Background/Aims: We examined the efficacy and safety of tegoprazan as a part of first-line triple therapy for Helicobacter pylori eradication. Methods: A randomized, double-blind, controlled, multicenter study was performed to evaluate whether tegoprazan (50 mg)-based triple therapy (TPZ) was noninferior to lansoprazole (30 mg)-based triple therapy (LPZ) (with amoxicillin 1 g and clarithromycin 500 mg; all administered twice daily for 7 days) for treating H. pylori. The primary endpoint was the H. pylori eradication rate. Subgroup analyses were performed according to the cytochrome P450 (CYP) 2C19 genotype, the minimum inhibitory concentration (MIC) of amoxicillin and clarithromycin, and underlying gastric diseases. Results: In total, 350 H. pylori-positive patients were randomly allocated to the TPZ or LPZ group. The H. pylori eradication rates in the TPZ and LPZ groups were 62.86% (110/175) and 60.57% (106/175) in an intention-to-treat analysis and 69.33% (104/150) and 67.33% (101/150) in a per-protocol analysis (non-inferiority test, p=0.009 and p=0.013), respectively. Subgroup analyses according to MICs or CYP2C19 did not show remarkable differences in eradication rate. Both first-line triple therapies were well-tolerated with no notable differences. Conclusions TPZ is as effective as proton pump inhibitor-based triple therapy and is as safe as first-line H. pylori eradication therapy but does not overcome the clarithromycin resistance of H. pylori in Korea

OBJECTIVE: The aim of this study was to evaluate the efficacy and safety of transradial percutaneous coronary intervention (TRI) compared with transfemoral percutaneous coronary intervention (TFI) in patients with ischemic heart disease. METHODS: We reviewed retrospectively the medical records including imaging data of the patients with ischemic heart disease who underwent TRI or TFI from January 2007 to December 2009 in Soonchunhyang University Seoul Hospital. We compared major adverse cardiac and cerebrovascular events (MACCEs) including death, myocardial infarction, revascularization, stent thrombosis, and cerebrovascular accident during follow-up period. We also compared procedure related vascular complications including hematoma, arteriovenous fistula, pseudoaneurysm, and infection. RESULTS: Total number of patients was 347 (256 patients of TRI and 91 patients of TFI). There were no significant differences in the rate of MACCEs between two groups. There were significantly less procedure-related vascular complications in TRI group (3.1% vs. 11.0%, P=0.010). CONCLUSION: TRI is as effective as TFI with no difference in the rate of MACCEs in patients with ischemic heart disease. TRI is superior to TFI in safety with reduction of vascular complications.
Aneurysm, False ; Arteriovenous Fistula ; Coronary Artery Disease ; Femoral Artery ; Follow-Up Studies ; Heart ; Hematoma ; Humans ; Medical Records ; Myocardial Infarction ; Myocardial Ischemia ; Percutaneous Coronary Intervention ; Radial Artery ; Retrospective Studies ; Stents ; Stroke ; Thrombosis

BACKGROUND: Atopic dermatitis (AD) is a chronic, relapsing disease with genetic and environmental background. Many factors may act as triggers and affect the course of the disease. However, little is known about the factors affecting the disease severities in Korean childhood AD. OBJECTIVE: The aim was to document the distinct characteristics of childhood AD in Korea and to determine which manifestations are prone to be present in the settings of different severity of the disease. METHOD: The clinical manifestations, past medical and family history, and inducing or aggravating factors were studied in patients, who participated in the open lectures for childhood AD patients in three provinces of Korea. The severity of the disease was evaluated using the Eczema Area and Severity Index (EASI) and the factors affecting the severity of the disease were determined. Skin prick tests with four allergens, Dermatophagoides pteronyssinus, milk, peanut and egg, were also carried out. RESULTS: Of the 93 patients, 38.7% had the disease onset between the age of three and six, while 17.2% had it between the age of seven and fifteen. Sixty-five percent of the patients had family members with a history of atopic diseases, such as AD, asthma, allergic rhinitis and allergic conjunctivitis. In order of frequency, the patients either had a history of or presently accompanying infantile eczema, allergic rhinitis, asthma or allergic conjunctivitis. Among the patients, 27% took herbal medication. The most frequently involved site was the flexural area. The most common aggravating factors were sweating in hot environment, wool fabric and stress. When AD patients were categorized into mild, moderate and severe groups by EASI, the older onset age, the longer duration, facial distribution, history of taking herbal medication, cholinergic condition, wool fabric and stress were found to be significant factors influencing the severity of the disease. Skin prick test with the four major allergens revealed the highest prevalence in Dermatophagoides pteronyssinus. CONCLUSION: The age of onset of AD was higher than that has been reported. Many suffered from infantile dermatitis and had other accompanying atopic diseases. Aggravating factors should be avoided to minimize the risk of disease aggravation. Based on the fact that late onset age, duration, facial distribution, history of taking herbal medication, cholinergic condition, wool and stress were the statistically significant factors, we may predict the severity or the course of the disease.
Age of Onset ; Allergens ; Antigens, Dermatophagoides ; Asthma ; Conjunctivitis, Allergic ; Dermatitis ; Dermatitis, Atopic* ; Dermatophagoides pteronyssinus ; Eczema ; Humans ; Korea* ; Lectures ; Milk ; Ovum ; Prevalence ; Rhinitis ; Skin ; Sweat ; Sweating ; Wool

BACKGROUND: Gamma-glutamyltransferase (GGT), which is an intracellular antioxidant due to maintain intracellular concentrations of glutathione, may be a marker of oxidative stress. In the present study, oxidative stress was thought to be a cause of diabetes mellitus. So, We performed a cross sectional study about the relations between GGT and prevalence of diabetes mellitus. METHODS: In total 5049 healthy men who had visited the Yonsei Wonju Christian Hospital for health care from 1st January 2002 to 31st December 2002, we measured BMI, blood pressure, GGT, total cholesterol, ALT and fasting blood sugar levels. RESULTS: There were strong relations between serum GGT concentrations and age, BMI, total cholesterol, systolic blood pressure, diastolic blood pressure and ALT level. GGT level had positive correlations with the prevalence of diabetes mellitus and impaired glucose tolerance when divided into four classes, 0~19 IU/L, 20~39 IU/L, 40~59 IU/L and over 60 IU/L. We got the same results after adjustment with BMI, total cholesterol, blood pressure and ALT level. CONCLUSION: There was a positive correlation between GGT level and the prevalence of diabetes mellitus, and that was definite especially when BMI, total cholesterol, blood pressure and ALT levels were in normal range. We suggest that serum GGT level would be an important marker in the development of diabetes mellitus.
Blood Glucose ; Blood Pressure ; Cholesterol ; Delivery of Health Care ; Diabetes Mellitus* ; Fasting ; gamma-Glutamyltransferase* ; Gangwon-do ; Glucose ; Glutathione ; Humans ; Male ; Oxidative Stress ; Prevalence* ; Reference Values

Rapid and reliable diagnosis of measles is important to establish an appropriate therapy and to monitor the epidemic. However, classical ELISA methods using purified virus or virus-infected cells as antigens are not only difficult to determine optimal condition for diagnosis but also highly expensive to establish routine and appropriate diagnostic systems. Nucleoprotein of measles virus is one of the major antigens of measles virus that evoke initial IgM responses. It can be used as an attractive antigen for sero-diagnosis of measles during early infection. To develop simple and inexpensive diagnostic method for measles, we expressed a recombinant nucleoprotein (60-kDa) and a fragmented portion of the nucleoprotein (50-kDa) in E. coli and evaluated their appropriateness as diagnostic antigens. The proteins strongly reacted with sera from measles patients but not with normal control sera. Efficiency of recombinant nucleoprotein-ELISA (rN-ELISA) to detect IgM was compared that of whole measles virus-ELISA (MV-ELISA) on the basis of a clinical diagnosis. In rN-ELISA, sensitivity was 73.8% and agreement was above 76.4%. In MV-ELISA, sensitivity was 76.9% and agreement was 79.2%. Therefore, efficacy of rN-ELISA seemed to be similar to that of MV-ELISA. In addition, we compared with Edmonston rN-ELISA and Korean isolate rN-ELISA on the basis of commercial MV-ELISA. In Edmonston rN-ELISA, sensitivity was 94.0% and agreement was 98.4%. In the case of Korean isolate rN-ELISA, sensitivity was 96.0% and agreement was 96.9%. Thus, there was no significant difference in the efficacy between Edmonston rN-ELISA and Korean isolate rN-ELISA. Furthermore, the correlation coefficient (R2) between Edmonston rN-ELISA and Korean isolate rN-ELISA was 0.9925. These results suggest both Edmonston and Korean isolate rN-ELISA may be useful to diagnose measles.
Diagnosis ; Enzyme-Linked Immunosorbent Assay* ; Humans ; Immunoglobulin M* ; Immunoglobulins* ; Measles virus* ; Measles* ; Nucleoproteins*

Non-Hodgkin's lymphoma is monoclonal expansion of malignant B or T cells. The immunocompromised status in this disease is accompanied by many infections. The cryptococcosis, caused by Cryptococcus neoformans, frequently occurs in leukemia, Hodgkin's disease, sarcoidosis, diabetes mellitus, tuberculosis, and long-term steroid-using patients. Recent increasing incidence of fungal infection could be due to the spread of AIDS and transplantation. We experienced one patient with lung mass in Non-Hodgkin's lymphoma after three cycles of chemotherapy, which could not be discriminated from the newly developed lymphoma mass. Cryptococcus neoformans was isolated from the lung tissue obtained by thoracoscopic biopsy. Herein we report this case with brief review of pertinent literature.
Biopsy ; Cryptococcosis* ; Cryptococcus neoformans ; Diabetes Mellitus ; Drug Therapy* ; Hodgkin Disease ; Humans ; Incidence ; Leukemia ; Lung ; Lymphoma ; Lymphoma, Non-Hodgkin* ; Sarcoidosis ; T-Lymphocytes ; Tuberculosis

Non-Hodgkin's lymphoma is monoclonal expansion of malignant B or T cells. The immunocompromised status in this disease is accompanied by many infections. The cryptococcosis, caused by Cryptococcus neoformans, frequently occurs in leukemia, Hodgkin's disease, sarcoidosis, diabetes mellitus, tuberculosis, and long-term steroid-using patients. Recent increasing incidence of fungal infection could be due to the spread of AIDS and transplantation. We experienced one patient with lung mass in Non-Hodgkin's lymphoma after three cycles of chemotherapy, which could not be discriminated from the newly developed lymphoma mass. Cryptococcus neoformans was isolated from the lung tissue obtained by thoracoscopic biopsy. Herein we report this case with brief review of pertinent literature.
Biopsy ; Cryptococcosis* ; Cryptococcus neoformans ; Diabetes Mellitus ; Drug Therapy* ; Hodgkin Disease ; Humans ; Incidence ; Leukemia ; Lung ; Lymphoma ; Lymphoma, Non-Hodgkin* ; Sarcoidosis ; T-Lymphocytes ; Tuberculosis

BACKGROUND: Measles is a highly contagious disease caused by measles virus. Although the introduction of live attenuated measles vaccines has dramatically abrogated the endemic incidence of measles in world-wide, there are still 30 million measles cases and nearly one million deaths from measles annually. In this study, we characterized the measles outbreak in Gwangju Metropolitan City during the 2000~200 1 epidemic. METHODS: Study population included measles patients in Gwangju Metropolitan City from April, 2000 to May, 200 1. We conducted a questionnaire survey on the patients and analyzed the records based on the clinical guideline of World Health Organization (WHO). Furthermore, we isolated the measles viruses from clinical specimens of patients and analyzed the nucleotide sequences of nucleoprotein (N) gene. RESULTS: During the April 2000 to May 2001, measles epidemic, a total of 3,2 17 measles patients were reported in Gwangju Metropolitan City. The first patient of measles was reported on April, 2000. The incidence reached its peak in November, 2000 and decreased thereafter. The age distribution of the patients were various, which was ranged from 1 month after birth to 30 year adult and the peak incidence was observed at 7~13 year old. Various complications were developed in 232 patients and 2 of them died. Phylogenetic analyses of nucleotide sequences and deduced amino acid sequences of the N genes of isolated viruses revealed that all viruses isolated in Gwangju Metropolitan City were grouped into the clade H1. This suggests that a single, predominant viral genotype was responsible for the measles epidemic in Gwangju Metropolitan City. CONCLUSION: In this study, we characterized the measles outbreak in Gwangju Metropolitan City during 2000~200 1. The measles outbreak in Gwangju Metropolitan City was considered to be caused by single genotype of measles virus (clade H1). After a massive vaccination campaign among 7~16 years old children to eliminate indigenous measles from this country, it is important to continue measles vaccination and intensive surveillance clinically as well as virologically.
Adult ; Age Distribution ; Amino Acid Sequence ; Base Sequence ; Child ; Genotype ; Gwangju* ; Humans ; Incidence ; Measles virus ; Measles* ; Nucleoproteins ; Parturition ; Vaccination ; Vaccines ; World Health Organization ; Surveys and Questionnaires

The infected endocarditis related permanent pacemaker occurs rare and most of them occur at generator pocket but endocarditis related permanant pacemaker lead itself occurs very rarely. The rate of infection after pacemaker implantation is reported as 0.13-7% or 0.13-19.9% and mortality rate is up to 24-33%. Focal inflammation of generator pocket is easily detected but it is difficult to diagnose endocarditis related pacemaker lead and it has poor prognosis. Especially, early diagnosis is most important because endocarditis related pacemaker is fatal. Thirteen years ago, a womon was inserted the permanent pacemaker and then only generator was removed after one month. We report a case that we had removed the pacemaker lead by open thoracostomy and cardiopulmonary circulation to treat endocarditis related pacemaker lead.
Early Diagnosis ; Endocarditis* ; Inflammation ; Mortality ; Prognosis ; Thoracostomy

Primary aldosteronism due to unilateral adenoma is a rare cause of surgically curable hypertension. Bilateral adrenal mass has occasionally been reported in this syndrome, and bilateral aldosterone-producing adenoma (APA), or bilateral adrenal nodular hyperplasia have been demonstrated in some cases. However, another possibility is the coexistence of a unilateral APA with a contralateral benign or metastatic nonfunctioning mass, because adrenal tumors are frequently found at autopsy or incidentally detected during abdominal morphological evaluation in patients without adrenal dysfunction. A 39 year-old woman presented with hyperaldosteronism, suppressed renin levels, and bilateral adrenal mass on adrenal CT scanning. Selective adrenal venous sampling was unsuccessful in demonstrating concentration gradient of aldosterone. Postoperative measurement of hormone content in the tumor extract revealed unilateral aldosteron-producing adenoma with contralateral nonfunctioning black adenoma, Determination of hormone content in the tumor extract could be useful for the discrimination of functioning and nonfunctioning endocrine tumors, particularly in case of multiple tumors.
Adenoma* ; Adult ; Aldosterone ; Autopsy ; Discrimination (Psychology) ; Female ; Humans ; Hyperaldosteronism ; Hyperplasia ; Hypertension ; Renin ; Tomography, X-Ray Computed