Gastric Angiolipoma Resected with Endoscopic Submucosal Dissection

Angiolipoma is a benign fatty neoplasm that has components of proliferating blood vessels. These types of lesions commonly occur in the subcutaneous tissue of the limbs and trunk. Angiolipoma in the gastrointestinal tract is extremely rare, and the final diagnosis generally depends on histological examination of the excised biopsy. In most previously reported cases, the lesions were diagnosed and treated with surgical management. In this study, we report a case of gastric angiolipoma of approximately 4 cm in size that was diagnosed and treated with endoscopic submucosal dissection.

Gastric Angiolipoma Resected with Endoscopic Submucosal Dissection

Angiolipoma is a benign fatty neoplasm that has components of proliferating blood vessels. These types of lesions commonly occur in the subcutaneous tissue of the limbs and trunk. Angiolipoma in the gastrointestinal tract is extremely rare, and the final diagnosis generally depends on histological examination of the excised biopsy. In most previously reported cases, the lesions were diagnosed and treated with surgical management. In this study, we report a case of gastric angiolipoma of approximately 4 cm in size that was diagnosed and treated with endoscopic submucosal dissection.

Azathioprine-Induced Non-Cirrhotic Portal Hypertension in a Patient with Crohn’s Disease / 대한내과학회지

Thiopurine-based drugs such as azathioprine and 6-MP are among the most common immunosuppressants used to treat inflammatory bowel disease, autoimmune hepatitis, various autoimmune diseases, and patients undergoing organ transplantation. The drugs are associated with various complications, of which one of the most serious is hepatotoxicity that may trigger non-cirrhotic portal hypertension. We report a case with this side-effect in a patient taking azathioprine to treat Crohn’s disease.

Local Recurrence and Its Risk Factor after Incomplete Resection of Colorectal Advanced Adenomas: A Single Center, Retrospective Study / 대한소화기학회지

BACKGROUND/AIMS: Colonoscopy can detect precancerous lesions, which can subsequently be removed and reduce incidences of and mortality from colorectal cancer (CRC). However, recently published data have highlighted a significant rate of CRC in patients who previously underwent colonoscopy. Among many reasons, incomplete resection has been considered as a significant contributor. However, to date, there have only been a few studies regarding incompletely resected polyps, especially advanced colorectal adenoma (ACA). Hence, we aimed to evaluate the prognosis of incompletely resected ACA. METHODS: We retrospectively reviewed the medical records of patients with ACA who had underwent endoscopic treatment with incomplete resection. The primary outcomes were (1) the incomplete resection rate of ACA, as determined by a histopathologic examination and (2) the recurrence rate of incompletely resected ACA. We also investigated the probable contributing factors that may have led to a relapse of incompletely resected ACA. RESULTS: A total of 7,105 patients had their colorectal polyps resected by endoscopic treatment, and 2,233 of these were considered as ACA. Of these, 354 polyps (15.8%) were resected incompletely, and only 163 patients were followed-up. Of those followed-up, 31 patients (19.0%) experienced local recurrence. The risk factors for recurrence after incomplete resection were evaluated; age, morphology of adenoma, and use of rescue therapy, such as argon plasma coagulation, were found to be associated with adenoma recurrence. CONCLUSIONS: Incompletely resected ACA in older patients or in patients with sessile-type adenomas should be monitored strictly, and if incomplete resection is suspected, rescue therapy must be considered.

A Case of Transgastrostomal Endoscopy to Diagnose and Treat Gastric Ulcer Bleeding

Gastrostomy tube feeding is a common method to provide nutritional support for patients with inadequate oral intake. Gastrostomy tube feeding carries the risk for various complications, with percutaneous hemorrhage being a major complication. Gastric ulcer bleeding is a rare complication in these patients and few researchers have reported such events. There has been no case report of gastric ulcer bleeding diagnosed and treated by endoscopy through a mature gastrostomy tract in Korea. We describe here a case in which gastric ulcer bleeding was diagnosed and treated by a transgastrostomal endoscopy.

A Case of Pancreatic Intraepithelial Neoplasia Presenting as Aucte Pancreatitis / 대한소화기내시경학회지

Pancreatic intraepithelial neoplasia (PanIN) is a precancerous lesion. A 72-year old man was admitted to our hospital because of abdominal pain, and he had an elevated serum level of pancreatic amylase. ERCP showed a focal stricture of the main pancreatic duct without upstream dilatation in the body of the pancreas. Cytologic evaluation with an endoscopic brush at the stricture suggested the presence of adenocarcinoma. After subtotal pancreatectomy, the features of PanIN were observed in the branch pancreatic duct. ERCP with brush cytology seems to be a useful method for detecting PanIN at the precancerous stage. We report here on a case of PanIN associated with a stricture of the main pancreatic duct.

A Case of Hepatic Abscess Caused by Toxocara / 대한간학회지

Toxocariasis is a helminozoonosis caused by the infection of a human host by the larva of Toxocara canis and Toxocara catis, which are common nematodes in dogs and cats, and occurs more frequently in school age children. Toxocariasis shows variable clinical manifestations including hepatomegaly, bronchial asthma, uveitis, central nervous system symptoms with peripheral eosinophilia and an increased total serum IgE level. However a hepatic abscess caused by toxocara infection in adults is rare. We experienced a case of heavy alcoholic patients with a hepatic eosinophilic abscess caused by toxocara infestation, which was confirmed by microscopic examination of liver biopsy, enzyme-linked immunosorbent assay test, abdominal CT and the ultrasonography findings.

Change of HBV DNA Level as a Predictor of HBeAg Loss after Lamivudine Treatment / 대한간학회지

BACKGROUND AND AIMS: Lamivudine is an effective, safe therapeutic agent for the treatment of chronic hepatitis B. The aim of this study was to investigate whether early suppression of the viral load predicts HBeAg loss within 1 year during lamivudine therapy. METHODS: This prospective study encompassed 74 patients (mean age: 37.1 years, male/female: 51/23) who were positive HBeAg, their AST or ALT levels were > or =2 times the upper limit of normal and their HBV DNA was > or =10(5) copies/mL. The patients received lamivudine 100 mg for 12 months with monitoring their HBV DNA, AST, ALT, HBeAg and anti-HBe, and all these tests were performed at pretreatment and 1, 3, 6, 9 and 12 months after treatment. The serum HBV DNA was measured by HBV branched DNA assay. RESULTS: HBeAg loss was observed in 12 patients (16.2%), and 9 patients achieved anti-HBe seroconversion during up to 1 year of lamivudine therapy. The mean time to HBeAg loss was 5.6 months (range: 1-12 months). The posttreatment HBV DNA (<2,000 copies/mL) after 3 month (P=0.008) and 6 month (P=0.012)) were significant predictors of HBeAg loss after 1 year of lamivudine treatment on univariate analysis. Pretreatment HBV DNA, AST/ALT, gender, age and liver cirrhosis had no impact on HBeAg loss. The six-month posttreatment HBV DNA level <2,000 copies/mL was a significant predictor of HBeAg loss on multivariate analysis (P=0.008, odds ratio=0.108). CONCLUSION: We suggest that an HBV DNA level <2,000 copies/mL at 6 month after lamivudine therapy is the most important predictor of HBeAg loss during up to 1 year of lamivudine therapy.

Expression of Mast Cell Tryptase in the Chronic Otitis Media with Effusion / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Mast cells are localized in the middle ear and Eustachian tube. They play a prominent role in the inflammatory and allergic conditions. The purpose of this study is to investigate if different inflammatory reactions depend on whether patients are allergic or not by measuring concentration of the mast cell tryptase that reflects the mast cell activity. MATERIALS AND METHOD: Twenty-five patients with chronic otitis media with effusion (COME) were studied. Thirteen patients were confirmed allergy positive by multiallergosorbent test. Mast cell tryptase in the middle ear effusions was measured using western blotting. RESULTS: Mast cell tryptase was more strongly expressed in the effusions with allergy positive than in the allergy negative (p<0.01). CONCLUSION: There was a correlation between mast cell tryptase from MEE and allergy, so we conclude that allergy plays a role in the pathogenesis of COME.