Food Habits and Dietary Behavior Related to Using Processed Food among Male College Students Residing in Dormitory and Self-boarding in Gangwon / 대한지역사회영양학회지

The purpose of this study was to examine food habits and dietary behavior related to using processed food among male college students residing in dormitory and self-boarding in Gangwon. A total of 344 students (dormitory group: 227, self-boarding group: 117) were surveyed from May to June of 2012. The results are summarized as follows: self-boarding group had a significantly higher frequency of skipping breakfast and lunch and frequency of out meal compared with the dormitory group (p < 0.05, p < 0.05, p < 0.05 respectively). The self-boarding group had a significantly lower the score of 'eat vegetables and Kimchi at every meal' (p < 0.001) and 'eat a variety of food everyday' (p < 0.001) compared with the dormitory group. The self-boarding group had a significantly higher the preference for meat products (p < 0.05) and canned food (p < 0.01) for selecting processed food compared with the dormitory group. The consideration for selecting processed food was ranked by 'taste', 'price', 'expiration', 'appearance' and 'nutrition' in both dormitory and the self-boarding group. In the dormitory group, nutrition labels were identified certainly 2.6%, sometimes 12.8%, and rarely 17.2%. In the self-boarding group, nutrition labels were identified certainly 1.7%, sometimes 18.0%, and rarely 24.8%. The necessity of nutrition education was high in both dormitory group (51.6%) and the self-boarding group (62.4%). Therefore, development of an educational program and application of the information from nutrition labels for male college students, especially self-boarding students will be effective in improving dietary life in order to maintain healthy dietary habits.

A case of anorexia Nervosa complicated by Pneumomediastinum and Retropneumoperitoneum / 대한내과학회지

Since anorexia nervosa is a multi-systemic disorder, as well as a psychiatric disorder, it needs a multidisciplinary approach. It causes many medical problems, including irregular menstruation, hematologic problems, decreased bone density, electrolyte imbalance, and dysrhythmias. Sometimes, this disorder also causes rare, unexpected complications, including abnormal air collections, such as pneumomediastinum, retropneumoperitoneum, or subcutaneous emphysema. The cause of these phenomena is unknown, although fragile parenchymal tissue that is disrupted easily when the local pressure is increased by coughing, vomiting, or defecation is a suggested cause. We experienced a case of anorexia nervosa complicated with abnormal air collections. After we excluded other possible causes, such as perforation of the gastrointestinal tract, and ordered the patient to undergo a short fast and inhale oxygen, the abnormal air collections resolved. We report this case because of its rarity and benign course.

Validation of the Korean Version of Liver Disease Quality of Life (LDQOL 1.0) Instrument / 대한간학회지

BACKGROUND/AIMS: Assessment of Health-related quality of life (HRQOL) outcomes in treatment of chronic disease is increasingly important. The objective of this study was to validate a Korean translation of the Liver Disease Quality of Life instrument (LDQOL version 1.0) for use in patients with chronic liver disease. METHODS: Two native Korean speakers with fluent English translated LDQOL including instructions, items, and response choices. This Korean translation of the LDQOL was administered to 121 patients with chronic liver disease. Cronbach's alpha coefficients were applied to test an internal consistency reliability of disease-specific scales of the LDQOL. MELD and modified CTP scores were calculated for all patients. Associations of MELD and modified CTP scores with severity of liver disease were analyzed with LDQOL. RESULTS: Internal consistency reliability was good (Cronbach's Alpha=0.69-0.94) in liver disease specific scales, except for the quality of social interaction scale (Cronbach's Alpha= 0.56). Mean modified CTP score and MELD score were 6.2+/-1.9 and 9.3+/-5.3, respectively. Both MELD score and modified CTP score showed correlations with most of the scores of liver disease specific scales of LDQOL 1.0, except for the quality of social interaction and sleep scale. CONCLUSIONS: The Korean version of the liver disease specific scales of the LDQOL 1.0 is validated and useful for measuring HRQOL in Korean patients with chronic liver disease.

A Case of Diffuse Large B Cell Lymphoma Transformed from a Duodenal Low Grade MALT Lymphoma / 대한소화기내시경학회지

Duodenal mucosa-associated lymphoid tissue (MALT) lymphoma is a very rare neoplasm. We report here a case of a 67-year-old woman with a diffuse large B cell lymphoma arising in a low grade MALT lymphoma in the duodenal bulb. She was asymptomatic and on a general health evaluation an upper endoscopy showed an extensive erosive lesion on the duodenal bulb. The biopsy specimen showed lymphocyte infiltration with lymphoepithelial lesions suggesting a low grade MALT lymphoma. A second upper endoscopy with biopsy discovered a focal diffuse large B cell lymphoma in the background of a low grade MALT lymphoma. A meticulous staging work-up revealed that the lymphoma was confined to the duodenum and regional lymph nodes. Finally, the patient was diagnosed as having a diffuse large B cell lymphoma transformed from a duodenal low grade MALT lymphoma. The patient was undergoing combination chemotherapy including the use of an anti-CD20 monoclonal antibody.

A Case of Focal Autoimmune Chronic Pancreatitis Improved with Oral Steroid Therapy / 대한소화기내시경학회지

Clinically, patients with pancreatic cancer and focal autoimmune chronic pancreatitis share many features, such as being elderly, painless jaundice, new-onset diabetes mellitus, and weight loss. Hence, it is difficult to differentiate between the two conditions. Nevertheless, it is very important to distinguish between focal autoimmune chronic pancreatitis and pancreatic cancer because they have different treatment modalities and prognoses. We encountered a case of a 72-year-old man who developed painless jaundice. The patient was diagnosed with focal autoimmune chronic pancreatitis instead of pancreatic cancer from the CT, ERCP, MRCP findings accompanying with an increased IgG4 level. The abnormalities in the clinical, laboratory, and radiological findings improved after 2 weeks of oral steroid treatment. After 3 months of oral steroid treatment, his disease showed further improvement. To our knowledge, this is a rare case of focal autoimmune chronic pancreatitis that improved with oral steroid treatment.

Clinical characteristics of constipation associated with diabetes mellitus / 대한내과학회지

BACKGROUND: Constipation occurs frequently in diabetes mellitus (DM). However, there are few reports that investigated the characteristics of constipation associated with DM. The purpose of this study was to evaluate the clinical features of constipation associated with DM. METHODS: Among constipated patients who visited Asan Medical Center from January 2000 to December 2004, 45 patients with DM (DM group) and 104 patients without DM (non-DM group) were included in this study. We reviewed the clinical presentation, results of anorectal manometry, colon transit time study, and defecogram. We also analyzed the response to biofeedback therapy. RESULTS: The severity of constipation symptoms before treatment was not different between DM and non-DM group. Patients with colon transit time over 56 hours were more frequent in DM group than in non-DM group (21/45, 46.7% vs. 31/104, 29.8% ; p=0.047). Among DM group, colon transit time and the duration of DM showed positive correlation (r=0.431, p=0.003). The resting anal sphincter pressure was significantly lower in DM group than in non-DM group (43.5+/-21.5 mmHg vs. 51.7+/-22.6 mmHg ; p=0.048). The results of defecography were similar between DM and non-DM group. Successful responses to biofeedback therapy were not different between DM and non-DM group (19/34, 55.9% vs. 43/79, 54.4% ; p=0.887). CONCLUSIONS: Slow transit constipation was more frequent in DM group than in non-DM group. The successful responses to biofeedback therapy appear to be similar between DM and non-DM group.

A Case of Pancreaticoportal Fistula Associated with Acute Severe Pancreatitis / 대한소화기학회지

Pancreatic fistulas are usually caused by the disruption of pancreatic duct. The majority of pancreatic fistulas are external fistulas and common causes of external and internal pancreatic fistulas are trauma and surgery. Internal pancreatic fistulas due to pancreatitis are rare. Internal pancreatic fistulas may communicate with peritoneal cavity, colon, small bowel, biliary system or pleural cavity. Among them, fistula between pancreatic duct and portal vein due to acute pancreatitis is rare. We report a case of 32-year-old male with fistula between pancreatic duct and portal vein as a complication of acute pancreatitis. Pancreaticoportal fistula was diagnosed by endoscopic retrograde cholangiopancreatography. He recovered after distal pancreatectomy with splenectomy and supportive care.

A Case of Diabetic Muscle Infarction Affecting Upper and Lower Limbs / 대한류마티스학회지

Spontaneous diabetic muscle infarction (DMI) is a rare condition that usually occurs in those with longstanding microvascular complications of diabetes. Typical presentation is abrupt onset of painful swelling in the lower limbs, uncommonly in the upper limbs. We report a 49 year-old woman with DMI affecting not only both thighs but also left arm. She had already advanced diabetic complications of retinopathy, nephropathy, and neuropathy. Magnetic resonance imaging (MRI) showed findings of hyper-intense T2 weighted signals and rim enhancement after intravenously administered gadolinium at the sites of infarction. Excisional biopsy specimens of the thigh muscle contained aseptic necrotic muscle mixed with areas of muscle fiber atrophy and fibrosis. The diagnosis of DMI was considered most likely, and she was treated with muscle rest, analgesics, and physical therapy. The swelling and pain of the involved limbs improved gradually without complications. Since ten months after discharge, her symptoms resolved almost completely, and never relapsed. Hence, we report a rare case of DMI involving left arm and both thighs with review of literature.

Two Cases of Intussusception Occurring through the Stoma after Gastric Surgery / 대한소화기내시경학회지

Intussusception is a rare but potentially serious complication of gastric surgery, and 6 cases have been reported in Korea. Diagnosis can be made by endoscopy, upper gastrointestinal series or computed tomography, but it needs a high index of suspicion for diagnosis. Early diagnosis and prompt surgical intervention is mandatory to avoid mortality. We report two cases of intussusception occurring through the stoma after gastric surgery. A 58-year-old woman presented with epigastric pain and vomiting followed by hematemesis, 30 years after gastrojejunostomy for pyloric obstruction caused by duodenal ulcer. Endoscopy showed jejunogastric intussusception and CT scan was compatible with the diagnosis. She was managed by segmental resection and anastomosis of the jejunum. Another 60-year-old man presented with epigastric pain and hematemesis, 7 years after total gastrectomy with a Roux-en-Y anastomosis for advanced gastric cancer. He was diagnosed as having chronic type jejunal intussusception by endoscopy and CT scan, and intussusception was resolved spontaneously.

A case of autoimmune chronic pancreatitis associated with sjogren's syndrome / 대한내과학회지

We report a case of autoimmune chronic pancreatitis associated with Sjogren's syndrome. A 68-year-old man was admitted to the hospital with jaundice. The serum IgG and IgE were elevated and endoscopic retrograde cholangiopancreatography demonstrated an irregular narrowing of the main pancreatic duct and stricture of the distal common bile duct. He complained of dry mouth and dry eyes with a gritty feeling. On physical examination, enlargement of both submandibular glands was noted. Schirmer test revealed positive result and the labial minor salivary gland biopsy showed infiltration of lymphocytes and plasma cells, consistent with Sjogren's syndrome. After one month of oral steroid therapy, the abnormalities in clinical, laboratory and radiological findings of autoimmune chronic pancreatitis were improved markedly. The enlargement of both submandibular glands was improved, too. To our knowledge, this is the first case of autoimmune chronic pancreatitis associated with Sjogren's syndrome in Korea.