No abstract available.
Colitis, Ulcerative* ; Ulcer*

BACKGROUND: The Helicobacter pylori(H. pylori) is associated with chronic gastritis and is now recognized to be the main factor in the pathogenesis of peptic ulcer disease. The eradication treatment of H. pylori significantly lowers ulcer relapse rate, which is accompanied by important histological change. We evaluated the prevalence of H. pylori infection in upper gastrointestinal diseases. METHODS: Total 491 patients(274 with chronic gastritis, 134 with gastric ulcer, 57 with duodenal ulcer, and 26 with gastroduodenal ulcer) were tested for H. pylori infection by the CLO test, hematoxylin-eosin stain and Giemsa stain. RESULTS: The prevalence of H. pylori infection was 74.0% in male and 58.6% in female. The prevalence of H. pylori infection was 73.2% in 30-59 year-old group and 60.2% in older age group. The sex and age adjusted prevalence of H. pylori infection was 64.7% in chronic gastritis, 69.4% in gastric ulcer, 84.5% in duodenal ulcer and 87.8% in gastroduodenal ulcer. CONCLUSIONS: The prevalence of H. pylori infection of upper gastrointestinal diseases is significantly higher in male, 30-59 year-old group, peptic ulcer and duodenal ulcer than in female, older age group(over 60), chronic gastritis and gastric ulcer, respectively.
Azure Stains ; Duodenal Ulcer ; Female ; Gastritis ; Gastrointestinal Diseases* ; Helicobacter pylori* ; Helicobacter* ; Humans ; Male ; Peptic Ulcer ; Prevalence* ; Recurrence ; Stomach Ulcer ; Ulcer

No abstract available.
Autopsy* ; Pneumocystis carinii* ; Pneumocystis* ; Pneumonia, Pneumocystis*

OBJECTIVE: Transpedicular screw fixation has some disadvantages such as postoperative back pain through wide muscle dissection, long operative time, and cephalad adjacent segmental degeneration (ASD). The purposes of this study are investigation and comparison of radiological and clinical results between interspinous fusion device (IFD) and pedicle screw. METHODS: From Jan. 2008 to Aug. 2009, 40 patients underwent spinal fusion with IFD combined with posterior lumbar interbody fusion (PLIF). In same study period, 36 patients underwent spinal fusion with pedicle screw fixation as control group. Dynamic lateral radiographs, visual analogue scale (VAS), and Korean version of the Oswestry disability index (K-ODI) scores were evaluated in both groups. RESULTS: The lumbar spine diseases in the IFD group were as followings; spinal stenosis in 26, degenerative spondylolisthesis in 12, and intervertebral disc herniation in 2. The mean follow up period was 14.24 months (range; 12 to 22 months) in the IFD group and 18.3 months (range; 12 to 28 months) in pedicle screw group. The mean VAS scores was preoperatively 7.16+/-2.1 and 8.03+/-2.3 in the IFD and pedicle screw groups, respectively, and improved postoperatively to 1.3+/-2.9 and 1.2+/-3.2 in 1-year follow ups (p<0.05). The K-ODI was decreased significantly in an equal amount in both groups one year postoperatively (p<0.05). The statistics revealed a higher incidence of ASD in pedicle screw group than the IFD group (p=0.029). CONCLUSION: Posterior IFD has several advantages over the pedicle screw fixation in terms of skin incision, muscle dissection and short operative time and less intraoperative estimated blood loss. The IFD with PLIF may be a favorable technique to replace the pedicle screw fixation in selective case.
Back Pain ; Follow-Up Studies ; Humans ; Incidence ; Intervertebral Disc ; Muscles ; Operative Time ; Skin ; Spinal Fusion ; Spinal Stenosis ; Spine ; Spondylolisthesis

Mycosis fungoides palmaris et plantaris is an uncommon expression of mycosis fungoides that manifests primarily on the palms and the soles. The lesions may be quite hyperkeratotic and mimic various inflammatory palmoplantar dermatoses. A biopsy is recommended in the evaluation of recalcitrant palmoplantar dermatoses. We report a case of mycosis fungoides palmaris et plantaris in a 36-year-old woman presented with hyperkeratotic plaque on her palms and soles.
Adult ; Biopsy ; Female ; Humans ; Mycosis Fungoides* ; Skin Diseases

PURPOSE: beta-catenin is an intracellular protein that is an integral component of the cadherin-mediated cell-cell interaction and a downstream transcriptional activator in the wnt signal transduction pathway. Inappropriate activation of beta-catenin has recently been implicated in the development of hepatocellular carcinoma and cholangiocarcinoma. Nuclear beta-catenin expression is strongly associated with gene mutation. This study was designed to evaluate the pattern of beta-catenin expression between hepatocellular carcinoma and cholangiocarcinoma. MATERIALS AND METHODS: Immunohistochemical expression of beta-catenin was studied in 7 normal livers, 33 hepatocellular carcinomas and 20 cholangiocarcinomas, that were formalin fixed and paraffin embedded. RESULTS: beta-catenin was expressed mainly in the cytoplasmic membrane of the normal hepatocytes and bile ducts. Nuclear expressions, not noted in the normal liver, were noted in 30% of the hepatocellular carcinomas and 10% of the cholangiocarcinomas. And, nuclear expression was more common in the high grade (50%) hepatocellular carcinomas than the low grade (18%) hepatocellular carcinomas (p<=0.05). CONCLUSION: The above results indicate that nuclear expression of beta-catenin is observed in the carcinoma but not the normal liver, and is associated with high grade liver carcinoma.
beta Catenin* ; Bile Ducts ; Carcinoma, Hepatocellular* ; Cell Membrane ; Cholangiocarcinoma* ; Formaldehyde ; Hepatocytes ; Liver ; Paraffin ; Signal Transduction

BACKGROUND: The role of extended-spectrum beta-lactamase (ESBL)-producing or multidrug-resistant (MDR) organisms in patients with sepsis secondary to urinary traction infection (UTI) has not been investigated extensively in the intensive care unit (ICU) setting. METHODS: Patients with UTI sepsis admitted to the ICU were retrospectively enrolled in this study (January 2009-December 2012). We investigated the impact of ESBL-producing and ESBL-negative MDR organisms on hospital outcome. RESULTS: In total, 94 patients were enrolled (median age, 73.0 years; female, 81.9%), and ESBL-producing and ESBL-negative MDR organisms accounted for 20.2% (n = 19) and 30.9% (n = 29), respectively. Both patients with ESBL-producing and ESBL-negative MDR organisms were more likely to experience a delay in adequate antibiotic therapy than those with non-ESBL/non-MDR organisms (p < 0.001 and p = 0.032, respectively). However, only patients with ESBL-producing organisms showed a higher mortality rate (ESBL vs. ESBL-negative MDR vs. non-ESBL/non-MDR, 31.6% vs. 10.3%.vs. 10.9%, respectively). In multivariate analyses, ESBL production was significantly associated with hospital mortality (odds ratio, 11.547; 95micro confidence interval, 1.047-127.373), and prior admission was a significant predictor of ESBL production. CONCLUSIONS: Although both ESBL-producing and ESBL-negative MDR organisms are associated with delayed administration of appropriate antibiotics, only ESBL production is a significant predictor of hospital mortality among patients with UTI sepsis in the ICU setting.
Anti-Bacterial Agents ; beta-Lactamases* ; Drug Resistance, Multiple* ; Female ; Hospital Mortality ; Humans ; Intensive Care Units* ; Mortality ; Multivariate Analysis ; Retrospective Studies ; Sepsis* ; Urinary Tract ; Urinary Tract Infections

PURPOSE: To predict the therapeutic efficacy of transcatheter oily chemoembolization(TOCE) in the treatment. MATERIALS AND METHODS: We reviewed the findings of 24 dynamic CT or MR scans examined for the purpose of diagnosis before TOCE, and follow-up CT scans obtained after this procedure. In 24 patients (M:F=20:4) with a mean age of 52.2 years, 43 nodular HCCs with a diameter of 5 cm or less were present. The patients underwent double dynamic CT or MR imaging as one arterial phase 30 seconds after the intravenous injection of contrast media, and this was followed by a delayed phase 5 minutes fter injection. HCCs were then classified as one of four types: Type I, high and low attenuation or intensity during the arterial and delayed phase, respectively; Type II, iso- and low; Type III, iso- and high; and Type IV, high and iso-. In addition, we classified the degree of lipiodol accumulation by HCC nodules as either Grade 5 (fullmoon-like lipiodolization), Grade 2 (about 40%), or Grade 1 (about 20%), as seen on follow-up CT scans after TOCE. RESULTS: Type I provided an accuracy of 72.1% considering to more than 50% lipiodol accumulation. However, a single finding demonstrating high atenuation or intensity during the arterial phase gave an accuracy of 79.1% better than that of Type I. CONCLUSION: A finding of high attenuation or intensity during the arterial phase, as seen on dynamic CT or MR images, provides the best information about the therapeutic efficacy of HCCs treated by means of with TOCE.
Carcinoma, Hepatocellular* ; Contrast Media ; Diagnosis ; Ethiodized Oil ; Follow-Up Studies ; Humans ; Injections, Intravenous ; Magnetic Resonance Imaging ; Tomography, X-Ray Computed

Bone and joint involvement develops in approximately 10 percent of patients with tuberculosis and half of these affected patients have tuberculosis of the spine. In the treatment of tuberculous spondylitis evacuation of the contents of the abscess, including the bone sequestra and the sequestrated intervertebral discs, combined with removal of all avascular bone and anterior fusion with a strut graft has widely applied since Hodgson and Stock published their successful results in 1960. Surgical approaches to the vertebral bodies at different levels, either anterior, anterolateral or modified approach, have been described in order to improve the exposure. The upper lumbar vertebral lesion is well exposed by the lateral or anterolateral approaches. But exposure of the lumbosacral lesion is limited because of iliac bone and other surrounding vital organs. We describe a surgical approach to lumbosacral spine which allows an adequate exposure of the vertebral bodies from L4 to S1. The transabodminal midline approach seems to be useful method for the lumbosacral vertebral body lesion, allows adequate exposure and easy reconstruction.
Abscess ; Humans ; Intervertebral Disc ; Joints ; Spine ; Spondylitis* ; Transplants ; Tuberculosis

Baek-ok injection (glutathione) has been widely used antioxidant therapy to whiten and has antiaging effects in Korea. Glutathione is an enzyme which synthesizes leukotriene, then it can induce asthma attack theoretically; however, there have been few case reports concerning this therapy. In this report, we described a 41-year-old woman who developed glutathione-induced life-threatening asthma attack. She has asthma history controlled by an intermittent salbutamol inhaler. She developed general weakness and dyspnea right after glutathione injection, and injection was discontinued. Dyspnea was progressively aggravated, and she lost consciousness with shock. Cardiopulmonary resuscitation was started, and she arrived at the Emergency Department with wheezing, hypoxia, severe respiratory acidosis, and nonmeasurable blood pressure. Intubation and mechanical ventilation were started with intramuscular epinephrine/intravenous methylprednisolone injection and repeated salbutamol/ipratropium/budesonide inhalation. After 5 hours, extubation and spontaneous breathing were successful without wheezing. Next day, pulmonary function test showed moderate an obstructive airway disease pattern, and she was discharged with inhaled fluticasone/salmeterol, oral methylprednisolone, and montelukast. We can exclude anaphylaxis, because serum tryptase obtained at the Emergency Department was 0.0 mg/dL and the absence of skin lesions and angioedema at arrival. Baek-ok injection (glutathione) should be carefully performed in asthma patients.