Serological tests for Helicobacter pylori needs local validation as the diagnostic accuracy may vary depending on the prevalence of H.pylori. This study examined the diagnostic performance of two ELISA, GastroPanel® (GastroPanel ELISA; Biohit Oyj) and GENE-DIA® (GENEDIA® H. pylori ELISA, Green Cross Co.) in Korean population. One thousand seventy seven patients who visited for esophagogastroduodenoscopy between 2013 and 2023 were prospectively enrolled, and serum samples from the subjects were tested using both GastroPanel® and GENEDIA® . The two tests were compared for their diagnostic accuracy in detecting atrophic gastritis (AG), intestinal metaplasia (IM), gastric adenoma (GA), and gastric cancer (GC), and the positivity rates by age and sexwere observed. There was substantial correlation (Pearson coefficient [r] = 0.512, P < 0.001) and agreement (Cohen’s Kappa coefficient [κ] = 0.723, P < 0.001) between the results obtained using GastroPanel® and GENEDIA® . The test results from the two kits did not match perfectly with a discrepancy observed in approximately 16% of cases, that 67 subjects were positive only on GENE-DIA® while 75 subjects were positive only on GastroPanel® . The area under receiver operating characteristic curve for AG, IM, GA,and GC using GastroPanel® were 0.666, 0.635, 0.540, and 0.575, while the results tested using GENEDIA® were 0.649, 0.604, 0.553, and 0.555, respectively, without significant difference between the two results. GastroPanel® and GENEDIA® showed similar performance in terms of diagnostic accuracy; but the test results did not match perfectly. A large-scale validation study in Koreansis needed.

Serological tests for Helicobacter pylori needs local validation as the diagnostic accuracy may vary depending on the prevalence of H.pylori. This study examined the diagnostic performance of two ELISA, GastroPanel® (GastroPanel ELISA; Biohit Oyj) and GENE-DIA® (GENEDIA® H. pylori ELISA, Green Cross Co.) in Korean population. One thousand seventy seven patients who visited for esophagogastroduodenoscopy between 2013 and 2023 were prospectively enrolled, and serum samples from the subjects were tested using both GastroPanel® and GENEDIA® . The two tests were compared for their diagnostic accuracy in detecting atrophic gastritis (AG), intestinal metaplasia (IM), gastric adenoma (GA), and gastric cancer (GC), and the positivity rates by age and sexwere observed. There was substantial correlation (Pearson coefficient [r] = 0.512, P < 0.001) and agreement (Cohen’s Kappa coefficient [κ] = 0.723, P < 0.001) between the results obtained using GastroPanel® and GENEDIA® . The test results from the two kits did not match perfectly with a discrepancy observed in approximately 16% of cases, that 67 subjects were positive only on GENE-DIA® while 75 subjects were positive only on GastroPanel® . The area under receiver operating characteristic curve for AG, IM, GA,and GC using GastroPanel® were 0.666, 0.635, 0.540, and 0.575, while the results tested using GENEDIA® were 0.649, 0.604, 0.553, and 0.555, respectively, without significant difference between the two results. GastroPanel® and GENEDIA® showed similar performance in terms of diagnostic accuracy; but the test results did not match perfectly. A large-scale validation study in Koreansis needed.

Serological tests for Helicobacter pylori needs local validation as the diagnostic accuracy may vary depending on the prevalence of H.pylori. This study examined the diagnostic performance of two ELISA, GastroPanel® (GastroPanel ELISA; Biohit Oyj) and GENE-DIA® (GENEDIA® H. pylori ELISA, Green Cross Co.) in Korean population. One thousand seventy seven patients who visited for esophagogastroduodenoscopy between 2013 and 2023 were prospectively enrolled, and serum samples from the subjects were tested using both GastroPanel® and GENEDIA® . The two tests were compared for their diagnostic accuracy in detecting atrophic gastritis (AG), intestinal metaplasia (IM), gastric adenoma (GA), and gastric cancer (GC), and the positivity rates by age and sexwere observed. There was substantial correlation (Pearson coefficient [r] = 0.512, P < 0.001) and agreement (Cohen’s Kappa coefficient [κ] = 0.723, P < 0.001) between the results obtained using GastroPanel® and GENEDIA® . The test results from the two kits did not match perfectly with a discrepancy observed in approximately 16% of cases, that 67 subjects were positive only on GENE-DIA® while 75 subjects were positive only on GastroPanel® . The area under receiver operating characteristic curve for AG, IM, GA,and GC using GastroPanel® were 0.666, 0.635, 0.540, and 0.575, while the results tested using GENEDIA® were 0.649, 0.604, 0.553, and 0.555, respectively, without significant difference between the two results. GastroPanel® and GENEDIA® showed similar performance in terms of diagnostic accuracy; but the test results did not match perfectly. A large-scale validation study in Koreansis needed.

Background: Rapid electrocardiography diagnosis within 10 minutes of presentation is critical for acute myocardial infarction (AMI) patients in the emergency department (ED).However, the coronavirus disease 2019 (COVID-19) pandemic has significantly impacted the emergency care system. Screening for COVID-19 symptoms and implementing isolation policies in EDs may delay the door-to-electrocardiography (DTE) time. Methods: We conducted a cross-sectional study of 1,458 AMI patients who presented to a single ED in South Korea from January 2019 to December 2021. We used multivariate logistic regression analysis to assess the impact of COVID-19 pandemic and ED isolation policies on DTE time and clinical outcomes. Results: We found that the mean DTE time increased significantly from 5.5 to 11.9 minutes (P < 0.01) in ST segment elevation myocardial infarction (STEMI) patients and 22.3 to 26.7 minutes (P < 0.01) in non-ST segment elevation myocardial infarction (NSTEMI) patients.Isolated patients had a longer mean DTE time compared to non-isolated patients in both STEMI (9.2 vs. 24.4 minutes) and NSTEMI (22.4 vs. 61.7 minutes) groups (P < 0.01). The adjusted odds ratio (aOR) for the effect of COVID-19 duration on DTE ≥ 10 minutes was 1.93 (95% confidence interval [CI], 1.51–2.47), and the aOR for isolation status was 5.62 (95% CI, 3.54–8.93) in all patients. We did not find a significant association between in-hospital mortality and the duration of COVID-19 (aOR, 0.9; 95% CI, 0.52–1.56) or isolation status (aOR, 1.62; 95% CI, 0.71–3.68). Conclusion Our study showed that ED screening or isolation policies in response to the COVID-19 pandemic could lead to delays in DTE time. Timely evaluation and treatment of emergency patients during pandemics are essential to prevent potential delays that may impact their clinical outcomes.

Vincristine (VCR) is a chemotherapeutic agent widely used in treatment of malignancies. However, VCR has a limitation in use since it commonly causes a painful neuropathy (VCR-induced peripheral neuropathy, VIPN). Inflammatory cytokines secreted by immune cells such as macrophages can exacerbate allodynia and hyperalgesia, because inhibiting the inflammatory response is a treatment target for VIPN. In this study, we investigated whether Trichinella spiralis, a widely studied helminth for its immunomodulatory abilities, can alleviate VCR-induced allodynia. Von Frey test showed that T. spiralis infection improved mechanical allodynia at 10 days after VCR injection. We further observed whether the difference was due to mitigated axon degeneration, but no significant difference between the groups in axonal degeneration in sciatic nerves and intra-epidermal nerve fibers was found. Conversely, we observed that number of infiltrated macrophages was decreased in the sciatic nerves of the T. spiralis infected mice. Moreover, treatment of T. spiralis excretory-secretory products caused peritoneal macrophages to secrete decreased level of IL-1β. This study suggests that T. spiralis can relieve VCR-induced mechanical allodynia by suppressing neuroinflammation and that application of controllable degree of helminth may prove beneficial for VIPN treatment.

Toxic megacolon is a fatal complication of inflammatory or infectious bowel disease.Prognosis depends on the severity of the disease. In cases of poor prognosis, clinical outcomes range from intestinal resection to death, so early diagnosis and appropriate treatment are very important. However, the prevalence of toxic megacolon in children is very low, and in those without underlying diseases such as inflammatory bowel disease, early diagnosis may be delayed. A previously healthy 12-year-old boy presented to our hospital with lower abdomen pain, fever, and hematochezia. Despite antibiotic therapy, the symptoms worsened. On the third day, abdominal computed tomography revealed severe dilatation of the transverse colon, which indicated toxic megacolon. Stool culture was positive for Salmonella enteritidis group D, and rectal endoscopy showed no signs of inflammatory bowel disease. Ceftriaxone and intravenous methylprednisolone were administered, and the patient's condition improved without any complications. We report a case of toxic megacolon as a complication of infectious colitis caused by S. enteritidis group D, which was diagnosed using early imaging and successfully treated without surgical intervention.

Toxic megacolon is a fatal complication of inflammatory or infectious bowel disease.Prognosis depends on the severity of the disease. In cases of poor prognosis, clinical outcomes range from intestinal resection to death, so early diagnosis and appropriate treatment are very important. However, the prevalence of toxic megacolon in children is very low, and in those without underlying diseases such as inflammatory bowel disease, early diagnosis may be delayed. A previously healthy 12-year-old boy presented to our hospital with lower abdomen pain, fever, and hematochezia. Despite antibiotic therapy, the symptoms worsened. On the third day, abdominal computed tomography revealed severe dilatation of the transverse colon, which indicated toxic megacolon. Stool culture was positive for Salmonella enteritidis group D, and rectal endoscopy showed no signs of inflammatory bowel disease. Ceftriaxone and intravenous methylprednisolone were administered, and the patient's condition improved without any complications. We report a case of toxic megacolon as a complication of infectious colitis caused by S. enteritidis group D, which was diagnosed using early imaging and successfully treated without surgical intervention.

PURPOSE: The optimal treatment for synchronous liver metastasis (LM) from colorectal cancer (CRC) depends on various factors. The present study was intended to investigate the oncologic outcome according to the time of resection of metastatic lesions. METHODS: Data from patients who underwent treatment with curative intent for primary CRC and synchronous LM between 2004 and 2009 from 9 university hospitals in Korea were collected retrospectively. One hundred forty-three patients underwent simultaneous resection for primary CRC and synchronous LM (simultaneous surgery group), and 65 patients were treated by 2-stage operation (staged surgery group). RESULTS: The mean follow-up length was 41.2 ± 24.6 months. In the extent of resection for hepatic metastasis, major hepatectomy was more frequently performed in staged surgery group (33.8% vs. 8.4%, P < 0.001). The rate of severe complications of Clavien-Dindo classification grade III or more was not significantly different between the 2 groups. The 3-year overall survival (OS) rate was 85.0% in staged surgery group and 69.4% in simultaneous surgery group (P = 0.013), and the 3-year recurrence-free survival (RFS) rate was 46.4% in staged surgery group and 30.2% in simultaneous surgery group (P = 0.143). In subgroup analysis based on the location of primary CRC, the benefit of staged surgery for OS and RFS was clearly shown in rectal cancer (P = 0.021 and P = 0.015). CONCLUSION: Based on our results, staged surgery with or without neoadjuvant chemotherapy should be considered for resectable synchronous LM from CRC, especially in rectal cancer, as a safe and fairly promising option.
Classification ; Colorectal Neoplasms ; Drug Therapy ; Follow-Up Studies ; Hepatectomy ; Hospitals, University ; Humans ; Korea ; Liver ; Neoplasm Metastasis ; Rectal Neoplasms ; Retrospective Studies

OBJECTIVE: The time to positivity (TTP) of blood culture reflects bacterial load and has been reported to be associated with outcome in bloodstream infections. This study was performed to evaluate the relationship between the TTP of blood culture and the mortality rates associated with sepsis and septic shock according to the site of infection. METHODS: We performed a retrospective cohort study on patients with sepsis and septic shock. The rates of blood culture positivity and mortality as well as the relationship between the TTP and 28-day mortality rate were compared among patients with different sites of infection, such as the lungs, abdomen, urogenital tract, and other sites. RESULTS: A total of 2,668 patients were included, and the overall mortality rate was 21.6%. The rates of blood culture positivity and mortality were different among the different infection sites. There was no relationship between the TTP and mortality rates of total, lung, and urogenital infections. Patients with abdominal infections showed a negative correlation between the TTP and 28-day mortality rate. In patients with abdominal infections, a TTP < 20 hours was independently associated with 28-day mortality compared with patients with negative blood culture (hazard ratio, 1.73; 95% confidence interval, 1.16–2.58). However, there was no difference in mortality rates of patients with a TTP≥20 hours and a negative blood culture. CONCLUSION: The shorter TTP in patients with abdominal infections in sepsis and septic shock was associated with a higher 28-day mortality rate.
Abdomen ; Bacterial Load ; Cohort Studies ; Humans ; Lung ; Mortality* ; Retrospective Studies ; Sepsis* ; Shock, Septic

Neuroleptic malignant syndrome is a rare, but potentially life-threatening adverse event associated with the use of neuroleptic agents. We describe the case of a 47-year-old schizophrenic woman who was treated with clozapine for years. The patient developed acute renal failure with pulmonary edema, and underwent mechanical ventilation and hemodialysis.
Acute Kidney Injury ; Antipsychotic Agents ; Clozapine* ; Female ; Humans ; Middle Aged ; Neuroleptic Malignant Syndrome* ; Pulmonary Edema ; Renal Dialysis ; Respiration, Artificial ; Rhabdomyolysis