ABSTRACT
Background/Aims@#While Helicobacter pylori (HP)-negative gastric cancer is frequently reported, little is known about the predictors for detecting HP-negative early gastric cancer (EGC). We aimed to evaluate the predictors for the detection of HP-negative EGC. @*Methods@#We retrospectively reviewed 13,477 consecutive asymptomatic cases where upper endoscopy was performed by nine physicians from April 2017 to March 2019 and analyzed the detection rate of high-risk lesions (HRLs), including EGC, tubular adenoma, and lymphoma, according to the status of HP infection. The observation time was corrected for multiple regression analyses. @*Results@#For all physicians, the average observation time for screening HP-eradicated and -naïve patients was shorter than that for screening HP-positive patients (p<0.05). Multiple regression analyses revealed that the observation time in the three groups was an independent predictor for detecting HRLs in HP-eradicated patients (p=0.03106, 0.01263, and 0.02485, respectively), while experience of endoscopy was an independent predictor for detecting HRLs in HP-naïve patients (p=0.02638). @*Conclusions@#While observation time during screening endoscopy was a quality indicator for detecting HRLs in HP-eradicated patients, experience of endoscopy was a quality indicator for detecting HRLs in HP-naïve patients.
ABSTRACT
Background/Aims@#While Helicobacter pylori (HP)-negative gastric cancer is frequently reported, little is known about the predictors for detecting HP-negative early gastric cancer (EGC). We aimed to evaluate the predictors for the detection of HP-negative EGC. @*Methods@#We retrospectively reviewed 13,477 consecutive asymptomatic cases where upper endoscopy was performed by nine physicians from April 2017 to March 2019 and analyzed the detection rate of high-risk lesions (HRLs), including EGC, tubular adenoma, and lymphoma, according to the status of HP infection. The observation time was corrected for multiple regression analyses. @*Results@#For all physicians, the average observation time for screening HP-eradicated and -naïve patients was shorter than that for screening HP-positive patients (p<0.05). Multiple regression analyses revealed that the observation time in the three groups was an independent predictor for detecting HRLs in HP-eradicated patients (p=0.03106, 0.01263, and 0.02485, respectively), while experience of endoscopy was an independent predictor for detecting HRLs in HP-naïve patients (p=0.02638). @*Conclusions@#While observation time during screening endoscopy was a quality indicator for detecting HRLs in HP-eradicated patients, experience of endoscopy was a quality indicator for detecting HRLs in HP-naïve patients.
ABSTRACT
Background and Objective: The cesarean section is preformed commonly in modern society, where safety is regarded as of utmost importance and maternal age at childbirth is on the rise. While the risk of pulmonary embolism is high and getting out of sickbed early is recommended after a cesarean delivery, a woman in labor suffers wound pain and uterine contraction pain. We reviewed several reports that spinal anesthesia with opioids offered a good analgesic effect and inquired the validity and safety of this procedure.<br>Methods: Subjects were 88 full-term pregnant women ronging in age from 19 to 41 years. They recieved a cesarean section without complications and nonreassuring fetal status. The subjects were divided into 2 groups: Group A underwent spinal anesthesia with 0.5% high-density bupivacaine (n＝51) and Group B is received bupivacaine with 0.1mg morphine and 0.01mg fentanyl added (n＝37). Comparison was made between the two groups with respect to the amount of intravenous ephedrine for hypotention, revelation of nausea, the frequency of use of a postoperative painkiller, NRS (Numerical Rating Scale) and Apgar score of newborns.<br>Results: In Group B, the quantity of ephedrine used was significantly less than in Group A to assure anesthesia. The significant difference was observed in the occurrence of nausea. (p＝0.002). The times in Group B. the painkiller was used could be reduced. The pain was reduced by half or over from the average value of NRS. There was no difference in Apgar score.<br>Conclusions:In the rural area which is short of medical workers, high-quality care during the perioperative period can be obtained performed only by spinal anesthesia with the addition of opioids.