Clinical Significance of Fecal Lactoferrin and Multiplex Polymerase Chain Reaction in Patients with Acute Diarrhea

BACKGROUND/AIMS: The diagnostic yield of fecal leukocyte and stool cultures is unsatisfactory in patients with acute diarrhea. This study was performed to evaluate the clinical significance of the fecal lactoferrin test and fecal multiplex polymerase chain reaction (PCR) in patients with acute diarrhea. METHODS: Clinical parameters and laboratory findings, including fecal leukocytes, fecal lactoferrin, stool cultures and stool multiplex PCR for bacteria and viruses, were evaluated prospectively for patients who were hospitalized due to acute diarrhea. RESULTS: A total of 54 patients were included (male, 23; median age, 42.5 years). Fecal leukocytes and fecal lactoferrin were positive in 33 (61.1%) and 14 (25.4%) patients, respectively. Among the 31 patients who were available for fecal pathogen evaluation, fecal multiplex PCR detected bacterial pathogens in 21 patients, whereas conventional stool cultures were positive in only one patient (67.7% vs 3.2%, p=0.000). Positive fecal lactoferrin was associated with presence of moderate to severe dehydration and detection of bacterial pathogens by multiplex PCR (21.4% vs 2.5%, p=0.049; 100% vs 56.5%, p=0.032, respectively). CONCLUSIONS: Fecal lactoferrin is a useful marker for more severe dehydration and bacterial etiology in patients with acute diarrhea. Fecal multiplex PCR can detect more causative organisms than conventional stool cultures in patients with acute diarrhea.

The Efficacy of Short-term Administration of Revaprazan on Gastroesophageal Reflux Symptoms: Comparison with Half Dose Esomeprazole, a Pilot Study

BACKGROUND/AIMS: Revaprazan, an acid pump antagonist, is a kind of gastric acid suppressant and is prescribed for the treatment of peptic ulcers and gastritis. However, the efficacy of revaprazan on gastroesophageal reflux symptoms has not been established. The aim of this study was to evaluate the short-term efficacy of revaprazan on gastroesophageal reflux symptoms. MATERIALS AND METHODS: Patients who complained of gastroesophageal reflux symptoms without any specific diseases except gastritis on esophagogastroduodenoscopy were included in this study. Patients were randomized to receive revaprazan 200 mg or esomeprazole 20 mg for 2 weeks. Symptoms were assessed by using the frequency score questionnaire before and after treatment. RESULTS: Fifteen patients received revaprazan and 19 patients received esomeprazole. The changes of the symptom frequency score before and after treatment were 7.0 in revaprazan group and 8.6 in esomeprazole group (P=0.778). CONCLUSIONS: Revaprazan is not inferior to esomeprazole in therapeutic efficacy for gastroesophageal reflux symptoms and is a safe and useful therapeutic agent to reduce the frequency of gastroesophageal reflux symptoms.

The Effect of Co-Administration of Rebamipide on the Expression of Serum Gastrin in Long-term Proton Pump Inhibitor Users: A Prospective Pilot Study

BACKGROUND/AIMS: In one animal study, co-administration of rebamipide with proton pump inhibitors (PPIs) could suppress hypergastrinemia but there have been no such reports on humans. The aim of this study was to evaluate whether rebamipide could prevent hypergastrinemia in long-term PPI users. MATERIALS AND METHODS: Patients who were diagnosed with reflux esophagitis endoscopically were enrolled in this study. In the control group, lansoprazole 30 mg was administered for 8 weeks and in the rebamipide group, lansoprazole 30 mg with rebamipide 300 mg was administered for 8 weeks. Serum gastrin level was checked before and after administration of the drugs. RESULTS: Thirty patients were enrolled in this study. The control group included 17 patients and the rebamipide group included 13 patients. The gastrin level was elevated in the control group (28.4 pg/mL) compared to the rebamipide group (38.5 pg/mL). However, the gastrin level was decreased in 3 patients in the rebamipide group (23.1%) compared to 2 patients in the control group (11.8%). CONCLUSIONS: Not all patients who are taking PPIs develop hypergastrinemia. Co-administration of rebamipide with PPI does not affect the serum gastrin level.

External Mass Compressing the Left Atrium on Transthoracic Echocardiography

No abstract available.

Percutaneous closure of a patent ductus arteriosus guided by intravascular ultrasound / 대한내과학회지

No abstract available.

A Case of Choledochoduodenal Fistula as a Delayed Complication after Biliary Metallic Stent Placement in Distal Cholangiocarcinoma / 대한소화기학회지

Biliary drainage in patients with malignant biliary obstruction relieves jaundice and prevents the development of cholangitis or hepatic failure from biliary obstruction. Therefore, this may result in better quality of life along with survival prolongation. Biliary stent placement is an effective and safe measure for biliary decompression and is preferred than bypass surgery in high risk patients. Entero-biliary perforation-communication is one of the rare complications of biliary stent. We herein report a case of duodeno-biliary perforation-communication in patient with distal cholangiocarcinoma who presented with duodenal ulcer and obstruction, occurring 4 years later from the metallic biliary stent insertion. Patient was managed with a pyloric metal stent and conservative care.

A Case of Rectus Sheath Hematoma and Intraperitoneal Hematoma Induced by Cough / 결핵및호흡기질환

Rectus sheath hematoma (RSH) is a rare condition that's caused by a sudden disruption of the deep epigastric vessels or direct damage to the rectus abdominis muscle. This condition is associated with old age, childbirth, abdominal surgery, severe cough, severe sneezing, anticoagulation therapy and/or coagulation disorders. RSH is characterized by abdominal pain and an abdominal mass, so that this is often misdiagnosed as a surgical condition such as appendicitis, intraabdominal abscess, torsion of the ovary and ruptured abdominal aortic aneurysm; this can lead to unnecessary surgery. Thus, we have to be cautious not to miss RSH when a patient with predisposing factors is suffered from abdominal pain and an abdominal mass. We report here on a case of rectus sheath hematoma that was induced by severe cough in a patient who was taking warfarin.

Factors Related to Taking Hormone Replacement Therapy in Postmenopausal Women

BACKGROUND: This study was performed to find out about the factors related to administration of hormone replacement therapy (HRT) in postmenopausal women. METHODS: One thousand seventy three postmenopausal women living in Busan and Kimhae were surveyed from August, 2000 to February, 2001. The subjects were asked whether they were receiving the HRT or not and about several factors that have known to be related to receiving the HRT. RESULTS: Among the total, 16.3% of women were current users, 12.4% were ex-users, and 71.2% were non-users. There were significant differences in age, marital status, number of children, education level, and income among the three groups. The proportions of hysterectomy and health-related behaviors were higher among current and ex-users than non-users. The current users were receiving the HRT by continuous combination method rather than cyclic therapy. Among them, 70% responded 'physician's recommendation' as the main reason for receiving the HRT. Among the current users 48% responded 'improved general condition' for receiving as the main reason the HRT currently. However, 29% of ex-users stopped therapy because of side effects. Among non-users 55% have not been provided with information about the HRT. Women having regular exercise at least once a week were 3.5 times more likely to be current users (95% C.I.: 1.3~9.6). One year after menopause women were 1.2 times (95% C.I: 1.0~1.4) more likely to be current users. CONCLUSION: Postmenopausal women who exercised regularly and experienced menopause at an older age seemed to be more likely current users. Therefore, women having such characteristics may need more adequate information about the HRT.

Oxygen Desaturation following the Use of Midazolam and Fentanyl during Spinal Anesthesia / 성인간호학회지

The purpose of this study was to find out the effeet of midazolam and fentanyl on oxygcn saturation by pulse oximetry in surgical patients under spinal anesthesia. The subjects of this study were 83 patients who were operated on under spinal anesthesia, at a general hospital in Pusan. from December 1st, 1997 to March 31st, 1998. The subjects of Group 1 were 53 patients who did not receive either of midazolam and fentanyl. The subjects of Group 2 were 21 patients who received midazolam. The subjects of Group 3 were 9 patients who received both midazolam and fentanyl. Oxygen saturation was measured with a pulse oximeter by time series. The collected data were analyzed by the SPSS / PC~ program and the results of the study were as follows 1. There were no significant differences among the three experimental groups in terms of age or cardiopulmonary disease. 2. Among the three groups, there were statistically significant differences in Sp02 at 5 minutes after starting the operation or after intravenous injection of drugs. The SpO2 mean for Group 3 was 92.4%, for Group 2 it was 97.7%. and for Group 1 it was 98.2%. 3. Hypoxemia cases occurred in 88.9% of Group 3, 28.6% of Group 2, and 17.0% of Group 1, respectively. It is concluded that oxygen saturation mo4oring should be done routinely to all patients under ~spinal anesthesia, especially during operating tim4. and patients receiving midazolam and fentanyl should be monitored closely. After monitoring oxygen should be administered to all patients who developed hypoxemia.