BACKGROUND: The aim of this study was to observe long-term outcomes of very low birth weight infants (VLBWIs) born between 2013 and 2014 in Korea, especially focusing on neurodevelopmental outcomes. METHODS: The data were collected from Korean Neonatal Network (KNN) registry from 43 and 54 participating units in 2013 and 2014, respectively. A standardized electronic case report form containing 30 items related to long-term follow up was used after data validation. RESULTS: Of 2,660 VLBWI, the mean gestational age and birth weight were 291/7 ± 26/7 weeks and 1,093 ± 268 g in 2013 and 292/7 ± 26/7 weeks and 1,125 ± 261 g in 2014, respectively. The post-discharge mortality rate was 1.2%–1.5%. Weight < 50th percentile was 46.5% in 2013 and 66.1% in 2014. The overall prevalence of cerebral palsy among the follow up infants was 6.2% in 2013 and 6.6% in 2014. The Bayley Scales of Infant Developmental Outcomes version II showed 14%–25% of infants had developmental delay and 3%–8% of infants in Bayley version III. For the Korean developmental screening test for infants and children, the area “Further evaluation needed” was 5%–12%. Blindness in both eyes was reported to be 0.2%–0.3%. For hearing impairment, 0.8%–1.9% showed bilateral hearing loss. Almost 50% were readmitted to hospital with respiratory illness as a leading cause. CONCLUSION: The overall prevalence of long-term outcomes was not largely different among the VLBWI born between 2013 and 2014. This study is the first large national data study of long-term outcomes.
Birth Weight ; Blindness ; Cerebral Palsy ; Child ; Child Development ; Follow-Up Studies ; Gestational Age ; Hearing Loss ; Hearing Loss, Bilateral ; Humans ; Incidence ; Infant* ; Infant, Very Low Birth Weight* ; Korea ; Mass Screening ; Mortality ; Prevalence ; Weights and Measures

A 51-year-old highly fit man presented for dyspnea with strenuous aerobic exercise. The patient was asymptomatic and all tests were normal at rest. With increasing exercise intensity, he suddenly complained of dyspnea and showed a severe exercise-induced hypoxemia with an excessive alveolar-arterial oxygen tension difference. In agitated saline contrast echocardiography at peak exercise, a large amount of left to right shunt was identified after > 5 cardiac cycles, which suggests the presence of exercise-induced intrapulmonary arteriovenous shunt in this patient.
Anoxia ; Dihydroergotamine ; Dyspnea* ; Echocardiography ; Exercise ; Humans ; Middle Aged ; Oxygen

Hypoxia-inducible factors (HIFs) are transcription factors that activate the transcription of target genes involved in crucial aspects of cancer development. This study investigated the expression of HIFs and their contribution to the regulation of target genes related to angiogenesis and glucose metabolism in gastric cancer. The data showed that HIFs were over-expressed in gastric cancer and that activation of the target genes was observed mainly in the early stages. Moreover, the results of the present study revealed that only HIF-1alpha, but not HIF-2alpha dimerizes with HIF-1beta and then regulates expression of target genes in response to hypoxia. The results of the present study demonstrate that HIF-1alpha and HIF-1beta enhances expression of VEGF and glucose metabolism-related genes in response to hypoxia in gastric cancer. These data offer important information regarding HIF pathways in the development of gastric cancer.
Aryl Hydrocarbon Receptor Nuclear Translocator/*genetics/metabolism ; Basic Helix-Loop-Helix Transcription Factors/*genetics/metabolism ; Cell Line, Tumor ; Gene Expression Regulation, Neoplastic ; Glucose/*metabolism ; Humans ; Hypoxia-Inducible Factor 1, alpha Subunit/*genetics/metabolism ; Neovascularization, Pathologic/genetics/metabolism ; Stomach Neoplasms/*genetics/metabolism ; Vascular Endothelial Growth Factor A/*genetics/metabolism

OBJECTIVE: The main complaints of users in existing electronic medical record systems are the complexity of recording system and long recording time. The records of patient moving and the diagnostic test performed outside emergency room are important. But emergency nurses can't record such information exactly and completely because of the highest priorities of emergency treatment and its record in overcrowded emergency room. METHODS: Emergency electronic medical record team of Asan Medical Center developed the automatic recording system of patient moving and diagnostic test information in 2006. The effectiveness of this system was evaluated by comparing the number of records in manual and automatic documentations before and after the system application. RESULTS: The numbers of total records per patient-order were not changed statistically, but the number of manual patient moving and diagnostic test records significantly reduced from 0.50+/-0.69 to 0.31+/-0.47 (p < 0.01). The number of automatic patient moving and diagnostic test records per patient-order was 1.98+/-0.99. CONCLUSION: This automatic recording system can reduce indirect nursing time and give more exact and complete information to emergency medical personnel. The effort to simplify documentation in electronic medical record systems is important, but 'automatic recording' strategy is also needed.
Automation ; Chungcheongnam-do ; Diagnostic Tests, Routine* ; Documentation ; Electronic Health Records ; Emergencies* ; Emergency Service, Hospital* ; Emergency Treatment ; Humans ; Moving and Lifting Patients* ; Nursing*

In vascular smooth muscle cells (VSMCs), induction of the heme oxygenase-1 (HO-1) confers vascular protection against cellular proliferation mainly via its up-regulation of the cyclin-dependent kinase inhibitor p21(WAF1/CIP1) that is involved in negative regulation of cellular proliferation. In the present study, we investigated whether the phytochemical curcumin and its metabolite tetrahydrocurcumin could induce HO-1 expression and growth inhibition in rat VSMCs and, if so, whether their antiproliferative effect could be mediated via HO-1 expression. At non-toxic concentrations, curcumin possessing two Michael-reaction acceptors induced HO-1 expression by activating antioxidant response element (ARE) through translocation of the nuclear transcription factor E2-related factor-2 (Nrf2) into the nucleus and also inhibited VSMC growth triggered by 5% FBS in a dose-dependent manner. In contrast, tetrahydrocurcumin lacking Michael-reaction acceptor showed no effect on HO-1 expression, ARE activation and VSMC growth inhibition. The antiproliferative effect of curcumin in VSMCs was accompanied by the increased expression of p21(WAF1/CIP1). Inhibition of VSMC growth and expression of p21(WAF1/CIP1) by curcumin were partially, but not completely, abolished when the cells were co- incubated with the HO inhibitor tin protoporphyrin. In human aortic smooth muscle cells (HASMCs), curcumin also inhibited growth triggered by TNF-alpha and increased p21(WAF1/CIP1) expression via HO-1-dependent manner. Our findings suggest that curcumin has an ability to induce HO-1 expression, presumably through Nrf2-dependent ARE activation, in rat VSMCs and HASMCs, and provide evidence that the antiproliferative effect of curcumin is considerably linked to its ability to induce HO-1 expression.
Active Transport, Cell Nucleus ; Animals ; Aorta/cytology ; Cell Nucleus/metabolism ; Cell Proliferation/*drug effects ; Cells, Cultured ; Curcumin/analogs & derivatives/*pharmacology ; Cyclin-Dependent Kinase Inhibitor p21/biosynthesis/metabolism ; Gene Expression Regulation ; Heme Oxygenase (Decyclizing)/biosynthesis/genetics/*physiology ; Heme Oxygenase-1/biosynthesis/genetics/*physiology ; Humans ; Metalloporphyrins/pharmacology ; Muscle, Smooth, Vascular/drug effects/*physiology ; Myocytes, Smooth Muscle/drug effects/*physiology ; NF-E2-Related Factor 2/metabolism ; Protoporphyrins/pharmacology ; Rats ; Regulatory Sequences, Nucleic Acid ; Response Elements ; Tumor Necrosis Factor-alpha/pharmacology

Hepatitis C virus (HCV) is a pathogen that is of great medical significance in chronic hepatitis, liver cirrhosis, and hepatocellular carcinoma worldwide. Although the HCV proteins have been intensively investigated over the past decade, the biochemical functions of the NS4B protein are still largely unknown. To investigate NS4B as a potential causative agent of liver disease, transgenic mice expressing the NS4B protein in liver tissue were produced. The transgenic animals were phenotypically similar to their normal littermates for up to 18 months of age. Our results suggest that the HCV NS4B protein is not directly cytopathic or oncogenic in our transgenic mice model.
Viral Nonstructural Proteins/genetics/*metabolism ; Reverse Transcriptase Polymerase Chain Reaction ; Mice, Transgenic ; Mice, Inbred C57BL ; Mice ; Male ; Liver/metabolism/pathology ; Immunohistochemistry ; Hepacivirus/genetics/*metabolism ; Gene Expression/genetics ; Female ; Blotting, Western ; Animals

Ras-related, estrogen-regulated, and growth-inhibitory gene (RERG) is a novel gene that was first reported in breast cancer. However, the functions of RERG are largely unknown in other tumor types. In this study, RERG expression was analyzed in hepatocellular carcinomas of human patients using reverse transcriptase PCR analysis. In addition, the possible regulation of RERG expression by histone deacetyltransferases (HDACs) was studied in several cell lines. Interestingly, the expression of RERG gene was increased in hepatocellular carcinoma (HCC) of male patients (57.9%) but decreased in HCC of females (87.5%) comparison with paired peri-tumoral tissues. Moreover, RERG gene expression was increased in murine hepatoma Hepa1-6 cells, human breast tumor MDA-MB-231 cells, and mouse normal fibroblast NIH3T3 cells after treated by HDAC inhibitor, trichostatin A. Our results suggest that RERG may function in a gender-dependent manner in hepatic tumorigenesis and that the expression of this gene may be regulated by an HDAC-related signaling pathway.
Signal Transduction ; Sex Factors ; Mice, Transgenic ; Mice, Inbred C57BL ; Mice ; Male ; Liver Neoplasms/*genetics ; Humans ; Histone Deacetylases/*physiology ; Hepatocytes/metabolism ; Growth Inhibitors/*genetics ; *Genes, ras ; *Gene Expression Regulation, Neoplastic ; Female ; Estrogens/*pharmacology ; Estrogen Receptor alpha/analysis ; Cell Proliferation ; Animals

Expression of estrogen receptors (ER)-alpha and -beta, as well as androgen receptor (AR), in hepatocellular carcinoma (HCC) is thought to be correlated with prognosis, survival, and male prevalence of HCC. These hypotheses are based on investigations of European patients; however the expression patterns of these receptors in Asian patients are largely unknown. In this study, we collected liver carcinoma and peritumor tissues from 32 patients (9 females and 23 males) in South Korea. The expression of ERs and ARs was studied using RT-PCR. Wild-type ER-alpha and AR were expressed in all of the samples investigated, and their expression was independent of the causal virus or patient sex. Expression of the ER-alpha variant was independent of sex (100% female vs. 91.3% male) and HCV and HBV status (91.3% vs. 100%). Wild-type ER-beta was expressed more often in HCV patients than in HBV patients (95.7% vs. 44.4%; p < 0.05). In conclusion, the stronger ER-alpha variant expression in HCC tissues implies that this variant has an important role in HCC development. However, at least in Korean patients, expression of the ER-alpha variant (vER-alpha) is not related to male HCC prevalence. In addition, the predominant expression of ER-beta in HCV patients suggests that it plays an important role in HCV-induced liver disease.
Sex Factors ; Receptors, Estrogen/*metabolism ; Receptors, Androgen/metabolism ; Middle Aged ; Male ; Liver Neoplasms/ethnology/*metabolism/virology ; Korea ; Humans ; Hepatitis B virus/isolation & purification ; Hepacivirus/isolation & purification ; Female ; Carcinoma, Hepatocellular/ethnology/*metabolism/virology ; Biological Markers/metabolism ; Asian Continental Ancestry Group ; Aged

This study investigated the incidence of acquired cytomegalovirus (CMV) infection in very low birth weight infants (VLBWI) given CMV seropositive blood, and sought to determine whether filtering and irradiation of blood products could help prevent CMV infection and the time required to clear passively-derived anti-CMV IgG among 80 VLBWI transfused with filtered-irradiated blood, 20 VLBWI transfused with nonfiltered- nonirradiated blood and 26 nontransfused VLBWI. CMV IgG and IgM values were obtained from all blood products prior to transfusions, and from VLBWI at birth until the infants became seronegative. Urine was obtained for CMV culture at birth and every 3-4 weeks until 12 weeks after the final transfusion. The incidence of CMV IgG seropositivity among the 126 infants at birth and the blood products given were 96% and 95%, respectively. The incidence of acquired CMV infection was 4/100 (4%) in the transfused group: 2/80 (2.5%) and 2/20 (10%) in the filtered-irradiated and nonfiltered-nonirradiated transfusion groups, respectively. Approximately 9-10 months elapsed to clear passively acquired CMV IgG. The irradiation and filtering of the blood products did not seem to decrease the transfusion-related CMV infection rate in Korea among VLBWI, however, further validation is recommended in a larger cohort of infants.
Antibodies, Viral/blood ; Blood Donors ; Blood Transfusion/*adverse effects/methods ; Comparative Study ; Cytomegalovirus/immunology/isolation & purification/radiation effects ; Cytomegalovirus Infections/blood/prevention & control/*transmission ; Female ; Filtration/methods ; Humans ; Immunoglobulin G/blood ; Immunoglobulin M/blood ; Infant, Newborn ; Infant, Very Low Birth Weight/*blood ; Intensive Care Units, Neonatal ; Linear Models ; Male ; Time Factors

This study was to investigate the changes in nutrition knowledge, nutrition attitude and food habit during 'meal management and diet' course to nonmajor university students by questionnaires. 280 students of Chungnam university who registered nonmajor 'meal management and diet' course in the 2003 were the subjects. The results of this study are as follows. BMIs of male and female students were 21.5 and 19.3. According to BMI, underweight subjects were 24.3%, normal and overweight (danger & obesity) subjects were each 62.4% and 13.6%, respectively. The nutrition knowledge scores significantly (p < 0.001) increased from 12.1 to 14.0 after the lecture, and the uncertainty rate of nutrition knowledge decreased significantly. Also, there were no significant differences in nutrition attitude score (39.5 to 39.8 points). Female subjects showed significantly (p < 0.05) higher nutrition knowledge scores (12.3 points) than male (11.4 points). 20% of the subjects smoked and 82.9% had alcohol drinks and 24.4% exercised more than 3 times per week. The subjects who ate regular meals significantly increased from 9.3 to 12.5% after the lecture, and smoking subjects decreased from 20 to 13%, but alcohol drinking subjects did not changed significantly.
Alcohol Drinking ; Chungcheongnam-do ; Diet* ; Education* ; Female ; Food Habits ; Humans ; Male ; Meals ; Overweight ; Smoke ; Smoking ; Thinness ; Uncertainty ; Surveys and Questionnaires