Background
Metabolic syndrome is a cluster of metabolic abnormalities leading diabetes and cardiovascular diseases. Helicobacter pylori (H. pylori) infection is suggested to be a risk factor of cardiovascular diseases. We aimed to investigate the association between H. pylori infection and metabolic syndrome. Methods: This study was designed with Korean adults having a health check-up in a university hospital in Ulsan from March 2008 to February 2009. The subjects were 17,448 over 20 years old. The analysis was undertaken according to sex separately. The association of H. pylori seropositivity (IgG) with metabolic syndrome components was investigated by multiple linear regression analysis. The association of H. pylori seropositivity with metabolic syndrome was investigated by multiple logistic regression analysis. Results: H. pylori seropositivity was significantly inversely associated with high density lipoprotein cholesterol in men (Coefficient, -0.02; 95% confidence interval [CI], -0.03 to -0.004; P = 0.01). However, H. pylori seropositivity was not significantly associated with metabolic syndrome in both men and women (OR, 1.01; 95% CI, 0.90 to 1.14; P = 0.81 for men; OR, 0.75; 95% CI, 0.55 to 1.02; P = 0.06 for women). Conclusion: H. pylori infection was significantly negatively associated with high density lipoprotein cholesterol in men, but not significantly associated with metabolic syndrome in both men and women.

Background
It has been reported that H.pylori causes changes in fundic leptin levels and plasma levels of ghrelin, and that eradication of H.pylori infection can increase appetite. There is also a report that showed changes of appetite between before and after eradication of H.pylori in peritoneal dialysis patients. Our study investigated the degree of appetite between H.pylori negative group and H.pylori positive group in adults. Methods: The subjects included those without appetite- related diseases. We carried out gastroscopy and then performed CLO test in subjects who had no gastric lesions. We interviewed the study subjects about appetite related behavior (three items: desire to eat, hunger before meal, deliciousness) using visual analogue scale. We examined the appetite related behavior between CLO (-) group and CLO (+) group. Results: The difference of age, sex, height, weight, body mass index, alcohol con sumption, blood pressure, hemoglobin, fasting blood sugar, AST, ALT, GGT between CLO (-) group and CLO (+) group were not statistically significant. The difference of appetite related behavior (three items) between CLO (-) group and CLO (+) group was not statistically significant. Conclusion: The degree of appetite between CLO (-) group and CLO (+) group was not different. (J Korean Acad Fam Med 2007;28:909-915)

The 68-year-old man who have no particular symptom except 10 kg weight loss was received the gastroscopy as a part of diagnostic tests. On his gastroscopic examination, it was ascertained as high grade B-cell type mucosa- associated lymphoid tissue (MALT) lymphoma from the biopsy of the erosive lesion on the angle of stomach. This lesion, after pharmacotherapy for Helicobacter pylori, was visible the normal mucosal pattern at the gastroscopic follow-up. Hereupon the writer tried to review the clinical aspect, the diagnosis, the treatment, and the prognosis, along with the literature investigation regarding MA LT lymphoma.

Background
: Upper gastrointestinal diseases are relatively important in Korea. There are various studies on upper gastrointestinal diseases, especially relationships with Helicobacter pylori, but studies on young adults are relatively fewer. Therefore, we conducted this study in order to know the prevalence of various upper gastrointestinal diseases and the association with Helicobacter pylori among young policemen.

Methods : Diagnosis and classification of upper gastrointestinal diseases were made in 260 policemen, who visited the outpatient department of family medicine at one general hospital in Seoul from March 2, 2001 to December 31, 2002.

Results : The frequencies of upper gastrointestinal diseases were gastritis (62.2%), duodenal ulcer (14.4%), gastric ulcer (7.5%), duodenitis (6.9%), and no active lesion (9.0%). The frequency of multiple upper gastrointestinal disease was chronic superficial gastritis and duodenal ulcer (37%), chronic superficial gastritis and duodenitis (21.9%), and acute gastritis and duodenal ulcer (16.4%), and these groups comprised the most with 75.3%. The location of the lesion was found at antrum (62.2%) and duodenum (21.6%). Ulcer stages in gastric and duodenal ulcer were mostly in active stage. Helicobacter pylori infection in gastric and duodenal ulcer were 36% and 85.4%, respectively.

Conclusion : Most symptomatic patients had lesions which were found at antrum and duodenum as in other studies. Ulcer diseases in duodenum were much more frequent than those in stomach, which probably be associated with Helicobacter pylori. Therefore, suitable examination and treatment are necessary.

Background
: Helicobacter pylori has been known to be not only associated with gastrointestinal diseases but also to be reported in several cases of increased incidence of anemia. The anemia associated with H. pylori infection was reported though the population studies and case reports. But in Korea, there have been not enough studies especially in adults group, so we investigated to find out if H. pylori infection is associated with anemia in adults with gastritis.

Methods : Subjects were 382 men older than 40 years and 158 postmenopausal women, who had visited a general hospital for physical examination from May 2001 to October 2001 and diagnosed as only gastritis. Data were analysed for the effects of H. pylori infection on anemia using logistic regression test.

Results : In men, Pearson correlation coefficients between age and hemoglobin, and hematocrit were -0.163, -0.136, respectively (P＜0.01). In women, Pearson correlation coefficients between age and hemoglobin, and hematocrit were 0.180 (P＜0.05), 0.031 (P＞0.05) respectively. Logistic regression analysis adjusted for age showed the lower odds ratio for anemia in both men and women without H. pylori than in those with H. pylori, but it was not significant.

Conclusion : H. pylori infection seems not to affect hemaglobin and hematocrit in the middled-aged men and the postmenopausal women with gastritis. Further investigations will be necessary for various individuals including infants and premenopausal women who may have high incidence for anemia.

Background
: Helicobacter pylori(H.pylori) infection is associated with peptic ulcer disease, gastric cancer and lymphoma. The prevalence of H.pylori infection increases with age and the risk factors of transmission are known to be poor socioeconomic status, crowding, sharing a bed in childhood and age. We attempted to determine the prevalence of H.pylori infection and identify the factors responsible for the different patterns of transmission in healthy Korean adults.

Methods : The study population was recruited from health promotion center and general health screening center in Seoul Joongang Hospital. We studied the 1,822 healthy 19 to 78-year-old adults form April 1998 to August 1998. lgG H.pylori Ab(ELISA) was measured to determine the infection of H.pylori and questionnaire for environmental information and demographic factor was surveyed.

Results : The mean age of study population was 41.2-year-old. The mean prevalence was 71.9%. A prevalence of H.pylori infection increased with age(p=0.001). An associated factor was crowding index (no of family using one room) in childhood(p<0.01). The total number of family and the number of family per one room in childhood were associated H.pylori infection, respectively(p<0.05). Current socioeconomic level, status of smoking and alcohol drinking, current crowding index, and sex were not associated with the infection rate.

Conclusion : The prevalence rate of H.pylori infection was 71.8% in Korean adults. The prevalence of H.pylori infection increased with age and crowding index in childhood.

Background
: It is well-known that dyspeptic symptoms in functional dyspepsia are related to psychological factors such as stress mood disorder. But it is still controversial whether H.pylori infection is a important factor for functional dyspepsia. We conducted this study to investigate whether H.pylori infection or stress are related to dyspeptic symptom severity in functional dyspepsia.

Methods : From Mar. 1 1999 to Apr. 30 1999, attendees to a Health Screening Center and a Family Practice Center were eligible study subjects. The subjects were responded to questionnaire including dyspeptic symptom severity items and BEPSI-K(stress scale). And among eligible subjects, one hundred and thirty two diagnosed with functional dyspepsia by gastrofibroscopy were final study subjects. H. pylori infection was confirmed by antral biopsies & smear (Giemsa stain).

Results : In fuctional dyspepsia, high BEPSI-K score group(upper tertile) complained more severe dyspeptic symptom severity than low BEPSI-K score group(lower tertile) after adjusted for other variables(adjusted OR=8.349, 95% C.I.=2.232-31.231). But the dyspeptic symptom severity was not associated with H.pylori infection status (adjusted OR=1.514, 95% C.I=0.567-4.046)

Conclusion : The dyspeptic symptom severity in functional dyspepsia was associated with stress but not with H.pylori infection status.

Background
: Helicobacter pylori infection is thought to be an important factor the pathogenesis of gastric and duodenal ulcer. But in Korea, there are new studies on the prevalence of Helicobacter pylori infection in peptic ulcer patients and their relationship between the location of ulcers and Helicobacter pylori infection. The aim of this study was to investigate the prevalence of Helicobacter pylori infection of gastric and duodenal ulcer patients in Korea and the relationship between the location of ulcers and Helicobacter pylori infection.

Methods : We studied 476 consecutive patients with duodenal ulcers or benign gastric ulcer which were diagnosed by gastrofiberscopy in Family Medicine of Hanil Hospital from January 1995 to December 1998l Helicobacter pylori infection was evaluated with rapid urease test(CLO test) in 72.7% patients.

Results : The test rate of CLO test was not significantly different by sex, age and site of gastric ulcer lesions, but test rate in the gastric ulcer was significantly lower than in the duodenal ulcer. The prevalence of Helicobacter pylori infection diagnosed with CLO test was 90.1%. The prevalence of Helicobacter pylori infection was not significantly different between males and females. Also it was also not significantly different according to age. 90.8% of those with gastric ulcer patients and 88.9% of the duodenal ulcer had Helicobacter pylori infection, but the difference was not significant. significantly. 94.6% of gastric ulcers located in only one area had Helicobacter pylori infection, compared to 83.6% of gastric ulcers which was located in multiple areas. The prevalence of Helicobacter pylori infection was significantly lower in patients who had lesions located in multiple areas.

Conclusion : We conclude that the majority of peptic ulcer patients in Korea have Helicobacter pylori infection. Gastric ulcer located in multiple areas had significantly lower prevalence of Helicobacter pylori infection, which may suggest that gastric ulcers in multiple areas have other etiologic factors.

Background
: Helicobacter pylori(H. Pylori) is a major risk factor for chronic gastritis, peptic ulcer, and low grade gastric lymphoma of mucosa-associated lymphoid tissues(MALT). Eradication of H. pylori can induce prevention of peptic ulcer relapse and regression of gastric MALT lymphoma. Smoking has also been known to be a major risk factor for peptic ulcer. The purpose of this study is to evaluate the effects of smoking on eradication of H. pylori according to smoking status, amount of smoking, and smoking cessation.

Methods : We studied 132 patients with H. pylori-positive gastroduodenal diseases. Diseases com-posed of gastritis in 36.4%, peptic ulcer 62.1%, gastric MALT lymphoma 1.5%. Patients were treated with amoxicillin 1.0g, clarithromycin 500mg, omeprazole 20mg bid for a period of 7 days. Patients underwent a follow-up gastroendoscopy 6 weeks later after eradication treatment. H. Pylori status was confirmed by initial and follow up biopsies of gastric antrum and corpus using Hematoxylin0Eosin stain and Wharthin0Starry silver stain. At the beginning of treatment, 66.7% of 132 patients were smokers, 9.8% ex-smokers, 25.3% non-smokers. Smokers were advised to stop smoking through education and counseling at each office visit.

Results : H. Pylori eradication was achieved in 111 patients(84.1%). The number of smokers who had quit smoking successfully during treatment were 25(28.4%). The rate of eradication did not seem to influence by initial smoking status and total amount of smoking(pack-years). However, during treatment, success group for smoking cessation(100%) had a higher rate or eradication than non-cessation group. Daily amount of smoking had an effect o eradication with significant statistical difference; Non-smokers showed 89.9% eradication rate, mild smokers (≤20 cigarettes/day) 81.8%, and heavy smokers ( >20/day) 50%.

Conclusion : These results suggest that current smoking status and daily amount of smoking during treatment seem to influence the rate of eradication of H. Pylori rather than past smoking history alone. There was some improvement in the eradication rate by quitting or reducing smoking together with H. Pylori eradication treatment. ( J Korean Acad Fam Med 1999;20:991-999)

Background
: It was reported that Helicobacter pylori causes duodenal ulcer and chronic active gastritis, but is still controversial on the relationship with gastric cancer. H. pylori is still clinically significant de-spite improvements in microbiologic, pathologic and therapeutic aspects. The purpose of this study is to evaluate the prevalence of H. pylori infection according to age and sex, the risk factors of H. pylori infection and the relationship with upper gastrointestinal symptoms.

Methods : The subjects were 409 people who underwent esophagogastroduodenoscopy and CLO test from Feb. to Jun. in 1997 at Health Promotion Center, Pundang CHA General Hospital. Six types of upper gastrointestinal symptoms and demographic characteristics were surveged by questionnaire. The relationship with H. pylori infection according to age, sex, education, smoking, alcohol, coffee, stress and exercise was evaluated. And, the frequencies of H. pylori according to the presence of symptoms and the six different symptoms(indigestion, frequent belching, dyspepsia, nausea/vomiting, distension, anorexia) were analyzed by Chisquare test.

Results : CLO test was positive for 264(64.5%) in total, 156(65.3%) in males, 108(63.5%) in females, not different significantly in each group. The frequency of CLO test positive was 53.3%(under 30 years old), 64%(thirties), 66.9%(forties), 67.9%(fifties), 48%(over 60 years old). H. pylori infection increased slightly as age increased, but decreased in over sixties. The frequency of H. pylori infection according to sex, education, smoking, alcohol, coffee, stress, and exercise was not different significantly. 174(60.2%) of 284 symptomatic subjects(who had more than one symptom) was positive by CLO test and 93(74.4%) of 125 asymptomatic subjects was positive. The frequency of H. pylori infection according to six symptoms was not different significantly. The sensitivity, specificity, false negative rate, false positive rate, positive predictive value and negative predictive value of CLO test to pathologic report were 77.4%, 81.3%, 22.6%, 18.7%, 93.2%, 52% respectively.

Conclusion : The prevalence of H. pylori infection was 64.5% and showed no difference by sex. H. pylori infection increased slightly as age increased. Education, smoking, alcohol, coffee, stress, exercise were not considered as risk factors. The relationship of upper gastrointestinal symptoms and H. pylori infection was not significant biostatistically.