Reinfection rate and endoscopic changes after successful eradication of Helicobacter pylori

AIM:To determine the long-term outcomes regarding reinfection with Helicobacter pylori(H.pylori)and endoscopic changes after successful H.pylori eradication. METHODS:From June 1994 to January 2007,186 patients(M:F=98:88;mean age 50.0±11.4 years), in whom H.pylori had been successfully eradicated, were enrolled.The mean duration of follow up was 41.2±24.0 mo. RESULTS:H.pylori reinfection occurred in 58 patients (31.2%).The average annual reinfection rate was 9.1% per patient year.No recurrence of peptic ulcer was detected at the follow up endoscopy.There were no significant differences between the H.pylori eradication regimens for the reinfection rate and no significant differences in endoscopic findings between the H.pylorirecurred group and the H.pylori-cured group.CONCLUSION:The reinfection rate in Korea is 9.1% which represents a decreasing trend.There was no relationship between H.pylori infection status and changes in endoscopic findings.There was also no recurrence or aggravation of ulcers.

Dyslipidemia and H pylori in gastric xanthomatosis

AIM: To investigate the relationship among gastric xanthomatosis (GX), H pylori, dyslipidemia, and gastritis in Korea, a well-known H pylori endemic area. METHODS: A total of 771 patients who had undergone gastroduodenoscopy by one endoscopist were included in this study. Among them, 54 patients with GX were assessed for H pylori infection and their endoscopic characteristics and serum lipid profiles. The findings were compared with 54 age-and sex-matched control subjects without GX. RESULTS: The prevalence of GX was 7% (54/771) with no sex difference. GX was mainly single (64.8%) and located in the antrum (53.7%). The mean diameter was 7 ± 3 mm. Mean body mass index (BMI) of patients with GX was 23.1 ± 2.8 and no one was above 30. Compared with the controls, lipid profiles of GX group showed significantly lower HDL-cholesterol (48.8 ± 12.3 vs 62.9 ± 40.5, P = 0.028) and higher LDL-cholesterol (112.9 ± 29.9 vs 95.9 ± 22.4, P = 0.032). The level of total serum cholesterol, triglyceride and the existence of dyslipoproteinemia were not related to the presence of GX. However, GX showed a close relationship with endoscopically determined atrophic gastritis and histologic severity (24/53, 44.4% vs 8/54, 14.8%, P = 0.0082). H pylori infection and bile reflux gastritis were not significantly related with GX. CONCLUSION: The prevalence of GX is 7% and it may be an increasing entity in Korea. Moreover, dyslipidemia and atrophic gastritis are found to be related to GX, but H pylori infection is not.

A p53 genetic polymorphism of gastric cancer: Difference between early gastric cancer and advanced gastric cancer

AIM: To investigate the role of the polymorphism of p53 codon 72 in early gastric cancer (EGC) and advanced gastric cancer (AGC) in Korean patients. METHODS: DNA was extracted from blood samples of gastric cancer patients (n = 291) and controls (n = 216). In the p53 codon 72 genotypes were determined by PCR-RFLP.RESULTS: Patients with gastric cancer had a significantly higher frequency of the homozygous proline (Pro) allele than the control (P = 0.032). Patients with AGC had a significantly higher frequency of the Arg/Arg (arginine) allele (P = 0.038) than EGC and a similar Pro/Pro allele. The signet ring cell type had a higher frequency of the Pro/Pro allele than other types (P = 0.031). The Pro/Pro genotype carries a 3.9-fold increased risk of developing gastric cancer (95% CI, 1.3-15.4, P = 0.039) when compared to Arg/Arg and Arg/Pro genotypes and to develop EGC is a 5.25 fold increased risk (95% CI, 1.8-19.6, P = 0.021). CONCLUSION: The Pro/Pro genotype of the p53 codon 72 polymorphism carries a higher risk for gastric cancer in general and is also associated with a much higher risk for EGC than AGC.

Pancreatic abscess following scrub typhus associated with multiorgan failure

Clinical severity of scrub typhus ranges from mild to fatal. Acute pancreatitis with abscess formation is a rare complication among patients with scrub typhus. This paper reports a case of scrub typhus in a 75 years old man with acute pancreatitis with abscess formation and multiorgan failure. Abdominal computed tomography showed multiple infected pancreatic pseudocysts with peri-pancreatic infiltration. Multiorgan failure was successfully treated with doxycycline, ceftriaxone, and supportive management. The pancreatic abscess was successfully drained percutaneously and the sizes of pseudocysts decreased remarkably.

Cytomegalovirus ileitis in an immunocompetent elderly adult

Cytomegalovirus 肠炎最通常与为人的免疫不全病毒积极的病人被联系或免疫镇压了 transplant 病人。胃肠道可以从食管被影响在任何地方到冒号，但是小肠参与是稀罕的。我们在一个免疫能力的成年人报导 cytomegalovirus 回肠炎的一个案例，它被组织病理学说的调查结果通过 colonoscopic 活体检视证实。

Seroprevalence of Helicobacter pylori in female Vietnamese immigrants to Korea

AIM:To investigate the seroprevalence of Helicobacter pylori(H.pylori) and its relationship to nutritional factors in female Vietnamese immigrants to Korea.METHODS:A total of 390 female immigrants from Vietnam and 206 Korean male spouses participated in the study.Blood samples from 321 female immigrants and 201 Korean male spouses were analyzed for H.pylori antibodies.Data on age,sex,alcohol consumption,smoking status,dietary nutritional factors and gastrointestinal symptoms were collected using questionnaires.The daily intakes of the following nutrients were estimated:energy,protein,niacin,lipid,fiber,calcium,iron,sodium,potassium,zinc,folate,cholesterol,and vitamins A,B1,B2,B6,C and E.RESULTS:The prevalence of H.pylori positivity was lower in the immigrants than in age-matched Koreanfemales(55.7% vs 71.4%,respectively;P < 0.0001) and the domestic population of Vietnam.The prevalence of H.pylori positivity among married couples was 31.7% for both spouses.There were no statistically significant differences in the incidence of smoking,amount of alcohol consumed,or nutritional factors between the H.pylori-positive and negative groups.CONCLUSION:The prevalence of H.pylori positivity was lower among female Vietnamese immigrants than among Korean females.Nutritional factors did not differ between the H.pylori-positive and negative groups.

Gallbladder carcinoma associated with anomalous union of pancreatobiliary ductal system

A 64-year-old woman was admitted with mild right upper quadrant abdominal pain. Her physical examination revealed a moderately nourished female with normal vital sign and no evidence of jaundice or anemia. Preoperative diagnosis was choledochal cyst with anomalous union of pancreaticobiliary duct (AUPBD), long Y-shaped type and gallbladder (GB) cancer. An extended cholecystectomy, excision of the common bile duct and biliary diversion via Roux-en Y hepaticojejunostomy was performed. The gallbladder cancer showed invasion to perimuscular connective tissue and no extension beyond serosa. Twelve months after curative resection, the patient had no evidence of tumor recurrence.