Esophageal Hemangioma Treated by Endoscopic Mucosal Resection: A Case Report and Review of the Literature / 대한소화기학회지

Hemangioma of the esophagus is a rare form of benign esophageal tumor. It usually presents as a single lesion located in the lower third of the esophagus and is mostly asymptomatic. However, it may occasionally cause hematemesis and/or obstruction. Surgical resection is the conventional treatment modality for managing esophageal hemangioma, but less invasive approaches such as endoscopic therapy are recently becoming more widely employed. Herein, we report a case of a 54-year-old man who presented with an esophageal hemangioma that was successfully treated by endoscopic mucosal resection without any complications.

A Case of Necrotizing Colitis Presenting with Hepatic Portal Venous Gas and Pneumatosis Intestinalis / 대한소화기학회지

Hepatic portal venous gas is a very rare radiologic sign which is characterized by gas accumulation in the portal venous circulation. Pneumatosis intestinalis is also very rare and is characterized by multiple air cysts in the serosal or submucosal layers of the gastrointestinal tract walls. These two findings are caused by various pathological conditions and can develop individually or simultaneously. The latter is clinically more significant because it is frequently related to bowel ischemia or necrosis, and represents a poor prognosis. However, prognosis is more influenced by the severity of underlying disease rather than hepatic portal venous gas or pneumatosis intestinalis itself. If bowel ischemia or necrosis is the primary cause, emergency operation is very important to improve patient's prognosis. Herein, we report a case of necrotizing colitis presenting as hepatic portal venous gas and pneumatosis intestinalis which was successfully managed by early surgery.

Trend in the eradication rates of Helicobacter pylori infection in the last 11 years / 대한내과학회지

BACKGROUND/AIMS: The standard triple therapy used as the first-line treatment for Helicobacter pylori that combines a proton pump inhibitor (PPI), amoxicillin, and clarithromycin had an initial eradication rate of 90%. However, many recent studies have not found this level of effectiveness. This study evaluated the trend in the eradication rates of H. pylori infection over the last 11 years. METHODS: This was a retrospective study of patients diagnosed with H. pylori infection between 1997 and 2007 and treated with triple therapy (PPI, amoxicillin, and clarithromycin). The patients answered questions about compliance and side effects within 2 weeks of completing their treatment. In addition, we assessed whether the H. pylori had been eradicated at least 4 weeks after the treatment using a 13C-urea breath test, rapid urease test, or histopathological examination. RESULTS: The eradication rate with first-line triple therapy decreased over the study period. There was no change in the eradication rate with second-line quadruple therapy (PPI, bismuth, metronidazole, and tetracycline). There were no differences in the eradication rate and recrudescence between 1- and 2-week regimens. CONCLUSIONS: The effectiveness of the recommended first-line triple therapy for H. pylori eradication has decreased significantly in the last decade. Therefore, the first-line therapy based on the combination of PPI, amoxicillin and clarithromycin may need to be changed in the near future.

ANCA-negative limited Wegener's granulomatosis / 대한내과학회지

Wegener's granulomatosis is a very rare autoimmune disease that forms inflammatory granulomas of the upper and lower respiratory tract, and causes necrotizing vasculitis by invading small vessels. Its etiology is uncertain, but antineutrophil cytoplasmic antibody (ANCA) is thought to play an important role in causing the inflammatory granuloma formation and vasculitis. The detection of ANCA is a valuable finding in diagnosing Wegener's granulomatosis. However, in the limited type of Wegener's granulomatosis, which lacks accompanying constitutional symptoms, the diagnostic value of ANCA is minimal, requiring careful interpretation of ANCA-negativity. We report a case diagnosed as limited-type Wegener's granulomatosis through repeated biopsies despite ANCA negativity.

A Case of Juvenile Polyposis Syndrome with Whole Gastrointestinal Tract Involvement / 대한소화기내시경학회지

Juvenile Polyposis Syndrome is a rare condition that is characterized by the development of multiple polyps in the gastrointestinal tract. It is a hamartomatous disorder that was first described in families in 1964. Both sporadic and familial cases with autosomal dominant inheritance have been reported on. Juvenile Polyposis Syndrome is regarded as a distinct from the solitary juvenile polyps that develop in 2% of children and adolescents, and the latter have no malignant potential. We report here on a case of Juvenile Polyposis Syndrome in an 18 year old male along with a review of the relevant literature. The patient had various numbers of different sized pedunculated polyps that were observed throughout the entire gastrointestinal tract.

The Bone Morphogenesis Protein-2 (BMP-2) is Associated with Progression to Metastatic Disease in Gastric Cancer / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: Bone Morphogenetic Proteins (BMPs) are members of the TGF-beta superfamily and it has been demonstrated that BMPs enhance migration, invasion and metastasis. The purpose of this study was to identify the association between the serum BMP-2 level and the progression status of gastric cancer. MATERIALS AND METHODS: Fifty-five patients with metastatic gastric cancer (metastatic disease group), six patients with early gastric cancer without lymph node metastasis (the EGC group), and ten healthy control subjects were enrolled in this study. The serum BMP-2 level was quantified by use of a commercially available ELISA kit. In EGC group patients and patients with metastatic disease, whole blood was obtained before endoscopic mucosal resection and before the commencement of a scheduled cycle of systemic chemotherapy, respectively. RESULTS: No significant difference in the mean serum BMP-2 levels was observed between the control subjects and the EGC group patients (87.95 pg/ml for the control subjects and 84.50 pg/ml for the EGC group, p=1.0). However, the metastatic disease group patients had a significantly higher level of serum BMP (179.61 pg/ml) than the control subjects and EGC group patients (87.95 pg/ml for the control subjects and 84.50 pg/ml for the EGC group, p<0.0001). Moreover, the mean serum BMP-2 level from patients with a bone metastasis was significantly higher than the mean serum BMP-2 level from patients without a bone metastasis (204.73 pg/ml versus 173.33 pg/ml, p=0.021). CONCLUSIONS: BMP-2 seems to have a role in progression to metastatic disease in gastric cancer, especially in the late stage of tumorigenesis, including invasion and metastasis. BMP-2 may facilitate bone metastasis in gastric cancer. To confirm these findings, further studies are required with tissue specimens and the use of a cancer cell line.