Histopathologic studies for Helicobacter pylori (H. pylori)-associated chronic gastritis have been mostly undertaken with endoscopic biopsy specimens, often leading to an inappropriate evaluation of the gastric mucosal alterations. The purpose of this paper was designed to investigate the actual prevalence of lymphoid follicle formation by H. pylori infection using the resected stomachs. A total of 16 fresh gastrectomy specimens bearing gastric carcinoma were examined under the quick and gentle procedure, with which H. pylori was detected in 12 cases (75%) and lymphoid follicles in 14 cases (87.5%), while the detection rate of H. pylori remained 56.3% in the control group which comprised the same 16 resected stomachs and were examined by routine tissue preparation procedure without any special care. There was a significant correlation between the presence of H. pylori and lymphoid follicle formation (p=0.05), but no correlation was found between the grades of H. pylori and lymphoid follicles. The topographical distribution of H. pylori or lymphoid follicles in antrum and body gave no statistical difference. Similarly, there was no correlation between H. pylori infection and intestinal metaplasia, activity of chronic gastritis or histologic types of accompanying adenocarcinoma. We conclude that studies of the gastric mucosal change by H. pylori infection using the gastrectomy specimens provide a useful information for analysis of lymphoid follicle formation which is a consistent morphological characteristic of H. pylori infection.
Adenocarcinoma ; Biopsy ; Gastrectomy* ; Gastritis ; Helicobacter pylori* ; Helicobacter* ; Metaplasia ; Prevalence ; Stomach

Cytomegalovirus (CMV) infection is an uncommon association with idiopathic inflammatory bowel disease (IBD) often leading to a variety of serious complications. A total of 41 resected cases of IBD were examined to elucidate the pathologic features of intestinal CMV infection which was assessed by histologic examination and confirmed by immunohistochemistry with CMV antibody. Six cases were positve for CMV antibody; five cases in 19 ulcerative colitis (UC, 26.3%) and one case in 22 Crohn's disease (CD, 4.5%). Of 7 cases of the steroid-treated UC group, five cases were superinfected with CMV (71.4%) but none in 12 cases of the steroid-untreated UC group. All of the five CMV-positive cases in UC showed deep ulceration and transmural inflammation, while none of 10 UC cases without above features were CMV positive. Fibrinoid necrosis and thrombi were found in 83.3% of the CMV infected group, while none in the CMV-negative group of UC cases (p=0.01). We conclude that IBD, particularly UC, is susceptible to the CMV infection when steroid hormone is administered, and that deep colonic ulceration, transmural inflammation and fibrinoid necrosis of vasculature may suggest superinfection of CMV in UC patients. It seems that deep colonic ulceration may be the consequence of an ischemic change following vascular luminal occlusion or vasculitis by CMV infection.
Colitis, Ulcerative ; Colon ; Crohn Disease ; Cytomegalovirus Infections* ; Cytomegalovirus* ; Humans ; Immunohistochemistry ; Inflammation ; Inflammatory Bowel Diseases* ; Necrosis ; Phenobarbital ; Superinfection ; Ulcer ; Vasculitis

BACKGROUND: This study was conducted to verify the hypothesis that the suppression of lipid peroxidation with the antioxidant, U-74389G, could improve the survivability of paraquat intoxicated rats. METHODS: First, we obtained the 24-h mortality by using several paraquat dosages and calculated the 24-h LD50 in 24 male Wistar rats(250~350g). To examine the effect of U-74389G, we divided the rats in 4 groups: a control group and U-74389G only group, a paraquat only group, and a paraquat plus U-74389G group(n=10 each). Paraquat, 35mg/kg, was injected intraperitoneally at 0 h. U-74389G, 10mg/kg, was administered intraperitoneally at 0, 12 h or at 1, 12 h in the respective groups. The rats were observed for 24 hours. At 24 h, plasma and lung, liver, and kidney tissues were obtained after sacrificing the surviving rats to determine the degree of lipid peroxidation by using a thiobarbituric acid reactive substances(TBARS) quantitative analysis. RESULTS: The 24-h LD50 of paraquat was calculated as 40mg/kg in our rats. The 24-h mortality was as follows: control group and U-74389G group 0%, paraquat group 30%, and paraquat plus U-74389G group 10%. The TBARS analysis showed no differences between the U-74389G and the control groups. The paraquat group showed significantly increased TBARS levels in the serum and in the kidney and lung tissue compared to the control group(p<0.05). With U-74389G, the increased TBARS levels were significantly decreased in the plasma, kidney, and lung tissues compared to the paraquat group(p<0.05). However, in the liver tissue, there were no significant differences among the groups. CONCLUSION: A 21-aminosteroid antioxidant, U-74389G, improved the survivablity of paraquat-intoxicated rats through the suppression of lipid peroxidation. Our result suggests the possibility of clinical application of this drug as an antidote for paraquat poisoning.
Animals ; Humans ; Kidney ; Lethal Dose 50 ; Lipid Peroxidation ; Liver ; Lung ; Male ; Mortality ; Paraquat ; Plasma ; Poisoning ; Rats* ; Thiobarbituric Acid Reactive Substances

PURPOSE: Severe hyperkalemia leads to significant morbidity and mortality if it is not immediately recognized and treated. The concentration of potassium (K+) in the serum increases along with deteriorating renal function. The use of point-of-care K+ (POC-K+) in chronic kidney disease (CKD) could reduce the time for an accurate diagnosis and treatment, saving lives. We hypothesized that POC-K+ would accurately report K+ serum level without significant differences compared to reference testing, regardless of the renal function of the patient. MATERIALS AND METHODS: The retrospective study was performed between January 2008 and September 2011 at an urban hospital in Seoul. The screening program using POC was conducted as a critical pathway for rapid evaluation and treatment of hyperkalemia since 2008. When a patient with CKD had at least one warning symptom or sign of hyperkalemia, both POC-K+ and routine laboratory tests were simultaneously ordered. The reliability of the two assays for serum-creatinine was assessed by intra-class correlation coefficient (ICC) analysis using absolute agreement of two-way mixed model. RESULTS: High levels of reliability were found between POC and the laboratory reference tests for K+ (ICC=0.913, 95% CI 0.903-0.922) and between two tests for K+ according to changes in the serum-creatinine levels in CKD patients. CONCLUSION: The results of POC-K+ correlate well with values obtained from reference laboratory tests and coincide with changes in serum-creatinine of patients with CKD.
Blood Chemical Analysis/methods ; Emergency Service, Hospital ; Humans ; Hyperkalemia/*diagnosis ; Point-of-Care Systems ; Potassium/*blood ; Renal Insufficiency, Chronic/*blood ; Reproducibility of Results ; Retrospective Studies ; Sensitivity and Specificity

PURPOSE: The severity of a stroke cannot be described by widely used prehospital stroke scales. We investigated the usefulness of the Kurashiki Prehospital Stroke Scale (KPSS) for assessing the severity of stroke, compared to the National Institutes of Health Stroke Scale (NIHSS), in candidate patients for intravenous or intra-arterial thrombolysis who arrived at the hospital within 6 hours of symptom onset. MATERIALS AND METHODS: We retrospectively analyzed a prospective registry database of consecutive patients included in the Emergency Stroke Therapy program. In the emergency department, the KPSS was assessed by emergency medical technicians. A cutoff KPSS score was estimated for candidates of thrombolysis by comparing KPSS and NIHSS scores, as well as for patients who actually received thrombolytic therapy. Clinical outcomes were compared between patients around the estimated cut-off. The independent predictors of outcomes were determined using multivariate logistic regression analysis. RESULTS: Excellent correlations were demonstrated between KPSS and NIHSS within 6 hours (R=0.869) and 3 hours (R=0.879) of hospital admission. The optimal threshold value was a score of 3 on the KPSS in patients within 3 hours and 6 hours by Youden's methods. Significant associations with a KPSS score > or =3 were revealed for actual intravenous administration of tissue plasminogen activator (IV-tPA) usage [odds ratio (OR) 125.598; 95% confidence interval (CI) 16.443-959.368, p<0.0001] and actual IV-tPA or intra-arterial urokinase (IA-UK) usage (OR 58.733; 95% CI 17.272-199.721, p<0.0001). CONCLUSION: The KPSS is an effective prehospital stroke scale for identifying candidates for IV-tPA and IA-UK, as indicated by excellent correlation with the NIHSS, in the assessment of stroke severity in acute ischemic stroke.
Administration, Intravenous ; Confidence Intervals ; Emergencies ; Emergency Medical Services ; Emergency Medical Technicians ; Emergency Service, Hospital ; Humans ; Logistic Models ; Methods ; National Institutes of Health (U.S.) ; Prospective Studies ; Retrospective Studies ; Stroke* ; Thrombolytic Therapy ; Tissue Plasminogen Activator ; Urokinase-Type Plasminogen Activator ; Weights and Measures

Bronchopulmonary infections caused by trichomonads have been reported principally in patients with pre-existing pulmonary diseases, such as bronchial carcinoma, lung abscess, or bronchiectasis. Pulmonary trichomoniasis is most often caused by Trichomonas tenax, which is usually regarded as a harmless commensal organism of the human mouth. However, pulmonary infection may rarely be caused by other trichomonas species, including Trichomonas vaginalis from the genitourinary tract and Trichomonas hominis from the intestines. Because of the rarity of trichomonas pulmonary infection, and because of its close association with underlying lung and systemic disease, pulmonary trichomoniasis is considered an opportunistic infection. We recently treated a case of pulmonary trichomoniasis occurring in a young, healthy male without obvious underlying pulmonary or systemic illness. To our knowledge, there has been only one reported case of pulmonary trichomoniasis in Korea, and there have been only two reported cases of pulmonary trichomoniasis occurring in normal lung worldwide.
Bronchiectasis ; Carcinoma, Bronchogenic ; Humans ; Intestines ; Korea ; Lung ; Lung Abscess ; Lung Diseases ; Male ; Mouth ; Opportunistic Infections ; Polymers ; Trichomonas ; Trichomonas vaginalis

PURPOSE: Recently, the trend of multi-cultural families is rising in number due to increasing marriage-based immigrants in Korea. We evaluated statistic changes of characteristics in international marriage, births, and off-springs for the past 20 years in Korea. METHODS: The annual report of national population from Statistics Korea, the survey results about the present status of resident foreigners from Korea Ministry of Health and Welfare, Korea Ministry of Public Administration and Security, and editorials from Health and Welfare Forum and other related reports of Korea Institute for Health and Social Affairs and Korea Ministry of Health and Welfare were used. RESULTS: There were 35,098 (10.8%) international marriages among total 326,104 marriages in 2010 in Korea. The regional distribution of the international marriage was the highest in Gyeonggi (18.5%), and the lowest in Jeju (1.1%). The metropolitan area Seoul (15.4%), Incheon (4.5%) and Gyeonggi (18.3%) comprised one third of the entire international marriage. The number of childbirths was 13,443 (2.9%) in 2008, 19,024 (4.3%) in 2009, and 20,312 (4.3%) in 2010 with increasing trend. The number of off-springs was 44,258 in 2007, 58,007 in 2008, 99,684 in 2009 and 105,502 in 2010. Children less than 18 years old was 93.1%. We expected 1.5 times of increase over the next coming 10 years in the number of multi-cultural international marriage and off-springs compared with 2011. CONCLUSION: When we evaluated the characteristics of multi-cultural marriages, childbirths, and off-springs, systemic nationwide care seemed to be necessary in the aspect of health problems such as perinatology, obstetrics, neonatology, and pediatrics. We expect our results to be utilized for the basic health data.
Birth Rate ; Child ; Emigrants and Immigrants ; Epidemiologic Methods ; Humans ; Korea ; Marriage ; Neonatology ; Obstetrics ; Parturition ; Pediatrics ; Perinatology

PURPOSE: There has been accumulating evidence that interleukin-10 (IL-10) influences on the production of proinflammatory cytokines, regulating the development of atopic diseases. In this study, we tested the genetic association between IL-10 haplotype polymorphism and the development of atopy. METHODS: The frequency of three single nucleotide polymorphisms (SNPs) at positions- 1082 (A/G), -819 (C/T), -592 (A/C) and corresponding haplotypes in the promotor region of the IL-10 gene were analysed in 174 atopic and 130 non-atopic children using Taqman method. The data were assessed for correlations with the eosinophil count and total serum IgE concentration. RESULTS: Three haplotypes (ATA, ACC, GCC) were identified without any ambiguous phasing due to linkage disequilibrium among SNPs. The frequency of IL-10 haplotype ACC was higher in non-atopic children compared to atopic children. (P=0.04) The frequency of IL-10 haplotype ATA was higher in atopic children compared to non-atopic children, but a statistical significance was not found. (P=0.099) ATA/ATA and ATA/ACC accounted for 80 percent of six different genotypes. Although the frequency of ATA/ATA genotype was higher in atopic children, there was no statistical significance. Although medians of serum IgE level and total eosinophil count were higher among atopic children with ATA/ATA genotype than in atopic children with ATA/ACC, no statistical significance was found. CONCLUSION: These results suggest that IL-10 promotor polymorphism may be associated with a genetic risk factor for the development of atopy in Korean children.
Child ; Cytokines ; Eosinophils ; Genotype ; Haplotypes ; Humans ; Immunoglobulin E ; Interleukin-10* ; Linkage Disequilibrium ; Polymorphism, Single Nucleotide ; Promoter Regions, Genetic ; Risk Factors

PURPOSE: A study was done to assess the incidence and classification of congenital urinary tract anomalies detected by antenatal ultrasonogram. METHODS: We reviewed 558 cases of urinary tract anomaly which were detected by antenatal ultrasonogram and postnatally confirmed between June 1989 and May 2002. We investigated the incidence and classified congenital urinary tract anomalies by review of medical records, antenatal and postnatal radiologic studies retrospectively. RESULTS: In 558 cases of congenital urinary tract anomalies, 292 cases of hydronephrosis were found and the most common. Another anomalies were composed of 65 cases of multicystic dysplastic kidney, 32 cases of hydroureteronephrosis, 31 cases of duplication of kidney, 25 cases of renal agenesis, 21 cases of simple renal cyst, 20 cases of polycystic disease, 13 cases of ureterocele, 11 cases of renal hypoplasia, 10 cases of horseshoe kidney, 9 cases of vesicoureteral reflux, 8 cases of posterior urethral valve, 7 cases of bladder diverticulum, 6 cases of megaureter, 5 cases of ectopia, 2 cases of megacystis, and 1 case of medullary cystic disease. In 82 of the 558 cases, there were two or more combined urinary tract anomalies. Associated diseases other than urinary tract were observed in 13 cases, of which the congenital heart disease was the most common. CONCLUSION: The congenital urinary tract anomaly is frequently found and diverse during the antenatal ultrasonography. The multicenter study is needed to investigate precise incidence and distribution of each anomalies in general population.
Classification* ; Diverticulum ; Heart Defects, Congenital ; Hydronephrosis ; Incidence ; Kidney ; Medical Records ; Multicystic Dysplastic Kidney ; Retrospective Studies ; Ultrasonography* ; Ureterocele ; Urinary Bladder ; Urinary Tract* ; Vesico-Ureteral Reflux

Advanced cancer patients with refractory ascites often do not respond to conventional treatments including dietary sodium restriction, diuretics, and repeated large volume paracentesis. In these patients, continuous peritoneal drainage by an indwelling catheter may be an effective option for managing refractory ascites with a relative low complication rate. Peritoneal catheter-induced complications include hypotension, hematoma, leakage, cellulitis, peritonitis, and bowel perforation. Although bowel perforation is a very rare complication, it can become disastrous and necessitates emergency surgical treatment. Herein, we report a case of a 57-year-old male with refractory ascites due to advanced liver cancer who experienced iatrogenic colonic perforation after peritoneal drainage catheter insertion and was treated successfully with endoscopic clipping.
*Catheters, Indwelling ; Colon/*injuries ; Colonoscopy ; Humans ; Intestinal Perforation/*etiology/surgery ; Male ; Medical Errors ; Middle Aged ; Paracentesis/*adverse effects ; Peritoneum ; Rupture ; Surgical Instruments ; Tomography, X-Ray Computed