Hye-Won Park

Endoscopic submucosal dissection for treatment of rectal carcinoid tumors

BACKGROUND Conventional EMR has been the endoscopic treatment of choice for rectal carcinoid tumors. However, histologically complete resection often cannot be achieved because the carcinoid tumors are located mainly in the submucosal layer. Endoscopic submucosal dissection (ESD), a new method for large colorectal neoplasm resection, may overcome this problem. OBJECTIVE To compare ESD with EMR for the endoscopic treatment of rectal carcinoid tumors. DESIGN A prospective case series with comparison to retrospective controls. SETTING Tertiary-care center. PATIENTS From January 2007 to January 2009 we prospectively enrolled consecutive patients with rectal carcinoid tumors less than 16 mm in diameter and with no regional lymph node enlargement shown by CT or EUS. For comparison, we retrospectively randomly selected patients who had undergone EMR for treatment of rectal carcinoid tumors between March 2000 and December 2006. INTERVENTION We performed ESD of rectal carcinoid tumors in prospectively enrolled patients. MAIN OUTCOME MEASUREMENTS Rate of en bloc resection, rate of histologically complete resection, incidence of complications, and length of procedures. RESULTS The ESD group contained 31 patients (18 male, 13 female; age range 34-65 years), and the EMR group contained 62 patients (42 male, 20 female; age range 22-77 years). Both groups had similar mean rectal carcinoid tumor diameters (ESD 6.8 +/- 2.4 mm, EMR 7.3 +/- 2.2 mm; P = .106). Resection time was longer in the ESD group than in the EMR group (11.4 +/- 3.7 minutes vs 4.2 +/- 3.2 minutes, P < .001). The en bloc resection rate was 100% (31 of 31) in the ESD group and 95.2% (59 of 62) in the EMR group (P = .213). The histologically complete resection rate was 90.3% (28 of 31) in the ESD group and 71.0% (44 of 62) in the EMR group (P = .035). Suspected perforation occurred in 1 ESD patient (3.2%) and in 1 EMR patient (1.6%), and both patients were successfully managed by conservative measures. Immediate bleeding occurred in 1 ESD patient (3.2%) and in 4 EMR patients (6.5%); all instances of bleeding were controlled endoscopically. LIMITATIONS Retrospective control study and limited experience at a single center. CONCLUSION Compared with EMR, ESD resulted in a higher histologically complete resection rate, had a similar complication rate, and took slightly longer to perform. Given the advantages of complete resection, these findings indicate that ESD may be considered for treatment of rectal carcinoid tumors.

Colorectal Neoplasm in Asymptomatic Average-risk Koreans: The KASID Prospective Multicenter Colonoscopy Survey

BACKGROUND/AIMS The incidence of colorectal cancer is increasing in Korea, but the epidemiology of colorectal neoplasm is not clearly defined. We aimed to elucidate the prevalence of colorectal neoplasm in average-risk Koreans and explore the underlying risk factors. METHODS A large-scale, multicenter, prospective study was conducted. Of the 19,460 subjects who underwent colonoscopy at 11 university hospitals, we analyzed 3,951 consecutive asymptomatic adults with no risk factors for colorectal cancer. RESULTS The subjects were aged 52.1+/-11.6 years (mean+/-SD) and 60.1% of them were men. The prevalences of colorectal neoplasm and advanced neoplasm were 33.3% and 2.2%, respectively. The prevalence of a neoplasm increased with age (trend: p<0.001) and was higher in males (p<0.001). The prevalence of a proximal neoplasm was higher in subjects with a distal neoplasm than in those without a distal neoplasm (11.9% vs. 5.4%, p<0.001). However, 150 (52.1%) of the 288 subjects with a proximal neoplasm had no distal neoplasm. CONCLUSIONS The overall prevalence of colorectal neoplasm in asymptomatic average-risk Koreans is comparable with that in Western countries. Being male and older are associated with a higher risk of colorectal neoplasm. Over half of proximal neoplasms are not associated with any distal sentinel lesions.

The prevalence and risk factors associated with isolated untreated systolic hypertension in Korea: the Korean National Health and Nutrition Survey 2001.

Although isolated systolic hypertension (ISH) increases the risk of coronary heart disease and stroke, more than any other hypertension subtype, the prevalence and risk factors associated with ISH in the Korean population are not known. The 2001 Korean National Health and Nutrition Survey was a cross-sectional and nationally representative survey conducted in 2001. The prevalence of ISH by age and body mass index (BMI) was examined in 6601 Korean adults over 20 years of age. After adjusting for age, 4.32±0.32% of Korean adults had ISH, 5.28±0.37% had isolated diastolic hypertension and 5.82±0.36% had systolic/diastolic hypertension. The overall prevalence of ISH was found to increase directly with advancing age and increasing BMI. Although the ISH was found to be more common in men overall (4.81±0.50% in men, 4.12±0.37% in women), it was more common in women over 70 years of age. Independent variables associated with risk for ISH included advanced age, BMI, triglyceride (TG) levels, monthly income and alcohol intake. However, gender, fasting blood glucose, total cholesterol and high-density lipoprotein cholesterol levels, residential area, education level and smoking were found not to be significantly associated with ISH risk. The findings of the present study demonstrate that the prevalence of untreated ISH in Korea was lower than in Western countries. Age, BMI, TG levels, monthly income and alcohol intake were associated with ISH.

Isolated terminal ileal ulcerations in asymptomatic individuals: natural course and clinical significance

BACKGROUND Although isolated terminal ileal ulcerations (ITIUs) are occasionally observed on colonoscopic examination of asymptomatic individuals, their clinical course and guidelines for treatment are unclear. OBJECTIVE To evaluate the clinical course and significance of ITIUs in asymptomatic individuals. DESIGN Single-center retrospective analysis. SETTING University hospital. PATIENTS AND INTERVENTIONS All patients diagnosed with ITIUs on colonoscopy from July 2001 to December 2007 were identified. Patients with colorectal symptoms, a history of nonsteroidal anti-inflammatory drug consumption, a history of colorectal surgery, oral or genital ulcerations, and coincidental ulceration in the ileocecal valve or colon were excluded. MAIN OUTCOME MEASUREMENTS Colonoscopic findings and clinical courses of patients were analyzed. RESULTS Of the 148 included patients, 93 were followed (mean duration, 29.9 months). Of these, 62 showed resolution of ITIU on follow-up colonoscopy, including 60 who resolved without any treatment and 2 who resolved after antituberculosis medication. Follow-up colonoscopy continued to show ITIUs in the remaining 31 patients, only 1 of whom developed typical Crohns disease, whereas the other 30 showed no significant changes in the lesions (n = 22), partial improvement (n = 6), or waxing and waning endoscopic appearance (n = 2). LIMITATIONS Retrospective design, relatively short-term follow-up. CONCLUSIONS Most ITIUs incidentally observed in asymptomatic individuals resolve without any treatment. Even if these lesions persist, it is unusual for them to progress or to cause any symptoms.

High Maternal Blood Mercury Level Is Associated with Low Verbal IQ in Children

The objective of the present study was to investigate the relationship of IQ in children with maternal blood mercury concentration during late pregnancy. The present study is a component of the Mothers and Childrens Environmental Health (MOCEH) study, a multi-center birth cohort project in Korea that began in 2006. The study cohort consisted of 553 children whose mothers underwent testing for blood mercury during late pregnancy. The children were given the Korean language version of the Wechsler Preschool and Primary Scale of Intelligence, revised edition (WPPSI-R) at 60 months of age. Multivariate linear regression analysis, with adjustment for covariates, was used to assess the relationship between verbal, performance, and total IQ in children and blood mercury concentration of mothers during late pregnancy. The results of multivariate linear regression analysis indicated that a doubling of blood mercury was associated with the decrease in verbal and total IQ by 2.482 (95% confidence interval [CI], 0.749–4.214) and 2.402 (95% CI, 0.526–4.279), respectively, after adjustment. This inverse association remained after further adjustment for blood lead concentration. Fish intake is an effect modifier of child IQ. In conclusion, high maternal blood mercury level is associated with low verbal IQ in children.

Basal and residual lower esophageal pressures increase in old age in classic achalasia, but not vigorous achalasia

Background and Aim:  The relationship between age and esophageal motility parameters (i.e. basal and residual pressure of the lower esophageal sphincter [LES]) remains to be established in achalasia patients, possibly because most previous studies did not distinguish between classic and vigorous achalasia patients. We investigated the relationship between age and esophageal motility parameters in both classic and vigorous achalasia patients.

Effect of Breastfeeding Duration on Cognitive Development in Infants: 3-Year Follow-up Study

We investigated the association between breastfeeding and cognitive development in infants during their first 3 years. The present study was a part of the Mothers’ and Children’s Environmental Health (MOCEH) study, which was a multi-center birth cohort project in Korea that began in 2006. A total of 697 infants were tested at age 12, 24, and 36 months using the Korean version of the Bayley Scales of Infant Development II (K-BSID-II). The use and duration of breastfeeding and formula feeding were measured. The relationship between breastfeeding and the mental development index (MDI) score was analyzed by multiple linear regression analysis. The results indicated a positive correlation between breastfeeding duration and MDI score. After adjusting for covariates, infants who were breastfed for ≥ 9 months had significantly better cognitive development than those who had not been breastfed. These results suggest that the longer duration of breastfeeding improves cognitive development in infants.

Removal of Pesticides during Washing and Cooking of Rice

In this study, the pesticide residues of polished rice and brown rice were measured after washing and cooking process. The initial concentrations of isoprothiolane and fthalide were and for polished rice, and and for brown rice, respectively. After first washing process, the removal rates of isoprothiolane were 23.0% (polished rice) and 18.5% (brown rice). Also, the case of fthalide, the removal rates were 14.0% and 9.7%, respectively. The removal dose was increased, but the removal rate was decreased in proportion to the number of washing process, After the cooking process, the removal rates of isoprothiolane and fthalide were 66.0% and 79.0% (polished rice), and 88.7% and 92.9% (brown rice), respectively. The removal rate of isoprothiolane was higher in the washing process, and the case of fthalide was higher in the cooking process. The optimum washing process for the pesticides removal was five times and the cooking process was the most effective to use the new water after soaking the rice in water during 30 minutes.

Trends in type 2 diabetes prevalence according to income levels in Korea (1998–2012)

There was no significant association between diabetes prevalence and income levels for either sex in 1998. However, the high income level in men and the low income level in women positively related to the odds of diabetes in 2011-2012. Preventive strategies for diabetes should consider the gender-specific economic discrepancy.

A Study on the Travel Fashion Bag Design Using the Op-Art Textile Patterns -Applying the Artwork of Victor Vasarely-

This study with `trip` as a theme, aims to develop textile designs and fashion bags for travel which is widely applicable fitting traveler`s T P O, applying Victor Vasarely`s artwork. During the planning process of design, `Whenever & Wherever`s concept was set by analyzing fashion trend information in 2010-11 F/W proposed by Interfashion Planning and FCK; in addition, `Bobos` were selected as research targets. It organized 4 images of `Modern`, `Romantic`, `Classic` and `Fantastic`. The motives are proposed textile design with ``, `Falling Z`, `Cir-Classicism` and `Skinny-holic` per each theme. The designs developed were printed out and into polyester canvas with a Polaris V6 DTP from dgen, Corp. Textile designs developed were applied for `two-way` formed fashion bags for traveling with high practicality. Fashion bags for traveling consisted of big bags, tote bags, and hip sacks; a total of 12 works (4 sets per theme) were produced. This study sought practical plans for artworks by producing fashion goods through a DTP system. The results of this study can be used as guidelines for further studies and as a significant contribution to the creation of high values for exciting fashion products.