Secular Trends in the Aerobic Fitness Test Performance and Body Mass Index of Korean Children and Adolescents (1968 - 2000)

There is increasing evidence that the aerobic fitness performance of children is declining, at least in developed countries. To see if there was evidence of similar trends in a non-Western country, this study analysed data on 6-18-year-old Koreans tested between 1968 and 2000 using distance runs ranging from 600 to 1200 m. All existing data on the results of children's aerobic fitness tests in Korea were collated. In addition to six individual studies, very large datasets were available from the Korean Ministries of Education, and the Ministry of Culture and Tourism. Data on a total of 22,127,265 6-18-year-old children were available in the form of group means and standard deviations. Data were collated for each age x sex x test group, and performances were expressed as percentages of the fitted values for the year 1992 to standardise across tests, ages and sexes. All age x sex x test groups were then combined, and curves were fitted using weighted regression. A two-linear segment model best described the pattern of change (r = 0.83, p < 0.001). There was a relatively slow decline (0.26 % per year) in the aerobic performance of Korean children between 1968 and 1984. After 1984, however, there was a steep decline in performance, averaging 0.80 % per year. The rate of decline was greater in boys, younger children and children from outside the capital Seoul. Changes in running performance showed a similar pattern to changes in estimated body mass index. Compared to other countries, there has been a sharp decline in Korean children's performance on tests of aerobic fitness, which has been concurrent with increases in estimated body mass index.

Clinical significance of pre-S mutations in patients with genotype C hepatitis B virus infection

We investigated the overall and site-specific prevalence of pre-S mutations and its clinical significance in patients with genotype C hepatitis B virus (HBV) infection. Three hundred subjects were included: 50 asymptomatic carriers (AC), 87 chronic hepatitis (CH), 91 liver cirrhosis (LC) and 72 hepatocellular carcinoma (HCC). Pre-S mutations were determined by nucleotide sequence analysis. Possible correlations between pre-S mutations and clinical/virological parameters were examined. Pre-S mutations were detected in 82 cases (27.3%); it was more frequently found in HCC (43.1%) and LC (35.2%) group than in the CH (20.7%) and AC (2.0%) group. Pre-S2 deletion was the most commonly found mutation (10.7%), followed by pre-S2 start codon mutation (9.7%), pre-S1-S2 deletion (3.0%) and both pre-S2 deletion and start codon mutation (2.7%). Pre-S2 deletion and pre-S2 start codon mutation were more frequently detected in advanced diseases (LC and HCC). Pre-S mutations were associated with older age and higher rates of positive HBV DNA (>/=0.5 pg/mL). Advanced disease and positive HBV DNA were shown to be independent predictors of pre-S mutations by logistic regression analysis. These findings suggest that pre-S mutations, especially pre-S2 deletions and pre-S2 start codon mutations, are common in patients with genotype C HBV infection and are associated with advanced liver disease and active viral replication.

Sonographic differences in venous return between piggyback versus caval interposition in adult liver transplantations

The piggyback technique (PT) is being used more frequently than caval interposition (CI) in adult orthotopic liver transplants (OLT). It is unclear whether PT alters venous return compared with CI, therefore leading to postoperative complications. The aim of our study was to analyze our experience with PT and CI by comparing ultrasound results of hepatic vein flow on the first postoperative day.

PATIENTS AND METHODS

This retrospective analysis of consecutive OLTs performed between 2002 and 2005 included data from a single blinded radiologist who reviewed all postoperative day 1 ultrasound examinations. The hepatic vein waveforms were scored as all phasic, all flat, or partially phasic/flat.

RESULTS

During the study period, we performed, 465 OLT among which 270 had available ultrasound examinations. The etiologies of liver disease were similar between the PT and CI cohorts, hepatitis C and alcoholic liver disease accounted for more than 60%. Two hundred eight (77%) had undergone PT and 62 (23%) CI. Among the PT, 60% were phasic, 31.1% were partially phasic/flat, and 8% were flat. When a CI was performed, 56.5% were phasic, 35.5% were partially phasic/flat, and 8% were flat.

CONCLUSIONS

There was no significant difference between PT and CI with regard to an effect on hepatic vein waveforms on the first operative day. Therefore, there do not appear to be early hemodynamic benefits of performing CI versus PT anastamoses of OLTs. Further studies may be needed to determine whether long-term sequelae follow the piggyback technique.

Birth of viable female dogs produced by somatic cell nuclear transfer

Since the only viable cloned offspring born in dogs was a male, the purpose of the present study was to produce female puppies by somatic cell nuclear transfer (SCNT). Adult ear fibroblasts from a 2-month-old female Afghan hound were isolated and used as donor cells. In vivo-matured canine oocytes surgically collected (approximately 72h after ovulation) from the oviducts of 23 donors were used for SCNT. After removal of the cumulus cells, oocytes were enucleated, microinjected, fused with a donor cell, and activated. A total of 167 reconstructed SCNT embryos were surgically transferred (Day 0) into the oviducts of 12 recipient bitches (average 13.9 embryos/recipient, range 6-22) with spontaneous, synchronous estrous cycles. Three pregnancies were detected by ultrasonography on Day 23, maintained to term, and three healthy female puppies (520, 460, and 520g), were delivered by Caesarean section on Day 60. These puppies were phenotypically and genotypically identical to the cell donor. In conclusion, we have provided the first demonstration that female dogs can be produced by nuclear transfer of ear fibroblasts into enucleated canine oocytes.

Renal Disease Burden Following Liver Transplantation

Significant chronic kidney disease (CKD) occurs following orthotopic liver transplant (OLT). Since CKD is associated with increased cardiovascular events, mortality, and hepatic allograft dysfunction, early recognition of CKD and implementation of changes may improve the long-term outcome. The purpose of this study was to determine the burden of renal disease following OLT.

PATIENTS AND METHODS

We retrospectively reviewed our OLT recipients from 1997 until 2004. We calculated glomerular filtration rates (GFR) using the Modification of Diet in Renal Disease study (MDRD) method. The GFRs were further subdivided into pre-MELD and post-MELD eras.

RESULTS

During the study period, we performed 407 OLTs. We censored data from living donor liver transplants (n = 14), combined liver-kidney transplants (n = 12), and from patients whom we did not have complete data for 6 months after transplant (n = 40). Mean MELD score at the time of transplant was 18 +/- 7 (mean +/- standard deviation). The mean GFR at 6 months following OLT was 63.7 +/- 30.2 mL/min per 1.73 m(2). Only 14% (n = 47) of our patients had normal renal function at 6 months, while 78% (n = 266) of our patients had mild to moderate risk for renal failure. Eight percent (n = 28) had stage 4 or 5 CKD. There were no differences between the pre-MELD and post-MELD GFRs.

CONCLUSIONS

The burden of renal disease is significant in our patient population at 6 months posttransplantation. It may be important to introduce CKD management as early as 6 months after transplant to impact the outcomes of OLT recipients.

Prognostic factors in gastric carcinoma with peritoneal dissemination

OBJECTIVE

The prognosis for gastric carcinoma patients with peritoneal dissemination is very poor. We evaluated the survival benefit of resection and intravenous chemotherapy in these patients.

MATERIAL AND METHODS

We reviewed the hospital records of 348 gastric carcinoma patients with peritoneal dissemination seen during the period from 1986 to 2000.

RESULTS

Based on the grade of anaplasia, 76 (21.8%) were differentiated and 272 (78.2%) were undifferentiated. In the univariate analyses, the factors influencing the 5-year survival rate were histologic type, resection, and intravenous chemotherapy. Using Cox's proportional hazard regression model, two factors were independent, statistically significant prognostic parameters: resection (risk ratio, 1.48; 95% confidence interval, 0.90-2.46; p < 0.05) and intravenous chemotherapy (risk ratio, 1.68; 95% confidence interval 1.15-2.47; p < 0.01). The 5-year survival rate was higher for patients who had intravenous chemotherapy (3.6%) than for patients who did not (2.4%), and also higher for patients who underwent resection (4.8%) than for patients who did not (0% ; p < 0.001).

CONCLUSION

The results highlight the improved survivorship of gastric carcinoma patients with peritoneal dissemination who had resection and received intravenous chemotherapy, compared with those who did not. Although curative resection cannot be performed in this group of patients, we recommend performing resection and subsequent intravenous chemotherapy.

Determination of the differential mode delay of a multimode fiber using Fourierdomain intermodal interference analysis

We present a novel differential mode delay (DMD) measurement method for a multimode optical fiber (MMF) based on Fourier-domain lowcoherence interferometry (fLCI) for the first time. An optical spectrum analyzer and a mode scrambler are used to obtain the intermodal interference signal in spectral domain after light passes an MMF. The MMF is used as a common path interferometer by itself without using any reference arm in an interferometer. Instead of using an offset launching technique, we present an effective method to obtain all available intermodal interference signals at a single shot by using a mode scrambler. The measured results using the proposed method are compared with those obtained using a conventional time-domain DMD measurement method.

Is complete surgical staging necessary in patients with stage I mucinous epithelial ovarian tumors?

OBJECTIVE

To evaluate the impact on prognosis of complete surgical staging in patients with stage I mucinous epithelial ovarian tumors.

METHODS

We retrospectively reviewed the medical records of all patients with stage I mucinous epithelial tumors apparently confined to ovaries treated in the Department of Obstetrics and Gynecology, Asan Medical Center, from 1990 through 2005.

RESULTS

Of 264 patients treated during this time period, 62 (23.5%) had complete and 202 (76.5%) had incomplete initial surgical staging. No patient with clinically apparent stage I borderline tumor was upstaged, 5 of 85 patients with invasive mucinous cancer was upstaged due to positive peritoneal cytology and there was no upstaged patient owing to occult lymph node metastasis. No recurrence was observed in the completely staged and 2 (1.4%) in the incompletely staged group among the patients with borderline tumor developed relapse. Three (11.5%) recurrences in the completely staged and four (6.8%) in the incompletely staged group among the patients with invasive cancer were observed, and the difference was not statistically significant. We also observed no significant differences between two groups in progression-free survival and overall survival.

CONCLUSION

Complete surgical staging could probably be omitted in patients with stage I mucinous epithelial tumors.

Primary peritoneal carcinoma: experience with cytoreductive surgery and combination chemotherapy

The objective of this study was to review the clinical outcome and prognosis of patients with primary peritoneal carcinoma (PPC) treated with cytoreductive surgery and combination chemotherapy. We retrospectively reviewed the charts of 27 patients with histologically confirmed PPC, treated between March 1990 and February 2004 at Asan Medical Center, South Korea. The review included demographic data, pathologic findings, treatments, and outcomes. The mean age of the 27 patients was 57.5 +/- 7.2 years, and the rate of optimal cytoreduction was 70.4%. Seven patients had stage IIIB, 17 had stage IIIC, and 3 had stage IV; all patients received adjuvant chemotherapy. There were 4 patients with progressive disease, 5 partial responders, and 15 complete responders; the remaining 3 patients were nonevaluable. At the time of the review, 10 patients were alive without evidence of disease, 3 were alive with disease, and 14 had died from disease. The median overall survival time was 41 months, and the overall 5-year survival rate was 18.1%. Patients who had optimal cytoreduction had a longer median survival (42 months) than those who had suboptimal cytoreduction (10 months; P < 0.05). Combination chemotherapy after optimal cytoreductive surgery may be effective in the treatment of patients with PPC.

Pre-operative chemo-radiotherapy improves the sphincter preservation rate in patients with rectal cancer located within 3 cm of the anal verge

AIMS

To evaluate whether pre-operative chemo-radiotherapy (CRT) improves the sphincter preservation rate for distal rectal cancers within 3 cm of the anal verge.

METHODS

Between January 2001 and December 2004, 49 patients underwent surgery with or without pre-operative CRT for primary rectal adenocarcinoma within 3 cm of the anal verge. Clinical data were retrospectively reviewed, including stage workups, surgical records and pathology records to determine sphincter preservation rate and the factors influencing sphincter preservation.

RESULTS

Of 49 patients with rectal tumours within 3 cm of the anal verge, 31 underwent pre-operative CRT followed by surgery (CRT group), and 18 underwent surgery alone (non-CRT group). Sphincter preservation was possible in 11 of 31 CRT patients, and only one of 18 non-CRT patients (p=0.036). The factors most influencing sphincter preservation were reduction in tumour size (p=0.005) and downstaging (p=0.001) following pre-operative CRT.

CONCLUSION

We could observe that sphincter preservation was improved in CRT group with statistical significance when compared to non-CRT group in our study patients with rectal cancer within 3 cm of the anal verge.

Novel phase-matching condition for a four wave mixing experiment in an optical fiber

A new phase-matching condition for a four-wave-mixing (FWM) experiment in an optical fiber is proposed to simultaneously measure the linear and nonlinear optical properties of an optical fiber such as dispersion-zero wavelength, dispersion slop, and nonlinear refractive index. Several different dispersion shifted fibers (DSFs) and nonzero dispersion shifted fibers (NZDSFs) were tested to demonstrate the validity of our proposed method. We have also shown that experimental results are in good agreement with those obtained using a conventional measurement method. We believe that technique is a very powerful and efficient tool for zero-dispersion and dispersion slop mapping for already installed optical fibers.

Malignant mixed mullerian tumors of the ovary: experience with cytoreductive surgery and platinum-based combination chemotherapy

This study reviews the clinical outcome and prognosis of patients with malignant mixed müllerian tumors (MMMTs) of the ovary treated with optimal cytoreductive surgery, leaving no residual disease, and platinum-based chemotherapy. Ten patients diagnosed with MMMT of the ovary after complete surgical staging from February 1993 to February 2004 at Asan Medical Center in Korea were studied retrospectively. All ten patients were treated with optimal cytoreductive surgery, leaving no gross residual disease. Seven patients received ifosfamide/cisplatin chemotherapy, and the remaining three patients received other platinum-based combination chemotherapy. Demographic data, pathologic findings, treatments, and survival time were reviewed. Of the ten patients, two were scored at FIGO stage IIC, seven were at stage IIIC, and one was at stage IV. The median survival time of all ten patients was 46 months. The overall survival rate was 60.0% at 1 year, 40.0% at 2 years, and 20.0% at 5 years. Platinum-based combination chemotherapy after optimal cytoreductive surgery may be effective in the treatment of ovarian MMMT.

Measurement of the D(s)+ lifetime

A high statistics measurement of the D(s)+ lifetime from the Fermilab fixed-target FOCUS photoproduction experiment is presented. We describe the analysis of the two decay modes, D(s)+ --> phi(1020)pi+ and D(s)+ -->K*(892)0K+, used for the measurement. The measured lifetime is 507.4 +/- 5.5(stat) +/- 5.1(syst) fs using 8961 +/- 105 D(s)+ --> phi(1020)pi+ and 4680 +/- 90 D(s)+ --> K*(892)0K+ decays. This is a significant improvement over the present world average.

Systemic AL amyloidosis associated with multiple myeloma in a horse

AL amyloidosis is the most common type of systemic amyloidosis in humans, and it is frequently associated with multiple myeloma. But, AL amyloidosis is very rare in domestic animals. A 16-year-old Quarter horse gelding was diagnosed with systemic AL amyloidosis associated with multiple myeloma. Clinical problems were rapid weight loss, muscle atrophy, soft unformed stool, and ventral edema. Grossly, diffuse gastrointestinal hemorrhage, markedly thickened jejunal mucosa, and splenomegaly were present. Microscopically, diffuse severe amyloid deposits were present in the lamina propria of glandular stomach, duodenum, and jejunum. Much of the spleen and sternal bone marrow was replaced by neoplastic round cells, and multiple foci of amyloid were also present in the spleen and bone marrow. Electron microscopy revealed the neoplastic round cells to be of plasma cell origin, and the amyloid showed a strongly positive immunoreactivity with polyclonal anti-human immunoglobin lambda light-chain antisera. To our knowledge, this is the second report describing systemic AL amyloidosis in domestic animals-associated plasma cell neoplasia and the first associated with multiple myeloma, as is common in humans.

Granulation in an upflow anaerobic sequencing batch reactor treating disintegrated waste activated sludge

An upflow anaerobic reactor operated with a sequencing batch mode to enhance high rate digestion of raw and thermally disintegrated waste activated sludge with formation of granules. The gas production rate doubled when disintegrated waste activated sludge was introduced. Gradual granulation took place and the dispersed particles become coarse granulation as the operation continued. The granular sludge showed relatively higher specific methanogenic activity than the dispersed sludge. Bacterial morphology by a scanning electron microscope showed diversity of bacteria such as filamentous, rod and spherical shape in the section of granules. Filamentous bacteria, which might support the frame of a granule, were observed as long chains at the outer surface. Meanwhile, rod and spherical bacteria, which might play a role in the initial stage of granule formation, were observed from the inner surface of the granule. High rate digestion of sludge along with efficient liquid-solids separation was achieved due mainly to development of sludge granules within the upflow reactor.

Effect of pretreatment on acid fermentation of organic solid waste

The effect of various pretreatment methods on acidogenesis of food waste from a cafeteria was investigated. Thermal, enzymatic, and combined thermal-enzymatic batch pretreatment were conducted. Solubilization of food waste in thermal or enzymatic pretreatment increased with either increasing thermal duration or enzyme dosage, respectively. An optimal condition in thermal or enzymatic pretreatment was 60 min of thermal processing or 0.1% (v/v) of enzyme dosage level, respectively, based on volatile suspended solids (VSS) reduction. In the combined pretreatment, increased thermal duration also increased VSS reduction and the solubilization efficiency was higher than that in only enzymatic or thermal pretreatment. The maximum volatile fatty acids (VFAs) production and the highest VFAs fraction in soluble COD in the acid fermentation were achieved with the food waste after 60 min of thermal processing followed by 0.1% (v/v) enzymatic treatment. Increase in VFAs production of the fermenter was over 380% compared to the control fermenter without any pretreatment.

Anti-protozoal efficacy of high performance liquid chromatography fractions of Torilis japonica and Sophora flavescens extracts on Neospora caninum and Toxoplasma gondii

We previously reported that alcoholic extracts of Sophora flavescens and Torilis japonica from South Korea demonstrated good efficacy in reducing replication of Toxoplasma gondii and Neospora caninum. To characterize the chemical component associated with anti-protozoal activity, specific fractions were isolated by high performance liquid chromatography (HPLC) and used for in vitro testing. These fractions were evaluated in vitro against T. gondii and N. caninum. Fractions of the herb extracts were serially diluted to final concentrations of 2.850 to 0.356 ng/ml in medium and added to wells containing replicating T. gondii and N. caninum. To determine the ability of each fraction to inhibit parasite proliferation, 3H-uracil incorporation was used to determine parasite replication. In cultures infected with T. gondii, a fraction of T. japonica (TJ2) inhibited T. gondii proliferation by 99.2, 94.4, 88.6 and 27.0% in the range from 2.850 to 0.356 ng/ml. Four fractions of S. flavescens (SF1-SF4) inhibited T. gondii proliferation by 99.6-60.6, 96.9-48.1, 92.3-68.2 and 95.4-52.9% in the range from 2.850 to 0.356 ng/ml. In cultures infected with N. caninum, a fraction of T. japonica (TJ2) inhibited N. caninum proliferation by 98.3, 95.5, 79.7 and 30.6% in the range from 2.850 to 0.356 ng/ml. Four fractions of S. flavescens (SF1-SF4) inhibited N. caninum proliferation by 97.1-25.9, 94.8-35.5, 95.9-33.7 and 95.4-49.4% in the range from 2.850 to 0.356 ng/ml. These fractions of T. japonica and S. flavescens extracts are currently undergoing in vivo evaluation in experimentally infected mice.

Computer-aided detection of kidney tumor on abdominal computed tomography scans

PURPOSE

To implement a computer-aided detection system for kidney segmentation and kidney tumor detection on abdominal computed tomography (CT) scans.

MATERIAL AND METHODS

Abdominal CT images were digitized with a film digitizer, and a gray-level threshold method was used to segment the kidney. Based on texture analysis performed on sample images of kidney tumors, a portion of the kidney tumor was selected as seed region for start point of the region-growing process. The average and standard deviations were used to detect the kidney tumor. Starting at the detected seed region, the region-growing method was used to segment the kidney tumor with intensity values used as an acceptance criterion for a homogeneous test. This test was performed to merge the neighboring region as kidney tumor boundary. These methods were applied on 156 transverse images of 12 cases of kidney tumors scanned using a G.E. Hispeed CT scanner and digitized with a Lumisys LS-40 film digitizer.

RESULTS

The computer-aided detection system resulted in a kidney tumor detection sensitivity of 85% and no false-positive findings.

CONCLUSION

This computer-aided detection scheme was useful for kidney tumor detection and gave the characteristics of detected kidney tumors.

Patterns of failure in gastric carcinoma after D2 gastrectomy and chemoradiotherapy: a radiation oncologist's view

The risk of locoregional recurrence in resected gastric adenocarcinoma is high, but the benefit of adjuvant treatment remains controversial. In particular, after extended lymph node dissection, the role of radiotherapy is questionable. Since 1995, we started a clinical protocol of adjuvant chemoradiotherapy after D2 gastrectomy and analysed the patterns of failure for 291 patients. Adjuvant chemotherapy consisted of five cycles of fluorouracil and leucovorin, and concurrent radiotherapy was given with 4500 cGy from the second cycle of chemotherapy. With a median follow-up of 48 months, 114 patients (39%) showed any type of failure, and the local and regional failures were seen in 7% (20 out of 291) and 12% (35 out of 291), respectively. When the recurrent site was analysed with respect to the radiation field, in-field recurrence was 16% and represented 35% of all recurrences. Our results suggest that adjuvant chemoradiotherapy has a potential effect on reducing locoregional recurrence. Moreover, low locoregional recurrence rates could give a clue as to which subset of patients could be helped by radiotherapy after D2 gastrectomy. However, in order to draw a conclusion on the role of adjuvant radiotherapy, a randomised study is needed.

Comparative analysis on the 5'-untranslated region of bovine viral diarrhea virus isolated in Korea

Samples of 249 bovine abortuses, one intestine, and four diarrheal stools from 254 cows were collected, and bovine viral diarrhea virus (BVDV) was detected by reverse transcription-polymerase chain reaction (RT-PCR). Subsequently, virus isolation was preformed with PCR-positive samples, and then PCR product of 5^′-untranslated region (UTR) of BVDV isolate was sequenced and analyzed. Among the samples collected, 20 (from 17 bovine abortuses, one intestine, and two diarrheal stools) were positive for BVDV RT-PCR; four BVDVs (from two bovine abortuses, one intestine, and one diarrheal stool) were isolated. When the four isolates were biotyped in cell culture, one BVDV isolate from a bovine abortus was cytopathic and the others were non-cytopathic. In addition, three isolates were genotyped as BVDV-1 and one isolate from a diarrheal stool as BVDV-2. In phylogenetic analysis, it suggested that the BVDV-2 isolate in Korea is closer to the North American strains than Asian strains. This is the first report on the identification and isolation of BVDV-2 in Korea.