A Case of Esophageal T-cell Lymphoma Presenting as Multiple Discrete Ulcers on a Background of Normal Mucosa / 대한소화기내시경학회지

Gastrointestinal involvement by a lymphoma occurs in 20% of patients with a lymphoma and frequently involves the stomach, small bowel or colon, but rarely involves the esophagus. Esophageal lymphomas are usually secondary to an adjacent lymph node invasion or the contiguous spread from a gastric lymphoma. Primary involvement of the esophagus by a lymphoma is quite rare. Primary versus secondary esophageal involvement by a lymphoma is difficult to determine. The radiological features of esophageal lymphomas may manifest nodules of various sizes, enlarged folds, polypoid mass, ulceration, stenosis, varicoid appearance, and aneurysmal dilatation. The presentation of multiple discrete ulcers in the esophagus on the background of the normal mucosa is most unusual. We describe a case of an esophageal T-cell lymphoma with multiple discrete ulcers on the background of the normal mucosa. The patient was treated with chemotherapy. After chemotherapy, the endoscopic findings of the esophagus showed a normal esophageal mucosa. We report this case with a review of the relevant literature.

Short-term Therapy with Pegylated Interferon plus Ribavirin for the Chronic Hepatitis C Genotype 2 Patients / 대한간학회지

BACKGROUND/AIMS: The standard treatment for chronic hepatitis C patients infected with HCV genotype-2 is a combination of pegylated interferon alfa and ribavirin over a 24 week period. It is unclear if a shorter treatment duration is possible for patients showing a rapid virological response (RVR) without compromising the sustained virologic response (SVR) in Korea. METHODS: 42 patients chronically infected with the HCV genotype-2 were treated with peginterferon alfa-2a 180 mcg/wk plus ribavirin 800 mg/d for 24 weeks and followed up for 24 weeks. The HCV RNA was qualitatively assessed after 4 weeks of treatment, and RVR was defined as undetectable HCV RNA at the 4th week. Retrospectively, 26 patients were treated with the standard treatment strategy (> or =80% of the intended duration and dosage), 14 patients with a short-term treatment strategy (<80% intended duration and dosage) and 2 patients were excluded. RESULTS: Among the 42 patients, 35 patients (83%) had RVR and 38 patients (90%) had a sustained virologic response (SVR). All 7 patients without RVR were treated with the standard treatment strategy, in whom 6 patients (86%) had SVR. Among the 35 patients with RVR, 14 patients were treated with short-term treatment and 19 patients were treated with the standard treatment. SVR was obtained in 12 out of the 14 patients (86%) in the short-term treatment group and 18 out of the 19 (95%) in the standard treatment group (P=0.373). CONCLUSION: HCV genotype-2 patients who have RVR with peginterferon and ribavirin treatment can be treated with a short-term treatment without compromising the chances for SVR. However, an additional trial will be needed to optimize the treatment duration.

Controlled Comparison of Endoscopic Epinephrine Injection and Endoscopic Argon Plasma Coagulation for the Treatment of Acute Peptic Ulcer Bleeding / 대한소화기내시경학회지

BACKGROUND/AIMS: Endoscopic injection therapy with hypertonic saline Epinephrine (HSE) is the easiest and most widely used procedure for the management of peptic ulcer bleeding. Argon plasma coagulation (APC) is a recently introduced endoscopic hemostatic procedure. Thus, we performed a prospective trial to compare the hemostatic efficacy of APC and HSE. METHODS: Forty patients with the diagnosis of bleeding ulcer were randomly assigned to receive either HSE (n=20) or APC (n=20) treatment during the period of September 2003 to April 2004. The two groups were matched for gender, age, site of bleeding, the endoscopic findings and the initial hemoglobin at the study baseline. RESULTS: The bleeding was initially controlled in 18 patients (90%) of the APC group, and in 20 patients (100%) of the HSE group. Rebeeding occurred in one patient (5%) of the APC group and in 3 patients (15.5%) of the HSE group. The lengths of stay in the hospital were 11.7 days in the APC group and 10.7 days in the HSE group. Death occurred in 1 case in the APC group and in 1 case in the HSE group. The initial hemostatic efficacy showed no difference between the two groups. CONCLUSIONS: Argon plasma coagulation is as effective as hypertonic saline epinephrine injection for the initial management of acute peptic ulcer bleeding.

A Case of Colonic Stricture Induced by Ulcerative Colitis / 대한소화기학회지

No abstract available.