A clinical research of tsutsugamushi disease occurred in and around Jeoung-up in the autumn of 2000

BACKGROUND: In korea, tsutsugamushi disease is one of the common diseases which occurs in more than 40% among acute febrile diseases during Autumn. The diagnosis is confirmed with Rickettsia tsutsugamushi antibody, and is characterised by fever, chill, headache, myalgia, skin rash, escha and lymphadenopathy. METHODS: We have conducted a survey on 16 clinically and serologically confirmed cases of Tsutsugamushi disease occurring during the period of October -November, 2000. RESULTS: Of 16 cases,7 were males and 9 were females with an average age of 67.76. Most patients had fever, chill, headache, myalgia, sore throat, cojunctival injection, cough, abdominal, pain, nausea, vomiting, hematuria in order of frequency. The physical findings were eachar (81.257) and skin rash (62.77) . Serologically 7 cases (43.75%) of 16 cases were confirmed positively R.tsutsugamushi antibody. General hematologic findings were decreased platelet count (37.57) , increased or decreased WBC (31.25% and 25% each other) , and anemia (25%) , Test for liver function included elevated AST, ALT (68.76%) , alkaline phosphatase (62.6%) , hypoalbuminemia (12.6%) , and hyperbilirubinemia(6.25) . Urinalysis showed hematuria (50%) , proteinuria (50%) , and pyuria (12.67) . Doxyrcycline therapy decreased fever in 2.85 days and after 5-6 days patients were discharged with improvement of almost all symptoms. CONCLUSION: Primary care physician in a community should always consider tsutsugamushi disease when he encounters patients with acute febrile disease in late Autumn and early winter and expect good prognosis with early diagnosis and treatment.

A Study of Anger, Alexithymia, and Depression in the Functional Dyspepsia

BACKGROUND: Functional dyspepsia (FD) is a commonly encountered disturbance of gut function and has been shown to be associated with psychological disturbance such as depression and anxiety. Of particular importance to clinicians are the relationship between anger, alexithymia, and depression. In this study, we investigated anger, alexithymia, and depression in patients with functional dyspepsia. METHODS: Thirty patients who visited Wonkwang University Hospital from January 2001 to June 2001, were diagnosed with functional dyspepsia by a gastroenterologist and compared with 37 healthy control group. Medical investigation of FD including gastrofiberscopy, esophageal manometry, and ambulatory 24-hours intraesophageal reflux test were negative. All subjects were evaluated for depression, anxiety, anger and anger expression, and alexithymia. The measures included Beck Depression Inventory (BDI), Spielberger State-Trait Anxiety Inventory (STAI), Spielberger State-Trait Anger Expression Scale (STAXI), and Toronto Alexithymia Scale (TAS). RESULTS: The FD patients reported significantly more symptoms of depression, more difficulty describing feeling to others in TAS, less anger-in and anger-out expression in STAXI than the control subjects. Depressive symptoms in FD were positively correlated with state anxiety, trait anxiety, alexithymia, state anger, trait anger, and anger-in expression. In multiple regression model, state anger and trait anxiety together accounted for 69.1% of the depression in FD. CONCLUSION: The FD patients reported more depressive symptoms, and the depressive symptoms were related to anxiety, anger and anger-in, and alexithymia. These finding lend support that FD is a syndrome in which biopsychosocial process and affect dysregulation may play a role in features of FD.

Body image perceptions and its related problems of local high school students

BACKGROUND: Recently, the trend pursuing slimness is significantly increasing in adolescents. Because of distorted body image, excessive body weight control can cause problems of health. The goal of this study is to investigate the factors of distorted body image and its problems. METHODS: The survey was performed in a high school of Jindo island on May, 2000. All of 258 students in 1st and 2nd grade participated in this study by questionnaires. Thirteen truthless questionnaires were excluded in this study. Therefore 245 student were selected. RESULTS: Only 20% of 245 repliers were satisfied with their body figure. In male, 24.1% wanted weight loss, and 39.8% wanted weight gain. In female, 73% wanted weight loss. In a populations(BMI<20), 70 males wanted weight loss, whereas 35(52.2%) among 67 females want weight loss. According to these result, female stuedents wanted strongly weight loss than male. The factors which most influenced body figure were sports star in males(36.1%), and movie stars in female.(43.8%) A group of 58.4% of repliers has experienced body weight control. A group of 37% in male and 39.6% in female suffered from side effects. 77% of total hoped to be educated about adequate body weight control method. CONCLUSION: Almost of adolescents dissatisfied with their body figure, Many adolescent who is not obese attempt weight loss, and are sufferd from side effects. Therefore, it is required for effective education about body weight control and social attitude permitting adequate body image.

The relationship between serum cholesterol level and violent behavior in suicidal patients

BACKGROUND: There are epidemiological clinical studies that describe the relationship of decreased serum cholesterol levels or their treatment with suicides, offensive actions and depression. METHODS: We studied 140 patients who were hospitalized at Asan Foundation Jeongup Hospital (in Korea) via emergency room after suicide attempts and whose serum cholesterol levels were acquired during 53 months (from Jan. 1. 1995 to May 31. 1999). They were evaluated with the use of t-test. The serum cholesterol levels were compared between the control group of 140 persons who underwent health check ups and 140 patients who were of similar age and sex ratios. RESULTS: Subjects showed significant decrease in serum cholesterol levels in comparison with the control group. Low serum cholesterol levels were related with the severity of suicidal attempts. 1) The subjects showed lower serum cholesterol levels than the control group(150.51+/-56.69mg/dl vs 185.61+/-31.94mg/dl; t= 6.382, df=278, P<0.001) (Table 3). 2) Those who killed themselves showed statistically significant decrease in serum cholesterol levels than those who survived after their suicidal attempts(169.13+/-49.29mg/dl vs 135.89+/-34.14; t=2.005, P<0.05) (Table 4). CONCLUSION: This study was carried out in farming and fishing villages of Korea. The result showed that the decrease in serum cholesterol levels increased the risk of suicide trials. This fact is similar to the results of the previous studies performed at other farming and fishing communities. In addition, those who killed themselves had lower serum cholesterol levels compared to those who survived suicide attempts. This relationship was associated with depression.