• Clinical and Experimental Pediatrics
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• v.53 no.4
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• pp.532-537
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• 2010

Purpose : Early postoperative arrhythmias are a major cause of mortality and morbidity after open heart surgery in the pediatric population. We evaluated the incidence and risk factors of early postoperative arrhythmias after surgery of congenital heart disease. Methods : From January 2002 to December 2008, we retrospectively reviewed the medical records of the 561 patients who underwent cardiac surgery in Kyungpook National University Hospital. We analyzed patients' age and weight, occurrence and type of arrhythmia, cardiopulmonary bypass (CPB) time, aortic cross clamp (ACC) time, and postoperative electrolyte levels. Results : Arrhythmias occurred in 42 of 578 (7.3%) cases of the pediatric cardiac surgery. The most common types of arrhythmia were junctional ectopic tachycardia (JET) and accelerated idioventricular rhythm (AIVR), which occurred in 17 and 13 cases, respectively. The arterial switch operation (ASO) of transposition of the great arteries (TGA) had the highest incidence of arrhythmia (36.4%). Most cases of cardiac arrhythmia showed good response to management. Patients with early postoperative arrhythmias had significantly lower body weight, younger age, and prolonged CPB and ACC times ($P$<0.05) than patients without arrhythmia. Although the mean duration of ventilator care and intensive care unit stay were significantly longer ($P$<0.05), the mortality rate was not significantly different among the 2 groups. Conclusion : Early postoperative arrhythmias are a major complication after pediatric cardiac surgery; however, aggressive and immediate management can reduce mortality and morbidity.

• Clinical and Experimental Pediatrics
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• v.53 no.4
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• pp.538-547
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• 2010

Purpose : This study aims to compare the outcome of total body irradiation (TBI)- or non-TBI-containing conditioning regimens for leukemia in children. Methods : We retrospectively evaluated 77 children conditioned with TBI (n=40) or non-TBI (n=37) regimens, transplanted at Chonnam National University Hospital between January 1996 and December 2007. The type of transplantation, disease status at the time of transplant, conditioning regimen, engraftment kinetics, development of graft-versus-host disease (GVHD), complications, cause of deaths, overall survival (OS), and event-free survival (EFS) were compared between the 2 groups. Results : Among 34 patients with acute lymphoblastic leukemia (ALL), 28 (82.4%) were in the TBI group, while 72.7% (24/33) of patients with myeloid leukemia were in the non-TBI group. Although the 5-year EFS of the 2 groups was similar for all patients (62% vs 63%), the TBI group showed a better 5-year EFS than the non-TBI group when only ALL patients were analyzed (65% vs 17%; $P$=0.005). In acute myelogenous leukemia patients, the non-TBI group had better survival tendency (73% vs 38%; $P$=0.089). The incidence of GVHD, engraftment, survival, cause of death, and late complications was not different between the 2 groups. Conclusion : The TBI and non-TBI groups showed comparable results, but the TBI group showed a significantly higher 5-year EFS than the non-TBI group in ALL patients. Further prospective, randomized controlled studies involving larger number of patients are needed to assess the late-onset complications and to compare the socioeconomic quality of life.

• Clinical and Experimental Pediatrics
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• v.53 no.4
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• pp.525-531
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• 2010

Purpose : Expression levels of tumor necrosis factor (TNF)-${\alpha}$ expression on the mucosa of the small intestine is increased in patients with villous atrophy in food protein-induced enterocolitis syndrome (FPIES). TNF-${\alpha}$ has been reported to induce apoptotic cell death in the epithelial cells. We studied the TNF family and TNF-receptor family apoptosis on the duodenal mucosa to investigate their roles in the pathogenesis of FPIES. Methods : Fifteen infants diagnosed as having FPIES using standard oral challenge test and 5 controls were included. Terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling (TUNEL) staining was performed to identify the apoptotic cell death bodies. Immunohistochemical staining of TNF-${\alpha}$, Fas ligand (FasL) for TNF family and TNF-related apoptosis-including ligand (TRAIL) receptor 1 (DR4), TRAIL receptor 2 (DR5), and Fas for TNF-receptor family were performed to determine the apoptotic mechanisms. Results : $TUNEL^+$ was significantly more highly expressed in the duodenal mucosa of FPIES patients than in controls ($P$-0.043). TNF-${\alpha}$ ($P$=0.0001) and DR4 ($P$=0.003) were significantly more highly expressed in FPIES patients than in controls. Expression levels of FasL, Fas, and DR5 were low in both groups and were not significantly different between the 2 groups. Conclusion : These results suggest that FPIES pathogenesis is induced by apoptosis, and that TNF-${\alpha}$ expression and DR4 pathway may have an important role in apoptosis.

• Clinical and Experimental Pediatrics
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• v.53 no.4
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• pp.488-494
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• 2010

Purpose : A human milk bank collects, processes, eliminates, and stores breast milk from donors and provides breast milk to those in need. The authors hereby present the experiences and the objective lessons obtained through operating a nationwide human milk bank over a period of 2 years. Methods : The characteristics of the donors and the recipients and the amounts of breast milk donated, processed, and received at the East-West Neo Medical Center Human Milk Bank were investigated from August 2007 to August 2009. Results : The donor pool consisted of 131 first-time donors and 39 repeat donors who made 341 and 127 donations, respectively. Seventy-nine percent of the donors resided in the Seoul-Kyunggi area, and 60% of the donors were in their 30s. Most information and motivation came from the Internet (66%) or television (14%). A total of 2,736 L of breast milk was collected, and 1,979 L were processed. The cumulative number of recipients was 160 preterm or full-term infants and 21 adults, each group receiving the breast milk 337 and 41 times, respectively. In total, infants received 1,663 L and adults received 179 L. Conclusion : Through the present study, the role and importance of a human milk bank in collecting, pasteurizing, and storing surplus breast milk in through sanitary, medically proven methods and providing this breast milk to recipients could be appreciated and reevaluated. The authors believe that a national support system is necessary to expand this practice to a nationwide scale.

• Clinical and Experimental Pediatrics
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• v.53 no.4
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• pp.481-487
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• 2010

Purpose: Recently many studies show early exposure during childhood growth to endotoxin (lipopolysaccharides, LPS) and/or early exposure to allergens exhibit important role in development of allergy including bronchial asthma. The aim of this study was to evaluate the role of endotoxin and allergen exposure in early life via the airways in the pathogenesis of allergic airways inflammation and airway hyperresposiveness (AHR) in mouse model of asthma. Methods: Less than one week-old Balb/c mice was used. Groups of mice were received either a single intranasal instillation of sterile physiologic saline, 1% ovalbumin (OVA), LPS or $1.0{\mu}g$ LPS in 1% OVA. On 35th day, these animals were sensitized with 1% OVA for 10 consecutive days via the airways. Animals were challenged with ovalbumin for 3 days on 55th days, and airway inflammation, hyperresponsiveness, and cytokine expression were assessed. Measurements of airway function were obtained in unrestrained animals, using whole-body plethysmography. Airway responsiveness was expressed in terms of % enhanced pause (Penh) increase from baseline to aerosolized methacholine. Lung eosinophilia, serum OVA-IgE and bronchoalveolar lavage (BAL) fluid cytokine levels were also assessed. ANOVA was used to determine the levels of difference between all groups. Comparisons for all pairs were performed by Tukey-Kramer honest significant difference test; $P$ values for significance were set to 0.05. Results: Sensitized and challenged mice with OVA showed significant airway eosinophilia and heightened responsiveness to methacholine. Early life exposure of OVA and/or LPS via the airway prevented both development of AHR as well as bronchoalveolar lavage fluid eosinophilia. Exposure with OVA or LPS also resulted in suppression of interleukin (IL)-4, 5 production in BAL fluid and OVA specific IgE in blood. Conclusion: These results indicate that antigen and/or LPS exposure in the early life results in inhibition of allergic responses to OVA in this mouse model of astham. Our data show that early life exposure with OVA and/or LPS may have a protective role in the development of allergic airway inflammation and development of allergen-induced airway responses in mouse model of asthma.

• Clinical and Experimental Pediatrics
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• v.50 no.4
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• pp.340-347
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• 2007

Purpose : The purpose of this study is to investigate the material in middle school and high school textbooks covering child care and children's health for medically inaccurate content and to make sure that the correct information is given to students. Methods : We have examined 47 kinds of textbooks on the subjects 'Home economics' and 'Technology and home economics' published in 2007 to find out how much importance is placed on children's health and childcare and to search for incorrect definitions, inaccurate facts or insufficient explanations. We have also analyzed the credentials of the writers of these textbooks. Results : Textbooks of middle school cover psychological and physical changes during adolescence and nutrition, and those of high school cover marriage and childcare. These materials covering health made up 27.5%, 11.7% of middle & high school texts. Age definitions of neonate and infant were incorrect. Inaccurate facts were mostly about fontanelles, primitive reflexes, breastfeeding and weaning. There also were wrong informations on the umbilical cord care and developmental milestones during infancy. The childhood immunization schedules and the growth curves were not up to date. Most of the authors major in home economics and the others were school teachers. There was no evidence of any review by a medical society or an expert. Conclusions : When writing about children's health and childcare in textbooks, a board-certified pediatrician or The Korean Pediatric Society should be consulted to provide accurate medical information to middle and high school students.

• Clinical and Experimental Pediatrics
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• v.50 no.10
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• pp.1011-1017
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• 2007

Purpose : We tried to assess the optimal conditions to improve low transduction efficiency and their effect on target cells. Methods : Cultured NIH 3T3 cells were incubated with retroviral vectors bearing an enhanced green fluorescent protein (eGFP) gene. We varied the ratio of viral vectors to target cells (1:1-1:8) and the number of transfections (${\times}1$, ${\times}2$), and compared transduction efficiencies. Also, the effects of polybrene on transduction efficiency and viability of target cells were assessed. Transduction of the eGFP gene was evaluated by observing NIH 3T3 cells under a fluorescence microscope and efficiencies were measured by the percentage of eGFP positive cells using FACscan. Results : As the ratio of retroviral vectors to target cells increased, transduction efficiency was greatly improved, from 7% (1:1) to 38% (1:4). However, transduction efficiency did not increase any more when the ratio increased from 1:4 to 1:8. Cells transfected twice showed higher transduction efficiencies than cells transfected once, at a ratio of 1:8. The eGFP gene transduced to NIH 3T3 cells sustained its expression during repeated passages. However, after the third passage (day 9), the percentage of eGFP positive cells began to decline. The degree of this decline in eGFP expression was lower in cells transfected twice than in cells transfected once (P<0.05). The addition of polybrene did not have any toxic effect on NIH 3T3 cells and greatly increased transduction efficiency (P=0.007). In addition to vector component, transduction efficiency was very sensitive to culture confluence. Cells cultured and transfected in 24-well plate showed higher transduction efficiency, although cells cultured in 6- well plate proliferated more (P=0.024). Conclusion : Our data could be used as a basis for retrovirus-based gene therapy. Further study will follow using human cells as target cells.

• Journal of the Korean Society of Food Science and Nutrition
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• v.30 no.2
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• pp.350-356
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• 2001

The purpose of this study is to verify the relation among vegetarian diet, physical activity and the risk factors of cardiovascular disease. Two hundred and forty five buddhist nuns (age : 23~79 yrs) were selected as vegetarians. For control subjects, 235 healthy female adults (age : 23~79 yrs) were selected. Study period was from October 1996 to February 1997. The contents are consist of food consumption survey, anthropometric measurement, amount of energy expenditure, physical activity and clinical examination. Results were summarized as follows : The average ages of vegetarians were $44.2{\pm}17.3\;yrs$ and those of non-vegetarians were $40.5{\pm}18.4\;yrs$. Average body mass indices (BMI) of vegetarians and non-vegetarians were $22.5{\pm}2.7\;and\;21.1{\pm}2.5$, WHRs were $0.9{\pm}0.1\;and\;0.8{\pm}0.1$, and the average duration of vegetarian diet of the vegetarians was 13.1{\pm}12.9 years. All the nutrient intakes of both groups were over RDA's except calcium and vitamin A intakes of non-vegetarians that were below RDA's Fiber and vitamin C intakes of the vegetarians were significantly higher than those of non-vegetarians (p<0.01). Average energy intakes of vegetarians and non-vegetarians were $2177.1{\pm}420.6\;kcal/day\;and\;2103.2{\pm}534.9\;kcal/day$, total daily energy expenditure were $1789.9{\pm}325.8\;kcal/day\;and\;1703.8{\pm}344.8\;kcal/day$, those by physical activity were $507.8{\pm}360.9\;kcal/day\;and\;400.0{\pm}247.8\;kcal/day$. Serum lipid level, blood sugar, systolic blood pressure of vegetarians were significantly lower than those of non-vegetarians, but ratio of HDL-cholesterol/total-cholesterol was higher than those of non-vegetarians. Levels of total serum cholesterol of vegetarians and non-vegetarians were 161.4{\pm}33.3 mg/dL and 189.6{\pm}33.6mg/dL, HDL-cholesterol were $48.2{\pm}11.4\;mg/dL\;and\;50.8{\pm}12.2\;mg/dL$, LDL-cholesterol were $86.6{\pm}26.9\;mg/dL\;and\;111.1{\pm}17.0\;mg/dL$, atherogenic indice(AI) were $2.4{\pm}0.6\;and\;2.9{\pm}0.7$, fasting blood sugar were $90.8{\pm}14.3\;mg/dL\;and\;103.6{\pm}24.6\;mg/dL$, systolic blood pressure were $107.5{\pm}14.9\;mmHg\;and\;119.3{\pm}15.3\;mmHg$. Energy expenditure by physical activity was negatively correlated with levels of serum total-cholesterol and LDL-cholesterol and atherogenic indice(AI). Therefore, physical activity and vegetarian diet effectively helped reduce blood lipids related to cardiovascular disease.

• Journal of the Korean Society of Food Science and Nutrition
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• v.11 no.1
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• pp.7-14
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• 1982

A survey was carried out to determine the nutritional status of rural elderly. Determination was made on 50 persons, aged 60 years and over, in the rural area of Paltan-myeon, Hwaseong-kun, Kyeonggi province from June 1 to August 20, 1980. Grains provided 82$\sim$85% of total energy input most nutrient intake was from vegetable foods. Daily energy intake was not sufficient as 77.2$\sim$89.8% of RDA. The energy input percentage of carbohydrate: fat: protein was 79 : 10 : 11. showing higher dependance on carbohydrate. The protein intake only met 53.7$\sim$65.3% % of RDA. The contribution of animal proteins to total protein was only 12.2$\sim$12.4%, far below the recommended allowance. Both calcium and iron was insufficiently ingested as 40.6$\sim$55.7% and 72.0$\sim$92.0% of RDA, respectively. The intake of vitamin A and ascorbic acid almost reached RDA whereas the intake of thimin, riboflavin and niacin was not sufficient as 63.0$\sim$97.0%, 51.0$\sim$58.5% and 59.1$\sim$83.9% of RDA, respectively. 32% of the subjects were higher blood pressure than 160/95 mmHg proven to be hypertension. The correlation coefficients between clinical sign score, index of appetite, balance of meal and nutrient intake were significant. (P<0.05)

• Journal of the Korean Society of Food Science and Nutrition
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• v.44 no.10
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• pp.1510-1516
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• 2015

The objective of this study was to investigate the quality and sensory characteristics of sweet persimmon mashes and spirits fermented by three different yeasts [Saccharomyces species, labeled as LB (Lalvin BM $4{\times}4$), LD (Lalvin DV10), and UC (Uvaferm CM)]. In the production of sweet persimmon wines, UC had the highest alcohol content of 10.20% (v/v) after 9 days of fermentation (P<0.05). The range of pH after fermentation was 3.63~3.75. The total aerobic bacteria and yeast contents increased until day 3 and then continuously decreased to approximately 8.60 log CFU/mL and 8.20 log CFU/mL, respectively. Reducing sugar contents were 3.37% in UC, 3.91% in LD, and 4.05% in LB after fermentation. Total sugar contents were 4.89% in UC, 6.24% in LD, and 5.47% in LB after fermentation. Two-stage single-pot distillation was conducted to produce sweet persimmon spirits. While conducting second distillation, spirits were collected every 100 mL fraction. The alcohol contents gradually decreased as more fractions were collected. The amounts of acetaldehyde were 226 mg/L for LD, 225 mg/L for LB, and 310 mg/L for UC in the first fraction. LD produced the highest volume (677.8 mL) of alcohol in its body part in comparison with LB (408.0 mL) and UC (445.4 mL). In the descriptive analysis, UC had stronger intensities of sweet aroma, sour aroma and taste, and persimmon flavor (P<0.05). Persimmon characteristics seemed to be well characterized by UC. In conclusion, LD was the most efficient in terms of production cost, whereas UC would be used to produce a more flavorful sweet persimmon spirit.