BACKGROUND/AIMS: Colorectal cancer, one of the most common cancers in developed countries, is curable when diagnosed at an early stage. However, for better screening, both a test that patients will tolerate and diagnostic accuracy are required. We compared patient experiences and preferences between computed tomographic (CT) colonography and conventional colonoscopy (CC) under conscious sedation. METHODS: Patients referred to the gastrointestinal clinic for CC were enrolled to also undergo CT colonography prior to CC. After each procedure, patients completed a questionnaire in which variables, such as abdominal pain, abdominal discomfort, and loss of dignity, were assessed using a 7-point Likert scale, with the highest score representing the worst experience. To verify response stability, a telephone questionnaire followed within 24 h after each procedure. Patients were then asked about their preference for CT colonography or CC. RESULTS: Data were collected from 51 patients who fulfilled all requirements, including CT colonography, CC, the two questionnaires after each procedure, and a follow-up questionnaire. Severity of abdominal pain, abdominal discomfort, and a loss of dignity were reported to be higher in CT colonography than in CC (p<0.01). In addition, the preference for CC was significantly higher than that for CT colonography (p<0.01). CONCLUSIONS: Although CT colonography is a safe and noninvasive screening test for colorectal cancer, further study is required to increase patient acceptance.
Colonography, Computed Tomographic/*methods/psychology ; Colonoscopy/*methods/psychology ; Colorectal Neoplasms/*diagnosis ; Diagnosis, Differential ; Female ; Humans ; Male ; Mass Screening/*methods/psychology ; Middle Aged ; Patient Acceptance of Health Care/*psychology ; *Patient Satisfaction ; Prospective Studies ; Questionnaires

Hemobilia is a cause of obscure gastrointestinal hemorrhage. Most cases have an iatrogenic or traumatic origin but cases of hemobilia with non-traumatic causes are rare. The non-traumatic causes of hemobilia are inflammation, gallstones, neoplasm and vascular lesions. Currently, various therapeutic options are available for hemobilia, and transarterial embolization is now the first line of intervention used to stop the bleeding of hemobilia, which shows a high success rate of approximately 80% to 100% with a lower morbidity and mortality rate than with surgery. We report a rare case of non-traumatic hemobilia caused by a pseudoaneurysm of the hepatic artery that was successfully treated with transarterial embolization.
Aneurysm, False* ; Gallstones ; Gastrointestinal Hemorrhage ; Hemobilia* ; Hemorrhage ; Hepatic Artery* ; Inflammation ; Mortality

Transforming growth factor (TGF)-beta1 is a key cytokine producing extracellular matrix. We evaluated the effect of TGF-beta1 gene polymorphism at codon 10 on the development of cirrhosis in patients with chronic hepatitis B. One hundred seventy eight patients with chronic hepatitis (CH, n=57) or liver cirrhosis (LC, n=121), who had HBsAg and were over 50 yr old, were enrolled. The genotypes were determined by single strand conformation polymorphism. There were no significant differences in age and sex ratio between CH and LC groups. HBeAg positivity and detection rate of HBV DNA were higher in LC than in CH groups (P=0.055 and P=0.003, respectively). There were three types of TGF-beta1 gene polymorphism at codon 10: proline homozygous (P/P), proline/leucine heterozygous (P/L), and leucine homozygous (L/L) genotype. In CH group, the proportions of P/P, P/L, and L/L genotype were 32%, 51%, and 17%, respectively. In LC group, the proportions of those genotypes were 20%, 47%, and 33%, respectively. The L/L genotype was presented more frequently in LC than in CH groups (P=0.017). Multivariate logistic regression analysis confirms that detectable HBV DNA (odds ratio [OR]: 3.037, 95% confidence interval [CI]: 1.504-6.133, P=0.002) and L/L genotype (OR: 3.408, 95% CI: 1.279-9.085, P=0.014) are risk factors for cirrhosis.
Aged ; Asian Continental Ancestry Group/genetics ; *Carrier State ; *Codon ; Female ; Genetic Predisposition to Disease ; Genotype ; Hepatitis B virus/genetics ; *Hepatitis B, Chronic/genetics/virology ; Humans ; *Liver Cirrhosis/genetics/virology ; Male ; Middle Aged ; Odds Ratio ; *Polymorphism, Genetic ; Risk Factors ; Transforming Growth Factor beta1/*genetics

Patulous Eustachian tube is a benign, but bothersome condition, which can cause severe physical and psychological problems. We investigated the clinical features and the therapeutic result of the surgery in three patients, whose patulous Eustachian tube symptom were treated by the surgical insertion of a specially designed, tripod-tipped-bone wax-filled angiocatheter into the bony orifice of the Eustachian tube. Immediate disappearance of the troublesome symptoms was observed in all six patients. No serious complications were observed during the follow-up period. Factors considered for this surgical therapy and the method of designing our specific angiocatheter are introduced in detail. Surgical therapy for patients with serious patulous Eustachian tube symptoms by inserting the tripod-tipped-bone wax-filled angiocatheter seemed promising. Further studies on its long-term therapeutic effects might be necessary using a large number of the patients.
Eustachian Tube* ; Follow-Up Studies ; Humans

To determine whether pinworm infections and head lice infestations spread among children in orphanages, 117 children from 4 orphanages in Busan-si and Ulsan-si, Korea, were examined for enterobiasis and head lice infestation between January and February 2014. The overall rate of Enterobius vermicularis egg positivity was 0.85%, whereas none of the children had head lice infestations. The rate of pinworm infection was much lower among the orphanage children compared to the rates observed in previous studies among kindergarten and primary school students. Moreover, the risk factors for enterobiasis were less frequent among these subjects than previously reported. The personal hygiene and health of the orphanage children were supervised by a regular, employed nurse through a health education program. In conclusion, pinworm infection was efficiently controlled among the children in orphanages, and this might be related to good personal hygiene practices in Korea.
Adolescent ; Animals ; Child ; Child, Preschool ; Enterobiasis/*epidemiology/parasitology ; Enterobius/genetics/*isolation & purification/physiology ; Female ; Humans ; Hygiene ; Lice Infestations/*epidemiology/parasitology ; Male ; Orphanages/statistics & numerical data ; Pediculus/genetics/*physiology ; Prevalence ; Republic of Korea/epidemiology

BACKGROUND/AIMS: Changes in subsite distribution of colorectal cancer have been shown in recent years. The carcinoma tend to shift to more proximal colon and this proximal shift is influenced by age and sex. This study was designed to delineate the relationship of age to subsite incidence of colorectal cancer and to define the role of gender in this difference. METHOD: We have analyzed the data by patients with colorectal cancer from 1985 to 1995 for elucidate the relationships between age, sex and prinmry location of colorectal cancer. 749 patients(male 454, female 295) were diagnosed of colorectal cancer performed by colonoscopy and/or sigmoidoeopy were divided into three groups by their location of cancer (Right colon: appendix, ascending colon, hepatic flexure, T-colon proximal 2/3 Left colon: T-colon distal 1/3, splenic flexure, descending colon, sigmoid colon Rectum: rectum). RESULTS: 1) The mean age of all patients was 53.84 +/- 13.11(yr). Mean ages of Right colon, Left colon, and Rectal cancer group were 55.54 +/- 14.12, 55.32 +/- 12.51, 52.22 +/- 13.09(yr), respectively. The mean age of Right colon and Left colon cancer group is significantly older than that of Rectal cancer group (p=0.0040, p=0.0042). 2) Infemale age group over 56, mean age of Right colon cancer group is shown to be 3.35 and 4.82 years older than Left colon cancer group and Rectal cancer group, respectively (p=0.0062, p=0.0053) and Colon cancer tend to develop on more right side according to increase in age. 3) Above correlation was not observed below 55 of both sexes and male age group over 56. 4) No significant differences in histological differentiation and tumor stage were observed among the three groups. 5) The study was conducted to evaluate the difference in the location of colorectal cancer between two following groups; The first group diagnosed from 1985 to 1990 and the second group from 1991 to 1995, yet significant statistical difference was not observed. CONCLUSION: Age increase seems to show correlation with right shifting of colon cancer, and this correlation was most significant in old women age group. This finding suggests unknown factor strongly linked to age and sex might play important role in carcinogenesis of colorectal cancer.
Appendix ; Carcinogenesis ; Colon ; Colon, Ascending ; Colon, Descending ; Colon, Sigmoid ; Colon, Transverse ; Colonic Neoplasms ; Colonoscopy ; Colorectal Neoplasms* ; Female ; Humans ; Incidence ; Male ; Rectal Neoplasms ; Rectum

Obstructive jaundice is most commonly attributed to a malignancy or stones affecting the common bile duct. Biliary tuberculosis and lymphadenitis around the periportal area have also been implicated but cases are quite rare. A 24 year old man presented with jaundice and abdominal pain for 3 days. Abdominal CT and ERCP revealed a stricture of the extrahepatic bile duct with multiple enlarged lymph nodes showing necrotic foci located at the periportal area. The colonoscopic biopsy showed evidence of M. tuberculosis. The patient was treated with ERBD insertion and oral anti-tuberculosis therapy. However, the abdominal pain recurred and there was progressive stenosis of the common bile duct. A bile duct resection with choledochojejunostomy was subsequently performed. Frozen sections revealed granulomatous inflammation with caseation necrosis, which was consistent with tuberculosis. We report a case of tuberculous cholangitis and lymphadenitis with obstructive jaundice that was managed surgically due to the progressive stricture of the bile duct.
Abdominal Pain ; Bile Ducts* ; Bile Ducts, Extrahepatic ; Bile* ; Biopsy ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis* ; Choledochostomy ; Common Bile Duct ; Constriction, Pathologic* ; Frozen Sections ; Humans ; Inflammation ; Jaundice ; Jaundice, Obstructive* ; Lymph Nodes ; Lymphadenitis* ; Necrosis ; Tomography, X-Ray Computed ; Tuberculosis ; Tuberculosis, Lymph Node ; Young Adult

The common sites of esophageal diverticula are the pharyngoesophageal junction, midesophagus and epiphrenic. The pathophysiological mechanisms of acquired esophageal diverticula are traction and pulsion forces. Traction diverticula of the midesophagus are usually asymptomatic, and found incidentally on an esophagogastroduodenoscopy or barium contrast esophagogram. Midesophageal traction diverticula are caused by inflammatory processes between the external wall of the esophagus and the adjacent structure. Pneumonia, bronchoesophageal fistula and gastrointestinal bleeding can occur due to an extension of inflammatory process into the lung or blood vessels. There are a few reports of midesophageal diverticular bleeding. We present a case of massive upper gastrointestinal bleeding from a traction diverticulum of the midesophagus that was successfully managed by endoscopic treatment.
Barium ; Blood Vessels ; Diverticulum* ; Diverticulum, Esophageal ; Endoscopy ; Endoscopy, Digestive System ; Esophagus ; Fistula ; Hemorrhage* ; Lung ; Pneumonia ; Traction*

Although ascending aortic aneurysm is a uncommon disease, it has fatal complications such as aortic rupture, dissection, or death. So, experts recommend a preemptive aortic operation. A 77-year-old man with hypertension visited for slow progressive exertional dyspnea and general weakness. Chest X-ray showed deviation of trachea to right, mediastinal widening, cardiomegaly, and bulging of right heart border to right. Transthoracic echocardiography(TTE) and transesophageal echocardiography(TEE) showed marked dilated ascending aorta with wall calcification associated with severe aortic regurgitation and pericardial effusion. Measured diameter of ascending aorta was 12 x 11 cm on Chest Computed Tomography (CT) scan, 8.35 cm on TTE, and 10.2 cm on TEE. Our exam found out the obstructive pneumonia and aortic regurgitation as consequences of complications of huge aneurysm. We report a case of huge ascending aortic aneurysm without any previous aortic operation, aortic complications, trauma, or other etiologic factors.
Aged ; Aneurysm ; Aorta ; Aortic Aneurysm* ; Aortic Rupture ; Aortic Valve Insufficiency ; Cardiomegaly ; Dyspnea ; Heart ; Humans ; Hypertension ; Pericardial Effusion ; Pneumonia ; Thorax ; Trachea