BACKGROUND/AIMS: The effect of proton pump inhibitors (PPI) in Asian functional dyspepsia (FD) patients has not been well established as in Western countries. DA-9701, a novel prokinetic agent, stimulates gastric emptying and modulates visceral hypersensitivity in vivo and in human studies. This study was conducted to compare the efficacy of DA-9701 with a conventional PPI in mono or combination therapy in patients with FD. METHODS: In this double-blind, randomized, non-inferiority trial, 389 patients diagnosed with FD using Rome III criteria were allocated among 3 groups: 30-mg DA-9701 t.i.d (means 3 times a day), 40-mg pantoprazole, and 30-mg DA-9701 t.i.d + 40-mg pantoprazole. The primary efficacy end-point was a global assessment of the patient binary response or response on a 5-Likert scale after 4 weeks. RESULTS: The global symptomatic improvement was 60.5% in the DA-9701 group, 65.6% in the pantoprazole group, and 63.5% in the DA-9701 + pantoprazole group using a 5-Likert scale at week 4 with no significant difference among 3 groups (P = 0.685). Symptom improvement measured by binary outcome was significantly achieved in each of the 3 groups, but not different among groups. Patients in all treatment groups reported significant improvement in the response rate and symptoms according to FD subtypes and dyspepsia-related quality of life (P < 0.001), but there were no significant differences among the 3 groups. CONCLUSIONS: DA-9701 improves global and individual symptoms and increases dyspepsia-specific quality of life in patients with FD. The efficacy of DA-9701 monotherapy is comparable with pantoprazole and there is no additive effect with combination of DA-9701 and pantoprazole in patients with FD.
Asian Continental Ancestry Group ; Dyspepsia* ; Gastric Emptying ; Humans ; Hypersensitivity ; Proton Pump Inhibitors ; Quality of Life

The prevalence of intestinal tuberculosis has been markedly decreased with the development of anti-tuberculous chemotherapy, preventive medicine, vaccinations, early detection and treatment of pulmonary tuberculosis, and improved eeonomic conditions. Nowadays, intestinal tuberculosis is a disease that should be differentiated from the inflammatory bowel diseases such as Crohn's disease and ulcerative colitis, Behcet's disease, and colon cancer and amebic colitis. This disease also has a new clinical significance in that it has an increased infection rate and unfavorable outcomes in patients infected by HIV or in those who undergo organ transplantation or receive immunosuppressive agents. Tuberculosis of the duodenum was a rare disease and was not reported in the last decade. Moreover Intestinal tuberculosis extensively involving the small bowel including the duodenum and colon was very rarely reported in the various relateid literature. Recently we experienced a case of advanced intestinal tuberculosis involving the duodenum, jejunum, ileum, and colon accompanied by tuberculous cervical and abdominal lymphadenopathies, in a 49-year-old woman who manifested profound general weakness, diarrhea, and marked weight loss. She was diagnosed pathologically by upper gastrointestinal endoscopy, colonoscopy, and fine needle aspiration cytology as well as by roentgenologic examination. The patient was given antituberculous medication which resulted in dramatic clinical improvement. In this report, we present this case with review of the related literature.
Biopsy, Fine-Needle ; Colitis, Ulcerative ; Colon ; Colonic Neoplasms ; Colonoscopy ; Crohn Disease ; Diarrhea ; Drug Therapy ; Duodenum ; Dysentery, Amebic ; Endoscopy, Gastrointestinal ; Female ; HIV ; Humans ; Ileum ; Immunosuppressive Agents ; Inflammatory Bowel Diseases ; Jejunum ; Middle Aged ; Organ Transplantation ; Prevalence ; Preventive Medicine ; Rare Diseases ; Transplants ; Tuberculosis* ; Tuberculosis, Lymph Node* ; Tuberculosis, Pulmonary ; Vaccination ; Weight Loss

OBJECTIVES: Recently, the studies for oncogene and tumor marker have been actively performed to investigate the carcinogenesis of gastric carcinoma, but it is not clearly understood. We investigated the expression of tumor suppressor gene and proliferation activity in gastric carcinoma. METHODS: Immunohistochemistry for p53 protein (wild and mutant type), retinoblastoma protein(wild type), and PCNA was performed in 131 cases of formalin fixed paraffin embedded tissue sections of gastric carcinoma. We compared that expression with tissue invasiveness, lymph node metastasis, staging and, Lauren classification, and that expression with each other. RESULTS: 1) The positive ratio of p53 protein, Rb protein, also PCNA in gastric carcinoma was 64.9%, 98.5%, 99.2%, 2) The expression of p53 protein was related to invasiveness, lymph node metastasis, staging, and Lauren classification(p<0.05). 3) The positive reaction for Rb gene was identified in tumor cells as well as proliferating cells. 4) There was a close relationship between Rb gene expression and PCNA in gastric carcinoma (p<0.05). CONCLUSION: Theses results suggested that the expression of p53 gene is related to invasiveness, lymph node metastasis, staging and Lauren classification in gastric carcinoma. Expression of retinoblastoma gene is a closely related to proliferating activity.
Carcinogenesis ; Classification ; Dronabinol* ; Formaldehyde ; Genes, p53 ; Genes, Retinoblastoma ; Genes, Tumor Suppressor ; Immunohistochemistry ; Lymph Nodes ; Neoplasm Metastasis ; Oncogenes ; Paraffin ; Proliferating Cell Nuclear Antigen* ; Retinoblastoma ; Retinoblastoma Protein

Carcinoid tumor of the ampulla of Vater comprises about 2.0-8.9% of the gastrointestinal earcinoid tumors and 3-5.5% of the duodenal tumor. The climcal manifestations of the carcinoid tumor of the ampulla of Vater are jaundice, hemorrhage, obstruction of duodenurn, or carcinoid syndrome. But the symptoms of carcinoid tumor are nonspecific and diagnosis is delayed until far advanced state, usually. Recently we experienced one case of carcinoid tienor in a 33-year-old woman who had epigastric pain and intermittent melena, so we report it with a review of the literature
Adult ; Ampulla of Vater* ; Carcinoid Tumor* ; Diagnosis ; Esophagus* ; Female ; Hemorrhage ; Humans ; Intestines* ; Jaundice ; Melena ; Stomach*

To examine the relationship between gastric ulcer and gastric cancer, we investigated petients with gastric ulcer diagnosed from 1986 to l993. We reviewed the endoscopic reports and films of patients with gastric ulcer retrospectively. We excluded the patients who was diagnosed as gastric cancer in two years follow-up. The results were as follaws; 1) During follow-up of the original cohort, there were 5 patients(0.5~%) in whom gastric cancer developed at the same site initially diagnosed as gastric ulcer. The gross type of the lesion was early gastric cancer in two and advanced gastric cancer in three patients 2) The time interval between the initial diagnosis of gastric ulcer and cancer development was from 31 months to 70 months (average 51 months). 3) At the initial examination of 5 gastric cancer patients, the diagnosis was active gastric ulcer in four, multiple gastric ulcer in one, and linear gastrie ulcer in one patient. Characteristic endoscopic findjngs were gastric ulcer with clubbing mucosal folds in three and gastric ulcer with bleeding in one patient. 4) During the follow-up period, endoscopicailly and histologically healing of gastric uleer was observed in one patient and histologic finding showed chronic superficial gastritits with intestinal metaplasia. These results suggest that gastric ulcers rarely progress to gastric cancer. However if the endoscopic findings are suspicious for malignancy, then follow-up endoscopy until complete healing should be done.
Cohort Studies ; Diagnosis ; Endoscopy ; Follow-Up Studies* ; Hemorrhage ; Humans ; Metaplasia ; Stomach Neoplasms* ; Stomach Ulcer* ; Ulcer

The aim of the present study was to evaluate the ability of Tl-201 abdominal SPECT to differentiate between chronic focal pancreatitis and pancreatic malignancy. Seventeen patients (12 men, 5 women; mean age, 56 years; 9 pancreatic cancer, 8 chronic pancreatitis) with pancreatic mass were prospectively investigated with Tl-201 abdominal SPECT. In all patients, CT and/or US could not clarify the nature of the pancreatic mass. Focal hot uptake was present in 8 of 9 patients with pancreatic cancer, while it was present in 2 of 8 patients with chronic pancreatitis. Therefore, the sensitivity and specificity of the present study were 89% and 75%, respectively. A significant difference of Tl-201 uptakes was noted between benign and malignant masses (p& 0.05). Therefore, we concluded that Tl-201 abdominal SPECT was a useful test in differentiation of malignant from benign pancreatic mass, especially when the differentiation could not be made by other imaging modalities
Abdomen/*radionuclide imaging ; Chronic Disease ; Diagnosis, Differential ; Evaluation Studies ; Female ; Follow-Up Studies ; Human ; Male ; Middle Age ; Pancreatic Neoplasms/*radionuclide imaging ; Pancreatitis/*radionuclide imaging ; Prospective Studies ; Reproducibility of Results ; Sensitivity and Specificity ; Support, Non-U.S. Gov't ; Thallium Radioisotopes/*diagnostic use ; Tomography, Emission-Computed, Single-Photon/methods

Leiomyosarcoma of the duodenum is an uncommon tumor and have not specific symptoms and signs, almost all cases of tumor were diagnosed in operating room. This tumor is generally firm, relatively well encapsulated, lobulated and often soft if they undergo hemorrhagic necrosis. Most authors emphasized the relative number of mitosis as the most reliable findings of leiomyosarcoma. Recently, we experienced a case of leiomyosarcoma of duodenum which was confirmed by operative and pathological diagnosis.
Diagnosis ; Duodenum* ; Leiomyosarcoma* ; Mitosis ; Necrosis ; Operating Rooms

No abstract available.
Humans ; Pepsinogen A*

Angiodysplasia of the small bowel is an uncommon disorder in Korea, and is often found to be the cause of unexplained gastrointestinal bleeding. A 53-year-old male patient visited an emergeney room because of repeated melena and dizziness, He underwent selective superior mesenteric arterial angiography which revealed abnormal clusters of small arteries and early opacification of veins draining a segment of lower jejunum. An exploratory laparotomy was performed under the impression of angiodysplasia. An ulceration on the lower jejunum was found, and was resected. Subsequent jejunojejunostomy was performed. Histology of the resected specimen showed an irregularly dilated vessels in mucosa and submucosa.
Angiodysplasia* ; Angiography ; Arteries ; Dizziness ; Hemorrhage ; Humans ; Jejunum* ; Korea ; Laparotomy ; Male ; Melena ; Middle Aged ; Mucous Membrane ; Ulcer ; Veins

Angiodysplasia of the small bowel is an uncommon disorder in Korea, and is often found to be the cause of unexplained gastrointestinal bleeding. A 53-year-old male patient visited an emergeney room because of repeated melena and dizziness, He underwent selective superior mesenteric arterial angiography which revealed abnormal clusters of small arteries and early opacification of veins draining a segment of lower jejunum. An exploratory laparotomy was performed under the impression of angiodysplasia. An ulceration on the lower jejunum was found, and was resected. Subsequent jejunojejunostomy was performed. Histology of the resected specimen showed an irregularly dilated vessels in mucosa and submucosa.
Angiodysplasia* ; Angiography ; Arteries ; Dizziness ; Hemorrhage ; Humans ; Jejunum* ; Korea ; Laparotomy ; Male ; Melena ; Middle Aged ; Mucous Membrane ; Ulcer ; Veins