Pneumocystis carinii is the most common cause of diffuse pulmonary infiltrates in the immunocompromised patients. Microscopically, Pneumocystis carinii pneumonia(PCP) shows characteristic frothy intraalveolar exudate and interstitial lymphocytic and plasma cell infiltrate. However, sometimes the only histologic finding of PCP on routine hematoxylin-eosin stain is that of diffuse alveolar damage(DAD), when we can miss the diagnosis without aid of special stains. We report a case of Pneumocystis carinii pneumonia presenting as DAD in a 50-year old man after chemotherapy due to malignant lymphoma. Open lung biopsy specimen reveals the early stage of DAD without any characteristic findings, such as foamy exudate. However many cysts of Pneumocystis carinii were found on Gomori's methenamine silver(GMS) stain. Therefore, GMS stain should be routinely performed on all biopsy specimens obtained from immunocompromised patients.
Male ; Humans ; Cysts ; Biopsy

PURPOSE: Walnut is known to have unique favorable fatty acids, phytochemicals, and other nutrient profiles. As a result, there has been growing interest in evaluation of its health benefit related to cardiovascular disease (CVD). Although inverse associations of nut consumption and risk factors of cardiovascular disease have been reported in many epidemiological studies and qualitative reviews, few meta-analysis studies have been reported. This meta-analysis was conducted in order to evaluate the effect of a walnut-enhanced diet on CVD risk factors. METHODS: We searched Pubmed, Cochrane, Science Direct, and KISS (Korean studies Information Service System) through July 2014. A random-effects meta-analysis was conducted on 17 trials reporting total cholesterol (TC), 14 trials reporting LDL cholesterol (LDL-C), 15 trials reporting HDL cholesterol (HDL-C), 17 trials reporting triglyceride (TG), and four trials reporting flow-mediated dilation (FMD). RESULTS: In meta-analysis, intake of a walnut-enhanced diet resulted in significantly lowered TC, LDL-C, and TG by -0.124 mmol/l (95% CI, -0.209, -0.039; p = 0.004), -0.085 mmol/lL (95% CI, -0.167, -0.004; p = l0.039), and -0.080 mmol/l (95% CI, -0.155, -0.004; p = 0.039), respectively. The overall pooled estimate of the effect on FMD was +1.313% (95% CI, 0.744, 1.882, p = 0.000). HDL-C was not affected by walnut intake. No statistical heterogeneity was observed for any analysis. Results of funnel plots and Egger's regression suggested a low likelihood of publication bias in all biomarkers (p > 0.05). CONCLUSION: Findings of this meta-analysis provide consistent evidence that walnut-enhanced diet intake reduces the CVD risk factors.
Biomarkers ; Cardiovascular Diseases ; Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Diet ; Fatty Acids ; Information Services ; Insurance Benefits ; Juglans* ; Nuts ; Phytochemicals ; Population Characteristics ; Publication Bias ; Risk Factors ; Triglycerides

Purpose: Although numerous systematic reviews or meta-analysis have reported the hypotensive effects of garlic, the application of these results in the area of functional food is limited. This is because the trials used various garlic preparations and patients with differing hypertensive intensities. To validate the use of garlic powder as a blood pressure lowering functional food, we performed the current meta-analysis, focusing on the study of prehypertensive subjects. Methods: Literature search was carried out using various database up to July 2020, including PubMed, Cochrane, ScienceDirect and Korean studies Information Service System, and each study was screened by pre-stated inclusion/exclusion criteria. We identified nine trials that met the eligibility, of which two studies with moderate or high risk of bias were excluded. Results: Meta-analysis of the seven studies revealed that an intake of garlic powder significantly lowered the systolic blood pressure (SBP) and diastolic blood pressure (DBP) by −6.0 mmHg (95% confidence interval [CI], −11.2, −0.8; p = 0.025) and −2.7 mmHg (95% CI, −5.3, −0.1; p = 0.046), respectively. Shapes of the funnel plot for both SBP and DBP seemed symmetrical, and the Egger's regression revealed no publication bias. Moreover, duration of the intervention period was inversely associated with the pooled effects of garlic powder on SBP (p = 0.019) and DBP (p = 0.019), and this result was supported by the subgroup-analysis. The daily dose of garlic powder, baseline value of each biomarker, and subject number, did not moderate the effects on SBP and DBP. Conclusion Results of the present meta-analysis indicate that garlic powder supplements are superior to placebo for improving the BP in prehypertensive individuals.

PURPOSE: To evaluate the usefulness of dynamic CT during the hepatic arterial phase with rapid IV injection ofcontrast material in distinguishing hepatocellular carcinoma (HCC) from intrahepatic cholangiocarcinoma (ICAC) asthe cause of biliary obstruction. MATERIALS AND METHODS: We retrospectively reviewed two-phase dynamic incrementalCT or helical CT findings in 22 patients with intrahepatic duct obstruction secondary to pathologically provenHCCs (n=12) or ICACs (n=10). Two-phase CT scans were obtained 20-45 seconds (hepatic arterial phase) or 2 minutes(equilibrium phase) after the initiation of a bolus injection of contrast material (5 mL/sec, 150 mL). Theenhancement patterns of tumors, as seen on two-phase images, were classified as hypo-, iso-, or hyperattenuated,relative to surrounding liver parenchyma. Two-phase images were compared and correlated with pathologic findings. RESULTS: During the hepatic arterial phase, diffuse high-enhancement was seen in nine HCCs (75%) and partialenhancement in three (25%); five (50%) of the ten ICACs were hypodense and five (50%) were hypodense withperipheral enhancement. During the equilibrium phase, however, all HCCs were hypodense and capsular enhancementwas seen in four cases (33.3%). All ICACs were hypodense with mild peripheral or central heterogeneousenhancement. Contrast enhancement patterns of HCCs during the hepatic arterial phase were significantly different(P<.0001) from those of ICACs. CONCLUSION: Our results suggest that dynamic CT during the hepatic arterial phase,with rapid IV injection of contrast material, is useful for the differentiation of HCC from ICAC as the cause ofbiliary obstruction.
Carcinoma, Hepatocellular* ; Cholangiocarcinoma* ; Humans ; Liver ; Retrospective Studies ; Tomography, Spiral Computed ; Tomography, X-Ray Computed

PURPOSE: The purpose of this study was to survey the health behaviors related to reproductive health, reproductive health history, and sexual behaviors of college students in local areas. METHOD: With a survey design, 792 college students from C and D areas were recruited to assess health behaviors such as smoking and alcohol drinking, as well as history of reproductive health and sexual behaviors. The data were collected by a self-administered questionnaire from November to December, 2007. RESULT: Mean age of the students was 20.8(SD=1.96) and gender distribution was 29.2% for male and 70.8% for female. Unhealthy behaviors were alcohol drinking, smoking, excessive weight loss, and irregular exercise; unsafe sex practices were experience of sexual intercourse with multiple sex partners and history of sexually transmitted disease (STD). Male students had more alcohol drinking (p=.04), smoking(p<.001), excessive weight loss(p=.01), experience of sexual intercourse with multiple sex partners(p<.001), history of STD(p=.025) compared to females. On the other hands, female students participated in regular exercise less than males(p<.001). CONCLUSION: College students seem to perform unhealthy behaviors related to reproductive health and less effective way of safe sex practices. Therefore, a planned education program for reproductive health promotion operated by college level is needed to assess and improve the level of reproductive health in college students.
Alcohol Drinking ; Coitus ; Female ; Hand ; Health Behavior ; Humans ; Male ; Surveys and Questionnaires ; Reproductive Health ; Safe Sex ; Sexual Behavior ; Sexually Transmitted Diseases ; Smoke ; Smoking ; Unsafe Sex ; Weight Loss

Poor dietary habits and inadequate nutrient intakes are of concern in the elderly, even it is worse in rural areas. In the present study, we conducted the anthropometric measurement and the dietary intakes including macronutrients, minerals and vitamins to assess the nutrient intakes and nutritional risk in elderly people in rural kyungpook province in South Korea. Subjects (n = 168, mean age, 67.3 yrs) were interviewed using d general questionnaire and 3 days of 24-hours recall for dietary intake. Nutrient intakes were analyzed using CAN-pro soft program and compared to Korean RDA and nutrition reference values (NRV). The anthropometric measurement showed that the weight and the height of the subjects in the rural area were below the average of the same age of Korean elderly people. The energy and protein intakes were 85% and 90% of Korean RDA, respectively. The intakes of lipid, cholesterol and dietary fiber were 62%, 40% and 22% of NRV for Korean adults. Main sources for protein and lipid intakes came from the vegetable sources and this pattern was more prominent in female elderly people. Ca intake was half of Korean RDA (56%), while P intake was 132% of Korean RDA. For the antioxidant trace mineral (Fe, Cu, Mn, Zn, and Se) intakes, Fe and Zn intakes were 78% and > 103% of Korean RDA. Cu, Mn and Se intakes were > 113%, > 275%, and > 185% of Korean NRV. Thiamin, niacin and vitamin C intakes were above Korean RDA, but the intakes of vitamin A and riboflavin were 88% and 63% of Korean RDA, respectively. On summarizing the results of the present study, the elderly people in rural area consume less lipid, cholesterol, Ca, and dietary fiber. Ca intake is lower, while P intake is higher, and this would be the potential risk for bone health. Also, Na intake was high, which can be the potential risk for the cardiovascular disease prevailance. Vitamin intakes were fairly good status, excepting riboflavin. Antioxidant mineral intakes were much higher than Korean NRV, unexpectedly. The results suggest that the elderly people in rural area have inadequate intakes of protein, lipid, dietary fiber and Ca, which mainly should be supplied from animal products. Recommendations to increase diet variety would be emphasized for this nutritionally poor-conditioned subjects, specially including animal food products and high dietary fiber food.
Adult ; Aged* ; Animals ; Ascorbic Acid ; Cardiovascular Diseases ; Cholesterol ; Diet ; Dietary Fiber ; Female ; Food Habits ; Gyeongsangbuk-do* ; Humans ; Korea* ; Minerals ; Niacin ; Surveys and Questionnaires ; Reference Values ; Riboflavin ; Vegetables ; Vitamin A ; Vitamins*

In our previous work, we reported consumers' perceptions of body shape and weight control. In an ongoing effort, we analyzed the purchasing behavior, intake patterns, future purchasing decisions, and degree of satisfaction in individuals consuming dietary formula for weight control (DF) or heath/functional foods (HFFs) by using the same survey questions. Portfolio analysis for marketing strategy was also investigated. Subjects were divided into two groups according to consumption of DF or HFF during the previous year : DF group (n = 89) and HFF group (n = 110). Average intake frequency was 1.7 +/- 0.7 per day for HFFs and 1.5 +/- 0.9 per day for the DF, and the most prevalent form was pill (58.2%) for HFFs and bar (42.7%) for DF. Duration of intake was 3.1 +/- 2.3 months for HFFs versus 3.9 +/- 3.5 months for DF. The average degree of satisfaction was 3.6 +/- 0.6 on a 5-point scale, meaning 'relatively satisfied'. For the weight control method to be used in the future, 44.5% of the HFF group selected 'HFFs' while 47.2% of the DF group selected 'DF', showing a tendency to use the current product type in the future. The average planned period for the intake was 3.8 +/- 3.7 months for HFFs and 3.0 +/- 2.4 months for DF (p < 0.05). The HFF group emphasized efficacy, functional ingredients of the products, reliable products, and higher satisfaction, whereas the DF group emphasized the added materials in addition to weight control effects.
Marketing

The purpose of this study was to investigate the general characteristics, body shape, and perceptions of weight control in individuals consuming health functional foods and weight-control foods. The survey was conducted between April 15 and June 17, 2010 among 199 (57 males and 142 females; age range, 25-45 years) in Seoul and Gyeonggi-do, who experienced eating health functional foods or weight control foods during the past year (June 2009 to June 2010). The subjects were divided into a weight-control food group (89 adults) and a health functional food group (110 adults). The subjects were comprised of a high proportion of aged (average age, 34.2 +/- 5.9 years), graduates (71.9%), and married (65.8%) individuals. In the weight control food group, gender, age, and educational background were similar and the ratios of service/technical employees, college students, and normal-weight individuals [body mass index (BMI), < 23] were high. BMI was significantly different by gender (p < 0.001), age (p < 0.01), marital status (p < 0.001), and job type (p < 0.001). Self-perceived health status showed a higher response for "in good health" in the 35-44 year old group than that in the 25-34 year old group (p < 0.05). Male group satisfaction for body shape was significantly higher than that in the female group. The main reason for going on a diet was significantly different by gender (p < 0.05) and BMI (p < 0.01). The main motives for dieting were "because I am not at an ideal weight" and "because of the social atmosphere and the attention of others" in men, but "can't wear the clothes I want" in women (p < 0.01). The most preferable product type related to the two groups was significantly different by job (p < 0.001) and BMI (p < 0.05). However, no significant differences were observed for questions about body shape perception and weight control. Consumers who had different general characteristics and used diet products perceived body shape and weight control differently. Additionally, no meaningful differences were observed when the results were categorized by product type, except job and BMI, but the distribution of consumer characteristics showed different tendencies. These results can be utilized as basic data for developing new diet products to help people control their weight more scientifically and appropriately in the future.
Aged ; Atmosphere ; Body Mass Index ; Diet ; Eating ; Female ; Functional Food ; Humans ; Male ; Marital Status

PURPOSE: The purpose of this study was to evaluate the incidcnce of extrapericardial fat in the left cardiacborder, and with regard to left extrapericardial fat, to correlate chest radiographs with CT scans. MATERIALS AND METHODS: This study involved 132 consecutive patients who underwent chest PA and lateral radiographs, and chestCT scans. According to the results of chest PA radiograph, patients were divided into three groups: those with aclear left cardiac border; those with an indistinct left cardiac border; and those with an indistinct left cardiacborder with increased density; cardiophrenic angle, as seen on lateral radiograph, the presence of increaseddensity in the anterior cardiophrenic angle, as seen on lateral radiograph radiographs was evaluated. On the basisof the results of CT scanning, patients were classified into four groups according to the amount of leftextrapericardial fat: negative, minimum, moderate, and maximum. Left extrapericardial fat, as seen on CT, wascorrelated with the conspicuity of left cardiac border seen on PA radiograph and the presence of increased densityin the anterior cardiophrenic angle, as seen on lateral radiograph. RESULTS: On CT, left extrapericardial fat wasobserved in 51 patients (38.6%). In 38 of these (28.8%), the amount was minimal, in 12 (9.1%), it was moderate,and in one (0.8%), it was maximal. On posteroanterior chest radiograph, clear, indistinct, and indistinct andincreased density of the left cardiac border was seen in 89 (67.4%), 28 (21.2%), and 15 cases (11.4%),respectively. On lateral radiograph, increased density of the anterior cardiophrenic angle was seen in 115 cases(87.1%) but in 17 (12.9%), increase density was not apparent. There was significant correlation between chestradiographs and CT(p<0.001) (sensitivity: 53%; specificity: 100%; positive predictive value: 100%; negativepredictive value: 84%). CONCLUSION: The conspicuousness of the left cardiac border, as seen on PA chestradiograph, correlated with the presence of left extrapericardial fat, as seen on CT, and was related to theamount of left extrapericardial fat. Increased density of the anterior cardiophrenic angle, as seen on lateralradiographs, correlated with the presence of left extrapericardial fat on CT, but the absence of increased densityon lateral radiograph corresponds to the absence or a minimal amount of left extrapericardial fat, as seen on CT.
Humans ; Radiography, Thoracic* ; Sensitivity and Specificity ; Thorax* ; Tomography, X-Ray Computed

PURPOSE: Approximately 29% of patients visiting the emergency department are children and teens. Training emergency medicine (EM) residents for treatment of pediatric emergency patients is essential. We conducted a survey of the status of pediatric emergency medicine (PEM) education and made recommendations with regard to the direction of educational programs for PEM using the Delphi method. METHODS: We conducted a survey of 93 emergency medicine training hospitals and conducted the Delphi study with the first and second round. Variables of educational status included general information on the hospital, educational contents, and method for PEM. The Delphi method was used to obtain the consensus of experts with regard to which objectives, essential procedures, and necessary components for PEM training should be included. RESULTS: The rate of response for PEM educational status was 60(62.4%). The type of pediatric department rotation was essential 40.5%, optional 21.4%, and no rotation 38.1%. Capability of EM residents was 33.3% in PEM objectives and 45% in PEM procedures. Each rate of response for the Delphi study was 65% in the first round and 56.9% in the second round. We obtained the consensus of experts, with 52 of 59 objectives and 18 of 20 procedures. The appropriate period for pediatric emergency rotation was three months and the appropriate staff members for pediatric emergency education were the pediatric emergency physician, pediatric physician, and emergency physician, in order. CONCLUSION: Pediatric emergency training was not appropriate for an EM residency program. Experts agreed with 52 objectives and 18 procedures for PEM training of EM residents. We recommended a training period of three months and the appropriate staff member for PEM was the pediatric emergency physician.
Adolescent ; Child ; Consensus ; Curriculum ; Delphi Technique ; Educational Status ; Emergencies ; Emergency Medicine ; Humans ; Internship and Residency ; Pediatrics