Anorexia nervosa is characterized by distortion of body image and profound weight loss due to self starvation. So, the patients are easily diagnosed with history and interview. We experienced a patient who had suffered for prolonged vomiting and profound weight loss without definite distorted body image, but had accompanied by autonomic dysfunction. Thus, we report a case with a brief review of literatures.
Anorexia Nervosa* ; Anorexia* ; Body Image ; Humans ; Starvation ; Vomiting ; Weight Loss

The treatment consensus of anorexia nervosa in the last century was to remove the patient from her family and home surroundings. A great range of treatment from prescribing hormonal extracts to prefrontal leucotomy has been tried. Although in former decades many quite different forms of treatment have been described and advocated for anorexia nervosa, there is today consensus concerning the overall management of the disorder. But there still remains a widespread clinical opinion that inpatient treatment is necessary for some as a means of reliably increasing weight. Over the last hundred years the management of anorexia nervosa has changed. Treatment has shifted from medical wards, through to psychiatric wards and now, following the trends in all of medicine, towards community care in Western society. In Korea, case reports of anorexia nervosa and related articles have been published since the late seventies. Recently several epidemiological studies and clinical reports suggested increasing rate of eating disorders including anorexia nervosa in Korea. However, systematic approaches for these patients have not been tried in Korea. The author introduces the treatment model for inpatients with anorexia nervosa of Johns Hopkin's Hospital, Maudsley Hospital, and St. John's Mercy Medical Center. The author also introduces treatment experience with anorexic inpatient at Seoul Paik Hospital.
Anorexia Nervosa* ; Anorexia* ; Consensus ; Diethylpropion ; Feeding and Eating Disorders ; Humans ; Inpatients* ; Korea ; Psychosurgery ; Seoul

Gelatinous transformation of the bone marrow is rarely found and characterized by accumulation of hyaluronic acid, fat atrophy and associated with bone marrow hypoplasia. This process has been reported to occur in severely malnourished patients. We report an anorexia nervosa patient showing pancytopenia and hypoplastic bone marrow associated with gelatinous transformation. Pathogenesis of this lesion remains unclear.
Anorexia Nervosa* ; Anorexia* ; Atrophy ; Bone Marrow* ; Gelatin* ; Humans ; Hyaluronic Acid ; Pancytopenia

Spontaneous pneumomediastinum (PM) is an uncommon condition in which free air enters the mediastinum. This usually occurs either through esophageal tears after vigorous vomiting, or after alveolar rupture subsequent to a rapid increase in intra-alveolar pressure. Spontaneous PM is a rare entity in anorexia nervosa (AN) and self-induced vomiting is often the cause of PM in patients with AN. We experienced a case of spontaneous PM in an anorexic adolescent, in whom vomiting was not the cause of PM.
Adolescent ; Anorexia Nervosa* ; Anorexia* ; Diethylpropion ; Humans ; Mediastinal Emphysema* ; Mediastinum ; Rupture ; Subcutaneous Emphysema ; Tears ; Vomiting

OBJECTIVES: This study compared cognitive-behavioral traits related to eating behaviors, obsessive-compulsive traits, and depression levels in bulimic subjects with and without a history of anorexia nervosa according to the perspective that there are common diagnostic transitions over time in subgroups of eating disorders (anorexia nervosa, bulimia nervosa, and eating disorder not otherwise specified). METHODS: We compared EDI-2, MOCI, and BDI scores between the bulimic group with a history of anorexia (n=98), the bulimic group without a history of anorexia (n=99), and the non-clinic group (n=100) by ANOVA. RESULTS: The bulimic group with a history of anorexia showed significantly higher scores on four of the EDI-2 subscales (Ineffectiveness, Interoceptive Awareness, Impulse Regulation and Social Insecurity) than the other two groups. They also indicated significantly higher scores on both the MOCI subscale 'rumination' and BDI than both the other groups. CONCLUSION: These findings suggest that it is important to consider a prior history of anorexia nervosa in order to understand symptom severity in patients with bulimia. Psychological variables such as ineffectiveness, impulse regulation, social insecurity, rumination, and depression are crucial to consider while treating bulimics with a history of anorexia.
Anorexia ; Anorexia Nervosa ; Bulimia ; Bulimia Nervosa ; Depression ; Feeding and Eating Disorders ; Feeding Behavior ; Female ; Humans

Anorexia nervosa is a kind of dietary disorder which causes amenorhea, weight loss, behavioral changes, and its hormonal status is typical hypogonadotrophic hypogonadism. The patients with anorexia nervosa showed many hormonal and chemical abonormal findings, like decresed follicular stimulating hormone, decreased lutealizing hormone and estrogen, increased cortisol, hypokalemia, hypercarotenemia. But tissue mineral contents of anorexia nervosa were not reported. We experience the typical increase of tissue copper contents in three anorexia nervosa patients in recent days, so report them with reviews of literatures.
Anorexia ; Anorexia Nervosa ; Copper ; Estrogens ; Hair ; Humans ; Hydrocortisone ; Hypogonadism ; Hypokalemia ; Weight Loss

Anorexia nervosa is a kind of dietary disorder which causes amenorhea, weight loss, behavioral changes, and its hormonal status is typical hypogonadotrophic hypogonadism. The patients with anorexia nervosa showed many hormonal and chemical abonormal findings, like decresed follicular stimulating hormone, decreased lutealizing hormone and estrogen, increased cortisol, hypokalemia, hypercarotenemia. But tissue mineral contents of anorexia nervosa were not reported. We experience the typical increase of tissue copper contents in three anorexia nervosa patients in recent days, so report them with reviews of literatures.
Anorexia ; Anorexia Nervosa ; Copper ; Estrogens ; Hair ; Humans ; Hydrocortisone ; Hypogonadism ; Hypokalemia ; Weight Loss

In young adolescent girls, anorexia nervosa is a significant cause of weight loss, and hospital admissions among children and adolescents. Anorexia nervosa is a life-threatening disorder, with about one-third of deaths caused by cardiac complications. A high rate of pericardial effusion has been recently reported in patients with anorexia nervosa, although relatively few cases require pericardiocentesis. Here, we describe three patients with anorexia nervosa who were diagnosed with large pericardial effusions. To prevent cardiac tamponade, pericardiocentesis was performed in two girls.
Adolescent ; Anorexia ; Anorexia Nervosa ; Cardiac Tamponade ; Child ; Humans ; Pericardial Effusion ; Pericardiocentesis ; Weight Loss

The treatment consensus of anorexia nervosa in the last century was to remove the patient from her family and home surroundings. A great range of treatment from prescribing hormonal extracts to prefrontal leucotomy has been tried. Although in former decades many quite different forms of treatment have been described and advocated for anorexia nervosa, there is today consensus concerning the overall management of the disorder. But there still remains a widespread clinical opinion that inpatient treatment is necessary for some as a means of reliably increasing weight. Over the last hundred years the management of anorexia nervosa has changed. Treatment has shifted from medical wards, through to psychiatric wards and now, following the trends in all of medicine, towards community care in Western society. In Korea, case reports of anorexia nervosa and related articles have been published since the late seventies. Recently several epidemiological studies and clinical reports suggested increasing rate of eating disorders including anorexia nervosa in Korea. However, systematic approaches for these patients have not been tried in Korea. The author introduces the treatment model for inpatients with anorexia nervosa of Johns Hopkin's Hospital, Maudsley Hospital, and St. John's Mercy Medical Center. The author also introduces treatment experience with anorexic inpatient at Seoul Paik Hospital.
Anorexia Nervosa* ; Anorexia* ; Consensus ; Diethylpropion ; Feeding and Eating Disorders ; Humans ; Inpatients* ; Korea ; Psychosurgery ; Seoul

Gastrointestinal (GI) symptoms in children and adolescents are influenced by diverse psychiatric components such as psychosocial stresses, familial environment, school-related situations, and comorbid psychiatric conditions. Absolutely psychiatric symptoms of pediatric patients are also affected by problems of GI system. Lots of symptoms including anorexia, dyspepsia, nausea and so on are commonly originated from either GI or psychiatric causes or both. Sometimes the negative interactions between GI and psychiatric problems aggravate the severity and eventually decline the functions of children and adolescents with GI symptoms. We summarized the common GI and psychiatric conditions which have GI and psychiatric associations. To a clinician who manages pediatric GI disorders, psychiatric considerations can be beneficial to understand the clinical manifestations of patients and to find the way to relieve them. This short and somewhat superficial review may help to have a bird's-eye view on this topic.
Adolescent ; Anorexia ; Child ; Dyspepsia ; Humans ; Nausea ; Psychophysiologic Disorders