• Asian Pacific Journal of Cancer Prevention
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• v.16 no.14
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• pp.6089-6092
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• 2015

Background: The prevalence of metronidazole-resistant H. pylori is almost 50% in Thailand which severely limits the use of this drug for eradication therapy. The aims of this study were to evaluate the efficacy and safety profiles of 7-day bismuth-based quadruple therapy including metronidazole as an initial treatment for H. pylori infection in a high metronidazole resistance area. Materials and Methods: This study was performed at Thammasat University Hospital and King Chulalongkorn Memorial Hospital during January 2009 to October 2010. Patients with non-ulcer dyspepsia (NUD) with active H. pylori infection were assigned to receive seven days of quadruple therapy (pantoprazole 40 mg bid, bismuth subsalicylate 1,048 mg bid, amoxicillin 1 gm bid and metronidazole 400 mg tid). H. pylori infection was defined as positive H. pylori culture or two positive tests (rapid urease test and histology). Antibiotic susceptibility test for metronidazole by Epsilometer test (E-test) was performed in all positive cultures. At least four weeks after treatment, $^{13}C$ urea breath test ($^{13}C-UBT$) was performed to confirm H. pylori eradication. Results: A total of 114 patients were enrolled in this study, 50 males and 64 females with a mean age of 49.8 years. All 114 patients had a diagnosis of NUD. Overall eradication as confirmed by negative $^{13}C-UBT$ was achieved in 94 out of 114 patients (82.5%). 44 patients had positive cultures and success for E-test. In vitro metronidazole resistance was observed in 22/44 (50%) patients. Eradication rate in patients with metronidazole resistant strains was 16/22 (72.7%) and 20/22 (90.1%) with metronidazole sensitive strains (72.7% vs 90.1%, p-value=0.12; OR=3.75 [95%CI=0.6-31.5]). Minor adverse reactions included nausea, bitter taste, diarrhea and black stools but none of the patients dropped out from the study. Conclusions: Initial treatment with 7-day bismuth-based quadruple therapy including metronidazole, amoxycillin and pantoprazole is highly effective and well tolerated for metronidazole-sensitive H. pylori infections. However, the efficacy markedly decline with metronidazole resistance. Longer duration of this regimen might be required to improve the eradication rate and larger multi-center studies are needed to confirm this hypothesis.

• Tuberculosis and Respiratory Diseases
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• v.59 no.4
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• pp.432-435
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• 2005

An 82-year-old female non-smoker with a history of hypertension presented with increasing dyspnea, cough and some purulent sputum without fever. Upon admission, the patient was in a distressed condition. Auscultation revealed diminished breath sounds with no rales over the right lung. An examination of the heart revealed a regular rhythm and a systolic murmur radiating from the apex of the heart. There was no pitting edema in the lower extremities. The blood tests showed mild leukocytosis and an increased C-reactive protein level. The $O_2$ saturation was 98 % whilst breathing room air. The electrocardiogram demonstrated sinus tachycardia. The chest radiograph showed a moderate cardiomegaly, right lobe infiltrates, and blunting of the both costophrenic sulcus suggesting a small pleural effusion. Three days after admission, the symptoms became slightly aggravated despite being treated with empirical antibiotics for presumed community-acquired pneumonia. Transthoracic color Doppler echocardiography indicated an ejection fraction of 48 %, mild left ventricular enlargement, and moderate left atrial enlargement resulting in severe mitral regurgitation. The clinical symptoms and right pulmonary edema resolved quickly with intravenous furosemide treatment.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.5 no.1
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• pp.107-124
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• 1998

Based on King's goal attainment theory, this research deals with applying nursing intervention of mutual goal settings to gastrectomy patients. It tests the effects of nursing intervention, according to the patients' health locus of control, suggested as external boundary criteria for the theory by employing a quasi-experimental design which consists of a pretest-posttest non-equivalent control and experimental groups. The subjects of this research were 62 gastrectomy patients hospitalized at Y medical center and the experimental and control groups consisted of 31 subjects. The experimental group received nursing intervention at the mutual goal setting of 5 times from the day before the surgery to the 5th day after the surgery, while the control group received only routine nursing care. Recovery indicators of both groups were measured and compared. Measurement variables included patients' characteristics, health locus of control, forced vital capacity, forced expiratory volume in one second, peak expiratory flow, bowel movement recovery, mobility recovery, level of pain, patients' stress and patients' satisfaction. Data were analyzed using SPSS statistical package and the hypotheses were tested by ANOVA and ANCOVA. Results of the analyses are summarized as follows : 1) Internal health locus of control had higher effects of the nursing intervention of mutual goal setting than external health locus of control on pulmonary ventilatory functions of forced vital capacity, forced expiratory volume in one second, and peak expiratory flow. 2) There was no statistically significant difference in the effects of nursing intervention of mutual goal setting on the bowel movement recovery between the internal and external health locus of control. 3) There was no statistically significant difference in the effects of nursing intervention of mutual goal setting on the mobility recovery between the internal and external health locus of control. 4) There was no statistically significant difference in the effects of nursing intervention of mutual goal setting on the level of pain between the internal and external health locus of control. 5) There was no statistically significant difference in the effects of nursing intervention of mutual goal setting on the level of stress between the internal and external health locus of control. 6) There was a statistically significant difference in the effects of nursing intervention of mutual goal setting on the level of satisfaction with provision of nursing information between the internal and external health locus of control, and there was no statistically significant difference in the effects of nursing intervention of mutual goal setting on the level of satisfaction with outcome of nursing between the internal and external locus of control. On the basis of the research results, the following are recommended : 1) Repeated research on responses to health locus of control is necessary. 2) Not only the effectiveness of nursing intervention in acute recovery periods, but also the long term effects are to be investigated. 3) The development of instruments is needed to accurately measure mutual goal setting regarding postoperative deep breath, coughing, early ambulation, etc. so that the relationship among the postoperative recovery indicators may be explored. 4) It is required that an instrument be developed to measure perception which facilitates goal attainment in the interactive setting between patients and nurses.

• The Korean journal of internal medicine
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• v.39 no.3
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• pp.439-447
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• 2024

Background: Helicobacter pylori infection, prevalent in more than half of the global population, is associated with various gastrointestinal diseases, including peptic ulcers and gastric cancer. The effectiveness of early diagnosis and treatment in preventing gastric cancer highlights the need for improved diagnostic methods. This study aimed to develop a simple scoring system based on endoscopic findings to predict H. pylori infection. Methods: A retrospective analysis was conducted on 1,007 patients who underwent upper gastrointestinal endoscopy at Asan Medical Center from January 2019 to December 2021. Exclusion criteria included prior H. pylori treatment, gastric surgery, or gastric malignancies. Diagnostic techniques included rapid urease and ¹³C-urea breath tests, H. pylori culture, and assessment of endoscopic features following the Kyoto gastritis classification. A new scoring system based on endoscopic findings including regular arrangement of collecting venules (RAC), nodularity, and diffuse or spotty redness was developed for predicting H. pylori infection, utilizing logistic regression analysis in the development set. Results: The scoring system demonstrated high predictive accuracy for H. pylori infection in the validation set. Scores of 2 and 3 were associated with 96% and 99% infection risk, respectively. Additionally, there was a higher prevalence of diffuse redness and sticky mucus in cases where the initial H. pylori eradication treatment failed. Conclusions: Our scoring system showed potential for improving diagnostic accuracy in H. pylori infection. H. pylori testing should be considered upon spotty redness, diffuse redness, nodularity, and RAC absence on endoscopic findings as determined by the predictive scoring system.

• Korean Journal of Biological Psychiatry
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• v.3 no.2
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• pp.222-239
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• 1996

The purpose of this study was to evaluate the effects of alcohol on the psychomotor performance and subjective assessment in healthy Korean adults with acetaldehyde dehydrogenase I(ALDH-I) isozyme variance. A total of 20 male subjects, half with active ALDH-I and the other half with inactive ALDH-I, were selected through both a self-reporting questionnaire examining alcohol sensitivity and the Higuchi's ethanol patch test detecting ALDH-I deficiency. In a doule-blind, placebo-controlled cross-over design, each subject consumed four doses of alcohol(0.25, 0.5, 0.75, 1.0g/kg) and placebo on five separate occasions at weekly intervals, Treatment order was fully balanced using a $5{\times}5$ Latin square, Psychomotor performance tests[coritical flicker fusion threshold(CFF) and choice reaction time(CRT)] and self-estimate questionnaires were conducted at baseline and at time points of 20, 40, 60, 90, 120, 150, 180 minutes after consuming the test drug for 20 minutes, Blood alcohol concentrations(BACs) using breath analyzer were measured at baseline and at time points of 10, 20, 30, 40, 50, 60, 75, 90, 105, 120, 150, 180 minutes after drinking, The BACs and the mean changes in the psychomotor performances and subjective assessments from pre-alcohol baseline, were compared between the two groups. The findings were summarized as follows : 1) BACs were tended to be higher in the inactive group than the active in all of the four alcohol doses. However significant group differences were only after the 0.5g/kg dose of alcohol. 2) The inactive group showed significant impairment in CFFT at most time points alter 0.75 and 1.0g/kg doses of alcohol. 3) In CRT, total reaction time(TRT) significantly prolonged in the inactive group than the active group at 20 minutes after 0.25 and 1.0g/kg doses of alcohol and at 40, 60, 90 minutes alter 0.75g/kg dose of alcohol. In the inactive group, recognition time component significantly increased at 20, 60, 90 minutes after 1.0g/kg dose of alcohol, while movement time component significantly increased at 40, 60 minutes after 0.75g/kg dose of alcohol. 4) Subjective evaluation of the effect of alcohol revealed that physical and mental conditions as well as a self-estimate of the effects of alcohol on performance were significantly worse in the inactive group than the active at some time points alter all of the lour alcohol doses, wihch were more pronounced after 0.75 and 1.0g/kg doses of alcohol. 5) Most of the group differences mentioned above, still remained statistically significant after BAC was entered as a covariate, These findings demonstrated that the alcohol sensitivity is higher in individuals with inactive ALDH-I than those with active ALDH-I both on the subjective assessments and the objective psychomotor performances. Furthermore, these results suggest thai the alcohol sensitivity may be determined by acetaldehyde concentration rather than BAC per se. In future studies, after more accurate genotyping for ALDH-I, the relationships between BAC, acetaldehyde concentration and alcohol sensitivities should be clearly defined.

• The Korean Journal of Nuclear Medicine Technology
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• v.15 no.1
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• pp.90-93
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• 2011

Purpose: A Pixelated BSGI gamma camera has features to enhance resolution and sensitivity and minimize the distance between detector and organs by narrow FOV. Therefore, it is known as useful device to examine small organs such as thyroid, parathyroid and gall bladder. In general, when we would like to enlarge the size of images and obtain high resolution images by gamma camera in nuclear medicine study, we use pinhole collimator. The purpose of this study is to evaluate the usefulness of Pixelated BSGI gamma camera and to compare to it using pinhole collimator in thyroid scan which is a study of typical small organs. Materials and methods: (1) The evaluation of sensitivity and spatial resolution: We measured sensitivity and spatial resolution of Pixelated BSGI with LEHR collimator and Infinia gamma camera with pinhole collimator. The sensitivity was measured by point source sensitivity test recommended by IAEA. We acquired images considering dead time in BSGI gamma camera for 100 seconds and used $^{99m}TcO4-\;400{\mu}Ci$ line source. (2) The evaluation of thyroid phantom: The thyroid phantom was filled with $^{99m}TcO4-$. After set 300 sec or 100 kcts stop conditions, we acquired images from both pixelated BSGI gamma camera and Infinia gamma camera with LEHR collimator. And we performed all thyroid studies in the same way as current AMC's procedure. Results: (1) the result of sensitivity: As a result, the sensitivity and spatial resolution of pixelated BSGI gamma camera were better than Infinia's. The sensitivities of pixelated BSGI and Infinia gamma camera were $290cps/{\mu}Ci$ and $350cps/{\mu}Ci$ respectively. So, the sensitivity of pixelated BSGI was 1.2 times higher than Infinia's (2) the result of thyroid phantom: Consequently, we confirmed that images of Pixelated BSGI gamma camera were more distinguishable between hot and cold spot compared with Infinia gamma camera. Conclusion: A pixelated BSGI gamma camera is able to shorten the acquisition time. Furthermore, the patients are exposed to radiation less than before by reducing amount of radiopharmaceutical doses. Shortening scan time makes images better by minimizing patient's breath and motion. And also, the distance between organ and detector is minimized because detector of pixelated BSGI gamma camera is small and possible to rotate. When patient cannot move at all, it is useful since device is feasible to move itself. However, although a pixelated BSGI gamma camera has these advantages, the effect of dead time occurs over 2000 cts/s since it was produced only for breast scan. So, there were low concentrations in organ. Therefore, we should consider that it needs to take tests to adjust acquisition time and amount of radiopharmaceutical doses in thyroid scan case with a pixelated BSGI gamma camera.

• Journal of the Korean Society of Radiology
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• v.15 no.7
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• pp.983-989
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• 2021

In this study, we intend to evaluate image quality and provide to clinical basic data by applying to 2D TSE (RT) and 3D GRASE (BH) techniques using Fast MRCP testing methods for application to patients in poor patient condition. Data were analyzed for 30 patients (15 males, 15 females, and 64±4.26 average age) who underwent MRCP tests. The equipment used was Ingenia CX 3.0 T equipment and Ds anterior coil was used for data acquisition. SNR and CNR of each image were measured through quantitative analysis, and the quality of the image was evaluated by dividing it into 5 grades for qualitative evaluation. The image evaluation was performed on the paired t-test and the Wilcoxon test, and when the p value was 0.05 or less, it was considered to be significant. As a result of quantitative analysis of SNR and CNR, 3D GRASE (BH) was measured high when comparing the two techniques, 2D TSE (RT) MRCP and 3D GRASE (BH) (p<0.05). The qualitative analysis result is a sharpness of the bile duct: 3D GRASE(BH): 4.12±0.03, Overall image quality: 3D GRASE(BH): 4.21±0.91 was high (p=0.001). The motion artifact of the bile duct showed no significant difference with two techniques(2D TSE(RT): 4.41±0.04, 3D GRASE(BH): 4.53±0.14(p=0.067). However, the background suppression obtained significant results with 2D TSE(RT) of 4.14±0.55(p=0.001). In conclusion, as a result of using the Fast MRCP testing method, MRCP images obtained by 3D GRASE (BH) had an advantage over MRCP images using 2D TSE (RT). However, there will be useful results of 2D TSE(RT) MRCP technique in patients who have difficulty holding their breath.