This study was conducted to improve the nutritional status of high school girls via lunch menu intervention. Surveys were carried out twice to evaluate basal status and status after lunch menu intervention. In the first survey nutrient intakes of 24-hour and school lunch were each estimated by 24-hour recall dietary survey and self-recording, respectively. Calcium intake was the lowest among nutrients, and stir-frying was the most preferred cooking method. Five dishes of school lunch menus which were included in the first survey were replaced with recipes containing foods with higher calcium level; anchovy stir-fried with red pepper paste, anchovy stir-fried with almond, pork stir-fried with shredded kelp, crab meat soup, and tteokbokki with cheese. In the second survey calcium intake from school lunch was significantly (p < 0.001) increased from 45.5% to 50.2% of one thirds of recommended intake (RI) after calcium enriched lunch menu intervention. Intakes of vitamin A and E were also significantly increased, whereas those of energy, thiamin, and vitamin C were decreased. Index of nutritional quality values of nutrients of 24-hour intakes (except thiamin, vitamin B6, vitamin C) is increased by intervention; however, those of calcium, folic acid, iron are still very low. Even though this study shows a possibility of improving nutrient intakes of students through school lunch menu intervention, lunch intervention by itself is not enough action to improve nutritional status of micronutrient for adolescents.
Adolescent ; Ascorbic Acid ; Calcium ; Capsicum ; Cheese ; Cooking ; Folic Acid ; Humans ; Iron ; Kelp ; Lunch ; Meat ; Micronutrients ; Nutritional Status ; Nutritive Value ; Prunus dulcis ; Vitamin A ; Vitamin B 6 ; Vitamins

Plasma carotenoid levels were compared among 64 healthy male subjects (control) and 38 patients of ischemic heart disease(IHD) and 20 ones of cerebral infarction(CI) all of whom were over 50years of age. Another 98 healthy male subjects aged 23 to 58 were selected to compare their plasma carotenoid levels by age groups, Levels of lutein, zeaxanthin and crpytoxanthin were lower in IHD(34+/-2, 13+/-1 and 62+/-7 microgram/dl)and CI(36+/-3, 12+/-2 and 41+/-6 microgram/dl)patient groups than in control group (84+/-5, 16+/-2 and 69+/-3 microgram/dl) while those of lycopene, alpha-and beta-carotene varied little among the three groups. The sum of the six carotenoid levels were levels were, therefore,highest(205+/-14 microgram/dl) in the control group followed by IHD(155+/-15 microgram/dl) and CI(128+/-17 microgram/dl) patient groups, Among the 98 healthy male subject for the age group study, levels of the three major carotenoids increased with age from the twenties to the fifities ; lutein, from 64+/-6 to 89+/-8 microgram/dl, cryptoxanthin, 57+/-8 to 73+/-4 microgram/dl and beta-carotene were more significantly correlated(r=0.30 to 0.61, p<0.01), whereas levels of lycopene and alpha-caroteme were significantly(r=0.21 - 0.23, p<0.05) correlated.
beta Carotene ; Cardiovascular Diseases* ; Carotenoids ; Cerebral Infarction ; Daegu* ; Heart ; Humans ; Lutein ; Male ; Myocardial Ischemia ; Plasma*

Middle-school students (158 boys and 199 girls) and their mothers were asked about nutritional attitudes, nutritional knowledge, dietary habits, and food intake using a questionnaire to examine whether nutritional knowledge and dietary behaviors of mothers affected their children's dietary habits. Nutritional attitude scores (total, 15 points) and nutritional knowledge scores (total, 20 points) of girls were 11.24 and 16.13 points, respectively, which were significantly higher than 10.47 and 15.43 points for boys. Generally, mothers received higher points than their children for all scores surveyed, but the results were not significantly different between boys' mothers and girls' mothers. The mean nutrient adequacy ratio (MAR) was calculated from dietary nutrient intakes to assess overall quality of meals. The results showed that girls had a higher MAR than that of boys (0.89 vs. 0.86, p < 0.01). Relationships among variables were examined by Pearson's correlation coefficient within children and between children and their mothers. Significant positive correlations were observed between nutritional attitudes and knowledge in both boys and girls. In girls, positive correlations between nutritional attitudes and dietary habits, nutritional knowledge and dietary habits, and dietary habits and MAR were also sig-nificant. In boys, only dietary habits and MAR were correlated with those of their mothers. Nutritional attitudes, dietary habits, and the MAR of girls' mothers were significantly correlated with nutritional attitude, dietary habits and the MAR of girls. The results indicate that the influence of mothers on dietary behaviors of children was greater in girls than that in boys, suggesting that a gender-specific nutrition education program is needed for middle school students.
Child ; Eating ; Food Habits ; Humans ; Meals ; Mothers ; Surveys and Questionnaires

Biliary hamartomas are tumor-like malformations of the liver. Biliary hamartomas are a type of fibrocystic disorder originating from ductal plate malformation and are typically considered benign, but with the risk of malignant transformation. In this case report, we present a rare occurrence of intrahepatic cholangiocarcinoma (ICC) that developed from biliary hamartomas, along with a literature review. A 76-year-old man with a diagnosis of biliary hamartomas had a history of recurrent cholangitis for 12 years, necessitating cholecystectomy, ERCP, and repeated antibiotic treatments. During his last episode, imaging studies revealed a hypervascular infiltrative mass in the right posterior liver segment. A liver biopsy confirmed adenocarcinoma and subsequent surgical pathology revealed ICC originating from biliary hamartomas. Chronic inflammation in the bile duct associated with biliary hamartomas may serve as a potential trigger for malignant transformation, as observed in this case. Therefore, close surveillance is essential for patients with biliary hamartomas presenting with infectious complications.

Bronchobiliary fistula is a rare condition. It is defined by the presence of a passage between the biliary tract and the bronchial tree. Many conditions can give rise to the developement of such a communication. The patient was a 71-year-old man who had obstructive jaundice due to liver mass. At first, we inserted an uncovered metallic stent for biliary drainage. However, the bile duct was perforated due to the trapping of a catheter in the distal end of the deployed stent. The operation was performed immediately, but only the sump draingage was placed in the retroperitoneum because the perforation site could not be found. After 20 days from the procedure, the patient complained of bilioptysis because of a bronchobiliary fistula. We inserted a covered stent into the previous uncovered metallic stent. Bilioptysis rapidly resolved after the successful procedure. We report a case of iatrogenic bronchobiliary fistula which was managed by endoscopic biliary stenting.
Aged ; Bile Ducts ; Biliary Tract ; Catheters ; Drainage ; Fistula* ; Humans ; Jaundice, Obstructive ; Liver ; Stents

We report a case of pancreatic pseudocyst presenting as an intramural gastric tumor on upper gastrointestinal examination, endoscopic ultrasound and computed tomography of the abdomen. Pancreatic pseudocysts in the stomach wall is rare and the most of them presented as a cystic mass, but this case was presented as a gastric mural solid tumor. Exploration revealed an about 4 4 2 cm sized round mass at the midbody of great curvature of stomach, it was in the muscle layer, and removed by surgical operation. The correct diagnosis of this case was established postoperately on the pathologic examination revealed pancreatic pseudocyst.
Abdomen ; Diagnosis ; Pancreatic Pseudocyst* ; Stomach ; Ultrasonography

BACKGROUND/AIMS: Recipients, at 13 months after administration of daily doses of 100 mg of lamivudine, were likely to have the highest rate of HBeAg seroconversion (32%); the greatest suppression of HBV DNA (98% reduction at week 52); and the highest rate of sustained normalization of ALT levels (72%). In a 1-year trial of lamivudine for chronic hepatitis B patients, the incidence of YMDD mutations was known to be about 14%. We intend to determine the incidence of YMDD mutations and the correlation between the mutation of the virus and the clinical characteristics of the patient. METHODS: Between Feb. 1999 and Sept. 2000 we conducted a prospective study. Patients received 100 mg of lamivudine per day orally for at least 9 months. The average period of follow-up was 15 months. The patients enrolled in this study were composed of 20 chronic hepatitis B patients and 3 liver cirrhosis patients. The male to female ratio was 18:5. The average age of the patients was 40 years. The HBV DNA was extracted from the initial serum and the serum on abnormal ALT level, and then PCR was done. Finally we sequenced a 459-bp fragment and analyzed which samples had YMDD mutation or did not. RESULTS: (1) The genetic mutations in the YMDD locus occurred in 3 of the 23 patients (13%), two patients exhibited YIDD mutation, and one patient exhibited YVDD at 24, 52, 48 weeks of therapy respectively. (2) During the 3 months of treatment, serum ALT levels returned to normal in 13 of the 23 patients (56%). The HBV DNA disappearance rate at 3 and 8 months was 63% and 84% respectively. The 8 of 19 patients who lost the HBV DNA during lamivudine treatment experienced the breakthrough at about 13 months (the range: 8~27 months). 4 patients experienced HBeAg seroconversion during the treatment period (17%). CONCLUSIONS: The mutations in the YMDD motif, especially the YIDD type, may aggravate the clinical outcome of the patients. We concluded that the treatment duration should be prolonged with these patients.
DNA ; Female ; Follow-Up Studies ; Hepatitis B e Antigens ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis B, Chronic* ; Hepatitis* ; Hepatitis, Chronic* ; Humans ; Incidence ; Lamivudine* ; Liver Cirrhosis ; Male ; Polymerase Chain Reaction ; Prospective Studies

Cyanoacrylate is well recognized for its effect in the treatment of the gastric variceal bleeding rather than the esopahgeal variceal bleeding. We used endoscopic injection sclerotherapy (EIS) with cyanoacrylate for the control of esophageal variceal bleeding in which endoscopic variceal ligation (EVL) was difficult due to severe post-EVL scar changes of the esophageal mucosa. The hemostasis by EIS with cyanoacrylate was successfully achieved despite the massive bleeding. However, esophageal obstruction occurred after the EIS treatment. Later, the obstruction resolved spontaneously as the polymer was expelled into the esophageal lumen. We report this case with a brief review of the literatures.
Cicatrix ; Cyanoacrylates* ; Deglutition Disorders ; Esophageal and Gastric Varices ; Hemorrhage ; Hemostasis ; Ligation ; Mucous Membrane ; Polymers ; Sclerotherapy*

BACKGROUND/AIMS: EUS can detect bile duct stones (BDS) that are undetectable on multidetector computed tomography (MDCT). BDS associated with acute biliary pancreatitis (ABP) are small and tend to be excreted spontaneously. This study evaluated the usefulness of early EUS in patients with ABP and undetectable BDS on MDCT. METHODS: Forty-one patients with ABP and undetectable BDS on MDCT underwent EUS within 24 hours of admission and were diagnosed with BDS, sludge, dilated common bile duct (CBD), or normal CBD. ERCP was performed in patients with BDS, sludge, or clinical deterioration. The diagnostic yield and the effects of early EUS on morbidity, mortality, and the length of hospitalization were evaluated. RESULTS: EUS detected BDS or sludge in 48.8% of patients examined. BDS was the diagnosis in 13 patients, sludge in seven, and neither for 21 patients. ERCP was performed in 20 patients with BDS or sludge, in two patients with coexisting cholangitis, and in one patient with worsening liver function tests. ERCP identified BDS in 12 patients and sludge in seven. No lesions were diagnosed in four patients by ERCP. All patients improved, and the length of hospitalization in patients with ERCP was 9.0 days, without ERCP 7.1 days. Two patients with major complications by ERCP were hospitalized for a prolonged time. CONCLUSIONS: Early EUS may be useful to select patients for therapeutic ERCP in cases of suspected ABP with undetectable BDS on MDCT.
Bile Ducts ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis ; Choledocholithiasis* ; Common Bile Duct ; Diagnosis ; Endosonography* ; Gallstones ; Hospitalization ; Humans ; Liver Function Tests ; Mortality ; Multidetector Computed Tomography* ; Pancreatitis* ; Sewage

BACKGROUND/AIMS: The aim of this study was to evaluate the diagnostic accuracy of 64-multidetector CT (MDCT) cholangiography for determining the causes of distal common bile duct (CBD) obstruction. METHODS: Two hundred fifty consecutive patients underwent 64-MDCT for diagnosing the clinical and biochemical signs of bile duct obstruction. The causes of bile duct obstruction were assessed by the pre- and post-enhanced axial and coronal multiplanar reformation images of 64-MDCT. The results were compared with ERCP, biopsy and surgery. RESULTS: The sensitivity and specificity of MDCT for CBD stones were 96.1% and 84.9%, respectively. In seven patients, The CBD stones in 7 patients could not be detected on MDCT. Eleven patients with stones in the distal CBD, as detected on MDCT, had no stones seen on ERCP. For malignant obstruction, the sensitivity and specificity of MDCT were 97.0% and 98.6%, respectively. Three patients who were diagnosed with periampullary cancers on MDCT were disclosed to have severe papillitis on ERCP. One patient who was diagnosed with CBD stone by MDCT was disclosed to have ampullary cancer. The overall accuracy of MDCT for determining the causes of biliary obstruction was 90.5%. CONCLUSIONS: MDCT cholangiography is a non-invasive method with relatively high sensitivity and high specificity for diagnosing the causes of distal CBD obstruction.
Biopsy ; Cholangiography ; Cholangiopancreatography, Endoscopic Retrograde ; Cholestasis ; Common Bile Duct ; Humans ; Papilledema ; Sensitivity and Specificity