Detection of Helicobacter pylori in Gastric Aspirates Using a Monoclonal Antibody-Based Test

BACKGROUND/AIMS: The objective of this study was to evaluate a monoclonal antibody-based test to detect Helicobacter pylori-specific antigen in gastric aspirates from humans. METHODS: Sixty-one volunteers were enrolled in the study. All of the subjects underwent a 13C-urea breath test (UBT) before esophagogastroduodenoscopy. Gastric aspirates were analyzed for pH and ammonia and used for polymerase chain reaction (PCR), culture, and monoclonal antibody-based detection of H. pylori. Multiple biopsies of the gastric antrum and body were obtained for a rapid urease test (RUT) and histological evaluation. RESULTS: Thirty-six subjects were H. pylori-positive and 25 were H. pylori-negative according to the UBT results. Compared with the H. pylori-negative subjects, H. pylori-positive subjects had a higher pH (4.77+/-1.77 vs 3.49+/-1.30, p<0.05) and ammonia level (1,130.9+/-767.4 vs 184.2+/-126.3, p<0.0001). The sensitivities and specificities of the PCR test, RUT, culture test, and monoclonal antibody-based test were 100% and 72%, 89% and 100%, 47% and 100%, and 78% and 100%, respectively. CONCLUSIONS: The monoclonal antibody-based test for diagnosing H. pylori infection in gastric aspirates has increased sensitivity compared with the culture test and specificity as high as that of the RUT. The test may be useful as an additive test for examining gastric aspirates.

Culture and Polymerase Chain Reaction of Helicobacter pylori from Rectal and Terminal Ileal Fluid after Polyethylene Glycol (Colyte(R)) Ingestion in Healthy Adults with Positive Urea Breath Test / 대한소화기학회지

BACKGROUND/AIMS: Helicobacter pylori (H. pylori) transmission route is not yet clearly understood. Isolating H. pylori from stool, saliva, and vomitus is very difficult. However, H. pylori could be cultured from feces in the setting of rapid gastrointestinal tract transit. The aim of this study was to isolate H. pylori by culture and PCR in the rectum and terminal ileum during colonoscopy. METHODS: Twenty subjects with positive UBT (urea breath test) were included. We performed polymerase chain reaction (PCR) test and culture of H. pylori with the rectal fluid and terminal ileal fluid during colonoscopy. RESULTS: H. pylori was cultured with rectal fluid from 9 (45.0%) of 20 subjects and with ileal fluid from 11 (55.0%) of 20 subjects. H. pylori was a little more frequently cultured from the terminal ileal fluid than the rectal fluid without statistical significance (p>0.05). PCR test detected flaA (16/20, 80.0% and 17/20, 85.0%), 16S rRNA gene (16/20, 80.0% and 17/20, 85.0%), cagA (10/20, 50.0% and 12/20, 60.0%), and ureC (9/20, 45% and 11/20, 54.5%) from the rectal fluid and the terminal ileal fluid, respectively. The specificity and sensitivity of ureC were 100%. CONCLUSIONS: H. pylori could be cultured from the rectal fluid and terminal ileal fluid in the setting of rapid gastrointestinal tract transit. These results suggest of fecal-oral transmission of H. pylori.

Two cases of endobronchial actinomycosis that were cured by bronchoscopic removal and short-term antibiotic therapy / 대한내과학회지

Actinomycosis is an uncommon, chronic granulomatous, suppurative disease related to Actinomyces israelii, which is a natural inhabitant of the oropharyngeal cavity and the major human pathogen of actinomycosis. In the past, dramatic presentation of thoracic actinomycosis, in conjunction with prominent chest pain and cutaneous fistulas that discharge sulfur granules, has frequently been reported. However, more recent data indicate that chest wall or rib involvement is now much less common than was previously encountered. This could result in more favorable responses to short-term intravenous antibiotic therapy. Foreign-body-associated actinomycosis is a very rare type of thoracic actinomycosis. We report two cases of endobronchial actinomycosis associated with a foreign body. In both cases, the foreign body was successfully removed by bronchoscopy. Each patient was treated with antibiotics for about 70 days. The duration of antibiotic therapy was relatively short, as compared to conventional therapy. Nevertheless, there was no recurrence or complications over 1 year.

Menarcheal timing and growth curve shape during the adolescent growth spurt / 대한치과교정학회지

OBJECTIVE: This study investigated the onset, peak height velocity (PHV) and end of adolescent growth spurt as well as menarcheal timing deduced from surveying accumulative height growth over many years. METHODS: Ninety six students of Samgoe high school between 1st and 3rd grade that were in good health participated in the research. A survey questionnaire was distributed to examine the students' health status and menarche timing. RESULTS: Adolescent growth spurt typically began at the age of 9.9 and reached a PHV at the age of 11.6. The growth spurt ended at the age of 14.1 on average. The average age of menarche was 12.6 years, which was about one year after the PHV of adolescent growth spurt. In most cases, menarche came after PHV. But in 24% of the students, menarche and PHV was nearly coincident or menarche preceded PHV. The growth curves were classified into four types. A typical adolescent growth spurt showed one PHV on graph that drastically drops after the PHV. However, there were cases with two PHVs. CONCLUSIONS: The results indicate that individual growth patterns show large individual differences, however the categorization into the various growth curves may aid in predicting individual growth patterns.

Dieulafoy's Lesion Coexisting with Early Gastric Cancer / 대한소화기내시경학회지

Dieulafoy's lesion is an uncommon cause of gastrointestinal (GI) bleeding, but can be associated with massive, life-threatening GI bleeding. This lesion is an isolated protruding vessel of the submucosal artery associated with a small mucosal defect and normal surrounding mucosa. Although this lesion can occur throughout the GI tract (esophagus, stomach, duodenum, colon, rectum, etc), it has been rarely reported elsewhere than the stomach. Especially, there have been no reports of Dieulafoy lesion coexistent with early gastric cancer in Korea. We report the successful application of endoscopic hemoclipping for the treatment of a very rare Dieulafoy lesion coexistent with early gastric cancer.

A Fatal Case of Simultaneous, Very Late Thrombosis Involving Three Drug-Eluting Stents in Three Coronary Arteries

Late stent thrombosis is one of the most serious complications associated with morbidity and mortality after coronary drug-eluting stent implantation, and is mainly caused by the withdrawal of antiplatelet agents. We report our experience of late stent thrombosis simultaneously involving three different coronary arteries in a young male patient who was treated with three drug-eluting stents two years ago. The patient stopped taking antiplatelet agents for several days. The patient did not recover from cardiogenic shock, even after repeated ballooning with thrombus aspiration, intra-aortic balloon pumping, and temporary pacing during cardiopulmonary resuscitation.