Menetrier's disease in childhood is a rare form of gastropathy characterized by hypoalbuminemia, endoscopic and/or radiologic findings of hypertrophic gastric folds, and histologic findings of foveolar hyperplasia in the stomach. It tends to have a self-limited course compared to the chronic and complicated course in adult Menetrier's disease. A 7-year-old boy was referred to Incheon St. Mary's Hospital for facial edema. Physical examination on admission showed periorbital swelling, pitting edema in both legs, and epigastric tenderness. Laboratory tests on admission indicated hypoproteinemia (3.0 g/dL) with hypoalbuminemia (2.1 g/dL) and hypogammaglobulinemia. Urinalysis showed no abnormalities. The test results for anti-cytomegalovirus immunoglobulin M and cytomegalovirus PCR were negative. Stool Helicobacter pylori antigen was positive and fecal alpha1-antitrypsin clearance was 40.1 mL/day, consistent with protein-losing gastroenteropathy. Gastroduodenoscopy showed hypertrophic edematous gastric folds, erythema, and superficial erosion in the body of the stomach. The duodenum was normal. Histologic findings showed foveolar hyperplasia. His symptoms improved with conservative treatment including proton pump inhibitor from day 9 of hospitalization and resolved completely. Here we reported a case of pediatric protein-losing hypertrophic gastropathy associated with Helicobacter pylori infection.
Adult ; Agammaglobulinemia ; Child ; Cytomegalovirus ; Duodenum ; Edema ; Erythema ; Gastritis, Hypertrophic* ; Helicobacter pylori* ; Hospitalization ; Humans ; Hyperplasia ; Hypoalbuminemia ; Hypoproteinemia ; Immunoglobulin M ; Incheon ; Leg ; Male ; Physical Examination ; Polymerase Chain Reaction ; Proton Pumps ; Stomach ; Urinalysis

No abstract available.
Lymph Nodes* ; Neoplasm Metastasis* ; Stomach Neoplasms*

No abstract available.
Helicobacter pylori* ; Helicobacter*

No abstract available.
Histiocytosis*

Esophageal carcinosarcoma is a rare malignant neoplasm that is composed of both carcinomatous and sarcomatous components. A 78-year-old man with esophageal carcinosarcoma presented with dysphagia, and was treated by endoscopic resection. Although surgery is the standard treatment for esophageal carcinosarcoma, endoscopic resection is an excellent alternative when the tumor is superficial and has no metastasis.
Aged ; Carcinosarcoma* ; Deglutition Disorders ; Endoscopy ; Esophagus ; Humans ; Neoplasm Metastasis

Brunner's gland hyperplasia, also known as Brunner's gland adenoma or hamartoma, is often encountered as a proliferative lesion arising from the Brunner's glands of the duodenum. This lesion has previously been described as being benign, with no malignant potential. We report a case of Brunner's gland hyperplasia that was incidentally discovered on endoscopy for evaluation of gastrointestinal bleeding. The histopathological findings of this lesion revealed a marked dysplastic and malignant changes from the normal Brunner's gland structure. Our case demonstrates the possibility of malignant potential in the natural history of Brunner's gland hyperplasia, even though its incidence is very rare.
Adenocarcinoma* ; Adenoma ; Brunner Glands ; Duodenum ; Endoscopy ; Hamartoma ; Hemorrhage ; Hyperplasia* ; Incidence ; Natural History

We report a case of spinal, cerebral and cerebellar embolism that occurred following injection sclerotherapy with n-butyl-2-cyanoacrylate for variceal bleeding. The patient had been diagnosed with alcoholic liver cirrhosis and esophageal variceal bleeding. We performed injection sclerotherapy with n-butyl-2-cyanoacrylate. The patient complained of both leg motor weakness and left arm motor weakness after injection and was diagnosed with spinal, cerebral and cerebellar embolism following the n-butyl-2-cyanoacrylate injection. At the follow-up examination, the patient's neurologic symptoms had improved, but left leg motor weakness remained. To our knowledge, this is the first report of a case of multiple embolizations including the spine, cerebrum and cerebellum after n-butyl-2-cyanoacrylate injection for treatment of esophageal variceal bleeding.
Arm ; Cerebellum ; Cerebrum ; Embolism* ; Enbucrilate* ; Esophageal and Gastric Varices* ; Follow-Up Studies ; Humans ; Leg ; Liver Cirrhosis, Alcoholic ; Neurologic Manifestations ; Sclerotherapy ; Spine

BACKGROUND/AIMS: Systemic chemotherapy for patients with metastatic gastric cancer is generally for palliative purposes. However some patients achieve long term survival after chemotherapy. Here we investigated the prognostic factors affecting long term survival for metastatic gastric cancer after chemotherapy. MATERIALS AND METHODS: We retrospectively reviewed 176 metastatic gastric cancer patients who received chemotherapy at the Kosin University Gospel Hospital from 2005 to 2010. Univariate and multivariate analyses were performed to evaluate the prognostic factors of long term survival. RESULTS: Overall survival time was 9 months and 5-year survival rate was 2.6%. Multivariate analysis revealed distant lymph nodes metastasis (hazard ratio [HR], 0.53; P=0.008), initial low albumin level (<3 g/dL) (HR, 2.64; P=0.003), patients <40 years (HR, 2.12; P=0.032), and poor performance status (Eastern Cooperative Oncology Group [ECOG], 2) (HR, 1.66; P=0.008) as significant factors of poor survival. 12 patients with metastatic gastric cancer survived more than 36 months. All of them had ECOG performance status of 0 or 1 and no one was <40 years at the time of diagnosis. In addition, there were no lung metastasis and bone metastasis. CONCLUSIONS: These results suggest that better performance status and the presence of only distant lymph nodes metastasis are favorable factors for long term survival of metastatic gastric cancer. Macroscopically scirrhous type of tumors, lung, bone or peritoneal metastasis and age of <40 years are poor prognostic factors for long term survival of metastatic gastric cancer.
Diagnosis ; Drug Therapy* ; Humans ; Lung ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Retrospective Studies ; Stomach Neoplasms* ; Survival Rate

BACKGROUND/AIMS: Determining the depth of tumor invasion and the presence of regional lymph node metastasis is important in deciding therapeutic strategies. We aimed to evaluate the diagnostic accuracy of EUS in detecting the depth of tumor invasion and regional lymph node metastasis. MATERIALS AND METHODS: A total of 141 consecutive patients underwent preoperative evaluation using EUS, CT, and PET CT from November 2005 to June 2009 in Pusan National University Hospital. We reviewed the patients' medical records and compared EUS and pathologic findings. RESULTS: A total of 59 patients were included in the final analysis. The overall accuracy of EUS in predicting the correct T stage was 79.7% (95% CI, 66.8~88.6%). EUS accurately predicted T stage in 93.2% (95% CI, 82.7~97.8%) of T1 tumors, 79.7% (95% CI, 66.8~88.6%) of T2 tumors, and 86.4% (95% CI, 74.5~93.6%) of T3 tumors. Overall, EUS accurately predicted N stage in 83.1% of cases. EUS correctly predicted N stage in 91.4% of N0 tumors and 70.8% of N1 tumors. CONCLUSIONS: Overall accuracy of EUS for the T and N staging of esophageal cancer was high. Thus, EUS is a useful diagnostic modality in determining the initial stage of esophageal cancer.
Busan ; Diagnosis ; Endosonography* ; Esophageal Neoplasms* ; Humans ; Lymph Nodes ; Medical Records ; Neoplasm Metastasis

BACKGROUND/AIMS: Noncardiac chest pain (NCCP) is substernal, squeezing chest pain, unrelated to the cardiac problem. Our study aimed to define the prevalence and clinical characteristics of reflux esophagitis in NCCP patients in Korea. MATERIALS AND METHODS: We reviewed medical records of patients who visited Department of Cardiology, St. Paul's Hospital due to chest pain and had normal coronary arteriography and who had received endoscopy within 6 months. Patients diagnosed with peptic ulcer or gastric cancer were excluded. The patients were classified into two groups according to their endoscopic results; the reflux esophagitis group and the control group. RESULTS: Two hundred seventeen NCCP patients were enrolled and 96 patients (44.2%) were diagnosed with reflux esophagitis: 68 patients (31.3%) with minimal change esophagitis; 26 patients (12.0%) with Los Angeles (LA) grade A; 2 patients (0.9%) with LA grade B. There were no patients with severe erosive reflux disease. There were no significantly different characteristics in the reflux esophagitis group and the control group. CONCLUSIONS: The prevalence of reflux esophagitis in NCCP patients in Korea was 44.2%. Most patients had mild reflux esophagitis.
Angiography ; Cardiology ; Chest Pain* ; Endoscopy ; Esophagitis ; Esophagitis, Peptic* ; Gastroesophageal Reflux ; Humans ; Korea* ; Medical Records ; Peptic Ulcer ; Prevalence* ; Stomach Neoplasms ; Thorax*