Effect of weight loss on health related quality of life in obese patients

BACKGROUND: Weight loss in obese patients has been shown to decrease plasma lipid level and high blood pressure, to improved glycemic control in diabetic patients and to decrease cardiovascular risk in obese patients. But, study for association of weight loss and Health related Quality of Life is not well known yet worldwide. This study was to determine whether weight loss would associate with improvements on Health Related Quality of Life. METHODS: Participants was recruited in 48 obese patient visiting obesity clinic of Family Medicine of Sungkyunkwan University Hospital. 27 patients who answered mailed questionnaire was analyzed. Health Related quality of life was measured by Catholic Medical Center Health Survey(CMCHS) V 1.0. Questionnaire included not only Health Related Quality of Life but also alcohol habit, excercise, smoking, marital status, economic status, education. RESULTS: In multiple regression analysis, weight loss is statistically significant differences on satisfaction, vitality, physical function, social function, role limitation general health dimensions of CMCHS. CONCLUSION: The Results of this study demonstrate that weight loss on obese patients may be associated with an improvement in Health Related Quality of Life.

A Case of Granulomatous Pancreatitis Caused by Syphilis / 대한내과학회지

Granulomatous pancreatitis is a granulomatous inflammatory disease of the pancreas and can he described only in infectious granulomas and pancreatic involvement by systemic granulomatosis. Sarcoidosis, isolated pancreatic involvement without systemic granulomatosis or a manifestation of systemic sarcoidosis, is more common cause of granulo-mataus pancreatitis than infectious granuloma. There has been some reports show a characteristic histological finding of the pancreatic involvement of sarcoidasis. Noncaseating granuloma is thought to be the characteristic finding of pancreatic sarcoidosis. But granulomatous pancreatitis caused by syphilis in a syrnptomatic patient is a very rare disease and, till now, to our knowledge, only a case was reported in 1987, Germany. We experienced a 55-year-old female patient with granulomatous pancreatitis caused by tertiary syphilis who presented as a recent onset jaundice, diarrhea, fatigue and vague epigastric discomfort. Radical pancreaticoduo-denectomy was performed, which showed noncaseating granulomatous pancratitis with vasculitis. To our knowledge, this is the first case of granulomatous pancreatitis caused by syphilis in Korea. We hereby report a case of granulomatous pancreatitis caused by syphilis with a brief review of literature.

Comparative Study of Signal-Averaged Electrocardiogram between Time Domain Analysis and Spectral Turbulence Analysis by 24-hr Holter Monitoring / 대한내과학회지

OBJECTIVES: Signal-averaged electrocardiography (SAECG) has been found to be a useful noninvasive technique for identifying patients at risk for life-threatening ventricular tachycardia. Delayed and fragmented activation of abnormal myocardial tissues causes the occurrence of high frequency low amplitude (HFLA) electocardiographic signals or late potentials. Generally, there are two methods in analyzing signal-averaged electrocardiography. Late potentials in the time domain analysis do not provide sufficient diagnostic power with regard to life-threatening Ventricular tachycardia. Buckingham et al. (1989) reported a time-domain sensitivity of 62%, a specificity of 75%. Spectral turbulence analysis (STA) of the signal-averaged ECG is the most recent frequency domain technique to improve the time domain sensitivity and specificity. So, We designed the study to compare the efficacy of Time Domain Analysis and Spectral Turbulence Analysis among five groups (Normal control, QRS widening, Postmyocardial infarction, Frequent VPC's with group beats, Nonsustained ventricular tachycardia). METHODS: 88 patients were selected from the patients who had been admitted between January 1994 and October l994, at National Medical Center. Patients were divided into five groups, which were respectively, Group A: Normal control group (n=33), Group B: QRS widening group (n=14), Group C: Postmyocardial infarction group (n=10), Group D: Frequent VPC's with group beats (n=22), Group E: Nonsustained VT group (n=9). We compared Spectral Turbulence Analysis and Time Domain Analysis of Signal-Averaged Electrocardiogram by 24 hours-Holter monitoring. RESULTS: 1) In normal control group(Group A), 9.1%(3 patients) were positive by Time Domain Analysis, but, all were negative by Spectral Turbulence Analysis. 2) In QRS widening group (Group B), 71.4%(10 patients) were positive by Time Domain Analysis, but, all were negative by Spectral Turbulence Analysis. 3) In postmyocardial infarction group (Group C), 309o were positive by Time Domain Analysis, and 10% were positive by Spectral Turbulence Analysis. 4) In frequent VPC's group (Group D), 22.7% (5 patients) were positive by Time Domain Analysis, and, 4.5%(1 patient) was positive by Spectral Tur-bulence Analysis. 5) In Nonsustained VT group (Group E), 33.3% (3 patients) were positive by Time Domain Analysis, and 11.1% (1 patient) was positive by Spectral Turbulence Analysis. CONCLUSIONS: In Time Domain Analysis, abnormal results were presented at Group R (QRS widening group) by 71.4%, which was markedly higher than other groups. But, in Spectral Turbulence Analysis, abnormal results were not presented at Group A and Group B. In Group A and Group B, Spectral Turbulence Analysis shows less false positive results than Time Domain Analysis.

A Case of Xanthogranulomatous Cholecystitis / 대한내과학회지

Xanthogranulomatous cholecystitis is an extremely rare benign inflammatory disease of the gall bladder characterized by yellowish focal nodular appearance with tissue necrosis and lipid-containing histiocyte (xanthomacell). Recently, we experienced a case of xanthogranulomatous cholecystitis. A 71-year old woman was admitted with the complaints of RUQ pain for 1 month. On abdominal ultrasound examination, there were diffuse gallbladder wall thickening, echogenic nodule with acoustic shadow, the calculous cholecystiti and the gall badder cancer were strongly suspected and the operation was performed. At operation the gall bladder was marked enlarged and wall thickening with two brownish, oval shaped, smooth surfaced stones. The specimen was revealed a xanthogranulomatous cholecystitis by the pathology.

A Case of Sarcoidosis with Bone Involvemnt / 결핵

Sarcoidosis is a chronic multisystemic disorder of unknown cause characterized by presence of noncaseating Epithelioid granuloma in affected organ. It was first reported in 1887 by Hutchinson and is relatively common in western countries. But it is not commonly seen in East Asia including Korea. All parts of the body can be affected, but the lung is the most frequently affected organ. Other common site of involvement include lymph node, eye, skin, etc. It is known that 3~9% of all cases of sarcoidos is associated with bone involvement. Bone involvement usually cause no symptom and frequently affect bones in hands an feet. In many cases, it is known to be associated with skin involvement. We recently experienced one case of sarcoidosis which typically showed X-ray finding of sarcoidosis with associated skin lesion(lupus pernio) and report it with review of the literature.

Bone Metastasis of Malignant Melanoma: A case report / 대한정형외과학회잡지

The following case report concerns a rare bone metastasis of malignant melanoma occurring in the 4th and 5th lumbar spines and adjacent iliac crests and sacrum. A 42-year-old woman was admitted with a 6 months history of severe lumbago ar right flank pain radiating to right lower extremity. Preoperative X-ray studies revealed stag horn stone in the right renal pelvis as spondylolisthesis of the 5th lumbar spine with bilateral isthmic defects. On physical examinations, dark brown colored nevus was noted at lower lumbar regio which was removed and subjected for biopsy. Surgical exploration demonstrated a melanoma metastasis to have invaded the spine process, lamina and transverse processes of the 5th lumbar spine, adjacent L4 and sacru and iliac crests. Surrounding soft tissues, however, were apparently normal. Postoperatively course of the patient seemed to follow a rapidly terminal clinical cours.

Diabetic Neuroarthropathy: 2 cases report / 대한정형외과학회잡지

Neuroarthropathy has infrequently been associated with diabetic patients. The initial presenting symptoms are in most cases the peripheral neuropathy involving chiefly the sensory components of peripheral nerves, leading to numbness, hyper-or paresthesia, and coldness of the extremity affected. The diabetic arthropathy, once occurred, is apt to show progressive deterioration of the function with destruction of both skeletal and supporting soft tissues Two cases of such arthropathy were presented here, the one was observed in a 29-year-old man with involvement of the left fourth and fifth tarsometatarsal joints and a large ulcer on the dorsal skin of the lesion, and the other in a 35-year-old man with destruction of the right ankle joint. Both of them showed remarkable remission of the symptoms with conservative measures such as arch support, cast immobilization and skin graft.

Congenital Multiple Joint Laxity: Report of 2 Cases / 대한정형외과학회잡지

Two cases of congenital multiple joint laxity are reported here. One was a 18-year-old boy, in whom the hypermobility of the joints was striking that 4 criterias (Carter & Wilkinson, 1964) could be observed. The other was a 18-year-old male who showed positive findings in three of the five diagnostic criterias. In both no familiar occurrence was noted.