• Title/Summary/Keyword: Gastroduodenal disease

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Gastroduodenal Intussusception Resulting from Large Hyperplastic Polyp

  • Kim, Dong Jin;Lee, Jun Hyun;Kim, Wook
    • Journal of Gastric Cancer
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    • v.12 no.3
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    • pp.201-204
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    • 2012
  • Gastroduodenal intussusception is an infrequent cause of gastrointestinal obstructive disease. Benign neoplasms, gastrointestinal stromal tumors and pedunculated adenocarcinomas of less than 5 cm have been reported to cause gastroduodenal intussusception. We report a case of 76-year-old woman who was presented with a 3-day history of nausea and vomiting due to upper gastrointestinal obstruction. Computed tomography revealed gastroduodenal intussusception with the transpyloric herniation of alarge gastric hyperplastic polyp. The patient underwent laparoscopic wedge resection with the eversion method.

Transcatheter Arterial Chemoembolization Combined with Interferon-α is Safe and Effective for Patients with Hepatocellular Carcinoma after Curative Resection

  • Zuo, Chaohui;Xia, Man;Liu, Jingshi;Qiu, Xiaoxin;Lei, Xiong;Xu, Ruocai;Liu, Hanchun;Li, Jianliang;Li, Yongguo;Li, Qinglong;Xiao, Hua;Hong, Yuan;Wang, Xiaohong;Zhu, Haizhen;Wu, Qunfeng;Burns, Michael;Liu, Chen
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.1
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    • pp.245-251
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    • 2015
  • Objectives: Intrahepatic recurrence is the major cause of death among patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) after curative surgical resection. Several approaches have been reported to decrease the recurrence rate. The objective of our study was to compare the clinical effects of transcatheter arterial chemoembolization (TACE) combined with interferon-alpha (IFN-${\alpha}$) therapy on recurrence after hepatic resection in patients with HBV-related HCC with that of TACE chemotherapy alone. Methods: We retrospectively analyzed the data from 228 patients who were diagnosed with HBV-related HCC and underwent curative resection between January 2001 to December 2008. The patients were divided into TACE (n = 126) and TACE-IFN-${\alpha}$ (n = 102) groups for postoperative chemotherapy. The TACE regimen consisted of 5-fluorouracil (5-FU), cisplatin (DDP), and the emulsion mixed with mitomycin C (MMC) and lipiodol. The recurrence rates, disease-free survival (DFS), overall survival (OS), and risk of recurrence were evaluated. Results: The clinicopathological parameters and adverse effects were similar between the 2 groups (P > 0.05). The median OS for the TACE-IFN-${\alpha}$ group (36.3 months) was significantly longer than that of the TACE group (24.5 months, P < 0.05). The 3-and 5-year OS for the TACE-IFN-${\alpha}$ group were significantly longer than those of the TACE group (P < 0.05) and the recurrence rate was significantly lower (P < 0.05). The TACE and IFN-${\alpha}$ combination therapy, active hepatitis HBV infection, the number of tumor nodules, microvascular invasion, liver cirrhosis, and the BCLC stage were independent predictors of OS and DFS. Conclusions: The use of the TACE and IFN-${\alpha}$ combination chemotherapy after curative hepatic resection safely and effectively improves OS and decreases recurrence in patients with HBV-related HCC who are at high risk. Our findings can serve as a guide for the selection of postoperative adjuvant chemotherapy for patients with HBV-related HCC who are at high risk of recurrence.

Evaluation of Endoscopic Characteristics of Upper Gastrointestinal Polyps in Patients with Familial Adenomatous Polyposis

  • Fatemi, Seyed Reza;Safaee, Azadeh;Pasha, Sara;Pourhoseingholi, Mohamad Amin;Bahrainei, Rasool;Molaei, Mahsa
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.16
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    • pp.6945-6948
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    • 2014
  • Background: Familial adenomatous polyposis (FAP) is a disease inherited in an autosomal dominant fashion. Most FAP patients develop upper gastrointestinal polyps; especially those in the antrum and duodenum are usually neoplastic. The aim of this study was to evaluate the prevalence of gastroduodenal polyps in Iranian FAP patients. Materials and Methods: 28 patients affected by FAP underwent front-view and side-view endoscopy. Papillary biopsies were performed in all patients. Location of polyps, their number and size, pathology study, patient general information (gender, age, family history of FAP or colorectal cancer and gastroduodenal polyps) were analyzed. Results: Gastric polyps were seen in 39.3 % of patients. Some 72.7% of the affected individuals had fundic gland polyps and 36.36% had hyperplastic polyps. Duodenal adenoma was observed in 25% of patients. While 57% of patients had tubular adenoma with low grade dysplasia, 42.8% showed tubulovillous adenoma with low grade dysplasia. Conclusions: Findings of this study indicated that the prevalence of gastroduodenal polyps in FAP patients is high and dysplasia may be evident in duodenal polyps. Therefore, it appears that routine gastroduodenal endoscopy in FAP patients is necessary.

Clinical and Endoscopic Findings in Children with Peptic Ulcer in Terms of $Helicobacter$ $pylori$ in Incheon

  • Cho, Sang-Hee;Chun, Ka-Yeong;Ryoo, Eell;Kim, Yeun-Sun;Tchah, Hann
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.15 no.1
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    • pp.23-28
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    • 2012
  • Purpose: Interest in peptic ulcer in children has been relatively low because the disease is rarer in children than in adults and there were restrictions in the application of endoscopy to children, but the recent development of pediatric endoscopy is activating research on pediatric peptic ulcer. Thus, this study compared the $H.$ $pylori$ infection rate and clinical and endoscopic findings among pediatric patients diagnosed with peptic ulcer. Methods: We analyzed retrospectively 58 pediatric patients for whom whether to be infected with $H.$ $pylori$ was confirmed selected out of pediatric patients diagnosed with gastric ulcer or duodenal ulcer through upper gastrointestinal endoscopy at the Department of Pediatrics of Gachon University Gil Hospital during the period from January 2002 to December 2007. A case was considered $H.$ $pylori$ positive if $H.$ $pylori$ was detected in the Giemsa stain of tissue or the results of UBT (urea breath test) and CLO (rapid urease test) were both positive. Results: Of the pediatric patients, 37 were infected with $H.$ $pylori$ and 21 were not. The $H.$ $pylori$ infection rate increased with aging and the result was statistically significant ($p$<0.05). However, $H.$ $pylori$ infection was not in a statistically significant correlation with sex, chief complaint, and gastroduodenal ulcer ($p$>0.05). Conclusion: $H.$ $pylori$ infection increased with aging, but was not significantly correlated with gastroduodenal ulcer. Further research may need to examine prospectively the relation between $H.$ $pylori$ and gastroduodenal ulcer in the Incheon area.

A Study of Oriental Herbal Medicine on the Treatment of Helicobacter Pylori Infections (Helicobacter pylori의 한약 치료에 대한 연구)

  • Lee, Seung-Yeon;Park, Sang-Eun;Hong, Sang-Hoon
    • The Journal of Internal Korean Medicine
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    • v.33 no.1
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    • pp.39-53
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    • 2012
  • Objectives : Many studies have shown that helicobacter pylori (H. pylori) infection is associated with gastroduodenal diseases. The purpose of this report was to evaluate recently published research on the influence of oriental herbal medicine on H. pylori infections. Methods : Recently published literature were systematically compared with their findings of how oriental herbal medical treatment affects H. pylori-associated disease. Results : The eradication rate of H. pylori in oriental herbal medicine groups was 66.93% while it was 66.02% in western medicine groups. In oriental herbal plus western medicine groups, interestingly, the rate increased to 84.78%. On the other hand, the total treatment efficacy rate of H. pylori in oriental herbal medicine groups was 91.27%. The treatment efficacy rate in oriental herbal plus western medicine groups rose to a record 93.22%, which was 15.34% higher than the rate in western medicine groups. In addition, the rate of adverse effects was 2.71%, 4.85%, 15.80% in oriental herbal medicine, western medicine, and oriental herbal plus western medicine groups, respectively. Diarrhea was most frequently observed in oriental herbal medicine groups, while nausea was most frequently observed in the other groups. Conclusions : The results of this study showed that herbal medicinal treatment can increase the rate of H. pylori eradication and improve H. pylori-related gastrointestinal symptoms. These findings suggest that herbal medicine can solve the problems including side effects due to antibiotic resistance of standard triple therapy.

Upper gastrointestinal tract involvement of Crohn disease: clinical implications in children and adolescents

  • Kim, Eun Sil;Kim, Mi Jin
    • Clinical and Experimental Pediatrics
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    • v.65 no.1
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    • pp.21-28
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    • 2022
  • Crohn disease (CD) is a multifactorial inflammatory disorder that can affect all segments of the gastrointestinal (GI) tract but typically involves the ileum and/or colon. To assess patient prognosis and choose appropriate treatment, it is necessary to accurately evaluate the factors influencing poor outcomes, including disease phenotype. Pediatric CD involving the upper GI (UGI) tract has become increasingly recognized with the introduction of routine upper endoscopy with biopsies for all patients and the increased availability of accurate small bowel evaluations. Most clinical manifestations are mild and nonspecific; however, UGI involvement should not be overlooked since it can cause serious complications. Although controversy persists about the definition of upper GI involvement, aphthoid ulcers, longitudinal ulcers, a bamboo joint-like appearance, stenosis, and fistula are endoscopic findings suggestive of CD. In addition, the primary histological findings, such as focally enhanced gastritis and noncaseating granulomas, are highly suggestive of CD. The association between UGI involvement and poor prognosis of CD remains controversial. However, the unstandardized definition and absence of a validated tool for evaluating disease severity complicate the objective assessment of UGI involvement in CD. Therefore, more prospective studies are needed to provide further insight into the standardized assessment of UGI involvement and long-term prognosis of CD. Our review summarizes the findings to date in the literature as well as UGI involvement in CD and its clinical implications.

Helicobacter pylori and Gastroesophageal Reflux Disease (헬리코박터 파일로리 감염과 위식도역류질환)

  • Yeon-Ji Kim
    • Journal of Digestive Cancer Research
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    • v.10 no.2
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    • pp.49-55
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    • 2022
  • Helicobacter pylori (H. pylori) infection is associated with gastroduodenal diseases such as gastritis, peptic ulcer diseases, gastric adenocarcinoma, and mucosa-associated lymphoid tissue lymphoma. Furthermore, various extragastroduodenal diseases have been suggested to be related with H. pylori infection. Although no single factor has been considered the cause of gastroesophageal reflux disease (GERD), a negative association was found between the prevalence of H. pylori and GERD severity. Additionally, the role of eradication therapy of H. pylori in reflux esophagitis is controversial, and a significant correlation was found between successful H. pylori eradication rate and reflux esophagitis development. H. pylori infection remains an inconclusive and important issue in GERD. Thus, more experimental studies are necessary to elucidate the potential mechanisms.

Diagnostic Significance of Cytotoxic Genes Expression by Western blotting of Serum in Helicobacter pylori Infection (Helicobacter pylori 감염 환자에서 Western blot 법에 의한 혈청내 세포독성 유전자의 발현에 관한 연구)

  • Kim, Dae-In;Lee, Goo;Shu, Jung-Ill;Lee, Chang-Woo;Kim, Jung-Ran;Ha, Gyoung-Yim;Lee, Kyu-Chun;Nam, Kyung-Soo;Yang, Chang-Heon
    • Journal of Life Science
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    • v.10 no.6
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    • pp.630-639
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    • 2000
  • The gastric pathogen Helicobacter pylori(H. pylori) establishes long-term chronic infection that can lead to atrophic gastritis, intestinal metaplasia, and gastric cancer. H. pylori, which express cytotoxic genes is now recohnized as a cause of peptic ulcer and is also a major risk factor for the development of gastric adenocarcinoma. We performed this study 1) to assess the detection rate of H. pylori according to direct investigation of bacteria of gastric biopsy specimen and two serologic tests of GAP test and Helico blot 2.0 system in the symptomatic and non-symptomatic group 2) to evaluate and compare the efficacy of two serologic tests of GAP test and Helico blot 2.0 system for the diagnosis of H. pylori infection. Forty-nine patients were positive for H pylori infection based on direct investigation of bacteria by histology. The detection rates of H. pylori infection based on direct investigation of bacteria by histology. The detection rates of H. phlori were significantly lower in gastric cancer than in other gastroduodenal disease(p<0.05). The concordance of two serologic tests of GAP test and Helico blot 2.0 system is poor. There was no statistically significant difference between the expression rate of CagA and VacA in the symptomatic and non-symptomatic group. Although Helico blot 2.0 system may not displace GAP test, it was a very sensitive serologic test for the diagnosis of H. pylori infection and it was used to detect IgG antibodies to H. pylori-specific antigens, including CagA, VacA and the various urease subunit. Our data suggest that further investigation is needed to determine whether or not the serologic expression of cytotoxic gene may be clinical usefulness of diagnostic methods in the gastroduodenal disease.

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The Mode of Detection of Helicobacter pylori in Saliva and Subgingival Plaques of Adult Periodontitis Patients (성인형 치주염 환자의 타액 및 치은연하치태에서 Helicobacter pylori의 발현양상)

  • An, Jong-Mo;Na, Myoung-Su;Kim, Byung-Ock
    • Journal of Periodontal and Implant Science
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    • v.34 no.4
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    • pp.723-731
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    • 2004
  • Helicobacter pylori(H. pylori) has been associated with the cause of chronic gastritis, peptic ulcers and gastric cancer. Although it may be transmitted through the oral cavity, it is unknown whether the oral cavity acts as a reservoir of H. pylori. The purpose of this study was to investigate the mode of detection of H. pylori in oral cavity of adult periodontitis patients with plaque and periodontal pocket which atmosphere is grown well H. pylori. We analysed detection rate of H. pylori in saliva and subgingival plaques of 17 adult periodontitis patients without symptoms of gastroduodenal disease by nested PCR. Samples tested comprised saliva and subgingival plaques from central incisor, 1st premolar and 1st molar. H. pylori DNA was not identified in saliva from all patients. The detection rate in subgingival plaque from incisors, premolars and molars was 5.9%, 5.9% and 17.7%, respectively. In conclusion, the dental plaque and periodontal pocket (especially, of molars) in adult periodontitis can be favorable reservoir of H. pylori and may be the source of infection and transmission of H. pylori.

A case of the patient with Wei symptom suspected Guillain-Barre syndrome (Guillain-Barre syndrome으로 추정되는 계증 치험 1례(例))

  • Jeong, Byoung-Mu;Sin, Won-Yong;Choi, En-Young;Yoon, Cheol-Ho;Jeong, Ji-Cheon;Hyun, Min-Kyung
    • The Journal of Internal Korean Medicine
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    • v.25 no.4
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    • pp.450-456
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    • 2004
  • Guillain-Barre syndrome, or acute inflammatory polyneuritis, is a disorder in which the body's immune system attacks parts of the peripheral nervous system. The causes and mechanisms of this syndrome are unknown. Typically, Guillain-Barre syndrome can be diagnosed from the patient's symptoms and physical examination such as the rapid onset of weakness, paralysis and loss of reflexes. The analysis of CSF and electrical tests on nerve and muscle function can be performed to confirm the diagnosis. Most cases occur shortly after a viral infection. This is a clinical report about one patient suspected as having Guillain-Barre syndrome. The patient, a 62-year-old man had weakness in both legs after gastroduodenal disease. His weakness and general condition improved after Korean medical treatments, so this is reported as a potential treatment.

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