Analysis of colorectal cancer screening practices in the general population of Tianjin / 中国肿瘤临床

Objective:Colorectal cancer screening was performed on a general population with age ranging between 40 and 74 years old to evaluate the screening effects of questionnaire survey, fecal occult blood (FOB) test, and colonoscopy, as well as to provide some implications of colorectal cancer screening strategies. Methods: Two-step screening model of questionnaire survey combined with FOB test was applied for the screening. Colonoscopy was conducted in a high-risk population identified through preliminary screening as final diagnosis. Results:Based on the 2,117,304 cases screened, the screening compliance was 39.72%, and 126,118 cases (5.96%) were identified as high risk. Colonoscopies were performed on 25,837 cases, of which 8,095, 1,236, 134, 112, and 336 were identified as adenoma, advanced adenoma, severe dysplasia lesions, early cancer, and advanced cancer, respectively. The early stage di-agnostic rate was 81.52%. Conclusion:The colorectal cancer screening method performed in Tianjin can significantly concentrate on the high-risk population with colorectal cancer, increase the positivity rate of total colonoscopy, and economize medical resources.

Clinical Significance of Total Colonoscopy in Patients with Active Pulmonary Tuberculosis without Gastrointestinal Symptoms / 대한소화기내시경학회지

BACKGROUND/AIMS: Pulmonary tuberculosis may coexist with intestinal tuberculosis even in the absence of gastrointestinal symptoms. The aim of this prospective study was to define the colonoscopic findings of early lesions of intestinal tuberculosis, incidence of asymptomatic intestinal tuberculosis in patients with active pulmonary tuberculosis and to evaluate the clinical response after standard anti- tuberculosis chemotherapy. METHODS: We examined 59 Korean patients with active pulmonary tuberculosis, who had no gastrointestinal symptoms. Patients underwent diagnostic total colonoscopy up to terminal ileum for evaluation of intestinal tuberculosis. Follow-up total colonoscopy was also done in 1~3 months after start of treatment. RESULTS: Intestinal tuberculous lesions were found in 54% of patients. The common locations of lesion were terminal ileum (84%) and cecum (69%). The combination of circumferential ulceration, hyperemic mucosa and erosions of the colon was the most common finding (37.5%), the combination of hyperemia and ulceration occurred in 34.4% of patients and hyperemia with/without erosion in 12.5%. The direction of ulceration was transevere in relation to long axis of the colon but occasionally longitudinal. Although most ulcers were multiple in number and various in size but some paitents had isolated single ulcer with erosion. All of the lesions regressed within 1~3 months of treatment. CONCLUSIONS: During screening total colonoscopy, if there are nonspecific hyperemia, erosion or shallow ulcer on colon or terminal ileum, it is necessary to check up chest X-ray for rule out tuberculous lesion, especially in countries with a high prevalence of tuberculosis.

Clinical Presentations of Salmonella Colitis on Total Colonoscopy / 대한소화기내시경학회지

BACKGROUND/AIM: Salmonella can cause an asymptomatic intestinal carrier state or clinical disease. The most common clinical manifestation is enterocolitis. In diagnosis of salmonellosis, total colonoscopy is not perfomed routinely, but to diagnose and treat the some of salmonellosis presented with acute massive rectal bleeding, fever, diarrhea, or abdominal pain resulted from vague cause. We evaluated colonoscopic findings of salmonella colitis, and the efficacy of the colonoscopic biopsy and tissue culture compared with conventional culture of blood, urine, and stool, retrospectively. METHODS: Six cases were performed total colonoscopy. We analyzed the correlation between clinical onset and colonoscopic findings and compared the efficacy of conventional culture methods. RESULTS: Colonoscopic findings were summarized as; 1. Major involved sites ere terminal ileum, cecum, and ascending colon, but in some cases, entire colon was involved. 2. Mucosal changes were nonspecific. Of variable culture methods, colonoscopic tissue culture was the most sensitive for identification of causative organisms. CONCLUSIONS: Colonoscopic features are not useful to diagnose salmonella colitis, because the findings are similar to those in inflammatory bowel disease, and there was no correlations between colonoscopic findings and symptom onset and severity. But, it is safe and useful method to isolate the causative organism of acute infectious colitis.

Clinical Presentations of Salmonella Colitis on Total Colonoscopy / 대한소화기내시경학회지

BACKGROUND/AIM: Salmonella can cause an asymptomatic intestinal carrier state or clinical disease. The most common clinical manifestation is enterocolitis. In diagnosis of salmonellosis, total colonoscopy is not perfomed routinely, but to diagnose and treat the some of salmonellosis presented with acute massive rectal bleeding, fever, diarrhea, or abdominal pain resulted from vague cause. We evaluated colonoscopic findings of salmonella colitis, and the efficacy of the colonoscopic biopsy and tissue culture compared with conventional culture of blood, urine, and stool, retrospectively. METHODS: Six cases were performed total colonoscopy. We analyzed the correlation between clinical onset and colonoscopic findings and compared the efficacy of conventional culture methods. RESULTS: Colonoscopic findings were summarized as; 1. Major involved sites ere terminal ileum, cecum, and ascending colon, but in some cases, entire colon was involved. 2. Mucosal changes were nonspecific. Of variable culture methods, colonoscopic tissue culture was the most sensitive for identification of causative organisms. CONCLUSIONS: Colonoscopic features are not useful to diagnose salmonella colitis, because the findings are similar to those in inflammatory bowel disease, and there was no correlations between colonoscopic findings and symptom onset and severity. But, it is safe and useful method to isolate the causative organism of acute infectious colitis.