Intradiploic encephalocele is a rare condition of herniation of the brain parenchyma through the diploic space. A 52-year-old man presented with a parietal intradiploic encephalocele manifesting as an intermittent headache for 7 months. CT revealed an osteolytic lesion involving the right parietal bone. MRI demonstrated brain herniation within the diploic space. Surgery may be unnecessary in the absence of concurrent symptoms or neurological deficits. After 2 years of follow-up, symptoms were improved without neurological deficits and CT findings. We report the X-ray, CT, and MRI findings of an extremely rare case of parietal intradiploic encephalocele in adulthood.

PURPOSE: Meconium aspiration syndrome (MAS), often progresses to respiratory failure and its' serious complication, persistent pulmonary hypertension of the newborn (PPHN) is a major cause of neonatal mortality. Early recognition of infants at the risk for respiratory failure in MAS patients is necessary for treatment. So we aimed to identify serum enzymes such as lactate dehydrogenase (LDH), aspartate transaminase (AST), and alanine transaminase (ALT) as serum biologic marker for early detection of respiratory failure in MAS patients. METHODS: Infants admitted within 24 hours after birth to Neonatal Intensive Care Unit of Dongguk University Ilsan Hospital and diagnosed with MAS from August 2005 to March 2014 were analyzed retrospectively. Serum enzymes were measured on admission. RESULTS: Of the total 60 patients diagnosed with MAS, 28 were in the positive pressure ventilation (PPV) group and 32 were in the non-PPV group. Six patients progressed to PPHN. Only serum LDH was significantly higher in the PPV group than the non-PPV group (median 1,123 vs. 831, P =0.01). Using the ROC curves, the cut-off value of 964 U/L for LDH offered the best predictive value for PPV requirement (sensitivity 61% and specificity 81%). Serum LDH was significantly higher in MAS with PPHN group than MAS without PPHN group (median 1,791 vs. 904, P =0.013). But serum AST, ALT were not predicting factor for the requirement of respiratory support and development of PPHN among MAS patients. CONCLUSION: LDH might be a good predicting factor for the requirement of respiratory support and development of PPHN among MAS patients.
Alanine Transaminase ; Aspartate Aminotransferases ; Biomarkers ; Humans ; Hypertension, Pulmonary ; Infant ; Infant Mortality ; Infant, Newborn ; Infant, Newborn* ; Intensive Care, Neonatal ; L-Lactate Dehydrogenase ; Meconium Aspiration Syndrome* ; Meconium* ; Parturition ; Positive-Pressure Respiration ; Respiratory Insufficiency ; Retrospective Studies ; ROC Curve ; Sensitivity and Specificity

Glanzmann's thrombasthenia is an autosomal recessive bleeding disorder caused by qualitative or quantitative abnormalities of the platelet glycoprotein IIb/IIIa (GP IIb/IIIa), which can lead to excessive bleeding. Glanzmann thrombasthenia is associated with clinical variability, with some patients only having minimal bruising and others having frequent, severe and potentially fatal hemorrhages. Platelet transfusions, which used to be the standard treatment, may lead to the development of antibodies to HLA and/or GPIIb/IIIa, thereby rendering future transfusions ineffective. Glanzmann's thrombasthenia can be a severe hemorrhagic disease; however, the prognosis is excellent with careful supportive care. In this case, administering allogenic plateletpheresis to patients with Glanzmann's thrombasthenia who were refractory to platelet transfusions was found to be successful during bone surgeries.
Anesthesia, General ; Antibodies ; Blood Platelets ; Glycoproteins ; Hemorrhage ; Humans ; Orthopedics ; Platelet Transfusion ; Plateletpheresis ; Prognosis ; Thrombasthenia

PURPOSE: Perinatal asphyxia is a major factor correlated with diseases that cause respiratory distress in a neonate. So we aimed to investigate the relationship between respiratory distress syndrome (RDS) and transient tachypnea of newborn (TTN) with plasma biological markers of perinatal asphyxia in full-term neonates. METHODS: Full-term neonates with transient tachypnea of the newborn (TTN) and respiratory distress syndrome (RDS) who were admitted within 24 hours after birth were enrolled in a study group. And control group are infants with premature rupture of amniotic membrane without significant findings. Serum lactate dehydrogenase (LDH), aspartate transaminase (AST), alanine transaminase (ALT), creatine kinase (CK) and myoglobin were measured at admission. RESULTS: Of the total 80 infants, 54 were of the study group and 26 were of the control group. The numbers of RDS and TTN groups were 27 and 27, and the numbers of RDS with hypoxic-ischemic encephalopathy (HIE) and RDS without HIE were 6 and 21 retrospectively. Serum AST, ALT, LDH and CK were significantly higher in the study group than the control group (P<0.05). When RDS group and TTN group were compared AST and LDH were significantly higher in RDS group than TTN group (P<0.05). Serum AST, ALT and LDH were significantly higher in RDS with HIE group than RDS without HIE group (P<0.05). A prediction of RDS by LDH analysis showed good correlation by receiver operating characteristic curve (P<0.05). A cut off level of 720 IU/L for LDH was the best predictor of RDS (sensitivity 63% and specificity 86%). CONCLUSION: LDH is an excellent predictor to differentiate RDS from TTN soon after birth in full-term neonates with respiratory distress.
Alanine Transaminase ; Amnion ; Aspartate Aminotransferases ; Asphyxia ; Biomarkers ; Creatine Kinase ; Humans ; Hypoxia-Ischemia, Brain ; Infant ; Infant, Newborn ; L-Lactate Dehydrogenase ; Myoglobin ; Parturition ; Plasma ; Retrospective Studies ; ROC Curve ; Rupture ; Sensitivity and Specificity ; Transient Tachypnea of the Newborn*

Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system (CNS) characterized by demyelination, focal infiltration of inflammatory cells and axonal injury, which leads to loss of neurological function. The exact cause of the disease remains unclear, but an autoimmune response directed against CNS antigens is suspected. Studies in experimental autoimmune encephalomyelitis (EAE), an animal model of MS, have provided important insights into mechanisms of T cell-mediated CNS autoimmune disease. It appears likely that when a genetically susceptible host encounters a common environmental antigen (such as an infectious organism), a process called 'molecular mimicry' results in the peripheral activation of cross-reactive T cells that can migrate to the CNS and mount pro-inflammatory responses to myelin epitopes. This review describes the current understanding on the immunopathogenesis of MS and the mechanisms of action of currently available disease-modifying therapies in the context of the underlying immunopathogenic processes they are thought to affect.
Autoimmune Diseases ; Autoimmunity ; Axons ; Central Nervous System ; Demyelinating Diseases ; Encephalomyelitis, Autoimmune, Experimental ; Epitopes ; Models, Animal ; Multiple Sclerosis* ; Myelin Sheath ; T-Lymphocytes

Exercise and diet control are essential for the management of diabetes mellitus. Beneficial effects of exercise have been established. Exercises improve the control of glucose level, decrease cardiac risk factors and prevent type 2 diabetes mellitus. Exercise can cause hypoglycemia or hyperglycemia, cardiac attack, dehydration, foot problems and aggravation of diabetic complications. Pre-exercise medical evaluation is needed to prevent the unwanted effect of exercise. Diabetic patients who have ketonuria and high blood glucose level(more than 250mg/dL) should postpone exercise until the problems are solved. Diabetic patients should enjoy their activities and do warming up and cool down exercise. Vigorous aerobic exercise, 60~85% of maximal oxygen uptake, 20~60 minutes at a time, 3~5 times a week is recommended. Moderate aerobic exercise, 40~60% of maximal oxygen uptake, more than 30 minutes at a time, over 5 times a week is also recommended instead. Muscle strengthening exercises, 2~3 times a week should be added. To prevent hypoglycemia during exercise, the dose of insulin should be reduced. If the patient suffer from hypoglycemic symptom, he or she should take glucose immediately. Therefore diabetic patients should carry some simple carbohydrates. To prevent dehydration during exercise, proper hydration and clothes must be prepared. Wearing well fitting shoes, frequent check up for any wounds on foot are needed to prevent diabetic foot complications. Diabetic patients have the rights to have good quality of life. Regular proper exercise could improve their quality of life.
Blood Glucose ; Carbohydrates ; Cool-Down Exercise ; Dehydration ; Diabetes Complications ; Diabetes Mellitus* ; Diabetes Mellitus, Type 2 ; Diabetic Foot ; Diet ; Exercise ; Foot ; Glucose ; Human Rights ; Humans ; Hyperglycemia ; Hypoglycemia ; Insulin ; Ketosis ; Oxygen ; Quality of Life ; Risk Factors ; Shoes ; Wounds and Injuries

Due to the diversification of the food industry and its heightened competition, the marketing strategy to be required the most would be to improve competitiveness by enhancing customer loyalty as a resulting variable of customer satisfaction. Thus, this study, taking a food service provider as a subject, is to find factors and the scope of the perceived quality ; and to analyze how far the perceived service quality factor as such could explain customer's overall satisfaction and customer loyalty ; finally to provide basic data for establishing a customer satisfaction marketing strategy as related to customer loyalty. The results of the study are as below. 1) 25 factors of service quality perceived by a food service provider have been categorized into 8 independent dimensions through factor analysis. Each of them are named 'Employee attitude', 'Cleanliness', 'Reputation', 'Reliability', 'Food', 'Price', 'Convenience', 'Variety', all of which explain 64.3% of the service again quality perception level. 2) After classifying customers into 3 groups according to two criteria -"will buy the service again" and "will suggest it to others" and making a pair of service providers with each customer, each customer loyalty group compared the service quality perception factor of the food service provider. The result was that the group having both the "will buy the service again" and "will suggest to others" criteria, that is, with higher loyalty, tend to have higher points than other group s in the dimension of 'Employee attitude' and 'Cleanliness'(p<0.05), which means these two dimensions are closely related to customer loyalty. 3) From a regression analysis for the service quality perception level of the food service provider and overall satisfaction, it has been found that : the regression models are different for each group, that 'Employee attitude' seems to be related more closely to the group with higher loyalty(p<0.05); that the 'Price' dimension is found to be a meaningful factor to the group categorized not having "will buy the service again" and "will suggest to others" criteria(p<0.05).
Food Industry ; Food Services ; Marketing ; Restaurants*

Service quality has become an important factor to meet customer satisfaction in the food service industry where competition is getting severe. Organizations are focused upon strengthening customer loyalty through customer satisfaction. Therefore, this study, taking customers as subjects, is intended to analyze factors affecting customer loyalty, on the basis of service quality satisfaction. In doing. so, the analysis has been done with 232 customers who are purchasing service from the food services industry, for general information, and service quality expectation, service quality satisfaction and overall satisfaction. The results of the study are as below. 1) From a factor analysis, the service quality expectation level of customer has been categorized into 4 factors, which are named General 'General management ', 'Food', 'Reliability' and 'Reputation'. 2) From the factor analysis, the service quality satisfaction level of customer has been categorized into 6 factors, which are named 'Employee attitude', 'Food', 'Reliability', 'Atmosphere', 'Reputation' and 'Price'. 3) After classifying customers into 3 groups according to two criteria-"will buy the service again" and "will suggest to others", a comparison has been done for the service quality expectation dimension of customers by each customer group. The result shows that the group having both the "will buy the service again" and "will buy the service again "and "will suggest to others" criteria, that is, with higher customer loyalty, tend to have higher point than other group in factors of 'Food', 'Reliability', 'Reputation'(p<.05). 4) As per the dimension of customer's service quality satisfaction level, factors like 'Employee attitude', 'Food', 'Reliability', 'Atmosphere', 'Reputation', and 'Price' have shown differences according to each loyalty group(P<.001). 5) Customers' overall satisfaction level according to each customer loyalty group has been found to be more important for the group having a higher loyalty level(p<.001) 6) From the discriminant analysis with employing judging variables, such as the customer's service quality expectation level, service quality satisfaction level and general satisfaction level, customer loyalty groups have been identified as accurately as 68.9% of the explanatory power.
Food Services ; Restaurants*

Aerobic and muscle-strengthening exercise is essential for weight management, in addition to diet control. Engaging in moderate-intensity aerobic exercise for 150 to 300 minutes a week and in muscle-strengthening exercise more than twice a week is recommended to reduce obesity. High-intensity aerobic exercise is also effective and can save time. Extra caution is needed to prevent injuries during high intensity exercise. Diabetic patients should prevent hypoglycemia and monitor the status of their feet. Exercise modification is needed in patients with complications of diabetes. Individuals with hypertension can do muscle-strengthening exercises safely. Lower-impact exercises are recommended for patients with osteoarthritis and extremely obese patients.
Diabetes Mellitus ; Diet ; Exercise ; Foot ; Humans ; Hypertension ; Hypoglycemia ; Obesity ; Osteoarthritis

The benefits of exercises and physical activities have been proven for all-cause mortality, cardiovascular morbidity and many illnesses. To workout safely, medical examination and exercise testing should be done prior to exercise. Cardiac disease and musculoskeletal problems should be ruled out by medical examination and test. The result of exercise testing is the basic data for exercise prescription because of wide range of fitness on the same age and sex. Cardiopulmonary endurance, muscle strength and endurance, flexibility and balance ability are the basic components of fitness measurement. Appropriate method to assess fitness among various methods can be used. Moderate aerobic exercise is recommended to be done more than 30minutes a day, 5 times a week. Recently 150 minutes of moderate exercise a week is being recommended. Vigorous aerobic exercise more than 20 minutes a day 3 times a week or 75 minutes a week is recommended. Muscle strengthening and endurance exercise is recommended to be done 2~3 times a week
Exercise ; Exercise Test ; Heart Diseases ; Motor Activity ; Muscle Strength ; Muscles ; Physical Endurance ; Physical Fitness ; Pliability ; Prescriptions