No abstract available.
Exophthalmos* ; Neurofibromatoses*

Bleeding that recur or continues after hospital admission for an acutely bleeding peptic ulcer is the single most important factor adversely affecting prognosis. The endoscopic findings of stigmata of recent hemorrhage such as active bleeding, a visible vessel or fresh blood clots in peptic ulcer indicate relatively high rebleeding risk. 30 patients with stigmata of recent hemorrhage in bleeding peptic ulcers were treated by endoscopic alcohol injection therapy during the 3-year period from August 1989 to July 1992. 30 cases included 24 gastric ulcers, 4 duodenal ulcers, and 2 stomal ulcers. 8 of these were actively bleeding at the time of endoscopy and non-bleeding visible vessels were identified in 15 patients and fresh blood clots were present in 7. 12 of total 30 cases had rebleeding or continuous bleeding. 3 of 8 with active bleeding, 5 of 15 with non-bleeding bisible vessels, and 4 of 7 with fresh blood clots had rebleeding. Emergency operations were done in 4 cases. There was no complication such as perforation and mortality. We think that this modality of endoscopic hemostasis is safe and simple, but further randomized controlled trials will be needed to evaluate the efficacy of hemostasis by endoscopic alcohol injection therapy.
Christianity ; Duodenal Ulcer ; Emergencies ; Endoscopy ; Hemorrhage* ; Hemostasis ; Hemostasis, Endoscopic ; Humans ; Mortality ; Peptic Ulcer* ; Prognosis ; Stomach Ulcer ; Ulcer

BACKGROUND/AIMS: The incidence of gastroesophageal reflux disease (GERD) is increasing in Korea. The aim of this study was to evaluate the relationship between GERD symptoms and dietary factors in Korea. METHODS: From January 2007 to April 2008, 162 subjects were enrolled (81 in GERD group and 81 in control group). They were asked to complete the questionnaires about GERD symptoms and dietary habits. The symptom severity score was recorded by visual analogue scale. RESULTS: Subjects with overweight or obesity had an increased risk for GERD (OR, 2.52; 95% CI, 1.18-5.39). Irregular dietary intake was one of the risk factors for GERD (OR, 2.33; 95% CI, 1.11-4.89). Acid regurgitation was the most suffering (2.85 +/- 2.95 by visual analogue scale) and frequent reflux-related symptom (57.5%) in GERD. Noodles (OR, 1.22; 95% CI, 1.12-1.34), spicy foods (OR, 1.09; 95% CI, 1.02-1.16), fatty meals (OR, 1.20; 95% CI, 1.09-1.33), sweets (OR, 1.42; 95% CI, 1.00-2.02), alcohol (OR, 1.16; 95% CI, 1.03-1.31), breads (OR, 1.17; 95% CI, 1.01-1.34), carbonated drinks (OR, 1.69; 95% CI, 1.04-2.74) and caffeinated drinks (OR,1.41; 95% CI, 1.15-1.73) were associated with symptom aggravation in GERD. Among the investigated noodles, ramen (instant noodle) caused reflux-related symptoms most frequently (52.4%). CONCLUSIONS: We found that noodles, spicy foods, fatty meals, sweets, alcohol, breads, carbonated drinks and caffeinated drinks were associated with reflux-related symptoms.
Bread ; Carbonated Beverages ; Diet ; Food Habits ; Gastroesophageal Reflux ; Incidence ; Korea ; Meals ; Obesity ; Overweight ; Surveys and Questionnaires ; Risk Factors ; Stress, Psychological

Neuroendocrine carcinoma of the colon is a very rare entity. However, this type of tumor is known to have aggressive progression and poor prognosis. A case of a 72-year-old male is presented in this report. A 3 cm sized tumor was found on the rectum with multiple liver metastases. The pathological findings including a positive immunohistochemical staining for synaptophysin and cytokeratin done with colonoscopic biopsy and liver biopsy confirmed the tumor as a neuroendocrine carcinoma. The nomenclature and definition of this disease still remains somewhat unclear, and not a small population of this disease may thus have been misdiagnosed and treated as other less aggressive entities, such as carcinoid tumor. The necessity to make an accurate differential diagnosis in such cases is thus emphasized because of different treatments and clinical courses. For its rarity and clinical significance, we report this case with a review of the literatures.
Aged ; Biopsy ; Carcinoid Tumor ; Carcinoma, Neuroendocrine* ; Colon ; Diagnosis, Differential ; Humans ; Keratins ; Liver ; Male ; Neoplasm Metastasis ; Prognosis ; Rectum* ; Synaptophysin

Neuroendocrine carcinoma of the colon is a very rare entity. However, this type of tumor is known to have aggressive progression and poor prognosis. A case of a 72-year-old male is presented in this report. A 3 cm sized tumor was found on the rectum with multiple liver metastases. The pathological findings including a positive immunohistochemical staining for synaptophysin and cytokeratin done with colonoscopic biopsy and liver biopsy confirmed the tumor as a neuroendocrine carcinoma. The nomenclature and definition of this disease still remains somewhat unclear, and not a small population of this disease may thus have been misdiagnosed and treated as other less aggressive entities, such as carcinoid tumor. The necessity to make an accurate differential diagnosis in such cases is thus emphasized because of different treatments and clinical courses. For its rarity and clinical significance, we report this case with a review of the literatures.
Aged ; Biopsy ; Carcinoid Tumor ; Carcinoma, Neuroendocrine* ; Colon ; Diagnosis, Differential ; Humans ; Keratins ; Liver ; Male ; Neoplasm Metastasis ; Prognosis ; Rectum* ; Synaptophysin

Background/Aims: Few studies have investigated the long-term outcomes of endoscopic resection for early gastric cancer (EGC) in very elderly patients. The aim of this study was to determine the appropriate treatment strategy and identify the risk factors for mortality in these patients. Methods: Patients with EGC who underwent endoscopic resection from 2006 to 2017 were iden-tified using National Health Insurance Data and divided into three age groups: very elderly (≥85 years), elderly (65 to 84 years), and non-elderly (≤64 years). Their long- and short-term outcomes were compared in the three age groups, and the survival in the groups was compared with that in the control group, matched by age and sex. We also evaluated the risk factors for long- and short-term outcomes. Results: A total of 8,426 patients were included in our study: 118 very elderly, 4,583 elderly, and 3,725 non-elderly. The overall survival and cancer-specific survival rates were significantly lower in the very elderly group than in the elderly and the non-elderly groups. Congestive heart failure was negatively associated with cancer-specific survival. A significantly decreased risk for mortality was observed in all groups (p<0.001). The very elderly group had significantly higher readmission and mortality rates within 3 months of endoscopic resection than the non-elderly and elderly groups. Furthermore, the cerebrovascular disease was associated with mortality within 3 months after endoscopic resection. Conclusions Endoscopic resection for EGC can be helpful for very elderly patients, and it may play a role in achieving overall survival comparable to that of the control group.

The Korean Society of Neurogastroenterology and Motility first published guidelines for chronic constipation in 2005 and was updated in 2011. Although the guidelines were updated using evidence-based process, they lacked multidisciplinary participation and did not include a diagnostic approach for chronic constipation. This study includes guidelines for diagnosis and treatment of chronic constipation to realistically fit the situation in Korea and to be applicable to clinical practice. The guideline development was based upon the adaptation method because research evidence was limited in Korea, and an organized multidisciplinary group carried out systematical literature review and series of evidence-based evaluations. Six guidelines were selected using the Appraisal of Guidelines for Research & Evaluation II process. A total 37 recommendations were adopted, including 4 concerning the definition and risk factors of chronic constipation, 8 regarding diagnoses, and 25 regarding treatments. The guidelines are intended tohelp primary physicians and general health professionals in clinical practice in Korea, to provide the principles of medical treatment to medical students, residents, and other healthcare professionals, and to help patients for choosing medical services based on the information. These guidelines will be updated and revised periodically to reflect new diagnostic and therapeutic methods.
Constipation* ; Delivery of Health Care ; Diagnosis* ; Health Occupations ; Humans ; Korea* ; Risk Factors ; Students, Medical

In Korea the system of medical management has been bifurcated into two parts since the restoration of nation from Japanese after World War II. One is 'Western Medicine' and the other is 'Oriental Medicine' like Chinese but not like Japanese. The authors attempted to study on the unification of both medicines to prevent the confusion of medicare for people. The major part of medical care is accomplished by Western medicine among people in Korea and China. However, Oriental medicine is still present as well as college of Oriental medicine in small number. There have been long struggles between two parts of medicine because of each assertions for the theories. The ancient medicine has been likely to have its characteristics either in Western or Oriental medicine although in many countries were succeeded by Western medicine except a few Asian countries such as Korea and China. In Japan since the license of Oriental(herb) medicine was ceased about one hundred years ago, the Western medicine has been authorized by law until today and the herb is the secondary medicine as a kind of folk treatment as well as continuous and enormous study for scientification. In only China and Korea this herb medicine has been kept to use as a part of medicine by law though China has developed combined medicine to use both Western and Oriental medicine by one physician since previous prime minister Chou En-Lai around the year 1950 who made a recommendation to the two medical societies, Western and Oriental. This fact has a big sense to establish the unification of two medicines in near future in Korea as well as China. For this accomplishment of medical unification both parts of medicine require sincere and enormous efforts to study the theory and practice of herb medicine even from now on. This unification of two medicines will provide the best medicare in most convenient way to the people in the world creating new world medicine like the third medicine including alternative medicine. The acupuncture is changing to a new method in Western medicine especially applying into anesthesia and pain clinic in even USA and Western countries at this time. In conclusion the unification of the Western and Oriental medicine will provide the most reasonable and practical medicare including alternative medicine to people in the world. Because the Oriental medicine will be used at least separately to supplement the Western medicine by one physician
Asia ; China ; English Abstract ; History of Medicine, 20th Cent. ; Korea ; *Medicine ; Medicine, Oriental Traditional/*history ; Philosophy, Medical/*history ; Western World

BACKGROUND: Transforming growth factor-beta (TGF-beta) is a potent inhibitor of epithelial cell growth. However, carcinoma cells, unlike normal cells, can escape from negative regulation by TGF-beta through lack of expression or mutation of TGF-beta receptor gene. In this study, we investigated the role of TGF-beta1 and TGF-beta type II receptors (TbetaR-II) in the progression of gastric cancer. METHODS: We analyzed TGF-beta1 and TbetaR-II mRNA expression semi-quantitatively, measured by comparative RT-PCR using GAPDH, in 23 patients who underwent gastric resection for gastric cancer. We analyzed the relationship between the clinicopathologic findings and the level of the TGF-beta1 and TbetaR-II mRNA expression in carcinoma tissues and in adjacent normal tissues of gastric cancer. RESULTS: (1) TGF-beta1 and TbetaR-II mRNA were expressed in all of the carcinoma tissues and adjacent normal tissues without statistical difference in the level of the expression. (2) The level of TGF-beta1 mRNA expression was higher in patients with early gastric cancer, negative lymph nodes or negative perineural invasion. There was no significant correlation between the level of TGF-beta1 mRNA expression and several parameters such as age, gender, tumor size, differentiation, Lauren's classification, and vascular invasion. (3) There was no significant correlation between the level of TbetaR-II mRNA expression and several prognostic variables described above. (4) There was significant correlation between the level of TGF-beta1 and TbetaR-II mRNA in carcinoma tissues. CONCLUSION: The above data indicates that TGF-beta1 may contribute in the early stages of gastric carcinogenesis. Further studies are required to clarify the role of TGF-beta 1 in gastric carcinogenesis.
Carcinogenesis ; Classification ; Epithelial Cells ; Humans ; Lymph Nodes ; Receptors, Transforming Growth Factor beta ; RNA, Messenger ; Stomach Neoplasms* ; Transforming Growth Factor beta* ; Transforming Growth Factor beta1 ; United Nations

BACKGROUND: Electrolyzed acid water (EAW) is a new liquid chemical germicide containing a mixture of oxidizing species and prepared by mixing a small amount of salt with tap water in an electrolyzer. We attempted an in-use evaluation of the high-level disinfection capability of Cleantop WM-1 , a new endoscope reprocessing system using EAW. METHODS: Forty-seven flexible endoscopes were randomly collected just after upper endoscopic examinations and were disinfected using Cleantop WM-1 . Parts of the endoscopes without contact to EAW were disinfected with 75% ethyl alcohol. Immediately after the disinfection procedure, samples were taken from the biopsy channel (S-1), tip of the insertion tube (S- 2), the umbilical cord (S-3), and the angulation knob (S-4). RESULTS: In EAW-disinfected parts of the endoscopes, the culture-positive rates were 4.3% (2/47) in S-1 samples and 12.8% (6/47) in S-2 samples. In ethyl alcohol-disinfected area, the culture-positive rates were 2.1% (1/47) in S-3 samples and 25.5% (12/47) in S-4 samples. The colony counts of culture-positive samples ranged from 1 to 144. Pseudomonas aeruginasa was recovered from the angulation knob of an endoscope, but other contaminating organisms were mostly: normal flora or opportunistic pathogens. CONCLUSOIN: Although parts of the endoscopes disinfected with 75% ethyl alcohol were contaminated with more organisms than EAW-disinfected areas, Cleantop WM-1 showed a relatively good disinfection efficacy in reprocessing patient-used endoscopes.
Biopsy ; Disinfection* ; Endoscopes* ; Ethanol ; Pseudomonas ; Umbilical Cord ; Water*