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GST Primary GST Primary Best Strategies for Health Care Quality Im... Best Strategies for Health Care Quality Improvement - Diabetes Quality Improvement Strategies for Antibio... Kathryn McDonald, Stanford-UCSF Evidence-b... Systematic review assessing the effect of ... Quality Improvement Strategies for Antibiotics Management Kathryn McDonald, Stanford-UCSF Evidence-based Practice Center, 117 Encina Commons, Stanford, CA 94305-6019, Kathy.mcdonald@stanford.edu Systematic review assessing the effect of quality improvement strategies on appropriate prescribing of antibiotics and appropriate choice of antibiotics. Adherence Adherence Assistive Devices Assistive Devices Childhood Burn Hanson MacMillan Childhood Burn Hanson MacMillan CLSA_9 CLSA_9 Cyberabuse Cyberabuse Cognitive Behavioural Therapy for Violent ... This review included randomized trials abo... Cognitive Behavioural Therapy for Violent Men who Batter Their Partners This review included randomized trials about the effects of cognitive behavioral therapy on domestic violence. The intervention included programs based on the Duluth Model. The violence had to be committed by a male toward his female partner. The violence also had to be physical. The primary outcomes were new arrests and convictions, and new reports of violence. CABG vs PCI CABG vs PCI Quality Improvement Strategies for Prevent... Quality Improvement Strategies for Preventing Nosocomial Infections (Created 17-Feb-06) Quality Improvement Strategies for Asthma ... Quality Improvement Strategies for Asthma Control Erectile Dysfunction (Created 30-Jan-06) Erectile Dysfunction (Created 30-Jan-06) Inequality - Smoking Cessation to Reduce S... This review was the first part of a projec... Inequality - Smoking Cessation to Reduce Socio-Economic Differences This review was the first part of a project about inequality. It included randomized trials about the effect of smoking cessation interventions on reducing socio-economic differences. The studies had to report data either on persons with low socio-economic groups status or, preferably, on both low and high socio-economic groups. Diet and Physical Activity to Reduce Socio... This review was the second part in a proje... Diet and Physical Activity to Reduce Socio-Economic Differences This review was the second part in a project about inequality. It included randomized trials about the effect of interventions on reducing socio-economic differences in diet and physical activity. The studies had to report data either on persons with low socio-economic groups status or, preferably, on both low and high socio-economic groups. Workfare The data in SRS are not identical to the d... Workfare The data in SRS are not identical to the data in the published report. We used SRS only for an updated search. The review included randomized trials about the effect of welfare-to-work programs. Participants were welfare recipients. There were basically two types of programs. The educational type tried to build knowledge and skills in order to help the welfare recipients acquire jobs that could support them economically. The "work first" approach was more aimed at getting the participants quickly into a job. Exercise interventions for the management ... The objective of this systematic review wa... Exercise interventions for the management of frailty The objective of this systematic review was to examine the effectiveness of current exercise interventions on the management of frailty. A comprehensive search of Medline, Embase, Psycinfo, Cinahl, Scopus, Ageline, Eric, and SportDiscus databases was conducted and produced 1808 citations. So far we have completed 2 levels of “title and abstract” screening and we ended up with 262 articles. We have just started the full text screening. Eligibility criteria included original studies whose participants were identified as frail or prefrail with specific criteria and in which structured physical activity was included as at least one component of the intervention. Create a free account, build a dictionary with saved terms to re-use later! Public Domestic Violence - Using Cognitive Behavior Therapy Smoking Cessation to Reduce Socio-Economic Differences Diet and Physical Activity to Reduce Socio-Economic Differences Workfare Exercise Interventions for the Management of Frailty Search     Simple Advanced Refine (4 coded questions)  Any of these:   Exact Phrase: All of these: None of these: Author: Periodical: Projects: No restrictions   Libraries: Public   Select SRS Projects Show Saved Terms Select Library Show articles that do not have abstracts  Type of Article Clinical Trial Editorial Letter Meta-Analysis Practice Guideline Randomized Controlled Trial Review Addresses Bibliography Biography Case Reports Classical Article Clinical Conference Clinical Trial, Phase I Clinical Trial, Phase II Clinical Trial, Phase III Clinical Trial, Phase IV Comment Comparative Study Consensus Development Conference Consensus Development Conference, NIH Controlled Clinical Trial Corrected and Republished Article Dictionary Directory Duplicate Publication English Abstract Evaluation Studies Festschrift Government Publications Guideline Historical Article Interview In Vitro Journal Article Lectures Legal Cases Legislation Multicenter Study News Newspaper Article Overall Patient Education Handout Periodical Index Published Erratum Retracted Publication Research Support, N.I.H., Extramural Research Support, N.I.H., Intramural Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, Non-P.H.S. 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Retraction of Publication Scientific Integrity Review Support of Research Technical Report Twin Study Validation Studies Not a Primary Study or Review Unknown Primary Study Case Series Case Control Cohort Study Observational Study Qualitative Research CBA or ITS Registry Double Blind Controlled before after study Quasi-randomized trial Simple before after study Cluster-RCT Non-Randomized Study Report Book Book chapter Dissertation Conference procedings Secondary Research Not RCT Humans or Animals Humans Animals Ages All Infant: birth-23 months All Child: 0-18 years All Adult: 19+ years Newborn: birth-1 month Infant: 1-23 months Preschool Child: 2-5 years Child: 6-12 years Adolescent: 13-18 years Adult: 19-44 years Middle Aged: 45-64 years Middle Aged + Aged: 45+ years Aged: 65+ years 80 and over: 80+ years Undetermined Language English French German Italian Japanese Russian Spanish Afrikaans Albanian Unknown Arabic Armenian Azerbaijani Bosnian Bulgarian Catalan Chinese Croatian Czech Danish Dutch Esperanto Estonian Finnish Georgian Greek, Modern Hebrew Hindi Hungarian Icelandic Indonesian Kinyarwanda Korean Latin Latvian Lithuanian Macedonian Malay Malayalam Maori Multiple Languages Norwegian Persian Polish Portuguese Pushto Romanian Sanskrit Scottish gaelic Serbian Slovak Slovenian Swedish Thai Turkish Ukrainian Vietnamese Not English Not French Results(1-25 of 3,038) Sort By: Publication Date Relevance Took: 0.483 seconds to search 17,750,454  Action: Copy Results to new Clipboard Build Search Link Page 1 of 122 1 2 3 4 > Last >> (3038 articles found) Comparison of a novel teeth-protecting mouthpiece with a traditional device in preventing endoscopy-related complications involving teeth or temporomandibular joint: a multicenter randomized trial. Jun 2008 B-H Min,H Lee,J S Jeong,H J Son,J J Kim,J C Rhee,P-L Rhee,Y B Yoon BACKGROUND AND STUDY AIMS: After upper endoscopy, patients have complained of symptoms involving teeth or the temporomandibular joint; however, these endoscopy-related complications are usually ignored with few attempts to prevent them. The aim of this study was to identify the incidence of endosco... ( view more )py-related complications involving teeth or temporomandibular joint, and to compare the effectiveness of a newly developed teeth-protecting mouthpiece (TPM) with a traditional mouthpiece (the MB-142) in preventing these complications. PATIENTS AND METHODS: 872 patients from 28 centers, who were undergoing their first upper endoscopy, were randomly assigned to TPM and MB-142 groups. At 3 - 4 days after the procedure, the occurrence of endoscopy-related complications involving the teeth or the temporomandibular joint was investigated using a structured questionnaire. Finally 865 patients (TPM group, n = 423; MB-142, n = 442) responded to this questionnaire and were included in the analysis. RESULTS: Overall, the incidence of complications was significantly lower in the TPM than in the MB-142 group (0.9% vs. 3.2%). With stratification according to sedation status, in nonsedated patients no significant difference was found between the two groups (0.7% vs. 0.9%). In sedated patients, however, the TPM group showed a significantly lower incidence of complication than the MB-142 group (1.7% vs. 11.6%). Clinically serious problems such as a tooth fracture or a loose tooth occurred only in sedated patients in the MB-142 group. CONCLUSIONS: The TPM showed an advantage over the MB-142 mouthpiece for preventing endoscopy-related complications involving teeth or the temporomandibular joint. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Response rate and predictors of response in a short-term empirical trial of high-dose rabeprazole in patients with globus. Jun 2008 D H Sinn,J H Kim,S Kim,H J Son,J J Kim,J C Rhee,P-L Rhee BACKGROUND: Although the aetiology of globus (the sensation of a lump in the throat) remains unclear, gastro-oesophageal reflux disease is associated with globus. A short-term trial with a high-dose proton pump inhibitor has been shown to be a sensitive tool for diagnosing gastro-oesophageal reflux... ( view more ) disease. AIM: To see whether patients with globus symptom responded to short-term high-dose rabeprazole trial and assess predictors of symptom response. METHODS: Sixty-four patients with globus symptom were analysed. Patients received rabeprazole 20 mg b.d. for 14 days. Patients completed a daily diary assessing the severity and frequency of globus. RESULTS: Forty-one patients (64%) were diagnosed clinically with gastro-oesophageal reflux disease. Based on the pH testing and endoscopy, the prevalence of gastro-oesophageal reflux disease was 22% (14 of 64). The globus symptom score was significantly higher in patients with gastro-oesophageal reflux disease compared with patients without gastro-oesophageal reflux disease (P = 0.004). Two patients (3%) had complete resolution and 22 (34%) had more than a 50% improvement in the globus symptom score. Endoscopic findings (P = 0.714), pathological acid exposure on pH testing (P = 0.741) or baseline gastro-oesophageal reflux disease symptoms (P = 0.606) were not associated with improvement of globus symptom. CONCLUSION: While gastro-oesophageal reflux disease may be an aggravating factor in patients with globus, it does not appear to be the sole cause of globus symptom. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Risk factors of lymph node metastasis in T1 esophageal squamous cell carcinoma. Apr 2008 Dong Uk Kim,Jun Haeng Lee,Byung-Hoon Min,Sang Goon Shim,Dong Kyung Chang,Young-Ho Kim,Poong-Lyul Rhee,Jae J Kim,Jong Chul Rhee,Kyoung-Mee Kim,Young Mog Shim BACKGROUND AND AIM: To perform endoscopic mucosal resection (EMR) for T1 esophageal cancer, it is essential to estimate the lymph node status exactly. In order to evaluate the feasibility of EMR for esophageal cancers, we evaluated the clinicopathological features of T1 esophageal squamous carcinom... ( view more )as with an emphasis on the risk factors and distribution patterns of lymph node metastasis. METHODS: From 1994 to 2006, a total of 200 patients with T1 esophageal carcinoma were treated surgically in our institution. Among them, clinicopathological features were evaluated for 197 consecutive patients with T1 squamous cell carcinoma. RESULTS: The frequency of lymph node involvement was 6.25% (4/64) in mucosal cancers and 29.3% (39/133) in submucosal cancers (P < 0.001). In patients with M1 (n = 32) and M2 (n = 14) cancers, no lymph node metastasis was found. In multivariate analysis, size larger than 20 mm, endoscopically non-flat type, and endo-lymphatic invasion were significant independent risk factors for lymph node metastasis. The differentiation of tumor cell was not a risk factor for lymph node metastasis. CONCLUSIONS: We suggest that EMR may be attempted for flat superficial squamous esophageal cancers smaller than 20 mm. After EMR, careful histological examination is mandatory. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Paenibacillus donghaensis sp. nov., a xylan-degrading and nitrogen-fixing bacterium isolated from East Sea sediment. Feb 2008 Jeong-Hwa Choi,Wan-Taek Im,Jae-Soo Yoo,Sang-Mahn Lee,Deok-Soo Moon,Hyeon-Ju Kim,Sung-Keun Rhee Rhee,Dong-Hyun Roh A Gram-positive and endospore-forming strain, JH8T, was isolated from deep-sea sediment and identified as a member of the genus Paenibacillus on the basis of 16S rRNA gene sequence and phenotypic analyses. According to a phylogenetic analysis, the most closely related species was Paenibacillus wynn... ( view more )ii LMG 22176T (96.9%). Strain JH8T was also facultatively anaerobic and grew optimally at 20-25degreesC. The major cellular fatty acid was anteiso-C15:0, and the DNA G+C content was 53.1 mol%. The DNA-DNA relatedness between the isolate and Paenibacillus wynnii LMG 22176T was 7.6%, indicating that strain JH8T and P. wynnii belong to different species. Based on the phylogenetic, phenotypic, and chemotaxonomic characteristics, strain JH8T would appear to belong to a novel species, for which the name Paenibacillus donghaensis sp. nov. is proposed (type strain =KCTC 13049T=LMG 23780T). ( view less ) View Full Abstract View Article Details View Coded Data Related Articles The comparison of the risk factors and clinical manifestations of proximal and distal colorectal cancer. Jan 2008 Sung-Wook Oh,Young-Ho Kim,Yong Sung Choi,Dong Kyung Chang,Hee Jung Son,Poong-Lyul Rhee,Jae J Kim,Jong Chul Rhee,Seong-Hyeon Yun,Woo-Yong Lee,Ho-Kyung Chun,Duk-Hwan Kim,Sang Goon Shim PURPOSE: Colorectal cancers in the proximal or distal site have distinct clinical characteristics. In this study, the authors compared the risk factors of proximal and distal colorectal cancer. METHODS: A 16-page questionnaire was administered to 529 patients with colorectal cancer before operation... ( view more ). Cancers were classified as proximal or distal relative to the splenic flexure. Of these 529 patients, 6 patients were excluded because of the presence of synchronous colorectal cancers. Data of the 523 patients were analyzed. RESULTS: Total numbers of proximal and distal cancers were 123 and 400. The proportion of patients with Type 2 diabetes was significantly higher for distal cancer (P = 0.034), whereas a greater proportion of patients with proximal cancer had a gallstone history (P = 0.005). Multivariate analysis revealed Type 2 diabetes to be a risk factor for distal colorectal cancer (P = 0.027) and cholelithiasis to be a risk factor for proximal cancer (P = 0.049). The odds ratio for distal colorectal cancer among males with Type 2 diabetes was 4.1 (95 percent confidence interval, 1.4-12.1). On the other hand, a gallstone history was more associated with proximal colon cancer, especially in females (odds ratio = 5.5; 95 percent confidence interval, 1.4-20.9). CONCLUSIONS: A comparison of the risk factors of proximal and distal colorectal cancer showed that Type 2 diabetes is associated with distal colorectal cancer in males and that cholelithiasis is associated with proximal colon cancer in females. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Comparison of malignant potential between serrated adenomas and traditional adenomas. Nov 2007 Sang Yong Song,Young-Ho Kim,Min Kyu Yu,Jeong Hwan Kim,Ji Min Lee,Hee Jung Son,Poong-Lyul Rhee,Jae J Kim,Seung Woon Paik,Jong Chul Rhee BACKGROUND: Serrated adenoma is a discrete colorectal epithelial neoplastic lesion that can evolve into colorectal cancer. However, the degree of malignant potential has not been firmly established as yet. The purpose of the present paper was to compare the malignant potential and clinicopathologic... ( view more )al features between serrated and traditional adenomas. METHODS: A total of 124 serrated adenomas from 116 patients were assessed, and 419 traditional adenomas from 200 were randomly selected. The combination of nuclear dysplasia and serration of > or =20% of crypts was regarded as serrated adenoma. The clinicopathological features of serrated and traditional adenomas were compared, and multivariate analysis performed to confirm whether the malignant potential of serrated adenoma was similar to that of traditional adenoma. RESULTS: The differences in age, sex, total number of adenomas, and synchronous lesions including adenoma with high-grade dysplasia and carcinoma between subjects with and without serrated adenoma were not significant. Serrated adenomas were more frequently located in the rectum and sigmoid colon (P < 0.001), and the average size of serrated adenomas was greater than that of traditional adenomas (P < 0.05). The incidence of malignant lesions including high-grade dysplasia and carcinoma in serrated adenomas was found to be lower than in traditional adenomas (3.2% vs 9.3%, P < 0.05). In the multivariate analysis, adenoma type and polyp size constituted the risk factors for the incidence of high-grade dysplasia and carcinoma. CONCLUSIONS: Serrated adenoma is a premalignant lesion, but it has a lower potential for the development of malignancy than traditional adenomas. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Clinical outcome of rumination syndrome in adults without psychiatric illness: a prospective study. Nov 2007 Hyuk Lee,Poong-Lyul Rhee,Eun-Ha Park,Jeong Hwan Kim,Hee Jung Son,Jae J Kim,Jong Chul Rhee BACKGROUND AND AIM: This prospective study was conducted to characterize the clinical features of adult rumination syndrome, in the absence of psychiatric illness, by applying newly modified clinical criteria, and to elucidate factors influencing outcomes after treatment. METHODS: Twenty-one adult ... ( view more )patients diagnosed with rumination syndrome at a tertiary referral center over a 2-year period were enrolled in the study. All patients received supportive psychotherapy and medical treatment. Changes in symptom parameters were analyzed using a pretreatment and a post-treatment questionnaire. Patients were classified into three groups according to symptomatic outcome: improved group, sustained group and aggravated group. RESULTS: The duration of treatment was longer in the improved group than in the sustained or aggravated groups (P = 0.018). Esophageal manometry testing demonstrated non-transmitted contractions of the esophageal body in 10 patients (47.6%) and low amplitude contractions in eight patients (38.1%). Mean lower esophageal sphincter (LES) pressure was 9.8 +/- 2.6 mmHg. Baseline LES pressure in the improved group was higher than in the other groups (P = 0.001). Ambulatory 24-h esophageal pH monitoring showed pathological acid reflux in six patients (28.6%). All pathological acid reflux occurred in post-rumination periods. Scintigraphic testing of gastric emptying revealed that the mean retention rate at 120 min was 34.2 +/- 2.5% of initial contents, and delayed emptying was noted in three patients (14.3%). CONCLUSIONS: Rumination syndrome is often accompanied by heterogeneous conditions such as postprandial gastroesophageal reflux, various abnormalities in esophageal manometric tests and delayed gastric emptying. Medical treatment and supportive psychotherapy can be effective in otherwise normal adult patients, especially in patients who comply with long durations of treatment and who demonstrate higher baseline LES pressures. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Is metabolic syndrome a risk factor for colorectal adenoma? Aug 2007 Jeong Hwan Kim,Yun Jeong Lim,Young-Ho Kim,In-Kyung Sung,Sang Goon Shim,Sung-Ook Oh,Sin-Sil Park,Sun Yang,Hee Jung Son,Poong-Lyul Rhee,Jae J Kim,Jong Chul Rhee,Yoon-Ho Choi BACKGROUND AND AIMS: Epidemiologic studies provide evidence for a link between obesity or diabetes and the risk for colorectal cancer. However, there is a lack of information about the relationship between metabolic syndrome and colorectal adenoma. Therefore, we investigated whether metabolic syndr... ( view more )ome is a risk factor for colorectal adenoma. METHODS: We did a study for consecutive subjects who underwent colonoscopy as a screening exam at the Center for Health Promotion, Samsung Medical Center, from March 2004 to December 2005. According to the modified ATP III criteria, metabolic syndrome was diagnosed. We classified a total of 2,531 subjects into the adenoma group (n = 731) and the control group (n = 1,800), including normal colonoscopic finding, nonpolyp benign lesions, or histologically confirmed hyperplastic polyp. RESULTS: The prevalence for metabolic syndrome was 17% in the adenoma group and 11% in the control group. On the multiple logistic regression analyses, metabolic syndrome was found to be associated with an increased risk of colorectal adenoma (odds ratio, 1.51; 95% confidence interval, 1.18-1.93). Also, waist circumference among the individual components of metabolic syndrome was an independent risk factor for colorectal adenoma. An increased risk for metabolic syndrome was more evident for proximal than distal colon, for multiple (>/=3), and for advanced adenoma in the adenoma group. CONCLUSION: Metabolic syndrome was associated with colorectal adenoma. Abdominal obesity of the individual components of metabolic syndrome was an important risk factor for colorectal adenoma. ( view less ) View Full Abstract View Article Details   Related Articles Unexpected anterograde amnesia associated with Buscopan used as a predmedication for endocscopy. Jul 28, 2007 Hyuk Lee,Hee Jung Son,Poong-Lyul Rhee,Jae J Kim,Jong Chul Rhee It has been known that peripheral adverse event is caused by peripheral antimuscarinic action, from hyoscine butylbromide (Buscopan; Boehringer Ingelheim, Germany) used as a premedication for endoscopy. However, symptoms or signs associated with the central nervous system are rarely reported in the... ( view more ) field of anesthesiology and peripartum labor. This central anticholinergic syndrome is likely caused by blockade of muscarinic cholinergic receptors in the central nervous system. There is no report on Buscopan-induced central anticholinergic syndrome in endoscopy room so far. Three middle-aged females unexpectedly suffered from anterograde amnesia after intramuscular injection of hyoscine butylbromide as an antispasmodic premedication for endoscopy at our endoscopy unit in the Health Promotion Center. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Prevalence and risk factors of Barrett's esophagus in Korea. Jun 2007 Jeong Hwan Kim,Poong-Lyul Rhee,Jun Haeng Lee,Hyuk Lee,Yong Sung Choi,Hee Jung Son,Jae J Kim,Jong Chul Rhee BACKGROUND AND AIM: Barrett's esophagus (BE) is diagnosed when specialized intestinal metaplasia (SIM) is detected histologically in endoscopically suspected columnar-lined esophagus (CLE). It is a premalignant condition and plays a pivotal role in the development of esophageal adenocarcinoma. It h... ( view more )as traditionally been believed to affect Asians less frequently. The aim of this study was to determine the prevalence of BE and possible associated risk factors in Korea. METHODS: A retrospective analysis of 70 103 patients who had undergone their first upper endoscopies was performed using computerized medical records. Of these, 696 (1%) patients had suspected CLE. After screening by telephone, 480 were enrolled. The clinical and endoscopic characteristics of histologically identifiable BE and endoscopically suspected CLE not confirmed by biopsy (suspected CLE without SIM) were investigated. RESULTS: Barrett's esophagus was present in 151 patients (0.22%) with a mean age of 53.8 +/- 10.9 years. BE was more commonly found in men. BE was associated with a set of features distinct from suspected CLE without SIM; older age, greater predominance of male sex, more frequent smoking history, and more frequent acid regurgitation symptom. CONCLUSIONS: Barrett's esophagus remains less common in Korea than in Western countries. Old age, male sex, smoking, and acid regurgitation symptom were significant risk factors. ( view less ) View Full Abstract View Article Details   Related Articles Is aperistalsis with complete lower esophageal sphincter relaxation an early stage of classic achalasia? Apr 2007 Jeong Hwan Kim,Poong-Lyul Rhee,Sang Soo Lee,Hyuk Lee,Yong Sung Choi,Hee Jung Son,Jae J Kim,Jong Chul Rhee BACKGROUND: Aperistalsis with complete lower esophageal sphincter (LES) relaxation, characterized by the complete relaxation of the LES and aperistalsis of the esophageal body on manometry, has been considered by some authors to be an early manifestation of classic achalasia, which is defined as in... ( view more )complete relaxation of the LES and aperistalsis of the esophageal body. The aim of the present study was to compare the clinical features of patients with aperistalsis with complete LES relaxation, with those of patients with classic achalasia. METHODS: Eighteen patients with aperistalsis with complete LES relaxation and 53 patients with classic achalasia were analyzed with regard to clinical history, the maximal diameter of the esophageal body on barium esophagogram, LES resting pressure and the duration of LES relaxation on manometric recordings, and the selected treatment and its efficacy. RESULTS: The aperistalsis with complete LES relaxation group had distinctly different features compared to those of the classic achalasia group including older age, more frequent association with non-cardiac chest pain, less frequent association with dysphagia and weight loss, lower LES resting pressures, and longer duration of LES relaxation. However, the two groups were similar in terms of maximal diameter of the esophageal body, and efficacy associated with pneumatic dilation. CONCLUSIONS: Aperistalsis with complete LES relaxation on manometry is not necessarily an early manifestation of classic achalasia. However, this condition does not preclude a diagnosis of achalasia or a good response to achalasia therapy. ( view less ) View Full Abstract View Article Details   Related Articles [An evaluation of web-based informations about gastroesophageal reflux diseases in Korea] Apr 2007 June Sang Lee,Tae Gun Moon,Hoi Jin Kim,Hyun Jeong Lee,Jun Haeng Lee,Sang Goon Shim,Poong -Lyul Rhee,Jae J Kim,Jong-Chul Rhee BACKGROUND/AIMS: Internet has become an important source of medical information not only for medical personnels but also for patients. The aim of this study was to evaluate the quality of internet based medical information about 'gastroesophageal reflux' or 'reflux esophagitis' in Korea. METHODS: T... ( view more )he first 15 internet sites using the key words 'gastroesophageal reflux' or 'reflux esophagitis' were retrieved from the 7 most frequently used internet search engines. The quality of information from a total of 108 websites was evaluated using a checklist. RESULTS: Among total 108 sites related to 'gastroesophageal reflux' or 'reflux esophagitis', fifty-six sites (51.8%) were made by hospitals or clinics and 94 sites (87.0%) were made for patients. Of the 108 sites, eleven web sites (10.1%) had more than three JAMA benchmarks (authorship, references, currency, and disclosure). Higher quality sites (at least three JAMA benchmarks) were less likely to contain inaccurate information than lower quality sites (fewer than three JAMA benchmarks)-3/11 (27.2%) vs. 60/97 (61.9%) (p<0.01). Despite the fact that articles in the literature emphasized an insufficient evidence to support an association between the lifestyle, dietary behaviors, and GERD, such guidelines continue to be recommended as first-line therapy in most websites. CONCLUSIONS: Informations about gastroesophageal reflux disease were incomplete in the majority of medical web sites. These would bring about confusion to patients seeking for an information about GERD through the internet. There is a need for better sources in evidence based informations about gastroesophageal reflux diseases on the web. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Clinical usefulness of subgrouping of patients with non-cardiac chest pain according to characteristic symptoms in Korea. Mar 2007 Jeong Hwan Kim,Poong-Lyul Rhee,Eun-Ha Park,Hee Jung Son,Jae J Kim,Jong Chul Rhee BACKGROUND: Non-cardiac chest pain (NCCP) is a heterogeneous disorder. There is controversy about the associations between symptoms and causes in NCCP patients. The purpose of the present study was to evaluate the clinical usefulness of subgrouping according to characteristic symptoms in NCCP patie... ( view more )nts. PATIENTS AND METHODS: Fifty-eight patients were classified into two groups, as patients with typical reflux symptoms (group I, n = 24) and those without typical reflux symptoms (group II, n = 34). They underwent upper endoscopy, manometry, and 24-h esophageal pH monitoring. RESULTS: Twenty-four (41%) of the patients were diagnosed with gastroesophageal reflux disease (GERD) at upper endoscopy or 24-h esophageal pH monitoring. Eleven (19%) were diagnosed with GERD-associated esophageal motility disorder and 13 (22%) were diagnosed with non-GERD-associated esophageal motility disorder. The two groups did not differ significantly in age, sex, weight, smoking history, history of chronic alcoholism, or the severity, duration and frequency of symptoms. The sensitivity, specificity, positive predictive value, negative predictive value, and likelihood ratio of group I for GERD-related NCCP were significantly higher than those of group II. Group I had a higher proportion of patients with GERD-associated esophageal motility disorder (55%) than non-GERD-associated esophageal motility disorder (23%). CONCLUSION: Typical reflux symptoms can be used to distinguish patients with GERD-related NCCP from patients with NCCP, and subgrouping according to characteristic symptoms may assist the diagnosis of these patients in Korea. ( view less ) View Full Abstract View Article Details   Related Articles Primary NK-/T-cell lymphoma of the gastrointestinal tract: clinical characteristics and endoscopic findings. Feb 2007 J H Kim,J H Lee,J Lee,S-O Oh,D K Chang,P-L Rhee,J J Kim,J C Rhee,J Lee,W S Kim,Y H Ko BACKGROUND AND STUDY AIMS: Primary NK-/T-cell lymphoma of the gastrointestinal tract is a very rare disease with a poor prognosis. The aim of this study was to determine the clinical and endoscopic characteristics of patients with primary gastrointestinal NK-/T-cell lymphoma. PATIENTS AND METHODS: ... ( view more )The clinical features of 14 patients with primary gastrointestinal NK-/T-cell lymphoma and the endoscopic findings in 11 of these patients were reviewed. Their median age was 42 years (range 23-78) at the time of diagnosis. RESULTS: The initial presenting symptoms of primary gastrointestinal NK-/T-cell lymphoma were gastrointestinal bleeding (n = 6, 42%), abdominal pain (n = 4, 29%), and epigastric soreness (n = 4, 29%). The disease was at an advanced stage at the time of diagnosis: stage II in 5 patients (36%); stage III in 4 (28%); and stage IV in 5 (36%). Initial treatment was with chemotherapy (n = 8, 57%) or surgical resection (n = 5, 36%). The median survival for all patients was 9 months. On endoscopy in 11 patients, the anatomic location of the primary lesion was found to be: stomach, n = 3 (27%); esophagus, n = 2 (18%); duodenum, n = 1 (9%); and the ileocolonic area, n = 5 (46%). These lesions were ulceroinfiltrative in 4 cases (36%), ulcerative in 3 cases (27%), superficial/erosive in 3 cases (27%), and infiltrative in 1 case (9%). No prominent fungating mass was seen in any patient. CONCLUSIONS: Primary gastrointestinal NK-/T-cell lymphoma was endoscopically characterized by superficial/erosive, ulcerative, or ulceroinfiltrative lesions without fungating mass. The most common presenting symptom was gastrointestinal bleeding. Despite aggressive treatments, the prognosis was very poor. ( view less ) View Full Abstract View Article Details   Related Articles [Comparative usefulness of erythrocyte sedimentation rate and C-reactive protein in assessing the severity of ulcerative colitis] Nov 2006 Jung Su Ha,June Sang Lee,Hoi Jin Kim,Tae Gun Moon,Dong Kyung Chang,Jun Haeng Lee,Young Ho Kim,Poong Lyul Rhee,Jae J Kim,Jong Chul Rhee BACKGROUND/AIMS: Although erythrocyte sedimentation rate (ESR) is included as a laboratory parameter in Truelove and Witts' classification, C-reactive protein (CRP) is also used for severity assessment in ulcerative colitis (UC). Frequently, the discordance between ESR and CRP is observed in clinic... ( view more )al practice. The aim of this study was to determine which parameter is more related with clinical activity in UC patients. METHODS: A total of 155 patients with UC were identified from January 2004 to March 2005. Their medical records were reviewed within these patients, a total of 541 assessments of disease activity were made. Correlation of clinical activity and laboratory tests were evaluated by Pearson's correlation coefficient. RESULTS: Pearson's correlation coefficients of ESR and CRP with clinical symptoms were 0.376 and 0.258, respectively. The correlation coefficient between ESR and CRP was 0.403 (p=0.000). A total of 131 (24.2%) assessments revealed discordance between ESR and CRP. When discordance occurred, the correlation coefficients with clinical symptoms were 0.338 for ESR (p=0.000) and 0.034 for CRP (p>0.01). Dividing discordant patients into high ESR/low CRP group and low ESR/high CRP group, the coefficients were 0.420 for ESR and 0.226 for CRP in high ESR/low CRP group, and 0.333 for ESR and 0.068 for CRP in low ESR/high CRP group. CONCLUSIONS: The correlation analysis indicates that ESR appears to be a more reliable laboratory parameter of disease activity than CRP in assessing the severity of UC. In particular, when the level of ESR and CRP is discordant, ESR is more useful in assessing the disease activity in UC patients. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Nonsurgical treatment of abdominal or pelvic abscess in consecutive patients with Crohn's disease. Sep 2006 H Lee,Y-H Kim,J H Kim,D K Chang,H J Son,P-L Rhee,J J Kim,S W Paik,J C Rhee BACKGROUNDS: There is little agreement about the efficacy of nonsurgical treatment for abscess associated with Crohn's disease. Furthermore, there is no study on characteristics of abscess or patient that nonsurgical treatment could be worth trying as initial treatment. AIMS: To evaluate the outcom... ( view more )e of nonsurgical treatment in Crohn's disease-related abscess and identify factor leading to failure of nonsurgical treatment of this complication. PATIENTS: Twenty-four patients, who consecutively admitted for Crohn's disease-related abscess to our institution during a 7-year period, underwent nonsurgical treatment as initial therapy. METHODS: Outcome data such as recurrence and intractability, and clinical features were retrospectively analysed. Univariate analysis with patient-related factors and abscess-related factors was performed for risk factor identification. RESULTS: Median follow-up period was 47.5 months. Of the eligible patients, 19 patients were treated medically and 5 patients underwent percutaneous catheter drainage with medical treatment. Overall success rate of nonsurgical treatment in our centre was 66.7%. The cumulative recurrence rate at 7 months was 12.5%. All recurrences occurred within 7 months from complete resolution on follow-up imaging. Univariate analysis showed that the significant factors which lead to failure of nonsurgical treatment were presence of associated fistula and concurrent steroid use (P=0.019 and P=0.019, respectively). CONCLUSION: Nonsurgical treatment can be considered as initial treatment modality for the Crohn's disease-related abscess without concurrent steroid therapy or relevant fistula. ( view less ) View Full Abstract View Article Details   Related Articles Tachycardiomyopathy induced by ventricular premature complexes: complete recovery after radiofrequency catheter ablation. Sep 2006 Kyoung-Hoon Rhee,Ju-Young Jung,Kyoung-Suk Rhee,Hyun-Sook Kim,Jei-Keon Chae,Won-Ho Kim,Jae-Ki Ko Ventricular premature complexes (VPCs) are known to be one of the most benign cardiac arrhythmias when they occur in structurally normal hearts. We experienced a 32-year old man who presented with dyspnea, palpitations and very frequent VPCs (31% of the total heart beats). Echocardiography revealed... ( view more ) a dilated left ventricle (LV 66 mm at end-diastole and 57 mm at end-systole) and a decreased ejection fraction (34%). Very frequent VPCs had been detected 10 years previously and he underwent a failed radiofrequency catheter ablation (RFCA) procedure at that time. The patient had been treated with heart failure medications including betablockers, ACE inhibitors and spironolactone for the two most recent years. Six months after we eliminated these VPCs with a second RFCA procedure, the heart returned to normal function and size. Long standing and very frequent VPCs could be the cause of left ventricular dysfunction in a subset of patients who suffer with dilated cardiomyopathy, and RFCA should be the choice of therapy for these patients. ( view less ) View Full Abstract View Article Details   Related Articles Non-surgical management of microperforation induced by EMR of the stomach. Aug 2006 G Jeong,J H Lee,M K Yu,W Moon,P-L Rhee,S W Paik,J C Rhee,J J Kim BACKGROUND: Perforation and bleeding are major complications associated with gastric endoscopic mucosal resection. Evident perforation during endoscopic mucosal resection can be managed by endoscopic clipping. However, management of microperforation is not well established. PATIENT AND METHOD: From... ( view more ) January 2002 to June 2004, 109 early gastric cancers and 300 adenomas were treated with endoscopic mucosal resection. Iatrogenic perforations occurred in 4.16% (n=17) patients. Following exclusion of four evident perforations, microperforation was observed in 3.18% (n=13) patients. The clinical features of microperforation in patients were retrospectively reviewed. RESULTS: In a total of 13 microperforation cases, 2 patients were managed surgically. The remaining patients successfully recovered without surgical management. In the case of 11 patients without surgery, 7 experienced abdominal pain, which required analgesics, 2 patients experienced mild discomfort and 2 patients experienced no symptoms. A body temperature above 37.5 degrees C was observed in 9.1% (n=1) patients and leucocytosis above 9000 microL-1 was in 72.7% (n=8) patients. The mean duration of nasogastric tube drainage was 2.36+/-1.03 days, of fasting 4.18+/-1.17 days, of intravenous antibiotics 5.55+/-1.44 days and of hospitalisation 7.45+/-1.04 days. CONCLUSION: Microperforation induced by gastric endoscopic mucosal resection can be managed successfully using a non-surgical approach including fasting, nasogastric tube drainage and intravenous antibiotics. ( view less ) View Full Abstract View Article Details   Related Articles Segmental heterogeneity of electrogenic secretions in human ascending colon and rectum. May 2006 Jung Ho Park,Poong-Lyul Rhee,Jun Haeng Lee,Jae Jun Kim,Jong Chul Rhee,Sung Joon Kim,Jiyeon Lee AIMS: We have attempted to ascertain putative segmental differences in the secretory responses of the human ascending colon and rectum. METHODS: From the mucosal biopsy samples of two segments, the short-circuit current (I(sc)) and tissue resistance (R(te)) were compared under control conditions, a... ( view more )s well as after the induction of secretion, using a modified Ussing chamber. We also performed semiquantitative reverse transcriptase-polymerase chain reaction (RT-PCR) to detect and quantify transport proteins. RESULTS: The spontaneous I(sc) in the ascending colon was found to be greater than that in the rectum (P<0.01), whereas isobutylmethylxanthine/forskolin and carbachol (CCh) induced a greater rise in I(sc) in the rectum than in the ascending colon (P<0.05). When coupled with indomethacin pretreatment, the increase in Delta I(sc) after the addition of CCh and forskolin was significant as compared to that observed without pretreatment (P<0.05). However, in the rectum, the secretory response to CCh and forskolin was abolished to a significant degree by indomethacin (P<0.05). Moreover, these indomethacin-induced changes were reversed by the addition of PGE2. Upon semiquantitative RT-PCR analysis, the amounts of cystic fibrosis transmembrane regulator, KCNQ1, and CLCA1 mRNAs were not found to be different between the two segments. CONCLUSION: There was a clear segmental heterogeneity with regard to electrogenic secretion in the human colon, and this difference can be explained by differences in the ascending colon and rectum. ( view less ) View Full Abstract View Article Details   Related Articles [Microsatellite instability in gastric B-cell lymphoma] Mar 2006 Hyuk Lee,Jae J Kim,Jeong Hwan Kim,Jun Haeng Lee,Hee Jung Son,Poong-Lyul Rhee,Jong Chul Rhee,Young Hyeh Ko BACKGROUND/AIMS: Microsatellite instability (MSI) reflects the defect in DNA mismatch repair (MMR) pathways and plays an important role in certain malignancies. However, the role of MSI in the development of gastric B-cell lymphomas remains unsettled. We aimed to investigate the clinical significan... ( view more )ce of MSI in patients with gastric B-cell lymphoma. METHODS: Seven micosatellite loci (BAT25, BAT26, D2S123, D5S346, D17S250, D14S50, IGF-IIR) were used for MSI analyses. Microsatellite genotypes were categorized as microsatellite stable (MSS, no positive marker), low frequency MSI (MSI-L,<40% positive marker) and high frequency MSI (MSI-H, >40% positive marker). Among the gastric B-cell lymphoma patients who underwent MSI analysis between September 2002 and May 2003, twenty-two patients were enrolled. Median follow-up duration was 23 months (6-32 months). RESULTS: Median age was 46 years (26-73 years). Male to female ratio was 1:1.4. Twelve patients (54.5%) underwent Helicobacter pylori (H. pylori) eradication and ten patients (45.5%) underwent chemoradiation therapy. No case presented MSI-H. MSI-L was observed in 40.9% (9/22). Between MSS group and MSI-L group, there was no significant difference in age, tumor stage, location, grade of large cell component, H. pylori infection, bulk of tumor and proportion of regression or recurrence. All positive markers belonged to the dinucleotide markers. CONCLUSIONS: The current study suggests that the role of MSI is questionable in the development of gastric B-cell lymphoma due to their low incidence. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Gender-related differences in visceral perception in health and irritable bowel syndrome. Feb 2006 Hyun Seo Kim,Poong-Lyul Rhee,Jungho Park,Jun Haeng Lee,Young-Ho Kim,Jae Jun Kim,Jong Chul Rhee BACKGROUND: Irritable bowel syndrome (IBS) is more common in female subjects, and IBS patients generally exhibit reduced pain thresholds to rectal distension. The aim of the present paper was to determine gender-related differences in rectal perception in both healthy controls and IBS patients. MET... ( view more )HODS: Fifty-nine IBS patients (age 20-65 years; mean, 39.2 years; 31 women, 28 men) with symptoms that fulfilled Rome-II criteria and 21 healthy controls (age 25-58 years; mean, 37.8 years; 11 women, 10 men) were recruited. Participants completed a questionnaire regarding bowel symptoms and psychological distress, and maximal tolerable pressures were evaluated via barostat tests. RESULTS: Although healthy women appear to have lower perception thresholds than men, significant gender differences in pain sensitivity were not detected (P > 0.05). In addition, female patients with IBS also exhibited no enhanced colorectal perception, as compared with male IBS patients (P > 0.05). CONCLUSIONS: No gender differences in visceral perception were determined to exist between the healthy controls and the IBS patients. Therefore, the increased prevalence of IBS in women may be related to another set of pathophysiological factors, and not to gender-related differences in visceroperception. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Mucosal mast cell counts correlate with visceral hypersensitivity in patients with diarrhea predominant irritable bowel syndrome. Jan 2006 Jung Ho Park,Poong-Lyul Rhee,Hyun Seo Kim,Jun Haeng Lee,Young-Ho Kim,Jae Jun Kim,Jong Chul Rhee BACKGROUND AND AIM: Although increased mast cells in the gut and their role in visceral hypersensitivity in irritable bowel syndrome have been postulated, this relationship remains unclear. Our aim was to determine whether a relationship exists between the number of mucosal mast cells in the gut an... ( view more )d visceral hypersensitivity. METHOD: Eighteen patients with diarrhea predominant irritable bowel syndrome (D-IBS) (eight females, 10 males aged 25-65 years; mean 42.6 years) with symptoms meeting the Rome-II criteria, and 15 healthy controls (five females, 10 males aged 31-57 years; mean 41.4 years) were recruited. Participants completed a questionnaire for bowel symptoms and psychological distress. Colonic mucosal mast cells were identified immunohistochemically and quantified by image analysis, and maximally tolerable pressures were evaluated using barostat test. RESULTS: Numbers of mast cells were significantly greater in the terminal ileum, ascending colon and rectum of D-IBS patients compared with controls (P<0.01). A multivariate analysis of the barostat test showed that maximally tolerable pressures of D-IBS patients were significantly lower than those of controls (P<0.01). When patients were divided into the rectal hypersensitivity (+) and (-) groups by the distension level of 34 mmHg, mast cell counts were significantly higher in the rectal hypersensitivity (-) group than in the rectal hypersensitivity (+) group for the terminal ileum, ascending colon and rectum (P<0.05, respectively). CONCLUSIONS: Rectal sensitivity was enhanced in D-IBS patients with moderately increased mucosal mast cells, but it was attenuated in patients with markedly increased ones. This study might provide evidence for an important role of mast cells in visceral hypersensitivity. ( view less ) View Full Abstract View Article Details   Related Articles Multigeneration reproductive and developmental toxicity study of bar gene inserted into genetically modified potato on rats. Dec 10, 2005 Gyu Seek Rhee,Dae Hyun Cho,Yong Hyuck Won,Ji Hyun Seok,Soon Sun Kim,Seung Jun Kwack,Rhee Da Lee,Soo Yeong Chae,Jae Woo Kim,Byung Mu Lee,Kui Lea Park,Kwang Sik Choi Each specific protein has an individual gene encoding it, and a foreign gene introduced to a plant can be used to synthesize a new protein. The identification of potential reproductive and developmental toxicity from novel proteins produced by genetically modified (GM) crops is a difficult task. A ... ( view more )science-based risk assessment is needed in order to use GM crops as a conventional foodstuff. In this study, the specific characteristics of GM food and low-level chronic exposure were examined using a five-generation animal study. In each generation, rats were fed a solid pellet containing 5% GM potato and non-GM potato for 10 wk prior to mating in order to assess the potential reproductive and developmental toxic effects. In the multigeneration animal study, there were no GM potato-related changes in body weight, food consumption, reproductive performance, and organ weight. Polymerase chain reaction (PCR) was carried out using extracted genomic DNA to examine the possibility of gene persistence in the organ tissues after a long-term exposure to low levels of GM feed. In each generation, the gene responsible for bar was not found in any of the reproductive organs of the GM potato-treated male and female rats, and the litter-related indexes did not show any genetically modified organism (GMO)-related changes. The results suggest that genetically modified crops have no adverse effects on the multigeneration reproductive-developmental ability. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Neurotoxic effects of alcohol and acetaldehyde during embryonic development. Dec 10, 2005 Rhee Da Lee,Sang Mi An,Soon Sun Kim,Gyu Seek Rhee,Seung Jun Kwack,Ji Hyun Seok,Soo Yeong Chae,Chul Hoon Park,Yo Woo Choi,Hyung Sik Kim,Hong Yon Cho,Byung Mu Lee,Kui Lea Park Alcohol drinking during pregnancy results in abnormal fetal development, including fetal alcohol syndrome (FAS) in humans and experimental animals. FAS is characterized by two major effects, including central nervous system (CNS) dysfunction and multiple anomalies recognizable mainly as a typical f... ( view more )ace. However, the mechanisms of alcohol-induced embryotoxicity have not been clearly demonstrated. The aim of the present study was to investigate the possible mechanisms underlying ethanol-induced FAS in the developing embryo. First, ethanol-induced developmental abnormalities were investigated in vitro. Postimplantation embryos at gestation day (GD) 9.5 were cultured for 48 h and observed for morphological changes. Ethanol-mediated changes in proteins regulated apoptosis (p53 and bcl-2), antioxidant (vitamin E and catalase) activities, generation of reactive oxygen species (ROS), and oxidative DNA damage shown as 8-hydroxy-2'-deoxyguanosine (8-OHdG) were measured in embryonic midbrain cells. Alcohol or acetaldehyde significantly induced cytotoxicity in cultured rat embryonic midbrain cells. The levels of p53, bcl-2, and 8-OHdG were concomitantly changed by alcohol and acetaldehyde treatment in midbrain cells. Injured cells induced by ROS were increased by alcohol or acetaldehyde treatment in midbrain cells. Cotreatment with alcohol or acetaldehyde and catalase decreased cytotoxicity in midbrain cells. In postimplantation embryo culture, alcohol or acetaldehyde-treated embryos showed retardation of embryonic growth and development in a concentration-dependent manner. These results indicate that alcohol and its metabolite acetaldehyde induce fetal developmental abnormalities by disrupting cellular differentiation and growth. Data demonstrate that some antioxidants can partially protect against the alcohol-induced embryonic developmental toxicity. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Assessment of estrogenic and androgenic activities of tetramethrin in vitro and in vivo assays. Dec 10, 2005 Soon Sun Kim,Seung Jun Kwack,Rhee Da Lee,Kwon Jo Lim,Gyu Seek Rhee,Ji Hyun Seok,Byung Ho Kim,Yong-Hyuck Won,Geun-Shik Lee,Eui-Bae Jeung,Byung-Mu Lee,Kui-Lea Park Tetramethrin, a synthetic pyrethroid insecticide, is used globally for agriculture, and thus potential environmental exposure to tetramethrin is a concern. Environmental chemicals that are hormonally active (particularly estrogen or androgen) may adversely affect the reproductive and endocrine syst... ( view more )ems. However, little is known about the estrogenic and androgenic activities of tetramethrin. In this study, uterine CaBP-9k gene expression assay and a uterotrophic assay were conducted for estrogenic activity assessment of tetramethrin, and a Hershberger assay was conducted for androgenic activity. Estrogen receptor (ERalpha and ERbeta) protein levels were also measured in tetramethrin-treated rat uteri. Northern blot analysis showed reduction in uterine CaBP-9k mRNA levels in response to tetramethrin, as well as when rats were given both tetramethrin and 17beta-estradiol (E2). In the uterotrophic assay using 18-d-old female Sprague-Dawley rats, subcutaneous treatment with tetramethrin (5 to 800 mg/kg/day) for 3 d led to a statistically significant decrease in absolute and relative uterine wet weights at all doses tested. Moreover, tetramethrin blocked the effect of E2 on uterine weights. In addition, tetramethrin reduced absolute and relative vaginal wet weights, and also inhibited the increases of vaginal weights produced by E2. Tetramethrin showed no androgenic on antiandrogenic activities in the Hershberger assay. These results suggest that tetramethrin might exert endocrine-disrupting effects on female rats through antiestrogenic action. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Page 1 of 122 1 2 3 4 > Last >> (3038 articles found)

      
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