BACKGROUND: Helicobacter pylori(H. pylori) has been implicated in the pathogenesis of chronic active gastritis and peptic ulcer disease. All patients with ulcers who are infected with H. pylori receive antimicrobial therapy. Therefore diagnosis of H. pylori infection is imperative for the treatment gastritis or ulcer patients. We evaluated the four diagnostic methods and three culture media for the isolation of H. pylori. MATERIALS AND METHODS: Rapid urease test(CLO test), modified Gram stain, culture, and nested polymerase chain reaction (PCR) were performed with 108 gastroscopic biopsy specimens from patients with peptic ulcer or chronic gastritis. Among them 40 specimens were inoculated onto each of 5% sheep blood agar, e99 Yolk emulsion (EYE) agar, and 7% horse blood agar containing antibiotics. RESULTS: The positive rates were the highest by the PCR(72%), 67% by modified Gram stain, 64% by CLO test, and 57% by culture. Among the three media the horse blood agar (selective medial) gave the highest isolation rate (48%), followed by sheep blood agar (45%), and EYE agar (38%). CONCLUSION: Though PCR was the most sensitive method for the detection H. pylori modified Gram stain was sensitive enough, simple, rapid, and economical as the routine diagnostic method of H. pylori. For the culture of H. pylori combination of sheep blood agar as nonselective media and horse blood agar as selective media would show the highest isolation rate.
Agar ; Anti-Bacterial Agents ; Biopsy* ; Culture Media* ; Diagnosis ; Gastritis ; Helicobacter pylori* ; Helicobacter* ; Horses ; Humans ; Peptic Ulcer ; Polymerase Chain Reaction ; Sheep ; Ulcer ; Urease

PURPOSE: This study was to determine the effects of a combined exercise program and telephone counseling in obese middle-aged women. The study also attempted to measure the effects of the program on physiological functions, self-efficacy and depression. METHOD: This research employed a nonequivalent control group pretest-posttest design. The experimental group consisted of 29 obese middle-aged women, and the control group of 30 women. The subjects in the experimental group participated in a combined exercises program and telephone counseling for 12 weeks. RESULTS: After performing the program for 12 weeks, BMI (p=.000), percent body fat (p<.007), TC (p=.026), TG (p=.035) and depression (p=.012) in the experimental group decreased significantly compared with the control group. Self-efficacy (p=.000) in the experimental group increased significantly compared with the control group after the program. CONCLUSION: From these findings, it was confirmed that a combined exercises program and telephone counseling for obese middle-aged women can increase self-efficacy and decrease BMI, percent body fat, total cholesterol, triglyceride and depression. Therefore, this program can be utilized for various population groups including women, and further researches are required on programs for men.
Adipose Tissue ; Cholesterol ; Counseling* ; Depression* ; Exercise ; Female ; Humans ; Male ; Middle Aged ; Population Groups ; Telephone* ; Triglycerides

PURPOSE: In order to evaluate microstructural changes after shock wave exposure, gross, light microscopic and transmission electron microscopic findings were analyzed with rabbit gallgladders. MATERIALS AND METHODS: A preliminary study(2 rabbits) was performed to determine the dosage intensity of shock waves needed to inflict damage, using a EDAP LT 01 piezoelectric extracorporeal shock wave Iothotriptor. The gallbladders of three different groups of rabbits were given shock waves of various intensity. A storage value of 100, 50, 25 at rate of 20/sec under 80% power were given to group I (4 rabbits), group II( 4 rabbits), and group III(3 tabits), respectively. The rabbits were sacrified 6--12 hours later. RESULTS: The observed pathologic changes in the transmission electron microscopy were vaculization of cytoplasm and swelling of epithelial cells with dilatation and structural alteration of intracellular organelles, especially endoplasmic reticulum. Cell membrane rupture and necrosis were observed at the markedly affected area. The structural changes of intracellular organelles were minimally found at a storage value of 25. However, above pathologeic changes with dilatation and structural alterations of endoplasmic reticulums were more profund at value of 100. CONCLUSION: Early histologic changes induced by shock waves are dose dependent and the findings of cellular damage caused by ESWL might be explained as above.
Cell Membrane ; Cytoplasm ; Dilatation ; Endoplasmic Reticulum ; Epithelial Cells ; Gallbladder* ; Microscopy, Electron, Transmission ; Necrosis ; Organelles ; Rabbits ; Rupture ; Shock*

BACKGROUND: Vibrio vulnificus sepsis is one of the notifiable disease(Class 3) in Korea. It is usually acquired through the consumption of raw or undercooked seafood in summer. We studied the clinical findings of V. vulnificus septicemia and the genomic patterns of V. vulnificus isolates. METHODS: Seven patients with V. vulnificus septicemia were admitted to Hanyang University hospital from 1998 to 2002. We analysed the clinical findings and the genomic patterns by infrequent restriction site-polymerase chain reaction(IRS-PCR). RESULTS: All patients were over forty years old, and five were male. The patients had underlying diseases;five with liver cirrhosis, two with DM, and four patients with heavy alcoholism. Five of seven patients had history of ingesting raw fish and four had tissue necrosis with bullae or vesicles in their extremities. Four patients who died showed disseminated intravascular coagulation symptoms. We applied IRS-PCR to 6 isolates from blood and 2 isolates from wound. The six isolates from blood showed various genomic patterns that were all different from one another, while the two isolates from wound showed IRS-PCR patterns that were identical to the blood isolates of the same patients. CONCLUSIONS: The genomic patterns of IRS-PCR are quite different in 6 cases of V. vulnificus isolates in Korea.
Alcoholism ; Disseminated Intravascular Coagulation ; Extremities ; Humans ; Korea ; Liver Cirrhosis ; Male ; Necrosis ; Seafood ; Sepsis ; Vibrio vulnificus* ; Vibrio* ; Wounds and Injuries

OBJECTIVE: To Compare the conventional Pap smear with the Liquid Pap smear in screening of cervical cancer and to evaluate the correspondence of their biopsy results. METHODS: From August 1, 2003 to July 31, 2005, the conventional Pap smears and the Liquid Pap smears were performed in 12,757 and 6,870 women, respectively. The results of 252 conventional Pap smear and 227 Liquid Pap smear were confirmed by colposcopic biopsy and evaluated for sensitivity, specificity, positive predictability, negative predictability and false negativity. RESULTS: In Liquid Pap smear, there were higher proportions of ASCUS, LSIL, HSIL and CIS. And the ratio of ASCUS/LSIL were 3.32 and 3.04 in conventional Pap smear and Liquid Pap smear respectively. The conventional Pap smear showed sensitivity 71.8%, specificity 93.9%, positive predictability 82.3%, negative predictability 89.4%, and false negativity 28.2%, while the Liquid Pap smear showed higher sensitivity (72.6%), specificity (96.1%), and positive predictability (89.8%), and lower negative predictability (88.0%), and false negativity (27.4%). The positive predictability was significantly higher (95% C.I.: 1.3-13.7). CONCLUSION: The positive predictability was significantly improved in the Liquid Pap smear. Therefore, the Liquid Pap smear is a more useful method in screening of cervical cancer.
Biopsy ; Female ; Humans ; Mass Screening ; Sensitivity and Specificity ; Uterine Cervical Neoplasms

BACKGROUND: The emergence of metronidazole (MTZ) resistance among Helicobacter pylori (H. pylori) isolates has compromised the efficacy of the triple therapy. Therefore, special attention should be given toward reliable methods for determining the in vitro susceptibility. But susceptibility testing of H. pylori is not yet either standardized or routinely performed. The purpose of this study was to establish more reliable, but simple to perform and cost-effective antimicrobial susceptibility testing method. METHODS: With 135 clinical isolates of H. pylori, antimicrobial susceptibility tests for MTZ and clarithromycin (CLR) were performed by antibiotic gradient method (E test, AB BIODISK, Sweden) and disk diffusion method (disk method), and the results were compared with the reference modified broth microdilution method (broth method). RESULTS: Resistant rates of Korean isolates of H. pylori for MTZ and CLR were 46.2% and 2.2%, respectively. There was 100% agreements between the E test, disk method and the broth method for CLR. For MTZ, however, agreements between the results obtained by the three methods were variable. Between the E test and broth method, the agreements were 85.1% in terms of susceptibility categories, 80.5% between the disk and broth method, and 93.1% between the E test and disk method. CONCLUSIONS: Routine susceptibility testing of H. pylori to MTZ seems to be required in Korea. The broth method is recommended for MTZ until more accurate, simple and practical alternative method become available. For the CLR, the disk method is recommended, because it is reliable, simple, and economical.
Clarithromycin ; Diffusion* ; Helicobacter pylori* ; Helicobacter* ; Korea ; Metronidazole

Among 12 clarithromycin-resistant Helicobacter pylori strains isolated in Guri, Korea, 8 showed an adenine to guanine mutation at position 2143 (formerly A2144G or E. coli 2059) in the 23S rRNA gene by the PCR-restriction fragment length polymorphism (RFLP) method. The remaining 4 strains, digested by neither BsaI nor BbsI, showed a thymine to cytosine mutation at position 2182 (T2182C) by direct sequencing of the PCR products. The T2182C mutants showed a tendency of higher levels of minimum inhibitory concentration to clarithromycin than the A2143G mutants. In conclusion, either the A2143G or the T2182C mutation was present in 100% of clarithromycin-resistant H. pylori isolates examined. The PCR-RFLP technique with restriction enzymes BbsI and BsaI was a rapid and relatively simple method to detect the clarithromycin resistance. But undigested isolates were quite frequent among our isolates (33.3%), the PCR-RFLP method with restriction enzymes BbsI and BsaI should not be used alone, and development of other rapid detection method for clarithromycin resistance is mandatory.
Amino Acid Sequence ; Anti-Bacterial Agents/*pharmacology ; Base Sequence ; Clarithromycin/*pharmacology ; DNA, Bacterial/genetics ; Drug Resistance, Bacterial/genetics ; *Genes, Bacterial ; Helicobacter Infections/drug therapy/microbiology ; Helicobacter pylori/*drug effects/*genetics ; Humans ; Korea ; Molecular Sequence Data ; Mutation ; RNA, Bacterial/genetics ; RNA, Ribosomal, 23S/genetics ; Sequence Homology, Nucleic Acid

BACKGROUND: A forceps-biopsy is performed to acquire tissue from patients with an endobronchial carcinoma using a flexible bronchoscope. Recently, a cryo-biopsy has also been used to acquire tissue samples. Cryo-biopsy is the diagnostic application of extreme cold for the local destruction of abnormal living tissue. This technique is safe, with no radiation danger, no risk of electrical accidents, and a little risk of bleeding. This study compared a forceps-biopsy with a cryo-biopsy using a flexible bronchoscope, and examined the chemosensitivity and level of VEGF (vascular endothelial growth factor) in the specimens obtained from the cryo-biopsy. METHODS: We present a prospective study of 30 consecutive patients who underwent a forceps-biopsy between January 2007 and October 2007 with a mean age of 62.1 years and a male:female ratio of 5 : 1. A flexible bronchoscope was inserted to the area of the abnormal lesions, and a cryo-probe was then applied through the working channel of the flexible bronchoscope. A temperature of approximately -80 was delivered to the tumor site for 8 seconds. The cryo-biopsy was performed after destroying the tumor mass. RESULTS: The mean size of the tissue from the forceps-biopsy and cryo-biopsy were 2.0+/-1.2 mm and 6.0+/-3.0 mm. A chemosensitivity test was performed on 5 specimens obtained using cryo-biopsy and the level of VEGF was examined in 2 specimens obtained from a cryo-biopsy. There were no side effects in either group. CONCLUSION: Cryo-biopsy using a flexible bronchoscope is a safe and effective technique for acquiring tissue samples.
Bronchoscopes ; Bronchoscopy ; Extreme Cold ; Hemorrhage ; Humans ; Prospective Studies ; Vascular Endothelial Growth Factor A

OBJECTIVE: To investigate the correlation between pre-morbid personality and depression scales in patients with stroke. METHOD: The subjects of this study included 45 patients with stroke and their caregivers. We conducted an interview of patients with Beck Depression Inventory (BDI) and also evaluated general characteristic (age, sex, location of lesion, cause of stroke, duration of illness, educational background, history of medication for depression) and functional level. Caregivers were evaluated with Hamilton Rating Scale for Depression (HRSD) for depressive mood, with NEO-PI (Neuroticism, Extraversion and Openness Personality Inventory) for pre-morbid personality. The results of each questionnaire were analyzed in order to investigate their correlation. The results were statistically analyzed with independent t-test, ANOVA, and Pearson correlation test. RESULTS: The HRSD score of the caregivers had a significant correlation with the BDI score (p=0.001) of the patients. The BDI score correlated with Neuroticism (p=0.021) and the HRSD score also correlated with Neuroticism (p=0.015). There were no statistical correlation of depression with sex, age, case of stroke, location of lesion, duration of illness and functional level. CONCLUSION: Among pre-morbid personalities, neuroticism of NEO-PI is the only factor which is significantly correlated with depression scales in stroke patients. Evaluating pre-morbid personality can be helpful in predicting the depressive mood in stroke patients, so we may have early intervention for it.
Anxiety Disorders ; Caregivers ; Depression ; Early Intervention (Education) ; Extraversion (Psychology) ; Humans ; Stroke ; Weights and Measures

Acardia is a very rare congenital anomaly occurring in less than 1 in 35,000 deliveries. Acardiac parabiotic twin has been reported only in multiple, monochronic pregnancies. This anomalous fetus is sustained in utero by parasitic anastomoses to the circulation of its usually normal co-twin and is therefore not compatible with extrauterine survival. A case of an acardiac parabiotic twin is described, and the literature concerning the incidence, classification and etiology of acardiac is reviewed.
Classification ; Fetus ; Humans ; Incidence ; Pregnancy