No abstract available.

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: A telomerase reverse transcriptase (TERT) promoter mutation was identified in thyroid cancer. This TERT promoter mutation is thought to be a prognostic molecular marker, because its association with tumor aggressiveness, persistence/recurrence, and disease-specific mortality in papillary thyroid carcinoma (PTC) has been reported. In this study, we attempted to determine whether the impact of the TERT promoter mutation on PTC persistence/recurrence is independent of clinicopathological parameters. MATERIALS AND METHODS: Using propensity score matching, 39 patients with PTC persistence or recurrence were matched with 35 patients without persistence or recurrence, with a similar age, sex, tumor size, multifocality, bilaterality, extrathyroidal extension, and lymph node metastasis. The TERT promoter and the BRAF V600E mutations were identified from PTC samples. RESULTS: The TERT promoter mutation was detected in 18% of PTC patients (13/74). No significant difference in the frequency of the TERT promoter mutation was observed between the persistence/recurrence group and the non-recurrence group. CONCLUSION: These results suggest that the prognostic implications of the TERT promoter mutation are dependent on clinicopathological parameters.
Humans ; Lymph Nodes ; Mortality ; Neoplasm Metastasis ; Propensity Score ; Recurrence ; Telomerase ; Thyroid Gland* ; Thyroid Neoplasms*

Cerebral aneurysms associated with arteriovenous malformation (AVM) have been reported with a variable incidence, averaged 10% of total AVM cases. It has been AVM. We report four cases of the intracranial aneurysm associated with AVM. Three cases of aneurysm were located in distal portion of feeding artery, and one case was proximal on major feeding artery. And bleeding resulted from rupture of aneurysm. Three of them located in the posterior circulation. Removal of aneurysm and AVM was successfully accomplished in 3 cases.
Aneurysm ; Arteries ; Arteriovenous Malformations* ; Hemorrhage ; Incidence ; Intracranial Aneurysm ; Rupture

The incidence of thymolipoma or thynuc cyst is very rare among the tumors of thymic origin, which are usually benign or invasive thymoma. Thymic tumor has been found among 10 to 15% of the patients with myasthenia gravis(MG). However the patients with thymolipoma or thynuc cyst rarely manifestated as MG. Moreover the case of MG with thymolipoma and thymic cyst is extremely rare ; Only one case has been reported hitherto. We hereby report a 41-year-old woman presenting as ocular MG with thymolipoma and thymic cyst. She complained diplopia, ptosis and headache, which had begun 3 months prior to admission and have been fluctuating thereafter. Ocular MG was confirmed by positive Tensilon and Jolly test. Her chest CT showed an enlarged thymus which turned out to be thymolipoma with thymic cyst on the pathologic examination. Although rare, thymolipoma and/or thymic cyst should be considered in the differential diagnosis of thymic tumor in MG.
Adult ; Diagnosis, Differential ; Diplopia ; Edrophonium ; Female ; Headache ; Humans ; Incidence ; Mediastinal Cyst* ; Myasthenia Gravis* ; Thymoma ; Thymus Gland ; Thymus Neoplasms ; Tomography, X-Ray Computed

The nuclear and infranuclear pathway of eye movement begins from the ocular mo-tor nuclei situated in thebrain stem, where the axons originate and form three ocular motor nerve s. Although each of the ocular motornerves follows a distinct route to reach the end organ, the extraocular muscles, they also have common housings inthe cavernous sinus and at the orbital apex, where part or all of them are frequently and simultaneously affectedby a common disease process. Since the fine details of normal and diseased structures can frequently be seen onradiologic imaging, especially mag-netic resonance (MR) imaging, a knowledge of the basic anatomy invo l ved innuclear and infranuclear eye movement is important. In this description, in addition to the normal nuclear andinfranuclear pathway of eye movement, we have noted the radio-logic findings of typical diseases involving eachsegment of the nuclear and infranu-clear pathway, particularly as seen on magnetic resonance images. Briefcomments on ocular motor pseudopalsy, which mimics ocular motor palsy, are also included.
Axons ; Brain ; Cavernous Sinus ; Cranial Nerves ; Eye Movements ; Muscles ; Ocular Motility Disorders* ; Orbit ; Paralysis

Central hyperthermia is a very rare disease; however, once it happens, it is associated with a poor prognosis and high mortality for patients with severe brainstem strokes. Following a pontine hemorrhage, a 46-years-old female developed prolonged hyperthermia. Work-ups to the fever gave no significant clues for the origin of fever, and hyperthermia did not respond to any empirical antibiotics or antipyretic agents. The patient's body temperature still fluctuated in a range of 37.5degrees C to 39.2degrees C. Considering the lesion of hemorrhage, we suspected central hyperthermia rather than infectious diseases. We started with baclofen administration at a dose of 30 mg/day. The body temperature changed to a range of 36.6degrees C to 38.2degrees C. We raised the dose of baclofen to 60 mg/day. The patient's body temperature finally dropped to a normal range. Central hyperthermia, caused by failures of thermoregulatory pathways in brainstem, following the pontine hemorrhage rarely occurs. Baclofen can be used to treat suspected central hyperthermia in a patient with pontine hemorrhage.
Anti-Bacterial Agents ; Antipyretics ; Baclofen* ; Body Temperature ; Brain Stem ; Communicable Diseases ; Female ; Fever* ; Hemorrhage* ; Humans ; Mortality ; Pons ; Prognosis ; Rare Diseases ; Reference Values ; Stroke

Central hyperthermia is a very rare disease; however, once it happens, it is associated with a poor prognosis and high mortality for patients with severe brainstem strokes. Following a pontine hemorrhage, a 46-years-old female developed prolonged hyperthermia. Work-ups to the fever gave no significant clues for the origin of fever, and hyperthermia did not respond to any empirical antibiotics or antipyretic agents. The patient's body temperature still fluctuated in a range of 37.5degrees C to 39.2degrees C. Considering the lesion of hemorrhage, we suspected central hyperthermia rather than infectious diseases. We started with baclofen administration at a dose of 30 mg/day. The body temperature changed to a range of 36.6degrees C to 38.2degrees C. We raised the dose of baclofen to 60 mg/day. The patient's body temperature finally dropped to a normal range. Central hyperthermia, caused by failures of thermoregulatory pathways in brainstem, following the pontine hemorrhage rarely occurs. Baclofen can be used to treat suspected central hyperthermia in a patient with pontine hemorrhage.
Anti-Bacterial Agents ; Antipyretics ; Baclofen* ; Body Temperature ; Brain Stem ; Communicable Diseases ; Female ; Fever* ; Hemorrhage* ; Humans ; Mortality ; Pons ; Prognosis ; Rare Diseases ; Reference Values ; Stroke

BACKGROUND: Exercise-induced coronary spasm is occasionally recognized in patients with variant angina, but the patterns of exercise-induced coronary spasm and its relation to clinical features are still not clear. METHODS: Eight consecutive patients with variant angina without significant stenosis of the coronary artery performed serial treadmill exercise tests during early morning, late morning, and in the afternoon. The subjects repeated the tests after administration of atropine and doxazosin or phentolamine. RESULTS: (Upon drug administration), anginal episodes with ST-segment changes (elevation 5, depression 1) Occurred repeatedly in 6 of the 8 patients during early morning; the episodes occurred in only 2 patients during the afternoon exercise test. Four patients showed exercise-induced angina and ST-segment changes during early morning but not in the afternoon, and 2 of them showed mild episodes of exercise-induced angina and ST-segment changes during late morning. Three of the four patients had the characteristic clinical history of angina in early morning during usual activities but not during daytime activities despite the activities being more strenuous. Another 2 patients showed both exercise-induced ST-segment elevation and angina in early morning and afternoon, and they had the characteristic history of more episodes at night and in early morning but only occasionally in the daytime with or without relation to activity. One of the two patients showed intermittent ST-segment elevation during the exercise test. The other two patients had exercise-induced episodes neither in the early morning nor in the afternoon; they had a characteristic history of episodes only at night during sleep but never in the early morning nor in the daytime. Atropine did not suppress the exercise-induced angina in 4 of 5 patients studied. Doxazosin or phentolamine suppressed the exercise-induced episodes in 3 of 5 patients studied but aggravated spontaneous episodes in 3 patients. CONCLUSION: These data suggest that there's possibility of presence of different patterns of exercise-induced coronary spasm, which may be induced by different mechanisms from those in spontaneous episodes in patients with variant angina.
Atropine ; Constriction, Pathologic ; Coronary Vessels ; Depression ; Doxazosin ; Exercise Test ; Humans ; Phentolamine ; Spasm*

In a double-blind randomized study of five groups of fifty patients scheduled for gynecologic lower abdominal surgery the analgesic efficacy and side effects of epidurai buprenorphine were tested and compared to epidural morphine. Single epidural injeetion of 0.15mg of buprenorphine in group B 0.15, 0.30 mg of buprenorphine in group B D.3, 0.45 mg of buprenorphine in group B 0.45, 3 mg of morphine in group M 3 or 6 mg of morphine in group M 6 mixed with 10 ml of normal saline was done when the patients complained of postoperative pain after general anesthesia with enflurane-N2O-O2. The results were as follows; 1) The onset of analgesia was the most rapid in group B 0.45(20.7+/-3.2 minutes), and appeared as following order: group M 6(29.3+/-14.3 minutes), group M 3(37.5+/-6.7 minutes), group B 0.3(39.3+/-8.7 minutes), and group B 0.15(60.7+/-20.2 minutes). 2) Additional requirement of analgesics during first 24 hours after epidural injection was more frequent in group B O.IS(70%) than in any other four groups. 3) The lowest pain score during 24 hours after epidural injection was the lowest in group M 6(1.6+/-0.5) and group B 0.45(1.8+/-0.4) and the increasing order of the lowest pain score were as follows; 2.2+/-0.4 in group M 3, 2.3+/-0.5 in group B 0.3 and 2.6+/-0.5 in group B 0.15. 4) The pain score measured 24 hours after epidural injection was significantly lower in group B 0.45(2.0+/-0.0) than in any other four groups. 5) Subjective rating of well-being for first 24 hours following epidural injection was better in group B 0.45(good in 60% of patients) than in group M 6(good in 10% of patients). 6) Subjective rating of sleep at the first postoperative night showed no significant differences among five groups. 7) Disturbance of micturition after removal of catheter was noted in group B 0.45 and group M 6(30% each) and spontaneous urination after removal of catheter was significantly delayed in group B 0.45(9.1+/-10.2 hours) and in group M 6(7.2+/-7.8 hours) comparing to other three groups. 8) Pruritus was noted only in the groups with epidural morphine(in group M 3 & M 6; 70% each) and there was no statistieal difference between group M 3 and group M 6. 9) The frequency of nausea or vomiting was the lowest in group B 0.45(30%) and the highest in group M 3(90%), and no significant differences were noted among other three groups. 10) Dizziness was noted in group B 0.45 and in group M 6(30% each), but there was no statistical significances among five groups. I I) No signs of respiratory depression were noted.
Analgesia ; Analgesics ; Anesthesia, General ; Buprenorphine* ; Catheters ; Dizziness ; Humans ; Injections, Epidural ; Morphine* ; Nausea ; Pain, Postoperative* ; Pruritus ; Respiratory Insufficiency ; Urination ; Vomiting