Clinicopathologic Features and Clinical Significance of Small and Diminutive Colorectal Polyps

PURPOSE: Small (6 to 10 mm) and diminutive colon polyps (below 5 mm) are routinely removed at the time of colonoscopy for the prevention of colon cancer. Our aims in this study were to determine clinicopathologic features and frequency of significant synchronous neoplastic lesions of small colon polyps and diminutive colon polyps and to investigate development of colorectal carcinoma via surveillance colonoscopy. METHODS: We evaluated medical reports of all patients undergoing total colonoscopic examination over a 12-month period. Three hundred thirty nine small colorectal polyps, removed during colonoscopy, have been analyzed. We investigated the result of surveillance colonoscopy, also. Using this database, all adenomas were categorized into two groups: Group I, < or =5 mm diameter (diminutive polyp), Group 2, 6 to 10 mm diameter (small polyp). Significant synchronous adenomas were defined as adenoma over 6 mm diameter, dysplasia or cancer. RESULTS: The most common age group was the sixth decade. The male-to-female ratio was 2.1 : 1. Of the small colorectal polyps, 180 (53.1%) were adenomatous, 32 (10.0%) were hyperplastic, 119 (34.9%) were chronic nonspecific inflammation, 3 (0.9 %) were lymphoid hyperplasia, and 4 (1.1%) were cancerous. The most frequent sites of these lesions were rectum and sigmoid (60.2%). Recognizable endoscopic features of polyps were redness (35.8%) and nodule (26.3%). The prevalence of advanced proximal synchronous polyps was 20.7% among patients with distal small lesions. And we detected 2 cases (25%) had new small polyps in follow up colonoscopic examination. CONCLUSIONS: All polyps should be removed when encountered during colonoscopy due to the higher prevalence of adenoma among these lesions. Effort to find new polyps via surveillance colonoscopy is needed.

A Study on The Change of HBsAg and Anti-HBs Positivities for A Recent 15 Year Period in Korea / 대한간학회지

BACKGROUND/AIMS: The HBsAg positivity in the normal Korean population has been reported as 2-10%. It has been decreasing since hepatitis B vaccine was introduced to routine vaccination regimens in 1992. Reports on the changes of anti-HBs over the years are hard to find since the discrepancies in sensitivities of test methods used by different researchers did not allow equivalent comparisons. The purpose of this study was to evaluate the changes of HBsAg and anti-HBs posivities for a recent 15 year period. METHODS: From 1998 to 2000, 4771 subjects in Chonnam province were included in this study. Serum HBsAg and anti-HBs were detected by reversed passive hemagglutination (RPHA) and passive hemagglutination (PHA) respectively. The changes in the HBsAg and anti-HBs positivity by the same test methods for the period were analyzed by comparing our results with those of 12 other previous reports. RESULTS: The positivities of HBsAg and anti-HBs were 5.3% and 47.5%. The positivity of HBsAg was significantly higher in males, while that of anti-HBs was significantly lower in males (p40) was significantly higher statistically (p<0.01). The positivity of HBsAg decreased with years (r=-0.845, p<0.01), while that of anti-HBs increased with years (r=0.616, p<0.05). CONCLUSION: The positivity of HBsAg has significantly decreased and that of anti-HBs has increased with years for the period under study.

A case of primary squamous cell carcinoma of the liver / 대한내과학회지

Primary squamous cell carcinoma of the liver is very rare. It has previously been reported to arise from the lining of developmental hepatic cyst or in hepatic teratoma. Also, there are published reports of the occurrence of such a tumor in association with intrahepatic cholesterol stones, hypercalcemia in a cirrhotic liver, and clonorchiasis. The previous reports showed male predominance. The prognosis of this tumor is extremely grave, and no case has survived more than one year. A 73-year-old woman was found to have a primary squamous cell carcinoma of the liver. The tumor, which measured 11x7 cm and located in the left hepatic lobe, was diagnosed by percutanous biopsy. No evidence of other primary foci was demonstrated in systemic workup. Left hepatectomy was done. In computed scan on 4 months after operation, tumor seedings were revealed on right hepatic lobe, omentum and several lymph nodes. She died on 6 months after operation.