Increased Risk of Asymptomatic Gallstones in Patients With Ulcerative Colitis

BACKGROUND/AIMS: The relationship between Crohn's disease and gallstones is established. However, the prevalence and risk factors for gallstones in patients with ulcerative colitis (UC) are not yet well understood. The aim of this study was to evaluate the prevalence and risk factors of gallstones in patients with UC. METHODS: This study was a retrospective single center study. A total of 87 patients with UC and 261 healthy controls were enrolled. Age, sex, and body mass index were matched. To investigate risk factors, the extent of UC, duration of disease, number of hospital admissions, and number of steroid treatments in patients with UC were evaluated. RESULTS: The prevalence of gallstones in patients with UC was 13.8%, whereas that in healthy controls was only 3.1% (P or =50 years of age had a 3.6-times higher risk of gallstones compared to that in those <50 years of age, and the difference was statistically significant (odds ratio, 3.60; confidence interval, 1.03-12.61) in univariate analysis. There were no statistically significant disease-related risk factors for gallstones in UC patients. CONCLUSIONS: This is the first study of gallstone prevalence in Korean UC patients. In this study, patients with UC had a higher prevalence of gallstones compared to that in well-matched healthy controls. Age seemed to be a possible risk factor, and more studies are needed. Further prospective, large-scale studies will be required to confirm the risk factors for gallstones in UC patients.

Increased Risk of Asymptomatic Gallstones in Patients With Ulcerative Colitis

BACKGROUND/AIMS: The relationship between Crohn's disease and gallstones is established. However, the prevalence and risk factors for gallstones in patients with ulcerative colitis (UC) are not yet well understood. The aim of this study was to evaluate the prevalence and risk factors of gallstones in patients with UC. METHODS: This study was a retrospective single center study. A total of 87 patients with UC and 261 healthy controls were enrolled. Age, sex, and body mass index were matched. To investigate risk factors, the extent of UC, duration of disease, number of hospital admissions, and number of steroid treatments in patients with UC were evaluated. RESULTS: The prevalence of gallstones in patients with UC was 13.8%, whereas that in healthy controls was only 3.1% (P or =50 years of age had a 3.6-times higher risk of gallstones compared to that in those <50 years of age, and the difference was statistically significant (odds ratio, 3.60; confidence interval, 1.03-12.61) in univariate analysis. There were no statistically significant disease-related risk factors for gallstones in UC patients. CONCLUSIONS: This is the first study of gallstone prevalence in Korean UC patients. In this study, patients with UC had a higher prevalence of gallstones compared to that in well-matched healthy controls. Age seemed to be a possible risk factor, and more studies are needed. Further prospective, large-scale studies will be required to confirm the risk factors for gallstones in UC patients.

Alcohol Drinking Increased the Risk of Advanced Colorectal Adenomas

BACKGROUND/AIMS: Age, sex, gene and life style are modulating risks for colon cancer. Although alcohol intake may impact on colorectal adenoma, clear association has not been established yet. We aimed to investigate effects of alcohol consumption on the characteristics of colorectal adenoma. METHODS: Patients who underwent colonoscopic polypectomy of colorectal adenoma in the department of gastroenterology of Eulji hospital through 2005 to 2012, having both blood tests and ultrasound or abdominal CT examination were enrolled. The alcohol drinking patients were subdivided into normal or abnormal laboratory group, and alcoholic liver diseases group. RESULTS: 212 patients with colorectal adenoma were analyzed; advanced adenoma and multiple adenoma were found in 68 (32.0%) and 79 (37.2%) patients. When compared to the nondrinker group (120/212 patients), the alcohol drinker group (92/212 patients) represented significantly high odds ratios (ORs) for advanced adenoma (OR, 2.697; P=0.002), and multiple adenoma (OR, 1.929; P=0.039). Among alcohol drinker (92 patients), the ORs of advanced adenoma were 6.407 (P=0.003) in alcoholic liver diseases group (17 patients), 3.711 (P=0.002) in the alcohol drinker with abnormal lab (24 patients), and 2.184 (P=0.034), in the alcohol drinker with normal lab (51 patients) compared to nondrinker group. CONCLUSIONS: This study showed that alcohol drinking may influence on the development of advanced colorectal adenoma and multiplicity. Especially in the group with alcoholic liver diseases and with abnormal lab presented significantly higher ORs of advanced adenoma.

Synchronous Undifferentiated Carcinoma of Gallbladder in a Patient with Intrahepatic Intraductal Papillary Mucinous Neoplasia (b-IPMN)

Simultaneous development of intrahepatic bile duct and gallbladder carcinoma is extremely rare. We report herein the case of an 86-year-old man found to have double cancer of the gallbladder and intrahepatic bile duct. Computed tomography and magnetic resonance cholangiopancreatography revealed a polypoid mass in the gallbladder and dilatation of the intrahepatic bile duct with intraductal papillary tumor in the left side of the liver. The patient underwent left hepatectomy, cholecystectomy with lymphadenectomy around the hepatoduodenal ligament. Pathological examination of the gallbladder revealed undifferentiated giant cell type carcinoma invading the muscularis propria. On the other hand, the liver tumor was intrahepatic intraductal papillary mucinous carcinoma in situ. Therefore, this was an extremely rare case of synchronous carcinoma of the gallbladder associated with intrahepatic cholangiocarcinoma.

Usefulness of Percutaneous Oxygen Saturation Monitoring as a Predictor of Deterioration of Lung Function in Korean Children with Asthma / 소아알레르기및호흡기학회지

PURPOSE:Our study was designed to verify the correlation between the level of percutaneous arterial oxygen saturation (SpO2) and forced expiratory volume in 1 second (FEV1) and to classify the severity according to SpO2 level when asthma exacerbation is developed. METHODS:We performed the methacholine bronchial provocation tests with monitoring SpO2 on 350 children who visited the pediatric allergy clinic with chronic cough or recurrent wheezing from August 2006 to August 2008. RESULTS:There was a significant correlation between FEV1%fall and SpO2 (r=-0.814, P< 0.01). The mean value of SpO2 was 95.80%+/-1.2% when decrement of FEV1 was 20%. It was 92.3%+/-0.81% when FEV1 decreased by 40%. CONCLUSION:Monitoring SpO2 is a convenient and reliable objective method to determine an appropriate therapeutic option when the pulmonary function test or arteial blood gas analysis is not available in children with asthma. We suggest less than 96% of SpO2 for the moderate attack, less than 92% for the severe attack, as the criteria for the severity of asthma exacerbations in Korea, which is higher than those suggested by GINA guideline or Japanese guidelines.

Cyclooxgenase-2 Expression in Chronic Inflammatory Bowel Disease:Comparing of Immunohistochemical Stain to Real-time PCR

BACKGROUND/AIMS: This study compared the results of cyclooxygenase-2 (COX-2) expression in inflammatory bowel disease and tuberculous colitis as evident by immunochemical staining and real time polymerase chain reaction (PCR). METHODS: Patients with ulcerative colitis (n=18), Crohn's disease (n=7), tuberculous colitis (n=7) and 10 normal controls were included. Biopsied colonic mucosa was simultaneously used for immunohistochemical staining and real time PCR. RESULTS: Patients with inflammatory bowel disease and tuberculous colitis showed high COX-2 expression by both methods compared to the normal controls. In Crohn's disease patients, the real time PCR value correlated well staining grade; this correlation was not evident in ulcerative colitis patients. In real time PCR, grossly normal colonic mucosa in ulcerative colitis also showed higher expression of COX-2 than normal mucosa. CONCLUSIONS: Real time PCR value of COX-2 is more representative of inflammation state in inflammatory bowel disease than the value from immunohistochemical staining.

Evaluation of Growth Information in Height on the Internet Web-sites / 대한소아내분비학회지

PURPOSE: The purpose of this study was to evaluate the problems and the quality of the Internet Web-sites for management of short stature in childhood and adolescent. METHODS: We evaluated 105 Web-sites identified from 5 search engines, Naver, Daum, Korean Yahoo, Nate and Empas, using the word of 'height and/or short stature'. According to Web-site author, total Web-sites were classified as academy & society, physician, commercials, portal site, oriental medicine, and unidentified. We accessed how well the Web-sites informed people about the diseases by of short stature. RESULTS: Of the 105 Web-sites, 98 were accessible. 45 Web-sites (46%) were operated by oriental medicine group. Difference in IS between oriental medicine group and non-oriental medicine groups was significant (P<0.001). CONCLUSION: A great portion of Web-sites on short stature was operating by oriental medicine group. Oriental medicine Web-sites had a tendency to be omitted essential information on short stature and occasionally even had unhealthy information. This investigation could have a adverse influence that internet navigators for short stature might miss a chance of managing in time and there were huge increasing medical expense. There was strongly demand for reliable national certification system to certify to exellent quality for medical and health Web-sites.

A Case of Menkes disease with Infantile Spasm

Menkes disease, so called kinky-hair syndrome, is a rare, genetic and progressive neurodegenerative disorder. It is caused by a mutation in the ATP7A gene, which codes for the copper transporting ATPase in the cell organelles. The dysfunction of many copper-dependent enzymes results in low concentration of copper in some tissues and accumulation of copper in others. We report a boy presented with kinky hairs, developmental delay, hypotonia and connective tissue abnormalities at the age of 4 months. Despite the treatment with various antiepileptic drugs, atonic seizures still persisted. At the age of 7 months, his atonic seizures was changed into extensor spasms with modified hypsarrhythmia for some years. The seizure were controlled by topiramate and vigabatrin. At the age of 22 months, serum copper and ceruloplasmin rechecked as 17 ug/dL(80-150 ug/dL) and 7.3 mg/dL(20-46 mg/ dL) respectively. The gene study showed ATP7A mutation and the patient was diagnosed as Menkes disease so that copper-histidine was daily injected. We experienced a case of a 4-month-old boy with Menkes disease and infantile spasm, confirmed by ATP7A mutation.

Tuberculin Response in Infants after BCG Vaccination during Neonatal Stage

PURPOSE: Mantoux test was widely used to identify the tuberculosis. But no reliable method exists for distinguishing tuberculin reactions caused by previous BCG vaccination from those caused by mycobacterial infections. So we studied Mantoux response in infants who had received BCG vaccination in the first month of life. METHODS: Mantoux testing was carried out in 143 healthy infants aged from 3 to 15months who had received BCG vaccination in the first month of life. Among them, 81 received Japan 172 strain BCG vaccination with multiple puncture method and 62 Copenhagen 1331 strain with intradermal method. RESULTS: The mean Mantoux reactions in the Japan 172 strain group were as follows : 10.0mm at 3 months, 9.7mm at 4-6months, 11.4mm at 7-9months, and 10.5mm at 10-15months. The mean Mantoux reactions in the Copenhagen 1331 strain group were as follows : 7.6mm at 3 months, 7.5mm at 4-6months, 7.5mm at 7-9months, and 6.8mm at 10-15months. Infants who received Japan strain had significantly larger sized induration in all ages. About 50% of Japan strain BCG-vaccinated infants had more than 10mm of tuberculin reaction. CONCLUSION: Infants who received Japan strain had significantly larger sized tuberculin reaction in all ages. Although the size of induration is more than 10mm in Tokyo strain BCG-vaccinated child, vaccine effect should be generally considered.