WCIM 2014 SEOUL KOREA 539
Poster Session
The Korean Journal of Internal Medicine Vol. 29, No. 5 (Suppl. 1)
PS 0861 Lower GI Tract
The Short Health Scale: A Valid Measure of Health Related Quality of Life in Korean Speaking Infl ammatory Bowel Disease Patients
Soo-Kyung Park1, Bong min Ko1, Jae Pil Han1, Su Jin Hong1, Seong Ran Jeon2, Hyun Gun Kim2, Jin Oh Kim2, Moon Sung Lee1
Soon Chun Hyang University Hospital Bucheon, Korea1, Soon Chun Hyang University Hospital Seoul, Korea2
Background: Health-related quality of life (HRQOL) is multidimensional construct that involves both psychosocial and physical domains. Although the incidence of infl am- matory bowel disease (IBD) in Asia has increased rapidly in recent years, only a few studies investigated HRQOL in Asian IBD patients. The Short Health Scale (SHS) is a new, simple four-part visual analogue scale questionnaire that are designed to assess the impact of IBD on a HRQOL. The four dimensions include bowel symptom, activities of daily life, disease related worry and general wellbeing. The aim of our study is to evaluate the SHS in Korean speaking IBD patients.
Methods: One hundred forty two Crohn’s disease (CD) and ulcerative colitis (UC) patients completed the SHS. Individual SHS items were correlated with Infl ammatory Bowel Disease Questionnaire (IBDQ) dimensions and with disease activity to assess validity. Test–retest reliability was assessed in 25 patients who completed the SHS one month apart.
Results: Total SHS scores correlated with total IBDQ scores in both CD (-0.76) and UC (-0.82). Correlation coeffi cients for the “bowel symptom”, “activities of daily life”
dimensions ranged from -0.71 to -0.72 (all p values <0.001).
Conclusions: The SHS is a valid and reliable measure of HRQOL in Korean speaking IBD patients. The SHS can be used in clinical trials and in clinical practice to identify the IBD patient’s main problems affecting health.
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Long-Term Outcomes of Laparoscopic Versus Open Surgery for Rectal Cancer: A Single-Center Retrospective Analysis
Jae Hyun Kim1, Seun Ja Park1, Moo In Park1, Won Moon1, Sung Eun Kim1, Hye Jung Kwan1, Youn Jung Choi1
Kosin University Gospel Hospital, Korea1
Background: Laparoscopic surgery has proven to be an effective tool as an alternative to open surgery in patients with colon cancer. But, there are insuffi cient data of lapa- roscopic surgery in patients with rectal cancer. The aim of this study was to compare laparoscopic and open surgery in patients with rectal cancer.
Methods: Between Jan 2001 and Dec 2011, a total of 380 patients with rectal cancer who were treated by open and laparoscopic curative resection at Kosin University Gospel Hospital (Busan, Korea) were reviewed retrospectively.
Results: 227 patients were treated by open and 153 patients by laparoscopic proce- dure. The local recurrence rate after laparoscopic resection was 0%, as compared with 2.1% after open resection. Distant metastases occurred in 12.1% in the open group, as compared with 2.9% in the laparoscopic group (p< 0.001). 2-year overall survival was 87.7% and 92.1%, and 5-year overall survival was 69.7% and 83.0% in the open group and laparoscopic group, respectively (p = 0.030). The prognostic factors affect- ing overall survival and cancer-free survival were high grade of tumor stage and open procedure.
Conclusions: Long-term outcome after laparoscopic resection of rectal cancer was better than that after conventional open resection. Laparoscopic resection as an alternative to open resection maybe better operative tool for rectal cancer, although further investigation is needed.
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Tolerance of Colonoscopy & Questioning Its Utility in the Elderly
Faizan RATHORE1, Naveed SULTAN1, Humphrey O CONNOR1 Kerry General Hospital/Naas General Hosptial, Ireland1
This study was carried out from Jan ‘12-Dec ‘12 to assess current practice in Kerry General Hospital against the age related indicators for colonoscopies.
Methods: We retrospectively analysed the data of colonoscopies performed at KGH from Jan ‘12-Dec’12. Data was divided 4 age groups,
Results: A total of 1474 colonoscopies were performed,1177(79.9%) diagnostic and 297 (20.1%) therapeutic, patients were divided into 4 age groups under 75, 75-80, 81-85, 86+. The trend analysis revealed an increase in diagnostic colonoscopies and decrease in therapeutic colonoscopies with age. 664(45.04%) of colonoscopies were reported normal , 1330 (90.2%) of colonoscopies occurred without any complications, Main complications were patient discomfort being the highest, present in 112(7.6%) of patients, and lowest being urticaria around the IV site present in 1 (0.1%) of the cases.
Patient discomfort was higher in younger patients as evidenced by 98 cases aged 86.
Highest percentage of poor tolerance was found in 14 (1.1%)of total patients 86.
Conclusion: We have established the safety of colonoscopy, low rate of complications and a better tolerance in the elderly from this study, however, its utility, especially in presence of other co morbidities in elderly is questionable. Our recommendation sug- gests that age alone should not be a contraindication to colonoscopy but in presence of co morbidities a multidisciplinary team should be set up that could decide whether to proceed with the colonoscopy or otherwise, based on the risk/benefi t ratio.
PS 0864 Lower GI Tract
Matrine Induces Intestinal Apoptosis in Experimental Colitis Model
Ja Seol Koo1, Chun hee Kim1, Seung Young Kim1, Jong Jin Hyun1, Sung Woo Jung1, Yoon Tae Jeen1, Sang Woo Lee1
Korea University College of Medicine, Korea1
Background: Matrine, the major alkaloid component from Sophora fl avescens, has been used to treat chronic hepatitis in China. It has been reported that matrine has several pharmacological effects including regulation of immune reaction, anti-infl am- mation. However, the impact of matrine on apoptosis of intestine is unknown.
Methods: Intestinal epithelial cells (IEC-18) were used to determine the in vitro effect of matrine on LPS-induced apoptosis signaling. The therapeutic effi cacy of matrine was assessed using dextran sulfate sodium (DSS) exposed mice. Matrine treatment (100 or 200 mg/kg) was adminstered by using oral gavage. Disease activity index including weight loss, stool consistency, and stool blood and histologic score was used to de- termine the colitis severity. Apoptosis of mouse was evaluated with western blot and TUNEL assay.
Results: In vitro study, the expression of Bax signifi cantly increased, Bcl-2 and Cox decreased in IEC-18 cells treated with matrine. The effect for inhibition of appoptosis, evaluated by Western blot was increased with dose of matrine. In DSS-induced acute colitis, disease activity index and histological scores were not signifi cantly different among the mice groups according to the matrine treatment. As shown in vitro study, the expression of Bcl-2 was decreased in the matrine treatment mice. However, Bax was increased in low dose matrine (100 mg/kg) and decreased in high dose (200 mg/
kg). In the same manner, cleaved Caspase-3 was increased in the mice group treated with low dose matrine. Furthermore, Tunel assay in colon tissues of matrine treated mice was not signfi cantly different with that of matrine untreated mice.
Conclusions: In our study, matrine increased apoptosis on LPS-induced IEC-18 cells. In DSS-induced colitis, low dose matrine resulted in decrease of the anti-apoptotic pro- tein Bcl-2 and increase of the proapoptotic protein Bax and cleaved Caspase-3.
