New monoclonal antibody-based test for Helicobacter pylori urease in gastric tissue.

BACKGROUND/AIMS: To evaluate a new monoclonal antibody for Helicobacter pylori urease in gastric tissue. METHODS: A total of 107 volunteers were enrolled. All subjects underwent a (13)C-urea breath test and esophagogastroduodenoscopy. Gastric aspirates were analyzed for pH and ammonia. Six biopsy specimens in the gastric antrum and body were obtained for a rapid urease test and histology. The new monoclonal antibody-based H. pylori urease test (HPU) was performed to rapidly and qualitatively detect urease in two biopsy specimens. RESULTS: H. pylori infection was diagnosed in 73 subjects. The sensitivity and specificity of the HPU was 89% and 74%, respectively. The subjects were divided into two groups: one with true-positive and true-negative HPU results (n = 90) and the other with false-positive and false-negative HPU results (n = 17). Across all subjects, ammonia levels were 900.5 ± 646.7 and 604.3 ± 594.3 µmol/L (p > 0.05), and pH was 3.37 ± 1.64 and 2.82 ± 1.51 (p > 0.05). Sensitivity was higher in the presence of atrophic gastritis or intestinal metaplasia. CONCLUSIONS: HPU detected H. pylori in approximately 10 min. Gastric aspirate ammonia and pH levels did not affect the test results. Sensitivity was good in the presence of atrophic gastritis or intestinal metaplasia.

Differences in the Postoperative Outcomes According to the Primary Treatment Options Chosen by Patients With Carpal Tunnel Syndrome: Conservative Versus Operative Treatment.

PURPOSE: We prospectively analyzed the differences in the preoperative status and final outcomes between patients with or without the motivation for prompt surgery after a recent diagnosis of carpal tunnel syndrome (CTS). METHODS: One hundred fifty-six patients were enrolled and followed up from a cohort of 220 patients who were diagnosed with CTS between 2011 and 2013. Basic demographic factors, including the occupational features, were investigated in group 1 (n = 52, conservative treatment followed by surgery) and group 2 (n = 100, surgery immediately after diagnosis). The preoperative electrodiagnosis, clinical items by Graham, Disabilities of the Arm, Shoulder, and Hand (DASH) outcomes questionnaire, Boston Carpal Tunnel Questionnaire scores, and grip/pinch strengths were evaluated, and the degree of improvements was compared. RESULTS: The onset period of the symptoms or signs, as well as the time from the diagnosis to surgery, was significantly longer in group 1 than in group 2. In group 1, nonprofessional, simple, and repetitive jobs were more prevalent; however, the professional category was more common in group 2. The preoperative distributions among the electrodiagnostic grades were not different in both groups. Most of the clinical items by Graham were more definitively improved in group 2. DASH improvement at the final follow-up was meaningfully more in group 2 (34 ± 5.3) than in group 1 (29 ± 6.5). Boston Carpal Tunnel Questionnaire showed a similar trend regarding the DASH score (preoperative, improvement at the final follow-up) with statistical significance. The increase in grip/pinch strength was also greater in group 2. CONCLUSIONS: Most patients, who refused/delayed surgery as the initial treatment for CTS, were not improved by conservative options. Eventually, carpal tunnel release was performed; however, the overall outcomes were inferior compared with those of the groups who agreed to operative treatment as the initial option.

Trunk muscles strength as a risk factor for nonspecific low back pain: a pilot study.

OBJECTIVE: To investigate the effects of asymptomatic back muscle weakness and spinal deformity on low back pain (LBP). METHODS: Sixty healthy subjects without LBP participated in this study. Radiography and an isokinetic/isometric dynamometer were used to respectively measure spinal scoliosis/lordosis and the strength of the trunk flexors/extensors. After 2 years, 48 subjects visited the hospital again and LBP episodes, its severity and the Korean version of the Oswestry Disability Index were assessed. Differences between the group with LBP and the group without LBP were evaluated and the association with LBP incidence and severity was determined. RESULTS: Sex, age, and trunk strength were significantly different in both group. Sex and age were significantly positive associated with LBP incidence. The isometric trunk flexor and extensor strength, maximum isokinetic trunk flexor and extensor strength were significantly and negatively associated with the LBP severity. The maximum isokinetic trunk extensor and maximum isometric trunk extensor strength was significantly negative associated with the LBP incidence. CONCLUSION: LBP incidence is associated with isometric and isokinetic trunk extensor weakness, whereas LBP severity is associated with age, sex, isokinetic trunk extensor and flexor weakness, isometric trunk extensor and flexor weakness.

Corrected QT Interval Prolongation during Severe Hypoglycemia without Hypokalemia in Patients with Type 2 Diabetes.

BACKGROUND: To evaluate the effects of severe hypoglycemia without hypokalemia on the electrocardiogram in patients with type 2 diabetes in real-life conditions. METHODS: Electrocardiograms of adult type 2 diabetic patients during the episodes of severe hypoglycemia and the recovered stage were obtained and analysed between October 1, 2011 and May 31, 2012. Patients who maintained the normal serum sodium and potassium levels during the episodes of severe hypoglycemia were only selected as the subjects of this study. Severe hypoglycemia was defined, in this study, as the condition requiring active medical assistance such as administering carbohydrate when serum glucose level was less than 60 mg/dL. RESULTS: Nine type 2 diabetes patients (seven men, two women) were included in the study. The mean subject age was 73.2±7.7 years. The mean hemoglobin A1c level was 6.07%±1.19%. The median duration of diabetes was 10 years (range, 3.5 to 30 years). Corrected QT (QTc) intervals were significantly increased during the episodes of severe hypoglycemia compared to the recovered stage (447.6±18.2 ms vs. 417.2±30.6 ms; P<0.05). However, the morphology and the amplitude of the T waves were not changed and ST-segment elevation and/or depression were not found during the episodes of severe hypoglycemia. CONCLUSION: In this study, QTc interval prolongation during the episodes of severe hypoglycemia was observed without hypokalemia. Therefore, the distinct alterations in cardiac repolarization during the episodes of severe hypoglycemia may not be associated with hypokalemia.