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Background: Up to present, omeprazole plus two antibiotics are used for Helicobacter pylori eradication therapy . Few studies have compared double-dose new-generation, proton pump inhibitors (PPI) with omeprazole. Therefore, we conducted a randomized, prospective study to evaluate differences in H. pylori eradication rates by PPI type. Material and Methods: Between January 2006 and December 2006, 576 consecutive patients with proven H. pylori infection were enrolled prospectively. Four different PPIs [omeprazole 20 mg b.i.d. (old generation), or pantoprazole 40 mg b.i.d., rabeprazole 20 mg b.i.d., or esomeprazole 40 mg b.i.d. (new generation)] were added to clarithromycin (500 mg b.i.d.) and amoxicillin (1 g b.i.d.) for 1 week. Results: By intention-to-treat analysis, no difference was found between the eradication rates of these four PPIs: 64.9% (omeprazole, n = 148), 69.3% (pantoprazole, n = 140), 69.3% (rabeprazole, n = 140), and 72.9% (esomoprazole, n = 148). When eradication rates were analyzed according to whether patients had an ulcer or not on a per-protocol basis, no difference was found between the eradication rates of the four PPIs. However, side-effects were more common in the esomeprazole-based triple therapy group than in the other groups (p

Several studies have reported that plasma brain natriuretic peptide (BNP) levels are increased in patients with chronic atrial fibrillation (AF). The objective of this study was to assess the factors influencing plasma BNP levels in patients with chronic AF and preserved left ventricular (LV) systolic function.Transthoracic echocardiography was performed in 104 patients (48 men, 56 women; mean age, 63.9+/-10.7 years) with chronic AF. At the same time, plasma BNP levels were measured with a Triage kit (Biosite, San Diego, CA).Women, long duration of AF, and hypertension were more prevalent in the highest quartile group of BNP levels than in the lowest quartile of BNP. Significant correlations were observed between plasma BNP levels and the following: mitral E velocity (r=0.343), mitral annular E' velocity (r=-0.402), ratio of mitral E velocity and mitral annular E' velocity (r=0.487), left atrial(LA) size (r=0.653), LA volume index (r=0.775), right atrial (RA) volume index (r=0.563), maximal velocity (V(max)) of mitral regurgitation (MR) (r=0.448), tricuspid regurgitation (TR) V(max) (r=0.532) and LV mass index (r=0.581). In stepwise multiple linear regression analysis, LA volume index (beta=0.326, p0.001), LV mass index (beta=0.395, p0.001) and duration of AF (beta=0.492, p0.001) independently predicted plasma BNP levels in the study subjects. The patients with increased LA volume index exhibited a longer duration of AF, larger RA volume index and LV mass index, higher MR V(max), TR V(max) and plasma BNP level.LA volume index, LV mass index and duration of AF are independent predictors of plasma BNP levels in patients with chronic AF and preserved LV systolic function.

Background/Aims: The prevalence of Helicobacter pylori (H. pylori) infection has been reported to be lower in individuals with inflammatory bowel disease (IBD) in some Western countries. We investigated H. pylori infection in Korean patients with IBD and any possible associations of H. pylori infection with drug therapy for IBD and the phenotype of Crohn’s disease (CD). Methods: We studied 316 unselected patients with IBD, including 169 ulcerative colitis (UC) patients and 147 with CD, and the control group consisted of 316 age- and gender- matched healthy people who received a comprehensive medical examination for a regular checkup purpose. Infection rates of H. pylori as detected by the urea breath test were compared between the IBD patients and the controls. Results: A statistically significant difference in H. pylori infection rate was noticed between the IBD patients (25.3%) and the controls (52.5%; p＜0.001), and between UC (32.0%) and CD patients (17.7%; p=0.04). Among the IBD patients, the age group of ＜60 and individuals with a history of taking metronidazole (13.0%; p=0.038) or ciprofloxacin (6.7%; p=0.001) were found to have a meaningfully lower infection rate, but those who did not take antibiotics still showed H. pylori infection rate significantly lower than the controls (CD 22.0% vs. UC 33.8% vs. Control 52.5%, p＜0.001). With an exception of age, phenotypic characteristics showed no significant relations with H. pylori infection rate in CD patients. Conclusions: Korean patients with IBD, particularly CD, were found to have a significantly lower H. pylori infection rate than the controls. This association was more evident in those ＜60 years old, which suggested that H. pylori infection might be deemed to lower possible risks of IBD in younger adults.

Purpose: To evaluate the short-term surgical results of MerocelⓇ nasal packing wrapped with human amniotic membrane on the internal ostium during endonasal dacryocystorhinostomy (DCR). Methods: Sixty patients who underwent endonasal DCR to treat nasolacrimal duct obstruction from October 2005 to April 2006 were enrolled in this prospective study. The patients were divided into two groups: 30 patients treated with MerocelⓇ packing wrapped with amniotic membrane were assigned to group 1, and the remaining 30 patients were assigned to group 2. During the follow-up period, the authors evaluated surgical wound healing, the incidence of granuloma, and the patency of the internal ostium. Results: Success rates at 6 months after surgery were higher in group 1 than in group 2, but these rates showed no statistically significant difference between the two groups (group 1: 93.3%, group 2: 86.7%, p=0.67). The time for mean wound healing in group 1 was significantly shorter than that in group 2 (group 1: 4.8±1.5 weeks, group 2: 7.3±1.5 weeks, p

Purpose: To evaluate the efficacy of autologus dermis-fixation on the orbital periosteum in patients with superior sulcus deformity. Methods: From September 2005 to February 2007, an appropriate amount of a rolled autologus dermis was added to the site of superior sulcus deformity by means of fixation to the orbital periosteum via lid crease incision. Four patients had superior sulcus deformity after undergoing evisceration or other ocular surgeries. Results: Superior sulcus deformities in all patients could be corrected satisfactorily with bilateral symmetry. During the follow-up period, no complications such as mechanical ptosis and recurrence of superior sulcus deformity were observed. Conclusions: The authors believe that autologus dermis-fixation to the orbital periosteum might be a useful method to correct superior sulcus deformity without disturbing movement of the upper eyelid. A study with a larger series of patients and longer follow-up period might be necessary in the future to obtain more information about autologous dermis-fixation to the periosteum in patients with superior sulcus deformity. J Korean Ophthalmol Soc 49(6):878-885, 2008

Background and Objectives:Recent studies have implicated inflammation as playing an important role in the occurrence, persistence and recurrence of atrial fibrillation and that C-reactive protein is a useful marker of the inflammation. The purpose of this study is to evaluate the association between serum CRP levels and the risk of atrial fibrillation. Subjects and Methods:This study was performed on 9,487 subjects (5,263 men and 4,224 women; mean age: 58.8±6.6 years) who underwent medical check-ups at the Health Promotion Center in Kanbuk Samsung Hospital. 9,438 normal control subjects and 49 atrial fibrillation patients were included in the study. The CRP was measured using a highly sensitive Behring Nephelometer II. Results:When comparing the two groups, there were significant differences in age, gender and the presence of hypertension and cerebrovascular accident, and these are the previously known risk factors for atrial fibrillation. After adjustment was made for the clinical significant variables of atrial fibrillation, multiple regression analysis revealed that the hsCRP levels were not associated with the risk for atrial fibrillation (p=0.52). Conclusion:The inflammatory markers (CRP, WBC count) were not predictive of a higher risk for atrial fibrillation in the Korean population. (Korean Circulation J 2005;35:309-314)

Background and Objectives:There is a seasonal variation in the incidence of diabetes mellitus and cardiovascular disease. Insulin resistance is important in the development of both non-insulin dependent diabetes mellitus (Type II DM) and cardiovascular disease. Hyperinsulinemia, induced by an insulin resistant state, causes the development of a chronic inflammatory response in vascular structures, which is one of the main causes of cardiovascular disease. There have been several studies on seasonal variation in insulin resistance. Therefore, seasonal variation in insulin resistance were investigated to discover if any relationship existed. Subjects and Methods:Korean people examined at a health care center were included. The subjects were divided into four groups, according to the season, and a homeostasis model assessment index (HOMA) calculated, as an indicator of insulin resistance, and compared between the groups. Results:Using the homeostasis model assessment, the highest insulin resistance was observed during winter. Also, the body mass index and waist-hip ratio were highest during winter. Conclusion:Compensating for other metabolic factors (age, gender, body mass index, waist-hip ratio and season), insulin resistance was still found to be higher during winter. Seasonal variation in insulin resistance can be associated with the incidence of DM or cardiovascular disease. Therefore, a prospective study will be needed. (Korean Circulation J 2005;35:620-624)

Background and Objectives:It is well known that, regardless of whether a person has cardiovascular diseases, the reduction of heart rate after exercise reflects the impairment of the autonomic nervous system. It is also a predictive factor of death rate and it correlates to insulin resistance. Therefore, we assessed these correlations in normoglycemic subjects. Subjects and Methods:Exercise stress testing was performed according to the Bruce protocol. Anthropometric indices of adiposity, metabolic variables, blood pressure (BP) and several cardiovascular risk factors were measured. The HOMA index was used as the insulin resistance, and the impairment of the autonomic nervous system was assessed by measuring the reduction of heart rate for 2 minutes after the cessation of exercise. Results:The reduction of heart rate during 2 minutes after the cessation of exercise statistically correlated with the HOMA index, gender, age, body mass index, the waist circumference, heart rate during rest, the maximum heart rate, serum total cholesterol concentration, serum high density lipoprotein cholesterol concentration and serum low density lipoprotein cholesterol concentration, (p

Background and Objectives:The proinflammatory state is considered to be a risk factor for develop atherosclerosis. Recently, certain components of the metabolic syndrome have been related to inflammatory markers. The purpose of this study was to assess the association of white blood cell (WBC) count with different components of the metabolic syndrome (MS). Subjects and Methods:We performed this study to investigate the relationships of white blood cell count, uric acid,and C-reactive protein (CRP) to components of metabolic syndrome (MS), such as abdominal obesity, elevated triglyceride, low high-density lipoprotein cholesterol (HDL), high blood pressure, and impaired fasting glucose in 3134 koreans. Results:WBC count, uric acid, and CRP were associated with several components of MS. WBC count increased, as did the number of MS. Conclusion:Our data suggests an association between the metabolic syndrome and WBC count. (Korean Circulation J 2004;34(3):280-287)