BACKGROUND/AIMS: Current international guidelines recommend colorectal cancer screening for average-risk people over 50 years of age. Accordingly, we aimed to estimate the prevalence of colorectal neoplasms in all age groups and evaluate associated risk factors. METHODS: Data of 14,932 subjects who underwent colonoscopy from July 2006 to January 2012 at Health Promotion Center, Gangnam Severance Hospital (Seoul, Korea) as part of a health check-up were reviewed retrospectively. RESULTS: The overall prevalence of colorectal neoplasms and adenoma were 34.6% and 25.3%, respectively. Colorectal adenoma was found in 3.2%, 13.0%, 21.7%, 33.8%, 44.0%, 50.5%, and 54.2% of subjects under 30 years, 30-39 years, 40-49 years, 50-59 years, 60-69 years, 70-79 years, and over 80 years of age (trend p<0.0001). Independent predictors of colorectal adenoma included male gender (OR 2.38, 95% CI 2.084-2.718), positive occult blood (2.266, 1.761-2.917), positive serology of Helicobacter pylori (1.253, 1.114-1.409) and hypertriglyceremia (1.267, 1.065-1.508). Compared to the 30-39 years of age reference group, the ORs for each age group were 0.195 (under 30 years), 1.634 (40-49 years), 2.954 (50-59 years), 5.159 (60-69 years), 5.640 (70-79 years), 11.020 (over 80 years), while the 95% CIs were 0.071-0.536 (under 30 years), 1.340-1.992 (40-49 years), 2.421-3.604 (50-59 years), 4.109-6.476 (60-69 years), 3.822-8.322 (70-79 years), and 2.809-42.234 (over 80 years). CONCLUSIONS: Colorectal adenoma prevalence increased proportionally with age. Only subjects under the age of 30 years had a definitely lower prevalence of colorectal adenoma. Male gender, positive occult blood, positive serology of H. pylori, and hypertriglyceremia were associated risk factors of colorectal adenoma.
Adenoma/*epidemiology/etiology ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; Colonoscopy ; Colorectal Neoplasms/*epidemiology/etiology ; Female ; Helicobacter Infections/complications ; Helicobacter pylori ; Humans ; Hypertriglyceridemia/complications ; Logistic Models ; Male ; Middle Aged ; Odds Ratio ; Republic of Korea/epidemiology ; Retrospective Studies ; Sex Factors

Background: Balancing parenting and work life poses challenges for women with children, potentially making them vulnerable to depression owing to their dual responsibilities.Investigating working mothers’ mental health status is important on both the individual and societal levels. This study aimed to explore the relationship between economic activity participation and depressive symptoms among working mothers. Methods: This study was a cross-sectional study and used data from the Korea National Health and Nutrition Examination Survey collected in 2014, 2016, 2018, and 2020. The participants in the study were women aged 19 to 50 who were residing with their children.In the total, 3,151 participants were used in the analysis. The independent variable was economic activity, categorized into two groups: 1) economically active and 2) economically inactive. The dependent variable was the depressive symptoms, categorized as present for a Patient Health Questionnaire-9 score of ≥ 10 and absent for a score < 10. Multiple logistic regression analysis was performed to assess the association between economic activity and depressive symptoms, and sensitivity analyses were performed based on the severity of depressive symptoms. Results: Among women with children, economically active women had reduced odds ratio of depressive symptoms compared with economically inactive women (odds ratio [OR], 0.54;95% confidence interval [CI], 0.36–0.80). In additional analysis, women working as wage earners had the lowest odds of depressive symptoms (OR, 0.43; 95% CI, 0.28–0.66). Women working an average of 40 hours or less per week were least likely to have depressive symptoms (OR, 0.42; 95% CI, 0.25–0.69). Conclusion Economic activity is significantly associated with depressive symptoms among women with children. Environmental support and policy approaches are needed to ensure that women remain economically active after childbirth.

Paragonimiasis has been continuously decreasing in Korea. However, it still occurs by ingesting raw or incompletely cooked fresh water crab or crayfish. The diagnosis of paragonimiasis is challenging because of its rarity. It may be confused with other inflammatory disease or carcinomatosis. Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) has lower risk of complications such as bleeding, perforation than percutaneous fine needle aspiration. EUS-FNA is more accurate and popular method to find mucosal or submucosal tumors and the lesions of several organs. Benign and malignant tumors, infectious diseases have been diagnosed by EUS-FNA, but there was no report describing the use of EUS-FNA for diagnosing paragonimiasis. Herein, we present a 47-year-old male patient with paragonimiasis diagnosed by EUS-FNA. Imaging studies revealed mass lesions in the lung and peritoneal cavity, which was eventually confirmed as paragonimiasis using EUS-FNA.
Endoscopic Ultrasound-Guided Fine Needle Aspiration ; Enzyme-Linked Immunosorbent Assay ; Humans ; Lung Neoplasms/pathology ; Male ; Middle Aged ; Paragonimiasis/*diagnosis/diagnostic imaging/immunology ; Positron-Emission Tomography ; Tomography, X-Ray Computed

BACKGROUND: Gastric cancer is the second most common cancer in Korea. Fatigue is a common symptom among cancer survivors. The aim of this study was to identify factors associated with fatigue in gastric cancer survivors. METHODS: Data were analyzed from 199 gastric cancer survivors who visited a cancer survivor outpatient clinic from July 2013 to June 2014. Patients were surveyed using a questionnaire containing a fatigue severity scale (FSS) and questions regarding associated symptoms. Participants were divided into fatigue (FSS) and non-fatigue groups based on FSS scores (> or =4 and <4, respectively). Age, sex, weight, body mass index, cancer stage, pathology, surgery type, chemotherapy, radiotherapy, comorbid disease, family history of cancer, smoking, alcohol consumption, exercise, and laboratory results were investigated. RESULTS: The fatigue and non-fatigue groups contained 42 and 157 survivors, respectively. Their mean age was 58 years, and the mean post-operative period was 6.58 years. Arthralgia (odds ratio [OR], 12.95; 95% confidence interval [CI], 3.21-52.34), dyspnea (OR, 10.54; 95% CI, 2.94-37.80), dyspepsia (OR, 8.26; 95% CI, 2.63-25.96), changed bowel habits (OR, 4.56; 95% CI, 1.09-19.11), anemia (OR, 3.18; 95% CI, 1.26-8.05), and regular exercise (OR, 0.31; 95% CI, 0.12-0.77) were significantly associated with fatigue in gastric cancer survivors, while weight, treatment, and depressive mood were not. CONCLUSION: Arthralgia, dyspnea, dyspepsia, bowel habit change, anemia, and regular exercise are associated with fatigue in gastric cancer survivors.
Alcohol Drinking ; Ambulatory Care Facilities ; Anemia ; Arthralgia ; Body Weight ; Drug Therapy ; Dyspepsia ; Dyspnea ; Fatigue* ; Humans ; Korea ; Pathology ; Radiotherapy ; Smoke ; Smoking ; Stomach Neoplasms* ; Survivors*

Korean autoimmune pancreatitis (AIP) criteria 2007 was aimed to diagnose the wide spectrum of AIP with high sensitivity. The most crucial issue when caring for patients with suspected AIP is to differentiate AIP from pancreatic cancer. Pancreatic cancer can be distinguished from AIP by pancreatic imaging, measurement of serum IgG4 levels, endoscopic ultrasound guided fine needle aspiration and trucut biopsy, and steroid trial. Autoimmune pancreatitis is a rare systemic fibroinflammatory disease which can affect not only the pancreas, but also a variety of organs such as the bile ducts, salivary glands, retroperitoneum, and lymph nodes. Organs affected by AIP have a lymphoplasmacytic infiltrate rich in IgG4-positive cells. This inflammatory process responds dramatically to oral steroid therapy. Granulocytic epithelial lesion (GEL) positive AIP patients differ from GEL negative AIP patients in clinical features such as equal gender ratio, younger mean age, no increase in serum IgG4, no association with extrapancreatic involvement, no relapse, and frequent association with inflammatory bowel disease. Further investigation is needed to clarify the pathogenic mechanisms including more definite serological markers for theses two entities.
Autoimmune Diseases/*diagnosis/pathology/ultrasonography ; Common Bile Duct/radiography ; Fibrosis/pathology ; Humans ; Immunoglobulin G/blood ; Pancreatitis/*diagnosis/pathology/ultrasonography ; Salivary Glands/pathology

BACKGROUND: Impaired fasting glucose (IFG) is an established risk factor for type 2 diabetes and cardiovascular disease. This study evaluated the relationship between sleep duration and IFG. METHODS: This cross-sectional study included 14,925 Korean adults (5,868 men and 9,057 women) > or =19 years of age who participated in the Korean National Health and Nutrition Examination Survey between 2011 and 2012. Blood glucose levels were measured after at least eight hours of fasting. Study subjects were categorized into three groups based on self-reported sleep duration (<7, 7-8, or >8 h/d). IFG was diagnosed according to recommendations American Diabetes Association guidelines. Multiple logistic regression analysis was performed with adjustment for covariates. RESULTS: In men, short sleep duration (<7 hours) was associated with increased risk of IFG (odds ratio [OR], 1.46; 95% confidence interval [CI], 1.08 to 1.96) compared to adequate sleep duration (7-8 hours), whereas long sleep duration (>8 hours) was not associated with risk of IFG (OR, 0.90; 95% CI, 0.37 to 2.18). In women, sleep duration was not associated with risk of IFG. CONCLUSION: The association between sleep duration and IFG differed by sex; sleep deprivation, was associated with increased risk of IFG, especially in men.
Adult* ; Asian Continental Ancestry Group ; Blood Glucose ; Cardiovascular Diseases ; Cross-Sectional Studies ; Fasting* ; Female ; Glucose* ; Humans ; Logistic Models ; Male ; Nutrition Surveys* ; Prediabetic State ; Risk Factors ; Sleep Deprivation

PURPOSE: The aim of this study was to compare the measurements of diameter and volume of hepatic metastases from CT images with the overall survival and tumor response, in patients with unresectable liver metastases of colorectal cancer treated with a targeted agent. MATERIALS AND METHODS: We recruited 43 patients with unresectable liver metastases of colorectal cancer, in whom targeted therapy was used as the first-line treatment. Three-dimensional quantification of the volume of hepatic metastases was performed for each patient. An independent survival analysis using the Response Evaluation Criteria in Solid Tumors guidelines was performed and compared to the volumetric measurement. Overall survival was evaluated using the Kaplan-Meier analysis and compared to the Cox proportional hazard ratios (HRs) following univariate and multivariate analyses. RESULTS: In patients classified as non-progressing and progressing by the volumetric criteria, the median overall survival time was 21 months [95% confidence interval (CI): 491.25–768.75] and 11 months (95% CI: 0–949.42), respectively (p = 0.001). Using a multivariate analysis, we found that volumetric response (HR: 3.467; p = 0.002) was a significant factor affecting the overall survival in patients with liver metastases of colorectal cancer. CONCLUSION Volumetric assessment of liver metastases could be an alternative predictor of the overall survival of patients with liver metastases of colorectal cancer treated with a targeted agent.

OBJECTIVES: This study aims to investigate the suitability of electronic health record (EHR) systems in Korea for global certification and to propose functions for future global systems by comparing and analyzing the certification criteria for Certification Commission for Health Information Technology (CCHIT) Certified Ambulatory EHR with BESTCare, which is the EHR system at Seoul National University Bundang hospital. METHODS: Domain expert groups were formed to analyze the inclusion of BESTCare functions and the types of differences for each of the CCHIT Certified 2011 Ambulatory EHR Certification Criteria. The types of differences were divided into differences in functions (F), differences in business processes (B), and differences in government policies (P). RESULTS: Generally, the criteria that showed differences in functions pertained to the connection between the diagnosis/problem list and order, the alert and warning functions for medication-diagnosis interactions, and the reminder/instruction/notification messages related to the patient's immunization status; these absent functions were enhanced clinical decision support system (CDSS) functions related to patient safety and healthcare quality. Differences in government policies were found in the pharmacy's electronic prescription functions, while differences in business processes were found in the functions constrained by the local workflow or internal policy, which require some customization. CONCLUSIONS: Functions that differed between the CCHIT certification criteria and the BESTCare system in this study should be considered when developing a global EHR system. Such a system will need to be easily customizable to adapt to various government policies and local business processes. These functions should be considered when developing a global EHR system certified by CCHIT in the future.
Certification ; Commerce ; Electronic Health Records ; Electronic Prescribing ; Immunization ; Korea ; Medical Informatics ; Patient Safety ; Quality of Health Care

Circumferential resection by performing endoscopic submucosal dissection (ESD) in the antrum can cause pyloric stenosis. Treatment with balloon dilation usually requires repeated sessions and this may cause bleeding or perforation. There are several studies regarding the treatment of benign pyloric stenosis by the temporary placement of self-expandable metallic stent (SEMS), but these studies did not include any case of pyloric stenosis caused by ESD for treating early gastric cancer (EGC). We experience a case of a man who had EGC encircling the antrum. After ESD, pyloric stenosis occurred and so a SEMS was applied. Eight weeks later, the stent was removed without complications. Stent insertion for benign pyloric stenosis has not been accepted as a standard therapeutic modality. However, continuous dilation of a stenotic lesion can be expected without major complications, except for migration. Therefore, temporary stent insertion can be considered as an alternative treatment option for benign pyloric stenosis. Further study on the long term outcome of this procedure is needed.
Hemorrhage ; Pyloric Stenosis ; Stents ; Stomach Neoplasms

Juvenile Polyposis Syndrome is a rare condition that is characterized by the development of multiple polyps in the gastrointestinal tract. It is a hamartomatous disorder that was first described in families in 1964. Both sporadic and familial cases with autosomal dominant inheritance have been reported on. Juvenile Polyposis Syndrome is regarded as a distinct from the solitary juvenile polyps that develop in 2% of children and adolescents, and the latter have no malignant potential. We report here on a case of Juvenile Polyposis Syndrome in an 18 year old male along with a review of the relevant literature. The patient had various numbers of different sized pedunculated polyps that were observed throughout the entire gastrointestinal tract.
Adolescent ; Child ; Gastrointestinal Tract ; Humans ; Intestinal Polyposis ; Male ; Neoplastic Syndromes, Hereditary ; Polyps ; Wills