BACKGROUND/AIMS: The meaning of specialized intestinal metaplasia (SIM) in the diagnosis of Barrett's esophagus (BE) is not clear. This study was designed to determine the clinical significance of SIM in the diagnosis of Barrett's esophagus. MATERIALS AND METHODS: Biopsies were taken from 601 subjects with endoscopically suspected columnar-lined esophagus. Under light microscopy with Alcian-blue stain, SIM was identified. Demographic characteristics, gastroesophageal (GE) reflux symptoms and endoscopic findings were compared between the SIM-present group and the SIM-absent group. RESULTS: Among 601 subjects, 184 (30.6%) were confirmed by pathology to have SIM. Age over 40 years (P<0.001) and a medication history of proton pump inhibitor or H2 blocker were found more frequently in the SIM-present group (P=0.01) than in the SIM-absent group. Any of 7 GE reflux symptoms (heartburn, acid regurgitation, chest pain, hoarseness, globus sensation, cough and epigastric soreness) were more frequent in the SIM-present group than SIM-absent group (P<0.001). Specifically, heartburn, chest pain and cough were significantly more common in the SIM-present group. There was no clinically significant difference associated with endoscopic findings or other clinical characteristics. CONCLUSIONS: When subjects with endoscopically suspected BE are analyzed based on the presence or absence of SIM, the SIM-present group was significantly associated with GE reflux symptoms suggestive of frequent GE reflux. However, the presence of SIM did not correlate with endoscopic findings.
Barrett Esophagus ; Biopsy ; Chest Pain ; Cough ; Esophagus ; Gastroesophageal Reflux ; Heartburn ; Hoarseness ; Light ; Metaplasia ; Microscopy ; Prospective Studies ; Proton Pumps ; Sensation

BACKGROUND/AIMS: Chronic gastritis is a common finding during endoscopy and it is very important to describe it correctly. This study was designed to evaluate the distribution of endoscopic gastritis and the differences according to age, sex or area. MATERIALS AND METHODS: A clinical analysis was conducted on 25,536 subjects who had undergone an upper endoscopy for routine health check-up. Endoscopic gastritis was classified into four types, superficial gastritis, erosive gastritis, atrophic gastritis and intestinal metaplasia. The distribution of the four types of gastritis was evaluated according to sex, age and area. RESULTS: 51.6% of the patients had experienced at least one of the symptoms (epigastric pain or discomfort, soarness, dyspepsia, abdominal pain) on at least a few occasions during the previous year. The incidence of normal gastric finding was 3,593 (14.1%). 21,943 (85.9%) subjects have at least more than one of endoscopic gastritis. The number of cases with superficial gastritis was 7,983 (31.3%), erosive gastritis 6,054 (23.7%), atrophic gastritis 6,918 (27.1%), and intestinal metaplasia 1,181 (7.1%). Erosive gastritis, atrophic gastritis and intestinal metaplasia were more frequent in men than women (P<0.001) and in the older age group (> or =60 years) than younger age group (P<0.001). CONCLUSIONS: The prevalence of endoscopic gastritis was very common, 85.9%. In addition, erosive gastritis, atrophic gastritis and intestinal metaplasia were more frequent in men and in the older age group, which is similar to gastric cancer or peptic ulcer. Cautious regular endoscopic follow-up might be necessary regardless of gastrointestinal symptoms in Korea.
Dyspepsia ; Endoscopy ; Female ; Gastritis ; Gastritis, Atrophic ; Helicobacter pylori ; Humans ; Incidence ; Korea ; Male ; Metaplasia ; Peptic Ulcer ; Prevalence ; Stomach Neoplasms

BACKGROUND/AIMS: Chronic gastritis is a common finding during endoscopy and it is very important to describe it correctly. This study was designed to evaluate the distribution of endoscopic gastritis and the differences according to age, sex or area. MATERIALS AND METHODS: A clinical analysis was conducted on 25,536 subjects who had undergone an upper endoscopy for routine health check-up. Endoscopic gastritis was classified into four types, superficial gastritis, erosive gastritis, atrophic gastritis and intestinal metaplasia. The distribution of the four types of gastritis was evaluated according to sex, age and area. RESULTS: 51.6% of the patients had experienced at least one of the symptoms (epigastric pain or discomfort, soarness, dyspepsia, abdominal pain) on at least a few occasions during the previous year. The incidence of normal gastric finding was 3,593 (14.1%). 21,943 (85.9%) subjects have at least more than one of endoscopic gastritis. The number of cases with superficial gastritis was 7,983 (31.3%), erosive gastritis 6,054 (23.7%), atrophic gastritis 6,918 (27.1%), and intestinal metaplasia 1,181 (7.1%). Erosive gastritis, atrophic gastritis and intestinal metaplasia were more frequent in men than women (P<0.001) and in the older age group (> or =60 years) than younger age group (P<0.001). CONCLUSIONS: The prevalence of endoscopic gastritis was very common, 85.9%. In addition, erosive gastritis, atrophic gastritis and intestinal metaplasia were more frequent in men and in the older age group, which is similar to gastric cancer or peptic ulcer. Cautious regular endoscopic follow-up might be necessary regardless of gastrointestinal symptoms in Korea.
Dyspepsia ; Endoscopy ; Female ; Gastritis ; Gastritis, Atrophic ; Helicobacter pylori ; Humans ; Incidence ; Korea ; Male ; Metaplasia ; Peptic Ulcer ; Prevalence ; Stomach Neoplasms

PURPOSE: We hypothesize that the cytolytic activity of Bacillus Calmette-Guerin (BCG) may act through nitric oxide (NO) production, and that cell death is correlated with apoptosis, changes of NO and cell proliferation following BCG and/or nitric oxide synthase (NOS) inhibition treatment of a murine bladder tumor-2 (MBT-2) cell line. If these cell lines show cell death due to apoptosis was also determined. MATERIALS AND METHODS: NO production and proliferation activity of the MBT-2 cell line were measured after stimulation, with BCG and/or L-NAME, using an enzyme- linked immunosorbent assay (ELISA). After incubation of the MBT-2 cells with BCG and/or L-NAME, the cell cycle was analysis was performed by immunocytometry. RESULTS: The production of NO in the MBT-2 cells was significantly increased by the BCG. The BCG had direct dose-dependent cytotoxic effects on the MBT-2 cell line. After the L-NAME treatment, both the NO production and cytotoxicity were decreased (p<0.05). When the MBT-2 cells were cultured with BCG, the apoptotic cell ratio increased compared to that of the MBT-2 cells treated with L-NAME (p<0.05). CONCLUSIONS: The up-regulation of the production of NO following BCG treatment of the MBT-2 cell line may be due, in part, to the cytolytic action of the BCG. The cell death, when BCG was instilled, correlated with apoptosis.
Apoptosis ; Bacillus* ; Cell Cycle ; Cell Death ; Cell Line* ; Cell Proliferation* ; Mycobacterium bovis ; NG-Nitroarginine Methyl Ester ; Nitric Oxide Synthase* ; Nitric Oxide* ; Up-Regulation ; Urinary Bladder*

Aortic valve is usually involved in infective endocarditis. Aortic valve endocarditis produces destruction and perforation of leaflets and results in ring abscess, frequently. Less commonly, direct extension or infected aortic regurgitant jet can produce secondary involvement of anterior mitral leaflet (AML) and result in the formation of an aneurysm or perforation of AML. A 60-year-old woman was admitted to Kyung Hee University hospital because of a febrile illness and dyspnea. Transthoracic echocardiography (TTE) showed an aortic valve vegetation, an aneurysm of AML, and an eccentric jet of mitral regurgitation through AML. Transe-sophageal echocardiography (TEE) showed a perforation of AML. -streptococcus was isolated from blood culture. The patient was treated with Vancomycin and Sisomicin sulfate. On hospital day 21, heart failure was aggravated and emergent double valve replacement was done. The patient was recovered and discharged.
Abscess ; Aneurysm* ; Aortic Valve* ; Dyspnea ; Echocardiography ; Endocarditis* ; Female ; Heart Failure ; Humans ; Middle Aged ; Mitral Valve Insufficiency ; Sisomicin ; Vancomycin