Acute myocardial infarction coincident with gastric ulcer bleeding following herbal medication-induced acute renal failure / 대한내과학회지

Acute renal failure, acute myocardial infarction (AMI), and gastric ulcer bleeding (GUB) are associated with high rates of morbidity and mortality, especially in older patients. The development of each of these conditions can be followed by the development of another; however, it is rare for these three conditions to develop concurrently. Here, we report the case of a 92-year-old man who was admitted because of generalized weakness that developed after the ingestion of nothing but functional foods, including herbal medications containing Glycyrrhiza and Aloe, for ten days. After admission, AMI and GUB developed approximately six hours apart. Conservative treatment was chosen for the bleeding ulcer because of the high procedural risk, and the use of antiplatelet agents and heparinization for treatment of the infarction were stopped. The patient remained hemodynamically stable following the administration of a statin, diuretics, and proton pump inhibitors. A healed scar at the site of the ulcer was confirmed three weeks later; however, postinfarct angina developed after the patient's last endoscopy. Percutaneous coronary intervention was successfully performed with two stents placed in the left anterior descending artery.

A Case of Severe Gastric Ulcer Bleeding after Exchange for Replacement Balloon Gastrostomy Tube in Percutaneous Endoscopic Gastrostomy / 대한소화기내시경학회지

PEG is a simple, safe and rapid method for the placement of feeding gastrostomy tube because of its low morbidity and mortality. Also, exchange of gastrostomy tube can be easily performed because several types of exchange tube, suich as replacement balloon gastrostomy tube are available. But, less has been known about complications of exchange tube. The authors experienced a case of severe gastric ulcer bleeding in seventy one years old male patient who had been suffered from melena after exchange of old PEG tube for replacement balloon gastrostomy tube. Gastroscopy showed bleeding from acute, large and deep ulcer on the body of stomach, and replacement tube tip directed to the center of ulcer. Bleeding was thought to be caused by gastric ulcer due to replacement balloon gastrostomy tube, After removal of tube and conservative management with H2 receptor antagonist, bleeding ceased

Clinical Application of Endoscopic Laser Therapy in Gastrointestinal Disese: Especially in early gastric cancer / 대한소화기내시경학회지

I tried the endoscopic laser therapy for the malignant and benign disease of the alimentary tract to evaluate efficacy in rejection of surgical treatment or inoperable state. I have experienced 16 cases of the laser therapy in my hospital from July 1990 to June 1991. The apparatus I used is the SLT contact Nd-YAG laser with the ceramic endoprobe of rounded or chisel or hollow type in each case. The irradiation was made at an output of 15-20 Watts within 1.5 seconds. Between the 2-4 weeks laser therapy, the treatment response was observed by rebiopsy, I treated 7 cases of early gastric cancer and post-laser follow-up study showed 70% negative for cancer cells by endoscopic biopsy. Failure of laser treatment was found in case of IIc type, Two cases of advanced gastric and I case of rectal cancer with severe obstruction were relieved by laser therapy. I also experienced 3 cases of esophageal or gastric polyp which were completely. resolved after irradiation. Besides, I could get hemostasis in 1 case of gastric ulcer bleeding with exposed vessels and 1 case of Mallory-Weiss syndrome. And a case of gastric bezoar was completely fragmentated after irradiation. As mentioned above, I achieved satisfactory results of 13 cases in 16 cases. Contact Nd - YAG laser treatment ean be applicated with excellent efficacy in any age, sex and severity of disease with or without complications and any site of lesions which can be reached within the endoscope. I suggest it is maybe highly promising medical technique in the future.