Feedback Survey of the Effect, Burden, and Cost of the National Endoscopic Quality Assessment Program during the Past 5 Years in Korea.

BACKGROUND/AIMS: In Korea, the nationwide gastric cancer screening program recommends biennial screening for individuals aged 40 years or older by way of either an upper gastrointestinal series or endoscopy. The national endoscopic quality assessment (QA) program began recommending endoscopy in medical institutions in 2009. We aimed to assess the effect, burden, and cost of the QA program from the viewpoint of medical institutions. METHODS: We surveyed the staff of institutional endoscopic units via e-mail. RESULTS: Staff members from 67 institutions replied. Most doctors were endoscopic specialists. They responded as to whether the QA program raised awareness for endoscopic quality (93%) or improved endoscopic practice (40%). The percentages of responders who reported improvements in the diagnosis of gastric cancer, the qualifications of endoscopists, the quality of facilities and equipment, endoscopic procedure, and endoscopic reprocessing were 69%, 60%, 66%, 82%, and 75%, respectively. Regarding reprocessing, many staff members reported that they had bought new automated endoscopic preprocessors (3%), used more disinfectants (34%), washed endoscopes longer (28%), reduced the number of endoscopies performed to adhere to reprocessing guidelines (9%), and created their own quality education programs (59%). Many responders said they felt that QA was associated with some degree of burden (48%), especially financial burden caused by purchasing new equipment. Reasonable quality standards (45%) and incentives (38%) were considered important to the success of the QA program. CONCLUSIONS: Endoscopic quality has improved after 5 years of the mandatory endoscopic QA program.

Trends of ulcerative colitis-associated colorectal cancer in Korea: A KASID study.

BACKGROUND AND AIM: The number of patients with ulcerative colitis (UC) in Korea has increased. In addition, the number of patients with colorectal cancer (CRC) associated with UC has also increased. Therefore, this population-based nationwide study was conducted to investigate the incidence of CRC in patients with UC in Korea and compare these results to those of studies conducted in other countries. METHODS: The Korean Association for the Study of Intestinal Diseases (KASID) reviewed 7061 cases of UC that occurred between 1970 and 2005 and found a total of 26 cases of CRC. RESULTS: The overall prevalence of CRC in patients with UC was 0.37%. In addition, the estimated cumulative risk of UC-associated CRCs was 0.7% for patients that had UC for 10 years, 7.9% for patients that had UC for 20 years, and 33.2% for patients that had UC for 30 years. The mean age at the time of diagnosis with CRC was 49.6 years, and the mean duration of UC prior to the development of CRC was 11.5 years. Most UC-associated CRCs were diagnosed after they were already in advanced stages; however, the stage at diagnosis was lower in patients that had good compliance with medical treatment. CONCLUSION: The cumulative incidence of UC-associated CRCs in Korea was found to be comparable to that of western countries. The overall occurrence of UC-associated CRC in Korea may be growing, therefore, intensive surveillance colonoscopy and constructive chemoprevention should be encouraged to enable early detection and treatment of UC-associated CRCs in Korea.

Anatomical research of peritrochanteric femur and clinical application of internal fixation for femoral intertrochanteric fractures / 中华创伤骨科杂志

Objective To measure the proximal femoral parameters which can provide anatomic evidence for the design of internal fixation components for intertrochanteric fractures of femur.Methods Femoral speci- mens were harvested randomly from 120 healthy adult cadavers(left 60,fight 60).The neck shaft angle,greater trochanter slope length,tilt angle of greater trochanter,axial length of head and neck,lengths of upper and lower borders of the neck,and the minimum transverse diameter of the neck were measured.On the basis of the anatomic study,a two-claw plate was designed to treat 145 cases of femoral intertrochanteric fractures.Results The femoral neck shaft angle was 128.59??6.31?,femoral greater trochanter slope length was(5.5?0.58)cm,tilt angle of femoral greater trochanter was 42.76??5.20?,and axial length of head and neck was(9.42?0.38)cm. There was a correlation between the parameters.All the patients were followed up for a mean time of 23.6 months. The fractures got clinic union in 3 to 6 months.Two cases experienced detachment of claws and hooks but their final outcome was not affected.Three cases suffered coxa vara.All the other cases obtained normal motion function of hips and normal neck shaft angle.No breakage of claw,hook or nail was found in them.Conclusions It is necessary to design an internal fixator that can fit the anatomical features of Chinese femurs in the treatment of intertrochanteric fractures of femur.The two-claw plate designed by us is a good attempt to improve the clinical effect.