The Relationship of the Helicobacter pylori Virulence Factor Gene Subtype in Gastric Adenocarcinoma

PURPOSE: The H. pylori cagA gene, vacA gene and iceA gene are considered to be important virurence factors that have been implicated in the development of gastric adenocarcinoma. It was reported that the presence of IS605 elements may be responsible for rearrangements and lead to partial or total deletions of the cag pathogenicity island (PAI) and the virulence of cag PAI may be changed. However, different results regarding the association between these virulence factors and clinical disease have been reported from different geographic regions. This study evaluated the relationship between H. pylori virulence factors such as cagA, vacA, iceA, IS605 and gastric adenocarcinoma. MATERIALS AND METHODS: H. pylori isolates were obtained from 54 infected patients (24 cases of gastric adenocarcinoma, 30 cases of control). H. pylori isolates were identified by PCR with ureC gene and 16S rRNA. PCR was performed to examine cagA, vacA, iceA and IS605 genotypes. RESULTS: Significant difference was found in the negative rates of cagA between gastric adenocarcinoma group and control (62.5% vs. 33.3% P=0.033). No significant difference was found in the prevalence of iceA, vacA between gastric adenocar cinoma and control. The genotype of cagA+ vacA s1-m1 iceA1 was predominant in H. pylori isolates irrespective of the clinical outcome. IS605 in PAI was not found in gastric adenocarcinoma gruop and control. The positive rates of IS605 in genome were 33.3% in gastric adenocarcinoma group and 36.7% in control (P>0.05). In gastric carcinoma, the positive rate of cagA+/IS605- was lower than in control (12.5% vs. 40.0%, P=0.025) and the positive rate of cagA-/IS605- was higher than in control (54.2% vs. 23.3%, P=0.02). CONCLUSION: H. pylori virulence factors had not related significantly with gastric adenocarcinoma. Further study is needed to examine the specificity of H. pylori strains.

The Study of Manometry and Gastric Emptying Time in Patients after Esophagectomy / 대한소화관운동학회지

BACKGROUND/AIMS: Resection of the esophagus for malignant disease or a benign stenosis, has a choice not only of palliative surgery, but also of replacement of the esophagus with a transposed stomach, jejunum, or colon. The first-line method is replacement with a tubulized stomach. The purpose of this study was to investigate the association of esophageal motor dysfunction and gastric emptying time with symptoms after esophagectomy. METHODS: We performed the esophageal manometry and gastric emptying time after esophagectomy for esophageal cancer in 12 patients and for benign esophageal disease in 2 patients. RESULTS: In manometric studies, a zone of high pressure in the esophago-gastric anastomosis distal to the upper esophageal sphincter was associated with symptoms after esophagectomy. The gastric emptying rate was slowed in 7 out of 14 patients, but not associated with symptoms after esophagectomy. CONCLUSIONS: Our data suggest that a high-pressure zone distal to the upper esophageal sphincter was associated with symptoms after esophagectomy in manometric study. The gastric emptying rate was not associated with postoperative symptoms.

Study of the Expression of FasL and of Apoptosis in Gastric Epithelial Dysplasia and Gastric Adenocarcinomas

PURPOSE: This study was to observe whether the apoptotic function of tumor-infiltrating lymphocytes (TIL) is induced in human gastric epithelial dysplasia and gastric adenocarcinoma according to the role of FasL expression. MATENRIALS AND METHODS: A total of 56 gastric epithelial dysplasia and gastric adenocarcinoma patients were enrolled in this study: 9 cases of gastric epithelial dysplasia, 18 cases of early gastric carcinomas (EGC) and 29 cases of advanced gastric carcinomas (AGC). Immunohistochemical staining was performed for FasL and CD45, and the terminal deoxynucleotidyl transferase mediated dUTP nick end labelling (TUNEL) method was used to detect cell death in tumor-infiltrating lymphocytes. RESULTS: 1) Positive reactions of FasL to neoplastic cells were 88.9% (8/9) in gastric epithelial dysplasia, 83.3% (15/18) in EGC, and 75.9% (22/29) in AGC. 2) Expression of TIL was decreased in the FasL positive region and was increased in the FasL negative region, and significant expression of TIL was observed in the AGC group (P=0.001). 3) Expression of apoptotic TIL was very similar to the FasL expression, and 100% expression was observed in gastric epithelial dysplasia group. 4) Expression of apoptotic TIL was increased in the FasL positive region and decreased in the FasL negative region, and significant apoptotic expression was observed in the gastric epithelial dysplasia and EGC groups (P=0.0420, P=0.0263, respectively). CONCLUSION: These results suggest that FasL is a prevalent mediator of immune privilege in epithelial dysplasia and cancer of the stomach.

A Case of Periosteal New Bone Formation Associated with Behcet? Disease / 대한류마티스학회지

Behcet? disease is a recurring illness characterized by the triple symptom complex of aphthous stomatitis, genital ulceration, and uveitis. The disease is multisystemic disorder with involvement of skin, gastrointestinal tract, blood vessels, central nervous system, joints, and epididymis. Vascular involvement of Behcet? disease affects both arteries and veins and blood vessels of all sizes. Periosteal new bone formation is one feature of hypertrophic osteoarthropathy. Other features are clubbing and arthritis. Periosteal new bone formation on the bones of the lower extremities without other features of hypertrophic osteoarthropathy has been reported in patients with varicose veins, vitamin A intoxication, infantile cortical hyperostosis, tuberous sclerosis, congenital syphilis and chronic renal failure with hyperparathyroidism, and chronic venous insufficiency. However, periosteal new bone formation has not, to our knowledge, been described in patients with Behcet? disease yet although similar findings are occasionally noted in polyarteritis nodosa. We report a case of Behcet? disease complicated by leg swelling with periosteal new bone formation of right lower leg.

Prevalence of Hepatitis G Virus Infection in Patients with Chronic Renal Failure / 대한간학회지

BACKGROUNDS/AIMS: To investigate the prevalence and clinical implications of hepatitis G virus (HGV) infection in patients with chronic renal failure, a cross-sectional study of 131 hemodialysis patients and 33 kidney transplantation recipients was conducted. METHODS: HGV RNA was amplified by reverse-transcription (RT) polymerase chain reaction (PCR) assay with primers from the 5'-untranslated region of the viral genome. RESULTS: The prevalence of HGV infection in patients with chronic renal failure was 25%(41/164). The following factors were taken into consideration: the mean age(43.15+/-11.97 years vs 46.46+/-13.08 years), the male to female ratio(2.15:1 vs 1.86:1), the mean of the dialysis duration(4.58+/-3.18 years vs 3.90+/-3.31 years), transfusion history (75.6% vs 62.6%), the mean of the ALT level during the prior 6 months(25.78+/-21.50 IU/L vs 23.00+/-59.49 IU/L), and the amount of transfusion(6.22+/-8.03 units vs 5.74+/-9.44 units). The anti-HCV(4.88% vs 8.94%) showed no difference between HGV RNA positive and negative group. The HBsAg positive ratio was 19.5% and 5.81% in HGV RNA positive group and negative group, respectively. CONCLUSION: The prevalence of HGV infection in patients with chronic renal failure was 25%. There was a higher rate of HBsAg positivity in the HGV RNA positive group rather than in the negative group. HGV infection did not seem to be associated with clinically significant hepatitis.

Evaluation of Left Internal Mammary Artery during Right Transradial Coronary Angiography: A New, Fast and Reliable Technique

BACKGROUND: The technique to evaluate left internal mammary artery (LIMA) is not well established during right transradial coronary angiography. MATERIALS AND METHODS: Following coronary angiography via right radial artery, LIMA angiography was performed using 5 French (F) Judkins JL-3.5 catheter in 110 patients (56+/-9 years [range: 46-81], 77 males). Eleven (10%) patients had grafted LIMAs. Subclavian and innominate arteries were moderately tortuous in 14 (13%) patients and aortic arches elongated and more vertically oriented in 16 (15%). The catheter, standing in the ascending aorta with its natural curve, was withdrawn slowly while being rotated clockwise to engage its tip in the proximal left subclavian artery. After the tip portion was adjusted, contrast material was injected while sphyngomanometer cuff inflation applied to the left upper arm. RESULTS: Nonselective LIMA angiography was successfully performed in 108 (98%) patients. The catheter was engaged in the subclavian artery in a mean of 11+/-8 seconds (range: 3-136) from the time when the catheter was withdrawn from the ascending aorta. The image quality of LIMA was satisfactory in 103 (95%) patients and not satisfactory in 5 (5%) in whom the catheter tip was not placed near the origin of LIMA. In ten (91%) of the 11 patients with grafted LIMA, the anastomosis site and distal coronary vessels were well visualized. There were no complications, including arterial dissection and thromboembolism. CONCLUSION: Nonselective technique using 5 F Judkins JL-3.5 catheter is easy, fast, safe and reliable for evaluating LIMA during right transradial coronary angiography.

Evaluation of Left Internal Mammary Artery during Right Transradial Coronary Angiography: A New, Fast and Reliable Technique

BACKGROUND: The technique to evaluate left internal mammary artery (LIMA) is not well established during right transradial coronary angiography. MATERIALS AND METHODS: Following coronary angiography via right radial artery, LIMA angiography was performed using 5 French (F) Judkins JL-3.5 catheter in 110 patients (56+/-9 years [range: 46-81], 77 males). Eleven (10%) patients had grafted LIMAs. Subclavian and innominate arteries were moderately tortuous in 14 (13%) patients and aortic arches elongated and more vertically oriented in 16 (15%). The catheter, standing in the ascending aorta with its natural curve, was withdrawn slowly while being rotated clockwise to engage its tip in the proximal left subclavian artery. After the tip portion was adjusted, contrast material was injected while sphyngomanometer cuff inflation applied to the left upper arm. RESULTS: Nonselective LIMA angiography was successfully performed in 108 (98%) patients. The catheter was engaged in the subclavian artery in a mean of 11+/-8 seconds (range: 3-136) from the time when the catheter was withdrawn from the ascending aorta. The image quality of LIMA was satisfactory in 103 (95%) patients and not satisfactory in 5 (5%) in whom the catheter tip was not placed near the origin of LIMA. In ten (91%) of the 11 patients with grafted LIMA, the anastomosis site and distal coronary vessels were well visualized. There were no complications, including arterial dissection and thromboembolism. CONCLUSION: Nonselective technique using 5 F Judkins JL-3.5 catheter is easy, fast, safe and reliable for evaluating LIMA during right transradial coronary angiography.

Transradial Stenting of an Anomalous Right Coronary Artery Originating from the Left Sinus of Valsalva

Anomalous right coronary artery arising from the left sinus of Valsalva is rare, but not protected from ather-osclerotic disease. Major factor determining successful angioplasty is the selection of the appropriate guiding catheter to provide optimal coaxial backup support. We report the first case of successful transradial stenting of an anomalous right coronary artery originating from the left sinus of Valsalva.