BACKGROUND/AIMS: The purpose of this study was to evaluate the effectiveness of lamivudine treatment in patients with chronic liver disease caused by chronic infection of hepatitis B virus (HBV). METHODS: Thirty-ive patients with chronic infection of HBV were included in this study who were diagnosed at Hanyang University Hospital from January 1998 to January 1999. They received 150mg of lamivudine per oral once daily for 6 months with follow-p of liver function test, serum HBV DNA and serologic markers for hepatitis B virus every two months. Lamivudine was well tolerated. Eight patients underwent liver biopsies before entering the study and follow-p biopsies were done at 5 patients. RESULTS: Out of all 35 patients, chronic hepatitis patients histologically confirmed were 8, chronic hepatitis patients clinically diagnosed were 25 and liver cirrhosis patients clinically diagnosed were 2. The mean age was 35.7 years. Male-female ratio was 2.2:1. There was no hepatitis B surface antigen (HBsAg) negative seroconversion. The HBeAg loss rate was 26.9%(7/26) and HBeAg seroconversion rate was 10.7%(3/28) at the end of follow-p. Ten patients were anti-Be positive prior to treatment, 3 of them became anti-Be negative at the end of follow-p. Five patients underwent follow-p liver biopsies, in which histologic improvements were shown in 4 cases. Serum replicative HBV DNA by bDNA assay was decreased in all patients and HBV DNA was undetectable in 52.9%(9/17) at the end of treatment. Out of the 15 patients with abnormal alanine aminotransferase (ALT) levels at baseline, ALT level in 7 patients(46.7%) was normalized at treatment completion. Pretherapy ALT level was the only predictive factor for loss of HBeAg by stepwise logistic regression analysis(odds ratio : 1.0208) (95% Confidence Interval : 1.0023 ~ 1.0396) (p value=0.0271). CONCLUSIONS: Lamivudine induced sustained suppression of HBV replication during treatment in all patients. In treating patients with lamivudine, who had chronic liver disease due to chronic infection of HBV, the improvement of liver function test and suppression of viral replication appeared early and was sustained during the 6months treatment. This, in turn, may induce histological improvement as well. Pretherapy ALT level was the only predictive determinant for HBeAg loss during lamivudine therapy, and that should be kept in mind in selecting patients for treatment.
Alanine Transaminase ; Biopsy ; Branched DNA Signal Amplification Assay ; DNA ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Hepatitis B* ; Hepatitis* ; Hepatitis, Chronic ; Humans ; Lamivudine* ; Liver ; Liver Cirrhosis ; Liver Diseases ; Liver Function Tests ; Logistic Models ; Prospective Studies*

No abstract available.
Lichen Planus ; Lichens

BACKGROUND/AIMS: As a tumor marker, alpha-etoprotein is widely used. Diagnositic cut-ff value is known as 400 ng/mL in sera. This study is aimed to determine the clinical features of hepatocellular carcinoma (HCC) with reference to serum AFP levels in Korean patients. METHODS: From May 1990 to March 1998, 367 patients diagnosed as HCC, hospitalized and followed-p at Hanyang University Hospital, have been retrospectively analyzed with special reference on serum AFP level at time of diagnosis. The differences in clinical, hematological, and radiological features of HCC, as well as the survival rate in the two groups have been compared. Group 1 (N=182) was defined as an AFP level lower than 400 ng/mL, group 2 (N=185) was defined as an AFP level greater than 400 ng/mL. Comparisons were made by student's t test or chi-quare test. Survival rate was calculated from the time of diagnosis by Kaplan-eier method. Survival curves were also compared using log-ank test. P values less than 0.05 were considered significant. RESULTS: The patients with serum AFP levels above 400 ng/mL showed (1) a lower mean age; (2) a higher level of AST; (3) a higher level of AST/ALT ratio; (4) a high incidence of liver cirrhosis; (5) a high incidence of portal vein thrombosis; (6) a high incidence of positive HBsAg; (7) a low incidence of anti-CV; (8) a low incidence of small HCC but high incidence of large HCC; (9) a high incidence of more advanced TNM stage; (10) a low incidence of single nodular type and high incidence of diffuse type. CONCLUSIONS: Depending on the value of AFP, HCC has some clinical features. In hepatocellular carcinoma, high levels of AFP represent young age, HBV infection more than HCV infection and advanced disease state.
Carcinoma, Hepatocellular* ; Diagnosis ; Hepatitis B Surface Antigens ; Humans ; Incidence ; Liver Cirrhosis ; Retrospective Studies ; Survival Rate ; Venous Thrombosis

Intestinal obstruction was diagnosed in two fetuses at maternal antenatal care. Both received emergency surgery on the day of their birth, at about 35 weeks gestational age. The disease progressed for a long time in both cases because prompt diagnosis and surgery are difficult to perform in utero. As a result, severe adhesion and distorted anatomy were observed in both cases. Massive third space losses and bleeding were predicted during the surgery. However, the accurate ongoing losses were difficult to anticipate. The assessment of fluid deficits cannot be based on measured losses alone, but hemodynamic status including blood pressure, heart rate, urine output, capillary refill, and/or central venous pressure should be evaluated additionally.
Blood Pressure ; Capillaries ; Central Venous Pressure ; Diagnosis ; Emergencies ; Fetus ; Fluid Therapy ; Gestational Age ; Heart Rate ; Hemodynamics ; Hemorrhage ; Humans ; Infant, Newborn ; Infant, Premature* ; Intestinal Obstruction ; Parturition ; Pathology* ; Prenatal Diagnosis ; Water-Electrolyte Balance*

No abstract available.
Capillaries* ; Hemangioma, Capillary*

No abstract available.
Animals ; Horns* ; Keratoderma, Palmoplantar*

Traumatic brain injury (TBI) is a major cause of long-term physical and psychological disability and death. In patients with TBI, undernutrition is associated with an increased mortality rate, more infectious complications, and worse neurologic outcomes. Therefore, timely and effective nutritional therapy is particularly crucial in the management of TBI to improve patients’ prognoses. This narrative review summarizes the issues encountered in clinical practice for patients with neurotrauma who receive acute and post-acute inpatient rehabilitation services, and it comprehensively incorporates a wide range of studies, including recent clinical practice guidelines (CPGs), with the aim of better understanding the current evidence for optimal nutritional therapy focused on TBI patients. Recent CPGs were reviewed for 6 topics: 1) hypermetabolism and variation in energy expenditure in patients with TBI, 2) delayed gastric emptying and intolerance to enteral nutrition, 3) decisionmaking on the route and timing of access in patients with TBI who are unable to maintain volitional intake (enteral nutrition versus parenteral nutrition), 4) decision-making on the enteral formula (standard or immune-modulating formulas), 5) glycemic control, and 6) protein support. We also identified areas that need further research in the future.

BACKGROUND: The purpose of this study was to identify health practices that would be helpful in order to reduce the prevalence of correctable cardiovascular risk factors (CVR), i.e. hypertension, hypercholesterolemia, and hyperglycemia in male workers by examining the association between health practices and the prevalence of the three risk factors. METHODS: For 1,815 male workers at a car manufacturer who participated in the basic health examination, survey on socioeconomic status and seven healthy practices suchas not currenly smoking, moderate alcohol drinking, proper weight control, regular exercise, 7-8 hour sleep, eating breakfast regularly, and not eating between meals was done and the prevalence of hypertension, hypercholesterolemia, and hyperglycemia as obtained. x2 test, Fisher's exact test, and multiple logistic regression analyses were done for workers under 40 years old and workers 40 and over in two, separate groups by adjusting socioeconomic variables. RESULTS: The prevalence of hypertension and hypercholesterolemia was 1.84 times and 5.22 times, respectively, showing, higher in overweight younger workers than in those of normal weight. The prevalence of hypercholesterolemia was 2.02 times higher in younger smokers than in younger non-smokers. In contrast, the prevalence of hyperglycemia was 4.99 times higher in older smokers than in older non-smokers. The prevalence of hyperglycemia was 16.5 times higher in older workers with regular snacking habit than in those without such a habit. The prevalence of hypercholesterolemia was 7.47 times higher only in younger workers practicing healthy behaviors below 3 than in those practicing at least 6 healthy behaviors. CONCLUSION: Our study suggests that overweight and smoking habit among younger workers, and smoking habit among older workers sould be controlled in order to decrease the prevalence of hypertension, hypercholesterolemia, and hyperglycemia.
Adult ; Alcohol Drinking ; Breakfast ; Eating ; Humans ; Hypercholesterolemia* ; Hyperglycemia* ; Hypertension* ; Logistic Models ; Male* ; Meals ; Overweight ; Prevalence ; Risk Factors ; Smoke ; Smoking ; Snacks ; Social Class

This research is focused on the attitudes toward dying and hospice. 4subjects groups are Ca. patient, Ca. patient's family, elderly, medical personnel. A 40 questionnaire was filled out by each participant. For this study chi-square and T-test was done. The results were as follows: 1. Telling the truth 61.2% of all subject groups agreed upon telling the impending death. About 40% of elderly group and cancer patient group were disagreed which is the highest percentage in all groups. Particularly medical personnel group were remarkably high in telling the truth. 2. Attitudes of medical personnels 43.3% of all groups agreed upon medical personnels prefer to avoid dying patient. In medical personnel group. 44% of respondents disagreed comparably higher than other group, But 37.3% of medical personnel agreed. It showed that medical personnels admitted their negative feelings toward dying patient in considerable degree. 3. Attitudes toward mechanical assistance for life-expanding or hopeless patient. 44.8% of all groups disagreed upon mechanical assistance for hopeless case. Elderly (54.9%) and medical personnels (50%) disagreed, which is higher than cancer patient (33.3%) and (22.8%) of cancer patient's family. 4. Special facility and educational preparation for dying patient. 67.4% of all groups agreed upon the needs of special facility for dying, 81.3% of medical personnels agreed which is highest percentage in all group. 5. Attitudes of family members of dying patient. 82.3% of all groups agreed upon the family members feel annoyed at dying patient. 34% of cancer patient's family member and 48% of cancer patients group agreed, but elderly group showed highest percentage (84%). 6. Perception of dying patient about imminent death. 58.3% of all group thought dying patients are aware of their impending death even though they had not been told. 77.3% of medical personnel agreed which is highest percentage in all group.
Aged ; Hospices* ; Humans ; Surveys and Questionnaires

PURPOSE: There have been studies concerning prognostic factors in patients with hepatocellular carcinoma (HCC) undergoing transcatheter arterial chemoembolization (TACE) but they reported different prognostic factors from each other. The aim of this study is to determine which prognostic factors contribute to long-term survival after TACE of hepatocellular carcinoma. MATERIAL AND METHOD: Two hundred and forty-one patients with HCC who had been treated by TACE were analyzed retrospectively. TACE was accomplished by hepatic arterial infusion of a suspension of lipodol and anticancer drugs (Mitomycin-C and Adriamycin), either alone or followed by gelfoam embolization. RESULTS: Male to female ratio was 4.7:1. Mean survival was 13.98 months. Maximum survival was 101 months. The overall cumulative survival rates at the end of the first and second years were, respectively, 41.54% and 20.06%. According to univariate analysis (log-rank scale test), variables significantly associated with survival were: sex, liver cirrhosis, Child-Pugh classification, gross type of the tumor, location of the tumor, size of the tumor, TNM stage, metastasis, portal vein thrombosis, arterioportal shunt, ascites, AFP, protein, albumin, alkaline phosphatase, AST, AST/ALT ratio, total bilirubin, and sodium. Multivariate analysis (Cox proportional hazard model) for the significant variables in a univarariate analysis revealed that the gross type of the tumor, portal vein thrombosis, and Child-Pugh classification were statistically significant independent prognostic factors. CONCLUSION: The prognosis of patients with HCC treated with TACE was affected favorably by the nodular type tumor, the patent main and the first-order portal vein, and the good liver function (Child-Pugh class A).
Alkaline Phosphatase ; Ascites ; Bilirubin ; Carcinoma, Hepatocellular* ; Classification ; Epidemiology ; Female ; Gelatin Sponge, Absorbable ; Humans ; Liver ; Liver Cirrhosis ; Male ; Multivariate Analysis ; Neoplasm Metastasis ; Portal Vein ; Prognosis ; Retrospective Studies ; Sodium ; Survival Rate* ; Venous Thrombosis