AIM： To evaluate the prevalence of chronic gastroin- testinal symptoms and their impact on health-related quality of life （HRQOL） in the Korean population. METHODS： A cross-sectional survey, using a reliable and v...AIM： To evaluate the prevalence of chronic gastroin- testinal symptoms and their impact on health-related quality of life （HRQOL） in the Korean population. METHODS： A cross-sectional survey, using a reliable and valid Rome I] based questionnaire, was per- formed on randomly selected residents, between 18 and 69 years in age. All respondents were interviewed at their homes or offices by a team of interviewers. The impact of chronic gastrointestinal symptoms on HRQOL was assessed using the Korean version of the 36-item Short-Form general health survey （SF-36）. RESULTS： Of the 1807 eligible subjects, 1417 （78.4%： male 762; female 655） were surveyed. Out of the respondents, 18.6% exhibited at least one chronic gastrointestinal symptom. The prevalence of gastro- esophageal reflux disease （GERD）, defined as heart- burn and/or acid regurgitation experienced at least weekly, was 3.5% （95% CI, 2.6-4.5）. The prevalence of uninvestigated dyspepsia, irritable bowel syndrome （IBS） and chronic constipation based on Rome Ⅱ criteria were 11.7% （95% CI, 10.1-13.5）, 2.2% （95% CI, 1.5-3.1）, and 2.6% （95% CI, 1.8-3.5） respectively. Compared with subjects without chronic gastrointesti- nal symptoms （n = 1153）, those with GERD （n = 50）, uninvestigated dyspepsia （n = 166） and IBS （n = 31） had significantly worse scores on most domains of the SF-36 scales. CONCLUSION： The prevalence of GERD, uninvesti- gated dyspepsia and IBS were 3.5%, 11.7% and 2.2% respectively, in the Korean population. The health- related quality of life was significantly impaired in subjects with GERD, uninvestigated dyspepsia and IBS in this community.展开更多
AIM: To evaluate the functional aspect of esophageal motility in healthy subjects and in patients who were referred for esophageal function testing using multichannel intraluminal impedance-esophageal manometry (MII-E...AIM: To evaluate the functional aspect of esophageal motility in healthy subjects and in patients who were referred for esophageal function testing using multichannel intraluminal impedance-esophageal manometry (MII-EM), and to assess the clinical utility of MII-EM. METHODS: From September 2003 to January 2004, we performed the MII-EM on healthy volunteers and all the patients who were referred for esophageal function testing. Each patient received 10 liquid and 10 viscous swallows. We analyzed the results, the impedance and the manometric findings. Some of the subjects had additional ambulatory 24-h pH study performed to diagnose gastroesophageal reflux disease (GERD). RESULTS: Among 89 studied subjects, the MII-EM findings showed normal esophageal motility in 50 (56.17%), ineffective esophageal motility (IEM) in 17 (19.10%), nutcracker esophagus in 7 (7.86%), achalasia in 4 (4.49%), and scleroderma esophagus in 11 (12.35%) cases. The completeness and the speed of bolus transit were in the order of nutcracker esophagus, normal manometry and IEM. Some of the swallows showing normal manometry and IEM had incomplete transit. In the achalasia and scleroderma esophagus, almost all the swallows had incomplete transit. The body amplitudes were higher for the swallows with complete transit than for the swallows with incomplete transit. There was not a significant difference in the manometric and impedance findings between the subjects with and without GERD. CONCLUSION: MII-EM is a useful tool in assessing theesophageal function in the patients having esophageal motility abnormality. The primary factors influencing the bolus transit are the amplitude of the esophageal body and normal peristalsis.展开更多
AIM： To examine the technical feasibility and clinical outcomes of the endoscopic insertion of a selfexpandable metal stent （SEMS） for the palliation of a malignant anastomotic stricture caused by recurrent gastric...AIM： To examine the technical feasibility and clinical outcomes of the endoscopic insertion of a selfexpandable metal stent （SEMS） for the palliation of a malignant anastomotic stricture caused by recurrent gastric cancer. METHODS： The medical records of patients, who had obstructive symptoms caused by a malignant anastomotic stricture after gastric surgery and underwent endoscopic insertion of a SEMS from January 2001 to December 2007 at Kangnam St Mary＇s Hospital, were reviewed retrospectively. RESULTS： Twenty patients （15 male, mean age 63 years） were included. The operations were a total gastrectomy with esophagojejunostomy （n = 12）, subtotal gastrectomy with Billroth-Ⅰ reconstruction （n = 2） and subtotal gastrectomy with Billroth- Ⅱ reconstruction （n = 8）. The technical and clinical success rates were 100% and 70%, respectively. A small bowel or colon stricture was the reason for a lack of improvement in symptoms in 4 patients. Two of these patients showed improvement in symptoms after another stent was placed. Stent reobstruction caused by tumor ingrowth or overgrowth occurred in 3 patients （15%） within 1 mo after stenting. Stent migration occurred with a covered stent in 3 patients who underwent a subtotal gastrectomy with Billroth-Ⅱ reconstruction. Two cases of partial stent migration were easily treated with a second stent or stent repositioning. The median stent patency was 56 d （range, 5-439 d）. The median survival was 83 d （range, 12-439 d）. CONCLUSION： Endoscopic insertion of a SEMS provides safe and effective palliation of a recurrent anastomotic stricture caused by gastric cancer, A meticulous evaluation of the presence of other strictures before inserting the stent is essential for symptom improvement.展开更多
AIM： To compare the recovery of thrombocytopenia and splenomegaly during long-term follow-up after liver transplantation in patients receiving a living donor transplant or a cadaveric donor transplant. METHODS： This...AIM： To compare the recovery of thrombocytopenia and splenomegaly during long-term follow-up after liver transplantation in patients receiving a living donor transplant or a cadaveric donor transplant. METHODS： This was a retrospective cohort study of 216 consecutive liver transplant patients who survived for 〉 6 mo after transplantation; 169 received a liver transplant from a living donor and 47 from a cadaveric donor. The platelet counts or spleen volumes were examined before transplant, i, 6, and 12 mo after transplant, and then annually until 5 years after transplant. RESULTS： The mean follow-up period was 49 mo （range, 21-66）. Platelet counts increased continuously for 5 years after orthotopic liver transplant. The restoration of platelet counts after transplant was significantly slower in patients with severe pretransplant thrombocytopenia （〈 50000/μL） until 4 years after transplant （P = 0.005）. Donor type did not significantlyaffect the recovery of platelet count and spleen volume in either patient group. In multivariate analysis, pretransplant severe thrombocytopenia （〈 50000/μL） was an independent factor associated with sustained thrombocytopenia （P 〈 0.001, odds ratio 6.314; confidence interval, 2.828-14.095）. Thrombocytopenia reappeared after transplant in seven patients with portal flow disturbance near the anastomosis site. CONCLUSION： Our study suggests that severe thrombocytopenia before transplant is closely associated with delayed recovery of platelet count after transplant and donor type did not affect the recovery of thrombocytopenia. The reappearance of thrombocytopenia after transplant should be considered a possible indicator of flow disturbance in the portal vein.展开更多
An 81-year-old man presented with epigastric pain and weight loss for one month. He had a past history of pulmonary tuberculosis, 10 years ago. We performed a gastroscopy, which showed a linear depressed whitish gastr...An 81-year-old man presented with epigastric pain and weight loss for one month. He had a past history of pulmonary tuberculosis, 10 years ago. We performed a gastroscopy, which showed a linear depressed whitish gastric ulcer scar (0.8 cm in length) in the posterior wall of the prepyloric antrum. The result of biopsy was reported as squamous epithelium. Immunohistochemical staining using an antibody to high molecular weight cytokeratin (HMC) revealed positive staining in the squamous epithelium. Two years later, the lesion was followed up. The lesion remained at same site endoscopically, but no squamous epithelium could be seen microscopically.展开更多
基金Supported by The Korean Society of Neurogastroenterlogy and Motility Fund and a 2000 grant from the Korean Academy of Medical Sciences, KMA
文摘AIM： To evaluate the prevalence of chronic gastroin- testinal symptoms and their impact on health-related quality of life （HRQOL） in the Korean population. METHODS： A cross-sectional survey, using a reliable and valid Rome I] based questionnaire, was per- formed on randomly selected residents, between 18 and 69 years in age. All respondents were interviewed at their homes or offices by a team of interviewers. The impact of chronic gastrointestinal symptoms on HRQOL was assessed using the Korean version of the 36-item Short-Form general health survey （SF-36）. RESULTS： Of the 1807 eligible subjects, 1417 （78.4%： male 762; female 655） were surveyed. Out of the respondents, 18.6% exhibited at least one chronic gastrointestinal symptom. The prevalence of gastro- esophageal reflux disease （GERD）, defined as heart- burn and/or acid regurgitation experienced at least weekly, was 3.5% （95% CI, 2.6-4.5）. The prevalence of uninvestigated dyspepsia, irritable bowel syndrome （IBS） and chronic constipation based on Rome Ⅱ criteria were 11.7% （95% CI, 10.1-13.5）, 2.2% （95% CI, 1.5-3.1）, and 2.6% （95% CI, 1.8-3.5） respectively. Compared with subjects without chronic gastrointesti- nal symptoms （n = 1153）, those with GERD （n = 50）, uninvestigated dyspepsia （n = 166） and IBS （n = 31） had significantly worse scores on most domains of the SF-36 scales. CONCLUSION： The prevalence of GERD, uninvesti- gated dyspepsia and IBS were 3.5%, 11.7% and 2.2% respectively, in the Korean population. The health- related quality of life was significantly impaired in subjects with GERD, uninvestigated dyspepsia and IBS in this community.
文摘AIM: To evaluate the functional aspect of esophageal motility in healthy subjects and in patients who were referred for esophageal function testing using multichannel intraluminal impedance-esophageal manometry (MII-EM), and to assess the clinical utility of MII-EM. METHODS: From September 2003 to January 2004, we performed the MII-EM on healthy volunteers and all the patients who were referred for esophageal function testing. Each patient received 10 liquid and 10 viscous swallows. We analyzed the results, the impedance and the manometric findings. Some of the subjects had additional ambulatory 24-h pH study performed to diagnose gastroesophageal reflux disease (GERD). RESULTS: Among 89 studied subjects, the MII-EM findings showed normal esophageal motility in 50 (56.17%), ineffective esophageal motility (IEM) in 17 (19.10%), nutcracker esophagus in 7 (7.86%), achalasia in 4 (4.49%), and scleroderma esophagus in 11 (12.35%) cases. The completeness and the speed of bolus transit were in the order of nutcracker esophagus, normal manometry and IEM. Some of the swallows showing normal manometry and IEM had incomplete transit. In the achalasia and scleroderma esophagus, almost all the swallows had incomplete transit. The body amplitudes were higher for the swallows with complete transit than for the swallows with incomplete transit. There was not a significant difference in the manometric and impedance findings between the subjects with and without GERD. CONCLUSION: MII-EM is a useful tool in assessing theesophageal function in the patients having esophageal motility abnormality. The primary factors influencing the bolus transit are the amplitude of the esophageal body and normal peristalsis.
文摘AIM： To examine the technical feasibility and clinical outcomes of the endoscopic insertion of a selfexpandable metal stent （SEMS） for the palliation of a malignant anastomotic stricture caused by recurrent gastric cancer. METHODS： The medical records of patients, who had obstructive symptoms caused by a malignant anastomotic stricture after gastric surgery and underwent endoscopic insertion of a SEMS from January 2001 to December 2007 at Kangnam St Mary＇s Hospital, were reviewed retrospectively. RESULTS： Twenty patients （15 male, mean age 63 years） were included. The operations were a total gastrectomy with esophagojejunostomy （n = 12）, subtotal gastrectomy with Billroth-Ⅰ reconstruction （n = 2） and subtotal gastrectomy with Billroth- Ⅱ reconstruction （n = 8）. The technical and clinical success rates were 100% and 70%, respectively. A small bowel or colon stricture was the reason for a lack of improvement in symptoms in 4 patients. Two of these patients showed improvement in symptoms after another stent was placed. Stent reobstruction caused by tumor ingrowth or overgrowth occurred in 3 patients （15%） within 1 mo after stenting. Stent migration occurred with a covered stent in 3 patients who underwent a subtotal gastrectomy with Billroth-Ⅱ reconstruction. Two cases of partial stent migration were easily treated with a second stent or stent repositioning. The median stent patency was 56 d （range, 5-439 d）. The median survival was 83 d （range, 12-439 d）. CONCLUSION： Endoscopic insertion of a SEMS provides safe and effective palliation of a recurrent anastomotic stricture caused by gastric cancer, A meticulous evaluation of the presence of other strictures before inserting the stent is essential for symptom improvement.
基金The Grant (Clinical Research Center of Liver Cirrhosis) of the Korea Health 21 Research and Development Project from Ministry of Health and Welfare, Republic of Korea, No. A050021
文摘AIM： To compare the recovery of thrombocytopenia and splenomegaly during long-term follow-up after liver transplantation in patients receiving a living donor transplant or a cadaveric donor transplant. METHODS： This was a retrospective cohort study of 216 consecutive liver transplant patients who survived for 〉 6 mo after transplantation; 169 received a liver transplant from a living donor and 47 from a cadaveric donor. The platelet counts or spleen volumes were examined before transplant, i, 6, and 12 mo after transplant, and then annually until 5 years after transplant. RESULTS： The mean follow-up period was 49 mo （range, 21-66）. Platelet counts increased continuously for 5 years after orthotopic liver transplant. The restoration of platelet counts after transplant was significantly slower in patients with severe pretransplant thrombocytopenia （〈 50000/μL） until 4 years after transplant （P = 0.005）. Donor type did not significantlyaffect the recovery of platelet count and spleen volume in either patient group. In multivariate analysis, pretransplant severe thrombocytopenia （〈 50000/μL） was an independent factor associated with sustained thrombocytopenia （P 〈 0.001, odds ratio 6.314; confidence interval, 2.828-14.095）. Thrombocytopenia reappeared after transplant in seven patients with portal flow disturbance near the anastomosis site. CONCLUSION： Our study suggests that severe thrombocytopenia before transplant is closely associated with delayed recovery of platelet count after transplant and donor type did not affect the recovery of thrombocytopenia. The reappearance of thrombocytopenia after transplant should be considered a possible indicator of flow disturbance in the portal vein.
文摘An 81-year-old man presented with epigastric pain and weight loss for one month. He had a past history of pulmonary tuberculosis, 10 years ago. We performed a gastroscopy, which showed a linear depressed whitish gastric ulcer scar (0.8 cm in length) in the posterior wall of the prepyloric antrum. The result of biopsy was reported as squamous epithelium. Immunohistochemical staining using an antibody to high molecular weight cytokeratin (HMC) revealed positive staining in the squamous epithelium. Two years later, the lesion was followed up. The lesion remained at same site endoscopically, but no squamous epithelium could be seen microscopically.
