A case of small cell carcinoma of the rectum manifesting as pathologic femur neck fracture / 대한내과학회지

Small cell carcinoma of the colon and rectum is a rare primary epithelial malignancy at this location. Histologically, this tumor represents a spectrum of neuroendocrine differentiation. The neuroendocrine cancers of the colon manifest a highly aggressive behavior, even more than their adenocarcinoma counterpart of the same stage. Small cell carcinoma in the colon has early metastasis and the prognosis is extremely poor. We report a case of small cell carcinoma of the rectum manifesting as femur neck fracture during sleep.

Clinical Features of Hepatitis A in Korean Adults / 대한내과학회지

OBJECTIVE: This study was aimed to characterize the clinical features and course of acute hepatitis A in Korean adults. METHODS: One-hundred and thirteen cases of acute hepatitis A, diagnosed between Jan. 1995 to July 1998 at 6 medical centers in Korea, were reviewed retrospectively. The clinical course of 94 cases with follow-up duration longer than 3 months were analyzed. RESULTS: The median age was 26 (16-65) years and 97.3% of the patients were under 40 years. The presumed sources of infection were identifed in 62 cases (54.9%). Among those, the leading source was ingestion of raw food. All patients showed normalization of bilirubin level within 8 weeks. The ALT levels normalized within 8 weeks in all patients except three patients (3.2%). Three patients with prolonged elevation of ALT showed second rise of ALT, suggesting a possibility of relapsing hepatitis. Prolonged fever (>38 degree C) more than 10 days was observed in 3 patients (3.2%). One case showed prolonged elevation of alkaline phosphatase (> x3 upper normal limit). No case of fulminant hepatic failure or death was observed. CONCLUSION: The majority of cases with acute hepatitis A in Korean adults showed self-limited course with full recovery.

Anthropometric Measurement of Newborn in Women with Gestational Diabetes Mellitus

PURPOSE: To find the anthropometric characteristics of newborn in women with gestational diabetes mellitus(GDM), and the relationship between the birth weight and anthropometric measurements of newborn, maternal body habitus and glycemic control in GDM group. METHODS: Maternal weight, height, and obstetric history of 82 women with GDM and 93 women with normal glucose tolerance were recorded at the time of screening test and delivery. Within 2 days after birth, the birth weight and anthropometric measurements were obtained, and maternal glycohemoglobin concentrations were measured and umbilical cord blood samples for C-peptide were collected in GDM group at delivery. RESULTS: There were no differences in the birth weight and frequency of LGA newborn between GDM and control group, although the primary C-section of GDM group was significantly higher compared with the control group. The abdominal circumference(AC) and triceps, subscapular, and thigh skinfold thickness(SFT) of newborn in GDM group were significantly increased compared with the control group. Maternal glycohemoglobin concentration was correlated with birth weight, but not with AC and three SFTs in GDM group. Umbilical cord blood C-peptide level had a correlation with birth weight and three SFTs in GDM group. Newborn's AC had a correlation with maternal weight and weight gain in GDM group, but not in control group. CONCLUSION: Although the birth weight and frequency of LGA did not differ, AC and triceps, subscapular, and thigh SFT were increased in GDM group. These increases of anthropometric measurements were observed in AGA newborn, and were greater in LGA newborn.

Bowel habits in routine check-up subjects / 대한내과학회지

BACKGROUND: To estimate bowel patterns in the Korean, we surveyed routine check-up subjects about their bowel habits, using self-reported questionnaire. METHODS: We analyzed 2939 subjects (male 1430, female 1509; age range 25 - 65 years) who had visited health promotion center for routine check-up. Subjects were given a validated self-report questionnaire, which measured the defecation frequency; stool consistency; self-report of constipation; straining to defecate; and levels of laxative use. RESULTS: Of the whole subjects 96.4% had defecation frequency between three per week and three per day. The prevalence of two or less bowel movements per week (4.1% compared to 0.6%), straining to defecate (20.8% compared to 13.0%) and hard stool (18.0% compared to 9.3%) was higher in women than men (p<0.01). The prevalence of self-reported constipation was higher in women than men (9.0% compared to 2.9%, p<0.01). Women were more likely to use laxatives than men (5.5% compared to 0.6%, p<0.01). CONCLUSIONS: Defecation frequency in most of routine check-up subjects is between three per week to three per day. Bowel dysfunction is a greater problem in women.