BACKGROUND/AIMS: Antibiotic resistance of Helicobacter pylori (H. pylori) is a significant clinical problem because it reduces the efficacy of eradication therapy. The aims of this study were to assess the changing patterns of antibiotic resistance of H. pylori in patients with peptic ulcer diseases and to evaluate the eradication rate in antibiotic resistant H. pylori strains. METHODS: One hundred forty four H. pylori isolates obtained from 466 patients with peptic ulcer disease between June 2001 and December 2005 were examined for antimicrobial resistance. The minimum inhibitory concentration (MIC) of metronidazole was determined by modified broth microdilution method (mBMD) and E test. MICs of clarithromycin and amoxicillin were determined by mBMD, E test, and disc diffusion test. The breakpoints for metronidazole, clarithromycin, and amoxicillin resistance were defined as >8microgram/mL, >1microgram/mL, and > or =1microgram/mL, respectively. RESULTS: Resistance to metronidazole and clarithromycin was detected in 34.7% and 16.7% of H. pylori isolates, respectively. During the recent 5-year study period, amoxicillin-resistant rate of H. pylori was 11.8%, and multi-drug resistance rate of H. pylori was 16.7%. The eradication rate of clarithromycin containing triple therapies was low (7.8%) in clarithromycin-resistant H. pylori strains. CONCLUSIONS: The proportions of clarithromycin-resistant H. pylori strains have increased significantly over the last 5-years. There is an increasing tendency for the emergence of strains with multi-drug resistance. The increase in clarithromycin-resistant strains results in a decrease in eradication rate for H. pylori. In areas with high clarithromycin resistance, new alternative first-line treatment combination should be considered.
Adult ; Aged ; Amoxicillin/therapeutic use ; Anti-Bacterial Agents/therapeutic use ; Clarithromycin/adverse effects/therapeutic use ; Disk Diffusion Antimicrobial Tests ; *Drug Resistance, Bacterial ; Drug Therapy, Combination ; Female ; Helicobacter Infections/*drug therapy/microbiology ; Helicobacter pylori/*drug effects/isolation & purification ; Humans ; Male ; Metronidazole/therapeutic use ; Microbial Sensitivity Tests ; Middle Aged ; Peptic Ulcer/*drug therapy ; Retrospective Studies

OBJECTIVE: The incidence of ectopic pregnancy is increasing recently. To establish the quick and accurate diagnosis of ectopic pregnancy, we reviewed and analyzed the cases during recent 5 years. METHODS: Study datas was acquired from the 448 cases of the ectopic pregnancies who were managed and confirmed histopathologically at the our hospital from Jan. 1 1995 to Dec. 31 1999. RESULTS: The incidence of ectopic pregnancy was 1 in 20 deliveries. The most common age group was 26-30 years of age(34.4%). A previous history of abdominal or pelvic surgery was in 42.1% and tubal sterilization was in 14.1%, pelvic inflammatory disease was in 8.3%. Hemoglobin value over 10.0 gm/dl was in 79.2% and below 8.0 gm/dl in 4.5%. Initial systolic blood pressure risen above 100mmHg was in 79.0%. The most frequent intervals between last menstrual period and the onset of symptom was 6~8 weeks in 56.0%. The clinical manifestations were appeared in 78.8% from the last menstrual period to the next 4~8 weeks. In clinical symptoms, amenorrhea was encountered in 91.7%, lower abdominal pain in 88.3% and vaginal spotting in 47.3%. Ectopic gestation was implanted on the fallopian tube in 97.1%, the ovary in 1.1%, the cervix in 0.7%, the intraabdominal in 0.9% and 1 case was intramural pregnancy. Total amount of intraperitoneal hemorrhage between 100-999ml was in 59.5%, above 1,000ml in 37.5% and less than 100 ml in 3.0%. Of total 448 cases, laparotomy was done in 229 cases(51.0%) and pelvisopic surgery in 219 cases(49.0%). The mean hospital stay was 3.1 days in pelviscopy procedure and 5.0 days in laparotomy. The operative precedures were salpingectomy in 87.5%, salpingo-oophorectomy in 4.9%, cornual resection in 6.3%, ovarian wedge resection in 0.7%, and oophorectomy in 0.2%. There was no dead case in all ectopic pregnancy. Average admission period after laparoscopy was 3.1 day and after laparotomy was 5.0 day. CONCLUSION: The cognizing of increasing incidence of ectopic pregnancy, early diagnosis and early treatment is presumed to decrease mortality and increase fertility. The successful treatment and decision is a challenge to the clinician who must consider the patient's needs with appropriate tactfulness.
Abdominal Pain ; Amenorrhea ; Blood Pressure ; Cervix Uteri ; Diagnosis ; Early Diagnosis ; Fallopian Tubes ; Female ; Fertility ; Hemorrhage ; Humans ; Incidence ; Laparoscopy ; Laparotomy ; Length of Stay ; Metrorrhagia ; Mortality ; Ovariectomy ; Ovary ; Pelvic Inflammatory Disease ; Pregnancy ; Pregnancy, Ectopic* ; Pregnancy, Tubal ; Salpingectomy ; Sterilization, Tubal

Riboflavin in unstable in light and has a maximum absorption at 450nm. A study was designed to determine whether riboflavin deficiency developed in neonate who received phototherapy with eight day light bulbs for hyperbilirubinemia and to get normal value of activity coefficient of erythrocyte glutathione reductase in neonate. Twenty-seven infants who received phototherapy were investigated. Thirth-eight normal infants without phototherapy served as controls. All the infants of the two groups were fed artificially and then dialy riboflavin intake in each was more than 0.3mg. Riboflavin was determined from the degree of flavin adenine dinucleotide saturation of erythrocyte glutathione reductase, a method shown to reflect riboflavin nutritional status on the neonates. This is expressed as the activity coefficient. The mean activity coefficient of erythrocyte glutathione reductase in control group was 1.15+/-0.16. In phototherapy group, mean activity coefficient of just prior to the initiation and just after cessation of phototherapy were similar with the mean activity coefficient of control group and there was no significant increment of activity coefficient after phototherapy. There was no significant difference between the changes of activity coefficient according to light intensity. And also there was no significnat difference between the changes of activity coefficient according to duration of phototherapy and according to total phototherapeuti cdose.
Absorption ; Erythrocytes ; Flavin-Adenine Dinucleotide ; Glutathione Reductase ; Humans ; Hyperbilirubinemia ; Hyperbilirubinemia, Neonatal* ; Infant ; Infant, Newborn ; Nutritional Status ; Phototherapy* ; Reference Values ; Riboflavin Deficiency ; Riboflavin*

Riboflavin in unstable in light and has a maximum absorption at 450nm. A study was designed to determine whether riboflavin deficiency developed in neonate who received phototherapy with eight day light bulbs for hyperbilirubinemia and to get normal value of activity coefficient of erythrocyte glutathione reductase in neonate. Twenty-seven infants who received phototherapy were investigated. Thirth-eight normal infants without phototherapy served as controls. All the infants of the two groups were fed artificially and then dialy riboflavin intake in each was more than 0.3mg. Riboflavin was determined from the degree of flavin adenine dinucleotide saturation of erythrocyte glutathione reductase, a method shown to reflect riboflavin nutritional status on the neonates. This is expressed as the activity coefficient. The mean activity coefficient of erythrocyte glutathione reductase in control group was 1.15+/-0.16. In phototherapy group, mean activity coefficient of just prior to the initiation and just after cessation of phototherapy were similar with the mean activity coefficient of control group and there was no significant increment of activity coefficient after phototherapy. There was no significant difference between the changes of activity coefficient according to light intensity. And also there was no significnat difference between the changes of activity coefficient according to duration of phototherapy and according to total phototherapeuti cdose.
Absorption ; Erythrocytes ; Flavin-Adenine Dinucleotide ; Glutathione Reductase ; Humans ; Hyperbilirubinemia ; Hyperbilirubinemia, Neonatal* ; Infant ; Infant, Newborn ; Nutritional Status ; Phototherapy* ; Reference Values ; Riboflavin Deficiency ; Riboflavin*