Clinicopathological Characteristics of NRG1 Fusion–Positive Solid Tumors in Korean Patients / Journal of the Korean Cancer Association, 대한암학회지

Purpose@#Neuregulin 1 (NRG1) gene fusion is a potentially actionable oncogenic driver. The oncoprotein binds to ERBB3-ERBB2 heterodimers and activates downstream signaling, supporting a therapeutic approach for inhibiting ERBB3/ERBB2. However, the frequency and clinicopathological features of solid tumors harboring NRG1 fusions in Korean patients remain largely unknown. @*Materials and Methods@#We reviewed archival data from next-generation sequencing panel tests conducted at a single institution, specifically selecting patients with in-frame fusions that preserved the functional domain. The clinicopathological characteristics of patients harboring NRG1 fusions were retrospectively reviewed. @*Results@#Out of 8,148 patients, NRG1 fusions were identified in 22 patients (0.27%). The average age of the patients was 59 years (range, 32 to 78 years), and the male-to-female ratio was 1:1.2. The lung was the most frequently observed primary site (n=13), followed by the pancreaticobiliary tract (n=3), gastrointestinal tract (n=2, stomach and rectum each), ovary (n=2), breast (n=1), and soft tissue (n=1). Histologically, all tumors demonstrated adenocarcinoma histology, with the exception of one case of sarcoma. CD74 (n=8) and SLC3A2 (n=4) were the most frequently identified fusion partners. Dominant features included the presence of fewer than three co-occurring genetic alterations, a low tumor mutation burden, and low programmed death-ligand 1 expression. Various clinical responses were observed in patients with NRG1 fusions. @*Conclusion@#Despite the rarity of NRG1 fusions in Korean patients with solid tumors, identification through next-generation sequencing enables the possibility of new targeted therapies.

Status and Needs Assessment on Nutrition Management and Meal Service for Elementary · Middle · High School Athletes among Athlete's Parents / 대한지역사회영양학회지

OBJECTIVES: Young athletes require adequate nutrition to maintain their athletic performance, growth and health. This study examined the status and needs of nutrition management and meal services for student athletes among the athlete's parents. METHODS: The subjects were parents of elementary, middle, and high school athletes (n=323) from 18 schools participating mainly in the Sports Food Truck. The questionnaire included general characteristics, status and needs on nutrition management and meal service for student athletes, and satisfaction with the Food Truck. The survey was done during 2018. The data were analyzed according to the school groups using a χ2-test or ANOVA. RESULTS: Approximately 45% of subjects had difficulty in the nutrition management of athletes, and 87.1% had not received nutrition education. Approximately 74% wanted nutrition education held for athletes, and mainly wanted topics on nutrition management for health and eating for athletic performance. The preferred methods were lectures and cooking activity. The responses on the necessity of nutrition education for athletes, desired education topics, and desired times for education differed significantly according to the school groups (p < 0.05). Most subjects also wanted nutrition information mainly through SNS. In the athlete's meal, breakfast and snacks were highlighted as the meal to supplement. Approximately 90.3% responded that providing a meal service is necessary. The subjects preferred snacks before/after exercise and dinner if a meal service was provided. They preferred Korean food, followed by snacks, and a dish meal. As the meal type, the subjects wanted the Food Truck and packed meal. The responses on necessity of a meal service (p < 0.05), preferred food (p < 0.001), and meal type (p < 0.001) in the meal service differed significantly according to the school groups. Approximately 43% were satisfied with the Food Truck and 50.8% responded as average. They made suggestions for the Food Truck in terms of foods, operations and frequency. CONCLUSIONS: Based on the study results, nutrition education and meal service may support nutrition for student athletes considering the needs of the parents according to the school groups.

Status and Needs Assessment on Nutrition Management and Meal Service for Elementary · Middle · High School Athletes among Athlete's Parents / 대한지역사회영양학회지

OBJECTIVES: Young athletes require adequate nutrition to maintain their athletic performance, growth and health. This study examined the status and needs of nutrition management and meal services for student athletes among the athlete's parents. METHODS: The subjects were parents of elementary, middle, and high school athletes (n=323) from 18 schools participating mainly in the Sports Food Truck. The questionnaire included general characteristics, status and needs on nutrition management and meal service for student athletes, and satisfaction with the Food Truck. The survey was done during 2018. The data were analyzed according to the school groups using a χ2-test or ANOVA. RESULTS: Approximately 45% of subjects had difficulty in the nutrition management of athletes, and 87.1% had not received nutrition education. Approximately 74% wanted nutrition education held for athletes, and mainly wanted topics on nutrition management for health and eating for athletic performance. The preferred methods were lectures and cooking activity. The responses on the necessity of nutrition education for athletes, desired education topics, and desired times for education differed significantly according to the school groups (p < 0.05). Most subjects also wanted nutrition information mainly through SNS. In the athlete's meal, breakfast and snacks were highlighted as the meal to supplement. Approximately 90.3% responded that providing a meal service is necessary. The subjects preferred snacks before/after exercise and dinner if a meal service was provided. They preferred Korean food, followed by snacks, and a dish meal. As the meal type, the subjects wanted the Food Truck and packed meal. The responses on necessity of a meal service (p < 0.05), preferred food (p < 0.001), and meal type (p < 0.001) in the meal service differed significantly according to the school groups. Approximately 43% were satisfied with the Food Truck and 50.8% responded as average. They made suggestions for the Food Truck in terms of foods, operations and frequency. CONCLUSIONS: Based on the study results, nutrition education and meal service may support nutrition for student athletes considering the needs of the parents according to the school groups.

Short-term changes in muscle activity and jaw movement patterns after orthognathic surgery in skeletal Class III patients with facial asymmetry / 대한치과교정학회지

OBJECTIVE@#To evaluate the short-term changes in masticatory muscle activity and mandibular movement patterns after orthognathic surgery in skeletal Class III patients with facial asymmetry.@*METHODS@#Twenty-seven skeletal Class III adult patients were divided into two groups based on the degree of facial asymmetry: the experimental group (n = 17 [11 male and 6 female]; menton deviation ≥ 4 mm) and control group (n = 10 [4 male and 6 female]; menton deviation < 1.6 mm). Cephalography, electromyography (EMG) for the anterior temporalis (TA) and masseter muscles (MM), and mandibular movement (range of motion [ROM] and average chewing pattern [ACP]) were evaluated before (T0) and 7 to 8 months (T1) after the surgery.@*RESULTS@#There were no significant postoperative changes in the EMG potentials of the TA and MM in both groups, except in the anterior cotton roll biting test, in which the masticatory muscle activity had changed into an MM-dominant pattern postoperatively in both groups. In the experimental group, the amount of maximum opening, protrusion, and lateral excursion to the non-deviated side were significantly decreased. The turning point tended to be shorter and significantly moved medially during chewing in the non-deviated side in the experimental group.@*CONCLUSIONS@#In skeletal Class III patients with facial asymmetry, the EMG activity characteristics recovered to presurgical levels within 7 to 8 months after the surgery. Correction of the asymmetry caused limitation in jaw movement in terms of both ROM and ACP on the non-deviated side.

Maxillomandibular advancement surgery after long-term use of a mandibular advancement device in a post-adolescent patient with obstructive sleep apnea / 대한치과교정학회지

Patients with obstructive sleep apnea (OSA) whose phenotype belongs to a craniofacial vulnerability are referred from sleep doctors to orthodontists. In adults, for osseo-pharyngeal reconstruction (OPR) treatment, permanent maxillomandibular advancement (MMA) surgery and use of a temporary mandibular advancement device (MAD) are applied. This case report demonstrates successful treatment of OSA through application of phased MAD and MMA in a 16-year-old male with craniofacial deformity and residual growth potential. This patient showed skeletal and dentoalveolar changes after 7-year MAD use throughout post-adolescence, which affected the design and timing of subsequent MMA surgery, as well as post-surgical orthodontic strategy. This case report suggests that OPR treatment can be useful for treatment of OSA in post-adolescent patients, from an orthodontic point of view, in close collaboration with sleep doctors for interdisciplinary diagnosis and treatment.

Targeted presurgical decompensation in patients with yaw-dependent facial asymmetry / 대한치과교정학회지

Facial asymmetry can be classified into the rolling-dominant type (R-type), translation-dominant type (T-type), yawing-dominant type (Y-type), and atypical type (A-type) based on the distorted skeletal components that cause canting, translation, and yawing of the maxilla and/or mandible. Each facial asymmetry type represents dentoalveolar compensations in three dimensions that correspond to the main skeletal discrepancies. To obtain sufficient surgical correction, it is necessary to analyze the main skeletal discrepancies contributing to the facial asymmetry and then the skeletal-dental relationships in the maxilla and mandible separately. Particularly in cases of facial asymmetry accompanied by mandibular yawing, it is not simple to establish pre-surgical goals of tooth movement since chin deviation and posterior gonial prominence can be either aggravated or compromised according to the direction of mandibular yawing. Thus, strategic dentoalveolar decompensations targeting the real basal skeletal discrepancies should be performed during presurgical orthodontic treatment to allow for sufficient skeletal correction with stability. In this report, we document targeted decompensation of two asymmetry patients focusing on more complicated yaw-dependent types than others: Y-type and A-type. This may suggest a clinical guideline on the targeted decompensation in patient with different types of facial asymmetries.

Status of Dietary Life Related Knowledge, Self-Efficacy, Food Preference and Dietary Behavior of Preschoolers in Kyunggi Area / 대한지역사회영양학회지

OBJECTIVES: The purpose of the study was to examine dietary life characteristics such as knowledge, self-efficacy and dietary behavior of preschoolers in Namyangju, Kyunggi-province, Korea. METHODS: The survey questionnaire was developed based on literature review. Preschoolers aged 4-5 years (n=208) responded to the questionnaire to measure knowledge, self-efficacy, food preference, and dietary behavior. After excluding incomplete responses, the data of 197 subjects were used for analysis. RESULTS: Mean score of dietary life knowledge was 8.0 out of 12, showing a low level of knowledge. Two out of 12 knowledge items were significantly different by gender. Percentage of correct answer on items of 'foods to make bones strong' and 'kinds of fast foods' was higher in girls than in boys (p<0.05). Total score of self-efficacy regarding dietary life was 40.1 (possible score: 12~48), on average. Compared to girls, boys had more confidence in 'not over-eating', and 'eating balanced meals with meat, fish and vegetables' (p<0.05). Boys scored higher on total score of food preference than girls (p<0.01). The preference for fruits was quite high. Among food items, boys scored higher on the preference for rice (p<0.01), fish (p<0.01), pork (p<0.05), beef (p<0.05), milk (p<0.01), and ice cream (p<0.05) than girls. Boys also liked fast foods more than girls did, showing preference for chicken (p<0.01) and soda (p<0.05). Compared to girls, boys showed more desirable behavior in 'eating breakfast everyday' (p<0.01). Dietary behavior was significantly correlated with self-efficacy (r=0.52, p<0.01), food preference (r=0.35, p<0.01), and knowledge (r=0.25, p<0.01) of subjects. CONCLUSIONS: In this study, we observed differences in food preference by gender. Dietary behavior of preschoolers was correlated with several factors, including dietary life related knowledge, self-efficacy and food preference. Thus, it is needed to develop nutrition education programs focusing on increasing dietary life related knowledge and self-efficacy, and consider the differences in food preference of preschoolers by gender.

Full mouth rehabilitation of a partially edentulous patient with crossed occlusion using implant-retained RPD with zirconia occlusal table

Conventional removable partial dentures (RPDs) with distal extensions are associated with some problems, including lack of stability that calls for frequent relining, and cantilever actions of claps that can produce excessive loading to abutment teeth, and the need for unesthetic retentive arm clasps. Therefore, IARPDs (Implant-assisted RPD) that use implants to support or retain RPDs has been reported to improve stability, esthetics and masticatory performance of RPDs. Also, an IARPD that has zirconia occlusal table can prevent the incongruity of occlusal plane and the extrusion of antagonistic tooth. In this case of partially edentulous patient with crossed occlusion, each edentulous area was restored with implant fixed prosthesis and implant retained partial denture to suit each situation. Through the procedure, satisfactory outcomes were achieved both in functional and esthetic aspects.

Eating habits, physical activity, nutrition knowledge, and self-efficacy by obesity status in upper-grade elementary school students

BACKGROUND/OBJECTIVES: Childhood obesity has increased in recent decades in Korea. This study was designed to examine differences in the eating habits, physical activity (PA), nutrition knowledge, and self-efficacy of children by obesity status. SUBJECTS/METHODS: Subjects were 5th-grade children from 70 elementary schools in 17 cities nationwide. Two-stage stratified cluster sampling was employed. Survey questionnaire included items related to general characteristics, eating habits, PA, nutrition knowledge and self-efficacy. Excluding incomplete responses, 3,531 data were analyzed using SPSS. Subjects were categorized into overweight·obesity (OW) and normal weight (NW) groups based on body mass index percentiles for age by sex. RESULTS: A total of 21.5% of subjects was overweight or obese. There were significant differences in gender, perceived stress, perception of body shape, body satisfaction, and interest in weight control between the OW and NW groups (P < 0.001). With respect to eating habits, the OW group ate breakfast (P < 0.05) and snacks (P < 0.01) less frequently, ate bigger meals (P < 0.001), and demonstrated less desirable behaviors during meals (P <0.05 in boys) compared to the NW group. The OW group participated in less PA than the NW group, especially boys. OW boys spent less time walking during weekdays (P < 0.05) or the weekend (P < 0.001), spent more time being sedentary during weekdays or the weekend (P < 0.001), and exercised a fewer number of days (P < 0.01). For girls, the OW group spent more time being sedentary during the weekend (P < 0.01) and exercised a fewer number of days by walking or bicycle riding (P < 0.05) than the NW group. Nutrition knowledge was not significantly different between the OW and NW groups. Self-efficacy (P < 0.01 in boys), especially PA self-efficacy (P < 0.01), was significantly lower in the OW than NW group. CONCLUSIONS: This study revealed differences in eating habits, PA, and self-efficacy between OW and NW children. Obesity management programs for children need to focus on increasing self-efficacy, modifying eating habits, and increasing PA.

Displacement pattern of the anterior segment using antero-posterior lingual retractor combined with a palatal plate / 대한치과교정학회지

OBJECTIVE: To evaluate and compare the effects of two appliances on the en masse retraction of the anterior teeth anchored by temporary skeletal anchorage devices (TSADs). METHODS: The sample comprised 46 nongrowing hyperdivergent adult patients who planned to undergo upper first premolar extraction using lingual retractors. They were divided into three groups, based on the lingual appliance used: the C-lingual retractor (CLR) group (group 1, n = 16) and two antero-posterior lingual retractor (APLR) groups (n = 30, groups 2 and 3). The APLR group was divided by the posterior tube angulation; posterior tube parallel to the occlusal plane (group 2, n = 15) and distally tipped tube (group 3, n = 15). A retrospective clinical investigation of the skeletal, dental, and soft tissue relationships was performed using lateral cephalometric radiographs obtained pretreatment and post en masse retraction of the anterior teeth. RESULTS: All groups achieved significant incisor and canine retraction. The upper posterior teeth did not drift significantly during the retraction period. The APLR group had less angulation change in the anterior dentition, compared to the CLR group. By changing the tube angulation in the APLR, the intrusive force significantly increased in the distally tipped tube of group 3 patients and remarkably reduced the occlusal plane angle. CONCLUSIONS: Compared to the CLR, the APLR provides better anterior torque control and canine tipping while achieving bodily translation. Furthermore, changing the tube angulation will affect the amount of incisor intrusion, even in patients with similar palatal vault depth, without the need for additional TSADs.

Regeneration of emergence profile with soft tissue graft and wide computer aided design/computer aided mamufacturing abutments: a clinical report

Fixed restoration using implants for patients with posterior partial edentulism is generalized technique. As patient demands increase, the functional and esthetic implant restoration to achieve similar results to lost natural teeth is becoming an important issue. It is inevitable to use customized CAD/CAM abutments rather than ready-made abutments for the creation of implant prosthesis which closely resembles natural teeth. Using CAD/CAM abutment made it possible to obtain natural emergency profiles for posterior implant prostheses, ensuring more comfortable, efficient management of oral hygiene. However, keratinized gingiva with sufficient width and height for a natural emergence profile is required to use a large diameter CAD/CAM abutment which ensures stability and esthetics of hard/soft tissue around the implants. In this case, for esthetical and functional implant zirconia prosthesis, soft tissue graft was performed and customized CAD/CAM abutments were used following ridge augmentation, sinus graft and implantation. Satisfactory results were obtained functionally and esthetically through periodic clinical evaluation, and I hereby report this case.

A new type of clear orthodontic retainer incorporating multi-layer hybrid materials / 대한치과교정학회지

Clear thermoplastic retainers have been widely used in daily orthodontics; however, they have inherent limitations associated with thermoplastic polymer materials such as dimensional instability, low strength, and poor wear resistance. To solve these problems, we developed a new type of clear orthodontic retainer that incorporates multi-layer hybrid materials. It consists of three layers; an outer polyethylenterephthalate glycol modified (PETG) hard-type polymer, a middle thermoplastic polyurethane (TPU) soft-type polymer, and an inner reinforced resin core. The resin core improves wear resistance and mechanical strength, which prevent unwanted distortion of the bucco-palatal wall of the retainer. The TPU layer absorbs impact and the PETG layer has good formability, optical qualities, fatigue resistance, and dimensional stability, which contributes to increased support from the mandibular dentition, and helps maintain the archform. This new type of vacuum-formed retainer showed improved mechanical strength and rate of water absorption.

Accuracy and precision of integumental linear dimensions in a three-dimensional facial imaging system / 대한치과교정학회지

OBJECTIVE: A recently developed facial scanning method uses three-dimensional (3D) surface imaging with a light-emitting diode. Such scanning enables surface data to be captured in high-resolution color and at relatively fast speeds. The purpose of this study was to evaluate the accuracy and precision of 3D images obtained using the Morpheus 3D(R) scanner (Morpheus Co., Seoul, Korea). METHODS: The sample comprised 30 subjects aged 24-34 years (mean 29.0 +/- 2.5 years). To test the correlation between direct and 3D image measurements, 21 landmarks were labeled on the face of each subject. Sixteen direct measurements were obtained twice using digital calipers; the same measurements were then made on two sets of 3D facial images. The mean values of measurements obtained from both methods were compared. To investigate the precision, a comparison was made between two sets of measurements taken with each method. RESULTS: When comparing the variables from both methods, five of the 16 possible anthropometric variables were found to be significantly different. However, in 12 of the 16 cases, the mean difference was under 1 mm. The average value of the differences for all variables was 0.75 mm. Precision was high in both methods, with error magnitudes under 0.5 mm. CONCLUSIONS: 3D scanning images have high levels of precision and fairly good congruence with traditional anthropometry methods, with mean differences of less than 1 mm. 3D surface imaging using the Morpheus 3D(R) scanner is therefore a clinically acceptable method of recording facial integumental data.

Reader's Forum / 대한치과교정학회지

No abstract available.

Sacral Cutaneous Clues to Underlying Spinal Abnormalities

PURPOSE: Sacral cutaneous lesions in newborns are associated with numerous spinal abnormalities. Early detection is important, because spinal abnormalities may cause neurological symptoms. Radiologic screening tests have been performed on newborns with sacral cutaneous lesions. This study aimed to substantiate the associations between sacral cutaneous lesions and spinal abnormalities. METHODS: From January 2007 until November 2013, we retrospectively reviewed the charts of 743 newborns with sacral cutaneous lesions that included sacral dimples, which were deeper than 5 mm and situated further than 2.5 cm from the anus, deviated gluteal furrow, hairy patch, hemangioma, dyspigmentaion, and the presence of mass, and skin tag. RESULTS: 743 newborns with sacral cutaneous lesions were examined, including 24 newborns with abnormal ultrasonographic images. Tethered cord which affected 18 (2.4%) of the newborns, was the most commonly found spinal abnormaility. Of these 9 newborns had other spinal abnormalities in addition to tethered cord including lipoma, cyst, spina bifida occulta, lipomyelomeningocele, and dermal sinus tract, and 9 newborns had isolated tethered cord only. Other spinal abnormalities found included isolated lipoma (3 newborns, 0.4%), and subarachnoid cyst (2 newborns, 0.3%), and of the 2 newborns (0.3%) who had dermal sinus tract, 1 also had a lipoma and the other also had a tethered cord. Normal variants included coccygeal pit (43 newborns, 5.8%), and ventriculus terminalis (10 newborns, 1.4%). Of the 646 newborns with isolated sacral cutaneous lesion, 11 (1.7%) had abnormal ultrasonographic images, and of the 97 newborns with combined sacral cutaneous lesions, 13 (13.4%) had abnormal ultrasonograpic images. CONCLUSION: Sacral cutaneous lesions in newborns can be associated with spinal abnormalities, and the strongest marker of spinal abnormality is a combined lesion. Therefore, ultrasonography should be performed on newborns who present with sacral cutaneous lesions to detect and investigate any underlying spinal abnormalities.

The TREK2 Channel Is Involved in the Proliferation of 253J Cell, a Human Bladder Carcinoma Cell

Bladder cancer is the seventh most common cancer in men that smoke, and the incidence of disease increases with age. The mechanism of occurrence has not yet been established. Potassium channels have been linked with cell proliferation. Some two-pore domain K+ channels (K2P), such as TASK3 and TREK1, have recently been shown to be overexpressed in cancer cells. Here we focused on the relationship between cell growth and the mechanosensitive K2P channel, TREK2, in the human bladder cancer cell line, 253J. We confirmed that TREK2 was expressed in bladder cancer cell lines by Western blot and quantitative real-time PCR. Using the patch-clamp technique, the mechanosensitive TREK2 channel was recorded in the presence of symmetrical 150 mM KCl solutions. In 253J cells, the TREK2 channel was activated by polyunsaturated fatty acids, intracellular acidosis at -60 mV and mechanical stretch at -40 mV or 40 mV. Furthermore, small interfering RNA (siRNA)-mediated TREK2 knockdown resulted in a slight depolarization from -19.9 mV+/-0.8 (n=116) to -8.5 mV+/-1.4 (n=74) and decreased proliferation of 253J cells, compared to negative control siRNA. 253J cells treated with TREK2 siRNA showed a significant increase in the expression of cell cycle boundary proteins p21 and p53 and also a remarkable decrease in protein expression of cyclins D1 and D3. Taken together, the TREK2 channel is present in bladder cancer cell lines and may, at least in part, contribute to cell cycle-dependent growth.

Correlation of expression and activity of matrix metalloproteinase-9 and -2 in human gingival cells of periodontitis patients

PURPOSE: Matrix metalloproteinases (MMPs) are capable of degrading extracellular matrix, and they are inducible enzymes depending on an inflammatory environment such as periodontitis and bacterial infection in periodontal tissue. Gingival inflammation has been postulated to be correlated with the production of MMP-2 and MMP-9. The objective of this study was to quantify the expression and activity of MMP-9 and -2, and to determine the correlation between activity and expression of these MMPs in human gingival tissues with periodontitis. METHODS: The gingival tissues of 13 patients were homogenized in 500 microL of phosphate buffered saline with a protease inhibitor cocktail. The expression and activity of MMP-2 and -9 were measured by enzyme-linked immunosorbent assay and Western blot analysis, and quantified by a densitometer. For the correlation line, statistical analysis was performed using the Systat software package. RESULTS: MMP-9 was highly expressed in all gingival tissue samples, whereas MMP-2 was underexpressed compared with MMP-9. MMP-9 activity increased together with the MMP-9 expression level, with a positive correlation (r=0.793, P=0.01). The correlation was not observed in MMP-2. CONCLUSIONS: The expression of MMP-2 and -9 might contribute to periodontal physiological and pathological processes, and the degree of MMP-9 expression and activity are predictive indicators relevant to the progression of periodontitis.

The Evaluation of Soft and Hard Tissue Change for Retraction of Lower Anterior Tooth in Bimaxillary Protrusion Patients according to Two Different Therapeutic Methods: Mandibular Anterior Segmental Osteotomy and Orthodontic Treatment with Teeth Extraction

Socioeconomic Costs of Overweight and Obesity in Korean Adults

This study was conducted to estimate the socioeconomic costs of overweight and obesity in a sample of Korean adults aged 20 yr and older in 2005. The socioeconomic costs of overweight and obesity include direct costs (inpatient care, outpatient care and medication) and indirect costs (loss of productivity due to premature deaths and inpatient care, time costs, traffic costs and nursing fees). Hypertension, diabetes mellitus, dyslipidemia, ischemic heart disease, stroke, colon cancer and osteoarthritis were selected as obesity-related diseases. The population attributable fraction (PAF) of obesity was calculated from national representative data of Korea such as the National Health Insurance Corporation (NHIC) cohort data and the 2005 Korea National Health and Nutrition Examination Survey (KNHANES) data. Direct costs of overweight and obesity were estimated at approximately U$1,081 million equivalent (men: U$497 million, women: U$584 million) and indirect costs were estimated at approximately U$706 million (men: U$527 million, women: U$178 million). The estimated total socioeconomic costs of overweight and obesity were approximately U$1,787 million (men: U$1,081 million, women: U$706 million). These total costs represented about 0.22% of the gross domestic product (GDP) and 3.7% of the national health care expenditures in 2005. We found the socioeconomic costs of overweight and obesity in Korean adults aged 20 yr and older are substantial. In order to control the socioeconomic burden attributable to overweight and obesity, effective national strategies for prevention and management of obesity should be established and implemented.

A Clinical Study of Congenital Intrahepatic Portosystemic Shunt Diagnosed in Neonatal Period

PURPOSE: Congenital intrahepatic portosystemic shunts are rare disease and clinically asymptomatic shunts may be detected by chance on ultrasonogram before and after birth. We studied clinical course, treatment and prognosis of congenital intrahepatic portosystemic shunt at prenatal or neonatal period. METHODS: Medical records of 8 patients which were diagnosed in intrahepatic portosystemic shunt in Cheil General Hospital from 2006 through 2010 were reviewed retrospectively. RESULTS: Eight patients with congenital intrahepatic portosystemic shunts were identified. Six patients were diagnosed at prenatal radiological screening, including three cases of intrauterine growth restriction and two cases of preterm baby. One case with increased serum ammonia underwent coil embolization. In four cases including one case that presented elevated direct bilirubin, shunts were closed spontaneously within 11th month after birth. Two patients were diagnosed on abdominal sonogram after birth because of elevated direct hyperbilirubinemia, all of whom presented intrauterine growth restriction. Closure of shunts was confirmed during 4th month to 6th month. CONCLUSION: Congenital intrahepatic portosystemic shunts are clinically asymptomatic mostly and spontaneous closure is expected within 2 years age. But occasionally they have severe complication, so clinical and radiological observation is needed. Specially in cases of intrauterine growth retardation without evident cause, the possible diagnosis of congenital intrahepatic portosystemic shunts should be considered and prenatal and postnatal examination should be performed. When prenatal diagnosis is made, fetal wellbeing should be monitored periodically until spontaneous closure of shunts.