No abstract available.
Glycerol* ; Hearing*

BACKGROUND/AIMS: The most effective method of improving survival in patients with HCC is early diagnosis and curative hepatic resection. However, longterm survival after curative resection remains low because of high recurrence rate after resection. The purpose of the study is to assess the prognosis and the efficacy of the various treatment modalities on recurrent HCC after curative resection. METHODS: The clinical records of 50 patients with recurrent HCC were reviewed retrospectively who underwent curative surgery in Yonsei University, Severance Hospital from Jan. 1987 through Oct. 1994. The cummulative recurrent rate after resection, the response rate of treatment after resection, the median progression free survival and the survival after recurrence according to the treatment modalities were evaluated. RESULTS: The cummulative recurrent rate after resection was 3.9% at 3 month, 8.3% at 6 month, 14.1% at 12 month, 21.5% at 24 month, 23.4% at 36 month and 24.4% at 60 month. The response rate of treatment after recurrence was 23.7% (9 patients). The median progression free survival of the patient with reoperation and hepatic embolization was 13.9 months, that of conservative treatment group was 6.8 months and that of no treatment group was 4 months(p = 0.004). The survival after recurrence of HCC was 19.7 months in reoperation and hepatic embolization group, 11.4 months in multimodality group, 16.9 months in conservative treatment group and 8.4 months in no treatment group(p=0.0998). CONCLUSION: Reoperation and hepatic embolization for HCC after curative resection was effective in improving progression free survival, but overall survival were not significantly different according to the treatment modalities. This results proposed that reoperation and hepatic embolization for recurrent HCC after curative resection improve progression free survival.
Carcinoma, Hepatocellular* ; Disease-Free Survival ; Early Diagnosis ; Humans ; Prognosis* ; Recurrence ; Reoperation ; Retrospective Studies

The objective of this study was to evaluate the relationship between beta-galactosidase activity in urine, in serum and urinary N-acetyl-beta-glucosarminidase activity as an early indicator of renal effect and mercurT concentration in urine and blood, reflecting the intensity of exposure to or the amount of body burden of mercury. This study was carried out among 70 workers exposed to mercury vapor and 63 non-exposed workers as a reference. The results were as follows ; 1. The mean concentration of urinary mercury (43.5 microgram/1) in exposed subjects was about nine times higher than that of non-exposed subjects, but the mean values of blood mercury were not different from each other 2. The mean values of beta-galactosidase activity in urine (119.7micromoleMU/h/g creatinine) and in blood (73.7 moIMU/H/l) of mercury-exposed subjects were significantly higher than those of non-exposed subjects. 3. In mercury-exposed subjects, beta-galactosidase activities in urine (r=0.38, p<0.01) and in serum (r=0.26, p<0.05) were correlated to urinary mercury concentration, but not to blood mercury concentration. The urinary excretion of beta-galactosidase activity was closely associated with urinary mercury concentration in the result of the multiple regression analysis. 4. The urinary beta-galactosidase activity in exposed subjects increased as the urinary mercury increased, and in the exposed subjects with more than 50microgram/1 of urinary mercury was highly related to urinary beta-galactosidase activity(r=0.47, p<0.05). 5. Among exposed subjects with more than 50microgram/l of urinary mercury, 20.0% of them showed abnormal value of urinary beta-galactosidase activity.
beta-Galactosidase* ; Body Burden

PURPOSE: We evaluated the prognostic significance of p53 and proliferating cell nuclear antigen(PCNA) in stage III gastric carcinoma to determine the correlation between the p53 and PCNA expression and various clinicopathological parameters. MATERIALS AND METHODS: The expression of p53 and PCNA were studied immunohistochemically in 64 cases of stage III gastric carcinomas with paraffin-embedded tissue specimens which were obtained surgically at the department of surgery, Presbyterian Medical Center from 1991 to 1992. Both expression were compared with known factors of prognosis. Survival rate and other clinicopathological parameters were analysed. RESULTS: Expression rates of p53 and high PCNA group were 40.6% and 26.6%, respectively. There was no significant correlation between the p53 and PCNA expression and various clinicopathological variables such as age, sex, stage, histology, tumor depth, number of metastatic node, tumor size, site and method of operation. To analyse survival, we evaluated overall survival according to the extent of p53 and PCNA expression. No significant correlations between the p53 and PCNA expression and overall survival were found. CONCLUSION: These results suggest that the p53 and PCNA expression seems to be hard to use as a prognostic indicator in stage III gastric carcinoma.
Prognosis ; Proliferating Cell Nuclear Antigen* ; Protestantism ; Survival Rate

PURPOSE: To evaluate the usefulness of fast magnetic resonance (MR) sequences combined with MR arterialportography in the preoperative assessment of hepatocellular carcinoma. MATERIALS AND METHODS: Twelve patients suffering from nodular hepatocellular carcinoma complicated by liver cirrhosis underwent T2-weighted turbo spinecho and T1-weighted multisection FLASH with and without fat-suppression MR imaging during single breath-holdsession in each sequence. MR arterial portography was performed with Gd-DTPA injected through a catheter into the superior mesenteric or splenic artery during the T1-weighted FLASH sequence. The pathologic findings of surgical specimen or follow-up lipiodol CT findings were compared with the MR imaging. RESULTS: MR arterial portography depicted 17 of the 19 masses (sensitivity, 89%) and the sensitivity of non-contrast fast MR sequences was 74%(14/19). The sensitivity for combined interpretation of all the above sequences was 89% (17/19). MR arterial portography showed perfusion defects from two cysts, one hemangioma, one inflammatory mass, and innumerable tiny regenerating nodules. Static T1-and T2-weighted imaging clearly differentiated, however, benign lesions and true hepatocellular carcinoma. CONCLUSION: MR arterial portography combined with other fast MR imaging allows tissue characterization as well as high detection rate in the evaluation of hepatocellular carcinoma complicated with cirrhosis.
Carcinoma, Hepatocellular ; Catheters ; Ethiodized Oil ; Follow-Up Studies ; Gadolinium DTPA ; Hemangioma ; Liver Cirrhosis ; Magnetic Resonance Imaging ; Perfusion ; Portography* ; Splenic Artery

BACKGROUND: Increasing incidences of epilepsy in the elderly are well-known. However, the causes of newly onset seizures in the elderly have rarely been described in Korea. METHODS: We selected 160 cases of individuals who had their first seizure at over the age of 60 (male : female = 1.5 : 1 ; mean age : 69.1 years), who were admitted to Hallym University Hospital from July 1, 1994 to June 31, 1998. We analyzed the etiology, type of seizures, EEG, neuro-imag-ing, morbidity and mortality of the patients. RESULTS: The etiologies of seizures were remote symptomatic in 87 (54.3%), acute symptomatic in 38 (23.8%), progressive encephalopathy in 21 (13.1%), and idiopathic in 14 (8.8%). Status epilepticus occurred in 34 cases, including 8 cases of multifocal myoclonic status after hypoxic brain damage. The most common single cause of seizure was old stroke (35%, infarction in 41 and hemorrhage in 15 cases). Partial seizure was more common in patients with remote symptomatic than with other causes. Newly developed neurological deficits were present in 30 of the 151 who survived, including 15 acute symptomatic, 9 remote symptomatic, and 6 pro-gressive encephalopathy cases. Morbidity and mortality were highest in the acute symptomatic group (P<0.05) and tend to be low in the idiopathic group. CONCLUSIONS: We conclude that newly onset seizures in the elderly requiring hospitalization occur mainly with acute and remote symptomatic neurological insults. Acute symptomatic neurological insults are associated with a significant morbidity and mortality, while the morbidity is low in the absence of any asso-ciated neurological insults.
Aged* ; Electroencephalography ; Epilepsy ; Female ; Hemorrhage ; Hospitalization ; Humans ; Hypoxia, Brain ; Incidence ; Infarction ; Korea ; Mortality ; Seizures* ; Status Epilepticus ; Stroke

OBJECTIVE: To predict the risk of falls, Fall Risk Assessment (FRA) system has been newly developed to measure multi-systemic balance control among community-dwelling older adults. The aim of this study was to examine the association between FRA and fall-related physical performance tests. METHODS: A total of 289 community-dwelling adults aged 65 years and older participated in this cross-sectional study. All participants underwent FRA test and physical performance tests such as Short Physical Performance Battery (SPPB), Berg Balance Scale (BBS), and Timed Up and Go Test (TUG). RESULTS: Participants who were younger, male, highly educated, living with family members, having high body mass index, having high appendicular lean mass index, and having no irritative lower urinary tract syndrome were more likely to have higher FRA scores. SPPB (β=1.012), BBS (β=0.481), and TUG (β=-0.831) were significantly associated with FRA score after adjusting for the variables (all p < 0.001). CONCLUSION: FRA composite score was closely correlated with SPPB, BBS, and TUG, suggesting that FRA is a promising candidate as a screening tool to predict falls among community-dwelling elderly people.
Accidental Falls ; Adult ; Aged ; Body Mass Index ; Cross-Sectional Studies ; Humans ; Male ; Mass Screening ; Risk Assessment ; Urinary Tract

BACKGROUND: Microalbuminuria (MA) is independent predictor of cardiovascular disease and it cause mortality regardless of the presence of diabetes (DM) and hypertension (HTN). However, few published studies on this topic have been reported in Korea. Therefore, we investigated the MA prevalence and relationship between MA, insulin resistance and cardiovascular risk factor. METHODS: A total of 5,915 (3,053 men and 2,852 women) health screen examinees were enrolled in this study. We measured the anthropometric and biochemical parameters of the atherogenic indexes. RESULTS: The MA prevalence was 7.7% in all participants. The prevalence of MA in the men and women was 9.5% and 5.7%, respectively. Elevated levels of serum fasting glucose, serum fasting insulin, HOMA index, total cholesterols, LDL cholesterol, TG, Body Mass Index (BMI) and the systolic and diastolic blood pressure were significantly associated with MA. The results of multiple logistic regression analysis about MA showed that frequent drinking, low BMI, newly diagnosed DM and elevated levels of HOMA index and blood pressure were significantly associated with MA prevalence. Also, excluding newly diagnosed diabetic and hypertensive subjects, the MA prevalence was 5.7% (6.9% in men, 4.7% in women) and in multiple logistic regression analysis, the MA prevalence significantly increased in the individuals with pre-HTN rather than in the normotensives. CONCLUSIONS: The MA prevalence was 7.7% in all subjects. Except the newly diagnosed diabetic and hypertensive subjects, it was 5.7%. The MA prevalence was significantly increased in the individuals with pre-HTN rather than in the normotensives and MA was related with insulin resistance.
Blood Pressure ; Body Mass Index ; Cardiovascular Diseases ; Cholesterol ; Cholesterol, LDL ; Cross-Sectional Studies* ; Drinking ; Fasting ; Female ; Glucose ; Humans ; Hypertension ; Insulin ; Insulin Resistance ; Korea ; Logistic Models ; Male ; Mortality ; Prehypertension ; Prevalence* ; Risk Factors

BACKGROUND AND OBJECTIVES: Recent studies have demonstrated that lipoprotein (a) [Lp(a)] plays an important role in atherothrombogenesis and to be associated with an increased risk for cardiovascular disease. SUBJECTS AND METHODS: We evaluated the distribution of Lp (a) and its association with cardiovascular risk factors, by conducting a cross sectional survey of 14,516 apparently healthy Koreans. The study group consisted of 8,007 men and 6,509 women, aged 20 years and over. RESULTS: The mean, medium and 75th percentile Lp (a) levels were 20.1, 13.2 and 23.8 mg/dL, respectively. The distribution of Lp (a) was highly skewed toward a lower level. The Lp (a) level was positively associated with age (p<0.001) and low density lipoprotein (LDL)(p<0.001). The body mass index (BMI)(p=0.006), log (triglyceride)(p<0.001) and alcohol consumption more than 3 times per week (p<0.047) were inversely related to the Lp (a) level. However, no relationship was seen with smoking, gender, exercise, homeostatic model assessment-insulin resistance (HOMA-IR) and high sensitivity C reactive protein (hsCRP). CONCLUSION: The Lp (a) level was positively associated with age and low density lipoprotein (LDL). The body mass index (BMI) and log (triglyceride) were inversely related to the Lp (a) level. However, the association between Lp (a) and cardiovascular disease in the general Korean population should be confirmed via large scale prospective cohort studies.
Alcohol Drinking ; Body Mass Index ; C-Reactive Protein ; Cardiovascular Diseases ; Cohort Studies ; Cross-Sectional Studies ; Female ; Humans ; Lipoprotein(a)* ; Lipoproteins ; Male ; Risk Factors* ; Smoke ; Smoking

BACKGROUND AND OBJECTIVES: Cancer invasion of the laryngeal cartilage is mainly found in the ossified portion of cartilage and contraindication for conservation surgery of laryngopharyngeal cancer. Thus, it is an important factor to consider in planning the management of laryngopharyngeal cancer. Computed tomographic (CT) scan is an useful tool for the evaluation of laryngopharyngeal cancer, but it is difficult to distinguish cancer invasion from non-ossified cartilage regions by the CT scan. Knowledge of the precise ossification pattern will be useful to determine the cancer invasion of laryngeal cartilage. The purposes of this study include ossi6cation pattern according to age, symmetry of ossification and incidence of bone marrow formation. MATERIALS AND METHODS: Fifty-three cases of normal laryngeal CT scans which were reviewed by two radiologists. They were all males, ranging in the ages from 40 to 69 (mean age 53). Ossification degree (%) was measured from the inferior cornu in the thyroid cartilage and the superior border of the posterior lamina in the cricoid cartilage. Age relation and symmetry of ossification and incidence of bone marrow formation were evaluated. RESULTS: There were no correlation between age and degree of laryngeal cartilage ossification (p> 0.05). But there was symmetry and definite pattern of ossification. Symmetry of ossification was 84.9% in the thyroid cartilage. Incidence of bone marrow formation was 60.6% in the thyroid cartilage and 82.8% in the cricoid cartilage. CONCLUSION: This study reveals that there is no ossification-age relationship, but the symmetry and the definite pattern of ossification in the laryngeal cartilage are useful clues in determining the cancer invasion on CT scan.
Bone Marrow ; Cartilage ; Cricoid Cartilage ; Humans ; Incidence ; Laryngeal Cartilages* ; Male ; Thyroid Cartilage ; Tomography, X-Ray Computed*