ABSTRACT
BACKGROUND/AIMS: Patient compliance and resistance to antibiotics are main factors determining the success of Helicobacter pylori eradication. This study provides basic data to verify the efficacy of currently implemented eradication therapy and reports changes in H. pylori resistance to all antibiotics used at Asan Medical Center, Seoul, Korea from 2004 to 2010. METHODS: We investigated the resistance rates to amoxicillin, clarithromycin, metronidazole, ciprofloxacin, and levofloxacin in 88, 100, and 47 strains isolated from adult patients without H. pylori eradication history in 2004, 2007, and 2010. RESULTS: The resistance rate to amoxicillin increased from 5.0% in 2007 to 10.6% in 2010. The resistance rate to clarithromycin increased from 10.2% in 2004 and 11.0% in 2007 to 14.8% in 2010. However, no difference was observed in the resistance rate to metronidazole, and strains resistant to tetracycline were not detected at all in this study. The resistance rates to quinolone lingered at 15-17% for 3 years. The non-resistant strains to antibiotics accounted for 56% of the total in 2004 and 62% in 2007. In contrast, a decreasing tendency was found for those strains in 2010 (43%). No significant differences were shown in the multi-drug resistance rate or the co-resistance rates of amoxicillin and clarithromycin over the 3 years. CONCLUSIONS: We showed increased resistance rates to clarithromycin and amoxicillin over the last 7 years, aligning with the results of previous studies performed domestically. Efforts are needed to inhibit the increase in resistant bacteria to maintain the effectiveness of eradication therapy.
Subject(s)
Adult , Humans , Amoxicillin , Anti-Bacterial Agents , Bacteria , Ciprofloxacin , Clarithromycin , Drug Resistance, Microbial , Drug Resistance, Multiple , Helicobacter pylori , Helicobacter , Korea , Levofloxacin , Metronidazole , Patient Compliance , Seoul , TetracyclineABSTRACT
Periorbital edema is a rare manifestation of systemic lupus erythematosus (SLE). We describe here a patient with bilateral periorbital edema as a presenting symptom of SLE. A 23-year-old woman was admitted for a sudden onset of severe periorbital edema that developed 7 days previously. On the basis of the malar rash, arthritis of the right hand and left wrist, leukopenia, proteinuria and the positive anti-nuclear and anti-dsDNA antibodies, she was diagnosed with SLE. Kidney biopsy revealed lupus nephritis (WHO class IV). After treatment with high dose of steroids, intravenous cyclophosphamide and daily hydroxychloroquine, her symptoms resolved, including the periorbital edema. She was discharged with prescriptions for prednisolone and hydroxychloroquine and she remains well.
Subject(s)
Female , Humans , Young Adult , Antibodies , Arthritis , Biopsy , Cyclophosphamide , Edema , Exanthema , Hand , Hydroxychloroquine , Kidney , Leukopenia , Lupus Erythematosus, Systemic , Lupus Nephritis , Prednisolone , Prescriptions , Proteinuria , Steroids , WristABSTRACT
BACKGROUND: Bronchiectasis (BE) remains a rare respiratory disease in Korea. This retrospective study was done to investigate the potential pathogenic microorganisms (PPMs) that cause in patients with BE, through the use of sputum specimens. METHODS: One hundred eleven adult patients, who had undergone chest computed tomography (CT), sputum gram stain/culture, and BE detected by chest CT, were included in this study. Sputum adequacy was determined by using Murray-Washington classification. RESULTS: The mean (+/-SD) age of patients was 60.9 (+/-14.0). The number of PPMs was 167 (67%) in the total 248 isolated organisms. The most frequent PPMs were P. aeruginosa (23.4%), K. pneumoniae (10.5%), and S. aureus (8.4%). The proportion of adequate sputum (AS) was 25.8% in the total sputum specimens. The patients with AS were 41 (37%) and the patients with inadequate sputum (IS) were 70 (63%). The proportion of P. aeruginosa was higher in AS compared to that of IS (44% vs. 19%, p=0.004). The BE score was also higher in P. aeruginosa (+) patients compared to that of P. aeruginosa (-) patients (10.8 vs. 7.6, p=0.001). CONCLUSION: Although the proportion of AS in the total sputum was low, PPMs were isolated in most patients with BE. It is likely that P. aeruginosa was isolated in AS and AS patients had higher BE scores.
Subject(s)
Adult , Humans , Bacteriology , Bronchiectasis , Korea , Pneumonia , Retrospective Studies , Sputum , ThoraxABSTRACT
Massive deposits of fat around heart are seen in overweight persons and are associated with coronary artery disease. Investigators have focused on the clinical significance of epicardial fat with respect to metabolic effects such as insulin resistance and inflammation, but the mechanical effects, such as constriction, have been largely ignored. We present an unusual case of a 59-year-old woman with obesity and diabetes mellitus who had been undergoing peritoneal dialysis due to end-stage renal disease, and who developed constrictive pericarditis, possibly secondary to extensive epicardial fatty accumulation.
Subject(s)
Female , Humans , Middle Aged , Cardiac Catheterization , Constriction , Coronary Artery Disease , Diabetes Mellitus , Echocardiography , Heart , Inflammation , Insulin Resistance , Kidney Failure, Chronic , Obesity , Overweight , Pericarditis, Constrictive , Pericardium , Peritoneal Dialysis , Research Personnel , Tomography, Spiral ComputedABSTRACT
Scrub typhus, which is caused by Orientia tsutsugamushi, is an acute febrile illness characterized by fever, rash, and myalgia. Recently, its incidence in Korea has increased. Many cases of scrub typhus with central nervous system involvement have been reported, while cases with hearing loss are rare. We experienced a case of scrub typhus with reversible hearing loss. To our knowledge, this is the first case confirmed by magnetic resonance imaging.
Subject(s)
Central Nervous System , Exanthema , Fever , Hearing , Hearing Loss , Incidence , Korea , Magnetic Resonance Imaging , Orientia tsutsugamushi , Scrub TyphusABSTRACT
Scrub typhus, which is caused by Orientia tsutsugamushi, is an acute febrile illness characterized by fever, rash, and myalgia. Recently, its incidence in Korea has increased. Many cases of scrub typhus with central nervous system involvement have been reported, while cases with hearing loss are rare. We experienced a case of scrub typhus with reversible hearing loss. To our knowledge, this is the first case confirmed by magnetic resonance imaging.
Subject(s)
Central Nervous System , Exanthema , Fever , Hearing , Hearing Loss , Incidence , Korea , Magnetic Resonance Imaging , Orientia tsutsugamushi , Scrub TyphusABSTRACT
Cholethorax (bilious pleural effusion) is an extravasation of bile into the thoracic cavity via a pleurobiliary fistula (and also a bronchobiliary fistula). It is an extremely rare complication of thoraco-abdominal injuries. It can be caused by congenital anomaly and also by hepatobiliary trauma, severe infection or iatrogenic procedures. The definitive diagnosis is made with aspiration of bilious fluid from the pleural space during thoracentesis, by finding a fistulous tract during endoscopic retrograde cholangiopancreatography (ERCP) or cholagioscopy, or with finding an abnormal pleural accumulation of radioisotope during hepatobiliary nuclear imaging. Its symptoms include coughing, fever, dyspnea and pleuritc chest pain. Herein we report on a case of cholethorax following performance of percutaneous transhepatic cholangioscopy (PTCS) to remove incidentally discovered common bile duct (CBD) stones.