No abstract availble.

There are many reasons why doctors would not to be able to communicate with patients. First, medicine is science or humanity? Although object of medicine is human, modern medicine tends to regard human as broken machine. Second, gastroenterologists are overloaded by treatment of patients, providing education, attending academic conference, and writing papers. Above all things, it is much worse for gastroenterologists because of endoscopic procedures. The other problem is attitude of modern society about human suffering. Sufferings come from not only body but also mind or spirit. Although there are may difficult problems, if doctors listen to patients' history by their side, it will help to restore their faith. In addition, we need humanity education and improvement plans for medical service system.
Delivery of Health Care ; Education, Medical, Continuing ; Gastrointestinal Diseases/*psychology ; Humans ; Physician-Patient Relations ; Physicians/*psychology

No abstract available.
Carcinoid Tumor/*diagnosis ; Female ; Humans ; Ki-67 Antigen/*metabolism ; Male ; Rectal Neoplasms/*diagnosis

No abstract available.
Neuroendocrine Tumors*

Endoscopic mucosal resection (EMR) is an endoscopic alternative to surgical resection of mucosal and submucosal neoplastic lesions. Prior to the development of knives, EMR could be performed with accessories to elevate the lesion. After the development of various knives, en bloc resection was possible without other accessories. So, recently, simple snaring without suction or endoscopic submucosal dissection using knife in the epithelial lesions such as adenoma or early mucosal cancer has been performed. However, for easy and complete resection of subepithelial lesions such as carcinoid tumor, a few accessories are needed. Complete resection of rectal carcinoid tumors is difficult to achieve with conventional endoscopic resection techniques because these tumors often extend into the submucosa. The rate of positive resection margin for tumor is lower in the group of EMR using a cap (EMR-C) or EMR with a ligation device (EMR-L) than conventional EMR group. EMR-C and EMR-L (or endoscopic submucosal resection with a ligation device) may be a superior method to conventional EMR for removing small rectal carcinoid tumors.
Adenoma ; Carcinoid Tumor ; Ligation ; SNARE Proteins ; Suction

Colorectal cancer (CRC) is the third most commonly diagnosed cancer in Korea. Despite recent developments in the treatment of CRC, the median overall survival time in patients with metastatic CRC is less than 30 months. The biologic agents that target the epidermal growth factor receptor (EGFR) or vascular endothelial growth factor (VEGF) have proven clinical benefits in the treatment of patient with metastatic CRC. Anti-EGFR agents, including cetuximab and panitumumab, as well as anti-VEGF agents, including bevacizumab, aflibercept, ramucirumab, and regorafenib have been shown to extend survival in combination with cytotoxic chemotherapy. In particular, the addition of anti-EGFR agents has demonstrated significant efficacy in patients with the RAS wild-type metastatic CRC. In the future, building a personalized treatment strategy, according to the clinical characteristics and biologic features of patients with unresectable or metastatic CRC, will be necessary. In this review, we summarized the mechanisms of target therapy, the results of main clinical trials, and the guideline of clinical practice in patients with unresectable or metastatic CRC.
Bevacizumab ; Biological Factors ; Cetuximab ; Colorectal Neoplasms* ; Drug Therapy ; Humans ; Korea ; Molecular Targeted Therapy ; Neoplasm Metastasis ; Receptor, Epidermal Growth Factor ; Vascular Endothelial Growth Factor A

No abstract available.
HIV* ; Humans ; Humans* ; Ulcer*

Menetrier's disease is a rare illness that is characterized by diffuse tremendous thickening of the gastric wall caused by excessive proliferation of the mucosa of unknown cause. An exact diagnosis is crucial due to the excellent prognosis as compared to other malignant lesions such as a gastric lymphoma and infiltrative gastric carcinoma. A 23-year-old woman presented with epigastric discomfort and dyspepsia. A rapid urease test, a test for H. pylori using serum IgG antibody, and a (13)C-urea breath test were all negative. A gastroscopic examination revealed a wide lesion encircling the lumen, which showed diffusely hard and thickened folds from an angle to the upper body near the cardia. Endoscopic ultrasonography showed diffusely hypoechoic thickness of the second wall layer, but the other wall layers were well preserved. The patient was diagnosed with Menetrier's disease without H. pylori infection, and the patient rapidly improved after short-term treatment with a proton pump inhibitor.
Breath Tests ; Cardia ; Dyspepsia ; Endosonography ; Female ; Gastritis, Hypertrophic ; Humans ; Immunoglobulin G ; Lymphoma ; Lymphoma, Non-Hodgkin ; Mucous Membrane ; Prognosis ; Proton Pumps ; Protons ; Stomach Neoplasms ; Urease ; Young Adult

No abstract available.
Humans ; Male ; Manometry ; Middle Aged

BACKGROUND/AIMS: Early gastric cancer (EGC) has a relatively long natural course compared to advanced gastric cancer (AGC). But, few studies about the natural course of EGC are currently available in the literature. In this study we investigated the natural course of EGC in patients who did not receive any treatment. METHODS: All patients diagnosed with gastric cancer on endoscopy at Kosin University Gospel Hospital between January 2001 and December 2010 were reviewed. Those among them who had EGC and did not receive any treatment were enrolled, and an analysis was performed. RESULTS: Twenty seven patients were enrolled. Nine of the enrolled patients were women and the median age was 73 years (range, 38-95). Initial endoscopic findings revealed 11 cases of protruded type, 16 cases of flat and depressed type. Histopathologic analysis indicated that there were 14 cases of well and moderately differentiated adenocarcinoma, 6 cases of poorly differentiated adenocarcinoma and signet ring cell carcinoma. Twelve patients underwent follow-up endoscopy and three of them developed AGC within a mean of 9.6 months (range, 5-12 months). Overall median survival time was 40 months and the 5-year survival rate was 45%. CONCLUSIONS: Although there were some differences in EGC progression, patients who did not receive any treatment progressed eventually. We were unable to identify specific factors predictive of median survival time in these patients.
Adult ; Aged ; Aged, 80 and over ; Female ; Gastroscopy ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Retrospective Studies ; Stomach Neoplasms/*mortality/pathology