BACKGROUND/AIMS: Chronic liquid and/or food stasis caused by retention esophagitis (RE) in achalasia is a notable endoscopic finding because of the presence of a thickened or whitish esophageal mucosa and histologically altered squamous hyperplasia. We aimed to identify the clinical features of RE associated with achalasia and to clarify the clinical definition of RE in achalasia as a precancerous lesion identified by analyzing biomarker expressions. METHODS: From 2006 to 2015, we retrospectively reviewed 37 patients with achalasia without previous treatment. Among them, 21 patients had diagnostic findings of RE (RE+) and 16 patients had no diagnostic findings of RE (RE−). Immunohistochemical staining of p53, p16, and Ki-67 was performed on the endoscopic biopsy tissues from the patients with achalasia and 10 control patients with non-obstructive dysphagia. RESULTS: The symptom duration and transit delay were significantly longer in the RE+ group than in the RE− group. We found particularly high p53 positivity rates in the RE+ group (p<0.001). The rate of p16 expression was also significantly higher in the RE+ group than in the other two groups (p=0.003). CONCLUSIONS: A high p53 expression rate was more frequently found in the RE+ group than in the other two groups. RE could be a meaningful clinical feature of achalasia for predicting esophageal carcinogenesis.
Biopsy ; Carcinogenesis ; Deglutition Disorders ; Esophageal Achalasia* ; Esophageal Neoplasms* ; Esophagitis* ; Humans ; Hyperplasia ; Mucous Membrane ; Retrospective Studies ; Tumor Suppressor Protein p53

Objectives: The delayed separation of whole blood can influence the concentrations of circulating blood components, including metabolites and cytokines. The aim of this study was to determine whether clinical-biochemistry analytes can be used to assess the delayed separation of whole blood. Methods: We investigated the plasma and serum concentrations of five clinical-biochemistry analytes and free hemoglobin when the centrifugation of whole blood stored at 4°C or room temperature was delayed for 4 hours, 6 hours, 24 hours, or 48 hours, and compared the values with those of matched samples that had been centrifuged within 2 hours after whole-blood collection. Results: The inorganic phosphorus (IP) levels in the plasma and serum samples were elevated ≥ 1.5-fold when whole-blood centrifugation was delayed at room temperature for 48 hours. Furthermore, the IP levels in the plasma samples showed excellent assessment accuracy [area under the receiver-operating-characteristic curve (AUC) > 0.9] after a 48-hour delay in whole-blood separation, and high sensitivity (100%) and specificity (95%) at an optimal cutoff point. The IP levels in the serum samples also exhibited good assessment accuracy (AUC > 0.8), and high sensitivity (81%) and specificity (100%). The potassium (K+) levels were elevated 1.4-fold in the serum samples following a 48-hour delay in whole-blood separation. The K+ levels showed excellent assessment accuracy (AUC > 0.9) following a 48-hour delay in whole-blood separation, and high sensitivity (95%) and specificity (91%) at an optimal cutoff point. Conclusion Our study showed that the IP and K+ levels in the plasma or serum samples could be considered as putative indicators to determine whether whole-blood separation had been delayed for extended periods.

BACKGROUND: American Heart Association (AHA) defined 7 cardiovascular health metrics for the general population to improve cardiovascular health in 2010: not smoking; having normal blood pressure; being physically active; normal body mass index, blood glucose, and total cholesterol levels; and eating a healthy diet. To investigate trends in cardiovascular health metrics in Korea, we used data from the third and fourth Korean National Health and Nutrition Examination Surveys. METHODS: We defined seven cardiovascular health metrics similar to the one defined by AHA but physical activity, body mass index, and healthy diet were properly redefined to be suited for the Korean population. We compared each cardiovascular health metric and calculated the sum of cardiovascular health metrics after dichotomizing each health metric to ideal (scored 1) and poor (scored 0). RESULTS: Health metric scores of smoking in males (P value for trend < 0.001), physical activity both in males and females (P-value for trend < 0.001 both), body mass index in females (P-value for trend = 0.030), and blood pressure both in males and females (P-value for trend < 0.001, both) were improved. On the other hand, health metric scores of healthy diet in males (P-value for trend = 0.002), and fasting blood glucose both in males and females (P-value for trend < 0.001 both) got worse. The total scores of seven health metrics were stationary. CONCLUSION: Total scores were not changed but each metric showed various trends. A long-term study is necessary for analyzing exact trends.
Adult* ; American Heart Association ; Blood Glucose ; Blood Pressure ; Body Mass Index ; Cholesterol ; Diet ; Eating ; Fasting ; Female ; Hand ; Humans ; Korea ; Male ; Motor Activity ; Smoke ; Smoking

PURPOSE: To assess the sensitivity, specificity, and diagnostic accuracy of individual contrast-enhanced helical CT findings of acute appendicitis. MATERIALS AND METHODS: We retrospectively reviewed the appendiceal helical CT scans, obtained after intravenous contrast administration (abdomen; 7-mm collimation, abdominopelvic junction; 5-mm collimation), of 50 patients with surgically proven acute appendicitis and 112 with alternative diagnoses. The following parameters were analysed by three radiologists: enlarged appendix (> 6 mm in diameter), appendiceal wall thickening, appendiceal wall enhancement, no identification of the appendix, appendicolith(s), (appendiceal) intraluminal air, (appendiceal) intraluminal air extraluminal air, periappendiceal fat stranding, extraluminal fluid, phlegmon, abscess, lymphadenopathy, terminal ileal wall thickening, focal cecal apical thickening, focal colonic wall thickening, and segmental colonic wall thickening. RESULTS: The CT findings of acute appendicitis that statistically distinguished it from alternative diagnoses were an enlarged appendix (sensitivity; 92%, specificity; 93%, diagnostic accuracy; 93%), appendiceal wall thickening (for these three parameters: 68%, 96% and 88%, respectively), periappendiceal fat stranding (90%, 79%, 82%), appendiceal wall enhancement (72%, 86%, 82%), appendicolith (16%, 100%, 74%), and focal cecal apical thickening (14%, 100%, 74%) (for each, p < 0.05). CONCLUSION: On thin-section contrast-enhanced helical CT, an enlarged appendix and periappendiceal fat stranding were found in 90% or more patients with acute appendicitis. Appendiceal wall thickening and enhancement were clearly demonstrated and significant findings for diagnosis. Less common but specific findings include appendicolith, focal cecal apical thickening and intramural air, can also help us establish a diagnosis of acute appendicitis.
Abscess ; Appendicitis* ; Appendix ; Cellulitis ; Colon ; Diagnosis ; Humans ; Lymphatic Diseases ; Retrospective Studies ; Sensitivity and Specificity* ; Tomography, Spiral Computed ; Tomography, X-Ray Computed*