• 한국융합학회논문지
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• 제12권9호
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• pp.373-385
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• 2021

글로벌 데이터를 사용하여 암 건강정보문해력과 암 조기진단 행위 사이의 관계를 체계적으로 평가하고자 하였다. PRISMA 리뷰 가이드라인에 따라 2021년 1월31일까지 PubMed, CINAHL, Embase, Cochrane Library 4개의 웹 데이터베이스에 발표된 원문을 검색하였으며, 참고문헌 목록을 통해 추가로 검색하였다. 18세 이상의 참여자, 암 건강정보문해력과 암 조기진단 행위를 포함하여 측정하였다. 포함 기준에 충족되는 17건의 원문은 암 건강정보문해력을 측정했고 암 조기진단 행위에는 유방 촬영술, 임상 유방암 검진, Papanicolaou 검사, 대장 내시경 검사, PSA 검진 등이 포함되었다. 그중에 11건의 원문에서 암 건강정보문해력과 암 조기진단 행위 사이는 통계적으로 높은 긍정적인 상관관계를 확인하였다. 이러한 결과를 바탕으로 추후 연구에서는 암 건강 지식에 대한 효과적인 중재프로그램과 가이드라인을 개발하는 것에 초점을 맞추어야 한다. 연구결과를 근거로 암 조기진단율 과 공중 보건 향상을 위해서 암 건강정보문해력과 암 조기진단 행위에 관한 모든 영역으로 연구 범위를 확대하여야 한다.

• 대한한방내과학회지
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• 제42권4호
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• pp.532-546
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• 2021

Objective: This study investigated the perception, diagnosis, and treatment of irritable bowel syndrome (IBS) in the general population, in patients, and in Korean medicine doctors (KMDs) in order to provide basic information for the development of Korean medicine clinical practice guidelines for IBS. Methods: A questionnaire was developed in two versions, one for the general population/patients and one for KMDs. The questions were about the general perception, diagnosis, and treatment of IBS. Both online and offline surveys were conducted using these questionnaires. Results: In total, 213 general population/patients and 435 KMDs responded to the survey. The results of the analysis were as follows. Most of the KMDs diagnosed IBS based on clinical aspects. Acupuncture was the most common treatment, followed by prescription herbal medicine, moxibustion, and manufactured herbal medicine. 34.3% of KMDs used clinical practice guidelines for IBS patient treatment. 57.8% of patients were diagnosed with IBS by doctors at primary medical institutions, and 53.1% were diagnosed with colonoscopy. More than half of the IBS patients who have been treated with Korean medicine said they experienced improvement of symptoms and prevention of recurrence, but more than 70% of the respondents said future safety and effectiveness studies of Korean medicine were needed. Conclusions: In spite of the positive perception of IBS treatment with Korean medicine, actual utilization was relatively low. The development and promotion of, as well as education about, appropriate and reasonable Korean medicine practice guidelines for IBS is necessary.

• Journal of Cancer Prevention
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• 제23권4호
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• pp.176-182
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• 2018

Background: Family physicians (FPs) play an important role in cancer control. The aim of this study was to understand the functions of FPs in cancer control and to explore FPs' perceptions of their own roles and the difficulties they face in cancer control in Karabuk province, Turkey. Methods: The study consisted of two methodological parts. The qualitative part included a descriptive study in which data were collected from 87.5% (n=56) out of all FPs in Karabuk using a questionnaire. In the quantitative part, in-depth interviews with 15 FPs were conducted and analyzed through content analysis. Results: Half of the FPs (50.0%) provided cancer prevention information for their registered people, focusing on especially smoking cessation. In the last three months, the proportion of FPs who had not invited anyone to screenings was 37.5% for the pap test, 26.8% for the mammography, 19.0% for the fecal occult blood test and 34.5% for the colonoscopy. Only 16.1% of them reported that they made home visits for cancer patients. In the qualitative part of study, the following themes were highlighted: the perceived responsibilities of FPs regarding cancer control; the effect of geographically undefined working area of FPs; the issues with coordination between FPs and specialists; the effect of the number of primary care team members. Conclusions: Cancer control services provided by FPs have significant problems in terms of the FPs' approach to the services and their content, continuity and coordination.

• Journal of Cancer Prevention
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• 제23권4호
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• pp.183-190
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• 2018

Background: As the number of big-cohort studies increases, validation becomes increasingly more important. We aimed to validate administrative database categorized as colorectal cancer (CRC) by the International Classification of Disease (ICD) 10th code. Methods: Big-cohort was collected from Clinical Data Warehouse using ICD 10th codes from May 1, 2003 to November 30, 2016 at Seoul National University Bundang Hospital. The patients in the study group had been diagnosed with cancer and were recorded in the ICD 10th code of CRC by the National Health Insurance Service. Subjects with codes of inflammatory bowel disease or tuberculosis colitis were selected for the control group. For the accuracy of registered CRC codes (C18-21), the chart, imaging results, and pathologic findings were examined by two reviewers. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for CRC were calculated. Results: A total of 6,780 subjects with CRC and 1,899 control subjects were enrolled. Of these patients, 22 subjects did not have evidence of CRC by colonoscopy, computed tomography, magnetic resonance imaging, or positron emission tomography. The sensitivity and specificity of hospitalization data for identifying CRC were 100.00% and 98.86%, respectively. PPV and NPV were 99.68% and 100.00%, respectively. Conclusions: The big-cohort database using the ICD 10th code for CRC appears to be accurate.

• Yonsei Medical Journal
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• 제59권9호
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• pp.1034-1040
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• 2018

Purpose: This study aimed to investigate inequalities in colorectal cancer (CRC) screening rates in Korea and trends therein using the slope index of inequality (SII) and relative index of inequality (RII) across income and education groups. Materials and Methods: Data from the Korean National Cancer Screening Survey, an annually conducted, nationwide cross-sectional survey, were utilized. A total of 17174 men and women aged 50 to 74 years were included for analysis. Prior experience with CRC screening was defined as having either a fecal occult blood test within the past year or a lifetime colonoscopy. CRC screening rates and annual percentage changes (APCs) were evaluated. Then, SII and RII were calculated to assess inequality in CRC screening for each survey year. Results: CRC screening rates increased from 23.4% in 2005 to 50.9% in 2015 (APC, 7.8%; 95% CI, 6.0 to 9.6). Upward trends in CRC screening rates were observed for all age, education, and household income groups. Education inequalities were noted in 2009, 2014, and overall pooled estimates in both indices. Income inequalities were inconsistent among survey years, and overall estimates did not reach statistical significance. Conclusion: Education inequalities in CRC screening among men and women aged 50 to 74 years were observed in Korea. No apparent pattern, however, was found for income inequalities. Further studies are needed to thoroughly outline socio-economic inequalities in CRC screening.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제25권5호
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• pp.387-395
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• 2022

Purpose: Toxins produced by Clostridioides difficile infection (CDI) can cause enteritis and diarrhea. Although the number of pediatric CDI cases is increasing, the clinical management of pediatric CDI, including patient characteristics and prognosis, remains unclear. This study aimed to elucidate the background and clinical course of patients with CDI and evaluate the reliability of diagnostic tests in a tertiary pediatric hospital in Japan. Methods: We retrospectively analyzed the clinical data of children diagnosed with CDI between 2011 and 2021 at the Saitama Children's Medical Center in Saitama, Japan. Results: During the study period, 1,252 C. difficile antigen/toxin tests were performed, and 37 patients were diagnosed with CDI. The main underlying diseases among the patients were hematological and malignant disorders and gastrointestinal diseases, including inflammatory bowel disease (IBD) (59.4%). Two patients (5.4%) had an unremarkable medical history. Among the 37 patients, 27 (73.0%) were immunocompromised, 25 (67.6%) had a history of antibiotic use within the past two months, and 6 (16.2%) were negative on the initial test but were positive on the second test. Finally, 28 patients (75.7%) required primary antibiotic therapy only, and two patients with IBD required additional antibiotic therapy as secondary treatment. Conclusion: The number of pediatric patients with CDI is increasing. Both a comprehensive interview, including underlying diseases and history of antibiotic use, and an understanding of the features of clinical examinations should be emphasized to appropriately diagnose and treat CDI.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제26권2호
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• pp.79-87
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• 2023

Purpose: Gastrointestinal (GI) endoscopy is an important tool for diagnosing and treating GI diseases in children. This study aimed to analyze the current GI endoscopy practice patterns among South Korean pediatric endoscopists. Methods: Twelve members of the Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition developed a questionnaire. The questionnaire was emailed to pediatric gastroenterologists attending general and tertiary hospitals in South Korea. Results: The response rate was 86.7% (52/60), and 49 of the respondents (94.2%) were currently performing endoscopy. All respondents were performing esophagogastroduodenoscopy, and 43 (87.8%) were performing colonoscopy. Relatively rare procedures for children, such as double-balloon enteroscopy (DBE) (4.1%), endoscopic retrograde cholangiopancreatography (ERCP) (2.0%), and endoscopic ultrasound (EUS) (2.0%), were only performed by pediatric gastroenterologists at very few centers, but were performed by adult endoscopists in most of the centers; of all the respondents, 83.7% (41/49) performed emergency endoscopy. In most centers, the majority of the endoscopies were performed under sedation, with midazolam (100.0%) and ketamine (67.3%) as the most frequently used sedatives. Conclusion: While most pediatric GI endoscopists perform common GI endoscopic procedures, rare procedures, such as DBE, ERCP, and EUS, are only performed by pediatric gastroenterologists at very few centers, and by adult GI endoscopists at most of the centers. For such rare procedures, close communication and cooperation with adult GI endoscopists are required.

• Journal of Digestive Cancer Research
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• 제1권1호
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• pp.6-16
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• 2013

식생활의 서구화와 대장암 검진의 증가로 인하여 국내의 대장암 유병률은 지속적으로 증가하고 있으며, 최근 보고에 의하면 남자에서는 종양 발생률 2위, 여자에서는 종양 발생률의 3위를 차지하고 있다. 비록 대장내시경이 대장암의 진단과 선별검사에 아주 효과적인 방법이지만, 여전히 대장암의 20-25%는 이미 진단 당시에 전이를 동반하고 있는 것으로 되어 있다. 최근 10년 동안 이러한 전이성대장암의 고식적인 치료로 irinotecan과 oxaliplatin 등의 약제들의 개발과 이들의 다양한 조합에 관련된 연구들이 보고되어 왔으며, 분자생물학적인 발전에 힘입은 표적 치료제의 개발과 이에 대한 다양한 연구들은 향후에도 진행성대장암 환자들의 종양 반응률과 생존기간을 증가시킬 것으로 기대된다.

• Clinical Endoscopy
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• 제56권3호
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• pp.283-289
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• 2023

Gastrointestinal (GI) bleeding is one of the most common conditions among patients visiting emergency departments in Korea. GI bleeding is divided into upper and lower GI bleeding, according to the bleeding site. GI bleeding is also divided into overt and occult GI bleeding based on bleeding characteristics. In addition, obscure GI bleeding refers to recurrent or persistent GI bleeding from a source that cannot be identified after esophagogastroduodenoscopy or colonoscopy. The small intestine is the largest part of the alimentary tract. It extends from the pylorus to the cecum. The small intestine is difficult to access owing to its long length. Moreover, it is not fixed to the abdominal cavity. When hemorrhage occurs in the small intestine, the source cannot be found in many cases because of the characteristics of the small intestine. In practice, small-intestinal bleeding accounts for most of the obscure GI bleeding. Therefore, in this review, we introduce and describe systemic approaches and examination methods, including video capsule endoscopy and balloon enteroscopy, that can be performed in patients with suspected small bowel bleeding in clinical practice.

• Clinical Endoscopy
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• 제56권4호
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• pp.479-489
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• 2023

Background/Aims: Accurate neoplastic prediction can significantly decrease costs associated with pathology and unnecessary colorectal polypectomies. Narrow-band imaging (NBI) and dual-focus (DF) mode are promising emerging optical technologies for recognizing neoplastic features of colorectal polyps digitally. This study aimed to clarify the clinical usefulness of NBI with and without DF assistance in the neoplastic prediction of small colorectal polyps (<10 mm). Methods: This cross-sectional study included 530 small colorectal polyps from 343 consecutive patients who underwent colonoscopy at the University Medical Center from September 2020 to May 2021. Each polyp was endoscopically diagnosed in three successive steps using white-light endoscopy (WLE), NBI, and NBI-DF and retrieved for histopathological assessment. The diagnostic accuracy of each modality was evaluated with reference to histopathology. Results: There were 295 neoplastic polyps and 235 non-neoplastic polyps. The overall accuracies of WLE, WLE+NBI, and WLE+NBI+NBI-DF in the neoplastic prediction of colorectal polyps were 70.8%, 87.4%, and 90.8%, respectively (p<0.001). The accuracy of WLE+NBI+NBI-DF was significantly higher than that of WLE+NBI in the polyp size ≤5 mm subgroup (87.3% vs. 90.1%, p<0.001). Conclusions: NBI improved the real-time neoplastic prediction of small colorectal polyps. The DF mode was especially useful in polyps ≤5 mm in size.