• Title/Summary/Keyword: 헬리코박터

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Power up! cheer up! - 속이 타는 듯한 느낌! 혹시 위궤양?

  • Jeong, Myeong-Jin
    • 건강소식
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    • v.39 no.9
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    • pp.20-21
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    • 2015
  • 우리나라는 다른 나라에 비해 위장질환의 유병률은 높은 편이지만 위궤양의 주요원인으로 꼽히는 헬리코박터 감염률이 지속적으로 감소하면서 위궤양 유병률은 줄어들고 있는 추세다. 하지만 안심할 단계는 아니다. 과음, 과식, 흡연 등의 잘못된 생활습관이 여전한 이상, 위궤양의 위험 또한 여전할 수밖에 없기 때문이다.

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Risk Factors of Gastrointestinal Bleeding in Patients Receiving New Oral Anticoagulants (New Oral Anticoagulants를 복용하는 환자들에서 위장관 출혈의 위험인자)

  • Lee, Ju Yup
    • The Korean journal of helicobacter and upper gastrointestinal research
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    • v.18 no.4
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    • pp.219-224
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    • 2018
  • New oral anticoagulants (NOACs) are now widely used for the prevention and treatment of venous thrombosis, and for the prevention of stroke and systemic embolism in patients with atrial fibrillation. As compared with warfarin, NOACs have the advantage of rapid onset of action and less drug interaction. However, they carry a higher risk of gastrointestinal (GI) bleeding than warfarin. The risk of GI bleeding in patients using NOACs varies according to the type and dose of the drug. By contrast, apixaban and edoxaban are reported to carry similar risks as warfarin, and the risks with dabigatran and rivaroxaban are higher than that with warfarin. In patients using NOACs, old age, impaired renal function, impaired liver function, concurrent use of antiplatelet agents, and nonsteroidal anti-inflammatory drugs are considered major risk factors of GI bleeding, and gastroprotective agents such as histamine-2 receptor antagonist and proton pump inhibitor have preventive effects. To prevent GI bleeding associated with NOACs, the characteristics of each NOAC and the risk factors of bleeding should be recognized.

Clinical Significance of Circulating Tumor Cells in Gastric Cancer (위암에서 순환종양세포의 임상적 의의)

  • Jeon, Hye Kyung;Kim, Gwang Ha
    • The Korean journal of helicobacter and upper gastrointestinal research
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    • v.18 no.3
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    • pp.162-167
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    • 2018
  • Cancer specimens obtained via surgical resection or biopsy are generally used to understand tumor-associated alterations; however, those approaches cannot always be performed because of their invasive nature, and they may fail to reflect current tumor dynamics and drug sensitivity, which may change during the therapeutic process. Therefore, many research groups have focused on developing a non-invasive biomarker with the ability to monitor tumor dynamics. Circulating tumor cells (CTCs) are metastatic cells released from the primary tumor into the bloodstream. Hematogenous spreading of CTCs is a crucial step in the metastatic cascade, which leads to the formation of overt metastases. CTCs have attracted considerable attention because of their easy accessibility and their superiority over conventional tumor markers. Detecting CTCs is considered a valuable modality to determine prognosis and monitor response to systemic therapies in patients with gastric cancer. Moreover, molecular analyses of CTCs may provide important biological information for individual patients with cancer, which may lead to the development of personalized cancer treatment. In this article, we review potential roles and clinical applications of CTCs in patients with gastric cancer.

A Case of Duodenal Ganglioneuroma Manifesting as a Subepithelial Tumor (상피하 종양으로 발견된 십이지장 신경절신경종 1예)

  • Joo, Dong Chan;Kim, Gwang Ha;Chae, Chul Byung;Lee, So Jeong;Park, Do Youn
    • The Korean journal of helicobacter and upper gastrointestinal research
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    • v.18 no.4
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    • pp.271-274
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    • 2018
  • Ganglioneuroma of the gastrointestinal tract is a rare tumor that consists of ganglion cells, nerve fibers, and supporting cells of the enteric nervous system. Ganglioneuromas are usually associated with genetic disorders such as the multiple endocrine neoplasia syndrome or neurofibromatosis. Ganglioneuromas of the gastrointestinal tract predominantly involve the colon and rectum, and reports about duodenal ganglioneuromas are few. Herein, we report a case of duodenal ganglioneuroma treated with endoscopic resection. A 56-year-old female patient visited our hospital because of a subepithelial tumor in the second portion of the duodenum. She had no remarkable medical or family history and revealed no history of genetic disorders. Endoscopic ultrasonography and abdominal computed tomography revealed a tumor located mainly in the submucosal layer, without any regional lymph node involvement. Endoscopic resection of the lesion was performed, and the pathological examination confirmed a duodenal ganglioneuroma.

Circulating Cell-free Tumor Nucleic Acids in Gastric Cancer (위암에서의 순환종양핵산)

  • Lee, Hyun-Ji;Lee, Sun Min
    • The Korean journal of helicobacter and upper gastrointestinal research
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    • v.18 no.3
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    • pp.168-173
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    • 2018
  • Gastric cancer is still the leading cause of cancer deaths, especially in Asian countries. Recently, many studies have analyzed cell-free nucleic acids (cfNAs) circulating in the blood, for the early diagnosis of cancer and monitoring its progression. Circulating tumor nucleic acids (ctNAs) originate in a tumor and contain tumor-related genetic or epigenetic alterations. This review defines the nomenclatures of each form of cfNAs and describes the characteristics of circulating tumor DNA (ctDNA) and microRNA (miRNA), two major forms of ctNAs studied in gastric cancer research to date. We compare available studies on ctDNA, and explain trends observed in studies of miRNAs in gastric cancers. As these new blood-based biomarkers have attracted increasing attention, we have discussed several important points to be considered before the clinical translation of ctNA detection. We have also discussed the current status of research in this field, and clinical applications of specific ctNAs as tumor markers for gastric cancer diagnosis.

Endoscopic Resection of Xanthogranulomatous Gastritis Presenting as a Subepithelial Tumor: A Case Report

  • Kim, Tae Wan;Kim, Tae Ho;Kim, Chang Whan;Chang, Jae Hyuck;Han, Sok Won;Kim, Jae Kwang
    • The Korean journal of helicobacter and upper gastrointestinal research
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    • v.18 no.3
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    • pp.198-203
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    • 2018
  • Xanthogranulomatous gastritis (XGG) presenting as a subepithelial tumor (SET) is a very rare entity. We report a case of SET-like XGG diagnosed and treated with endoscopic resection. A 55-year-old female patient was initially referred with a 1.5-cm SET located at the anterior wall of the middle antrum. Endoscopic ultrasound examination revealed submucosal invasion without any perigastric lymph node enlargement. Endoscopic resection was performed for an accurate diagnosis and treatment, and the lesion was diagnosed histopathologically as XGG. At the 18-month follow-up after endoscopic resection, there was no evidence of XGG recurrence. SET-like XGG is very rare and the diagnosis is a preoperative challenge. However, inflammatory tumors should be considered in the differential diagnosis of SET.

Risk Stratification for Patients with Upper Gastrointestinal Bleeding (상부위장관 출혈 환자에서 위험의 계층화와 이에 따른 치료 전략)

  • Lee, Bong Eun
    • The Korean journal of helicobacter and upper gastrointestinal research
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    • v.18 no.4
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    • pp.225-230
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    • 2018
  • Upper gastrointestinal (GI) bleeding (UGIB) is the most common GI emergency, and it is associated with significant morbidity and mortality. Early identification of low-risk patients suitable for outpatient management has the potential to reduce unnecessary costs, and prompt triage of high-risk patients could allow appropriate intervention and minimize morbidity and mortality. Several risk-scoring systems have been developed to predict the outcomes of UGIB. As each scoring system measures different primary outcome variables, appropriate risk scores must be implemented in clinical practice. The Glasgow-Blatchford score (GBS) should be used to predict the need for interventions such as blood transfusion or endoscopic or surgical treatment. Patients with GBS ${\leq}1$ have a low likelihood of adverse outcomes and can be considered for early discharge. The Rockall score was externally validated and is widely used for prediction of mortality. The recently developed AIMS65 score is easy to calculate and was proposed to predict in-hospital mortality. The Forrest classification is based on endoscopic findings and can be used to stratify patients into high- and low-risk categories in terms of rebleeding and thus is useful in predicting the need for endoscopic hemostasis. Early risk stratification is critical in the management of UGIB and may improve patient outcome and reduce unnecessary health care costs through standardization of care.

A Case of Anticoagulant-induced Spontaneous Intramural Intestinal Hematoma (항응고제에 의한 자발성 장관 벽내 혈종 1예)

  • Park, Ho Joon;Kim, Gwang Ha;Park, Sang Kyu;Park, Do Youn
    • The Korean journal of helicobacter and upper gastrointestinal research
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    • v.18 no.3
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    • pp.204-208
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    • 2018
  • Spontaneous intramural hematoma is a rare complication of oral anticoagulants, and its incidence is expected to increase because of the increasing number of elderly patients undergoing anticoagulant therapy. Clinical manifestations of spontaneous intramural hematoma vary from mild abdominal pain to intestinal obstruction or acute abdomen. Early diagnosis is important because most patients can be treated successfully without surgery. The role of endoscopy in the diagnosis of intramural hematoma is not well established because almost all cases are diagnosed non-invasively with computed tomography scans. However, confirmation of the intramural hematoma through direct visualization of the involved bowel mucosa is helpful, if the imaging diagnosis is uncertain. We report a case of anticoagulant-induced spontaneous intramural hematoma, which was diagnosed using endoscopy, with relevant literature review.