This study was conducted in order to improve nutritional support based on analysis of the eating habits and training schedule of junior and senior high school fencers. A survey was conducted on 30 fencers (junior boys=9, girls=7; senior boys=4, girls=10) using a questionnaire. Total daily calorie intakes were 2325.7+/-1168.5 kcal (boy), 2344.0+/-786.3 kcal (girl) for junior fencers and 2183.3+/-726.6 kcal (boys), 2654.4+/-1043.6 kcal (girls) for senior fencers. Nutrients below the RDIs were riboflavin and vitamin C for junior boy fencers and vitamin A, riboflavin, niacin, and vitamin C for senior boy fencers. The rates of the participants who had obtained nutritional information were 44.4% (boys) and 14.3% (girls) for junior fencers and 50.0% (boys) and 80.0% (girls) for senior fencers. Approximately half of the fencers had meals twice a day (55.6% for junior boy fencers, 57.1% for junior girl fencers, and 50.0% for senior fencers). The number of the fencers who were interested in nutrition varied: 66.7% and 28.6% of the junior boy and girl fencers answered they were interested in nutrition, while 25% and 60% of the senior boy and girl fencers showed interest in nutrition issues. Recommendations of total calories were 2,874 kcal (boys) and 2,377 kcal (girls) for junior fencers and 3,398 kcal (boys) and 2,375 kcal (girls) for senior fencers respectively. A dietary plan for the fencing players during training periods was designed to improve their health and performance. Athletes can simultaneously refuel and repair their bodies while contributing to their rehydration goals by consuming fluids that are sources of carbohydrates and protein, e.g., flavored milk and liquid meal supplement. Specific sport nutrition education applicable to athletes, especially young athletes, is recommended under professional support. Professionals may then target particular categories of athletes for the development of educational programs aimed at improving growth and athletic performance.
Appointments and Schedules ; Ascorbic Acid ; Athletes ; Athletic Performance ; Carbohydrates ; Eating ; Fluid Therapy ; Humans ; Meals ; Milk ; Niacin ; Nutritional Support ; Surveys and Questionnaires ; Riboflavin ; Sports ; Vitamin A

Acute liver failure due to malignant melanoma is uncommon. We presents a case of acute liver failure secondary to hepatic infiltration of a malignant melanoma. An 86-year-old man was admitted with elevated liver enzymes and an increased lactate dehydrogenase level. His condition progressed to acute liver failure, but the etiology of liver failure was unclear. Esophagogastroduodenoscopy was performed to evaluate dyspepsia, which showed signs indicative of malignant melanoma. Based on the endoscopy findings and elevated liver enzyme levels, liver biopsy was performed to confirm the presence of malignant melanoma. Hepatic infiltration of malignant melanoma was observed histologically. However, massive and diffuse liver metastasis is very rare and difficult to identify on imaging studies. If the etiology of liver failure is unclear, diffuse metastatic melanoma infiltration should be considered as differential diagnosis. Early liver biopsy can help to clarify the diagnosis.

Endoscopic retrograde cholangiopancreatography (ERCP)-related perforations of the duodenum are rare but serious complications. Some ERCP-related perforations can be successfully managed without surgery. However, the presence of duodenal perforation may lead to premature termination of the ERCP and need for additional procedure such as percutaneous biliary drainage. If the ERCP-related perforation is identified early during the procedure, primary closure of the perforation can be attempted first or after completion of ERCP. We report two cases of duodenal perforation during ERCP in which ERCP was successfully completed after primary closure of the perforation.
Cholangiopancreatography, Endoscopic Retrograde ; Drainage ; Duodenum ; Intestinal Perforation

On 11 February, 2020, the World Health Organization announced that COVID-19 was a novel coronavirus disease first detected in Wuhan, Hubei Province, China. COVID-19 is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The complete clinical picture is not fully known. Illness ranges from mild to fatal. The common symptoms include fever, cough, and dyspnea usually developing 2-14 days after exposure. However, diarrhea was present in a few patients with COVID-19. We report a case of COVID-19 mimicking acute colitis.

Traditionally, tissue biopsies of kidney lesions are usually performed with CT or percutaneous ultrasound guidance, but biopsies using EUS have rarely been reported. In this report, we describe a case of renal cell carcinoma (RCC) diagnosed using EUS-guided fine-needle aspiration biopsy. A 75-year-old woman taking aspirin due to stable angina continued to exhibit weight loss and anemia and visited the gastroenterology department. No bleeding was observed on upper and lower gastrointestinal endoscopy. A contrast-enhanced mass was observed in the left kidney, accompanied by 8.9×10.8 cm-sized necrosis suggesting RCC on abdominal CT. Chest CT showed masses in both lungs. We planned to administer targeted therapy after pathological confirmation using EUS. Aspirin was continued, and we performed fine-needle biopsy using a 22-gauge needle three times. No adverse events were observed after the procedure. Pathological examination confirmed RCC, clear cell type, and the patient is currently undergoing treatment with sunitinib. EUS-guided fine-needle aspiration biopsy is safe for liver, pancreatic, or other tumors accessible from the upper gastrointestinal tract. This technique shows fewer adverse events. To the best of our knowledge, there have been no other reports on EUS-guided fine-needle aspiration biopsy to identify RCC in Korea.

On 11 February, 2020, the World Health Organization announced that COVID-19 was a novel coronavirus disease first detected in Wuhan, Hubei Province, China. COVID-19 is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The complete clinical picture is not fully known. Illness ranges from mild to fatal. The common symptoms include fever, cough, and dyspnea usually developing 2-14 days after exposure. However, diarrhea was present in a few patients with COVID-19. We report a case of COVID-19 mimicking acute colitis.

Traditionally, tissue biopsies of kidney lesions are usually performed with CT or percutaneous ultrasound guidance, but biopsies using EUS have rarely been reported. In this report, we describe a case of renal cell carcinoma (RCC) diagnosed using EUS-guided fine-needle aspiration biopsy. A 75-year-old woman taking aspirin due to stable angina continued to exhibit weight loss and anemia and visited the gastroenterology department. No bleeding was observed on upper and lower gastrointestinal endoscopy. A contrast-enhanced mass was observed in the left kidney, accompanied by 8.9×10.8 cm-sized necrosis suggesting RCC on abdominal CT. Chest CT showed masses in both lungs. We planned to administer targeted therapy after pathological confirmation using EUS. Aspirin was continued, and we performed fine-needle biopsy using a 22-gauge needle three times. No adverse events were observed after the procedure. Pathological examination confirmed RCC, clear cell type, and the patient is currently undergoing treatment with sunitinib. EUS-guided fine-needle aspiration biopsy is safe for liver, pancreatic, or other tumors accessible from the upper gastrointestinal tract. This technique shows fewer adverse events. To the best of our knowledge, there have been no other reports on EUS-guided fine-needle aspiration biopsy to identify RCC in Korea.

OBJECTIVE: To explore plastic changes in the red nucleus (RN) of stroke patients with severe corticospinal tract (CST) injury as a compensatory mechanism for recovery of hand function. METHODS: The moderate group (MG) comprised 5 patients with synergistic hand grasp movement combined with limited extension, and the severe group (SG) included 5 patients with synergistic hand grasp movement alone. The control group (CG) included 5 healthy subjects. Motor assessment was measured by Motricity Index (MI). Diffusion tensor imaging was analyzed using fractional anisotropy (FA) and radial diffusivity (RD) in the individual regions of interest (ROIs)—bilateral internal capsule and anterior pons for CST injury and bilateral RN for rubrospinal tract (RST) injury. RESULTS: The SG showed a significantly lower MI score than the MG mainly due to differences in hand subscores. Significantly reduced FA was observed in both MG and SG compared with CG, while SG showed increased MD and RD in the affected ROIs of CST, and increased FA on the unaffected side compared with CG. However, in the RN ROI, a significantly increased FA and decreased RD on the unaffected side similar to the affected side were found only in the SG. The relative index of FA was lower and RD in SG was higher than in CG in RST. CONCLUSION: The diffusion metrics of RST showed changes in patients with severe CST injury, suggesting that RST may play a role in the recovery of hand function in patients with severe CST injury.
Anisotropy ; Diffusion Tensor Imaging ; Diffusion* ; Extrapyramidal Tracts ; Hand ; Hand Strength ; Healthy Volunteers ; Humans ; Internal Capsule ; Neuronal Plasticity ; Paraplegia ; Plastics ; Pons ; Pyramidal Tracts* ; Recovery of Function ; Red Nucleus* ; Stroke* ; Upper Extremity

Arteriovenous malformation (AVM) of the pancreas is exceedingly rare, although it may be increasingly diagnosed due to the widespread use of cross-sectional imaging of the abdomen; even rarer is its association with pancreatitis. A 45-year-old male was admitted to our hospital with symptom of epigastric pain. Dynamic contrast imaging scans of the abdomen showed a focal acute pancreatitis and pancreatic AVM. The angiography findings were compatible with pancreatic AVM. The cause of abdominal pain was diagnosed by acute pancreatitis caused by pancreatic AVM, and, for definitive treatment of symptomatic pancreatic AVM, distal pancreatectomy with splenectomy was performed. The histological results confirmed the presence of irregular dilated tortuous arteries and veins, and a retention cyst with epithelial cell lining. We experienced a rare case of a 45-year-old-Korean male who had acute pancreatitis associated with pancreatic AVM. Pancreatic AVM is extremely rare; even rarer is its association with pancreatitis.
Abdomen ; Abdominal Pain ; Angiography ; Arteries ; Arteriovenous Malformations* ; Epithelial Cells ; Humans ; Male ; Middle Aged ; Pancreas* ; Pancreatectomy ; Pancreatitis ; Splenectomy ; Veins

Background and Objectives: Tcfs and Lef1 are DNA-binding transcriptional factors in the canonical Wnt signaling pathway. In the absence of β-catenin, Tcfs and Lef1 generally act as transcriptional repressors with co-repressor proteins such as Groucho, CtBP, and HIC-5. However, Tcfs and Lef1 turn into transcriptional activators during the interaction with β-catenin. Therefore, the activity of Tcfs and Lef1 is regulated by β-catenin. However, the intrinsic role of Tcfs and Lef1 has yet to be examined. The purpose of this study was to determine whether Tcfs and Lef1 play differential roles in the regulation of self-renewal and differentiation of mouse ES cells. Methods: and Results: Interestingly, the expression of Tcfs and Lef1 was dynamically altered under various differentiation conditions, such as removal of LIF, EB formation and neuronal differentiation in N2B27 media, suggesting that the function of each Tcf and Lef1 may vary in ES cells. Ectopic expression of Tcf1 or the dominant negative form of Lef1 (Lef1-DN) contributes to ES cells to self-renew in the absence of leukemia inhibitory factor (LIF), whereas ectopic expression of Tcf3, Lef1 or Tcf1-DN did not support ES cells to self-renew. Ectopic expression of either Lef1 or Lef1-DN blocked neuronal differentiation, suggesting that the transient induction of Lef1 was necessary for the initiation and progress of differentiation. ChIP analysis shows that Tcf1 bound to Nanog promoter and ectopic expression of Tcf1 enhanced the transcription of Nanog. Conclusions The overall data suggest that Tcf1 plays a critical role in the maintenance of stemness whereas Lef1 is involved in the initiation of differentiation.