BACKGROUND: It has been estimated that 1 unit per 493,000 blood donations could transmit HIV by infected persons in seroconversion window in America. The 4th generation enzyme immunoassay (EIA) kits which are designed to detect HIV antigen and antibody simultaneously, could reduce the period of seroconversion window and thereby increase the safety of donated bloods without additional expenses. METHODS: Sensitivity and specificity of Vironostika HIV Uni-Form II Ag/Ab (Organon Technika, Boxtel, Netherlands) were evaluated using 53 samples (11 western blot positive samples and 42 sera from BBI panel) and 391 samples (282 healthy donors, 20 anti-HCV positive sera and 89 FANA positive sera), respectively. Seroconversion window was compared with that of COBAS CORE Anti-HIV-1/HIV-2 EIA DAGS (Roche Diagnostics, Basel, Switzerland) using 6 kinds of BBI seroconversion panel. RESLUTS: Sensitivity was 100% (53/53). Aggregated specificity was 99.5% (389/391), while all the samples from the healthy donors showed negative (282/282). COBAS CORE Anti-HIV-1/HIV-2 EIA DAGS also showed 100% sensitivity (53/53) and 100% specificity (391/391). Vironostika HIV kit detected HIV-1 infection earlier about 9.8 days than COBAS CORE Anti-HIV-1/HIV-2 EIA DAGS. CONCLUSION: Sensitivity and specificity of Vironostika HIV kit were as good as those of COBAS CORE kit. Vironostika HIV kit, however, could get more safety of donated bloods than the 3rd generation EIA such as COBAS CORE Anti-HIV-1/HIV-2 EIA DAGS, in that it can reduce seroconversion window of HIV infection.
Americas ; Blood Donors ; Blotting, Western ; HIV Infections ; HIV* ; HIV-1 ; Humans ; Immunoenzyme Techniques* ; Sensitivity and Specificity ; Tissue Donors

Infection status of intestinal flukes was investigated in residents of Muan-gun, Jeollanam-do, the Republic of Korea. Total 1,257 fecal samples of residents were examined by formalin-ether sedimentation technique and Kato-Katz thick smear method. Helminth eggs were detected from 95 (7.6%) residents, and eggs of heterophyid flukes and Clonorchis sinensis were found from 62 (4.9%) and 40 (3.2%) cases, respectively. The larger heterophyid eggs, somewhat dark-brown in color and 37.7 x 21.5 micrometer in average size, and found in 32 (2.6%) out of 62 egg positive cases of heterophyid flukes. To confirm the adult flukes, we performed worm recovery from 12 cases after praziquantel treatment and purgation with MgSO4. A total of 1,281 adult flukes, assigned to 7 species, were recovered from 9 cooperative cases. Heterophyes nocens (total 981 specimens) was collected from 9 cases, Stictodora fuscata (80) from 7, Gymnophalloides seoi (75) from 5, Pygidiopsis summa (140) from 3, Stellantchasmus falcatus (3) from 2, and Stictodora lari and Acanthotrema felis (each 1 worm) from 1 case each. The intrauterine eggs of S. fuscata collected from the recovered worm were identical with the larger heterophyid eggs detected in the stool examination. By the present study, it was confirmed that A. felis is a new intestinal fluke infecting humans, and residents in Muan-gun, Jeollanam-do are infected with variable species of intestinal trematodes.

The prevalence of hepatocellular carcinoma (HCC) has increased in recent years. However, HCC remains poorly characterized in elderly patients, and comprehensive data are limited. This study aimed to investigate the clinical characteristics, prognostic features and survival outcome of elderly HCC patients. We retrospectively analyzed 992 HCC patients treated at Dongsan Hospital from January 2003 to December 2007. The patients were divided into two age groups: < 70 yr (n = 813) and > or = 70 yr (n = 179). Elderly HCC patients, compared to younger patients, had significantly higher incidence of females (31.3% vs 18.9%, P = 0.001), hepatitis C-related disease (HCV antibody positivity 26.3% vs 9.2%, P = 0.001) and comorbid condition (53.6% vs 32.1%), but lower rates of hepatitis B-related disease (HBs antigen positivity 31.3% vs 69.4%, P = 0.001). There were no significant differences in underlying liver function, stage and survival outcomes. Factors significantly influencing the prognosis of HCC were Child-Pugh grade, number of HCC, level of alpha-fetoprotein, presence of metastasis. The survival outcome of older patients with HCC was not different from that of younger patients. There were no differences between groups in independent factors influencing the prognosis of HCC. Therefore, determining the optimal management strategy for elderly HCC patients is important to improve survival and long-term outcomes.
Adult ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; Carcinoma, Hepatocellular/etiology/*mortality/*therapy ; Chemoembolization, Therapeutic ; Female ; Hepatitis B/complications/diagnosis ; Hepatitis B Surface Antigens/blood ; Hepatitis C/complications/diagnosis ; Hepatitis C Antibodies/blood ; Humans ; Liver Neoplasms/etiology/*mortality/*therapy ; Male ; Middle Aged ; Palliative Care ; Regression Analysis ; Republic of Korea ; Retrospective Studies ; Survival Analysis ; alpha-Fetoproteins/analysis

OBJECTIVES: To assess the ability of risk of malignancy index (RMI) 1 to discriminate between benign and malignant pelvic masses. METHODS: Between January 2007 and December 2010, 547 women with pelvic masses were evaluated. Their medical records are reviewed here retrospectively. The sensitivity, specificity and positive and negative predictive values of the cancer antigen (CA) 125 level, ultrasound findings and menopausal status in the prediction of malignant pelvic masses were calculated and compared individually or combined using the RMI 1. RESULTS: The receiver operating characteristic (ROC) curves of CA 125, the ultrasound score and the RMI 1 were all found to be relevant predictors of malignancy. ROC analysis of the RMI 1, CA 125 serum levels, ultrasound score and menopausal status showed areas under the curves of 0.795, 0.782, 0.784 and 0.594, respectively. The RMI 1 was found to be statistically significantly correlated with menopausal status (P = 0.001), while not statistically significantly correlated with CA 125 (P = 0.628) or the ultrasound score (P = 0.541). The RMI 1 at a cut-off of 150 - with a sensitivity of 77.9%, specificity of 81.1%, positive predictive value of 51.7% and negative predictive value of 93.4% - showed the highest performance in determining the malignant tendency of pelvic masses. CONCLUSION: Accepting a RMI 1 cut-off value of 150 results in statistically more significant diagnostic criteria than menopausal status for the discrimination of benign and malignant pelvic masses.
Discrimination (Psychology) ; Female ; Humans ; Medical Records ; Retrospective Studies ; ROC Curve ; Sensitivity and Specificity

PURPOSE: Hepatocyte growth factor (HGF) stimulates proliferation, migration, and morphogenesis of epithelial cells by specifically binding to its receptor c-met. Abnomalities of the c-met oncogene have been studied in cancers of many organs including thyroid, lung, pancreas, and stomach. However, little is known about the clinical significance of c-met oncogene abnormalities in colorectal carcinomas. In this study, we investigated over- expression of the c-met protein in colorectal adenomas and adenocarcinomas, and analyzed the clinicopathologic significance of this over-expression. METHODS: Expression of the c-met protein localized in colorectal adenoma and adenocarcinoma tissues was analyzed by using immunohistochemistry. The results were compared with clinicopathologic parameters to find clinical correlation. RESULTS: c-met protein was detected in 42.5% (17/40) of colorectal cancers and in 10.0% (4/40) of colorectal adenomas (P= 0.001). In colorectal cancer, the proportion of expression of c-met protein was 0% (0/40) in stage I, 47.6% (10/40) in stage II, 53.8% (7/40) in stage III and, 0% (0/40) in stage IV. c-met protein expression was 18.8% (3/40) in tumors with invasion into the muscularis propria (MP), and 58.3% (14/40) in tumors with invasion beyond the MP. The depth of tumor invasion was a statistically significant factor (P=0.022) for c-met expression. CONCLUSIONS: The c-met protein expression was related to the depth of invasion of colorectal cancer and showed a significant difference in its rate of expression between adenoma and adenocarcinomas.
Adenocarcinoma ; Adenoma* ; Colorectal Neoplasms* ; Epithelial Cells ; Hepatocyte Growth Factor ; Immunohistochemistry ; Lung ; Morphogenesis ; Oncogenes ; Pancreas ; Stomach ; Thyroid Gland

Tuberculous peritonitis in pregnancy is a rare form of extrapulmonary tuberculosis that is not easily diagnosed. The clinical presentations of tuberculous peritonitis are usually non-specific and mimic those of other diseases, such as ovarian malignancy or chronic liver disease, and this non-specificity can cause diagnostic delays and complications. The authors report the case of a 31-year-old primigravida woman who presented with uncontrolled fever, dyspnea, elevated liver enzymes, and mild abdominal distension at 13+2 weeks of gestation. At 14+2 weeks, a therapeutic abortion was conducted and tuberculous peritonitis was confirmed by laparoscopic excisional biopsy of peritoneal nodules and histopathologic examination. The patient recovered on antituberculosis therapy and abdomen and chest follow up radiographic findings have confirmed improvement.
Abdomen ; Abortion, Therapeutic ; Adult ; Biopsy ; Dyspnea ; Female ; Fever ; Follow-Up Studies ; Humans ; Liver ; Liver Diseases ; Peritonitis ; Peritonitis, Tuberculous* ; Pregnancy ; Pregnancy Trimester, First* ; Pregnancy* ; Thorax ; Tuberculosis

OBJECTIVE: To know whether HPV Oligonucleotide Microarray (HPVDNAChip) can detect the HPV DNA in the urine and, if it can, to compare the results with Pap smear, biopsy, and cervix HPVDNAChip. METHODS: The authors had done Pap smear, cervix HPVDNAChip and colposcopy-guided punch biopsy as well as detailed information to those who visited Dept. of Ob. And Gyn. during 1st of April to 31st of May in 2003 for their uterine cervical problems related to the neoplasia. When they were determined to admit for treatment, urine had been collected to be tested by HPVDNAChip. RESULTS: Among 25 patients enrolled in this study, there were 10 whose urine HPVDNAChip test turned out positive (40%). Among 10 positive results, 9 patients had HPV 16 subtypes. Among 10 urine HPVDNAChip positive patients, there were 5 HSIL, 4 squamous cell cancer (SCC), and 1 ASCUS cell types on the Pap smears. Among 15 urine HPVDNAChip negative patients, there were 7 HSIL, 5 SCC, 1 ASCUS, 1 LSIL, and 1 AGUS. Among 10 urine HPVDNAChip there are 5 CIN3, and 4 invasive SCC, and 1 adenocarcinoma at the biopsy. Among 15 urine HPVDNAChip negative patients, there are 7 CIN3, 6 invasive SCC, 1 adenocarcinoma in situ, and 1 CIN1 patient. Whenever there were a urine HPVDNAChip 16 subtype positive, there were always cervix HPVDNAChip 16 subtype positive, but among the 12 urine HPVDNAChip negative patients, 5 had HPV 16 subtype positive and 4 had another subtypes and 3 had negative on cervix HPVDNAChip tests. CONCLUSION: Using HPVDNAChip, we verified that 40% of patients had the HPV DNA in their urine who had admitted for the treatment of their cervical neoplasm. And HPV 16 subtype was the most common type in the urine. If we can extend this data more widely, we might use it as an auxiliary tool for cervical HPV infection.
Adenocarcinoma ; Biopsy ; Cervix Uteri* ; DNA ; Female ; Human papillomavirus 16 ; Humans ; Neoplasms, Squamous Cell ; Oligonucleotide Array Sequence Analysis* ; Uterine Cervical Neoplasms*

PURPOSE: To evaluate the effectiveness of emergent transcatheter arterial embolization(TAE) in the treatmentof bleeding from ruptured hepatocellular carcinoma(HCC) and long-term follow-up. MATERIALS AND METHODS: Twentypatients with ruptured HCC underwent emergent TAE; diagnosis was based on clinical and radiologic findings.Mesoportography was used to determine the presence of portal vein thrombosis, and celiac angiography to determinethe presence of hypervascular mass and extravasation of contrast material. All patients underwent TAE; a mixtureof adriamycin, mitomycin, lipiodol, and gelfoam particles was used. In four of the 20 patients, adjuvantembolization was performed, using stainless steel coils. After three week of follow-up CT, follow-up TAE wasperformed between two and ten times. RESULTS: Technical and clinical success was up to 100%. Mesoportographyshowed the presence of portal vein thrombosis in nine patients and its absence in 11. In 15 patients, three weeksof follow-up by CT showed lipiodol uptake by the mass and the disappearance of highly attenuated peritoneal fluid.Within one week of embolization, four of the 20 patients died of sepsis, shock, and hepatic failure, and withinone month of this procedure, one died of renal failure. Three-month, six-month, and one-year survival rates afterTAE were repectively 50%, 45%, and 30%; the mean duration of survival was 260 days. In nine patients with portalvein thrombosis, the one-year survival rate was 11%, while in 11 patients not suffering from this condition, therate was 70%; the difference between the two groups was statistically significant(p < 0.05). CONCLUSION: As thefirst choice of treatment for patients with hemoperitoneum from ruptured HCC, emergent TAE is an effective,life-saving therapeutic procedure; in these patients, portal vein thrombosis may be a factor influencing risk andprognosis.
Angiography ; Carcinoma, Hepatocellular* ; Diagnosis ; Doxorubicin ; Ethiodized Oil ; Follow-Up Studies* ; Gelatin Sponge, Absorbable ; Hemoperitoneum ; Hemorrhage ; Humans ; Liver Failure ; Mitomycin ; Renal Insufficiency ; Sepsis ; Shock ; Stainless Steel ; Survival Rate ; Thrombosis ; Venous Thrombosis

BACKGROUND/AIMS: The treatment for chronic hepatitis C (CHC) is removal of the virus in order to prevent progression to liver cirrhosis and hepatocellular carcinoma (HCC). Few data have been presented regarding the clinical significance of changes in the alanine aminotransferase (ALT) level in this context. We analyzed the patterns of changes in ALT level and investigated the relationship between the rapid normalization of ALT and sustained virologic response (SVR) after combined treatment with peginterferon and ribavirin. METHODS: CHC patients (n=370) were classified into four groups according to the initial ALT level and subsequent changes: (1) initially abnormal ALT level and sustained abnormal ALT level during treatment, (2) initially abnormal ALT level but achievement of ALT normalization, (3) initially normal ALT level and variable ALT abnormality during treatment, and (4) initially normal ALT level and sustained normalization of ALT level during treatment. We subdivided groups 1 and 2 into those with patterns of decreased and normalization of ALT, with or without rapid normalization. We checked the end-treatment response (ETR) and SVR rates in each group and the factors associated with SVR, including patterns of changes in ALT level. RESULTS: A total of 168 patients completed the therapy (age=54.34+/-10.64 years [mean+/-SD], 95 males [56.5%], genotype 1:82 [48.8%]). SVR was achieved in 115 (68.45%) of the completely treated patients. The SVR rate was significantly lower in group 1 than in group 2 (37.8 vs. 81.6%, P<0.001), and significantly higher in the rapid normalization group than in the group without rapid normalization (78.5% vs. 41.2%, P<0.001). Multiple logistic regression analysis revealed that age (odds ratio [OR]=0.94, 95% confidence interval [CI]=0.91-0.98, P=0.005), viral genotype (OR=2.76, 95% CI=1.20-6.38, P=0.017), and initial hepatitis C virus RNA titer (OR=0.28, 95% CI=0.10-0.75, P=0.012) were identified as independent significant predictive factors for SVR. CONCLUSIONS: The SVR rate is significantly associated with normalization, and especially rapid normalization of ALT. Rapid normalization of ALT by 4 weeks after treatment might be a useful response factor that is readily available in clinical practice, and especially for genotype 1 patients.
Adult ; Age Factors ; Aged ; Alanine Transaminase/*blood ; Antiviral Agents/*therapeutic use ; Drug Therapy, Combination ; Female ; Genotype ; Hepatitis C, Chronic/*drug therapy/genetics ; Humans ; Interferon-alpha/*therapeutic use ; Male ; Middle Aged ; Odds Ratio ; Polyethylene Glycols/*therapeutic use ; Predictive Value of Tests ; RNA, Viral/analysis ; Recombinant Proteins/therapeutic use ; Retrospective Studies ; Ribavirin/*therapeutic use

BACKGROUND/AIMS: The increasing use of diagnostic and therapeutic endoscopic retrograde cholangiopancreatography (ERCP) calls for greater consideration of radiation exposure risk to endoscopists and assistants, and emphasizes the proper system of radiation protection. This study was designed to assess the effect of a newly developed, self-designed, protective lead shield. METHODS: A curtain-shaped protective shield composed of seven movable lead plates was developed, each with the following dimensions: depth, 0.1 cm; width, 15 cm; length, 70 cm. The curtain-shaped protective shield was designed to be located between the patient and the endoscopist. Twenty-nine patients (11 men and 18 women) undergoing ERCP between January 2010 and March 2010 were selected for this study. The dose of radiation exposure was recorded with or without the protective lead shield at the level of the head, chest, and pelvis. The measurement was made at 50 cm and 150 cm from the radiation source. RESULTS: The mean patient age was 64 years. The mean patient height and weight was 161.7+/-6.9 cm and 58.9+/-9.9 kg, respectively. The mean body mass index (BMI) was 22.5+/-3.0 kg/m2. Endoscopists received 1522.2+/-537.0 mR/hr without the protective lead shield. At the same distance, radiation exposure was significantly reduced to 68.8+/-88.0 mR/hr with the protective lead shield (p-value<0.0001). The radiation exposure to endoscopists and assistants was significantly reduced by the use of a protective lead shield (p value<0.0001). The amount of radiation exposure during ERCP was related to the patient's BMI (r=0.749, p=0.001). CONCLUSIONS: This self-designed, protective lead shield is effective in protecting endoscopists and assistants from radiation exposure.
Adult ; Aged ; Body Mass Index ; Cholangiopancreatography, Endoscopic Retrograde/*adverse effects ; Common Bile Duct Diseases/diagnosis/therapy ; Female ; Humans ; Male ; Middle Aged ; Radiation Dosage ; Radiation Injuries/*prevention & control ; *Radiation Monitoring/methods ; Radiation Protection/*methods