The routine value of anogenital distance as an anthropometric measurement in newborns.

OBJECTIVE: Anogenital distance (AGD) is a sexually dimorphic trait; AGD is an external marker of sexual differentiation at birth in animals. STUDY DESIGN: The present study used a prospective, cross-sectional design. Data were collected from newborn infants that were delivered at hospital in Bucheon between March and September 2009. The mothers of the infants provided sociodemographic information and obstetric history. The relationships between AGD and other anthropometric measures (i.e., weight, height, and head circumference) were analyzed. Moreover adjusted AGD values were compared with obstetric characteristics, including number of deliveries, abortion history, preterm history, and duration of gestation. RESULTS: Significant correlations were noted for all anthropometric measures in male and female newborns (p < 0.0001). The adjusted AGD values in males and females were also significantly associated with the duration of gestation (p = 0.0008 and p = 0.0148, respectively). Moreover, the adjusted AGD in female newborns, but not in males, was significantly associated with maternal abortion history (p = 0.0242). CONCLUSION: The AGD is a valuable anthropometric marker in term infants.

Effect of nalbuphine hydrochloride on the active phase during first stage of labour: a pilot study.

The aim of this pilot study was to determine whether nalbuphine shortens the duration of the active phase during the first stage of labour in pregnant women. Among 1,619 deliveries, we enrolled 302 pregnant women between March 2003 and August 2005. The case group received a nalbuphine injection (n = 57), while the remaining patients served as a control group (n = 245). The effects of nalbuphine on the length of labour were analysed using a survival analysis (log-rank test). The average duration of the initial active phase was 75 and 160 min for the case and control groups, respectively. The reduced duration of the active phase in the case group occurred regardless of oxytocin infusion (p < 0.01) and was without significant risks.

Perinatal exposure to di-(2-ethylhexyl) phthalate induces hepatic lipid accumulation mediated by diacylglycerol acyltransferase 1.

INTRODUCTION: Di-(2-ethylhexyl) phthalate (DEHP) is a commonly used plasticizer in consumer products and medical devices. It is also suspected to exacerbate the development of fatty liver. However, the mechanisms underlying excessive lipid synthesis and its deposition in the liver are yet to be identified. This study was aimed to evaluate the molecular mechanisms of hepatic lipid accumulation in adult male offspring after perinatal exposure to DEHP. METHOD: Corn oil and DEHP (0.75 mg/kg/day) were administered once per day to dam from gestation day 6 to postnatal day (PND) 21 by oral gavage. After the weaning period, DEHP treated male pups were categorized into early life stage- and lifelong period group. Male rats both control and early life stage group administered corn oil, and lifelong period group administered DEHP from PND 22 to 70. Histological examination and triglyceride (TG) levels in the liver were analyzed. Expressions of transcription factors associated with lipid accumulation in the liver were analyzed. RESULTS: Both early life stage- and lifelong period group, hepatic TG levels, and mRNA and protein expression of diacylglycerol acyltransferase 1 (DGAT1) were significantly higher than control (TG: all p < 0.05, mRNA & protein: p < 0.05 and p < 0.001, respectively). The average body weight from PND 35 to 63, and mRNA and protein expression of sterol regulatory element binding protein 1c in lifelong period group were significantly lower than control (all p < 0.05); however, alanine transaminase were significantly higher than control (p < 0.01). CONCLUSION: Perinatal exposure to DEHP may induce the hepatic lipid accumulation through up-regulation of DGAT1 expression.

Retraction of articles by H. Zhong et al.

A series of 41 papers by H. Zhong et al. are retracted.

Gate dependence of upper critical field in superconducting (110) LaAlO3/SrTiO3 interface.

The fundamental parameters of the superconducting state such as coherence length and pairing strength are essential for understanding the nature of superconductivity. These parameters can be estimated by measuring critical parameters such as upper critical field, Hc2. In this work, Hc2 of a superconducting (110) LaAlO3/SrTiO3 interface is determined through magnetoresistive measurements as a function of the gate voltage, VG. When VG increases, the critical temperature has a dome-like shape, while Hc2 monotonically decreases. This relationship of independence between the variation of Tc and of Hc2 suggests that the Cooper pairing potential is stronger in the underdoped region and the coherence length increases with the increase of VG. The result is as for high temperature superconducting cuprates and it is different than for conventional low temperature superconductors.

Chloroplast DNA diversity among trees, populations and species in the California closed-cone pines (Pinus radiata, Pinus muricata and Pinus attenuata).

The amount, distribution and mutational nature of chloroplast DNA polymorphisms were studied via analysis of restriction fragment length polymorphisms in three closely related species of conifers, the California closed-cone pines-knobcone pine: Pinus attenuata Lemm.; bishop pine: Pinus muricata D. Don; and Monterey pine: Pinus radiata D. Don. Genomic DNA from 384 trees representing 19 populations were digested with 9-20 restriction enzymes and probed with cloned cpDNA fragments from Douglas-fir [Pseudotsuga menziesii (Mirb.) Franco] that comprise 82% chloroplast genome. Up to 313 restriction sites were surveyed, and 25 of these were observed to be polymorphic among or within species. Differences among species accounted for the majority of genetic (haplotypic) diversity observed [Gst = 84(+/- 13)%]; nucleotide diversity among species was estimated to be 0.3(+/- 0.1)%. Knobcone pine and Monterey pine displayed almost no genetic variation within or among populations. Bishop pine also showed little variability within populations, but did display strong population differences [Gst = 87(+/- 8)%] that were a result of three distinct geographic groups. Mean nucleotide diversity within populations was 0.003(+/- 0.002)%; intrapopulation polymorphisms were found in only five populations. This pattern of genetic variation contrasts strongly with findings from study of nuclear genes (allozymes) in the group, where most genetic diversity resides within populations rather than among populations or species. Regions of the genome subject to frequent length mutations were identified; estimates of subdivision based on length variant frequencies in one region differed strikingly from those based on site mutations or allozymes. Two trees were identified with a major chloroplast DNA inversion that closely resembled one documented between Pinus and Pseudotsuga.

Body mass index and blood pressure in Korean men and women: the Korean National Blood Pressure Survey.

AIMS AND METHODS: The association between body mass index (BMI) and blood pressure is well known in relatively obese populations. The purpose of the present study was to investigate the relationship between BMI and blood pressure in a lean population. Through cluster sampling, individuals aged > 30 years in 190 out of 154,082 districts were selected for study. Among 25,567 eligible individuals, measurements of blood pressure and BMI were made in 22,354. RESULTS: The BMI for males was 22.8 +/- 2.7 kg/m2 and for females was 23.4 +/- 3.2 kg/m2 (means +/- SD). Over a BMI range from 16 to 31 kg/m2 the relationships between BMI and systolic and diastolic blood pressure were almost linear. Over the BMI range 25-31 kg/m2 (overweight-to-obese) each BMI unit was associated with a difference of 1.0 mmHg in diastolic blood pressure. Over the BMI range 16-25 kg/m2 (normal-to-lean) each BMI unit was associated with a difference of 0.89 mmHg in diastolic blood pressure. CONCLUSION: We conclude that a strong association between BMI and blood pressure exists for lean as well as for obese subjects.

An analysis of pulmonary tuberculosis data in Taiwan and Korea.

An analysis is carried out on pulmonary tuberculosis survey data from Taiwan and Korea. A mathematical model based on a Markov process is developed and used to estimate transition rates between various disease states, as well as certain 'infection parameters', which measure the strength of the relative contributions of different disease states and of endogenous reactivation to the incidence of tuberculosis in the population. It is found that endogenous reactivation plays a primary role in generating cases, followed by chronic sources of infection, particularly those with drug-sensitive organisms. Some recommendations are made with regard to optimizing treatment regimens. The methodology can easily be applied to other countries.

Hypertension in Korea: a national survey.

To determine the prevalence of hypertension (HTN) and its risk factors, we performed a population-based national cross-sectional blood pressure (BP) survey in Korea in 1990. Through cluster sampling, we selected for study individuals older than 30 years of age in 190 of 154,082 districts. Among 25,567 eligible individuals, 21,242 subjects had measurements of BP and body mass index (BMI) and underwent a standard interview. BP was recorded as the mean of two measurements on a standard mercury manometer. The prevalence of HTN varied widely by area of residence. Overall prevalence was 19.8% for HTN defined as BP > or = 140/90 mm Hg or subject on medication, and 12.4% for BP > or = 160/95 mm Hg or subject on medication. Correlates for HTN identified by logistic regression analysis included positive family history of HTN (odds ratio [OR] = 2.2,), age (10 years); OR = 1.9), alcohol intake (500 cc; OR = 1.4), urban location (versus rural; OR = 1.3), and BMI (1 BMI unit; OR = 1.2). [Am J Prev Med 1994;10:200-4]

Drug-resistant tuberculosis in Korea, 1994.

SETTING: Sample survey based on pulmonary tuberculosis (TB) patients registered in 264 health centres in Korea, compared with data obtained from nationwide TB prevalence surveys conducted since 1965. OBJECTIVE: To determine the level of antituberculosis drug resistance (DR) and to assess its impact on treatment outcome and its relationship with cure rates in the National TB Programme (NTP). DESIGN: Mycobacterium tuberculosis isolates from 2,486 new patients and 189 previously treated patients were subjected to susceptibility testing against 10 antituberculosis drugs. Treatment outcome was assessed. The DR levels were compared with those observed in the national TB prevalence surveys, and the trend was correlated with the cure rate of patients treated in the NTP. RESULTS: Resistance to any drug was 11.3% in new cases and 54.0% in previously treated cases. Initial resistance to isoniazid (INH) or rifampicin (RMP) was 7.7% or 2.2%, and to INH and RMP (+/- other drugs) 1.6%. Compared with previous data, initial drug resistance (IDR) has decreased significantly and is inversely related to improvement of cure rates in the NTP. The treatment outcome of patients with single drug resistance was satisfactory. CONCLUSION: Drug-resistant TB has decreased remarkably during the last decades in Korea as a result of improved efficiency in the treatment programme of the NTP.

Ambulatory treatment of multidrug-resistant pulmonary tuberculosis patients at a chest clinic.

SETTING: Retrospective cohort analysis of multidrug-resistant tuberculosis (MDR-TB) patients treated at a Korean National Tuberculosis Association out-patient chest clinic. OBJECTIVE: To evaluate treatment outcomes and contributing factors. DESIGN: A review of clinical records of 1011 pulmonary MDR-TB patients retreated with individualised regimens selected on the basis of previous chemotherapy and drug susceptibility testing from 1988 to 1996. RESULTS: The patients (mean age 38.6 years) had resistant organisms to an average of 3.7 drugs and were retreated with an average of 4.2 drugs which they had previously not taken and to which they were susceptible. Treatment outcomes were as follows: 487 cases (48.2%) cured, 82 (8.1%) failed, 394 (39.0%) defaulted, 45 (4.5%) transferred out, and three (0.3%) died. The treatment efficacy among those who completed chemotherapy was 85.6%. In a multivariate analysis favourable response was significantly associated with a greater number of newly prescribed drugs in the regimen to which they were susceptible (odds ratio [OR] 3.6; 95% confidence interval [CI] 1.3-9.5), younger age (OR 2.0; 95%CI 1.1-3.9), and a lower number of drugs to which they were resistant (OR 1.8; 95%CI 1.1-3.1). The case fatality rate, including the follow-up period, was 1.7% (17 cases). CONCLUSION: The cure rate of MDR-TB patients treated at an out-patient clinic was 48.2% due to a high defaulter rate (39.0%). However, 85.6% of those who completed treatment were cured.

Twenty-year trend of chronic excretors of tubercle bacilli based on the nationwide tuberculosis prevalence surveys in Korea, 1975-1995.

SETTING: A study of chronic excretors of tubercle bacilli (chronic cases) based on the nationwide random sample surveys of tuberculosis prevalence conducted in Korea from 1975 through 1995. OBJECTIVE: To investigate the temporal trend of the prevalence of chronic cases, and to match these with treatment outcomes and drug resistance rates. DESIGN: Bacillary cases were classified by history of chemotherapy into new (those who denied a history of chemotherapy), non-chronic (those who had taken chemotherapy for less than 2 years) and chronic cases (those who had taken chemotherapy for more than 2 years). RESULTS: Chronic cases decreased from 107 to 12 per 100000 population (annual rate of reduction [ARR] 11.89%) over the 20-year period. The ARR of chronic cases was significantly greater than that of new cases, and accelerated from 1985 (ARR 15.83%), after the application of short course chemotherapy. Rates of overall drug resistance rates increased up to 1980, and those of multidrug resistance up to 1985, followed by a decrease thereafter. A reduction in chronic cases was observed even during the period of increase in drug resistance (including multidrug resistance). CONCLUSION: The prevalence of chronic tuberculosis cases has decreased due to improvements in overall treatment outcome.

Tuberculin PPD RT23: has it lost some of its potency?

PPD RT23 is a tuberculin that is used worldwide. Korea has been using 1TU RT23 for its nationwide tuberculosis prevalence surveys at five-yearly intervals since 1965, and found a drop in its potency after the 1975 survey. This finding draws attention to the interpretation of tuberculin survey data observed with RT23 at different time periods.

Treatment of bacillary pulmonary tuberculosis at the chest clinics in the private sector in Korea, 1993.

SETTING: Cohort study of bacillary pulmonary tuberculosis patients treated at private sector chest clinics in Korea. OBJECTIVE: To assess the treatment behaviour of physicians in private chest clinics and the treatment outcomes of their patients. DESIGN: 1) A retrospective analysis of a cohort of patients admitted from July through October in 1993, and 2) comparison with results from health centres under the National Tuberculosis Programme (NTP). RESULTS: Nine hundred and sixty bacillary patients (507 newly diagnosed--'new', and 453 retreatment--'old') were admitted to the study. Initial smears and cultures were not performed in 7% and 21%, and follow-up smears and cultures not done in 19% and 28%, respectively. The regimens prescribed were variable: 23 in 'new' and 72 in 'old' patients, 86 in total. Six-month short-course treatment using HRZE was prescribed for 26.2% of 'new' patients. In many instances, the planned treatment duration was excessive. The success rates (cured plus completed) for 'new' and 'old' patients were 74% and 51%, respectively. The failure rates were less than 1% in 'new' and 9% in 'old' patients. CONCLUSION: Prescribed regimens were variable in terms of drug combinations and treatment duration. Overall treatment outcome was inferior to that of the health centres under the NTP.

Cohort analyses of the treatment of smear-positive pulmonary tuberculosis patients under programme conditions in Korea, 1983-1994.

SETTING: Cohort analyses of the results of sputum smear-positive pulmonary tuberculosis patients registered in health centres in Korea under programme conditions from 1983 to 1994. OBJECTIVE: To assess the overall treatment results and their annual changing trend. DESIGN: Retrospective sample surveys of the nationwide treatment results of registered new smear-positive and retreatment patients. RESULTS: The numbers of registered smear-positive pulmonary tuberculosis patients have decreased steadily, from over 35000 in 1983 to about 14000 in 1994. Over 90% of health centres, and 60-80% of registered patients, were covered in the cohort analyses. The overall cure rate for all patients was 56% in 1983; this improved to around 80% in the last three years of the period studied, owing to increased use of short-course chemotherapy. Over 5000 patients per year required retreatment during the first four years; this number decreased steadily to less than 700 in 1994, due to the reduction in initial treatment failures. CONCLUSION: The overall treatment results have improved significantly in Korea, due to the application of short-course chemotherapy.

The seventh nationwide tuberculosis prevalence survey in Korea, 1995.

SETTING: Nationwide random sample survey for tuberculosis prevalence in Korea in 1995. OBJECTIVE: To investigate the prevalence of tuberculosis infection, morbidity and drug resistance, and BCG coverage, and to compare the findings with those of the previous six surveys. DESIGN: The following investigations were performed: tuberculin test, BCG scar screening, chest miniature radiography (70 x 70 mm) for those aged over five years, sputum direct smear, culture and drug susceptibility test, and a questionnaire to obtain history of antituberculosis chemotherapy and symptoms. RESULTS: The coverages of the 1995 survey were as follows: tuberculin 87.0%, radiology 88.4%, bacteriology 98.3%. The observed tuberculin positivity (> or =10 mm in diameter) of subjects aged under 30 was 15.5%. The prevalence of pulmonary tuberculosis per 100000 has decreased in the last 30 years: direct smear positive from 686 to 93, smear and/or culture positive from 940 to 219, active tuberculosis from 5065 to 1032. Rates of drug resistance have also fallen: of those with no previous chemotherapy from 26.2% to 5.8%, of those with history of chemotherapy from 55.2% to 25.0%, and in total from 38.0% to 9.9%. BCG scar prevalence of infants (aged under one year) was 87.7%, and of those under 30 it was 91.8% in 1995. CONCLUSION: Tuberculosis prevalences and the drug resistance rates have decreased significantly.

Conditional survival in patients treated with vascular endothelial growth factor-targeted therapy for advanced renal cell carcinoma.

PURPOSE: Conditional survival (CS) offers more relevant prognostic information for patients once they have survived for some time. The objective of this study was to determine the CS for advanced renal cell carcinoma (RCC) patients treated with vascular endothelial growth factor-targeted therapy. METHODS: A total of 345 patients treated between 2006 and 2011 fulfilled the inclusion criteria and were reviewed for analyses. The 1-year conditional and actual survival rates were calculated for survivors from treatment to month 24. Subgroup-specific CS rates were generated after adjustment of the covariate influence. The Cox proportional hazard models were used to assess the prognostic factors at baseline and 1-year landmark. RESULTS: The probabilities of surviving an additional year given survival to 6, 12, 18, and 24 months were 72.2, 76.3, 78.2, and 78.6 %, respectively. Remarkable increase in CS was observed in patients initially classified as intermediate or poor risk according to Heng risk groups. For patients survived 24 months after treatment, the adjusted CS for the following year was over 80 % regardless of initial risk attribution. Compared to baseline analysis, Heng risk groups were less predictive of survivorship after surviving 1 year. The addition of disease control status to multifactorial model significantly improved survival estimation for 1-year survivors (p < 0.01). CONCLUSIONS: CS provides useful information regarding life expectancy for survivors of advanced RCC treated with targeted therapy. Furthermore, disease control status within a specific period of time is critical to the prediction of subsequent survival.

Drug resistance of Mycobacterium tuberculosis in Korea.

Drug resistance of Mycobacterium tuberculosis has been investigated with isolates from patients screened from a sample population of the nationwide tuberculosis prevalence surveys or from routine cultures. The results showed a close inverse relationship between the prevalence of drug resistance and the efficiency of the past or current National Tuberculosis Control Program (NTP) treatment regimens. Individual drug resistance also showed a close relationship with the extent of use of the relevant drugs. Drug resistance was found in 38.0% of M. tuberculosis isolates from patients in the 1965 survey and remained unchanged until it increased to 48.0% in 1980. The resistance prevalence, however, dropped to 25.3% in the 1990 survey. Such a decrease coincided fairly well with a continuous increase of the treatment efficiency (from 60% in 1984 to 77% in 1989) in the 1980s. Initial drug resistance (IR) also showed a similar trend, namely 26.2% in 1965, 23.9% in 1970, 20.1% in 1975, 30.6% in 1980, 17.4% in 1985 and 15.0% in 1990. A higher prevalence of IR was observed among urban patients than rural patients and among young as opposed to old patients.