Choon-Jo Jin

G protein β3 subunit, interleukin‐10, and tumor necrosis factor‐α gene polymorphisms in Koreans with irritable bowel syndrome

Background  The association between irritable bowel syndrome (IBS) based on Rome III criteria and G protein β3 subunit (GNB3), interleukin (IL)‐10, and tumor necrosis factor (TNF)‐α gene polymorphisms is uncertain.

Plasma adiponectin and insulin resistance in Korean type 2 diabetes mellitus.

Insulin resistance, which implies impairment of insulin signaling in the target tissues, is a common cause of type 2 diabetes. Adipose tissue plays an important role in insulin resistance through the dysregulated production and secretion of adipose-derived proteins, including tumor necrosis factor-α, plasminogen activator inhibitor-1, leptin, resistin, angiotensinogen, and adiponectin. Adiponectin was estimated to be a protective adipocytokine against atherosclerosis, and also to have an anti-inflammatory effect. In this study, the relationship between fasting plasma adiponectin concentration and adiposity, body composition, insulin sensitivity (ITT, HOMAIR, QUICK), lipid profile, fasting insulin concentration were examined in Korean type 2 diabetes. The difference in the adiponectin concentrations was also examined in diabetic and non-diabetic subjects, with adjustment for gender, age and body mass index. 102 type 2 diabetics and 50 controls were examined. After a 12-h overnight fast, all subjects underwent a 75gram oral glucose tolerance test. Baseline blood samples were drawn for the determinations of fasting plasma glucose, insulin, adiponectin, total cholesterol, triglyceride, LDL-cholesterol, and HDL-cholesterol. The body composition was estimated using a bioelectric impedance analyzer (Inbody 2.0). The insulin sensitivity was estimated using the insulin tolerance test (ITT), HOMAIR and QUICK methods. In the diabetic group, the fasting adiponectin concentrations were significantly lower in men than in women. They were negatively correlated with BMI (r=-0.453), hip circumference (r=-0.341), fasting glucose concentrations (r=-0.277) and HOMAIR (r=-0.233). In addition, they were positively correlated with systolic blood pressure (r=0.321) and HDL-cholesterol (r=0.291). The systolic blood pressure and HDL-cholesterol were found to be independent variables, from a multiple logistic regression analysis, which influenced the adiponectin concentration. Compared with the non-diabetic group, the adiponectin concentrations were significantly lower in the diabetic group, with the exception of obese males. In conclusion, the plasma adiponectin concentrations were closely related to the insulin resistance parameters in Korean type 2 diabetic patients.

Irritable Bowel Syndrome Is More Common in Women Regardless of the Menstrual Phase: A Rome II-based Survey

Functional gastrointestinal disorders are more common in women in relation to the fluctuations of female sex hormones. We tried to know the gender-related differences in the prevalence of irritable bowel syndrome and gastrointestinal symptoms according to the menstrual phase. A total of 253 women before menopause and 252 men below age 50 were examined by a gastroenterologist after completing the questionnaire. Blood tests, endoscopic procedures, and imaging studies were done, if needed. Women were subclassified into three groups according to their menst- ruation period; menstrual phase, proliferative phase, and secretory phase. Finally, 179 men and 193 women were analyzed. Irritable bowel syndrome was more frequently noticed in women than in men (p=0.01). The diarrhea-dominant type was more common in men, while constipation-dominant or alternating types were more common in women (p<0.001). Of 193 women, there was no significant difference in their gastrointestinal symptoms according to their menstrual phase. Regardless of the menstrual phase, gastrointestinal symptoms are more frequent in women. Physicians should consider different symptomatic manifestations between men and women should be considered when evaluating functional gastrointestinal disorders.

Does a small biopsied gastric specimen limit the usage of two directional transnasal esophagogastroduodenoscopy

Background and Aims:  It is difficult to approach certain gastric regions due to the limited bending ability of transnasal esophagogastroduodenoscopy (TN‐EGD). We analyzed the TN‐EGD biopsied specimens according to where they were obtained inside the stomach.

M1923 Gastric Cancers With Microsatellite Instability Exhibits Higher Standard Uptake Values on FDG-PET Imaging Study

G A A b st ra ct s included patients was 10.21 for CD31 and 11.85 for CD34 in all patients, while VEGF was positive only in 18 patients (45%). The microvessel density was higher in patients with advanced TNM stage, as assessed by both methods (CD31, CD34). Moreover, there was a correlation between the microvessel density and the risk of UGIB (p=0.0436 for CD31 and p=0.0138 for CD34, respectively). VEGF expression was well correlated with TNM stage (especially with the M stage, p<0.0001) and also with the risk of upper GI bleeding (p= 0.0138).Survival rate after first year of follow-up was 37.5% and 30% respectively after two years of follow-up. Survival rate was positively correlated with MVD (reaching statistical significance), while VEGF expression was not correlated with survival rate.Conclusions: According to the results of our study, MVD was involved in local advanced disease, while VEGF was correlated to distant metastasis in gastric cancer patients. There was a clear correlation between VEGF, MVD and the risk of upper GI bleeding. However, the result of our study should be confirmed in future studies with a large number of patients included and preferably multicentric design.

Importance of the Surrounding Colonic Mucosa in Distinguishing Between Hyperplastic and Adenomatous Polyps During Acetic Acid Chromoendoscopy

AIM To examine the characteristics of colonic polyps, where it is difficult to distinguish adenomatous polyps from hyperplastic polyps, with the aid of acetic acid chromoendoscopy. METHODS Acetic acid spray was applied to colonic polyps smaller than 10 mm before complete excision. Endoscopic images were taken before and 15-30 s after the acetic acid spray. Both pre- and post-sprayed images were shown to 16 examiners, who were asked to interpret the lesions as either hyperplastic or adenomatous polyps. Regression analysis was performed to determine which factors were most likely related to diagnostic accuracy. RESULTS In 50 cases tested by the 16 examiners, the overall accuracy was 62.4% (499/800). Regression analysis demonstrated that surrounding colonic mucosa was the only factor that was significantly related to accuracy in discriminating adenomatous from hyperplastic polyps (P < 0.001). Accuracy was higher for polyps with linear surrounding colonic mucosa than for those with nodular surrounding colonic mucosa (P < 0.001), but was not related to the shape, location, or size of the polyp. CONCLUSION The accuracy of predicting histology is significantly related to the pattern of colonic mucosa surrounding the polyp. Making a histological diagnosis of colon polyps merely by acetic acid spray is helpful for colon polyps with linear, regularly patterned surrounding colonic mucosa, and less so for those with nodular, irregularly patterned surrounding colonic mucosa.