Development and validation of a functional dyspepsia-related quality of life (FD-QOL) scale in South Korea

BACKGROUND: Quality of life (QOL) in patients with functional dyspepsia in South Korea has never been studied, mostly due to the lack of a psychometrically validated disease-specific instrument for measuring the QOL. The aim of the present study was to develop and validate a QOL scale for patients with functional dyspepsia. METHODS: A Functional Dyspepsia-Related QOL (FD-QOL) scale was developed and validated as follows: item generation, pilot test, and psychometric test. Patients with functional dyspepsia (n = 220) were recruited from seven university hospitals. The participants were asked to complete the preliminary item-generated FD-QOL, the Short Form-36 (SF-36), and the Index of Dyspepsia Symptoms-Korean (IDS-K). The data were analyzed using factor analysis, correlation, anova, and Cronbach's alpha. RESULTS: Twenty-three items were generated based upon content validity. Factor analysis extracted a four-factor solution, and two items were deleted because they were not loaded significantly on any factor. The FD-QOL was correlated with the SF-36 subscales, of which scores were differentiated according to the levels of dyspepsia symptoms. Cronbach's alpha of the FD-QOL was 0.94. CONCLUSIONS: The FD-QOL scale is a rapid and easily applicable instrument with excellent psychometric properties of content, factorial, convergent, and known-groups validity, and internal consistency reliability in Korean patients with functional dyspepsia

The clinical features and treatment modality of esophageal neuroendocrine tumors: a multicenter study in Korea

BACKGROUND: Neuroendocrine tumors (NETs) of the esophagus are extremely rare, and few cases have been reported worldwide. Thus, a comprehensive nationwide study is needed to understand the characteristics of and treatment strategy for esophageal NETs. METHODS: We collected data on esophageal NET patients from 25 hospitals in Korea from 2002–2012. The incidence, location, clinical symptoms, histopathology, treatment response, and the biochemical, radiologic and endoscopic characteristics of esophageal NETs were surveyed. RESULTS: Among 2,037 NETs arising in different gastrointestinal sites, esophageal NETs were found in 26 cases (1.3%). The mean patient age was 60.12 ± 9.30 years with a 4:1 male predominance. In endoscopic findings, 76.9% (20/26) of NETs were located in the lower third of the esophagus and the mean size was 2.34 ± 1.63 cm. At diagnosis, more than half the patients (15/26, 57.7%) had regional lymph node metastasis or widespread metastasis. Endoscopic resection was conducted in three cases, and in all three of them, lymph node metastasis was not found and tumor size was below 1.0 cm. All tumors were completely removable through endoscopic procedures and there was no recurrence during the follow-up period. Eighteen other patients received an operation, chemotherapy or both. Among them, nine patients (50.0%) expired because of the progression of their cancer or post-operative complications. In Kaplan-Meier survival analysis, only tumor size (more than 2.0 cm) showed prognostic significance (P = 0.045). CONCLUSIONS: Despite the general assumption that gastrointestinal NETs are benign and slow-growing tumors, the prognosis of advanced esophageal NETs is not favorable

Delayed Viral Clearance of Chronic Hepatitis C in Patients after Treatment Failure

Hepatitis C virus (HCV) infection usually progresses to chronic hepatitis, with rare cases of spontaneous viral eradication. We present herein four cases involving patients that were initially declared to have failed to respond to treatments, based on the presence of HCV RNA that was still detectable after completion of the standard treatment for chronic hepatitis C with genotype 2. However, the HCV RNA became undetectable, with a delayed response, after discontinuation of therapy. Two of the four patients were diagnosed as treatment failures after extended treatment, and the other two received no further treatment after the standard treatment. All four patients maintained a sustained virological response during the periodic follow-up after delayed viral clearance