Background/Aims: Tegoprazan, a novel potassium-competitive acid blocker, has shown rapid action and gastric acid inhibition. In this study, we evaluated the efficacy of a tegoprazan-based, nonbismuth-containing quadruple (concomitant) therapy for the primary eradication of Helicobacter pylori. Methods: We conducted a prospective, single-arm, single-center, primitive study to verify the efficacy of a 10-day tegoprazan- based (50-mg dose) concomitant therapy, including amoxicillin (1,000-mg dose), clarithromycin (CLA; 500-mg dose), and metronidazole (MET; 500-mg dose) twice daily as a first-line treatment for H. pylori eradication. Results: We tested consecutive cultures for antibiotic susceptibility and minimum inhibitory concentrations. We enrolled 84 participants; 79 (94.0%) completed first-line therapy. The overall intention-to-treat and per-protocol eradication rates were 90.5% (95% confidence interval [CI], 82.1−95.8) and 96.2% (95% CI, 83.4–97.6), respectively. Of the 73 participants evaluated for antibiotic resistance, 19 (26.0%), 32 (42.5%), and 8 (11.0%) exhibited CLA, MET, and CLA and MET dual resistance, respectively. Of these, 39 participants (66.1%) exhibited successful eradication after the therapeutic regimen despite antibiotic resistance. Conclusions The 10-day tegoprazan-based concomitant therapy may be an effective first-line treatment for eradicating H. pylori.

Background: Use of opioids for chronic intractable pain is increasing globally, and their proper use can improve patients’ quality of life. In contrast, opioid use disorders, such as abuse or addiction, caused by prescribing opioids, are a worldwide issue. This study aimed to understand current opioid prescribing patterns and pain physicians’ experiences with opioid use in South Korea. Methods: Pain physicians in 42 university hospitals in South Korea were asked to complete anonymous questionnaires regarding opioid prescriptions. Results: A total of 69 surveys were completed. Most pain physicians started prescribing opioids at a pain score of 7/10 and aimed to reduce pain by 50%. Most physicians (73.1%) actively explained the prescribed medications and possible side effects, and 61.2% of physicians preferred the prescription interval of 4 weeks.Immediate-release opioids were the most popular treatment for breakthrough pain (92.6%). The most common side effect encountered by physicians was constipation (43.3%), followed by nausea/vomiting (34.3%). Of the physicians, 56.5% replied that addiction and misuse prevalences were less than 5%. However, the most concerning side effect was addiction (33.0%). Conclusions The survey results showed that the prescribing patterns of pain physicians generally followed Korean guidelines. Physicians were most interested in the safety and effectiveness of opioid prescriptions. They were most concerned about respiratory depression and abuse or addiction. A significant number of physicians agreed that the NHIS regulations needed improvement for patient convenience and safe and effective treatment, though there were pros and cons of the NHIS restrictions on prescription conditions.

Purpose: Respiratory virus infection is a common cause of hospitalization in children. Rapid testing for respiratory viruses, such as the FilmArray method, can be clinically useful. However, insufficient evidence exists to support its use in standard clinical care. Methods: We retrospectively analyzed data from children under 18 years old who received the multiplex real-time polymerase chain reaction array (multiplex RT-PCR) method in 2017 and by FilmArray respiratory panel (FilmArray RP) in 2018. Results: Between January, 2017 and December, 2018, we reviewed data from 1,480 hospitalized children. The number of children with virus detection in respiratory viral PCR was 523 in the multiplex RT-PCR method and 419 in the FilmArray method. Seasonal virus outbreak patterns were similar to those of Korea Centers for Disease Control and Prevention in both groups. There was no difference between the 2 groups in the mean length of hospital stay. The time from admission to isolation by influenza infection was significantly shorter in the FilmArray group than in the multiplex RT-PCR group among patients who were not diagnosed with influenza infection by rapid antigen test at the time of admission. Conclusion The use of FilmArray method for respiratory viruses did not diminish length of hospital stay. However, the FilmArray method may quickly detect the prevalence of respiratory infection and aid in clinical treatment. In addition, it was related with a reduced time from admission to isolation by influenza infection in hospitalized children who were not identified with influenza infection by rapid antigen test at the time of admission.

Background and Objectives: Mesenchymal stem cells (MSCs) elicit therapeutic effects against liver fibrosis in animal models. Human liver stem cells (HLSCs) are cells isolated from human liver tissue that have mesenchymal morphology and express MSC markers. HLSCs also possess intrahepatic stem cell properties. We introduce a rat model of liver fibrosis and trans-portal transplantation of HLSC to demonstrate alleviation of liver fibrosis. Methods: and Results: Liver fibrosis was induced by intraperitoneal injection of Carbon tetrachloride (CCl 4 ). Sprague Dawley rats underwent simultaneous partial hepatectomy of the left hepatic lobe and HLSC transplantation via the portal vein. Gross appearance of the liver observed following CCl 4 injection showed cholestasis and surface nodularity. Sirius red staining revealed deposition of collagen fibers in the extracellular matrix (ECM). Following HLSC transplantation, human albumin secreting cells were detected by immunohistochemistry in liver specimens. Quantitative measurements of fibrosis area stained by Sirius red were compared between baseline and post-HLSC transplant (1×10 7 cells) following 10 weeks of CCl 4treatment liver specimens. Fibrosis area (p＜0.05), serum markers of liver inflammation and fibrosis (AST, ALT levels and APRI, p＜0.05) significantly decreased from baseline after HLSC transplantation. RNA expression in liver tissues revealed significant decrease in tissue inhibitor of matrix metalloproteinase 1 (TIMP1), TIMP2 expression and increase in hepatocyte growth factor expression following HLSC transplantation (p＜0.05). Conclusions HLSC transplantation effectively reduced the area of liver fibrosis with increased expression of factors promoting ECM degradation. These findings suggest the potential therapeutic role of HLSCs in various liver diseases presenting with liver fibrosis.

Purpose: Single-photon emission computed tomography/computed tomography (SPECT/CT) is an advanced hybrid nuclear medicine technology that generates both functional and anatomical images in a single study. As utilization of SPECT/CT in Korea has been increasing, the purpose of this study was to survey its application of cardiac and skeletal SPECT/CT imaging for protocol optimization. Methods: We surveyed CT protocols established for cardiac and skeletal SPECT/CT. We searched the guidelines for the CT protocols for SPECT/CT and reviewed the literature recently published. Results: Among 36 hybrid SPECT scanners equipped with four or more multi-channel detector CTs (MDCTs), 18 scanners were used to perform cardiac studies at both very low current CT (30–80 mA; 11.1%) and ultra-low current CT (13–30 mA; 88.9%). Among the 33 canners, very low current (≤ 80 mA) CT or low current CT (80–130 mA) was used in 23.5%, and 41.8% for spine disorders, and in 36.4% or 30.3% for foot/ankle disorders, respectively. In the CT reconstructions, slice thickness of 5 mm for cardiac studies was most commonly used (94.4%); thinner slices (0.6–1.0 mm) for spine and foot/ankle studies were used in 24.2% and 45.5%, respectively. We also reviewed the international guidelines. Conclusions The results and current recommendations will be helpful for optimizing CT protocols for SPECT/CT. Optimization of SPECT/CT protocols will be required for generating the proper strategy for the specific lesions and clinical purpose.

PURPOSE: Both atopy and bronchial hyperresponsiveness (BHR) are characteristic features of asthma. Several BHR studies comparing groups of atopic and nonatopic asthmatics have reported conflicting results. The aim of this study was to compare BHR to indirect stimuli, such as mannitol or exercise, between atopic and nonatopic asthmatics in children. METHODS: We performed a retrospective analysis of data from 110 children with asthma, aged 6–18 years using skin prick tests, and serum total and specific IgE levels. Atopy degree was measured using the sum of graded wheal size or the sum of the allergen-specific IgE. Bronchial provocation tests (BPTs) using methacholine were performed on all subjects. BPTs using indirect simuli, including exercise and mannitol, were also performed. RESULTS: Asthma cases were classified as atopic asthma (n=83) or nonatopic asthma (n=27) from skin prick or allergen-specific IgE test results. There was no significant difference in the prevalence of BHR to mannitol or exercise between atopic and nonatopic asthmatics. Atopic asthma had a significantly lower postexercise maximum decrease in % forced expiratory volume in 1 second (FEV1) (geometric mean [95% confidence interval]: 31.9 [22.9–40.9] vs. 14.0 [9.4–18.6], P=0.015) and a methacholine PC20 (provocative concentration of methacholine inducing a 20% fall in FEV1) than nonatopic asthmatics (geometric mean [95% confidence interval]: 1.24 [0.60–1.87] ng/mL vs. 4.97 [3.47–6.47]) ng/mL, P=0.001), whereas mannitol PD15 (cumulative provocative dose causing a 15% fall in FEV1) was not significantly different between the 2 groups. CONCLUSION: There was no significant difference in the prevalence of BHR to mannitol or exercise between atopic and nonatopic asthmatics in children.
Asthma ; Bronchial Provocation Tests ; Child* ; Forced Expiratory Volume ; Humans ; Immunoglobulin E ; Mannitol ; Methacholine Chloride ; Prevalence ; Retrospective Studies ; Skin

PURPOSE: It was found that periostin and squamous cell carcinoma-related antigens (SCCAs) were strongly interleukin-13-inducible gene products. This study measures the serum periostin and SCCA levels in children suffering from atopic dermatitis (AD) and to evaluate the association between the severity of AD and their values. METHODS: Seventy AD children aged 1 month to 10 years were included in our study. Subjects were characterized as having atopic eczema (AE; n=55) or non-AE (NAE; n=15) by atopic sensitization. Serum SCCA and periostin levels were measured. RESULTS: The serum periostin levels were significantly higher in children with AE than in those with NAE (geometric mean [95% confidence interval]: 80.47 ng/mL [75.06–85.93 ng/mL] vs. 67.45 ng/mL [59.99–75.64] ng/mL, P=0.020). The serum concentrations of both SCCA1 and SCCA2 were significantly higher in children with AE than in those with NAE (geometric mean [95% confidence interval]: 1.401 [1.198–1.643] ng/mL vs. 0.969 [0.723–1.268] ng/mL, P=0.039 for SCCA1) (1.178 [0.974–1.455] ng/mL vs. 0.711 [0.540–0.994] ng/mL, P=0.025 for SCCA2). The serum periostin levels were significantly correlated with disease severity and with peripheral blood eosinophil counts. The SCCA levels were not significantly correlated with disease severity. Both SCCA1 and SCCA2 were significantly correlated with serum periostin levels and blood eosinophil counts. CONCLUSION: Serum periostin levels may be significantly correlated with disease severity and blood eosinophil counts in children with AD. Serum SCCA levels can be significantly correlated with serum periostin levels and blood eosinophil counts in children with AD.
Child* ; Dermatitis, Atopic* ; Eosinophils ; Epithelial Cells* ; Humans

This study attempted to calculate and investigate the incidence of hospitalized acute myocardial infarction (AMI) and stroke in Korea. Using the National Health Insurance claim data, we investigated patients whose main diagnostic codes included AMI or stroke during 2006 to 2010. As a result, we found out that the number of AMI hospitalized patients had decreased since 2006 and amounted to 15,893 in 2010; and that the number of those with stroke had decreased since 2006 and amounted to 73,501 in 2010. The age-standardized incidence rate of hospitalized AMI, after adjustment for readmission, was 41.6 cases per 100,000-population in 2006, and had decreased to 29.4 cases in 2010 (for trend P < 0.001). In the case of stroke was estimated at 172.8 cases per 100,000-population in 2006, and had decreased to 135.1 cases in 2010 (for trend P < 0.001). In conclusion, the age-standardized incidence rates of both hospitalized AMI and stroke in Korea had decreased continuously during 2006 to 2010. We consider this decreasing trend due to the active use of pharmaceuticals, early vascular intervention, and the national cardio-cerebrovascular disease care project as the primary and secondary prevention efforts.
Acute Disease ; Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Female ; Hospitalization/*trends ; Humans ; Incidence ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Myocardial Infarction/*epidemiology ; Patient Readmission ; Republic of Korea/epidemiology ; Sex Factors ; Stroke/*epidemiology ; Young Adult

The purpose of this study was to investigate and examine the relationship between dietary habits, food intake patterns, and depression in Korean women with polycystic ovary syndrome (PCOS). The Center for Epidemiologic Studies Depression Scale Korean Version was used to determine whether a participant was depressed or not. The dietary habits were assessed by the Min-Dietary Assessment (MDA) method, and food intake data were collected by the 24-hour recall method on two non-consecutive days, at least 7 days apart, and the average of the two days was used to estimate the usual dietary intake. The total MDA scores of the Depression Group was significantly lower than that of the No-Depression Group (31.5 +/- 6.4 vs 33.4 +/- 6.0, p = 0.027). The intake of cereals/potatoes/sugar products, milk and milk products, plant protein, and calcium for the Depression Group were significantly lower compared to the No-Depression Group. The Depression Group had a significantly higher percentage of energy intakes from protein as well as the consumption of fish and shellfish compared to the No-Depression Group. There was a significant inverse relationship between milk and milk products consumption and the prevalence of depression [OR (95% CI) for the highest tertile compared to the lowest: 0.390 (0.177-0.857); p for trend = 0.016]. There were also significant positive relationships between the prevalence of depression and the consumption of the following: fish and shellfish [OR (95% CI) for the highest tertile compared to the lowest: 2.319 (1.128-4.770); p for trend = 0.009], animal protein (p for trend = 0.049), and the percentage of energy intakes from protein [OR (95% CI) for the highest tertile compared with the lowest: 2.546(1.156-5.609); p for trend = 0.025]. Further studies are needed in order to investigate whether the intake of protein and of animal protein is indeed associated with depression in PCOS patients in Korea and the possible mechanisms thereof. The results of our study can be applicable for the development of effective nutrition counseling and education programs regarding PCOS patients with depression as part of their successful treatment regimen.
Animals ; Calcium ; Counseling ; Depression ; Eating ; Epidemiologic Studies ; Female ; Food Habits ; Humans ; Korea ; Milk ; Plants ; Polycystic Ovary Syndrome ; Prevalence ; Shellfish ; Staphylococcal Protein A

Coronary arteriovenous fistula is a more prevalent, hemodynamically significant congenital malformation. Both coronary arteries arise normally from their aortic sinuses, but the branches of fistula communicate directly with cardiac chamber, pulmonary trunk, coronary sinus, superior vena cava, or pulmonary vein. Fistula associated with coronary aneurysm is an uncommon finding. We report a rare case of 76-year-old female patient who had a coronary arteriovenous fistula with giant coronary artery aneurysm. This case is clearly diagnosed by echocardiography, three-dimensional computed tomography (3D-CT), and coronary angiography (CAG).
Aged ; Aneurysm ; Arteriovenous Fistula ; Coronary Aneurysm ; Coronary Angiography ; Coronary Sinus ; Coronary Vessels ; Echocardiography, Three-Dimensional ; Female ; Fistula ; Humans ; Pulmonary Veins ; Sinus of Valsalva ; Vena Cava, Superior