OBJECTIVES: Peptic ulcer is the major condition that affect numerous individuals every year. In 1983, Warren and Marshall presented the evidence that H. pylori was associated with gastritis and peptic ulcer. Thereafter, K. pylori infection is thought to be a important factor in the pathogenesis of gastric and duodenal ulcer. In western studies, about 58% to 100% of patients with peptic ulcer disease were infected with H. pylori. But in Korea, there is no study about the prevalence of H. pylori infection in peptic ulcer disease despite of its high prevalence and importance. The aim of this study was to investigate the prevalence of H. pylori infection in case of gastric and duodenal ulcer disease in Korea. METHODS: We surveyed the prevalence of H. pylori infection of 1031 patients, who were diagnosed as gastric or duodenal ulcer by gastrofiberoscopy. H. pylori infection was evaluated with Rapid Urease Test(CLO test) and/or histology by Wright-Giemsa staining. RESULTS: 1) Peptic ulcer was more frequently developed in males than females, as the frequency of peptic ulcer was 77% in males, and 23% in females. But in view of the prevalence of H. pylori infection, there was no significant difference between males and females, 73% in males and 71% in females. 2) Gastric ulcer was most common in sixth decade(29.8%), but the prevalence of H. pylori infection was peak in fourth(76%), and fifth decade (73%). 3) Duodenal ulcer was most common in fourth decade(26.3%), but the prevalence of H. pylori infection was peak in teenagers(93%) and third decade(87%). 4) The patients who had both gastric ulcer and duodenal ulcer concurrently were most common in sixth decade(27.9%), but the prevalence of H, pylori infection was peak in third decade(100%). CONCLUSION: We concluded that the majority of peptic ulcer patients in Korea had H. pylori infection. Particularly, young aged patients had higher H. pylori infection rate than old aged.
Duodenal Ulcer* ; Female ; Gastritis ; Helicobacter pylori* ; Helicobacter* ; Humans ; Korea ; Male ; Peptic Ulcer ; Prevalence* ; Prospective Studies* ; Stomach Ulcer* ; Urease

Pulmonary thromboembolism (PTE) increases the pressure of the right ventricle and leads to symptoms and signs, such as dyspnea and hypoxia. If PTE causes hemodynamic instability, thrombolytic therapy should be considered. A mechanical thrombectomy is an alternative treatment to thrombolytic therapy and should be considered when thrombolytic therapy is contraindicated. Various devices are used in mechanical maceration and catheter-directed thrombolysis, but there is no standard mechanical device for PTE as yet. We report here on 2 clinical experiences of mechanical thrombectomy using the Arrow-Trerotola percutaneous thrombolytic device to remove residual clots after systemic thrombolysis in patients with massive PTE.
Anoxia ; Dyspnea ; Heart Ventricles ; Hemodynamics ; Humans ; Pulmonary Embolism* ; Thrombectomy ; Thrombolytic Therapy

Umbilical cord stricture is a very rare cord abnormality that cause intrauterine fetal death. An extreme focal deficiency of Wharton's jelly is suggested as a cause of cord stricture, and was most commonly occurred at the fetal end of umbilical cord. Antenatal detection of umbilical cord stricture is very difficult. We experienced a case of the intrauterine fetal death due to umbilical cord stricture, and we report this case with a brief review of literatures.
Constriction, Pathologic* ; Fetal Death* ; Umbilical Cord* ; Wharton Jelly

Acute portal vein and mesenteric vein thrombosis (PVMVT) can cause acute mesenteric ischemia and be fatal with mortality rate of 37%-76%. Therefore, early diagnosis and prompt venous revascularization are warranted in patients with acute symptomatic PVMVT. Due to advances in catheter-directed treatment, endovascular treatment has been used for revascularization of affected vessels in PVMVT. We report two cases of symptomatic PVMVT treated successfully by transhepatic percutaneous mechanical thrombectomy-assisted thrombolysis.
Early Diagnosis ; Endovascular Procedures ; Humans ; Ischemia ; Mesenteric Veins ; Mortality ; Portal Vein ; Thrombosis ; Venous Thrombosis*

BACKGROUND: Reports on the relationship between osteoporosis and osteoarthritis (OA) have tended to disagree, especially in non-weight bearing joints such as the hand joints. We aimed to investigate the relationship between bone mineral density (BMD) and hand and knee OA in a general Korean elderly population. METHODS: We evaluated femur neck BMD and the hand and knee radiographs of 143 men and 123 women over 65 years of age who participated in a population-based cohort study. The Kellgren-Lawrence criteria for grading OA were implemented, and grade 2 or higher were categorized as radiographic OA. BMD was compared according to the existence of radiographic OA in the hand and knee using analysis of covariance, and correlation analyses were performed to explore the relationship between BMD and radiographic OA grade. RESULTS: After controlling for age and body mass index, there was no significant difference in BMD between participants with and without hand OA (p = 0.717 in male and p = 0.862 in female), between those with and without knee OA (p = 0.974 in male and p = 0.563 in female), and between those with only hand OA and those with only knee OA (p = 0.920 in male and p = 0.961 in female). Furthermore, there was no significant correlation between BMD and the radiographic OA grade of the hands (p = 0.182 in male and p = 0.897 in female) and knees (p = 0.245 in male and p = 0.098 in female). CONCLUSIONS: In our cohort of the general Korean elderly population, no association was found between osteoporosis and OA, regardless of the weight bearing status of the joints.
Aged ; *Bone Density ; Female ; Femur Neck/*radiography ; Hand/*radiography ; Humans ; Male ; Osteoarthritis, Knee/complications/*radiography ; Osteoporosis/complications/*radiography ; Republic of Korea ; Sex Factors

PURPOSE: To evaluate the clinical and radiological results of distal transfer of the greater trochanter in patients with a high-standing greater trochanter as a sequela of LCP disease. MATERIALS AND METHODS: Between 1994 and 2005, ten cases (nine patients) underwent distal transfer of a highstanding greater trochanter and were followed up for more than 2 years after surgery. The clinical findings, such as the abduction of the hip, VAS score, and Trendelenburg sign, were evaluated. In addition, the centrotrochanteric distance (CTD) and Lever arm ratio (LAR) were used for the radiographic assessment. RESULTS: The mean range of abduction improved from 27.5degrees to 40degrees , and the VAS score improved from 4.1 to 1.2. Seven cases with positive Trendelenburg sign before surgery showed negative Trendelenburg sign after the surgery. At the last follow-up, the CTD improved from -1.52 cm to -0.2 cm and the LAR decreased from 2.2 to 1.8. CONCLUSION: The distal transfer of the greater trochanter in patients with a high standing greater trochanter as a consequence of LCP is an effective procedure that can reduce the level of hip pain and improve the hip abduction if careful patient selection is performed.
Arm ; Femur* ; Follow-Up Studies ; Hip ; Humans ; Patient Selection

PURPOSE: Recent studies have suggested microscopic positive resection margin should be revised according to the presence of tumor cells within 1mm of the margin surface in resected specimens of pancreatic cancer. However, the clinical meaning of this revised margin status for R1 resection margin was not fully clarified. METHODS: From July 2012 to December 2014, the medical records of 194 consecutive patients who underwent pancreaticoduodenectomy for ductal adenocarcinoma of the pancreatic head were analyzed retrospectively. They were divided into 3 groups on margin status; revised microscopic negative margin (rR0) – tumor exists more than 1 mm from surgical margin, revised microscopic positive margin (rR1) – tumor present within less than 1 mm from surgical margin, classic microscopic positive margin (cR1) – tumor is exposed to surgical margin. RESULTS: There were 76 rR0 (39.2%), 100 rR1 (51.5%), and 18 cR1 (9.3%). There was significant difference in disease-free survival rates between cR1 vs. rR1 (8.4 months vs. 24.0 months, P = 0.013). Margin status correlated with local recurrence rate (17.1% in rR0, 26.0% in rR1, and 44.4% in cR1, P = 0.048). There is significant difference in recurrence at tumor bed (11.8% in rR0 vs. 23.0 in rR1, P = 0.050). Of rR1, adjuvant treatment was found to be an independent risk factor for local recurrence (hazard ratio, 0.297; 95% confidence interval, 0.127–0.693, P = 0.005). CONCLUSION: Revised R1 resection margin (rR1) affects recurrence at the tumor bed. Adjuvant treatment significantly reduced local recurrence of rR1. Accordingly, adjuvant chemoradiation for rR1 group should be taken into account.
Adenocarcinoma* ; Carcinoma, Pancreatic Ductal ; Disease-Free Survival ; Head* ; Humans ; Medical Records ; Pancreatic Neoplasms ; Pancreaticoduodenectomy ; Recurrence ; Retrospective Studies ; Risk Factors

Actinomycosis is a rare disease in human and has variable clinical features, which make the diagnosis difficult. Actinomycosis may be confused with malignancy and other inflammatory diseases because of its infiltrative nature and its tendency to invade normal anatomic barriers. We have experienced a case of abdominal actinomycosis combined with ovarian mucinous cystadenocarcinoma and report this case with brief review of literatures.
Actinomycosis* ; Cystadenocarcinoma, Mucinous ; Diagnosis ; Humans ; Ovarian Neoplasms* ; Rare Diseases

Endoscopic submucosal dissection (ESD) is a widely accepted treatment for early gastric and esophageal cancer. Compared to endoscopic mucosal resection, ESD has the advantage of enabling en bloc removal of tumors regardless of their size. However, ESD can result in a large artificial ulcer, which may lead to a considerable deformity. Circumferential mucosal defects of more than three-fourths the esophageal circumference, long longitudinal mucosal defects (>30 mm), and lesions in the upper esophagus are significant risk factors for the development of post-ESD strictures of the esophagus. In the stomach, a circumferential mucosal defects more than three-fourths in extent and longitudinal mucosal defects >5 cm are risk factors of post-ESD stricture. If scheduled early, regular endoscopic balloon dilation is effective in controlling and preventing post-ESD stricture. Moreover, intralesional steroid injections or oral steroids can achieve remission of dysphagia or reduce the need for repeated endoscopic balloon dilation. However, further study is needed to improve the prevention of stricture formation.
Congenital Abnormalities ; Constriction, Pathologic* ; Deglutition Disorders ; Esophageal Neoplasms ; Esophagus ; Risk Factors ; Steroids ; Stomach ; Ulcer

BACKGROUND AND OBJECTIVES: Intermediate coronary lesion that can be under- or over-estimated by visual estimation frequently results in stenting of functionally nonsignificant lesions or deferral of percutaneous coronary intervention (PCI) of significant lesions inappropriately. We evaluated current status of PCI for intermediate lesions from a standardized database in Korea. METHODS: We analyzed the Korean percutaneous coronary intervention (K-PCI) registry data which collected a standardized PCI database of the participating hospitals throughout the country from January 1, 2014, through December 31, 2014. Intermediate lesion was defined as a luminal narrowing between 50% and 70% by visual estimation and then compared whether the invasive physiologic or imaging study was performed or not. RESULTS: Physiology-guided PCI for intermediate lesions was performed in 16.8% for left anterior descending artery (LAD), 9.8% for left circumflex artery (LCX), 13.2% for right coronary artery (RCA). PCI was more frequently performed using intravascular ultrasound (IVUS) than using fractional flow reserve (FFR) for coronary artery segments (27.7% vs. 13.9% for LAD, 32.9% vs. 8.1% for LCX, and 33.8% vs. 10.8% for RCA). In accordance with or without FFR, PCI for intermediate lesions was more frequently performed in the hospitals with available FFR device than without FFR, especially in left main artery (LM), proximal LAD lesion (40.9% vs. 5.9% for LM, 24.6% vs 7.6% for proximal LAD). CONCLUSIONS: These data provide the current PCI practice pattern with the use of FFR and IVUS in intermediate lesion. More common use of FFR for intermediate lesion should be encouraged.
Arteries ; Coronary Artery Disease ; Coronary Stenosis ; Coronary Vessels ; Fractional Flow Reserve, Myocardial ; Korea ; Percutaneous Coronary Intervention ; Phenobarbital ; Stents ; Ultrasonography