No abstract availble.

Diverticular disease is not uncommon problem in clinical practice, and sometimes causes serious complication such as lower gastrointestinal bleeding or perforation. The severity of both diverticular complications can differ. Most of diverticular bleeding stops spontaneously, but if a massive bleeding is presented, quick and optimal decision to find the focus of the bleeding and to treat the bleeding lesion using colonoscopy, abdominal CT, and angiography should be required. It is important to understand which procedure is indicated and what measures should be considered before moving to the next diagnostic or therapeutic procedures in individual cases. Diverticular perforation usually accompanies abscesses or peritonitis. Based on the CT classification of diverticular perforation, antibiotics and percutaneous drainage can be one of the choices for treatment in abscesses without general peritonitis. In case of free wall perforation and generalized peritonitis, it has been thought that Hartmann's procedure should be carried out. However, recently several reports demonstrated that the less invasive procedure such as laparoscopic lavage can be the treatment option for purulent peritonitis without fecal contamination. Clinical diagnosis and treatment of diverticular bleeding and perforation based on current literature are discussed in this review.
Abscess ; Angiography ; Anti-Bacterial Agents ; Classification ; Colon ; Colonoscopy ; Diagnosis* ; Diverticulum ; Drainage ; Hemorrhage* ; Peritonitis ; Therapeutic Irrigation ; Tomography, X-Ray Computed

No abstract availble.
Colitis, Ulcerative/complications/*diagnosis/pathology ; Colonoscopy ; Female ; Humans ; Intestinal Obstruction/*diagnosis/etiology/pathology ; Middle Aged

No abstract available.
Autonomic Pathways ; Diabetes Mellitus ; Gastroesophageal Reflux

Natural orifice transluminal endoscopic surgery (NOTES) is a novel technique that utilizes the natural orifices of the human body (e.g., the mouth, anus, vagina and urethra) for surgical procedures. After insertion of an endoscope into organs such as the esophagus, stomach and urinary bladder, these hollow organs are intentionally cut to reach the peritoneal or thoracic cavity to perform various surgical procedures. NOTES is anticipated to become an important part of future medical procedures to treat diverse conditions that cannot endure ordinary surgery with the use of laparotomy or laparoscopy. To take advantage of this new technology, a number of researchers have devoted time and effort to improve both the basic and clinical aspects of NOTES in order to apply this medicinal art fully in the near future. In this review, we evaluate the status of NOTES and attempt to examine the future use of this promising technique that has also been subject to skepticism.
Anal Canal ; Endoscopes ; Esophagus ; Human Body ; Imidazoles ; Intention ; Laparoscopy ; Laparotomy ; Mouth ; Natural Orifice Endoscopic Surgery ; Nitro Compounds ; Stomach ; Thoracic Cavity ; Urinary Bladder ; Vagina

For the regulation of energy balance in various internal organs including gut, pancreas and liver, visceral adipose tissue and brain perform important sensing and signaling roles via neural and endocrine pathway. Among these, adipose tissue has been known as a simple energy-storing organ, which stores excess energy in triglyceride. However, it became apparent that adipocytes have various receptors related to energy homeostasis, and secrete adipocytokines by endocrine, paracrine and autocrine mechanisms. In this review, basic roles of adipocytes in energy homeostasis and the correlation between adipocyte signals and digestive diseases are discussed.
Adipocytes/*metabolism ; Adipokines/*physiology ; Adiponectin/physiology ; Digestive System Diseases/*metabolism ; *Energy Metabolism ; Homeostasis ; Humans ; Leptin/physiology ; Peroxisome Proliferator-Activated Receptors/physiology ; Resistin/physiology ; Signal Transduction

BACKGROUND/AIMS: Inflammatory bowel disease (IBD) management guidelines have been released from Western countries, but no adequate data on the application of these guidelines in Asian countries and no surveys on the treatment of IBD in real practice exist. Since there is a growing need for a customized consensus for IBD treatment in Asian countries, Asian Organization of Crohn's and Colitis performed a multinational survey of medical doctors who treat IBD patients in Asian countries. METHODS: A questionnaire was developed between August 2013 and November 2013. It was composed of 4 domains: personal information, IBD diagnosis, IBD treatment, and quality of IBD care. Upon completion of the questionnaire, a web-based survey was conducted between 17 March 2014 and 12 May 2014. RESULTS: In total, 353 medical doctors treating IBD from ten Asian countries responded to the survey. This survey data suggested a difference in available medical treatments (budesonide, tacrolimus) among Asian countries. Therapeutic strategies regarding refractory IBD (acute severe ulcerative colitis [UC] refractory to intravenous steroids and refractory Crohn's disease [CD]) and active UC were coincident, however, induction therapies for mild to moderate inflammatory small bowel CD are different among Asian countries. CONCLUSIONS: This survey demonstrated that current therapeutic approaches and clinical management of IBD vary among Asian countries. Based on these results and discussions, we hope that optimal management guidelines for Asian IBD patients will be developed.
Asia* ; Asian Continental Ancestry Group* ; Colitis* ; Colitis, Ulcerative ; Consensus ; Crohn Disease ; Diagnosis ; Hope ; Humans ; Inflammatory Bowel Diseases* ; Seoul* ; Steroids

BACKGROUND/AIMS: Patients with type II diabetes mellitus (DM) were known to have higher prevalence of gastroesophageal reflux disease (GERD). Recent studies have shown that neuropathy has positive role on the development of GERD in type II DM, although its pathogenesis has not been fully understood yet. The aim of this study was to investigate whether neuropathy really contribute to the development of GERD and typical GERD symptoms in patients with type II DM in Korea. METHODS: One hundred and nineteen patients with type II DM who had given informed consents were enrolled. All patients underwent electromyography to check the presence of peripheral neuropathy, face-to-face interview to evaluate their typical GERD symptoms and esophagogastroduodenoscopy to look for the presence of erosive esophagitis. Ninety-five patients were finally included for this study and they were divided according to the presence or absence of the peripheral neuropathy. RESULTS: The mean age of 95 patients was 59.3 +/- 9.1 years and the mean disease duration of DM was 9.3 +/- 5.9 years. Typical GERD symptoms were similarly found in both groups with and without peripheral neuropathy (23.6% vs 22.8%, P = 0.921). Erosive esophagitis was more prevalent in patients with neuropathy than in those without neuropathy (31.5% vs 10.5%, P = 0.022). CONCLUSIONS: In patients with type II DM, peripheral neuropathy is an independent risk factor for the erosive esophagitis. However, peripheral neuropathy did not contribute to the presence of the typical GERD symptoms.
Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Electromyography ; Endoscopy, Digestive System ; Esophagitis ; Gastroesophageal Reflux ; Humans ; Peripheral Nervous System Diseases ; Prevalence ; Risk Factors

In this article, the third author's name was spelled incorrectly.

In this article, the third author's name was spelled incorrectly.