Clarithromycin-Based Standard Triple Therapy Can Still Be Effective for Helicobacter pylori Eradication in Some Parts of the Korea

We evaluated the antibiotic resistance rates and eradication rates of clarithromycin based triple therapy from 2005 to 2010 retrospectively. In addition, we investigated the mechanism of clarithromycin resistance in Helicobacter pylori strains isolated from Korean patients. Two hundred and twelve strains of H. pylori were isolated from 204 patients. H. pylori ATCC 43504 was used as the standard strain. The eradication rates of H. pylori from 2005 to 2010 were 89.3%, 82.6%, 86.3%, 87.7%, 81.8%, and 84.2%, respectively. Total eradication rate was 84.9%. DNA sequences of the 23S RNA gene in clarithromycin-resistant strains were determined. The resistance rates of H. pylori to amoxicillin, clarithromycin, metronidazole, tetracycline, ciprofloxacin, moxifloxacin, and levofloxacin were 9.0%, 8.5%, 36.3%, 0%, 14.2%, 14.2%, and 14.2%, respectively. The multidrug resistance rate of H. pylori was 16.5%. Sequence analysis of clarithromycin-resistant strains showed an A2144G mutation in 8 of 14 strains (57.1%), a T2183C mutation in 5 of 14 strains (35.7%), and double mutations of both A2144G and T2183C in 1 of 14 strains (7.1%). In the present study, triple therapy may still be an effective eradication therapy for H. pylori infections in Korea. The A2144G and T2183C mutations are mainly present in clarithromycin-resistant isolates.

Influence of Exposure to Extremely Low Frequency Magnetic Field on Neuroendocrine Cells and Hormones in Stomach of Rats

Extremely low frequency magnetic fields (ELF-MF) have the ability to produce a variety of behavioral and physiological changes in animals. The stomach, as the most sensitive part of the neuroendocrine organ of the gastrointestinal tract, is crucial for the initiation of a full stress response against all harmful stress. Thus, the purpose of this study was to examine whether ELF-MF stimuli induce changes in the activity of neuroendocrine cells, considering their involvement in endocrine or paracrine effect on surrounding cells. The exposure to ELF-MF (durations of 24 h and 1 or 2 weeks, 60 Hz frequency, 0.1 mT intensity) altered the distribution and occurrence of gastrin, ghrelin and somatostatin-positive endocrine cells in the stomach of rats. The change, however, in the secretion of those hormones into blood from endocrine cells did not appear significantly with ELF-MF exposure. Comparing with sham control, ELF-MF exposure for 1 and 2 week induced an increase in BaSO4 suspension propelling ratio of gastrointestinal tract, indicating that ELF-MF affects gastrointestinal motility. Our study revealed that ELF-MF exposure might influence the activity of endocrine cells, an important element of the intrinsic regulatory system in the digestive tract. The pathophysiological character of these changes and the mechanism responsible for neuroendocrine cell are still unclear and require further studies.

A 56-Year-Old Woman With Severe Chronic Constipation: What Is the Underlying Pathology?

No abstract available.

A perinephric abscess caused by Streptococcus agalactiae / 대한내과학회지

Group B streptococcus (GBS, Streptococcus agalactiae) has recently been recognized as an important, increasingly common cause of invasive disease in non-pregnant adults with underlying medical conditions. Diabetes mellitus, malignancies, liver cirrhosis, and previous trauma history increase the risk for invasive GBS disease. We report a rare case of perinephric abscess caused by GBS in a non-pregnant diabetic woman. A 24-year-old woman with diabetes and a history of urinary tract infection presented with a 4-week history of intermittent febrile sensation, chills, right flank pain, and anorexia. Computed tomography revealed an 8-cm right perinephric abscess. She was treated with percutaneous drainage of the abscess and intravenous antibiotics directed at the GBS, which had grown from the abscess drainage. She had a satisfactory clinical course.

Gastrointestinal amyloidosis secondary to chronic tophaceous gout / 대한내과학회지

Secondary amyloidosis is associated with infectious, inflammatory, or neoplastic disorders. Gouty arthritis, unlike other forms of chronic inflammatory arthritis, is not usually associated with amyloidosis. A 70.year.old man was admitted because of generalized edema, anorexia, and diarrhea. He had been diagnosed with gouty arthritis 12 years earlier and took over-the-counter medication during acute attacks. The physical examination revealed multiple tophi on his ears, right hand, and right foot. No evidence of amyloidosis involving the heart or bone marrow was detected. Biopsy of the antrum, duodenum, ileum, and descending colon showed green birefringence with Congo red stain. Immunohistochemistry was strongly positive for amyloid A. We diagnosed him as having secondary gastrointestinal amyloidosis AA with chronic tophaceous gouty arthritis. Allopurinol was administered and oral rednisolone was increased. However, he died from septic shock 25 days after admission.

A Case of Humeral Osteomyelitis and Soft Tissue Abscess Accompanied with Streptococcus anginosus Bacteremia / 감염과화학요법

Streptococcus anginosus is a normal flora found in multiple body sites and belongs to the Streptococcus milleri group. It has often been associated with pyogenic infection, such as perio-dontitis, endocarditis, pulmonary abscess and abdominal or cerebral abscess. Also uncommonly, it can cause osteomyelitis. A 42-year-old man was admitted due to gastric ulcer perforation. At 12th hospital day, left humeral osteomyelitis and soft tissue abscess developed. Streptococcus anginosus grew in blood culture. He was treated with intravenous penicillin and surgical debridement of the necrotic tissue which lead to a satisfactory result. We report a rare case of Streptococcus anginosus-induced humeral osteomyelitis and soft tissue abscess.

A Case of Stevens-Johnson Syndrome Associated with Mycoplasma pneumoniae Pneumonia in an Adult Patient / 감염과화학요법

Stevens-Johnson syndrome is an acute mucocutaneous syndrome that is related to drugs and infections. Mycoplasma pneumoniae infection is known as one of the causes of Stevens-Johnson syndrome in children and young adults. In Korea, Mycoplasma pneumoniae infection is rarely reported as a cause of Stevens-Johnson syndrome in adults. We report a case of Stevens-Johnson syndrome associated with Mycoplasma pneumoniae pneumonia in an adult patient. A 34-years old woman was admitted to our hospital and was diagnosed with mycoplasma pneumonia. At the time of admission, she had hemorrhagic crusts on her lips. On the 2nd day of admission, target lesions also developed on her skin. We diagnosed her disease as Stevens-Johnson syndrome associated with Mycoplasma pneumoniae pneumonia. She completely recovered from pneumonia and Stevens-Johnson syndrome after treatment with antibiotics and conservative management.

A Case of Humeral Osteomyelitis and Soft Tissue Abscess Accompanied with Streptococcus anginosus Bacteremia / 감염과화학요법

Streptococcus anginosus is a normal flora found in multiple body sites and belongs to the Streptococcus milleri group. It has often been associated with pyogenic infection, such as perio-dontitis, endocarditis, pulmonary abscess and abdominal or cerebral abscess. Also uncommonly, it can cause osteomyelitis. A 42-year-old man was admitted due to gastric ulcer perforation. At 12th hospital day, left humeral osteomyelitis and soft tissue abscess developed. Streptococcus anginosus grew in blood culture. He was treated with intravenous penicillin and surgical debridement of the necrotic tissue which lead to a satisfactory result. We report a rare case of Streptococcus anginosus-induced humeral osteomyelitis and soft tissue abscess.

A Case of Stevens-Johnson Syndrome Associated with Mycoplasma pneumoniae Pneumonia in an Adult Patient / 감염과화학요법

Stevens-Johnson syndrome is an acute mucocutaneous syndrome that is related to drugs and infections. Mycoplasma pneumoniae infection is known as one of the causes of Stevens-Johnson syndrome in children and young adults. In Korea, Mycoplasma pneumoniae infection is rarely reported as a cause of Stevens-Johnson syndrome in adults. We report a case of Stevens-Johnson syndrome associated with Mycoplasma pneumoniae pneumonia in an adult patient. A 34-years old woman was admitted to our hospital and was diagnosed with mycoplasma pneumonia. At the time of admission, she had hemorrhagic crusts on her lips. On the 2nd day of admission, target lesions also developed on her skin. We diagnosed her disease as Stevens-Johnson syndrome associated with Mycoplasma pneumoniae pneumonia. She completely recovered from pneumonia and Stevens-Johnson syndrome after treatment with antibiotics and conservative management.

Etanercept-related Cutaneous Nodulosis in a Patient with Rheumatoid Arthritis / 대한류마티스학회지

Etanercept is a recombinant human tumor necrosis factor (TNF) receptor fusion protein, which inhibits the biological activity of TNF-alpha. The common side effects of TNF-alpha inhibitors are injection site reactions, infusion reactions and infection. Rheumatoid nodules are the most common extraarticular manifestation of rheumatoid arthritis. Drugs such as methotrexate were reported to be associated with rheumatoid nodules, but etanercept-related nodules were uncommonly observed. We report the new formation of cutaneous rheumatoid nodules in a 58-year-old man during anti-TNF alpha therapy with etanercept. He had 2-year history of seropositive rheumatoid arthritis, and been treated with methotrexate, hydroxychloroquine, sulfasalazine, prednisolone and nonsteroidal anti-inflammatory drugs before etanercept regimen. Rheumatoid nodules developed on the palmar surface of fingers 4 month after treatment of etanercept, although his disease activity was maintained low. One month later, we decided to stop etanercept because his nodulosis extended to elbow. Since then, he has been followed up without any progression of rheumatoid nodules or aggravation of arthritis.

Abnormal Blood Flow Between a Pericardial Mass and Right Atrium Detected by Echocardiography in a Case of a Ruptured Angiosarcoma of the Right Atrium

Spontaneous rupture of a primary cardiac angiosarcoma is a rare condition with a poor prognosis. The authors describe the case of a 48-year-old man with abnormal blood flow from a pericardial mass to the right atrium 3 months after pericardiocentesis. The flow was presumed to have occurred due to rupture of this cardiac angiosarcoma of the right atrial wall and pericardium into the right atrial cavity.

Abnormal Blood Flow Between a Pericardial Mass and Right Atrium Detected by Echocardiography in a Case of a Ruptured Angiosarcoma of the Right Atrium

Spontaneous rupture of a primary cardiac angiosarcoma is a rare condition with a poor prognosis. The authors describe the case of a 48-year-old man with abnormal blood flow from a pericardial mass to the right atrium 3 months after pericardiocentesis. The flow was presumed to have occurred due to rupture of this cardiac angiosarcoma of the right atrial wall and pericardium into the right atrial cavity.