Effects of macronutrients in mixed meals on postprandial glycemic response / 한국영양학회지

PURPOSE: The aim of study was to determine the effects of carbohydrate, fat, protein, and fiber contents on glycemic responses in a single food item or meal. METHODS: Glycemic responses were measured in 30 healthy young adults (17 males and 13 females) with various test foods, including rice, egg whites, bean sprouts, olive oil, noodles, prune, broccoli, Korean dishes, Western dishes, and salad dishes, etc. Test foods were designed to contain various carbohydrate, fat, protein, and fiber contents in single or mixed foods or dishes. After 12 hours of fasting, participants consumed test foods, and the glycemic response was measured for a subsequent 120 min (0, 15, 30, 60, 90, and 120 min). Three hundred and fifty three glycemic responses from 62 foods were collected. The incremental area under the curve (AUC) was calculated for each test food for each subject to examine glycemic responses. Statistical analysis was conducted to identify which macronutrient (carbohydrate, fat, protein and fiber) affected the AUC using a mixed model. RESULTS: Carbohydrates (β= 37.18, p < 0.0001) significantly increased while fat (β= −32.70, p = 0.0054) and fiber (β= −32.01, p = 0.0486) significantly reduced the glycemic response. CONCLUSION: It can be concluded that the glycemic response of a meal can be modified depending on the fat and fiber contents of ingredient foods, even though carbohydrate content is maintained.

Association of serum carotenoid, retinol, and tocopherol concentrations with the progression of Parkinson's Disease

BACKGROUND/OBJECTIVES: A pivotal role of oxidative stress has been emphasized in the pathogenesis as well as in the disease progression of Parkinson's disease (PD). We aimed at investigating serum levels of antioxidant vitamins and elucidating whether they could be associated with the pathogenesis and progression of PD. MATERIALS/METHODS: Serum levels of retinol, α- and γ-tocopherols, α- and β-carotenes, lutein, lycopene, zeaxanthin and β-cryptoxanthin were measured and compared between 104 patients with idiopathic PD and 52 healthy controls matched for age and gender. In order to examine the relationship between antioxidant vitamins and the disease progression, multiple group comparisons were performed among the early PD (Hoehn and Yahr stage I and II, N = 47), advanced PD (stage III and IV, N = 57) and control groups. Separate correlation analyses were performed between the measured antioxidant vitamins and clinical variables, such as Hoehn and Yahr stage and Unified Parkinson's Disease Rating Scale (UPDRS) motor score. RESULTS: Compared to controls, PD patients had lower levels of α- and β-carotenes and lycopene. α-carotene, β-carotene and lycopene levels were significantly reduced in advanced PD patients relative to early PD patients and were negatively correlated with Hoehn and Yahr stage and UPDRS motor score in PD patients. No significant differences were found in serum levels of retinol, α- and γ-tocopherols, and other carotenoids between PD patients and controls. No significant correlations were found between these vitamin levels and clinical variables in PD patients. CONCLUSIONS: We found that serum levels of some carotenoids, α-carotene, β-carotene and lycopene, were lower in PD patients, and that these carotenoids inversely correlated with clinical variables representing disease progression. Our findings suggest that decreases in serum α-carotene, β-carotene and lycopene may be associated with the pathogenesis as well as progression of PD.

Comparison of Maternal Fatty Acid Intake and Fatty Acid Composition of Serum Phospholipids Between Singleton and Twin Pregnancies / 대한지역사회영양학회지

Essential fatty acids are important essential nutrients during pregnancy. The objective of this study was to compare fatty acid composition of serum phospholipids and essential fatty acid intakes between Korean pregnant women with a single baby and Korean pregnant women with twins. A total of 116 pregnant women who had maintained their health without any symptoms of pregnancy complications participated in the study. The subjects consisted of 57 women of singleton pregnancy and 58 women of twin pregnancy at the 1st, 2nd, or 3rd trimester of pregnancy. A 24-hour dietary recall was administered to each subject to obtain dietary information. The mean ages of the singleton pregnancy group and the twin pregnancy group were 31.44 years and 32.27 years, respectively, and the mean height values were 161.86 cm and 160.64 cm, respectively. The mean daily energy intakes in the singleton pregnancy group were 1639.95 kcal, 1904.71 kcal, and 1882.82 kcal for the 1st, 2nd, and 3rd trimester group, respectively. The mean daily energy intakes in the twin pregnancy group were 1745.99 kcal, 2203.46 kcal, and 2092.26 kcal for the 1st, 2nd, and 3rd trimester group, respectively. There were no significant differences in the mean fatty acid intakes by the type of pregnancy (i.e., singleton vs. twins and the stage of pregnancy (i.e., 1st vs. 2nd vs. 3rd trimester). However, the mean total fatty acid intake of those at the 1st trimester among the singleton pregnancy group tended to be higher than that of those at the 1st trimester among the twin pregnancy group. Such a trend seemed to be retro-versed. That is, the mean total fatty acid intakes of the twin pregnancy group were higher compared to the singleton pregnancy group for the 2nd and 3rd trimester group. The LA and total n6 concentrations of serum phospholipids of the singleton pregnancy group were significantly higher as the gestational age increased (p < 0.05). The alpha-LNA(p < 0.05), EPA (p < 0.05), and total n3 (p < 0.001) concentrations of serum phospholipids of the twin pregnancy group were significantly lower as the gestational age increased. The alpha-LNAconcentrations of serum phospholipids in the singleton pregnancy group at the 3rd trimester were significantly higher than that in the twin pregnancy group at the same trimester (p < 0.05). The serum phospholipids levels of AA and DHA of the twin pregnancy group were generally higher compared to those of the singleton pregnancy group. Particularly the differences reached at the level of statistical significance for those at the 1st trimester (p < 0.01). It is concluded that the study findings imply that fatty acid metabolism may meaningfully differ by the type and stage of pregnancy. Future research needs to be conducted to more elucidate grounding etiology and possible roles of dietary fatty acid intake levels in relation to the study findings.

Comparison of Maternal Fatty Acid Intake and Fatty Acid Composition of Serum Phospholipids Between Singleton and Twin Pregnancies / 대한지역사회영양학회지

Essential fatty acids are important essential nutrients during pregnancy. The objective of this study was to compare fatty acid composition of serum phospholipids and essential fatty acid intakes between Korean pregnant women with a single baby and Korean pregnant women with twins. A total of 116 pregnant women who had maintained their health without any symptoms of pregnancy complications participated in the study. The subjects consisted of 57 women of singleton pregnancy and 58 women of twin pregnancy at the 1st, 2nd, or 3rd trimester of pregnancy. A 24-hour dietary recall was administered to each subject to obtain dietary information. The mean ages of the singleton pregnancy group and the twin pregnancy group were 31.44 years and 32.27 years, respectively, and the mean height values were 161.86 cm and 160.64 cm, respectively. The mean daily energy intakes in the singleton pregnancy group were 1639.95 kcal, 1904.71 kcal, and 1882.82 kcal for the 1st, 2nd, and 3rd trimester group, respectively. The mean daily energy intakes in the twin pregnancy group were 1745.99 kcal, 2203.46 kcal, and 2092.26 kcal for the 1st, 2nd, and 3rd trimester group, respectively. There were no significant differences in the mean fatty acid intakes by the type of pregnancy (i.e., singleton vs. twins and the stage of pregnancy (i.e., 1st vs. 2nd vs. 3rd trimester). However, the mean total fatty acid intake of those at the 1st trimester among the singleton pregnancy group tended to be higher than that of those at the 1st trimester among the twin pregnancy group. Such a trend seemed to be retro-versed. That is, the mean total fatty acid intakes of the twin pregnancy group were higher compared to the singleton pregnancy group for the 2nd and 3rd trimester group. The LA and total n6 concentrations of serum phospholipids of the singleton pregnancy group were significantly higher as the gestational age increased (p < 0.05). The alpha-LNA(p < 0.05), EPA (p < 0.05), and total n3 (p < 0.001) concentrations of serum phospholipids of the twin pregnancy group were significantly lower as the gestational age increased. The alpha-LNAconcentrations of serum phospholipids in the singleton pregnancy group at the 3rd trimester were significantly higher than that in the twin pregnancy group at the same trimester (p < 0.05). The serum phospholipids levels of AA and DHA of the twin pregnancy group were generally higher compared to those of the singleton pregnancy group. Particularly the differences reached at the level of statistical significance for those at the 1st trimester (p < 0.01). It is concluded that the study findings imply that fatty acid metabolism may meaningfully differ by the type and stage of pregnancy. Future research needs to be conducted to more elucidate grounding etiology and possible roles of dietary fatty acid intake levels in relation to the study findings.

National Questionnaire Survey on Managing Patients with Severe Acute Respiratory Syndrome, 2003

BACKGROUND: There was an worldwide outbreak of the Severe Acute Respiratory Syndrome (SARS) originated from China in late 2002. During that period three cases of suspected SARS and 17 cases of probable SARS were reported in Korea. With the concerns about the reemergence of SARS-coV transmission, it is important to be prepared for any possibility. So, this study is aimed to analysis the past measures in managing SARS and propose the amendatory plans to improve the preparedness. RESULTS:Questionnaires were collected among clinicians with any experience in managing the probable or suspected SARS cases in Oct. 2003. 17 out of 22 hospitals responded to the questionnaire. The contents in the questionnaire were practical activities, personal equipments, response plans, isolation facilities in emergency centers, outpatient clinics, general wards and intensive care units, and relationship with the public health department. RESULTS: The dedicated isolation rooms in emergency centers, outpatient clinics, general wards, and intensive care units were prepared in 9 (9/17, 52.9%), 5 (5/17, 29.4%), 15 (15/16, 93.7%), and 4 (4/16, 25.0%) hospitals, respectively. Except for one hospital that newly made negative pressure room for SARS, single or multi-bed rooms without airborne infection control were used in all the other hospitals. The personal precaution principles were kept quite well in general wards. Before the designation of SARS hospital by the public health department prior evalution to see if the hospital was suitable for managing SARS was conducted in only 1 (1/12, 8.3%) hospital. The results of laboratory diagnosis were reported back in 1 (1/15, 6.6%) hospital. CONCLUSIONS: The isolation facilities which can control airborne infection were almost deficient not only for SARS but also for other respiratory transmissible diseases. For the infection control of transmissible diseases including SARS, more investment is needed on medical facilities and comprehensive support from the public health department required.

National Questionnaire Survey on Managing Patients with Severe Acute Respiratory Syndrome, 2003

BACKGROUND: There was an worldwide outbreak of the Severe Acute Respiratory Syndrome (SARS) originated from China in late 2002. During that period three cases of suspected SARS and 17 cases of probable SARS were reported in Korea. With the concerns about the reemergence of SARS-coV transmission, it is important to be prepared for any possibility. So, this study is aimed to analysis the past measures in managing SARS and propose the amendatory plans to improve the preparedness. RESULTS:Questionnaires were collected among clinicians with any experience in managing the probable or suspected SARS cases in Oct. 2003. 17 out of 22 hospitals responded to the questionnaire. The contents in the questionnaire were practical activities, personal equipments, response plans, isolation facilities in emergency centers, outpatient clinics, general wards and intensive care units, and relationship with the public health department. RESULTS: The dedicated isolation rooms in emergency centers, outpatient clinics, general wards, and intensive care units were prepared in 9 (9/17, 52.9%), 5 (5/17, 29.4%), 15 (15/16, 93.7%), and 4 (4/16, 25.0%) hospitals, respectively. Except for one hospital that newly made negative pressure room for SARS, single or multi-bed rooms without airborne infection control were used in all the other hospitals. The personal precaution principles were kept quite well in general wards. Before the designation of SARS hospital by the public health department prior evalution to see if the hospital was suitable for managing SARS was conducted in only 1 (1/12, 8.3%) hospital. The results of laboratory diagnosis were reported back in 1 (1/15, 6.6%) hospital. CONCLUSIONS: The isolation facilities which can control airborne infection were almost deficient not only for SARS but also for other respiratory transmissible diseases. For the infection control of transmissible diseases including SARS, more investment is needed on medical facilities and comprehensive support from the public health department required.

A case of hyperthyroidism as a cause of pulmonary hypertension / 대한내과학회지

Pulmonary hypertension has variable causes. Reported causes are autoimmune diseases, liver cirrhosis with portal hypertension, HIV infection, use of anorectic drugs or oral contraceptives, sleep apnea syndrome and endocrinopathies. Primary pulmonary hypertension is a rare, progressive, and often fatal disease of unknown cause. The disease is most common in women (ratio 1.7:1) and the mean age at the time of diagnosis is the mid-30s. Variable cardiovascular manifestations are frequent in hyperthyroidism. These include sinus tachycardia, atrial dysrhythmias, decreased exercise tolerance, cardiomegaly, increased cardiac output and congestive heart failure. Herein, we report a case with hyperthyroidism and coincidental pulmonary hypertension. After successful therapy of the thyrotoxic state, the pulmonary pressure decreased markedly, indicating a possible pathogenetic link.

A case of hyperthyroidism as a cause of pulmonary hypertension / 대한내과학회지

Pulmonary hypertension has variable causes. Reported causes are autoimmune diseases, liver cirrhosis with portal hypertension, HIV infection, use of anorectic drugs or oral contraceptives, sleep apnea syndrome and endocrinopathies. Primary pulmonary hypertension is a rare, progressive, and often fatal disease of unknown cause. The disease is most common in women (ratio 1.7:1) and the mean age at the time of diagnosis is the mid-30s. Variable cardiovascular manifestations are frequent in hyperthyroidism. These include sinus tachycardia, atrial dysrhythmias, decreased exercise tolerance, cardiomegaly, increased cardiac output and congestive heart failure. Herein, we report a case with hyperthyroidism and coincidental pulmonary hypertension. After successful therapy of the thyrotoxic state, the pulmonary pressure decreased markedly, indicating a possible pathogenetic link.

A False Diagnosis of Hypoplastic Left Heart Syndrome in a Fetus

Typical hypoplastic left heart syndrome(HLHS) is a distinct pathologic entity with aortic atresia, mitral atresia, very hypoplastic or absent left ventricle and thread like ascending aorta. Occasionally, the lesser degree of hypoplasia is found and is called hypoplastic left heart complex(HLHC) by some authors. This HLHC is often associated with critical aortic stenosis. Fetal echocardiography has enabled us to observe human fetal heart in-utero and to diagnose congenital heart disease prenatally over the last 20 years. The diagnosis of HLHS in fetal echocardiography is based on 2-dimensional echocardio -graphic evidence of a diminutive ascending aorta, aortic atresia, mitral atresia or severe stenosis and a hypoplastic left ventricle. Abnormal flow direction through atrial septum or through isthmus greatly aids the diagnosis. This report shows a fetal case who showed hypoplastic left side chambers and retrograde isthmic flow and was diagnosed with hypoplastic left heart syndrome. After birth, although the baby had tachy-dyspnea for the first 3 weeks, she finally recovered without any intervention and showed catch up growth of left side chambers. This case illustrates the extreme difficulty of assessing left ventricle in a fetus.

Two cases of severe cholesterol embolism after coronary angiography : Proven by skin biopsy / 대한내과학회지

Cholesterol embolism is due to dislodgment of cholesterol crystals from the atheromatous aorta resulting in an occlusion of small arteries. Cholesterol emboli may occur spontaneously but usually develops as a complication of vascular procedures. The organs most frequently involved are the skin and the kidneys but any organ can be affected. Cutaneous manifestations include livedo reticularis, indurated firm violaceous painful plaques and noduli tending to show central necrosis and tender blue toes. We report two cases of cutaneous cholesterol embolization of lower extremities with the impairment of renal function after coronary angiography, proven by skin biopsy.

Factors Associated with Renal Scar in Children with Vesicoureteral Reflux

PURPOSE : The urinary tract infection associated with vesicoureteral reflux(VUR) in children may result in serious complications such as renal scarring, hypertension, proteinuria and end stage renal disease. The purpose of this study was to evaluate the factors affecting renal scar such as age, gender, grade of VUR, and ACE gene polymorphism, and body growth in the patients with and those without renal scar associated with VUR METHODS : During the period from January 1994 to July 2000, We had 93 children with urinary tract infection associated with VUR who were admitted to the Department of pediatrics of Chonbuk National University Hospital. The patients were divided into two groups according to follow up 99mTc-DMSA renal scan; patients with renal scar group and those with non-scar group. We analyzed and compared the factors associated with renal scarring between the two groups. RESULTS : There were no significant difference in gender, causative organism, ACE gene polymorphism, height and weight at diagnosis between renal scar group and non-scar group. Fifty four patients were in renal scar group and forty seven of them had VUR. The age at diagnosis was significantly higher in renal scar group (2.48 +/-2.64yr) than in non renal scar group (1.26+/-1.83yr). Especially, the infants who were less than 1 year of age with VUR developed relatively more renal scar compared with infants older than 1 year of age. The incidence of renal scarring showed a direct correlation with the severity of VUR. CONCLUSION : The factors affecting renal scar formation were age at diagnosis, presence and grade of VUR, but the other factors such as gender, causative organism, ACE gene polymorphism were not associated with renal scarring. Therefore, further evaluation about uropathogenic E. coli and follow up study about body growth associated with severity of renal scar would be necessary.

A Case of Central Nervous System Atypical Teratoid/Rhabdoid Tumor of The 4th Ventricle : A Highly Malignant Tumor in Infancy and Childhood Frequently Mistaken for Medulloblastoma

Central nervous system atypical teratoid/rhabdoid tumor(CNS rhabdoid tumor) is a rare malignancy of uncertain origin. It typically occurs in infants and young children and comprises only a small fraction of pediatrics CNS malignancies. The tumor contains a large spindled cell component as classical rhabdoid morphology and focal areas resembling primitive neuroectodermal tumor. The tumor is defined histopathologically by the presence of rhabdoid cells, but contains considerable heterogeneity of the cell type, including the frequent presence of primitive neuroectodermal tumor. The prognosis for children with CNS rhabdoid tumor is dismal. We experienced a case of a three-year-old female who had been transferred to our hospital for seizure and vomiting. She was diagnosed as CNS atypical teratoid/rhabdoid tumor by biopsy. In spite of surgery and intensive postoperative multi-agents chemotherapy, she developed a local recurrence around the operation site at six months after surgery. We present this case with a brief review of related literatures.

A case of spontaneous pneumomediastinum and pneumopericardium in a young adult

Spontaneous medialstinal emphysema (pneumomediastinum) and pneumopericardium may be defined as the presence of free air or gas in the mediastinal structures and in the pericardial sac without an apparent precipitating cause. It most frequently occurs in young healthy adults without serious underlying pulmonary disease. Although pneumomediastinum and pneumopericardium is often asymptomatic, it may cause pain in the neck and chest, dysphonia and shortness of breath. Treatment is supportive unless the patient has a history of trauma from foreign body aspiration. The course of spontaneous pneumomediastinum and pneumopericardium is usually benign and self-limited. A case of spontaneous pneumomediastinum, pneumopericardium and subcutaneous emphysema in a 20-year-old male is reported in this paper

Three cases of listeria infection in the immunocompromised children

No abstract available.

Clinical considerations of acute leukemia or transient myeloprolifo- rative disorder in Down syndrome

No abstract available.