BACKGROUND/AIMS: The efficacy of standard triple therapy (STT) in treating Helicobacter pylori infection has decreased. Many investigators have attempted to increase the eradication rate. We investigated the outcomes of concomitant therapy (CT) and STT combined with probiotics (STP) as a first-line treatment for H. pylori infection. METHODS: We reviewed the medical records of 361 patients who received either STP (n=286) or CT (n=75). The STP group received STT combined with a probiotic preparation for 1 week. The CT group received STT and metronidazole for 1 week. RESULTS: The intention-to-treat and per-protocol eradication rates were 83.6% (95% confidence interval [CI], 79.0 to 87.7) and 87.1% (95% CI, 81.2 to 89.7) in the STP group and 86.7% (95% CI, 78.7 to 93.3) and 91.4% (95% CI, 83.6 to 97.1) in the CT group (p=0.512 and p=0.324), respectively. The frequency of adverse effects was higher in the CT group (28.2%) than in the STP group (12.8%) (p=0.002). CONCLUSIONS: STP and CT are encouragingly efficacious as first-line treatments for H. pylori infection. Therefore, adding probiotics to STT may be a feasible option to avoid side effects.
Helicobacter pylori* ; Helicobacter* ; Humans ; Medical Records ; Metronidazole ; Probiotics* ; Research Personnel

PURPOSE: Presence of a cephalomedullary nail (CMN) in the medullary canal has been thought as advantageous in the control of femoral neck shortening (FNS) and lag screw sliding in trochanteric fracture compared to extramedullary fixation system. However, researches on the factors that influence the degree of FNS after cephalomedullary nailing are lacking. MATERIALS AND METHODS: We observed 95 patients (mean age, 75+/-2.8 years) with trochanteric fractures who were treated with a CMN, and evaluated the relationship between FNS and patient factors including age, gender, fracture type (AO/OTA), bone mineral density, medullary canal diameter, canal occupancy ratio (COR=nail size/canal diameter), and tip-apex distance using initial, immediate postoperative, and follow-up radiography. RESULTS: Univariate regression analyses revealed that the degree of FNS was significantly correlated with fracture type (A1 versus A3, p<0.001), medullary canal diameter (p<0.001), and COR (p<0.001). Multiple regression analyses revealed that FNS was strongly correlated with fracture type (p<0.001) and COR (p<0.001). CONCLUSION: Presence of a CMN in the medullary canal could not effectively prevent FNS in patients with low COR and in A3 type fracture.
Aged ; *Bone Nails ; Female ; Femur Neck/*radiography ; Hip Fractures/radiography/*surgery ; Humans ; Male ; Orthopedic Procedures/*methods ; Regression Analysis

OBJECTIVES: Recently, recombinant FSH (rFSH) has been manufactured using a Chinese hamster ovary cell line transfected with the gene encoding human FSH. Both rFSH and urinary gonadotropin (uFSH) could be used for controlled ovarian hyperstimulation (COH). However, uFSH implies a number of disadvantages, such as batch-to-batch inconsistency, no absolute source control, dependence on large amounts of urine, low specific activity, and low purity. The purpose of this study was to evaluate the efficacy of rFSH in human IVF-ET program. MATERIALS AND METHODS: A total of 508 infertile women was enrolled in this study. They are classified into rFSH group (n=177) or uFSH group (n=331), and all of them were matched by age and cause of infertility in same period. The Puregon(R) (Organon, Holland) was used as rFSH, and the Metrodin-HP(R) (Serono, Switzeland) and Humegon(R) (Organon, Holland) was used as uFSH. We subdivided the patients into three age groups. The outcomes of IVF-ET program were analyzed using the statistical package for social sciences (SPSS). RESULTS: There was no significant differences in the level of estradiol on hCG injection day, the numbers of retrieved oocytes, matured oocytes, fertilized oocytes, transferred embryos, frozen embryos between the two groups. The total dose (IU) of gonadotropin for COH was significantly lower in the rFSH group compared to uFSH group (1339+/-5491.1 vs 2527.8+/-1075.2 IU, p<0.001). Clinical pregnancy rate per embryo transfer in the rFSH group showed increasing tendency, compared to the uFSH group, but there was no statistical significance (35.2% vs 29.3%). Our results demonstrated that the relative efficiency of rFSH compared with uFSH is higher in older patients. CONCLUSIONS: The ovarian stimulatory effect and clinical outcome of recombinant FSH was similar to that of the urinary gonadotropin. The IVF-ET cycles with significantly lower dose of gonadotropin in rFSH group showed comparable results. Therefore, we suggest that recombinant FSH is more potent and effective than urinary gonadotropin.
Animals ; Cell Line ; Cricetinae ; Cricetulus ; Embryo Transfer ; Embryonic Structures ; Estradiol ; Female ; Follicle Stimulating Hormone, Human* ; Gonadotropins ; Humans* ; Infertility ; Oocytes ; Ovary ; Pregnancy Rate ; Social Sciences

Ammonia excretion in the renal collecting duct is critical in the regulation of the acid-base homeostasis. A novel family of ammonium transporter protein, Rh C Glycoprotein (RhCG) was recently identified in the mouse and rat kidney collecting duct. The purpose of this study was to examine the ultrastructural localization of RhCG in the collecting duct. Rat kidneys were processed for light and electron microscope immunocytochemistry using anti-RhCG rabbit polyclonal antibody. Strong RhCG immunolabeling was observed in the apical domain of AE1-positive type A intercalated cells in the collecting duct. Transmission electron microscopy revealed that a high level of RhCG was expressed in the apical plasma membrane and in subapical vesicles of type A intercalated cell. Interestingly, type A cells also expressed weak immunolabel in the basolateral plasma membrane. Type B cells had weak apical plasma membrane and subapical vesicle immunolabel, and very weak basolateral plasma membrane immunolabel. Principal cells had very weak apical plasma membrane immunolabel without detectable subapical or basolateral immunolabel These results demonstrate that RhCG is mainly expressed in the apical plasma membrane and in subapical vesicles of acid-secreting type A cells and may mediate ammonia excretion in the collecting duct.
Ammonia* ; Ammonium Compounds ; Animals ; B-Lymphocytes ; Cell Membrane ; Glycoproteins ; Homeostasis ; Humans ; Immunohistochemistry ; Kidney Tubules, Collecting* ; Kidney* ; Mice ; Microscopy, Electron, Transmission ; Rats*

Compare to aortic aneurysm, peripheral artery aneurysm is rare but has a tendency of developing multiple arterial aneurysms at the same time. Popliteal artery is the most frequent site of involvement and followed by femoral artery. More than 90% of peripheral artery aneurysms are occurred at these two arteries. Since we have no written nationwide report of peripheral artery aneurysm, we reviewed aneurysms that developed outside of the thoracoabdominal cavity and compared it with western reports. From January 1991 through December 1998, we experienced 19 cases of peripheral artery aneurysms and these included pseudoaneurysms that developed long after vascular trauma. Most frequent ages were 30's and about 3/4 of the patients were male. More than 75% of the patients had symptom of pulsating mass or tender mass when they visited hospital but symptoms associated with mass, such as compression of surrounding structure, were developed in only one patient. Nine cases were developed at femoral arteries and three at popliteal artery and these included 5 cases of pseudoaneurysm. One patient showed multiple arterial aneurysms and 7 patients had atherosclerosis or hypertension. Three cases had Behcet's disease and two of them developed pseudoaneurysm at arterial puncture site and vascular anastomotic site. Most of the aneurysms were excised and performed patch graft, bypass graft or simple closure according to the size of the aneurysm. Three of the patients were died due to myocardial infarction, sepsis and advanced renal failure but aneurysm related mortality was only one who developed sepsis after bypass graft. In summary, we have different incidence of peripheral artery aneurysm in site, multiplicity and presenting symptoms but these are not sufficient because of small limited number of patients. Nationwide report and analysis is necessary.
Aneurysm* ; Aneurysm, False ; Aortic Aneurysm ; Arteries* ; Atherosclerosis ; Femoral Artery ; Humans ; Hypertension ; Incidence ; Male ; Mortality ; Myocardial Infarction ; Popliteal Artery ; Punctures ; Renal Insufficiency ; Sepsis ; Transplants

BACKGROUND: A desmoid tumor is a rare neoplasm of a mature fibroblast within an extensive collagen matrix. These tumors are classified pathologically as aggressive fibromatosis with local invasiveness, showing recurrences after surgical treatment, although they do not metastasize. Complete surgical excision without leaving a remnant tumor seems to be the primary treatment option, but these tumors often recur after resection. Therefore, alternative treatment strategies, including radiation therapy, nonsteroidal anti-inflammatory agents, anti-estrogen compounds, and cytotoxic chemotherapy, have been employed. METHOD: The authors report the clinical characteristics and prognoses after treatment for seven patients who were diagnosed as having desmoid tumors and who underwent surgical excision for therapy during the ten-year period from 1986 to 1997 at Keimyung University Dongsan Medical Center. RESULTS: There were two males and five females. The most common chief complaint was a slowly growing painless mass. The duration of the symptom before diagnosis was quite different from patient to patient. The locations in the trunk were scattered diffusely: the shoulder, the chest wall, the abdominal wall, the retroperitoneum, and the pelvic cavity. The tumors were well visualized by imaging techniques such as ultrasonograms, CT scans, and MRI. Four of the seven patients experienced recurrent tumors after surgical excision; two are dead. The tumors in the recurrent patients were excised incompletely at initial surgery. CONCLUSION: Although the uncommon, solid desmoid tumors which develop in the musculoaponeurosis of the trunk are benign pathologically, they were recurrent after surgical excision when the resection margin is incomplete. Therefore, complete excision is the only curative therapeutic modality.
Abdominal Wall ; Anti-Inflammatory Agents, Non-Steroidal ; Collagen ; Diagnosis ; Drug Therapy ; Female ; Fibroblasts ; Fibroma ; Fibromatosis, Aggressive* ; Humans ; Magnetic Resonance Imaging ; Male ; Prognosis ; Recurrence ; Shoulder ; Thoracic Wall ; Tomography, X-Ray Computed ; Ultrasonography

BACKGROUND: 1-8D gene is a member of human 1-8 interferon inducible gene family and was shown to be overexpressed in fresh colon cancer tissues. Three peptides 1-6, 3-5 and 3-7 derived from human 1-8D gene were shown to have immunogenicity against colon cancer. METHODS: To study tumor immunotherapy of three peptides we established an active immunization model using HHD mice. D(b-/-) x beta2 microglobulin (beta2 m) null mice transgenic for a chimeric HLA-A2.1/D(b-)beta2 m single chain (HHD mice) were challenged with B16/HHD/1-8D tumor cells and were immunized with irradiated peptide-loaded RMA- S/HHD/B7.1 transfectants. In therapy model tumor growth was retarded in HHD mice that were injected with 3-5 peptide-loaded RMA-S/HHD/B7.1. In survival test vaccination with 1-8D-derived peptide protects HHD mice from tumor progression after tumor challenge. RESULTS: These studies show that peptide 3-5 derived from 1-8D gene can be the most effective candidate for the vaccine of immunotherapy against colon cancer and highlight 1-8D gene as putative colon carcinoma associated antigens. CONCLUSION: We demonstrated that RMA-S/HHD/ B7.1 loaded with 1-8D peptides, especially 3-5, immunization generates potent antitumor immunity against tumor cells in HHD mice and designed active immunization as proper immunotherapeutic protocols.
Animals ; Antigens, Tumor-Associated, Carbohydrate ; Colon* ; Colonic Neoplasms* ; Humans ; Immunization ; Immunotherapy ; Interferons ; Mice* ; Peptides ; Vaccination*

Rabies is a major zoonotic disease that causes approximately 55,000 human deaths worldwide on an annual basis. The nucleocapsid protein and glycoprotein genes of the Korean rabies virus (RABV) have been subjected to molecular and phylogenetic analyses. Although the phosphoprotein (P) has several important functions in viral infection and pathogenicity, the genetic characterizations of the P of Korean RABV isolates have not yet been established. In the present study, we conducted genetic analyses of P genes of 24 RABV isolates circulating in the Republic of Korea (hereafter, Korea) from 2008 to 2011. This study revealed that the P genes of Korean RABVs are genetically similar to those of RABV strains of lyssavirus genotype I including V739 (dogs, Korea), NNV-RAB-H (humans, India), NeiMeng925 (raccoon dogs, China), and RU9.RD (raccoon dogs, Russia). Among Korean isolates, the RABV P genes showed low variability in the variable domains among Korean isolates; they had specific consensus sequences and amino acid substitutions capable of identifying geographic characteristics and retained specific sequences thought to be important for viral function. These results provide important genetic characteristics and epidemiological information pertaining to the P gene of the Korean RABV.
Amino Acid Substitution ; Animals ; Consensus Sequence ; Dogs ; Genotype ; Glycoproteins ; Humans ; Korea ; Lyssavirus ; Molecular Epidemiology ; Nucleocapsid Proteins ; Rabies ; Rabies virus ; Republic of Korea

BACKGROUND: Hybrid coronary revascularization (HCR) was developed to combine the advantages of coronary artery bypass graft (CABG) with percutaneous coronary intervention (PCI). However, it is still controversial whether it is more optimal to perform CABG or PCI first. The purpose of this study was to compare the clinical outcomes of these 2 approaches. METHODS: Eighty patients who underwent HCR from May 2010 to December 2015 were enrolled in this retrospective analysis. The CABG-first group comprised 12 patients and the PCI-first group comprised 68 patients. Outcomes of interest included in-hospital perioperative factors, major adverse cardiac and cerebrovascular events (MACCEs), and the incidence of repeated revascularization, especially for the target vessel lesion. RESULTS: No significant difference was found in the amount of postoperative bleeding (p=0.239). The incidence of MACCEs was similar between the CABG-first and PCI-first groups (1 of 12 [8.3%] vs. 5 of 68 [7.4%], p>0.999). Repeated revascularization was performed on 3 patients (25%) in the CABG-first and 9 patients (13.2%) in the PCI-first group (p=0.376). CONCLUSION: There were no significant differences in postoperative and medium-term outcomes between the CABG-first and PCI-first groups. Based on these results, it can be inferred that it is safe to opt for either CABG or PCI as the primary procedure in 2-stage HCR.
Coronary Artery Bypass* ; Coronary Artery Disease ; Coronary Vessels* ; Hemorrhage ; Humans ; Incidence ; Percutaneous Coronary Intervention ; Retrospective Studies ; Transplants

Osteopontin (OPN), a potent chemoattractant for the monocyte/macrophage infiltration, is highly upregulated in the renal tubular epithelium during various pathologic conditions associated with tubulointerstitial injury. The purpose of this study was to establish the distribution and localization of OPN in the tubulointerstitial injury induced by chronic potassium (K+) deprivation in the rat kidney. Sprague-Dawley rats were fed either a normal or a K+ -deficient diet for 2 weeks. Kidney tissues were preserved by in vivo perfusion with paraformaldehyde-lysine-periodate (PLP) and processed for light and electron microscope immunocytochemistry using monoclonal antibodies to OPN. K+ -depleted kidneys showed tubulointerstitial injury with renal hypertrophy, monocyte/macrophage infiltration, interstitial fibrosis, and OPN overexpression. OPN immunoreactivity was observed only in the descending thin limb (DTL) and the papillary surface epithelium (PSE) in the control kidney. However, the OPN labeling was observed not only in DTL and PSE but also in the thick ascending limb (TAL) in the K+ -depleted kidney. Electron microscopy revealed that OPN induced in the TAL cells was not located in the basal plasma membrane, but in the Golgi apparatus and in subapical cytoplasmic vesicles. There was no OPN expression in the epithelium of the collecting ducts, which showed marked morphological damages with mononuclear cell infiltration. These results demonstrate that chronic K+ -deprivation causes renal injury with the increased OPN expression in tubular epithelial cells. However, the localization of the induced OPN suggests other roles rather than a chemoattractant function in this renal injury model.
Animals ; Antibodies, Monoclonal ; Cell Membrane ; Cytoplasmic Vesicles ; Diet ; Epithelial Cells ; Epithelium ; Extremities ; Fibrosis ; Golgi Apparatus ; Hypertrophy ; Hypokalemia ; Immunohistochemistry ; Kidney ; Microscopy, Electron ; Osteopontin* ; Perfusion ; Potassium* ; Rats ; Rats, Sprague-Dawley