A Case of Gastric Intramural Hematoma after Endoscopic Injection of Hypertonic Saline-Epinephrine for Hemostasis

A gastric intramural hematoma is very rare and commonly associated with trauma, anticoagulation therapy, coagulopathy, pancreatic disease, aneurysm and peptic ulcer disease. This is a case of gastric intramural hematoma which occurred in a patient taking aspirin after hypertonic saline-epinephrine injection for bleeding from a biopsy site. We describe a case of gastric intramural hematoma that was successfully managed with conservative therapy.

Comparison of effect of interferon-alpha, lamivudine monotherapy and combination therapy in chronic hepatitis B / 대한내과학회지

BACKGROUND: Alpha-interferon achieves HBeAg seroconversion in about 30 to 40% of patients with chronic hepatitis B, and recently discovered lamivudine, an oral nucleoside analogue, inhibits hepatitis B virus replication and reduces hepatic necroinflammation in patients with chronic hepatitis B effectively. In this study, we compared the efficacy and safety of alpha-interferon, lamivudine and their combination regimen. METHODS: Fourty chronic hepatitis B patients, who were diagnosed through HBV DNA, HBeAg positivity, alanine aminotransferase elevation, and liver biopsy were enrolled in this study. Twelve patients were treated with 500 MU of alpha-interferon subcutaneously 3 times a week for 6 months, 9 patients were treated with 150 mg of lamivudine and alpha-interferon, and 19 patients were treated with 150 lamivudine daily for 6 months. RESULTS: After treatment, all of the three groups showed rapid decline in HBV DNA level, but lamivudine group showed more clearance of HBV DNA than interferon group (alpha-interferon: 75%, combination group: 89%, lamivudine group: 100%, respectively) (p=0.04). HBeAg seroconversion rate was 25% for interferon group, 11% for combination group, 26% for lamivudine group, showing no difference between three groups (p=0.705). Mean serum ALT level and rate of ALT normalization during therapy showed no differnece (83% for interferon group, 78% for combination group, 84% for lamivudine group). CONCLUSION: It is suggested that the efficacy of combination interferon/lamivudine therapy appears disappointing and further study should be done for appropriate combination or monotherapy of lamivudine for patients with chronic hepatitis B.