• Asian Pacific Journal of Cancer Prevention
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• v.16 no.7
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• pp.2999-3001
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• 2015

Background: This study aimed to evaluate upper gastrointestinal polyps detected during esophago-gastroduodenoscopy tests. Materials and Methods: We conducted a retrospective analysis on data regarding 55,987 upper gastrointestinal endoscopy tests performed at the endoscopy unit of Istanbul Education and Research Hospital between January 2006 and June 2012. Results: A total of 66 upper gastrointestinal polyps from 59 patients were analyzed. The most common clinical symptom was dyspepsia, observed in 41 cases (69.5%). The localizations of the polyps were as follows: 29 in the antrum (43.9%), 15 in the corpus (22.7%), 11 in the cardia (16.7%), 3 in the fundus (4.54%), 3 in the second portion of the duodenum (4.54%), 2 in the bulbus (3.03%) and 3 in the lower end of the esophagus (4.54%). Histopathological types of polyps included hyperplastic polyps (44) (66.7%), faveolar hyperplasia (8) (12.1%), fundic gland polyps (4) (6.06%), squamous cell polyps (4) (6.06%), hamartomatous polyps (3) (4.54%), and pyloric gland adenoma (3) (4.54%). Histopathological analysis of the gastric mucosa showed chronic atrophic gastritis in 30 cases (50.84%), HP infection in 33 cases (55.9%) and intestinal metaplasia in 19 cases (32.20%). In 3 cases with multiple polyps, adenocarcinoma was detected in hyperplastic polyps. Conclusions: Among polypoid lesions of the upper gastrointestinal tract, the most common histological type is hyperplastic polyps. Generally, HP infection is associated with chronic atrophic gastritis and intestinal metaplasia. The incidence of adenocarcinoma tends to be higher in patients with multiple hyperplastic polyps.

• Journal of Gastric Cancer
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• v.7 no.4
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• pp.261-264
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• 2007

A gastric adenocarcinoma is the second most common cause of cancer deaths worldwide, but there are some geographical differences in its incidence. A gastrointestinal tumor is an uncommon disease with a wide spectrum of aggressive behavior. These two tumors have a distinct pathogenesis, and synchronous occurrence of an adenocarcinoma and a GIST (gastrointestinal stromal tumor) in the stomach is very rare. We report a case of synchronous occurrence of a gastric adenocarcinoma and GIST in a 64-year-old man. We performed the following tests: barium swallowing test, gastroduodenoscopy, and CT scanning. We performed a total gastrectomy, and a 9 em-sized GIST at the fundus and a small early gastric cancer at the antrum were confirmed pathologically. Some explanations for this rare case exist, but in our opinion, the synchronous occurrence is a rare but probable event that can happen in an endemic area. We describe a case of synchronous occurrence of a gastric adenocarcinoma and GIST in the stomach, with a review of the literature.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.8 no.1
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• pp.60-63
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• 2005

Accidental foreign body ingestion is one of the general pediatric problems. If more than one magnet are ingested, they can attract each other across the intestinal wall. This kind of event may cause necrosis, perforation or fistula. Therefore, they must be retrieved by gastroduodenoscopy while they are still in the stomach. The authors have experienced an unusual small bowel complication, which was small bowel-mesentery-small bowel fistula, caused by the ingestion of magnets.

• The Korean Journal of Nuclear Medicine
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• v.39 no.1
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• pp.21-25
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• 2005

Purpose: $^{14}C$-urea breath test (UBT) is a non-invasive and reliable method for the diagnosis of Helicobacter pylori (HP) infection. In this study, we evaluated the diagnostic performance of a new and rapid $^{14}C$-UBT (Heliprobe method), which was equipped with $Geiger-M\ddot{u}ller$ counter and compared the results with those obtained by using the conventional method. Materials and Methods: Forty-nine patients with dyspepsia underwent gastroduodenoscopy and $^{14}C$-UBT. A 37 KBq $^{14}C$-urea capsule was administered to patients and breath samples were collected. In Heliprobe method, patients exhaled into a Hellprobe BreathCard for 10 min. And then the activities of the BreathCard were countered using Heliprobe analyzer. In the conventional method, results were countered using liquid scintillation counter. During gastroduodenoscopy, 18 of 49 patients were underwent biopsies. According to these histologic results, we evaluated the diagnostic performance of two different methods and compared them. Also we evaluated the concordant and disconcordant rates between them. Results: In all 49 patients, concordant rate of both conventional and Heliprobe methods was 98% (48/49) and the discordant rate was 2% (1/49). Thirteen of 18 patients to whom biopsies were applied, were found to be HP positive on histologic results. And both Heliprobe method and conventional method classified 13 of 13 HP-positive patients and 5 of 5 HP-negative patients correctly (sensitivity 100%, specificity 100%, accuracy 100%). Conclusion: The Heliprobe method demonstrated the same diagnostic performance compared with the conventional method and was a simpler and more rapid technique.

• Journal of Society of Preventive Korean Medicine
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• v.3 no.1
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• pp.36-36
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• 1999

From January 1994 to April 1997, there was 15 survivals who was admitted to the department of internal medicine, Wonkwang Oriental Medicine' Hospital in Cheun-ju, after ingestion of paraquat, and treated with Oriental and western medicine therapy. For the patients, I investigated clinical symptoms, gastroduodenoscopy, intake by oral and parenteral route, and output by urine and stool, serum ALP, AST. ALT, Bilirubin, BUN, Creatinine level and urine analysis. On admission day, the LFT level was as follows. The serum mean ALP, AST, ALT, Total Bilirubin and Direct Bilirubin was 10.05${\pm}$2.75 KAU, 66.67${\pm}$9.88 IU／L, 43.80${\pm}$7.74 IU／L, 1.89${\pm}$1.22 ㎎／dl and 1.10${\pm}$1.14 ㎎／dl respectively. After that day, administered Gamdutang and checked the mean LFT level regullary. Until the 3rd day, the mean ALP, AST, ALT, Total Bilirubin and Direct Bilirubin level was 11.0l${\pm}$3.16 KAU, 56.47${\pm}$7.19 IU／L, 59.00${\pm}$7.57 IU／L, 2.54${\pm}$1.78 ㎎／dl, 1.64${\pm}$1.59 ㎎／dl respectively. From 4th day to 7th day, the mean ALP; AST, ALT, Total Bilirubin and Direct Bilirubin level was 12.51${\pm}$3.49 KAU, 77.85${\pm}$7.17 IU／L, 58.00${\pm}$9.09 IU／L, 2.54${\pm}$1.97 ㎎／dl, and 1.80${\pm}$1.81 ㎎／dl respectively. From 8th day to 10th day, the mean ALP, AST, ALT, Total Bilirubin and Direct Bilirubin level was 12.43${\pm}$3.14 KAU, 41.13${\pm}$6.49 IU／L, 50.40${\pm}$7.17 IU／L, 1.66${\pm}$1.90 ㎎／dl and 1.14${\pm}$1.50 ㎎／dl respectively. From 11th day to 14th day, the mean ALP, AST, ALT, Total Bilirubin and Direct Bilirubin level was 12.30${\pm}$3.25 KAU, 31.07${\pm}$3.85 IU／L, 43.33${\pm}$5.49 IU／L, 1.62${\pm}$1.95 ㎎／dl, 1.17${\pm}$1.71 ㎎／dl respectvely. On admission day, the mean RFT level as follows. Serum BUN and Creatinine level was 28.73${\pm}$5.19 ㎎／dl and 1.82${\pm}$1.27 ㎎／dl respectively. After that day, administered Gamdutang and checked the mean RFT level regullary. Until the 3rd day, the mean BUN and Creatinine level was 32.12${\pm}$5.65 ㎎／dl and 2.31${\pm}$0.45 ㎎／dl respectively. From 4th day to 7th day, the mean BUN and Creatinine level was 31.07${\pm}$5.47 ㎎／dl and 1.92${\pm}$0.79 ㎎／dl respectively. From 7th day to 10th day, the mean BUN and Creatinine level was 17.47${\pm}$3.57 ㎎／dl and 1.33${\pm}$0.59 ㎎／dl respectively. From 11th day to 14th day, the mean BUN and Creatinine level was 11,93${\pm}$3.16 ㎎／dl, 1.27${\pm}$0.38 ㎎／dl respectively.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.4 no.1
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• pp.71-76
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• 2001

Purpose: Many diagnostic modalities for neonatal cholestasis have shown features that are helpful, however until recently none of them are not pathognomonic of biliary atresia (BA). We carried out a prospective study of infants with cholestatic jaundice with the aim of establishing an efficient method of diagnosing BA. Methods: Twenty-seven consecutive infants with cholestatic jaundice were enrolled in this study and ranged from 7 to 152 days in age (mean; $51.2{\pm}34.2$ days). Gastroduodenoscopy was carried out using a fiberscope (Olympus N30). All the babies were fasted for at least 4 hours before the procedure and 20 ml of 10% dextrose solution was given at the time of endoscopy. The endoscopic examination focused on the 5 minutes observation of the evidence of biliary secretion. If there was lack of the evidence of the biliary secretion, endoscopy was removed and repeated the examination with some pause. Results: There are lack of the evidence of biliary secretion in all infants with BA. In non-BA group, 8 out of the 10 infants showed biliary secretion on the first trial, however one (Alagille syndrome) of the two infants without evidence of biliary secretion, finally exhibited biliary secretion on the second trial. The above observations resulted in the diagnostic accuracy of 96.3% with 100.0% sensitivity and 90.0% specificity. Conclusion: In light of the results from our relatively small study, endoscopy is a convenient, and relative inexpensive procedure. we strongly support the use of endoscopy for the diagnosis of BA in the screening and evaluation of infantile cholestasis.

• The Korean Journal of Nuclear Medicine
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• v.35 no.1
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• pp.61-68
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• 2001

Purpose: The C-14 urea breath test (C-14 UBT) is the most specific noninvasive method to detect Helicobacter (H) pylori infection. We investigated if the C-14 UBT can reflect the presence and degree of H. pylori detected by gastroduodenoscopic biopsies (GBx). Materials and methods: One hundred fifty patients (M:F=83:67, age $48.6{\pm}11.2$ yrs) underwent C-14 UBT, rapid urease test (CLO test) and GBx on the same day. For the C-14 UBT, a single breath sample was collected at 10 minutes after ingestion of C-14 urea (137 KBq) capsule and counting was done in a liquid scintillation counter for 1 minute, and the results were classified as positive (${\geq}200dpm$), Intermediate ($50{\sim}199dpm$) or negative (<50 dpm). The results of CLO tests were classified as positive or negative according to color change. The results of GBx on giemsa stain were graded 0 (normal) to 4 (diffuse) according to the distribution of H. pylori by the Wyatt method. We compared C-14 UBT results with GBx grade as a gold standard. Results: In the assessment of the presence of H. pylori infection, the C-14 UBT global performance yielded sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of 92.5%, 88.4%, 97.1%, 88.4% and 91.3%, respectively. However, the CLO test had sensitivity, specificity, PPV, NPV and accuracy of 83.2%, 81.4%, 91.8%, 81.4% and 82.7%, respectively. The quantitative values of the C-14 UBT were $45{\pm}27$ dpm in grade 0, $707{\pm}584dpm$ in grade 1, $1558{\pm}584dpm$ in grade 2, $1851{\pm}604dpm$ in grade 3, and $2719{\pm}892dpm$ in grade 4. A significant correlation (r=0.848, p<0.01) was found between C-14 UBT and the grade of distribution of H. pylori infection on GBx with giemsa stain. Conclusion: We conclude that the C-14 UBT is a highly accurate, simple and noninvasive method for the diagnosis of ongoing H. pylori infection and reflects the degree of bacterial distribution.

• Journal of Society of Preventive Korean Medicine
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• v.3 no.1
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• pp.55-65
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• 1999

From January 1994 to April 1997, there was 15 survivals who was admitted to the department of internal medicine, Wonkwang Oriental Medicine Hospital in Cheun-ju, after ingestion of paraquat, and treated with Oriental and western medicine therapy. For the patients, I investigated clinical symptoms, gastroduodenoscopy, intake by oral and parenteral route, and output by urine and stool, serum ALP, AST. ALT, Bilirubin, BUN, Creatinine level and urine analysis. On admission day, the LFT level was as follows. The serum mean ALP, AST, ALT, Total Bilirubin and Direct Bilirubin was $10.05{\pm}2.75\;KAU$, $66.67{\pm}9.88\;IU／L$, $43.80{\pm}7.74\;IU／L$, $1.89{\pm}1.22\;mg／dl$ and $1.10{\pm}1.14\;mg／dl$ respectively. After that day, administered Gamdutang and checked the mean LFT level regullary. Until the 3rd day, the mean ALP, AST, ALT, Total Bilirubin and Direct Bilirubin level was $11.01{\pm}3.16\;KAU$, $56.47{\pm}7.19\;IU／L$, $59.00{\pm}7.57\;IU／L$, $2.54{\pm}1.78\;mg／dl$, $1.64{\pm}1.59\;mg／dl$ respectively. From 4th day to 7th day, the mean ALP; AST, ALT, Total Bilirubin and Direct Bilirubin level was $12.51{\pm}3.49\;KAU$, $77.85{\pm}7.17\;IU／L$, $58.00{\pm}9.09\;IU／L$, $2.54{\pm}1.97\;mg／dl$, and $1.80{\pm}1.81\;mg／dl$ respectively. From 8th day to 10th day, the mean ALP, AST, ALT, Total Bilirubin and Direct Bilirubin level was $12.43{\pm}3.14\;KAU$, $41.13{\pm}6.49\;IU／L$, $50.40{\pm}7.17\;IU／L$, $1.66{\pm}1.90\;mg／dl$ and $1.14{\pm}1.50\;mg／dl$ respectively. From 11th day to 14th day, the mean ALP, AST, ALT, Total Bilirubin and Direct Bilirubin level was $12.30{\pm}3.25\;KAU$, $31.07{\pm}3.85\;IU／L$, $43.33{\pm}5.49\;IU／L$, $1.62{\pm}1.95\;mg／dl$, $1.17{\pm}1.71\;mg／dl$ respectvely. On admission day, the mean RFT level as follows. Serum BUN and Creatinine level was $28.73{\pm}5.19\;mg／dl$ and $1.82{\pm}1.27\;mg／dl$ respectively. After that day, administered Gamdutang and checked the mean RFT level regullary. Until the 3rd day, the mean BUN and Creatinine level was $32.12{\pm}5.65\;mg／dl$ and $2.31{\pm}0.45\;mg／dl$ respectively. From 4th day to 7th day, the mean BUN and Creatinine level was $31.07{\pm}5.47\;mg／dl$ and $1.92{\pm}0.79\;mg／dl$ respectively. From 7th day to 10th day, the mean BUN and Creatinine level was $17.47{\pm}3.57\;mg／dl$ and $1.33{\pm}0.59\;mg／dl$ respectively. From 11th day to 14th day, the mean BUN and Creatinine level was $11.93{\pm}3.16\;mg／dl$, $1.27{\pm}0.38\;mg／dl$ respectively.

• Korean Journal of Psychosomatic Medicine
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• v.14 no.1
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• pp.62-66
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• 2006

Introduction: Unexpected serious and lethal drug interactions can be occurred by polypharmacy for treatment-resistant psychiatric disorders. We report a case who has suspected upper gastrointestinal bleeding after the combination of clozapine and buspirone. Case : A 69-year-old woman with DSM-IV schizophrenia who was admitted to our hospital had no previous medical problems. Findings on physical exam, laboratory values, EEG, and a magnetic reso-nance imaging scans were no abnormality, except for slightly low level of hemoglobin at admission. Because of aggravating anxiety symptom, a trial of buspirone was begun from 15mg, in addition to olanzapine 30mg. And then olanzapine was switched to clozapine due to her treatment-refractory his-tory and poor response on this admission. Moreover, At the admission 11 weeks later, after 4 weeks of starting buspirone and clozapine, she was placed on a regimen of clozapine 300mg and buspirone 60mg. At this point, she started to complaint nonspecific abdominal pain for 4 days and then hematemesis, melena and hypotension were developed suddenly with negative findings in gastroduodenoscopy. After stopping all medication, the suspected upper gastrointestinal bleeding was subsided. After the regimen was switched back to clozapine only, psychotic symptoms were improved without the recurrence of the adverse events. Conclusion : We concluded that the upper gastrointestinal bleeding in this case was attributed to the drug interaction with clozapine and buspirone, although the definite mechanism is not clear. The clini-cians should be very cautious to prescribe the combination of clozapine and buspirone due to a possible lethal adverse effect.

• Clinical and Experimental Pediatrics
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• v.49 no.3
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• pp.268-272
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• 2006

Purpose : The reinfection rate of H. pylori reported before $^{13}C$-urea breath test($^{13}C$-UBT) era was higher than that of the post $^{13}C$-UBT era. Children are usually reluctant to receive invasive endoscopic evaluation for the reinfection of H. pylori, particularly when they are asymptomatic. The aim of the study is to discover the reinfection rate by different diagnostic tests, and to find out what causes the difference. Methods : Children confirmed to be eradicated from H. pylori were included in the study. Reinfection was evaluated by endoscopic biopsy based tests(n=34, mean age $11.5{\pm}3.7$ years) and/or a $^{13}C$-UBT(n=38, mean age $10.0{\pm}3.6$ years) at the time of 18 months after eradication. At first visit, H. pylori infection had been diagnosed by positive results from a rapid urease test, Giemsa stain and Warthin-Starry stain and/or a positive culture. Eradication was defined as negative results from all above tests 1-3 months after eradication therapy. Results : Reinfection rate by endoscopic biopsy based tests was 35.3 percent(12/34). All patients had abdominal symptoms(P=0.000). Reinfection rate was 13.2 percent(5/38) by a $^{13}C$-UBT. Reinfection rate was higher in children with abdominal symptoms(P=0.008). There was no evidence that reinfection rate depended on the sex(P=0.694), age(P=0.827), diseases(peptic ulcers vs gastritis, P=0.730) and eradication regimen(P=0.087). Conclusion : Helocibacter pylori reinfection rate in Korean children was 13.2 percent per 18 months by a non-invasive test or $^{13}C$-UBT. Accurate determinations of the reinfection rate in children is affected by the compliance of the diagnostic tests. Non-invasive tests should be considered to investigate the reinfection rate in children.