Menetrier's disease in childhood is a rare form of gastropathy characterized by hypoalbuminemia, endoscopic and/or radiologic findings of hypertrophic gastric folds, and histologic findings of foveolar hyperplasia in the stomach. It tends to have a self-limited course compared to the chronic and complicated course in adult Menetrier's disease. A 7-year-old boy was referred to Incheon St. Mary's Hospital for facial edema. Physical examination on admission showed periorbital swelling, pitting edema in both legs, and epigastric tenderness. Laboratory tests on admission indicated hypoproteinemia (3.0 g/dL) with hypoalbuminemia (2.1 g/dL) and hypogammaglobulinemia. Urinalysis showed no abnormalities. The test results for anti-cytomegalovirus immunoglobulin M and cytomegalovirus PCR were negative. Stool Helicobacter pylori antigen was positive and fecal alpha1-antitrypsin clearance was 40.1 mL/day, consistent with protein-losing gastroenteropathy. Gastroduodenoscopy showed hypertrophic edematous gastric folds, erythema, and superficial erosion in the body of the stomach. The duodenum was normal. Histologic findings showed foveolar hyperplasia. His symptoms improved with conservative treatment including proton pump inhibitor from day 9 of hospitalization and resolved completely. Here we reported a case of pediatric protein-losing hypertrophic gastropathy associated with Helicobacter pylori infection.
Adult ; Agammaglobulinemia ; Child ; Cytomegalovirus ; Duodenum ; Edema ; Erythema ; Gastritis, Hypertrophic* ; Helicobacter pylori* ; Hospitalization ; Humans ; Hyperplasia ; Hypoalbuminemia ; Hypoproteinemia ; Immunoglobulin M ; Incheon ; Leg ; Male ; Physical Examination ; Polymerase Chain Reaction ; Proton Pumps ; Stomach ; Urinalysis

Objective: This study aimed to identify the clinical characteristics for differential diagnosis of Parkinson’s disease dementia (PDD) and dementia with Lewy bodies (DLB) by analyzing the differences in cognitive function and caregiver burden between the patient groups. Methods: We conducted a retrospective cross-sectional study with idiopathic Parkinson’s disease patients and DLB patients. Differences in cognitive function were measured using the standardized neuropsychological test battery (Seoul Neuropsychological Screening Battery-II). Differences in the caregiver burden were measured by the Neuropsychiatric Inventory-Questionnaire (NPIQ) for behavioral psychological symptoms of dementia (BPSD) and Korean-Instrumental Activities of Daily living (K-IADL) for daily living activities. For statistical analysis, chi-square test and multivariate analysis of variance and binary logistic regression and correlation analysis were conducted using SPSS 22. Results: Nine Parkinson’s disease-Normal cognition (PD-NC), 25 Parkinson’s disease-mild cognitive impairment (PD-MCI), 20 PDD and 11 DLB patients were included. Compared with PDD and DLB, attentional deficit correlated more strongly with DLB, but language dysfunction showed more correlation with PDD. Caregiver burden correlated more strongly with DLB than PDD. Delusion and aberrant motor behaviors of NPI-Q and taking medicine of K-IADL were strongly related with the caregiver burden of both PDD and DLB. Conclusion This study identified that neuropsychological profile and caregiver burden in comparison of BPSD and ADL can contribute to the differential diagnosis of PDD and DLB.

Background and objectives: To compare the safety and efficacy of a new everolimus-eluting stent with an abluminal-coated biodegradable polymer (Osstem Cardiotec Centum) with those of the Xience Alpine stent (Xience). Methods: This randomized, prospective, multicenter, parallel-designed, single-blind trial was conducted among patients with myocardial ischemia undergoing percutaneous coronary intervention (PCI) from 21st September 2018 until 3rd July 2020. The primary efficacy endpoint was in-segment late lumen loss (LLL) at 270 days after the procedure and the primary safety endpoints were major adverse cardiac events (MACE), composite of cardiac death, myocardial infarction, and target lesion revascularization. Results: We enrolled 121 patients and analyzed 113 patients who finished 270 days of followup for the primary efficacy endpoint. The mean age of the participants was 66.8 years. As for the primary efficacy endpoint, LLL of the Osstem Cardiotec Centum group was 0.09±0.13 mm and that of the Xience group was 0.12±0.14 mm (upper limit of 1-sided 95% confidence interval, 0.02; p for non-inferiority, 0.0084). This result demonstrates the non-inferiority of the Osstem Cardiotec Centum. As for the primary safety endpoint, MACE occurred in one patient (1.59% of the Xience group). Meanwhile, no MACE occurred in the Osstem Cardiotec Centum group. Conclusions The Osstem Cardiotec Centum is non-inferior to the Xience Alpine ® stent and is confirmed to be safe. It could be safely and effectively applied to patients with coronary artery disease undergoing PCI.

BACKGROUND: Specific immunoglobulin E (IgE) sensitization to staphylococcal enterotoxin (SE) has been recently considered to be related to allergic disease, including asthma. Despite studies on specific IgE (sIgE) to SE and its relationship to asthma diagnosis and severity, the association of sIgE to SE with airway hyperresponsiveness (AHR) remains unclear. METHODS: We enrolled 81 asthma patients admitted to the Severance Hospital in Korea from March 1, 2013, to February 28, 2015 and retrospectively reviewed the electronic medical records of the enrolled subjects. The serum levels of sIgE to SE (A/B) of all subjects was measured using the ImmunoCAP 250 (Phadia) system with SE-sIgE positive defined as >0.10 kU/mL. RESULTS: The SE-sIgE level was not significantly correlated with asthma severity (forced expiratory volume in 1 second [FEV₁], FEV₁/forced vital capacity, sputum eosinophils, and serum eosinophils), whereas the SE-sIgE level in patients with positive AHR (mean±standard error of the mean, 0.606±0.273 kU/mL) was significantly higher than that in patients with negative AHR (0.062±0.015 kU/mL, p=0.034). In regression analysis, SE sensitization (sIgE to SE ≥0.010 kU/mL) was a significant risk factor for AHR, after adjustment for age, sex, FEV₁, and sputum eosinophils (odds ratio, 7.090; 95% confidence interval, 1.180–42.600; p=0.032). Prevalence of SE sensitization was higher in patients with allergic rhinitis and non-atopic asthma patients, as compared to patients without allergic rhinitis and atopic asthma patients, respectively, but without statistical significance. CONCLUSION: SE sensitization is significantly associated with AHR.
Asthma* ; Diagnosis ; Electronic Health Records ; Enterotoxins* ; Eosinophils ; Humans ; Immunoglobulin E* ; Immunoglobulins* ; Korea ; Prevalence ; Retrospective Studies ; Rhinitis, Allergic ; Risk Factors ; Sputum ; Staphylococcus ; Vital Capacity