Relapse Rates of Ulcerative Colitis in Remission and Factors Related to Relapse / 대한소화기학회지

BACKGROUND/AIMS: Ulcerative colitis (UC) is a chronic inflammatory bowel disease with heterogeneous clinical features. Data on the disease course and prognosis of UC patients who have been regularly treated are lacking. We aimed to investigate relapse rates of UC in remission and factors related to relapse. METHODS: We retrospectively analyzed clinical courses of 84 patients (43 males, median age 43 years, ranged 20-73 years) diagnosed as UC at Ajou University Hospital between January 1997 and December 2005 based on clinical, endoscopic and pathologic findings, and who were regularly followed for at least one year after the remission. RESULTS: Study subjects consisted of 32 proctitis (38%), 21 left-sided colitis (25%), and 31 subtotal or total colitis (37%). Of 84 patients, relapse was observed in 52 patients (62%) during the follow-up period (ranged 1-9 years). The relapse rate was 24%, 41%, 51%, 65%, 71%, and 79% at 1 year, 2 years, 3 years, 4 years, 5 years and 6 years, respectively. Among sex, age, hemoglobin, ESR, and the extent of disease on admission, decrease of hemoglobin level was the only independent factor related to relapse (odds ratio=2.67, 95% CI (1.32-5.42), p<0.01). CONCLUSIONS: In Korea, relapse of UC in remission is not rare. Decrease of hemoglobin level is an independent risk factor related to its relapse, while the extent of disease is not.

The Clinical Effect of Supplementary Argon Plasma Coagulation after Endoscopic Mucosal Piecemeal Resection of a Gastric Adenoma and Carcinoma / 대한소화기내시경학회지

BACKGROUND/AIMS: This study was designed to determine the effect of supplementary argon plasma coagulation (APC) after piecemeal resection of a gastric adenoma or an intramucosal adenocarcinoma. METHODS: Cases of 62 lesions of 56 consecutive patients with either a gastric adenoma or carcinoma were retrospectively reviewed at the Ajou University Medical Center. APC was performed after an endoscopic complete resection using the piecemeal method of endoscopic mucosal resection (EMR) for patients in the EMR-APC group. For patients in the EMR group, APC was not performed. RESULTS: There was no significant difference in the recurrence rate of the cancers for both groups (9.7%, for the EMR group, 6.5% for the EMR-APC group). The recurrence rate of a low grade dysplasia was 6.7% (EMR group) and 6.3% (EMR-APC group) (p=1.000), the recurrence rate for a high grade dysplasia was 11.1% (EMR group) and 25.0% (EMR-APC group) (p=1.000), and the recurrence rate for an intramucosal adenocarcinoma was 14.3% (EMR group) and 0% (EMR-APC group) (p=0.389). The recurrence rates of lesions in which the lesion size was less than 20 mm and over 20 mm for each group were 6.7% and 9.1% (EMR group) (p=1.000) versus 12.5% and 0% (EMR-APC group) (p=0.520). There was also no significant statistical difference in the recurrence rates for both groups according to the location and macroscopic type of lesion. CONCLUSIONS: Supplementary treatment with APC could not significantly reduce the recurrence rate after complete piecemeal resection determined macroscopically. A large- scale and prospective study is necessary to elucidate the clinical significance of supplementary APC for gastric neoplasm treatment.