Pub Date : 2023-10-01DOI: 10.3904/kjm.2023.98.5.249
Jinhyun Kim
Idiopathic inflammatory myopathies (IIM) are a heterogeneous group of autoimmune muscle diseases with systemic involvement. Patients with IIM present with varying degrees of muscle disease, cutaneous manifestations, and internal organ involvement. The diagnosis of IIM is frequently delayed because of non-specific symptoms including weakness, easy fatigability, or myalgia. Laboratory tests can give clues for the diagnosis of myositis and other muscle diseases. Creatine kinase can be the screening tool for muscle diseases. About 40-60% of IIM had positive antinuclear antibody (ANA). Thus, positive ANA results increase the possibility of IIM diagnosis. In addition, the identification of myositis-related autoantibodies can help the diagnosis and classification. Myositis-specific autoantibodies (MSA) are found exclusively in IIMs and facilitate the identification of subsets of patients with relatively homogeneous clinical features. Myositis-associated antibodies are frequently found in association with other MSA; however, they may also be detected in various connective diseases.
{"title":"The Laboratory Test for the Diagnosis of Idiopathic Inflammatory Myopathies","authors":"Jinhyun Kim","doi":"10.3904/kjm.2023.98.5.249","DOIUrl":"https://doi.org/10.3904/kjm.2023.98.5.249","url":null,"abstract":"Idiopathic inflammatory myopathies (IIM) are a heterogeneous group of autoimmune muscle diseases with systemic involvement. Patients with IIM present with varying degrees of muscle disease, cutaneous manifestations, and internal organ involvement. The diagnosis of IIM is frequently delayed because of non-specific symptoms including weakness, easy fatigability, or myalgia. Laboratory tests can give clues for the diagnosis of myositis and other muscle diseases. Creatine kinase can be the screening tool for muscle diseases. About 40-60% of IIM had positive antinuclear antibody (ANA). Thus, positive ANA results increase the possibility of IIM diagnosis. In addition, the identification of myositis-related autoantibodies can help the diagnosis and classification. Myositis-specific autoantibodies (MSA) are found exclusively in IIMs and facilitate the identification of subsets of patients with relatively homogeneous clinical features. Myositis-associated antibodies are frequently found in association with other MSA; however, they may also be detected in various connective diseases.","PeriodicalId":84452,"journal":{"name":"Chungang uihak = The Korean central journal of medicine","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134979243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-01DOI: 10.3904/kjm.2023.98.5.223
Soo-Young Na
Biologics such as anti-tumor necrosis factor agents have been the cornerstone for the treatment of inflammatory bowel disease but face limitations, including loss of response and risk of opportunistic infections and malignancies. Newer biologics and small molecules like vedolizumab, ustekinumab, and tofacitinib offer favorable safety profiles and demonstrate efficacy in moderate-to-severe ulcerative colitis. The landscape of the pipeline of biologics and small molecules is rapidly evolving. Upcoming drugs such as upadacitinib, filgotinib, and ozanimod show promise in recently concluded clinical trials, expanding the therapeutic options for ulcerative colitis. This review aims to discuss the medical treatment options available for the management of moderate-to-severe ulcerative colitis, with a focus on biologics and small molecules recommended in revised 2023 Korean guidelines.
{"title":"Advancements in the Management of Moderate-to-Severe Ulcerative Colitis: A Revised 2023 Korean Treatment Guidelines","authors":"Soo-Young Na","doi":"10.3904/kjm.2023.98.5.223","DOIUrl":"https://doi.org/10.3904/kjm.2023.98.5.223","url":null,"abstract":"Biologics such as anti-tumor necrosis factor agents have been the cornerstone for the treatment of inflammatory bowel disease but face limitations, including loss of response and risk of opportunistic infections and malignancies. Newer biologics and small molecules like vedolizumab, ustekinumab, and tofacitinib offer favorable safety profiles and demonstrate efficacy in moderate-to-severe ulcerative colitis. The landscape of the pipeline of biologics and small molecules is rapidly evolving. Upcoming drugs such as upadacitinib, filgotinib, and ozanimod show promise in recently concluded clinical trials, expanding the therapeutic options for ulcerative colitis. This review aims to discuss the medical treatment options available for the management of moderate-to-severe ulcerative colitis, with a focus on biologics and small molecules recommended in revised 2023 Korean guidelines.","PeriodicalId":84452,"journal":{"name":"Chungang uihak = The Korean central journal of medicine","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134979571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-01DOI: 10.3904/kjm.2023.98.5.205
Myung-Jin Cha
In the field of arrhythmia, the significance of wearable devices is steadily increasing. These devices are becoming increasingly recognized not only among patients and physicians but also among the general population. Atrial fibrillation, in particular, benefits significantly from these devices in both diagnosis and treatment of this disease. However, there is a tendency to overlook various challenges associated with wearables. These include limitations in diagnostic accuracy, an inability to evaluate various types of cardiac arrhythmias, potential increases in patient anxiety, and the demands placed on expert physicians due to the vast amounts of data produced by wearable devices. This article emphasizes that while wearable devices play a pivotal role in cardiac arrhythmia diagnosis, areas for improvement remain.
{"title":"Perspective on Wearable Devices for Cardiac Arrhythmia Detection","authors":"Myung-Jin Cha","doi":"10.3904/kjm.2023.98.5.205","DOIUrl":"https://doi.org/10.3904/kjm.2023.98.5.205","url":null,"abstract":"In the field of arrhythmia, the significance of wearable devices is steadily increasing. These devices are becoming increasingly recognized not only among patients and physicians but also among the general population. Atrial fibrillation, in particular, benefits significantly from these devices in both diagnosis and treatment of this disease. However, there is a tendency to overlook various challenges associated with wearables. These include limitations in diagnostic accuracy, an inability to evaluate various types of cardiac arrhythmias, potential increases in patient anxiety, and the demands placed on expert physicians due to the vast amounts of data produced by wearable devices. This article emphasizes that while wearable devices play a pivotal role in cardiac arrhythmia diagnosis, areas for improvement remain.","PeriodicalId":84452,"journal":{"name":"Chungang uihak = The Korean central journal of medicine","volume":"1128 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134979354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-01DOI: 10.3904/kjm.2023.98.5.241
Young-Hee Nam, Byeol-A Yoon, Song-Hee Han
Hypereosinophilic syndrome (HES) is a heterogeneous group of rare disorders characterized by blood and tissue eosinophilia accompanied by eosinophil-driven tissue damage and dysfunction. Clinical manifestations of HES are highly variable, as it is a multisystem disorder involving nearly all organs, but the skin, lungs, and gastrointestinal tract are the most common sites. Identifying and diagnosing HES is challenging because it requires the diagnostic elimination of many eosinophilic conditions, so a detailed stepwise approach should be considered.
{"title":"A 43-Year-Old Man with Abdominal Pain and Diarrhea for 2 Months","authors":"Young-Hee Nam, Byeol-A Yoon, Song-Hee Han","doi":"10.3904/kjm.2023.98.5.241","DOIUrl":"https://doi.org/10.3904/kjm.2023.98.5.241","url":null,"abstract":"Hypereosinophilic syndrome (HES) is a heterogeneous group of rare disorders characterized by blood and tissue eosinophilia accompanied by eosinophil-driven tissue damage and dysfunction. Clinical manifestations of HES are highly variable, as it is a multisystem disorder involving nearly all organs, but the skin, lungs, and gastrointestinal tract are the most common sites. Identifying and diagnosing HES is challenging because it requires the diagnostic elimination of many eosinophilic conditions, so a detailed stepwise approach should be considered.","PeriodicalId":84452,"journal":{"name":"Chungang uihak = The Korean central journal of medicine","volume":"154 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134936320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-01DOI: 10.3904/kjm.2023.98.5.212
Tae Wan Kim, Won-Young Kim
Acute respiratory distress syndrome (ARDS) accounts for 10% of patients admitted to the intensive care unit and 23% of patients using mechanical ventilation, with a mortality rate of 45% in severe cases. The perception that patients with ARDS are vulnerable to ventilator-induced lung injury has led to lung-protective ventilation strategies. Accordingly, the American Thoracic Society, the European Society of Intensive Care Medicine (ESICM), and the Society of Critical Care Medicine announced ARDS mechanical ventilation guidelines in 2017. Since then, based on the results of newly reported research and data accumulated throughout the coronavirus disease 2019 pandemic, the ESICM announced an amendment to the previous guidelines in 2023. The revised ARDS guidelines discuss extending the ARDS definition and its phenotypes that were not mentioned in the previous guidelines. The new guidelines encompass ventilation strategies, including positive end-expiratory pressure and recruitment maneuvers in patients receiving mechanical ventilation. In addition, various oxygenation devices, such as high-flow nasal cannulated oxygen and continuous positive airway pressure in nonmechanically ventilated patients, are introduced. This review discusses new changes in the diagnosis and treatment of ARDS based on the new ESICM guidelines, providing a supportive background and rationale.
{"title":"Updated Guidelines for Acute Respiratory Distress Syndrome","authors":"Tae Wan Kim, Won-Young Kim","doi":"10.3904/kjm.2023.98.5.212","DOIUrl":"https://doi.org/10.3904/kjm.2023.98.5.212","url":null,"abstract":"Acute respiratory distress syndrome (ARDS) accounts for 10% of patients admitted to the intensive care unit and 23% of patients using mechanical ventilation, with a mortality rate of 45% in severe cases. The perception that patients with ARDS are vulnerable to ventilator-induced lung injury has led to lung-protective ventilation strategies. Accordingly, the American Thoracic Society, the European Society of Intensive Care Medicine (ESICM), and the Society of Critical Care Medicine announced ARDS mechanical ventilation guidelines in 2017. Since then, based on the results of newly reported research and data accumulated throughout the coronavirus disease 2019 pandemic, the ESICM announced an amendment to the previous guidelines in 2023. The revised ARDS guidelines discuss extending the ARDS definition and its phenotypes that were not mentioned in the previous guidelines. The new guidelines encompass ventilation strategies, including positive end-expiratory pressure and recruitment maneuvers in patients receiving mechanical ventilation. In addition, various oxygenation devices, such as high-flow nasal cannulated oxygen and continuous positive airway pressure in nonmechanically ventilated patients, are introduced. This review discusses new changes in the diagnosis and treatment of ARDS based on the new ESICM guidelines, providing a supportive background and rationale.","PeriodicalId":84452,"journal":{"name":"Chungang uihak = The Korean central journal of medicine","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134979443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-01DOI: 10.3904/kjm.2023.98.5.231
Ga-Young Song, Deok-Hwan Yang
Follicular lymphoma (FL) is the third most common subtype of non-Hodgkin lymphoma in Korea. Patients with FL generally present with asymptomatic lymphadenopathy, which may wax and wane for years and have indolent disease course. Most patients with FL have advanced-stage disease at diagnosis and less than 20% of patients with FL have stage I/II disease. Radiation therapy is generally accepted with the treatment of choice for limited-stage FL and results in 60-80% of 10-year overall survival rates. Patients with advanced-stage FL do not require an immediate treatment unless they have symptomatic disease, compromised end organ function, B symptoms, or cytopenia. The initial treatment of advanced-stage FL recommends rituximab-containing immunochemotherapy followed by 2 years of maintenance with rituximab, or bendamustine plus rituximab is a preferred choice because of superior progression-free survival with less toxicity than other rituximab-containing immunochemotherapy. For patients with relapsed or refractory FL, there are many options ranging from anti-CD20 monoclonal antibody alone to a combination with lenalidomide and chemotherapy or autologous stem cell transplantation. In addition, the novel approaches for relapsed or refractory FL have been applied with phosphoinositide 3-kinase inhibitor, Bruton’s tyrosine kinase inhibitor, enhancer of zeste homolog 2 inhibitor, anti-CD19 chimeric antigen receptor T-cell therapy and bispecific antibodies.
{"title":"Recent Updates on Diagnosis and Treatment of Follicular Lymphoma","authors":"Ga-Young Song, Deok-Hwan Yang","doi":"10.3904/kjm.2023.98.5.231","DOIUrl":"https://doi.org/10.3904/kjm.2023.98.5.231","url":null,"abstract":"Follicular lymphoma (FL) is the third most common subtype of non-Hodgkin lymphoma in Korea. Patients with FL generally present with asymptomatic lymphadenopathy, which may wax and wane for years and have indolent disease course. Most patients with FL have advanced-stage disease at diagnosis and less than 20% of patients with FL have stage I/II disease. Radiation therapy is generally accepted with the treatment of choice for limited-stage FL and results in 60-80% of 10-year overall survival rates. Patients with advanced-stage FL do not require an immediate treatment unless they have symptomatic disease, compromised end organ function, B symptoms, or cytopenia. The initial treatment of advanced-stage FL recommends rituximab-containing immunochemotherapy followed by 2 years of maintenance with rituximab, or bendamustine plus rituximab is a preferred choice because of superior progression-free survival with less toxicity than other rituximab-containing immunochemotherapy. For patients with relapsed or refractory FL, there are many options ranging from anti-CD20 monoclonal antibody alone to a combination with lenalidomide and chemotherapy or autologous stem cell transplantation. In addition, the novel approaches for relapsed or refractory FL have been applied with phosphoinositide 3-kinase inhibitor, Bruton’s tyrosine kinase inhibitor, enhancer of zeste homolog 2 inhibitor, anti-CD19 chimeric antigen receptor T-cell therapy and bispecific antibodies.","PeriodicalId":84452,"journal":{"name":"Chungang uihak = The Korean central journal of medicine","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134936336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Podocytic infolding glomerulopathy (PIG) is a rare disease diagnosed by its characteristic structure on electron microscopy. Histologically, there are microtubules and microspheres in the glomerular basement membrane (GBM). Most PIG has been reported in Japan, with a single case in South Korea; there are no previous reports of PIG in kidney transplant patients. Here, we report a 47-year-old Korean woman diagnosed with PIG after a kidney transplant. She was diagnosed with systemic lupus erythematosus. She was suspected of having lupus nephritis and subsequently underwent kidney transplantation. Routine testing showed increased proteinuria without renal functional impairment. A biopsy of the allograft kidney revealed mild interstitial fibrosis, tubular atrophy, and GBM thickening with intramembranous microspherules and microtubules on light microscopy. Electron microscopy showed GBM thickening with intramembranous microspherules and microtubules. These findings are consistent with PIG.
{"title":"A Case of Podocytic Infolding Glomerulopathy in an Allograft Kidney","authors":"SaeYoung Jeong, Jiwon Lee, Woon Yong Jung, Mi-Yeon Yu, Sang-Woong Han","doi":"10.3904/kjm.2023.98.5.253","DOIUrl":"https://doi.org/10.3904/kjm.2023.98.5.253","url":null,"abstract":"Podocytic infolding glomerulopathy (PIG) is a rare disease diagnosed by its characteristic structure on electron microscopy. Histologically, there are microtubules and microspheres in the glomerular basement membrane (GBM). Most PIG has been reported in Japan, with a single case in South Korea; there are no previous reports of PIG in kidney transplant patients. Here, we report a 47-year-old Korean woman diagnosed with PIG after a kidney transplant. She was diagnosed with systemic lupus erythematosus. She was suspected of having lupus nephritis and subsequently underwent kidney transplantation. Routine testing showed increased proteinuria without renal functional impairment. A biopsy of the allograft kidney revealed mild interstitial fibrosis, tubular atrophy, and GBM thickening with intramembranous microspherules and microtubules on light microscopy. Electron microscopy showed GBM thickening with intramembranous microspherules and microtubules. These findings are consistent with PIG.","PeriodicalId":84452,"journal":{"name":"Chungang uihak = The Korean central journal of medicine","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134979356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-01DOI: 10.3904/kjm.2023.98.5.208
Eun-Jeong Joo
This review provides the complex interaction between human immunodeficiency virus (HIV) infection and gut microbiota. HIV infection exerts chronic effects by impairing the immune system, closely linked with alterations in gut microbiota. While advances in highly active antiretroviral therapy have achieved HIV undetectable in the bloodstream, persistent microbial translocation in the gut microbiota despite antiviral treatment leads to systemic immune activation and chronic inflammation in people living with HIV (PLHIV). There is the need for elucidating which specific microbes and their byproducts that contribute to immune activation and chronic inflammation in PLHIV. Furthermore, gaining a deeper understanding of the connection between HIV infection and metabolic disorders holds significant potential for addressing and managing conditions like premature aging and metabolic diseases. Monitoring alterations in gut microbiota composition shows promise in developing diagnostic markers and therapeutic potential for metabolic disorders in PLHIV.
{"title":"Human Immunodeficiency Virus Infection and Gut Microbiota: A Review on Gut Microbiome Associated with Immune Activation and Metabolic Diseases","authors":"Eun-Jeong Joo","doi":"10.3904/kjm.2023.98.5.208","DOIUrl":"https://doi.org/10.3904/kjm.2023.98.5.208","url":null,"abstract":"This review provides the complex interaction between human immunodeficiency virus (HIV) infection and gut microbiota. HIV infection exerts chronic effects by impairing the immune system, closely linked with alterations in gut microbiota. While advances in highly active antiretroviral therapy have achieved HIV undetectable in the bloodstream, persistent microbial translocation in the gut microbiota despite antiviral treatment leads to systemic immune activation and chronic inflammation in people living with HIV (PLHIV). There is the need for elucidating which specific microbes and their byproducts that contribute to immune activation and chronic inflammation in PLHIV. Furthermore, gaining a deeper understanding of the connection between HIV infection and metabolic disorders holds significant potential for addressing and managing conditions like premature aging and metabolic diseases. Monitoring alterations in gut microbiota composition shows promise in developing diagnostic markers and therapeutic potential for metabolic disorders in PLHIV.","PeriodicalId":84452,"journal":{"name":"Chungang uihak = The Korean central journal of medicine","volume":"179 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134979444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-01DOI: 10.3904/kjm.2023.98.4.191
I. Oh, K. Rhee, O. Kim
Background/Aims: Helicobacter pylori (H. pylori) infection is correlated with erythematous gastritis, which is one of the endoscopic findings of the Sydney classification system. The present study evaluated the association between the endoscopic severity of erythematous gastritis and H. pylori infection.Methods: We prospectively enrolled asymptomatic adults who were diagnosed with erythematous gastritis during screening esophagogastroduodenoscopy. A rapid urease test was performed in all participants to diagnose H. pylori infection. The severity of erythematous gastritis was determined based on the Sydney classification system. The primary endpoint was the H. pylori infection rate according to the severity of erythematous gastritis (mild to moderate vs. severe).Results: In total, 131 patients with erythematous gastritis were included. The rate of H. pylori infection was 45.8% across all patients. Of the 131 included patients, 45 had mild gastritis, 43 had moderate gastritis, and 43 had severe gastritis. The H. pylori infection rate was significantly different between patients with mild to moderate erythematous gastritis and those with severe erythematous gastritis (20.5% vs. 97.7%, respectively; p = 0.000). After adjustment for potential confounding variables, the severity of erythematous gastritis was associated with the H. pylori infection rate. The kappa value was 0.563, and interobserver variation was 14.43%.Conclusions: H. pylori infection is observed to a moderate degree in patients with erythematous gastritis. The severity of erythematous gastritis is associated with the H. pylori infection rate.
背景/目的:幽门螺杆菌(Helicobacter pylori, H. pylori)感染与红斑性胃炎相关，是悉尼分类系统的内镜检查结果之一。本研究评估了内镜下红斑性胃炎严重程度与幽门螺杆菌感染之间的关系。方法:我们前瞻性地招募了在食管胃十二指肠镜检查中被诊断为红斑性胃炎的无症状成年人。在所有参与者中进行快速脲酶试验以诊断幽门螺杆菌感染。根据悉尼分类系统确定红斑性胃炎的严重程度。主要终点是根据红斑性胃炎严重程度的幽门螺杆菌感染率(轻度至中度vs重度)。结果:共纳入131例红斑性胃炎患者。所有患者幽门螺杆菌感染率为45.8%。在131例纳入的患者中，45例为轻度胃炎，43例为中度胃炎，43例为重度胃炎。轻、中度红斑性胃炎患者与重度红斑性胃炎患者幽门螺杆菌感染率差异有统计学意义(分别为20.5%和97.7%;P = 0.000)。在对潜在的混杂变量进行调整后，红斑性胃炎的严重程度与幽门螺杆菌感染率相关。kappa值为0.563，观察者间变异为14.43%。结论:在红斑性胃炎患者中存在中等程度的幽门螺杆菌感染。红斑性胃炎的严重程度与幽门螺杆菌感染率有关。
{"title":"Prediction of Helicobacter pylori Infection by Endoscopic Severity of Erythematous Gastritis in Asymptomatic Adults","authors":"I. Oh, K. Rhee, O. Kim","doi":"10.3904/kjm.2023.98.4.191","DOIUrl":"https://doi.org/10.3904/kjm.2023.98.4.191","url":null,"abstract":"Background/Aims: Helicobacter pylori (H. pylori) infection is correlated with erythematous gastritis, which is one of the endoscopic findings of the Sydney classification system. The present study evaluated the association between the endoscopic severity of erythematous gastritis and H. pylori infection.Methods: We prospectively enrolled asymptomatic adults who were diagnosed with erythematous gastritis during screening esophagogastroduodenoscopy. A rapid urease test was performed in all participants to diagnose H. pylori infection. The severity of erythematous gastritis was determined based on the Sydney classification system. The primary endpoint was the H. pylori infection rate according to the severity of erythematous gastritis (mild to moderate vs. severe).Results: In total, 131 patients with erythematous gastritis were included. The rate of H. pylori infection was 45.8% across all patients. Of the 131 included patients, 45 had mild gastritis, 43 had moderate gastritis, and 43 had severe gastritis. The H. pylori infection rate was significantly different between patients with mild to moderate erythematous gastritis and those with severe erythematous gastritis (20.5% vs. 97.7%, respectively; p = 0.000). After adjustment for potential confounding variables, the severity of erythematous gastritis was associated with the H. pylori infection rate. The kappa value was 0.563, and interobserver variation was 14.43%.Conclusions: H. pylori infection is observed to a moderate degree in patients with erythematous gastritis. The severity of erythematous gastritis is associated with the H. pylori infection rate.","PeriodicalId":84452,"journal":{"name":"Chungang uihak = The Korean central journal of medicine","volume":"222 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77012592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-01DOI: 10.3904/kjm.2023.98.4.199
J. Ahn, Dongyeong Lee, Joohee Jeon, J. Ryu, J. Chang
Peritoneal glucose absorption in peritoneal dialysis causes hyperglycemia. Nonketotic hyperglycemia (NKH) includes hyperosmolar hyperglycemic state, which refers to a condition that includes hyperglycemia, hyperosmotic pressure, and dehydration without severe acidosis. NKH is associated with various types of epileptic seizures, but aphasic seizure as a neurological complication of NKH is very rare. Here we report a case of aphasic seizure in a patient with NKH who underwent peritoneal dialysis. A 57-year-old man who had been undergoing peritoneal dialysis visited our hospital with the chief complaint of aphasia. His magnetic resonance imaging scan was normal, but his electroencephalography showed frequent generalized delta slow activity as well as epileptiform discharges originating from the left frontotemporal lobe. His dialysis modality was switched to hemodialysis and he was started on insulin for glucose control. The latter resulted in the disappearance of his seizures and of his aphasia.
{"title":"A Case of Aphasic Seizure as a Manifestation of Nonketotic Hyperglycemia in a Patient Undergoing Peritoneal Dialysis","authors":"J. Ahn, Dongyeong Lee, Joohee Jeon, J. Ryu, J. Chang","doi":"10.3904/kjm.2023.98.4.199","DOIUrl":"https://doi.org/10.3904/kjm.2023.98.4.199","url":null,"abstract":"Peritoneal glucose absorption in peritoneal dialysis causes hyperglycemia. Nonketotic hyperglycemia (NKH) includes hyperosmolar hyperglycemic state, which refers to a condition that includes hyperglycemia, hyperosmotic pressure, and dehydration without severe acidosis. NKH is associated with various types of epileptic seizures, but aphasic seizure as a neurological complication of NKH is very rare. Here we report a case of aphasic seizure in a patient with NKH who underwent peritoneal dialysis. A 57-year-old man who had been undergoing peritoneal dialysis visited our hospital with the chief complaint of aphasia. His magnetic resonance imaging scan was normal, but his electroencephalography showed frequent generalized delta slow activity as well as epileptiform discharges originating from the left frontotemporal lobe. His dialysis modality was switched to hemodialysis and he was started on insulin for glucose control. The latter resulted in the disappearance of his seizures and of his aphasia.","PeriodicalId":84452,"journal":{"name":"Chungang uihak = The Korean central journal of medicine","volume":"53 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88727649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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