Agrifood consumer competency index and food consumption behaviors based on the 2019 Consumption Behaviors Survey for Food / 한국영양학회지

Purpose@#This study investigated the food consumption behaviors in Korean adults, according to the agrifood consumer competency index (ACCI). @*Methods@#Data obtained from the 2019 Consumption Behaviors Survey for Food were analyzed. A total of 6,176 adults (2,783 males, 3,393 females) aged ≥ 19 years, were included in the study. Based on the score of agrifood consumer competency index, the subjects were classified into three groups. The dietary habits, eating-out and food-delivery/take-out behaviors, opinion of food labeling, and concerns for domestic products were compared among the 3 groups. @*Results@#The ACCI scores of the male and female subjects were 63.6 and 64.8, respectively. Subjects of both genders in the highest tertile of the ACCI were more likely to have a higher education level and higher health concerns, as compared to subjects in the lowest tertile (p < 0.05). Male subjects having highest tertile of the ACCI reported significantly more exercise and alcohol consumption, as compared to subjects in the lowest tertile (p < 0.05). A higher score of the ACCI also portrayed a higher satisfaction in own diet and greater checking of the food label. Moreover, subjects with a higher score of the ACCI showed greater satisfaction and reliability in the food label, as well as increased concerns for domestic agrifoods, local foods, and eco-friendly foods. Subjects in the lowest tertile of the ACCI acquired their dietary information from acquaintances, whereas subjects in the highest tertile of the ACCI learnt the information from food labels themselves. @*Conclusion@#These results are indicative of the food consumption and behaviors of Koreanadults according to their ACCI scores, and provide basic data that will be useful for implementing an effective food policy.

Impact of Menstrual Attitudes, Premenstrual Syndrome, and Stress Response on Quality of Life among Nursing Students

PURPOSE: To identify effects of menstrual attitude, premenstrual syndrome, and stress response on quality of life of nursing students. METHODS: Subjects were 135 nursing students who agreed to participate in this study. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation, and stepwise multiple regression. RESULTS: Premenstrual syndrome, younger than 20 years of age, and habit of eating bland food in everyday life were factors influencing quality of life of nursing students. These factors accounted for 17.6% of quality of life. Premenstrual syndrome toward quality of life was the most influential factor. CONCLUSION: Premenstrual syndrome is the most significant factor affecting the quality of life of nursing students. To increase their quality of life, it is important to develop and apply educational programs using factors influencing quality of life of the nursing students. Results of this study will be useful as basic data for improving quality of life of nursing students. Additional study is needed to test its effect in the future.

Uric Acid as a Predictor of Severe Intraventricular Hemorrhage in Very Low Birth Weight Infants

PURPOSE: To determine whether serum uric acid levels in the first 7 days of life can predict development of severe intraventricular hemorrhage (IVH) among very low birth weight (VLBW) infants. METHODS: VLBW infants admitted to the neonatal intensive care unit of Asan Medical Center between January 2009 and December 2012 were selected for chart review. Infants were divided into groups with and without severe IVH (grade> or =3). To determine whether uric acid is a predictor of severe IVH, uric acid levels on the first day (within 24 hours of birth), peak uric acid levels (during the first 7 days for infants without severe IVH, prior to IVH documentation by cranial sonogram for infants with severe IVH, and trend in uric acid levels were analyzed for both groups. Various antenatal and postnatal factors were compared between the groups, and risk factors associated with severe IVH were identified. RESULTS: A total of 397 VLBW infants were included, with mean birth weight of 1,075+/-292 g and a mean gestational age of 29.6+/-3.3 weeks. Higher levels of uric acid on day 1, higher peak levels, and rising uric acid levels were all found to be associated with the development of severe IVH on univariate analysis. Multivariate analysis confirmed that rising uric acid levels predicted subsequent development of severe IVH. Other factors associated with development of severe IVH included higher sodium, higher potassium, higher PaCO2, higher lactic acid, and lower PaO2. CONCLUSION: Careful attention to uric acid levels, which are easily measured, may be useful in predicting subsequent development of severe IVH among VLBW infants.

Continuous Renal Replacement Therapy in the Neonatal Intensive Care Unit: A Single-Center Study

PURPOSE: Continuous renal replacement therapy (CRRT) has become an essential modality for the care of critically ill pediatric patients who require renal support. However, experience with CRRT in the neonatal population is not common in Korea. In this study, we aimed to investigate the clinical features, outcomes, and complications of CRRT in neonates in a single neonatal intensive care unit (NICU). METHODS: We reviewed the medical records of 17 neonates who underwent CRRT at a NICU of a tertiary hospital. The data included demographic characteristics, diagnosis, complications, and laboratory and CRRT parameters. RESULTS: The median age at initiation of CRRT was 6 days after birth. All patients were treated with CRRT in continuous venovenous hemodiafiltration mode, with a median treatment duration of 57 hours. The main indication for CRRT was an inborn error of metabolism (IEM), followed by congenital renal disease and multiorgan failure. In patients with an IEM, the median plasma ammonia level at the CRRT initiation was 1,232 micromol/L, and the mean duration until the ammonia level decreased to half of the peak ammonia level was 7.3+/-2.5 hours. The overall hospital mortality rate was 41.2%. The outcomes of the 10 survivors after discharge included death (n=2), loss to follow-up (n=3), and survival with developmental delay (n=4). CONCLUSION: Although CRRT was effective in lowering the plasma ammonia level of neonates with IEM, the associated mortality and morbidity were high. Hence, further studies are needed to optimize the CRRT protocol and to establish an effective patient referral system in Korea.

Seizure Scoring System and Neurodevelopmental Outcomes in Very Low Birth Weight Infants with Neonatal Seizures

PURPOSE: To evaluate the utility of seizure scoring system in the prediction of neurodevelopmental outcomes in very low birth weight (VLBW) infants who presented with neonatal seizures. METHODS: A retrospective review was performed in VLBW infants who were treated with antiepileptic drugs (AED) for the control of neonatal seizures. A total of 25 infants who survived and were followed-up for at least 2 years of age were included. A new seizure scoring system (the composite score 0-8) was constructed by choosing the following variables: onset, response to the AED, presence of status epilepticus, seizure types and EEG findings including background activity and epileptiform discharges. Neurodevelopmental outcomes were graded from 1 to 5 based on the developmental status and the neurologic abnormalities assessed at 18 to 24 months of postconceptional age. Risk factor analyses for predicting unfavorable outcomes (grade 3-5) versus favorable outcomes (grade 1-2) were performed. RESULTS: Compared to favorable outcome group (n=11), unfavorable outcome group (n=14) had higher incidence of subtle or generalized tonic-type seizures, the abnormal EEG background activity and poor response to AED. The composite seizure score was significantly higher in the unfavorable outcome group (3.2+/-0.7) than in the favorable outcome group (1.2+/-1.2) and it significantly correlated with the neurodevelopmental grading (P<0.001). In multivariate analysis, abnormal MRI findings at term and the composite seizure score were significant risk factors for unfavorable outcomes. CONCLUSION: In VLBW infants with neonatal seizure, the proposed seizure scoring system was a simple and useful predictor of long-term neurologic outcomes.

The Role of One-Year Endoscopic Follow-Up for the Esophageal Remnant and Gastric Conduit after Esophagectomy with Gastric Reconstruction for Esophageal Squamous Cell Carcinoma

PURPOSE: After esophagectomy and gastric reconstruction for esophageal cancer, patients suffer from various symptoms that can detract from quality of life. Endoscopy is a useful diagnostic tool for evaluating patients after esophagectomy. This observational study was performed to investigate the correlation between symptoms and endoscopic findings one year after esophageal surgery and to assess the clinical usefulness of one-year endoscopic follow-up. MATERIALS AND METHODS: From 2001 to 2008, 162 patients who underwent esophagectomy with gastric reconstruction were endoscopically examined one year after operation. RESULTS: Patients suffered from the following symptoms: nocturnal cough (n=10), regurgitation (n=7), cervical heartburn (n=3), lump sensation (n=2), dysphagia (n=20) and odynophagia (n=22). Eighty-five (52.5%) patients had abnormal findings on endoscopic examination. Twelve (7.4%) patients had reflux esophagitis, and 37 (22.8%) patients had an anastomotic stricture. Only stricture-related symptoms were correlated with the finding of anastomotic strictures (p<0.001). Two patients had recurrences at the anastomotic sites, and four patients had regional lymph node recurrences with gastric conduit invasion visualized by endoscopy. Newly-developed malignancies in the esophageal remnant or hypopharynx that were not detected by clinical symptoms and imaging studies were reported in two patients. CONCLUSION: One year after esophagectomy, endoscopic findings were not correlated with clinical symptoms, except those related to stricture. Routine endoscopic follow-up is a useful tool for identifying latent functional and oncological lesions.

Appendiceal Orifice Inflammation in an 8-Year-Old Girl with Ulcerative Colitis Complicating Wilson's Disease

Appendiceal orifice inflammation (AOI) may occur as a skipped lesion in ulcerative colitis (UC). Cases of ulcerative colitis complicated by Wilson's disease have also been reported. We report herein a case of AOI that occurred as a missed lesion in an 8-year-old girl with UC complicating Wilson's disease, which is rare in children.

Ototoxicity in children receiving cisplatin chemotherapy / 소아과

PURPOSE: Cisplatin is highly effective for the treatment of solid tumors in children. However, the clinical use of cisplatin is limited by its ototoxicity. The aim of this study was to evaluate the ototoxicity in children treated with cisplatin. Method: We performed a single institution retrospective analysis of pediatric oncology patients who received cisplatin therapy between January 2001 and January 2008. Thirty-seven patients with sufficient medical and audiologic data were included in this study. RESULTS: The median age at the time of diagnosis was 10.7 (range 3.8-16.7) years. There were 16 males and 21 females. The underlying diseases were osteosarcoma (15 cases), medulloblastoma (14 cases), germ cell tumors (7 cases), and hepatoblastoma (1 case). The median individual dose was 100 mg/m2/cycle (56-200). The median cumulative dose was 480 mg/m2 (200-1,490). Sixteen patients (43%) received cranial radiotherapy. Of the 37 patients, 17 developed hearing loss, leading to an overall incidence of 46%. Logistic regression showed that age at treatment (P=0.04) and cumulative dose of cisplatin (P=0.005) were the significant risk factors in predicting hearing loss in children treated with cisplatin. In all the patients who had hearing loss, there was neither improvement nor aggravation during the follow-up (3-68 months). CONCLUSION: The cumulative dose of cisplatin (>500 mg/m2) and younger age at treatment (<12 years) were 2 most important risk factors for ototoxicity in patients treated with cisplatin. Serial audiometric evaluations are needed in the patients with risk factors during and after cisplatin treatment.

Video-Assisted Thoracic Surgery Lobectomy for Non-SmallCell Lung Cancer: Experience of 133 Cases / 대한흉부외과학회지

BACKGROUND: We evaluated the feasibility and the efficacy of Video-Assisted Thoracic Surgery (VATS) lobectomy for treating patients with non-small cell lung cancer (NSCLC) and we compared the outcomes of VATS lobectomy with those of open lobectomy. MATERIAL AND METHOD: From 2003 to March 2008, 133 NSCLC patients underwent VATS lobectomy. The patients were selected on the basis of having clinical stage I disease on the chest CT and PET scan. The outcomes of 202 patients who underwent open lobectomy (OL group) for clinical stage I NSCLC were evaluated to compare their results with those of the patients who underwent VATS lobectomy (the VL group). RESULT: The number of females and the number of patients with adenocarcinoma and stage IA disease were greater in VL group (p<0.05). There was no operative mortality or major complications in the VL group. Conversion to thoracotomy was needed in 8 cases (6%), which was mostly due to bleeding. The chest tube indwelling time and the length of the postoperative hospital stay were significantly shorter in the VL group (p<0.001). The number of dissected lymph nodes and the size of tumor were significantly smaller in the VL group (p<0.001). For the pathologic stage I patients, there was no significant difference in the three-year survival rates between the two groups (p=0.15). CONCLUSION: VATS lobectomy is a safe procedure with low operative mortality and morbidity. VATS lobectomy is feasible for early stage NSCLC and it provides outcomes that are comparable to those for open lobectomy. Further long-term data are needed

Pleural Incarceration of the Transverse Colon after Transthoracic Esophagectomy: A case report / 대한흉부외과학회지

A 65 year-old man, who underwent transthoracic esophagectomy for mid-thoracic esophageal squamous cell carcinoma, suffered from an incarcerated herniation of the transverse colon through a defect in the left mediastinal pleura. The patient had a gas collection in the left lower lung field and this then insidiously progressed; the final result was total collapse of the left lung and hemodynamic compromise. The life-threatening herniation of the transverse colon into the pleural cavity after pervious esophagectomy was corrected by emergency laparotomy. Postoperative pulmonary complications after esophagectomy can induce potentially lethal transhiatal herniation because of the danger of intestinal obstruction or strangulation. The optimal approach to transhiatal herniation after esophagectomy is prevention.

Primary Pulmonary Choriocarcinoma in the Lung: A case report / 대한흉부외과학회지

Choriocarcinoma is a germ-cell tumor that originates from syncytiotrophoblastic cells and this tumor secrets beta-human chorionic gonadotropin. It has been reported that extragonadal primary pulmonary choriocarcinoma is extremely rare. We report here on a 28-years-old woman who underwent right lower lobectomy for extragonadal nongestational primary pulmonary choriocarcinoma and she has survived for 2 years without recurrence.

Results of Mitral Valve Repair in Patients with Congenital Mitral Disease / 대한흉부외과학회지

BACKGROUND: Mitral valve abnormalities in the pediatric population are rare. Mitral valve replacement for pediatric mitral lesions can cause problems such as a lack of growth potential. There are only limited experiences with mitral valve repair at any institution, so the purpose of this study is to evaluate the outcomes of mitral valve repair in pediatric patients. MATERIAL AND METHOD: Sixty-four consecutive children (28 males and 36 females) with a mean age of 5.5+/-4.7 years underwent mitral valve repair for treating their congenital mitral valve disease between January 1996 and December 2005. The patients were divided into two groups: group 1 (34 patients (53.1%)) had isolated disease (mitral anomaly with or without atrial septal defect or patent ductus arteriosus) and group 2 (30 patients (46.9%)) had complex disease (mitral anomaly with concurrent intracardiac disease, except atrioventricular septal defect). RESULT: The overall in-hospital mortality was 6.3%; group 1 had 5.9% mortality and group 2 had 10.0% mortality. The postoperative morbidity was 18.8%; group 1 and 2 had 14.7% and 23.3% postoperative morbidity, respectively, and there was no significant difference among the groups. The median follow-up was 4.6 years (range: 0.5~12.2 years). The 10-year survival rate was 95.3%. The 10-year freedom from re-operation rate was 76.1% with 10 re-operations. The majority of the functional classifications were annular dilatation and leaflet prolapse. A mean of 2.1+/-1.1 procedures per patient were performed. The echocardiography that was done at the immediate postoperative period showed a significant improvement in the mitral valve function. The follow-up echocardiographic results were significantly improved. However, mitral stenosis newly developed over time, and there were significant differences according to the repair strategies. CONCLUSION: The patients who underwent mitral valve repair for congenital mitral anomalies showed good results. The follow-up echocardiography revealed satisfactory short-term and long-term results. Close follow-up is necessary to detect the development of postoperative mitral stenosis or regurgitation.

A case of benign metastasizing leiomyoma in the lung of woman with a history of myomectomy / 대한내과학회지

Benign metastasizing leiomyoma is usually detected years after hysterectomy or myomectomy and characterized by well-circumscribed, singular or, often, multiple nodules. The patient was a 33-year-old woman who presented with cough. She underwent a myomectomy for a large uterine leiomyoma 9 years ago. And now she has recurrent uterine myoma. Multiple nodular lesions in both whole lung fields were incidentally found on a routine chest radiograph. Video-assisted thoracoscopy (VATs) was performed. The resected small nodular lesions composed of extremely well- defferentiated smooth muscle cells with collagen. On immunohistochemical stain, they are positive for smooth muscle markers (desmin and actin). There is no definite evidence of malignancy. Therefore, these multiple nodules are considered as benign metastasizing leiomyoma from a uterine leiomyoma. We report this case with review of literatures.

Prevalence and Clinicopathologic Features of Mucinous Cystic Tumor and Intraductal Papillary Mucinous Tumor of Pancreas in Korea

BACKGROUND: Mucin producing cystic neoplasms, such as mucinous cystic tumor (MCT) and intraductal papillary mucinous tumor (IPMT) of the pancreas, are uncommon but become increasing in their incidences. The pathologic classification and biologic potential of these neoplasmsremain the subject of controversy. METHODS: The Gastrointestinal Pathology Study Group of the Korean Society of Pathologists analyzed the clinicopathologic characteristics of 85 casesof MCT and 72 cases of IPMT and examined the expression patterns of p53, CEA and MUC1. RESULTS: IPMT was located largely in the head, and showed connection with the main pancreatic duct (MPD, 68.1%), no ovarian-like stroma (0/72), and presence of intervening intratumoralnormal or atrophic parenchyma. On the other hand, MCT was located largely in thetail (73%), and showed common ovarian-like stroma (66/80), rare connection with the MPD(7/85) and no intervening pancreatic parenchyma. CEA and p53 immunoexpressions weresignificantly increased from adenoma through borderline to carcinoma, but MUC 1 was expressedonly in the invasive carcinoma among cases of MCT and IPMT. CONCLUSIONS: The tumorlocation, ovarian-like stroma, connection with the MPD and intratumoral intervening nonneoplastictissue were helpful in the differential diagnosis between IPMT and MCT. CEA and p53expressions can be indicators of malignancy, while MUC 1 expression can indicate invasion.

Changes of Plasma and Urine IL-8 and TNF-alpha in Children with Minimal Change Nephrotic Syndrome / 대한신장학회잡지

PURPOSE: Minimal Change Nephrotic Syndrome (MCNS) is one of the most common primary nephrotic syndromes in children. T-cell dysfunction has been thought to be involved in the pathogenesis of MCNS. However, the exact pathogenesis of MCNS has not been proven yet in spite of many studies which support T-cell dysfunction being involved in the pathogenesis of MCNS. A present study was done to determine the role of IL-8 and TNF-alpha in the pathogenesis of MCNS. METHODS: Study patients consisted of 19 biopsy-proven MCNS children aged 2-15 years old. Ten age-matched healthy children were used as controls. Both plasma and urinary IL-8 and TNF-alpha were measured during relapse and remission period using ELISA kit. Urinary cytokine values were corrected for urinary creatinine. RESULTS: Each value of urinary IL-8 measured during relapse and remission period in MCNS and controls was 13,996+/-2,811, 2,811+/-3,734 and 5,331+/-6,403ng/mg cr, respectively, and we noted that the value of urinary IL-8 measured during relapse period in MCNS significantly increased compared to those measured during remission period and in controls(p< 0.05). And each value of urinary TNF-alpha measured in the same group was 364.4+/-512.1, 55.3+/-208.0 and 36.0+/-45.0ng/mg cr, respectively, and we also noted that the value of urinary TNF-alpha measured during relapse period in MCNS was signficantly increased compared to those measured during remission period and in controls. The plasma cytokine values measured during relapse and remission period and in controls were 1.19+/-1.23, 0.51+/-0.84 and 0.77+/-0.62ng/mL, respectively, in the case of IL-8 and 2.42+/-3.86, 1.95+/-3.24 and 2.25+/-3.50ng/mL, respectively, in the case of TNF-alpha, and we noted the value of plasma IL-8 measured during relpase was also significantly increased compared to those of remission period and in control(p<0.05), but the change of plasma TNF-alpha values was not significant. CONCLUSION: It can be said that both IL-8 and TNF-alpha play an important role in the pathogenesis of MCNS in children. The fact that changes of urinary IL-8 and TNF-alpha were more prominent than those of plasma suggests that immune dysregulation may occur intrarenally rather than systemically in MCNS.

A Case of palisaded, Encapsulated Neuroma / 대한피부과학회지

Palisaded, encapsulated neuroma is characterized clinically by a solitary, slowly-growing and dome-shaped papule or nodule, usually accompanied by telangiectasia on the surface, and histopathologically by an encapsulated nodule in the dermis and the palisading arrangement of nuclei. A 57-year-old female patient presented with a 1cm-sized, solitary nodule on the right ala nasi which had been present for about 5 years. The nodule had a tendency to slow growth and it became a polypoid nodule. Telangiectasia was shown on the surface of the lesion. Histopathlogical findings showed a well-defined and encapsulated nodule in the dermis, composed of spindle cells with basophilic and plump nuclei in a palisading fashion. On immunohistochemical staining, the tumor cells of the nodule were positive for S-100 protein, while the capsule of the nodule was negative for S-100 protein. Epithelial membrane antigens were focally positive only on the capsule of the nodule. We report herein a case of palisaded, encapsulated neuroma, one case of which has been reported in Korea.

Eosinophilic gastroenteritis associated with food allergy and bronchial asthma

I n some patients, eosinophilic gastroenteritis(EG) occurs in those with food allergy. We experienced a non-atopic asthmatic who had an EG associated with food allergy to fish and eggs, and blood eosinophilia. A skin prick test and RAST to causative food allergens showed a negative result. A fiber-optic endoscopic biopsy from the gastric mucosa showed an intense eosinophilic infiltration. We could find symptomatic improvement and a disappearance of eosinophilic infiltration in gastric mucosa after complete avoidance from the causative food and oral cortcosteroid. It was suggested that fiber-optic endoscopic biopsy might be needed to identify coexisting EG if an allergic patient with blood eosinophilia complains of severe gastrointestinal symptoms.