The prevalence and risk factors of diabetes mellitus in people of Hope Village / 대한내과학회지

BACKGROUND: Recently, the prevalence of diabetes mellitus in Korea is rapidly increasing. It is known that this increase is related with the change of environmental factors. We performed study to determine the prevalence of diabetes and to investigate their risk factors in Hope Village taking in low socio-economic people. METHODS: Total 1,425 subjects (905 men and 520 women) aged over 20 years in Daegu city Hope Village were venipunctured after overnight fasting to measure plasma glucose level and interviewed about their past medical and social history. We also collected standard anthropometric data. All the data were analyzed by SPSS 9.0 program. RESULTS: The prevalence of diabetes by using the revised new American Diabetes Association criteria was 13.5% (male=10.1%, female=19.4%) and the prevalence of impaired fasting glucose was 11.3% (male=8.7%, female=15.8%). It was observed that the significant factors associated with diabetes were age, sex, serum triglyceride level, systolic blood pressure. CONCLUSION: The prevalence of diabetes in Hope Village was relative higher than that of the previous suggested population based studies in Yonchon County and Jungup District. But the risk factors of newly diagnosed diabetes were similar with those of the previous studies.

A Case of Graves' Disease Associated with Guillain-Barre Syndrome / 대한내분비학회지

Graves disease, an autoimmune endocrine disorder, which causes defects in cellular and humoral immunity, is associated with insulin-dependent diabetes mellitus, Addisons disease, pemicious anemia, and rheumatoid arthritis. Graves disease is associated with various neuro-muscular disorders, such as myopathy, exophalmous oculopathy, periodic paralysis, myastenia gravis and rarely Guillain-Barre syndrome. Guillain-Barre syndrome is considered as an autoimmune disease which can occur concurrently with other autoimmune disorders. This syndrome is characterized by segmental demyelination and axonal degeneration in electrophysiology due to autoantibody to nervous systems via cellular and humoral autoimmunity. In Graves disease, the exact mechanism of the associated Guillain-Barre syndrome is not well understood but it is considered that the autoimmunity is the leading cause of development of both diseases. A 37 year-old man had suffered from thyrotoxic symptoms and progressive symmetrical muscular paralysis. In nerve conduction velocity studies, the result shows peripheral neuropathy; axonopathy; myelinopathy; motor nerve and sensory nerve derangement; right first sacral nerve neuropathy; and decreased CMAP amplitude. The patient was treated with propylthiouracil and high dose intravenous immunoglobulin (400mg/kg/day for Sdays). He responded to the therapy well and became euthyroid state with improvement of muscle weakness. We report a case of Graves' disease associated with Guillain-Barre syndrome with brief review of literature which shows a possible relationship between both diseases.

Endoscopie Variceal Ligation As an Alternative Treatment to Sclerotherapy for Esophageal Varices / 대한소화기내시경학회지

Currently, endoscopic injection sclerotherapy(EIS) is the most widely used method for treating and eradicating acutely bleeding esophageal varices in repeated sessions, but may be associated with some undesirable local and systemic complications. (continue...)

Endoscopic Local Injection of Hypertionic Saline Epinephrine Solution for Arrest Hemorrhage from Upper Gastrointestinal Tract: Hemostatic and diagnostic rate according to the time interval / 대한소화기내시경학회지

A prospective randomised trial was performed to assess the diagnostic accuracy according to the time interval and the efficacy of endoscopic injection of hypertonic saline-epinephrine(HS- E)solution, consisting of 3.5% sodium chloride with 0.0045% epinephrine, for actively bleeding peptic ulcers, exposed vessel or blood clot on ulcer bed, or Mallory-Weiss tear. Over 24 month, emergency endoscopy in 180 patients admitted for upper gastrointestinal hemorrhage identified 51 patients with nonvariceal hemorrhage. The causes of bleeding were; gastric ulcer in 32; duodenal ulcer in 13; gastric cancer in 4; Mallory-Weiss tear in 2. With this method, the hemostatic effect was permanent in 40 cases(84.3%), temporary in 9 cases(11.8%), and failed in 2 cases(3.9%). By applying this method, the rate of emergency operation for patients with bleeding from the upper gastrointestinal tract was significantly reduced from 20.0% (8/40)to 3.9%(2/51)(p<0.05). Emergency endoscopy in acute UGI bleeding increases the accuracy of detection of actual bleeding sites(p<0.05), but if the endoscopic procedure was performed within 48 hours, the hemostatic rate was not affected(p<0.05). We concluded that hypertonic saline-epinephrine injection method could provide a simple maneuver with reasonable cost, high safety, and satisfactory hemostatic efficacy in the treatment of nonvariceal upper gastrointestinal bleeding.