The aims of this study were to assess the clinical observation of outpatient who showed hematochezia, and to determine whether specific clinical symptoms associated with hematochezia were predictive of important gastrointestinal pathology.

Prospective study was carried out from July 1998 to July 1999 with sixty-five outpatients(35 males and 30 females with mean age, 43±11 years) who had no evidence of recent bleeding. Patients were interviewed by questionnaires about the amount and frequency of bleeding, change in bowel habits, weight loss, usage of aspirin/NSAIDs, and family history, prior gastrointestinal pathologic illness before colonoscopy. Based on this information, endoscopist were asked to predict whether the bleeding was from a benign perianal or other lesion. Important gastrointestinal pathology was defined as carcinoma, adenomas more than 1cm, active ulcerative colitis, and active tuberculosis by colonoscopy.

Colonoscopic findings were as follows : 27 cases of benign anorectal lesion ; 16 cases of polyps, 10 cases of normal ; 8 cases of acute colitis and nonspecific colitis ; 7 cases of coloerctal cancer, 7 cases of ulcerative colitis and intestinal tuberculosis ; and other cases. Important gastrointestinal pathology was 17 cases. Variables including duration, type and frequency of bleeding, weight loss and change in bowel habit did not predict the colonoscopic diagnosis. Of the 35 patients diagnosed clinically by endoscopist to begin anorectal lesion alone, 18 patients were found to have benign anorectal lesion, 2 patients had cancer, 2 patient had polyp(bigger than 1cm), and 1 patient had ulcerative colitis.

In outpatients with hematochezia, the incidence of colon cancer was 10.8%. Clinicians were unable to distinguish significant colonic lesions by history. Therefore accurate diagnostic workup is needed for this group of patients.

Helicobacter pylori(H. pylori) infection causes an active chronic gastritis and is an important etiological factor in developement of peptic ulcers. Successful treatment of this infection heals ulcers and reduces the risk of peptic ulcer relapse. We performed this study to assess the safety, tolerance and efficacy of a one week course of triple therapy with twice daily dosing using ranitidine bismuth citrate(RBC) with clarithromycin and amoxicillin for eradication of H. pylori.

H. pylori positive thirty-five patient(mean age 51.7±15.8 years, range : 16-74 years, Male : Female=27 : 9) with active peptic ulcer were enrolled in study. H. pylori infection was detected by CLO-test or histology, both antral and corpus biopsies. Patients were treated for 7 days with combination of RBC 400mg bid, clarithromycin 500mg bid, amoxicillin 1g bid. Eradication was defined as no evidence of H. pylori infection by Urea breath test performed at 4-6 weeks after the completion of therapy. Adverse events and compliance were assessed.

Twenty six out of 35 subjects completed the study. Patient's sex, age, smoking status, alcohol consumption, or history of ulcer had no significant effect on eradication of H. pylori. The per protocol and intention-to-treat eradication rate was 88.5%(23/26) and 65.7% (23/35), respectively. The per protocol eradication rate was 100%(10/10) for duodenal ulcer, 92.3%(12/13) for gastric ulcer, and 33.4%(1/3) for gastric and duodenal ulcer, respectively. Three patients experienced side effects during therapy, none that were considered severe.

Ranitidine bismuth citrate in combination with clarithromycin and amoxicillin in a one week b.i.d dosing regimen is well tolerated and effective in eradicating H. pylori infection.

Helicobacter pylori causes chronic gastritis, which progress to peptic ulcer, gastric atrophy, or gastric cancer. However, little is known about the role of Helicobacter pylori in reflux esophagitis. Corpus gastritis reduces the parietal cell mass and decreased peak acid output as a known risk factor for reflux esophagitis. So the relationship among reflux esophagitis and corpus gastritis and Helicobacter pylori needs to be clarified.

In prospective, controlled study of patients with reflux esophagitis without other gastrointestinal disease, the prevalence of Helicobacter pylori was assessed. Antral and corpus biopsy were performed and rapid urease test and Giemsa staining were taken for Helicobacter pylori status.

The prevalence of Helicobacter pylori was 43.8%(21/48) in reflux esophagitis and 67.5%(27/40) in reference group. The prevalence of Helicobacter pylori was significantly lower in patients compared with the reference group(p<O.O5). The corpus gastritis was no significant relationship with reflux esophagitis and Helicobacter pylory.

The prevalence of Helicobacter pylori infection in patients with reflux esophagitis is significantly lower than in the reference group, irrespective of corpus gastritis. It is suggested that Helicobacter pylori infection have a preventive role to reflux esophagitis, so we may be aware of balance between 'deleterious' and 'beneficial' effects of Helicobacter pylori eradication.

The apparent acute hepatitis A was occuring among adolescene and young adults during last several years. So here we present the clinical manifestations and laboratory finding and risk factors of 72 patients with acute hepatitis A who were referred to our community hospital.

Seventy-two Patients, 6 to 40 years of age(mean ; 22±8 years) with hepatitis A identified by testing their sera for IgM anti-HAV antibody. Medical records for patients with HAV infection were retrospectively reviewed for symptoms, signs, and laboratory values.

The prevalence of hepatitis A have been increased recently, especially during last 2 years. The probable exposures to HAV included food- or waterborne source, household, foreign travel, day care centers. The clinical symptoms are not distinguishable from hepatitis due to other agents. The mean laboratory tests included total bilirubin 6.0mg/dl, AST/ALT 1064.0±1123.4mIU/mL, 1561.7±1203.0mIU/ml, respectively. All 72 patients experienced complete clinical and biochemical recovery within 6 months after onset of illness.

Abrupt increase of hepatitis A was occuring among the adolescents and young adults recently. Improved sanitation has brought our countries shifting a nearly universal asymptomatic infection in children to a less common but more significant disease expression in adults.