BACKGROUND: The adolescent years are a window of opportunity to influence lifelong bone health. Bone acquisition is accelerated within the genetic potential by lifestyle choices. But some adolescent girls do not care about healthy lifestyle and nutrient uptake. Therefore, we investigated the nutrition and health behavior relating to bone acquisition. METHODS: A cross-sectional study was administered to high school girl students from 4 general and 4 commercial high schools in Uijongbu, Incheon, Suwon, and Yongin. The data was gathered from 378 girls by self-reported questionnaire, which included age, height, weight, health behavior relating to bone acquisition and food-frequency. Nutrient uptake was assessed by DIET PLUS 3.0 program. RESULTS: Girls with bone acquisition inhibiting health habits were reported. Among subjects, 12.2% had regular alcohol intake, 21% smoked daily, 77.7% did not exercise regularly, 58% had light-activity, 42.2% experienced weight reduction trial, 30% had low body weight and 72.8% had less than 2 meals a day. In nutrient uptake, 33.1% of subjects took less calcium uptake and 4% less protein uptake than recommended daily allowance. Comparing general and commercial high schools, commercial students had more bone acquisition inhibiting health habits. CONCLUSION: There were many high school girl students with bone acquisition inhibiting health and eating habits. Family physicians need to promote and educate good health habits with a balanced meal associated with bone acquisition in girls, especially commercial high school students.
Adolescent ; Body Weight ; Calcium ; Cross-Sectional Studies ; Diet ; Eating ; Female* ; Gyeonggi-do ; Health Behavior* ; Humans ; Incheon ; Life Style ; Meals ; Physicians, Family ; Recommended Dietary Allowances ; Smoke ; Weight Loss ; Surveys and Questionnaires

There has been little data on the prevalence of supplement use and the characteristics of the dietary supplement users in the Republic of Korea. This study presents the prevalence and the details of any dietary supplement use and the characteristics of the adults who use dietary supplements in the Republic of Korea. Between May 18 and June 16, 2006, nationwide and population-weighted personal interviews with 6,201 adult aged from 30 to 69 years were conducted and the final sample consisted of 3,000 people with a 49.8% response rate. We examined the prevalence and details of the use of dietary supplements and the characteristics of those who use the dietary supplement among adults. About sixty two percent of adults had taken any dietary supplement during the previous 12-month period in 2006. The most commonly reported dietary supplement was ginseng, followed by multivitamins, glucosamine, probiotics, and vitamin C. Female (versus male), an older age group, a higher family income, those living in metropolitan cities, those with marital experience, those with a higher level of education, and those having medical problems had a greater likelihood of reporting the use of any dietary supplements. The particular relationships differed depending on the type of supplement. The most Korean adults took one more dietary supplement and the dietary supplement users had different demographic and health characteristics compared to those of the nonusers. Research on diet supplements by the medical community is needed in the future.
Adult ; Aged ; Ascorbic Acid ; Complementary Therapies ; Demography ; Diet ; Dietary Supplements ; Female ; Glucosamine ; Humans ; Morinda ; Panax ; Prevalence ; Probiotics ; Republic of Korea

There is no doubt that the diastolic dysfunction of the left ventricular plays an important role in the pathophysiogy of clinical heart faliure in some patients, if not all, and that many hypertensive subjects manifest diastolic dysfunction of the left ventricle in its early hypertensive stage. But yet, it is not clear which paramenter is most sensitive and/or specific, and consistent with pathophysiologic states. In order to have an insight into the problems, 30 hypertensives and 30 normotensive subjects were studied by phonocardiogram and pulsed Doppler echocardiogram at the left ventricular inflow and then isovolumic relaxation time(A2D time), early diastolic deceleration time(EDDT), early diastolic deceleration rate(EDDR), late diastolic time(LDT), E.A velocity ratio[E/A(v)]and E/A area ratioA(a)] were measured and calculated. And the values of each parameters of different groups were subgrouped according to the severity of the hypertension(Group A:mild, B:moderate and C:severe hypertension) and according to the LV mass(Group D:LVMI<125g/m2, GroupE:LVMI> or =125g/m2) were compared with those of the normal control subjects and also between each subgroups. The results were as follows : 1) In the 30 normotensive subjects, A2D time was averaged out 60.8+/-12.5msec, E/A(v) 1.55+/-0.59, E/A(a) 2.61+/-1.35, EDDT 1.35+/-37.8msec, EDDR8.3+/-4, 6m/sec2 and LDT 151+/-42.2msec. 2) In group A, A2D time was significantly prolonoged(82.5+/-26.0msec, p<0.005) and E/A(v) markedly decreased(1.12+/-0.40, p<0.05) compared to those of normotensive group. 3) In group B, A2D time was significantly prolonged(78+/-20.8msec, p<0.005), and E/A(v)(0.92+/-0.42, p<0.005) and EDDR(4.9+/-1.5m/sec2, p<0.05) were significantly decreased compared to those of the control group. 4) In group C, A2D and EDDT were increased(p<0.005, p<0.05 respectively) while E/A(v) and EDDR decreased(p<0.01, p<0.05 respedtively), while E/A(v) and EDDR decreased(p<0.01, p<0.005 respectively). 5) In group D, A2>D and EDDT were significantly prolonged(p<0.005), while E/A(v), E/A(a) and EDDR wer significantly decreased(p<0.005, p<0.05 respectively). 6) In group E, A2D and EDDT were significantly increased(p<0.005, p<0.05 respectively), while E/A(v) and EDDR significantly decreased(p<0.005, p<0.05 respectively). Above results suggest that diastolic function of the left ventricle can be deteriorated in the hypertensive subjects before systolic dysfunction is apparent even in the mild hypertensives and in the patients devoid of hypertensive hypertrophy of the left ventricle.
Deceleration ; Heart ; Heart Ventricles ; Humans ; Hypertension* ; Hypertrophy ; Relaxation

The left ventricular hypertrophy(LVH) in the hypertensive patients is known to be associated with relatively higher risk for cardiovascular morbidity and mortality. In this sense the reversal of LVH with blood pressure control, if attained, could yeild an additional benefit of reducing cardiovascular morbidity and/or mortaility associated with hypertension. However pathogenesis of LVH, the attitude of the LVH to regerss with blood pressure control in a particular patient and whether the regression is really beneficial are not clear. In order to see the effect of angiotensin converting enzyme(ACE) inhibitors on LVH and the age group difference of the LVH regresion, if attainable, 26 hypertensive patients with LVH(LVMI:Left Ventricular Mass Index>125g/m2) were treated with enalapril or captopril for more than 12 weeks and the LVMI followed and the regression rates in younger group "A"(less than 50 years of age) and elder group "B" were compared(LVMI, level of blood pressure, kinds and dosage of enalapril or captopril were not different between the two groups). The LVMI was significantly decreased in both groups, in group A from 191.6+/-74.9g/m2 to 139.7+/-52.0g/m2, and in group B from 185.5+/-58.7g/m2 to 163.9+/-58.7g/m2. In group A the percent decrease of LVMI was significantly higher than that of group B(25.3+/-14.9% versus 10.3+/-8.6%, p<0.005). Above results suggest that enalapril and captopril are equally effective in reducing LVMI in hypertensive patients with LVH and the regression of the LVMI is more marked in the younger age group in this relatively short-term treated small population study.
Angiotensin-Converting Enzyme Inhibitors ; Angiotensins* ; Blood Pressure* ; Captopril ; Enalapril ; Humans ; Hypertension ; Hypertrophy, Left Ventricular* ; Mortality ; Peptidyl-Dipeptidase A*

Von Meyenburg complexes (VMC) have many synonyms such as bile duct hamartomas and biliary hamartoma. These rare benign disorders are considered as congenital diseases caused by malformed differentiation of ductal plate. The diagnosis of VMC by common radiologic modality such as ultrasound and computed tomography was nearly impossible until the emergence of cholangiopancreatography by magnetic resonance imaging (MRCP) and the pathologic examination was the only way to confirm the diagnosis of VMC. But MRCP is now considered as most accurate noninvasive method for diagnosis of VMC. We report a histologically proven case of VMC associated with calculous cholecystitis, cerebral aneurysm and renal cortical cyst. To our knowledge, no comparable case has been reported and this would be the only second reported case of VMC, which was diagnosed by MRCP.
Bile Ducts ; Cholecystitis* ; Diagnosis ; Hamartoma ; Intracranial Aneurysm* ; Magnetic Resonance Imaging ; Ultrasonography

PURPOSE: This study was conducted to identify the effects of the critical pathway (CP) on the quality of medical care, and to determine means of reducing costs for lumbar posterolateral fusion in patient with lumbar spinal stenosis. MATERIALS AND METHODS: The subjects were 25 control patients with lumbar posterolateral fusion, and 25 experimental patients with application of CP. We compared the patients' functional status using the Oswestry disability index, patients'satisfaction by quality patient care scale, the length of hospitalization and the medical charges between the two groups. RESULTS: Differences between the Oswestry disability index of the experimental and control groups were not significant. No differences were found between two groups regarding general care, but the experimental group was more satisfied with specific care related to spinal fusion. The mean length of stay of the experimental group was shorter than that of the control group, and the charge of medication and treatment of the experimental group was lower than that of the control group. CONCLUSION: Critical pathway improves the quality of care and reduces medical charges.
Critical Pathways* ; Hospitalization ; Humans ; Length of Stay ; Patient Care ; Spinal Fusion ; Spinal Stenosis*

Background/Aims: Adenoid cystic carcinoma (ACC) is a rare salivary gland tumor characterized by indolence, with a high rate of local recurrence and distant metastasis. This study aimed to investigate the effect of concurrent chemoradiation (CCRT) on locally advanced unresectable ACC. Methods: We retrospectively analyzed clinical data from 10 patients with pathologically confirmed ACC of the head and neck who received CCRT with cisplatin in Seoul National University Hospital between 2013 and 2018. Results: Ten patients with unresectable disease at the time of diagnosis or with positive margins after surgical resection received CCRT with weekly cisplatin. Eight patients (80%) achieved complete remission, of which three later developed distant metastases without local relapse; one patient developed distant metastasis and local relapse. Two patient achieved partial remission without progression. Patients experienced several toxicities, including dry mouth, radiation dermatitis, nausea, and salivary gland inflammation of mostly grade 1 to 2. Only one patient showed grade 3 oral mucositis. Median relapse-free survival was 34.5 months (95% confidence interval, 22.8 months to not reached). Conclusions CCRT with cisplatin is effective for local control of ACC with manageable toxicity and may be an effective treatment option for locally advanced unresectable ACC.

BACKGROUND/AIMS: The role of induction chemotherapy (IC) for eyeball preservation has not been established in head and neck squamous cell carcinoma (HNSCC) of the paranasal sinus and nasal cavity (PNSNC). Periorbital involvement frequently leads to eyeball exenteration with a margin of safety. We evaluated the treatment outcomes, including survival and eyeball preservation, of patients who received IC for HNSCC of the PNSNC. METHODS: We reviewed 21 patients diagnosed with HNSCC of the PNSNC who were treated with IC. We analyzed response, eyeball preservation rate, and overall survival. RESULTS: Tumors were located in the paranasal sinus (n = 14) or nasal cavity (n = 7). Most patients had stage T4a (n = 10) or T4b (n = 7) disease. More than half of the patients received a chemotherapy regimen of docetaxel, fluorouracil, and cisplatin (n = 11). Thirteen patients (61.9%) achieved a partial response after IC and 15 patients (71.4%) achieved T down-staging. Among 17 patients with stage T4 disease, which confers a high risk of orbital exenteration, 14 (82.4%) achieved preservation of the involved eye. The 3-year overall survival (OS) rate of patients who achieved a partial response to IC was 84.6%. The 3-year OS rate of patients with stable disease or disease progression after IC was 25.0% (p = 0.038). CONCLUSIONS: IC could be considered for down-staging patients with advanced T-stage disease. It could also be a reasonable option for eyeball preservation in locally advanced HNSCC of the PNSNC.
Carcinoma, Squamous Cell* ; Cisplatin ; Disease Progression ; Drug Therapy ; Fluorouracil ; Head and Neck Neoplasms ; Head* ; Humans ; Induction Chemotherapy* ; Nasal Cavity* ; Neck* ; Orbit ; Orbit Evisceration ; Organ Preservation* ; Paranasal Sinuses

BACKGROUND/AIMS: Since patients with human papillomavirus (HPV)-associated head and neck squamous cell carcinoma (HNSCC) have favorable outcomes after treatment, treatment de-escalation for these patients is being actively investigated. However, not all HPV-positive HNSCCs are curable, and some patients have a poor prognosis. The purpose of this study was to identify poor prognostic factors in patients with HPV-positive HNSCC. METHODS: Patients who received a diagnosis of HNSCC and tested positive for HPV from 2000 to 2015 at a single hospital site (n = 152) were included in this retrospective analysis. HPV typing was conducted using the HPV DNA chip assay or liquid bead microarray system. Expression of p16 in the tumors was assessed by immunohistochemistry. To determine candidate factors associated with overall survival (OS), univariate and multivariable Cox regression analyses were performed. RESULTS: A total of 152 patients with HPV-positive HNSCC were included in this study; 82.2% were male, 43.4% were current or former smokers, and 84.2% had oropharyngeal cancer. By univariate analysis, old age, performance status ≥ 1, non-oropharyngeal location, advanced T classification (T3–4), and HPV genotype 18 were significantly associated with poor OS. By multivariable analysis, performance status ≥ 1 and non-oropharyngeal location were independently associated with shorter OS (hazard ratio [HR], 4.36, p = 0.015; HR, 11.83, p = 0.002, respectively). Furthermore, HPV genotype 18 positivity was also an independent poor prognostic factor of OS (HR, 10.87, p < 0.001). CONCLUSIONS Non-oropharyngeal cancer, poor performance status, and HPV genotype 18 were independent poor prognostic factors in patients with HPV-positive HNSCC. Patients with these risk factors might not be candidates for de-escalation treatment.