Objectives: Gastric cancer (GC) demonstrates a sex disparity that may also be associated with body mass index (BMI). This study explored whether the effect of BMI on the risk of GC varies by sex. Methods: The study cohort included 341,999 Koreans aged 40 years or older from the National Health Insurance Service–Health Screening Cohort, with a median follow-up period of 10 years. Participants were categorized into five groups based on their BMI. The effect of BMI was evaluated using Cox proportional hazard regression. Additionally, stratification analysis was performed according to waist circumference. Results: An increased risk of developing GC was observed across the study population among those with obesity (BMI 25.0–29.9 kg/m2 ; hazard ratio [HR], 1.11; 95% CI , 1.03–1.20) and severe obesity (BMI ≥30.0 kg/m2 ; HR, 1.22; 95% CI, 1.01–1.47), considering a 2-year latency period. Notably, the rise in GC risk was particularly pronounced among women with obesity and men with severe obesity. In the age-stratified analysis, severe obesity (BMI ≥30.0 kg/m2 ) was associated with an increased risk of GC in men under 50 years old (HR, 1.83; 95% CI, 0.99–3.37). For individuals aged ≥50 years, obesity was linked to a heightened risk of GC in both sexes. Furthermore, normal BMI (18.5–22.9 kg/m2 ) was associated with an increased GC risk in women. Conclusion These findings indicate a positive association between excess body weight and the risk of GC in Koreans, particularly among men with severe obesity.

Colorectal cancer (CRC) is one of the most common causes of cancer morbidity in both sexes but shows sex differences.First, sex-specific differences in tumor recurrence and survival rates have been reported. For example, the development of CRC is found about 1.5 times higher and 4–8 years earlier in males compared to females, suggesting the protective role of estrogen in the disease. Furthermore, female patients have a higher risk of developing right-sided (proximal) colon cancer than male patients, which is known to have more aggressive clinical character compared to left-sided (distal) colon cancer. That is, left and right CRCs show differences in carcinogenic mechanism, that the chromosomal instability pathway is more common in left colon cancer while the microsatellite instability and serrated pathways are more common in right colon cancer.It is thought that there are sex-based differences on the background of carcinogenesis of CRC. Sex differences of CRC have two aspects, sexual dimorphism (biological differences in hormones and genes) and gender differences (non-biological differences in societal attitudes and behavior). Recently, sex difference of colon adenoma pathway and sexual dimorphism in the biology of gene and protein expression, and in endocrine cellular signaling in the CRC carcinogenesis have been accumulated. In addition, behavioral patterns can lead to differences in exposure to risk factors such as drinking or smoking, diet and physical activity. Therefore, understanding sex/gender-related biological and sociocultural differences in CRC risk will help in providing strategies for screening, treatment and prevention protocols to reduce the mortality and improve the quality of life.In this review, sex/gender differences in colon adenoma pathway and various aspects such as clinicopathological, biological, molecular, and socio-cultural aspects of CRC were described.

We selected one hundred magnetic resonance imaging(MRI) in knees of patients with internal derangement of the knee, in all of those cases, arthroscopic operations were performed. Twenty medical doctors, who didnt know the arthroscopic findings, reviewed these MRI; 5 radiology specialists, 5 radiology residents, 5 orthopedic surgeons and 5 orthopedic residents. The radiologists were not informed about the medical history and physical examination of the patients when they read the MRI, but the orthopedic surgeons had the information about those of the patients. The accuracy of reading of MRI was compared between radiologists and orthopedic surgeons, and between specialists and residents. The check-list of the reading were medial and lateral meniscus, ACL and PCL, medial synovial plica and osteochondral lesion. Overall results of accuracy of MRI reading were as follows; radiology specialist-86%-, radiology resident-77%-, orthopedic surgeon-90%- and orthopedic resident-84%-. So accuracy was superior in orthopedic group and specialist group. The medical history and the physical examination of the patients were very helpful to improve accuracy of MRI reading. Reading skill was also important for accurate reading of MRI.
Humans ; Knee* ; Magnetic Resonance Imaging* ; Menisci, Tibial ; Orthopedics ; Physical Examination ; Specialization

PURPOSE: In the field of pediatric surgery, neonatal surgery occupies a special portion and has clinical varieties. Recently many associated physicians, such as pediatric surgeons, neonatologists, anesthetists, pathologists and radiologists, work collaboratively for care. This study was designed to identify characteristics of neonatal surgery based on clinical experiences in a single institute. METHODS: Neonates receiving operation during a 5-year period between Jan. 2003 and Dec. 2007 in Pusan National University Children's Hospital were reviewed. Patients were divided into 2 groups of age after birth; early neonatal (before 7 days) and late neonatal period (after 7 days) and the operation was classified as a primary procedure for definite treatment and a staged procedure including 2nd look operation. We analyzed their clinical data and postoperative results. RESULTS: 286 cases of neonates were included during this period, 118 cases (41.3%) in early neonatal and 168 (58.7%) in late neonatal period. Distribution of diseases was as follows, sequentially; 60 (21.0%) anorectal malformations, 46 (16.1%) intestinal atresia, 44 (15.4%) Hirschsprung's disease, 35 (12.2%) necrotizing enterocolitis, 24 (8.3%) hypertrophic pyloric stenosis, 20 (6.9%) inguinal hernia, 13 (4.5%) malrotation, 9 (3.1%) tumor, 8 (2.7%) diaphragmatic hernia, 6 (2.0%) abdominal wall defect and 21 (7.3%) others. According to the operation, a primary procedure was performed in 205 cases (71.7%) and a staged procedure in 81 cases (28.3%). The morbidity and mortality was 3.1% and 2.8% respectively. CONCLUSION: When considering morbidity and mortality after neonatal surgery for patients who have associated anomalies, collaborative care is necessary to expect a good outcome.
Abdominal Wall ; Enterocolitis, Necrotizing ; Hernia, Diaphragmatic ; Hernia, Inguinal ; Hirschsprung Disease ; Humans ; Infant, Newborn ; Intestinal Atresia ; Pyloric Stenosis, Hypertrophic

PURPOSE: The final aim of operation for anorectal malformations (ARMs) is acquisition of normal bowel habit by preserving an anorectal function. This study was performed to assess the functional results after definite correction of the malformations. METHODS: 37 patients (Group 1) without rectocutaneous fistula and 23 patients (Group 2) with rectocutaneous fistula were Included in the study. The authors examined functional assessment of children over 3-years-old, according to Krickenbeck classification, and analyzed the results. RESULTS: Group 1 showed significant soiling in 24.3% and constipation requiring management in 35.1%.But Group 2 showed constipation in only 8.7%. The results of Krickenbeck assessment are as follows: Group 1 showed good results in 64.9% and poor results in 35.1% with improvement over time. Group 2 showed 91.3%, 8.7%, respectively. CONCLUSION: Constipation rather than soiling was the main functional problem after surgical repair of anorectal malformations but improved over time. It seems that more aggressive management of constipation warrants good results after definite surgical repair.
Child ; Constipation ; Defecation ; Fistula ; Humans ; Soil

PURPOSE: This study was conducted to describe health in optimal fitness (HOF) in young children born prematurely and to analyze factors affecting HOF in health status, investment resources, and anthropological values, based on HOF theory. METHODS: A case-control study of 76 children with preterm births (PTB) was conducted at 24 to 42 months of corrected age. Their HOF status was evaluated based on height, weight, head circumference, and the Korean-Bayley Scale of Infant Development-II and classified as either HOF-achieved or HOF-uncertain in the domain of growth, development, and all together. RESULTS: For growth, development, and all, 26.3%, 27.6%, and 47.4% of children, respectively, belonged to the HOF-uncertain group. Logistic regression analysis showed that longer length of hospital stay (≥21days; OR=7.8; 95% CI [1.5, 40.5]), worse scores on the Home Observation for Measurement of the Environment (HOME) (≥38; OR=0.1; 95% CI [0.0, 0.4]), having a working mother, (OR=5.7; 95% CI [1.2, 27.6]), and an older mother (≥35 years; OR=8.8; 95% CI [2.1, 37.3]) were statistically significant contributors of HOF-uncertain in the domain of all. CONCLUSION: Findings show that young children born prematurely with prolonged stays in a neonatal intensive care unit and insufficient socioeconomic resources at home are more likely to exhibit delayed growth and development.
Case-Control Studies ; Child* ; Growth and Development ; Head ; Humans ; Infant ; Infant, Newborn ; Intensive Care, Neonatal ; Investments ; Length of Stay ; Logistic Models ; Mothers ; Premature Birth

Xanthogranulomatous cholecystitis (XGC) is known to be a rare, variant type of chronic cholecystitis and more frequently found in the adults with a prevalence of 0.7 to 13.2% of all cholecystitis, moreover very rare in children. Clinically, this usually presents as chronic or acute cholecystitis associated with gallstones, but biliary colic is unusual. Although it requires surgery for management, it may accompany some difficulties during cholecystectomy and postoperative complications such as biliary fistula. It could also give rise to higher conversion rates than other diseases of the gallbladder during laparoscopic procedures. We experienced a very rare pediatric case of xanthogranulomatous cholecystitis not associated with gallstones, successfully managed by laparoscopic cholecystectomy and hereby report it with literature reviews.
Adult ; Biliary Fistula ; Child ; Cholecystectomy ; Cholecystectomy, Laparoscopic ; Cholecystitis ; Cholecystitis, Acute ; Colic ; Gallbladder ; Gallstones ; Granuloma ; Humans ; Postoperative Complications ; Prevalence ; Xanthomatosis

Background/Aims: NOVAponin, a functional health food derived from Dolichos lablab Linne extract improves gastric mucosal injury and increases regeneration and proliferation. This study aims to investigate the efficacy and safety of NOVAponin in individuals with mild functional dyspepsia (FD). Methods: In this single-center, double-blind, randomized clinical trial, 131 patients with FD meeting the Rome IV criteria were enrolled. Changes in the gastrointestinal symptom rating scale (GSRS), FD-related quality of life (FD-QoL), gastrointestinal symptom (GIS) scores, inflammatory and anti-inflammatory markers, and adverse effects before and after administration were compared. Results: After 12 weeks of administration, GSRS upper abdominal symptom scores were significantly improved in the test group compared to the control group (–5.30 ± 0.60 vs –2.35 ± 0.56, P < 0.001). GSRS upper abdominal symptom scores (–5.13 ± 0.55 vs –1.92 ± 0.44, P < 0.001), GSRS total scores (–7.02 ± 0.91 vs –3.33 ± 0.73, P < 0.001), GIS total scores (–11.21 ± 0.53 vs –6.65 ± 0.70, P < 0.001) after 6 weeks of administration, GSRS total scores (–7.54 ± 0.94 v. –3.31 ± 0.85, P < 0.001), GIS total scores (–11.90 ± 0.52 vs –7.61 ± 0.73, P < 0.001), and FD-QoL total scores (–11.41 ± 1.75 vs –5.55 ± 1.20, P = 0.007) after 12 weeks of administration also showed significant differences between groups. The differences were slightly more pronounced in epigastric pain syndrome subtypes and in females than the others, although more females were assigned to the test group. There were no significant changes in inflammatory and anti-inflammatory markers or adverse reactions. Conclusion NOVAponin significantly improved mild FD symptoms especially in epigastric pain syndrome subtype and in females, and was found to be safe.

Background/Aims: NOVAponin, a functional health food derived from Dolichos lablab Linne extract improves gastric mucosal injury and increases regeneration and proliferation. This study aims to investigate the efficacy and safety of NOVAponin in individuals with mild functional dyspepsia (FD). Methods: In this single-center, double-blind, randomized clinical trial, 131 patients with FD meeting the Rome IV criteria were enrolled. Changes in the gastrointestinal symptom rating scale (GSRS), FD-related quality of life (FD-QoL), gastrointestinal symptom (GIS) scores, inflammatory and anti-inflammatory markers, and adverse effects before and after administration were compared. Results: After 12 weeks of administration, GSRS upper abdominal symptom scores were significantly improved in the test group compared to the control group (–5.30 ± 0.60 vs –2.35 ± 0.56, P < 0.001). GSRS upper abdominal symptom scores (–5.13 ± 0.55 vs –1.92 ± 0.44, P < 0.001), GSRS total scores (–7.02 ± 0.91 vs –3.33 ± 0.73, P < 0.001), GIS total scores (–11.21 ± 0.53 vs –6.65 ± 0.70, P < 0.001) after 6 weeks of administration, GSRS total scores (–7.54 ± 0.94 v. –3.31 ± 0.85, P < 0.001), GIS total scores (–11.90 ± 0.52 vs –7.61 ± 0.73, P < 0.001), and FD-QoL total scores (–11.41 ± 1.75 vs –5.55 ± 1.20, P = 0.007) after 12 weeks of administration also showed significant differences between groups. The differences were slightly more pronounced in epigastric pain syndrome subtypes and in females than the others, although more females were assigned to the test group. There were no significant changes in inflammatory and anti-inflammatory markers or adverse reactions. Conclusion NOVAponin significantly improved mild FD symptoms especially in epigastric pain syndrome subtype and in females, and was found to be safe.

Background/Aims: NOVAponin, a functional health food derived from Dolichos lablab Linne extract improves gastric mucosal injury and increases regeneration and proliferation. This study aims to investigate the efficacy and safety of NOVAponin in individuals with mild functional dyspepsia (FD). Methods: In this single-center, double-blind, randomized clinical trial, 131 patients with FD meeting the Rome IV criteria were enrolled. Changes in the gastrointestinal symptom rating scale (GSRS), FD-related quality of life (FD-QoL), gastrointestinal symptom (GIS) scores, inflammatory and anti-inflammatory markers, and adverse effects before and after administration were compared. Results: After 12 weeks of administration, GSRS upper abdominal symptom scores were significantly improved in the test group compared to the control group (–5.30 ± 0.60 vs –2.35 ± 0.56, P < 0.001). GSRS upper abdominal symptom scores (–5.13 ± 0.55 vs –1.92 ± 0.44, P < 0.001), GSRS total scores (–7.02 ± 0.91 vs –3.33 ± 0.73, P < 0.001), GIS total scores (–11.21 ± 0.53 vs –6.65 ± 0.70, P < 0.001) after 6 weeks of administration, GSRS total scores (–7.54 ± 0.94 v. –3.31 ± 0.85, P < 0.001), GIS total scores (–11.90 ± 0.52 vs –7.61 ± 0.73, P < 0.001), and FD-QoL total scores (–11.41 ± 1.75 vs –5.55 ± 1.20, P = 0.007) after 12 weeks of administration also showed significant differences between groups. The differences were slightly more pronounced in epigastric pain syndrome subtypes and in females than the others, although more females were assigned to the test group. There were no significant changes in inflammatory and anti-inflammatory markers or adverse reactions. Conclusion NOVAponin significantly improved mild FD symptoms especially in epigastric pain syndrome subtype and in females, and was found to be safe.