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.

Pseudomembranous colitis (PMC) is mostly related with the antibiotics and it presents with diarrhea, abdominal pain, fever, hypoalbuminemia and hypovolemia. In the clinical course of pseudomembranous colitis (PMC), ascites is a rare presentation, and high elevation of carcinoembryonic antigen (CEA) associated with PMC is also a very rare presentation. We experienced a case taken cephalosporin group antibiotics for six weeks and presented with fever, abdominal pain, severe diarrhea, and massive ascites. During evaluation, we found low serum-ascites albumin gradient and high level of CEA in both ascites and plasma. With the impression of hidden malignancy, the special studies were done, but PMC was only found without malignancy. After vancomycin therapy, all symptoms were relieved and CEA level declined.
Abdominal Pain ; Anti-Bacterial Agents ; Ascites* ; Carcinoembryonic Antigen ; Diarrhea ; Enterocolitis, Pseudomembranous* ; Fever ; Hypoalbuminemia ; Hypovolemia ; Plasma ; Vancomycin

We studied and analyzed 66 cases of choledochal cyst in a 9 year period from March, 1985 to December, l993 at Hangang, Kangnam and Chuncheon Sacred Heart Hospital. The results were as follows; 1) Age ranged from 1 year to 82 years and ll of 66 cases were below 10 years. The ratio of men to women was 1: 1.9. 2) The frequency of the triad of symptoms and signs were in order of abdominal pain 53 cases(80.3%), jaundice 12 cases(18.2%) and abdominal mass 9 cases(13.6%). The classical triad of pain, mass and jaundice was present in only 2 cases(3.0%). 3) Alkaline phosphatase was elevated in 42 cases(63.6%), hyperbilirubinemia in 29 cases(43.9%) and hyperamylasemia in 9 cases(13.6%). 4) Performed diagnostic procedures were ultrasonogram in 57 cases(86.4%), endo- scopic retrograde cholangiopancreatogram in 32 cases(48.5%), DISIDA scan in 18 cases(27.3%), computed tomogram in 14 cases(21.2%) and percutaneous transhepatic cholangiagram in 6 cases(9.1%). 5) Among 38 cases which ERCP or PTC were performed, according to the Todani's classification, Type I was seen in 28 cases(73.7%), Type IVA in 7 cases(18. 4%), Type II in 2 cases(5.3%) and Type V in I case(2.6%). 6) The associated diseases were cholangitis in 15 cases(22.7%), choledocholithiasis in 12 cases(18.2%) and cholangiocarcinoma in 2 cases(3.0%). 7) Operative procedures were performed in 22 of 66 cases, excision of cyst with Roux-en-Y c~holedochojejunostomy in 17 cases, choledochocystojejunostomy in 2 cases and external drainage in 3 cases.
Abdominal Pain ; Alkaline Phosphatase ; Cholangiocarcinoma ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis ; Choledochal Cyst* ; Choledocholithiasis ; Classification ; Drainage ; Female ; Gangwon-do ; Heart ; Humans ; Hyperamylasemia ; Hyperbilirubinemia ; Jaundice ; Male ; Surgical Procedures, Operative ; Ultrasonography

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

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

Papillary cystic neoplasms of the pancreas are uncommon. They occurs almost entirely in young women. Generally, the lesion averages 10 cm 17 size and are usually located in the pancreatic tail, resulting in displacement of the pancreatic duct. A varialbe amount of hemorrhage and liquefaction necrosis occurs, resulting in pseudopapillae cysts. Resection of the tumor is usually associated with a excellent prognosis because of the lack of metastases and rare recurrences. In this report present a case of a papillary cystic neoplasm of the pancreas with a review of references. Unlike most, the neoplasm we discovered was small (about 1.5 x 1.5 cm), and, occured in the pancreatic head of eldcrly woman. Moreover it was communicated by the main pancreatic duct via a side branch.
Female ; Head ; Hemorrhage ; Humans ; Necrosis ; Neoplasm Metastasis ; Pancreas* ; Pancreatic Ducts* ; Prognosis ; Recurrence

Hemosuccus pancreaticus is a rare cause of chronic and intermittent chronic gastrointestinal hemorrhage, and this condition cannot be easily detected by endoscopy. We report here on a 51-year-old woman with obstructive jaundice and a history of acute pancreatitis and chronic alcoholism. Abdominal computed tomography showed a dilated distal common bile duct. We performed endoscopic retrograde cholangiopancreatography to decompress the bile duct and we found a blood clot on the orifice of the ampulla of Vater. Hemobilia with massive bleeding was seen during the examination. Angiography for controlling the hemorrhage showed the pseudoaneurysm of the pancreaticoduodenal artery. Angiographic embolization was successful for controlling the arterial hemorrhage. The patient remained symptom-free and he was discharged without complications.
Alcoholism ; Ampulla of Vater ; Aneurysm, False ; Angiography ; Arteries ; Bile Ducts ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct ; Endoscopy ; Female ; Gastrointestinal Hemorrhage ; Hemobilia ; Hemorrhage ; Humans ; Jaundice ; Jaundice, Obstructive ; Middle Aged ; Pancreatitis ; Pancreatitis, Chronic

Brunner's gland hyperplasia is a tumor arising from the Brunner's gland and the lesions account for 10.6% of benign duodenal tumors. These lesions are usually asymptomatic and detected incidentally by endoscopy or by a UGI barium study. In the case of severe and atypical forms, these lesions cause bleeding, intestinal obstruction or intussuception. However, Brunner's gland hyperplasia causing an annular duodenal stricture and subsequent intestinal obstruction has been rarely reported. We report here a very rare case of Brunner's gland hyperplasia presenting as an annular stricture and obstruction.
Barium ; Constriction, Pathologic ; Endoscopy ; Hemorrhage ; Hyperplasia ; Intestinal Obstruction