Risk Factors for Development and Recurrence of Peptic Ulcer Disease / 대한소화기학회지

BACKGROUND/AIMS: Peptic ulcer disease (PUD) is one of the common gastrointestinal diseases, and its medical management has been developed so much that the incidence of its serious complications, such as bleeding and perforation, are declining significantly. Its prevalence in Korea is not definitely decreased, probably due to increasing proportion of elderly patients and their rising usage of non-steroidal anti-inflammatory drugs (NSAIDs) and aspirins. This study was conducted to identify the risk factors for development and recurrence of peptic ulcer disease in Korea. METHODS: From 2003 to 2008, upper gastrointestinal endoscopy and detailed personal questionnaires were performed for patients who visited Department of Gastroenterology at Seoul National University Bundang Hospital. In total, 475 PUD patients and 335 non-ulcer dyspepsia patients were included. The results of questionnaires and repeated upper gastrointestinal endoscopy at initial diagnosis time and follow-up periods were analyzed. RESULTS: Multivariable analysis showed that male, H. pylori infection, NSAIDs use and smoking were risk factors for the development of PUD. The use of proton pump inhibitors (PPIs) and H2 receptor antagonists has significantly reduced the risk of PUD in patients who had taken NSAIDs and/or aspirins. H. pylori infection was found as the only risk factor for the recurrence of PUD. CONCLUSIONS: For the old patients who are taking drugs, such as NSAIDs and aspirins, concomitant use of PPIs or H2 receptor antagonists should be considered to protect from the development of PUD. H. pylori eradication has been confirmed again to be essential for the treatment of PUD patients infected with H. pylori.

A case of acute renal failure and IgA nephropathy associated with acute hepatitis A / 대한내과학회지

Hepatitis A is usually a mild, non-fulminant, self-limiting disease of the liver. Acute renal failure, in associated with non-fulminant hepatitis A, is extremely rare and is rarely documented by kidney biopsy. Here we report the case of a 28-year old male with acute non-fulminant hepatitis A who developed acute renal failure early in the course of the disease and recovered without dialysis. In this report, renal biopsy was done. The renal biopsy showed acute tubular necrosis and IgA nephropathy. We discuss the mechanism responsible for renal failure in acute hepatitis A virus infection on the basis of presumed pathogenesis and renal biopsy.

Social Support and Self-rated Health Status in a Low Income Neighborhood of Seoul, Korea / 예방의학회지

OBJECTIVES: To assess the distribution of social support, and explore its effects on self-rated health status in a low income neighborhood of Seoul, Korea. METHODS: In September 2001 we conducted a survey in a low income neighborhood of Seoul, Korea, in which 862 residents, aged 18 years or over, participated. We measured the general sociodemographic characteristics, self-rated health status and social support with the instrument developed from Korean translation of the Medical Outcomes Study Social Support Survey (MOS-SSS) scale of the US. Logistic regression was used to identify the determinants of social support, and explore its effects on self-rated health status. RESULTS: Lower social class, women or divorced people had much less social support compared to higher social class, men or those never married, respectively. Those families on much lower income also received less social support. Social support has a positive impact on the self-rated health status, which remains statistically significant even when other relevant variables are adjusted. CONCLUSIONS: This study suggests that social support has an important role in health, and the socially disadvantaged have lower social support. Therefore, to improve the health status of the poor, it is necessary to encourage community participation, and develop strategies that could strengthen their provision of social support.