ABSTRACT
Large hyperplastic polyps of the duodenum are very rare. We report the case of a 61-year-old women with a large lobulated and pedunculated hyperplastic polyp in the distal second portion of the duodenum causing anemia which was treated with snare polypectomy. Endoscopy revealed a 2.5 cm sized lobulated and pedunculated polyp with a long stalk in the distal second portion of duodenum. Previous studies reported that duodenal polyps larger than 10 mm in diameter or polyps in the second portion as independent risk factors of neoplastic lesions, and thus an accurate pathologic examination was needed. Many patients with large duodenal hyperplastic polyps present with gastrointestinal bleeding and anemia. We removed the duodenal polyp by a snare with electrocautery after clipping and epinephrine injection into the stalk to prevent bleeding. Histopathological examination of the polyp revealed hyperplasia.
Subject(s)
Female , Humans , Middle Aged , Anemia , Duodenum , Electrocoagulation , Endoscopy , Epinephrine , Hemorrhage , Hyperplasia , Polyps , Risk Factors , SNARE ProteinsABSTRACT
In amebic liver abscess, communication between liver abscess and intrahepatic bile ducts is an uncommon cause of bile leak. This condition can be treated surgically or endoscopically. However, these treatment modalities are related with high morbidity and mortality. A 49-year-old man was diagnosed with amebic liver abscess. Percutaneous drainage was performed due to poor medical response and for the purpose of preventing abscess rupture. Liver abscess-biliary communication was found at follow-up imaging study. He was treated successfully with medical therapy and supportive care without further interventions.
Subject(s)
Humans , Middle Aged , Abscess , Bile , Bile Ducts, Intrahepatic , Biliary Fistula , Drainage , Follow-Up Studies , Liver , Liver Abscess , Liver Abscess, Amebic , Mortality , RuptureABSTRACT
BACKGROUND/AIMS: Adefovir (ADV) and lamivudine (LAM) combination therapy (ADV+LAM) has been a useful option for patients with LAM-resistant (LAM-r) chronic hepatitis B (CHB). However, the long-term outcomes of LAM+ADV and 1-mg entecavir (ETV) rescue therapies have still been limited. The aim of this study was to determine the long-term outcomes of these two rescue therapies. METHODS: Sixty patients with LAM-r CHB underwent rescue therapy with LAM+ADV (n=36) or 1-mg ETV (n=24). We determined the duration of rescue therapy, timing and type of mutation, undetectable serum hepatitis B virus (HBV) DNA by PCR (lower limitation of detection, < 140 copies/mL), biochemical response (alanine aminotransferase < 40 IU/mL), and the incidence of hepatitis B virus e antigen (HBeAg) seroconversion and virologic breakthrough. RESULTS: Baseline characteristics did not differ between the two therapy groups. The duration of rescue therapy was 56 months (range, 14-100 months) in the ADV+LAM group and 42 months (range, 12-73 months) in the ETV group (P=0.036). The cumulative rates of HBV DNA undetectability and HBeAg seroconversion up to 6 years were 88.6% and 43.0%, respectively, in the ADV+LAM group, and 45.8% and 31.8% in the ETV group. The rate of virologic breakthrough and resistance was 14.4% in the ADV+LAM group and 71.9% in the ETV group (P=0.001). CONCLUSIONS: Combination of LAM and ADV therapy for up to 6 years achieved modest rates of virological suppression and resistance. ETV is not an optimal therapy because the risk of viral breakthrough to ETV increases over time.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Adenine/analogs & derivatives , Alanine Transaminase/blood , Antiviral Agents/therapeutic use , DNA, Viral/blood , Drug Resistance, Viral/genetics , Drug Therapy, Combination , Genotype , Guanine/analogs & derivatives , Hepatitis B e Antigens/blood , Hepatitis B virus/genetics , Hepatitis B, Chronic/drug therapy , Lamivudine/therapeutic use , Organophosphonates/therapeutic use , Retrospective Studies , Treatment OutcomeABSTRACT
The epidemiological study to evaluate the risk factors and types of cataract was performed in 183 cataract patients who received cataract operation in Chung-Ang University Hospital and in 80 control patients from March 1992 to Febraury 1994. Our study revealed that the sun light exposure and smoking were related to nuclear opacity, and drinking and smoking were related to cortical opacity. Also anterior subcortical opacity was more common in patients with heart disease. And the long term use of steroid and patient with diabetes mellitus were risk factors of posterior subcapsular opacity cataractogenesis. In this study we could confirm some risk factors were closely related to the type of lens opacity.