PURPOSE: The C-14 urea breath test (C-14 UBT) is the most specific noninvasive method to detect Helicobacter (H) pylori infection. We investigated if the C-14 UBT can reflect the presence and degree of H. pylori detected by gastroduodenoscopic biopsies (GBx). MATERIALS AND METHODS: One hundred fifty patients (M:F=83:67, age 48.6+/-11.2 yrs) underwent C-14 UBT, rapid urease test (CLO test) and GBx on the same day. For the C-14 UBT, a single breath sample was collected at 10 minutes after ingestion of C-14 urea (137 KBq) capsule and counting was done in a liquid scintillation counter for 1 minute, and the results were classified as positive ( 200 dpm), intermediate (50~199 dpm) or negative (<50 dpm). The results of CLO tests were classified as positive or negative according to color change. The results of GBx on giemsa stain were graded 0 (normal) to 4 (diffuse) according to the distribution of H. pylori by the Wyatt method. We compared C-14 UBT results with GBx grade as a gold standard. RESULTS: In the assessment of the presence of H. pylori infection, the C-14 UBT global performance yielded sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of 92.5%, 88.4%, 97.1%, 88.4% and 91.3%, respectively. However, the CLO test had sensitivity, specificity, PPV, NPV and accuracy of 83.2%, 81.4%, 91.8%, 81.4% and 82.7%, respectively. The quantitative values of the C-14 UBT were 45+/-27 dpm in grade 0, 707+/-584 dpm in grade 1, 1558+/-584 dpm in grade 2, 1851+/-604 dpm in grade 3, and 2719+/-892 dpm in grade 4. A significant correlation (r=0.848, p<0.01) was found between C-14 UBT and the grade of distribution of H. pylori infection on GBx with giemsa stain. CONCLUSION: We conclude that the C-14 UBT is a highly accurate, simple and noninvasive method for the diagnosis of ongoing H. pylori infection and reflects the degree of bacterial distribution.
Azure Stains ; Biopsy ; Breath Tests* ; Diagnosis ; Eating ; Helicobacter pylori* ; Helicobacter* ; Humans ; Scintillation Counting ; Sensitivity and Specificity ; Urea* ; Urease

No abstract available.
Thyroid Gland* ; Thyroid Nodule*

Ewing's sarcoma is a highly malignant, small, round cell tumor that usually affects long bones. The acral part of the extremities is a very rare primary site for this neo plasm. A fifteen-year-old girl was seen for a lobulated, dome-shaped, 2.7cm diameter, denuded mass on the distal phalanx of the right middle finger which had increased in size over a 14-month period. The radiological featuies of the hand showed a cortical brick of distal phalanx and surrounding soft tissue mass. Histologically, the biopsy specimen showed sheets of small round to oval cells with scanty cytoplasm, that were closely packed and separated into lobules by trands of fibrous tissue. A periodic acid-Schiff stain demonsirated glycogen in the cytoplasm of the tumor cells. Electron microscopy showed large aggregates of glycogen in the cytoplasm of the neoaplastic cells. Immunohistochemical stains revealed positive staining for vimentin, glial fibrillary acid potein, and neuron specific enolase, stains for S-100, Factor VIII, and cytokeratin were negative.
Biopsy ; Coloring Agents ; Cytoplasm ; Extremities ; Factor VIII ; Female ; Fingers ; Glycogen ; Hand ; Humans ; Keratins ; Microscopy, Electron ; Phosphopyruvate Hydratase ; Sarcoma* ; Sarcoma, Ewing ; Vimentin

Ewing's sarcoma is a highly malignant, small, round cell tumor that usually affects long bones. The acral part of the extremities is a very rare primary site for this neo plasm. A fifteen-year-old girl was seen for a lobulated, dome-shaped, 2.7cm diameter, denuded mass on the distal phalanx of the right middle finger which had increased in size over a 14-month period. The radiological featuies of the hand showed a cortical brick of distal phalanx and surrounding soft tissue mass. Histologically, the biopsy specimen showed sheets of small round to oval cells with scanty cytoplasm, that were closely packed and separated into lobules by trands of fibrous tissue. A periodic acid-Schiff stain demonsirated glycogen in the cytoplasm of the tumor cells. Electron microscopy showed large aggregates of glycogen in the cytoplasm of the neoaplastic cells. Immunohistochemical stains revealed positive staining for vimentin, glial fibrillary acid potein, and neuron specific enolase, stains for S-100, Factor VIII, and cytokeratin were negative.
Biopsy ; Coloring Agents ; Cytoplasm ; Extremities ; Factor VIII ; Female ; Fingers ; Glycogen ; Hand ; Humans ; Keratins ; Microscopy, Electron ; Phosphopyruvate Hydratase ; Sarcoma* ; Sarcoma, Ewing ; Vimentin

BACKGROUND: Helicobacter pylori(H. pylori) infection is known to be strongly associated with varied dermatoses such as rosacea, vasculitic purpura, and Sweet's syndrome. Also, many antibiotics including amoxicillin, clarithromycin, and tetracycline have been used to ameliorate chronic urticaria. This recent knowledge posed the plausibility that H. pylori infection might be an underlying causative factor of chronic urticaria. OBJECTIVE: This study was conducted to investigate the role of H. pylori infection in patients with chronic urticaria. METHODS: Sixty-five subjects with chronic urticaria were examined for H. pylori infection with enzyme-linked immunosorbent assay for IgG/M against H. pylori and rapid urease test(CLO test) for endoscopically biopsied gastric mucosa. Amoxicillin or clarithromycin combined with omeprazole as a therapy was administrated to the 44 patients with positive test results for 4 weeks. RESULTS: H. pylori infection was more frequently diagnosed in 44 of 65(67.7%) patients with chronic urticaria than in the control subjects(8.8%). After the completion of treatment for 4 weeks, specific IgG antibodies and a CLO test against H. pylori were negative in 28 of 38(73.7%) and 43 of 44(97.7%) patients respectively. At the post-treatment evaluation, 37 of 44(84.1%) patients with H. pylori-positive urticaria showed significant clinical remission of urticaria. CONCLUSION: Eradication of H. pylori in patients with chronic urticaria was accompanied by clinical remission of urtication. There is substantial evidence that unexplained causes of chronic urticaria may be associated with H. pylori infection.
Amoxicillin ; Anti-Bacterial Agents ; Antibodies ; Clarithromycin ; Enzyme-Linked Immunosorbent Assay ; Gastric Mucosa ; Helicobacter pylori* ; Helicobacter* ; Humans ; Immunoglobulin G ; Korea* ; Omeprazole ; Prevalence* ; Prospective Studies* ; Purpura ; Rosacea ; Skin Diseases ; Sweet Syndrome ; Tetracycline ; Urease ; Urticaria*

PURPOSE: The aim of this study was to determine whether crossed cerebellar hyperperfusion (CCH) was helpful in discriminating mesial from lateral temporal lobe epilepsy (TLE) and what other factors were related in the development of CCH on ictal brain SPECT. MATERALS AND METHODS: We conducted retrospective analysis in 59 patients with TLE (M:41, F:18; 27.4+/-7.8 years old; mesial TLE: 51, lateral TLE: 8), which was confirmed by invasive EEG and surgical outcome (Engel class I , II). All the patients underwent ictal Tc-99m HMPAO brain SPECT and their injection time from ictal EEG onset on video EEG monitoring ranged from 11 sec to 75 sec (32.6+/-19.5 sec) in 39 patients. Multiple factors including age, TLE subtype (mesial TLE or lateral TLE), propagation pattern (hyperperfusion localized to temporal lobes, spread to adjacent lobes or contralateral hemisphere) and injection time were evaluated for their relationship with CCH using multiple logistic regression analysis RESULTS: CCH was observed in 18 among 59 patients. CCH developed in 29% (15/51) of mesial TLE patients and 38% (3/8) of lateral TLE patients. CCH was associated with propagation pattern; no CCH (0/13) in patients with hyperperfusion localized to temporal lobe, 30% (7/23) in patients with propagation to adjacent lobes, 48% (11/23) to contralateral hemisphere. Multiple logistic regression analysis revealed that propagation pattern (p=0.01) and age (p=0.02) were related to the development of CCH. CONCLUSION: Crossed cerebellar hyperperfusio ictal brain SPECT did not help differentiate mesial from lateral temporal lobe epilepsy. Crossed cerebellar hyperperfusion was associated with propagation pattern of temporal lobe epilepsy and age.
Brain* ; Electroencephalography ; Epilepsy ; Epilepsy, Temporal Lobe* ; Humans ; Logistic Models ; Retrospective Studies ; Technetium Tc 99m Exametazime* ; Temporal Lobe* ; Tomography, Emission-Computed, Single-Photon*

Background: Desflurane, a fluorinated methyl-ethyl ether, has some advantageous properties including low blood solubility, stability in soda lime, and resistance to biodegradation. Desflurane in vivo has demonstrated myocardial depressant property. The purpose of this study was to test the direct effects of desflurane on myocardial contractile function and coronary flow in the isolated heart. Methods: Twelve isolated rat hearts were continuously perfused with modified Krebs solution containing 6, 9 and 12 vol% of desflurane for 10 min at each concentration. Systolic left ventricular pressure and rate of change of ventricular pressure (dp/dt) were measured. Heart rate and coronary flow were also measured. To differentiate direct vasodilatory effect of desflurane from an indirect metabolic effect due to autoregulation of coronary flow, oxygen delivery, myocardial oxygen consumption and percent oxygen extraction were calculated. Results: Heart rate (control 266+/-22 beats/min) decreased to 250+/-23 beats/min at 6 vol%, 236+/-26 beats/min at 9 vol% and 223+/-22 beats/min at 12 vol% of desflurane. Systolic left ventricular pressure and dp/dt decreased in a concentration-dependent manner. In spite of decrement of myocardial oxygen consumption, coronary flow (control 12.0+/-1.2 ml/min) increased to 12.8+/-1.6 ml/min at 6 vol%, 12.9+/-1.6 ml/min at 9 vol% and 13.7+/-1.4 ml/min at 12 vol% of desflurane. Oxygen delivery increased proportionally with coronary flow. Percent oxygen extraction decreased in a concentration-dependent manner. Conclusion: These results suggest that desflurane has a direct myocardial depressing and coronary vasodilating effect in a concentration-dependent manner.
Animals ; Ether ; Heart Rate ; Heart* ; Homeostasis ; Oxygen ; Oxygen Consumption ; Rats* ; Solubility ; Ventricular Pressure

OBJECTIVE: The purpose of this study is to analyze the patterns of intervertebral disc enhancement seen in infectious spondylitis, differentiate between two groups(tuberculous vs pyogenic spondylitis). METHODS: Between January 1994 and December 2002, 83patients underwent operative procedure with confirmed to histopathologic evaluation. Magnetic resonance(MR) images were obtained in all patients and were analyzed retrospectively. 57patients had tuberculosis and 26patients were infected by pyogens. The patterns of gadolinium enhancement of disc were classified into 4 types(post's classification): Type I, non-enhancing; Type II, enhancement of the peripheral rim; Type III, Type II with central area and partial endplate; Type IV, general enhancement. RESULTS: The enhancement patterns observed were as follows: Common pattern of tuberculous spondylitis was Type II, and pyogenic spondylitis was Type III.(p<0.01) This difference may result from pathophysiologic varieties of organisms. CONCLUSION: Careful preoperative MR analysis of the patterns of disc enhancement occuring in infectious spondylitis can be useful for differentiating between the tuberculous and pyogenic spondylitis.
Gadolinium ; Humans ; Intervertebral Disc ; Retrospective Studies ; Spondylitis* ; Surgical Procedures, Operative ; Tuberculosis

PURPOSE: This study was designed to describe the burnout experiences of nurses counseling people living with HIV/AIDS (PLWHA) in hospital-based counseling services in Korea. METHODS: A qualitative research technique with focus group interviews was used and the data were collected in 2012. Participants were 13 counseling nurses from 16 medical hospitals in South Korea who had worked full-time for more than six months as a counseling nurse for PLWHA. The 13 nurses made up 68.4% of all 19 official HIV counseling nurses in South Korea. Data were collected using focus group interviews and analyzed with the content analysis methodology of Downe-Wamboldt. RESULTS: Burnout experience of counseling nurses for PLWHA was analyzed for two domains-causes of, and effects of burnout. Each domain was classified into three categories; personal, job-related, and relationships. Further 17 sub-categories and 47 concepts were discovered. CONCLUSION: In this study various causes and effects of burnout experienced by nurses counseling PLWHA were identified. These findings can be used in developing effective strategies for nurses, administrators, and health policy makers to solve the burnout of counseling nurses. Further research is required to develop detailed and practical job description for nurses counseling PLWHA.
Administrative Personnel ; Counseling ; Focus Groups ; Health Policy ; HIV ; Humans ; Job Description ; Qualitative Research ; Republic of Korea

Background: Postoperative sore throat is a complaint after general anesthesia of multifactorial etiology. The laryngeal mask airway (LMA) reduces sore throat and discomfort during maintenance of the airway and make patients more comfortable. The purpose of this study was to compare effect of patient's position during operation on postoperative sore throat after the use of LMA. Methods: The fifty three patients were randomly divided into two groups. Group 1 (n=30) was underwent general anesthesia with supine position and group 2 (n=23) with prone position. After the LMA was positioned in the hypopharynx and the cuff inflated, fiberoptic laryngoscope was immediately passed down through the LMA. Number of attempts, degree of postoperative sore throat and other complications were also noted. Results: The incidence of postoperative sore throat after the use of LMA was 10% in supine position and 4% in prone position. But the difference between the groups was not statistically significant. All of the reported sore throats were rated as mild. Conclusions: Postoperative sore throat after the use of LMA is mild and the incidence is not affected by the prone position during the operation.
Anesthesia, General ; Humans ; Hypopharynx ; Incidence ; Laryngeal Masks* ; Laryngoscopes ; Pharyngitis* ; Prone Position* ; Supine Position