BACKGROUND/AIMS: The influence of Helicobacter pylori infection on gastric motility and sensation is unclear. Our hypothesis is that H. pylori infection increases gastric sensation and reduces gastric accommodation. METHODS: Seventeen healthy volunteers were recruited by public advertisement. Gastrointestinal symptoms were assessed by a questionnaire. All subjects underwent gastrofiberoscopy for assessment of organic diseases and for diagnosis of H. pylori infection. We evaluated for (1) proximal gastric compliance, (2) gastric sensation for three symptoms (nausea, abdominal fullness, and abdominal discomfort/pain) during balloon inflation and (3) fasting and postprandial proximal gastric tone using a barostat. RESULTS: The H. pylori negative (HP-) volunteers were eight (M:F=7:1, mean age 28+/-4 years) and the H. pylori positive (HP+) volunteers were nine (M:F=5:4, mean age 31+/-11 years). There was no difference in the fasting and the postprandial proximal gastric tone between the two groups. The minimal distending pressure was similar between the two groups [5.50+/-1.69(HP-) vs. 5.78+/-1.72 (HP+)]. No differences were detected on aggregate perception scores during the three levels of phasic distension. CONCLUSIONS: Our study suggests that H. pylori infection in asymptomatic subjects may not significantly alter gastric sensitivity or gastric accommodation.
Compliance ; Diagnosis ; Fasting ; Healthy Volunteers* ; Helicobacter pylori* ; Helicobacter* ; Inflation, Economic ; Sensation* ; Volunteers ; Surveys and Questionnaires

Tuberculous involvement of the esophagus is very rare even in the presence of extensive pulmonary tuberculosis or in the endemic area. This is resulted from local extension to the esophagus from contiguous tuberculosis organs or miliary spread. Such secondary involvement is more common than primary tuberculosis, in which there is no evidence of tuberculosis elsewhere. The diagnosis of esophageal tuberculosis may be difficult. So the radiologic, endoscopic, histologic findings and clinical feature including the response to chemotherapy may be needed to avoid misdiagnosis. Most cases can be treated successfully with antituberculosis medication. A 67-year-old man was admitted to our hospital complaining of swallowing difficulty for 2 months. On the gastrofibroscopic examination, 22 cm sized protruding mass with central deep ulceration was discovered at the mid-esophagus. The biopsy showed the ulcer with chronic granulomatous inflammation and multinucleated giant cells consistent with tuberculosis. After antituberculosis medication, the lesion of esophageal tuberculosis was healed completely remaining minimal ulcer scar.
Aged ; Biopsy ; Cicatrix ; Deglutition ; Diagnosis ; Diagnostic Errors ; Drug Therapy ; Esophageal Neoplasms* ; Esophagus ; Giant Cells ; Humans ; Inflammation ; Tuberculosis* ; Tuberculosis, Pulmonary ; Ulcer

OBJECTIVES: This study aimed to propose criteria for evaluating the validity of dental education systems in Korea and suggest future directions for their improvement. METHODS: We looked into dental educational institutions and derived criteria for analysis and comparison of dental education systems in Korea. Using analytical methods, we compared the strengths and weaknesses of each education system, and suggested core areas of improvement. RESULTS: Considering the demands placed on the Korean dental education sector, it is desirable to have an integrated education system that includes the preliminary and main courses, comprehensive training linking the basic medicine and clinical practice, and complete career guidance. CONCLUSIONS: A good dental education system is one that meets the educational goals set by a dental school. If the goal is to train a student to be a good dental practitioner, a 2+4 or 4+4 system is recommended, while a 3+4 model is more suitable when the objective is to train students to be researchers.
Education ; Education, Continuing ; Education, Dental ; Humans ; Korea ; Schools, Dental

BACKGROUND/AIMS: We evaluated the effects of cisapride tartrate on gastrointestinal symptoms and gastric emptying times in diabetic patients with dysmotility like dyspeptic symptoms. METHODS: Cisapride was administered before each meal in 61 patients for 4 weeks. The intensity of gastrointestinal symptoms before and after cisapride administration was scored from 0 to 4, in the order of increasing severity of symptoms. In addition, a gastric emptying test was performed. RESULTS: A significant reduction in the total intensity score of symptoms was observed during the first two weeks, from 8.5+/-2.1 to 4.0+/-3.0 (p < 0.05), and a further reduction was noted during the next two weeks, to 2.8+/-2.8 (p < 0.05). Good to excellent improvement was obtained in 70.4% of the patients, but the improvement in symptoms was not related to age, duration of diabetes, glucose, Hb A1c, neuropathy, or retinopathy. Treatment with cisapride induced a significant regression of symptoms and a significant improvement of delayed gastric emptying from 104.0+/-31.7 minutes to 79.5+/-17.1 (p < 0.05). However, there was a lack of association between the changes in gastric emptying times and improvements in symptoms(r(2)=0.00186). Only 3 patients complained of loose stool, nausea, or dizziness. CONCLUSIONS: Cisapride was effective in improving dysmotility like dyspeptic symptoms in diabetic patients without serious side effects.
Cisapride* ; Dizziness ; Dyspepsia ; Gastric Emptying ; Glucose ; Hemoglobin A, Glycosylated ; Humans ; Meals ; Nausea

BACKGROUND/AIMS: Chronic gastrointestinal (GI) symptoms are believed to be common in the general population, but there is a lack of data from Korea. The aim of this study was to estimate the prevalence of chronic gastrointestinal symptoms in a rural community in Korea by using the Bowel Symptom Questionnaire (BSQ), which was based on the multinational diagnostic Rome criteria for functional bowel disorders, as a measure of GI symptoms. METHODS: A cross-sectional survey, using a reliable and valid questionnaire based on the fulfillment of the Rome criteria, was performed in a densely populated district in a Korean rural community on the residents aged 18-69 yr (mean 48 +/- 14 yr). 95.5% responded (n=420). All respondents were interviewed at their home or offices by a team of interviewers. RESULTS: Two thirds of Korean rural residents experience gastrointestinal symptoms and one fifth of them visit a clinic or hospital at least once a year. Prevalences of weekly heartburn, gastroesophageal reflux disease, dyspepsia, irritable bowel syndrome (IBS), and chronic constipation were 5.2% (95% confidence interval [CI], 3.1-7.4), 2.6% (95% CI, 1.1-4.2), 15.5% (95% CI, 11.9-19.0), 8.6% (95% CI, 5.8-11.3), and 24.3% (95% CI, 20.1-28.5) respectively. The prevalence of dyspepsia was 25%, taking medication usage into consideration. Ulcer-like dyspepsia (11.2%) was the most common subtype and 40% of the subjects with dyspepsia were classified into more than one subtype of dyspesia. There was an overlap between subjects with IBS and dyspepsia with 6.1% of dypeptics having IBS and 11.1% of IBS patients having dypepsia. CONCLUSIONS: The prevalence of GERD was low in Korea compared with that of the Western contries. The prevalences of dyspepsia and IBS were similar to those of the Western countries. The most common gastrointestinal symptom in a rural community in Korea is dyspepsia.
Constipation ; Cross-Sectional Studies ; Surveys and Questionnaires ; Dyspepsia ; Gastroesophageal Reflux ; Gastrointestinal Diseases ; Heartburn ; Humans ; Irritable Bowel Syndrome ; Korea* ; Prevalence* ; Rural Population*

BACKGROUND/AIMS: There was some technical difficulty in applying the hemoclip on the posterior wall of the body, cardia of the stomach and posterior wall of duodenum because the angle of approach was tangential. Use of transparent cap on the tip of the endoscope could reduce some of these problems. The purpose of this study was to examine the efficacy of endoscopic hemoclipping using a transparent cap. METHODS: From August 1997 to July 2000, 74 patients with bleeding peptic ulcer and stigmata of recent hemorrhage were treated with endoscopic hemoclipping. There was technical difficulty in applying the hemoclip in 18 patients and the transparent cap was used. RESULTS: There was no statistically significant difference between the patients treated with cap and the patients treated without cap in initial hemostasis rate (91.1% vs 94.4%), rebleeding rate (11.8% vs 11.7%), and permanent hemostasis rate (92.9% vs 94.4%). CONCLUSIONS: Use of transparent cap on the tip of the endoscope was an efficient method when the angle of approach was tangential.
Cardia ; Christianity ; Duodenum ; Endoscopes ; Hemorrhage ; Hemostasis ; Humans ; Peptic Ulcer ; Stomach

BACKGROUND/AIMS: Endoscopic aspiration mucosectomy (EAM) can always lift up the lesion by suction regardless of its location and does not injure the mucosal surface. The clinical usefulness of this method was evaluated as follows. METHODS: Thirty two patients with gastric adenoma (35 lesions) and 6 patients with early gastric carcinoma were treated by EAM from March 1997 to February 1999. Their characteristics (diameter, macroscopic appearance, and histologic diagnosis) were verified at endoscopy with a biopsy specimen. The complete resection was defined as the presence of normal mucosa at the resected margin. RESULTS: The average size of the resected specimens was 17.8 mm in antrum and 16.5 mm in body. The ratio of complete resection by location was 67% in anterior wall, 88% in posterior wall, 86% in lesser curvature and 92% in greater curvature. The complete resection rate for smaller lesions (< or =15 mm) was highly distinguished from that of larger lesions (>15 mm). No serious complication was encountered. CONCLUSIONS: EAM is suitable for the treatment of gastric tumors. Lesions 15 mm or less in diameter can be resected easily by single procedure regardless of its location.
Adenoma* ; Biopsy ; Endoscopy ; Humans ; Mucous Membrane ; Stomach Neoplasms* ; Suction