ABSTRACT
BACKGROUND/AIMS: Conflicting results have been reported whether patients with non-ulcer dyspepsia (NUD) respond differently to Helicobacter pylori (H. pylori) eradication treatment compared with patients with peptic ulcer diseases (PUD). The aim of this study was to evaluate any difference in H. pylori eradication rates between patients with NUD and PUD according to each proton pump inhibitor (PPI). METHODS: From September, 2004 to April, 2007, we retrospectively reviewed 2,297 patients with NUD (1,050 patients) or PUD (1,247 patients) infected with H. pylori. All patients received a standard 1 week triple therapy comprising of one of the five PPIs (pantoprazole, esomeprazole, omeprazole, lansoprazole, rabeprazole), clarithromycin and amoxicillin. The follow-up H. pylori test was performed 4 weeks after the completion of therapy. RESULTS: There was no significant difference in the eradication rates between the two groups. In comparison of eradication rates according to PPI, omeprazole- based triple therapy group showed higher eradication rate than other groups in patients with NUD, but not in patients with PUD. CONCLUSIONS: This study failed to show any difference in H. pylori eradication rate between patients with NUD and PUD. There is no convincing evidence that the eradication rate may be affected by different PPI.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , 2-Pyridinylmethylsulfinylbenzimidazoles/therapeutic use , Amoxicillin/administration & dosage , Anti-Bacterial Agents/administration & dosage , Anti-Ulcer Agents/administration & dosage , Clarithromycin/administration & dosage , Data Interpretation, Statistical , Drug Therapy, Combination , Dyspepsia/drug therapy , Enzyme Inhibitors/therapeutic use , Helicobacter Infections/complications , Helicobacter pylori , Omeprazole/analogs & derivatives , Peptic Ulcer/drug therapy , Proton Pump Inhibitors/therapeutic useABSTRACT
BACKGROUND/AIMS: Helicobacter pylori infection is a recognized cause of chronic gastritis, peptic ulcer and gastric adenocarcinoma. However, both positive and negative associations with colorectal neoplasia have been reported. The aim of this study was to determine whether H. pylori infection is associated with an increased risk of colonic neoplasia in a Korean population. METHODS: We examined 1,590 subjects (1,297 men and 293 women) who underwent colonoscopy and serologic testing for IgG antibodies against H. pylori at the Health promotion Center in Kangbuk Samsung Hospital and at Samsung Medical Center. We compared the prevalence of colonic neoplasia in the seropositive subjects with that of the seronegative subjects. RESULTS: The overall prevalence of H. pylori in our study population was 56.2%. There were no significant differences of the baseline characteristics between the two groups. There was no statistically significant difference in the prevalence of colonic neoplasia between the seropositive group and the seronegative group (p=0.090). CONCLUSIONS: These findings suggest that there is no significant association between H. pylori infection and colonic neoplasia.
Subject(s)
Humans , Male , Adenocarcinoma , Antibodies , Colon , Colonoscopy , Gastritis , Health Promotion , Helicobacter , Helicobacter pylori , Immunoglobulin G , Peptic Ulcer , Prevalence , Serologic TestsABSTRACT
BACKGROUND/AIMS: Antibiotic resistance and poor compliance are the main causes of Helicobacter pylori (H. pylori) eradication failure. Proton pump inhibitor (PPI)-based triple therapy is the most preferred regimen in clinical practice. However, a critical fall in the H. pylori eradication rate has been observed in the recent years. A novel 10 day-sequential therapy consists of five days of dual therapy followed by five days of triple therapy regimen has recently been described. We aimed to evaluate whether 10 day-sequential therapy eradicated H. pylori infection better than the PPI-based triple therapy in Korea. METHODS: 158 patients with proven H. pylori infection were randomized to receive either 10 day-sequential therapy (20 mg of omeprazole, 1.0 g of amoxicillin, each administered twice daily for the first 5 days, followed by 20 mg of omeprazole, 500 mg of clarithromycin, 500 mg of metronidazole, each administered twice daily for the remaining 5 days) or PPI-based triple therapy (20 mg of omeprazole, 1.0 g of amoxicillin, 500 mg of clarithromycin, each administered twice daily for 1 week). Outcome of eradication therapy was assessed 8 weeks after the cessation of treatment. RESULTS: Eradication rates of 10 day-sequential therapy and PPI-based triple therapy were 77.9% (60/77) and 71.6% (58/81) by intention to treat analysis, respectively (p=0.361). By per protocol analysis, eradication rates of 10 day-sequential therapy and triple therapy were 85.7% (60/70) and 76.6% (58/76), respectively (p=0.150). There were no significant differences in adverse event rates and treatment compliance between two groups. CONCLUSIONS: The 10 day-sequential therapy regimen failed to achieve significantly higher eradication rates than PPI-based triple therapy.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Amoxicillin/administration & dosage , Anti-Bacterial Agents/administration & dosage , Anti-Ulcer Agents/administration & dosage , Data Interpretation, Statistical , Drug Therapy, Combination , Helicobacter Infections/drug therapy , Helicobacter pylori , Korea , Metronidazole/administration & dosage , Omeprazole/administration & dosage , Time Factors , Treatment OutcomeABSTRACT
Cowden syndrome, which is also known as 'multiple hamartoma syndrome', is an autosomal dominant condition with variable expression resulting from a mutation in the PTEN gene on the chromosome arm, 10q23. Cowden syndrome causes hamartomatous neoplasms of the skin and mucosa, breast, thyroid, and gastrointestinal tract, and is associated with the development of several types of malignancy. In particular, a marked increase in the incidence of breast carcinoma in women and of thyroid carcinoma in both men and women has been reported. We report a case of Cowden syndrome associated with both carcinomas with a review of the relevant literature.
Subject(s)
Female , Humans , Male , Arm , Breast Neoplasms , Breast , Gastrointestinal Tract , Hamartoma , Hamartoma Syndrome, Multiple , Incidence , Mucous Membrane , Skin , Thyroid Gland , Thyroid NeoplasmsABSTRACT
PURPOSE: When used in the second-line setting, single- agent chemotherapy has produced response rates of more than 10% or median survival times greater than 4 months. We studied the safety and efficacy of using second-line single docetaxel (75 mg/m2) for advanced NSCLC patients who were previously treated with platinum-based chemotherapy in Korea. MATERIALS AND METHODS: Thirty-three patients with advanced NSCLC received chemotherapy from May 2002 to January 2005. We retrospectively reviewed the charts of these patients. The patients received 75 mg/m2 of doxetaxel on day 1 and this was repeated at 3-week intervals. RESULTS: The median age was 63 years (range: 42~77 years); 16 patients had adenocarcinoma and 8 patients had squamous cell carcinoma. The median number of cycles was 4 (range: 1~7 cycles). Of the 33 patients, 6 patients had partial responses, 13 patients had stable disease and 14 patients had progressive disease. The response rate was 18.2%. The median overall survival was 11 months (range: 7~15 months), and the median progression free survival was 5 months (range: 3~7 months). The median response duration was 5 months (range: 4~9 months). A total of 137 cycles were evaluated for toxicity. We observed grade 3 or 4 neutropenia in 79 cycles (57.6%), grade 3 or 4 leukopenia in 46 cycles (33.6%), and grade 3 febrile neutropenia in 2 cycles (1.5%). The median nadir day was day 9 (range: day 5~19), and the median number of G-CSF injections was 2 (range: 0~6). The most common non-hematologic toxicities were myalgia/arthralgia and neurotoxicity, but any grade 3 or 4 non-hematologic toxicity was not observed. The major toxicity of this therapy was neutropenia. The absolute neutrophil count decreased relatively rapidly, but neutropenic fever or related infection was rare. There were no treatment-related deaths. CONCLUSION: These results revealed a satisfactory response rate (18.2%) with using docetaxel as the second- line chemotherapy for NSCLC. The second-line docetaxel was an active and well-tolerated regimen in patients with advanced NSCLC pretreated with platinum-based chemotherapy.
Subject(s)
Humans , Adenocarcinoma , Carcinoma, Non-Small-Cell Lung , Carcinoma, Squamous Cell , Disease-Free Survival , Drug Therapy , Febrile Neutropenia , Fever , Granulocyte Colony-Stimulating Factor , Korea , Leukopenia , Neutropenia , Neutrophils , Retrospective StudiesABSTRACT
Central pontine myelinolysis (CPM)is a demyelinating disorder that affects pons and is characterized by disturbance of consciousness, quadriparesis, and mutism and has been considered to have poor prognosis. It commonly occurs in patients with rapidly corrected hyponatremia. However, hypoglycemia induced CPM has been rarely reported. Diagnosis is confirmed by MR imaging. Here we report a case of CPM after severe hypoglycemia without any electrolyte disturbance in a patients with diabetic nephropathy.
Subject(s)
Humans , Consciousness , Demyelinating Diseases , Diabetic Nephropathies , Diagnosis , Hypoglycemia , Hyponatremia , Magnetic Resonance Imaging , Mutism , Myelinolysis, Central Pontine , Pons , Prognosis , QuadriplegiaABSTRACT
We experienced a 25 year-old male patient with typhoid fever complicated with massive hemoptysis. Pulmonary complication in typhoid fever is very rare and to our knowledge, there has been no report of hemoptysis as a main cause of death with this disease. We herein report a rare case of typhoid fever.
Subject(s)
Adult , Humans , Male , Cause of Death , Hemoptysis , Salmonella Infections , Typhoid FeverABSTRACT
We experienced a 25 year-old male patient with typhoid fever complicated with massive hemoptysis. Pulmonary complication in typhoid fever is very rare and to our knowledge, there has been no report of hemoptysis as a main cause of death with this disease. We herein report a rare case of typhoid fever.
Subject(s)
Adult , Humans , Male , Cause of Death , Hemoptysis , Salmonella Infections , Typhoid FeverABSTRACT
Primary aortic malignant tumors are extremely rare. When symptomatic, aortic intimal sarcomas give clinical findings secondary to embolic phenomena;they can produce mesenteric ischemia, hypertension, skin necrosis, absence of peripheral pulses. The diagnosis can be suspected radiologically Fibrosarcoma is the most common primary aortic malignancy, but angiosarcoma and leiomyosarcoma may also occur. We experienced a case of intraaortic mass, that was suspected as angiosarcoma, that diagnosed by chest CT, transesophageal echocardiography, aortography, and biopsy.