Significance: Accurate detection of Helicobacter pylori (HP) is essential for the diagnosis of HP infection. The use of antibiotics and proton pump inhibitors (PPI) may result in false-negative rapid urease test (RUT) results. We aimed to determine the sensitivity and specificity of RUT compared with histology and assess the detection rate of combined RUT and histology for HP infection. Methodology: Retrospective data collection was performed on 192 patients who were tested for both RUT and histology at the time of upper endoscopy from 2017 to 2018. At least two gastric biopsies (1 from corpus, 1 from antrum) were taken each for RUT and histology. The endoscopy was performed by a single gastroenterologist and a single pathologist was responsible for interpreting the histology with hematoxylin and eosin (H&E) and Giemsa stain. The gold standard test for the diagnosis of HP infection was histology. Demographic profile, RUT and histology results were reviewed. Tests for diagnostic accuracy were computed using SPSSv23. Results: 192 patients were tested for RUT and histology. 52(27.1%) were males and 140(72.9%) were females with a mean age of 54±17 years. Epigastric pain was the most common indication (42.7%). 24(12.5%) patients tested positive for HP infection. Among these; 16(8.3%) tested positive for both RUT and histology(true-positive), while 8(4.2%) tested negative for RUT but had positive histology(false-negative). 6 out of 8(75%) patients with false negative results had PPI use. The sensitivity and specificity of RUT for the diagnosis of HP infection were 66.7 and 98.2%, respectively. While the positive and negative likelihood ratio were 37.3 and 0.34, respectively with a diagnostic odds ratio of 110. Conclusion The HP detection rate of RUT combined with histology increased by 33% compared with RUT alone. RUT is a highly specific test for diagnosing HP infection. Given its modest sensitivity, histology plays an important role in the diagnosis of HP infection, especially in patients taking PPIs. We recommend doing histology when RUT is negative to increase the HP detection rate.
Helicobacter Pylori ; Histology ; Azure Stains

PURPOSE: Allergic rhinitis is the most common atopic disease and the most common chronic disease of children. Eosinophil count and percentage in nasal smear are useful for differential diagnosis of allergic rhinitis. The aim of this study is to investigate the correlation between nasal eosinophil count and percentage.METHODS: Between January 2017 and August 2018, 221 children patients with a clinical history of rhinitis were tested at the outpatient respiratory and allergy unit of the Department of Pediatrics, School of Medicine, The Catholic University of Korea. Nasal secretion was collected by swabbing a children's nasal inferior turbinate 3–4 times with a cotton swab and then placed on to a glass slide. Later, the smear was stained by Giemsa stain.RESULTS: This is the first study to assess the comparison of nasal eosinophil count and percent. There is a positive correlation between nasal eosinophil count and percent Y=1.02 X+2.82 (Y=Eosinophil count, X=Eosinophil percentage). To determine the usefulness of nasal eosinophil count and percentage in the diagnosis of allergic rhinitis, we analyzed receiver operating characteristic curves. The cutoff value of the nasal eosinophil count was 6.5/high-power field, and that of the nasal eosinophil ratio was 3% for the diagnosis of allergic rhinitis.CONCLUSION: In patients with suspected rhinitis, one of the values of nasal eosinophil count or percentage can be used in clinical practice.
Azure Stains ; Child ; Chronic Disease ; Diagnosis ; Diagnosis, Differential ; Eosinophils ; Glass ; Humans ; Hypersensitivity ; Korea ; Outpatients ; Pediatrics ; Rhinitis ; Rhinitis, Allergic ; ROC Curve ; Turbinates

BACKGROUND/AIMS: In the ABC classification system, group A consists of seronegative subjects without gastric corpus atrophy. This study aimed to determine the prevalence and characteristics of pseudo group A subjects. METHODS: Group A subjects were identified among consecutive Korean adults who underwent a serum anti-Helicobacter pylori immunoglobulin G (IgG) test and pepsinogen (PG) assay on the day of endoscopy. Past infection was defined as the presence of either eradication history or endoscopic findings suggesting past infection (i.e., gastric xanthoma, metaplastic gastritis, or advanced atrophy >closed-type 1). RESULTS: Among 2,620 group A subjects, 448 (17.1%) had eradication history, and 133 (5.1%) showed endoscopic findings suggesting past infection. Older age (odds ratio [OR], 1.148; 95% confidence interval [CI], 1.067 to 1.236) and earlier year of birth (OR, 1.086; 95% CI, 1.009 to 1.168) were independent risk factors for classification into pseudo group A, with cutoff points at 50.5 years and birth year of 1959.5, respectively. Positive H. pylori test findings were found in 22 subjects (3.1%) among the 715 subjects who underwent the urea breath test or Giemsa staining on the same day. Current infection was positively correlated with PG I and PG II levels (p<0.001) but not with age, anti-H. pylori IgG titer, or classification into pseudo group A. CONCLUSIONS: Among the group A subjects, 22.2% had past infection. The risk was higher in subjects older than 50 years, especially those born before 1960. Furthermore, current infection was found in 3.1% of the subjects and was correlated with increased gastric secretory ability.
Adult ; Atrophy ; Azure Stains ; Breath Tests ; Classification ; Endoscopy ; Gastritis ; Helicobacter pylori ; Humans ; Immunoglobulin G ; Parturition ; Pepsinogen A ; Prevalence ; Risk Factors ; Urea ; Xanthomatosis

BACKGROUND/AIMS: Nodular gastritis (NG) is a well-known endoscopic finding observed in patients with a Helicobacter pylori infection, which may lead to invasive gastric cancer. Lymphofollicular gastritis consists of lymphoid follicles or lymphoid cell aggregates, and is common in children. The aim of this study was to identify patients with NG from those in whom gastric biopsied specimens showed lymphoid follicles and lymphoid cell aggregates. METHODS: Subjects, whose gastric biopsy specimens showed lymphoid follicles or lymphoid cell aggregates, were included in this study. The inclusion criterion was that they underwent a serum pepsinogen assay on the day of upper gastrointestinal endoscopy. NG was diagnosed if the endoscopy findings revealed regular-sized, multiple, colorless subepithelial nodules. RESULTS: Among 108 subjects who showed lymphoid follicles or lymphoid cell aggregates, 13 (12.0%) revealed NG on endoscopy, and all these subjects showed positive Giemsa staining. Patients diagnosed with NG were younger (p=0.012) and showed a female predominance (p=0.001) compared to those without NG. The mean serum pepsinogen levels were higher (p=0.001) and lymphoid follicle-dominant subjects were more common (p<0.001) in the NG subjects than in those without NG. Logistic regression analysis revealed a younger age (p=0.041) and female gender (p=0.002) to be significant independent risk factors for NG. CONCLUSIONS: NG should be distinguished from lymphofollicular gastritis because only 12% of patients showing gastric biopsy findings of lymphoid follicles and lymphoid cell aggregates demonstrated NG on endoscopy. NG is an endoscopic finding that is more common in women and in the younger population, irrespective of the biopsy findings and gastric secretory ability.
Azure Stains ; Biopsy ; Child ; Endoscopy ; Endoscopy, Gastrointestinal ; Female ; Gastritis* ; Helicobacter pylori ; Humans ; Logistic Models ; Lymphocytes ; Lymphoid Tissue ; Pepsinogen A ; Risk Factors ; Stomach Neoplasms

BACKGROUND/AIMS: The eradication rate of triple therapy for Helicobacter pylori is decreasing and one of the main causes is increased clarithromycin resistance. Recently, new methods have been introduced for the diagnosis of clarithromycin resistance. The aim of this study was to investigate the diagnostic rate of dual priming oligonucleotide-polymerase chain reaction (DPO-PCR) compared with histology and the eradication rates of triple therapy for clarithromycin susceptible H. pylori. MATERIALS AND METHODS: We retrospectively reviewed patients who underwent DPO-PCR exam and Giemsa stain for diagnosis of H. pylori between January, 2015 and March, 2016 at Incheon St. Mary's Hospital. Clarithromycin resistance of H. pylori was determined by DPO-PCR and the diagnostic accuracy of DPO-PCR was compared with histology. We also examined the eradication rates of triple therapy for clarithromycin susceptible strains. RESULTS: A total of 928 patients underwent DPO-PCR exam and Giemsa stain for diagnosis of H. pylori. The resistance rate for clarithromycin was 39%. The sensitivity and specificity of PCR exam compared with histology were 96.2% and 96.9%. The positive predictive values, negative predictive values, and accuracy were 90.54%, 98.87%, 96.88%, each. A total of 53 patients received triple therapy, and 39 patients completed ¹³C-urea breath test. The overall eradication rate was 97.4%. CONCLUSIONS: DPO-PPR showed high accuracy compared with biopsy and the eradication rates of triple therapy for clarithromycin susceptible H. pylori was 97.4%. DPO-PCR may be effective in determining treatment regimens in areas of high clarithromycin resistance.
Azure Stains ; Biopsy ; Breath Tests ; Clarithromycin ; Diagnosis* ; Helicobacter pylori* ; Helicobacter* ; Humans ; Incheon ; Polymerase Chain Reaction ; Retrospective Studies ; Sensitivity and Specificity

Low parasitemic condition in malaria remains a diagnostic challenge; as the available diagnostic methods failed to detect. Currently, hemozoin (Hz) pigment is gaining attention in the diagnosis of malaria. The major drawback is ease of detection of Hz in routine practice. A pilot study was conducted to evaluate the role of Hz pigment and to compare the performance of quantitative buffy coat assay (QBC) and PCR in such conditions. Clinically suspected cases of malaria were examined by both Giemsa stain and immunochromatographic test (ICT). Samples positive by ICT and negative by Giemsa stain were further examined by nested PCR targeting 18S rRNA and QBC for the presence of malaria parasites and pigments. Thirty blood samples fulfilled the inclusion criteria out of which 23 were Plasmodium vivax (Pv), 4 Plasmodium falciparum (Pf), and 3 mixed (Pv and Pf) by immunochromatographic test. Twenty-one out of 30 (70%) were positive by nested PCR in comparison to 25/30 (83%) by QBC. Samples containing both malaria parasites and Hz pigment by QBC completely showed concordance with the PCR result. However, 61% of total samples containing only Hz pigment were observed positive by PCR. Hz pigment remains an important tool for malaria diagnosis. Identification of leukocytes containing pigments by QBC not only indicates recent malarial infections but also puts light on severity of the disease. QBC assay is a rapid, highly sensitive, and cost-effective method to detect malaria parasites and Hz pigment especially in low parasitemic conditions.
Azure Stains ; Diagnosis* ; Leukocytes ; Malaria ; Methods ; Parasites ; Pilot Projects ; Plasmodium falciparum ; Plasmodium vivax ; Polymerase Chain Reaction

BACKGROUND: Research on RBC production from hematopoietic stem cells has been conducted competitively in many countries. However those were in vitro successes and many hurdles still remain for large scale transfusable RBC production from stem cells. A need for large volume of culture media is a crucial factor for culture condition which researchers must overcome. In this study, we evaluated the efficiency of two commercial serum-free media, StemPro(R)-34 SFM and Stemline II hematopoietic stem cell expansion medium, in RBC differentiation from cord derived stem cells. METHODS: We cultured cord derived CD34+ cells in vitro and evaluated over the periods of 7 days, 14 days, 17 days and 21 days in culture for expanded cell count, cell morphology and differential count using the Wright Giemsa stain. RESULTS: Cell expansion and RBC differentiation developed rapidly in Stemline media compared to StemPro media. Enucleated RBCs were observed at 10~14 culture days and orthochromatic erythroblasts were shown up to 50% among culture cells at 17 days in Stemline media. The enucleated RBCs were observed at 17 days in StemPro Media. Although the erythroblasts in StemPro media are slow at differentiation, they maintain continuous expansion up to 21 days. CONCLUSION: In Stemline media, the expansion and differentiation to mature RBCs are processed much faster, but the cell condition slows down after 17 days. In the RBC production aspects, Stemline media is better than StemPro media as a rapid differentiation because it reduces the cost due to in vitro short culture duration.
Azure Stains ; Cell Count ; Culture Media ; Culture Media, Serum-Free* ; Erythroblasts ; Hematopoietic Stem Cells* ; Humans ; Stem Cells

Mastocytosis is characterized by an accumulation of mast cells in various organs, most frequently in the skin. A solitary mastocytoma is a clinical variant of cutaneous mastocytosis. It is defined as a localized collection of mast cells in the skin without evidence of extracutaneous organ involvement. Here we report on a 2-year-old female patient presenting with Solitary erythematous bulla on her lower back. The patient had a history of spinal tap on the lower back for evaluation of meningitis at 5 months of age, which resulted in trauma at the site. Histopathology showed mast cells infiltrating the papillary and reticular dermis and metachromatic purple cytoplasmic granules seen with Giemsa staining. As a result, the patient was diagnosed with a solitary bullous mastocytoma and administered antihistamine. The patient showed complete remission at 3 months. Herein, we report a rare case of solitary bullous mastocytoma occurring at a trauma site.
Azure Stains ; Child, Preschool ; Cytoplasmic Granules ; Dermis ; Female ; Humans ; Mast Cells ; Mastocytoma* ; Mastocytosis ; Mastocytosis, Cutaneous ; Meningitis ; Skin ; Spinal Puncture*

The cytogenetic analysis of mesenchymal stromal cells (MSCs) is essential for verifying the safety and stability of MSCs. An in situ technique, which uses cells grown on coverslips for karyotyping and minimizes cell manipulation, is the standard protocol for the chromosome analysis of amniotic fluids. Therefore, we applied the in situ karyotyping technique in MSCs and compared the quality of metaphases and karyotyping results with classical G-banding and chromosomal abnormalities with fluorescence in situ hybridization (FISH). Human adipose- and umbilical cord-derived MSC cell lines (American Type Culture Collection PCS-500-011, PCS-500-010) were used for evaluation. The quality of metaphases was assessed by analyzing the chromosome numbers in each metaphase, the overlaps of chromosomes and the mean length of chromosome 1. FISH was performed in the interphase nuclei of MSCs for 6q, 7q and 17q abnormalities and for the enumeration of chromosomes via oligo-FISH in adipose-derived MSCs. The number of chromosomes in each metaphase was more variable in classical G-banding. The overlap of chromosomes and the mean length of chromosome 1 as observed via in situ karyotyping were comparable to those of classical G-banding (P=0.218 and 0.674, respectively). Classical G-banding and in situ karyotyping by two personnel showed normal karyotypes for both cell lines in five passages. No numerical or structural chromosomal abnormalities were found by the interphase-FISH. In situ karyotyping showed equivalent karyotype results, and the quality of the metaphases was not inferior to classical G-banding. Thus, in situ karyotyping with minimized cell manipulation and the use of less cells would be useful for karyotyping MSCs.
Azure Stains ; Chromosome Banding/*methods ; Humans ; In Situ Hybridization, Fluorescence/*methods ; Karyotyping/*methods ; Mesenchymal Stromal Cells/*cytology

A loop-mediated isothermal amplification (LAMP) assay allows rapid diagnosis of Toxoplasma gondii infection. In the present study, the LAMP assay was evaluated using blood from both naturally and experimentally infected pigs. The sensitivity of the LAMP assay was compared with that of Q-PCR. Both assays detected T. gondii in the blood of experimentally infected pigs, with 100% agreement. In infected blood samples, the parasite was detected as early as 2 days post-infection and reached a peak in 3-5 days. In 216 field serum samples, the detection rates of LAMP and Q-PCR assays were 6.9% and 7.8%, respectively. This result indicates that the sensitivity of the LAMP assay was slightly lower than that of the Q-PCR assay. However, the LAMP may be an attractive diagnostic method in conditions where sophisticated and expensive equipment is unavailable. This assay could be a powerful supplement to current diagnostic methods.
Animals ; Azure Stains ; Biological Assay ; Brain/parasitology ; DNA, Protozoan/*blood/genetics ; Lung/parasitology ; Mice ; Nucleic Acid Amplification Techniques/*veterinary ; Parasitemia ; Real-Time Polymerase Chain Reaction/veterinary ; Sensitivity and Specificity ; Swine ; Swine Diseases/*diagnosis/parasitology ; Toxoplasma/genetics/*isolation & purification ; Toxoplasmosis, Animal/*diagnosis/parasitology