As part of an initial inquiry into the function of the outer membrane proteins (OMPs) of Helicobacter pylori Korean strain 51, we have conducted an extensive proteome analysis via quadrupole time of flight (Q-TOF) mass spectrometry (MS). Fifty one OMPs of H. pylori were purified using sarcosine and resolved via two-dimensional electrophoresis with immobilized pH gradient strips. The most abundant proteins were observed in the alkaline pI regions (6.0~11.0) at molecular masses between 10~100 KDa. Here, 15 spots were identified, representing 9 types of genes (KHP0852, KHP0853, KHP1353, KHP1017, KHP0172, KHP0076, KHP0617, KHP1069, KHP0614) from the sarcosin-insoluble fraction of H. pylori 51. These may be employed in the characterization of the OMPs of H. pylori 51, which will help to identify new potential target proteins for vaccine development and drug therapy.
Electrophoresis ; Helicobacter ; Helicobacter pylori ; Mass Spectrometry ; Membrane Proteins ; Membranes ; Proteins ; Proteome ; Proton-Motive Force ; Sarcosine ; Sprains and Strains

Mirizzi syndrome is a rare complication, resulting in bile duct obstruction and jaundice that usually arise from impacted gallstone in the cystic duct or neck of the gallbladder. It is vitally important to confirm underlying cystic duct anomaly in Mirizzi syndrome since it can produce surgical difficulty and higher complications. Generally, Mirizzi syndrome is treated surgically while endoscopic treatment is limited. Herein, we present Mirizzi syndrome with low lying cystic duct and remnant cyst duct calculi treated successfully by biliary stent and administration of choleretic agent, following by balloon dilatation on cystic duct and balloon extraction of the stone.
Calculi ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis ; Cholestasis ; Cystic Duct* ; Deception* ; Dilatation ; Gallbladder ; Gallstones ; Humans ; Jaundice ; Mirizzi Syndrome* ; Neck ; Stents

Mirizzi syndrome is a rare complication, resulting in bile duct obstruction and jaundice that usually arise from impacted gallstone in the cystic duct or neck of the gallbladder. It is vitally important to confirm underlying cystic duct anomaly in Mirizzi syndrome since it can produce surgical difficulty and higher complications. Generally, Mirizzi syndrome is treated surgically while endoscopic treatment is limited. Herein, we present Mirizzi syndrome with low lying cystic duct and remnant cyst duct calculi treated successfully by biliary stent and administration of choleretic agent, following by balloon dilatation on cystic duct and balloon extraction of the stone.
Calculi ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis ; Cholestasis ; Cystic Duct* ; Deception* ; Dilatation ; Gallbladder ; Gallstones ; Humans ; Jaundice ; Mirizzi Syndrome* ; Neck ; Stents

BACKGROUND AND AIMS: To investigate the morphological and histopathological associations between an individual pit seen on stereomicroscopy or magnifying colonoscopy and an individual crypt seen in histological sections of colorectal tumors. METHODS: Fifty two colorectal lesions were examined by colonoscopy. The mucosal pits of the lesions were observed using a magnifying colonoscopy with a zoom 1 to 100 magnification after administering indigo carmine spray. The pits of the excised specimens were observed by using a stereomicroscopy after 0.2% cresyl violet stain. The pit patterns were classified into six types: normal round pit (I); asteroid pit (II); small round pit (IIIs); large tubular pit (IIIL); gyrus-like pit (IV); and non-structural pattern or amorphysm (V). Histologic diagnoses were determined by H&E staining under light microscopy. RESULTS: The histologic findings according to the pit patterns were 1 chronic nonspecific inflammation and 1 submucosal tumor in 2 cases with type I pit pattern; 4 hyperplastic polyps in 4 cases with type II; 1 hyperplastic polyp, 16 adenomas with low-grade dysplasia, 3 adenomas with high-grade dysplasia, and 1 carcinoma in situ in 21 cases with type IIIL; 4 adenomas with low-grade dysplasia, 3 adenomas with high-grade dysplasia, and 4 carcinoma in situ in 11 cases with type IV; 1 adenoma with low-grade dysplasia in 1 case with type II IIIL; 3 adenomas with low-grade dysplasia, 4 adenomas with high-grade dysplasia, and 2 carcinoma in situ in 9 cases with type IIIL IV; 1 adenoma with high-grade dysplasia, 2 carcinoma in situ, and 1 adenocarcinoma in 4 cases with type IV V. In assessing the histologic findings according to pit pattern by stereomicroscopy, the overall diagnostic predictive value was 82.6% (43/52), and the diagnostic accuracy in differential diagnosis between nonneoplastic and neoplastic lesions was 98% (51/52). The ratio of agreement of the pit pattern between the magnifying colonoscopy and the stereomicroscopy was 68% (17/25). CONCLUSIONS: The results suggest that there was a close correlation between the pit patterns and the histologic findings of colorectal tumors, and that the observation of pit patterns of colorectal lesions provides a differential diagnosis between neoplastic and nonneoplastic lesions.
Adenocarcinoma ; Adenoma ; Carcinoma in Situ ; Colonoscopy ; Colorectal Neoplasms* ; Diagnosis ; Diagnosis, Differential ; Indigo Carmine ; Inflammation ; Microscopy ; Polyps ; Viola

Trans-radial (TR) approach is increasingly recognized as an alternative to the routine use of trans-femoral (TF) approach. However, there are limited data comparing the outcomes of these two approaches for the treatment of coronary bifurcation lesions. We evaluated outcomes of TR and TF percutaneous coronary interventions (PCI) in this complex lesion. Procedural outcomes and clinical events were compared in 1,668 patients who underwent PCI for non-left main bifurcation lesions, according to the vascular approach, either TR (n = 503) or TF (n = 1,165). The primary outcome was major adverse cardiac events (MACE), including cardiac death, myocardial infarction (MI), and target lesion revascularization (TLR) in all patients and in 424 propensity-score matched pairs of patients. There were no significant differences between TR and TF approaches for procedural success in the main vessel (99.6% vs 98.6%, P = 0.08) and side branches (62.6% vs 66.7%, P = 0.11). Over a mean follow-up of 22 months, cardiac death or MI (1.8% vs 2.2%, P = 0.45), TLR (4.0% vs 5.2%, P = 0.22), and MACE (5.2% vs 7.0%, P = 0.11) did not significantly differ between TR and TF groups, respectively. These results were consistent after propensity score-matched analysis. In conclusion, TR PCI is a feasible alternative approach to conventional TF approaches for bifurcation PCI (clinicaltrials.gov number: NCT00851526).
Aged ; Angioplasty, Balloon, Coronary/adverse effects/*methods ; Coronary Angiography ; Coronary Stenosis/mortality/radiography/*therapy ; Coronary Vessels/radiography/surgery ; *Drug-Eluting Stents ; Female ; Follow-Up Studies ; Hemorrhage/etiology ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Myocardial Infarction/etiology ; Myocardial Revascularization ; Proportional Hazards Models ; Registries

The protein identity of sarcosine-insoluble outer membrane proteins (OMPs) of Helicobacter pylori J99 was determined with the basic study of understanding the function of proteins. A sarcosine-insoluble OMPs was resolved by two-dimensional electrophoresis with immobilized pH gradient strips. The most abundant proteins were shown in the alkaline pI regions (6.0~11.0) with molecular masses of 10 to 100 kDa. We have performed an extensive proteome analysis by quadrupole time of flight (Q-TOF) mass spectrometry (MS). Here, of 50 spots processed, 42 spots were identified, which represented 16 genes and we newly detected 8 kinds of proteins (JHP0119, JHP0388, JHP1046, JHP1405, JHP0073, JHP0551, JHP1382, JHP0552) from the sarcosin-insoluble fraction of H. pylori J99. Those may be used to elucidate the characterization of the OMPs of H. pylori J99, which will help identify new potential target proteins for vaccine development and drug therapy.
Electrophoresis ; Helicobacter ; Helicobacter pylori ; Mass Spectrometry ; Membrane Proteins ; Membranes ; Proteins ; Proteome ; Proton-Motive Force ; Tandem Mass Spectrometry

BACKGROUND: The early coronary reperfusion with tissue type plasminogen activator(t-PA) influenced on the short term mortality and long term mobidity in acute myocardial infarction. The attention for thrombolysis with t-PA has been focused in identifying the optimal t-PA regimen and on the possibility of achieving effective and safe thrombolysis with a bolus of t-PA. Experimental data demonstrates that rapid t-PA infusion resulted in improved thrombolysis with minimal fibrinogenolysis and without excessive bleeding than prolonged infusion. METHODS: Consecutive patients presenting up to 6 hour from the onset of symptoms were recruited for the study. Aspirin(200mg daily) should be given immediately, 100mg t-PA was administered as two intravenous bolus injections of 50mg t-PA each given 30 minute apart, and followed by 5,000 unit heparin IV bolus with continuous infusion for 5 days. Angiography was performed at 60 and 90min after the first bolus and between 12-24 hour after study entry. After 7-10 days of myocardial infacrtion, coronary angiograms were performed in all patients who had been taken ddouble bolus t-PA. RESULTS: At 60min, angiography revealed infarct-related coronary artery patency of TIMI flow grade 3 in 15(88%) of 17 patients. At 90min, infarct-related coronary artery patency of TIMI flow grade 3 was achieved in 16(94%) of 17 patients. Bleeding episodes were mostly minor(6 of 33 patients, 18%), and hemorrhagic stroke was developed in 1 patients(1/33, 3.0%). Three patients(9.0%) died in hospitalization probably due to ventricular rupture. CONCLUSION: The administration of 100mg of double bolus t-PA in acute myocardial infarcion results in remarkably high early TIMI flow grade 3 on infarct-related coronary artery patency rates(88% and 94% at 60 and 90min, respectively). The bolus injection of t-PA may be simple and effective strategy in the treatment of acute myocardial infarction. However, large numbers of prospective study would be required.
Angiography ; Coronary Vessels ; Hemorrhage ; Heparin ; Hospitalization ; Humans ; Mortality ; Myocardial Infarction* ; Myocardial Reperfusion ; Plasminogen ; Rupture ; Stroke ; Tissue Plasminogen Activator*