Antimicrobial resistance is a growing problem in the eradication of Helicobacter pylori. A combination therapy with proton pump inhibitor, clarithromycin, and amoxicillin is recommended as the first-line treatment regimen in Korea. However, the eradication rate with a standard triple therapy has been unsatisfactory in the last decade, and one of the main reasons for treatment failure is the increasing prevalence of strains resistant to antimicrobials. Therefore, comprehensive and detailed information on antimicrobial resistance is mandatory to optimize the strategy of eradication treatment. The antimicrobial resistance of H. pylori is reported to vary according to study population, geographical region, and test methods. In this review, the prevalence of antimicrobial resistance of H. pylori isolates in Korea is summarized on the basis of recent studies.
Amoxicillin ; Clarithromycin ; Drug Resistance, Microbial ; Helicobacter pylori* ; Helicobacter* ; Korea* ; Prevalence ; Proton Pumps ; Treatment Failure

The correction is being published to correct the grant number in above article.

Various cancer types have been associated with cancer-related cerebral infarction. In this study, we describe the first case of cancer-related cerebral infarction in which the underlying disease was primary bone marrow lymphoma (PBML). A 79-year-old man presented with abruptly developed bilateral lower extremity weakness and confusion. Diffusion-weighted imaging on admission showed multiple cortical and subcortical embolic infarction lesions in multiple vascular territories. Diagnostic evaluations to determine the embolic source revealed no abnormalities. Laboratory testing demonstrated elevated D-dimer (2.59 μg/mL) but no other prothrombotic abnormalities. In suspicion of cancer-related stroke, we performed chest CT, abdomen CT, and FDG-PET to detect the hidden malignancy. Findings revealed no evidence of cancer; however, they did reveal signs of anemia (hemoglobin 9.0 g/dL). Bone marrow aspiration biopsy showed large atypical B cell involvement suggestive of high-grade B cell lymphoma. The patient was diagnosed with primary bone marrow diffuse large B-cell lymphoma initially presenting with ischemic stroke. Our case suggests that primary bone marrow cancer may be a candidate for the differential diagnosis of hidden malignancy in patients with suspected cancer-related stroke. Bone marrow biopsy may be essential for establishing an appropriate differential diagnosis in patients with abnormal hematologic findings.

Purpose: We present a case of internal astigmatism correction using a toric scleral contact lens in a patient with high myopia after implantable collamer lens (ICL) surgery.Case summary: A 45-year-old man presented with a significant decrease in visual acuity despite previous ICL surgery. Initial attempts to fit a corneal rigid gas permeable contact lens to the left eye were unsuccessful due to fitting challenges. Subsequently, the use of a spherical scleral contact lens effectively corrected corneal astigmatism but failed to address internal astigmatism, thereby limiting improvement in visual acuity. Postoperative corneal ectasia and ICL rotation were suspected to be the underlying causes of this astigmatism. The introduction of a front toric scleral lens resulted in a significant improvement in visual acuity and sustained comfort throughout the 3-month follow-up period. Conclusions The use of toric scleral lenses can significantly improve visual acuity and provide exceptional comfort in cases where corneal morphology and lens position change after ICL surgery. This modality presents a promising alternative for future consideration.

OBJECTIVE: The ovarian cycle is characterized by repeating patterns of cellular proliferation and differentiation that accompany follicular development and the formation and regression of the corpus luteum (CL). That angiogenesis may play an important role in this process. Angiogenesis is supposed to be regulated by vascular endothelial growth factor (VEGF). The goal of the present investigation, therefore, was to determine whether the expression of VEGF was changed in the normally cycling human ovary. We also investigated VEGF expression in the regressed CL (ie, nonfunctiong CL) of normal term pregnancy to define the association with steroidogenic activity. To our knowledge there is no report available on VEGF expression in the CL of term pregnancy. METHODS: We assessed VEGF expression in ovaries obtained from, 26-42 yr of age, and from patients undergoing hysterectomy and salpingo-oophorectomy for nonendocrinological or nonovarian disorders. Tissue samples from premenopausal women included specimens from follicular (n=4) and luteal (n 4) phases. In addition, we studied ovarian specimens from pregnant women (n=3). Immunohistochemical analysis for VEGF was performed using a rabbit polyclonal antibody directed against human VEGF. RESULTS: These data demonstrate a development-related VEGF expression in the follicle and indirectly show that VEGF expression may be up to the existence of LH-receptor. And also, VEGF was overexpressed in the regressed CL of pregnant women compared with the functioning CL of nonpregnant cycles CONCLUSION: This study suggests that the intensity of VEGF expression is not correlated with steroidogenic activity, although both of them are stimulated by LH.
Cell Proliferation ; Corpus Luteum ; Female ; Humans* ; Hysterectomy ; Menstrual Cycle ; Ovarian Follicle ; Ovary* ; Pregnancy ; Pregnant Women ; Vascular Endothelial Growth Factor A*

BACKGROUND: Androgenetic alopecia is characterized by local and gradual transformations of terminal scalp hair to vellus hair, which has a shorter and thinner shaft. The proportion of patients with androgenetic alopecia, among the total number of patients with alopecia, seems to be gradually increasing. OBJECTIVE: The purpose of this study was to evaluate the family history, and clinical and endocrine status of patients with androgenetic alopecia. METHOD: 796 patients with androgenetic alopecia were assessed at the Alopecia Clinic, Department of Dermatology, College of Medicine, Chung-Ang University Hospital over a 3 year period (from January 2001 to December 2003). RESULTS: The following results were obtained: 1) There were found to be 1.7 more male patients (498) than female patients (298). They were also found to be mostly in their twenties (male 253; 50.8%, female 90; 30.2%). Previously, male to female ratio was 3.46: 1, but was now found to be 1.7: 1. 2) In the 498 male patients, Norwood class II was dominant (130 patients; 26.2%). In the 298 female patients, Ludwig class I was superior (204 patients; 68.5%). 3) 321 patients (64.5%) of 498 male patients and 177 (59.4%) of 298 female patients hada family history of androgenetic alopecia. 4) The most common accompanying disorder was seborrheic dermatitis (male 287; 73.0%, female 137; 64.6%). 5) Serum testosterone levels were increased in 84 (16.9%) of 498 male patients and 44 (14.8%) of 298 female patients. CONCLUSION: Most of these results are compatible with our previous study carried out in 1995. But, female androgenetic alopecia patients are nowadays increasing in number, therefore, the ratio of male to female is markedly different.
Alopecia* ; Dermatitis, Seborrheic ; Dermatology ; Female ; Hair ; Humans ; Male ; Scalp ; Testosterone

BACKGROUND: Atopic dermatitis, characterized by dry, flasky, easily irritated skin, is the most common form of dermatitis seen during childhood. Infants with atopic dermatitis and other eczematous conditions need special dermatologic care to hydrate their skin and to minimize contact with irritants or allergens. OBJECTIVE: The purpose of our study is to evaluate the safety and efficacy of the skin products developed for children. METHODS: Twenty-eight normal children and 26 children with atopic dermatitis were evaluated clinically after using following commercal skin products : (lotion, cream, shampoo, soap, face wash wash) for 2 weeks. Water content of the skin of 14 volunteers was measured serialy over 8 haurs at 2 hour intervals after the application of each skin product. The skin pH of 16 volunteers was also measured serialy over 60 minutes at 30 minute intervals after application. We performed visual skin erythema grading, skin erythema grading by dermaspectrometer, transepidermal water loss measurement, skin water content measurement, and keratinocyte morphology observation by D-squame after the application of the skin products to 13 volunteers for 4 days.
Allergens ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Child ; Dermatitis ; Dermatitis, Atopic ; Erythema ; Humans ; Hydrogen-Ion Concentration ; Infant ; Irritants ; Keratinocytes ; Keratosis, Seborrheic ; Skin* ; Soaps ; Volunteers

PURPOSE: Study purposes were to exam effects of self-care education for children with type 1 diabetes on their diabetes management behaviors and to explore the relationship among diabetes management behaviors, knowledge, self-efficacy and clinical variables. METHODS: This study was a one group quasi-experimental study. Study participants were children with type 1 diabetes and attended a four hour self-care education of a diabetes camp. Data were collected using structured questionnaires including Diabetes Management Behavior Scale (DMBS), Michigan Diabetes Research and Training Center's Brief Diabetes Knowledge Test and Self-Efficacy for Diabetes Self-Management. RESULTS: The mean age of the participants was 12 (+/-2.3) years. After the education, their DMBS and knowledge improved, but the improvement was not statistically significant (t=1.758, p=.101; t=0.528, p=.606). Two areas of DMBS, daily prevention behaviors and modification of care plan, were associated with study variables. Daily prevention behaviors were associated with duration of diabetes (r=.653, p=.008), HbA1c (r=.563, p=.038) and having a complication (r=-2.788, p=.015). Modification of care plan was associated with age at diagnosis (r=-.552, p=.033). CONCLUSION: Children with type 1 diabetes could improve some parts of their diabetes management behaviors even after a short diabetes camp.
Child* ; Diabetes Mellitus, Type 1 ; Diagnosis ; Disease Management ; Education* ; Humans ; Michigan ; Self Care* ; Self Efficacy

BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) is associated with metabolic syndrome including insulin resistance, hypertension, dyslipidemia, central obesity, type 2 diabetes, and cardiovascular disease. In NAFLD, insulin resistance plays an important role in the progression of liver damage. In this study, we evaluated insulin resistance, plasma adiponectin, hepatic steatosis, and their association in adults with normal liver transaminase concentrations. METHODS: We analyzed 111 subjects, aged over 20 years old, who visited the Health Management Center at Chung-Ang University Hospital between May 2006 and August 2006. They had neither history nor clinical evidence of diabetes, cardiovascular or liver disease. They were divided into three groups by the degree of hepatic steatosis based on ultrasound findings. Anthropometric parameters were measured and blood samples were drawn after eight hours of fasting. RESULTS: Hepatic steatosis had a positive correlation with body mass index, waist circumference, blood pressure, triglycerides, HOMA-IR, and QUICKI. Moreover, it had a negative correlation with high-density lipoprotein cholesterol and adiponectin. Triglycerides, Adiponectin, and QUICKI were independent variables in predicting the degree of hepatic steatosis. CONCLUSION: This finding suggests that triglycerides and plasma adiponectin are independent predictors of hepatic steatosis in adults with normal liver transaminase concentrations.
Adiponectin ; Adult ; Aged ; Blood Pressure ; Body Mass Index ; Cardiovascular Diseases ; Cholesterol ; Dyslipidemias ; Fatty Liver ; Humans ; Hypertension ; Insulin Resistance ; Lipoproteins ; Liver ; Liver Diseases ; Obesity, Abdominal ; Plasma ; Triglycerides ; Waist Circumference

Mycoplasma pneumoniae pneumonia is one of the most prevalent community-acquired pneumonias in pediatric patients. It commonly presents with mild respiratory symptoms and is well controlled by macrolide antibiotics. Rarely, it can progress to acute respiratory distress syndrome (ARDS) despite appropriate antibiotic therapy, and systemic corticosteroids and quinolone antibiotics are required. We recently treated 2 patients who presented with M. pneumoniae pneumonia with ARDS. Case 1: A 17-year-old girl was admitted with pneumonia that showed no response to antibiotics and progressed to ARDS, which required initiation of mechanical ventilation therapy. The patient was negative for M. pneumoniae IgM; but positive for, M. pneumoniae. After treatment with methylprednisolone and levofloxacin, rapid improvement was observed in both clinical manifestations and chest radiographic findings. Two days after discontinuing a 5-day methylprednisolone treatment regimen, she developed fever, and investigations revealed an elevated C-reactive protein level; this necessitated additional methylprednisolone treatment. Subsequently, she showed complete recovery with no sequelae. Case 2: A 14-year-old girl was admitted with M. pneumoniae pneumonia with ARDS that required mechanical ventilation therapy. She showed a IgM titers against M. pneumoniae of 1:320. After treatment with antibiotics and methylprednisolone, she recovered and was discharged at 48 admission days; however, mild dyspnea persisted. The chest computed tomography showed multiple bronchiectasis areas. After 15 days, because of aggravated dyspnea, she was readmitted and adminis-tered methylprednisolone pulse therapy. Despite 3 courses of methylprednisolone pulse therapy, she still showed mild dyspnea.
Adolescent ; Adrenal Cortex Hormones ; Anti-Bacterial Agents ; Bronchiectasis ; C-Reactive Protein ; Child ; Dyspnea ; Female ; Fever ; Humans ; Immunoglobulin M ; Levofloxacin ; Methylprednisolone ; Mycoplasma pneumoniae* ; Mycoplasma* ; Pneumonia* ; Pneumonia, Mycoplasma* ; Radiography, Thoracic ; Respiration, Artificial ; Respiratory Distress Syndrome, Adult* ; Thorax