BACKGROUND/AIMS: Idiopathic portal hypertension (IPH) is defined as portal hypertension with splenomegaly and hypersplenism in the absence of cirrhosis or obstruction of portal vein or hepatic vein. It has been recently suggested that hypercoagulable state and thromboembolic event of small portal veins have an important role in the pathogenesis of IPH. In this study, we evaluated the clinical and pathological characteristics of IPH. METHODS: We reviewed clinical, endoscopic, radiologic and liver biopsy findings of 10 cases of IPH retrospectively. RESULTS: The tests for antithrombin III deficiency, protein C deficiency, protein S deficiency, resistance to activated protein C, lupus anticoagulant, antiphospholipid antibodies, anticardiolipin antibodies were normal. Pathologic findings revealed portal vein dilatation (10/10), loss of portal vein (6/10), portal vein sclerosis (1/10), dilated megasinusoids (9/10), dilation of terminal hepatic vein (8/10), narrowing of terminal hepatic vein (2/10), hairline fibrous septa (1/10), and regenerative nodule (1/10). CONCLUSIONS: The pathologic finding of IPH showed various manifestations of obliterative portal venopathy although there was no hypercoagulable state.
Antibodies, Anticardiolipin ; Antibodies, Antiphospholipid ; Antithrombin III Deficiency ; Biopsy ; Dilatation ; Fibrosis ; Hepatic Veins ; Hypersplenism ; Hypertension, Portal* ; Liver ; Lupus Coagulation Inhibitor ; Portal Vein ; Protein C ; Protein C Deficiency ; Protein S Deficiency ; Retrospective Studies ; Sclerosis ; Splenomegaly

No abstract available.
Carcinoma, Hepatocellular*

OBJECTIVES: The purpose of this study was to investigate the demographic and clinical characteristics of patients with medication-related osteonecrosis of the jaw (MRONJ) and to elucidate factors affecting recurrence in surgical treatment. MATERIALS AND METHODS: A total of 51 patients who were diagnosed with MRONJ were analyzed according to demographic and clinical features and treatment results through a retrospective chart review from 2013 to 2017 in the Department of Oral and Maxillofacial Surgery, Korea University Anam Hospital, Seoul in Korea. RESULTS: Alendronate composed the majority of medication doses (55.6%), followed by ibandronate (20.0%), risedronate (15.6%), and zoledronate (6.7%). Forty patients (88.9%) were given oral medication, and five patients (11.1%) were intravenously treated, and the mean duration of medication use was 61.1±42.9 months. A total of 10 patients (22.2%) had a drug holiday before MRONJ-induced dental treatment lasting an average of 6.8±7.0 months. MRONJ occurred 2.7 times more in the mandible, with 41 cases (73.2%) occurring in the mandible and 15 cases (26.8%) occurring in the maxilla, and the prevalence of affected posterior parts (premolar-molar) was six times greater than that of the anterior parts (incisor-canine) (48 cases vs 8 cases, 85.7% vs 14.3%). The most common dental cause of MRONJ was tooth extraction (69.6%). Regarding recurrence, there was no statistical difference in recurrence rate according to either site or stage. However, recurrence occurred in 4 out of 34 cases (11.8%) in the primary closure group and 9 out of 20 cases (45.0%) in the secondary healing group, and there was a statistical difference with respect to closure technique. CONCLUSION: The identified risk factors in patients taking bone resorption inhibitors can aid dental clinicians in ensuring prevention and proper treatment of MRONJ.
Alendronate ; Bone Density Conservation Agents ; Holidays ; Humans ; Jaw* ; Korea ; Mandible ; Maxilla ; Osteonecrosis* ; Prevalence ; Recurrence ; Retrospective Studies ; Risedronate Sodium ; Risk Factors ; Seoul ; Surgery, Oral ; Surgical Procedures, Operative ; Tooth Extraction

This correction is being published to provide the approval number of the Institutional Review Board at the Ethics Approval and Consent to Participate section in the above article. The authors apologize for this error.

BACKGROUND: Both Helicobacter pylori (H. pylori) cagA, vacA, iceA genotype and host IL-1B/IL-1RN polymorphisms play a role in determining the clinical consequences of H. pylori infection. This study aimed to investigate whether there might be any combinations of H. pylori cagA, vacA, iceA genotype and host IL-1B/IL-1RN polymorphisms that are particularly associated with the occurrence of gastric carcinoma in Korean patients. METHODS: This study population was comprised of 239 patients with H. pylori infection: 122 with gastric carcinoma and 117 with gastritis only. DNA was isolated from gastric biopsy sample and H. pylori cagA, vacA and iceA genotype were determined by PCR. IL-1B-511 polymorphisms were genotyped by PCR-RFLP and IL-1RN polymorphisms were analyzed with variable number of tandom repeat after PCR. RESULTS: H. pylori cagA, vacA, and iceA genotype were not associated with an increased risk for gastric carcinoma. IL-1B-511*T carriers and IL-1RN*2 carriers did not show increased risk for gastric carcinoma. On combination of bacterial/host genotypes, cagA+/IL-1B-511*T carriers and cagA+/IL-1RN*2 carriers, vacA s1/IL-1B-511*T carriers, vacA s1/IL-1RN*2 carriers, vacA m1/IL-1B-511*T carriers, vacA m1/IL-1RN*2 carriers, iceA1/IL-1B-511*T carriers, iceA1/IL-1RN*2 carriers showed no increased risk of gastric carcinoma. CONCLUSIONS: Combined H. pylori cagA, vacA, iceA genotype and host IL-1B/IL-1RN polymorphisms shows no increased risk of gastric carcinoma. Therefore, it seems other endogenous or exogenous factors may play more important role in the development of gastric carcinoma in Korean.
Biopsy ; DNA ; Gastritis ; Genotype ; Helicobacter pylori* ; Helicobacter* ; Humans ; Interleukin-1* ; Interleukin-1beta* ; Polymerase Chain Reaction ; Stomach Neoplasms

Colonic diverticulum is uncommon disease of gastrointestinal diverticulum, but as many as 20% of patients with colonic diverticula suffer at least one episode of bleeding in their lifetimes. Herein, we report a case of hemostasis by capping recurrent bleeding diverticulum of the colon with clips. A 36-year-old man presented recurrent hematochezia. Emergent colonoscopy was performed and showed bleeding diverticulum. Although hypertonic saline with epinephrine was injected, there was still oozing on diverticulum, and so hemostasis by hemoclip was performed. After that procedure, there have been no bleeding episode. Although further cases will be required to prove the usefulness of the technique, this endoscopic treatment is recommended in colonic diverticulum of a small amount of bleeding or post-treatment bleeding.
Adult ; Colon* ; Colonoscopy ; Diverticulum ; Diverticulum, Colon* ; Endoscopy ; Epinephrine ; Gastrointestinal Hemorrhage ; Hemorrhage* ; Hemostasis ; Humans

BACKGROUND: It is well known that both gastric and intestinal phenotypic cell markers are expressed in gastric cancers. This study was aimed at investigating the correlation between gastric and intestinal phenotypic marker expression patterns of tumors and the clinicopathologic characteristics of gastric carcinomas. METHODS: We evaluated phenotypic marker expression by immunohistochemical staining with monoclonal antibodies. All tumors were classified as gastric (G), gastric and intestinal mixed (GI), intestinal (I), or null (N) phenotype. RESULTS: The tumors were phenotypically divided into G-phenotype tumors (33.2%), GI-phenotype tumors (25.7%), I-phenotype tumors (26.8%), and N-phenotype tumors (14.3%). N-phenotype tumors were associated with more corporeal location than GI- and I-phenotype tumors (p=0.009 and p=0.007, respectively), a larger size than I-phenotype tumors (p=0.007), a higher proportion of advanced gastric cancers than G-, GI-, and I-phenotype tumors (p=0.003, p< 0.001, and p< 0.001, respectively), more perineural invasion than G-, GI-, and I-phenotype tumors (p=0.076, p=0.003, and p=0.003, respectively), and more lymph node metastasis than GI-phenotype tumors (p=0.017). I-phenotype tumors were associated with a higher proportion of intestinal-type tumors than G-, GI-, and N-phenotype tumors (p< 0.001, p=0.011, and p< 0.001, respectively). CONCLUSION: Our results indicate that the gastric and intestinal phenotypic marker expression pattern of tumors is prognostically useful for patients with gastric carcinoma.
Tumor Markers, Biological/genetics ; Stomach Neoplasms/genetics/immunology/*pathology ; Prognosis ; *Phenotype ; Middle Aged ; Male ; Intestinal Neoplasms/genetics/immunology/*pathology ; Immunohistochemistry ; Humans ; Female ; Carcinoma/genetics/immunology/*pathology ; Antibodies, Neoplasm ; Antibodies, Monoclonal

Gastric antral vascular ectasia (GAVE) is a rare but important cause of chronic gastrointestinal bleeding. Endoscopically, it has characteristic thickened red vascular folds radiating from the pylorus to the antrum. Diagnosis is made primarily by endoscopy. Histologic examination of the endoscopic mucosal biopsies may confirm the endoscopic diagnosis. Many treatment modalities of the gastric antral vascular ectasia exist. One of them, the argon plasma coagulation (APC) is an excellent therapeutic tool. Inactive argon gas is converted to ionized form by means of electrical energy. Ionized argon plasma conducts high frequency electrical energy to tissues and leads coagulation necrosis of tissues. We experienced a case of gastric antral vascular ectasia presenting melena for about one month in a 72-year-old man treated endoscopically in four sessions with argon plasma coagulation.
Aged ; Argon Plasma Coagulation* ; Argon* ; Biopsy ; Diagnosis ; Endoscopy ; Gastric Antral Vascular Ectasia* ; Hemorrhage ; Humans ; Melena ; Necrosis ; Plasma ; Pylorus

Peptic ulcer which extend beyond the serosa of the bowel wall may not perforate freely into the peritoneal cavity but instead penetrate adjacent structures (confined perforation). It has been reported that the frequency of penetration of peptic ulcer has been estimated around 20 percent in patients undergoing laparotomy for peptic ulcers. A 46-year- old male was admitted with chief complaint of hematemesis. Endoscopic examination revealed submucosal tumor like lesion with central ulcer and active bleeding which was located at the upper body, posterior wall of the stomach. Angiography demonstrated hypervascular tumor like lesion supplied by left gastric artery and short gastric branches of splenic artery. Postoperative biopsies showed inflammatory cell infiltration at the typical ulcer base and no evidence of malignancy. There was loss of acinus structure and fibrous adhesion with omentum at the pancreas. We report a case of gastric ulcer penetrating into pancreas, spleen with hypervascular nature with brief review of literatures.
Angiography ; Arteries ; Biopsy ; Hematemesis ; Hemorrhage ; Humans ; Laparotomy ; Male ; Omentum ; Pancreas ; Peptic Ulcer ; Peritoneal Cavity ; Serous Membrane ; Spleen ; Splenic Artery ; Stomach ; Stomach Ulcer* ; Ulcer

BACKGROUND/AIMS: Histoacryl forms hard substances in an instance after a brief exposure to polar liquid, blood or body temperature. This often causes obstruction of injector and endoscopic channel. Furthermore, splashed Histoacryl during injection can lead to accidental loss of vision. We propose a new convenient method of Histoacryl-lipiodol sequential injection and report the results. METHODS: From May 2001 to August 2004, sequential injector method was performed in treating consecutive thirty gastric varices patients. Histoacryl (S.G. 1.0) 1 mL and lipiodol (S.G. 1.28) 1~1.5 mL are filled in 2.5 mL disposable syringe with 16 gauge needle, which are separated into two compartments by specific gravity difference. The injector attached side of charged syringe is gently placed upward and the piston is pushed after the lesion site puncture. Then, normal saline is promptly infused to wash out and the needle is withdrawn. RESULTS: There were 26 males and 4 females. 4 had active bleeding and 26 had the stigmata of bleeding. Varices types were Lg-c in 10, Lg-cf in 16 and Lg-f in 4 patients and the Child-Pugh classification were A in 17%, B in 53% and C in 30%. The average amount was 1.53 mL. Initial hemostasis rate was 97%, 3 of patients re-bled in 4 weeks and 2 patients later. One patient died after the procedure and a case of procedure related bacteremia has occurred. CONCLUSIONS: Histoacryl-lipiodol sequential injection by specific gravity difference is convenient and safe. Also, it carries less damage to the instruments.
Bacteremia ; Body Temperature ; Christianity ; Classification ; Enbucrilate ; Esophageal and Gastric Varices* ; Ethiodized Oil ; Female ; Hemorrhage* ; Hemostasis ; Humans ; Male ; Needles ; Punctures ; Specific Gravity ; Syringes ; Varicose Veins