BACKGROUND Few studies have compared the efficacy and safety profile of a tailored eradication(TR)strategy based on the presence of a 23S ribosomal RNA point mutation with those of empirical bismuth-based quadruple th...BACKGROUND Few studies have compared the efficacy and safety profile of a tailored eradication(TR)strategy based on the presence of a 23S ribosomal RNA point mutation with those of empirical bismuth-based quadruple therapy(EBQT)for first-line eradication of Helicobacter pylori(H.pylori)in Korean patients.AIM To compare the efficacy and safety of a TR strategy and those of EBQT regimen as first-line eradication therapy for H.pylori.METHODS This is an open-label,comparative study in which we prospectively enrolled patients over 18 years of age with H.pylori infection and retrospectively reviewed their data.H.pylori-positive patients diagnosed by rapid urease test,Giemsa staining,or dual priming oligonucleotide polymerase chain reaction(DPO-PCR)were enrolled from May 2016 to September 2018 at Gil Medical Center.Patients with H.pylori infection received either a TR regimen or the EBQT regimen.In the tailored therapy group that underwent DPO-PCR testing,patients with A2142G and/or A2143G point mutations were treated with a bismuth-containing quadruple regimen.The eradication rate,patient-reported side effect rate,and H.pylori eradication success rate were evaluated and compared between the groups.RESULTS A total of 150 patients were assigned to the TR(n=50)or EBQT group(n=100).The first-line eradication rate of H.pylori did not differ between the groups(96.0%vs 95.7%,P=0.9).The rate of eradication-related side effects for TR was 12.0%,which differed significantly from that of EBQT(43.0%)for first-line treatment(P<0.001).CONCLUSION DPO-PCR-based TR for H.pylori eradication may be equally efficacious,with less treatment-related complications,compared to EBQT in Korea,where clarithromycin resistance is high.展开更多
Cowden syndrome is a rare autosomal dominant disorder that is characterized by multiple hamartomas in a variety of tissues and this is associated with germline mutations in the phosphatase and tensin homologue (PTEN) ...Cowden syndrome is a rare autosomal dominant disorder that is characterized by multiple hamartomas in a variety of tissues and this is associated with germline mutations in the phosphatase and tensin homologue (PTEN) gene, which is the tumor suppressor gene located on chromosome 10q23.3. It is characterized by multiple hamartomatous neoplasms of the skin, oral mucosa, gastrointestinal (GI) tract, bones, central nervous system, eyes, and genitourinary tract. Cowden syndrome does not have increased risk of GI malignancy; however, it has an increased risk of breast, thyroid and endometrial cancer development. Herethe authors report a rare case of Cowden syndrome incidentally diagnosed from multiple gastric polyposis. A 29-year-old woman presented with multiple gastric polyps. The laboratory results were normal except for mild anemia, with a hemoglobin level of 11.9 g/dL. Esophagogastroduodenoscopy revealed multiple gastric, duodenal polyps and esophageal acanthosis. Colonoscopy revealed possible hamartomatous polyps in the rectum. Under the suspicion of Cowden syndrome, sonography of the thyroid and breasts was carried out, which revealed multiple thyroid masses. Subsequent fine-needle aspiration biopsy revealed the presence of clusters of follicular epithelial cells, and due to the possibility of malignancy, the patient underwent total thyroidectomy. The pathology was reported as invasive follicular carcinoma. A gene study by direct sequencing showed the presence of a PTEN mutation (c.633C > A /p.Cys211*).展开更多
文摘BACKGROUND Few studies have compared the efficacy and safety profile of a tailored eradication(TR)strategy based on the presence of a 23S ribosomal RNA point mutation with those of empirical bismuth-based quadruple therapy(EBQT)for first-line eradication of Helicobacter pylori(H.pylori)in Korean patients.AIM To compare the efficacy and safety of a TR strategy and those of EBQT regimen as first-line eradication therapy for H.pylori.METHODS This is an open-label,comparative study in which we prospectively enrolled patients over 18 years of age with H.pylori infection and retrospectively reviewed their data.H.pylori-positive patients diagnosed by rapid urease test,Giemsa staining,or dual priming oligonucleotide polymerase chain reaction(DPO-PCR)were enrolled from May 2016 to September 2018 at Gil Medical Center.Patients with H.pylori infection received either a TR regimen or the EBQT regimen.In the tailored therapy group that underwent DPO-PCR testing,patients with A2142G and/or A2143G point mutations were treated with a bismuth-containing quadruple regimen.The eradication rate,patient-reported side effect rate,and H.pylori eradication success rate were evaluated and compared between the groups.RESULTS A total of 150 patients were assigned to the TR(n=50)or EBQT group(n=100).The first-line eradication rate of H.pylori did not differ between the groups(96.0%vs 95.7%,P=0.9).The rate of eradication-related side effects for TR was 12.0%,which differed significantly from that of EBQT(43.0%)for first-line treatment(P<0.001).CONCLUSION DPO-PCR-based TR for H.pylori eradication may be equally efficacious,with less treatment-related complications,compared to EBQT in Korea,where clarithromycin resistance is high.
文摘Cowden syndrome is a rare autosomal dominant disorder that is characterized by multiple hamartomas in a variety of tissues and this is associated with germline mutations in the phosphatase and tensin homologue (PTEN) gene, which is the tumor suppressor gene located on chromosome 10q23.3. It is characterized by multiple hamartomatous neoplasms of the skin, oral mucosa, gastrointestinal (GI) tract, bones, central nervous system, eyes, and genitourinary tract. Cowden syndrome does not have increased risk of GI malignancy; however, it has an increased risk of breast, thyroid and endometrial cancer development. Herethe authors report a rare case of Cowden syndrome incidentally diagnosed from multiple gastric polyposis. A 29-year-old woman presented with multiple gastric polyps. The laboratory results were normal except for mild anemia, with a hemoglobin level of 11.9 g/dL. Esophagogastroduodenoscopy revealed multiple gastric, duodenal polyps and esophageal acanthosis. Colonoscopy revealed possible hamartomatous polyps in the rectum. Under the suspicion of Cowden syndrome, sonography of the thyroid and breasts was carried out, which revealed multiple thyroid masses. Subsequent fine-needle aspiration biopsy revealed the presence of clusters of follicular epithelial cells, and due to the possibility of malignancy, the patient underwent total thyroidectomy. The pathology was reported as invasive follicular carcinoma. A gene study by direct sequencing showed the presence of a PTEN mutation (c.633C > A /p.Cys211*).
