Microbiome is associated with a wide range of diseases. The gut microbiome is also a dynamic reflection of health status, which can be modified, thus representing great potential to exploit the mechanisms that influence human physiology. Recent years have seen a dramatic rise in gut microbiome studies, which has been enabled by the rapidly evolving high-throughput sequencing methods (i.e. 16S rRNA sequencing and shotgun sequencing). As the emerging technologies for microbiome research continue to evolve (i.e. metatranscriptomics, metabolomics, culturomics, synthetic biology), microbiome research has moved beyond phylogenetic descriptions and towards mechanistic analyses. In this review, we highlight different approaches to study the microbiome, in particular, the current limitations and future promise of these techniques. This review aims to provide clinicians with a framework for studying the microbiome, as well as to accelerate the adoption of these techniques in clinical practice.
Humans ; Gastrointestinal Microbiome ; Phylogeny ; RNA, Ribosomal, 16S/genetics* ; Health Status

Health Research Institute (OSHRI) of the Korea had not recognized gastrointestinal cancer as work-related disease during their evaluation. However, in 2018 OSHRI recognized gastric and rectal cancers as work-related disease in asbestos-exposed workers. We present 2 such cases along supportive evidence of causation.CASE PRESENTATION: Patient A: A 57-year-old man had worked for about 40 years since 1978 as an oxygen cutter at workplaces that dismantle ships, buildings, boilers, and thermal power plants. In November 2016, endoscopy and biopsy confirmed the diagnosis of advanced gastric cancer, for which he underwent subtotal gastrectomy and chemotherapy; however, he later died of the cancer. Patient B: A 71-year-old man had worked in shipbuilding and repair workplaces for approximately 49 years, being employed in pipe laying, asbestos insulation installation, grinding, and other ship repair work. In 2003, he was diagnosed of rectal cancer by abdominal computed tomography. He accordingly underwent surgical removal of the cancer. Based on the occupational history of the 2 patients and our review of the relevant literature addressing the occupational environment, we concluded that both patients had continuous exposure to high levels of asbestos while performing their jobs for 40 and 49 years, respectively.CONCLUSION: Both patients had a history of smoking and drinking (non-occupational personal risk factors). However, the possibility of an increased risk of gastric and rectal cancers from asbestos exposure cannot be excluded. Therefore, we considered that occupational exposure to asbestos had contributed to the cancer diagnosis in these cases. Workers exposed to asbestos should be made aware of the possibility of gastric or rectal cancer, and should undergo monitoring and medical examinations. Appropriate compensation for gastric and rectal cancers that occur in workers exposed to asbestos are anticipated in future.]]>
Academies and Institutes ; Aged ; Asbestos ; Biopsy ; Compensation and Redress ; Diagnosis ; Drinking ; Drug Therapy ; Endoscopy ; Gastrectomy ; Gastrointestinal Neoplasms ; Humans ; Korea ; Middle Aged ; Occupational Exposure ; Occupational Health ; Oxygen ; Power Plants ; Rectal Neoplasms ; Ships ; Smoke ; Smoking ; Stomach Neoplasms

BACKGROUND/AIMS: Public hospitals were established to provide high quality medical services to low socioeconomic status patients. This study examined the effects of public hospitals on the treatment and prognosis of patients with five-major gastrointestinal (GI) cancers (stomach cancer, colon cancer, liver cancer, bile duct cancer, and pancreatic cancer).METHODS: Among the 1,268 patients treated at Seoul National University Boramae Medical Center from January 2010 to December 2017, 164 (13%) were in the medicare group. The data were analyzed to identify and compare the clinical manifestations, treatment modality, and clinical outcomes between the groups.RESULTS: No statistically significant differences in the clinical data (age, sex), treatment method, and five-year survival rate were observed between the health insurance group and medicare group in the five major GI cancer patients. On the other hand, some medicare group patients tended more comorbidities and fewer treatment options than health insurance patients.CONCLUSIONS: Public hospitals have a positive effect on the treatment and prognosis in medicare group patients with the five-major GI cancers.
Bile Duct Neoplasms ; Colonic Neoplasms ; Comorbidity ; Gastrointestinal Neoplasms ; Hand ; Hospitals, Public ; Humans ; Insurance Coverage ; Insurance, Health ; Liver Neoplasms ; Medicare ; Methods ; Prognosis ; Retrospective Studies ; Seoul ; Social Class ; Survival Rate

PURPOSE: In some patients who receive adjuvant radiotherapy (RT) for the left breast, the stomach is located inside the RT field. This study investigates the incidence of gastric complications following adjuvant RT for breast cancer using data of the Health Insurance Review and Assessment Service in South Korea. METHODS: We identified 37,966 women who underwent surgery and received adjuvant RT for breast cancer. The cumulative incidence rate of gastric hemorrhage and gastric cancer was calculated and compared for left and right breast cancers. RESULTS: Among 37,966 patients, 19,531 (51.4%) and 18,435 (48.6%) had right and left breast cancers, respectively. After a median follow-up duration of 6.3 years, the cumulative incidence of gastric cancer and gastric hemorrhage did not differ between right and left breast cancers (p = 0.414 and p = 0.166, respectively). The multivariable analysis revealed that old age was the only factor associated with the development of gastric cancer (p < 0.001) and gastric hemorrhage (p < 0.001). The incidence of gastric cancer and hemorrhage did not differ between patients who received adjuvant RT for right and left breast cancers. CONCLUSION: Irradiation-related chronic complications of the stomach in patients with breast cancer are minimal. A study with a longer follow-up duration might be needed to assess the risk of gastric cancer.
Breast Neoplasms ; Breast ; Female ; Follow-Up Studies ; Gastrointestinal Hemorrhage ; Hemorrhage ; Humans ; Incidence ; Insurance, Health ; Korea ; Radiotherapy ; Radiotherapy, Adjuvant ; Stomach ; Stomach Neoplasms

Obesity is a critical target for public health interventions worldwide. There are many causes of obesity, and the importance of the gut microbiota in its pathogenesis has recently been recognized. The composition and function of the gut microbiota play a role in obesity and metabolic disease, yet the underlying mechanisms are unclear. Advances in our understanding of the link between obesity and the gut microbiota have suggested the potential of its manipulation for treating obesity. In this review, we summarize current knowledge of the interactions between the gut microbiota and obesity as well as the therapeutic potential of its modulation.
Gastrointestinal Microbiome ; Metabolic Diseases ; Obesity ; Public Health

Coffee is a well-known beverage being processed from coffee beans of either Arabica and/or Robusta. Observational and experimental research on coffee shows positive health impact. Coffee often relates with dyspeptic condition (i.e. Gastric release) and manifest Gastro-esophageal Reflux (GERD) and peptic ulcer (PU) diseases. Despite much contradictive results, epidemiological studies were inclined towards debunking the possible relationship between coffee and gastrointestinal diseases. Putative compounds were experimentally found to be chlorogenic acid (CQA), caffeine (CAFF), βN-alkanoyl-5-hydroxytryptamide (C5HT), N-methylpyridinium (NMP), chlorogenic acid lactones (CQL) and hydroxybenzenes in coffee that leads to gastric release. The type 2 bitter taste receptors (TAS2Rs), were physiologically involve in the gastric acid secretion. These contrarily results need much considerations involving genetic, types of coffee used and the compounds in coffee that might interact causing gastrointestinal problem
Gastrointestinal health

BACKGROUND: This study was conducted to identify the types and incidence of adverse events associated with midazolam, which is the most widely used drug to induce conscious sedation during gastrointestinal endoscopy, and to analyze the factors associated with hypoxemia and sedation failure.METHODS: Of 87,740 patients who underwent gastrointestinal endoscopy between February 2015 and May 2017, the electronic medical records of 335 who reportedly developed adverse events were retrospectively reviewed, and analysis was performed to determine the risk factors for hypoxemia and sedation failure, the two most frequent adverse events among those manifested during gastrointestinal endoscopy.RESULTS: The overall adverse event rate was 0.38% (n = 335); hypoxemia was most frequent, accounting for 40.7% (n = 90), followed by sedation failure (34.8%, n = 77), delayed discharge from the recovery room (22.1%, n = 49), and hypotension (2.2%, n = 5). Compared with the control group, the hypoxemia group did not show any significant differences in sex and body weight, but mean age was significantly older (P < 0.001) and a significantly lower dose of midazolam was administered (P < 0.001). In the group with sedation failure, the mean rate was higher in men (P < 0.001) and a significantly higher dose of midazolam was administered (P < 0.001), but no age difference was found.CONCLUSIONS: Midazolam-based conscious sedation during gastrointestinal endoscopy can lead to various adverse events. In particular, as elderly patients are at higher risk of developing hypoxemia, midazolam dose adjustment and careful monitoring are required in this group.
Aged ; Anoxia ; Body Weight ; Conscious Sedation ; Electronic Health Records ; Endoscopy, Gastrointestinal ; Humans ; Hypotension ; Incidence ; Male ; Midazolam ; Recovery Room ; Retrospective Studies ; Risk Factors

PURPOSE: This study evaluates the effect of behavioral relaxation training on distress and cancer screening intention of patients with upper gastrointestinal endoscopy.METHODS: The research was conducted in a non-equivalent control group posttest design. Data were collected from endoscopy subjects in B city from October to November of 2018. Fifteen minutes of behavioral relaxation training were provided to the experimental group (n=40) and traditional relaxation therapy methods were provided to the control group (n=40). Outcome measures were distress and cancer screening intention of patients with upper gastrointestinal endoscopy. Data were analyzed with a χ²-test, independent t-test, Fisher's exact test with SPSS/PC version 23.0.RESULTS: The objective discomfort (t=8.81, p<.001) of the experimental group was lower than that of the control group; there were no significant differences in the subjective discomfort (t=1.73, p=.088). The cancer screening intention (t=−5.85, p<.001) of the experimental group was significantly higher than that of the control group.CONCLUSION: Behavioral relaxation training was effective in heightening cancer screening intention. Therefore it can be usefully applied to increase cancer screening intention.
Early Detection of Cancer ; Education ; Endoscopy ; Endoscopy, Gastrointestinal ; Humans ; Intention ; Outcome Assessment (Health Care) ; Relaxation Therapy ; Relaxation

Anisakidosis is a term that collectively refers to a human infection caused by larvae of the family Anisakidae. Because Anisakis simplex was the main cause, it was originally called anisakiasis or anisakiosis, but since other parasites such as Pseudoterranova decipiens also cause similar diseases, the family name is now used as the diagnostic name. Anisakidosis cases have been increasing steadily owing to the propagation of the Japanese raw-fish-eating culture, such as sushi and sashimi, around the world; the traditional raw-fish-eating habits of individual countries; the establishment of marine mammal protection laws; and the development of endoscopic diagnostic techniques. The disease continues to occur in Korea, where most human parasites are believed to have been eradicated and is probably the most common parasitic disease encountered in clinical practice. Anisakidosis is a disease associated with acute abdominal pain. Anisakid larvae can invade the entire digestive tract and abdominal cavity and cause abdominal pain and a variety of digestive system symptoms. Thus, the history of eating raw fish is very important for its differential diagnosis. The lack of a precise understanding of the pathogenesis and clinical course of this disease may lead to unnecessary surgery. Anisakidosis may also manifest as allergic symptoms. Therefore, it is necessary to understand anisakidosis from the perspective of public health, food hygiene, and preventive medicine.
Abdominal Cavity ; Abdominal Pain ; Anisakiasis ; Anisakis ; Asian Continental Ancestry Group ; Diagnosis, Differential ; Digestive System ; Eating ; Food Hypersensitivity ; Gastrointestinal Tract ; Host-Parasite Interactions ; Humans ; Hygiene ; Jurisprudence ; Korea ; Larva ; Mammals ; Parasites ; Parasitic Diseases ; Preventive Medicine ; Public Health ; Raw Foods ; Unnecessary Procedures

Type 2 diabetes mellitus has become one of the fastest growing public health problems worldwide. The disease is believed to involve a complex process involving genetic susceptibility and environmental factors. The human intestine harbors hundreds of trillions of bacteria, as well as bacteriophage particles, viruses, fungi, and archaea, which constitute a complex and dynamic ecosystem referred to as the gut microbiota. Increasing evidence has indicated changes in the gut microbiota composition or function in type 2 diabetic patients. An analysis of ‘dysbiosis’ enables the detection of alterations in the specific bacteria, clusters of bacteria, or bacterial functions associated with the occurrence of type 2 diabetes. These bacteria are involved predominantly in the control of inflammation and energy homeostasis. This review attempts to show that the gut microbiota are important factors for the occurrence of type 2 diabetes and are important for the treatment of gut microbiota dysbiosis through bariatric surgery, fecal microbiota transplantation, prebiotics, and probiotics.
Archaea ; Bacteria ; Bacteriophages ; Bariatric Surgery ; Diabetes Mellitus, Type 2 ; Dysbiosis ; Ecosystem ; Fecal Microbiota Transplantation ; Fungi ; Gastrointestinal Microbiome ; Genetic Predisposition to Disease ; Homeostasis ; Humans ; Inflammation ; Intestines ; Prebiotics ; Probiotics ; Public Health ; Virion