Trajectories of Handgrip Strength and Their Associations with Mortality among Older Adults in Korea: Analysis of the Korean Longitudinal Study of Aging / 가정의학회지

Background@#Handgrip strength (HGS) is a good predictor of adverse health outcomes in later life. This prospective study aimed to investigate whether HGS trajectory patterns were associated with all-cause mortality among older adults in Korea. @*Methods@#This study used the database of the 2006–2016 Korean Longitudinal Study of Aging. Study participants included 3,069 adults aged ≥65 years without a previous history of cancer. The trajectory model was developed to identify different homogeneous trajectory patterns of HGS according to study period. Cox proportional hazards models were then applied to investigate the association between HGS and all-cause mortality. @*Results@#The survival probability according to HGS during the follow-up period decreased as base HGS weakened. We identified four distinct trajectory groups of HGS among men and three among women. The risk of mortality increased as the HGS of both males and females decreased. Compared with the highest HGS group, the adjusted hazard ratios for all-cause mortality of the lowest, lower-mid, and upper-mid HGS groups among males were 3.46 (95% confidence interval [CI], 2.17–6.69), 2.26 (95% CI, 1.47–3.48), and 1.58 (95% CI, 1.07–2.32). Those of the low and mid HGS groups among females were 2.69 (95% CI, 1.39–5.21) and 1.97 (95% CI, 1.05–3.69). @*Conclusion@#The faster HGS declined over time, the greater the all-cause mortality risk increased compared with the slowly decreasing or maintained HGS groups among men and women. HGS measurement among older adults will be helpful in assessing their health statuses and pre-assessing disease-associated morbidity.

Trajectories of Handgrip Strength and Their Associations with Mortality among Older Adults in Korea: Analysis of the Korean Longitudinal Study of Aging / 가정의학회지

Background@#Handgrip strength (HGS) is a good predictor of adverse health outcomes in later life. This prospective study aimed to investigate whether HGS trajectory patterns were associated with all-cause mortality among older adults in Korea. @*Methods@#This study used the database of the 2006–2016 Korean Longitudinal Study of Aging. Study participants included 3,069 adults aged ≥65 years without a previous history of cancer. The trajectory model was developed to identify different homogeneous trajectory patterns of HGS according to study period. Cox proportional hazards models were then applied to investigate the association between HGS and all-cause mortality. @*Results@#The survival probability according to HGS during the follow-up period decreased as base HGS weakened. We identified four distinct trajectory groups of HGS among men and three among women. The risk of mortality increased as the HGS of both males and females decreased. Compared with the highest HGS group, the adjusted hazard ratios for all-cause mortality of the lowest, lower-mid, and upper-mid HGS groups among males were 3.46 (95% confidence interval [CI], 2.17–6.69), 2.26 (95% CI, 1.47–3.48), and 1.58 (95% CI, 1.07–2.32). Those of the low and mid HGS groups among females were 2.69 (95% CI, 1.39–5.21) and 1.97 (95% CI, 1.05–3.69). @*Conclusion@#The faster HGS declined over time, the greater the all-cause mortality risk increased compared with the slowly decreasing or maintained HGS groups among men and women. HGS measurement among older adults will be helpful in assessing their health statuses and pre-assessing disease-associated morbidity.

A Case of Pheochromocytoma Antenatally Diagnosed in the Mid Gestation / 대한주산의학회잡지

Pheochromocytoma during pregnancy is very rare tumor, and this condition is life threatening to both mother and fetus. We describe a case of pheochromocytoma antenatally diagnosed at the midtrimester in gestation. A patient was transferred to National Medical Center during gestational week 24 with severe hypertension, generalized edema. Pheochromocytoma caused by a left adrenal mass was diagnosed. The patient was treated with titrated dose of phenoxybenzamine, propranolol, and intravenous nicardipine, but, intermittent severe hypertension was developed. At 33 weeks gestation, fetal distress was developed, and emergent c-sec was done. Two weeks after delivery, she underwent a successful left adrenalectomy. Two months after surgery, all antihypertensive medications were discontinued and her blood pressure have remained normal range.

A case of endometrial cancer in a single horn of bicornuate uterus / 대한산부인과학회잡지

The occurrence of carcinoma in a congenital uterine anomaly is uncommon. Indeed, malignancy of the uterine fundus with congenital uterine anomaly is quite rare, with fewer than 50 cases reported in the world liturature. Many patients go through life without the knowledge of their presence, and they are discovered at autopsy. Early diagnosis and proper management is necessary to decrease the high mortality. We present a case of endometrial carcinoma in a single horn of a bicornuate uterus.

Three Cases of Primary Ovarian Pregnancy / 대한산부인과학회잡지

Primary ovarian pregnacy is a rare form of ectopic pregnacy of which an estimated overall incidence is highly variable, but improved diagnosis of acute hemoperitoneum of ovarian may reveal a higher incidence than reported earlier. Ovarian pregnancy is uaually accompanied with the rupture of the ovary and massive hemoperitoneum. It usually presents with abdominal pain, menstural irregularities, vaginal bleeding, a palpable adnexal mass and other symptoms which are very similar to those of tubal ectopic pregnacy and hemorrhgic corpus luteum cysts. Risk factors to ovarian pregnancy include a history of pelvic inflammatory disease (PID), prior pelvic surgery, and use of an intrauterine contraceptive devices (IUD). We have experienced three cases of ovarian pregnancy, which are presented with a brief review of the literature.

Three Cases of Primary Ovarian Pregnancy / 대한산부인과학회잡지

Primary ovarian pregnacy is a rare form of ectopic pregnacy of which an estimated overall incidence is highly variable, but improved diagnosis of acute hemoperitoneum of ovarian may reveal a higher incidence than reported earlier. Ovarian pregnancy is uaually accompanied with the rupture of the ovary and massive hemoperitoneum. It usually presents with abdominal pain, menstural irregularities, vaginal bleeding, a palpable adnexal mass and other symptoms which are very similar to those of tubal ectopic pregnacy and hemorrhgic corpus luteum cysts. Risk factors to ovarian pregnancy include a history of pelvic inflammatory disease (PID), prior pelvic surgery, and use of an intrauterine contraceptive devices (IUD). We have experienced three cases of ovarian pregnancy, which are presented with a brief review of the literature.

A Case of Discovery of Heterotopic Pregnancy After Elective Abortion / 대한산부인과학회잡지

Heterotopic pregnancy, simultaneous intrauterine and extrauterine pregnancy, is an extremely rare case. The incidence of heterotopic pregnancy was about 1 to 30,000 pregnancy, but it has been increased. Ectopic pregnancy is associated with significant mortality if not promptly diagnosed. Careful pelvic examination combined serial beta-hCG determinations and transvaginal sonography to evaluation the adnexal region are necessary prerequisites for early diagnosis. We report a case of discovery of heterotopic pregnancy after elective abortion with brief review of literature.

A Case of Idiopathic Long QT Syndrome(LQTS)

The idiopathic long-QT syndrome is an infrequent inherited disorder, characterized by prolonged QT interval and by the occurrence of life-threatening tachyarrhythmia, particularly in association with emotional or physical stree. In its characteristic presentation, with obvious QT prolongation and stree induced syncope with torsades de points, the diagnosis is straightforward for physicians aware of the disease. But sometimes in cases of borderline QT prolongation and vague symptom, a correct diagnosis is delayed and frequently misdiagnosed as a seizure disorder. The mortality of untreated symptomatic patients with LQTS exceeds 20% in the year after their first syncopal episode and aapproaches 50% within 10 years. But this high mortality rate has been significantly reduced by the use of pharmacological or surgical antiadrenergic therapy or both. So early detection of the disease and antiadrenergic treatment sympathetic innervation to the heart. Second, there was intrinsic gene abnormality in the mechanisms responsible for cardiac repolarization. We report one case of LQTS in a 24 years old female patient who had been suffering from stree related syncope. Her initial EKG had prologed QT interval(588msec) and increased QT intrval dispersion(200msec). In the Holter monitor, long and short cycle sequence induced (pause-dependent) torsades de pointes was detected. She has been treated by beta-blocker and has maintained her condition without recurrence of the symptoms.