Association between Recurrence and Survival Rates According to the Location of Gastric Gastrointestinal Stromal Tumor

BACKGROUND/AIMS: This study aimed to evaluate the clinicopathological parameters of gastric gastrointestinal stromal tumors (GISTs) and to investigate the effect of tumor site on clinical outcomes. MATERIALS AND METHODS: Patients treated for a surgically confirmed gastric GIST were retrospectively evaluated between January 2001 and June 2016. The risk level was determined on the basis of the tumor size and number of mitoses. The risk level, recurrence rate, and survival rates were evaluated on the basis of the site of the gastric GISTs. RESULTS: The 97 patients identified included 42 men and 55 women. The median follow-up period was 36 months (range: 12~72 years). Of the 97 patients, 57 (58.7%) and 40 (41.3%) patients had proximally and distally located gastric GISTs, respectively. The high- and low-risk groups had higher proportions of proximally and distally located tumors, respectively (P=0.033). The recurrence rates of proximal and distal GISTs were 8.8%, and 2.5%, respectively (P=0.307). The overall survival rate was not associated with the site of the gastric GISTs (P=0.549). CONCLUSIONS: No relevant associations were found among recurrence, overall survival, and gastric GIST location.

Enough Observation Time in Esophagogastroduodenoscopy Increases the Detection Rate of Neoplasia

No abstract available.

Helicobacter pylori Eradication Rate in Patients with Diabetes

BACKGROUND/AIMS: The prevalence of diabetes mellitus is increasing. Little is known about the difference in Helicobacter pylori eradication rates between diabetic patients and non-diabetics. The aim of this study was to compare the eradication rate between diabetic and non-diabetic patients. MATERIALS AND METHODS: The medical records of patients who received a proton pump inhibitor (PPI)-based eradication therapy between 2012 and 2015 were retrospectively reviewed. All the patients underwent endoscopic biopsy to confirm H. pylori infection. Successful eradication was confirmed by using the ¹³C-urea breath test, biopsy, or rapid urease test, which was performed at least 4 weeks after the end of eradication therapy. RESULTS: A total of 1,402 patients were included. The eradication rate was 74.3% (1,041/1,402; 95% CI, 72.0~76.5%). Excluding 151 patients who were confirmed to have no diabetes, 182 diabetic and 1,069 non-diabetic patients were compared. No significant difference (P=0.667) in eradication rate with PPI-amoxicillin-clarithromycin therapy was found between the diabetic (75.8%, 138/182; 95% CI, 69.6~82.0%) and non-diabetic groups (74.0%, 791/1,069; 95% CI, 71.4~76.6%). Peptic ulcer was much more common in the diabetic group than in the non-diabetic group (67.0% vs. 57.9%, P=0.038). CONCLUSIONS: The H. pylori eradication rate with PPI-based triple therapy in the diabetic patients was probably not different from that in non-diabetic patients.

Successful Healing of the Myocardial Rupture Complicated by the Occlusion of a Single Diagonal Branch / 대한내과학회지

Myocardial rupture is a rare but lethal complication of myocardial infarction. Immediate conservative management is critical, but surgery should be considered if the patient's hemodynamic state and degree of hemopericardium do not improve after pericardiocentesis. In this case, a 54-year old patient without underlying disease came to the emergency after experiencing chest pain for two weeks with suddenly aggravated severe dyspnea. The patient was found to have a hemopericardium with cardiac tamponade, so pericardiocentesis was immediately executed. Transthoracic echocardiogram revealed akinesia of the left ventricular muscle and focal wall thinning. The patient was diagnosed with complete occlusion of a single diagonal branch and ventricular free wall rupture using a coronary computed tomography scan. After conservative treatment, vital signs and cardiac function stabilized, and there was no definitive sequela. This case is clinically significant because myocardial rupture, a lethal complication of myocardial infarction, was successfully managed with non-surgical, conservative treatment.

A Case of Synchronous Occurrence of Gastric Schwannoma and Gastric Adenoma

Gastric schwannomas are rare benign tumors among the mesenchymal tumor of the gastrointestinal tract, arising from the nerve tissue which has a schwann cell sheath. These neoplasms are grossly similar to gastrointestinal stromal tumor (GIST), however, the clinical course of GIST is more aggressive compared to that of schwannomas. Synchronous occurrence of gastric epithelial and subepithelial tumors is rare. Besides, most subepithelial lesions are GIST. We present the case of a 57-year-old male with synchronous gastric schwannoma and gastric adenoma in the stomach. We found a gastric subepithelial lesion incidentally, the size of which was increasing and tubular adenoma was discovered in the covering mucosa during endoscopy follow-up. The synchronous lesion was removed by wedge resection, which was diagnosed as schwannoma with adenoma.