This research was performed to investigate the effects of NEP (Nutritional Education Practice) program developed by KHyDDI (Korea Hypertension Diabetes Daegu Initiative) for hypertension and diabetes patients. The subjects were 116 patients (hypertension 70, diabetes 46) who had completed basic education program at the education information center and four-session program was implemented for them. Nutrient intake was analyzed and compared before and after the program by 24-hr recall method and evaluate weight, waist circumference, body fat, blood pressure and eating habits in terms of nutrition knowledge, eating behavior, salty taste assessment. The improved results after the program were observed in weight, waist circumference, body fat ratio, blood pressure, slightly salty taste in salty taste assessment, nutrition knowledge, eating behavior, sodium, energy, carbohydrate and protein intake ratio to total energy (p < 0.001). Therefore, this program is effective in the improvement of weight, waist circumference and eating behavior, and the continued management would lead to the prevention of cardio-cerebrovascular diseases in the community.
Adipose Tissue ; Blood Pressure ; Eating ; Feeding Behavior ; Humans ; Hypertension ; Information Centers ; Nutrition Assessment ; Sodium ; Waist Circumference

Cholangiocarcinoma is a malignant disease originating from the epithelium of the biliary tract, and its prognosis is dismal due to distant metastasis in its early stages. The most common metastatic sites are the intra-abdominal organs, lymph nodes, and lungs. A patient was diagnosed with intrahepatic cholangiocarcinoma and underwent surgical resection. During the follow-up period, metastases were detected at the remnant liver and both lung fields. Eleven months after resection, the patient complained of severe headache. An approximately 5-cm cystic mass was found at the left occipital lobe of the cerebrum, and metastatic malignant cells were present on cerebrospinal fluid cytology. The patient underwent whole-brain radiotherapy. We herein report a rare case of cholangiocarcinoma with cystic brain metastasis together with a review of the relevant literature.
Biliary Tract ; Brain ; Cerebrum ; Cholangiocarcinoma ; Epithelium ; Follow-Up Studies ; Headache ; Humans ; Liver ; Liver Neoplasms ; Lung ; Lymph Nodes ; Meningeal Carcinomatosis ; Neoplasm Metastasis ; Occipital Lobe ; Prognosis

When neurological symptoms occur during the treatment of acute lymphoblastic leukemia, the differential diagnosis includes a leukemic infiltration of the nervous system, drug toxicity, infection, and other neurological disorders. We describe a 16-year-old girl with acute lymphoblastic leukemia that appeared to be complicated by vincristine-induced peripheral and cranial polyneuropathy after induction chemotherapy. She presented with right ptosis six weeks after the first dose of vincristine, and her neurological symptoms progressed to peripheral polyneuropathy. She recovered from these neurological symptoms over the next three months. Leukemic involvement of the nervous system and other neurological disorders could be excluded as potential causes of the neurological symptoms. This report shows that vincristine-induced neurotoxicity should be considered as a cause of cranial neuropathy that develops during the treatment of acute lymphoblastic leukemia.
Adolescent ; Cranial Nerve Diseases ; Diagnosis, Differential ; Drug Toxicity ; Humans ; Induction Chemotherapy ; Leukemia ; Leukemic Infiltration ; Nervous System ; Nervous System Diseases ; Polyneuropathies ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Vincristine

Klebsiella pneumoniae causes pyogenic infections in various sites, with the risk of which increases in patients with diabetes mellitus. Recently, K. pneumoniae has emerged as a leading cause of pyogenic liver abscess. Primary liver abscess caused by K. pneumoniae in the absence of underlying hepatobiliary disease is commonly associated with metastatic infections such as endophthalmitis, meningitis, brain abscess and infection in other sites. We experienced a case of K. pneumoniae liver abscess associated with septic metastatic lesions including pyomyositis and infected aneurysm of aorta. Despite the aggressive management with antibiotics, surgical pus drainage and aortic bypass graft, patient died of ventilator associated pneumonia and multiorgan failure. Our experience suggests that clinicians should be alert to septic metastatic infections when they treat a patient with K. pneumoniae liver abscess.
Aneurysm, Infected ; Anti-Bacterial Agents ; Aorta ; Aortic Aneurysm ; Brain Abscess ; Diabetes Mellitus ; Drainage ; Endophthalmitis ; Humans ; Klebsiella ; Klebsiella pneumoniae ; Liver ; Liver Abscess ; Liver Abscess, Pyogenic ; Meningitis ; Pneumonia ; Pneumonia, Ventilator-Associated ; Pyomyositis ; Suppuration ; Transplants

Klebsiella pneumoniae causes pyogenic infections in various sites, with the risk of which increases in patients with diabetes mellitus. Recently, K. pneumoniae has emerged as a leading cause of pyogenic liver abscess. Primary liver abscess caused by K. pneumoniae in the absence of underlying hepatobiliary disease is commonly associated with metastatic infections such as endophthalmitis, meningitis, brain abscess and infection in other sites. We experienced a case of K. pneumoniae liver abscess associated with septic metastatic lesions including pyomyositis and infected aneurysm of aorta. Despite the aggressive management with antibiotics, surgical pus drainage and aortic bypass graft, patient died of ventilator associated pneumonia and multiorgan failure. Our experience suggests that clinicians should be alert to septic metastatic infections when they treat a patient with K. pneumoniae liver abscess.
Aneurysm, Infected ; Anti-Bacterial Agents ; Aorta ; Aortic Aneurysm ; Brain Abscess ; Diabetes Mellitus ; Drainage ; Endophthalmitis ; Humans ; Klebsiella ; Klebsiella pneumoniae ; Liver ; Liver Abscess ; Liver Abscess, Pyogenic ; Meningitis ; Pneumonia ; Pneumonia, Ventilator-Associated ; Pyomyositis ; Suppuration ; Transplants

Precursor B-cell lymphoblastic lymphoma (B-LBL) is an uncommon high-grade neoplasm of immature B cells. It occurs predominantly in childhood with extranodal involvement such as skin and bone. Therefore, primary cutaneous involvement in elderly adults is a very rare manifestation of B-LBL. Here, we report a 78-year-old man with B-LBL presenting as a single cutaneous lesion which was immunohistochemically positive for leukocyte common antigen (LCA), CD79a, paired box 5 (PAX5), B cell lymphoma-2 (bcl-2), and terminal deoxynucleotidyl transferase (TdT) staining, but was without systemic involvement. The patient was treated using cyclophosphamide, adriamycin, vincristine, and prednisolone (CHOP), and achieved complete response (CR) at the first response assessment conducted after 3 CHOP cycles. After an additional cycle of CHOP treatment, radiotherapy was administered at a total dose of 3,600 cGy over 4 weeks. At the 21-month follow-up, he had maintained CR.
Adult ; Aged ; Antigens, CD45 ; B-Lymphocytes ; Cyclophosphamide ; DNA Nucleotidylexotransferase ; Doxorubicin ; Follow-Up Studies ; Humans ; Precursor B-Cell Lymphoblastic Leukemia-Lymphoma ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Precursor Cells, B-Lymphoid ; Prednisolone ; Skin ; Vincristine

There have been 5 case reports about immune hemolytic anemia related with cimetidine, but there has been no such report in Korea. A sixty-four-year-old woman was admitted to the emergency department in a coma. She was diagnosed with diffuse large B-cell lymphoma 5 years ago and she achieved a complete remission after treatment. She was in a state of shock, and her blood pressure was 70/40 mmHg. The laboratory test results were consistent with hemolytic anemia (HA) as follows: hemoglobin: 1.9 g/dL, corrected reticulocyte count: 2%, total/conjugated bilirubin: 6.4/2.1 mg/dL, lactate dehydrogenase: 1,083 U/L and haptoglobin <10 mg/dL. She had a history of taking the drugs including cimetidine, acetaminophen and etizolam for two days. She urgently received transfusion of 3 units of packed red blood cells and then she regained consciousness. To investigate the relation between cimetidine and HA, we subsequently performed a drug-induced immune complex test and an antibody test by using cimetidine, AB serum and phosphate-buffered saline. The results proved that cimetidine was the cause of the HA. Patient was treated with steroid, and the following laboratory tests showed rapid improvement. This is the first case report from Korea that shows the causal relationship between cimetidine and immune HA.
Acetaminophen ; Anemia, Hemolytic ; Antigen-Antibody Complex ; Blood Pressure ; Cimetidine ; Coma ; Consciousness ; Diazepam ; Emergencies ; Erythrocytes ; Female ; Haptoglobins ; Humans ; Korea ; Lactic Acid ; Lymphoma, B-Cell ; Reticulocytes ; Shock