BACKGROUND/AIMS: The purpose of this study was to evaluate the clinicopathologic characteristics of colon cancers detected at the SOK Sokpeynhan Internal Medical Network, a nationwide system of primary health care institutions. METHODS: We analyzed 579 colon cancer patients diagnosed using colonoscopy at the SOK network from January 2011 through December 2012. Cancers from the rectum to the splenic flexure were classified as left colon cancer. Patients over 65 were classified as senior. RESULTS: The mean age (+/-SD) of subjects was 60.9+/-10.5 years and 61.1% were men. More than one quarter (28.2%) of patients were asymptomatic. The prevalence of left colon cancer was higher (77.9%) than that for right colon cancer. The most frequent macroscopic and histologic types were depressed (58.9%) and moderately differentiated adenocarcinoma (52.2%), respectively. Asymptomatic subjects displayed protruding or well differentiated adenocarcinoma, while symptomatic patients were more likely to display depressed or moderately differentiated adenocarcinoma (P<0.05). The mean age of the right colon cancer group was higher than that for the left colon cancer group (P<0.05). Among symptomatic patients, the most frequent symptoms were bloody stool for patients with left colon cancer and abdominal discomfort for patients with right colon cancer (P<0.05). The prevalence of depressed cancer was higher in older subjects as compared to younger subjects (P<0.05). The prevalence of right colon cancer tended to increase with age, although this difference did not achieve statistical significance (P>0.05). CONCLUSIONS: Study results indicated an increase of colon cancer amongst younger demographics in recent years. The effectiveness of colonoscopy screening was also evident, as asymptomatic patients demonstrated frequent findings of well differentiated adenocarcinomas. Study results also suggested a need for closer examination of older patients, as right colon cancer tended to increase with age.
Adenocarcinoma ; Colon, Transverse ; Colonic Neoplasms* ; Colonoscopy ; Demography ; Humans ; Male ; Mass Screening ; Population Characteristics ; Prevalence ; Primary Health Care* ; Rectum

BACKGROUND/AIMS: Stomach cancer is prevalent in Korea. The purpose of this study was to evaluate the characteristics of superficial gastric cancers detected at SOK Sokpeynhan Internal Medical Network, the nationwide primary health care institutions. METHODS: We prospectively analysed the clinicopathologic and endoscopic characteristics of 218 superficial gastric cancer patients diagnosed using gastric endoscopy at SOK network from January 2011 through December 2011. RESULTS: The mean age was 58.5 years old and male to female ratio was 1.7 : 1. Asymptomatic patients were most common (45.0%). The macroscopic classification revealed that simple types (63.8%) were more common than complex types (36.2%). The most common type was IIc (28.4%) and other types were as follows; IIb (16.1%), IIb+IIc (13.3%), IIa (10.6%), III (9.2%), IIa+IIc (7.3%), IIc+IIa (6.0%), IIc+IIb (5.0%). The most commonly involved sites were the body (53.1%) and greater curvature (32.6%) of the stomach. The size of lesion was less than 1 cm (69.3%) and less than 5 mm (33.5%) in diameter. The most common pathologic type was tubular adenocarcinoma (75.7%). Helicobacter pylori infection rate was 50.2%. Fifty five percent of the cases were diagnosed via endoscopy of National Health Insurance Corporation screenings. CONCLUSIONS: Superficial gastric cancers in 2011 at primary health care SOK network were different from those of previous reports. Type IIc was most common but type IIb was more prevalent and the body and greater curvature of the stomach were the most commonly involved sites. Therefore, careful observation of the proximal gastric mucosa and mucosal color change is needed.
Adenocarcinoma/pathology ; Adult ; Aged ; Aged, 80 and over ; Female ; Gastroscopy ; Helicobacter Infections/diagnosis ; Humans ; Male ; Middle Aged ; National Health Programs ; Primary Health Care ; Prospective Studies ; Stomach Neoplasms/*pathology

To investigate the potential implication of the subtype of intestinal metaplasia in the progression to the gastric carcinoma, we analyzed the mutations of the p53 gene and microsatellite instability (MSI) both in the complete type (type I) and in the sulphomucin-secreting incomplete type (type III) intestinal metaplasia located adjacent to the gastric carcinoma. p53 mutations were observed in 13.3% of type I, in 6.6% of type III intestinal metaplasia, and in 40% of gastric carcinoma. The difference between p53 mutations observed in type I and type III intestinal metaplasia was not statistically significant. No identical mutation of the p53 gene was found in the intestinal metaplasia and carcinoma specimens from the patients. There was no case of intestinal metaplasia showing MSI. In gastric carcinomas, MSI was observed in six cases (40%). The cases harboring BAT-26 instability did not have the mutation of the p53 gene. These data suggest that intestinal metaplasia adjacent to gastric carcinoma, irrespective of its subtype, do not have the genetic alterations as showing in their carcinoma tissues.
Carcinoma/genetics/pathology ; Exons ; *Genes, p53 ; Humans ; Metaplasia/genetics/pathology ; *Microsatellite Repeats ; *Mutation ; Precancerous Conditions ; Stomach/*pathology ; Stomach Neoplasms/genetics/pathology ; Tumor Suppressor Protein p53/genetics/metabolism

In vitro subcultures of bacteria can lead to genetic and phenotypic changes. This study aimed at investigating the effect of repeated subcultures on the adhesion, motility, cytotoxicity, and gastric inflammation caused by Helicobacter pylori. H.pylori SS1 strain was subcultured 64 times on agar plates containing Brucella broth and 5% bovine calf serum. The adhesion, motility, cytotoxicity, and gastric inflammation produced in Mongolian gerbils were compared between the first and 64th subcultured strain. The adhesion rates, following 3 hr exposure of AGS cells to either the first strain or the 64th-transferred strain, were 21% and 12%, respectively. The motility of the 64th-transferred strain decreased significantly when compared to the 1st strain (9.1 mm vs. 15.1 mm). The cytotoxicity index tended to be higher in the first strain than in the 64th-transferred strain (73.7% vs. 69.2%). The initial infection rate on the gerbils showed no difference between the two strains. However, chronic gastric inflammation of the first strain-infected gerbils was somewhat more severe than that of the 64th-transferred strain-infected gerbils. Therefore, the use of repeatedly subcultured strains of H. pylori in virulence experiments can lead to different results from thoses of the original strain.
Animals ; Bacterial Adhesion ; Gastritis/immunology/*microbiology ; Gerbillinae ; Helicobacter Infections/immunology/*microbiology ; Helicobacter pylori/growth & development/*pathogenicity ; Male ; Virulence

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

Polyethylene glycol solutions have been usually available for clinical use since 1980 and been considered a standard method of bowel preparations for colonoscopy. There have been many reports about minor complications such as nausea and bloating associated with their use, which are frequently occurred. After ingestion of polyethylene glycol, vomiting occurrs less frequently but it can make major complication such as Mallory-Weiss syndrome and aspiration pneumonia. We have reported here two cases of Mallory-Weiss syndrome, which were occurred after ingestion of polyethylene glycol solution for colonoscopy.
Colonoscopy* ; Eating ; Mallory-Weiss Syndrome* ; Nausea ; Pneumonia, Aspiration ; Polyethylene Glycols ; Vomiting

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

Colonic pseudo-obstruction (CPO) is a syndrome characterized by obstructive symptoms and signs without mechanical obstruction. Parkinson's disease is one of the various clinical situations developing CPO. Recently, one study group reported that neostigmine was significantly more effective than placebo in rapidly decreasing colonic dilatation in the majority of patients with acute CPO. We experienced a 69-year-old male patient with Parkinson's disease who complained abdominal distension. There was a marked colonic dilatation on plain abdominal radiographs without mechanical obstruction. Colonic dilatation failed to improve with conservative management. Immediate clinical response was achieved after patient received 2.0 mg of neostigmine intravenously under monitoring by electrocardiography. One month later, he had recurrent colonic dilatation, but no clinical response to second administration of neostigmine, leading to colonic decompression. After a third recurrence of colonic dilatation, the patient was refractory to conservative management, and he underwent surgical treatment.
Aged ; Colon* ; Colonic Pseudo-Obstruction* ; Decompression ; Dilatation ; Electrocardiography ; Humans ; Male ; Neostigmine ; Parkinson Disease* ; Recurrence

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

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*