BACKGROUND: The precore mutant hepatits B virus (HBV) cannot produce HBeAg due to the formation of transnational stop codon at nucleotide 1896 of the HBV-DNA precore region. This mutant has been detected worldwide in acute fulminant hepatitis, carrier and chronic HBV infections. It has been controversial whether the emergence of precore mutant HBV is related to the severity of the chronic hepatitis B or not. METHODS: To determine the prevalence and clinical implication of precore mutant infection, 137 HBsAg (+) patients including 12 acute hepatitis, 59 carriers, 41 chronic hepatitis, 15 liver cirrhosis, and 10 hepatomas were examined with mutation site specific assay-polymerase chain reaction (MSSA-PCR). The specificity for the detection of mutant by MSSA-PCR method was confirmed by direct sequencing of PCR products. RESULTS: The precore mutant HBV was detected in 67 of 137 (49%) subjects : none of 12 (0%) acute hepatitis patients, 17 of 59 (29%) carriers, 31 of 41 (76%) chronic hepatitis patients, 12 of IS (80%) liver cirrhosis patients, and 6 of 10 (60%) hepatoma patients. According to the status of serum HBeAg, the emergence rate of precore mutant HBV in HBeAg(-) cases was relatively higher than in HBeAg(+) cases with blood donor and chronic hepatitis. In anti-HBe (+) patients with chronic hepatitis, the precore mutant HBV was found regardless of ALT level in all patients. Emergence rate of precore mutant HBV was abruptly increased after 30 years of age. Among HBV-DNA (-) sera by DNA probe method, the core region of HBV was amplified in 94% of sera by MSSA-PCR method. CONCLUSIONS: The presence of precore mutant HBV may be related to the duration of HBV infections and there seems to be no causal relationship between the presence of precore mutant HBV and the severity of chronic hepatitis.
Blood Donors ; Carcinoma, Hepatocellular ; Codon, Terminator ; DNA ; Hepatitis ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens ; Hepatitis B, Chronic ; Hepatitis, Chronic ; Herpesvirus 1, Cercopithecine ; Humans ; Liver Cirrhosis ; Polymerase Chain Reaction ; Prevalence ; Sensitivity and Specificity

No abstract available.
Estradiol ; Growth Hormone* ; Testosterone

Subretinal fluid drainage produces the indentation of the sclera by facilitating firm adhesion between the retina and either retinal pigment epithelium or Bruch's membrane and has the advantage that show the state of fundus and degree of indentation of sclera accurately during the operation. Becaulse it has complications such as choroidal bleeding, retinal incarceration, iatrogenic retinal break, choroidal detachment and loss of vitreous, it should be done carefully. The authors analyzed the clinical data of 128 cases(137 eyes) of retinal detachment surgery with subretinal fluid drainage at the Department of Ophthalmology, Pusan Paik Hospital, College of medicine, Inje University from May, 1988 to April, 1990. And the results were as follows: 1. The most common operative method of rhegmatogenous retinal detachment were explant buckling and encirclement with subretinal fluid drainage, and the success rate of first operation was 86.13% and the overall success rate of rhegmatogemous retinal detachment was 91.2% in 137 eyes of operation. 2. In 116 cases(92.8%) who were done subretinal fluid drainage, absorption of residual subretinal fluid took in a day. 3. The most common cause of surgical failure was proliferative vitreoretinopathy. 4. The most common complication was choroidal hemorrhage and it was developed 14 eyes(10.2%) mong 137 eyes. 5. The preoperative duration of symptom and extent of detachment were influenced to the surgical success rate and they had statistical significance(p<0.05). 6. The power of refraction was changed to myopia and ERG b-wave amplitude were increased and 89 eyes out of 137 eyes(69.6%) showed an improvement of vision at the three months after retinal detachment surgery.

No abstract available.
Humans ; Thyroid Gland* ; Turner Syndrome*

BACKGROUND: Herpes zoster is an important and troublesome disease. OBJECTIVE: The purpose of this study was the elucidation of the epidemiological and clinical characteristics of herpes zoster through patient assessrnent. METHODS: During a 5- Year period, January 1990 to December 1994, 215 patients with herpes zoster were assessed with regard to annual and monthly frequency in occurrence, age and gender incidence. Associated conditions, dermatomic distributions, the relationship of onset of pain and skin lesions, Multi-CMI test and complications were also evaluated. RESULTS: 1. The annual freguency of herpes zoster ranged from 0.88% to 1.78% (mean 1.23%) during the 5-year period. The highest number of herpes zoster patients was observed in winter (p<0.001) especially in January. 2. Herpes zoster was found to most frequently afflict persons aged 50-59 (27.9%). 71% of the patients were over 40 years of age. 3. In 76 patients (41.8%), neuralgia occurred several days (4 days mean) before the development of skin lesions. In 92 patients (50.5%), pain and skin lesions developed simultaneously while skin lesion development occurred before the onset of pain in 14 patients (7.7%). 4. Among the patients, 42.8% had associated conditions such as diabetes mellitus, hypertension, pulmonary tuberculosis, liver diseases, peptic ulcer, hypothyroidism, pharyngitis, fracture, etc. 5. The dermatomic invclvement of herpes zoster patients having one dermatome was most frequent in thoracic dermatome ca. es (52.6%). Others included cervical (16.7%), trigeminal (11.6%), sacral (6. 0%), lumbar (4.2%), facial (0.5%). Cases having two different dermatomes constituted 8.4%. 6. The most common complication of herpes zoster was postherpetic neuralgia although instance of ophthalmologic compiications, secondary bacterial infection, scar formation, Ramsay-Hunt syndrome, keloid formation, and urinary difficulty were also documented. 7. Multi-CMI (Cell-mediated immunity) tests were done on 88 herpes zoster patients. Thirteen of them (14.8%) were found to have comparatively depressed scores. Ten of the 79 single dermatome involvement patients (12.7%) and three of the 9 two dermatome involvement patients (33.3%) exhibited similar scores. CONCLUSION: These results are in accordance with those of previous reports with the exception of the higher incidence ot two different dermatome involvements and seasonal variation.
Bacterial Infections ; Cicatrix ; Diabetes Mellitus ; Herpes Zoster* ; Humans ; Hypertension, Pulmonary ; Hypothyroidism ; Incidence ; Keloid ; Liver Diseases ; Neuralgia ; Neuralgia, Postherpetic ; Peptic Ulcer ; Pharyngitis ; Seasons ; Skin ; Tuberculosis

No abstract available.
Arthritis, Juvenile* ; Rheumatoid Factor*

No abstract available.
Endoderm* ; Endodermal Sinus Tumor* ; Female ; Ovary*

Superior mesenteric artery (SMA) injuries remain a challenge to most trauma surgeons and continue to result in significant mortality despite aggressive management. We report successful management of a proximal SMA injury through endovascular treatment in a 56-year-old man. The patient presented with hypotension due to a stab wound after the epigastrium. He underwent emergency laparotomy and repair of the penetrated wall of the stomach. Right retroperitoneal hematoma at the initial laparotomy expanded and ruptured, requiring a massive transfusion. At the second laparotomy, we performed lateral arteriorrhaphy of the proximal SMA. Follow-up abdominal computed tomography angiography on post-injury day 7 showed a pseudoaneurysm on the left side of the SMA trunk. The patient was treated successfully with an endovascular stent graft.
Aneurysm, False* ; Angiography ; Blood Vessel Prosthesis ; Emergencies ; Endovascular Procedures ; Follow-Up Studies ; Hematoma ; Humans ; Hypotension ; Laparotomy ; Mesenteric Artery, Superior* ; Middle Aged ; Mortality ; Stomach ; Wounds, Stab

No abstract available.
Adult ; Humans ; Still's Disease, Adult-Onset

PURPOSE: We report clinical charateristics of percutaneous central venous catheteriza- tion(PCVC) that is performed commonly as a vascular access procedure in the neonatal intensive care unit(NICU) including comparision between the success rate and com- plication rate of groups performed by a doctor and by nurses who were accustomed to the IV procedure. METHODS: We evaluated a total of 158 PCVC cases performed in the NICU of Soonchunhyang Chunan hospital over 2 years 5 rnonths from May, 1995 to September, 1997. The 24 cases of PCVC were performed by doctors and 134 cases of this proce- dures were performed by well trained nurses. We have compared success rates, clinical characteristics, insertion sites, indwelling time, causes of removal of the catheters, and associated complication of both doctor performed group (D) and nurse performed group (N) retrospectively. RESULTS: The mean gestational age, birth weight, weight at the time of insertion were significantly lower in the doctor performed group than in the nurse group(P<0.001). There were significant differences in postnatal age and mean duration per catheter in both groups. The overall success rate of insertions was 89.9%(142/158), the success rate of doctor performed group was 54.2%(13/24) and nurse group was 96.3%(129/134) and there was significant difference(P<0.001). In the doctor performed group, 100% were axillary however in the nurse group 43.4% were axillary, 38.8% were antecubital, 9.4% were temporal, and 5.4% were hand. The most common cause of the removal of the catheter was elective in both groups but there was also substantial spontaneous removal by the patients and mechanical complication. Cultures of catheter tips were done after removal in 110 cases, among then were positive in 36 cases(33.6%), the most common causes were Staphylococcus aureus and Candida albicans. CONCLUSION: In this report, the authors emphasize that percutanous central venous catheterization performed by well trained nurses has a higher success rates than the doctor performed group and can be considered safe. We would also like to emphasize that more attention should be paid to the maintanace of PCVC.
Birth Weight ; Candida albicans ; Catheterization, Central Venous ; Catheters ; Central Venous Catheters ; Chungcheongnam-do ; Gestational Age ; Hand ; Humans ; Infant, Newborn ; Intensive Care, Neonatal ; Retrospective Studies ; Staphylococcus aureus