Although, the prevalence of Helicobacter pylori infection in Korea has declined owing to the eradication therapy, recent seroprevalence of H. pylori infection is still reported to be as high as 54.4%. Until now, "standard regimen" for eradication of H. pylori has been conventional triple therapy consisting of proton pump inhibitor, amoxicillin, and clarithromycin. However, with the increase in antibiotic resistance, especially against clarithromycin, the eradication rate of conventional triple therapy has steadily declined during the past 13 years in Korea. Present eradication rate of standard triple therapy is reported to be less than 80%, which is the Maginot line of efficacy for the currently available regimen. Therefore, new first line eradication regimen is needed to enhance the eradication rate of H. pylori infection.
Amoxicillin/pharmacology/therapeutic use ; Anti-Bacterial Agents/pharmacology/*therapeutic use ; Asian Continental Ancestry Group ; Clarithromycin/pharmacology/therapeutic use ; Disease Eradication/trends ; Drug Administration Schedule ; Drug Therapy, Combination ; Helicobacter Infections/*drug therapy ; *Helicobacter pylori/drug effects ; Humans ; Proton Pump Inhibitors/therapeutic use ; Republic of Korea

Renal angiomyolipomas are uncommon benign neoplasms composed of mature adipose tissue, thick-walled blood vessels and smooth muscle in varying proportions, which are found in more than half of the patients with tuberous sclerosis. When associated with tuberous sclerosis, they are usually small, bilateral and multifocal. We present a case of bilateral renal angiomyolipoma with tuberous sclerosis in a 33-year-old female.
Adipose Tissue ; Adult ; Angiomyolipoma* ; Blood Vessels ; Female ; Humans ; Muscle, Smooth ; Tuberous Sclerosis*

The double-blind, placebo-controlled study was performed to evaluate the efficacy and safety of once-a-day terazosin in 35 patients with benign prostatic hyperplasia. The dose of terazosin was titrated to 5 mg during 4 week period and then maintained throughout 24 week follow up. In terazosin group(n= 18), the maximum flow rates improved 32% from 10.4ml/sec at baseline to 13.7ml/sec, and the mean flow rate improved 38% from 5.5ml/sec to. 7.6ml/sec after 24 weeks of treatment(p <0.01). The obstructive symptom score decreased 59% from 9.8 to 4.l, and the irritative symptom score decreased 34% from 5.4 to 3.5 after.24 weeks of terazosin therapy (p<0.01). In placebo group(n= 17), the obstructive symptom score only significantly decreased 39% from 9.1 at baseline to 5.5 after 24 weeks of terazosin therapy(p>0.06). Adverse event occurred in one case of the terazosin group. In summary, terazosin administered once-a-day improved the obstructive and irritative symptoms of BPH and urine flow rates. Terazosin was well tolerated.
Follow-Up Studies ; Humans ; Prostatic Hyperplasia*

No abstract available.
Pregnancy*

Nowadays, endoscopic mucosal resection or endoscopic submucosal dissection has shown effectiveness equivalent to that of gastrectomy and has emerged as a popular technique for curative treatment of gastric cancer. However, noncurative resection or resection beyond the indication may lead to lymphatic and extended organ metastasis resulting in loss of the opportunity for full recovery. Therefore, it is an important issue to decide the range of curative resection in the endoscopic resection field. Furthermore, management of noncurative endoscopic resection in early gastric cancer is also important. The most favorable treatment after noncurative resection would be surgery. However, other noninvasive treatments such as argon plasma coagulation, additional endoscopic resection and close observation for recurrence are thought to be the optional treatments after the noncurative resection. In the future, prospective research studies and observations are expected to verify the effectiveness of noninvasive treatments.
Argon Plasma Coagulation ; Gastrectomy ; Neoplasm Metastasis ; Recurrence ; Stomach Neoplasms

PURPOSE: Chronic prostatitis/chronic pelvic pain syndrome (CPPS) presents various symptoms, such as various pains, voiding and sex-related symptoms. To elucidate the characteristic symptoms of CPPS we compared BPH patients with healthy men. MATERIALS AND METHODS: We obtained questionnaires from 530 men, consisting of three groups: 243 CPPS patients aged 40 or below with small sized prostate (<25ml); 115 BPH patients aged 45 or older with non-small sized prostate (> OR =25ml); and 172 healthy men aged below and equal 40 years without pyuria. We compared various pains and voiding symptoms among the three groups, and the sex-related symptoms between 145 CPPS patients and 64 healthy men who had been married at least 6 months, and had regular sexual intercourse with their wife. RESULTS: In comparison with healthy men, the CPPS patients had a higher prevalence of the various pains and most of the voiding symptoms. The CPPS patients had a higher prevalence of pain over the penis, urethra, perineum and prostate gland compared to the BPH patients (p<0.05). There was no statistical significance in voiding symptoms between the CPPS and BPH patients. In respect to the sex-related symptoms, the CPPS patients had a higher prevalence of decreased maintenance time, rigidity at erection, libido, orgasmic feeling and a more painful ejaculation than the healthy men (p<0.01). The frequencies of sexual intercourse and orgasmic sensation following ejaculation were slightly decreased, bur with no statistical significance (p>0.05). CONCLUSIONS: The CPPS patients showed a higher prevalence of various pains and voiding symptoms than the healthy men. Pains over the penis, urethra, perineum and prostate gland are characteristic in CPPS patients. Both the CPPS and BPH patients felt trouble due to the voiding symptoms. The CPPS patients had a higher prevalence of most of sex-related symptoms, but had similar frequencies of sexual intercourse and orgasmic sensation following ejaculation compared to the healthy men.
Coitus ; Ejaculation ; Humans ; Libido ; Male ; Orgasm ; Pelvic Pain* ; Penis ; Perineum ; Prevalence ; Prostate ; Pyuria ; Surveys and Questionnaires ; Sensation ; Spouses ; Urethra

BACKGROUND/AIMS: Stomach cancer is the most common malignancy and one of the leading causes of cancer-related death in Korea. The early diagnosis and treatment of gastric cancer are very important because the prognosis of early gastric cancer is excellent. Gastric screening may provide an opportunity to detect asymptomatic early gastric cancer. We analyzed the characteristics of gastric cancer diagnosed with a health screening test to evaluate the usefulness of a screening program for gastric cancer. METHODS: We retrospectively reviewed the clinicopathological characteristics of 111 gastric cancer patients diagnosed using gastric endoscopy as a gastric screening test at the Health Promotion Center of Kyungpook National University Hospital from July 1997 through December 2005. RESULTS: The incidence of gastric cancer was 0.38% and the mean patient age was 58.5 years old. The proportion of early gastric cancer was 73% of all gastric cancer. In 55 cases, constituting 49.6% of all gastric cancer and 68% of early gastric cancer, the lesions were confined to the mucosa. The most common macroscopic types were type IIc in early gastric cancer and Borrmann type 3 in advanced gastric cancer. There were significant positive correlations between lymph node metastasis and both the depth of tumor invasion and size of the lesion. The 5-year survival rates are 82.7% in total gastric cancer and 97.2% in early gastric cancer. CONCLUSIONS: Gastric cancer detected during health screening has a favorable prognosis because gastric cancer confined to the mucosa predominates and early gastric cancer detected at screening has a lower incidence of metastasis to regional lymph nodes.
Early Diagnosis ; Endoscopy ; Health Promotion ; Humans ; Incidence ; Korea ; Lymph Nodes ; Mass Screening ; Mucous Membrane ; Neoplasm Metastasis ; Prognosis ; Retrospective Studies ; Stomach Neoplasms ; Survival Rate

BACKGROUND: Early reperfusion therapy with thrombolytic agents or primary PTCA is most important to salvage ischemic myocardium in acute myocardial infarction(AMI). Timely reperfusion of jeopardized myocardium clearly improves hemodynamics, decreases infarct size and improves survival. The extent of protection appears to be directly related to the rapidity of reperfusion after onset of coronary occlusion. Although the intravenous thrombolysis is a feasible therapy in the patients with evolving AMI, the benifit of thrombolytic therapy decreases because of the time delay after onset of symptom. This study was perfomed to analyze the factors time delay between onset of symptom and the thrombolytic therapy with retrospective and prospective questionaire in the patients with AMI. METHOD: Eighty one patients with AMI were included in this study who came to the emergency room(ER) of Chungnam National University Hospital(CNUH) from Feburary 1995 to October 1996. Delay between door and thrombolytic therapy was defined as hospital time delay. RESULTS: Thrombolytic therapy(rt-PA or urokinase iv) was done in 60 patients(74.1%) and mean prehopital time delay was significantly decreased in the patients with thrombolytic therpapy when compared with those without thormbolytic threapy(462+/-90 vs 1375+/-473 minutes, p=0.005). There were no singificant factors for prehospital time delay such as age, sex, redsidence, ER near residence, transfer time to ER near residence, family status, family history of AMI, severity of chest pain, presence of risk factors of cardiovascular disease(CVD), previous CVD, degree of education, history of other disease and routine check, transfer methods. The only 8 patients(9.8%) knew about AMI and 7 patients among these patient came to ER earlier and received thrombolytic therapy. From 57 referred patients, 40 patients(70.2%) received reperfusion therapy and only 30 patients(52.6%) had recored EKG in the referred hospital. In the analysis of hospital delay from patient's arrival to the thrombolytic therapy, the arrival time at weekdays and weekend had no differences, but hospital delay were significantly prolonged when patients arrived at ER in the night. CONCLUSION: Since prehospital time delay is a most important factor of time delay for the effective thrombolytic therapy in AMI, the pubic education program and effective transport system are needed. And routine record of EKG in patient with chest pain in the local hospital is very helpful to start effective thromolytic therapy at ER. The well designed prospective study with more patinets in our local region is essential to get more accurate information about transport system and to improve survival rate in patients with AMI.
Chest Pain ; Chungcheongnam-do ; Coronary Occlusion ; Education ; Electrocardiography ; Emergencies ; Fibrinolytic Agents ; Hemodynamics ; Humans ; Myocardial Infarction* ; Myocardium ; Prospective Studies ; Reperfusion ; Retrospective Studies ; Risk Factors ; Survival Rate ; Thrombolytic Therapy* ; Urokinase-Type Plasminogen Activator

For the treatment of coarction of aorta, surgical intervention has been known as a standard therapy.During last decade balloon angioplasty for coarctation of the aorta has been reported as a successful and safe procedure in about 300 cases. This angioplasty was done mainly in infants and children, and little cases in adults and adolescents. A 22 year-old adult with coarctation of aorta have recieved balloon angioplasty. He visited to emergency room due to severe headache and the blood presure of arm was 240/130mmHg at emergency room. The blood pressure at ward was 168/92mmHg in upper extremities, 104/82mmHg in lower extrimities. His aortogram showed coarctation of thoracic aorta below left subclavian artery. The pressure gradient beween ascending aorta and right femoral artery was decreased from 60mmHg to 0mmHg after balloon dilatation (2 times, balloon diameter 18mm). There were no significant complications. The follow-up magnetic resonance image in 4 month after balloon angioplasty showed no evidence of restenosis or saccular aneurysm. Initial hypertension turned to normal blood pressure in 4 months after balloon angioplasty. This adult case of successful balloon angioplasty for coarctation of aorta is the first case reported in Korea.
Adolescent ; Adult* ; Aneurysm ; Angioplasty ; Angioplasty, Balloon* ; Aorta ; Aorta, Thoracic ; Aortic Coarctation* ; Arm ; Blood Pressure ; Child ; Dilatation ; Emergency Service, Hospital ; Femoral Artery ; Follow-Up Studies ; Headache ; Humans ; Hypertension ; Infant ; Korea ; Subclavian Artery ; Upper Extremity ; Young Adult

Here, we report a case of newly diagnosed diabetes, with concurrent pancreatic cancer manifested as hyperglycemic crisis, and aggravated by urinary tract infection. We summarize the initial clinical manifestations and pertinent laboratory, radiologic, and clinical findings in an elderly patient with hyperglycemic emergency. A review of the documents involving pancreatic tumors and hyperglycemic hyperosmolar state, which is an acute complication of diabetes mellitus, is presented. In the absence of other identifiable conditions, it is reasonable to speculate that some factor (or factors) produced by the tumor had a role in the metabolic decompensation. In addition, this discussion should be more carefully considered in the aged people group.
Aged ; Diabetes Mellitus ; Emergencies ; Humans ; Pancreatic Neoplasms ; Urinary Tract Infections