The incidence and mortality rates for gastric cancer have decreased in the developed countries for the last several decades. On the other hand, they remain high in far Eastern countries such as Japan, China, and Korea and also in many developing countries. The risk of gastric cancer is greater among lower socioeconomic classes. The causes of this disease are still unclear. Long-term ingestion of highly concentrated nitrates in dried, smoked, and salted foods might be related with higher risk. Helicobacter pylori infection was classified as a group I definite human gastric carcinogen by the International Agency for Research on Cancer, World Health Organization (IARC/WHO) in1994. However, there are some debates on the association between H. pylori infection and gastric cancer. Complete surgical removal of the tumor with resection of adjacent lymph nodes offers the only chance for cure. As yet, this kind of treatment is possible in less than a half of patients. The prognosis after complete surgical resection depends on the degree of tumor penetration to the gastric wall. Cases with regional lymph node involvement, vascular invasion,and abnormal DNA content show poor prognosis. Gastric carcinoma is a relatively radio-re-sistant tumor, and the major role of radiation therapy has been the palliation of pain. Combinations of cytotoxic drugs for patients with advanced gastric cancer have shown a partial response in 20~60% of the patients, however, and complete remission was rare. In some recent studies, chemotherapy plus irradiation after surgical resection showed a better disease-free survival and overall survival. In conclusion, early detection and curative resection are very important to improve the survival of patients with gastric cancer. Newer therapeutic strategies such as preoperative chemotherapy or chemoradiotherapy have the potential to benefit the high-risk patients.
Chemoradiotherapy ; China ; Developed Countries ; Developing Countries ; Disease-Free Survival ; DNA ; Drug Therapy ; Eating ; Epidemiology* ; Hand ; Helicobacter pylori ; Humans ; Incidence ; International Agencies ; Japan ; Korea ; Lymph Nodes ; Mortality ; Nitrates ; Prognosis ; Smoke ; Stomach Neoplasms* ; World Health Organization

Incidence of simple localized esophageal ulcer has been infrequent, but recently, clinical report of the disease has increased with remarkable improvement of diagnostic instrument and handling of endoscopy. Nine patients of simple localized esophageal ulcer with abrupt onset of symptoms and rapidhealing process were clinically studied and observed with the other literatures on the basis af age, sex, site, symptoms, causes, endoscopic findings, microscopic findings, and healing pracess. The results were followed. 1) The eiophageal ulcer revealed variable size and shape and generally localized middle third of esophagus. 2) History of therapeutic drug medication auch as capaule or/and tablet was noted mostly. 3) The symptoms were disappeared with general measures and ulcer lesions were comyletely healed without scar or stricture rapidly.
Cicatrix ; Constriction, Pathologic ; Endoscopy ; Esophagus ; Humans ; Incidence ; Ulcer*

This is a clinical analysis of 48 patients who had tuberculous peritonitis laparoscopically confirmed at the Gastroenterologic Department of the Korea University Hae Wha Hospital from March 1980 to February 1988, and the results are as fallows: 1) The ratio of male to female was 1:1.7, and the age of the peak incidence was the third decade. 2) The freqeent symptoms were abdominal distension (77.1%), abdominal pain (60.4%), and fever (60.4%); others were indigestion (27.1%), diarrhea (18.8%), weight loss (6.3%), abdominal mass (6.3%), vomiting (6.3%), and dysmenorrhea (2.1%). The freguent physical signs were ascites (93.8%) and abdominal tenderness (45.8%); others were palpable mass (8.3%), hepatomegaly (8.3%), and mild jaundice (4,2%). 3) Hematologic findings in mean value revealed 11.8 g/m% in hemoglobin, 6088/mm in WBC, and 36 mm/hour in ESR, 4) Ascitic analysis revealed 1,031 in specific gravity, 5.2% in protein, and 1700/mm in WBC count with lymphocytic predominance (83%). AFB stain and culture were all negative in the specimens less than 20 ml. 5) On chest X-ray, pulmonary Tuberculosis or associated lesions were noted in 19 patients (39.6%). 6) Studded whitish miliary tubercle, omental change, ad adhesions were noted in a mixed nature. 7) Classifications according to laparoscopic finding revealed wet type in 28 patients (58.3%), mixed type in 13 patients (27.1%), and dry type in 7 patients (14.6%); and laparoscopic type was not related with the duration of symptom up to admission. 8) Microscopic finding of biopsy specimens revealed caseous necrosis or granuloma in 43 patient (89.6%) and nonspecific inflammation in 5 patients. In these 5 patients, characteristic gross findings of tuberculous peritionitis were noted. 9) Intestinal perforation was developed in 2 patients.
Abdominal Pain ; Ascites ; Biopsy ; Classification ; Diarrhea ; Dysmenorrhea ; Dyspepsia ; Female ; Fever ; Granuloma ; Hepatomegaly ; Humans ; Incidence ; Inflammation ; Intestinal Perforation ; Jaundice ; Korea ; Male ; Necrosis ; Peritonitis, Tuberculous* ; Specific Gravity ; Thorax ; Tuberculosis, Pulmonary ; Vomiting ; Weight Loss

The duodenal lipoma is infrequent and few reports deseribed its endoscopic features, We recently encountered one case of duodenal lipoma which was large polypoid one in the descending portion of the duodenum. The patient had been suffred from epigastric dull pain and bloating sensatio for 5 months. We did endoscopic polypectomy of the lipoma successfully.
Duodenum ; Humans ; Lipoma*

Acute appendicitis is the most common operative disease in general surgery, but it is not also rate disease to see in other clinical department such as Internal Medicine and Obstetric and Gynecology, because it reqnires to differenciate from many other diseases which have similar symptoms. Expecially, because the clipical aymptoms of acute appendicitis are not typieal in children, elderly, and women, it is hard to be diagnosed as acute appendicitis and it is often misdiagnosed as other disease. We performed colonoscopy due to be interpretated aa one of the colon diseases rather than acute appendicitis. But in colonoscopic findings, there were hyperemie and edematous change on the appendiceal orifice of cecum(cherry or acorn shape). So we report 5 cases of acute appendicitis diagnosed br colonoscopy.
Aged ; Appendicitis* ; Child ; Colon ; Colonoscopy* ; Female ; Gynecology ; Humans ; Internal Medicine

PURPOSE: The purpose of our study was to compare the serum levels of CEA, CA19-9 and H.pylori antibody in patients with the Lewis (a+) blood group with that of the patients with the Lewis (a-) blood group. We also compared the outcome of the stomach cancer patients with the Lewis (b+) blood group with that of the stomach cancer patients with the Lewis (b-) blood group. METHODS: All of the 94 patients who underwent gastrectomy for stomach cancer at our hospital were retrospectively reviewed. The outcomes of the CEA, CA19-9 and H.pylori. antibody serum levels, the TNM stage, the ABO blood group and the Rh blood group were compared between the patients with the Lewis blood groups (a+) and (a-) and the patients with the Lewis blood groups (b+) and (b-), respectively. RESULTS: The mean serum level of CEA between the patients with the Lewis blood group (a+) and (a-) showed a statistical correlation (mean value: 5.51 ng/ml vs 3.25 ng/ml, respectively, P=0.016). But the mean serum level of CA19-9 and H.pylori. antibodies between the patients with the Lewis blood group (a+) and (a-) did not show a significant difference. The mean serum levels of CEA, CA19-9 and H.pylori antibodies between the patients with the Lewis blood group (b+) and (b-) did not show a significant difference. CONCLUSION: It was revealed that an elevated CEA level was related with the Lewis blood group (a), but this was not related with the Lewis blood group (b) in stomach cancer patients.
Antibodies ; Blood Group Antigens ; Gastrectomy ; Humans ; Retrospective Studies ; Stomach Neoplasms* ; Stomach*

The foreign bodies in the upper GI tract are produced chiefly by accidental swallowing and rarely produce symptoms. But it is recommended to remove the foreign bodies if they produce symptoms or retained in GI tract for long duration, and if they have the possibilities of producing complications. Nowadays the development of therapeutic endoscopy enables the removal of the foreign bodies easily. We have reviewed 88 cases of foreign bodies diagnosed by endoscopy from January, 1980 to July 1990 and had the following results. 1) The most common foreign bodies were coins and bezoars, common with the ages under 10 years and over 50 years. 2) The foreign bodies were found in the upper gastrointestinal tract in the order of stomach, esophagus and duodenum. 3) The esophageal stricture especially by lye was the most common underlying cause of upper gastrointestinal foreign bodies. 4) The symptoms and complications were more common with esophageal foreign bodies. 5) By therapeutic endoscopy, the success rate for removal of foreign bodies was 98%.
Bezoars ; Deglutition ; Duodenum ; Endoscopy* ; Esophageal Stenosis ; Esophagus ; Foreign Bodies* ; Gastrointestinal Tract ; Lye ; Numismatics ; Stomach ; Upper Gastrointestinal Tract*

OBJECTIVES: We were to analyze the effect of managing metabolic syndrome using a u-health service in a health center. METHODS: We collected biometric data from 316 subjects living in a county (gun) in South Korea before and after the introduction of uhealth services in 2010. Analysis was done by contingency table using SPSS and latent growth model using AMOS. RESULTS: We found that regional u-health services affected instance of metabolic syndrome. Further, biometrics and health behavior improved. After six months of u-health services, the number of subjects with three or more factors for metabolic syndrome decreased by 62.5%; 63.3% of regular drinkers stopped drinking; 83.3% of subjects who rarely exercised began to exercise twice a week or more; and 60.9% of smokers stopped smoking. CONCLUSIONS: U-health services can change health behavior and biometrics to manage metabolic syndrome in rural areas. The usefulness of u-health services is discussed.
Disease Management ; Health Behavior ; Republic of Korea

Clostridium perfringens is an anaerobe responsible for a wide range of diseases in animals and humans. Symptoms associated with C. perfringens food poisoning are caused by enterotoxin expressed only during sporulation of C. perfringens. It has been known that only 6% of global C. perfringens isolates carry the enterotoxin gene. We found 2 strains of enterotoxigenic C. perfringens out of 33 strains isolated from various sources in Korea using PCR. It was also found that these two strains were both type A that were strongly associated with food poisoning by checking the presence of four major lethal toxins (a-, B-, e-, l-toxin) using PCR. These results suggest that foodborne illness caused by C. perfringens may be common in Korea and that public education is necessary to prevent contamination of foods by this organism.
Animals ; Clostridium perfringens* ; Clostridium* ; Education ; Enterotoxins* ; Foodborne Diseases ; Humans ; Korea* ; Polymerase Chain Reaction

BACKGROUND: The purpose of this study was to evaluate the postoperative magnetic resonance imaging (MRI) results of minimal-tying (one medial-row tie among 4 medial-row sutures) on the medial-row in double-row suture-bridge configuration (2x2 anchor with 4x4 suture stands). METHODS: From 2011 March to 2012 July, 79 patients underwent arthroscopic rotator cuff repair using 2x2 anchor double-row configuration. The mean age was 61.3 years (range, 31-81 years). Two double-loaded suture anchors were used for medial-row. Four medialrow stitches were made with only one medial-row knot-tying (the most anterior suture). Lateral-row was secured using the conventional suture-bridge anchor technique; all 4 strands were used for each anchor. Repair integrity was evaluated with MRI at mean 6.2 months postoperatively. Retear and the pattern of retear, change of fatty infiltration, and muscle atrophy of supraspinatus were evaluated using pre- and postoperative MRI. RESULTS: Repaired tendon integrity was 38 for type I, 30 for type II, 6 for type III, 4 for type IV, and 1 for type V, according to Sugaya classification. Considering type IV/V as retear, the rate was 6.3% (5 out of 79 patients). Medial cuff failure was observed in 4 patients. Fatty atrophy of supraspinatus was significantly improved postoperatively according to Goutallier grading (p=0.01). The level of muscle atrophy of supraspinatus was not changed significantly after surgery. CONCLUSIONS: Minimal tying technique with suture configuration of four-by-four strand double-row suture-bridge yielded a lower retear rate (6.3%) in medium to large rotator cuff tears.
Arthroscopy ; Atrophy ; Classification ; Humans ; Magnetic Resonance Imaging ; Muscular Atrophy ; Rotator Cuff* ; Shoulder ; Suture Anchors ; Sutures ; Tears* ; Tendons