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The serum pepsinogen (PG) assay findings are correlated with the status of Helicobacter pylori infection, but there are controversies on the link with upper gastrointestinal (UGI) endoscopic findings. The aim of this study was to determine the significance of a serum PG assay for correlating with endoscopic findings in H. pylori-seroprevalent adult population. Korean adults who visited for a health check-up were included consecutively. Subjects after gastrectomy or H. pylori eradication were excluded. After completing the serum PG assay and anti-H. pylori immunoglobulin G (IgG) titer on the same day of UGI endoscopy, subjects with equivocal serology test finding or gastric neoplasm were excluded. Of the 4,830 included subjects, 3,116 (64.5%) were seropositive for H. pylori. Seropositive finding was related to high serum PG I (P < 0.001) and PG II (P < 0.001) concentrations, low PG I/II ratio (P < 0.001), old age (P < 0.001), and male gender (P = 0.006). After adjusting age and gender, the serum PG I and II concentrations were positively correlated with the presence of nodular gastritis (NG) (all P = 0.003). The serum PG I was positively correlated with gastric ulcer (P = 0.003), and it was correlated with duodenal ulcer in seropositive subjects (P = 0.008). The PG I/II ratio was positively correlated with erosive esophagitis, while it was inversely related to chronic atrophic gastritis and metaplastic gastritis (all P < 0.001). Our findings suggest that the serum PG assay finding correlates well with the UGI endoscopic finding. A higher serum PG concentration in subjects with NG and peptic ulcer disease suggests that endoscopic findings reflect gastric secreting ability.
Biopsy of rectal carcinoid tumor is commonly taken before endoscopic resection. Howeverthe preceding biopsy can inhibit complete resection by causing blurred tumor border andfibrosis of the tissue. The objective of the study was to investigate the effect of precedingbiopsy on complete endoscopic resection in rectal carcinoid tumor. It was also determinedif rectal carcinoid tumors can be macroscopically distinguished by endoscopy. We reviewedretrospectively the records of patients with rectal carcinoid tumor who had undergone anendoscopic treatment at our hospital, during a 7-yr period. The resection margin was clearin 57 of 98 cases. The preceding biopsy was taken in 57 cases and the biopsy wassignificantly associated with the risk of incomplete tumor resection (OR, 3.696; 95% CI,1.528-8.938, P = 0.004). In 95.9% of the cases, it was possible to suspect a carcinoidtumor by macroscopic appearance during initial endoscopy. The preceding biopsy maydisturb complete resection of rectal carcinoid tumor. In most cases, the carcinoid tumorcould be suspected by macroscopic appearance. Therefore the preceding biopsy is notessential, and it may be avoided for the complete resection.
Background/Aims: DA-9701, a standardized extract ofPharbitis Semen and Corydalis Tuber, is a new prokineticagent that exhibits an analgesic effect on the abdomen. Weinvestigated whether DA-9701 affects visceral pain inducedby colorectal distension (CRD) in rats. Methods: A total of21 rats were divided into three groups: group A (no CRD+nodrug), group B (CRD+no drug), and group C (CRD+DA-9701). Expression of pain-related factors, substance P (SP), c-fos,and phosphorylated extracellular signal-regulated kinase (p-ERK) in the dorsal root ganglion (DRG) and spinal cord wasdetermined by immunohistochemical staining and Westernblotting. Results: The proportions of neurons in the DRGand spinal cord expressing SP, c-fos, and p-ERK were higherin group B than in group A. In the group C, the proportion ofneurons in the DRG and spinal cord expressing p-ERK waslower than that in group B. Western blot results for p-ERK inthe spinal cord indicated a higher level of expression in groupB than in group A and a lower level of expression in group Cthan in group B. Conclusions: DA-9701 may decrease visceralpain via the downregulation of p-ERK in the DRG andspinal cord.
An 82-yr-old man was presented with fever and cough accompanied by generalized erythematous rash. He had taken mexiletine for 5 months, as he had been diagnosed with dilated cardiomyopathy and ventricular arrhythmia. Laboratory studies showed peripheral blood eosinophilia and elevated liver transaminase levels. Chest radiographs showed multiple nodular consolidations in both lungs. Biopsies of the lung and skin lesions revealed eosinophilic infiltration. After a thorough review of his medication history, mexiletine was suspected as the etiologic agent. After discontinuing the mexiletine and starting oral prednisolone, the patient improved, and the skin and lung lesions disappeared. Subsequently, mexiletine was confirmed as the causative agent based on a positive patch test. Drug-induced hypersensitivity syndrome is a severe adverse reaction to drugs and results from treatment with anticonvulsants, allopurinol, sulfonamides, and many other drugs. Several cases of mexiletine-induced hypersensitivity syndrome have been reported in older Japanese males with manifestation of fever, rash, peripheral blood eosinophilia, liver dysfunction without other organ involvement. Here, we report a case of mexiletine-induced hypersensitivity syndrome which presented as eosinophilic pneumonia in a Korean male.
Bronchial hyperresponsiveness(BHR) resuts from airway inflammation in bronchial asthmatics. The corticosteroid is widely used in bronchial asthmatics with antiinflammatory action, and improves in the late response or bronchial hyperreactivity by the effect on airway smooth muscle. Also, corticosteroid alters the immunologic properties by the mechanism which effects on the blood cells and their chemical mediators. In order to investigate the effect of oral short-term prednisolone therapy on BHR in mild extrinsic asthmatics, we measured nonspecfic-BHR with methacholine bronchial provocation test [Meth-PC_(20)(mg/ml)], including IgE, eosinophil, skin test, specific serum IgE level before and after treatment in extrinsic asthmatic patients. They were devided into two groups, the countrol group(n=15) was treated with ordinary bronchodilator and antihistamine, and the steroid group(n=9) was treated with above regimen plus oral prednisolone(total 12Wks 30-40mg/day for 1-2Wks and tapering for 10-11 Wks). The results were as follows; 1) Baseline FEV1 demonstrated no significant different both groups as 2664 ±685ml, 2711 ±551ml in control group, and 2801 ±616ml, 2839 ±666ml in steroid group before and after treatment. 2) Meth-PC_(20) was 7.94 ×÷0.44mg/ml, before treatment and 5.89 ×÷0.46mg/ml, after treatment in control group, which was not significantly changed. In steroid group it was 6. 92 ×÷0.40mg/ml, before treatment and 13.18 ×÷0.39mg/ml, after treatment, there was significant improvement. 3) Peripheral eosinophil count was 323.59 ×÷0.35/㎣ before treatment and 309.03 ×÷-0.33/㎣ after treatment in countrol group, which was not significantly improved. In steroid group it was 524.81 ×÷-0.1644/㎣ before treatment and 229.09 ×÷0.33/㎣ after treatment, there was signific ant decrement(p $lt;0.0 5 ). 4) Total serum IgE was measured in 309.03 ×÷0.54U/ml before treatment and 199.5 3 ×÷0.44U/ml after treatment in countrol group, which was not significantly improved, Though it was 363.08 ×÷0.51U/ml before treatment and 186.21 ×÷0.52U/ml after treatment in steroid group, which was statistically significan tly decreased(p$lt;0.05 ). 5) The results of skin test and specific IgE levels were improved in both groups, but there was no significant correlationships between improvement of BHR, peripheral eosinophil count, and total serum IgE levels. In conclusion, the oral corticosteroid therapy reduces BHR in extrinsic asthmatics with decrement of recruitment or activation and IgE production by the antiinflammatory effects.