BACKGROUND/AIMS: The emergence of lamivudine-resistant mutant hepatitis B virus (HBV), with aminoacid substitution in the YMDD motif of DNA polymerase, has been reported in the long-term lamivudine use group. However there is no report about the emergence of mutant viruses during the short-term lamivudine therapy. The objective of this study was to investigate the emergence of YMDD mutant HBV during short-term lamivudine therapy. METHODS: We evaluated twenty-eight chronic hepatitis B patients who were HBeAg and HBV DNA positive and treated with lamivudine 100mg p.o. daily for 12 weeks. First, we investigated the emergence of YMDD mutants by nested polymerase chain reaction (PCR) method developed by Chayama et al in 19 patients who lost HBV DNA during lamivudine therapy but showed HBV DNA re-emergence 2 weeks after the end of therapy. Second, DNA subcloning and sequencing of HBV DNA polymerase including YMDD motif was undertaken in one patient's serial blood samples at 0, 8, 12 weeks to confirm the results of nested PCR. RESULTS: YMDD motif mutation was detected in 17(90%) out of 19 patients at the end of therapy and the type of mutations were YIDD only. At the end of therapy, mutant was predominant in 5 patients, both mutant and wild type were similar in proportion in 3 patients, and wild type was predominant in 9 patients. When we carried out nested PCR serially with samples of 0, 2, 4, 8, 12, 14 weeks after initiation of therapy in 5 patients who were mutant predominant at 12 weeks, YIDD mutant began to be detected from 2 weeks in 4 patients and from 4 weeks in one patient. However, rapid turnover from mutant to wild type happened after the end of therapy, so only wild type was detected in 3 patients and wild type became predominant in 2 patients at 2 weeks after the end of therapy. All the sequencing results of serial blood samples in one patient were consistent with nested PCR data. CONCLUSIONS: The presence of YMDD motif HBV polymerase mutant may be possible before administration of lamivudine in Korean chronic hepatitis B patients. Nested PCR assay would be an useful method to detect YMDD mutant.
DNA ; Hepatitis B e Antigens ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis B, Chronic ; Hepatitis* ; Humans ; Lamivudine* ; Polymerase Chain Reaction

A retrospective study was designed to determine the diagnostic contribution of oblique view in 740 consecutive lumbar spine examinations done in adults. In 12 cases (1.62%) there was a change in the radiographic interpretation when the oblique views were used for diagnosis. Considering the significant gonadal radiation, additional cost, and limited diagnostic value, the authors feel that the oblique view should not be a routine part of the initial lumbar spine examination in adults.
Adult ; Diagnosis ; Gonads ; Humans ; Retrospective Studies ; Spine

Although many invasive studies in the biliary tract disase are replaced by noninvasive techniques such asultrasonography and CT, PTC does still play an important role indiagnosis of obstructive jaundice. Authors hadperformed 42 patients of PTC with Chiba needle at the department of radiology, Han Gang Sacred Heart Hospital for4 years from Jan. 1978 to April 1982. And we reviewed literatures. The results were as follows; 1. Forty twopatients of PTC were 22 males and 20 females. The success rate was 90.5%(38/42). The failed 4 cases of PTC werenonobstructive hepatobiliary diseases. 2. The PTC diagnosis of 38 cases were biliary stone (21 cases),cholangiocarcinoma(7 cases), pancreatic carcinoma (2 cases), hepatoma (2 cases), ascariasis(2 cases), andclonorchiasis(1 case), and the remainders were normal. 3. We made 2 cases of misdiagnosis on the basis of PTCfindings. They were one case of distal CBD stone with severe cholangitis diagnosed as ampullary carcioma andanother case of proximal CBD stone with cholangitis diagnosed as pancreas carcinoma. 4. We experienced 2 cases ofcomplication such as sepsis and severe hypotension, but they were recovered.
Biliary Tract ; Carcinoma, Hepatocellular ; Cholangiography ; Cholangitis ; Diagnosis ; Diagnostic Errors ; Female ; Heart ; Humans ; Hypotension ; Jaundice, Obstructive ; Male ; Needles ; Pancreas ; Sepsis

PURPOSE: The purpose of this study was to investigate Seoul teacher's satisfaction with and needs for health examination and health promotion programs. METHODS: The participants were 3,186 teachers in Seoul. Data were collected through an on-line survey system from November 16 to December 7, 2008. Collected data were analyzed by descriptive statistics, t-test, ANOVA, and Scheffe's test using PASW 18.0 program. RESULTS: Teacher's satisfaction with teacher health examination was low and needs for detailed tests of cancer and vocal cord disorders were high. Teacher's satisfaction with teacher health promotion programs was low and needs for stress management, exercise and vocal cord protection program were high. CONCLUSION: Vocal cord disorders should be included in teacher health examination and vocal cord protection program should be provided for teacher's health promotion. Stress management and exercise program should also be provided for teacher's health promotion.
Health Promotion ; Physical Examination ; Vocal Cords

OBJECTIVE: Arrhythmogenic right ventricular cardiomyopathy(ARVC) is a progressive cardiac muscle disease characterized as progressive fibrofatty replacement of the right ventricle, severe ventricular arrhythmia, and sudden death. However, there is no report of ARVC as a cause of sudden death in Korea. METHODS and RESULTS: Postmortem studies were done to 115 cases of sudden unexplained death at department of legal medicine, school of medicine, Kyungpook national university in year 1999. We identified 7 cases(6%) of typical ARVC with no other identifiable cause of sudden death. The subjects included 5 males and 2 females, ranging in age from 19 to 41 years (mean 29.7 years). All were found dead at bed (5 cases) or workshop (2 cases). Five cases were fibrofatty types and two cases were fatty types. Right ventricular aneurysm, inflammatory infiltrates and left ventricular involvement were found in 4, 2 and 1 cases, repectively. Two cases had family history of sudden death before age 40. No one was suspected of having cardiovascular disease or ARVC before death. CONCLUSION: These findings indicate that ARVC in Taegu-Kyungpook area may be more frequent than previously thought. ARVC may be a major cause of sudden unexplained death.
Aneurysm ; Arrhythmias, Cardiac ; Arrhythmogenic Right Ventricular Dysplasia* ; Cardiovascular Diseases ; Death, Sudden ; Education ; Female ; Forensic Medicine ; Gyeongsangbuk-do ; Heart Ventricles ; Humans ; Korea ; Male ; Myocardium

PURPOSE: To investigate the effect of unilateral medial rectus muscle resection for recurrent exotropia after bilateral lateral rectus muscle recession for intermittent exotropia METHODS: A retrospective analysis was made of thirtypatients who underwent unilateral medial rectus resection for recurrent exotropia. All had prior bilateral lateral rectus recession for intermittent exotropia. Data were collected for age, the preoperative deviation, the postoperative deviation at 2 weeks, 3 months, 6 months and the last visit, and the amount of medial rectus resection performed. RESULTS: The average preoperative deviation was 27.0+/-3.6 PD. After unilateral medial rectus resection, average deviation at distance was 2.8 PD at postoperative 2 weeks, 4.5 PD at 3 months, 5.1 PD at 6 months and 5.8 PD at last visit. The average deviation corrected per millimeter of medial rectus resection was 3.53+/-0.17 PD/mm. CONCLUSIONS: Considering that deviation angles of recurrent exotropia is smaller than those of primary surgery and the possibility of saving the other medial rectus muscle, unilateral rectus muscle resection could be effective surgical method for recurrent exotropia.
Child ; Exotropia/*surgery ; Female ; Humans ; Male ; Oculomotor Muscles/*surgery ; *Ophthalmologic Surgical Procedures ; Recurrence ; Refraction, Ocular ; Retrospective Studies

OBJECTIVES: Health is closely related to an individual's assessment of their quality of life and their subjective level of happiness. The aim of this study was to investigate the association between happiness index and self-rated health by utilizing a community health survey in Korea. METHODS: The study participants were 17,937 people living in Gyeongsangnam-do, Korea, who completed a community health survey in 2014. The non-subjective variables included in the statistical analysis were sex, age, region, education, income, and economic activity. The subjective awareness variables included self-rated health, self-rated oral health, chewing difficulty, pronunciation difficulty, and happiness index. Statistical analysis of the data was done using the SPSS 21.0 program. RESULTS: Evaluation of the subjective awareness levels revealed that the respondents that were better educated, whose income levels were higher, and those who engaged in an economic activity found themselves to be in better physical health and oral health. In contrast, the respondents that were female, older, and with residence in the counties reported a higher incidence of chewing difficulty. There was a positive correlation between happiness index and subjective awareness level, and a negative correlation between chewing difficulty and pronunciation difficulty. Happiness index was influenced the most by subjective health levels, followed by income, age, pronunciation difficulty, subjective oral health, chewing difficulty, academic credential, region, and sex. CONCLUSIONS: Therefore, in order to improve the happiness index of community residents, regular health checkups and systematic oral health education should be prepared in order to improve awareness of subjective health and reduce discomfort in the oral cavity, and efforts should be made to reduce the gap between regions.
Diagnostic Self Evaluation* ; Education ; Female ; Gyeongsangnam-do ; Happiness* ; Health Surveys* ; Humans ; Incidence ; Korea ; Mastication ; Mouth ; Oral Health ; Quality of Life ; Surveys and Questionnaires

PURPOSE: To evaluate changes in ocular alignment in partially accommodative esotropic children age ranged from 3 to 8 years during occlusion therapy for amblyopia. METHODS: Angle measurements of twenty-two partially accommodative esotropic patients with moderate amblyopia were evaluated before and at 2 years after occlusion therapy. RESULTS: Mean deviation angle with glasses at the start of occlusion treatment was 19.45+/-5.97 PD and decreased to 12.14+/-12.96 PD at 2 years after occlusion therapy (p<0.01). After occlusion therapy, 9 (41%) cases were indications of surgery for residual deviation but if we had planned surgery before occlusion treatment, 18 (82%) of patients would have had surgery. There was a statistical relationship between increase of visual acuity ratio and decrease of deviation angle (r=-0.479, p=0.024). CONCLUSIONS: There was a significant reduction of deviation angle of partially accommodative esotropic patients at 2 years after occlusion therapy. Our results suggest that occlusion therapy has an influence on ocular alignment in partially accommodative esotropic patients with amblyopia.
*Accommodation, Ocular ; Adult ; Aged ; Amblyopia/*etiology/*physiopathology ; Esotropia/*physiopathology/*therapy ; Female ; Humans ; Male ; Middle Aged ; Occlusive Dressings/adverse effects ; Retrospective Studies ; *Sensory Deprivation ; Treatment Outcome

Isosulfan blue dye can be used to mark the sentinel lymph node during various surgeries. The dye was known to have minimal side effects, but recently a few cases of an anaphylactic reaction were reported in melanoma and breast surgery. We experienced an anaphylactic reaction during peritumoral injection of this dye in a patient with cervical cancer. Immediately after dye injection, the patient showed an anaphylactic reaction with cardiovascular collapse and oxygen desaturation. We resuscitated the patient and she recovered without complications.
Anaphylaxis* ; Breast ; Humans ; Lymph Nodes ; Melanoma ; Oxygen ; Uterine Cervical Neoplasms

PURPOSE: To establish new in vitro model systems that better reflect in vivo condition, multicellular tumor spheroids(MTS) and raft culture were developed using cell lines of squamous cell carcinoma(SCCHN) of the head and neck. In these 3-dimensional systems, the expression of cell surface molecules which are important for modulation of physiology of tumor cells were studied with or without the treatment of interferon(IFN)-gamma. MATERIALS AND METHODS: Four SCCHN cell lines were used for MTS and raft culture. The effects of interferon-gamma on SCCHN cells were examined by immunohistochemistry. RESULTS: All cell lines formed MTS, but only Tu-138 showed a good stratification at the air-liquid interface in the raft culture system. Immunohistochemical studies of MTS using monoclonal antibodies revealed a strong staining for MHC class I, no staining for MHC-DR, a weak patch expression of ICAM-1 and a central strong staining for integrin a 6. Staining patterns were similar for the raft cultures except integrin a 6(intense full-thickness positivity). In both systems, IFN-gamma enhanced the expression of MHC-DR and ICAM-1. No significant change was found in the expression of MHC class I and integrin a 6. CONCLUSIONS: MTS and raft culture system were established successfully from the SCCHN cell lines. IFN-gamma can modulate the surface molecules of tumor cells in the 3-dimensional culture systems.
Antibodies, Monoclonal ; Carcinoma, Squamous Cell* ; Cell Line ; Head* ; Immunohistochemistry ; Intercellular Adhesion Molecule-1 ; Interferon-gamma ; Neck* ; Physiology