Trends of Gastrointestinal Diseases at a Single Institution in Korea over the Past Two Decades

Kim²,

Park³

et al. 2011

Oncol Rep

Abstract.With an increased incidence of early gastric cancer (egc) and advances in endoscopic technologies, endoscopic resection (er) has become an important treatment modality for egc. therefore, precise assessment of the risk of lymph node (ln) metastasis in er specimens has become essential. the widely accepted criteria for er have been mostly obtained from surgical data. this study was performed to evaluate the adequacy of these criteria and re-evaluate the predictive power of the criteria for ln metastasis. We evaluated a series of pathologic factors in er specimens from 79 gastric cancer patients treated with endoscopic mucosal resection (7) or endoscopic submucosal dissection (72) and underwent subsequent surgical resection due to the potential risk of ln metastasis. of the 79 patients, 10 patients (12.7%) exhibited regional ln metastasis. Univariate analysis revealed that the presence of lymphovascular invasion (lVI) was significantly associated with ln metastasis (26/69, 37.7 vs. 9/10, 90%, p=0.004). the number of LVI was significantly higher in the LN metastasis group (1.1±2.3 vs. 7.7±8.4, p<0.001). By multivariate analysis, the presence of lVI (odds ratio, 21.41; p=0.010) and undifferentiated histology (odds ratio, 11.15; P=0.016) were significantly correlated with ln metastasis. the presence of lVI, undifferentiated histology and the numbers of lVI were important risk factors for ln metastasis. Among these factors, the presence of lVI was the most important risk factor for ln metastasis in endoscopically resected early gastric cancer.

Section: Patientsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Lymphovascular invasion is an important predictor of lymph node metastasis in endoscopically resected early gastric cancers

Kim²,

Park³

et al. 2011

Oncol Rep

“…10 In one retrospective study for the past two decades in a single institute, admission due to PUD has not been changed for that period. 11 We compared Considering the previous epidemiological data, while the ratio of GU, DU, and combined GU and DU has not been changed much from 1970's to 2000's, it is likely that the ratio of GU is increasing compared to DU in our serial data.…”

Section: Incidence and Prevalencementioning

confidence: 96%

Peptic Ulcer Diseases in Korea

Chung

Korean J Helicobacter Up Gastrointest Res

2012

Self Cite

Peptic ulcer disease (PUD) is one of the most commonly encountered gastroenterologic diseases in Korea. The trend in diagnosis and treatment of PUD in Korea has changed in the past decade with the introduction of endoscopy and potent acid suppressants such as proton pump inhibitors. The discovery of Helicobacter pylori has opened a new era for the understanding of pathogenesis and management of PUD. In this review, we tried to look back at the history of PUD in Korea and the changes of epidemiologic features and treatment of PUD in Korea. INTRODUCTIONPeptic ulcer disease (PUD) is one of the most commonly encountered gastroenterologic diseases. It is defined as a break in the lining of the mucosa, with appreciable depth at endoscopy or histologic evidence of involvement of the submucosa. EPIDEMIOLOGIC DATABefore 1980's, experts in gastroenterology described PUD several times and analyzed them into complicated and un-complicated ones in patients who underwent surgical treatment.However, epidemiological studies for PUD was first described in 1984 and 8 epidemiological studies were published so far. 2-9Two studies included data of 1970's, 6 studies included data of 1980's, 3 studies included data of 1990's, and one study included data of 2000's.We have been performed a series of surveys for PUD in the 8 institutes of the Catholic University of Korea over two decades. These serial surveys included over 1,000 patients each time, with questionnaires on general life style, medical histories, and endoscopic findings of PUD patients. The first survey was performed between 1988 and 1989, second one between 1996 and 1997, and now third one is under way which contains over 250 enrolled patients so far. Considering the previous epidemiological data, while the ratio of GU, DU, and combined GU and DU has not been changed much from 1970's to 2000's, it is likely that the ratio of GU is increasing compared to DU in our serial data. Incidence and prevalenceIn-Sik Chung, Byung-Wook Kim：Peptic Ulcer Diseases in Korea 21 Age and sexThe mean ages of patients with GU and DU tend to increase both in the previous epidemiological data and in our serial data.Peak ages of PUD also have been increased for the past two decades, i.e., peak age of GU changed from 40's to 50's, peak age of DU changed from 30's to 50's, and peak age of combined GU and DU changed from 40's to 50's.Male over female ratio is declining in GU but not in DU in the previous epidemiologic studies and in our serial data. It is plausible that the increasing consumption of aspirin and non-steroidal anti-inflammatory drugs (NSAIDs) both in male and female elderly patients is associated with this tendency. ComplicationsThe incidence and prevalence of complicated PUD such as bleeding and perforation have been reported in various ranges in previous epidemiologic studies. Bleeding was reported in 3.9∼10.4% of GU, 6.2∼12.4% of DU, and 0∼14.4% in combined GU and DU groups. Perforation was reported in 0.1∼0.7% of GU, 0.1∼2.7% of DU, and 0% in combined GU and DU groups. Obstructio...

“…4 Chronic or unspecified gastric ulcer with hemorrhage K25. 6 Chronic or unspecified gastric ulcer with both hemorrhage and perforation K26.0…”

mentioning

confidence: 99%

“…4 Chronic or unspecified peptic ulcer, site unspecified with hemorrhage K27. 6 Chronic or unspecified peptic ulcer, site unspecified with both hemorrhage and perforation Diagnostic codes for peptic ulcer disease without complication K25 Gastric ulcer K25. 3 Acute gastric ulcer without hemorrhage or perforation K25.…”

mentioning

confidence: 99%

Optimal Operational Definition of Patient with Peptic Ulcer Bleeding for Big Data Analysis Using Combination of Clinical Characteristics in a Secondary General Hospital

Lee

Woo

et al. 2016

Korean J Gastroenterol

Background/Aims: Peptic ulcer bleeding (PUB) is the most common cause of upper gastrointestinal bleeding in Korea but there has been no research done using big data. This study evaluates the optimal operational definition (OD) for big data research by analyzing clinical characteristics of PUB. Methods: We reviewed the clinical characteristics of 92 patients with PUB confirmed on endoscopy in Wonkwang University Sanbon Hospital (January 2013 to December 2014). We calculated sensitivity and positive predictive value (PPV) to detect confirmed PUB patients using ODs developed by combining clinical features of patients with PUB. Results: The mean patient age was 63 years. Men had higher prevalence of PUB than women. Bleeding gastric ulcer was proportionately common in the age range of 40s to 60s in men, while a significantly higher rate of bleeding occurred in women older than 70s. The rate of drug-induced ulcer was 28.2%, whereas the prevalence of Helicobacter pylori was 47.8%. Among the hospitalized patients with diagnostic code of PUB, we ruled out patients with endoscopic removal of gastric adenoma or peritonitis, and selected patients who had been administered intravenous proton pump inhibitor. The sensitivity in this setting was 82.6%, and PPV was 88.4%. Conclusions: PUB was more common in older patients, and there was a clear gender difference in gastric ulcer bleeding by age. With a proper OD using PUB diagnostic codes, we can identify true patients with sufficiently high sensitivity and PPV. (Korean J Gastroenterol 2016;68:77-86)