Clinical Characteristics and Treatment Outcome of Peginterferon Plus Ribavirin in Patients Infected with Genotype 6 Hepatitis C Virus in Korea: A Multicenter Study

BACKGROUND/AIMS: Because of the limited geographic distribution, there have been insufficient data regarding hepatitis C virus (HCV) genotype 6 in Korea. This study aimed to investigate the clinical characteristics and available treatment outcomes of patients with genotype 6 HCV in Korea. METHODS: From 2004 to 2014, data were collected from Korean patients infected with genotype 6 HCV in eight hospitals. RESULTS: Thirty-two patients had genotype 6 HCV. The median age was 44 years, and 6c was the most common subtype. The baseline median alanine transaminase level was 88 (21 to 1,019) IU/mL, and the HCV RNA level was 1,405,000 (96,500 to 28,844,529) IU/mL. Twenty-five patients were treated with peginterferon (PEG-IFN) and ribavirin. Three follow-up losses occurred. Additionally, 13 patients attained a sustained virologic response (SVR), seven patients relapsed, and two patients exhibited a null response. The SVR rates were 40% and 75% for the 24- and more than 48-week treatments, respectively, and five of the six patients who achieved a rapid virologic response (RVR) attained a SVR. CONCLUSIONS: Korean patients infected with genotype 6 HCV are relatively young, and 6c is the most common subtype. When treated with PEG-IFN and ribavirin, the SVR rate was 52%. Similar to other genotypes, a longer duration of treatment and attainment of RVR are important for SVR.

A Multicenter Clinical Trial of Cisapride Tartrate in Diabetic Patients with Dysmotility Like Dyspeptic Symptoms / 대한소화관운동학회지

BACKGROUND/AIMS: We evaluated the effects of cisapride tartrate on gastrointestinal symptoms and gastric emptying times in diabetic patients with dysmotility like dyspeptic symptoms. METHODS: Cisapride was administered before each meal in 61 patients for 4 weeks. The intensity of gastrointestinal symptoms before and after cisapride administration was scored from 0 to 4, in the order of increasing severity of symptoms. In addition, a gastric emptying test was performed. RESULTS: A significant reduction in the total intensity score of symptoms was observed during the first two weeks, from 8.5+/-2.1 to 4.0+/-3.0 (p < 0.05), and a further reduction was noted during the next two weeks, to 2.8+/-2.8 (p < 0.05). Good to excellent improvement was obtained in 70.4% of the patients, but the improvement in symptoms was not related to age, duration of diabetes, glucose, Hb A1c, neuropathy, or retinopathy. Treatment with cisapride induced a significant regression of symptoms and a significant improvement of delayed gastric emptying from 104.0+/-31.7 minutes to 79.5+/-17.1 (p < 0.05). However, there was a lack of association between the changes in gastric emptying times and improvements in symptoms(r(2)=0.00186). Only 3 patients complained of loose stool, nausea, or dizziness. CONCLUSIONS: Cisapride was effective in improving dysmotility like dyspeptic symptoms in diabetic patients without serious side effects.

Herpes Simplex Esophagitis Presenting as Melena: A case report / 대한소화기내시경학회지

A 29-year-old man was admitted because of melena for 5 days. Two years ago, he underwent allogenic bone marrow transplantation for chronic myeloid leukemia and received immunosuppressive agents. Esophagogastroduodenoscopy showed a picture - multiple scattered deep ulcers and friable pseudomembranes - of highly suggestive of a herpes simplex esophagitis and biopsy revealed multinucleated giant cells and pathognomonic intranuclear inclusion bodies. Esophageal lesions and melena improved after acyclovir therapy.

The Pattern of Gastroesophageal Reflux in Patients with Gastroesophageal Reflux Disease / 대한소화관운동학회지

BACKGROUND/AIMS: Generally, it is recommended for patients with gastroesophageal reflux disease to sleep with the head of the bed elevated; however, many patients in Korea do not have heartburn symptoms during the night. METHODS: We investigated the pattern of acid reflux in patients who were diagnosed as having definite pathological acid reflux on 24-hour pH monitoring. RESULTS: One hundred patients were categorized into 3 groups; upright refluxer (68%), supine refluxer (2%), or combined refluxer (30%). Acid reflux was rare in supine positions but instead, usually occurred in upright positions. Acid reflux was found to occur most commonly after meals. The reflux symptoms occurred during pH monitoring with the average frequency of 5.5 times (total of 254 times) in 46 patients. The acid related symptoms were more common in the upright period and postprandially than the supine period. The presence of an esophagitis, an esophageal motility disorder, or the LES pressure did not make a significant difference between upright refluxer and supine refluxer. CONCLUSIONS: Gastroesophageal reflux was found to be rare in supine positions but usually occurred in upright positions. Gastroesophageal reflux occurred most commonly after meals, and was frequently associated with reflux symptoms.

A Case of a Diffuse Esophageal Spasm Diagnosis by Ambulatory 24 hour Manometry / 대한소화관운동학회지

Diffuse esophageal spasm (DES) is a motility disorder of the esophagus characterized by symptoms of retrosternal chest pain and intermittent dysphagia. The diagnosis of DES has relied on criteria obtained from a standard esophageal manometry (more than one simultaneous contraction in a series of 10 wet swallows with the rest being peristaltic). Because symptoms and/or typical manometric findings are not always documented during the standard manometry, 24 hour manometry may be more useful in such cases. We recently assessed a 29-year-old male patient who complained of chest pain and dysphagia. He showed nonspecific findings on the laboratory based manometry, but DES was diagnosed by his typical manometric findings on the 24 hour manometry. Therefore, a 24 hour manometry should always be performed when the patient's history suggests the presence of DES and the laboratory based manometry failed to detect the symptomatic contractions of DES. Following we report this case with a review of the literature.

A Case of Cysticercosis in the Anterior Chamber of the Eye

We investigated a case of cyst icercosis in the anterior chamber of right eye in a 45 year-old Korean man. Surgical intervention was performed through the superior limbal incision and cyst, about 5 mm diameter of size. was extracted from the anterior chamber. The microscopic studies revealed a cysticercus cellulosae. Three months after operation, visual acuity improved from 0.4 to 0.9 and the ocular functions are satisfactory. We report here a case of cysticercosis with a brief review of literature.

A Case of Angioid Streaks Associated with Pseudoxanthoma Elasticum

Angioid streakes are seen relatively rarely and their basic histopathology seems to be generally accepted as representing ruptures and breaks in lamina vitrea, although the pathogenesis of these ruptures has not been well understood. Angioid streaks appear ophthalmoscopically as a network of red or dark brown streaks emanating from a more or less complete peripapillary ring of the same color. Angioid streaks associated with the cutaneous lesions is called the Groenblad-Strandberg syndrome. Pseudoxanthoma elasticum is a relatively uncommon disorder of elastic tissue involving dermal, ocular, gastrointestinal, and cardiovascular tissues. The purpose of this paper is to describe a case of angioid streakes associated with pseudoxanthomsa elasticum found in a 39 year-old Korean male.

Clinical Studies on Hyphema in The Complications of Cataract Extraction

The history of surgical treatment of cataract extends back at least Before Christ. In 1748 Jacques Daviel, French ophthalmic surgeon, was attempted to cataract extraction with modern operating techniques and since then development of operation methods, techniques and instruments were contributed to recovery of the loss of vision. Although the occurrence of during and postoperative complications of cataract extraction diminish, cataract complications still remain troublesome in the minds of cataract operators. The authors reported the result of hyphema in the many complications of cataract extraction for the 7 of the 47 eyes(42 cases), which were operated from January 1976 to August 1977, using the sex, types of cataract, age, methods of operation, onset and procedure.