Menetrier's disease is a rare disease characterized by the presence of large rugal folds involving part or all of the stomach. Patients with hypertrophic gastropathy often have distressing abdominal symptoms, weight loss and edema due to gastric protein loss. The 48-year-old male patient was admitted to the Hangang Sacred Heart Hospital with cheif complaints of indigestion and epigastric pain. The diagnosis of Menetriers disease is established by radiologic, endoscopic, and pathologic examination. He was treated with soft diet, antacid, H2- receptor antagonist, and IV albumin. We report a case of Menetriers disease with brief review of literatures.
Diagnosis ; Diet ; Dyspepsia ; Edema ; Gastritis, Hypertrophic* ; Heart ; Humans ; Male ; Middle Aged ; Rare Diseases ; Stomach ; Weight Loss

BACKGROUND: Telomerase, an enzyme synthesizing telomere, plays an important role in cell immortalization and carcinogenesis. Telomerase activity is detected in large number of malignant tumors and also in precancerous lesions, such as intestinal metaplasia. It suggests that telomerase activation may be an early event in carcinogenesis. Helicobacter pylori (H. pylori) infection is the major carcinogen in gastric cancer. The aim of this study was to evaluate the relationship between telomerase activation and H. pylori infection in gastric cancer. METHODS: We measured telomerase activity and H. pylori infection using the tissues obtained by gastroduodenoscopy in 50 patients of gastric cancer. Telomerase activity was detected with a Telomerase PCR ELISA(R) kit and H. pylori infection was examined with a CLO(R) kit. RESULTS: Telomerase activity was detected in 32% of intestinal metaplasia and 72% of gastric cancer. The histological type, degree of differentiation, stage and ECOG performance status were found to be unrelated to telomerase activity. H. pylori infection was significantly higher in telomerase-positive patients of gastric cancer (p=0.016). Telomerase activity measured by photometric absorbance was significantly higher in intestinal metaplasia and cancers with H. pylori infection than in those without infection (p<0.05). CONCLUSION: This study suggested that H. pylori infection may induce telomerase activation in intestinal metaplasia and gastric cancer.
Carcinogenesis ; Helicobacter pylori* ; Helicobacter* ; Humans ; Metaplasia ; Polymerase Chain Reaction ; Stomach Neoplasms* ; Telomerase* ; Telomere

Background/Aims: Various endoscopic submucosal dissection (ESD) methods for gastric tumors have been tried. However, no studies have yet compared results according to the ESD method for gastric body tumors using a dual knife. The objective of this study was to compare outcomes of two ESD methods for gastric body tumors: the pocket-creation method and conventional method. Methods: Patients who underwent ESD for a gastric body tumor were retrospectively reviewed.Patients were divided into two groups according to the ESD method: the conventional method (group I) and pocket-creation method (group II). Characteristics of patients and tumors, hospitalization period, incidence of complications, resection margin status, incidence of surgical operation, procedure time, and laboratory findings were investigated. Results: Of the total of 100 patients, 52 belonged to group I and 48 to group II. All tumors were successfully resected en bloc. Resection margin involvement was found in six (11.5%) of group I and six (12.5%) of group II. Complications were observed in seven (13.5%; major complication five, minor two) of group I and eight (16.7%; major two, minor six) of group II. There were no significant differences in ESD outcomes such as hospitalization period, incidence of complications, resection margin status, incidence of surgical operation, procedure time, or inflammatory response after ESD between the two groups. Conclusions Both methods are suitable for treating gastric body tumors with adequate treatment success rates and comparable complication rates.

BACKGROUND: Lactate dehydrogenase (LDH) has been reported to be a sensitive indicator of pancreatic necrosis (PN), and some studies suggested that an elevation of the ratio of LDH to AST (LDH/AST ratio) woud be more accurate indicator of PN in acute biliary pncreatitis (BP). However, there were no studies in alcoholic pancreatitis (AP). The aim of this study was to assess the clinical usefulness of LDH/AST ratio in alcoholic pancreatitis (AP) as a indicator of PN. METHODS: On the basis of CT scan findings, the patients were categorized into two groups as having PN or non-PN. The plasma levels of the LDH, AST and LDH/AST ratio over two weeks postadmission period were evaluated and compared with in two groups of patients with BP (consiting of 12 PN and 34 non-PN patients), and with AP (consisting of 14 PN and 38 non-PN patients). RESULTS: In acute BP, on post-admission days 1 and 2, the LDH/AST ratio were low in both groups without significant difference. In the group with PN, thereafter, the LDH/AST ratio increased gradually, reached peak values at the 7th days and decreased. In the non-PN patients, the LDH/AST ratio increased gradually, but remained below the control range. The LDH/AST ratios were significantly higher from post-admission day 3 in the group with PN than in the non-PN group. In acute AP, the LDH levels were significantly higher over two weeks from admission day in the PN patients. The LDH/AST ratios were remained within or below the control range in both groups, though with statistically significnat difference. CONCLUSION: The LDH/AST ratio could be used as an indicator of PN in acute BP. In acute AP, however, LDH was a more useful indicator from the early stage in the course.
Alcoholics* ; Humans ; L-Lactate Dehydrogenase ; Necrosis* ; Pancreatitis, Alcoholic* ; Plasma ; Tomography, X-Ray Computed

Brunner's gland adenoma is a rare benign proliferative lesion developing most commonly in the posterior wall of the duodenum. It is usually small in size and asymptomatic. Depending on its size or location, however, the clinical manifestations of this tumor may be variable from nonspecific symptoms to gastrointestinal bleeding or obstruction. Brunner's gland adenoma in the proximal jejunum is extremely rare. We report a very rare case of giant Brunner's gland adenoma developing in the proximal jejunum which presented as iron deficiency anemia and mimicked intussusceptions on radiologic studies.
Adenoma ; Anemia, Iron-Deficiency ; Duodenum ; Hemorrhage ; Intussusception ; Iron ; Jejunum

Anisakiasis refers to a parasitic infestation by nematode larvae that belong to the subfamily Anisakinae. Colonic anisakiasis is very rare, and it is hard to diagnose compared with gastric anisakiasis. Endoscopic or radiologic findings, history of raw fish intake and ELISA test might be helpful, however, exploratory operations were needed to confirm the diagosis in the many cases of colonic anisakiasis. Colonoscopy and endoscopic ultrasonography showed a submucosal tumor in the ascending colon in a 47-year-old woman who complained of right upper quadrant abdominal pain. Right hemicolectomy was performed to diagnose and cure the lesion. Pathologic examination revealed some destructed cuticle of a parasite and dense eosinophilic abscess showing central necrosis. She had a history of raw squid intake recently. We report a case of submucosal tumor in the ascending colon probably caused by Anisakis.
Abdominal Pain ; Abscess ; Anisakiasis ; Anisakis* ; Colon ; Colon, Ascending* ; Colonoscopy ; Decapodiformes ; Endosonography ; Enzyme-Linked Immunosorbent Assay ; Eosinophils ; Female ; Humans ; Larva ; Middle Aged ; Necrosis ; Parasites

Acute extensive ischemic gastritis is an extremely rare disease because the stomach has an abundant submucosal vascular plexus with a dual blood supply from the pancreaticoduodenal and gastroduodenal arteries. Smoking, hypertension, and atherosclerotic vascular diseases can be major risk factors for ischemic gastritis. Acute gastric ischemia presents as an acute abdomen with diarrhea or hematemesis that rapidly progresses to acute peritonitis, irreversible septic shock, and death if untreated. We report a case of acute extensive ischemic gastritis combined with tetraplegia due to cervical myelopathy and extensive atherosclerotic changes of the celiac trunk and abdominal aorta.
Abdomen, Acute ; Aorta, Abdominal ; Arteries ; Diarrhea ; Gastritis* ; Hematemesis ; Hypertension ; Ischemia ; Peritonitis ; Quadriplegia ; Rare Diseases ; Risk Factors ; Shock, Septic ; Smoke ; Smoking ; Spinal Cord Diseases ; Stomach ; Vascular Diseases

Retroperitoneal paraganglioma is a kind of uncommon tumor that occurs most commonly in the organ of Zuckerkandl located in the paraaortic area between the origin of the inferior mesenteric artery and the origin of the iliac artery. We experienced a case of retroperitoneal paraganglioma with an unusual location in a 52-year-old woman who had epigastric pain. Abdominal CT scan and ERCP showed a hypervascular mass near the distal CBD with bile duct dilatation. The surgically resected mass was diagnosed as paraganglioma. We report this unusual retroperitoneal paraganglioma, with a review of the literature.
Bile Ducts* ; Bile* ; Cholangiopancreatography, Endoscopic Retrograde ; Dilatation* ; Female ; Humans ; Iliac Artery ; Mesenteric Artery, Inferior ; Middle Aged ; Para-Aortic Bodies ; Paraganglioma* ; Tomography, X-Ray Computed

Multiple primary cancer is defined as the multiple occurrence of malignant neoplasm in the same individual. Synchronous cancers are usually defined as finding the second cancer at the same time or within a 6-month period after the diagnosis of the primary lesion, and metachronous cancers are found at more than 6 months after the initial diagnosis. Multiple primary cancers have been increasing reported on due to prolonged lifespans and the improvement of diagnostic techniques. Nevertheless, triple synchronous cancers have been regarded as a relatively rare finding. We report here on an unusual case of triple synchronous cancer of early gastric cancer, carcinoid tumor of the ampulla of Vater and renal cell carcinoma.
Adenocarcinoma* ; Ampulla of Vater* ; Carcinoid Tumor* ; Carcinoma, Renal Cell* ; Diagnosis ; Neoplasms, Second Primary ; Stomach Neoplasms

Although the development of wireless capsule endoscopy made it possible to visualize the entire small bowel endoscopically, capsule endoscopy has some limitations such as the impossibility of taking biopsies and carrying out therapeutic interventions. The new double-balloon method of enteroscopy has advantages over capsule endoscopy or push enteroscopy. This method is possible to take biopsies and perform therapeutic procedures such as thermal coagulation, injection, or polypectomy. It is also possible to visualize entire small bowel through oral and anal approach and improve endoscopic image by rinsing and air insufflation. We herein report a case of proximal jejunal diverticular bleeding diagnosed by double-balloon enteroscopy.
Biopsy ; Capsule Endoscopy ; Double-Balloon Enteroscopy* ; Hemorrhage* ; Insufflation