Predictive Factors of Malignant Potential in Gallbladder Polyps / 대한췌담도학회지

BACKGROUND/AIMS: Although the incidence of GB polyps is increasing with improved surveillance, the study of predictive factors of malignant potential has not been sufficient. The aim of this retrospective study is to investigate the predictive factors of malignant potential in GB polyps. METHODS: Among 3,159 patients with laparoscopic cholecystectomy in Chonbuk National University hospital January 2009 to December 2013, 437 patients confirmed GB polyps pathologically were enrolled. The patients were divided into two groups; one with benign GB polyp and another with GB adenoma and incidental GB cancer. RESULTS: Group I with benign GB polyp was seen in 359 patients. On the other hand, 53 patients with GB adenoma and 25 patients with GB cancer in gourp II were identified. The patients in group II had shown a significantly higher incidence of age older than 50 years (53/78, 67.9% vs. 163/359, 45.4%, p=0.001), size larger than 10mm (40/78, 51.3% vs. 37/359, 10.3%, p<0.001), and GB wall thickening (36/78, 46.2% vs. 77/359, 21.5%, p<0.001). The presence of GB stone had not shown significant differences between two groups (26/78, 33.3% vs. 96/359, 26.7%, p=0.378). CONCLUSIONS: Cholecystectomy should be considered for the patients with GB polyp with these predictive factors.

Multiple Sclerosis in a Patient with Primary Sjogren Syndrome / 대한내과학회지

Sjogren syndrome (SS) is a chronic inflammatory autoimmune disorder involving the exocrine glands, which often presents with salivary and tear gland dysfunction leading to dry mouth and eyes (sicca symptoms). This disease occurs alone as primary SS, or in the background of connective tissue diseases as secondary SS. Neurological involvement is seen in 20-25% of SS cases. Cerebral involvement is generally heterogeneous both in terms of localization (focal or diffuse) and progression (acute, progressive or reversible) and may resemble the clinical and radiological findings of multiple sclerosis (MS). Here we present the case of a patient with primary SS who experienced acute progressive diffuse MS.

Churg-Strauss Syndrome Presenting with Diffuse Alveolar Hemorrhage / 대한내과학회지

Churg-Strauss syndrome (CSS), known as eosinophilic granulomatosis with polyangiitis, is a rare type of systemic vasculitis characterized by the presence of asthma, peripheral eosinophilia, and necrotizing vasculitis with eosinophilic infiltration of multiple organs. Approximately 3-4% of all CSS cases are associated with alveolar hemorrhage. Untreated CSS may lead to a poor prognosis, but glucocorticoid and cytotoxic agent treatments may result in clinical remission. The careful diagnosis and understanding of CSS is important for making treatment decisions and providing effective care. Here, we report a case of CSS with diffuse alveolar hemorrhage.

Retroperitoneal Fibrosis in a Patient with Rheumatoid Arthritis

A 54-year-old male diagnosed with rheumatoid arthritis (RA) was effectively treated with methotrexate and adalimumab. He was admitted with fatigue and right lower back pain which had persisted for 1 month. An enhanced abdominal computed tomography scan showed an ill-defined mass with soft tissue attenuation surrounding the right common iliac artery involving the right middle portion of the ureter. Laparoscopic ureterolysis and biopsy were performed. Microscopic evaluation confirmed the presence of fibroblastic proliferation, with a pleomorphic inflammatory cell infiltrate consisting predominantly of lymphocytes, macrophages, and vascular endothelial cells, without granuloma or neoplastic cells. Therefore, our diagnosis was retroperitoneal fibrosis (RPF)-associated RA. Clinicians should consider the possibility of RPF in patients with RA who experience lower back pain, abdominal pain, or dysuria, and order suitable imaging studies.

Homonymous hemianopia in a patient with Behcet's disease

No abstract available.

Relationships of Body Image, Body Stress and Eating Attitude, and Dietary Quality in Middle School Girls Based on Their BMI

This study investigated the body image, body stress, eating attitude, and dietary quality in middle school girls. Questionnaires were administered to one hundred fifty seven middle school girls in Seoul area. The subjects were categorized into the five groups according to their body mass index (BMI); 1) severely under-weight (BMI or = 25 kg/m2). 7.0%, 14.6%, 58.9%, 10.2%, and 10.2% of the subjects were classified as severely under-weight, under-weight, normal weight, overweight and obese groups, respectively. Regardless of the BMI, the subjects had disturbed body image, body stress, and poor eating attitude. The actual BMIs of the normal weight, overweight and obese subjects were significantly different from their desired BMI and perceived BMI, representing these subjects dissatisfied their body shape. Almost all subjects tried to lose their body weight even in the severely under-weight and under-weight groups. There were significant correlations of BMI with body image disturbance (p < 0.05), body stress (p < 0.01) and eating attitude (p < 0.05). These results indicated that middle school girls who have higher BMI seemed to have more body image distortion, body stress and risk of eating disorder. However, any significant difference in dietary quality among the five groups was not observed even though their dietary patterns were not balanced. As a conclusion, it is required that middle school girls should correct their distorted body image and body stress. Also, efforts to improve eating attitude, dietary pattern and nutritional status in the middle school girls are needed.