Chronic constipation is one of the most common digestive diseases encountered in clinical practice. Constipation manifests as a variety of symptoms, such as infrequent bowel movements, hard stools, feeling of incomplete evacuation, straining at defecation, a sense of anorectal blockage during defecation, and use of digital maneuvers to assist defecation. During the diagnosis of chronic constipation, the Bristol Stool Form Scale, colonoscopy, and a digital rectal examination are useful for objective symptom evaluation and differential diagnosis of secondary constipation. Physiological tests for functional constipation have complementary roles and are recommended for patients who have failed to respond to treatment with available laxatives and those who are strongly suspected of having a defecatory disorder. As new evidence on the diagnosis and management of functional constipation emerged, the need to revise the previous guideline was suggested. Therefore, these evidence-based guidelines have proposed recommendations developed using a systematic review and meta-analysis of the treatment options available for functional constipation. The benefits and cautions of new pharmacological agents (such as lubiprostone and linaclotide) and conventional laxatives have been described through a meta-analysis. The guidelines consist of 34 recommendations, including 3 concerning the definition and epidemiology of functional constipation, 9 regarding diagnoses, and 22 regarding managements. Clinicians (including primary physicians, general health professionals, medical students, residents, and other healthcare professionals) and patients can refer to these guidelines to make informed decisions regarding the management of functional constipation.

OBJECTIVES: The purpose of the study was to compare plaque characteristics by coronary computed tomography angiography (CCTA) with those by virtual histology-intravascular ultrasound (VH-IVUS). METHODS: We enrolled 50 asymptomatic patients with diabetes mellitus or more than two risk factors for coronary artery disease such as hypertension, smoking, and hyperlipidemia. If the patient had a coronary lesion (plaque with more than 50% stenosis or calcium score more than 100), we recommended coronary angiography and VH-IVUS and compared CCTA findings with VH-IVUS findings. RESULTS: 35 patients (70%) had coronary lesions, and we performed both CCTA and VH-IVUS in 23 patients. All 23 patients had multiple risk factors, and the majority of target lesions were located at left anterior descending artery (73.9%), and calcium score of lesion site was 106+/-162 with plaque volume of 232+/-153 mm3 by CCTA. Calcium score of lesion site was significantly greater in diabetic patients (n=14) than non-diabetic patients (n=9) (118+/-159 vs. 88+/-175, p=0.038). By VH-IVUS, plaque volume was 174+/-127 mm3, absolute necrotic core (NC) volume was 22+/-21 mm3, and relative NC volume was 20.8+/-8.7%. Absolute dense calcium (DC) volume and absolute NC volumes were significantly greater in diabetic patients than non-diabetic patients (11.5+/-13.8 mm3 vs. 9.1+/-11.0 mm3, p=0.028, and 23.9+/-24.7 mm3 vs. 18.1+/-14.3 mm3, p=0.035, respectively). Plaque volume by CCTA correlated with that of VH-IVUS (r=0.742, p<0.001), and plaque volume by CCTA correlated with absolute NC volume by VH-IVUS (r=0.621, p<0.001), and calcium score of lesion site by CCTA correlated with absolute dense calcium volume by VH-IVUS (r=0.478, p=0.028). CONCLUSION: Coronary lesion was detected by CCTA in 70% of asymptomatic patients with multiple coronary risk factors, and parameters detected by CCTA correlated well with those detected by VH-IVUS.
Angiography* ; Arteries ; Calcium ; Constriction, Pathologic* ; Coronary Angiography ; Coronary Artery Disease* ; Diabetes Mellitus ; Humans ; Hyperlipidemias ; Hypertension ; Risk Factors* ; Smoke ; Smoking ; Ultrasonography*

BACKGROUND: We report here the results of surveys for external quality assessment of blood bank tests performed in 2009. METHODS: Survey specimens were sent three times to 488, 491 and 490 participant institutes, and the response rates for the 1st, 2nd and 3rd trial were 97.7%, 98.0%, and 98.0%, respectively. Test items for the surveys were ABO grouping, Rh (D) typing, crossmatching, direct antiglobulin test, antibody screening and antibody identification test. RESULTS: The average accuracy rates of ABO grouping and Rh typing were 99.6-100% and 98.5-100%, respectively. In crossmatching test, the accuracy rates were 99.3-99.8% for the compatible samples, 92.7-100% for the incompatible samples, and 92.6-93.1% for the samples which could be detected as incompatible only by antiglobulin method. The accuracy rates of direct antiglobulin test were 98.5-100% for negative samples and 98.1-98.8% for positive samples. The correctresults were reported by 98.0-100% of the surveyed institutions for antibody screening test and 82.9-100% for antibody identification test. Nineteen institutions gave repeatedly incorrect answers for crossmatching test. Eight institutions out of them gave incorrect answers for all the test specimens sent out 3 times last year. CONCLUSIONS: The overall results of this survey were good, however, it is required that the institutions where the incorrect results were reported should perform corrective actions for quality improvement.
Academies and Institutes ; Blood Banks ; Coombs Test ; Korea ; Mass Screening ; Quality Improvement

A 43-year-old man presented painless protruding mass on left side of penile shaft only during erection. 1 year ago he had a dorsal penile neurectomy for the treatment of premature ejaculation at local clinic. A protruding cavernousal aneurysm about 2 cm in diameter was developed 6 months after surgery and confirmed on penile duplex ultrasonography after PDE5 inhibitor ingestion with visual sexual stimulation. We have observed the lesion every month and found there was slight enlargement for the last 3 months without any other symptoms. We performed cavernosoplasty under the genereal anesthesia. There was a round cavernosal aneurysm on the left side of penile mid-shaft about 4cm in diameter after artificial erection with intracavernosal saline injection. We prevented cavernosal protrusion by covering the aneurismal surface with bovine pericardium patch (Supple Peri-Guard(R)). There was no side effect for 6 months postoperatively. This is an unusual type of complication of dorsal penile neurectomy.
Adult ; Anesthesia ; Aneurysm ; Dilatation ; Eating ; Humans ; Pericardium ; Premature Ejaculation

We report here the results of surveys for external quality assessment of blood bank tests performed in 2008. Survey specimens were sent three times to 460, 470 and 473 participant institutes, and the response rates for the 1st, 2nd and 3rd trial were 97.6%, 97.7%, and 97.7%, respectively. Test items for the surveys were ABO grouping, Rh (D) typing, crossmatching, direct antiglobulin test, antibody screening and antibody identification test. The average accuracy rates of ABO grouping and Rh typing were 100% and 98.3-100%, respectively. In crossmatching test, the accuracy rates were 97.5-99.7% for the compatible samples, 92.4-99.2% for the incompatible samples, and 88.2-98.9% for the samples which could be detected as incompatible only by antiglobulin method. The accuracy rates of direct antiglobulin test were 98.4-99.7% for negative samples and 93.4-99.7% for positive samples. The correct results were reported by 99.6-100% of the surveyed institutions for antibody screening test and 98.2-100% for antibody identification test. Twenty-three institutions gave repeatedly incorrect answers for crossmatching test. Ten institutions out of them gave incorrect answers for all the test specimens sent out 3 times last year.
Academies and Institutes ; Blood Banks ; Coombs Test ; Korea ; Mass Screening

We report here the results of external quality assessment of blood bank tests performed in 2007. Survey specimens were sent three times to 448, 450, and 455 participant institutes, and the response rates were 99.3%, 97.3%, and 98.0%, respectively. Test items for the surveys were ABO grouping, Rh(D) typing, crossmatching, direct antiglobulin test, antibody screening and identification test. The average accuracy rates of ABO grouping and Rh typing were in the range of 99.5-100% and 98.9-100%, respectively. In crossmatching test, the accuracy rates were 96.0-97.1% for the compatible samples, 89.6-92.4% for the incompatible samples, and 89.6-92.4% for the samples which could be detected as incompatible only by antiglobulin method. The accuracy rates of direct antiglobulin test were 98.0-99.7% for negative samples and 96.3-99.0% for positive samples. The correct results were reported by 95.7-100% of the surveyed institutions for antibody screening test and 98.2-100% for identification test. Fifteen institutions gave repeatedly incorrect answers for crossmatching. Five institutions out of them gave incorrect answers for all the test specimens sent out 3 times last year.
Academies and Institutes ; Blood Banks ; Coombs Test ; Korea ; Mass Screening

We report here the results of external quality assessment of blood bank tests performed in 2007. Survey specimens were sent three times to 448, 450, and 455 participant institutes, and the response rates were 99.3%, 97.3%, and 98.0%, respectively. Test items for the surveys were ABO grouping, Rh(D) typing, crossmatching, direct antiglobulin test, antibody screening and identification test. The average accuracy rates of ABO grouping and Rh typing were in the range of 99.5-100% and 98.9-100%, respectively. In crossmatching test, the accuracy rates were 96.0-97.1% for the compatible samples, 89.6-92.4% for the incompatible samples, and 89.6-92.4% for the samples which could be detected as incompatible only by antiglobulin method. The accuracy rates of direct antiglobulin test were 98.0-99.7% for negative samples and 96.3-99.0% for positive samples. The correct results were reported by 95.7-100% of the surveyed institutions for antibody screening test and 98.2-100% for identification test. Fifteen institutions gave repeatedly incorrect answers for crossmatching. Five institutions out of them gave incorrect answers for all the test specimens sent out 3 times last year.
Academies and Institutes ; Blood Banks ; Coombs Test ; Korea ; Mass Screening

We report here the results of surveys for external quality assessment of blood bank tests performed in 2005. Response rates for the 1st, 2nd and 3rd trial were 97.0%, 96.8%, and 97.1% respectively. Test items for the surveys were ABO grouping, Rh(D) typing, crossmatching, direct antiglobulin test, antibody screening and identification test. The average accuracy rates of ABO grouping and Rh typing were in the range of 99.5-100% and 99.7-100% respectively. In crossmatching test, the accuracy rates were 94.3-98.2% for the compatible samples, 88.5-92.9% for the incompatible samples, and 88.5-92.9% for the samples which could be detected as incompatible only by antiglobulin method. The accuracy rates of direct antiglobulin test were 98.9-99.3% for negative samples and 89.2-96.9% for positive samples. The correct results were reported by 98.3-100% of the surveyed institutions for antibody screening test and 98.9-100% for identification test. Seventeen institutions gave repeatedly incorrect answers for crossmatching. Thirteen institutions out of them gave incorrect answers for all the test specimens sent out 3 times last year.
Blood Banks* ; Coombs Test ; Korea* ; Mass Screening

BACKGROUND: Non-erosive reflux disorder, which represents more than 60% of gastro-esophageal reflux disorders, lacks objective parameters for diagnosis. The purpose of this study was to evaluate the correlation between non-erosive minimal lesions at the lower esophagus and gastro-esophageal reflux disorder. METHODS: Patients were asked to answer a symptom questionnaire. The endoscopic findings were either graded by LA classification or recorded as non-erosive minimal lesions. Patients with minimal lesions were treated with rabeprazole or a placebo and responses were evaluated at weeks 1 and 4. RESULTS: In 8 centers, 3454 patients were screened. In patients with heartburn or acid regurgitation as the most bothersome symptom, 23.7% had endoscopy negative reflux disorder, 40.1% showed minimal lesions, and 36.2% had mucosal break esophagitis. Thirty-four percent of patients with minimal lesions and 39.1% of patients with LA 'grade A' mild esophagitis reported typical reflux symptoms as their main symptom. In patients with minimal lesions, medication with rabeprazole reduced symptoms significantly at weeks 1 and 4, but not with the placebo. CONCLUSION: Patients with non-erosive minimal esophageal lesions had similar reflux symptoms comparable to those with mild erosive reflux esophagitis, and reflux symptoms were improved with a short-term proton pump inhibitor. Thus, non-erosive minimal esophageal lesion constitutes a great part of gastro-esophageal reflux disorder.
2-Pyridinylmethylsulfinylbenzimidazoles ; Adult ; Aged ; Aged, 80 and over ; Anti-Ulcer Agents/*therapeutic use ; Benzimidazoles/*therapeutic use ; Enzyme Inhibitors/*therapeutic use ; Esophageal Diseases/*pathology ; Female ; Follow-Up Studies ; Gastroesophageal Reflux/drug therapy/epidemiology/*pathology ; Humans ; Korea/epidemiology ; Male ; Middle Aged ; Omeprazole/*analogs & derivatives/therapeutic use ; Prospective Studies ; Proton-Translocating ATPases/*antagonists & inhibitors ; Treatment Outcome

No abstract available.
Burkholderia cepacia* ; Burkholderia*