ABSTRACT
BACKGROUND/AIMS: In the Helicobacter pylori (H. Pylori)-negative normal stomach, collecting venules are visible over all the gastric body as numerous minute points evaluated with standard endoscopy. This finding was termed regular arrangement of collecting venules (RAC), and its absence suggests H. Pylori gastritis. The aim of this study was to evaluate the correlation between the RAC and rapid urease test. METHODS: Two hundred sixty three consecutive adults undergoing upper digestive endoscopy and rapid urease test were included. The lesser curvature of the lower corpus was evaluated for the RAC pattern using a standard endoscope and different hemoglobin index. Two biopsies from the lesser curvature of the antrum and the greater curvature of the body were collected for rapid urease test. RESULTS: H. Pylori were detected in 51.3% (135/263) patients. Of the 57 patients with H. Pylori-negative normal stomachs 53 patients (93%) had RAC. As a determinant of the normal stomach without H. Pylori infection, the presence of RAC had 41.4% sensitivity, 97.0% specificity, 93.0% positive predictive value and 63.6% negative predictive value. CONCLUSIONS: RAC-positive finding by standard endoscopy showed high positive predictive value and specificity of H. Pylori-negative normal stomach. RAC-positive finding by standard endoscopy could be an useful finding to predict H. Pylori negativity.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Diagnosis, Differential , Endoscopy, Gastrointestinal , Gastritis/microbiology , Gastroscopy , Helicobacter Infections/diagnosis , Helicobacter pylori , Hemoglobins , Pyloric Antrum/blood supply , Retrospective Studies , Sensitivity and Specificity , Urease/metabolism , Venules/anatomy & histologyABSTRACT
An osteoclast-like giant cell tumor of the pancreas is a very rare neoplasm, with only three cases reported in Korea. Due to the rarity of this tumor type, few clinical data are available. We present a case of undifferentiated carcinoma with osteoclast-like giant cell tumor arising in the tail of the pancreas in a 72-year-old woman hospitalized to evaluate epigastric pain and a palpable abdominal mass. Magnetic resonance imaging revealed the presence of a large enhancing mass with septation arising from the tail of the pancreas. A distal pancreatectomy with splenectomy was performed. The pathological diagnosis was undifferentiated carcinoma with osteoclast-like giant cell tumor. Here, we describe the histopathological and immunohistochemical findings and review the clinical features of the cases reported in the Korean literature.
Subject(s)
Aged , Female , Humans , Carcinoma , Giant Cell Tumors , Giant Cells , Korea , Magnetic Resonance Imaging , Pancreas , Pancreatectomy , Pancreatic Neoplasms , SplenectomyABSTRACT
Primary hepatic epithelioid hemangioendothelioma is a rare neoplasm of endothelial origin. The clinical manifestations are nonspecific, ranging from complete absence of symptoms to hepatic failure and death. Spontaneous rupture of a hepatic epithelioid hemangioendothelioma is an extremely rare presentation. We present a case of primary hepatic epithelioid hemangioendothelioma in a 65-year-old male patient with alcoholic liver cirrhosis. He was hospitalized due to epigastric pain and multiple liver masses on abdominal ultrasound. Dynamic liver CT imaging revealed multiple peripheral nodular enhanced mass lesions with delayed centripetal enhancement, and the adjacent collection of high-attenuation fluid along the liver capsule. Abdominal tapping revealed blood in the peritoneal cavity. Primary hepatic epithelioid hemangioendothelioma with spontaneous rupture was finally diagnosed based on a histopathologic examination revealing positive immunohistochemical staining for CD34.
Subject(s)
Humans , Male , Antigens, CD34/metabolism , Bone Neoplasms/diagnosis , Diagnosis, Differential , Hemangioendothelioma, Epithelioid/diagnosis , Liver Cirrhosis, Alcoholic/complications , Liver Neoplasms/diagnosis , Pancreatic Neoplasms/diagnosis , Rupture, Spontaneous , Tomography, X-Ray ComputedABSTRACT
Budd-Chiari syndrome (BCS) is an uncommon disease caused by obstruction of hepatic venous outflow. This results in centrilobular congestion and necrosis, ultimately leading to fibrosis and cirrhosis of liver. Stenosis of the inferior vena cava (IVC) can be a one of causes of BCS. We report the a case of a 72-year-old woman who presented significant IVC stenosis due to extrinsic compression resulting by a tortuous abdominal aorta which was incidentally detected by echocardiography and successfully treated by stenting. To the date the extrinsic compression of IVC resulting from tortous aorta has never been reported to cause of BCS.
Subject(s)
Aged , Female , Humans , Aorta , Aorta, Abdominal , Budd-Chiari Syndrome , Constriction, Pathologic , Echocardiography , Estrogens, Conjugated (USP) , Fibrosis , Liver , Necrosis , Stents , Vena Cava, InferiorABSTRACT
Neuromyelitis optica (NMO) is an idiopathic inflammatory demyelinating disease, characterized by optic neuritis and myelitis. NMO is a very uncommon and serious neurologic manifestation of systemic lupus erythematous (SLE). We report a 28-year-old man with NMO as neuropsychiatric manifestation of SLE. He was diagnosed as lupus nephritis at 16-year-old. He had optic neuritis at three years and seven months ago. Oral prednisolone was tapered off according to the improved eye symptoms. Two months later, he visited rheumatology clinics for urinary disturbance and paresthesia on both feet. A spinal magnetic resonance imaging revealed increased signal intensity in T2-weighted images from second to sixth cervical level and from eleventh to twelfth thoracic level. We diagnosed neuromyelitis optica and treated with intravenous cyclophosphamide therapy monthly for three times. He was discharged without any neurological deficits and has been followed up.
Subject(s)
Adolescent , Adult , Humans , Cyclophosphamide , Demyelinating Diseases , Foot , Lupus Nephritis , Magnetic Resonance Imaging , Myelitis , Neurologic Manifestations , Neuromyelitis Optica , Optic Neuritis , Paresthesia , Prednisolone , RheumatologyABSTRACT
Obstructive jaundice is most commonly attributed to a malignancy or stones affecting the common bile duct. Biliary tuberculosis and lymphadenitis around the periportal area have also been implicated but cases are quite rare. A 24 year old man presented with jaundice and abdominal pain for 3 days. Abdominal CT and ERCP revealed a stricture of the extrahepatic bile duct with multiple enlarged lymph nodes showing necrotic foci located at the periportal area. The colonoscopic biopsy showed evidence of M. tuberculosis. The patient was treated with ERBD insertion and oral anti-tuberculosis therapy. However, the abdominal pain recurred and there was progressive stenosis of the common bile duct. A bile duct resection with choledochojejunostomy was subsequently performed. Frozen sections revealed granulomatous inflammation with caseation necrosis, which was consistent with tuberculosis. We report a case of tuberculous cholangitis and lymphadenitis with obstructive jaundice that was managed surgically due to the progressive stricture of the bile duct.
Subject(s)
Humans , Young Adult , Abdominal Pain , Bile Ducts , Bile Ducts, Extrahepatic , Bile , Biopsy , Cholangiopancreatography, Endoscopic Retrograde , Cholangitis , Choledochostomy , Common Bile Duct , Constriction, Pathologic , Frozen Sections , Inflammation , Jaundice , Jaundice, Obstructive , Lymph Nodes , Lymphadenitis , Necrosis , Tomography, X-Ray Computed , Tuberculosis , Tuberculosis, Lymph NodeABSTRACT
BACKGROUND: Apolipoprotein E has been one of the most thoroughly studied genetic polymorphisms, particularly for its effects on lipid profiles and coronary heart disease risk. This study investigated the relationship between the apolipoprotein E polymorphism and essential hypertension in a Korean population. METHODS: The subjects (n=1,243) were participants in a population-based study in Incheon metropolitan City, Korea. The apolipoprotein E polymorphism was determined using a polymerase chain reaction method. RESULTS: The frequencies of the genotypes did not differ significantly between the hypertensive groups (60.0% epsilon2/epsilon2, 30.8% epsilon2/epsilon3, 44.4% epsilon2/epsilon4, 33.3% epsilon3/epsilon3, 32.3% epsilon3/epsilon4, and 15.4% epsilon4/epsilon4; p=0.498). After adjusting for other risk factors, genotypes were not associated with hypertension(OR 5.74, 95% CI 0.81-40.76, epsilon2/epsilon2 vs. epsilon3/epsilon3; OR 0.94, 95% CI 0.60-1.47, epsilon2/epsilon3 vs. epsilon3/epsilon3; OR 1.21, 95% CI 0.30-4.89, epsilon2/epsilon4 vs. epsilon3/epsilon3; OR 0.79, 95% CI 0.56-1.13, epsilon3/epsilon4 vs. epsilon3/epsilon3; OR 0.29, 95% CI 0.06-1.45, epsilon4/epsilon4 vs. epsilon3/epsilon3). CONCLUSIONS: These findings suggest that the apolipoprotein E polymorphism is not associated with hypertension.
Subject(s)
Adult , Humans , Apolipoproteins , Coronary Disease , Genotype , Hypertension , Korea , Polymerase Chain Reaction , Polymorphism, Genetic , Risk FactorsABSTRACT
Congenital sinus of Valsalva (SOV) aneurysm is a rare cardiac abnormality. Rarely the aneurysm enlarges without rupture, cause symptoms of the mass effect by compressing the adjacent structures, obstruction of the right ventricular outflow with tricuspid regurgitation, infectious endocarditis, thrombus formation and myocardial ischemia/infarction. And SOV aneurysm can also be a source of embolism. We observed a patient with cerebral infarction in whom a huge SOV aneurysm, was diagnosed as the presumed source of cerebral embolism and the cause of hypoplastic tricuspid valve.