Standard Esophageal Manometric Finding in Dysmotility-like Functional Dyspepsia / 대한소화관운동학회지

BACKGROUND/AIMS: Functional dyspepsia(FD) is primarily a symptom complex. There is no consensus on the pathogenesis of functional dyspepsia. Disorders of motor function of the upper gastrointestinal tract have been implicated in the pathogenesis of FD. About 25-60% of patients with FD have delayed gastric emptying and postprandial antral hypomotility. Intestinal dysmotility is common in patients with severe and incapacitating FD. But there were few reports about association with esophageal dysmotility in FD. We performed this study to investigate the esophageal motility in patients with dysmotility-like FD. METHODS: The study included twenty-three patients (M:F=6;17, mean age: 42.5 years) referred to Ajou University Hospital for evaluation of their dyspepsia from July 1994 to July 1997. All patients underwent routine blood tests, upper gastrointestinal series or esophagogastroduodenoscopy and abdominal ultrasound to rule out organic cause of dyspepsia. The patients with reflux-like symptoms such as heartbum and/or regurgitation and noncardiac chest pain were also excluded. Standard esophageal manometry was done with pneumohydraulic capillary infusion system. RESULTS: 1) Out of 23 patients, 12 patients showed normal esophageal manometric finding, 11 patients(47.8%) abnormal finding. Esophageal manometry revealed hypertensive upper esophageal sphinter (UES) in 3 patients, hypertensive lower esophageal sphinter (LES) in 2 patients, hypotensive LES in 1 patients. Four patients showed nonspecific esophageal motility disorder low-amplitude contractions in 3 patients, nontransmitted contractions in 1 patient). One patient exhibited nutcracker esophagus. 2) Out of 23 patients, 5 patients also complained of symptoms consistent with lower gut dysfuctian, chiefly irritable bowel syndrome. Three of these patitnets revealed abnormal esophageal manometric finding (hypertensive UES in 2 patient, low-amplitude contractions in one patient). CONCLUSIONS: This findings indicate that some patients with FD have esophageal manometric abnormalities. The esophageal motor dysfunction was mainly observed in esophageal body and lower esophageal sphinter, which are made up of smooth muscle.

Hepatitis B and C Virs in Hepatocellular Carcinoma / 대한간학회지

BACKGROUND/AIMS: To evaluate the role of hepatitis B virus(HBV) and hepatitis C virus(HCV) in the development of hepatocellular carcinoma(HCC) in Korea, we investigated the status of HBV and HCV infection in Korean patients with HCC. METHODS: HBV DNA and HCV DNA were detected in the scrum from 45 unseiected patients with HCC.' by polymerase chain reaction. RESULTS: Among 45 patients with HCC, 31 paticnts(68.9%) were positive for serum HBsAg. HBV DNA was detected in 24(77.4%) ot 31 HBsAg-positive patients and 6(42.8%) of 14 HBsAg-negative patients. Thirty-three patients(82.2'%) were positive for HBsAg and/or HBV DNA. Among 45 patients, anti-HCV was positive in 7 patients(15.5%) by first generation enzyme-linked immunoassay(EIA) and in 11 patients(24.4%) by second generation EIA. Anti-HCV positive patients by first generation EIA were all positive for anti-HCV by second generation EIA. HCV RNA was detected in 4 of ll anti-HCV-positive patients and 4 patients of 34 anti-HCV-negative patients. Among 45 patients, tifteen patients(33.3%) were positive for anti-HCV and/or HCV RNA. HCV infection was evident for 9(24.3%) of 37 patients with HBV infection and 6(75%) of 8 patients without HBV intection. Among 45 patients with HCC, only two patients(4.5%) were all negative for HBsAg, anti-HCV, HBV DNA and HCV RNA. CONCLUSIONS: These data suggest that HBV is thc main etiologic factor for HCC and HCV is considered another risk factor in some patients without evidence of HBV infection. HBV and HCV could be detected in spite of the absence of serological marker tor viral iinfection.

A Case Report of Gastric Lymphangioma / 대한소화기내시경학회지

Lymphangioma of the stomach is known to be extremely rare, benign tumor, reported only 13 cases now, worldwidely, The lesions are soft, sponge like, and pinkish colored and filled with watery fluid exudates. The histologic examination reveals that lymphangiomas are composed of endothelium-lined spaces that contain a eosinophilic protein-rich fluid. They usually present as polypoid lesions because they are originated from submucosal layer. By endoscopy, they appear as smooth, soft, polypoid submucosal mass. The endoscopic ultrasonographic findings of gastric lyrnphangioma were cystic mass with multi-septation originated from submucosal layer of the stomach. Recently, We experienced a case of lymphangioma associated with early gastric cancer of the stomach. So we report this case with brief review of world literature.