The IL-1B Genetic Polymorphism Is Associated with Aspirin-Induced Peptic Ulcers in a Korean Ethnic Group

BACKGROUND/AIMS: Single nucleotide polymorphisms (SNPs) are associated with aspirin-induced peptic ulcers. However, SNPs of specific genes vary among races, and data regarding SNPs in the Korean population are scarce. In this study, we aimed to investigate the relationships between SNPs of the COX-1, IL-1β, IL-1RN, and TNF genes and aspirin-induced peptic ulcers, as pilot research in a Korean population. METHODS: Patients who had been taking low-dose aspirin (100 mg) for at least 4 weeks were prospectively enrolled. DNA was extracted from whole blood, and DNA sequencing was subsequently performed. RESULTS: A total of 48 patients were enrolled (23 peptic ulcer patients vs 25 nonulcer controls). Three exon SNPs (IL-1β-581C/T [rs1143627], IL-1β-1061C/T [rs16944], and IL-1RN-1129 [rs4251961]) and one intron SNP (IL-1β IVS2+242C/T) were significantly different between the two groups. On the multivariate analysis after adjustments for age and sex, the CC/CT genotypes of IL-1β-581C/T, and the CT/TT genotypes of IL-1β-1061C/T were positively associated with aspirin-induced peptic ulcers (odds ratio [OR], 4.6, 95% confidence interval [CI], 1.054 to 20.303, p=0.04; OR, 4.6, 95% CI, 1.054 to 20.303, p=0.04). CONCLUSIONS: The IL-1β-581C/T and IL-1β-1061C/T genotypes may be associated with low-dose aspirin-induced peptic ulcers in a Korean ethnic group.

A Case of Successful Treatment of Portal Venous Gas Caused by Acute Pancreatitis / 대한소화기학회지

Hepatic portal venous gas (HPVG) has been considered a rare entity associated with a poor prognosis. Portal vein gas is most commonly caused by mesenteric ischemia but may have a variety other causes. HPVG can be associated with ischemic bowel disease, inflammatory bowel disease, intra-abdominal abscess, small bowel obstruction, acute pancreatitis, and gastric ulcer. Because of high mortality rate, most HPVG requires emergent surgical interventions and intensive medical management. We experienced a case of hepatic portal venous gas caused by acute pancreatitis and successfully treated with medical management.

An Unusual Cause of Gastrointestinal Hemorrhage: Gastrocolic Fistula Caused by Colon Cancer Invasion / 영남의대학술지

Gastrocolic fistula is a fistulous communication between the stomach and the colon. It is a passage between the gastric epithelium and the colonic epithelium. This uncommon complication is caused by benign and malignant diseases of the stomach or the colon. Its clinical manifestations include weight loss, diarrhea and fecal vomiting; occasionally, anemia, poor oral intake, fatigue and dizziness; and very rarely, gastrointestinal bleeding. In this paper, an unusual case of gastrocolic fistula accompanied by hematochezia, which was revealed to have been caused by colon cancer invasion, is described.

A Case of IgG4 Associated Sclerosing Cholangitis without Clinical Manifestations of Autoimmune Pancreatitis / 대한소화기학회지

IgG4-related systemic diseases are characterized by a diffuse or mass forming inflammatory reaction rich in lymphocytes and IgG4-positive plasma cells (lymphoplasmacytic infiltration), fibrosclerosis of variable organs and obliterative phlebitis. They usually involve various organs including the pancreas, bile duct, gallbladder, salivary gland, retroperitoneum, kidney, lung, and prostate. However, most of them are accompanied by autoimmune pancreatitis, and good response to steroid treatment is one of the hallmarks of this disease. We report a case of an 67-year-old man with IgG4 associated sclerosing cholangitis, who was diagnosed by endoscopic retrograde cholangiopancreatography and successfully treated with steroid therapy.

A Case of Reversal of Takotsubo Cardiomyopathy in Patient with Pheochromocytoma

'Takotsubo cardiomyopathy' or 'stress-induced cardiomyopathy' is a newly described clinical entity characterized by transient left ventricular apical ballooning and left ventricular apical dyskinesis in the absence of angiographic feature of significant coronary artery disease. The cause of takotsubo cardiomyopathy is unclear, but catecholamines probably play a role in the takotsubo cardiomyopathy. We report a case of pheochromocytoma-induced takotsubo cardiomyopathy that showed atypical pattern of reversed takotsubo cardiomyopathy with transient significant mitral regurgitation. This is the first case showing the reversal of takotsubo cardiomyopathy due to pheochromocytoma in Korea.

Endoscopic Argon Plasma Laser Trimming of Biliary Self Expanding Metallic Stent / 대한소화기내시경학회지

A self-expanding metal stent is an effective treatment for biliary stenosis, improving obstructive jaundice and maintaining the long term patency of the bile duct. The complications of the metal stent are a perforation, distal migration, restenosis and duodenal mucosa injury from the contralateral wall impaction or trauma. However, the metal stent is a relatively permanent device and its removal is technically challenging. We report a case of protrusion of biliary stents into the duodenal lumen of a distal common bile duct cancer patients that was managed successfully by endoscopic argon plasma laser trimming.

A Case of Acute Ischemic Enteritis Caused by Polyarteritis Nodosa / 대한소화기내시경학회지

Polyarteritis nodosa is a systemic necrotizing vasculitis of the small- and medium-sized arteries with gastrointestinal involvement in more than 50% of cases at some time during the course of the disease. The gastrointestinal manifestations can be diverse and include abdominal pain, nausea and vomiting, ulceration, hemorrhage, occlusion and perforation. Gut involvement is a serious prognostic factor. A 65-year-old man was referred to our department suffering from epigastric pain. A push enteroscopy revealed ischemic enteritis at the proximal small bowel and the CT scan showed a large dilation of the small bowel. His condition deteriorated rapidly and an exploratory laparotomy and total resection of the small bowel was performed. We report a rare case in which the push enteroscopy revealed acute ischemic enteritis of the small bowel and where the pathology specimen showed transmural necrosis of the involved small bowel due to vessel occlusion caused by polyarteritis nodosa.

A Case of Asymptomatic Central Pontine Myelinolysis after Severe Hypoglycemia in a Patient with Diabetic Nephropathy / 대한신장학회잡지

Central pontine myelinolysis (CPM)is a demyelinating disorder that affects pons and is characterized by disturbance of consciousness, quadriparesis, and mutism and has been considered to have poor prognosis. It commonly occurs in patients with rapidly corrected hyponatremia. However, hypoglycemia induced CPM has been rarely reported. Diagnosis is confirmed by MR imaging. Here we report a case of CPM after severe hypoglycemia without any electrolyte disturbance in a patients with diabetic nephropathy.

A case of rhabdomyolysis developed in patient with thyroid storm / 대한내과학회지

Rhabdomyolysis is defined as skeletal muscle injury with release of muscle cell constituents into the plasma. Trauma and drugs are important causes of rhabdomyolysis and not rarely it is associated with metabolic disorders such as diabetic coma, severe electrolyte disturbances and myxedema coma. There are a few reports about rhabdomyolysis developed in patient with thyroid storm. which is defined as a sudden, life threatening exacerbation of thyrotoxicosis. In this report, we described the case of thyroid storm complicated by rhabdomyolysis.