The Influence of Iron Deficiency on Helicobacter pylori Eradication

BACKGROUND/AIMS: Helicobacter pylori is a distinctive pathogen that lives in the gastric mucosa and is a well known risk factor of gastric adenocarcinoma. Iron deficiency aggravates the development of H. pylori-induced premalignant and malignant lesions in a cagA-dependent manner, enhancing H. pylori virulence. The aim of this study was to identify the relationship between iron deficiency and H. pylori eradication rates. MATERIALS AND METHODS: Participants who received 7 days of first-line triple therapy with serum iron level measured in parallel were retrospectively investigated between 2005 and 2014. H. pylori eradication was confirmed by the rapid urease test or 13C-urea breath test at least 4 weeks after completion of triple therapy. Iron deficiency was defined as either a serum iron level less than 50 µg/dL or a serum ferritin level less than 12 ng/mL. RESULTS: A total of 194 patients received 7 days of first-line triple therapy along with parallel serum iron level measurements over the 10-year period. The mean average age was 53.3 years (range, 21~86 years), and 135 patients (69.6%) were male. The overall H. pylori eradication rate was 83.5%. Proportions of eradication success with ferritin level less than 12 ng/mL and iron less than 50 µg/dL were 90.5% and 88.6%, respectively. However, there was no statistical difference in eradication rates according to iron deficiency. CONCLUSIONS: Iron deficiency might not be related with H. pylori eradication rates in this study. Further large-scale studies are needed to confirm this result.

Factors Affecting Long Term Survival for Metastatic Gastric Cancer Treated with Chemotherapy

BACKGROUND/AIMS: Systemic chemotherapy for patients with metastatic gastric cancer is generally for palliative purposes. However some patients achieve long term survival after chemotherapy. Here we investigated the prognostic factors affecting long term survival for metastatic gastric cancer after chemotherapy. MATERIALS AND METHODS: We retrospectively reviewed 176 metastatic gastric cancer patients who received chemotherapy at the Kosin University Gospel Hospital from 2005 to 2010. Univariate and multivariate analyses were performed to evaluate the prognostic factors of long term survival. RESULTS: Overall survival time was 9 months and 5-year survival rate was 2.6%. Multivariate analysis revealed distant lymph nodes metastasis (hazard ratio [HR], 0.53; P=0.008), initial low albumin level (<3 g/dL) (HR, 2.64; P=0.003), patients <40 years (HR, 2.12; P=0.032), and poor performance status (Eastern Cooperative Oncology Group [ECOG], 2) (HR, 1.66; P=0.008) as significant factors of poor survival. 12 patients with metastatic gastric cancer survived more than 36 months. All of them had ECOG performance status of 0 or 1 and no one was <40 years at the time of diagnosis. In addition, there were no lung metastasis and bone metastasis. CONCLUSIONS: These results suggest that better performance status and the presence of only distant lymph nodes metastasis are favorable factors for long term survival of metastatic gastric cancer. Macroscopically scirrhous type of tumors, lung, bone or peritoneal metastasis and age of <40 years are poor prognostic factors for long term survival of metastatic gastric cancer.

A Case of Endobronchial Actinomycosis with a Broncholith cured by Cryotherapy through a Flexible Bronchoscope / 고신대학교의과대학학술지

We report the case of a 53-year-old man who presented with obstructive pneumonitis and broncholithiasis. We attempted to remove the broncholith with forceps through a flexible endoscope, but the potential for bleeding due to partial synechia did not allow this. We succeeded in removing it with cryotherapy. The histopathological diagnosis was thoracic actinomycosis associated with broncholithiasis. Endobronchial actinomycosis with a broncholith is very rare. We successfully treated a patient with endobronchial actinomycosis with a broncholith by administering short-term antibiotics after broncholithectomy via cryotherapy through a flexible bronchoscope.

Localized Empyema due to Mycobacterium bovis / 대한내과학회지

Bovine tuberculosis, which is caused by Mycobacterium bovis, a member of the M. tuberculosis complex, is a zoonosis transmitted through the inhalation of infected droplets or the ingestion of raw milk. Human bovine tuberculosis has been reported rarely in most countries since the introduction of pasteurized milk and M. bovis eradication programs. However, it has been reported in other areas with poorly controlled programs. We encountered a case of localized empyema due to M. bovis infection in a pregnant female immigrant from Vietnam. We report this case with a brief review of the related literature.

Localized Empyema due to Mycobacterium bovis / 대한내과학회지

Bovine tuberculosis, which is caused by Mycobacterium bovis, a member of the M. tuberculosis complex, is a zoonosis transmitted through the inhalation of infected droplets or the ingestion of raw milk. Human bovine tuberculosis has been reported rarely in most countries since the introduction of pasteurized milk and M. bovis eradication programs. However, it has been reported in other areas with poorly controlled programs. We encountered a case of localized empyema due to M. bovis infection in a pregnant female immigrant from Vietnam. We report this case with a brief review of the related literature.

The Efficacy of Antiviral Agents in Patients with Hepatitis B-related Liver Cirrhosis / 고신대학교의과대학학술지

OBJECTIVES: Improvement of liver synthetic function and the incidence of complication in the patients with hepatitis B-related liver cirrhosis is important. In this study, we study whether antiviral therapy was effective in patients with hepatitis B-related liver cirrhosis. METHODS: 103 patients with hepatitis B-related liver cirrhosis treated with lamivudine 100mg daily over 6 months and followed up over 30 months. 71 patients were positive for serum HBeAg. HBeAg, HBV DNA , CBC, prothrombin time, biochemistry, ultrasonography and endoscopy were tested every 6 months. RESULTS: The medians of ALT, albumin improved after 6 months and then aggravated after 18 months, but they didn't aggravated at 30 months compared with initial test. The median of Child-turcotte-pugh (CTP) score imporved after 6 months and then aggravated after 12 months, but they didn't aggravated at 30 months compared with initial test. The CTP score improved (2 point reduction) in 29 patients. The finding of ultrasonography didn't aggravaed (improved or didn't changed) in 58 patients. The 5 year incidence rate of hepatocelluar carcinoma was 8.3%. CONCLUSIONS: The antiviral therapy in patients with hepatitis B-related liver cirrhosis is improved CTP score and biochmical data. The improvement is more useful in decompensated cirrhosis the compensated cirrhosis. The incidence of hepatocellular carcinoma decreases than other studies. Therefore, the antiviral medication in patients with hepatitis B-related liver cirrhosis is helpful to consider more aggressively.