BACKGROUND: Today, the eradication of H. pylori represents a generally accepted and beneficial therapeutic strategy for treatment and prevention of peptic ulcer relapse. Major factors that have affected H. pylori eradication are eradication rate of regimen, compliance of patients and complications of drugs. Recently, the combination of omeprazole, amoxicillin and clarithromycin has been accepted as one of the most effective treatment for the eradication of H. pylori. The primary aim of this study was to evaluate the efficacy of this therapeutic modality in Korean patients. METHODS: Two hundred twenty three patients with peptic ulcer and H. pylori infection were taken two types of triple therapy. Group A were treated with omeprazole 20 mg bid, amoxicillin 500 mg tid, clarithromycin 500 mg tid daily for 14 days. Group B were treated with omeprazole 20 mg bid, amoxicillin 1g bid, clarithromycin 500 mg bid daily for 7 days. Endoscopy with H. pylori tests was repeated 4 weeks after the end of treatment and then biopsy specimens were taken in antrum and body. CLO test and Warthin Starry silver stain were conducted concordantly. RESULTS: The H. pylori eradication rate was 92.5% in group A, 90.4% in group B. There was no significant difference in eradication rate. More than 50% of ulcer size reduction was observed 90.5% in group A, 86.3% in group B. There was no significant difference in ulcer healing(p > 0.05). The incidence of all side effects in both group were as follows; 22.6% in group A, 19.1% in group B. But major side effect was found only group A, of whom the symptom was too serious for the treatment to continue. CONCLUSION: We concluded that the seven days regimen was more favorable, because the eradication rate was almost the same as the 14 days regimen. And drug compliance and cost effectiveness were better than 14 days treatment regimen.
Amoxicillin* ; Biopsy ; Clarithromycin* ; Compliance ; Cost-Benefit Analysis ; Endoscopy ; Helicobacter pylori* ; Helicobacter* ; Humans ; Incidence ; Omeprazole* ; Peptic Ulcer ; Recurrence ; Silver ; Ulcer

PURPOSE: The purpose of this study was to understand the principle of percutaneous nephrolithotomy(PNL), toincrease its success rate, and to base the radiologic approach on preoperative interventional tract dilatation. MATERIALS AND METHODS: Twenty-six patients(male, 19, female, 7) with staghorn or pelviocalyceal calculi who hadundergone PNL were included in this study. After percutaneous nephrostomy(PCN) was performed in each patient, thetract was dilated to 30F with Amplatz dilators using coaxial techniques or a 30F, 10cm high-pressure tractdilatation balloon. One day before the calculi were fragmented and removed by PNL, a 30F Amplatz sheath wasinserted under local anesthesia. The time required for tract dilatation, complications, and surgery was analyzed. RESULTS: Percutaneous tract dilatation were successful in all patients, and forceps, a nephrolithotome and anephroscope were successfully introduced into the pelvocalyceal system. The average procedure time was 19.5minutes ; a double J stent was replaced in the pelvocalyceal system of 13 of 26 patients (50%) ; because ofimproper catheter direction or/and bleeding, the Amplatz sheath was replaced in three. After PNL, complicationsinvolving renal hematoma occurred in one patient. This did not affect the patient's prognosis, however. CONCLUSION:Owing to its short procedure time and low complication rate, interventional preoperative tract dilatation forPNL is thought to be an effective technique for patients with staghorn or pelvocalceal calculi.
Anesthesia, Local ; Calculi ; Catheters ; Dilatation* ; Female ; Hematoma ; Hemorrhage ; Humans ; Nephrostomy, Percutaneous* ; Prognosis ; Stents ; Surgical Instruments

OBJECTIVES: Routine vaccination against influenza is recommended for all people aged 65 years or more. Without active encouragement to receive the vaccine, the rate of compliance is generally low. A study was undertaken to assess and compare the effectiveness of two reminder systems in improving the influenza vaccination rate. METHODS: A total of 2,017 patients aged 65 or over in a tertiary care hospital family practice center were randomly assigned to a control, a telephone reminder, or a postcard reminder group before the influenza season in 1998. The outcome measure, receipt of vaccination, was determined by telephone interview. Demographic and clinical characteristics were checked through the medical chart review. RESULTS: Among the 1,312 patients who actually received reminders and interviewed, the vaccination rate was 46.7% in the control group, 56.3% in the postcard reminder group, and 63.3% in the telephone reminder group. Vaccination compliance was significantly higher in people reminded by telephone (Odds ratio [OR], 2.00; 95% confidence interval [CI], 1.52-2.64) and postcard (OR, 1.55; 95% CI, 1.18-2.02) compared to that in the control group. Of the characteristics investigated, number of high risk co-morbidity was positively associated with vaccination compliance while current smoking was negatively associated. CONCLUSIONS: This result suggests that telephone and postcard reminders can significantly improve compliance with influenza vaccination in this group of Korean elderly. However, additional strategies need to be developed to encourage vaccination among noncompliant.
Aged* ; Compliance ; Family Practice* ; Humans ; Influenza, Human* ; Interviews as Topic ; Outcome Assessment (Health Care) ; Reminder Systems ; Seasons ; Smoke ; Smoking ; Telephone* ; Tertiary Healthcare* ; Vaccination*

PURPOSE: E-cadherin gene, located on chromosome 16q22, may play crucial roles in the cell adhesion and propensity for more malignant properties of various organs. Although loss of heterozygosity (LOH) and DNA hypermethylation at various chromosomal loci have been reported on many malignant tumors, they have been rarely studied in hepatocarcinogenesis, especially for the E-cadherin gene. Our objectives were to evaluate E-cadherin LOH and hypermethylation in hepatocellular carcinomas (HCC) and to correlate with various clinicopathological facors. METHODS: The LOH analysis was performed by using polymerase chain reaction (PCR) with three polymorphic microsatellite markers (D16S419, D16S3106, D16S498) in 40 surgically resected HCCs and each non-tumorous counterpart. The hypermethylation was studied using methylation specific PCR. RESULTS: LOH and hypermethylation were detected in 35% and 55% of HCC, respectively. Also, LOH and hypermethylation were detected in 0% and 32.5% of non-tumor lesions, respectively. LOH results correlated well with higher tumor histologic grade, tumor size and intrahepatic metastasis or vascular tumor invasion. Hypermethylation results correlated well with presence of cirrhosis. Correlation between LOH and hypermethylation was not recognized, but 45.5% of hypermethylation cases showed LOH detection. CONCLUSION: These results suggest that E-cadherin LOH may be associated with more malignant phenotype and tumor progression. And E-cadherin DNA hypermethylation may participates in the early hepatocarcinogenesis by preceding LOH but not causing LOH.
Cadherins ; Carcinoma, Hepatocellular* ; Cell Adhesion ; DNA Methylation ; DNA* ; Fibrosis ; Loss of Heterozygosity* ; Methylation ; Microsatellite Repeats ; Neoplasm Metastasis ; Phenotype ; Polymerase Chain Reaction

PURPOSE: Transforming growth factor (TGF)-beta1 and Hypoxia inducible factor (HIF)-1alpha are renal fibrogenetic cytokines involved with the fibrosis of renal allograft. The aim of this study was to investigate TGF-beta1 and HIF-1alpha in renal allograft patients. METHODS: Between January, 1995 and February, 2005, we performed 72 renal allograft biopsies from 61 recipients. Immunohistochemical studies were performed with a immunoperoxidase technique using the primary antibody, rabbit anti-human TGF-beta1 polyclonal antibody (C-teminus, 1:1,000, Santa-Cruz Biotechnology, Santa Cruz, CA, USA) and mouse anti-human HIF-1alpha monoclonal antibody (clone H1alpha 67-sup, 1:1,000, Novus Biological Inc., Littleton, CO, USA). RESULTS: Tubular and interstitial TGF-beta1 expressions in CAN were higher than other groups, showing significant differences (P<0.05). HIF-1alpha expression in CAN was much higher than other groups (P<0.05). The glomerular TGF-beta1 expression of the heavy proteinuria (2.5 gm/day <) group was significantly higher than the low proteinuria group (<1.0 gm/day) (P<0.05). The tubular TGF-beta1 expression of the graft functioning group was significantly lower than the graft loss group (P<0.05). CONCLUSION: In conclusion, HIF-1alpha expression in renal allograft strongly suggests the development of CAN as well as tubular or interstitial TGF-beta1 expression. TGF-beta1 expression in the glomerulus shows significant correlation with the amount of 24 hours urine protein. The tubular TGF-beta1 expression has strong correlation with graft survival.
Allografts* ; Animals ; Anoxia* ; Biopsy ; Biotechnology ; Cytokines ; Fibrosis ; Graft Survival ; Humans ; Immunoenzyme Techniques ; Kidney Transplantation ; Mice ; Proteinuria ; Transforming Growth Factor beta1 ; Transforming Growth Factors ; Transplants

PURPOSE: To determine the effectiveness of saline-enhanced radiofrequency electrocoagulation in bovine liver tissue MATERIALS AND METHODS: Saline-enhanced radiofrequency electrocoagulation (group I), hot saline injection induced by radiofrequency electrocoagulation (group II), and radiofrequency electrocoagulation (group III) were performed in ex vivo bovine liver. Radiofrequency power was 100 and 200 watts, and current was applied for 10, 20, and 30 seconds. Tissue was histopathologically examined for thermal injury. RESULTS: The largest diameter of thermal injury was about 41.0 mm in group I, 12.3 mm in group II and 9.3 mm in group III. The mean diameter of the injury increased with higher wattage in group I and II and with longer procedure time in group I (p<0.05). At corresponding wattage and times, group I showed a larger diameter of thermal injury and more increase in than group II or III(p<0.05). The degree of carbonization was more severe in group III than in groups I and II. Grossly, thermal injury showed a well-defined, relatively spherical configuration without extension along parenchymal interstitium. CONCLUSION: In an animal model, saline-enhanced radiofrequency electrocoagulation may effectively induce thermal injury, and may thus be another effective tool for use in the treatment of hepatic tumors. Further clinical experience is needed.
Animals ; Carbon ; Catheter Ablation ; Electrocoagulation* ; Liver* ; Models, Animal

Despite the accuracy of nucleic acid amplification tests (NAATs), rapid antigen tests (RATs) for severe acute respiratory syndrome coronavirus-2 are widely used as point-of-care tests. A total of 282 pairs of reverse transcription-polymerase chain reaction and Standard Q COVID-19 Ag tests were serially conducted for 68 patients every 3–4 days until their discharge. Through a field evaluation of RATs using direct nasopharyngeal swabs, the sensitivities were 84.6% and 87.3% for E and RNA-dependent RNA polymerase (RdRp) genes, respectively, for specimens with cycle thresholds (Cts) < 25. The Ct values of E and RdRp genes for 95% detection rates by RATs were 16.9 and 18.1, respectively. The sensitivity of RAT was 48.4% after the onset of symptoms, which was not sufficient. RAT positivity gradually decreased with increased time after symptom onset and had continuously lower sensitivity than NAATs.

Foreign bodies in the maxillofacial area are not commonly seen. If occurred, the immediate removal of foreign bodies is recommended to avoid further complications. The most important thing is a exact localization of foreign bodies using X-rays such as plain radiography, computed tomography, magnetic resonance imaging and ultrasound before treatment. During removal of foreign bodies, tissue should be dissected carefully and complete exploration of the whole wound required.
Foreign Bodies* ; Magnetic Resonance Imaging ; Radiography ; Ultrasonography ; Wounds and Injuries

BACKGROUND: Maximum standardized uptake value (SUVmax) and maximum tumor diameter (MTD) have been shown to reflect survival outcome in diffuse large B cell lymphoma (DLBCL). However, applying these values to primary extranodal DLBCL is difficult because they are separate nosological entities with differences in genetic origin. We therefore decided to evaluate whether SUVmax and MTD on 2-[fluorine-18]-fluoro-2-deoxy-D-glucose (18-FDG) positron emission tomography (PET) would affect the survival outcome in primary extranodal DLBCL. METHODS: From October 2005 to November 2010, 76 primary extranodal DLBCL patients receiving R-CHOP therapy were analyzed. All patients had undergone an initial 18-FDG PET/CT and conventional computed tomography (CT) of the neck, chest, abdomen, and pelvis for staging. Median follow-up period was 35 months. RESULTS: The SUVmax and MTD cut-off values were 11.0 and 7.5 cm, respectively. SUVmax> or =11.0 predicted a short progression free survival (PFS, P=0.002) and overall survival (OS, P=0.002). MTD> or =7.5 cm was associated with poor PFS (P=0.003) and OS (P=0.003). High International Prognostic Index (IPI) was also associated with the survival outcome (PFS, P=0.046; OS, P=0.030). Multivariate analysis revealed that SUVmax> or =11.0 (PFS, hazard ratio [HR]=10.813, P=0.024; OS, HR=6.312, P=0.015); MTD> or =7.5 cm (PFS, HR=5.631, P=0.008; OS, HR=4.072, P=0.008); and high IPI (PFS, P=0.027; OS, P=0.046) were independent prognostic factors. CONCLUSION: It appears that both MTD and SUVmax can be independent prognostic factors in primary extranodal DLBCL.
Abdomen ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Lymphoma ; Lymphoma, B-Cell ; Multivariate Analysis ; Neck ; Pelvis ; Positron-Emission Tomography ; Thorax

Aged ; Dislocations ; Female ; Humans ; Recurrence ; Temporomandibular Joint ; Temporomandibular Joint Disorders ; Transplants