This paper presents dynamic-behavior comparisons and related forensic analyses of a submerged floating tunnel(SFT)between numerical simulation and physical experiment under regular and irregular waves.The experiments ...This paper presents dynamic-behavior comparisons and related forensic analyses of a submerged floating tunnel(SFT)between numerical simulation and physical experiment under regular and irregular waves.The experiments are conducted in the 3Dwave tank with 1:33.3 scale,and the corresponding coupled time-domain simulation tool is devised for comparison.The entire SFT systemconsists of a long concrete tunnel and 12 tubular aluminummooring lines.Two numerical simulation models,the Cummins equation with 3D potential theory including second-order wave-body interaction effects and the much simpler Morison-equation-based formula with the lumped-massbased line model,are designed and compared.Forensic analyses for mooring-line adjustments in the simulation are carried out in view of the best representation of the physical system.After that,the measured pre-tension distribution and systemstiffness of twelvemooring lines arewell reproduced in the numericalmodel.Subsequently,the dynamic responses and mooring tensions of the SFT are compared under regular and irregular waves.The measured and simulated results coincide reasonably well for both regular-and irregular-wave conditions.展开更多
AIM:To investigate the clinical characteristics and outcomes of idiopathic Helicobacter pylori(H.pylori)-negative and drug-negative]peptic ulcer bleeding(PUB).METHODS:A consecutive series of patients who experienced P...AIM:To investigate the clinical characteristics and outcomes of idiopathic Helicobacter pylori(H.pylori)-negative and drug-negative]peptic ulcer bleeding(PUB).METHODS:A consecutive series of patients who experienced PUB between 2006 and 2012 was retrospectively analyzed.A total of 232 patients were enrolled in this study.The patients were divided into four groups according to the etiologies of PUB:idiopathic,H.pylori-associated,drug-induced and combined(H.pylori-associated and drug-induced)types.We compared the clinical characteristics and outcomes between the groups.When the silver stain or rapid urease tests were H.pylori-negative,we obtained an additional biopsy specimen by endoscopic re-examination and performed an H.pylori antibody test 6-8 wk after the initial endoscopic examination.For a diagnosis of idiopathic PUB,a negative result of an H.pylori antibody test was confirmed.In all cases,re-bleeding was confirmed by endoscopic examination.For the risk assessment,the Blatchford and the Rockall scores were calculated for all patients.RESULTS:For PUB,the frequency of H.pylori infection was 59.5%(138/232),whereas the frequency of idiopathic cases was 8.6%(20/232).When idiopathic PUB was compared to H.pylori-associated PUB,the idiopathic PUB group showed a higher rate of rebleeding after initial hemostasis during the hospital stay(30%vs 7.4%,P = 0.02).When idiopathic PUB was compared to drug-induced PUB,the patients in the idiopathic PUB group showed a higher rate of rebleeding after initial hemostasis upon admission(30%vs 2.7%,P < 0.01).When drug-induced PUB was compared to H.pylori-associated PUB,the patients in the drug-induced PUB were older(68.49 ± 14.76 years vs 47.83 ± 15.15 years,P< 0.01) and showed a higher proportion of gastric ulcer(77%vs 49%,P < 0.01).However,the Blatchford and the Rockall scores were not significantly different between the two groups.Among the patients who experienced drug-induced PUB,no significant differences were found with respect to clinical characteristics,irrespective of H.pylori infection.CONCLUSION:Idiopathic PUB has unique clinical characteristics such as re-bleeding after initial hemostasis upon admission.Therefore,these patients need to undergo close surveillance upon admission.展开更多
AIM:To investigate whether tissue samples processed by the rapid urease test(RUT)kit are suitable for dualpriming oligonucleotide-based multiplex polymerase chain reaction(DPO-PCR)to detect Helicobacter pylori(H.pylor...AIM:To investigate whether tissue samples processed by the rapid urease test(RUT)kit are suitable for dualpriming oligonucleotide-based multiplex polymerase chain reaction(DPO-PCR)to detect Helicobacter pylori(H.pylori).METHODS:A total of 54 patients with specific gastrointestinal symptom were enrolled in this study.During endoscopy,gastric biopsy specimens were taken for histology,RUT,and DPO-PCR.DPO-PCR was performed on gastric biopsy samples and tissue samples that were analyzed by RUT at 2 separate institutes.In detecting H.pylori,the concordance rate of the DPO-PCR tests between the tissue samples that had been submitted to RUT and the gastric biopsy samples was investigated.RESULTS:H.pylori co-occurred with 76.0%(19/25)of gastric ulcers,64.3%(9/14)of duodenal ulcers,and 33.3%(4/12)of gastritis cases.H.pylori infection was found in 100%(3/3)of the patients with both gastric and duodenal ulcers.Overall,H.pylori was detected in 35 of 54(64.8%)patients.The diagnostic sensitivities of histology,RUT,and DPO-PCR were85.7%(30/35),74.3%(26/35),and 97.1%(34/35),respectively(P=0.02).The positive predictive value(PPV)of DPO-PCR was 94.4%,whereas the negative predictive value(NPV)was 94.7%.In the rapid urease test(CLOtest)-negative cases,the frequency of positive DPO-PCR and histologic results was 20.0%(7/35).The concordance rate of the DPO-PCR tests between the tissue samples from the RUT kit and the gastric biopsy samples was 94.4%(51/54).The rate of DPOPCR and silver stain positivity in the RUT-negative cases was 20.0%(7/35).CONCLUSION:In diagnosing H.pylori infection,DPO-PCR can be performed on tissue samples that have been processed by the RUT kit.Particularly,in patients with RUT-negative results,DPO-PCR on these tissue samples could be helpful in detecting of H.pylori infection.展开更多
I schemic colitis is an uncommon complication in patients with systemic lupus erythematosus (SLE). In previously reported cases of colitis caused by SLE, intestinal vasculitis is implicated as the causative process, b...I schemic colitis is an uncommon complication in patients with systemic lupus erythematosus (SLE). In previously reported cases of colitis caused by SLE, intestinal vasculitis is implicated as the causative process, but is rarely confirmed histologically. We described a case of a 32-year-old man with increased activity of SLE, who presented with hematochezia and abdominal pain due to ischemic colitis with small vessel vasculitis which was proven by sigmoidoscopic biopsy. The clinical course of the patient was improved after steroid and conservative management.展开更多
AIM: To compare the Helicobacter pylori(H.pylori) eradication rate of clarithromycin-based triple therapy,metronidazole-based triple therapy,sequential therapy and concomitant therapy.METHODS: A total of 680 patients ...AIM: To compare the Helicobacter pylori(H.pylori) eradication rate of clarithromycin-based triple therapy,metronidazole-based triple therapy,sequential therapy and concomitant therapy.METHODS: A total of 680 patients infected with H.pylori were divided into 4 groups and each group was treated with a different eradication therapy.Clarithromycin-based triple therapy was applied to the first group [rabeprazole,amoxicillin and clarithromycin(PAC) group: proton pump inhibitor(PPI),amoxicillin,clarithromycin],whereas the second group was treated with metronidazole-based triple therapy [rabeprazole,amoxicillin and metronidazole(PAM) group: PPI,amoxicillin,metronidazole].The third group was treated with rabeprazole and amoxicillin,followed by rabeprazole,clarithromycin and metronidazole(sequential group).The final group was simultaneously treated with rabeprazole,amoxicillin clarithromycin and metronidazole(concomitant therapy group).In the case of a failure to eradicate H.pylori,second-line quadruple and third-line eradication therapies were administered.RESULTS: The per protocol(PP) analysis was performed on 143,139,141 and 143 patients in the PAC,PAM,sequential and concomitant groups,respectively.We excluded patients who did not receive a C13-urea breath test(22,20,23 and 22 patients,respectively) and patients with less than an 80% compliance level(5,11,6 and 5 patients,respectively).The eradication rates were 76.2%(109/143) in the PAC group,84.2%(117/139) in the PAM group,84.4%(119/141) in the sequential group and 94.4%(135/143) in the concomitant group(P = 0.0002).All 14 patients who failed second-line therapy were treated with thirdline eradication therapy.Among these 14 patients,6 infections were successfully eradicated with the thirdline therapy.Both PP and intention-to-treat analysis showed an eradication rate of 42.9%(6/14).In the PAC group,3 of 4 patients were successfully cured(3/4,75%); 2 of 2 patients in the PAM group(2/2,100%) and 1 of 5 patients in the sequential group(1/5,20%) were also cured.In the concomitant group,all 3 patients failed(0/3,0%).CONCLUSION: The eradication rate for the concomitant therapy was much higher than those of the standard triple therapy or sequential therapy(Clinical Trials.gov number NCT01922765).展开更多
AIM:To evaluate the relationship between peptic ulcer disease(PUD) and acute pancreatitis.METHODS:A cohort of 78 patients with acute pancreatitis were included in this study.The presence of PUD and the Helicobacter py...AIM:To evaluate the relationship between peptic ulcer disease(PUD) and acute pancreatitis.METHODS:A cohort of 78 patients with acute pancreatitis were included in this study.The presence of PUD and the Helicobacter pylori(H.pylori) status were assessed by an endoscopic method.The severity of acute pancreatitis was assessed using Ranson's score,the Acute Physiology and Chronic Health Evaluation(APACHE) □ score,computed tomography severity indexand the clinical data during hospitalization,all of which were compared between the patients with and without PUD.The risk factors for PUD were also evaluated.RESULTS:Among 78 patients,41 patients(52.6%) with acute pancreatitis suffered from PUD,but only 13(31.7%) patients with PUD were infected by H.pylori.On univariate analysis,male gender,an etiology of alcohol-induced pancreatitis,a history of smoking or alcohol consumption,elevated triglyceride and C-reactive protein levels,and high APACHE □ score were signif icantly associated with PUD.However,on multivariate logistic regressionanalysis,the APACHE □ score(odds ratio:7.69;95% conf idence interval:1.78-33.33;P < 0.01) was found to be the only independent risk factor for PUD.CONCLUSION:Patients with acute pancreatitis are liable to suffer from PUD.PUD is associated with severeacute pancreatitis according to the APACHE □ score,and treatment for PUD should be considered for patients with severe acute pancreatitis.展开更多
Lymphangioma of the colon is a relatively rare nonepithelial tumor and usually presents as a submucosal polypoid lesion.Many cases incidentally discovered are usually asymptomatic.However,they may present as abdominal...Lymphangioma of the colon is a relatively rare nonepithelial tumor and usually presents as a submucosal polypoid lesion.Many cases incidentally discovered are usually asymptomatic.However,they may present as abdominal pain or bleeding,and their resection is normally required.Lymphangioma itself is generally recognized as a benign tumor and no cases of malignant transformation have yet been reported,although its natural history is currently unknown.To the best of our knowledge,this study is the first to describe a case of spontaneous resolution in multiple colonic lymphangiomas without any specific treatment.展开更多
AIM:To determine the precise incidence and clinical features of endoscopic ulcers following gastrectomy.METHODS:A consecutive series of patients who underwent endoscopic examination following gastrectomy between 2005 ...AIM:To determine the precise incidence and clinical features of endoscopic ulcers following gastrectomy.METHODS:A consecutive series of patients who underwent endoscopic examination following gastrectomy between 2005 and 2010 was retrospectively analyzed.A total of 78 patients with endoscopic ulcers and 759 without ulcers following gastrectomy were enrolled.We analyzed differences in patient age,sex,size of the lesions,method of operation,indications for gastric resection,and infection rates of Helicobacter pylori(H.pylori) between the nonulcer and ulcer groups.RESULTS:The incidence of endoscopic ulcers after gastrectomy was 9.3% and that of marginal ulcers was 8.6%.Ulcers were more common in patients with Billroth Ⅱ anastomosis and pre-existing conditions forpeptic ulcer disease(PUD).Infection rates of H.pyloridid not differ significantly between the two groups.The patients who underwent operations to treat PUD had lower initial levels of hemoglobin and higher rates of hospital admission.CONCLUSION:H.pylori was not an important factor in ulcerogenesis following gastrectomy.For patients who underwent surgery for PUD,clinical course of marginal ulcers was more severe.展开更多
Background:The rapid antibiotics treatment targeted to a specific pathogen can improve clinical outcomes of septicemia.We aimed to evaluate the clinical characteristics and outcomes of biliary septicemia caused by cho...Background:The rapid antibiotics treatment targeted to a specific pathogen can improve clinical outcomes of septicemia.We aimed to evaluate the clinical characteristics and outcomes of biliary septicemia caused by cholangitis or cholecystitis according to causative organisms.Methods:We performed a retrospective cohort study in 151 patients diagnosed with cholangitis or cholecystitis with bacterial septicemia from January 2013 to December 2015.All patients showed clinical evidence of biliary tract infection and had blood isolates that demonstrated septicemia.Results:Gram-negative,gram-positive,and both types of bacteria caused 84.1%(127/151),13.2%(20/151),and 2.6%(4/151)episodes of septicemia,respectively.The most common infecting organisms were Escherichia coli among gram-negative bacteria and Enterococcus species(Enterococcus casseliflavus and Enterococcus faecalis)among gram-positive bacteria.There were no differences in mortality,re-admission rate,and need for emergency decompression procedures between the gram-positive and gram-negative septicemia groups.In univariate analysis,previous gastrectomy history was associated with gram-positive bacteremia.Multivariate analysis also showed that previous gastrectomy history was strongly associated with gram-positive septicemia(Odds ratio=5.47,95%CI:1.19–25.23;P=0.029).Conclusions:Previous gastrectomy history was related to biliary septicemia induced by gram-positive organisms.This information would aid the choice of empirical antibiotics.展开更多
AIM: To evaluate duodenal polyps, divided into nonneoplastic and neoplastic lesions. In addition, the clinical characteristics of duodenal hyperplastic polyps are determined. METHODS: We analyzed medical records of 50...AIM: To evaluate duodenal polyps, divided into nonneoplastic and neoplastic lesions. In addition, the clinical characteristics of duodenal hyperplastic polyps are determined. METHODS: We analyzed medical records of 50 114 consecutive patients submitted to for first diagnostic esophago-gastroduodenoscopy between January 2004 and December 2009. We excluded lesions on the ampulla of Vater and submucosal tumors. We studied 510 cases that were diagnosed endoscopically with duodenal polyps and enrolled a total of 221 cases that had undergone tissue biopsy. We analyzed the differences between non-neoplastic and neoplastic lesions, and determined the clinical features of duodenal hyperplastic polyps. RESULTS: Non-neoplastic lesions were found in 196 patients and neoplastic lesions in 25 patients. On uni-variate analysis, there were significant differences in shape, location, and size. Polyps more than 10 mm in diameter or polyps in the second portion had independent risk factors for being neoplastic lesions, as identified by multivariate analysis. In 23 cases of hyperplastic polyps (79.3%), they were accompanied by gastroduodenal pathology, which was possibly associated with Helicobacter pylori . CONCLUSION: Polyps of more than 10 mm or polyps in the second portion of the duodenum should be evaluated by histological examination.展开更多
Lymphangioma is an uncommon malformation of lymphatic system. Multiple colonic lymphangioma named as lymphangiomatosis is considered an extremely rare disease. Although lymphangioma is a benign tumor and most colonic ...Lymphangioma is an uncommon malformation of lymphatic system. Multiple colonic lymphangioma named as lymphangiomatosis is considered an extremely rare disease. Although lymphangioma is a benign tumor and most colonic lymphangiomas do not cause symptoms and do not require treatment, resection of lymphangioma is necessary in the presence of symptoms such as abdominal pain, bleeding, intussusceptions. We report a case of colonic lymphangiomatosis in a man who presented with abdominal discomfort and anemia, which was diagnosed and treated with endoscopic snare polypectomy.展开更多
基金supported by the National Research Foundation of Korea(NRF)grant funded by the Korea Government(MSIT)(No.2017R1A5A1014883).
文摘This paper presents dynamic-behavior comparisons and related forensic analyses of a submerged floating tunnel(SFT)between numerical simulation and physical experiment under regular and irregular waves.The experiments are conducted in the 3Dwave tank with 1:33.3 scale,and the corresponding coupled time-domain simulation tool is devised for comparison.The entire SFT systemconsists of a long concrete tunnel and 12 tubular aluminummooring lines.Two numerical simulation models,the Cummins equation with 3D potential theory including second-order wave-body interaction effects and the much simpler Morison-equation-based formula with the lumped-massbased line model,are designed and compared.Forensic analyses for mooring-line adjustments in the simulation are carried out in view of the best representation of the physical system.After that,the measured pre-tension distribution and systemstiffness of twelvemooring lines arewell reproduced in the numericalmodel.Subsequently,the dynamic responses and mooring tensions of the SFT are compared under regular and irregular waves.The measured and simulated results coincide reasonably well for both regular-and irregular-wave conditions.
文摘AIM:To investigate the clinical characteristics and outcomes of idiopathic Helicobacter pylori(H.pylori)-negative and drug-negative]peptic ulcer bleeding(PUB).METHODS:A consecutive series of patients who experienced PUB between 2006 and 2012 was retrospectively analyzed.A total of 232 patients were enrolled in this study.The patients were divided into four groups according to the etiologies of PUB:idiopathic,H.pylori-associated,drug-induced and combined(H.pylori-associated and drug-induced)types.We compared the clinical characteristics and outcomes between the groups.When the silver stain or rapid urease tests were H.pylori-negative,we obtained an additional biopsy specimen by endoscopic re-examination and performed an H.pylori antibody test 6-8 wk after the initial endoscopic examination.For a diagnosis of idiopathic PUB,a negative result of an H.pylori antibody test was confirmed.In all cases,re-bleeding was confirmed by endoscopic examination.For the risk assessment,the Blatchford and the Rockall scores were calculated for all patients.RESULTS:For PUB,the frequency of H.pylori infection was 59.5%(138/232),whereas the frequency of idiopathic cases was 8.6%(20/232).When idiopathic PUB was compared to H.pylori-associated PUB,the idiopathic PUB group showed a higher rate of rebleeding after initial hemostasis during the hospital stay(30%vs 7.4%,P = 0.02).When idiopathic PUB was compared to drug-induced PUB,the patients in the idiopathic PUB group showed a higher rate of rebleeding after initial hemostasis upon admission(30%vs 2.7%,P < 0.01).When drug-induced PUB was compared to H.pylori-associated PUB,the patients in the drug-induced PUB were older(68.49 ± 14.76 years vs 47.83 ± 15.15 years,P< 0.01) and showed a higher proportion of gastric ulcer(77%vs 49%,P < 0.01).However,the Blatchford and the Rockall scores were not significantly different between the two groups.Among the patients who experienced drug-induced PUB,no significant differences were found with respect to clinical characteristics,irrespective of H.pylori infection.CONCLUSION:Idiopathic PUB has unique clinical characteristics such as re-bleeding after initial hemostasis upon admission.Therefore,these patients need to undergo close surveillance upon admission.
基金Supported by Research grant from Jeil Pharma.Co.,Seoul,South Korea
文摘AIM:To investigate whether tissue samples processed by the rapid urease test(RUT)kit are suitable for dualpriming oligonucleotide-based multiplex polymerase chain reaction(DPO-PCR)to detect Helicobacter pylori(H.pylori).METHODS:A total of 54 patients with specific gastrointestinal symptom were enrolled in this study.During endoscopy,gastric biopsy specimens were taken for histology,RUT,and DPO-PCR.DPO-PCR was performed on gastric biopsy samples and tissue samples that were analyzed by RUT at 2 separate institutes.In detecting H.pylori,the concordance rate of the DPO-PCR tests between the tissue samples that had been submitted to RUT and the gastric biopsy samples was investigated.RESULTS:H.pylori co-occurred with 76.0%(19/25)of gastric ulcers,64.3%(9/14)of duodenal ulcers,and 33.3%(4/12)of gastritis cases.H.pylori infection was found in 100%(3/3)of the patients with both gastric and duodenal ulcers.Overall,H.pylori was detected in 35 of 54(64.8%)patients.The diagnostic sensitivities of histology,RUT,and DPO-PCR were85.7%(30/35),74.3%(26/35),and 97.1%(34/35),respectively(P=0.02).The positive predictive value(PPV)of DPO-PCR was 94.4%,whereas the negative predictive value(NPV)was 94.7%.In the rapid urease test(CLOtest)-negative cases,the frequency of positive DPO-PCR and histologic results was 20.0%(7/35).The concordance rate of the DPO-PCR tests between the tissue samples from the RUT kit and the gastric biopsy samples was 94.4%(51/54).The rate of DPOPCR and silver stain positivity in the RUT-negative cases was 20.0%(7/35).CONCLUSION:In diagnosing H.pylori infection,DPO-PCR can be performed on tissue samples that have been processed by the RUT kit.Particularly,in patients with RUT-negative results,DPO-PCR on these tissue samples could be helpful in detecting of H.pylori infection.
文摘I schemic colitis is an uncommon complication in patients with systemic lupus erythematosus (SLE). In previously reported cases of colitis caused by SLE, intestinal vasculitis is implicated as the causative process, but is rarely confirmed histologically. We described a case of a 32-year-old man with increased activity of SLE, who presented with hematochezia and abdominal pain due to ischemic colitis with small vessel vasculitis which was proven by sigmoidoscopic biopsy. The clinical course of the patient was improved after steroid and conservative management.
基金Supported by Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Education,Science and Technology,No.2013R1A1A2062603
文摘AIM: To compare the Helicobacter pylori(H.pylori) eradication rate of clarithromycin-based triple therapy,metronidazole-based triple therapy,sequential therapy and concomitant therapy.METHODS: A total of 680 patients infected with H.pylori were divided into 4 groups and each group was treated with a different eradication therapy.Clarithromycin-based triple therapy was applied to the first group [rabeprazole,amoxicillin and clarithromycin(PAC) group: proton pump inhibitor(PPI),amoxicillin,clarithromycin],whereas the second group was treated with metronidazole-based triple therapy [rabeprazole,amoxicillin and metronidazole(PAM) group: PPI,amoxicillin,metronidazole].The third group was treated with rabeprazole and amoxicillin,followed by rabeprazole,clarithromycin and metronidazole(sequential group).The final group was simultaneously treated with rabeprazole,amoxicillin clarithromycin and metronidazole(concomitant therapy group).In the case of a failure to eradicate H.pylori,second-line quadruple and third-line eradication therapies were administered.RESULTS: The per protocol(PP) analysis was performed on 143,139,141 and 143 patients in the PAC,PAM,sequential and concomitant groups,respectively.We excluded patients who did not receive a C13-urea breath test(22,20,23 and 22 patients,respectively) and patients with less than an 80% compliance level(5,11,6 and 5 patients,respectively).The eradication rates were 76.2%(109/143) in the PAC group,84.2%(117/139) in the PAM group,84.4%(119/141) in the sequential group and 94.4%(135/143) in the concomitant group(P = 0.0002).All 14 patients who failed second-line therapy were treated with thirdline eradication therapy.Among these 14 patients,6 infections were successfully eradicated with the thirdline therapy.Both PP and intention-to-treat analysis showed an eradication rate of 42.9%(6/14).In the PAC group,3 of 4 patients were successfully cured(3/4,75%); 2 of 2 patients in the PAM group(2/2,100%) and 1 of 5 patients in the sequential group(1/5,20%) were also cured.In the concomitant group,all 3 patients failed(0/3,0%).CONCLUSION: The eradication rate for the concomitant therapy was much higher than those of the standard triple therapy or sequential therapy(Clinical Trials.gov number NCT01922765).
文摘AIM:To evaluate the relationship between peptic ulcer disease(PUD) and acute pancreatitis.METHODS:A cohort of 78 patients with acute pancreatitis were included in this study.The presence of PUD and the Helicobacter pylori(H.pylori) status were assessed by an endoscopic method.The severity of acute pancreatitis was assessed using Ranson's score,the Acute Physiology and Chronic Health Evaluation(APACHE) □ score,computed tomography severity indexand the clinical data during hospitalization,all of which were compared between the patients with and without PUD.The risk factors for PUD were also evaluated.RESULTS:Among 78 patients,41 patients(52.6%) with acute pancreatitis suffered from PUD,but only 13(31.7%) patients with PUD were infected by H.pylori.On univariate analysis,male gender,an etiology of alcohol-induced pancreatitis,a history of smoking or alcohol consumption,elevated triglyceride and C-reactive protein levels,and high APACHE □ score were signif icantly associated with PUD.However,on multivariate logistic regressionanalysis,the APACHE □ score(odds ratio:7.69;95% conf idence interval:1.78-33.33;P < 0.01) was found to be the only independent risk factor for PUD.CONCLUSION:Patients with acute pancreatitis are liable to suffer from PUD.PUD is associated with severeacute pancreatitis according to the APACHE □ score,and treatment for PUD should be considered for patients with severe acute pancreatitis.
文摘Lymphangioma of the colon is a relatively rare nonepithelial tumor and usually presents as a submucosal polypoid lesion.Many cases incidentally discovered are usually asymptomatic.However,they may present as abdominal pain or bleeding,and their resection is normally required.Lymphangioma itself is generally recognized as a benign tumor and no cases of malignant transformation have yet been reported,although its natural history is currently unknown.To the best of our knowledge,this study is the first to describe a case of spontaneous resolution in multiple colonic lymphangiomas without any specific treatment.
文摘AIM:To determine the precise incidence and clinical features of endoscopic ulcers following gastrectomy.METHODS:A consecutive series of patients who underwent endoscopic examination following gastrectomy between 2005 and 2010 was retrospectively analyzed.A total of 78 patients with endoscopic ulcers and 759 without ulcers following gastrectomy were enrolled.We analyzed differences in patient age,sex,size of the lesions,method of operation,indications for gastric resection,and infection rates of Helicobacter pylori(H.pylori) between the nonulcer and ulcer groups.RESULTS:The incidence of endoscopic ulcers after gastrectomy was 9.3% and that of marginal ulcers was 8.6%.Ulcers were more common in patients with Billroth Ⅱ anastomosis and pre-existing conditions forpeptic ulcer disease(PUD).Infection rates of H.pyloridid not differ significantly between the two groups.The patients who underwent operations to treat PUD had lower initial levels of hemoglobin and higher rates of hospital admission.CONCLUSION:H.pylori was not an important factor in ulcerogenesis following gastrectomy.For patients who underwent surgery for PUD,clinical course of marginal ulcers was more severe.
文摘Background:The rapid antibiotics treatment targeted to a specific pathogen can improve clinical outcomes of septicemia.We aimed to evaluate the clinical characteristics and outcomes of biliary septicemia caused by cholangitis or cholecystitis according to causative organisms.Methods:We performed a retrospective cohort study in 151 patients diagnosed with cholangitis or cholecystitis with bacterial septicemia from January 2013 to December 2015.All patients showed clinical evidence of biliary tract infection and had blood isolates that demonstrated septicemia.Results:Gram-negative,gram-positive,and both types of bacteria caused 84.1%(127/151),13.2%(20/151),and 2.6%(4/151)episodes of septicemia,respectively.The most common infecting organisms were Escherichia coli among gram-negative bacteria and Enterococcus species(Enterococcus casseliflavus and Enterococcus faecalis)among gram-positive bacteria.There were no differences in mortality,re-admission rate,and need for emergency decompression procedures between the gram-positive and gram-negative septicemia groups.In univariate analysis,previous gastrectomy history was associated with gram-positive bacteremia.Multivariate analysis also showed that previous gastrectomy history was strongly associated with gram-positive septicemia(Odds ratio=5.47,95%CI:1.19–25.23;P=0.029).Conclusions:Previous gastrectomy history was related to biliary septicemia induced by gram-positive organisms.This information would aid the choice of empirical antibiotics.
文摘AIM: To evaluate duodenal polyps, divided into nonneoplastic and neoplastic lesions. In addition, the clinical characteristics of duodenal hyperplastic polyps are determined. METHODS: We analyzed medical records of 50 114 consecutive patients submitted to for first diagnostic esophago-gastroduodenoscopy between January 2004 and December 2009. We excluded lesions on the ampulla of Vater and submucosal tumors. We studied 510 cases that were diagnosed endoscopically with duodenal polyps and enrolled a total of 221 cases that had undergone tissue biopsy. We analyzed the differences between non-neoplastic and neoplastic lesions, and determined the clinical features of duodenal hyperplastic polyps. RESULTS: Non-neoplastic lesions were found in 196 patients and neoplastic lesions in 25 patients. On uni-variate analysis, there were significant differences in shape, location, and size. Polyps more than 10 mm in diameter or polyps in the second portion had independent risk factors for being neoplastic lesions, as identified by multivariate analysis. In 23 cases of hyperplastic polyps (79.3%), they were accompanied by gastroduodenal pathology, which was possibly associated with Helicobacter pylori . CONCLUSION: Polyps of more than 10 mm or polyps in the second portion of the duodenum should be evaluated by histological examination.
文摘Lymphangioma is an uncommon malformation of lymphatic system. Multiple colonic lymphangioma named as lymphangiomatosis is considered an extremely rare disease. Although lymphangioma is a benign tumor and most colonic lymphangiomas do not cause symptoms and do not require treatment, resection of lymphangioma is necessary in the presence of symptoms such as abdominal pain, bleeding, intussusceptions. We report a case of colonic lymphangiomatosis in a man who presented with abdominal discomfort and anemia, which was diagnosed and treated with endoscopic snare polypectomy.
