BACKGROUND/AIMS: Although several studies have suggested overlaps between gastroesophageal reflux symptom and irritable bowel syndrome (IBS), the studies for the association between erosive esophagitis and IBS are rare. The aim of this study was to evaluate the association among IBS, non-erosive reflux disease (NERD), and erosive esophagitis. METHODS: A total of 2,769 participants completed questionnaires and underwent esophagogastroduodenoscopy and colonoscopy. IBS was diagnosed by Rome III; NERD was defined as heartburn or acid regurgitation occurring at least once per week without erosive esophagitis. Erosive esophagitis was defined by Los Angeles classification. Psychological distress was evaluated with modified 4 dimensions from revised Hopkins symptom checklist 90. RESULTS: Psychological distress was associated with both IBS and NERD, but not with erosive esophagitis. IBS was associated with somatization (adjusted OR, 2.88; 95% CI, 1.55-5.36; P < 0.001), anxiety (adjusted OR, 2.82; 95% CI, 1.36-5.88; P = 0.005), and hostility (adjusted OR, 2.06; 95% CI, 1.10-3.87; P = 0.024) and NERD was associated with somatization (adjusted OR, 5.65; 95% CI, 2.92-10.98; P < 0.001) and anxiety (adjusted OR, 3.29; 95% CI, 1.47-7.34; P = 0.004). Erosive esophagitis was associated with somatization (adjusted OR, 2.69; 95% CI, 1.26-7.91; P < 0.001). Hiatal hernia and male sex were related with erosive esophagitis but not with IBS or NERD. H. pylori had an inverse relationship with erosive esophagitis, but had no association with IBS. Whereas IBS was positively associated with NERD (adjusted OR, 2.72; 95% CI, 1.84-4.03; P < 0.001), it had no association with erosive esophagitis. CONCLUSIONS: IBS shared many risk factors with NERD but not with erosive esophagitis. It partially explains why IBS was associated with NERD, but not with erosive esophagitis.
Anxiety ; Checklist ; Colonoscopy ; Endoscopy, Digestive System ; Esophagitis* ; Gastroesophageal Reflux* ; Heartburn ; Hernia, Hiatal ; Hostility ; Humans ; Irritable Bowel Syndrome* ; Male ; Surveys and Questionnaires ; Risk Factors

INTRODUCTION: The prevalence of irritable bowel syndrome (IBS) after excluding organic disease has not been reported in Korea. METHODS: Of 5,605 participants in a health screening program, inclusion criteria were persons who underwent colonoscopy and completed questionnaires. Exclusion criteria were persons diagnosed with colon cancer, inflammatory bowel disease, previous colectomy, and abnormal results of thyroid function tests. IBS was defined by Rome III criteria. Physical and psychological stress was evaluated with visual analogue scales, ranging from 0 to 10. Risk factors for IBS were estimated with odds ratios (OR) and 95% confidence intervals (CI) using logistic regression analysis. RESULTS: The prevalence of IBS was 8.2% (5,605) in the total population and 9.1% (393/4,296) in the final study sample. IBS had a positive association with female sex (adjusted OR, 1.33; 95% CI, 1.00-1.79; p = 0.05) and current smoking (adjusted OR, 1.31; 95% CI, 1.00-1.71; p = 0.05). The prevalence of IBS increased with increased psychological stress (adjusted p for trend = 0.005) and decreased with increasing age (adjusted p for trend <0.001), with adjusted OR of 0.95 (95% CI, 0.68-1.33) for age of 40.0 to 49.9 years; 0.79 (95% CI, 0.54-1.15) for age of 50.0 to 59.9 years; and 0.51 (95% CI, 0.30-0.86) for age of 60 years or more, compared with age less than 40 years. Drinking status, body mass index, hypertension, diabetes, and use of sedatives had no association with IBS. CONCLUSIONS: The prevalence of IBS increased with decreasing age and increasing psychological stress, and was positively associated with female sex and current smoking.
Body Mass Index ; Colectomy ; Colonic Neoplasms ; Colonoscopy ; Drinking ; Female ; Humans ; Hypertension ; Hypnotics and Sedatives ; Inflammatory Bowel Diseases ; Irritable Bowel Syndrome ; Korea ; Logistic Models ; Mass Screening ; Odds Ratio ; Prevalence ; Surveys and Questionnaires ; Risk Factors ; Rome ; Smoke ; Smoking ; Stress, Psychological ; Thyroid Function Tests ; Weights and Measures

BACKGROUND/AIMS: The aims of this study were to examine the expressions of endothelium specific VE-cadherin, intestine specific LI-cadherin, and vascular endothelial growth factor (VEGF), and to determine their relationships with the clinicopathological parameters of gastric cancer. METHODS: A total 47 patients with gastric cancer who underwent surgery were enrolled. Endoscopic biopsies were obtained from the cancer and normal mucosa, respectively. Using semiquantitative RT-PCR, the mRNA expression levels of VE-cadherin, LI-cadherin and VEGF were measured by tumor/normal (T/N) ratios. The protein expressions of VE-cadherin, LI-cadherin and VEGF were examined by Western blot and immunohistochemical stain in surgically resected tissues. The clinicopathological variables were reviewed and analyzed, retrospectively. RESULTS: Twenty two cases (46.8%) of VE-cadherin, 25 cases (53.2%) of LI-cadherin and 27 cases (51.1%) of VEGF mRNA expressions were overexpressed in gastric cancer compared to normal tissue. There was a tendency for T/N ratio of VE-cadherin mRNA to correlate with the lymphatic invasion (p=0.07) and the lymph node metastasis (p=0.099) in advanced gastric cancer. The T/N ratio of LI-cadherin mRNA showed significant association with distant metastasis (p=0.031) and lymphatic invasion especially in advanced gastric cancer (p=0.023). There was a tendency for the T/N ratio of VEGF mRNA to correlate with the distant metastasis (p=0.073) in advanced gastric cancer. CONCLUSIONS: As increased mRNA expression of LI-cadherin was associated with distant metastasis and lymphatic invasion especially in the biopsy specimen of advanced gastric cancer before surgery, it may provide useful preoperative information on tumor aggressiveness.
Adult ; Aged ; Aged, 80 and over ; Antigens, CD/genetics/*metabolism ; Cadherins/genetics/*metabolism ; Female ; Gastroscopy ; Humans ; Immunohistochemistry ; Lymphatic Metastasis ; Male ; Middle Aged ; Retrospective Studies ; Stomach Neoplasms/*metabolism/pathology/surgery ; Vascular Endothelial Growth Factor A/genetics/*metabolism

No abstract available.
Administration, Oral ; Adult ; Colon/radiography ; Colonoscopy ; Female ; Foreign Bodies/complications/*radiography ; Gastrointestinal Tract/radiography ; Humans ; Lethargy/*chemically induced ; Mercury/*toxicity ; Tomography, X-Ray Computed

BACKGROUND: Emergency management in hemoptysis is bronchial artery angiography and embolization. This study was designed to investigate the accuracy of localization of bleeding site by simple roentgenogram, computed tomography(CT) and bronchoscopy prior to embolization and to evaluate the outcome of embolotherapy. METHOD: We retrospectively evaluated 50 patients performed bronchial artery embolization(BAE), admitted to tertiary university hospital due to hemoptysis. RESULTS: The most common causes were pulmonary tuberculosis, old tuberculous related parenchymal damage, aspergilloma, and bronchiectasis. The success rate of BAE within one month was 90%; within 3 months was 88%; during follow up period of mean 11.6 months was 76%. The concordant rate of simple roentgenogram with angiographic outcome in terms of bleeding site is 70%; in chest CT 80%; in bronchoscopy 81%; in combined information of simple roentgenogram and CT 83%; in combined information of simple roentgenogram and bronchoscopy 78%. CONCLUSION: The diagnostic accuracy for the bleeding site was similar between chest CT and bronchoscopy, showing high diagnostic yield. The success rate of BAE was comparative to prior studies. Further study will be needed in a large scale in near future.
Angiography* ; Bronchial Arteries* ; Bronchiectasis ; Bronchoscopy* ; Embolization, Therapeutic ; Emergencies ; Follow-Up Studies ; Hemoptysis* ; Hemorrhage ; Humans ; Retrospective Studies ; Thorax* ; Tomography, X-Ray Computed* ; Tuberculosis, Pulmonary

BACKGROUND: Emergency management in hemoptysis is bronchial artery angiography and embolization. This study was designed to investigate the accuracy of localization of bleeding site by simple roentgenogram, computed tomography(CT) and bronchoscopy prior to embolization and to evaluate the outcome of embolotherapy. METHOD: We retrospectively evaluated 50 patients performed bronchial artery embolization(BAE), admitted to tertiary university hospital due to hemoptysis. RESULTS: The most common causes were pulmonary tuberculosis, old tuberculous related parenchymal damage, aspergilloma, and bronchiectasis. The success rate of BAE within one month was 90%; within 3 months was 88%; during follow up period of mean 11.6 months was 76%. The concordant rate of simple roentgenogram with angiographic outcome in terms of bleeding site is 70%; in chest CT 80%; in bronchoscopy 81%; in combined information of simple roentgenogram and CT 83%; in combined information of simple roentgenogram and bronchoscopy 78%. CONCLUSION: The diagnostic accuracy for the bleeding site was similar between chest CT and bronchoscopy, showing high diagnostic yield. The success rate of BAE was comparative to prior studies. Further study will be needed in a large scale in near future.
Angiography* ; Bronchial Arteries* ; Bronchiectasis ; Bronchoscopy* ; Embolization, Therapeutic ; Emergencies ; Follow-Up Studies ; Hemoptysis* ; Hemorrhage ; Humans ; Retrospective Studies ; Thorax* ; Tomography, X-Ray Computed* ; Tuberculosis, Pulmonary

BACKGROUND/AIMS: The effect of dietary micronutrients on non-erosive reflux disease (NERD) and reflux esophagitis is unclear. We aim to evaluate the gender-specific effect of micronutrient on erosive esophagitis and NERD. METHODS: A total of 11 690 participants underwent endoscopy and completed 3-day recordings for dietary intake and questionnaires for reflux symptoms from 2004 to 2008. To evaluate the effect of dietary micronutrients on NERD or erosive esophagitis, adjusted regression analysis with odds ratio (OR) and 95% confidence interval (CI) was used. In addition, we performed gender-specific analysis. RESULTS: Prevalence of NERD and erosive esophagitis was 6.8% and 11.2% in men and 9.1% and 2.4% in women. In adjusted analysis, high intake of vitamin A (OR, 0.78; 95% CI, 0.64–0.96), retinol (OR, 0.73; 95% CI, 0.59–0.90), vitamin B2 (OR, 0.68; 95% CI, 0.54–0.87), vitamin B6 (OR, 0.75; 95% CI, 0.58–0.96), folic acid (OR, 0.77; 95% CI, 0.62–0.96), calcium (OR, 0.66; 95% CI, 0.53–0.82), and iron (OR, 0.68; 95% CI, 0.53–0.87) had an inverse association with NERD. However, erosive esophagitis has no relationship with micronutrients except vitamin C (OR, 0.78; 95% CI, 0.62–0.98). High dietary intake of calcium reduced the risk of NERD in men and high dietary intake of many micronutrients reduced NERD in women. CONCLUSIONS: While many dietary micronutrients reduced NERD, they had no effect on erosive esophagitis. The effect of micronutrient on NERD was more prominent in women than men.
Ascorbic Acid ; Calcium ; Endoscopy ; Esophagitis ; Esophagitis, Peptic ; Female ; Folic Acid ; Gender Identity ; Humans ; Iron ; Male ; Micronutrients ; Odds Ratio ; Prevalence ; Riboflavin ; Vitamin A ; Vitamin B 6

Patients with gastrointestinal disease (GI) are at risk for osteopenia or osteoporosis, which can lead to fractures. Although these patients may be at risk from a young age, gastroenterologists often overlook this fact in practice. There are well-known GI diseases associated with osteopenia and osteoporosis, such as the post-gastrectomy state, inflammatory bowel disease (IBD), and celiac disease. As there is an increase in the prevalence of IBD patients, newly diagnosed celiac disease in adulthood, and gastric cancer survivors following gastrectomy, bone disease in these patients becomes an important issue. Here, we have discussed osteoporosis and fractures in GI disease, especially in the post-gastrectomy state, IBD, and celiac disease. Although the pathogenesis of bone loss in each disease has not been fully identified, we have confirmed that the prevalence of osteoporosis and fractures in each of these diseases is high. There are scarce studies comparing the prevalence of osteoporosis or osteoporotic fractures in GI disease patients with studies in postmenopausal women, and specific guidelines for their management in each disease have not been established. Intensive surveillance and management are needed to ensure that these patients attain peak bone mass for age and sex to prevent fractures.
Bone Diseases ; Bone Diseases, Metabolic ; Celiac Disease ; Female ; Gastrectomy ; Gastrointestinal Diseases* ; Humans ; Inflammatory Bowel Diseases ; Osteoporosis* ; Osteoporotic Fractures* ; Prevalence ; Stomach Neoplasms ; Survivors

HACEK organisms are the normal flora of upper respiratory tract and orophaynx. They infect abnormal cardiac valves, causing subacute native valve endocarditis or prosthetic valve endocarditis more than one year after valve surgery. Haemophilus species are responsible for only 0.5-1% of all infectious endocarditis cases. Embolization occurs in 60% and the mortality rate ranges from 16-45% of cases of infective endocarditis caused by H. parainfluenzae. We report two cases of H. parainfluenzae endocarditis, one of them is a 25-year-old male with tricuspid valve vegetations complicated with pulmonary embolism and the other is a 22-year-old female presented with heart failure.
Adult ; Endocarditis* ; Female ; Haemophilus parainfluenzae* ; Haemophilus* ; Heart Failure ; Heart Valves ; Humans ; Male ; Mortality ; Paramyxoviridae Infections ; Pulmonary Embolism ; Respiratory System ; Tricuspid Valve ; Young Adult

HACEK organisms are the normal flora of upper respiratory tract and orophaynx. They infect abnormal cardiac valves, causing subacute native valve endocarditis or prosthetic valve endocarditis more than one year after valve surgery. Haemophilus species are responsible for only 0.5-1% of all infectious endocarditis cases. Embolization occurs in 60% and the mortality rate ranges from 16-45% of cases of infective endocarditis caused by H. parainfluenzae. We report two cases of H. parainfluenzae endocarditis, one of them is a 25-year-old male with tricuspid valve vegetations complicated with pulmonary embolism and the other is a 22-year-old female presented with heart failure.
Adult ; Endocarditis* ; Female ; Haemophilus parainfluenzae* ; Haemophilus* ; Heart Failure ; Heart Valves ; Humans ; Male ; Mortality ; Paramyxoviridae Infections ; Pulmonary Embolism ; Respiratory System ; Tricuspid Valve ; Young Adult