A randomized trial of combination hepatitis B therapy in HIV/HBV coinfected antiretroviral naïve individuals in Thailand.

Unlabelled: Coinfection with human immunodeficiency virus (HIV) and hepatitis B virus (HBV) is associated with considerable liver disease morbidity and mortality. Emerging HIV epidemics in areas of high HBV endemicity such as Asia are expanding the population with HIV/HBV coinfection. Limited randomized trial data exist to support current guidelines for HBV combination therapy in HIV/HBV coinfection.

Asia Pacific consensus recommendations for colorectal cancer screening.

Colorectal cancer (CRC) is rapidly increasing in Asia, but screening guidelines are lacking. Through reviewing the literature and regional data, and using the modified Delphi process, the Asia Pacific Working Group on Colorectal Cancer and international experts launch consensus recommendations aiming to improve the awareness of healthcare providers of the changing epidemiology and screening tests available. The incidence, anatomical distribution and mortality of CRC among Asian populations are not different compared with Western countries.

Risk of bacteremia in bleeding and nonbleeding gastric varices after endoscopic injection of cyanoacrylate.

Background And Study Aim: Bacteremia is common in cirrhosis with gastrointestinal bleeding, including variceal bleeding. Elective esophageal sclerotherapy and banding have been reported to cause bacteremia. The risk associated with therapeutic endoscopy in patients with gastric varices has not yet been reported.

A novel SPINK1 gene mutation, c.206C>T, in a Thai patient with chronic alcoholic pancreatitis.

Context: The exact mechanism of alcoholic pancreatitis has not yet been clarified. Recent studies suggest that alcohol represents only a risk factor for developing pancreatic inflammation in genetic or environmental susceptible subjects. In this regard, various genes involving an alcohol-metabolizing pathway or pancreatitis protecting factors have been extensively studied in order to identify genetic predisposition to alcoholic pancreatitis.

Adrenal hemorrhage as the first presentation of hepatocellular carcinoma.

We report a 67-year-old man who presented with sudden onset of pain in the left flank in association with anemia and hypotension. Imaging studies revealed hepatocellular carcinoma (HCC) at the right lobe of the liver with bilateral adrenal metastases and recent hemorrhage in the left adrenal gland. His serology for hepatitis C was positive.

Metastatic mucinous cystic adenocarcinoma of the pancreas presenting as Sister Mary Joseph's nodule.

Context: Sister Mary Joseph's nodule usually represents metastatic cancers from gastrointestinal malignancy including adenocarcinoma of the pancreas. Mucinous cystadenocarcinoma is a rare malignancy of the pancreas. However, pancreatic mucinous cystadenocarcinoma metastasized to Sister Mary Joseph's nodule is much rarer and has never been reported before.

Differences in characteristics of colorectal neoplasm between young and elderly Thais.

Aim: To analyze the differences of clinical characteristics of colorectal neoplasm including polyps between the elderly and young Thai patients.

Methods: Colonoscopy database from December 2000 to October 2004 was retrospectively analyzed. There were 1822 eligible patients who underwent colonoscopy (with a mean age of 56.

Efficacy of leukocyte esterase dipstick test as a rapid test in diagnosis of spontaneous bacterial peritonitis.

Aim: To evaluate the efficacy of dipstick test in diagnosis of spontaneous bacterial peritonitis (SBP) in cirrhotic patients who underwent abdominal paracentesis based on the locally available dipstick test.

Methods: There were 200 consecutive samples from cirrhotic patients who underwent abdominal paracentesis. Urine dipstick (Combur10 TestM, Roche, Mannheim, Germany) was used as a screening test.

Trimming a metallic biliary stent using an argon plasma coagulator.

Background: Distal migration is one of the common complications after insertion of a covered metallic stent. Stent repositioning or removal is not always possible in every patient. Therefore, trimming using an argon plasma coagulator (APC) may be a good alternative method to solve this problem.

Mediastinal pseudocyst with pericardial effusion and dysphagia treated by endoscopic drainage.

Context: Pancreatic pseudocysts located in the mediastinum are rare. Symptomatic mediastinal pseudocysts can present with dysphagia, dyspnea, airway obstruction and/or cardiac tamponade. Generally, the standard approaches are surgery and external drainage.

Results of gastroscope bacterial decontamination by enzymatic detergent compared to chlorhexidine.

Aim: To compare the efficacy of enzymatic detergent with chlorhexidine for gastroscope bacterial decontamination.

Methods: A prospective randomized controlled study was undertaken to evaluate the ability of these 2 agents to achieve high level disinfection in a gastroscope. A total of 260 samples were collected from 5 different gastroscopes.

Clinical characteristics of inflammatory bowel disease in Thailand: a 16 years review.

Objective: Inflammatory bowel disease is an uncommon gastrointestinal problem in Asia. Recently, there have been many reports from Japan and India demonstrating a higher incidence of this disease entity in this region. To date, there has been only one report from Thailand regarding clinical manifestation of ulcerative colitis.

Bleeding gastric varices: results of endoscopic injection with cyanoacrylate at King Chulalongkorn Memorial Hospital.

Aim: To evaluate the efficacy and safety of gastric varices injection with cyanoacrylate in patients with gastric variceal bleeding.

Methods: Twenty-four patients (15 males, 9 females) with gastric variceal bleeding underwent endoscopic treatment with cyanoacrylate injection. Successful hemostasis, rebleeding rate, and complications were retrospectively reviewed.

Result of wireless capsule endoscopy in patients with suspected small bowel disease: the first series from Thailand.

Background And Aims: Capsule endoscopy (CE) is a promising diagnostic tool for patients with obscure gastrointestinal bleeding. Only a few papers have reported data from Asian countries. This retrospective study aimed to demonstrate result of capsule endoscopy in patients with suspected small bowel disease as the first series from Thailand.

Experience on endoscopic retrograde cholangiopancreatography at tertiary referral center in Thailand: risks and complications.

Background: Several complications from ERCP have been described, including pancreatitis, hemorrhage, perforation, and cholangitis. The actual incidences and risk factors in Thailand have never been analyzed.

Material And Method: The authors retrospectively reviewed the outcome of ERCP at Chulalongkorn University Hospital between September 2000 and December 2002.

Result of endoscopic biliary drainage in hilar cholangiocarcinoma.

Patients with hilar obstruction usually require bilateral biliary drainage. The prognosis of patients who fail bilateral biliary drainage after contrast injection into both intrahepatic ducts is poor due to a high infection rate in the undrained segments. The incidence of post-endoscopic retrograde cholangiopancreatography cholangitis in those with successful bilateral biliary drainage was less, but still significant.

Results of emergency gastroscopy for acute upper gastrointestinal bleeding outside official hours at King Chulalongkorn Memorial Hospital.

This study was to evaluate the epidemiological characteristics, etiology and therapeutic outcome of active upper gastrointestinal bleeding in patients who underwent emergency gastroscopy outside official hours at the Gastroenterology Unit, King Chulalongkorn Memorial Hospital. From January to December 2002, 103 emergency gastroscopies were performed in 99 patients. There were 66 men and 33 women (mean age 55.

Clinical indications of patients with colorectal neoplasm who underwent colonoscopy at King Chulalongkorn Memorial Hospital (presentations of colorectal neoplasm from colonoscopy database).

Even though colorectal cancer in Thailand is not the number one leading cause of death, the incidence of this malignancy is not ignorable. Unfortunately, the majority of patients are diagnosed at a very late stage because of no screening protocol for a high risk group. The authors retrospectively reviewed clinical presentations of patients with colorectal neoplasm who underwent colonoscopy at King Chulalongkorn Memorial Hospital during the two-year period from September 2000 to December 2002.

Result of orthotopic liver transplantation at King Chulalongkorn Memorial Hospital: the first series from Thailand.

Liver transplantation is one of the best treatments for advanced liver disease since it can prolong the patient's survival. In Thailand, the first liver transplantation was performed in 1987 at King Chulalongkorn Memorial Hospital. Up till now the authors have transplanted the most in Thailand, having done more than 30 cases.

Microbiology of bile in patients with cholangitis or cholestasis with and without plastic biliary endoprosthesis.

Background: Cholangitis is a frequent complication of biliary stents. Empiric antibiotic selection is primarily based on bile cultures obtained from patients undergoing surgery and few data are available with respect to ERCP and biliary stents. This study analyzed the microbiology of bile and the antibiotic sensitivities of the organisms identified in patients presenting with clinical cholangitis or cholestasis.

A retrospective study of colorectal cancer patients in King Chulalongkorn Memorial Hospital.

To determine the basic clinical information of colorectal cancer in Thailand, the authors retrospectively reviewed the medical records and pathological reports of 293 patients with histologically proven colonic cancer but only 137 patients met the inclusion criteria in King Chulalongkorn Memorial Hospital during the three-year period from July 1997 to June 2000. There were 72 males (53%) and 65 females (47%) with an age ranging from 24 to 90 years (mean age 61.2 years).