• Journal of Preventive Medicine and Public Health
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• 제27권4호
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• pp.677-691
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• 1994

To evaluate the validity of serum pepsinogen levels as a screening tool for gastric cancer and adenoma, immunoradiometric assays of serum pepsinogen I level (PG I), II level (PG II) and esphagogastroduodenal endoscopies were done in 757 health examinees. Serum PG I level was higher in subjects with active duodenal ulcer (n=45, $75.2{\pm}34.3{\mu}g/l(mean{\pm}standard\;deviation)$, p<0.01) and gastroduodenal ulcers (n=8, $75.6{\pm}19.8{\mu}g/l$, p<0.05), and was lower in those with gastric adenoma(n=4, $37.7{\pm}37.2{\mu}g/l$, p<0.2) than those with normal, mild gastritis findings or ulcer scars (n=378, $56.6{\pm}24.9{\mu}g/l$. Serum PG II level was higher in subjects with active duodenal ulcer($17.2{\pm}13.8{\mu}g/l$, p<0.2), active gastro-duodenal ulcers ($18.3{\pm}7.4{\mu}g/l$, p<0.2) and gastric carcinoma (n=3, $23.8{\pm}10.9{\mu}g/l$, p<0.05) than those with normal, mild gastritis findings or ulcer scars $(14.5{\pm}7.9{\mu}g/l)$. Serum PG I/PG II ratio was higher in subjects with active duodenal ulcer($5.1{\pm}1.6$, p<0.05) and was lower in those with chronic gastritis(n=107, $4.1{\pm}1.7$, p<0.05), gastric polyp(n=19, $3.9{\pm}1.4$, p<0.2), gastric adenoma(n=4, $2.1{\pm}1.9$, p<0.01) and gastric carcinoma(n=3, $2.7{\pm}1.2$, p<0.1) than those with normal, mild gastritis findings or ulcer scars ($4.5{\pm}1.7$). Serum PG II level increased with age until 6th decade, whereas serum PG I/PG II ratio decreased with age in 378 subjects with normal, mild gastritis findings or ulcer scars. The screening criteria of serum PG I<$70{\mu}g/l$ and PG I/PG II ratio<3.0 for detecting gastric cancer and adenoma gave a positive rate of 15.7%, sensitivity of 57.1% and specificity of 84.7%.

• Journal of Yeungnam Medical Science
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• 제28권1호
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• pp.84-89
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• 2011

Brunneroma, also known as Brunner's gland adenoma or harmatoma, is a very rare benign tumor of the duodenum, which is usually asymptomatic, and is discovered incidentally during endoscopic exam. These lesions are most commonly located in the duodenal bulb and clinical manifestations are variable. We report on a case of a large Brunner's gland adenoma in a 54-year-old man, which was successfully removed by endoscopic resection without complications, such as bleeding or perforation. Microscopically, it was composed entirely of variable Brunner's gland.

• Asian Pacific Journal of Cancer Prevention
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• 제15권16호
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• pp.6945-6948
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• 2014

Background: Familial adenomatous polyposis (FAP) is a disease inherited in an autosomal dominant fashion. Most FAP patients develop upper gastrointestinal polyps; especially those in the antrum and duodenum are usually neoplastic. The aim of this study was to evaluate the prevalence of gastroduodenal polyps in Iranian FAP patients. Materials and Methods: 28 patients affected by FAP underwent front-view and side-view endoscopy. Papillary biopsies were performed in all patients. Location of polyps, their number and size, pathology study, patient general information (gender, age, family history of FAP or colorectal cancer and gastroduodenal polyps) were analyzed. Results: Gastric polyps were seen in 39.3 % of patients. Some 72.7% of the affected individuals had fundic gland polyps and 36.36% had hyperplastic polyps. Duodenal adenoma was observed in 25% of patients. While 57% of patients had tubular adenoma with low grade dysplasia, 42.8% showed tubulovillous adenoma with low grade dysplasia. Conclusions: Findings of this study indicated that the prevalence of gastroduodenal polyps in FAP patients is high and dysplasia may be evident in duodenal polyps. Therefore, it appears that routine gastroduodenal endoscopy in FAP patients is necessary.

• Clinical Endoscopy
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• 제55권1호
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• pp.95-100
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• 2022

Background/Aims: Endoscopic mucosal resection (EMR) is the primary treatment for duodenal adenomas; however, it is associated with a high risk of perforation and bleeding, especially with larger lesions. The goal of this study was to demonstrate the feasibility and safety of endoscopic suturing (ES) for the closure of mucosal defects after duodenal EMR. Methods: Consecutive adult patients who underwent ES of large mucosal defects after EMR of large (>2 cm) duodenal adenomas were retrospectively enrolled. The OverStitch ES system was employed for closing mucosal defects after EMR. Clinical outcomes and complications, including delayed bleeding and perforation, were documented. Results: During the study period, ES of mucosal defects was performed in seven patients in eight sessions (six for prophylaxis and two for the treatment of perforation). All ES sessions were technically successful. No early or delayed post-EMR bleeding was recorded. In addition, no clinically obvious duodenal stricture or recurrence was encountered on endoscopic follow-up evaluation, and no patients required subsequent surgical intervention. Conclusions: ES for the prevention and treatment of duodenal perforation after EMR is technically feasible, safe, and effective. ES should be considered an option for preventing or treating perforations associated with EMR of large duodenal adenomas.

• Parasites, Hosts and Diseases
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• 제53권1호
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• pp.95-99
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• 2015

Strongyloides stercoralis can cause systemic infection, termed strongyloidiasis, and gastrointestinal ulcer disease in immunocompromised patients. However, to our knowledge, there are no reported cases of comorbid gastric adenocarcinoma and S. stercoralis infection. Here, we report a case of an 81-year-old Korean man who presented with S. stercoralis infection coexisting with early gastric adenocarcinoma (T1aN0M0). S. stercoralis eggs, rhabditiform larvae, and adult females were observed in normal gastric and duodenal crypts. They were also observed in atypical glands representative of adenocarcinoma and adenoma. Preliminary laboratory tests revealed mild neutrophilic and eosinophilic leukocytosis. A routine stool test failed to detect rhabditiform larvae in the patient's fecal sample; however, S. stercoralis was identified by PCR amplification and 18S rRNA sequencing using genomic DNA extracted from formalin-fixed paraffin-embedded tissues. Postoperatively, the patient had a persistent fever and was treated with albendazole for 7 days, which alleviated the fever. The patient was followed-up by monitoring and laboratory testing for 4 months postoperatively, and no abnormalities were observed thus far. The fact that S. stercoralis infection may be fatal in immunocompromised patients should be kept in mind when assessing high-risk patients.