BACKGROUND: Both atrophic gastritis and intestinal metaplasia may progress to gastric dysplasia. This study aimed to analyze the factors influencing progression of atrophic gastritis and intestinal metaplasia to dysplasia. METHODS: People diagnosed with atrophic gastritis and intestinal metaplasia for the first time received a follow-up endoscopy and were investigated for the cumulative incidence rate of gastric dysplasia by age, gender, smoking habit, alcohol intake, rice consumption and family history of stomach cancer. RESULTS: The cumulative incidence rate increased with age, consuming > or =3 bowls of rice per day and family history of stomach cancer. Multivariate analysis showed that the cumulative incidence rate of gastric dysplasia increased in subjects >61 years (RR=2.54, P=0.014), in those consuming > or =3 bowls of rice per day (RR=1.46, P=0.021) and in those with a family history of stomach cancer (RR=1.31, P=0.037). CONCLUSIONS: More active management, such as intensive endoscopic follow-up examinations, lifestyle change and education regarding gastric dysplasia, are required in those older than 61 years, having a higher intake of grain or with a family history of stomach cancer.
Edible Grain ; Endoscopy ; Follow-Up Studies ; Gastritis, Atrophic ; Humans ; Incidence ; Life Style ; Metaplasia ; Multivariate Analysis ; Risk Factors ; Smoke ; Smoking ; Stomach ; Stomach Neoplasms

No abstract available.
Aeromonas/isolation & purification ; *Drug Resistance, Bacterial ; Gram-Negative Bacteria/drug effects/isolation & purification ; Humans ; Korea ; Methicillin Resistance ; Peritonitis/drug therapy/*microbiology

Objective: This study aimed to analyze the clinical characteristics of patients with acute glufosinate ammonium (GLA) poisoning and investigate the indicators associated with the severity of neurotoxicity in GLA-poisoned patients. Methods: We retrospectively collected the data of patients who were admitted due to GLA poisoning from 2018 to 2022, to gather the factors that could influence neurologic outcomes. These outcomes were estimated based on the Glasgow Coma Scale (GCS) scores at admission, the worst GCS score during impaired consciousness, the GCS score at discharge, and the presence and duration of seizures. Results: Among the 67 GLA-poisoned patients, the average GCS score at admission was 13.8±2.6 points, the worst GCS score recorded was 11.2±3.5 points, and the GCS score at discharge was 13.7±2.9 points. The factors significantly influencing the GCS score at the initial admission included respiration rate, saturation, white blood cell count, and pH (P=0.037, P=0.005, P=0.021, and P=0.001, respectively). Factors affecting the worst GCS score included age, diastolic blood pressure, platelet count, blood urea nitrogen (BUN), and pH (P=0.001, P=0.016, P=0.015, P=0.002, and P<0.001, respectively). The GCS score at discharge exhibited significant correlations with age, BUN, and pH (P<0.001, P<0.001, and P=0.011, respectively). The average age of the patients who experienced seizures after GLA poisoning was significantly higher at 75.1±12.9 years compared to that of patients without seizures (mean age, 65.0±15.2 years; P=0.006). Additionally, the average bicarbonate level was lower in patients with seizures, measuring 19.0±4.7 mmol/L, when compared with that of patients without seizures (average, 21.4±4.3 mmol/L; P=0.045). Conclusion The elderly, metabolic acidosis, and elevated BUN could serve as good indicators for adverse neurological outcomes in GLA-poisoned patients.

BACKGROUND/AIMS: The Dieulafoy lesion is an important cause of gastrointestinal bleeding. The bleedings from caliber- persistent vessel or abnormally large and tortuous submucosal artery are usually located on proximal stomach. Endoscopic band ligation (EBL) is currently regarded as the treatment of choice of Dieulafoy lesions. This study reports on the clinical features, the efficacy and safety of EBL. METHODS: 10 patients with Dieulafoy-like lesion (median age: 47 yr range: 22~71, M:F 8:2 ) were treated using EBL. EBL was performed as the primary hemostatic tratment as follows in 8 cases of urgency and 2 cases of emergency. RESULTS: The location of all lesions (n=10) were in stomach, 8 in body (4 in posterior wall), 2 in fundus. The bleeding focuses were identified during the first endoscopy. Five lesions were bleeding, 5 had adherent clots or protruding vessels without active bleeding. Hemostasis were achieved with first session of EBL in 9 patients successfully, one case in the fundus was failed due to early band release. CONCLUSION: EBL is a simple, effective, and safe endoscopic method of Dieulafoy-like lesions and, it should be proposed as a primary option.
Arteries ; Emergencies ; Endoscopy ; Hemorrhage ; Hemostasis ; Humans ; Ligation* ; Stomach

BACKGROUND: To evaluate the prognostic factors of seizure recurrence in newly diagnosed epilepsy at 1 year follow up. METHODS: From the IUED (Inje University Epilepsy Database) we retrieved the epilepsy patients who had never before taken any antiepileptics (AED) and were followed up for 1 year. We retrospectively reviewed the medical records with special attention to : a) age of onset, b) history of antecedents, c) seizure frequency before starting AED, d) abnormal neurological examination, e) MRI findings, f) EEG findings, g) epileptic syndrome classification. We defined seizure recurrence as any seizure occurring during the 1 year evaluation follow up except during the AED titra-tion period, having only an aura and being in poor compliance. We analyzed the prognostic factors that could reliably predict the seizure recurrence at 1 year follow up. RESULTS: We found 104 patients (64 male, 40 female) who met the inclusion criteria. The mean age of onset was 23.7 years. Of 104 patients 19 had generalized epilepsy, 82 had partial epilepsy and 3 had unclassified epilepsy. Thirteen percent (13/104) developed seizure recurrence at the 1 year follow up. Significant univariate associations were noted between seizure recurrence and these factors: presence of antecedents [odds ratio (OR) 4.8; 95% confidence interval (CI) 1.2-18.5 ], post-encephalitic epilepsy (OR 7.7; 95% CI 2.1 ~ 28), and abnormal neurological examination(OR 14.6; 95% CI 3.9-55). With multivariate logistic regression, the independent predictor of seizure recurrence was the abnormal neurological examination (OR 9.7; 95% CI 2.4 ~ 39.4). CONCLUSIONS: The chance of developing a seizure recurrence at the 1 year follow up was 13 percent and the prognostic factors were the presence of antecedents, post-encephalitic epilepsy and an abnormal neurological examination.
Age of Onset ; Anticonvulsants ; Classification ; Compliance ; Electroencephalography ; Epilepsies, Partial ; Epilepsy* ; Epilepsy, Generalized ; Follow-Up Studies ; Humans ; Logistic Models ; Magnetic Resonance Imaging ; Male ; Medical Records ; Neurologic Examination ; Recurrence* ; Retrospective Studies ; Seizures*

Oculogyric crisis is an acute dystonia involving ocular muscles characterized by sustained conjugate upward or lateral deviation of the eyes. Metronidazole is a commonly used antimicrobial agent in treatment of anaerobic infections. However, its long-term use can cause toxic encephalopathy particularly in patients with hepatic dysfunction. Here, we describe a case of oculogyric crisis as a presenting manifestation of metronidazole-induced encephalopathy.
Brain Diseases ; Dystonia ; Humans ; Metronidazole ; Muscles ; Neurotoxicity Syndromes

Objective: This study aimed to clarify the relationship between several viral infections and clinical features of febrile seizures. The clinical expression pattern was determined according to the virus. Methods: Data were collected on patients who visited the emergency room with febrile seizures from March 2016 to February 2019. The clinical characteristics of seizures and the clinical differences between each respiratory viral infection were analyzed. The severity of febrile seizures was measured by checking complex febrile seizures and electroencephalogram abnormalities. Results: Of the 227 febrile convulsions, 138 (60.8%) were men, and 89 (39.2%) were women. Sixty-five patients (28.6%) had a family history of febrile seizure, 68 (30.0%) had complex seizures, and 13 (7.1%) had electroencephalogram (EEG) abnormalities. Of the 13 respiratory viruses examined, rhinoviruses were detected more significantly in 63 patients (32.4%), but there was no significant difference when comparing the rate of febrile seizure among patients with fever. There were no significant differences in the clinical features, such as body temperature, duration, and complex seizure. In addition, each virus showed a similar incidence of EEG abnormalities. Conclusion No significant difference in the clinical features and objective examination according to the virus were observed, and the tendency of developing febrile seizures is similar.

Objective: This study aimed to clarify the relationship between several viral infections and clinical features of febrile seizures. The clinical expression pattern was determined according to the virus. Methods: Data were collected on patients who visited the emergency room with febrile seizures from March 2016 to February 2019. The clinical characteristics of seizures and the clinical differences between each respiratory viral infection were analyzed. The severity of febrile seizures was measured by checking complex febrile seizures and electroencephalogram abnormalities. Results: Of the 227 febrile convulsions, 138 (60.8%) were men, and 89 (39.2%) were women. Sixty-five patients (28.6%) had a family history of febrile seizure, 68 (30.0%) had complex seizures, and 13 (7.1%) had electroencephalogram (EEG) abnormalities. Of the 13 respiratory viruses examined, rhinoviruses were detected more significantly in 63 patients (32.4%), but there was no significant difference when comparing the rate of febrile seizure among patients with fever. There were no significant differences in the clinical features, such as body temperature, duration, and complex seizure. In addition, each virus showed a similar incidence of EEG abnormalities. Conclusion No significant difference in the clinical features and objective examination according to the virus were observed, and the tendency of developing febrile seizures is similar.

BACKGROUND/AIMS: Serum HBV DNA levels are correlated with hepatic histologic activity in chronic HBV infection based on HBeAg. Liver injury may persist, even though HBV DNA are not detected by hybridization assay. This study was to investigate whether serum HBV DNA levels determined by more sensitive quantitative method are correlated with histologic activities in chronic HBV infections. METHODS: This study included 66 chronic HBV infected patients. HBV DNA level was quantified by Cobas Amplicor HBV Monitor(TM). RESULTS: Serum HBV DNA levels in HBeAg-positive patients were significantly higher than HBeAg-negative patients. In HBeAg-positive patients, serum HBV DNA levels showed a significant negative correlation with portal-periportal activity and fibrosis (r=-0.451, -0.446 respectively). AST levels were correlated with lobular, portal-periportal activity and fibrosis (r=0.432, 0.365, 0.301 respectively), whereas ALT levels were related to lobular activity (r=0.294). Elevated AST levels predicted lobular activity, portal-periportal activity, and fibrosis with moderate to severe degree (OR 1.733, 95% CI 1.083-2.775; OR 1.518, 95% 1.028-2.243, p=0.336; OR 17.897, 95% CI 1.517-211.208, p=0.022, respectively). CONCLUSIONS: In HBeAg-positive patients, serum HBV DNA level correlates inversely with histologic activity. On the other hands AST level correlates with histologic activity and the stage of moderate or severe degree.
Adolescent ; Adult ; Child ; Child, Preschool ; DNA, Viral/*blood ; Female ; Hepatitis B e Antigens/analysis ; Hepatitis B virus/genetics/*isolation & purification ; Hepatitis B, Chronic/pathology/*virology ; Humans ; Liver/*pathology ; Male ; Middle Aged

BACKGROUND: To decide the optimal antibiotics and application of chest tube, examination of pleural fluid is fundamental in the management of empyema. Some criteria for drainage of pleural fluid have been recommended but some controversies have been suggested. Recently, newer radiologic methods including ultrasound and computed tomography scanning, have been applied to the diagnosis and management of pleural effusions. We undertook a retrospective analysis of 30 patients with pleural effusion who had CT scans of the chest in order to apply the criteria of Light et at retrospectively to patients with loculation and to correlate the radiologic appearance of pleural effusions with pleural fluid chemistry. METHOD: We analyzed the records of 30 out of 147 patients with pleural effusion undergoing chest CT scans. RESULTS: 1) Six of the pleural fluid cultures yielded gram negative organisms and three anaerobic bacterias and one Staphylococcus aureus and one non-hemolytic Streptococci. No organism was cultured in nineteen cases(63.0%). 2) The reasons for taking chest CT scans were to rule out malignancy or parenchymal lung disease(46.7%), Poor response to antibiotics(40.0%), hard to aspirate pleural fluid(10.0%) and to decide the site for chest tube insertion(3.3%). 3) There was no significant correlations between ATS stages and loculation but there was a tendency to Inoculate in stage III. 4) There was a significant inverse relationship between the level of pH and loculation(P<0.05) but there appeared to be no relationship between pleural fluid, LDH, glucose, protein, loculation and pleural thickening. 5) In 12 out of 30, therapeutic measures were changed according to the chest CT scan findings. CONCLUSION: We were unable to identify any correlations between the plerual fluid chemistry, ATS stages and loculations except pH, and we suggest that tube thoracotomy should be individualized according to the clinical judgement arid serial observation. All patients with empyema do not need a chest CT scan but a CT scan can provide determination of loculation, guiding and assessing therapy which should decrease morbidity and hospital stay.
Anti-Bacterial Agents ; Bacteria, Anaerobic ; Chemistry ; Chest Tubes ; Diagnosis ; Drainage ; Empyema* ; Glucose ; Humans ; Hydrogen-Ion Concentration ; Length of Stay ; Lung ; Pleural Effusion ; Retrospective Studies ; Staphylococcus aureus ; Thoracotomy ; Thorax* ; Tomography, X-Ray Computed* ; Ultrasonography