Patients can be tested for the H. pylori infection via invasive or non-invasive methods. At present, no single test is absolutely relied upon to detect colonization of H. pylori, and a combination of two tests is recommended if feasible. A growing interest in non-invasive tests for the detection of Helicobacter pylori has been observed recently. Although serology for IgG often is chosen in the outpatient setting because of its convenience, it is less accurate than either the urea breath test (UBT) or stool antigen test. In addition, the UBT and stool antigen test can be used to confirm eradication, whereas serology remains positive for months after eradication. The test should be used in the basis of the clinical circumstances, the likelihood ratio of positive and negative tests, the cost-effectiveness of the testing strategy, and the availability of the tests.
Breath Tests ; Colon ; Diagnosis* ; Helicobacter pylori* ; Helicobacter* ; Humans ; Immunoglobulin G ; Outpatients ; Urea

Desmoplastic fibroma, which develops predominantly in long bones and the mandible, is a rare and benign but locally aggressive tumor. Desmoplastic fibroma of the cranium is extremely rare. We report a case of desmoplastic fibroma of the frontal bone in a young man. Because of its locally aggressive behavior, complete surgical excision with a safety margin is essential.
Fibroma, Desmoplastic ; Frontal Bone ; Mandible ; Skull

Although a tracheal stent can be an option for inoperable tracheal stenoses there still are some troublesome side effects including overgranulation from foreign body irritation restenosis and patient's discomfort associated with the procedure. We report a successful case of a retrievable stent made of self-expandable 'shape memory' metal and polyurethane in a 24 year old female patient with respiratory distress and tight stenosis in the trachea and left main bronchus, The stent was inserted following a balloon dilatation and was successfully removed on the 7th days after the procedure. She regained a normal active life without any repiratory symptoms and a follow-up of 8 months showed satisfactory results.
Bronchi ; Constriction, Pathologic* ; Dilatation ; Female ; Follow-Up Studies ; Foreign Bodies ; Humans ; Polyurethanes ; Stents* ; Trachea ; Tracheal Stenosis ; Young Adult

BACKGROUND: The purpose of this study was to evalute the diagnostic value of 2mm video thoracoscopy for primary spontaneous penumothorax. MATERIAL AND METHOD: During the period of March to June 1999, we prospectively analyzed 33 consecutive patients suffering from primary spontaneous pneumothorax. 2mm video-assisted thoracoscopy was compared with the operative finding. We observed recurrence during the mean follow-up of 3months. RESULT: Blebs were present in 24 patient(73%: 24/33). These were treated by 10mm video-assised thoracoscopic stapling. Nine pateints with no bleb were treated with pleural drainage. There were no significant differences in the bleb finding. No recurrence occurred during the follow-up period. CONCLUSIONS: A 2mm video thoracoscopic examination for primary spontaneous pnumothorax is a useful alternative in deciding the operative indication.
Blister ; Drainage ; Follow-Up Studies ; Humans ; Pneumothorax ; Prospective Studies ; Recurrence ; Thoracoscopy

This report describes two cases of complete heart block associated with acute myocarditis. Both cases developed Adams-Stokes attack. One patients was considered to be due to viral infection as judged by clinical course and the other patient was confirmed as Korean hemorrhagic fever by indirect immunofluorescent antibody test. Both cases improved during about 4 weeks admission without sequelae with general supportive treatment only.
Heart Block* ; Heart* ; Hemorrhagic Fever with Renal Syndrome* ; Humans ; Myocarditis*

PURPOSE: Accurate diagnosis and prompt treatment of infection with Streptococcus pyogenes (group A streptococci) is required as it may cause many complications, and chronic serious sequelae, acute rheumatic fever and acute glomerulonephritis. Recently, the assay methods of ASO concentration tend to be changed into quantitatively from semi-quantitative or qualitative methods in this country. We would like to know relationships and degree of concurrences between two methods. METHODS: Total eighty-three elementary school children, aged from 7 to 8, were involved for this study. They had been examined throat swab culture with conventional methods and letting down the blood for measuring ASO titer simultaneously. We examined ASO titer by both Rantz-Randall method and Nephelometry. RESULTS: The correlation between a semi-quantitative ASO assay by Rantz-Randall (X) and a quantitative ASO assay by Nephelometry (Y) was Y=1.69X+76.7 (r=0.81). Compared to the Nephelometry test, Rantz-Randall test showed a sensitivity of 72.7% and specificity of 100%. Accordingly, the concordance rate of two methods was 89.2%. CONCLUSIONS: There seems to be high correlation and concordance rate between Rantz-Randall and Nephelometry. It needs to be changed methods for ASO titer measurement from semi-quantitative to quantitative methods for reducing possible laboratory error and for reliable standardization. Altogether, interpretation of ASO titer should be on the ASO value of different geographic areas, in different seasons, and year by year.
Antistreptolysin ; Child ; Diagnosis ; Glomerulonephritis ; Humans ; Linear Energy Transfer ; Nephelometry and Turbidimetry* ; Pharynx ; Rheumatic Fever ; Seasons ; Sensitivity and Specificity ; Streptococcus pyogenes

PURPOSE: Accurate diagnosis and prompt treatment of infection with Streptococcus pyogenes (group A streptococci) is required as it may cause many complications, and chronic serious sequelae, acute rheumatic fever and acute glomerulonephritis. Recently, the assay methods of ASO concentration tend to be changed into quantitatively from semi-quantitative or qualitative methods in this country. We would like to know relationships and degree of concurrences between two methods. METHODS: Total eighty-three elementary school children, aged from 7 to 8, were involved for this study. They had been examined throat swab culture with conventional methods and letting down the blood for measuring ASO titer simultaneously. We examined ASO titer by both Rantz-Randall method and Nephelometry. RESULTS: The correlation between a semi-quantitative ASO assay by Rantz-Randall (X) and a quantitative ASO assay by Nephelometry (Y) was Y=1.69X+76.7 (r=0.81). Compared to the Nephelometry test, Rantz-Randall test showed a sensitivity of 72.7% and specificity of 100%. Accordingly, the concordance rate of two methods was 89.2%. CONCLUSIONS: There seems to be high correlation and concordance rate between Rantz-Randall and Nephelometry. It needs to be changed methods for ASO titer measurement from semi-quantitative to quantitative methods for reducing possible laboratory error and for reliable standardization. Altogether, interpretation of ASO titer should be on the ASO value of different geographic areas, in different seasons, and year by year.
Antistreptolysin ; Child ; Diagnosis ; Glomerulonephritis ; Humans ; Linear Energy Transfer ; Nephelometry and Turbidimetry* ; Pharynx ; Rheumatic Fever ; Seasons ; Sensitivity and Specificity ; Streptococcus pyogenes

Thoracic sympathicotomy has been used safely and successfully to treat essential hyperhidrosis. However, it has been difficult to treat compansatory hyperhidrosis after thoracic sympathicotomy and focal hyperhidrosis. The sweat glands were innervated by post-ganglionic sympathetic fibers with acetylcholic serving as the transmitter. Botulinum A toxin has been reported to block neuro-transmission at the cholinergic autonomic nerve terminals. Prospecting its effect for the sweat gland, we treated 5 patients with focal hyperhidrosis with botulinum A toxin. Three patients received bilateral thoracic sympathectomy (1 case) and sympathicotomy(2 case) via VAT. The hyperhidrosis area was marked with betadine and was subdivided into squares of 2x2 cm(4cm(2)) each. Botulinum A toxin was injected intracutaneously in a dosage of 2.5U/0.1ml(100U/4ml) /4cm(2). A total dose of 100U of Botulinum A toxin was injected into the affected sites. Subjective assessment of sweat production by the patients using a visual analogue scale showed a 20~70% improvement. During the follow-up period, no toxic effects were observed.
Adrenergic Fibers ; Autonomic Pathways ; Botulinum Toxins, Type A* ; Follow-Up Studies ; Humans ; Hyperhidrosis* ; Povidone-Iodine ; Sweat ; Sweat Glands ; Sympathectomy

Because of the possibility of increased the risk of soft tissue or bone infection, surgeon have been somewhat reluctant to use the anterior cervical approach in spinal injury patients who had previously undergone tracheostomy. The authors investigated whether the use of a Caspar plate in such patients during anterior cervical fixation altered the risk of infection. We analyzed the mechanism and level of injury, operative procedures, post-operative course and infection in 12 cervical injury patients with previous tracheostomy. The procedure had been performed on the day of injury because of semicoma resulting from combined head injury in two cases, and because of multiple rib fracture with hemothorax, and old age with chronic obstructive lung disease in one case each; it had been performed between 1-6 days after injury because of high fever with pneumonia and atelectasis in eight cases. The interval between tracheostomy and anterior fixation was 5-20(average, 13) days. During clinical follow-up at 8-21 (average, 16) months, bone union without infection was observed in all patients. The authors concluded that in patients with cervical cord injury, tracheostomy did not increase the risk of infection in subsequent anterior cervical fixation using a Caspar plate.
Craniocerebral Trauma ; Fever ; Follow-Up Studies ; Hemothorax ; Humans ; Pneumonia ; Pulmonary Atelectasis ; Pulmonary Disease, Chronic Obstructive ; Respiratory Insufficiency ; Rib Fractures ; Spinal Injuries ; Spine* ; Surgical Procedures, Operative ; Tracheostomy*

PURPOSE: The purpose of this study was to examine the molecular basis for steroid-induced cataract and the specific aim was to investigate the potential effects of glucocorticoids on modulation of alpha-crystallin gene expression in lens epithelial cells. METHOD: Bovine lens epithelial explants, B-3 human lens epithelial cells, and alphaTN4 mouse lens epithelial cells were incubated in the absence or presence of dexamethasone. At the indicated time point, total cellular RNA was isolated and subjected to RT-PCR and Northern blot analysis to assess mRNA expression of alphaA- and alphaB-crystallin. RESULTS: The mRNA expression of alphaA-crystallin was drastically downregulated by treatment with dexamethasone in bovine, human, and mouse lens epithelial cells. The mRNA level of alphaA-crystallin was also decreased in response to hydrocortisone but not to estrogen. The stability of the alphaA-crystallin mRNA was decreased after dexamethasone treatment. CONCLUSIONS: These results suggest that the alteration of alphaA-crystallin gene expression by glucocorticoids may result in abnomal structure and differentiation of lens epithelial cells on steroid-induced cataract formation.
alpha-Crystallins* ; Animals ; Blotting, Northern ; Cataract ; Dexamethasone ; Epithelial Cells* ; Estrogens ; Gene Expression* ; Glucocorticoids* ; Humans ; Hydrocortisone ; Mice ; RNA ; RNA, Messenger