BACKGROUND/AIMS: In western courtry, Helicobacter pylori (H. pylori) serology is a screening test for non-ulcer dyspepsia (NUD) before endoscopy in dyspeptic patients under 45 years old without alarm symptoms. The aim of this study was to determine the usefulness of H. pylori serology before endoscopy in Korea. METHODS: Six hundred and fifteen outpatients (M:F=339:276, mean age 43.6+/-13.8, range 15-81) with dyspepsia performed anti-H. pylori IgG (GAP or HM-CAP) and upper gastrointestinal endoscopy with biopsy. Exclusion criteria were alarm symptoms, history of gastrectomy, NSAID use and previous anti-H. pylori treatment. RESULTS: The prevalence of anti-H. pylori IgG was 61.0% in patients under and 40 years old and 63.8% in patients over 40 years old. There was no significant difference between age groups. For patients under and 40 years old, serology predicted all pathology except 5 gastric ulcer, 8 duodenal ulcer, 2 reflux esophagitis and 2 gastric submucosal tumor. The sensitivity and negative predictive value (76.7, 85.8%) in patients under and 40 years old were higher than that (61.9, 64.0%) in patients over 40 years old (p=0.037, p=0.001). CONCLUSIONS: H. pylori serology seems to be an acceptable screening test for NUD in dyspeptic patients under and 40 years old without alarm symptoms.
Adult ; Biopsy ; Duodenal Ulcer ; Dyspepsia* ; Endoscopy ; Endoscopy, Gastrointestinal ; Esophagitis, Peptic ; Gastrectomy ; Helicobacter pylori* ; Helicobacter* ; Humans ; Immunoglobulin G ; Korea ; Mass Screening ; Middle Aged ; Outpatients ; Pathology ; Prevalence ; Stomach Ulcer

BACKGROUND/AIMS: Functional dyspepsia(FD) is primarily a symptom complex. There is no consensus on the pathogenesis of functional dyspepsia. Disorders of motor function of the upper gastrointestinal tract have been implicated in the pathogenesis of FD. About 25-60% of patients with FD have delayed gastric emptying and postprandial antral hypomotility. Intestinal dysmotility is common in patients with severe and incapacitating FD. But there were few reports about association with esophageal dysmotility in FD. We performed this study to investigate the esophageal motility in patients with dysmotility-like FD. METHODS: The study included twenty-three patients (M:F=6;17, mean age: 42.5 years) referred to Ajou University Hospital for evaluation of their dyspepsia from July 1994 to July 1997. All patients underwent routine blood tests, upper gastrointestinal series or esophagogastroduodenoscopy and abdominal ultrasound to rule out organic cause of dyspepsia. The patients with reflux-like symptoms such as heartbum and/or regurgitation and noncardiac chest pain were also excluded. Standard esophageal manometry was done with pneumohydraulic capillary infusion system. RESULTS: 1) Out of 23 patients, 12 patients showed normal esophageal manometric finding, 11 patients(47.8%) abnormal finding. Esophageal manometry revealed hypertensive upper esophageal sphinter (UES) in 3 patients, hypertensive lower esophageal sphinter (LES) in 2 patients, hypotensive LES in 1 patients. Four patients showed nonspecific esophageal motility disorder low-amplitude contractions in 3 patients, nontransmitted contractions in 1 patient). One patient exhibited nutcracker esophagus. 2) Out of 23 patients, 5 patients also complained of symptoms consistent with lower gut dysfuctian, chiefly irritable bowel syndrome. Three of these patitnets revealed abnormal esophageal manometric finding (hypertensive UES in 2 patient, low-amplitude contractions in one patient). CONCLUSIONS: This findings indicate that some patients with FD have esophageal manometric abnormalities. The esophageal motor dysfunction was mainly observed in esophageal body and lower esophageal sphinter, which are made up of smooth muscle.
Capillaries ; Chest Pain ; Consensus ; Dyspepsia* ; Endoscopy, Digestive System ; Esophageal Motility Disorders ; Gastric Emptying ; Hematologic Tests ; Humans ; Irritable Bowel Syndrome ; Manometry ; Muscle, Smooth ; Ultrasonography ; Upper Gastrointestinal Tract

BACKGROUND: A prolonged QT interval can lead to malignant ventricular arrhythmias and sudden cardiac death, and has frequently been found in end-stage liver disease (ESLD). However, myocardial repolarization lability has not yet been fully investigated. We evaluated the QT variability index (QTVI), a marker of temporal inhomogeneity in ventricular repolarization and an abnormality associated with re-entrant malignant ventricular arrhythmias. We determined whether QTVI is affected by the head-up tilt test in ESLD. METHODS: We assessed 36 ESLD patients and 12 control subjects without overt heart disease before and after the 70-degree head-up tilt test. The electrocardiography signal (lead II) was recorded on a computer with an analog-to-digital converter. The RR interval (RRI) and QT interval were measured after recording 5 min of the digitized electrocardiography. Then, the QT intervals were corrected with Bazett's formula (QTc). QTVI was calculated through the following formula: QTVI = log10 [(QTv/QTm2)/(RRIv/RRIm2)], QTv/RRIv: variance of QTI/RRI, QTm/RRIm: mean of QT interval/RRI. RESULTS: Cirrhotic patients exhibited an elevated QTVI. In particular, Child class C patients had a significantly increased QTVI compared to Child class A patients and the control subjects in the supine position. However, the head-up tilt test did not cause a significant difference in QTVI in relation to the severity of ESLD. CONCLUSIONS: Myocardial repolarization lability was significantly altered in end-stage liver disease. Our data suggest that the severity of ESLD is associated with the degree of the alteration in the QT variability index.
Arrhythmias, Cardiac ; Child ; Death, Sudden, Cardiac ; Electrocardiography ; Heart Diseases ; Humans ; Liver Diseases* ; Liver* ; Supine Position

PURPOSE: The rising prevalence of childhood obesity may be due to an energy imbalance between food intake and energy expenditure. Recently, consumption of beverages in children has increased. The aim of this study is to provide useful information for the prevention and the control of childhood obesity by assessment of variable beverage consumption. METHODS: Fight hundred seventy seven children(M : F=1 : 1.02, mean age; 9.7 years) from two primary schools in Seoul in May 2003 were enrolled. Body mass index(BMI) was calculated and the degree of obesity was classified into normal, overweight and obese groups by BMI percentile. Parental BMI, socio-economic factor, 3-day dietary intake, calory intake and beverage intake were examined by questionnaires. We researched beverages and classified them into six categories, milk, other milk products, soda, sports beverage, other beverage. RESULTS: The prevalence of obesity was 7.2%. The parental BMI of the obese group were higher than those of the other groups. There was no significant difference in birth weight, or parents' intellectual and economic levels between the obese group and the other groups. There was no significant difference in daily total calory intake between the obese group and the other groups. The obese group of 7-9 year-old-males was higher than the other groups in sodas, and sports beverages intake. The obese group of 10-12 year-old-males was higher than the other groups in total beverage intake and other beverage intakes. The obese group of 10-12 year-old-females was higher than the other groups in other milk products. CONCLUSION: Excessive intake of beverages is associated with childhood obesity. Efforts to decrease intake of beverages may be important approaches to counter the rise in the prevalence of obesity.
Beverages* ; Birth Weight ; Body Mass Index ; Child ; Eating ; Energy Metabolism ; Fast Foods ; Humans ; Milk ; Obesity ; Overweight ; Parents ; Pediatric Obesity* ; Prevalence ; Surveys and Questionnaires ; Seoul ; Sports

PURPOSE: The aim of this study was to determine whether insulin resistance may be present and to analyze factors affecting the development of insulin resistance in children and adolescents born small for gestational age (SGA). METHODS: This study includes 24 children and 18 SGA adolescents and 13 children and 14 control adolescents. All patients underwent a standard, 2-hour oral glucose tolerance test (OGTT). Serum levels of fasting blood sugar, insulin, leptin, adiponectin, homeostasis model assessment-insulin resistance (HOMA- IR), quantitative insulin sensitivity check index (QUICKI), insulin sensitivity index (ISI), mean serum insulin (MSI) and mean serum glucose (MSG) were evaluated. RESULTS: The insulin responses at 30 min and 120 min after glucose load were significantly higher in pubertal SGA than control groups (P<0.05). Impaired glucose tolerance was found from 2 subjects (8.7 %) in prepubertal SGA group and from 3 subjects (15.0%) in pubertal SGA group. None of the patients had developed type 2 diabetes. MSI levels during OGTT were higher in pubertal SGA than in control. Pubertal SGA group had a significantly lower mean serum adiponectin level than control group (9.04+/-4.51 vs. 18.83+/-11.65 microgram/mL, P<0.05). Adiponectin level was correlated with HOMA-IR, QUICKI and ISI (r=-0.37, r=0.32, r=0.51, respectively, P<0.05). CONCLUSION: Adiponectin level was correlated with HOMA-IR, QUICKI and ISI. Pubertal SGA group had a significantly lower mean serum adiponectin level than control group. We suggest the check of insulin resistance using HOMA-IR, QUICKI, ISI and adiponectin is important for the prevention of metabolic syndrome (MS) in adolescents born SGA.
Adiponectin ; Adolescent ; Blood Glucose ; Child ; Fasting ; Gestational Age ; Glucose ; Glucose Tolerance Test ; Homeostasis ; Humans ; Infant ; Insulin ; Insulin Resistance ; Leptin ; Succinimides

PURPOSE: Measurement of testicular volume is useful for the evaluation of puberty and testicular development in boys. Four mililiter of testicular volume means Tanner stage 2, the beginning of puberty, and its ethnic differences were reported. However, there is no reference value for Korean children. We tried to establish the standard testicular volume for Korean boys. METHODS: The subjects were selected among the children who visited the out-patient clinic of Kangdong Sacred Heart Hospital and Korea Cancer Center Hospital for the evaluation of growth from 2003 to 2008. Three hundred seventy two healthy Korean boys, 3 to 17 years of age, were included. We excluded the patients who were diagnosed as precocious puberty, delayed puberty, hypopituitarism, adrenal disorder and other endocrinologic disorder. The testicular volume was determined with Prader orchidometer. Clinical data were collected from patient's chart retrospectively. RESULTS: Right and left testicular volumes were 3.65 +/- 1.82 mL and 3.55 +/- 1.80 mL at 10 (10.0 - 10.9) year of age (n = 53), 6.17 +/- 3.60 mL and 6.13 +/- 3.69 mL at 11 (11.0 - 11.9) year of age (n = 52), respectively. There was no significant difference between right and left testicular volumes. CONCLUSION: The time when testicular volume reached 4 mL seemed to be not changed than previous Korean data. However, further study will be required to determine the secular trend of pubertal timing in Korean boys.
Child ; Heart ; Humans ; Hypopituitarism ; Korea ; Outpatients ; Puberty ; Puberty, Delayed ; Puberty, Precocious ; Reference Values ; Retrospective Studies

PURPOSE: Being small for gestational age (SGA) is a risk factor of short stature in children. Genetic background such as mid-parental height (MPH) is known to influence growth of children born SGA. We studied the relationship between growth of children born SGA and MPH and studied the effects of insulin-like growth factor (IGF-I) and insulin-like growth factor binding protein 3 (IGFBP-3) on postnatal growth in children born SGA according to MPH. METHODS: Forty-nine neonates born SGA were included in this study. We defined corrected height standard deviation score (cHtSDS) by modified height SDS (HtSDS) based on their MPH. We categorized subjects into group 1 consisting of children with cHtSDS > or =0 (n=35) and group 2 consisting of children with cHtSDS <0 (n=14), and compared IGF-I and IGFBP-3 between the two groups. RESULTS: The HtSDSs and cHtSDSs in groups 1 and 2 were 0.06+/-1.05 vs. -0.95+/-0.85 (P=0.000) and 0.78+/-0.93 vs. -0.46+/-0.67 (P=0.000), respectively. IGF-I SDS was higher in group 1 than in group 2 (2.82+/-3.69 vs. 0.23+/-2.42, P=0.012). Total cHtSDS (0.42+/-1.03) was significantly higher than HtSDS (-0.22+/-1.10) (P=0.000). CONCLUSION: Our results show that cHtSDS differs significantly from HtSDS. Growth assessment by standardized growth curve does not uniformly show effects of genetic factors. A more accurate assessment of growth uses a personalized corrected growth curve that considers the genetic factor measured by MPH.
Child ; Gestational Age ; Humans ; Infant, Newborn ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor I ; Phenazines ; Risk Factors

PURPOSE: Being small for gestational age (SGA) is a risk factor of short stature in children. Genetic background such as mid-parental height (MPH) is known to influence growth of children born SGA. We studied the relationship between growth of children born SGA and MPH and studied the effects of insulin-like growth factor (IGF-I) and insulin-like growth factor binding protein 3 (IGFBP-3) on postnatal growth in children born SGA according to MPH. METHODS: Forty-nine neonates born SGA were included in this study. We defined corrected height standard deviation score (cHtSDS) by modified height SDS (HtSDS) based on their MPH. We categorized subjects into group 1 consisting of children with cHtSDS > or =0 (n=35) and group 2 consisting of children with cHtSDS <0 (n=14), and compared IGF-I and IGFBP-3 between the two groups. RESULTS: The HtSDSs and cHtSDSs in groups 1 and 2 were 0.06+/-1.05 vs. -0.95+/-0.85 (P=0.000) and 0.78+/-0.93 vs. -0.46+/-0.67 (P=0.000), respectively. IGF-I SDS was higher in group 1 than in group 2 (2.82+/-3.69 vs. 0.23+/-2.42, P=0.012). Total cHtSDS (0.42+/-1.03) was significantly higher than HtSDS (-0.22+/-1.10) (P=0.000). CONCLUSION: Our results show that cHtSDS differs significantly from HtSDS. Growth assessment by standardized growth curve does not uniformly show effects of genetic factors. A more accurate assessment of growth uses a personalized corrected growth curve that considers the genetic factor measured by MPH.
Child ; Gestational Age ; Humans ; Infant, Newborn ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor I ; Phenazines ; Risk Factors

PURPOSE: This study was designed to examine the effects of adiponectin, leptin, insulin, insulin-like growth factor (IGF)-I and IGF binding protein (BP)-3 levels in cord blood on weight, length, and adiposity at birth in healthy term infants. In addition, we evaluated the mechanism to change the hormone levels in appropriate for gestational age (AGA) during the first month. METHODS: We collected cord blood from 200 term neonates (109 males, 91 females) with no perinatal problems, and measured the hormone levels and anthropometric parameters including weight, length, and skin-fold thickness. Term neonates were divided into 3 groups as follows: birth weight appropriate for gestational age (AGA) (n=132), birth weight less for gestational age (SGA) (n=29), and birth weight more for gestational age (LGA) (n=39). Venous blood samples of 15 fullterm healthy neonates were obtained at 3, 7, and 30 d after birth. RESULTS: The adiponectin, insulin, and IGF-I levels were significantly lower in the SGA group than in the AGA and LGA groups. The leptin levels were significantly higher in the LGA group than in the AGA and SGA groups. Cord blood adiponectin, leptin, insulin, IGF-I, and IGFBP-3 levels correlated significantly and positively with birth weight and the sum of the skin-fold thickness. A significant positive correlation was observed between adiponectin, leptin, and IGF-I levels and birth weight. Adiponectin level correlated significantly with that leptin level (r=0.191, P=0.038), but not with insulin, IGF-I and IGFBP-3 levels. IGF-I levels were higher in females than in males. At 7 d after birth, the leptin level decreased along with physiologic weight loss, and then increased. IGF-I, also decreased at 3 d, significantly increased 1 month later. CONCLUSION: We suggest that adiponectin, leptin, insulin, IGF-I, and IGFBP-3 play an important role in regulating fetal growth. Adiponectin may be involved in regulating fetal growth through mechanisms different from those mediated by insulin or IGF-I. High levels of IGF-I in female neonates indicates a gender difference which serves as evidence for in utero sexual dimorphism. It is likely that IGF-I has a more important role than that of hormones in postnatal growth.
Adiponectin ; Adiposity ; Birth Weight ; Carrier Proteins ; Female ; Fetal Blood ; Fetal Development ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; Insulin ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor I ; Leptin ; Male ; Parturition ; Weight Loss

No abstract available.