ABSTRACT
Portal biliopathy is defined as abnormalities in the extra- and intrahepatic ducts and gallbladder of patients with portal hypertension. This condition is associated with extrahepatic venous obstruction and dilatation of the venous plexus of the common bile duct, resulting in mural irregularities and compression of the biliary tree. Most patients with portal biliopathy remain asymptomatic, but approximately 10% of them advance to symptomatic abdominal pain, jaundice, and fever. Magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography are currently used as diagnostic tools because they are noninvasive and can be used to assess the regularity, length, and degree of bile duct narrowing. Management of portal biliopathy is aimed at biliary decompression and reducing the portal pressure. Portal biliopathy has rarely been reported in Korea. We present a symptomatic case of portal biliopathy that was complicated by cholangitis and successfully treated with biliary endoscopic procedures.
Subject(s)
Cholestasis/diagnosis , Hypertension, Portal/diagnosis , Stents , Abdomen/diagnostic imaging , Cholangiopancreatography, Endoscopic Retrograde , Humans , Male , Middle Aged , Portal Vein , Tomography, X-Ray ComputedABSTRACT
BACKGROUND/AIMS: This study aimed to evaluate the antiviral response and safety of tenofovir (TDF) versus entecavir (ETV) in treatment-naïve CHB patients. PATIENTS AND METHODS: We performed a retrospective cohort study of treatment-naive CHB patients who were treated with TDF or ETV. We analyzed virologic, biochemical, and serologic responses at 3, 6, and 12 months. RESULTS: A total of 107 patients (TDF group = 49, ETV group = 58) were included. Baseline characteristics were similar between the two groups. The estimated proportion of complete virologic response (CVR) in the TDF or ETV group was 44.9% versus 39.7% at 6 months and 89.6% versus 83.2% at 12 months, respectively (P = 0.991). Viral breakthrough was not observed in both groups. One patient in the TDF group and two patients in the ETV group experienced HBeAg loss, respectively (P = 0.657). High HBV DNA level at baseline was a significant negative predictor of virologic response by Cox regression analysis (P = 0.007). The safety profile was similar between the two groups. There was no case with serious adverse event. CONCLUSIONS: Both TDF and ETV were effective in achieving CVR and had a favorable safety profile in treatment-naïve CHB patients. High viral load at baseline was a negative predictive factor of CVR.
Subject(s)
Antiviral Agents/therapeutic use , Guanine/analogs & derivatives , Hepatitis B virus/drug effects , Hepatitis B, Chronic/drug therapy , Hepatitis B, Chronic/virology , Reverse Transcriptase Inhibitors/therapeutic use , Tenofovir/therapeutic use , Adult , Antiviral Agents/adverse effects , Cohort Studies , DNA, Viral/genetics , Female , Guanine/adverse effects , Guanine/therapeutic use , Hepatitis B e Antigens/immunology , Hepatitis B virus/genetics , Hepatitis B virus/isolation & purification , Hepatitis B, Chronic/blood , Hepatitis B, Chronic/metabolism , Humans , Kaplan-Meier Estimate , Male , Middle Aged , Proportional Hazards Models , Retrospective Studies , Reverse Transcriptase Inhibitors/adverse effects , Tenofovir/adverse effects , Viral Load/drug effectsSubject(s)
Arthritis, Rheumatoid/complications , Lupus Erythematosus, Systemic/complications , Antirheumatic Agents/therapeutic use , Arthritis, Rheumatoid/blood , Arthritis, Rheumatoid/diagnosis , Arthritis, Rheumatoid/drug therapy , Arthritis, Rheumatoid/physiopathology , Biomarkers/blood , Drug Therapy, Combination , Facial Dermatoses/complications , Facial Dermatoses/diagnosis , Female , Hand Joints/diagnostic imaging , Hand Joints/physiopathology , Humans , Immunosuppressive Agents/therapeutic use , Inflammation Mediators/blood , Knee Joint/diagnostic imaging , Knee Joint/physiopathology , Lupus Erythematosus, Systemic/blood , Lupus Erythematosus, Systemic/diagnosis , Lupus Erythematosus, Systemic/drug therapy , Middle Aged , Radiography , Syndrome , Treatment OutcomeABSTRACT
Anaplastic lymphoma kinase (ALK) rearrangement, is a kind of driver mutation, accounts for 3%-5% of non-small cell lung cancer (NSCLC). NSCLC patients harboring ALK fusion genes have distinct clinical features and good response to ALK inhibitors. Metastasis from lung cancer to the ovary has rarely been known. We report a case of a 54-year-old woman with bilateral ovarian metastases from ALK rearranged NSCLC. She underwent bilateral salpingo-oophorectomy for ovary masses, which were progressed after cytotoxic chemotherapy although primary lung mass was decreased. Histopathological examination of the ovary tumor showed characteristic adenocarcinoma patterns of the lung and ALK rearrangement.
