Aneurysms of the ascending aorta are relatively uncommon disorders which are located in ascending portion of the thoracic aorta. The commenest cause of aneurysms of the ascending aorta is arteriosclerosis, but syphilis, marfan syndrome, cystic medial necrosis, trauma, and aging of the aorta must also be noted as causes. We report a case with a aneurysm of the ascending aorta, 23 years old female, who was performed the open heart surgery because of ventricular septal defect with aortic insufficiency about 10 years ago.
Aging ; Aneurysm* ; Aorta* ; Aorta, Thoracic ; Arteriosclerosis ; Female ; Heart Septal Defects, Ventricular ; Heart* ; Humans ; Marfan Syndrome ; Necrosis ; Syphilis ; Thoracic Surgery* ; Young Adult

The purpose of this study was to understand the management status of food wastes in school meal to find the effective ways that would reduce and recycle them. Data was collected using questionnaires from 223 school dietitians located in Jeonbuk area. The results were as followed : 1) Waste was managed by the dietitians(54.7%) and cook(42.2%). The waste disposal contract was made by dietitians(65.0%), executives(31.4%). Therefore, school dietitians had primary responsibilities in the waste management. 2) As disposal ways, 48.9% processed municipal solid waste and food waste together and 46.6% processed separately. 3) A half of schools(52.9%) produced food wastes weighed under 10~15kg daily and using food wastes as animal food for farms was most popular method to dispose(87.4%). 4) Reasons to have food-wastes were disliking the taste of menu(50.2%) and the inappropriate ways of dealing with remaining food(64.1%) and donating to food bank(33.6%) in order. 5) The suggested ways to reduce the food-waste was to improve on cooking method(72.2%), changing of portion size(61.0%), measuring the amount of leftover food(53.4%) and requesting cooperation to educators(52.9%). 6) The reported consequences of reducing the food waste were: lowered grocery expenses(46.2%), and inspiring students on helping environmental preservation(23.8%). Therefore, the administration should work on finding a method to reduce food-waste and a way to use these resources efficiently. It is important to induct student's attitude on recycling remaining products by using food bank via nutrition education. Dietitian also should consider to reduce the leftover of food by using a standardized recipe.
Animals ; Contracts ; Cooking ; Food Services ; Humans ; Meals ; Surveys and Questionnaires ; Recycling ; Solid Waste ; Waste Management

BACKGROUND: Cytokeratins are epithelial markers whose expressions are not lost during malignant transformation. The utility of cytokeratin fragment (Cyfra) 21-1, a new tumor marker, was investigated in 110 patients with lung cancer. The aims of this study were to confirm sensitivity of Cyfra 21-1 in detecting non-small cell cancer, to assess the potential relationship between Cyfra 21-1 and disease stage of the lung cancer. METHODS: We measured serum levels of four tumor marker (NSE, CEA, SCC Ag, Cyfra 21-1) in 110 patients with lung cancer. The measurement of serum level of Cyfra 21-1 was performed with a cut off value of 3.3 ng/mL. An immunoradiometric assay was used to detect a fragment of the cytokeratin 19. The patients were grouped according to the stage of the disease and tumor type. RESULTS: Overall sensitivity of Cyfra 21-1 was relatively high (51.8%) than others tumor markers. Sensitivity of this marker was especially high for adenocarcinoma (63.2%) and squamous cell carcinoma (54.1%). In contrast, sensitiviy of Cyfra 21-1 was relatively low for small cell lung carcinoma (40.0%). Serum levels of Cyfra 21-1 were higher in advanced nonsmall cell lung cancer than early stage disease. CONCLUSION: We conclude that Cyfra 21-1 is a sensitive tumor marker of nonsmall cell lung cancer, especially adenocarcinoma and also may be a useful adjunctive marker for disease monitoring.
Adenocarcinoma ; Carcinoma, Non-Small-Cell Lung ; Carcinoma, Squamous Cell ; Humans ; Immunoradiometric Assay ; Keratin-19 ; Keratins ; Lung Neoplasms* ; Lung* ; Small Cell Lung Carcinoma ; Biomarkers, Tumor

BACKGROUND/AIMS: The aim of this study was to quantitatively measure changes in lipids and lipoproteins during perimenopause and to identify variables related to these changes. METHODS: Among women who had three regular health evaluations over a span of 2-4 years, 34 women remained in the premenopausal state, 34 premenopausal women transitioned to the postmenopausal state, and 36 postmenopausal women were enrolled. The menopausal state was determined not only by a history of amenorrhea but also by levels of female sex hormones. Yearly changes in lipids were calculated using a linear regression of the three measurements. RESULTS: The transition from premenopause to postmenopause was associated with increased total cholesterol and low-density lipoprotein (LDL) cholesterol levels by 7.4 +/- 8.0 mg/dL (4.2 +/- 4.9%) and 6.9 +/- 6.5 mg/dL (6.8 +/- 7.0%) over one year, resulting in an elevation of 19.6 +/- 22.6 mg/dL (10.9 +/- 13.0%) and 18.9 +/- 19.5 mg/dL (18.6 +/- 20.3%), respectively, during perimenopause. There were no changes observed in premenopausal and postmenopausal women. Body weight, blood pressure, high-density lipoprotein (HDL) cholesterol, and triglycerides did not change in any of the three groups. In all women, changes in both total cholesterol and LDL cholesterol were associated with changes in follicle stimulating hormone (r = 0.40, p < 0.001 and r = 0.38, p < 0.001, respectively). Changes in triglycerides were associated with changes in body weight (r = 0.28, p = 0.005). CONCLUSIONS: During perimenopause, total and LDL cholesterol levels increase and these changes in cholesterol are mainly dependent on changes in female sex hormones.
Adult ; Cholesterol, HDL/blood ; Cholesterol, LDL/blood ; Female ; Follicle Stimulating Hormone/blood ; Humans ; Lipids/*blood ; Lipoproteins/*blood ; Middle Aged ; Postmenopause/*blood ; Premenopause/*blood

We report a case of Churg-Strauss syndrome with cardiac involvement presenting without cardiomegaly or cardiopulmonary symptoms. A 47-year-old woman was referred to our institution for myalgia, peripheral numbness, and eosinophilia. She had been diagnosed with bronchial asthma and allergic rhinitis four years ago. The patient exhibited eosinophilia (71%) and elevated cardiac enzymes (cTnI, 2.977 ng/mL). Cardiomegaly was not observed on chest radiography, but nonspecific ST segment changes were observed on electrocardiography. A transthoracic echocardiography revealed a dilated left ventricular cavity, a decreased left ventricle (42%), and diastolic dysfunction. Contrast-enhanced cardiac magnetic resonance imaging revealed delayed hyperenhancement 10 minutes after injecting gadolinium. An endomyocardial biopsy showed eosinophilic myocarditis associated with vasculitis. The patient was diagnosed with Churg-Strauss syndrome and received combination therapy with steroid and cyclophosphamide. After the second treatment cycle, the blood eosinophilia disappeared and the vasculitis and infiltration of eosinophils into the endomyocardial tissue had completely resolved.
Asthma ; Biopsy ; Cardiomegaly ; Churg-Strauss Syndrome ; Cyclophosphamide ; Echocardiography ; Electrocardiography ; Eosinophilia ; Eosinophils ; Female ; Gadolinium ; Heart Ventricles ; Humans ; Hypesthesia ; Magnetic Resonance Imaging ; Middle Aged ; Myocarditis ; Rhinitis ; Rhinitis, Allergic, Perennial ; Thorax ; Vasculitis

BACKGROUND: Frailty is a wasting syndrome that presents loss of physiological function by aging, lowering of reserve capacity, and disability of body system. It is currently being considered an important issue in geriatrics. This study examined frailty level of Korean elderly in community and whether frailty can be meaningful a predictive factor for functional disability. METHODS: Demographic characteristics, the number of chronic diseases and medications, cardiovascular health study (CHS) frailty index, study of osteoporotic fractures (SOF) frailty index, activities of daily living, Instrumental activities of daily living, depression, mini-mental state examination (MMSE) and fall history were examined for 302 men and women over 65 years old who visited the three community seniors welfare centers from February 2008 to June 2008. RESULTS: There were definite differences of frailty status by age, educational level, marital status, monthly income, body mass index, the number of chronic diseases, the number of medications, depression, MMSE and fall history (P < 0.05), except in gender (P < 0.432). In logistic regression analysis for functional disability with frailty status defined by SOF frailty index, odds ratio to dependency of instrumental activities of daily living (IADL) from the healthy to the prefrail stage increased 6.84 times while from the healthy to the frail stage increased 130.87 times. These effects still increased after covariate adjustment. Also, the CHS frailty index showed the same result although there was some difference in odds ratio. CONCLUSION: There were meaningful correlations of frailty with functional disability when dividing Korean elderly's frailty levels into the healthy, the prefrail and the frail stages.
Activities of Daily Living ; Aged ; Aging ; Body Mass Index ; Chronic Disease ; Dependency (Psychology) ; Depression ; Female ; Geriatrics ; Humans ; Logistic Models ; Male ; Marital Status ; Odds Ratio ; Osteoporotic Fractures ; Wasting Syndrome

PURPOSE: The aim of this study is to compare the quality of chest compressions between cardiopulmonary resuscitation (CPR) performed by a single trained rescuer and two rescuer CPR performed by a trained rescuer and an untrained rescuer in a prolonged out-of-hospital CPR scenario. METHODS: For the phase I experiment, thirty-six emergency medical technician students (trained rescuers) were asked to perform 10 minutes of lone rescuer CPR on an instrumented manikin. For the phase II experiment, thirty-six volunteers with no previous CPR training (untrained rescuers) were recruited. Each untrained rescuer was randomly assigned to one trained rescuer. They were asked to perform 10 minutes of two rescuer CPR during the phase II experiment. RESULTS: During phase I, the percent of correct compressions diminished over time. The number of total compressions attempted for 10 minutes was increased significantly in phase II (786+/-50 versus 689+/-50 in phase I, p<0.01). However, the mean percentage of correct compressions for 10 minutes did not show a significant difference between phases (66+/-34% in phase I versus 64+/-22% in phase II). The duration of chest compression interruption was significantly reduced in phase II (3.0+/-0.4 versus 3.5+/-0.5 min in phase I, p<0.01). CONCLUSION: The quality of two rescuer CPR performed by a trained rescuer and an untrained rescuer was comparable to that of lone rescuer CPR performed by a single trained rescuer in a 10-min CPR scenario. When CPR goes on for a prolonged period, changing the person doing the chest compressions to an untrained rescuer may improve the quality of CPR.
Cardiopulmonary Resuscitation ; Emergency Medical Technicians ; Fatigue ; Humans ; Manikins ; Thorax

Leptospirosis is a spirochetal infectious disease caused by Leptospira interrogans, and may vary in degree from an asymptomatic infection to a severe and fatal illness. The kidney is one of the principal target organs of Leptospira. Renal disorders caused by Leptospira infection vary from an abnormality in urinalysis to acute kidney injury (AKI). Incidence of AKI in severe leptospirosis varies from 40% to 60%. AKI reflects the severity of leptospirosis and is generally accompanied by cholestatic jaundice. The pathophysiology of AKI in leptospirosis consists of hypovolemia, direct tubular toxicity, and rhabdomyolysis. Most patients with acute leptospirosis experience severe myalgias, and show laboratory evidence of mild rhabdomyolysis. However, occurrence of severe rhabdomyolysis is rare. We report here on a patient with leoptospirosis, who had severe rhabdomyolysis and acute kidney injury without jaundice.
Acute Kidney Injury ; Asymptomatic Infections ; Communicable Diseases ; Humans ; Hypovolemia ; Incidence ; Jaundice ; Jaundice, Obstructive ; Kidney ; Leptospira ; Leptospira interrogans ; Leptospirosis ; Rhabdomyolysis ; Urinalysis

PURPOSE: Metastatic biliary tract cancer (mBTC) has a dismal prognosis. In this study, an independent dataset of patients with mBTC was used to implement and validate a routine clinico-laboratory parameter-based scoring model for risk group identification. MATERIALS AND METHODS: From September 2006 to February 2015, 482 patients with mBTC were assigned randomly (ratio, 7:3) into investigational (n=340) and validation datasets (n=142). The continuous variables were dichotomized using a normal range or the best cutoff values determined using the Contal and O'Quigley statistical methods. Following a Cox’s proportional hazard model, the scoring model was derived by summing the rounded chi-square scores for the factors identified by multivariate analysis. RESULTS: The performance status (Eastern Cooperative Oncology Group 3-4), hypoalbuminemia (< 3.4 mg/dL), carcinoembryonic antigen (≥ 9 ng/mL), neutrophil-to-lymphocyte ratio (≥ 3.0), and carbohydrate antigen 19-9 (≥ 120 U/mL) were identified as independent prognosticators (Harrell’s C index, 0.682; integrated area under the curve, 0.653). Survival was clearly correlated with the risk groups (low, intermediate, and high, 14.0, 7.3, and 2.3 months, respectively; p < 0.001). The prognosis was also discriminative in the validation data set (median survival, 16.7, 7.5, and 1.9 months, respectively; p < 0.001). Chemotherapy did not offer any survival benefits for high-risk patients. CONCLUSION: These proposed prognostic criteria for mBTC can facilitate accurate patient risk stratification and treatment-related decision-making.
Biliary Tract Neoplasms* ; Biliary Tract* ; Carcinoembryonic Antigen ; Dataset ; Drug Therapy ; Humans ; Hypoalbuminemia ; Multivariate Analysis ; Prognosis ; Proportional Hazards Models ; Reference Values ; Social Identification

BACKGROUND: Type B insulin resistance syndrome is a manifestation of autoantibodies to the insulin receptor that results in severe hyperglycemia and acanthosis nigricans. However, the mechanisms by which these autoantibodies induce hypoglycemia are largely unknown. In this paper, we report the case of patient with type B insulin resistance syndrome who presented with frequent severe fasting hypoglycemia and acanthosis nigricans. METHODS: To evaluate the mechanism of hypoglycemia, we measured the inhibition of insulin binding to erythrocytes and IM9 lymphocytes in a sample of the patient's dialyzed serum before and after immunosuppressive therapy. RESULTS: In the patient's pre-treatment serum IgG, the binding of 125I-insulin to erythrocytes was markedly inhibited in a dose-dependent manner until the cold insulin level reached 10-9 mol/L. We also observed dose-dependent inhibition of insulin binding to IM9 lymphocytes, which reached approximately 82% inhibition and persisted even when diluted 1:20. After treatment with glucocorticoids, insulin-erythrocyte binding activity returned to between 70% and 80% of normal, while the inhibition of insulin-lymphocyte binding was reduced by 17%. CONCLUSION: We treated a patient with type B insulin resistance syndrome showing recurrent fasting hypoglycemia with steroids and azathioprine. We characterized the patient's insulin receptor antibodies by measuring the inhibition of insulin binding.
Acanthosis Nigricans ; Antibodies ; Autoantibodies ; Azathioprine ; Cold Temperature ; Erythrocytes ; Glucocorticoids ; Humans ; Hyperglycemia ; Hypoglycemia ; Immunoglobulin G ; Insulin ; Insulin Resistance ; Lymphocytes ; Receptor, Insulin ; Steroids