BACKGROUND/AIMS: This study was performed to investigate the cost effectiveness of Helicobacter pylori screening/eradication in South Korean patients treated with nonsteroidal anti-inflammatory drugs (NSAIDs) and/or aspirin. METHODS: A decision Markov model was used to estimate the effectiveness and economic impact of an H. pylori screening/eradication strategy compared to a no-screening strategy among patients who were included in the model at the age of 40 years. Utility weights were applied to four of the health status groups to reflect quality-adjusted life years (QALY). The costs of screening, H. pylori eradication, and managing peptic ulcer and ulcer complications were obtained from South Korea-specific data. RESULTS: The total costs per patient were US $2,454 for the H. pylori screening/eradication and US $3,182 for the no-screening strategy. The QALYs for the two strategies were 16.05 and 15.73, respectively. The results were robust for the analyses of all different cohort groups who entered the model at the age of 30, 50, or 60 years and for NSAIDs-naive patients. Through the probabilistic sensitivity analysis, the robustness of our study's results was also determined. CONCLUSIONS: The H. pylori screening/eradication strategy was found to be less expensive and more effective compared to the no-screening strategy among South Korean patients taking NSAIDs and/or aspirin.
Anti-Inflammatory Agents, Non-Steroidal ; Aspirin ; Cohort Studies ; Cost-Benefit Analysis ; Helicobacter ; Helicobacter pylori ; Humans ; Mass Screening ; Peptic Ulcer ; Quality-Adjusted Life Years ; Ulcer ; Weights and Measures

Atrophic gastritis (AG) and intestinal metaplasia (IM) are the main precursor lesions of gastric cancer as the incidence of gastric cancer increases in the gastric mucosa involved with AG and IM. The prevalence of AG and IM vary depending on countries, even it represents diverse results in the same nation. Usually AG is antecedent of IM but the etiologies of AG and IM are not always the same. The sensitivity and specificity of diagnostic methods to detect AG and IM are different. Furthermore, the management strategy of AG and IM has not been established, yet. Helicobacter pylori infection has been proved as the most important cause of AG and IM. Thus the eradication of H. pylori is very important to prevent the progression to gastric cancer which is still placed in the high rank in morbidity and mortality among cancers. However, the reversibility of AG and IM by eradication of H. pylori which was assumed to be certain by meta-analysis is; however, controversial now. Therefore, the understanding and early diagnosis of AG and IM are very important, especially, in high incidence area of gastric cancer such as Republic of Korea.
Early Diagnosis ; Gastric Mucosa ; Gastritis, Atrophic* ; Helicobacter pylori ; Incidence ; Metaplasia* ; Mortality ; Prevalence ; Republic of Korea ; Sensitivity and Specificity ; Stomach Neoplasms*

BACKGROUND/AIMS: Despite numerous studies on the relation of genetic polymorphisms with irritable bowel syndrome (IBS), the results still remain inconclusive. The aim of this study was to assess the possible association between SLC6A4 serotonin transporter gene linked polymorphic region (5-HTTLPR), ADRA2A -1291C>G, GNB3 825C>T, CCK1R intron 779T>C and TRPV1 945G>C polymorphisms and IBS based on Rome III criteria in Korea. METHODS: Study subjects were prospectively recruited from visitors to Seoul National University Bundang Hospital between July 2009 and January 2014. Ninety-nine IBS patients and 171 healthy controls were enrolled. Polymorphisms of above-mentioned 5 genes were genotyped. Serum serotonin from 101 participants was measured by ELISA and compared according to SLC6A4 5-HTTLPR polymorphisms and IBS subtypes. RESULTS: Regarding SLC6A4 5-HTTLPR polymorphism, L/L genotype was significantly associated with the total IBS, constipation predominant IBS (IBS-C) and mixture of diarrhea and constipation IBS (IBS-M) (adjusted OR: 4.35, 95% CI: 1.04-16.67; adjusted OR: 11.11, 95% CI: 1.69-50.00 and adjusted OR: 5.56, 95% CI: 1.05-33.33, respectively). Carrying ADRA2A -1291G allele was significantly associated with total IBS and diarrhea predominant IBS (adjusted OR: 3.37, 95% CI: 1.16-9.77 and adjusted OR: 5.64, 95% CI: 1.18-27.01, respectively). IBS-C patients showed reduced level of serum serotonin compared to controls and patients with diarrhea predominant IBS (50.2 ng/mL vs. 69.0 ng/mL and 92.9 ng/mL, P = 0.017 and P = 0.001, respectively). CONCLUSIONS: Genetic polymorphisms of SLC6A4 5-HTTLPR and ADRA2A -1291C>G could be one of the pathophysiological factors of IBS in Korea. Reduced serum serotonin shown in the IBS-C group suggested a role of serotonin in IBS, but large study is needed for confirming genotypic difference in serum serotonin level.
Alleles ; Constipation ; Diarrhea ; Enzyme-Linked Immunosorbent Assay ; Genotype ; Humans ; Introns ; Irritable Bowel Syndrome* ; Korea ; Polymorphism, Genetic ; Polymorphism, Single Nucleotide ; Prospective Studies ; Receptors, Adrenergic ; Seoul ; Serotonin ; Serotonin Plasma Membrane Transport Proteins*

Purpose: The 2020 Dietary Reference Intakes for Koreans (KDRIs) serves as a foundation for daily nutrient and energy recommendations aiming to enhance public health and prevent chronic diseases. They act as guidelines for maintaining proper nutrition and overall health.Using KDRIs is crucial for promoting healthier lifestyles and making informed dietary choices. Thus, this study explores the influence of a nutrition education program, based on the 2020 KDRIs, on the nutrition knowledge and dietary habits of undergraduates in Gyeongsangnam-do and Gyeonggi-do. Methods: The nutrition education program, designed with diverse instructional materials, was executed across a wide range of universities. The education group (n = 75) engaged in the program for a 6-week instructional period, while the control group (n = 53) underwent the survey without participating in the education program. Nutrition Quotient (NQ) and knowledge assessments were administered to both groups immediately before and after the instructional period. Results: Within the education group, the nutrition education program positively impacted responses to NQ practice items, including knowledge of nutrition, daily intake, and portion sizes (p < 0.05). In contrast, there were no significant differences between the before and after responses of the control group for most survey items. Post-program evaluations showed significantly higher self-assessment scores and increased satisfaction levels (p < 0.05), with the satisfaction rate for the education program using the 2020 KDRIs reaching 99.2%. Conclusion This study has demonstrated the positive impact of an effective nutrition education program. However, there is a need for the continuous development and implementation of nutrition education programs to sustain these outcomes and further enhance the nutritional education experience.

BACKGROUND/AIMS: Eradication of Helicobacter pylori reduces the incidence of gastric cancer, and may inhibit gastric dysplasia progression into gastric cancer. The aim of this study was to investigate the effect of eradication of Helicobacter on the incidence of subsequent gastric dysplasia development after endoscopic resection. METHODS: Medical records of patients who underwent endoscopic resection for gastric dysplasia were retrospectively reviewed. Presence of H. pylori was assessed by the Campylobacter-like organism test and histology. The rate of subsequent dysplasia development after endoscopic resection between the eradication group and non-eradication group was compared. RESULTS: Total of 129 patients positive for H. pylori infection were included for analysis. Of these, 85 patients received successful eradication therapy and 44 patients did not receive eradication therapy or failed to achieve successful eradication. Sex, mean age and pathologic grade of dysplasia did not differ between the two groups. In univariate analysis, the grade of intestinal metaplasia (p=0.013) significantly differed between metachronous dysplasia group and non-metachrounous dysplasia group. In multivariate analysis, eradication of H. pylori (p=0.014) was related to reduced incidence of subsequent gastric dysplasia development after endoscopic resection. CONCLUSIONS: Eradication of H. pylori likely has a beneficial effect in preventing the development of subsequent gastric dysplasia, a premalignant lesion of gastric cancer, after endoscopic resection.
Aged ; Anti-Bacterial Agents/*therapeutic use ; Female ; Gastric Mucosa/pathology/surgery ; Gastroscopy ; Helicobacter Infections/*drug therapy ; *Helicobacter pylori ; Humans ; Male ; Metaplasia/pathology ; Middle Aged ; Neoplasm Recurrence, Local/pathology ; Precancerous Conditions/*pathology ; Proportional Hazards Models ; Retrospective Studies ; Stomach Neoplasms/pathology/*surgery

BACKGROUND: The recent change in pharmaceutical education system following the paradigm shift to patient-oriented pharmacy service requires an in-depth discussion to reorganize a future direction and establish a basis for maximizing social values of community pharmacy service. OBJECTIVE: This study was conducted to review the current status of community pharmacy service provision in Korea based on published literatures. METHODS: The electronic databases of National Digital Science Library and Electronic National Assembly Library were used to search the journal articles and dissertation papers. A search term "community pharmacy" was used and the published period was limited to papers published after year 2001, when the legal separation of prescribing and dispensing was implemented. Relevant study reports were also searched manually. Information about pharmacy service provision and study outcomes were retrieved from the selected papers, and classified by predefined individual service scope. RESULTS: A total 33 papers reporting services provided by community pharmacies were selected (journal article 11, dissertation paper 17, and study report 5). Pharmacy services identified in these papers could be classified into prescription dispensing service, pharmaceutical care service, self medication service, other products service, and health promotion service. Twenty papers reported prescription dispensing services, three papers reported pharmaceutical care service, and only two papers reported health promotion service. Current community pharmacy services are highly dependent on prescription drugs while expanded services such as pharmaceutical care and health promotion are peripheral. Most prevalent research topic was medication counseling service (18 papers), reflecting that community pharmacists generally consider it to be the most important and fundamental service. Overall, current pharmacy services are very limited and focus on prescription dispensing service. CONCLUSION: At this point of time requiring expansion and quality improvement of community pharmacy services, we suggest further lively discussion to strengthen pharmacist's functional identity and set conditions for providing socially expected services.
Community Pharmacy Services ; Counseling ; Education, Pharmacy ; Health Promotion ; Humans ; Korea* ; Pharmaceutical Services* ; Pharmacies* ; Pharmacists ; Prescription Drugs ; Prescriptions ; Quality Improvement ; Self Medication ; Social Values

BACKGROUND/AIMS: The aim of this study was to evaluate the ability of Helicobacter pylori eradication treatment to increase platelet counts in Korean patients with chronic idiopathic thrombocytopenic purpura (ITP). METHODS: A total of 102 patients were evaluated against two criteria. First, those diagnosed with H. pylori infections in whom eradication was successful were assigned to the H. pylori-positive and -eradicated group (n=39), whereas those diagnosed with H. pylori infections in whom eradication failed were assigned to the H. pylori-positive and -non-eradicated group (n=3), and those without H. pylori infections were assigned to the H. pylori-negative group (n=60). Second, patients with complete remission in whom the platelet recovery effect was maintained over the average follow-up period of 6 months after eradication therapy were defined as the responder group (n=58), whereas those with partial or no response were defined as the nonresponder group (n=44). RESULTS: The platelet counts of the H. pylori-positive and -eradicated group were significantly increased 6 months after eradication therapy compared to those of the H. pylori-positive and -non-eradicated group and the H. pylori-negative group (43.2±29.1 to 155.3±68.7×10(3)/μL vs 42.5±28.1 to 79.8±59.7×10(3)/μL vs 43.1±28.9 to 81.2±62.2×10(3)/μL; p=0.041). The eradication therapy success rate in the responder group was 100.0% (39/39), in contrast to the nonresponder group (0%, 0/3) (p<0.001). CONCLUSIONS: H. pylori eradication therapy was related to increased platelet count, and successful eradication affected the increased platelet count in Korean patients with chronic ITP.
Blood Platelets ; Follow-Up Studies ; Helicobacter pylori* ; Helicobacter* ; Humans ; Platelet Count ; Purpura, Thrombocytopenic, Idiopathic*

Approximately 90% of nontuberculous mycobacterium (NTM) infections involve the pulmonary system; NTM infections involving areas of the musculoskeletal system such as the joints or spine are uncommon. This report describes a case of refractory knee swelling in a patient with systemic lupus erythematosus (SLE). Indolent arthritis of the knee eventually progressed to spondylitis and a paraspinal abscess requiring surgical incision and drainage. The cause of the infectious arthritis and spondylitis was diagnosed as NTM infection, specifically Mycobacterium kansasii. This case emphasizes the importance of a high index of clinical suspicion for mycobacterial infection, as well as repeated attempts to isolate the organism, in patients with SLE who present with atypical chronic arthritis.
Abscess ; Arthritis* ; Arthritis, Infectious ; Drainage ; Humans ; Joints ; Knee ; Lupus Erythematosus, Systemic ; Musculoskeletal System ; Mycobacterium kansasii ; Nontuberculous Mycobacteria* ; Spine ; Spondylitis*

We developed a user-friendly, interactive program to simultaneously cluster and visualize omics data, such as DNA and protein array profiles. This program provides diverse algorithms for the hierarchical clustering of two-dimensional data. The clustering results can be interactively visualized and optimized on a heatmap. The present tool does not require any prior knowledge of scripting languages to carry out the data clustering and visualization. Furthermore, the heatmaps allow the selective display of data points satisfying user-defined criteria. For example, a clustered heatmap of experimental values can be differentially visualized based on statistical values, such as p-values. Including diverse menu-based display options, QCanvas provides a convenient graphical user interface for pattern analysis and visualization with high-quality graphics.
DNA ; Genomics ; Protein Array Analysis

BACKGROUND/AIMS: The validity of ¹³C-urea breath test (¹³C-UBT) for Helicobacter pylori detection is influenced by atrophic gastritis. The aim of this study was to evaluate the effect of citric acid on the accuracy of ¹³C-Urea breath test after H. pylori eradication therapy in a region where atrophic gastritis is common. METHODS: In this prospective study, H. pylori-positive patients received ¹³C-UBT after H. pylori eradication regimen. They were classified into citric acid group and control group. To determine diagnostic accuracy of ¹³C-UBT, patients were offered invasive methods. RESULTS: A total of 1,207 who successfully took H. pylori-eradication regimen received UBT. They were assigned into the citric acid group (n=562) and the control group (n=645). The mean ¹³C-UBT value of the citric acid group was 10.3±26.4‰, which was significantly (p<0.001) higher than that of that control group (5.1‰±12.6‰). Of these patients 122 patients were evaluated by endoscopic biopsy methods. Based on invasive tests, the accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of ¹³C-UBT for the citric acid group were 83.3%, 91.7%, 81.3%, 55.0%, and 97.5%, respectively. Those of the control group were 87.7%, 90.9%, 88.2%, 62.5%, and 97.8%, respectively. They were not significantly different between the two groups. Although the presence of gastric atrophy and intestinal metaplasia (IM) decreased the accuracy, the decrease was not significant. CONCLUSIONS: In a country with high prevalence of atrophic gastritis or IM, false positivity remained common despite the use of citric acid in ¹³C-UBT.
Atrophy ; Biopsy ; Breath Tests ; Citric Acid ; Diagnosis ; Gastritis, Atrophic ; Helicobacter pylori ; Helicobacter ; Humans ; Metaplasia ; Prevalence ; Prospective Studies ; Sensitivity and Specificity