A Case of Primary Gastric T-cell Lymphoma with Helicobacter pylori Infection / 대한소화기내시경학회지

The primary T-cell lymphoma of the stomach is a extremely rare disease, only about 33 cases were described in the literature since 1986. Recent studies have proved a strong relation between Helicobacter pylori infection and several gastric diseases such as peptic ulcer, chronic gastritis, gastric cancer, and lymphoma. We report a case of primary gastric T-cell lymphoma with H. pylori infection in a 63-year-old male who had a history of epigastric fullness for 2 years. Gastroscopy showed a round ulcer of 1cm in size on anterior side of gastric angle. The gastroscopic biopsy revealed diffuse large cell malignant non-Hodgkin' s lymphoma on light microscopic examination, and T-cell immunophenotype with immunohistochemical study. The result of CLOtest was positive. No lymphadeno-pathy was found with chest roentgenogram and computed omography of abdomen and pelvis. Bone marrow examination showed normal finding.

Salt Consumption as a risk factor of Gastric Cancer and Helicobacter pylori Infection / 대한내과학회지

OBJECTIVES: Gastric cancer is one of the most important malignancy of the gastrointestinal tract. High salt intake has been suggested as a risk factor of gastric cancer and promoting Helicobacter pylori infection. Few studies have been addressed about the relation between excessive salt intake and gastric cancer. This study was performed to investigate the relation of high salt intake to H. pylori infection and gastric cancer. METHODS: Between May 1996 and July 1997, hospitalized patients with epigastric pain or dyspepsia were prospectively recruited. Patients with underlying diseases which could reduce kidney function were excluded. Salt consumption was estimated by the urine sodium to creatinine ratio(U-Na/Cr) on fresh single urine sample. Gastric cancer was diagnosed by endoscopic biopsies. H. pylori infection was evaluated by CLOtest. Gastric cancer was classified histologically by Lauren classification. RESULTS: Ninety seven patients, 52 patients with gastric cancer and 45 patients with chronic gastritis were enrolled. There was no statistically significant difference in the sodium to creatinine ratio between gastric cancer group (173.60+/-123, range; 21-665.2) and chronic gastritis group (164.02+/-138, range; 20.4-482.7) (p=0.361). In gastric cancer, the sodium to creatinine ratio was not different between CLOtest positive and negative group (p=0.201), and among intestinal, diffuse and mixed type (p=0.419), either. CONCLUSION: This study does not support the causal relation of high salt diet on gastric carcinogenesis. There is no significant difference in H. pylori infection rate between CLOtest positive group and negative group.

Edge Dissection after Intracoronary Stenting: Predictor, Angiographic and Clinical Follow-up after Additional Procedures

BACKGROUND AND OBJECTIVES: This study was performed to determine the predictive factors for edge dissection (ED) and clinical significance of ED after coronary stenting. MATERIALS AND METHODS: The study group comprised 215 patients (243 lesions, mean age 59 years, 157 male) in whom coronary stents were implanted between June, 1994 and June, 1998. By angiography, EDs were categorized into minor (a very focal segment 5mm with prominent adventitial staining and >50% of lumen compromize), and acute closure. RESULTS: 1.ED occurred in 30 (12.3%, minor 15, major 12) out of 243 lesions. Twelve of 30 EDs were located at the distal margin of the stent and occurred during high pressure. 2.Development of ED after stenting significantly correlated with severity of stenosis at the stent margin (> or =30%, 19/30 vs. 33/213, p=0.0001), degree of angulation (>45 0 , 16/30 vs. 48/213, p=0.0001), and calcification in the lesion (2/30 vs. 4/213, p=0.02). 3.There was no significant difference in clinical success rate between two groups (27/30 vs. 175/185, NS). 4.CRR in major and acute closure EDs (n=12) were significantly higher in patients treated with repeated angioplasty than in patients treated with additional stents (5/6 vs. 1/8, p=0.02). CONCLUSIONS: EDs after coronary stenting are relatively common and lesion's characteristics such as severity of stenosis (> or =30%) at the stent margin, angulation (>45 0 ), and calcification of the lesion are predictive factors for EDs. EDs are not associated with early adverse clinical events. However, CRR was significantly higher in patients treated by repeated angioplasty in major and acute closure EDs.

A Case of Pernicious Anemia with Positive Anti Intrinsic Factor Antibody and Antiparietal Cell Antibody / 대한내과학회지

We present a case of pernicious anemia without history of operation in 52 year old female. She suffered from oral ulcer, gum bleeding, nausea, vomiting, and beefy tongue. She had dysesthesia on the both arm and foot, and hypesthesia of global and stocking type by neurologic examination. Laboratory findings were as follows: serum cobalamin 9.1 pg/mL (normal range: 180-710pg/mL), anti intrinsic factor antibody (strong positive), antiparietal cell Antibody 1:10 (positive), first stage of Schilling test (1.4%). The findings of peripheral blood and bone marrow were compatible with megaloblastic anemia. We report a case of pemicious anemia with positive anti intrinsic factor antibody and antiparietal cell antibody.

Non-Invasive Early Assessment of Successful Reperfusion in Acute Myocardial Infarction Using Serial Plasma Troponin-T and Troponin-T Rapid Assay Kit

BACKGROUND: An earlier index of reperfusion after thrombolytic therapy in patients with acute myocardial infarction is desirable to determine whether additional therapy is necessary to salvage the myocardium. Cardiac troponin-T has been developed as a new myocardial specific marker for myocardial injury and has been used for early assessment of reperfusion therapy. This study was performed to investigate the utility of cardiac troponim-T for assessment of reperfusion therapy using serial serum troponin-T and the rapid assay kit. METHODS: The study was comprised of 70patients(M/F : 64/6, mean age 56+/-2 year) with acute myocardial infarction and reperfusion therapy was initiated within 6 hours after the onset of symtoms. Blood samples for CK and troponin-T were taken before thrombolysis and then 60, 90 munutes, 3, 6, 12, 24, 48, and 72 hours after thrombolysis. We compared successful reperfusion index of troponin-T [successful Reperfusion Index : troponin-T90 or 60min-base> or =0.3 or 0.2ng/ml, Rapid Assay Kit(n=40) : Base(-), 90 or 60min(+)] with the real reperfusion that was assessed by coronary angiogram(TIMI grade 3 at 90 minutes after thrombolysis) or clinical reperfusion index defined as early peak of cardiac enzyme(within 12 hours for CK and within 24 hours for cardiac troponin-T). RESULTS: 1) The cardiac troponin-T and CK activity in patients with successful reperfusion showed early peak within 12 hours after thrombolysis was initiated. 2) Successful reperfusion by angiography or clinical reperfusion index were shown in 64(91%) of 70 patients with thrombolysis. 3) The sensitivity, specificity, positive and negative predictive value, and predictive accuracy for detecting reperfusion using a threshold value of 0.2ng/ml of delta troponin-T at 90 minutes after thrombolysis were 95%, 83%, 98%, 63%, and 96% respectively. 4) The sensitivity, specificity, positive, and negative predictive value, and predictive accuracy of successful reperfusion index using the rapid assay kit at 90 minutes after thrombolysis were 97%, 100%, 100%, 67%, and 97% respectively. CONCLUSIONS: The successful reperfusion index using delta troponin-T> or = 0.2ng/ml and the rapid assay kit at 90 min after thrombolysis are simple and usful for early assessment of reperfusion therapy. Thus bedside monitoring for cardiac troponin-T is now possible to improve the decision making process as to whether rescue angioplasty after thrombolysis is necessary to salvage the myocardium.