BACKGROUND/AIMS: Eradication of Helicobacter pylori is a main treatment of peptic ulcer disease. A triple therapy comprised of a proton pump inhibitor, clarithromycin, and amoxicillin is the most commonly used treatment for H. pylori eradication. The eradication of H. pylori infection requires combination of antibiotics. However, development of antibiotic resistance is a major cause of treatment failure. MATERIALS AND METHODS: This study was to observe H. pyrori eradication rate change for 10 years. From August 2005 to June 2014, a total of 4,891 patients with H. pylori infection were treated with standard H. pylori triple eradication therapy (proton pump inhibitor, amoxicillin, clarithromycin) and were analyzed by urea breath test. RESULTS: The overall rates of eradication with standard triple therapy was 82.8% (4,048/4,891). H. pylori eradication rates decreased from 92.2% in 2005 to 80.2% in 2014 (P=0.037). CONCLUSIONS: This study shows that the overall rate of H. pylori eradication with standard triple therapy decreased meaningfully for 10 years.
Amoxicillin ; Anti-Bacterial Agents ; Breath Tests ; Clarithromycin ; Drug Resistance, Microbial ; Helicobacter pylori* ; Humans ; Peptic Ulcer ; Proton Pumps ; Retrospective Studies* ; Treatment Failure ; Urea

Background: Previous studies showed that the prognosis for severe trauma patients is better after transport to trauma centers compared to non-trauma centers. However, the benefit from transport to trauma centers may differ according to age group. The aim of this study was to compare the effects of transport to trauma centers on survival outcomes in different age groups among severe trauma patients in Korea. Methods: Cross-sectional study using Korean national emergency medical service (EMS) based severe trauma registry in 2018–2019 was conducted. EMS-treated trauma patients whose injury severity score was above or equal to 16, and who were not out-of-hospital cardiac arrest or death on arrival were included. Patients were classified into 3 groups:pediatrics (age < 19), working age (age 19–65), and elderly (age > 65). The primary outcome was in-hospital mortality. Multivariable logistic regression analysis was conducted to evaluate the effect of trauma center transport on outcome after adjusting of age, sex, comorbidity, mechanism of injury, Revised Trauma Score, and Injury Severity Score. All analysis was stratified according to the age group, and subgroup analysis for traumatic brain injury was also conducted. Results: Overall, total of 10,511 patients were included in the study, and the number of patients in each age group were 488 in pediatrics, 6,812 in working age, and 3,211 in elderly, respectively. The adjusted odds ratio (95% confidence interval [CI]) of trauma center transport on in-hospital mortality from were 0.76 (95% CI, 0.43–1.32) in pediatrics, 0.78 (95% CI, 0.68–0.90) in working age, 0.71(95% CI, 0.60–0.85) in elderly, respectively. In subgroup analysis of traumatic brain injury, the benefit from trauma center transport was observed only in elderly group. Conclusion We found out trauma centers showed better clinical outcomes for adult and elderly groups, excluding the pediatric group than non-trauma centers. Further research is warranted to evaluate and develop the response system for pediatric severe trauma patients in Korea.

Sclerosing peritonitis is an uncommon complication of continuous ambulatory peritoneal dialysis (CAPD) and can lead to small bowel dysfunction involving abdominal pain, progressive loss of ultrafiltration, and small intestinal obstruction. Peritoneal thickening, in which calcification can develop, often starts as a small plaque which gradually becomes larger. We report a case of CAPD-related calcifying peritonitis.
Abdominal Pain ; Intestinal Obstruction ; Peritoneal Dialysis, Continuous Ambulatory ; Peritonitis* ; Ultrafiltration

OBJECTIVES: The purpose of this study was to investigate the relationship between restricted activity due to oral diseases and oral health behaviors among adolescents. METHODS: A cross-sectional study design was used. The subjects were 238 middle school students and 231 high school students; a total of 469 students from 15 different schools located in 7 regions of Bucheon in Gyeonggi Province, Daejeon, and others. The adolescents who participated in the survey were chosen by convenience sampling. The association between restricted activities due to oral diseases and oral health behaviors was analyzed using multiple logistic regression analysis. RESULTS: The annual experience rate of oral diseases stood at 1.4 percent, while the number of days absent and early departures from school was 0.15 days per student. The rate of middle school students who were disturbed by oral disease with respect to sleep, eating, speaking, and/or schoolwork was 33.1 percent. In high school students, it was 40.6 percent. Dental pain and gingival bleeding were identified as major factors to the restriction of activities, and being disturbed while eating was related to cariogenic beverages. CONCLUSIONS: It would be of great social interest to support and promote oral health programs among adolescents. Therefore, a national survey of the status of activity restrictions due to oral diseases in adolescents should be implemented in order to make specific future plans.
Adolescent ; Cross-Sectional Studies ; Eating ; Hemorrhage ; Humans ; Logistic Models ; Oral Health

Few studies have assessed the neural mechanisms of the effects of emotion on cognition in generalized anxiety disorder (GAD) patients. In this functional MRI (fMRI), we investigated the effects of emotional interference on working memory (WM) maintenance in GAD patients. Fifteen patients with GAD participated in this study. Event-related fMRI data were obtained while the participants performed a WM task (face recognition) with neutral and anxiety-provoking distracters. The GAD patients showed impaired performance in WM task during emotional distracters and showed greater activation on brain regions such as DLPFC, VLPFC, amygdala, hippocampus which are responsible for the active maintenance of goal relevant information in WM and emotional processing. Although our results are not conclusive, our finding cautiously suggests the cognitive-affective interaction in GAD patients which shown interfering effect of emotional distracters on WM maintenance.
Amygdala ; Anxiety Disorders* ; Anxiety* ; Brain* ; Cognition ; Hippocampus ; Humans ; Magnetic Resonance Imaging ; Memory, Short-Term*

PURPOSE: The author tried to compare the therapeutic effectiveness of urokinase instillation via PCD catheter with other conventional therapeutic modalities such as thoracentesis, closed thoracostomy and percutaneou scatheter drainage in the management of patients with early and late stage II empyema. MATERIALS AND METHODS: Twenty seven of early and 19 of late stage II empyema patients were reviewed. We compared each results of the treatments including the average hospitalization day, success rate, and interval between first procedure and 75% improvement on simple chest film. RESULTS: The average hospitalization day and improvement interval of stage II empyema patients, who were treated with urokinase instillation via PCD catheter, were shortest of all. In earlystage II, they were 11.8 and 8.5 days, and 16.7 and 9.4 days in late stage II patients. In each patient with early and late stage II empyema, they were 17.2, 11.5 days and 24.3, 16.2 days with thoracentesis, 48.0, 32.3 days and 37.7, 24.0 days with closed thoracostomy, 35.2, 17.2 days and 34.8, 20.0 days with percutaneous cathter drainage. All patients treated with intracavitary urokinase showed complete drainage of empyema. CONCLUSION: Intracavitary urokinase facilitates percutaneous catheter drainage of empyema, with resultant reduction of hospitalization days. Also this method has high success rate.
Catheters ; Drainage ; Empyema* ; Hospitalization ; Humans ; Thoracostomy ; Thorax ; Urokinase-Type Plasminogen Activator*

Purpose: Patients who undergo radical surgery for rectal cancer often experience low anterior resection syndrome (LARS). Symptoms of this syndrome include frequent bowel movements, gas incontinence, fecal incontinence, fragmentation, and urgency. The aim of this study was to investigate the convergent validity, discriminative validity, and reliability of the Korean version of the LARS score questionnaire. Methods: The English LARS score questionnaire was translated into Korean using the forward-and-back translation method. A total of 146 patients who underwent radical surgery for rectal cancer answered the Korean version of the LARS score questionnaire including an anchor question assessing the impact of bowel function. Participants answered the questionnaire once more after 2 weeks. Results: The Korean LARS score questionnaire showed high convergent validity in terms of high correlation between the LARS score and quality of life (perfect fit 55.5% vs. moderate fit 37.6% vs. no fit 6.8%, respectively; P < 0.001). The LARS score also showed good discriminative validity between groups of patients differing by sex (29 for males vs. 25 for females; P = 0.014), tumor level (29 for ≤8 cm vs. 24 for >8 cm; P = 0.021), and radiotherapy (32 for yes vs. 24 for no; P = 0.001). The LARS score also demonstrated high reliability at test-retest with no difference between scores at the first and second tests (intraclass correlation coefficient: Q1 = 0.932; Q2 = 0.909, Q3 = 0.944, Q4 = 0.931, and Q5 = 0.942; P < 0.001, respectively). Conclusion The Korean version of the LARS score questionnaire has proven to be a valid and reliable tool for measuring LARS in Korean patients with rectal cancer.

BACKGROUND: The donor selection criteria should ensure the safety of both the donors and the recipients of blood products. However, modifications may help promote more blood donors in keeping with the rapidly aging Korean population. Our goal was to gather opinions of the medical staff at blood centers on the current donor selection criteria. METHODS: A survey was sent out via email to 55 medical staff at hospital blood banks, the Korean Red Cross and Hanmaeum blood centers. The survey included 14~16 questions regarding age, weight, donation volume, donation interval and frequency, hemoglobin, blood pressure, pulse rate, and the level of alanine aminotransferase (ALT). RESULTS: Survey responses from 38 out of 55 (69.1%) medical staff were analyzed. The donor selection criteria that showed significantly higher acceptable rates included the upper age limit (71%, P=0.009) and whole blood donation frequency and intervals (68%, P=0.023). The ALT level showed the highest unacceptable rate (84%, P<0.0001) and other criteria with significantly higher unacceptable rates included donor weight (68%, P=0.023) and donation volume (76%, P=0.001). Responses from medical staff at supply blood banks and hospital blood banks showed a significant difference regarding the use of parent/guardian consent forms in blood donors that were 16 years or younger (75% versus 41%, respectively; P=0.0368). CONCLUSION: This study outlines the perspectives of medical staff at blood centers regarding the current donor selection criteria. According to the survey, the ALT level, donor weight, and donation volume should be considered for revision. These results can be referenced in the future when proposing modifications to the donor selection criteria.
Aging ; Alanine Transaminase ; Blood Banks ; Blood Donors ; Blood Pressure ; Consent Forms ; Dietary Sucrose ; Donor Selection ; Electronic Mail ; Heart Rate ; Hemoglobins ; Humans ; Medical Staff ; Red Cross ; Tissue Donors

BACKGROUND: There has not been a comprehensive review to compare the international eligibility criteria for apheresis donation. This study assessed the international variations of the eligibility criteria for apheresis donors to help improve our national criteria for safer and more efficient screening of donors. METHODS: We reviewed the websites of the American Red Cross, Canadian Blood Service, Australian Red Cross Blood Service, New Zealand Blood Service, Japanese Red Cross Society, Hong Kong Red Cross (HKRC), Health Sciences Authority of Singapore and the National Blood Service of the UK (NBS) and the European Union (EU). Only those criteria that were different from ours were analyzed. RESULTS: A considerable number of differences were identified between the international criteria and our criteria. The lower age limit was 17~18 years and the upper limit were 50~69 years for plasma donation and 50~59 years for platelet donation. The regulations for donation frequency ranged from none to 12~57 times/year for plasma and none to 12~24 times/year for platelets. The donation interval for plasma and platelets was 1~4 weeks. A minimum hemoglobin level of 12.5 g/dL was used in most countries, excluding the HKRC (11.5 g/dL for women). The NBS and EU had criteria regarding the volume of donation. CONCLUSION: Different international eligibility criteria for apheresis donors are used according to the characteristics of each country. Thus, the compiled data from various countries will provide the basis to improve our national eligibility criteria for apheresis donors.
Asian Continental Ancestry Group ; Blood Component Removal ; Blood Platelets ; European Union ; Hemoglobins ; Hong Kong ; Humans ; Mass Screening ; New Zealand ; Plasma ; Red Cross ; Singapore ; Social Control, Formal ; Tissue Donors

Xanthogranulomatous cholecystitis is an unusual inflammatory disease of the gallbladder characterized by severe proliferative fibrosis and the accumulation of lipid-laden macrophages in areas of destructive inflammation. Its macroscopic appearance may occasionally be confused with gallbladder carcinoma. We present a case of perforated xanthogranulomatous cholecystitis presenting as biloma. An 80-year-old woman was referred to our hospital with a 1-week history of abdominal pain and febrile sensation. Abdominal CT showed a biloma in the subhepatic area. The follow-up CT showed that the biloma increased in size. Therefore, ultrasonography-guided aspiration was performed. The aspirated fluid/serum bilirubin ratio was greater than 5, which was strongly suggestive of bile leakage complicated by perforated cholecystitis. She underwent a laparoscopic cholecystectomy with cyst aspiration and adhesiolysis. A histological diagnosis of perforated xanthogranulomatous cholecystitis was made.
Aged, 80 and over ; Bilirubin/blood ; Cholecystectomy ; Cholecystitis/*diagnosis/pathology/ultrasonography ; Drainage ; Female ; Gallbladder Neoplasms/diagnosis ; Granuloma/*diagnosis/pathology/ultrasonography ; Humans ; Tomography, X-Ray Computed ; Xanthomatosis/*diagnosis/pathology/ultrasonography