A Case of Gastric Bezoar Treated with a Distal Attachment Device / 대한소화기내시경학회지

Bezoars are collection of indigestible materials in the gastrointestinal tract. Many endoscopic techniques for removal of bezoars have been reported recently, but these methods need much equipment. We treated a gastric bezoar with a distal attachment device easily available for an endoscope. A 74-year-old man with a history of diabetes mellitus was admitted to hospital with hematemesis. On the second endoscopic examination, a gastric bezoar (6x4x4 cm) was detected in the stomach. Then, using a distal attachment device, we injected Coca-Cola directly into the bezoar by an injector. With tension force, the bezoar was easily broken due to the impulse of the distal attachment device. The endoscopic technique used in our case can be easily performed and has fewer complications compared to those of other techniques. Therefore, we report here on this new treatment modality that uses a distal attachment device.

Evaluation of Fasting Plasma Glucose as a Screening for Diabetes Mellitus in Middle-aged Adults of Naju Country / 당뇨병

BACKGROUND: The criteria for the diagnosis of diabetes mellitus have been modified by the American Diabetes Association (ADA) in 1997. The ADA proposed that the diagnosis of diabetes be defined by a fasting plasma glucose (FPG) of 7.0 mmol/L. Disagreement has been reported between criteria based on FPG and postchallenge 2-h plasma glucose (2-h PG). The aim of the present study is to assess the FPG criteria as the diagnostic screening test for diabetes in Korean middle-aged adults in comparison to the 2-h PG criteria. METHODS: Randomly selected 1,731 subjects (679 men and 1,052 women) aged 40~70 years (mean age: 58.4 +/- 7.89 years) without previously diagnosed diabetes completed 75 g oral glucose tolerance test (OGTT). We assessed the prevalence of diabetes mellitus and the level of agreement (kappa statistics) according to the different diagnostic glucose categories. RESULTS: The frequency of newly diagnosed diabetes was 2.7% (n = 51) using the FPG criteria only; 6.4% (n = 120) using the 2-h PG criteria only; and 6.9% (n = 130) using concentrations of > or = 7.0 mmol/L for FPG or > or = 11.1 mmol/L for 2-h PG. Of the 120 subjects with diabetes by the 2-h PG criteria, 65.8% (n = 79) were not diagnosed with diabetes according to FPG concentration. The level of agreement between two diagnostic criteria was low (kappa = 0.268). The receiver operating characterstic (ROC) curve analysis determined FPG of 5.6 mmol/L to yield optimal sensitivity and specificity corresponding to 2-h PG 11.1 mmol/L. CONCLUSION: The findings in this study demonstrate that the discordance between the FPG and 2-h PG criteria in the diagnosis of diabetes in Korean middle-aged adults is large. We suggest that IFG group (FPG 5.6~6.9 mmol/L) were performed 75 g OGTT for diagnosing diabetes mellitus in Korean middle-aged adults.