Adherence of Helicobacter pylori to Areas of Gastric Intestinal Metaplasia by the Genta Stain / 대한소화기내시경학회지

BACKGROUND/AIMS: Infection with Helicobacter pylori is the most important cause of chronic active gastritis. One means of evolution of chronic active gastritis is the development of atrophic gastritis, a condition almost universally associated with extensive intestinal metaplasia. But Helicobacter pylori is not usually found in areas of intestinal metaplasia. Recently Genta RM developed a staining technique that allows simultaneous visualization of Helicobacter pylori and gastric morphology, including intestinal metaplasia. Therefore, the evaluation of the frequency of Helicobacter pylori adherence to intestinal metaplasia using the Genta stain is herein reported. METHODS: The study was conducted on 69 gastric biopsy specimens with intestinal metaplasia. Slides from each specimen were stained using the Genta stain to identify the adherence of bacteria and types of intestinal metaplasia. RESULTS: In 56 (81%) of 69 patients, incomplete intestinal metaplasia was found. In 9 (16%) of 56 patients with incomplete intestinal metaplasia, H. pylori was attached in the area of intestinal metaplasia. But in all of the intestinal metaplasia, H. pylori was not attached in the area of the intestinal metaplasia. CONCLUSIONS: The common subtype of intestinal metaplasia was incomplete metaplasia. Although in small cases, H. pylori was attached only to the area of the incomplete type of intestinal metaplasia.

A Case of Gastric Hamartoma Prolapsing Through the Pylorus / 대한소화기내시경학회지

Gastric hamartoma is usually an asymptomatic, small, sessile polyp, located in the body and fundus of the stomach. A case was experienced involving a solitary large hamartomatous polyp prolapsing through the pylorus in a 63-year old female presented with melena. A gastroendoscopy determined a pedunculated gastric polyp prolapsing through the pylorus with fresh blood oozing and congestion. A UGI series revealed that a 5 cm sized lobulated mass with a long stalk attached at the greater curvature side of the fundus. The polyp was removed by an endoscopic snare polypectomy and diagnosed as a gastric hamartoma.

Assessment of body composition using dual energy x-ray absorptiometry in patients with liver cirrhosis: comparison with anthropometry

OBJECTIVES: The aim of this study was to evaluate changes of body composition in cirrhotic patients. Dual energy x-ray absorptiometry (DEXA) and anthropometry were used, and the values obtained were compared. METHODS: Mid-arm fat and muscle areas were calculated by anthropometry in 66 cirrhotic patients and 94 healthy controls. In 37 of the cirrhotic patients and 39 of the controls, fat mass, lean soft tissue mass and bone mineral contents were measured with DEXA. RESULTS: The number of cirrhotic patients with measured values below the fifth percentile of normal controls was 21 (31.8%) by mid-arm fat area, six (9.1%) by mid-arm muscle area, 15 (40.5%) by fat mass and 0 (0%) by lean soft tissue mass. The fat mass in cirrhotic patients was less than in controls, whereas lean soft tissue mass and bone mineral content were not different. Fat depletion was severe in Child-class C patients and with severe ascites. Mid-arm fat area and fat mass showed close correlation (r = 0.85, p < 0.01), but mid-arm muscle area and lean soft tissue mass showed poor correlation (r = 0.32, p < 0.05). CONCLUSION: Cirrhotic patients showed lower fat component, with preserved lean soft tissue mass and bone mineral content. In clinical practice, the measurement of mid-arm fat area was useful for the assessment of fat mass.

A Case of a Pseudoaneurysm in Chronic Pancreatitis / 대한소화기내시경학회지

The bleeding pseudoaneurysm is a rare condition but one of the lethal complications in patients with chronic pancreatitis. Early diagnosis and emergent intervention can reduce mortality and promise better outcomes. We experienced a case of a bleeding pseudo- aneurysm in a chronic pancreatitis patient. The 44-year-old male was suffering from con- tinuous, vague epigastric pain and black tarry stool. An abdominal CT scan revealed a homogeneously enhancing round mass in the pancreatic pseudocyst, and celiac angi- ography found that a pseudoaneurysm had originated from the pancreaticoduodenal artery. The patient was treated with Whipple's operation and was later discharged, having improved in his condition.