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Biliary Atresia in Korea - A Survey by the Korean Association of Pediatric Surgeons - (담도폐색증 - 대한소아외과학회회원 대상 전국조사 -)

  • Choi, Kum-Ja;Kim, S.C.;Kim, S.K.;Kim, W.K.;Kim, I.K.;Kim, J.E.;Kim, J.C.;Kim, H.Y.;Kim, H.H.;Park, K.W.;Park, W.H.;Song, Y.T.;Oh, S.M.;Lee, D.S.;Lee, M.D.;Lee, S.K.;Lee, S.C.;Jhung, S.Y.;Jhung, S.E.;P.M., Jung;S.O., Choi;Choi, S.H.;Han, S.J.;Huh, Y.S.;Hong, C.;Hwbang, E.H.
    • Advances in pediatric surgery
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    • v.8 no.2
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    • pp.143-155
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    • 2002
  • A survey on biliary atresia was made among 26 members of the Korean Association of Pediatric Surgeons. The members were required to complete a questionnaire and a case registration form for each patient during the twentyone-year period of 1980-2000. Three hundred and eighty patients were registered from 18 institutions. The average number of patients per surgeon was one to two every year. The male to female ratio was 1:1.3. The age of patients on diagnosis with biliary atresia was on average $65.4{\pm} 36.2$ days old. The national distribution was 32.8% in Seoul, 25.3% in Gyoungki-Do, 21.6% in Gyoungsang-Do, 9.27% in Choongchung-Do, etc. in order. The most common clinical presentation was jaundice (98.4%) and change of stool color (86.2%) was second. Two hundred eighty (74.7%) of 375 patients were operated by 80 days of age. Three hundred thirty six (9 1.9%) of 366 patients were operated on by the original Kasai procedure, and 305 (84.3%) of 362 patients were observed by bile-drainage postoperatively. The overall postoperative complication rate was 18.5% and the overall postoperative mortality rate was 6.8%. The associated anomalies were observed in 72 cases (22.5%). One hundred ninty five (64.7%) of 302 patients have been alive in follow-up and 49 (25.1%) have survived over 5 years without problem after operation. Ascending cholangitis, varices and ascites affected survival significantly, and the important long-term prognostic factor was the occurrence of complications.

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A Study on the Meaning of Outer Space Treaty in International Law (우주조약의 국제법적 의미에 관한 연구)

  • Kim, Han-Taek
    • The Korean Journal of Air & Space Law and Policy
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    • v.28 no.2
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    • pp.223-258
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    • 2013
  • 1967 Outer Space Treaty(Treaty on Principles Governing the Activities of States in the Exploration and Use of Outer Space, including the Moon and Other Celestial Bodies; OST) is a treaty that forms the basis of international space law. OST is based on the 1963 Declaration of Legal Principles Governing the Activities of States in the Exploration and Use of Outer Space announced by UNGA resolution. As of May 2013, 102 countries are states parties to OST, while another 27 have signed the treaty but have not completed ratification. OST explicitly claimed that the Moon and Other Celestial Bodies are the province of all mankind. Art. II of OST states that "outer space, including the Moon and other celestial bodies, is not subject to national appropriation by claim of sovereignty, by means of use or occupation, or by any other means", thereby establishing res extra commercium in outer space like high seas. However 1979 Moon Agreement stipulates that "the moon and its natural resources are the Common Heritage of Mankind(CHM)." Because of the number of the parties to the Moon Agreement(13 parties) it does not affect OST. OST also established its specific treaties as a complementary means such as 1968 Rescue Agreement, 1972 Liability Convention, 1975 Registration Convention. OST bars states party to the treaty from placing nuclear weapons or any other weapons of mass destruction in orbit of Earth, installing them on the Moon or any other celestial body, or to otherwise station them in outer space. It exclusively limits the use of the Moon and other celestial bodies to peaceful purposes and expressly prohibits their use for testing weapons of any kind, conducting military maneuvers, or establishing military bases, installations, and fortifications. However OST does not prohibit the placement of conventional weapons in orbit. China and Russia submitted Draft Treaty on the Prevention of the Placement of Weapon in Outer Space and of the Threat or Use of Force against Outer Space Objects(PPWT) on the Conference on Disarmament in 2008. USA disregarded PPWT on the ground that there are no arms race in outer space. OST does not have some articles in relation to current problems such as space debris, mechanisms of the settlement of dispute arising from state activities in outer space in specific way. COPUOS established "UN Space Debris Mitigation Guidelines" based on "IADC Space Debris Mitigation Guidelines" and ILA proposed "International Instrument on the Protection of the Environment from Damage Caused by Space Debris" for space debris problems and Permanent Court of Arbitration(PCA) established "Optional Rules for Arbitration of Disputes Relating to Outer Space Activities" and ILA proposed "1998 Taipei Draft Convention on the Settlement of Space Law Dispute" for the settlement of dispute problems. Although OST has shortcomings in some articles, it is very meaningful in international law in considering the establishment of basic principles governing the activities of States in the exploration and use of outer space, including the Moon and Other Celestial Bodies. OST established the principles governing the activities of states in the exploration and use of outer space as customary law and jus cogens in international law as follows; the exploration and use of outer space shall be carried out for the benefit and in the interests of all countries and shall be the province of all mankind; outer space shall be free for exploration and use by all States; outer space is not subject to national appropriation by claim of sovereignty, by means of use or occupation, or by any other means. The principles of global public interest in outer space imposes international obligations erga omnes applicable to all States. This principles find significant support in legal norms dealing with following points: space activities as the "province of all mankind"; obligation to cooperate; astronauts as envoys of mankind; avoidance of harmful contamination; space activities by States, private entities and intergovernmental organisations; absolute liability for damage cauesd by certain space objects; prohibition of weapons in space and militarization of the celestial bodies; duty of openness and transparency; universal application of the international space regime.

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The study for the roles of intratracheally administered histamine in the neutrophil-mediated acute lung injury in rats: (호중구를 매개하는 백서의 급성 폐손상의 병리가전에 있어 기도내로 투여한 히스타민의 역활에 관하여)

  • Koh, Youn-Suck;Hybertson, Brooks M.;Jepson, Eric K.;Kim, Mi-Jung;Lee, In-Chul;Lim, Chae-Man;Lee, Sang-Do;Kim, Dong-Soon;Kim, Won-Dong;Repine, John E.
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.3
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    • pp.308-322
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    • 1996
  • Background : Neutrophils are considered to play critical roles in the development of acute respiratory distress syndrome. Histamine, which is distributed abundantly in lung tissue, increases the rolling of neutrophills via increase of P-selectin expression on the surface of endothelial cells and is known to have some interrelationships with IL-1, IL-8 and TNF-$\alpha$. We studied to investigate the effect of the histamine on the acute lung injury of the rats induced by intratracheal insufflation of TNF-$\alpha$ which has less potency to cause lung injury compared to IL-1 in rats. Methods : We intratracheally instilled saline or TNF(R&D, 500ng), IL-1(R&D, 50ng)or histamine of varius dose(1.1, 11 and $55\;{\mu}g/kg$) with and without TNF separately in Sprague-Dawley rats weighing 270-370 grams. We also intratracheally treated IL-1(50ng) along with histamine($55\;{\mu}g/kg$). In cases, there were synergistic effects induced by histamine on the parameters of TNF-induced acute lung injury, antihistamines(Sigma, mepyramine as a $H_1$ receptor blockade and ranitidine as a $H_2$ receptor blockade, 10 mg/kg in each)were co-administered intravenously to the rats treated TNF along with histamine($1.1\;{\mu}g/kg$) intratraeheally. Then after 5 h we measured lung lavage neutrophil numbers, lavage cytokine-induced neutrophil chemoattractants(CINC), lung myeloperoxidase activity(MPO) and lung leak. We also intratracheally insufflated TNF with/without histamine($11\;{\mu}g/kg$), then after 24 h measured lung leak in rats. Statistical analyses were done by Kruskal-Wallis nonparametric ANOVA test with Dunn's multiple comparison test or by Mann-Whitney U test. Results : We found that rats given TNF, histamine alone(11 and $55\;{\mu}g/kg$), and TNF with histamine(l.1, 11, and $55\;{\mu}g/kg$) intratracheally had increased (p<0.05) lung MPO activity compared with saline-treated control rats. TNF with histamine $11\;{\mu}g/kg$ had increased MPO activity (P=0.0251) compared with TNF-treated rats. TNF and TNF with histamine(1.1, 11, and $55\;{\mu}g/kg$) intratracheally had all increased (p<0.05) lung leak, lavage neutophil numbers and lavage CINC activities compared with saline. TNF with histamine $1.1\;{\mu}g/kg$ had increased (p=0.0367) lavage neutrophil numbers compared with TNF treated rats. But there were no additive effect of histamine with TNF compared with TNF alone in acute lung leak on 5 h and 24 h in rats. Treatment of rats with the $H_1$ and $H_2$ antagonists resulted in inhibitions of lavage neutrophil accumulations and lavage CINC activity elevations elicited by co-treated histamine in TNF-induced acute lung injury intratracheally in rats. We also found that rats given IL-1 along with histamine intratracheally did not have increase in lung leak compared with IL-1 treated rats. Conclusion : Histamine administered intratracheally did not have synergistic effects on TNF-induced acute lung leak inspite of additive effects on increase in MPO activity and lavage neutrophil numbers in rats. These observations suggest that instilling histamine intratracheally would not play synergistic roles in neutrophil-mediated acute lung injury in rats.

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The National Survey of Open Lung Biopsy and Thoracoscopic Lung Biopsy in Korea (개흉 및 흉강경항폐생검의 전국실태조사)

  • 대한결핵 및 호흡기학회 학술위원회
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.1
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    • pp.5-19
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    • 1998
  • Introduction: Direct histologic and bacteriologic examination of a representative specimen of lung tissue is the only certain method of providing an accurate diagnosis in various pulmonary diseases including diffuse pulmonary diseases. The purpose of national survey was to define the indication, incidence, effectiveness, safety and complication of open and thoracoscopic lung biopsy in korea. Methods: A multicenter registry of 37 university or general hospitals equipped more than 400 patient's bed were retrospectively collected and analyzed for 3 years from the January 1994 to December 1996 using the same registry protocol. Results: 1) There were 511 cases from the 37 hospitals during 3 years. The mean age was 50.2 years(${\pm}15.1$ years) and men was more prevalent than women(54.9% vs 45.9%). 2) The open lung biopsy was performed in 313 cases(62%) and thoracoscopic lung biopsy was performed in 192 cases(38%). The incidence of lung biopsy was more higher in diffuse lung disease(305 cases, 59.7%) than in localized lung disease(206 cases, 40.3%) 3) The duration after abnormalities was found in chest X-ray until lung biopsy was 82.4 days(open lung biopsy: 72.8 days, thoracoscopic lung biopsy: 99.4 days). The bronchoscopy was performed in 272 cases(53.2%), bronchoalveolar lavage was performed in 123 cases(24.1%) and percutaneous lung biopsy was performed in 72 cases(14.1%) before open or thoracoscopic lung biopsy. 4) There were 230 cases(45.0%) of interstitial lung disease, 133 cases(26.0%) of thoracic malignancies, 118 cases(23.1%) of infectious lung disease including tuberculosis and 30 cases (5.9 %) of other lung diseases including congenital anomalies. No significant differences were noted in diagnostic rate and disease characteristics between open lung biopsy and thoracoscopic lung biopsy. 5) The final diagnosis through an open or thoracoscopic lung biopsy was as same as the presumptive diagnosis before the biopsy in 302 cases(59.2%). The identical diagnostic rate was 66.5% in interstitial lung diseases, 58.7% in thoracic malignancies, 32.7% in lung infections, 55.1 % in pulmonary tuberculosis, 62.5% in other lung diseases including congenital anomalies. 6) One days after lung biopsy, $PaCO_2$ was increased from the prebiopsy level of $38.9{\pm}5.8mmHg$ to the $40.2{\pm}7.1mmHg$(P<0.05) and $PaO_2/FiO_2$ was decreased from the prebiopsy level of $380.3{\pm}109.3mmHg$ to the $339.2{\pm}138.2mmHg$(P=0.01). 7) There was a 10.1 % of complication after lung biopsy. The complication rate in open lung biopsy was much higher than in thoracoscopic lung biopsy(12.4% vs 5.8%, P<0.05). The incidence of complication was pneumothorax(23 cases, 4.6%), hemothorax(7 cases, 1.4%), death(6 cases, 1.2%) and others(15 cases, 2.9%). 8) The 5 cases of death due to lung biopsy were associated with open lung biopsy and one fatal case did not describe the method of lung biopsy. The underlying disease was 3 cases of thoracic malignancies(2 cases of bronchoalveolar cell cancer and one malignant mesothelioma), 2 cases of metastatic lung cancer, and one interstitial lung disease. The duration between open lung biopsy and death was $15.5{\pm}9.9$ days. 9) Despite the lung biopsy, 19 cases (3.7%) could not diagnosed. These findings were caused by biopsy was taken other than target lesion(5 cases), too small size to interpretate(3 cases), pathologic inability(11 cases). 10) The contribution of open or thoracoscopic lung biopsy to the final diagnosis was defininitely helpful(334 cases, 66.5%), moderately helpful(140 cases, 27.9%), not helpful or impossible to judge(28 cases, 5.6%). Overall, open or thoracoscopic lung biopsy were helpful to diagnose the lung lesion in 94.4 % of total cases. Conclusions: The open or thoracoscopic lung biopsy were relatively safe and reliable diagnostic method of lung lesion which could not diagnosed by other diagnostic approaches such as bronchoscopy. We recommend the thoracoscopic lung biopsy when the patients were in critical condition because the thoracoscopic biopsy was more safe and have equal diagnostic results compared with the open lung biopsy.

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Lung Injury Indices Depending on Tumor Necrosis Factor-$\alpha$ Level and Novel 35 kDa Protein Synthesis in Lipopolysaccharide-Treated Rat (내독소처치 흰쥐에서 Tumor Necrosis Factor-$\alpha$치 상승에 따른 폐손상 악화 및 35 kDa 단백질 합성)

  • Choi, Young-Mee;Kim, Young-Kyoon;Kwon, Soon-Seog;Kim, Kwan-Hyoung;Moon, Hwa-Sik;Song, Jeong-Sup;Park, Sung-Hak
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.6
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    • pp.1236-1251
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    • 1998
  • Background : TNF-$\alpha$ appears to be a central mediator of the host response to sepsis. While TNF-$\alpha$ is mainly considered a proinflammatory cytokine, it can also act as a direct cytotoxic cytokine. However, there are not so many studies about the relationship bet ween TNF-$\alpha$ level and lung injury severity in ALI, particularly regarding the case of ALI caused by direct lung injury such as diffuse pulmonary infection. Recently, a natural defense mechanism, known as the stress response or the heat shock response, has been reported in cellular or tissue injury reaction. There are a number of reports examining the protective role of pre-induced heat stress proteins on subsequent LPS-induced TNF-$\alpha$ release from monocyte or macrophage and also on subsequent LPS-induced ALI in animals. However it is not well established whether the stress protein synthesis such as HSP can be induced from rat alveolar macrophages by in vitro or in vivo LPS stimulation. Methods : We measured the level of TNF-$\alpha$, the percentage of inflammatory cells in bronchoalveolar lavage fluid, protein synthesis in alveolar macrophages isolated from rats at 1, 2, 3, 4, 6, 12, and 24 hours after intratracheal LPS instillation. We performed histologic examination and also obtained histologic lung injury index score in lungs from other rats at 1, 2, 3, 4, 6, 12, 24 h after intratracheal LPS instillation. Isolated non-stimulated macrophages were incubated for 2 h with different concentration of LPS (0, 1, 10, 100 ng/ml, 1, or 10 ${\mu}g/ml$). Other non-stimulated macrophages were exposed at $43^{\circ}C$ for 15 min, then returned to at $37^{\circ}C$ in 5% CO2-95% for 1 hour, and then incubated for 2 h with LPS (0, 1, 10, 100ng/ml, 1, or 10 ${\mu}g/ml$). Results : TNF-$\alpha$ levels began to increase significantly at 1 h, reached a peak at 3 h (P<0.0001), began to decrease at 6 h, and returned to control level at 12 h after LPS instillation. The percentage of inflammatory cells (neutrophils and alveolar macrophages) began to change significantly at 2 h, reached a peak at 6 h, began to recover but still showed significant change at 12 h, and showed insignificant change at 24 h after LPS instillation compared with the normal control. After LPS instillation, the score of histologic lung injury index reached a maximum value at 6 h and remained steady for 24 hours. 35 kDa protein band was newly synthesized in alveolar macrophage from 1 hour on for 24 hours after LPS instillation. Inducible heat stress protein 72 was not found in any alveolar macrophages obtained from rats after LPS instillation. TNF-$\alpha$ levels in supernatants of LPS-stimulated macro phages were significantly higher than those of non-stimulated macrophages(p<0.05). Following LPS stimulation, TNF-$\alpha$ levels in supernatants were significantly lower after heat treatment than in those without heat treatment (p<0.05). The inducible heat stress protein 72 was not found at any concentrations of LPS stimulation. Whereas the 35 kDa protein band was exclusively found at dose of LPS of 10 ${\mu}g/ml$. Conclusion : TNF-$\alpha$ has a direct or indirect close relationship with lung injury severity in acute lung injury or acute respiratory distress syndrome. In vivo and in vitro LPS stimulation dose not induce heat stress protein 72 in alveolar macrophages. It is likely that 35 kDa protein, synthesized by alveolar macrophage after LPS instillation, does not have a defense role in acute lung injury.

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Thermal Environments of Children's Parks during Heat Wave Period (폭염 시 어린이공원의 온열환경)

  • Ryu, Nam-Hyong;Lee, Chun-Seok
    • Journal of the Korean Institute of Landscape Architecture
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    • v.44 no.6
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    • pp.84-97
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    • 2016
  • This study was to investigate the user's thermal environments of the children's parks according to pavements and sunscreen types during periods of heat waves. The measurements were conducted at the sand pits, rubber chip pavement, shelters, and green shade ground of the two children's parks located in Jinju, Korea(Chilam: $N\;35^{\circ}11^{\prime}1.4{^{\prime}^{\prim}}$, $E\;128^{\circ}5^{\prime}31.7{^{\prime}^{\prime}}$, elevation 38m, Gaho: $N\;35^{\circ}09^{\prime}56.8{^{\prime}^{\prime}}$, $E\;128^{\circ}6^{\prime}41.1{^{\prime}^{\prime}}$, elevation 24m) over three days during 11-13, August, 2016. The highest ambient air temperatures at the Jinju Meteorological Office during the three measurement days were $35.9{\sim}36.8^{\circ}C$, which corresponded with the extremely hot weather. A series of experiments measured air temperature, relative humidity, wind velocity, black globe temperature, and long-wave and short-wave radiation of the six directions 0.6 m above ground level. The wet bulb globe temperature(WBGT) and the universal thermal climatic index(UTCI) were used to evaluate thermal stress. Surface temperature images of the play equipment were also taken using infrared thermography. Surface temperatures of the play equipment and grounds were used to evaluate burn risk through contact with playground materials. The results showed the following. The maximum air temperatures averaged over 1-hour period for three days were $36.6{\sim}39.4^{\circ}C$. The sun shades reduced those temperatures by up to $2.8^{\circ}C$(green shade) and $1.0^{\circ}C/2.3^{\circ}C$(shelters). The minimum relative humidity values averaged over 1-hour period for three days were 44~50%. The sun shades increased those humidity values by up to 6%(green shade) and 4%/6%(shelters). The risk of heat related illness at the measurement sites of the children's parks were extreme and high in the daytime hours. The maximum WBGT values averaged over a 30-minute period for three days were $31.2{\sim}33.6^{\circ}C$. The sun shades reduced those WBGT values by up to $2.4^{\circ}C$(green shade) and $0.5^{\circ}C/2.1^{\circ}C$(shelters) compared to sandpits, but would not block the risk of heat related illness in the daytime hours. The category of heat stress at the measurement sites of the children's parks were extreme and very strong in the daytime hours. The maximum UTCI values averaged over a 30-minute period for three days were $39.9{\sim}48.1^{\circ}C$. The sun shades reduced those UTCI values by up to $7.8^{\circ}C$(green shade) and $4.1^{\circ}C/8.2^{\circ}C$(shelters) compared to sandpits, but could not lower heat stress category from extreme and very strong to strong and moderate in the daytime hours. According to the burn threshold criteria when skin was in contact with playground materials, the maximum surface temperature of the stainless steels($70.8^{\circ}C$) surpassed three seconds $60^{\circ}C$ threshold for uncoated steel, that of the rubber chip($76.5^{\circ}C$) surpassed five seconds $74^{\circ}C$ threshold for the plastic, that of the plastic slide($68.5^{\circ}C$) and seats($71.0^{\circ}C$) surpassed the one min $60^{\circ}C$ threshold for plastic, respectively. The surface temperatures of shaded play equipment were lower approximately $20^{\circ}C$ than those of play equipment exposed to the sun. Therefore, sun shades can block the risk of burns in daytime hours. Because of the extreme and high risk of heat related illness and extreme and high heat stress at the children's parks during periods of heat waves, parents and administrators must protect children from the use of playgrounds. The risk of burn when contact with play equipments and grounds at the children's parks during periods of heat waves, was very high. The sun shades are essential to block the risk of burn from play equipments and grounds at the children's parks during heat waves.

Effect of Posture on the Distribution of Pulmonary Ventilation in Patients with Increased Closing volume (폐쇄용적(Closing Volume)이 증가된 만성 폐질환 환자에서 체위에 따른 폐환기량의 변화)

  • Kim, Young-Tae;Kim, Mee-Kyung;Lim, Chae-Man;Koh, Youn-Suck;Kim, Woo-Sung;Ryu, Jin-Sook;Lee, Myung-Hae;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.6
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    • pp.631-637
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    • 1993
  • Background: In normal adults, ventilation is uneven and greater in the base than the apex of the lung in tidal volume breathing. However infants have fragile chest wall and reduced elastic recoil, resulting in easy closure of peripheral airways especially in the dependent portion of the lung. So ventilation in infants is greater in the apex than the base of the lung. We assumed that in adults whose closing volume is increased, dependent portion could be easily collapsed during tidal breathing and ventilation could be greater in the uppear than than the lower portion of the lung. Methods: We measured spirometry and closing volume(CV) in normal controls and in patients with chronic lung disease. Also we measured fractional distribution of ventilation at supine, left lateral and right lateral decubitus with $^{133}Xe$ ventilation scan in normal controls, patients with normal closing volume and patients with increased closing volume. Results: The subjects consisted of 7 normal controls(mean $age{\pm}SD$, $62.9{\pm}6.1$ years). 6 patients with normal CV($62.8{\pm}8.2$ years) and 7 patients with increased CV($63.0{\pm}15.3$ years). 1) Normal controls have mean(${\pm}SD$) FVC $104{\pm}11%$ of predicted value, $FEV_1\;120{\pm}16%,\;FEV_1/FVC\;112{\pm}5%$ and CV $86.9{\pm}12.5%$. Patients with normal CV have FVC $62{\pm}11%,\;FEV_1\;54{\pm}17%,\;FEV_1/FVC\;84{\pm}23%$ and CV $92.6{\pm}15.5%$. Patients with increased CV, have FVC $53{\pm}9%,\;FEV_1\;38{\pm}13,\;FEV_1/FVC\;69{\pm}16%$ and CV $176.1{\pm}36.6%$, CV was significantly different between two patient groups(p<0.02) 2). In normal controls mean fractional ventilation to left lung was $48.1{\pm}5.3%$ at supine, $54.1{\pm}9.8%$ at dependent and $40.9{\pm}6.5%$ at left uppermost position. In patients with normal CV mean fractional ventilation to left lung was $44.6{\pm}2.1%$ at supine, $59.7{\pm}5.6%$ at left dependent and $31.7{\pm}8.3%$ at left uppermost position. In patients with increased CV mean fractional ventilation to left lung was $48.7{\pm}4.5%$ at supine, $41.7{\pm}6.6%$ at left dependent and $60.9{\pm}15.7%$ at left uppermost position. In normal controls and patients with normal CV, ventilation to left lung at left dependent position tends to be higher than that at supine position but without statisitical significance and it was significantly lower at left uppermost than at left lung dependent position. In patients with increased CV, ventilation to left at left dependent position tends to be higher than that at supine position but without significance and it was significantly higher at left uppermost than that at left dependent position. Conclusion: These data suggest that in patients with increased CV ventilation to one side of lung could be higher at uppermost than at dependent position on lateral decubitus during tidal breathing and this fact should be taken into account in positioning of patients with unilateral lung disease.

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Analysis of p53 and Retinoblasoma(Rb) Gene Polymorphisms in Relation to Lung Cancer in Koreans (한국인 폐암 환자에 대한 p53 및 Rb유전자의 다형성 분석)

  • Lee, Kyung-Sang;Sohn, Jang-Won;Yang, Suck-Chul;Yoon, Ho-Joo;Shin, Dong-Ho;Park, Sung-Soo;Lee, Jung-Hee;Lee, Chun-Geun;Cho, Youl-Hee
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.3
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    • pp.534-546
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    • 1997
  • Background : The p53 and retinoblastoma(Rb) tumor suppressor genes are associated with the pathogenesis of several types of human cancer. Substantial proportion of the primary lung cancers or cell lines have been reported to have the p53 and/or the Rb gene mutations. But, so far there is no report on the analysis of the Rb gene polymorphism as one of the genetic susceptibility marker. This study was undertaken to establish the gene frequencies of the polymorphic genotypes of the p53 and Rb genes in Koreans to evaluate the possible involvement of these genotypes as a risk factor of lung cancer. Methods : In this study 145 controls without previous and present tumor history and 128 lung cancer patients were subjected to analysis. The two intragenic polymorphisms of the p53 gene(exon 4/ AccII, intron 6/MspI) and one intron 17/XbaI polymorphism of the Rb gene were analysed by the method of polymersae chain reaction- restriction fragment length polymorphisms(PCR-RFLPs). The genotype of the intron 3/16 bp repeat polymorphism of p53 was determined by PCR and direct gel electrophoresis. Results : There were no significant differences in the genotype distributions of the p53 gene between lung cancer patients and controls. But heterozygotes(Arg/Pro) of the exon 4/AccII polymorphisms were slightly over-represented than controls, especially in the Kreyberg type I cancer, which was known to be associated with smoking. The intron 3/16 bp duplication and the intron 6/MspI polymorphisms were in complete linkage disequilibrium. About 95% of the individuals were homozygotes of the common alleles both in the 16 duplication and MspI polymorphisms, and no differences were deteced in the genotype distributions between lung cancer patients and controls. Overall genotype distributions of the Rb gene polymorphisms between lung cancer patients and controls were not significantly different However, the genotype distributions in the Kreyberg type I cancer were significantly different from those of controls(p = 0.0297) or adenocarcinomas(p = 0.0008). It was noticeable that 73.4% of the patients with adenocarcinomas were heterozygotes(r1/r2) whereas 39.2% of the Kreyberg type I cancer were heterozygous at this polymorphisms. In the lung cancer patients, significant differences were also noted between the high dose smokers and low dose smokers including non-smokers(p = 0.0258). The relative risk to Kreyberg type I cancer was significantly reduced in the individuals with the genotype of r1/r2(odds ratio = 0.46, 95% C.I. = 0.25-0.86, p = 0.0124). The combined genotype distribution of the exon 4 AccII of the p53 and the intron 17 Rb gene polymorphisms in Kreyberg type I cancers were significantly different from dose of controls or adenocarcinomas. The highest odds ratio were observed in the individuals with the genotypes of Arg/Pro and r2/r2(odds ratio = 1.97,95% C.I. = 0.84-4.59) and lowest one was in the patients with Arg/Arg, r1/r2 genotype(odds ratio = 0.54, 95% C.I. = 0.25-1.14). Conclusion : The p53 and the Rb gene polymorphisms modulate the risk of smoking induced lung cancer development in Koeans. However, the exact mechanism of risk modulation by these polymorphism remains to be determined. For more discrete clarification of associations between specific genotypes and lung cancer risk, the evaluations of these polymorphisms in other ethnics and more number of patients will be needed.

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Effect of Smoking and Drinking Habits on the Nutrient Intakes and Health of Middle and High School Boy Students (남자 중.고생의 흡연과 음주습관이 영양소 섭취 및 건강상태에 미치는 영향)

  • Shin, Kyung-Ok;An, Chang-Hun;Hwang, Hyo-Jeong;Choi, Kyung-Soon;Chung, Keun-Hee
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.38 no.6
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    • pp.694-708
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    • 2009
  • The principal objective of this study was to determine the effects of smoking & drinking on the diet, nutrient intake, and overall health. A sample of 262 youths, aged 16 to 18 year-old, was randomly selected from Seoul and its vicinity. The subjects participated by answering survey questions including general questions, questions regarding health, smoking & drinking habits, dietary habits, nutrient intake, physical characteristics, and smoking cessation plans. The average height, weight, and BMI of the subjects were $173.5{\pm}6.8\;cm$, $64.8{\pm}11.8\;kg$, and $21.4{\pm}3.7\;kg/m^2$, respectively. Among the subjects, 88% appeared to be interested in health and 43.5% of youth asserted that the best way to keep healthy was to engage in regular exercise. Among 63 smokers, 52 students (82.5%) used alcoholic beverages while 11 students (17.5%) did not use alcoholic beverages, meaning that smoking was a causative factor in drinking. 55.6% of youth reported beginning to smoke in middle school, and 38.1% of them asserted that curiosity was the motive for smoking. The youth reported that the craving for smoking was highest when hungry, and the best place to smoke was the restroom. 20 students (69.0%) answered that the only way to quit smoking was just to stop. 12 students (44.4%) reported that the main reason for failures in smoking cessation attempts was a lack of intention or willpower. 87.1% of all subjects answered that they were inclined to quit smoking, and 56.7% of them would be interested in attending a smoking cessation program if they had the opportunity. Among the smoking and drinking group, 50% of drinkers began to drink in high school, and the reason for drinking given was peer pressure-40% of drinkers answered that they wished to quit drinking. 34.4% of students appeared to have breakfast everyday, but 16.4% of students answered that they had quit eating breakfast. 52.5% of all students reported that the principal reason for overeating was the presence of one's favorite food, and the smoking and drinking group reported overeating more frequently than other groups (p<0.05). 72.6% of all subjects reported eating interim meals $1{\sim}2$ times daily, 36.4% of smokers ate carbonated beverages, 38.5% ate ice cream as a interim meal, and 38.5% of the drinking and smoking groups ate fruits, 26.9% of them ate fried foods, and some of them ate fast foods as a interim meal. Among smokers, the ratio of eating fat-rich foods, and meats such as kalbi and samgyupsal more than two times per week was higher, and 54.3% of smokers ate ice cream, cookies, and carbonated beverages more than two times per week (p<0.05). The total nutrient intake of the $15{\sim}19$-year youth group was much higher than the standard value. The energy intake of the smoking group and the drinking and smoking group was significantly higher than that of the normal group (p<0.05). Intakes of phosphorus (p<0.05), cholesterol (p<0.05), and sodium (p<0.05) were the highest among all groups. Accordingly, it is recommended that practical education programs be implemented to teach young students to resist peer pressures to smoke and drink. Additionally, education that acknowledges the importance of nutrition is necessary to avoid preferential eating and overeating due to smoking and drinking.such education can also teach students to eat a balanced diet and improve their physical development.

A Study on Jurisdiction under the International Aviation Terrorism Conventions (국제항공테러협약의 관할권 연구)

  • Kim, Han-Taek
    • The Korean Journal of Air & Space Law and Policy
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    • v.24 no.1
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    • pp.59-89
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    • 2009
  • The objectives of the 1963 Tokyo Convention cover a variety of subjects, with the intention of providing safety in aircraft, protection of life and property on board, and promoting the security of civil aviation. These objectives will be treated as follows: first, the unification of rules on jurisdiction; second, the question of filling the gap in jurisdiction; third, the scheme of maintaining law and order on board aircraft; fourth, the protection of persons acting in accordance with the Convention; fifth, the protection of the interests of disembarked persons; sixth, the question of hijacking of aircraft; and finally some general remarks on the objectives of the Convention. The Tokyo Convention mainly deals with general crimes such as murder, violence, robbery on board aircraft rather than aviation terrorism. The Article 11 of the Convention deals with hijacking in a simple way. As far as aviation terrorism is concerned 1970 Hague Convention and 1971 Montreal Convention cover the hijacking and sabotage respectively. The Problem of national jurisdiction over the offence and the offender was as tangled at the Hague and Montreal Convention, as under the Tokyo Convention. Under the Tokyo Convention the prime base of jurisdiction is the law of the flag (Article 3), but concurrent jurisdiction is also allowed on grounds of: territorial principle, active nationality and passive personality principle, security of the state, breach of flight rules, and exercise of jurisdiction necessary for the performance of obligations under multilateral agreements (Article 4). No Criminal jurisdiction exercised in accordance with national law is excluded [Article 3(2)]. However, Article 4 of the Hague Convention(hereafter Hague Article 4) and Article 5 of the Montreal Convention(hereafter Montreal Article 5), dealing with jurisdiction have moved a step further, inasmuch as the opening part of both paragraphs 1 and 2 of the Hague Article 4 and the Montreal Article 5 impose an obligation on all contracting states to take measures to establish jurisdiction over the offence (i.e., to ensure that their law is such that their courts will have jurisdiction to try offender in all the circumstances covered by Hague Article 4 and Montreal Article 5). The state of registration and the state where the aircraft lands with the hijacker still on board will have the most interest, and would be in the best position to prosecute him; the paragraphs 1(a) and (b) of the Hague Article 4 and paragraphs 1(b) and (c) of the Montreal Article 5 deal with it, respectively. However, paragraph 1(b) of the Hague Article 4 and paragraph 1(c) of the Montreal Article 5 do not specify if the aircraft is still under the control of the hijacker or if the hijacker has been overpowered by the aircraft commander, or if the offence has at all occurred in the airspace of the state of landing. The language of the paragraph would probably cover all these cases. The weaknesses of Hague Article 4 and Montreal Article 5 are however, patent. The Jurisdictions of the state of registration, the state of landing, the state of the lessee and the state where the offender is present, are concurrent. No priorities have been fixed despite a proposal to this effect in the Legal Committee and the Diplomatic Conference, and despite the fact that it was pointed out that the difficulty in accepting the Tokyo Convention has been the question of multiple jurisdiction, for the reason that it would be too difficult to determine the priorities. Disputes over the exercise of jurisdiction can be endemic, more so when Article 8(4) of the Hague Convention and the Montreal Convention give every state mentioned in Hague Article 4(1) and Montreal Article 5(1) the right to seek extradition of the offender. A solution to the problem should not have been given up only because it was difficult. Hague Article 4(3) and Montreal Article 5(3) provide that they do not exclude any criminal jurisdiction exercised in accordance with national law. Thus the provisions of the two Conventions create additional obligations on the state, and do not exclude those already existing under national laws. Although the two Conventions do not require a state to establish jurisdiction over, for example, hijacking or sabotage committed by its own nationals in a foreign aircraft anywhere in the world, they do not preclude any contracting state from doing so. However, it has be noted that any jurisdiction established merely under the national law would not make the offence an extraditable one under Article 8 of the Hague and Montreal Convention. As far as international aviation terrorism is concerned 1988 Montreal Protocol and 1991 Convention on Marking of Plastic Explosives for the Purpose of Detention are added. The former deals with airport terrorism and the latter plastic explosives. Compared to the other International Terrorism Conventions, the International Aviation Terrorism Conventions do not have clauses of the passive personality principle. If the International Aviation Terrorism Conventions need to be revised in the future, those clauses containing the passive personality principle have to be inserted for the suppression of the international aviation terrorism more effectively. Article 3 of the 1973 Convention on the Prevention and Punishment of Crimes Against Internationally Protected Persons, Including Diplomatic Agents, Article 5 of the 1979 International Convention against the Taking of Hostages and Article 6 of the 1988 Convention for the Suppression of Unlawful Acts Against the Safety of Maritime Navigation would be models that the revised International Aviation Terrorism Conventions could follow in the future.

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