Usefulness of Dual Priming Oligonucleotide-Polymerase Chain Reaction for Diagnosis and Treatment of Helicobacter pylori

BACKGROUND/AIMS: The eradication rate of triple therapy for Helicobacter pylori is decreasing and one of the main causes is increased clarithromycin resistance. Recently, new methods have been introduced for the diagnosis of clarithromycin resistance. The aim of this study was to investigate the diagnostic rate of dual priming oligonucleotide-polymerase chain reaction (DPO-PCR) compared with histology and the eradication rates of triple therapy for clarithromycin susceptible H. pylori. MATERIALS AND METHODS: We retrospectively reviewed patients who underwent DPO-PCR exam and Giemsa stain for diagnosis of H. pylori between January, 2015 and March, 2016 at Incheon St. Mary's Hospital. Clarithromycin resistance of H. pylori was determined by DPO-PCR and the diagnostic accuracy of DPO-PCR was compared with histology. We also examined the eradication rates of triple therapy for clarithromycin susceptible strains. RESULTS: A total of 928 patients underwent DPO-PCR exam and Giemsa stain for diagnosis of H. pylori. The resistance rate for clarithromycin was 39%. The sensitivity and specificity of PCR exam compared with histology were 96.2% and 96.9%. The positive predictive values, negative predictive values, and accuracy were 90.54%, 98.87%, 96.88%, each. A total of 53 patients received triple therapy, and 39 patients completed ¹³C-urea breath test. The overall eradication rate was 97.4%. CONCLUSIONS: DPO-PPR showed high accuracy compared with biopsy and the eradication rates of triple therapy for clarithromycin susceptible H. pylori was 97.4%. DPO-PCR may be effective in determining treatment regimens in areas of high clarithromycin resistance.

Effects of Gastrodiae rhizoma on proliferation and differentiation of human embryonic neural stem cells

OBJECTIVE@#To investigate the effects of Gastrodiae rhizoma, a dried root of Gastrodia elata Blume, on proliferation and differentiation of human NSCs derived from embryonic stem cells.@*METHODS@#A 70% ethanol extract of Gastrodiae rhizoma (EEGR) was estimated with 4-hydroxybenzyl alcohol as a representative constituent by HPLC.@*RESULTS@#MTT assay showed that the treatment with EEGR increased the viability of NSCs in growth media. Compared to control, EEGR increased the number of dendrites and denritic spines extended from a differentiated NSC. Whereas EEGR decreased the mRNA expression of Nestin, it increased that of Tuj1 and MAP2 in NSCs grown in differentiation media. Immunocytochemical analysis using confocal microscopy also revealed the increased expression of MAP2 in dendrites of EEGR-treated NSCs. Furthermore, EEGR decreased mRNA expression of Sox2 in NSCs grown even in growth media.@*CONCLUSIONS@#In conclusion, our study demonstrates for the first time that EEGR induced proliferation and neuronal differentiation of NSCs, suggesting its potential benefits on NSC-based therapies and neuroregeneration in various neurodegenerative diseases and brain injuries.

Effects of Gastrodiae rhizoma on proliferation and differentiation of human embryonic neural stem cells

Objective: To investigate the effects of Gastrodiae rhizoma, a dried root of Gastrodia elata Blume, on proliferation and differentiation of human NSCs derived from embryonic stem cells. Methods: A 70% ethanol extract of Gastrodiae rhizoma (EEGR) was estimated with 4-hydroxybenzyl alcohol as a representative constituent by HPLC. Results: MTT assay showed that the treatment with EEGR increased the viability of NSCs in growth media. Compared to control, EEGR increased the number of dendrites and denritic spines extended from a differentiated NSC. Whereas EEGR decreased the mRNA expression of Nestin, it increased that of Tuj1 and MAP2 in NSCs grown in differentiation media. Immunocytochemical analysis using confocal microscopy also revealed the increased expression of MAP2 in dendrites of EEGR-treated NSCs. Furthermore, EEGR decreased mRNA expression of Sox2 in NSCs grown even in growth media. Conclusions: In conclusion, our study demonstrates for the first time that EEGR induced proliferation and neuronal differentiation of NSCs, suggesting its potential benefits on NSC-based therapies and neuroregeneration in various neurodegenerative diseases and brain injuries.

Triple-negative breast cancer that progressed as estrogen receptor-positive skin metastases

No abstract available.

Portal Vein Thrombosis with Sepsis Caused by Inflammation at Colonic Stent Insertion Site / 대한소화기학회지

Portal vein thrombosis is an uncommon but an important cause of portal hypertension. The most common etiological factors of portal vein thrombosis are liver cirrhosis and malignancy. Albeit rare, portal vein thrombosis can also occur in the presence of local infection and inflammation such as pancreatitis or cholecystitis. A 52-year-old male was admitted because of general weakness and poor oral intake. He had an operation for colon cancer 18 months ago. However, colonic stent had to be inserted afterwards because stricture developed at anastomosis site. Computed tomography taken at admission revealed portal vein thrombosis and inflammation at colonic stent insertion site. Blood culture was positive for Escherichia coli. After antibiotic therapy, portal vein thrombosis resolved. Herein, we report a case of portal vein thrombosis with sepsis caused by inflammation at colonic stent insertion site which was successfully treated with antibiotics.

Hypernatremia-Induced Rhabdomyolysis in a Patient with Meningioma Involving the Pituitary Gland / 대한내과학회지

Hypernatremia is a rare cause of rhabdomyolysis. Here, we report a case of hypernatremia-induced rhabdomyolysis in a patient with meningioma involving the pituitary gland. A 61-year-old male was admitted for decreased mentality and poor oral intake. He had undergone an operation for meningioma 10 years prior. At admission, he appeared lethargic and severely dehydrated with an initial sodium level of 178 mEq/L. Hypernatremia remained persistent despite massive hydration and the serum creatine phosphokinase level was 18,047 U/L after 3 days. Bone scintigraphy also showed findings consistent with rhabdomyolysis. Brain magnetic resonance imaging revealed extensive masses involving the pituitary gland and an intranasal biopsy confirmed meningioma. Polyuria, and low anti-diuretic hormone levels supported the diagnosis of central diabetes insipidus-induced hypernatremia. Desmopressin was administered intranasally and the patient's serum sodium and muscle enzyme levels were normalized.

Esophageal Cancer Initially Presenting as Severe Paraneoplastic Hypercalcemia Requiring Hemodialysis / 대한소화기학회지

Paraneoplastic hypercalcemia without bone metastasis occurs rarely in esophageal cancer. A 75-year-old man was admitted for general weakness and lethargy. Laboratory data showed high serum calcium level (corrected calcium 14.6 mg/dL), low parathyroid hormone level (3.3 pg/mL) and high parathyroid hormone-related peptide level (3.5 pmol/L). Esophagogastroscopy showed a malignant tumor in the esophagus. Histology showed moderately differentiated squamous cell carcinoma. Bone scan showed no evidence of bone metastasis. Since the patient's calcium levels remained high and mental state did not show improvement despite intravenous fluid therapy, diuretics and intravenous bisphosphonate, hemodialysis was started. After hemodialysis treatment, the serum calcium level subsequently normalized and his mental status improved. Herein, we report a rare case of paraneoplastic hypercalcemia in a patient with esophageal cancer.

Psychometric Properties of the Korean Version of the King's Health Questionnaire in Women with Stress Urinary Incontinence

PURPOSE: The purpose of this study is to evaluate the psychometric properties of the Korean version of the King's Health Questionnaire(KHQ) in patients with stress urinary incontinence. MATERIALS AND METHODS: Multicenter prospective study was undertaken in 106 patients with stress urinary incontince. Psychometric properties including discriminant validity, convergent validity were evaluated and the Cronbach's alpha coefficients were calculated. Test-retest analysis was performed and the sensitivity to clinical change before and after treatment was also evaluated. RESULTS: The psychometric properties and clinical validity of the KHQ Korean version were confirmed in 106 study population. The KHQ's good reliability was evidenced by Cronbach's alpha coefficients of>0.60, indicating to change in patients' perception of bladder condition in all domains. CONCLUSION: Our analyses confirm excellent psychometric properties for the Korean version of KHQ, which appears to provide a valid and reliable instrument for clinical usages in Korea.

Relationship between Microdeletions on the Y Chromosome and Defect of Spermatogenesis / 대한불임학회지

OBJECTIVES: To estimate the frequency of Y chromosome microdeletions in the Korean population of infertile men and to evaluate the relationship between microdeletion on the Y chromosome and clinical phenotypes of infertile men with idiopathic azoospermia and oligozoospermia. MATERIALS AND METHODS: Genomic DNA was extracted from blood samples collected from 330 infertile men attending the Infertility Clinic at Samsung Cheil Hospital, Korea. Six sequence tagged sites (STSs) spanning the azoospermia factor (AZF) regions of the Y chromosome were amplified by polymerase chain reactions (PCRs). RESULTS: Microdeletions on Y chromosome were detected in 35 (10.6%) of the 330 infertile men. Most of the microdeletions (91.4%) involved AZFb or AZFc. The high incidence of microdeletions were found in AZFc region (57.1%), but the low in AZFa (8.6%) and AZFb (5.7%). Larger microdeletions involving two or three AZF regions were detected in 28.6% of cases. All patients (6 patients) with deletion of AZFa region showed no germ cell phenotypes, Sertoli cell only syndrome or Leydig cell hyperplasia in histopathologic examinations. CONCLUSION: Microdeletions on the Y chromosome, especially, at AZFc/DAZ regions may be the major cause of azoospermia and severe oligozoospermia. We suggest that idiopathic infertile men have genetic counselling and microdeletion analysis on the Y chromosome before IVF-ET and ART program.

Relationship between Microdeletions on the Y Chromosome and Defect of Spermatogenesis / 대한불임학회지

OBJECTIVES: To estimate the frequency of Y chromosome microdeletions in the Korean population of infertile men and to evaluate the relationship between microdeletion on the Y chromosome and clinical phenotypes of infertile men with idiopathic azoospermia and oligozoospermia. MATERIALS AND METHODS: Genomic DNA was extracted from blood samples collected from 330 infertile men attending the Infertility Clinic at Samsung Cheil Hospital, Korea. Six sequence tagged sites (STSs) spanning the azoospermia factor (AZF) regions of the Y chromosome were amplified by polymerase chain reactions (PCRs). RESULTS: Microdeletions on Y chromosome were detected in 35 (10.6%) of the 330 infertile men. Most of the microdeletions (91.4%) involved AZFb or AZFc. The high incidence of microdeletions were found in AZFc region (57.1%), but the low in AZFa (8.6%) and AZFb (5.7%). Larger microdeletions involving two or three AZF regions were detected in 28.6% of cases. All patients (6 patients) with deletion of AZFa region showed no germ cell phenotypes, Sertoli cell only syndrome or Leydig cell hyperplasia in histopathologic examinations. CONCLUSION: Microdeletions on the Y chromosome, especially, at AZFc/DAZ regions may be the major cause of azoospermia and severe oligozoospermia. We suggest that idiopathic infertile men have genetic counselling and microdeletion analysis on the Y chromosome before IVF-ET and ART program.

Early Clinical Outcome and Complications of Tension Free Vaginal Tape Procedure in Stress Incontinent Women / 대한비뇨기과학회지

PURPOSE: The aim of the study was to evaluate the clinical outcome and complications of tension free vaginal tape (TVT) procedure for the surgical treatment of female stress urinary incontinence. MATERIALS AND METHODS: Between April 1999 and May 2000, 41 women with stress urinary incontinence underwent TVT procedure. Preoperative evaluation included questionnaires study, physical examination, one hour pad test and urodynamic study. Postoperative clinical outcome, patient's satisfaction and complications were checked after 3-months. RESULTS: The mean age of patients was 51.6 years (range 40-76) and mean hospital stay 2.1 days (range 1-10). The mean follow-up period was 9.9 months (range 3-15). Thirty six patients (87.8%) were cured, 2 patients (4.9%) were improved. Two of 3 patients with failed operation who developed postoperative urge incontinence had grade III cystocele. Five bladder perforations and 1 obturator nerve injury occurred. The abdominal leak point pressure (LPP) increased from 50.6cmH20 to 110.8cmH2O, detrusor pressure of maximal flow rate (Pdet.Qmax) increased from 15.8cmH2O to 28.6cmH2O and maximal flow rate (Qmax) decreased from 32.8ml/s to 22.5ml/s after operation. CONCLUSIONS: The TVT procedure is an effective and feasible surgical treatment for female stress urinary incontinence. However, in patients with grade III cystocele, postoperative urge incontinence may develop after the procedure. Since TVT procedure involves securing the mid-urethra, urinary obstruction may also occur, necessitating the need for continued follow-up as well as a careful comparison with other sling procedure.

Influence on the Pregnancy Rate of Motility of Fresh and Frozen Testicular Spermatozoa in Obstructive Azoospermic Patients / 대한불임학회지

OBJECTIVE: ICSI with testicular sperm could achieve optimal fertilization and pregnancy. This study was performed to observe the influence on fertilization and pregnancy of motility of fresh testicular sperm and sperm extracted from frozen-thawed seminiferous tubules in obstructive azoospermia. MATERIALS ANDMETHODS: We analysed clinical outcome of ICSI using fresh testicular sperm and sperm extracted from thawed seminiferous tubules. The presence of motility were compared to determine the factor for optimal fertilization and pregnancy rates. RESULTS: In 316 cases of TESE-ICSI in obstructive azoospermia, ICSI with fresh testicular sperm (fresh sperm group) were 163 cases and ICSI with sperm testicular sperm extracted from frozen-thawed seminiferous tubule (thawed sperm group) were 153 cases. The fertilization rates were 71.3% and pregnancy rates were 32.5% in fresh sperm group, in thawed sperm group, 65.1% and 33.3% respectively. The fertilization and pregnancy rates of motile and non-motile testicular sperm were 72.9% and 33.6%, 50.0% and 18.2%, respectively (p<0.05). The fertilization and pregnancy rates of motile and non-motile sperm extracted from the thawed seminiferous tubule were 67.8% and 34.7%, 55.1% and 28.1%, respectively (p<0.05). The comparative of the results of ICSI using motile fresh testicular sperm and motile sperm extracted from thawed seminiferous tubule, fertilization and pregnancy rates were not significantly different (72.9% and 33.6%, 67.8% and 34.7%, respectively). CONCLUSION: These results suggest that successful pregnancy in TESE-ICSI treatment is influenced by the motility of fresh testicular sperm and sperm extracted from thawed seminiferous tubule in obstructive azoospermic patients.

Urinary Incontinence in the Patients with Dementia / 대한비뇨기과학회지

No abstract available.

Effects and Compliance of Pelvic Floor Muscle Exercise using Biofeedback in Women with Stress Urinary Incontinence

No abstract available in English.

The Effect of Pelvic Floor Muscle Training with Biofeedback and Functional Electrical Stimulation for Genuine Stress Urinary Incontinence / 대한비뇨기과학회지

No abstract available.

Morphometric Analysis of the Collagen Changes Induced by Subcutaneous Injection of Interferon-gamma following Partial Unilateral Ureteral Obstruction in the Rat Kidney / 대한비뇨기과학회지

PURPOSE: Interfenon-gamma(IFN-gamma) has been tried to decrease fibrosis in liver cirrhosis in the human and animals. To decrease collagen content in the partially obstructed kidney, we examined collagen changes by IFN-gamma after creating partial ureteral obstruction in the rat. We applied IFN-gammato the partially obstructed kidney and examined collagen contents in the renal cortex by morphometric analysis. MATERIALS AND METHODS: In a total of 50 Sprague Dawley adult male rats(300-350gm), we created partial unilateral ureteral obstruction(PUUO). We divided rats into 5 groups(n=10 in each group): normal control, sham operation group, sham operation with IFN-gamma 4 weeks, PUUO 4 weeks, PUUO with IFN-gamma 4 weeks. IFN-gamma(LG Chemical, Korea) 100,000 IU was subcutaneously injected daily for 4 weeks from operation day 1 in the treated groups. The rats were sacrificed on the expected day and renal cortex was prepared for Masson`s trichrome special staining. With the image analyser, we calculated the relative ratio of collagen to renal cortex area randomly in each kidney. RESULTS: Relative percent of collagen content of the normal control, sham-operation, and sham-operation with IFN-gamma treated groups were 2.42+/-0.53%(n=10), 2.62+/-0.53%(n=10), and 2.22+/-0.65%(n=10), respectively. While relative percent of collagen content of PUUO group, and PUUO with IFN-gamma treated group were 12.25+/-2.41%(n=5) and 7.14+/-3.43%(n=9) respectively. There was significant difference between those of last two groups.(p<0.05, Wilcoxon-rank sum test) CONCLUSIONS: We applied interferon-gamma to the partially obstructed kidney and examined collagen contents in the kidney by morphometric analysis. From the above data, IFN-gammaseems to have a decreasing effect upon collagen content in the partially obstructed rat kidney.

Long-term Followup Results of Desmopressin-based Combined Drug Therapy in the Nocturnal Enuretic Children / 대한비뇨기과학회지

PURPOSE: This study was designed to evaluate the effectiveness of desmopressin-based combined drug therapy in nocturnal enuretic children who had been followed at least 6 months. MATERIALS AND METHODS: Thirthy eight patients(5 to 16 years old) with 4 or more wet nights per week were studied. We used desmopressin-based combined drug therapy(imipramine or/and oxybutynin chloride) depending upon associated daytime voiding symptom. Patient response to treatment was categorized as complete(0 to 1 wet night per month), near complete(2 to 4 wet nights per month), intermediate(5 to 7 wet nights per month) and poor(more than 7 wet nights per month). We evaluated the results at the initial 6 week and at the last follow-up visit on medication. RESULTS: After 6 weeks, 13(34.2%) patients were complete responder, 13(34.2%) near complete responder, 7(18.4%) intermediate responder and 5(13.1%) poor responder, respectively. The response rate in this period was 86.8%. At the last follow-up visit on medication, 20(52.6%) patients were classified as complete responder, 13(34.2%) as near complete responder, 4(10.5%) as intermediate responder and 1(2.6%) as poor responder. Therefore, overall response rate was 97.3%. There was no obvious side effect that made discontinue drug therapy. CONCLUSIONS: From the above data, we think that longterm desmopressin-based combined drug therapy is the highly successful and safe treatment method for enuretic children.

Ureteral Submucosal Macroplastique Injection in the Treatmenet of vesicoureteral Reflux

No abstract available.

Mutations of the Human Androgen Receptor Gene in Men Infertile from Testicular Causes / 대한남성과학회지

PURPOSE: Many men with a normal phenotype but decreased or absent production may have abnormalities of the androgen receptor (AR). Here, we investigated men with severe oligospermia and azoospermia to ascertain wether mutations of the AR gene are associated with male infertility having testicular causes. PATIENTS AND METHODS: A total of 43 infertile men with a normal phenotype and severe oligospermia or azoospermia and three normally fertile men entered this study. Included was one man with known incomplete androgen insensitivity syndrome (AIS). Deoxyribonucleic acid was isolated from peripheral blood samples of the subjects, and polymerase chain reaction (PCR) was carried out using sets of primers designed to amplify sequences of eight exons of the AR gene. For convenience and repidity of analyses, the multiplex PCR method was employed. RESULTS: PCR resulted in amplification of all eight exons. In all samples, amplified products were shown to be appropriate-sized bands on agarose gels. No gross abnormalities were found in most of the infertile patients. However, an increased number of CAG repeat in exon 1 of the AR gene and point mutations (T to C, nt 3897; A to T, nt 3903) in exon 7 were found in the AIS subject. CONCLUSIONS: Our results showed no gross deletions of the AR gene in most infertile subjects. However, point mutations may have been overlooked by the techniques used, as demonstrated in the AIS subject. Further study will be required to clarify expression and localization of AR I the testis and consequently to understand the precise roles of the AR in regulating the normal spermatogenesis.

Therapeutic Laparoscopy for Impalpable Testis / 대한비뇨기과학회지

Management of impalpable testis is one of the most controversial issues in cryptorchidism. There is wide variation in approach to this subset of patients. In the child with an impalpable testis, laparoscopy is increasingly used as the diagnostic study of choice. We have recently extended its value by using it as a therapeutic tool. Ten laparoscopic surgical procedures were performed in 10 patients with 12 intra-abdominal testes. In 2 adults with a small intra-abdominal testis and normal contralateral testis, laparoscopic orchiectomy was performed. In 3 patients with 5 intra-abdominal testes, the first phase of two-stage Fowler-Stephens orchiopexy was performed. These patients underwent an open surgical procedure three or four months later. In 3 patients, one stage orchiopexy was performed without dividing the spermatic vessels. In 2 Patients these testes could be mobilized after division of the spermatic vessels (laparoscopic one-stage Fowler-stephens orchiopexy). follow-up ranged from 3 months to 35 months (mean 16.8 months). At follow up 9 of 10 testes (90%) are in the scrotum without atrophy, while 1 (10%) is atrophic. Our early results suggest that increased experience will allow laparoscopic surgery to be a valuable option in the treatment of impalpable testis