PURPOSE: Despite the popularity of dietary supplements, little data are available on their use by university students. The purpose of this study was to examine the use of vitamin mineral supplements and to identify factors related to supplement use among university students. METHODS: University students (N = 345) in Seoul were surveyed. Survey questions included descriptive demographics, types of vitamin and mineral supplements used, health related lifestyle factors, mini dietary assessment, and knowledge and behaviors related to supplement use. RESULTS: Of university students surveyed, 41% consumed vitamin and mineral supplements. Among the supplement users, multivitamins were the most commonly used dietary supplements (68.6%), followed by vitamin C (31.4%) and calcium (17.1%). In particular, the use of vitamin C and iron supplements was more common in females than males (p < 0.05). For the number of supplements taken daily, 32.1% of supplement users consumed 2 or more supplements; 20% of supplement users had almost no knowledge of the supplements being taken. Based on the results of multivariable logistic regression analysis, supplement use was associated with higher interest in their own health, non-smoker, and supplement use by family (p < 0.05). In addition, supplement use was slightly associated with healthy dietary behavior such as consuming a variety of foods (p = 0.05) and current disease status (p = 0.05). CONCLUSION: University students with relatively healthy lifestyles appear to take vitamin and mineral supplements, but they had little knowledge of the supplements. Given high prevalence of dietary supplement use among university students, nutrition education regarding supplement use is needed.
Ascorbic Acid ; Calcium ; Demography ; Dietary Supplements ; Education ; Female ; Health Behavior ; Humans ; Iron ; Life Style ; Logistic Models ; Male ; Minerals ; Prevalence ; Seoul* ; Vitamins*

Objective: The study aimed to ascertain the clinical manifestations of inflammatory arthritis accompanying tuberculosis (TB) for the differential diagnosis. Methods: We retrospectively reviewed patients with active TB who presented with inflammatory arthropathy at Seoul Medical Center. Among 2,872 patients with active TB infection, 47 had inflammatory arthropathy: 14 had crystal-induced arthropathy; 12, TB arthritis; 12, Poncet’s disease (PD); 8, Rheumatoid arthritis (RA); and 1, septic arthritis. The clinical characteristics and laboratory and radiographic findings of each group were analyzed. Results: In TB arthritis, weight-bearing joints were more commonly affected than the elbow and wrist joints. When compared to TB arthritis, PD demonstrated a significantly higher proportion of polyarthritis and involved both large and small-to-mediumsized joints. The duration of arthritis symptoms after anti-TB treatment was significantly shorter in patients with PD (56 days vs. 90 days, p=0.028). When compared to PD, RA flares during active TB infection involved only small-to-medium-sized joints rather than a mixed distribution (62.5% vs. 16.7%, p=0.035). Patients with PD more commonly had fever at onset and showed a good response to nonsteroidal anti-inflammatory drugs alone or were in remission within 3 months after anti-TB treatment. The presence of rheumatoid factor or anti-cyclic citrullinated peptide and radiographic progression after 12 months was frequently observed in patients with RA flares. Conclusion The differential diagnosis of inflammatory arthritis accompanying active tuberculosis infection is challenging. Comprehensive history taking and physical examination, synovial fluid analysis, and a high level of clinical suspicion are essential to avoid delayed diagnosis and to reduce the significant morbidity involved.

Enterovirus infection is often aggravated and manifests as various neurological complications such as aseptic meningitis, brainstem encephalitis, poliomyelitis-like acute flaccid paralysis, transverse myelitis, and severe systemic diseases. There are a few reports indicating that enterovirus is associated with acute disseminated encephalomyelitis (ADEM), acute flaccid paralysis, or Guillain-Barre syndrome separately. However, none of these report ADEM and acute flaccid paralysis occurring simultaneously. Here, we present a case of combined ADEM and acute flaccid paralysis associated with enteroviral infection in a child and reviewed the relevant literature. A 5-year-old boy was admitted to the hospital for headache and vomiting with evident meningeal irritation signs. Despite of antibiotic therapy, his mental state rapidly declined to coma with abnormal upper motor neuron (UMN) signs. During 5 consecutive days of steroid pulse therapy, his abnormal UMN signs abruptly changed to flaccid paralysis. Suspected acute flaccid paralysis due to enterovirus prompted the addition of intravenous immunoglobulin (IVIG). On hospital day 33, he was discharged with full recovery of muscle tone and strength with an alert mental state.
Attention Deficit Disorder with Hyperactivity ; Brain Stem ; Child ; Child, Preschool ; Coma ; Encephalitis ; Encephalomyelitis ; Encephalomyelitis, Acute Disseminated* ; Enterovirus ; Enterovirus Infections ; Guillain-Barre Syndrome ; Headache ; Humans ; Immunoglobulins ; Male ; Meningitis, Aseptic ; Motor Neurons ; Muscle Hypotonia ; Muscles ; Myelitis, Transverse ; Paralysis* ; Vomiting

Severe acute respiratory distress syndrome (ARDS) is a life-threatening disease with a high mortality rate. Although many therapeutic trials have been performed for improving the mortality of severe ARDS, limited strategies have demonstrated better outcomes. Recently, advanced rescue therapies such as extracorporeal membrane oxygenation (ECMO) made it possible to consider lung transplantation (LTPL) in patients with ARDS, but data is insufficient. We report a 62-year-old man who underwent LTPL due to ARDS with no underlying lung disease. He was admitted to the hospital due to influenza A pneumonia-induced ARDS. Although he was supported by ECMO, he progressively deteriorated. We judged that his lungs were irreversibly damaged and decided he needed to undergo LTPL. Finally, bilateral sequential double-lung transplantation was successfully performed. He has since been alive for three years. Conclusively, we demonstrate that LTPL can be a therapeutic option in patients with severe ARDS refractory to conventional therapies.
Extracorporeal Membrane Oxygenation ; Humans ; Influenza, Human* ; Lung Diseases ; Lung Transplantation* ; Lung* ; Middle Aged ; Mortality ; Pneumonia* ; Respiratory Distress Syndrome, Adult*

Any strenuous muscular exercise may trigger rhabdomyolysis. We report an episode of clinically manifested exertional rhabdomyolysis due to stationary cycling, commonly known as spinning. Reports of spinning-related rhabdomyolysis are rare in the English literature, and the current case appears to be the first such case reported in South Korea. A previously healthy 21-year-old Asian woman presented with severe thigh pain and reddish-brown urinary discoloration 24–48 hours after attending a spinning class at a local gymnasium. Paired with key laboratory findings, her symptoms were suggestive of rhabdomyolysis. She required hospital admission to sustain renal function through fluid resuscitation therapy and fluid balance monitoring. Because exertional rhabdomyolysis may occur in any unfit but otherwise healthy individual who indulges in stationary cycling, the potential health risks of this activity must be considered.
Acute Kidney Injury ; Asian Continental Ancestry Group ; Female ; Humans ; Korea ; Resuscitation ; Rhabdomyolysis* ; Thigh ; Water-Electrolyte Balance ; Young Adult

Any strenuous muscular exercise may trigger rhabdomyolysis. We report an episode of clinically manifested exertional rhabdomyolysis due to stationary cycling, commonly known as spinning. Reports of spinning-related rhabdomyolysis are rare in the English literature, and the current case appears to be the first such case reported in South Korea. A previously healthy 21-year-old Asian woman presented with severe thigh pain and reddish-brown urinary discoloration 24–48 hours after attending a spinning class at a local gymnasium. Paired with key laboratory findings, her symptoms were suggestive of rhabdomyolysis. She required hospital admission to sustain renal function through fluid resuscitation therapy and fluid balance monitoring. Because exertional rhabdomyolysis may occur in any unfit but otherwise healthy individual who indulges in stationary cycling, the potential health risks of this activity must be considered.
Acute Kidney Injury ; Asian Continental Ancestry Group ; Female ; Humans ; Korea ; Resuscitation ; Rhabdomyolysis* ; Thigh ; Water-Electrolyte Balance ; Young Adult

OBJECTIVE: Understanding the neural functional organization of swallowing in the elderly is essential when diagnosing and treating older adults with swallowing difficulties. While brain-imaging studies in young adults have implicated multiple cortical regions in swallowing, only a few investigations were performed on older subjects. In this study, we aimed to compare neural activation in regions for swallowing between healthy young and older adults and to better understand neural control of deglutition, complex sensory-motor process which occurs as a result of old age. METHOD: Fifteen young and fifteen older healthy individuals without a swallowing problem were examined with functional magnetic resonance imaging (fMRI) during voluntary saliva swallowing. Functional image data was obtained with a T2 gradient-echo, echo planar imaging (EPI) pulse sequence optimized for blood-oxygen level dependent (BOLD) contrast. Two samples t-test was conducted to perform group comparison (younger adults versus older adults) for the areas in which the activation was larger for the swallowing condition than the non-swallow condition. RESULT: Both groups showed activations in areas involved in the motor control and execution. In both groups, main regions of activation included bilateral prefrontal cortex, primary somatosensory cortex, insula, basal ganglia, and cerebellum. Between-group comparisons revealed statistically stronger activations in the prefrontal cortex and middle temporal gyrus of older adults during swallowing. CONCLUSION: This study provides evidence that swallowing requires larger and more widespread areas of neural control in older adults group, especially in prefrontal cortex and inferior frontal gyrus. These findings suggest that more demanding swallowing tasks are necessary for elderly patients because of their inefficient neural network due to their age.
Adult ; Aged ; Basal Ganglia ; Cerebellum ; Deglutition* ; Echo-Planar Imaging ; Humans ; Magnetic Resonance Imaging* ; Methods ; Prefrontal Cortex ; Saliva ; Somatosensory Cortex ; Temporal Lobe ; Young Adult

Mixed cryoglobulinemic vasculitis (CV) is occasionally caused by autoimmune diseases including systemic sclerosis. Multiorgan involvement such as skin, kidney, and peripheral nerve involvement is common in mixed CV. However, central nervous system (CNS) involvement is extremely rare. Here, we report a case of overlap syndrome of limited cutaneous systemic sclerosis and mixed cryoglobulinemic vasculitis with CNS involvement. The neurologic deficits and systemic symptoms improved promptly after steroid and cyclophosphamide therapy.

Mixed cryoglobulinemic vasculitis (CV) is occasionally caused by autoimmune diseases including systemic sclerosis. Multiorgan involvement such as skin, kidney, and peripheral nerve involvement is common in mixed CV. However, central nervous system (CNS) involvement is extremely rare. Here, we report a case of overlap syndrome of limited cutaneous systemic sclerosis and mixed cryoglobulinemic vasculitis with CNS involvement. The neurologic deficits and systemic symptoms improved promptly after steroid and cyclophosphamide therapy.

Neurofibromatosis type 1 (NF-1) is an autosomal dominant disorder with a prevalence of approximately 1 in 3,500 live births. NF-1 predisposes to various benign and malignant neoplasms. Neurological malignancies are most frequent, but the risks of non-nervous system tumors, such as of the esophagus, stomach, colon, liver, biliary tract, pancreas, lung, melanoma, thyroid gland, female breast and ovaries, are also increased. Malignant tumors are the most common cause of death in patients with NF-1. Cases with double primary tumors have been reported, but cases involving three or more primary cancers are rarely reported. Therefore, we present the case of a NF-1 patient diagnosed with gastrointestinal stromal tumor, breast cancer and ampulla of Vater cancer.
Ampulla of Vater* ; Biliary Tract ; Breast Neoplasms ; Breast* ; Cause of Death ; Colon ; Esophagus ; Female ; Gastrointestinal Stromal Tumors* ; Humans ; Live Birth ; Liver ; Lung ; Melanoma ; Neurofibromatoses* ; Neurofibromatosis 1* ; Ovary ; Pancreas ; Prevalence ; Stomach ; Thyroid Gland