Weon-Seon Hong

Incidence and prevalence of ulcerative colitis in the Songpa-Kangdong district, Seoul, Korea, 1986-1997.

Background and Aims : Ulcerative colitis (UC) is regarded as a rare disease in developing countries, but accurate data are generally lacking. We performed the present study to evaluate the incidence and prevalence of UC in Korea.

Appendiceal orifice inflammation as a skip lesion in ulcerative colitis: an analysis in relation to medical therapy and disease extent☆☆☆

BACKGROUND Although several reports have claimed that the appendix can be involved as a skip lesion in ulcerative colitis, they do not exclude the possibility that this skip lesion occurs as a result of medical therapy. Also, little is known about the relation between the presence of appendiceal orifice inflammation and the extent of the disease. METHODS The presence of appendiceal orifice inflammation was prospectively assessed both endoscopically and histologically in 94 patients with active ulcerative colitis, the extent of whose disease had not been beyond the hepatic flexure. To evaluate the effect of prior medical therapy on the prevalence of appendiceal orifice inflammation, all cases were divided into two groups. Group A consisted of 66 patients who had been treated before inclusion; group B was composed of 28 patients newly diagnosed at inclusion. RESULTS Appendiceal orifice inflammation was diagnosed in 24 (26%) of 94 patients with active subtotal ulcerative colitis, with no statistical difference observed between group A (23%) and group B (32%). In all 94 patients, the frequency of appendiceal orifice inflammation decreased significantly as the extent of disease increased, i.e., 37% in proctitis (n = 49), 17% in left-sided colitis (n = 36), and 0% in extensive colitis (n = 9) (p < 0.05). CONCLUSIONS Appendiceal orifice inflammation as a skip lesion of ulcerative colitis is not rare, is more frequently observed in patients with less extensive disease, and is not the result of patchy improvement due to medical therapy.

Screening colonoscopy in asymptomatic average-risk Koreans : Analysis in relation to age and sex

Background and Aims:  Although the incidence of colorectal cancer is rising in Asian countries, there are no guidelines for its screening in this region due in part to the lack of epidemiological data regarding colorectal neoplasms. This study aimed to evaluate the prevalence of colorectal neoplasms in average‐risk Koreans and to assess the effectiveness of screening colonoscopy in Korea.

Clinical course of distal ulcerative colitis in relation to appendiceal orifice inflammation status

Background: Although appendiceal orifice inflammation (AOI) is frequently observed as a skip lesion of ulcerative colitis (UC), its clinical significance is not clearly understood. We aimed to evaluate whether AOI is associated with the clinical course of UC. Methods: Ninety‐four patients with newly diagnosed distal UC were prospectively enrolled at the Asan Medical Center between March 1996 and October 2002. Clinical features and colonoscopic findings during the follow‐up period were analyzed in relation to initial AOI status. Results: Forty‐eight patients were found to be initially AOI‐positive and 46 to be initially AOI‐negative. We found no difference in the baseline demographics and clinical characteristics between these two groups. The median follow‐up periods for AOI‐positive and AOI‐negative groups were 45 and 41 months, respectively. Clinical remission was achieved in all patients of each group. The cumulative risk of relapse at 1, 3, and 5 years after remission was 31.2%, 59.8%, and 69.2%, respectively, in the AOI‐positive group and 17.4%, 46.5%, and 67.2%, respectively, in the AOI‐negative group (P = 0.124). The cumulative risk of proximal disease extension at 1, 3, and 5 years after diagnosis was 17.9%, 24.9%, and 44.5%, respectively, in the AOI‐positive group and 9.8%, 21.5%, and 43.9%, respectively, in the AOI‐negative group (P = 0.522). Proctocolectomy was performed in no patients in the AOI‐positive group and in 1 patient in the AOI‐negative group. No mortalities were observed in either group. Conclusions: In patients with distal UC, AOI may have no prognostic implications in terms of remission, relapse, or proximal disease extension.

A Prospective Analysis of Low‐Grade Gastric MALT Lymphoma after Helicobacter pylori Eradication

Background:  Primary gastric low‐grade B‐cell lymphoma of mucosa‐associated lymphoid tissue (MALT lymphoma) is known to be successfully treated with anti‐Helicobacter pylori (H. pylori) therapy alone. However, there are few reports on long‐term results after eradication therapy. The aims of this study were to analyze the rate and the interval to reach complete remission (CR), and to assess the rate and the factors affecting recurrence of MALT lymphoma.

ZINC DEFICIENCY MANIFESTED BY DERMATITIS AND VISUAL DYSFUNCTION IN A PATIENT WITH CROHN'S DISEASE

Abstract: We report a case of Crohns disease with low serum zinc concentration in a 26-year-old woman. She demonstrated acrodermatitis enteropathica and decreased visual acuity during total parenteral nutrition. Subsequent intravenous zinc supplementation resulted in alleviation of the skin lesions and improvement of visual acuity. This case supports the notion that depressed serum zinc in Crohns disease may cause clinical manifestations, such as acrodermatitis enteropathica and retinal dysfunction, which may be correctable with zinc supplementation.

Intestinal tuberculosis with abdominal complications: radiologic and pathologic features

AbstractBackground: To investigate radiologic and pathological features of intestinal tuberculosis with abdominal complications. Methods: Twenty-two patients with 23 surgically proven complications (nine intestinal obstructions, eight perforations, three fistulae, and three intestinal bleeds) were analyzed. Medical records, radiologic studies, and pathologic examinations were reviewed with special emphasis on searching for the common features in each group of complication. Results: The most important single feature in seven of the nine patients with intestinal obstruction was the presence of stricture. In the remaining two patients, bowel adhesion was a primary cause of obstruction. In eight patients with intestinal perforation, both obstruction and ulcerations in the dilated proximal loop were the important features in six, and multiple deep ulcerations without obstruction was a primary cause in the remaining two. The common features in three patients with fistulae were focal or multiple strictures, severe adhesions, and fibrotic bowel wall. Intestinal bleeding originated from diffuse mucosal ulcerations. The abdominal complications occurred during antituberculous therapy in 10 of the 22 patients. Conclusion: Understanding the radiologic and pathologic features of intestinal tuberculosis with complications help in making an appropriate clinical decision for the treatment strategy. Close observation is necessary, especially in those patients who are acutely ill during antituberculous medical therapy.

HLA-DRB1*1502 confers susceptibility to ulcerative colitis, but is negatively associated with its intractability: a Korean study.

Abstract.Background and aims: Several studies have documented the high incidence of several HLA class II alleles in Japanese patients with ulcerative colitis (UC). Although the characteristics of the HLA system in Koreans are quite similar to those in the Japanese, it is not clear whether the HLA pattern in Korean UC is similar to that in Japanese UC. We investigated an association between HLA class II genes and UC patients and the clinical meaning of these genes in Korea. Patients and methods: Unrelated Korean patients with UC (n=70) and ethnically matched unrelated controls (n=182) were genotyped for HLA-DR by PCR followed by reverse hybridization using sequence-specific oligonucleotide probes. The clinical characteristics of the patients were analyzed with regard to anti-neutrophil cytoplasmic antibody (ANCA) status and total colectomy for intractability. Results: HLA-DR2 and DRB1*1502 were found significantly more frequently in patients (42.9% and 21.4%) than controls (20.3% and 5.5%). DRB1*1502 was more frequent in p-ANCA-positive (5/23) than in p-ANCA-negative (1/11) patients. Total colectomy for intractability was performed more commonly in patients without DRB1*1502 (14/55) than in those with it (0/15). Conclusions: Our data are consistent with those of Japanese studies in that DR2 and DRB1*1502 are positively associated with UC patients. In contrast to the Japanese study, however, our results demonstrates that DRB1*1502 is negatively associated with the risk of colectomy in Korean patients with UC.

Clinicopathological significance of vascular endothelial growth factor-C and cyclooxygenase-2 in esophageal squamous cell carcinoma.

Background:  Vascular endothelial growth factor‐C (VEGF‐C) is a specific growth factor of lymphatics, which is known to play some role in tumor growth and metastasis to lymph nodes and distant organs in various malignancies. The purpose of the present study was to investigate the expression of VEGF‐C in human esophageal squamous cell carcinomas (ESCC) to elucidate its role in tumor progression and lymph node metastasis. Another aim of the study was to investigate the relation between VEGF‐C and cyclooxygenase‐2 (COX‐2) in ESCC.

The Increased Expression of an Array of C-X-C and C-C Chemokines in the Colonic Mucosa of Patients With Ulcerative Colitis: Regulation by Corticosteroids

OBJECTIVE:To better understand the extent to which chemokines participate in the mucosal inflammatory response in patients with ulcerative colitis (UC), we assessed the expression of an array of chemokines in the colonic mucosa of UC patients and evaluated the effect of corticosteroids on their expression.METHODS:Colonic mucosal biopsy specimens were obtained from 15 patients with UC and 12 normal controls. Messenger RNA levels for 10 chemokines were quantitated by reverse transcription polymerase chain reaction using synthetic standard RNAs. The biopsy specimens were also cultured in the presence or absence of tumor necrosis factor α (TNFα) and/or dexamethasone, and secreted chemokines in culture supernatants were assayed by ELISA.RESULTS:The messenger RNA expression of C-X-C (interleukin 8, growth-related α [GROα], GROβ, GROγ, epithelial cell-derived neutrophil activator 78, and interferon-γ-inducible protein 10) and C-C (monocyte chemotactic protein 1, macrophage inflammatory protein 1β, and RANTES [regulated on activation, normal T-cell expressed and secreted]) but not C (lymphotactin) chemokines was significantly higher in the affected mucosa of UC patients than in the unaffected mucosa of UC patients or in the normal mucosa of normal controls. The degree of increased expression was more prominent in the C-X-C than in the C-C chemokines. Further, the secretion of interleukin 8, GROα, epithelial cell-derived neutrophil activator 78, and monocyte chemotactic protein 1 was higher in UC patients than in normal controls, induced significantly by TNFα, and downregulated by dexamethasone. Secretions of macrophage inflammatory protein 1β and RANTES also showed a trend toward an increase in UC, induction by TNFα, and downregulation by dexamethasone, but it did not reach statistical significance.CONCLUSIONS:The increased expression of a variety of chemokines in UC and their downregulation by dexamethasone suggest that chemokines may play an important role in the immunopathogenesis of UC.