Gastric Angiolipoma Resected with Endoscopic Submucosal Dissection.

Angiolipoma is a benign fatty neoplasm that has components of proliferating blood vessels. These types of lesions commonly occur in the subcutaneous tissue of the limbs and trunk. Angiolipoma in the gastrointestinal tract is extremely rare, and the final diagnosis generally depends on histological examination of the excised biopsy. In most previously reported cases, the lesions were diagnosed and treated with surgical management. In this study, we report a case of gastric angiolipoma of approximately 4 cm in size that was diagnosed and treated with endoscopic submucosal dissection.

Validation of loop-mediated isothermal amplification to detect Helicobacter pylori and 23S rRNA mutations: A prospective, observational clinical cohort study.

BACKGROUND: Identifying point mutations in 23S rRNA closely associated with clarithromycin resistance can increase the eradication rate of Helicobacter pylori (H pylori). In this study, we verified the sensitivity, specificity, and reliability of a newly developed loop-mediated isothermal amplification (LAMP) assay kit to detect H pylori and 2143G and 2182C mutations in 23S rRNA. METHODS: LAMP assay to detect H pylori and a mutant strain with 2143G and 2182C was conducted with the Isopollo® H pylori & ClaR kit. A prospective, open-label, observational study was conducted to validate the reliability of the LAMP assay in both a development cohort and a bedside direct LAMP cohort. RESULTS: The LAMP assay had good sensitivity, as it could detect as few as 10-100 copies of H pylori and mutants with 2143G and 2182C in 23S rRNA, and good specificity, as it did not react with other bacterial species. In the development cohort with 622 participants, the LAMP assay showed good agreement with RUT for detecting H pylori (kappa value 0.923, P < .001) and had exactly the same results as sequencing analysis for 2143G and 2182C point mutations. The direct LAMP cohort including 93 patients had 97.7% (42/43) of concordance in detecting 2143G and 2182C point mutations compared to the PCR-based sequencing analysis. CONCLUSION: The Isopollo® H pylori & ClaR LAMP assay was a valid method for detecting H pylori and for 2143G and 2182C point mutations in 23S rRNA in a clinical setting.

Clinical relevance of point mutations in the 23S rRNA gene in Helicobacter pylori eradication: A prospective, observational study.

Clarithromycin-based triple therapy is prescribed worldwide for Helicobacter pylori eradication. However, increases in the clarithromycin resistance of H pylori are thought to be responsible for eradication failure. Here, we studied whether point mutations in domain V of the 23S rRNA gene can affect H pylori eradication failure in a prospective, open-label, observational study. Of the 755 enrolled patients, 299 patients (39.6%) had positive Campylobacter-like organism (CLO) tests. DNA sequencing analysis of H pylori 23S rRNA in 295 patients revealed that 2143G was the most frequent point mutation (24.7% of patients), followed by the 2182T mutation (11.5%). The overall eradication failure rate was 20.9% (42/201) in clarithromycin-based triple therapy. Patients with the 2143G had an approximately 60% eradication failure rate, which suggested that 2143G was a high-risk genotype for eradication failure. Patients with the 2182C genotype without 2143G had an 8.7% failure rate, and patients without 2143G or 2182C had only a 4.3% failure rate. The presence of 2143G, which was associated with previous eradication history and female sex, was an independent risk factor for eradication failure. In conclusion, the 2143G point mutation in the 23S rRNA of H pylori was an independent risk factor for eradication failure in clarithromycin-based triple therapy. Personalized tailored therapy based on the genotypes of 23S rRNA can increase eradication success rates in H pylori infections.

High-Performance Polymer Solar Cell with Single Active Material of Fully Conjugated Block Copolymer Composed of Wide-Band gap Donor and Narrow-Band gap Acceptor Blocks.

We synthesized a novel fully conjugated block copolymer, P3, in which a wide-band gap donor block (P1) was connected to a narrow-band gap acceptor block (P2). As P3 contains P1 block with a wide bandgap and P2 block with a narrow bandgap, it exhibits a very wide complementary absorption. Transient photoluminescence measurement using P3 dilute solution demonstrated intramolecular charge transfer between the P1 block and the P2 block, which was not observed in a P1/P2 blend solution. A P3 thin film showed complete PL quenching because the photoinduced inter-/intramolecular charge transfer states were effectively formed. This phenomenon can play an important role in the photovoltaic properties of P3-based polymer solar cells. A single active material polymer solar cell (SAMPSC) fabricated from P3 alone exhibited a high power conversion efficiency (PCE) of 3.87% with a high open-circuit voltage of 0.93 V and a short-circuit current of 8.26 mA/cm2, demonstrating a much better performance than a binary P1-/P2-based polymer solar cell (PCE = 1.14%). This result facilitates the possible improvement of the photovoltaic performance of SAMPSCs by inducing favorable nanophase segregation between p- and n blocks. In addition, owing to the high morphological stability of the block copolymer, excellent shelf-life was observed in a P3-based SAMPSC compared with a P1/P2-based PSC.

Endoscopic experience improves interobserver agreement in the grading of esophagitis by Los Angeles classification: conventional endoscopy and optimal band image system.

BACKGROUND/AIMS: Interobserver variation by experience was documented for the diagnosis of esophagitis using the Los Angeles classification. The aim of this study was to evaluate whether interobserver agreement can be improved by higher levels of endoscopic experience in the diagnosis of erosive esophagitis. METHODS: Endoscopic images of 51 patients with gastroesophageal reflux disease (GERD) symptoms were obtained with conventional endoscopy and optimal band imaging (OBI). Endoscopists were divided into an expert group (16 gastroenterologic endoscopic specialists guaranteed by the Korean Society of Gastrointestinal Endoscopy) and a trainee group (individuals with fellowships, first year of specialty training in gastroenterology). All endoscopists had no or minimal experience with OBI. GERD was diagnosed using the Los Angeles classification with or without OBI. RESULTS: The mean weighted paired κ statistics for interobserver agreement in grading erosive esophagitis by conventional endoscopy in the expert group was better than that in the trainee group (0.51 vs 0.42, p<0.05). The mean weighted paired k statistics in the expert group and in the trainee group based on conventional endoscopy with OBI did not differ (0.42, 0.42). CONCLUSIONS: Interobserver agreement in the expert group using conventional endoscopy was better than that in the trainee group. Endoscopic experience can improve the interobserver agreement in the grading of esophagitis using the Los Angeles classification.

A multicenter, randomized, comparative study to determine the appropriate dose of lansoprazole for use in the diagnostic test for gastroesophageal reflux disease.

BACKGROUND/AIMS: The diagnostic proton pump inhibitor test (PPI test) is a method used in diagnosing gastroesophageal reflux disease (GERD). This study aimed to determine the appropriate dose of lansoprazole for use in the diagnostic test for GERD. METHODS: This study was a randomized, controlled, multicenter trial in the Daegu-Gyeongbuk area. Patients with typical reflux symptoms such as regurgitation and heartburn for at least three months were enrolled in this study. Patients were divided into two groups, the erosive reflux disease (ERD) group and the non-erosive reflux disease (NERD) group, and randomized to 14 days of treatment with lansoprazole at a dose of 15 mg, 30 mg or 60 mg once daily. The PPI test was considered positive if the patient's symptoms improved by more than 50%. RESULTS: A total of 218 patients were enrolled, and analysis was performed on the 188 patients who completed the study. The PPI test was positive in 93.2% of the ERD group and 87.2% of the NERD group. A positive PPI test was observed in 91.7%, 89.4%, and 87.2% of the 15 mg, 30 mg, and 60 mg groups, respectively. Significant symptom score changes were observed starting on day 8 for the 15 mg, 30 mg, and 60 mg groups. CONCLUSIONS: In this multicenter, randomized study of Korean patients, the standard dose of lansoprazole was as effective as a high dose of lansoprazole in relieving the symptoms of GERD, regardless of the presence of ERD, by day 14 of treatment.