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1.
The Korean Journal of Helicobacter and Upper Gastrointestinal Research ; : 63-67, 2023.
Article Dans Coréen | WPRIM | ID: wpr-968720

Résumé

Gastric subepithelial tumors (SETs) are usually asymptomatic and are often detected incidentally during screening endoscopy. A gastric inverted hyperplastic polyp (IHP) is characterized by downward growth of hyperplastic mucosa into the submucosal layer. Owing to these characteristics, a gastric IHP is frequently misdiagnosed as a SET. Gastric IHPs are asymptomatic in most cases and are discovered incidentally. Notably, IHPs may be accompanied by an adenocarcinoma or anemia owing to chronic bleeding associated with this lesion; therefore, endoscopic submucosal dissection is recommended for complete excision of IHPs measuring > 2 cm. We report a case of gastric IHP that was diagnosed during screening endoscopy in an asymptomatic patient. We observed a whitish purulent exudate expressed from the SET, and endoscopic ultrasonography revealed a SET originating from the muscularis mucosa. Endoscopic submucosal dissection was performed to remove the SET, and final histopathological findings revealed a gastric IHP. This case report highlights that IHPs should be suspected in patients with a SET associated with whitish exudates.

2.
Korean Journal of Aerospace and Environmental Medicine ; : 32-36, 2023.
Article Dans Anglais | WPRIM | ID: wpr-968673

Résumé

Purpose@#Melioidosis is a zoonosis that can infect humans or animals. The disease is caused by the bacteria Burkholderia pseudomallei, which is found in contaminated soil and water. We investigated the epidemiological aspects of melioidosis cases among oversea travelers in Korea and Japan during 2011 to 2020. @*Methods@#Raw data were obtained from the website of melioidosis cases from the Korea Diseases Control and Prevention Agency, and the National Institute of infectiousDiseases in Japan, 2011−2020. @*Results@#There were 26 cases of melioidosis cases in Korea and 14 cases in Japan between 2011 and 2020. Cumulative incidence rate per 1,000,000 oversea travelers (OTs) of Korea (0.14) did not substantially differ that of Japan (0.09), respectively.The incidence of melioidosis in males (96.2% of total 26 cases) was much more common than in females (3.8%) in OTs of Korea (P<0.01), while there were significant differences level between males (85.7% of total 14 cases) and females (14.3%) in OTs of Japan (P<0.01). On the other hand, the distribution by adjusted-age groups for melioidosis cases were statistically similar distribution between Korean and Japanese that total cases occurred in the over 40-years old age, clearly showing a more infected of melioidosis (P<0.05). @*Conclusion@#This study demonstrates that there is a similar pattern of imported melioidosis cases in Korea and Japan. Therefore, to prevent melioidosis infections, greater attention should be paid to individuals who are planning to travel to the presumptive regions of melioidosis.

3.
Nutrition Research and Practice ; : 122-134, 2023.
Article Dans Anglais | WPRIM | ID: wpr-968428

Résumé

BACKGROUND/OBJECTIVES@#Consumption of certain protective foods may help inhibit Helicobacter pylori (H. pylori) associated gastric pathologies. However, studies conducted to assess the efficacy of protective foods in H. pylori-infected subjects are either limited or inconsistent. This study evaluated the association of individual or a combination of protective foods on the incidence of gastric cancer (GC) in H. pylori-positive subjects through a casecontrol study.MATERIALS/METHODS: Subjects aged 20–79 years were selected from 2 hospitals between December 2002 and September 2006. In total, 134 patients and 212 controls tested positive for H. pylori infection. Among these, we included 82 pairs of cases and controls matched by sex, age (± 5 years), enrollment period (± 1 years), and hospital. @*RESULTS@#A higher intake of soy products was associated with a significantly lower risk of GC than a lower intake of soy products (odds ratio [OR] = 0.37, 95% confidence interval [CI] = 0.14–0.96). Additionally, a higher fruit intake resulted in a significantly lower risk of GC than a lower fruit intake (OR = 0.35, 95% CI = 0.13–0.94). A combination of food groups was evaluated, and a lower risk of GC was observed with a high intake of both soy products and fruits (OR = 0.20, 95% CI = 0.06–0.67), high intake of soy and dairy products (OR = 0.28, 95% CI = 0.10–0.78) and high intake of fruits and dairy products (OR = 0.28, 95% CI = 0.09–0.83). @*CONCLUSIONS@#A high intake of soy products or fruits was associated with a lower risk of GC.A combination of soy products or fruits with dairy products was associated with a lower risk of GC. A balanced intake of soy products, fruits, and dairy products may help reduce GC risk.

4.
Korean Journal of Radiology ; : 235-246, 2023.
Article Dans Anglais | WPRIM | ID: wpr-968279

Résumé

Objective@#It is difficult to predict the treatment response of tissue after stereotactic radiosurgery (SRS) because radiation necrosis (RN) and tumor recurrence can coexist. Our study aimed to predict tumor recurrence, including the recurrence site, after SRS of brain metastasis by performing a longitudinal tumor habitat analysis. @*Materials and Methods@#Two consecutive multiparametric MRI examinations were performed for 83 adults (mean age, 59.0 years; range, 27–82 years; 44 male and 39 female) with 103 SRS-treated brain metastases. Tumor habitats based on contrastenhanced T1- and T2-weighted images (structural habitats) and those based on the apparent diffusion coefficient (ADC) and cerebral blood volume (CBV) images (physiological habitats) were defined using k-means voxel-wise clustering. The reference standard was based on the pathology or Response Assessment in Neuro-Oncologycriteria for brain metastases (RANO-BM). The association between parameters of single-time or longitudinal tumor habitat and the time to recurrence and the site of recurrence were evaluated using the Cox proportional hazards regression analysis and Dice similarity coefficient, respectively. @*Results@#The mean interval between the two MRI examinations was 99 days. The longitudinal analysis showed that an increase in the hypovascular cellular habitat (low ADC and low CBV) was associated with the risk of recurrence (hazard ratio [HR], 2.68; 95% confidence interval [CI], 1.46–4.91; P = 0.001). During the single-time analysis, a solid low-enhancing habitat (low T2 and low contrast-enhanced T1 signal) was associated with the risk of recurrence (HR, 1.54; 95% CI, 1.01–2.35; P= 0.045). A hypovascular cellular habitat was indicative of the future recurrence site (Dice similarity coefficient = 0.423). @*Conclusion@#After SRS of brain metastases, an increased hypovascular cellular habitat observed using a longitudinal MRI analysis was associated with the risk of recurrence (i.e., treatment resistance) and was indicative of recurrence site. A tumor habitat analysis may help guide future treatments for patients with brain metastases.

5.
Korean Journal of Radiology ; : 133-144, 2023.
Article Dans Anglais | WPRIM | ID: wpr-968256

Résumé

Objective@#Cyclin-dependent kinase inhibitor (CDKN)2A/B homozygous deletion is a key molecular marker of isocitrate dehydrogenase (IDH)-mutant astrocytomas in the 2021 World Health Organization. We aimed to investigate whether qualitative and quantitative MRI parameters can predict CDKN2A/B homozygous deletion status in IDH-mutant astrocytomas. @*Materials and Methods@#Preoperative MRI data of 88 patients (mean age ± standard deviation, 42.0 ± 11.9 years; 40 females and 48 males) with IDH-mutant astrocytomas (76 without and 12 with CDKN2A/B homozygous deletion) from two institutions were included. A qualitative imaging assessment was performed. Mean apparent diffusion coefficient (ADC), 5th percentile of ADC, mean normalized cerebral blood volume (nCBV), and 95th percentile of nCBV were assessed via automatic tumor segmentation.Logistic regression was performed to determine the factors associated with CDKN2A/B homozygous deletion in all 88 patients and a subgroup of 47 patients with histological grades 3 and 4. The discrimination performance of the logistic regression models was evaluated using the area under the receiver operating characteristic curve (AUC). @*Results@#In multivariable analysis of all patients, infiltrative pattern (odds ratio [OR] = 4.25, p = 0.034), maximal diameter (OR = 1.07, p = 0.013), and 95th percentile of nCBV (OR = 1.34, p = 0.049) were independent predictors of CDKN2A/B homozygous deletion. The AUC, accuracy, sensitivity, and specificity of the corresponding model were 0.83 (95% confidence interval [CI], 0.72–0.91), 90.4%, 83.3%, and 75.0%, respectively. On multivariable analysis of the subgroup with histological grades 3 and 4, infiltrative pattern (OR = 10.39, p = 0.012) and 95th percentile of nCBV (OR = 1.24, p = 0.047) were independent predictors of CDKN2A/B homozygous deletion, with an AUC accuracy, sensitivity, and specificity of the corresponding model of 0.76 (95% CI, 0.60–0.88), 87.8%, 80.0%, and 58.1%, respectively. @*Conclusion@#The presence of an infiltrative pattern, larger maximal diameter, and higher 95th percentile of the nCBV may be useful MRI biomarkers for CDKN2A/B homozygous deletion in IDH-mutant astrocytomas.

6.
Journal of Pathology and Translational Medicine ; : 1-27, 2023.
Article Dans Anglais | WPRIM | ID: wpr-967634

Résumé

The first edition of ‘A Standardized Pathology Report for Gastric Cancer’ was initiated by the Gastrointestinal Pathology Study Group of the Korean Society of Pathologists and published 17 years ago. Since then, significant advances have been made in the pathologic diagnosis, molecular genetics, and management of gastric cancer (GC). To reflect those changes, a committee for publishing a second edition of the report was formed within the Gastrointestinal Pathology Study Group of the Korean Society of Pathologists. This second edition consists of two parts: standard data elements and conditional data elements. The standard data elements contain the basic pathologic findings and items necessary to predict the prognosis of GC patients, and they are adequate for routine surgical pathology service. Other diagnostic and prognostic factors relevant to adjuvant therapy, including molecular biomarkers, are classified as conditional data elements to allow each pathologist to selectively choose items appropriate to the environment in their institution. We trust that the standardized pathology report will be helpful for GC diagnosis and facilitate large-scale multidisciplinary collaborative studies.

7.
Journal of Neurogastroenterology and Motility ; : 58-64, 2023.
Article Dans Anglais | WPRIM | ID: wpr-967607

Résumé

Background/Aims@#Patients with gastroesophageal reflux disease (GERD) frequently experience nighttime heartburn and sleep disturbance. Tegoprazan is a new potassium-competitive acid blocker that can rapidly block acid secretion. This study aims to evaluate the efficacy of tegoprazan compared with esomeprazole in relieving nighttime heartburn and sleep disturbances. @*Methods@#Patients with erosive esophagitis, nighttime heartburn, and sleep disturbances were randomized to receive tegoprazan 50 mg or esomeprazole 40 mg for 2 weeks. The primary endpoint was time to first nighttime heartburn-free interval. The percentage of nighttime heartburn-free days was also compared between the 2 groups. @*Results@#A total of 46 patients were enrolled in this study. Time to the first nighttime heartburn-free interval was shorter with tegoprazan than with esomeprazole but the difference was not statistically significant (1.5 days vs 3 days, P = 0.151). The percentage of nighttime heartburn-free days was higher in the tegoprazan group but the difference was insignificant (57.8% vs 43.1%, P = 0.107). Adverse events occurred in 2 patients. They were mild in severity. @*Conclusions@#Tegoprazan may induce faster relief of nighttime heartburn symptoms and may improve sleep disorders associated with nighttime heartburn. Further large-scale studies are required to validate our findings.

8.
Journal of Korean Medical Science ; : e24-2023.
Article Dans Anglais | WPRIM | ID: wpr-967451

Résumé

Background@#It remains unclear whether a combination of glycemic variability and glycated hemoglobin (HbA1c) status leads to a higher incidence of cardiovascular disease (CVD).Therefore, to investigate CVD risk according to the glucose control status during early diabetes, we examined visit-to-visit HbA1c variability among patients with type 2 diabetes (T2DM). @*Methods@#In this 9-year retrospective study, we measured HbA1c levels at each visit and tracked the change in HbA1c levels for 3 years after the first presentation (observation window) in newly diagnosed T2DM patients. We later assessed the occurrence of CVD in the last 3 years (target outcome window) of the study period after allowing a 3-year buffering window. The HbA1c variability score (HVS; divided into quartiles, HVS_Q1–4) was used to determine visit-to-visit HbA1c variability. @*Results@#Among 4,817 enrolled T2DM patients, the mean HbA1c level was < 7% for the first 3 years. The group with the lowest HVS had the lowest rate of CVD (9.4%; 104/1,109 patients).The highest incidence of CVD of 26.7% (8/30 patients) was found in HVS [≥ 9.0%]_Q3, which was significantly higher than that in HVS [6.0–6.9%]_Q1 (P = 0.006), HVS [6.0–6.9%]_Q2 (P = 0.013), HVS [6.0–6.9%]_Q3 (P = 0.018), and HVS [7.0–7.9%]_Q3 (P = 0.040). @*Conclusion@#To our knowledge, this is the first long-term study to analyze the importance of both HbA1c change and visit-to-visit HbA1c variability during outpatient visits within the first 3 years. Lowering glucose levels during early diabetes may be more critical than reducing visit-to-visit HbA1c variability.

9.
Journal of Gastric Cancer ; : 107-145, 2023.
Article Dans Anglais | WPRIM | ID: wpr-967164

Résumé

The first edition of ‘A Standardized Pathology Report for Gastric Cancer’ was initiated by the Gastrointestinal Pathology Study Group of the Korean Society of Pathologists and published 17 years ago. Since then, significant advances have been made in the pathologic diagnosis, molecular genetics, and management of gastric cancer (GC). To reflect those changes, a committee for publishing a second edition of the report was formed within the Gastrointestinal Pathology Study Group of the Korean Society of Pathologists. This second edition consists of two parts: standard data elements and conditional data elements.The standard data elements contain the basic pathologic findings and items necessary to predict the prognosis of GC patients, and they are adequate for routine surgical pathology service. Other diagnostic and prognostic factors relevant to adjuvant therapy, including molecular biomarkers, are classified as conditional data elements to allow each pathologist to selectively choose items appropriate to the environment in their institution. We trust that the standardized pathology report will be helpful for GC diagnosis and facilitate large-scale multidisciplinary collaborative studies.

10.
Intestinal Research ; : 61-87, 2023.
Article Dans Anglais | WPRIM | ID: wpr-967009

Résumé

Ulcerative colitis (UC), a relapsing-remitting chronic inflammatory bowel disease (IBD), has a variable natural course but potentially severe disease course. Since the development of anti-tumor necrosis factor (TNF) agents has changed the natural disease course of moderate-to-severe UC, therapeutic options for patients who failed conventional treatments are expanding rapidly. IBD clinical trials have demonstrated the potential efficacy and safety of novel biologics such as anti-integrin α4β7 and anti-interleukin-12/23 monoclonal antibodies and small molecules such as a Janus kinase inhibitor. Anti-TNF biosimilars also have been approved and are widely used in IBD patients. Wise drug choices should be made considering evidence-based efficacy and safety. However, the best position of these drugs remains several questions, with limited data from direct comparative trials. In addition, there are still concerns to be elucidated on the effect of therapeutic drug monitoring and combination therapy with immunomodulators. The appropriate treatment regimens in acute severe UC and the risk of perioperative use of biologics are unclear. As novel biologics and small molecules have been approved in Korea, we present the Korean guidelines for medical management of adult outpatients with moderate-to-severe UC and adult hospitalized patients with acute severe UC, focusing on biologics and small molecules.

11.
Intestinal Research ; : 43-60, 2023.
Article Dans Anglais | WPRIM | ID: wpr-967005

Résumé

Crohn’s disease (CD) is a relapsing and progressive condition characterized by diarrhea, abdominal pain, weight loss, and hematochezia that results in serious complications such as perforations, fistulas, and abscesses. Various medications, interventions, and surgical treatments have been used to treat CD. The Korean guidelines for CD management were distributed in 2012 and revised in 2017 by the Inflammatory Bowel Disease (IBD) Research Group of the Korean Association for the Study of Intestinal Diseases. Substantial progress in mucosal immunologic research has elucidated the pathophysiology of IBD, leading to development of biological agents for treatment of CD. The first developed biologic agent, tumor necrosis factor-α agents, were shown to be efficacious in CD, heralding a new era in management of CD. Subsequently, vedolizumab, a monoclonal antibody against integrin α4β7, and ustekinumab, a human monoclonal antibody that inhibits the common p40 subunit of interleukin-12 and interleukin-23, were both approved for clinical use and are efficacious and safe for both induction and maintenance of remission in moderate-to-severe CD patients. Moreover, a recent study showed the non-inferiority of CT-P13, an infliximab biosimilar, compared with infliximab in CD patients. The third Korean guidelines for CD management provide updated information regarding treatment of moderate-to-severe CD patients with biologic agents.

12.
Endocrinology and Metabolism ; : 129-138, 2023.
Article Dans Anglais | WPRIM | ID: wpr-966835

Résumé

Background@#The severity of gestational diabetes mellitus (GDM) is associated with adverse pregnancy outcomes. We aimed to generate a risk model for predicting insulin-requiring GDM before pregnancy in Korean women. @*Methods@#A total of 417,210 women who received a health examination within 52 weeks before pregnancy and delivered between 2011 and 2015 were recruited from the Korean National Health Insurance database. The risk prediction model was created using a sample of 70% of the participants, while the remaining 30% were used for internal validation. Risk scores were assigned based on the hazard ratios for each risk factor in the multivariable Cox proportional hazards regression model. Six risk variables were selected, and a risk nomogram was created to estimate the risk of insulin-requiring GDM. @*Results@#A total of 2,891 (0.69%) women developed insulin-requiring GDM. Age, body mass index (BMI), current smoking, fasting blood glucose (FBG), total cholesterol, and γ-glutamyl transferase were significant risk factors for insulin-requiring GDM and were incorporated into the risk model. Among the variables, old age, high BMI, and high FBG level were the main contributors to an increased risk of insulin-requiring GDM. The concordance index of the risk model for predicting insulin-requiring GDM was 0.783 (95% confidence interval, 0.766 to 0.799). The validation cohort’s incidence rates for insulin-requiring GDM were consistent with the risk model’s predictions. @*Conclusion@#A novel risk engine was generated to predict insulin-requiring GDM among Korean women. This model may provide helpful information for identifying high-risk women and enhancing prepregnancy care.

13.
Diabetes & Metabolism Journal ; : 211-219, 2023.
Article Dans Anglais | WPRIM | ID: wpr-966789

Résumé

Background@#This study investigated the trends of insulin use among Korean patients with type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM). Changes in prescription of antidiabetic medications in T2DM patients taking insulin therapy were evaluated. @*Methods@#We analyzed data from the National Health Insurance Service database in Korea to evaluate the prevalence of insulin users and trends of insulin use in T1DM and T2DM patients from January 2002 to December 2019. We also investigated numbers and types of antidiabetic medications in insulin users with T2DM. @*Results@#The overall total number of insulin users increased from 2002 to 2019, reaching 348,254 for T2DM and 20,287 for T1DM in 2019 compared with 109,974 for T2DM and 34,972 for T1DM in 2002. The proportion of patients using basal analogs and short acting analogs have increased and those using human insulin, premixed insulin, or biphasic human insulin have decreased (rapid acting analogs: 71.85% and 24.12% in T1DM and T2DM, respectively, in 2019; basal analogs: 76.75% and 75.09% in T1DM and T2DM, respectively, in 2019). The use of other antidiabetic medication in addition to insulin increased for T2DM, especially in dual therapy, reaching up to 52.35% in 2019 compared with 16.72% in 2002. @*Conclusion@#The proportion of the patients using basal or rapid acting analogs increased among all insulin users in both T1DM and T2DM patients. Among patients with T2DM, the proportion of patients using antidiabetic medications in addition to insulin was significantly increased compared to those who used insulin alone.

14.
Asian Spine Journal ; : 118-129, 2023.
Article Dans Anglais | WPRIM | ID: wpr-966389

Résumé

Methods@#Magnetic resonance imaging (MRI) and clinical evaluation were performed for patients with single-level uniportal endoscopic lumbar decompression with a minimum follow-up of 2 years. @*Results@#A total of 126 patients were recruited with a minimum follow-up of 26 months. The incidence of epidural fluid hematoma was 27%. Postoperative MRI revealed a significant improvement in the postoperative dura sac area at postoperative day 1 and at the upper endplate at 6 months in the hematoma cohort (39.69±15.72 and 26.89±16.58 mm2) as compared with the nonhematoma cohort (48.92±21.36 and 35.1±20.44 mm2), respectively (p <0.05); and at the lower endplate on postoperative 1 day in the hematoma cohort (51.18±24.69 mm2) compared to the nonhematoma cohort (63.91±27.92 mm2) (p <0.05). No significant difference was observed in the dura sac area at postoperative 1 year in both cohorts. The hematoma cohort had statistically significant higher postoperative 1-week Visual Analog Scale (VAS; 3.32±0.68) pain and Oswestry Disability Index (ODI; 32.65±5.56) scores than the nonhematoma cohort (2.99±0.50 and 30.02±4.84, respectively; p <0.05). No significant difference was found at the final follow-up VAS, ODI, and MRI dura sac area. @*Conclusions@#Epidural fluid hematoma is a common early postoperative MRI finding in lumbar endoscopic unilateral laminotomy with bilateral decompression. Conservative management is the preferred treatment option for patients who do not have a neurological deficit. Symptoms last only a few days and are self-limiting. A common endpoint is a remodeled fluid hematoma and the subsequent expansion of the dura sac area.

15.
The Korean Journal of Internal Medicine ; : 831-843, 2023.
Article Dans Anglais | WPRIM | ID: wpr-1003034

Résumé

Background/Aims@#Metachronous gastric cancer (MGC) can occur after endoscopic resection for gastric cancer. Further studies on factors other than Helicobacter pylori infection are needed. This systematic review and meta-analysis aimed to evaluate risk factors for metachronous recurrence of endoscopically resected gastric cancer. @*Methods@#We searched medical literature published by February 2023 and identified patients with MGC after endoscopic resection for gastric cancer. The occurrence of MGC and the presence of intestinal metaplasia (IM), severe atrophic gastritis (AG), and H. pylori infection were quantitatively analyzed. @*Results@#We identified 2,755 patients from nine cohort studies who underwent endoscopic resection for gastric cancer by 2018. Those with severe AG or presence of IM had a significantly higher incidence of MGC than those without (RR 2.00, 95% CI 1.35–2.98, I2 = 52% for severe atrophy on antrum; RR 7.08, 95% CI 3.63–13.80, I2 = 0% for antral IM). Absolute risk difference of MGC occurrence was 7.1% in those with severe AG and 9.2% in those with IM. The difference in incidence rate per 1,000 person-years was 17.5 person-years for those with severe AG and 24.7 person-years for those with IM. However, H. pylori eradication did not significantly affect the occurrence of MGC (RR 1.18, 95% CI 0.88–1.59, I2 = 10%). @*Conclusions@#Gastric cancer patients with severe AG or presence of IM had a 2.0-fold or 7.0-fold higher risk of MGC occurrence after endoscopic resection than those without, respectively. They need more stringent follow-up to monitor MGC occurrences (CRD42023410940).

16.
The Korean Journal of Helicobacter and Upper Gastrointestinal Research ; : 159-166, 2023.
Article Dans Coréen | WPRIM | ID: wpr-1003025

Résumé

Gastric acid-related disorders are commonly encountered in clinical practice. Acetylcholine, gastrin, and histamine are physiological agonists that stimulate acid secretion from parietal cells. Histamine plays a decisive role in the transformation of parietal cells into acid-secreting forms. The H+, K+- ATPase proton pump, which represents the final step of acid secretion, translocates from cytoplasmic tubulovesicles to secretory canaliculi upon parietal cell stimulation and facilitates exchange of intracellular H+ with extracellular K+ in a 1:1 ratio. Histamine-2 receptor antagonists and proton pump inhibitors (PPIs) are widely used in clinical practice, and potassium-competitive acid blockers (P-CABs) have gained attention in recent times. P-CABs address the unmet needs of patients who receive conventional PPIs and have broadened the spectrum of drug choices; however, further research is warranted to confirm long-term safety of these drugs. Comprehensive understanding of the mechanisms of actions, characteristics, advantages and disadvantages, and the adverse effect profile is essential for appropriate prescription of gastric acid-suppressive drugs. In this review, we provide a developing history and outline the pharmacological mechanisms underlying various gastric acid-suppressive drugs used in clinical settings.

17.
The Korean Journal of Helicobacter and Upper Gastrointestinal Research ; : 214-217, 2023.
Article Dans Coréen | WPRIM | ID: wpr-1003021

Résumé

A 51-year-old man with a 10-day history of acute-onset dysphagia presented with inability to swallow anything orally. The patient was unable to swallow any radiopaque contrast medium; therefore, a videofluoroscopic swallow study could not be performed. Brain imaging, neurological findings, and initial endoscopy findings were normal. Neck computed tomography suggested left vocal cord paralysis. The patient was diagnosed with diabetes one year prior to presentation but did not receive any treatment. Insulin therapy during hospitalization controlled the patient’s blood glucose levels, and his symptoms improved without any sequelae. We present a rare case of vocal cord paralysis secondary to controlled diabetes. The initial endoscopic examination did not include thorough evaluation of the vocal cords; therefore, accurate diagnosis was challenging in this case.

18.
The Korean Journal of Gastroenterology ; : 194-197, 2023.
Article Dans Anglais | WPRIM | ID: wpr-1002973

Résumé

In Korea, the prevalence of paragonimiasis has decreased markedly since 1970 and is now rarely encountered. Although the lung is the primary site of paragonimiasis, ectopic infestation can occur in other sites. The central nervous system is the most commonly involved ectopic site, accounting for only approximately 1% of all paragonimiasis patients. Therefore, the liver is an extremely rare site of ectopic infestation. The authors experienced the case of a 55-year-old female with hepatic paragonimiasis who presented with abdominal colicky pain.

19.
The Korean Journal of Gastroenterology ; : 145-153, 2023.
Article Dans Anglais | WPRIM | ID: wpr-1002923

Résumé

Patients frequently report that stress causes or exacerbates gastrointestinal (GI) symptoms, indicating a functional relationship between the brain and the GI tract. The brain and GI tract are closely related embryologically and functionally, interacting in various ways. The concept of the brain–gut axis was originally established in the 19th and early 20th centuries based on physiological observations and experiments conducted in animals and humans. In recent years, with the growing recognition that gut microbiota plays a vital role in human health and disease, this concept has been expanded to the brain–gut–microbiota axis. The brain influences the motility, secretion, and immunity of the GI tract, with consequent effects on the composition and function of the gut microbiota. On the other hand, gut microbiota plays an essential role in the development and function of the brain and enteric nervous system. Although knowledge of the mechanisms through which the gut microbiota influences distant brain function is incomplete, studies have demonstrated communication between these organs through the neuronal, immune, and endocrine systems. The brain–gut–microbiota axis is an essential aspect of the pathophysiology of functional GI disorders such as irritable bowel syndrome, and is also involved in other GI diseases, including inflammatory bowel disease. This review summarizes the evolving concept of the brain–gut–microbiota axis and its implications for GI diseases, providing clinicians with new knowledge to apply in clinical practice.

20.
Korean Journal of Aerospace and Environmental Medicine ; : 71-75, 2023.
Article Dans Anglais | WPRIM | ID: wpr-1002914

Résumé

Purpose@#To observe and compare the trends in epidemic aspects of imported shigellosis (Sg) cases from overseas travelers (OTs) in Korea and Japan between 2016 and 2020. @*Methods@#We analyzed the raw data of imported Sg cases from the Korea Diseases Control and Prevention Agency and the National Institute of Infectious Diseases in Japan between 2016 and 2020. @*Results@#In Korea, there were a total of 596 Sg infections, including 353 cases from overseas travel-associated imported cases, with a cumulative incidence rate (CIR) of 0.23 per 100,000 populations. The CIR of imported Sg cases was 0.32 per 100,000 OTs. In Japan, during the same period, there were a total of 757 Sg cases, including 388 imported cases, with a CIR of 0.12 per 100,000 populations. The CIR of imported Sg cases was 0.50 per 100,000 OTs. The CIR of total Sg cases in Korea was higher than in Japan, but the CIR of imported cases in Korea was lower than in Japan (P<0.01).Additionally, the imported-to-domestic cases ratio of Sg in Korea (1.45) was higher than in Japan (1.05) (P<0.05). @*Conclusion@#Based on the trends in the epidemiological aspects of domestic and imported Sg infection cases in both countries, a robust information system is needed to provide effective warnings and preventive measures for travelers visiting high-risk areas.

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