Relationship between Intrahepatic Expression of Hepatitis Be Antigen and Histology in Patients with Hepatitis B Virus Infection / 대한내과학회지

BACKGROUND: It has been known that the sero- logic markers of infectivity and viral replication in patients with hepatitis B virus(HBV) infection are hepatitis B e antigen(HBeAg), HRV DNA and HBV DNA polymerase. METHODS: In order to clarify the relationship between chronic liver diseases and HBV infection, and the mechanism of chronicity in HBV related liver diseases, the expression patterns of hepatic HBeAg by imrnunohistochemical stain and histologic activity index(HAI) were studied from 10% formalin fixed paraffin embedded tissues in 114 patients performed liver biopsy. RESULTS: The results were as follows: 1) Incidence of serum HReAg positivity in HBsAg positive patients was 74.6% and that of hepatic HBeAg expression was 77.6% among serum HBeAg positive cases. Hepatic HBeAg expression was 72.4% in serum HBeAg negative cases. 2) In serum HBeAg positive cases, almost all infected hepatocytes exhibited cytoplasmic HBeAg expression and half of patients showed nuclear HBeAg expression, but cytoplasmic HBeAg expression was solely predominant in serum HBeAg negative cases. Hepatic HBeAg expression showed a decreasing trend from AVH and CPH, through CAH, to cirrhosis with or without HCC, which was a consistent finding with serum HBeAg in decreasing manner. Hepatic HBeAg expreassion was highly sustained in about 60-90% of cases, regardless of duration of their illnesses. 3) HAI showed slighf3y higher tendency in patients with hepatic HBeAg negative expression than in positive cases. CONCLUSION: The above results suggest that HBeAg may play a role as a viral target antigen for immune-mediated liver injury and may be also related to the pathogenetic mechanism of chronicity in chronic hepatitis B.

Esophagus, Stomach & Intestine; A Case of Adenomyoma of Duodenum / 대한소화기내시경학회지

Adenomyoma of the gastrointestinal tract has been considered to be a form of pancreatic heterotopia. Heterotopic pancreatic tissue in the gastrointestinal tract is a relatively not uncommon abnormality, but adenomyoma is a rarely reported tumor and its ineidence is difficult to determine. Adenomyoma is similar to aberrant pancreas in both appearance and location, and cannot be differentiated endoscopically or radiographically. Histologically, adenomyoma is primarily composed of smooth muscle and undifferentiated duct like structures. It is usually of no clinical importance and incidentally detected, but according to its location and size of the mass, it may become a serious clinical problem. Its real importance lies in the recognition of its existence, to facilitate a timely diagnosis, We present a case of adenomyoma of the duodenum with a brief literature review.