Background:The incidence of upper gastrointestinal bleeding has decreased in the general population but has increased in geriatric patients worldwide. The aim of this study was to evaluate the clinical characteristics and outcomes of geriatric patients (aged 65 or older) with upper gastrointestinal bleeding and to compare them with non-geriatric patients (less than 65 years old). Methods: We conducted a retrospective study of 288 patients with upper gastrointestinal bleeding from January 2007 to August 2010. We compared the clinical characteristics and outcomes of geriatric patients (n=148, 51.4%) with those of non-geriatric patients (n=140, 48.6%). Results: Cardiovascular disease, hypertension, and cerebrovascular accidents were more prevalent in the geriatric group, compared with those in the non-geriatric group (p<0.05). Vital signs were more unstable in the geriatric group than those in the non-geriatric group (p<0.05). The geriatric group had taken more ulcerogenic drugs than those in the non-geriatric group (p<0.05). The most common cause of upper gastrointestinal bleeding was peptic ulcer (72.3%) in the geriatric group, whereas it was variceal bleeding (41.4%) in the non-geriatric group. Treatment methods, transfusion volume, operation rate, and mortality were not different between the two groups. The length of hospital stay and length of intensive care unit (ICU) stay were significantly longer in geriatric patients than those in the non-geriatric group (p<0.05). Conclusion: Geriatric patients with upper gastrointestinal bleeding had longer ICU and hospital stays than those of nongeriatric patients. Important emerging etiologies such as ulcerogenic drugs and associated chronic illness should be monitored and treated early in these patients.

Ultra-narrow-linewidth mode-locked lasers with wide wavelength tunability can be versatile light sources for a variety of newly emergent applications. However, it is very challenging to achieve the stable mode locking of substantially long, anomalously dispersive fiber laser cavities employing a narrowband spectral filter at the telecom band. Here, we show that a nearly dispersion-insensitive dissipative mode-locking regime can be accessed through a subtle counterbalance among significantly narrowband spectral filtering, sufficiently deep saturable absorption, and moderately strong in-fiber Kerr nonlinearity. This achieves ultra-narrow-linewidth (a few gigahertz) nearly transform-limited self-starting stable dissipative soliton generation at low repetition rates (a few megahertz) without cavity dispersion management over a broad tuning range of wavelengths covering the entire telecom C-band. This unique laser may have immediate application as an idealized pump source for high-efficiency nonlinear frequency conversion and nonclassical light generation in dispersion-engineered tightly light-confining microphotonic/nanophotonic systems.

Humans can be incidentally parasitized by third-stage larvae of Anisakis species following the ingestion of raw or undercooked seafood. Acute gastric anisakiasis is one of the most frequently encountered complaints in Korea. However, duodenal anisakiasis with duodenal ulcer had not been reported in Korea, despite the habit of eating raw fish. In this case, a 47-year-old man was hospitalized because of sharp epigastric pain and repeated vomiting after eating raw fish 3 days previously. On admission, esophagogastroduodenoscopic examination revealed an active duodenal bulb ulcer. At 5 mm away from the ulcer margin, a whitish linear worm was found with half of its body penetrating the duodenal mucosa. Herein, we report this case of duodenal anisakiasis accompanied by duodenal ulcer.

Vector beams, structured optical beams with nonuniform polarization distributions over the cross-section, have been recently found to be more beneficial than the scalar beams to many applications ranging from super-resolution imaging and creation of strongly localized spins or magnetic resonances to multimode classical and quantum communications. The distribution of vector beams over a strand of low-cost optical fiber would alleviate the space constraint in their use and radically broaden their applications. Here, we experimentally demonstrate that both the radially polarized and azimuthally polarized vector beams can be stably guided over a wide spectral range in a highly germanium-doped-core optical fiber even with a simple step-index profile. Our careful fiber characterization and full-vectorial theoretical analysis show that the heavydoping-induced significant in-fiber stress that is usually developed during the fiber drawing process plays a crucial role in robust vector beam guidance. Our study provides entirely new perspectives of fiber design suitable for cost-effective multimode optical communications and highly efficient multimode nonlinear fiber optics.

Aims/IntroductionEarly initiation of basal insulin therapy is recommended for normalizing fasting blood glucose in type 2 diabetes mellitus. However, basal insulin treatment might not adequately control postprandial glucose levels. The present study evaluated whether the combination of the α-glucosidase inhibitor, acarbose, and basal insulin improved blood glucose control under daily-life treatment conditions in a large sample of Korean patients.Materials and MethodsThe present study was a multicenter, prospective, observational study under daily-life treatment conditions. A total of 539 patients with type 2 diabetes who were treated with basal insulin and additional acarbose were enrolled and followed up for 20 weeks. Changes in hemoglobin A1c, fasting and postprandial blood glucose were evaluated at baseline and at the end of the observation period. The physician and patient satisfaction of the combination treatment and safety were assessed.ResultsHemoglobin A1c decreased by 0.55 ± 1.05% from baseline (P < 0.0001). Fasting and postprandial blood glucose levels were reduced by 0.89 ± 3.79 and 2.59 ± 4.77 mmol/L (both P < 0.0001). The most frequently reported adverse drug reactions were flatulence (0.37%) and abnormal gastrointestinal sounds (0.37%), and all were mild in intensity and transient. In the satisfaction evaluation, 79.0% of physicians and 77.3% of patients were ‘very satisfied’ or ‘satisfied’ with the combined basal insulin and acarbose therapy.ConclusionsCombination therapy of basal insulin and acarbose in patients with type 2 diabetes improved glucose control, and had no drug-specific safety concerns, suggesting that the treatment might benefit individuals who cannot control blood glucose with basal insulin alone.