BACKGROUND/AIMS: Because of the poor prognosis of diffuse-type gastric cancer, early detection is important. We investigated the clinical characteristics and prognosis of diffuse-type early gastric cancer (EGC) diagnosed in subjects during health check-ups. METHODS: Among 121,111 subjects who underwent gastroscopy during a routine health check-up, we identified 282 patients with 286 EGC lesions and reviewed their clinical and tumor-specific parameters. RESULTS: Patients with diffuse-type EGC were younger, and 48.1% of them were female. Serum anti-Helicobacter pylori IgG (Hp-IgG) was positive in 90.7% of diffuse-type EGC patients (vs 75.9% of intestinal-type EGC, p=0.002), and the proportion of diffuse-type EGC cases increased significantly with increasing Hp-IgG serum titers (p < 0.001). Diffuse-type EGC had pale discolorations on the tumor surface (26.4% vs 4.0% in intestinal-type EGC, p < 0.001) and were often located in the middle third of the stomach. Submucosal invasion or regional nodal metastasis was observed more commonly in patients with diffuse-type EGC. However, during the median follow-up period of 50 months, 5-year disease-free survival rates did not differ between the groups. CONCLUSIONS: Diffuse-type EGC shows different clinical and endoscopic characteristics. Diffuse-type EGC is more closely associated with Hp-IgG seropositivity and a higher serum titer. Early detection results in excellent prognosis.
Disease-Free Survival ; Early Diagnosis ; Endoscopy ; Female ; Follow-Up Studies ; Gastroscopy ; Humans ; Immunoglobulin G ; Neoplasm Metastasis ; Prognosis* ; Stomach ; Stomach Neoplasms*

BACKGROUND/AIMS: Helicobacter pylori is a major risk factor for atrophic gastritis (AG) and gastric cancer. The correlation between H. pylori, AG and colorectal neoplasm (CRN) has only been examined in a limited number of studies, and findings have been inconclusive. We aimed to investigate the association between H. pylori infection status, AG and advanced CRN. METHODS: This cross-sectional study investigated the relationship between the presence of serum anti-H. pylori IgG antibodies, AG, and advanced CRN in 6,351 consecutive asymptomatic subjects who underwent a screening colonoscopy. RESULTS: A total of 316 participants (5.0%) had advanced CRN. H. pylori seropositivity was 61.3%. In a univariate analysis, the presence of H. pylori infection was associated with advanced CRN (odds ratio [OR], 1.49; 95% confidence interval [CI], 1.17 to 1.91; p=0.001). H. pylori infection was associated with an increased risk of advanced CRN after adjusting for clinically relevant confounders (OR, 1.34; 95% CI, 1.04 to 1.72; p=0.023). H. pylori-related AG was significantly associated with the risk of advanced CRN (OR, 1.40; 95% CI, 1.03 to 1.91; p=0.030), whereas H. pylori infection without AG was not. CONCLUSIONS: H. pylori infection increased the risk of advanced CRN, especially when it was combined with AG. Strict colonoscopy screening and surveillance may be warranted in those with H. pylori-positive AG.
Antibodies ; Atrophy ; Colon* ; Colonic Neoplasms* ; Colonoscopy ; Colorectal Neoplasms ; Cross-Sectional Studies ; Gastritis ; Gastritis, Atrophic* ; Helicobacter pylori* ; Helicobacter* ; Immunoglobulin G ; Mass Screening ; Risk Factors* ; Stomach Neoplasms

BACKGROUND/AIMS: Helicobacter pylori is a major risk factor for atrophic gastritis (AG) and gastric cancer. The correlation between H. pylori, AG and colorectal neoplasm (CRN) has only been examined in a limited number of studies, and findings have been inconclusive. We aimed to investigate the association between H. pylori infection status, AG and advanced CRN. METHODS: This cross-sectional study investigated the relationship between the presence of serum anti-H. pylori IgG antibodies, AG, and advanced CRN in 6,351 consecutive asymptomatic subjects who underwent a screening colonoscopy. RESULTS: A total of 316 participants (5.0%) had advanced CRN. H. pylori seropositivity was 61.3%. In a univariate analysis, the presence of H. pylori infection was associated with advanced CRN (odds ratio [OR], 1.49; 95% confidence interval [CI], 1.17 to 1.91; p=0.001). H. pylori infection was associated with an increased risk of advanced CRN after adjusting for clinically relevant confounders (OR, 1.34; 95% CI, 1.04 to 1.72; p=0.023). H. pylori-related AG was significantly associated with the risk of advanced CRN (OR, 1.40; 95% CI, 1.03 to 1.91; p=0.030), whereas H. pylori infection without AG was not. CONCLUSIONS: H. pylori infection increased the risk of advanced CRN, especially when it was combined with AG. Strict colonoscopy screening and surveillance may be warranted in those with H. pylori-positive AG.
Antibodies ; Atrophy ; Colon* ; Colonic Neoplasms* ; Colonoscopy ; Colorectal Neoplasms ; Cross-Sectional Studies ; Gastritis ; Gastritis, Atrophic* ; Helicobacter pylori* ; Helicobacter* ; Immunoglobulin G ; Mass Screening ; Risk Factors* ; Stomach Neoplasms

BACKGROUND/AIMS: Chicken skin mucosa (CSM), surrounding colorectal adenoma, is an endoscopic finding with pale yellow-speckled mucosa; however, its clinical significance is unknown. This study aimed to evaluate the prevalence and clinical characteristics of CSM, and the association between colorectal carcinogenesis and CSM. METHODS: This cross-sectional study was performed in 733 consecutive patients who underwent endoscopic polypectomy for colorectal adenoma after the screening of colonoscopy at the Asan Health Promotion Center between June 2009 and December 2011. The colonoscopic and pathological findings of colorectal adenoma including number, size, location, dysplasia, morphology, and clinical parameters were reviewed. RESULTS: The prevalence of CSM was 30.7% (225 of 733 patients), and most CSM-related adenomas were located in the distal colon (93.3%). Histological analysis revealed lipid-laden macrophages in the lamina propria of the mucosa. Multivariate analyses showed that CSM was significantly associated with advanced pathology, including villous adenoma and high-grade dysplasia (odds ratio [OR], 2.078; 95% confidence interval [CI], 1.191-3.627; P=0.010), multiple adenomas (i.e., > or =2 adenomas; OR, 1.692; 95% CI, 1.143-2.507; P=0.009), and a protruding morphology (OR, 1.493; 95% CI, 1.027-2.170; P=0.036). There were no significant differences in polyp size or clinical parameters between patients with and without CSM. CONCLUSIONS: CSM-related adenoma was mainly found in the distal colon, and was associated with advanced pathology and multiple adenomas. CSM could be a potential predictive marker of the carcinogenetic progression of distally located colorectal adenomas.
Adenoma* ; Adenoma, Villous ; Carcinogenesis ; Chickens* ; Chungcheongnam-do ; Colon* ; Colonoscopy ; Cross-Sectional Studies ; Health Promotion ; Humans ; Macrophages ; Mass Screening ; Mucous Membrane* ; Multivariate Analysis ; Pathology ; Polyps ; Prevalence ; Skin*

BACKGROUND/OBJECTIVES: The purposes of this study were to compare total energy expenditure (including PAL and RMR) of Korean farmers between the farming season and off farming season and to assess the accuracy of estimated energy requirement (EER) prediction equation reported in KDRIs. SUBJECTS/METHODS: Subjects were 72 Korean farmers (males 23, females 49) aged 30-64 years. Total energy expenditure was calculated by multiplying measured RMR by PAL. EER was calculated by using the prediction equation suggested in KDRIs 2010. RESULTS: The physical activity level (PAL) was significantly higher (P < 0.05) in the farming season (male 1.77 +/- 0.22, female 1.69 +/- 0.24) than the off farming season (male 1.53 +/- 0.32, female 1.52 +/- 0.19). But resting metabolic rate was significantly higher (P < 0.05) in the off farming season (male 1,890 +/- 233 kcal/day, female 1,446 +/- 140 kcal/day) compared to the farming season (male 1,727 +/- 163 kcal/day, female 1,356 +/- 164 kcal/day). TEE (2,304 +/- 497 kcal/day) of females was significantly higher in the farming season than that (2,183 +/- 389 kcal/day) of the off farming season, but in males, there was no significant difference between two seasons in TEE. On the other hand, EER of male and female (2,825 +/- 354 kcal/day and 2,115 +/- 293 kcal/day) of the farming season was significantly higher (P < 0.05) than those (2,562 +/- 339 kcal/day and 1,994 +/- 224 kcal/day) of the off farming season. CONCLUSIONS: This study indicates that there is a significant difference in PAL and TEE of farmers between farming and off farming seasons. And EER prediction equation proposed by KDRI 2010 underestimated TEE, thus EER prediction equation for farmers should be reviewed.
Energy Metabolism* ; Female ; Hand ; Humans ; Male ; Motor Activity ; Seasons*

BACKGROUND/OBJECTIVES: This study analyzed factors affecting consumption frequencies of vegetables and fruits in Korean adolescents. SUBJECTS/METHODS: Consumption frequencies of vegetables and fruits, general characteristics, meal, health, and other variables were analyzed for a total of 147,047 adolescents who participated in the KYRBWS (Korea Youth Risk Behavior Web-based Survey) conducted in 2006 and 2011 by the Korea Centers for Disease Control and Prevention. RESULTS: Consumption frequencies of vegetables and fruits more than once a day significantly decreased in 2011 compared to 2006 based on Chi-square test conducted for every factor employed in the study. Analysis of factors showed that consumption frequencies of vegetables and fruits were reduced in both study years as subjective income decreased, whereas intake frequencies increased with mother's education level and reduction of adolescent stress level. CONCLUSIONS: In general, consumption frequencies of vegetables and fruits decreased in 2011 compared to those in 2006. Thus, future research needs to improve dietary guidelines for nutrition education in order for students to recognize the importance of food consumption and necessity of increasing daily serving sizes of vegetables and fruits for their balanced consumption.
Adolescent* ; Centers for Disease Control and Prevention (U.S.) ; Chi-Square Distribution ; Education ; Fruit* ; Humans ; Korea ; Meals ; Nutrition Policy ; Risk-Taking* ; Serving Size ; Vegetables*

PURPOSE: The aim of this study was to develop a reliable measurement tool to assess the urban food environment, particularly focusing on food stores in Korea. METHODS: The items for the measurement tool were selected through systematic literature reviews and adjusted to the Korean food environment. A total of 25 food stores in an urban area were recruited for the pilot test to evaluate the time required for completion of the survey, ease of response, willingness to participate, difficulties in conducting the survey, and appropriateness, and 34 food stores were recruited for assessment of the reliability of the tool using percent agreement and kappa value. RESULTS: The measurement tool is composed of questions regarding food store characteristics, accessibility, and food availability. On average, 26 minutes was required to survey a single food store, and the subjects and interviewers answered that the process was not difficult for the survey. The percent agreement for the inter-rater and test-retest reliability ranged from 93.9~98.8% and 91.9~97.9, respectively. The kappa values ranged from 0.78 to 0.97, which was very high. Percent agreement and kappa value of food with healthy option were lower than those of the general food in the inter-rater reliability (p = 0.0027, p = 0.0095 respectively) as well as in the test-retest reliability (p = 0.0081, p = 0.0290, respectively), although they were still high enough (86.4~98.0% for percent agreement, 0.64~0.96 for kappa value). CONCLUSION: The newly developed measurement tool for assessment of food store environment appears to be feasible and reliable; therefore, it can be applied to research on the association between food environment and dietary behaviors as well as health outcomes.
Korea

This study was conducted to investigate nutrient consumption by Korean adults in various places. To accomplish this, we used the 1998-2009 Korea National Health and Nutrition Examination Survey (KNHANES). Subjects of this investigation were over 19 years and the study included 37,160 people. The meals were categorized as breakfast, lunch, dinner, and snacks consumed at home, or while eating-out. Investigation of the rate of consumption at serving places based on daily meals and years showed that eating-out generally increased with time. The consumption of meals prepared at home was higher than that of meals consumed anyplace else in 1998, 2001, 2005, and 2007-2009. However, the rate of consumption of home meals decreased from 1998 to 2007-2009, while the rate of eating-out increased during this period. Annual nutrient intake according to serving places with respect to meals, energy, fat, and sodium were significantly lower in home meals than those consumed elsewhere in 2007-2009 relative to 1998. The sodium intake and energy distribution ratio of fat in meals consumed while eating-out increased significantly from 1998 to 2007-2009. The energy, fat and sodium intake and energy contribution ratio of fat consumed in meals at institutions was significantly higher in 2007-2009 than in 1998. Based on these results, additional research is required to develop guidelines for dietary life improvement at each serving place and to address education and policies for balanced nutrition intake.
Adult ; Breakfast ; Education ; Humans ; Korea* ; Lunch ; Meals* ; Nutrition Surveys* ; Snacks ; Sodium*

PURPOSE: The purpose of this study was to measure accessibility and to examine distribution of restaurants in the local community. METHODS: The target area of this study was two urban areas and a rural area in a city. We collected location information on all restaurants in target areas and classified all restaurants according to Korean food restaurants and Non-Korean food restaurants. We measured restaurant density per 100 m from the residences of the study population and calculated the distance of the nearest restaurant from the residences of the subjects using the Geographic Information System (GIS) analysis method. We compared the accessibility and distribution of restaurants in urban areas with that of the rural area, and compared the accessibility and distribution of Korean restaurants with that of Non-Korean restaurants. RESULTS: Restaurants in urban areas were more dense than those in the rural area, and, in urban areas, restaurants were intensively distributed around the subjects' residence. Also, there were more Non-Korean food restaurants than Korean food restaurants in urban areas, and it was opposite in the rural area. CONCLUSION: It is important that we understood the current state of the restaurant environment in the local community using GIS analysis for the first time in the field of food environment. Further research is necessary on the association of restaurant environments and the dietary life of the population.
Geographic Information Systems ; Restaurants*

PURPOSE: The aim of this study was to assess the food environment, particularly focusing on restaurants in three areas (Suwon city, Hwaseong Byeongieom-dong, and Bibong-myun). METHODS: A total of 662 persons were surveyed on customers' perceptions of the food environment in restaurants. A structured questionnaire composed of 30 questions on 7 factors, sanitation (4 items), displaying information (5), food quality (12), information on nutritional and healthy food choice (6), restaurant's accessibility (1), availability (1), and affordability (1) was used. In addition, an expert assessment of restaurant sanitation, and information on nutritional.healthy food choice was conducted through visiting 126 restaurants. RESULTS: Scores (range of score : 1~7) for each factors assessing the restaurant food environment were 5.06 for sanitation factors, 5.05 for displaying information factors, 5.13 for taste.appearance factors, and 4.35 for healthy menu factors. Informations on nutritional.healthy food choice showed a low rate: only 16.24% of the subjects answered that there is a message encouraging choice of healthy foods and 27.4% answered that menus contain nutritional information. Significant differences in food environment were observed by region (city, town, rural). The restaurants food environment in the rural area turned out to be poorer than that of the other two areas. In comparison of customer perception and expert assessment, significant differences were observed for 'Employee appearances and uniforms are clean and tidy' (p < .05), and 'There is a message encouraging the choice of healthy foods' (p < .05). CONCLUSION: This study provided evidence for differences of restaurant food environment by regions. In the rural area, there is a problem in restaurant's accessibility, availability, and affordability because of a lack of variety in menu items and restaurants. This results suggest that there is a need for more healthy food restaurants in the rural area.
Food Quality ; Gyeonggi-do ; Humans ; Surveys and Questionnaires ; Restaurants* ; Sanitation