OBJECTIVE: The study purpose was to develop a drug information leaflet for the elderly and to evaluate it with performance-based user-testing. METHODS: We performed a stratified randomized controlled trial. We recruited 62 elderly patients with age of 65 or above who were taking antidiabetic medications at the point of participating and excluded those who suffered illiteracy. We randomly allocated them into the intervention group with a leaflet for the elderly and the control group with a leaflet for the general public. Main outcome measures were to ‘be able to find information’ and to ‘be able to understand information.’ We measured outcome variables by employing performance-based user-testing and analyzed data to find any differences between two groups with t-tests, chi-squared tests or Fisher's exact tests accordingly. RESULTS: More participants in the intervention group understood how to store their medications than those in the control group (intervention group 93% vs. control group 70%; p=0.02). There were no significant differences in other information items between two groups. Mostly ‘being able to understand information’ was lower than ‘being able to find information.’ The gaps between two outcome variables were about 10% in the intervention group and about 18% in the control group. The lowest understanding was observed in information relating to drug names and their potential adverse events. CONCLUSION: Without providing personalized drug information, it might be hard for the elderly to improve their drug knowledge even with leaflets that were developed specifically for the elderly.
Aged ; Health Literacy ; Humans ; Hypoglycemic Agents ; Literacy ; Outcome Assessment (Health Care)

Hereditary angioneurotic edema (HAE) is an autosomal dominant disease that results from the deficiency of C1 esterase inhibitor (C1-INH) function. Urgent proper intervention of the upper airway is warranted to save the life of patients with the disease, which often causes acute airway obstruction. We present, with a review of literature, a case of 37-year old woman with HAE of larynx.
Adult ; Airway Obstruction ; Angioedema ; Angioedemas, Hereditary* ; Female ; Hereditary Angioedema Types I and II ; Humans ; Larynx*

BACKGROUND/AIMS: Rapid urease tests are used commonly for the detection of H. pylori. These tests are inexpensive and can be done easily and rapidly in the endoscopy room. A new rapid urease test, Hp Kit test, was developed for the first time in Korea. The test kit has two wells for two biopsies taken from each gastric antrum and corpus. We performed this study to estimate the diagnostic usefulness of Hp Kit test for the detection of H. pylori. METHODS: In one hundred patients undergoing gastroscopy, biopsy specimens were taken for Hp Kit test, polymerase chain reaction, culture, and histologic examination (Warthin-Starry stain). The 13C-urea breath test was also performed. The results of Hp Kit test were read after 2 hours. RESULTS: The sensitivity, specificity, positive and negative predictive value of Hp Kit test to diagnose H. pylori infection were 90.0%, 97.5%, 98.2%, and 86.7%, respectively. The positive reactions in only one well were observed in 12.9% of true positives with Hp Kit test. The reaction times of the Hp Kit test were 35.2+/-21.4, 26.6+/-15.3, and 17.8+/-15.8 minutes (mean+/-S.D.) at grade 1, 2, and 3, respectively (r=-0.3, p<0.05), therefore the results were usually observed within 1 hour. CONCLUSIONS: Hp Kit test has a high sensitivity and specificity, and may be used as an alternative rapid urease test to diagnose H. pylori infection.
Biopsy ; Breath Tests ; Endoscopy ; Gastroscopy ; Helicobacter pylori* ; Helicobacter* ; Humans ; Korea ; Polymerase Chain Reaction ; Pyloric Antrum ; Reaction Time ; Sensitivity and Specificity ; Urease

BACKGROUND/AIMS: Pronto Dry test, a new rapid urease test, is consisted of a dry filter paper containing urea and has been reported to have a more rapid reaction time than others. We performed this study to compare the accuracy of Pronto Dry test with the other conventional tests for detection of H. pylori. METHODS: One hundred patients underwent gastroscopy in our hospital for gastrointestinal symptoms. Biopsy specimens were taken for Pronto Dry test, polymerase chain reaction, culture, and histologic examination (Warthin-Starry stain). 13C-urea breath test was also performed. The results of Pronto Dry test were read after 1 hour. RESULTS: The sensitivity, specificity, positive and negative predictive value of Pronto Dry test to diagnose H. pylori infection were 90.0%, 100%, 100%, and 90.9%, respectively. The kappa statistic between H. pylori status and Pronto Dry test was 0.90, demonstrating an acceptable level of reliability. CONCLUSIONS: Pronto Dry test has a high sensitivity and specificity, and can be used as a rapid test to diagnose H. pylori infection.
Biopsy ; Breath Tests ; Diagnosis* ; Gastroscopy ; Helicobacter pylori* ; Helicobacter* ; Humans ; Polymerase Chain Reaction ; Reaction Time ; Sensitivity and Specificity ; Urea ; Urease

BACKGROUND/AIMS: Pronto Dry test, a new rapid urease test, is consisted of a dry filter paper containing urea and has been reported to have a more rapid reaction time than others. We performed this study to compare the accuracy of Pronto Dry test with the other conventional tests for detection of H. pylori. METHODS: One hundred patients underwent gastroscopy in our hospital for gastrointestinal symptoms. Biopsy specimens were taken for Pronto Dry test, polymerase chain reaction, culture, and histologic examination (Warthin-Starry stain). 13C-urea breath test was also performed. The results of Pronto Dry test were read after 1 hour. RESULTS: The sensitivity, specificity, positive and negative predictive value of Pronto Dry test to diagnose H. pylori infection were 90.0%, 100%, 100%, and 90.9%, respectively. The kappa statistic between H. pylori status and Pronto Dry test was 0.90, demonstrating an acceptable level of reliability. CONCLUSIONS: Pronto Dry test has a high sensitivity and specificity, and can be used as a rapid test to diagnose H. pylori infection.
Biopsy ; Breath Tests ; Diagnosis* ; Gastroscopy ; Helicobacter pylori* ; Helicobacter* ; Humans ; Polymerase Chain Reaction ; Reaction Time ; Sensitivity and Specificity ; Urea ; Urease

The primary esophageal lymphoma is extremely rare, and shows various morphologic characteristics. Only a single case of mucosa-associated lymphoid tissue (MALT) type lymphoma confined to the esophagus has been reported in the literature. A 61-yr-old man was referred to our hospital for evaluation of an esophageal submucosal tumor (SMT) that had been detected incidentally by endoscopy. He had a history of pulmonary tuberculosis with long-term anti-tuberculosis medication 15 yr before, and also had a history of syphilis, which had been treated one year before. He had been taking a synthetic thyroid hormones for the past 10 months because of an autoimmune thyroiditis. Endoscopy showed a longitudinal round and tubular shaped smooth elevated lesion, which was covered with intact mucosa and located at the mid to distal esophagus, 31 cm to 39 cm from the incisor teeth. Endoscopic ultrasonography (EUS) showed a huge longitudinal growing intermediate- to hypo-echoic mass located in the submucosal layer with internal small, various sized honeycomb-like anechoic lesions suggesting germinal centers. Subsequently, he underwent a surgery, which confirmed the mass as a primary esophageal low-grade B-cell lymphoma of MALT type.
Alcoholism/complications ; Diagnosis, Differential ; Esophageal Neoplasms/pathology* ; Esophageal Neoplasms/radiography ; Esophageal Neoplasms/ultrasonography ; Esophagoscopy ; Gastritis/complications ; Helicobacter Infections/complications ; Hemangioma, Cavernous/diagnosis ; Human ; Incidental Findings ; Lymphoma, Mucosa-Associated Lymphoid Tissue/pathology* ; Lymphoma, Mucosa-Associated Lymphoid Tissue/radiography ; Lymphoma, Mucosa-Associated Lymphoid Tissue/ultrasonography ; Male ; Middle Aged ; Mucous Membrane/pathology ; Neoplasm Invasiveness ; Smoking ; Thyroiditis, Autoimmune/complications

BACKGROUND/AIMS: When a submucosal lesion is discovered through an upper gastrointestinal endoscopy, it may be often difficult to differentiate an extra-gastric compression from a true submucosa1 tumor (SMT). An endoscopic ultrasonography (EUS) provides information about the relationship between a lesion and the gastric or esophageal wall. Furthermore, EUS helps in identifying the compression caused by surrounding organs. The diagnostic usefulness of EUS for extralumina1 compressed lesion was assessed. METHODS: The 261 patients who received an endoscopic diagnosis of submucosal tumors had EUS examinations performed. The results of EUS to additional diagnostic procedures such as UGI, USG, CT scan or tissue biopsy were then compared. RESULTS: Of 261 patients who received endoseopic diagnosis as SMT, extraluminal compression existed in 46 (17.6%) cases and true intramural lesion were found in 215 (82.4%) cases on EUS. The causes of extraluminal compression are lymph nodes (2 case.), the gallbladder (12 cases), the pancreas (9 cases), the spleen (6 cases), a pancreatic pseudocyst (5 cases), pancreatic cancer (2 cases), a hepatic cyst (2 cases), the left lobe of the liver (4 cases), hepatoma (1 case), a mesenteric tumor (2 caws) and a splenic vein (1 case). CONCLUSIONS: EUS is considered to be a useful diagnostic method not only for differential diagnosis of extraluminal compression from true SWT, but also for clarifying the cause of extraluminal compressed lesions.
Biopsy ; Carcinoma, Hepatocellular ; Diagnosis ; Diagnosis, Differential ; Endoscopy, Gastrointestinal ; Endosonography ; Gallbladder ; Humans ; Liver ; Lymph Nodes ; Pancreas ; Pancreatic Neoplasms ; Pancreatic Pseudocyst ; Spleen ; Splenic Vein ; Tomography, X-Ray Computed

BACKGROUND/AIMS: There were two blind spots during colonoscopy, one was on angulated portion of colon, other was on non-fixated portion of colon. In spite of careful inspection during routine colonoscopy, small lesions behind the semilunar folds can be situated in blind spots, where they are easily overlooked. The aim of this study was to evaluate the efficacy of total colonoscopy with transparent cap in identifying such lesions, in comparison with colonoscopy without the cap. METHODS: We performed colonoscopy with or without transparent cap in 30 patients and 30 controls. During colonoscopy, frequencies of ileal intubation, time required for intubation as far as the terminal ileum and degrees of patients discomfort were checked. RESULTS: Colonoscopy with a transparent cap ensured good visual fields during insertion and withdrawal of the colonoscopy. There were no significant differences in the intubation times to the terminal ileum or in the frequencies of terminal ileal intubation, degree of patients discomfort between the two procedures. CONCLUSIONS: Total Colonoscopy with a transparent cap allows inspection of the blind area of the colonic mucosa behind the semilunar folds, with good visual fields. But the statistical significance was not found in this study. This method may be potentially useful for both screening and diagnostic purposes. Further study in more cases would be needed.
Colon ; Colonoscopy* ; Humans ; Ileum ; Intubation ; Mass Screening ; Mucous Membrane ; Optic Disk ; Visual Fields

BACKGROUND/AIMS: At present, various methods of endoscopic esophageal variceal treatment have been developed. But a superlative method has yet not been developed for endoscopic esophageal variceal treatment. For overcoming various disadvantages of endoscopic esophageal variceal treatment. We manufactured and reported the usefulness of a newly designed mini-detachable snare (stainless steel) in the treatment of esophageal varices. METHODS: In this randomized trial, we performed mini-detachable snare ligation (MDL) on 46 patients who had esophageal varices and we compared the results with the group of multiple band ligation (MBL) performed on 57 patients in the aspects of urgent hemostatic rate, rebleeding rate, eradication rate and recurrence rate etc. from March, 1997 to present. RESULTS: 6 of 7 patients (86%) in mini-detachable snare ligation group and 11 of 13 patients (85%) in multiple band ligation group were successfully controlled by urgent hemostasis. Rebleeding following initiation occured in 2 (5.5%) in MDL group and 3 (5.3%) in MBL group. Esophageal varices were eradicated or reduced to grade I in 96% and 98% by 2-7 snares and 3-10 ligation/one session in 3-9 and 3-8 session (mean+ SD: 4.8+/-2.1 and 4.5+/-1.9 session) in the MDL group and MBL group respectively. The recurrence rate was 5 (11%) and 6 (11%) in MDL group and MBL group respectively during 6 to 16 months follow up period. The mean procedure time taken during 5 snares or 5 bands was 4.07+/-3.8 min and 3.23+/-1.2 min in MDL group and MBL group respectively. No serious complications occurred in both groups. CONCLUSIONS: The mini-detachable snare ligation may be considered as a new and relatively safe, and effective therapeutic modality in the treatment for esophageal varices, Also the mini-detachable snare system is much cheaper than other multi-fire ligation devices but further clinical evaluation and more technical improvements in mini-detachable snare ligation will be needed.
Esophageal and Gastric Varices* ; Follow-Up Studies ; Hemostasis ; Humans ; Ligation* ; Recurrence ; SNARE Proteins*

Obstruction of the gastrointestinal tract by the progressive fibrotie process of chronic pancreatitis is being recognized with increasing frequency. The structures commonly affected are parapancreatic in location and include the common bile duct in its intrapancreatic portion, the second and third portion of the duodenum and the colon, most commonly the transverse segment. Colonic involvement of varying severity is less common and not well recongnized, and stenosing lesions of the colon are a rare and confusing sequale to pancreatitis. Some cases of colonic stenosis complicated by pancreatitis cannot be differentiated radiologically from carcinoma. The clinical history, enzyme studies and location of the stenosis in the left colon may alert the clinician to this rare diagnosis. We report a patient with stenosis of the colon due to chronic pancreatitis in whom the initial presenting symptoms and radiologic finding resemble colon cancer.
Colon* ; Colonic Neoplasms* ; Common Bile Duct ; Constriction, Pathologic* ; Diagnosis ; Duodenum ; Gastrointestinal Tract ; Humans ; Pancreatitis ; Pancreatitis, Chronic*