Eradication Rates of Helicobacter pylori in Korea Over the Past 10 years and Correlation of the Amount of Antibiotics Use: Nationwide Survey.

BACKGROUND: The efficacy of proton-pump inhibitor-amoxicillin-clarithromycin therapy for H. pylori eradication has decreased over time. OBJECTIVE: We assessed the trend of H. pylori eradication rates over the last 10 years and the relationship between the eradication rates and the amount of macrolide antibiotic use in a country with a high prevalence of H. pylori infection. METHODS: This vast nationwide multicenter study was conducted with 34,139 adults treated for H. pylori infection from January 2001 to December 2010. The defined daily dose per km(2) (DSD) of macrolide antibiotics was calculated (n = 141,019) using the Health Insurance Review & Assessment data base from 2008 to 2010 in the two cities which had the lowest (Jeju city) or highest (Chuncheon city) eradication rate. RESULTS: The eradication rates of proton-pump inhibitor-amoxicillin-clarithromycin therapy ranged 84.9-87.5% from 2001 to 2007, and those of 2008 to 2010 ranged 80.0-81.4% with a decreasing trend (p < 0.0001). The decreasing trend of eradication rates for the overall first-line therapy was observed only in three of the seven geographic areas in Korea (p < 0.0001). The DSD of macrolide antibiotics was significantly higher in Jeju than Cheunchon city (0.85 vs 0.52, p < 0.0001). CONCLUSIONS: H. pylori eradication rates with clarithromycin-containing triple therapy in Korea showed a decreasing trend over the past 10 years, although the trend varied among geographic areas. This difference may be associated with the amount of macrolide antibiotic use.

Diagnostic accuracy of hepatic venous pressure gradient measurement in the prediction of stage 1 compensated liver cirrhosis in patients with chronic hepatitis B.

OBJECTIVE: Hepatic venous pressure gradient (HVPG) of 6-10 mmHg has been accepted as a hemodynamic parameter of stage 1 compensated liver cirrhosis (LC). The diagnostic accuracy of HVPG in the prediction of stage 1 compensated LC has been investigated in patients with chronic hepatitis B (CHB). METHODS: A total of 219 patients with CHB who underwent HVPG and liver biopsy were enrolled. The diagnostic accuracy of two methods was compared. Risk factors associated with the diagnosis of stage 1 compensated LC on the basis of the findings of HVPG, biopsy, and both HVPG and biopsy were evaluated. RESULTS: The HVPG score was correlated positively with the stage of biopsy (r=0.439). The sensitivity/specificity of HVPG for predicting stage 1 compensated LC were 78/81% in 6 mmHg, respectively. A total of 57 (26%), 28 (13%), and 20 (9%) patients were diagnosed with stage 1 compensated LC on the basis of the findings of HVPG, biopsy, and both HVPG and biopsy (P>0.05), respectively. Platelet/age (-0.77-0.01×platelet+0.03×age), albumin/platelet (5.05-1.19×albumin-0.01×platelet), and platelet (0.24-0.01×platelet) were found to be risk factors (logit model) for the diagnosis of stage 1 compensated LC on the basis of the findings of HVPG, biopsy, and both HVPG and biopsy. CONCLUSION: HVPG showed a positive correlation with biopsy, and platelet was found to be a common risk factor for the diagnosis of stage 1 compensated LC in patients with CHB.

Clinical significance of GADD153 expression in stage I non-small cell lung cancer.

The transcription factor growth arrest and DNA damage-inducible gene 153 (GADD153), also known as CHOP, is considered to function as a proapoptotic molecule. Overexpression of GADD153 leads to cell cycle arrest and/or apoptosis. However, its clinical implications in non-small cell lung cancer (NSCLC) remain controversial. Therefore, we investigated the expression of GADD153 in stage I NSCLC using immunohistochemistry. Paraffin-embedded tissue sections from 76 patients, who were diagnosed with primary stage I NSCLC and had undergone a curative lung resection, were stained using an anti-GADD153 antibody. The intensity of GADD153 immunostaining was evaluated within the cell membrane and cytoplasm of invasive cancer components. The correlation between the intratumoral expression of GADD153 and various clinical parameters were explored. GADD153 was detected in 29 (38.2%) cases. No statistically significant difference in expression was demonstrated between stage IA and stage IB tumors (35.0 vs. 39.3%; P=0.735). The expression of GADD153 was not affected by histological subtypes or histological grades of differentiation. The intratumoral expression of GADD153 did not influence the overall survival rate (53.29 vs. 52.18 months; P=0.743) or disease-free survival rate (46.97 vs. 54.19 months; P=0.084) of stage I NSCLC patients. However, patients with GADD153 expression demonstrated an improved disease-specific survival rate (28.80 vs. 53.85 months; P=0.020). No patients with GADD153 expression demonstrated distant metastasis (P=0.029). These data suggest that GADD153 expression may be a valuable prognostic factor of early-stage NSCLC in patients who have undergone curative lung resection.