Won Sohn

Effect of multispecies probiotics on irritable bowel syndrome: A randomized, double-blind, placebo-controlled trial

The efficacy of treatment with multispecies probiotics on irritable bowel syndrome (IBS) symptoms and the alterations of gut microbiota in patients who have taken probiotics were investigated.

Mast cell number, substance P and vasoactive intestinal peptide in irritable bowel syndrome with diarrhea

Abstract Background. Recent studies have shown that mast cells play an important role in irritable bowel syndrome (IBS). We investigated the relationship between mast cells and the gut hormones substance P and vasoactive intestinal peptide (VIP) in irritable bowel syndrome with diarrhea (IBS-D). Methods. Colonoscopic biopsies were performed on the rectal mucosa of 43 subjects (IBS-D patients: 22, healthy volunteers: 21) diagnosed according to the Rome III criteria. Mast cells, and substance P & VIP were evaluated by quantitative immunohistology and image analysis. Mast cells were counted as tryptase-positive cells in the lamina propria, and substance P and VIP levels were expressed as percentages of total areas of staining. Results. Mast cell counts were higher in IBS-D patients than healthy volunteers (9.6 ± 3.3 vs. 5.7 ± 2.5/high power field (HPF), p < 0.01). Substance P was also elevated (0.11 ± 0.08% vs. 0.03 ± 0.02 %, p < 0.01) while VIP was only high in women with IBS-D. Mast cell counts were positively correlated with levels of substance P & VIP in women but not men (women: r = 0.625, p < 0.01 for substance P and r = 0.651, p < 0.01 for VIP). However, mast cell counts were not correlated with IBS symptoms including abdominal pain. Conclusion. Mast cells are activated leading to the raised levels of substance P & VIP in IBS-D patients. However, the correlation between mast cells and levels of substance P & VIP differs according to gender.

Upper limit of normal serum alanine and aspartate aminotransferase levels in Korea.

Background and Aim:u2002 The widely accepted range of upper limits of normal (ULN) alanine aminotransferase (ALT) levels (ULNu2003<u200340u2003U/L) was recently challenged by several reports. Both ALT and aspartate aminotransferase (AST) are commonly used as surrogate markers of liver disease, but almost all studies of aminotransferase activity were conducted on ALT. We investigated not only ULN of ALT but also AST activity and to identify factors modulating them in healthy Korean.

The Relationship Between Existence of Typical Symptoms and Psychological Factors in Patients With Erosive Esophagitis

Background/Aims In Asian countries including Korea, the prevalence of gastroesophageal reflux disease (GERD) is on the rise and its clinical impact has been emphasized. The purpose of this study was to investigate the clinical characteristics of esophagitis patients with or without symptoms, and their association with psychological factors. Methods Subjects diagnosed as erosive esophagitis of Los Angeles-A or more in screening by upper gastrointestinal endoscopy were enrolled. Questionnaires regarding GERD symptoms and Symptom Checklist-90-Revision were used to identify the presence of psychological symptoms. Results There was no difference between the subjects general characteristics (gender, age, body mass index, smoking and alcohol intake) according to the existence of typical symptoms in these patients with erosive esophagitis. Patients with typical GERD symptoms were more likely to have atypical symptoms, dyspepsia and higher scores on psychological symptoms (somatization, obsessive-compulsiveness and phobic anxiety) than those without. Conclusions Psychological symptoms and other gastrointestinal symptoms should be considered in the patients with erosive esophagitis.

Association between Symptoms of Irritable Bowel Syndrome and Methane and Hydrogen on Lactulose Breath Test

Whether hydrogen and methane gas produced during lactulose breath test (LBT) are associated with symptoms of irritable bowel syndrome (IBS) is not determined. We aimed to investigate whether hydrogen and methane on LBT are associated with IBS symptoms. Sixty-eight IBS patients meeting the Rome III criteria for IBS, and 55 healthy controls, underwent LBT. The IBS subjects recorded their customary gastrointestinal symptoms on a questionnaire using visual analogue scales. LBT positivity was defined to be above 20 ppm rise of hydrogen or 10 ppm rise of methane within 90 min. Gas amounts produced during LBT were determined by calculating area under the curve of hydrogen and methane excretion. Symptom severity scores were not different between the LBT (+) IBS and LBT (-) IBS subjects and also between methane producers and non-methane producers. Gas amounts produced during LBT were not associated with IBS symptoms, except a weak correlation between total gas amounts and a few IBS symptoms such as bloating (r = 0.324, P = 0.039), flatulence (r = 0.314, P = 0.046) and abdominal pain (r = 0.364, P = 0.018) only in LBT (+) IBS. In conclusion, hydrogen and methane gas on LBT are not useful for predicting the customary symptoms and subtypes of IBS.

Duodenal involvement in multiple myeloma.

A 48-year-old man presented with a 1-week history of pigastric pain and dyspepsia. Multiple myeloma with monolonal gammopathy was diagnosed 1 year previously, and he as treated with chemotherapy and autologous bone marrow ransplantation. Until recently, he had received high dose oral examethasone and his disease was in remission according to ll clinical and laboratory data. Esophago-gastro-duodenoscopy howed a huge ulcerative mass in the second portion of the duoenum (Fig. 1A). A biopsy was performed: on light microscopy, here was diffuse infiltration of atypical plasma cells in the uodenal mucosa that mimicked malignant lymphoma histologcally (Fig. 2A, H & E, ×400). On immunohistochemical staining, he neoplastic plasma cells were diffusely positive for CD138 Fig. 2B) and negative for CD20 and CD3. Abdominal computer omography demonstrated a huge mass in the second duodenal ortion (Fig. 1B; arrow) and multiple lymphadenopathies in the eriduodenal, portocarval, peripancreatic, and aortocaval areas. uodenal involvement of multiple myeloma with lymphadenopahy was diagnosed, and radiotherapy and chemotherapy were nitiated. Duodenal involvement of multiple myeloma is rare. Several eports have suggested that extramedullary relapses can occur in he absence of systemic progression after bone marrow transplanation [1]. The possibility of gastrointestinal involvement should e considered in myeloma patients presented with gastrointestinal ymptoms regardless of disease state or previous therapy modality.