Urinary phthalate metabolites over the first 15months of life and risk assessment – CHECK cohort study

Kim, Sunmi,Lee, Jangwoo,Park, Jeongim,Kim, Hai-Joong,Cho, Geum Joon,Kim, Gun-Ha,Eun, So-Hee,Lee, Jeong Jae,Choi, Gyuyeon,Suh, Eunsook,Choi, Sooran,Kim, Sungjoo,Kim, Sung Koo,Kim, Young Don,Kim, Su You Elsevier 2017 The Science of the total environment Vol.607 No.-

<P><B>Abstract</B></P> <P>Phthalates are important group of endocrine disruptors. Infants and young children are susceptible to phthalate exposure. However, information on the phthalate exposure during the early stages of life is very limited. This study was conducted to understand the temporal trend of exposure to major phthalates among infants of Korea during the first 15months after birth, and to estimate associated risks. A total of 286 urine samples were collected from 171 children at 3, 9, 12, or 15months of age, with 77 children sampled for two or more times. Four phthalates, i.e., di(2-ethylhexyl) phthalate (DEHP), di-isobutyl phthalate (DiBP), di-n-butyl phthalate (DnBP), and diethyl phthalate (DEP) were chosen, and their major metabolites were analyzed in the urine. The DEHP metabolites were detected in 100% of the urine samples at relatively higher levels compared to those reported in other countries. The levels of mono-ethyl phthalate (MEP) were generally lower. Urinary concentrations of most phthalate metabolites, especially DEHP metabolites, increased as children grew older. Intra-class correlation coefficients (ICCs) calculated for DEHP metabolites over time were high (0.7–0.8), suggesting persistence of consistent exposure sources during this sensitive period of life. Hazard quotient (HQ) and hazard index (HI) were calculated from daily intake estimates divided by recommended toxicity thresholds. Among the study population, 4, 16, and 26% of the children showed HI >1 at 9, 12, and 15months of age, respectively. DEHP exposure explained most of the risk estimates. Considering vulnerability of young children to endocrine disruption, efforts to identify sources of exposure and to develop appropriate mitigation options are warranted.</P> <P><B>Highlights</B></P> <P> <UL> <LI> Multiple urines were collected at 3, 9, 12, or 15months of age from 171 children. </LI> <LI> High intra-individual correlation and age-dependent increase were observed. </LI> <LI> Up to 26% of children showed hazard index >1 by exposure to target phthalates. </LI> <LI> Estimated risks are mostly due to the exposure to DEHP and DnBP. </LI> </UL> </P> <P><B>Graphical abstract</B></P> <P>[DISPLAY OMISSION]</P>

Association of diethylhexyl phthalate with obesity-related markers and body mass change from birth to 3 months of age

Kim, Jin Hee,Park, Hyunkyung,Lee, Jangwoo,Cho, Geumjoon,Choi, Sooran,Choi, Gyuyeon,Kim, Su Young,Eun, So-Hee,Suh, Eunsook,Kim, Sung Koo,Kim, Hai-Joong,Kim, Gun-Ha,Lee, Jeong Jae,Kim, Young Don,Eom, So BMJ Publishing Group 2016 Journal of epidemiology & community health Vol.70 No.5

<P><B>Background</B></P><P>Several studies have suggested potential links of phthalates to obesity in children and adults. Limited evidence, however, has been available for the relations between diethylhexyl phthalate (DEHP) and obesity-related markers or body mass change in early life.</P><P><B>Methods</B></P><P>128 healthy pregnant women were recruited and, after delivery, their newborns’ first urine and umbilical cord blood samples were collected. We measured urinary levels of two DEHP metabolites, mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP) and mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP). We also measured the levels of leptin, total cholesterol and triglyceride (TG) in cord serum, and used them along with weight, length, head circumference and ponderal index (PI, 100 g/cm<SUP>3</SUP>) at birth, as obesity-related markers, and estimated the relations between DEHP metabolites and obesity-related markers using generalised linear models. For the evaluation of body mass increase by early life DEHP exposure, body mass index (BMI) z-score change during 3 months after birth by DEHP metabolites in the first urine samples of the newborns were evaluated using logistic regression.</P><P><B>Results</B></P><P>DEHP exposure was associated with decrease of PI and increase of TG (PI, β=−0.11, p=0.070 and TG, β=0.14, p=0.027), especially for boys (PI, β=−0.13, p=0.021; and TG, β=0.19, p=0.025). Moreover, DEHP exposure was positively associated with body mass increase during 3 months after birth (change of BMI z-scores, OR=4.35, p=0.025).</P><P><B>Conclusions</B></P><P>Our findings suggest that DEHP exposure may affect body mass change in early life through changes of obesity-related markers.</P>

Association between maternal exposure to major phthalates, heavy metals, and persistent organic pollutants, and the neurodevelopmental performances of their children at 1 to 2years of age- CHECK cohort study

Kim, Sunmi,Eom, Soyong,Kim, Hai-Joong,Lee, Jeong Jae,Choi, Gyuyeon,Choi, Sooran,Kim, Sungjoo,Kim, Su Young,Cho, Geumjoon,Kim, Young Don,Suh, Eunsook,Kim, Sung Koo,Kim, Seunghyo,Kim, Gun-Ha,Moon, Hyo-B Elsevier 2018 Science of the Total Environment Vol.624 No.-

<P><B>Abstract</B></P> <P>Exposure of the developing fetus and infants to toxic substances can cause serious lifelong health consequences. Several chemicals have been associated with adverse neurodevelopmental disorders in the early life stages of humans. However, most epidemiological studies have focused on a limited number of chemicals, and hence may exclude important chemicals from consideration or result in conclusions built on associations by chance. In the present study, we investigated the chemical exposure profile of the women, and associated these with the early neurodevelopmental performance of their offspring at 13–24months of age. The chemicals assessed include four phthalates, bisphenol A, three heavy metals, 19 polychlorinated biphenyls (PCBs), 19 organochlorine pesticides, and 19 polybrominated diphenyl ethers, which were measured from urine, whole blood, serum, and/or breastmilk of the pregnant or lactating women. For neurodevelopmental performance, the Bayley Scales of Infant Development-II (BSID-II), Social Maturity Scale (SMS), and Child Behavior Checklist (CBCL) were measured from a total of 140 toddlers. Among the measured chemicals, monoethyl phthalate (MEP) in maternal urine was significantly associated with early mental, psychomotor, and social development. In addition, breast milk di-ethylhexyl phthalate (DEHP) metabolite and blood lead concentrations were inversely associated with mental and psychomotor development indices, respectively. Maternal blood PCB153, heavy metals, and urinary MEP levels were also higher among the children with behavioral problems, as indicated by the CBCL range. Taken together, maternal exposure to several EDCs such as PCBs and DEHP was associated with adverse neurodevelopmental performances among the children aged 1–2years. Confirmation of these association in larger populations, as well as longer-term consequences of such exposure warrant further investigation.</P> <P><B>Highlights</B></P> <P> <UL> <LI> Prenatal Hg, Pb, BPA, or DEP exposures were associated with neurodevelopmental delay. </LI> <LI> DEHP exposure through lactation showed negative association with mental index. </LI> <LI> Prenatal Hg, DEP, or PCB exposures showed positive associations on CBCL scores. </LI> </UL> </P> <P><B>Graphical abstract</B></P> <P>[DISPLAY OMISSION]</P>

Phase II Study of Gemcitabine and Vinorelbine as Second-Line Chemotherapy in Non-Small Cell Lung Cancer

Yoon Jae Kim,Jae Yong Cho,Joo Hyuk Sohn,Chul Kim,Yong Tai Kim,Hai Jin Kim,Joong Bae Ahn,Se Kyu Kim,Joon Chang,Nae Choon Yoo,Joo Hang Kim 대한암학회 2003 Cancer Research and Treatment Vol.35 No.4

Association between Several Persistent Organic Pollutants in Serum and Adipokine Levels in Breast Milk among Lactating Women of Korea

Kim, Sunmi,Park, Jeongim,Kim, Hai-Joong,Lee, Jeong Jae,Choi, Gyuyeon,Choi, Sooran,Kim, Sungjoo,Kim, Su Young,Lee, Duk Hee,Moon, Hyo-Bang,Kim, Sungkyoon,Choi, Kyungho American Chemical Society 2015 Environmental science & technology Vol.49 No.13

<P>Exposure to several persistent organic pollutants (POPs) has been linked to alteration of lipid metabolism. Adipokines, such as leptin and adiponectin, are hormones that play roles in lipid metabolism, and have been suggested as markers of health effects that may lead to obesity. To date, only serum adipokines have been associated with POPs exposure. In the present study, for the first time, the associations between leptin and adiponectin in breast milk, and several POPs in serum were investigated among 82 lactating Korean women between 25 and 46 years of age. Breast milk adipokines are important because adipokine intake of infant through breastfeeding may influence the growth of infants. The median concentrations of leptin and adiponectin in skimmed milk of the Korean lactating women were 17.9 ng/L and 16.5 μg/L, respectively. Leptin concentrations in breast milk were negatively associated with ∑hexachlorohexane (HCH), oxychlordane, ∑chlordane, or 2,2′,4,4′,5,5′-hexachlorobiphenyl (CB 153) levels in maternal serum. Linear relationships between adiponectin and POPs concentrations were not observed, however, nonmonotonic relationship which showed generally positive associations was suggested for <I>p</I>,<I>p</I>′-dichlorodiphenyltrichloroethane (DDT) and ∑chlordane in quartile analysis. Our observations show that POPs at the current level of exposure may be associated with the alteration of lipid metabolism among lactating women. Implication of adipokine transfer to breastfed infants is of concern and deserves further investigation.</P><P><B>Graphic Abstract</B> <IMG SRC='http://pubs.acs.org/appl/literatum/publisher/achs/journals/content/esthag/2015/esthag.2015.49.issue-13/acs.est.5b00520/production/images/medium/es-2015-00520t_0003.gif'></P><P><A href='http://pubs.acs.org/doi/suppl/10.1021/es5b00520'>ACS Electronic Supporting Info</A></P>

제2형 당뇨병 환자에서의 혈중 렙틴 농도

김현리,배학연,장성종,김희중,정재용,김양수,김태균,박유환,정춘해 조선대학교 부설 의학연구소 1999 The Medical Journal of Chosun University Vol.24 No.2

Objective: Leptin, the product of obesity (ob) gene, is a 16-kDa peptide hormone secreted by adipocytes and is thought to be a homeostatic signal that contributes to body weight regulation through modulating feeding behavior and/or energy expenditure. Mutations of the ob gene that led to leptin deficiency or production of a truncated inactive protein are associated with hyperphagia, hypometabolism, obesity, and noninsulindependent diabetes mellitus(NIDDM) in obese ob/ob mice. Leptin' s role in humans with obesity and NDDM is not known. Plasma leptin concentrations are shown to be elevated in obese humans. We questioned whether subjects with NIDDM have an altered regulation of serum leptin levels. Therefore, the object of this study is to evaluate the relationships between the serum leptin level and BMI, NIDDM. Method: This study were made of 70 subjects(control: 35, NIDDM:35) at Chosun University Hospital in Kwangju from March, 1998 to September, 1998. We measured the height and weight for BMI. Also, we measured leptin and C-peptide through radioimmunoassay. Result: The serum leptin concentration were not different in patients with type II diabetic and nondiabetic subjects (6.3 0.86/7.22 0.96, p=0.476) and the BMI was similar in diabetic and nondiabetic subjects(24 0.57/24 0.45, p=0.93). The leptin concentration were higher in women than in men regardless of diabetic status (diabetes: male 3.07 0.40 / female 8.20 1.18, p<0.05 control: male 4.88 1.28 / female 8.60 1.25, p<0.05). Conclusion: We concluded that the leptin concentrations were not different in diabetic and nondiabetic subjects and that the association of leptin with sexual dimorphism was similar in diabetic and nondiabetic subjects.

자궁경부의 편평상피암이 동반된 자궁의 Mullerian adenosarcoma 1예

김철환,김영식,신중식,김해중,이낙우 대한부인종양 콜포스코피학회 1999 Journal of Gynecologic Oncology Vol.10 No.2

Mu¨llerian adenosarcoma is an uncommon variant of Mu¨llerian mixed tumors of the uterus and a mixed, biphasic neoplasia in which the mesenchymal component is malignant and the epithelial component is benign. In contrast to typical malignant Mu¨llerian mixed tumor(MMMT), Mu¨llerian adenosarcomas are usually tumors of low malignant potential. These tumors usually present as pedunculated endometrial masses in postmenopausal women with vaginal bleeding. We experienced a case of Mu¨llerian adenosarcoma of the uterus with squamous cell carcinoma of the uterine cervix and report with a brief review of literatures.

Perinatal outcomes using knotless barbed suture in cesarean section

( Yezi Kim ),( Ju Yeon Hong ),( Ji Man Heo ),( Ho Yeon Kim ),( Hai-joong Kim ) 대한산부인과학회 2020 대한산부인과학회 학술대회 Vol.106 No.-

Objective: Cesarean section is the most frequent obstetrical surgery worldwide, with markedly increasing rates along the last several decades. In this regard, competent surgical technology regarding speed, safety, and efficacy is essential in operating cesarean section. This study was conducted to estimate the efficacy and safety of knotless barbed suture for closure of myometrium during cesarean section compared to conventional method. Methods: This is retrospective cohort study. Patients who underwent cesarean delivery at Korea University Ansan Hospital, Republic of Korea between August 2018 and December 2019, were reviewed. Main outcome measures were surgical outcomes including uterine closure time, operative time, estimated blood loss and sonographic results of residual myometrial thickness at site of cesarean section scar at 6 to 8 weeks after operation. Results: Out of total 78 women, 44 women had knotless barbed suture and 34 women had conventional method. The number of previous cesarean section was similar as well as demographic and clinical characteristics between groups. Compared to conventional suture, the suturing time to close the uterine incision were significantly reduced(p=0.012). Operation time, estimated blood loss during operation, hemoglobin difference on third operative day, transfusion and postpartum infection and bleeding demonstrated no significant difference between two groups. At 6 to 8 weeks after operation, transvaginal ultrasound revealed no differences in residual myometrial scar thickness between two groups. Significantly shorter uterine closure time was identified with knotless barbed suture compared to conventional method. There were no increased rate of perioperative complications with knotless barbed suture. Conclusion: Our results support that the use of knotless barbed suture for cesarean section is comparable to conventional method.

Preeclampsia : Management of chronic hypertension

김해중 ( Hai Joong Kim ) 대한산부인과학회 2006 서울심포지움 Vol.11 No.-

A report of anti-M alloimmunization managed with intrauterine transfusion

( Yezi Kim ),( Soyeon Kim ),( Ho Yeon Kim ),( Geum Joon Cho ),( Ki Hoon Ahn ),( Soon Cheol Hong ),( Min Jeong Oh ),( Hai Joong Kim ) 대한산부인과학회 2018 대한산부인과학회 학술대회 Vol.104 No.-

Hemolytic disease of the fetus causes hydrops fetalis and intrauterine fetal death. Anti-M antibodies are naturally occurring, cold reactive but seldom active at 37C. Such anti-M is capable of causing severe hemolysis. However only a few cases have been reported with fetal hydrops with the anti-M IgG antibody. Hereby we report a successful treatment with intrauterine transfusion. A 32 year old mother had a history of two fetal hydrops resulting termination of pregnancy in second trimester. She visited our center from the beginning of the pregnancy and was diagnosed with suspicious fetal anemia at 24 weeks of gestation. No evidence of fetal hydrops was found but peak systolic velocity of middle cerebral artery was increased to 1.5-2.0 MOM. Her blood test revealed anti-M IgG antibody in serum. We performed intrauterine intravascular transfusion at the placental root of umbilical cord. Two intrauterine transfusions with compatible red blood cells(RBC) resulted in continuation pregnancy until 28 weeks of gestation. The baby(APGAR score 5-6) was delivered by cesarean delivery at 28+2 weeks of gestation with hemoglobin 7.8 g/dL. The baby had three times of transfusion and is healthy at age of 7 months. Although clinically significant anti-M antibodies are rare, once encountered, antigen-negative intrauterine tranfusion is effective in preventing fetal morbidity and mortality.