ABSTRACT
The aim of this study was to analyze the location, the cause and treatment of iatrogenic gastrointestinal perforations following therapeutic endoscopic procedures. Perforation occurred in 12 patients out of 3,389, giving cases occurred intraoperatively or postoperatively. Among them, 6 cases were closed by titanium clipping and 1 case by purse string suture. In another case after cap-assisted endoscopic mucosal resection [EMRC], attempted titanium clipping failed, emergency surgery had to be performed. One each case, after Argon plasma coagulation [APC] and case after endoscopic piecemeal mucosal resection [EPMR], recovered well spontaneously. In two cases, titanium clips fell off endoscopic mucosal resection [EMR] resulting in delayed perforation, required surgery. Key factors for preventing and managing the perforation of endoscopic treatment, include the choice of endoscopic approach, processing method of perforation, detail processing in endoscopic therapy, proficient degree of operators and psychological quality
ABSTRACT
The aim of study was to determine relationship between cagA and genetic characterization of metronidazole [MTZ] resistant H. pylori strains from a region at high risk of gastric cancer. 172 H. pylori strains were isolated from the patients with dyspeptic symptoms, and antimicrobial susceptibility testing for MTZ was assessed by E-test. rdxA and frxA genes were amplified using PCR among the MTZ resistant isolates. The status of the plasmid and classes 1-3 integrons were investigated in all isolates. MTZ was detected in 88 isolates [51.16%]. Variations in the rdxA gene leading to alterations of amino acids in RdxA proteins were identified in all MTZ resistant strains. FrxA contained missense alterations in 55 MTZ resistant isolates, while the premature truncation of FrxA was caused by frameshift mutations in 9 MTZ resistant strains. Plasmid was found in one MTZ sensitive strain [0.58%], and none of Class 1-3 integrases gene was detected in the studied isolates. The conservative cagA fragment was obtained from all clinical isolates of H. pylori. The sequence of cagA 3' variable region in 164 strains were obtained, including East Asian-type [122, 74.39%] and Western-type [42, 25.61%]. Prevalence of Western-type cagA 3' variable region was significantly higher in MTZ resistant [33.73%, 28/83] than those of MTZ-sensitive strains [17.28%, 14/81] [p=0.02]. A high prevalence of MTZ resistance was found in the region, and bacterial chromosome mutations in the rdxA and frxA gene still contribute to the high-level MTZ resistance. H. pylori strains characterized with West-type cagA 3' variable region tend to acquire MTZ resistance in the region
ABSTRACT
<p><b>OBJECTIVE</b>To isolate and determine the chemical constituents from Ranunculus sceleratus.</p><p><b>METHOD</b>Six compounds were isolated and purified by extraction and different kinds of column chromatography. The structures were determined on the basis of extensive spectral analysis such as EI-MS, 1H-NMR, 13C-NMR, DEPT and NOEDS.</p><p><b>RESULT</b>The structures were elucidated as stigmasta-4-ene-3,6-dione I, stigmasterol II, isoscopoletin III, scoparone IV, protocatechuic aldehyde V and protocatechuic acid VI, respectively.</p><p><b>CONCLUSION</b>Compound I, III, IV, V and VI were isolated from R. genus for the first time.</p>