• 제목/요약/키워드: Duodenal ulcer

검색결과 85건 처리시간 0.033초

Comorbid Gastric Adenocarcinoma and Gastric and Duodenal Strongyloides stercoralis Infection: A Case Report

  • Seo, An Na;Goo, Youn-Kyoung;Chung, Dong-Il;Hong, Yeonchul;Kwon, Ohkyoung;Bae, Han-Ik
    • Parasites, Hosts and Diseases
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    • 제53권1호
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    • pp.95-99
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    • 2015
  • Strongyloides stercoralis can cause systemic infection, termed strongyloidiasis, and gastrointestinal ulcer disease in immunocompromised patients. However, to our knowledge, there are no reported cases of comorbid gastric adenocarcinoma and S. stercoralis infection. Here, we report a case of an 81-year-old Korean man who presented with S. stercoralis infection coexisting with early gastric adenocarcinoma (T1aN0M0). S. stercoralis eggs, rhabditiform larvae, and adult females were observed in normal gastric and duodenal crypts. They were also observed in atypical glands representative of adenocarcinoma and adenoma. Preliminary laboratory tests revealed mild neutrophilic and eosinophilic leukocytosis. A routine stool test failed to detect rhabditiform larvae in the patient's fecal sample; however, S. stercoralis was identified by PCR amplification and 18S rRNA sequencing using genomic DNA extracted from formalin-fixed paraffin-embedded tissues. Postoperatively, the patient had a persistent fever and was treated with albendazole for 7 days, which alleviated the fever. The patient was followed-up by monitoring and laboratory testing for 4 months postoperatively, and no abnormalities were observed thus far. The fact that S. stercoralis infection may be fatal in immunocompromised patients should be kept in mind when assessing high-risk patients.

급성 출혈 환자에서 N-Butyl Cyanoacrylate를 이용한 경도관 동맥색전술의 유용성 (Efficacy of Transcatheter Arterial Embolization with N-Butyl Cyanoacrylate in Acute Bleeding Patient)

  • 제환준;김상윤;이의중;이활;서길준
    • Journal of Trauma and Injury
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    • 제18권2호
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    • pp.112-118
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    • 2005
  • Background: N-Butyl Cyanoacrylate (NBCA) is a liquid embolic material that can be useful for transcatheter arterial embolization (TAE) of acute bleeding especially in patients with coagulopathy, because it does not depend on coagulation for its therapeutic effect. The aims of this study were to evaluate the clinical efficacy and safety of TAE with NBCA in acute bleeding patients. Methods: Between August 2003 and September 2004, TAE using NBCA for acute bleeding was performed in 23 patients (16 men, 7 women; mean age, 56.5years). The causes of bleeding were gastric ulcer (n=5), postoperative bleeding (n=4), post-biopsy bleeding (n=3), postpartum bleeding (n=3), duodenal ulcer (n=2), angiodysplasia (n=2), gastric lymphoma (n=1), iatrogenic injury (n=1), CMV gastritis (n=1), stab injury of the liver (n=1). TAE was performed using 1:3 mixtures of NBCA and iodized oil. The angiographic and clinical success rate, recurrent bleeding rate, procedure-related complication and clinical outcomes were evaluated. Results: The angiographic and clinical success rate was 100% and 91.3% (21/23), respectively. There was no serious ischemic complication. Recurrent bleeding occurred in 2 patients (8.7%) and they were managed with successful second TAE (n=1) and endoscopic treatment (n=1). Nine patients (39.1%) had coagulopathy at the time of TAE and clinical success rate in this group of patients was 88.9% (8/9). Conclusions: TAE with NBCA is highly effective and safe treatment modality for acute bleeding patients, especially when the patient has a coagulopathy.

H. pylori 감염 진단 시 14C-요소호기검사의 임상적 유용성 (Clinical Usefulness of 14C-Urea Breath Test for the Diagnosis of H. pylori Infection)

  • 김윤식
    • 대한임상검사과학회지
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    • 제39권3호
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    • pp.271-276
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    • 2007
  • Helicobacter pylori (H. pylori) infection is common in korea and high incidence at gastric ulcer and duodenal ulcer. $^{14}C-urea$ breath test ($^{14}C-UBT$) is regarded as a highly reliable and non-invasive method for the diagnosis of H. pylori infection. The purpose of this study was to evaluate the diagnositc performance of a new and rapid $^{14}C-UBT$, which was equipped with Geiger-Muller counter and compared the results with those obtained by gastroduodenoscopic biopsies (GBx). One hundred sixty-eight patients (M : F = 118 : 50) underwent $^{14}C-UBT$, rapid urease test (CLO test), and GBx. The results of $^{14}C-UBT$ were classified as positive (>50 cpm), borderline (25$^{14}C-UBT$ or CLO test results with GBx as a glod standard. In the assessment of the presence of H. pylori infection, the $^{14}C-UBT$ global performance yielded positive predictive value, negative predictive value and accuracy of 93.3% and 83.3%, respectively. However, the CLO test had performance yielded positive predictive value, negative predictive value and accuracy of 76.9%, 50.0%, respectively. In this study $^{14}C-UBT$ is a highly accurate, simple and non-invasive method or the diagnosis of follow up H. pylori infection.

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Helicobacter pylori Infection and a P53 Codon 72 Single Nucleotide Polymorphism: a Reason for an Unexplained Asian Enigma

  • Pandey, Renu;Misra, Vatsala;Misra, Sri Prakash;Dwivedi, Manisha;Misra, Alok
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권21호
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    • pp.9171-9176
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    • 2014
  • Aim: P53, the most commonly mutated tumor suppressor gene in all types of human cancer, is involved in cell cycle arrest and control of apoptosis. Although p53 contains several polymorphic sites, the codon 72 polymorphism is by far more common. There are divergent reports but many studies suggest p53 pro/pro SNP may be associated with susceptibility to developing various cancers in different regions of the world. The present study aimed to find any correlation between H. pylori infection and progression of carcinogenesis, by studying apoptosis and the p53 gene in gastric biopsies from north Indian population. Materials and Methods: A total of 921 biopsies were collected and tested for prevalence of H. pylori by rapid urease test (RUT), imprint cytology and histology. Apoptosis was studied by the TUNEL method. Analysis of p53 gene polymorphism at codon 72 was accomplished by PCR using restriction enzyme BstU1. Observation: Out of 921 samples tested 56.7% (543) were H. pylori positive by the three techniques. The mean apoptotic index (AI) in the normal group was 2.12, while gastritis had the maximum 4.24 followed by gastric ulcer 2.28, gastropathy 2.22 and duodenal ulcer 2.08. Mean AI in cases with gastric cancer (1.72) was less than the normal group. The analysis of p53 72 SNP revealed that p53 (Arg/Arg), (Pro /Arg) variant are higher (40.59% & 33.66%) as compared to p53 pro/pro variant (25.74%) inthe healthy population. Conclusions: The North Indian population harbors Arg or Pro/Arg SNP that is capable of withstanding stress conditions; this may be the reason of low incidence of gastric disease in spite of high infection with H. pylori. There was no significant association with H. pylori infection and AI. However, there is increased apoptosis in gastritis which may occur independent of H. pylori or p53 polymorphism.

Analysis of Somatostatin-Secreting Gastric Delta Cells according to Upper Abdominal Symptoms and Helicobacter pylori Infection in Children

  • Kim, Dong-Uk;Moon, Jin-Hwa;Lee, Young-Ho;Paik, Seung Sam;Kim, Yeseul;Kim, Yong Joo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제23권3호
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    • pp.243-250
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    • 2020
  • Purpose: Gastric delta cells (D-cells), which are somatostatin-secreting cells, are the main paracrine inhibitor of acid secretion. The number of D-cells was studied in children presenting with upper gastrointestinal (UGI) disease. Methods: We retrospectively investigated the number of D-cells in the gastric body and antrum through immunofluorescence examinations according to symptoms, endoscopic findings, and Helicobacter pylori infection in 75 children who visited Hanyang University Hospital Pediatrics. Results: The mean patient age was 12.2±3.3 years. The male-to-female ratio was 1:1.4. The mean D-cell number per high-power field in the antrum and body was 20.5 and 12 in children with substernal pain, 18.3 and 10.3 in vomiting, 22.3 and 6 in diarrhea, and 9.3 and 6 in abdominal pain, respectively (p>0.05). According to endoscopic findings, the mean D-cell number in the antrum and body was 14.3 and 6 with gastritis, 14 and 9.3 with reflux esophagitis, 16.7 and 8.7 with duodeno-gastric reflux, 19.3 and 12.7 with gastric ulcer, 16 and 13.7 with duodenitis, and 12.3 and 4 with duodenal ulcer, respectively (p>0.05). The D-cell number in the gastric body was 2.7 and 8.7 in children with current H. pylori infection and non-infected children, respectively (p=0.01), while those in the antrum were 15.5 and 14, respectively, with no statistical significance. Conclusion: The D-cell number was lower in the gastric body of children with current H. pylori infection. Further studies concerning peptide-secreting cells with a control group would provide information about the pathogenic pathways of UGI disorder.

섬유제조업 여성 근로자들의 교대작업에 따른 수면실태와 위장관장애 (Sleeping Patterns and Gastrointestinal Disorders According to the Shift Works in Female Textile Workers)

  • 류기하
    • Journal of Preventive Medicine and Public Health
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    • 제27권1호
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    • pp.74-83
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    • 1994
  • To investigate the sleeping patterns and gastrointestinal disorders of shift workers, the author studied 434 female workers who worked at textile industry ill Taejon city from September 1,1992 to September 31,1992. Shift pattern were divided into 3 categories ; 3 shift(shifts per 8 hours), 2 shift(day and night shift) and day work. The results obtained were as follows : 1 The average sleeping hours when adjusted for the education level of the total study subjects was 6.1 hours. That of 3 shift workers was 6.1 hours, 2 shift workers was 6.0 hours, but that of day workers was 6.5 hours. There were no significant difference among the shift workers. 2. For the 3 shift workers, the average physiologic adjusted duration in day shift (2.2 days) was shorter than that of night shift(2.7 days) and there were significant difference among the rotating shift works (p<0.001). The sleeping problems in day shift was less than those of night shift (p<0.001). 3. 44.9% of 3 shift workers, 39.3% of 2 shift workers and 33.1% of day workers complained gastrointestinal symptoms when adjusted for the age, education level, job tenure, work post. And the rates of gastrointestinal symptoms complained increase with job tenures (p<0.001). 4. The most frequent gastrointestinal diseases were gastitis and gastric ulcer with 14.2% , Irritable bowel syndrome with 3.1 %, duodenitis and duodenal ulcer with 2.1% and combined gastrointestinal disease with 2.1%. Age, eating habit, amount of coffee per day, job tenure, work post and shift pattern showed no significant difference with the gastrointestinal diseases when adjusted for the age. According to the above results, the author suggested that the shift pattern and job tenure can affect to the sleeping problem and gastrointestinal symptoms.

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외래환자의 위장관계 다빈도 질환과 처방 분석 (Analysis of Frequently Diagnosed Gastrointestinal Disorders and Therapeutic Regimens in the Outpatients)

  • 김민정;최경업
    • 한국임상약학회지
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    • 제7권1호
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    • pp.22-32
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    • 1997
  • The gastrointestinal disorders (GI disorders) is one of the most common diseases in Korea. The community pharmacists are often faced with the complaints of symptoms due to the GI disorders. However the drugs used to treat the GI disorders are frequently abused by the patients themselves because these drugs are easily available and have high placebo effects. Therefore, we have reviewed the digestive diseases statistics of 1996 to find out the frequencies of the GI disorders in the outpatients of Samsung Medical Center. Using these statistic data, we figured out the frequently diagnosed GI disorders and analysed commonly used prescriptions from February 1st to 28th of 1997. In addition, we also evaluated the commonly used drugs in these prescriptions. About twenty thousands of patients visited the hopital because of their GI symptoms in 1996. It was found that dyspepsia, viral hepatitis, and gastric and duodenal ulcer disease are frequently diagnosed in these patients. In a point of view on other GI disorders, gastritis and duodenitis, irritable bowel syndrome, gastroesophageal reflux disease, constipation and diarrhea were commonly detected. And a number of drugs were prescribed to treat the GI disorders, which included the prokinetics, Histamine-2 receptor antagonists, proton pump inhibitor, antacids, tranquillizers, antidepressants, antispasmodics, laxatives and so on. Interestingly, there were many prescriptions composing of the antibiotic regimens to eradicate H. pylori which has been proven to cause peptic ulcers.

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복부 대동맥류의 외과적 치료 (Surgical Treatment of the Abdominal Aortic Aneurysm)

  • 황석하
    • Journal of Chest Surgery
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    • 제26권5호
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    • pp.355-359
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    • 1993
  • Ten consecutive patients with abdominal aortic aneurysm were treated in Chungnam National University Hospital from May of 1985 to June of 1993. Pulsating palable mass was the most common first sign [7 patients]. The ratio of male to female was 8:2. The age ranged from 53 to 73 years with mean age of 65 years. The etiology and location of the aneurysm was atherosclerosis and infrarenal aorta in all. Dacron graft interposition [straight graft-1, bifurcation graft-7] and wrapping with aneurysmal sac were performed in 8 patients. In one patient with infected abdominal aortic aneurysm, we performed aneurysmectomy and left axillo-bifemoral bypass with 8 mm PTFE graft. And in another patient with complete thrombotic obstruction of infrarenal aortic aneurysm, we performed the suturing of the proximal part of the abdominal aortic aneurysm and aorto-bifemoral bypass with 18 x 9 mm PTFE graft. There was one operative death with the mortality rate of 11 % and 8 complications in 4 patients; ARF[2], duodenal ulcer[1], mechanical ileus[1], genitourinary dysfunction[2] and wound infection with abdominal abscess[1]. Because of the high operative mortality after rupture of the aneurysm, we think it is better to operate on early at the diagnosis of abodominal aortic aneurysm is made.

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성상신경절 차단 후 발생한 심한 경부혈종 -증례 보고- (Severe Hematoma in the Neck Following the Stellate Ganglion Block -A case report-)

  • 강형창;김유재
    • The Korean Journal of Pain
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    • 제11권2호
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    • pp.346-349
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    • 1998
  • The technique of the stellate ganglion block is widely used as it is relatively simple and safe. But it can cause severe complications because there are major blood vessels and nerves around the stellate ganglion. We practiced CPR because of the respiratory failure caused by severe hematoma in the neck following the stellate ganglion block. A 46-year-old male patient admitted to ENT department because of the both sudden sensorineural hearing loss that happened after URI. He was referred to Pain Clinic for further evaluation and treatment. We decided to block the stellate ganglion. We injected 6ml of 0.5% mepivacaine on both sides of the stellate ganglion. There were no blood aspiration and abnormal vital signs during the 30 minute observation, either. Three hours after he went to the private room, he had pain and edema in his neck, but no respiratory defficulty. But later, respiratory failure was suddenly followed. So we practiced CPR. We confirmed severe hematomas in the neck through CT scanning. Hematomas is removed and the ruptured blood vessels which is supposed to be muscular branch of vertebral artery is ligated under general anesthesia. The patient was discharged from hospital after the treatment of pneumonia and duodenal ulcer as complications. We recommand you to compress the block site more than five minutes and not to prick with the needle several times at one point to prevent the formation of hematomas.

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경구투여 백신 후보물질로서의 Helicobacter pylori 외막 단백질의 조사

  • 박형배;최태부
    • 한국미생물·생명공학회지
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    • 제25권2호
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    • pp.129-136
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    • 1997
  • Helicobacter pylori is a spiral-shaped, microaerophilic human gastric pathogen causing chronic-active gastritis in association with duodenal ulcer and gastric cancer. To investigate the possibility of H. pylori outer membrane proteins (OMPS) as the oral vaccine antigens, sarcosine-insoluble outer membrane fraction has been prepared from H. pylori NCTC 11637. The major OMPs having apparent molecular masses of 62 kDa, 54 kDa and 33 kDa were detected by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), which were identified as urease B subunit (UreB), heat shock protein (Hsp54 kDa) and urease A subunit (UreA), respectively. Minor protein bands of 57 kDa, 52 kDa, 40 kDa, 36 kDa and 31 kDa were also observed. The antigenicity of H. pylori OMPs and antigenic cross-reactivity among the strains were determined by immunoblot analysis using anti-H. pylori OMPs antisera or intestinal lavage solutions. The results showed that UreB, Hsp54 kDa, UreA and 40 kDa proteins vigorously stimulated mucosal immune response rather than systemic immunity. From this results, these proteins seemed to be useful as the antigen candidates for the oral vaccine. The immunoblotting results with surface proteins from eight isolated H. pylori strains were similar to that of H. pylori NCTC 11637. The IgA which had been arised from oral administration of H. pylori OMPs, was able to bind H. pylori whole-cells.

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