The most common cause of small bowel obstruction is postoperative adhesion, and besides a hernia, metastatic or primary cancer and small bowel tumors are possible causes. Superior mesenteric artery (SMA) syndrome is a rare cause of upper gastrointestinal obstruction and is associated with debilitating conditions with marked weight loss. SMA syndrome results from the compression of the third part of the duodenum due to the narrowing of the aortomesenteric angle. We report a 28-year-old woman with SMA syndrome after acute gastroenteritis. Her stomach was severely dilated due to the duodenal obstruction and computed tomography showed the compression of the third portion of the duodenum by SMA. She was conservatively cared for and thus favorably improved.
Adult ; Duodenal Obstruction ; Duodenum ; Female ; Gastroenteritis ; Hernia ; Humans ; Mesenteric Artery, Superior ; Stomach ; Superior Mesenteric Artery Syndrome ; Weight Loss

BACKGROUND: Attention deficit hyperactivity disorder (ADHD) is caused by multiple risk factors and accompany many problems. This study aimed to analyze the association of childhood obesity with ADHD and to know the related factors of ADHD. METHODS: In 2006, 427 students in fourth grade were recruited from two elementary schools in Gwangmyeong city. Height and weight were measured and children's weight status was classified as normal weight, overweight and obese using the age and gender-specific BMI established by Korean Academy of Pediatrics. The Korean abbreviated Conners' parent rating scale (ACRS) was used to measure the ADHD state. RESULTS: The obesity rate was higher in ADHD group than in non-ADHD group (P = 0.005). The Kovacs' children's depression inventory score (CDI score) of ADHD group was higher than that of non-ADHD group (P = 0.003). In ADHD group, there were many cases where students were looked after by members of the family other than the parents after school (P = 0.01). ADHD group had a tendency to have breakfast heavily (P = 0.01). The average monthly income of the parents of ADHD group was relatively higher than that of the non-ADHD group (P = 0.03), and the fathers of ADHD group tend to have night eating syndrome (P = 0.003). CONCLUSION: The ADHD was significantly associated with childhood obesity, and was likely to be more depressive and had different life styles than non-ADHD group.
Attention Deficit Disorder with Hyperactivity ; Breakfast ; Depression ; Eating ; Fathers ; Humans ; Life Style ; Obesity ; Overweight ; Parents ; Pediatrics ; Risk Factors

BACKGROUND: This study was performed to evaluate the effect of group intervention by primary care physicians on the changes of drinking behaviors in Korean heavy drinkers. METHODS: A total of 32 male heavy drinkers participated in group intervention by family physicians of Chungnam National University Hospital. Initially, they were assessed for general characteristics, family function and drinking characteristics prior to the intervention conducted 4 times (about 40 minutes/each session). Reassessment on their drinking frequencies (times/week), drinking amounts (drinks/drinking day) and Alcohol Use Disorders Identification Test (AUDIT) score was achieved at directly, at 12 weeks and at 1 year after intervention. RESULTS: The mean drinking frequency was significantly (P < 0.01) decreased from 5.2 +/- 1.7 before to 3.5 +/- 2.4 at directly, 3.9 +/- 2.3 at 12 weeks and 4.0 +/- 2.3 at 1 year after intervention. The mean drinking amounts were significantly (P < 0.01) decreased from 17.0 +/- 16.5 before to 11.0 +/- 16.9 at directly, 14.2 +/- 17.8 at 12 weeks and 13.9 +/- 17.8 at 1 year after intervention. The mean AUDIT score was significantly (P < 0.01) decreased from 29.4 +/- 5.8 before to 19.1 +/- 11.0 at directly, 21.8 +/- 9.1 at 12 weeks and 23.0 +/- 9.4 at 1 year after intervention. The number of heavy drinkers and binge drinkers were significantly (P < 0.05) decreased from 32 (100%) and 32 (100%) before to 20 (62.5%) and 22 (68.8%) at directly, 23 (71.9%) and 24 (75.0%) at 12 weeks, and 22 (68.8%) and 19 (59.4%) at 1 year after intervention. CONCLUSION: It is suggested that group intervention by family physicians may be effective on the improvement of drinking behavior at 12 weeks and 1 year after the intervention in heavy drinkers.
Drinking ; Drinking Behavior ; Family Characteristics ; Follow-Up Studies ; Humans ; Male ; Physicians, Family ; Physicians, Primary Care ; Primary Health Care

BACKGROUND: Sleep is an essential restorative physiologic phenomenon. Impaired sleep results in significant negative effect to the health. Symptoms like sleep initiation difficulty, frequent awakening, severe snoring have related to poor sleep quality. We studied frequency and compared the characteristics of common sleep disorders at family practice. METHODS: We surveyed patients over 18 years of age and their guardians who visited 16 familial practices for 6 days. We investigated sleep characteristics, frequency of sleep disorder and associated factors by questionnaires and analyzed by frequency analysis, Spearman's correlation coefficient, multiple logistic regression. RESULTS: We enrolled 1,117 participants. Older participants were more likely to report early sleep onset and off time, short sleep duration. Mean number of awakening during a typical night is 1.69. Female complained difficulties in initiation and maintenance of sleep more than male. A total of 32.5% had these insomnia symptoms and related to hypertension, stroke, stress, arthralgia, depression, urological disorder. 31.1% had excessive daytime sleepiness, related to stress, arthralgia, depression. Loud snoring and gasp for breath showed positive correlation between male, high BMI. Disrupted sleep over 3 times was related to old age, female, diabetes, hypertension, stroke, stress, arthralgia, depression. Restless leg syndrome were high in elderly, high BMI, stress, arthralgia and depression. CONCLUSION: About one in three who visit in primary medical practice have sleep disorder symptoms like insomnia, daytime fatigue, snoring. 3% of them have gasp for breath, 8% have restless leg syndrome.
Aged ; Arthralgia ; Depression ; Family Practice ; Fatigue ; Female ; Humans ; Hypertension ; Leg ; Male ; Prevalence ; Sleep Wake Disorders ; Sleep Initiation and Maintenance Disorders ; Snoring ; Stroke

Generalized or localized edema is a very common symptom in primary care. Edema is developed from an imbalance in the filtration system between the vessel and interstitial spaces. A systematic approach is extremely important to determine the underlying diagnosis, because its management plan depends on the cause of edema. Treatment includes sodium restriction, diuretic use, appropriate management of the underlying disorder, et al. This review can be helpful in establishing the management of edema in clinical practice.
Diuretics ; Edema ; Filtration ; Glycosaminoglycans ; Primary Health Care ; Sodium ; Water

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Humans ; Japan

No abstract available.

We report a case of acute calculous cholecystitis through scrub typhus. A 69-year-old woman presented with a history of general myalgia, fever, and right abdominal pain. She referred to our hospital for surgical treatment of clinically suspected acute cholecystitis. Physicians concluded the cause of cholecystitis as gall bladder (GB) stone and proper antibiotics treatment of scrub typhus was started later. The patient developed acute respiratory distress syndrome and multi organ failure through scrub typhus. Five days after admission, the patient was treated with proper antibiotics and discharged on the 13th day after starting doxycycline treatment without any sequelae. In areas endemic for tsutsugamushi disease, even though a patient with GB stone presents with symptoms of acute cholecystitis, careful history and physical examination are required to reveal the existence of eschars or skin eruptions.
Abdominal Pain ; Aged ; Anti-Bacterial Agents ; Cholecystitis ; Cholecystitis, Acute ; Doxycycline ; Female ; Fever ; Gallstones ; Humans ; Physical Examination ; Respiratory Distress Syndrome, Adult ; Scrub Typhus ; Skin ; Urinary Bladder