Differences in Clinical Manifestations according to the Positivity of Interferon-γ Assay in Patients with Intestinal Tuberculosis

Intestinal tuberculosis (ITB) remains prevalent in Asia. An interferon-γ assay (QuantiFERON-TB gold test [QFT]) is considered to be an effective supplementary tool for diagnosing ITB. We retrospectively analyzed the clinical features of ITB patients based on the initial results of QFT. A total of 109 patients with ITB were enrolled, and 82 patients (75.2%) showed positive QFT results. In the QFT-positive group, the mean age (44.1±12.0 years) was significantly higher than that in the QFT-negative group (37.0±14.8, p=0.0096). Abdominal pain (p=0.006) and diarrhea (p=0.030) were more frequent in the QFT-negative group. Further, C-reactive protein (CRP) levels were significantly higher in the QFT-negative group (6.4±9.9 mg/dL) than in the QFT-positive group (1.3±2.3, p<0.001). Multivariate analysis confirmed that younger age (p=0.016), diarrhea (p=0.042), and high levels of CRP (p=0.029) were independent predictors of QFT-negative results in patients with ITB. These results suggest that prior exposure to TB, reflected by QFT positivity, may cause mild inflammation in patients with ITB.

The Hemostatic Effect and Prognosis of Endoscopic Ethanol Injection in Bleeding Peptic Ulcer / 대한소화기내시경학회지

BACKGROUND AND AIMS: Endoscopic injection therapy improves the outcome in bleeding peptic ulcer, but the optimum regimen is unknown. Although endoscopic injection therapy is effective in controlling initial hemorrhage from a peptic ulcer, between 10% to 30% of patients suffer rebleeding. The aim of this study was to evaluate the initial and ultimate success rate of hemostasis, the rebleeding rate, hospital stay (days), and the emergency operation rate in patients who had undergone endoscopic ethanol injection for bleeding peptic ulcer. METHODS: Thirty nine patients presented with active bleeding (spurting), visible vessels, or blood clots on endoscopic findings were given an endoscopic ethanol injection with a total of 1.0-3.0 ml of ethanol. The initial and ultimate success rate of hemostasis, rebleeding rate, and emergency operation rate after the endoscopic injection was evaluated. RESULTS: 1) The initial success of hemostasis was 38/39 (97.4%). 2) The rebleeding rate after ethanol injection was 8/39 (20.5%). 3) The success rate of the second trial of ethanol injection was 3/8 (37.8%). 4) Emergency operations were conducted in5/39 (12.8%). 5) The ultimate success rate of hemostasis was 34/39 (87.2%). 6) There were no mortalities [0/39 (0%)] related to the ethanol injections and bleeding peptic ulcers. 7) There were no complications [0/39 (0%)] related to the ethanol injections. 8) The mean duration of hospitalization was 9.5 4.5 days. CONCLUSIONS: Endoscopic ethanol injection in the treatment of bleeding peptic ulcers was as effective and safe as any other injection or mechanical hemostatic method. Further prospective studies or endoscopic trials for hemostasis are needed to reduce the rebleeding rate and emergency operation rate of bleeding peptic ulcer.