Clnical and endoscopic manifestations of gastro-duodenal injuries in 178 patients caused by nonsteroidal anti-inflammatory drugs (NSAID) were compared with these of 84 patients without treatment of NSAID. We concluded that abnomal rate in gastro-duodenal endoscopy is 86.0 % in the group treated by NSAID. Gastric injury rate is 80.9 %, including 22.5% of gastric ulcer (p<0.01). Duodenal injury rate is 29.2 %. including 22.5% of duodenal ulcer (p<0.01). Clinical features: epigastric pain rate is 42.7%; abdominal distention is 11.8%. These symploms are useful in predicting gastrointestinal injuries. These lesions more likely severe if the patient have following factors: above 60 years old; alcoholism, smosking, using NSAIDs for long time, using high dose of the NSAIDs. There is not relation between endoscopic manifestations, type of rheumatic disease and HP infections.
Anti-Inflammatory Agents, Peptic Ulcer

The auther had utilized the continuous irrigation with saline and antibiotics to 1 case of serpent corneal ulcer and 2 cases alkaline burn by Lippas' original technique. Two cases of alkaline burn were healed up without any complications and one case of serpent corneal ulcer showed relatively good result. According to review through a few literature, the method of continuous irrigation is much better one than any other systemic or local administration of the drug to the particular external ocular disease.
Anti-Bacterial Agents ; Burns* ; Corneal Ulcer*

PURPOSE: Diabetic foot infection is one of the most common and severe complications of diabetes mellitus that delays healing of the wound. Deep tissue biopsy is considered to be the gold standard method for antibiotic selection in treating infected chronic diabetic ulcers. However, swab culture or superficial tissue biopsy is often performed for a microbiologic test since deep tissue biopsy has limitations in application. The purpose of this study is to find out whether microbiologic results of swab culture or superficial tissue biopsy could be used for selection of antibiotics in treating diabetic ulcers. METHODS: This study involved 42 patients with diabetic foot ulcers with negative results in bone probing test. Tissue samples for microbiologic tests were collected from all the patients by using superficial cotton swab, superficial tissue, and deep tissue. The microbiologic results of deep tissue biopsy were compared with swab culture and superficial tissue biopsy statistically. RESULTS: Microbiology of the deep tissue showed the same results with those of the swab culture and superficial tissue in 67% and 71%, respectively. Statistical analysis demonstrated that the microbiology of the swab culture and superficial tissue does not coincide with that of the deep tissue. CONCLUSION: These results suggest that the microbiology of the swab culture and superficial tissue is not concordant with that of the deep tissue in infected chronic diabetic ulcers. To select appropriate antibiotic regimen, the specimen for the microbiologic test should be obtained from deep tissue.
Anti-Bacterial Agents ; Biopsy ; Diabetes Complications ; Diabetic Foot ; Humans ; Ulcer

No abstract availble
Anti-Ulcer Agents/therapeutic use ; Gastroesophageal Reflux/*drug therapy ; Humans

We report a case of trichilemmal carcinoma in a 82-year-old man who presented an ulcerative tumor. Initially, a crusted mass was observed on the scalp and with subsequent removal of the crust, purulent and ulcerative lesion was seen. After treatment with sensitive antibiotics for 8 days, purulent discharge was markedly decreased in the lesion. Histopathologic findings showed clear cells tumor with trichilemmal keratinization. The tumor cells stained positive to PAS, sensitive to diastase and showed negative findings to CEA, EMA and S-100.
Aged, 80 and over ; Amylases ; Anti-Bacterial Agents ; Humans ; Scalp ; Ulcer*

Before the discovery of H. pylori, the therapy of peptic ulcer disease(PUD) was focused on the acid secretion. Although acid secretion is still important in the pathogenesis of PUD, eradication of H. pylori and therapy/prevention of NSAIDinduced disease is the mainstay of therapy these days. Multiple drugs have been evaluated in the therapy of H. pylori. No single agent is effective in eradicating the organism. Combination therapy for 10 to 14 days provides the greatest efficacy. The combination of two antibiotics among amoxicillin, metronidazole and clarithromycin plus either a PPI or bismuth compound(RBC: ranitidine bismuth citrate) has comparable success rates. Medical intervention for NSAIDrelated mucosal injury includes treatment of an active ulcer and prevention of future injury. Ideally the injurious agent should be stopped as the first step in the therapy of an active NSAIDinduced ulcer. If that is possible, then treatment with one of the acid inhibitory agents (H2 blockers, PPIs) is indicated. Cessation of NSAIDs is not always possible because of the patient's severe underlying disease. Only PPIs can heal GUs or DUs, independent of whether NSAIDs are discontinued. Prevention of NSAIDinduced ulceration can be accomplished by misoprostol (200 microgram qid) or a PPI. The use of COX2 specific inhibitor may also reduce injury to gastric mucosa. H. pylorinegative idiopathic peptic ulcer disease appears to be increasing. Antisecretory drugs remain the mainstay of treatment for promoting healing of idiopathic peptic ulceration. However, in the absence of H. pylori infection, antisecretory drugs are less effective in inhibiting gastric acidity. Managment of idiopathic PUD needs to be further de-fined and will require new clinical studies.
Amoxicillin ; Anti-Bacterial Agents ; Anti-Inflammatory Agents, Non-Steroidal ; Bismuth ; Clarithromycin ; Duodenal Ulcer ; Gastric Acid ; Gastric Mucosa ; Helicobacter pylori ; Metronidazole ; Misoprostol ; Peptic Ulcer* ; Ranitidine ; Stomach Ulcer ; Ulcer

BACKGROUND: The proportion of the aged (>60 years old) population is increasing in South Korea and it is expected to reach 30.8% in 2030. The aim of this study was to analyze the clinical characteristics of peptic ulcer disease in the aged population in South Korea. METHODS: A total of 134 patients (89 men and 45 woman) with peptic ulcers were investigated. The ulcers were diagnosed using esophagogastroduodenoscopy. The main symptom, the duration of the symptoms, the location of the ulcer, the presence of Helicobacter pylori as well as the history of Anti-Inflammatory Agents, Non-Steroidal (NSAID) use were analyzed. The parameters between the two age groups: under 60 years (n=73) and over 60 years (n=61), were compared. RESULTS: In the aged, the frequency of a Helicobacter pylori infection was lower. In a gastric ulcer (GU) in aged patients, the rate of Helicobacter pylori infection was less common than in younger GU patients. In aged duodenal ulcer (DU) patients, the rate of a Helicobacter pylori infection was similar to that of younger DU patients. Bleeding peptic ulcers were more common in NSAID-users than in nonusers. DU was less common in the aged group (29.5% vs. 47.9%, p=0.030) and the incidence of typical epigastric pain in the aged and young groups were similar (33.3% vs. 40.0%, p=0.439). The frequency of ulcer bleeding was not different (22.8% vs. 17.1%, p=0.425) between aged and young groups. However in the aged group, the NSAID users experienced more frequent ulcer bleeding than nonusers. The Helicobacter pylori (+) NSAID users are believed to have a higher tendency to bleed than the Helicobacter pylori (-) NSAID users but without statistical significance. Among the aged, 40% of the NSAID-nonusing peptic ulcer patients was Helicobacter pylori (-). The duration of symptoms was shorter in the aged. An atypical location of the aged and younger groups was similar (13.2% vs. 7.0%, p=0.352). CONCLUSION: In the aged gastric ulcer patients, factors other than NSAID and Helicobacter pylori are believed to play roles in the development of gastric uclers. However, in the aged duodenal ulcer patients, the role of Helicobacter pylori in the development of a duodenal ulcer was similar to that in the younger group. NSAID is believed to be an important risk factor in the bleeding of ulcers in aged patients. In addition, the Helicobacter pylori (+) NSAID users had more frequent bleeding than the Helicobacter pylori (-) NSAID users but without statistical significance.
Anti-Inflammatory Agents ; Anti-Inflammatory Agents, Non-Steroidal ; Duodenal Ulcer ; Endoscopy, Digestive System ; Helicobacter pylori ; Hemorrhage ; Humans ; Incidence ; Korea* ; Male ; Morinda ; Peptic Ulcer* ; Risk Factors ; Stomach Ulcer ; Ulcer

Helicobacter pylori (H. pylori) infection and non-steroidal anti-inflammatory drugs (NSAIDs) are well-established causes of gastrointestinal mucosal damage, such as uncomplicated and complicated peptic ulcer diseases. Many epidemiologic studies suggest that H. pylori infection increases the risk of developing peptic ulcer complications among non-aspirin NSAID consumers. According to data from randomized clinical trials, H. pylori eradication may prevent NSAID-induced ulcers in non-aspirin NSAID-naive patients and long-term aspirin consumers with a history of ulcer complications. H. pylori eradication by itself is insufficient to prevent NSAID-induced peptic ulcers and complications among low-risk NSAID consumers. In patients receiving long-term non-aspirin NSAIDs with a history of ulcer complications, proton pump inhibitor is more effective in preventing ulcer recurrence and bleeding.
Anti-Inflammatory Agents ; Anti-Inflammatory Agents, Non-Steroidal ; Aspirin ; Helicobacter ; Helicobacter pylori ; Humans ; Peptic Ulcer ; Proton Pumps ; Recurrence ; Ulcer

It is difficult to know whether the presence of infection in the plantar ulcer in patients with leprosy or not. Because routine bacteriology is often unhelpful, we need to investigate diagnostic method in this situation. C-reactive protein(CRF) levels have been known to be useful in detecting infection in some diseases. In this study, CRP levels were measured in 20 leprosy patients with plantar ulceration and 14 patients with leprosy alone. The results were as follows : 1. There was no elevation of CRP levels in patients with leprosy alone, and in the majority of patients with ulcers. 2. Of 20 patients with plantar ulcers, four had raised CRP levels one had clinically obvious infection, and three had erythematous skin of uncertain cause surrounding their ulcers. 3. Treatment with an appropriate antibiotics reduced CRP levels to normal, which was associated with clinical improvement. Therefore, it is suggested that increased CRP levels can be a useful probe for detecting significant bacterial infection in plantar ulcers of leprosy patients.
Anti-Bacterial Agents ; Bacterial Infections ; Bacteriology ; Foot Ulcer ; Humans ; Leprosy* ; Skin ; Ulcer*

We experienced a case of chronic keratitis with corneal ulcer and conjunctival injection while wearing contact lens. In spite of broad-spectrum antibiotics therapy, corneal lesion was not improved, and bacterial smear and culture were negative. Specimens from corneal scraping were examined with Giemsa-Wright stain and H and E(Hematoxylin-Eosin) stain. We could find double walled acanthamoebic cysts. The specimens were cultured on 1.5% non-nutrient agar with E, coli suspension, and aeanthamoebic cysts and trophozoites were found with H and E stain. Aeanthamoebic cysts and trophozoites were cultured from the specimens of ulcered cornea. So we report this case.
Acanthamoeba Keratitis* ; Acanthamoeba* ; Agar ; Anti-Bacterial Agents ; Cornea ; Corneal Ulcer ; Keratitis ; Trophozoites ; Ulcer