OBJECTIVES: Epidemiological studies have suggested that a higher consumption of whole grain foods can significantly reduce the risk of chronic diseases including cardiovascular diseases, type 2 diabetes and obesity. The objective of the current study was to examine associations among the consumption of whole grains and nutrient intakes and biochemical indicators associated with chronic diseases among generally healthy middle-aged Korean women. METHODS: Using 24-hour recall data from the 2008-2009 National Health and Nutrition Examination Surveys, whole grain intake (g/day) was calculated for a total of generally healthy 1,953 subjects. The subjects were divided into three groups by the level of whole grain consumption (0 g/day, > 0 and < 20 g/day or > or = 20 g/day). Mean values or proportions of various nutrient intakes and metabolic risk factors were compared according to the level of whole grain consumption. All statistical analysis was conducted using SAS software version 9.2. RESULTS: We observed that the overall consumption of whole grains was quite low. Specifically, 58.2% of subjects reported no whole grain consumption on the day of the survey, and the mean whole grain intake was only 15.3 g/day. The whole grain consumption was positively associated with intakes of various macro and micronutrients, namely, plant proteins and fats, dietary fiber, calcium, plant iron, potassium, zinc, vitamin A, beta-carotene, thiamin, riboflavin, niacin, vitamin B6 and folic acid. In addition, we found significantly decreasing trends in abdominal obesity and hypertriglyceridemia as whole grain intake levels increase. CONCLUSIONS: The study findings suggested the importance of promoting whole grain consumption as an efficient tool for improving various dietary aspects and preventing chronic diseases.
beta Carotene ; Calcium ; Cardiovascular Diseases ; Edible Grain* ; Chronic Disease ; Dietary Fats ; Female ; Folic Acid ; Humans ; Hypertriglyceridemia ; Iron ; Micronutrients ; Niacin ; Obesity ; Obesity, Abdominal ; Plant Proteins ; Plants ; Potassium ; Riboflavin ; Risk Factors* ; Vitamin A ; Vitamin B 6 ; Zinc

Cholangiocarcinoma has been associated with various fibrocystic diseases of liver and biliary tract, but cholangiocarcinoma in polycystic liver disease (PLD) was extremely rare. It was reported that the prognosis of cholangiocarcinoma associated PLD was very poor and distant metastases were common. We report a rare case of intrahepatic cholangiocarcinoma associated with PLD in 58- year- old female who presented vague abdominal pain. She had also polycystic kidneys with normal renal function. MRI showed well demonstrated tumor with central scar and a adjacent large cyst in the left lobe of the liver. She underwent extended left lobectomy. On microscopic examination, the tumor was moderately differentiated cholangiocarcinoma having abundant fibrous stroma and necrosis and the adjacent cyst showed focal in situ carcinomatous changes in the lining epithelium.
Abdominal Pain ; Biliary Tract ; Cholangiocarcinoma* ; Cicatrix ; Epithelium ; Female ; Humans ; Liver Diseases* ; Liver* ; Magnetic Resonance Imaging ; Necrosis ; Neoplasm Metastasis ; Polycystic Kidney Diseases ; Prognosis ; Cholangiocarcinoma

BACKGROUND: It has recently been shown that esmolol provided consistent and reliable protection against increase in both heart rate and systolic blood pressure accompanying laryngoscopy and intubation. This study was therefore designed to establish whether esmolol was as effective in controlling the responses to awake fiberoptic tracheal intubation as it was in controlling the responses to traditional intubation and to assess the effect of esmolol for conditions of intubation, sedation, respiratory system during fiberoptic laryngoscopy and intubation. METHODS: Thirty patients, ASA physical status I-II, scheduled for oral and maxillofacial surgery, were randomly assigned to receive preintubation dose of either fentanyl 100 microgram(Group F) or fentanyl 50 microgram and esmolol 100 mg(Group E). And during awake fiberoptic nasotracheal intubation, heart rate, systolic and diastolic arterial pressures, minimal peripheral oxygen saturation, sedation score, intubation condition and time were recorded. RESULTS: There were no significant differences in arterial blood pressures, sedation score, intubation condition and time. But the change of heart rate in Group E was significantly less at 1 minite and 2 minites after the start of tracheal intubation and in Group F, minimal peripheral oxygen saturation was significantly reduced and two patients in Group F were hypoxemic and apneic. CONCLUSIONS: The present results show that esmolol provides attenuation of the change of heart rate by awake fiberoptic nasotracheal intubation and minimize the risk of apnea and hypoxia due to combination of fentanyl with midazolam.
Anoxia ; Apnea ; Arterial Pressure ; Blood Pressure ; Fentanyl ; Heart Rate ; Humans ; Intubation* ; Laryngoscopy ; Midazolam ; Oxygen ; Respiratory System ; Surgery, Oral

Cough is one of the common symptoms, which is usually related to respiratory infections for children. This symptom is not considered crucial. Published data reported that the community prevalence of chronic cough in primary school children is 5%-10%, while the prevalence is likely to be higher in younger children. The cause of persistent cough should be investigated. There were significant differences in the causes and management for cough according to age. Chronic cough is defined as duration of 4 weeks or longer. Common culprits for chronic cough in children are different from those in adults. The authors reviewed articles about chronic cough of children to help improve the understanding and management for pediatric chronic cough.
Adult ; Child* ; Cough* ; Diagnosis ; Humans ; Prevalence ; Respiratory Tract Infections

Primary malignant tumor of trachea is rare and often extensive at presentation and frequently causes life threatening airway obstruction. Primary extranodal lymphomas comprise about 10% of all malignant lymphomas. However, the primary malignant lymphoma of trachea is extremely rare. We presented here a case of 62-year-old male, was diagnosed as a primary extranodal lymphoma arising in the trachea with review of literature.
Airway Obstruction ; Humans ; Lymphoma* ; Male ; Middle Aged ; Trachea*

This study compared levels of whole grain consumption-related predisposing, reinforcing, and enabling factors according to socio-demographic variables, and examined how these factors are associated with whole grain consumption frequency among Korean adults. A survey questionnaire was administered to a convenience sample of adult males and females aged 20~59 years (n=300). The questionnaire included questions on predisposing, reinforcing, and enabling factors in relation to whole grain consumption as well as a brief whole grain food frequency questionnaire. Female subjects showed a significantly higher level of negative beliefs on health.nutrition.taste.texture while showing a significantly lower level of social support compared to that of males. The age group of 40~59 years showed a significantly higher social support level than the age group of 20~39 years. Results from multivariate regression analyses showed that different combinations of predisposing, reinforcing, and enabling variables were significant in predicting whole grain consumption frequency according to sex and age. The study findings can be used for developing specific target-oriented nutrition intervention programs for promotion of whole grain intake among Korean adults.
Adult* ; Causality* ; Edible Grain* ; Female ; Humans ; Male ; Surveys and Questionnaires

Anti-N-methyl D-aspartate receptor (anti-NMDAR) encephalitis, recently recognized as a form of paraneoplastic encephalitis, is characterized by a prodromal phase of unspecific illness with fever that resembles a viral disease. The prodromal phase is followed by seizures, disturbed consciousness, psychiatric features, prominent abnormal movements, and autonomic imbalance. Here, we report a case of anti-NMDAR encephalitis with initial symptoms of epilepsia partialis continua in the absence of tumor. Briefly, a 3-year-old girl was admitted to the hospital due to right-sided, complex partial seizures without preceding febrile illness. The seizures evolved into epilepsia partialis continua and were accompanied by epileptiform discharges from the left frontal area. Three weeks after admission, the patient's seizures were reduced with antiepileptic drugs; however, she developed sleep disturbances, cognitive decline, noticeable oro-lingual-facial dyskinesia, and choreoathetoid movements. Anti-NMDAR encephalitis was confirmed by positive detection of NMDAR antibodies in the patient's serum and cerebrospinal fluid, and her condition slowly improved with immunoglobulin, methylprednisolone, and rituximab. At present, the patient is no longer taking multiple antiepileptic or antihypertensive drugs. Moreover, the patient showed gradual improvement of motor and cognitive function. This case serves as an example that a diagnosis of anti-NMDAR encephalitis should be considered when children with uncontrolled seizures develop dyskinesias without evidence of malignant tumor. In these cases, aggressive immunotherapies are needed to improve the outcome of anti-NMDAR encephalitis.
Anti-N-Methyl-D-Aspartate Receptor Encephalitis* ; Antibodies ; Anticonvulsants ; Antihypertensive Agents ; Cerebrospinal Fluid ; Child* ; Child, Preschool ; Cognition ; Consciousness ; D-Aspartic Acid ; Diagnosis ; Dyskinesias ; Encephalitis ; Epilepsia Partialis Continua* ; Female ; Fever ; Humans ; Immunoglobulins ; Immunotherapy ; Korea* ; Methylprednisolone ; Rituximab ; Seizures ; Virus Diseases

BACKGROUND: It is well known that the prone position affects hemodynamics. In this study, we investigate whether the prone position will affect the heart rate variability compared with the supine position. METHODS: Sixty five pediatric patients were assigned to supine group (n = 36) and prone group (n = 29) according to position during surgery. The patients were induced with thiopental and vecuronium and maintained with O2-enflurane-N2O. ECG data was collected for 15 minutes after saturation at the end tidal concentration of the inhalent agent. From the ECG data, power spectral analysis was performed and approximate entropy was calculated. RESULTS: In the prone group, low frequency power and ratio of low to high frequency power were lower and approximate entropy was higher than those in the supine group. Mean heart rate and blood pressure were no different between the two groups. CONCLUSIONS: In the prone position, sympathetic autonomic activity and balance of the autonomic nervous system decreased. However the complexity of regulation of heart rate variability was maintained in the prone position.
Anesthesia, General* ; Autonomic Nervous System ; Blood Pressure ; Child* ; Electrocardiography ; Entropy ; Heart Rate* ; Heart* ; Hemodynamics ; Humans ; Prone Position* ; Supine Position ; Thiopental ; Vecuronium Bromide

BACKGROUND: It is well known that the prone position affects hemodynamics. In this study, we investigate whether the prone position will affect the heart rate variability compared with the supine position. METHODS: Sixty five pediatric patients were assigned to supine group (n = 36) and prone group (n = 29) according to position during surgery. The patients were induced with thiopental and vecuronium and maintained with O2-enflurane-N2O. ECG data was collected for 15 minutes after saturation at the end tidal concentration of the inhalent agent. From the ECG data, power spectral analysis was performed and approximate entropy was calculated. RESULTS: In the prone group, low frequency power and ratio of low to high frequency power were lower and approximate entropy was higher than those in the supine group. Mean heart rate and blood pressure were no different between the two groups. CONCLUSIONS: In the prone position, sympathetic autonomic activity and balance of the autonomic nervous system decreased. However the complexity of regulation of heart rate variability was maintained in the prone position.
Anesthesia, General* ; Autonomic Nervous System ; Blood Pressure ; Child* ; Electrocardiography ; Entropy ; Heart Rate* ; Heart* ; Hemodynamics ; Humans ; Prone Position* ; Supine Position ; Thiopental ; Vecuronium Bromide

BACGROUND: Physical fitness is defined as the ability to carry out work necessary for muscle exercise satisfactorily. Generally, obese person have been considered to have low physical performance. In addition, obesity has been known to be a risk factor of cardiovascular disease such as hyperlipidemia, hypertension, and coronary arterial disease. Based on previous epidemiologic studies, abdominal obesity, especially, visceral obesity, is thought to be more important risk factor for cardiovascular disease rather than obesity itself. Therefore, the interest on assessment of abdominal visceral fat has been increasing. The aim of this study was to see the difference in physical fitness and blood pressure according to obesity degree assessed by BMI, and compare the anthropometric obesity indices with abdominal visceral fat accumulation measured by abdominal CT (Computed Tomogram). METHODS: Four hundred thirty-two subjects, who participated in the exercise program for more than one month duration at the 'Clinic for Obesity' in St. Mary's Hospital from November 1998 to June 2000, were included in the analysis. They were categorized into 4 groups [severe obesity group (BMI 30), obesity group (25 BMI <30), overweight group (23 BMI<25), normal group (BMI<23)] according to their BMI. Blood pressure, anthropometric obesity indices and physical fitness (V02 max, back muscle strength, sit up, forward bending, vertical jump, side step, balance) were measured by one skillful exercise trainer. Among them, one hundred thirty-one subjects performed abdominal CT to assess visceral fatness. We compared anthropometric indices (waist to hip ratio, body mass index, abdominal circumference, skin foldness) with abdominal visceral fat accumulation measured by CT. RESULTS: Blood pressure, cardiovascular endurance, muscular endurance, muscle strength, speed and balance were significantly different among the four groups categorized by BMI in both sexes, but flexibility and agility were not significant. In women, the correlation coefficients between visceral fat area measured by abdominal CT and each of waist to hip ratio, BMI, abdominal circumference, and skin foldness adjusted for age were 0.487, 0.479, 0.464, 0.31, respectively (P<0.01). However in men, there were no significant correlations. CONCLUSION: Obesity tended to increase blood pressure, and reduce physical performance. Only in women, obesity related indices reflected the abdominal visceral fat accumulation.
Back Muscles ; Blood Pressure ; Body Mass Index ; Cardiovascular Diseases ; Epidemiologic Studies ; Female ; Hip ; Humans ; Hyperlipidemias ; Hypertension ; Intra-Abdominal Fat ; Male ; Muscle Strength ; Obesity* ; Obesity, Abdominal ; Overweight ; Physical Fitness* ; Pliability ; Risk Factors ; Skin ; Tomography, X-Ray Computed ; Waist-Hip Ratio