Background/Aims: H2 receptor antagonists (H2RA) have been used to treat gastritis by inhibiting gastric acid. Proton pump inhibitors (PPIs) are more potent acid suppressants than H2RA.However, the efficacy and safety of low-dose PPI for treating gastritis remain unclear. The aim was to investigate the efficacy and safety of low-dose PPI for treating gastritis. Methods: A double-blind, noninferiority, multicenter, phase 3 clinical trial randomly assigned 476 patients with endoscopic erosive gastritis to a group using esomeprazole 10 mg (DW1903) daily and a group using famotidine 20 mg (DW1903R1) daily for 2 weeks. The full-analysis set included 319 patients (DW1903, n=159; DW1903R1, n=160) and the per-protocol set included 298 patients (DW1903, n=147; DW1903R1, n=151). The primary endpoint (erosion improvement rate) and secondary endpoint (erosion and edema cure rates, improvement rates of hemorrhage, erythema, and symptoms) were assessed after the treatment. Adverse events were compared. Results: According to the full-analysis set, the erosion improvement rates in the DW1903 and DW1903R1 groups were 59.8% and 58.8%, respectively. According to the per-protocol analysis, the erosion improvement rates in the DW1903 and DW1903R1 groups were 61.9% and 59.6%, respectively. Secondary endpoints were not significantly different between two groups except that the hemorrhagic improvement rate was higher in DW1903 with statistical tendency. The number of adverse events were not statistically different. Conclusions DW1903 of a low-dose PPI was not inferior to DW1903R1 of H2RA. Thus, lowdose PPI can be a novel option for treating gastritis (ClinicalTrials.gov Identifier: NCT05163756).

PURPOSE: Recently, the prevalence and disease burden of asthma have increased. Thus, the need for early diagnosis and appropriate management of asthma is emerging. However, it is difficult to identify the diagnosis, symptoms and the prevalence of asthma due to lack of reliable investigating items. The purpose of this study was to develop a standardized survey format in order to assess the prevalence of asthma in Koreans. METHODS: We investigated surveys and related information that are utilized to assess asthma diagnosis and prevalence by systematic review. After that, Delphi survey was conducted on 44 Korean allergists in order to develop a standardized survey in Korea. The process consisted of 3 serial rounds across 3 age groups. Each subsequent round narrowed investigating items for the decision of standard set about asthma prevalence, current asthma, and asthma aggravation. RESULTS: Lifetime asthma was defined as “ever doctor-diagnosed asthma” in all age groups. Current asthma was defined as “treatment for asthma during the past 12 months” in all age groups, and “doctor-diagnosed asthma during the past 12 months” was added on the ≥5-year-old and adult groups. “Wheezing ever” was defined as “wheezing at any time in the past,” and current wheeze was defined as “wheezing in the last 12 months.” Asthma aggravation was defined as “visits at the emergency department or admission due to asthma attack within the last 12 months” in all age groups. CONCLUSION: We established applicable nationwide definitions of “lifetime asthma,” “current asthma,” and “asthma aggravation” in Koreans by the Delphi survey.
Adult ; Asthma ; Diagnosis ; Early Diagnosis ; Emergency Service, Hospital ; Humans ; Korea ; Prevalence

BACKGROUND/AIMS: We evaluated the long-term outcome and clinical course of patients of nonsteroidal anti-inflammatory drug (NSAID)-induced small intestinal injury by performing capsule endoscopy (CE). METHODS: A multicenter retrospective study was conducted using data collected from the CE nationwide database registry, which has been established since 2002. RESULTS: A total of 140 patients (87 males; mean age, 60.6+/-14.8 years) from the CE nationwide database registry (n=2,885) were diagnosed with NSAID-induced small intestinal injury and enrolled in our study. Forty-nine patients (35.0%) presented with a history of aspirin use and an additional 49 (35.0%) were taking NSAIDs without aspirin. The most prominent findings after performing CE were multiple ulcerations (n=82, 58.6%) and erosions or aphthae (n=32, 22.9%). During the follow-up period (mean, 15.9+/-19.0 months; range, 0 to 106 months), NSAID-induced small intestinal injury only recurred in six patients (4.3%). Older age and hypertension were positive predictive factors for recurrence. CONCLUSIONS: These results suggest that the recurrence of NSAID-induced small bowel injury was not frequent in the presence of conservative treatment. Therefore, the initial diagnosis using CE and the medication history are important.
Age Factors ; Aged ; Anti-Inflammatory Agents, Non-Steroidal/*adverse effects ; Aspirin/adverse effects ; *Capsule Endoscopy ; Female ; Humans ; Intestinal Diseases/chemically induced/*pathology ; Intestine, Small/*drug effects/injuries/*pathology ; Male ; Middle Aged ; Recurrence ; Republic of Korea ; Retrospective Studies ; Time Factors ; Ulcer/chemically induced/*pathology

BACKGROUND/AIMS: Capsule endoscopy (CE) is widely used. However, CE has limitations including incomplete examination, inadequate bowel preparation, and retention. The aim of this study was to estimate the indications for and detection, completion, and retention rates of small intestine CE based on the 10-year data from the Korean Capsule Endoscopy Registry. METHODS: Twenty-four hospitals participated in this study. Clinical information, such as reasons for CE, method and quality of bowel preparation, and incomplete examination and capsule retention rates, was collected and analyzed. RESULTS: A total of 2,914 CEs were registered. The most common reason for CE was obscure gastrointestinal bleeding (59%). Significant lesions were detected in 66% of cases. Positive CE diagnosis occurred in 63% of cases. The preparation method did not significantly affect the quality of bowel preparation for CE. The overall incomplete rate was 33%, and was high in the elderly and those with poor bowel preparation. Capsule retention was 3% and high in patients with small bowel tumors and Crohn's disease and in children under 10 years of age. CONCLUSIONS: CE is a valuable technique; while the overall detection rate is high, incompletion and retention rates are also relatively high. CE should be carefully considered in the elderly and children less than 10 years of age, as well as in patients with small bowel tumors and Crohn's disease.
Aged ; Capsule Endoscopy* ; Child ; Crohn Disease ; Diagnosis ; Hemorrhage ; Humans ; Intestine, Small

PURPOSE:The purpose of this study was to determine the prevalence of asthma, allergic rhinitis, atopic dermatitis and allergic conjunctivitis among primary school pupils in Ilsan, Gyeonggi province. We also investigated change of symptoms after environmental control. METHODS:In April 2005, a cross-sectional study was performed among 2,745 1st to 6th graders of 3 primary schools in Ilsan, Gyeonggi province. International Study of Asthma and Allergies in Childhood (ISAAC) standardized questionnaires and additional questionnaires about environmental changes were distributed to their parents. RESULTS:Data were collected from 2,535 children (1,279 boys and 1,256 girls). The most common allergic symptom was rhinorrhea (43.0%), and atopic skin lesions, ocular lesions and wheezing were 24.5%, 19.7% and 18.2%, respectively. There was no significant relationship between allergic diseases and environmental status. One thousand four hundred nineteen children moved to a new place or had new interior decorations within the last 2 years. Of these children, 352 (24.8%) had allergic symptoms (OR=2.76, CI= 1.96-3.41, P=0.001). Interestingly, we found that children who had moved into apartments experienced more symptom changes than those who had not (P=0.022). CONCLUSION:The results of this study demonstrated that the prevalence of allergic conditions in primary school children in Ilsan, Gyeonggi province in 2005 was higher than those of nation-wide studies in 2000. We found the results of our study is similar to those of Seoul in 2005. We found a significant relationship between environmental status and changes of symptoms in primary school children in Ilsan, Gyeonggi province.
Asthma ; Bronchial Hyperreactivity ; Child* ; Conjunctivitis, Allergic ; Cross-Sectional Studies ; Dermatitis, Atopic ; Gyeonggi-do* ; Humans ; Hypersensitivity ; Parents ; Prevalence* ; Pupil ; Surveys and Questionnaires ; Respiratory Function Tests ; Respiratory Sounds ; Rhinitis ; Seoul ; Skin

PURPOSE:The purpose of this study was to determine the prevalence of asthma, allergic rhinitis, atopic dermatitis and allergic conjunctivitis among primary school pupils in Ilsan, Gyeonggi province. We also investigated change of symptoms after environmental control. METHODS:In April 2005, a cross-sectional study was performed among 2,745 1st to 6th graders of 3 primary schools in Ilsan, Gyeonggi province. International Study of Asthma and Allergies in Childhood (ISAAC) standardized questionnaires and additional questionnaires about environmental changes were distributed to their parents. RESULTS:Data were collected from 2,535 children (1,279 boys and 1,256 girls). The most common allergic symptom was rhinorrhea (43.0%), and atopic skin lesions, ocular lesions and wheezing were 24.5%, 19.7% and 18.2%, respectively. There was no significant relationship between allergic diseases and environmental status. One thousand four hundred nineteen children moved to a new place or had new interior decorations within the last 2 years. Of these children, 352 (24.8%) had allergic symptoms (OR=2.76, CI= 1.96-3.41, P=0.001). Interestingly, we found that children who had moved into apartments experienced more symptom changes than those who had not (P=0.022). CONCLUSION:The results of this study demonstrated that the prevalence of allergic conditions in primary school children in Ilsan, Gyeonggi province in 2005 was higher than those of nation-wide studies in 2000. We found the results of our study is similar to those of Seoul in 2005. We found a significant relationship between environmental status and changes of symptoms in primary school children in Ilsan, Gyeonggi province.
Asthma ; Bronchial Hyperreactivity ; Child* ; Conjunctivitis, Allergic ; Cross-Sectional Studies ; Dermatitis, Atopic ; Gyeonggi-do* ; Humans ; Hypersensitivity ; Parents ; Prevalence* ; Pupil ; Surveys and Questionnaires ; Respiratory Function Tests ; Respiratory Sounds ; Rhinitis ; Seoul ; Skin

Pulmonary infection by capsule-deficient Cryptococcus neoformans (CDCN) is a very rare form of pneumonia and it is seldom seen in the immunocompetent host. The authors experienced a case of pulmonary cryptococcosis by CDCN in 25-year-old woman who was without any significant underlying disease. The diagnosis was made from the percutaneous lung biopsy and special tissue staining, including Fontana-Masson silver (FMS) staining. Fungal culture confirmed the diagnosis afterward. Her clinical and radiologic features improved under treatment with fluconazol. It's known that CDCN is not so readily confirmed because fungal culture does not always result in growth of the organism and the empirical fungal stain is not helpful for the differentiation between CDCN and the other infections that are caused by the nonencapsulated yeast-like organisms. In this report, we emphasize the diagnostic value of performing FMS staining for differentiating a CDCN infection from the other confusing nonencapsulated yeast-like organisms.
Silver Nitrate ; Lung Diseases/*diagnosis/*microbiology ; Humans ; Female ; Cryptococcus neoformans/*isolation & purification ; Cryptococcosis/*diagnosis/microbiology ; Cough ; Chest Pain ; Adult

Leflunomide is a new disease modifying anti rheumatic drug (DMARD) for the treatment of active rheumatoid arthritis. Its mechanism of action differs from other DMARDs in that it inhibits the de novo pyrimidine synthesis by inhibiting dihydroorotate dehydrogenase and therefore prevents the proliferation of activated lymphocytes. As it has been prescribed worldwide, there is a great deal of much concerns regarding its potential adverse effects. Because leflunomide has an active metabolite with a long elimination half life of approximately 2 weeks, serious adverse reactions may occur even after the leflunomide treatment has been stopped. The profile of serious reactions includes liver dysfunction, hematological disorders, severe skin reactions and respiratory dysfunction. Respiratory dysfunctions with leflunomide therapy are very rare and its incidence is lower than that of methotrexate therapy. However, there are reports in Japan showing that 5 patients died of interstitial pneumonitis and another 11 patients developed serious lung complications associated with leflunomide. This suggests the possibility of fatal respiratory toxicity of leflunomide. There are no reports of interstitial pneumonitis associated with leflunomide in Korea. We report a case of a 62-year old woman who developed interstitial pneumonitis, which might have been induced by leflunomide during the treatment of rheumatoid arthritis.
Antirheumatic Agents ; Arthritis, Rheumatoid ; Female ; Half-Life ; Humans ; Incidence ; Japan ; Korea ; Liver Diseases ; Lung ; Lung Diseases, Interstitial* ; Lymphocytes ; Methotrexate ; Middle Aged ; Oxidoreductases ; Skin

The bronchial varices in mitral stenosis are uncommon and incidentally discovered during bronchoscopy. Although bronchial varices are primarily associated with bronchial or pulmonary disease, the bronchial vein can be dilated with increased pulmonary venous pressure secondary to mitral stenosis. The bronchial varices may present massive hemoptysis. The hemoptysis can be controlled by mitral commissurotomy or mitral valve replacement in case of mitral stenosis. We report a case of bronchial varies in a patient with severe mitral stenosis. The bronchial varices were found incidentally during bronchoscopy and they were nearly disappeared by mitral valve replacement.
Bronchoscopy ; Hemoptysis ; Humans ; Lung Diseases ; Mitral Valve ; Mitral Valve Stenosis* ; Varicose Veins* ; Veins ; Venous Pressure

PURPOSE: Cooling and rewarming have been described to contribute to the pathogenesis of exercise induced asthma. However, little is known about the cellular response to cooling and rewarming of respiratory epithelial cells. Hypersecretion of mucus and allergic inflammation are important pathologic finding of patients who suffered from asthma. We investigated whether cooling and rewarming of respiratory epithelial cells induce mucin gene (MUC5AC, MUC5B) expression and IL-8 production. METHODS: NCI-H292 (human lung mucoepidermoid carcinoma cell line) cells were cultured in 6 well plates. Experimental groups were preserved at 1degree C, 4degrees C, 18degrees C and control groups at 37degrees C for 2 hours. And then both group were kept at 37degrees C. MUC5AC, MUC5B and IL-8 mRNA expressions were examined by RT-PCR. IL-8 concentration in the cell culture medium after rewarming was measured by ELISA. RESULTS: Cooling and cooling-rewarming stimuli did not increase MUC5AC and MUC5B expression. IL-8 concentration was remarkably decreased in experimental groups after cooling and then markedly increased during first 6 hours. IL-8 concentration of 1degrees C, 4degrees Cgroups were significantly increased compared to control group at 6 hour, of 18degrees C group at 12 hour and then persisted until 24 hour. CONCLUSION: Cooling and rewarming stimuli to respiratory epithelial cells did not increase MUC gene expression. However, increased IL-8 production provides evidence of cooling and rewarming induced airway inflammation. Further investigation will be needed to support this result.
Asthma ; Asthma, Exercise-Induced ; Carcinoma, Mucoepidermoid ; Cell Culture Techniques ; Enzyme-Linked Immunosorbent Assay ; Epithelial Cells* ; Gene Expression ; Humans ; Inflammation ; Interleukin-8* ; Interleukins* ; Lung ; Mucins ; Mucus ; Rewarming* ; RNA, Messenger