T homozygotic mutations. CONCLUSIONS: The PCR method may be effectively used for the genotyping of the FUT3 and FUT2 genes and offers an attractive alternative to Lewis phenotyping using hemagglutination method.
Agglutination ; Alleles ; Antibodies, Monoclonal ; Blood Grouping and Crossmatching ; Genotype* ; Healthy Volunteers ; Hemagglutination ; Leukocytes ; Phenotype* ; Polymerase Chain Reaction

PURPOSE: Obesity is a significant health problem with medical and psychological consequences for children and adolescents. The purpose of this study was to assess the correlation between body fat percent using bioelectrical impedance(BI) and other variable methods. METHODS: We measured height, weight, body mass index(BMI) and body fat percent by skinfold thickness(ST) and BI in 1,035(496 male; 539 female) children from seven to 18 years of age. The correlation coefficients between BI and each of the other different methods were obtained. The sensitivity and specificity to predict obesity by these several methods were studied. RESULTS: Fat percent estimated by BI analysis and BMI showed a strong correlation(r=0.749). Fat percent estimated by BI analysis and ST showed a very strong correlation(r=0.835). At the 95th percentile cut-off point for BI, ST showed a sensitivity of 57.7%, and a specificity of 97.6% for estimating body fat. At the 95th percentile cut-off point for BI, BMI showed a sensitivity of 84.9%, and a specificity of 99.3% for estimating body fat. CONCLUSION: The fat percent estimated by BI analysis correlated strongly with ST or BMI. BI analysis is an objective and accurate method for estimating body fat in childhood obesity.
Adipose Tissue* ; Adolescent ; Body Mass Index ; Body Weight ; Child ; Electric Impedance* ; Humans ; Male ; Obesity ; Pediatric Obesity ; Sensitivity and Specificity ; Skinfold Thickness