BACKGROUND: The multifactorial hypothesis is proposed as a working hypothesis which encompass both the genetic and environmental factors known to participate in the etiology of congenital heart anomalies. So, at the moment, it is believed that avoidance of suspected environmental factors in early pregenancy is most certain preventive measure of congenital heart anomalies. This study has been undertaken in order to find the possible environmental risk factors for congenital heart anomalies in Korea. METHOD: A total of 320 mothers of infants with congenital heart anomalies diagnosed at Seoul National University Hospital were included in this study as case group. And 413 mothers of healthy infants, who visited well baby clinic at the hospital during the same period of 2 years from 1987, comprised the control group. Data related to environmental risk factors including drug use during the first trimester of pregnancy, any other confounders were collected by direct interview using questionmaires. RESULT: There were positive associations for lower educational level of mother, indoor smoking habit of father, number of pregnancy, and of experience of previous abortion of mother, and multiple(or twin) birth. Relative risk estimates for the first trimester exposure to anti-emetics and herb medicine were 2.1(p<0.006) and 1.4(p<0.044), respectively. Data showed a positive association between anti-inflammatory drug exposure and congenital anomalies of pulmonary valve(OR=22.7, p<0.01), and between anti-histamine exposure and coarctation of aorata(OR=12.7, p<0.017). CONCLUSION: Environmental factors such as smoking habit of father, certain drugs used in early pregnancy, plays a role in the etiology of congenital heart anomlaies. Further studies, designed to focus on specific drug and to differentiate the effect of the suspected drug and to differentiate the effect of the suspected drug form that of the underlying conditions prompting its use, should be called upon.
Abortion, Induced ; Antiemetics ; Case-Control Studies* ; Fathers ; Female ; Heart* ; Humans ; Infant ; Korea* ; Mothers ; Parturition ; Pregnancy ; Pregnancy Trimester, First ; Risk Factors ; Seoul ; Smoke ; Smoking

Over the past decade, advances in the antiviral therapy in patients with chronic hepatitis B have enabled the sustained suppression of hepatitis B viral replication and the prevention of progressive liver disease. Hepatitis B surface antigen (HBsAg) has been used to diagnose patients with hepatitis B virus infection. Recently, test for quantitative HBsAg titers are available and on-treatment HBsAg quantitations are used to predict treatment outcome. Serum HBV DNA levels have been shown to predict natural course of chronic hepatitis B infection. The HBV DNA levels have been reported to be positively correlated with the development of cirrhosis, hepatocellular carcinoma and related death. The baseline and on-treatment levels of HBV DNA are important factors for predicting treatment outcomes. In this article, we will discuss the role of HBV DNA and HBsAg quantitation during antiviral therapy.
Antiviral Agents/*therapeutic use ; Carcinoma, Hepatocellular/etiology ; DNA, Viral/*blood ; Hepatitis B Surface Antigens/*blood ; Hepatitis B virus/*genetics ; Hepatitis B, Chronic/complications/*drug therapy ; Humans ; Lamivudine/therapeutic use ; Liver Cirrhosis/etiology ; Liver Neoplasms/etiology ; Nucleosides/therapeutic use ; Pyrimidinones/therapeutic use

No abstract available.
Hepatitis* ; Korea*

Hepatitis viruses are most important cause of acute and chronic hepatitis. In past, hepatitis B virus was one of the major causes of acute hepatitis. Recently, around 60-70% of acute hepatitis is attributed to hepatitis A virus infection. In this article, we will discuss the route of hepatitis virus infection, how to prevent transmission of viral hepatitis and who should be immunized to each hepatitis viruses.
Hepacivirus ; Hepatitis ; Hepatitis A virus ; Hepatitis B virus ; Hepatitis Delta Virus ; Hepatitis E virus ; Hepatitis Viruses ; Hepatitis, Chronic ; Vaccination

PURPOSE: In Korea, there was no specific guidelines for the management of benign prostatic hyperplasia (BPH). We reviewed the practice patterns of Korean urologists in the management of BPH and aimed to describe the need to develop specific guidelines. MATERIALS AND METHODS: A probability sample was taken from the Korean Urological Association Registry of Physicians, and a structured questionnaire, that explored practice patterns in the management of BPH, was mailed to a random sample of 251 Korean urologists. RESULTS: For the initial evaluation of BPH, most urologists routinely performed prostatic specific antigen (PSA) (96.4%), digital rectal exam (94.4%), international prostate symptom score (IPSS) (83.2%) and transrectal ultrasound (79.2%). Symptom assessment (36.4%) followed by transrectal ultrasound of prostate (TRUS) (20.0%) was considered as the most important diagnostic examination affecting the decision about individual treatment options. Almost all urologists (92.2%) chose medical treatment as the first-line treatment option for uncomplicated BPH with moderate symptoms. Of the respondents, 57.2% had prescribed alpha blocker and 41.6% alpha blocker plus 5-alpha reductase inhibitors as the medical treatment option for BPH. The prescription of 5-ARIs was dependent on the size of the prostate and the severity of symptoms. CONCLUSION: The results of our current survey provide useful insight into variations in the clinical practice of Korean urologists. They also indicate the need to develop further practical guidelines based on solid clinical data and to ensure that these guidelines are widely promoted and accepted by the urological community.
Adrenergic alpha-Antagonists/therapeutic use ; Cholestenone 5 alpha-Reductase/antagonists & inhibitors ; Data Collection ; Humans ; Korea ; Male ; Prostatic Hyperplasia/*diagnosis/*drug therapy ; Urology/statistics & numerical data

Sialadenosis, characterized by a uniform hypertrophy and hyperplasia of the acinar parenchyma of salivary glands, is associated with a variety of systemic diseases or functional disorders. The disease is associated with underlying systemic factors such as diabetes, malnutrition, alcohol abuse and drugs. So it is also referred to as nutritional mumps. Bulimia nervosa is a disorder that is defined as binge eating combined with inappropriate ways of stopping weight gain. It is significantly more common in females than in males. In the past few years, the number of reports concerning eating disorders have increased in developing countries including Korea, where economic development has also brought about rapid introduction of the Western culture. The authors have observed a rare case of sialadenosis of the submandibular gland in association with bulimia nervosa and report this with literature review.
Alcoholism ; Bulimia Nervosa* ; Bulimia* ; Developing Countries ; Feeding and Eating Disorders ; Economic Development ; Female ; Humans ; Hyperplasia ; Hypertrophy ; Korea ; Male ; Malnutrition ; Mumps ; Salivary Glands ; Sialadenitis ; Submandibular Gland ; Weight Gain

BACKGROUND/AIMS: p53 mutation is the most common genetic abnormality in human cancers. However, although it has been reported that p53 overexpression in hepatocellular carcinoma (HCC) is associated with the aggressive behavior of tumor, the prognostic significance of p53 overexpression in HCC remains controversial. The aims of the present study were to examine the correlations between p53 overexpression and the clinicopathologic parameters of HCCs, and to determine the prognostic significance of p53 overexpression in HCC. METHODS: Immunohistochemical analysis of p53 overexpression was performed in 105 consecutive cases of HCC who underwent curative hepatic resection. Survival curves were calculated using the Kaplan-Meier method and multivariate analysis of outcome predictors for HCCs was assessed by logistic regression analysis. RESULTS: p53 overexpression was observed in 20 of 105 HCCs (19.0%). Multivariate analysis identified significant correlations between p53 overexpression and microvascular invasion (p=0.027), liver cirrhosis (p=0.035), 1-year survival rate (p=0.016), multiple tumors (p=0.014), and the presence of tumor capsule (p=0.010). The 2-year survival rate was poorer in patients without tumor capsule (p=0.043). CONCLUSIONS: Our results show a positive association between p53 overexpression and microvascular invasion in HCC, and indicate that p53 overexpression is a poor prognostic factor of survival, especially within 1 year after liver resection in HCC patients.
Adult ; Aged ; Carcinoma, Hepatocellular/*metabolism/mortality/surgery ; Female ; *Hepatectomy ; Humans ; Liver Neoplasms/*metabolism/mortality/surgery ; Male ; Middle Aged ; Prognosis ; Survival Rate ; Tumor Suppressor Protein p53/*metabolism

Gastric stump cancer is defined as cancers that develop in the gastric remnant after the gastric resection of nonmalignant lesions or malignant lesions. The interval between gastrectomy and the detection of gastric stump cancer must be over 5 years in nonmaligant lesions and 10 years in malignant lesions. Symptoms of gastric stump cancer are not specific, so, diagnosis is often delayed. Early detection and curative operation is very important in gasric stump cancer and follow-up endoscopic examination is the most importaint diagnostic tool to detect gastric stump cancer. Recently we experienced a case of early gastric stump cancer. We report review of the literature to remind the important of gastric stump cancer and the important of follow-up endoscopic examination.
Diagnosis ; Esophagus* ; Follow-Up Studies ; Gastrectomy* ; Gastric Stump* ; Intestines* ; Stomach*

Flow cytometric DNA analysis was performed on 17 rhabdomyosarcomas in conjunction with a histopathological review to determine the usefulness of this technique to predict the biologic behavior of the tumor and to establish the characteristic ploidy pattern of rhabdomyosarcoma compared to other small round cell tumors occurring in childhood. Aneuploidy including near-tetraploidy is the most common ploidy pattern encountered, followed by multiploidy and diploidy, and the presence of multiploidy in this tumor is useful for differentiating rhabdomyosarcoma from other kinds of small round cell tumors in which there are rare previous reports on occurrence of multiploidy. Even though there is no significant correlation between ploidy pattern and histologic type of rhabdomyosarcoma, patients with multiploid tumors or aneuploid tumors with a DNA index of 1.10-1.80 tend to have a high risk of treatment failure. Therefore, the ploidy pattern seems to be useful for predicting the patient's survival in concert with other variables.
Adolescent ; Child ; Child, Preschool ; DNA, Neoplasm/*analysis ; Female ; Flow Cytometry ; Human ; Immunohistochemistry ; Male ; Ploidies ; Retrospective Studies ; Rhabdomyosarcoma/*genetics/mortality ; Soft Tissue Neoplasms/*genetics/mortality ; Support, Non-U.S. Gov't

We present the case of an adult flexible flatfoot that was managed with dynamic and multiplarnar approaches which consist of Young's tenosuspension, Evans osteotomy, posterior tibialis tendon advancement with flexor digitorum longus tendon transfer and Lapidus procedure.
Adult* ; Flatfoot* ; Humans ; Osteotomy ; Tendon Transfer ; Tendons