No abstract available.
Hepatitis, Chronic*

BACKGROUND/AIMS: Hepatitis C virus(HCV) was known to most common etiologic agent of chronic liver disease in United states and Japan. Although hepatitis B virus(HBV) was well known to be a its major etiologic agent in Korea, it has been showed that HCV and HBV are associated with liver cirrhosis and hepatocellular carcinoma as major causative agent of chronic liver disease. Interferon alpha therapy is generally accepted as effective single agent for chronic hepatitis or to decrease the chronicity of acute hepatitis C. So, we evaluated the efficacy of interferon alpha in hepatitis C. METHODS: 46 patients who were positive for anti-HCV antibody and HCV RNA were included in this study. Liver biopsy was per formed on all patients and all of them were tested as negative for serum HBsAg, anti Hbe. Patients were divided into 2 groups . 30 patients received interferon therapy(treated group) and 16 patients received no therapy(untreated group). We compared the change of liver function test and HCV RNA before and after therapy between two groups. Treated group was subdivided into 5 groups according to response to interferon therapy '. Non-response, partial response, breakthrough, relapse and sustained response. RESULTS: 1) The mean age and sex distribution were 49.9 year old, male 19, female 11 in treated group and 48.7 years, male 12, female 4 in untreated group. 2) The number of patients with acute hepatitis, chronic persistent hepatitis, chronic active hepatitis and liver cirrhosis were 1, 2, 23, 4 in treated group and 0, 1, 12, 3 in untreated group, respectively. 3) The mean follow up period was 1.7 year and 2.3 years in treated and untreated group, respectively. 4) The activity of serum ALT before and after therapy were 195+ 134.6 IU/L, 87.4+ 40.5 IU/L and 186.7+ 106.4 IU/L, 157+ 87.1 IU/L in treated and untreated group, respectively. Serum ALT after therapy in treated group was significantly lower than untreated group(P<0.01). 5) The number of patients for patterns of reponse in treated group was non-response 5, partial response 8, breakthrough 1, relapse 4, sustained response 12 and there was no difference in age among them(P>0.05). 6) The case of negative conversion for HCV RNA in treated group was 12, but there was no case in untreated group. 7) Sex distribution of sustained response was 6(31% ) of 19 male, 6(54.5%) of 11 female and 12 patients(40.0%)(1 of 1 patients with acute hepatitis, 1 of 2 chronic persistent hepatitis, 10 of 23 chronic active heaptitis) included in sustained reponse, but any patients with liver cirrhosis had response. 8) Mean total dose and duration of interferon therapy was non-response 10353.6 million unit(MU)/5.8month(M), partial response 20025.06MU/6.4 M, breakthrough 36000.0MU/5.0M, relapse 11700.0MU/3.3M, sustained response 28100.0MU/6.6M, respectively. 9) 3 of 7 patients who were followed up over 1 year in sustained response and mean time to the relapse was 2.2 years. CONCLUSION: Our results showed that interferon alpha therapy is effective in patients with hepatitis C and further study and attempts should be performed to augument the efficacy of interferon alpha for the treatment of hepatitis C.
Biopsy ; Carcinoma, Hepatocellular ; Female ; Follow-Up Studies ; Hepatitis B ; Hepatitis B Surface Antigens ; Hepatitis C* ; Hepatitis* ; Hepatitis, Chronic ; Humans ; Interferon-alpha* ; Interferons* ; Japan ; Korea ; Liver ; Liver Cirrhosis ; Liver Diseases ; Liver Function Tests ; Male ; Recurrence ; RNA ; Sex Distribution ; United States

No abstract available.
Child* ; Edema* ; Humans

PURPOSE: Attempts have been made to insert a urethral Foley catheter as a primary urethral realignment immediately after a urethral injury. There has been much debate about the time and method of the realignment. The feasibility and complications of early primary endoscopic realignment in a urethral injury were evaluated. MATERIALS AND METHODS: From November 1990 to May 2003, 63 patients with urethral injuries received early endoscopic realignment within 72hrs. The diagnosis was made by retrograde urethrography. Primary realignment was successfully performed for 61 patients; 52 (85.2%) had an anterior urethral injury and 9 (14.8%) a posterior urethral injury. All operations were performed under spinal anesthesia. A cystoscope was inserted through the dilated suprapubic cystotomy and a guide wire passed through the cystoscope, and caught by transurethral foreign body forceps just distal to the injured site. The urethral catheter was removed after pericatheter urethrography, usually on the 14th postoperative day. Patients were retrospectively reviewed for complications, including urethral stricture, urinary incontinence and erectile dysfunction. RESULTS: Of the 63 patients, 61 (96.8%) were successfully treated. The mean operation and catheter indwelling times were 71.8 minute (5-109) and 17.4 days (6-32), respectively. The mean follow-up duration was 423.2 days (94-1432). Urethral strictures were detected in 14 patients (23.0%), who were treated with an internal urethrotomy. Urinary incontinence in 5 patients (8.2%) and erectile dysfunction in 14 patients (23.0%) were the observed complications. CONCLUSIONS: Our results show that immediate endoscopic realignment is a less invasive and more feasible therapy for patients with a urethral injury.
Anesthesia, Spinal ; Catheterization ; Catheters ; Cystoscopes ; Cystotomy ; Diagnosis ; Endoscopy ; Erectile Dysfunction ; Follow-Up Studies ; Foreign Bodies ; Humans ; Male* ; Retrospective Studies ; Surgical Instruments ; Urethra ; Urethral Stricture ; Urinary Catheters ; Urinary Incontinence

Holoprosencephaly is a rare malformation complex or development defect including different degrees of incomplete cleavages of the embryonic prosencephalon and varying degrees of the midface defects, resulting from the defect of prechordal mesoderm, migrating forward into the area anterior to the notochord during the third week of fetal development. Early antenatal diagnosis of holoprosencephaly is important to find out its severity, to predict its prognosis, and to determine proper management according to its prognosis and severity. The possibility of early antenatal diagnosis of holoprosencephaly by ultrasound has been suggested, but occasionally missed and rarely confirmed. We present one case of lobar holoprosencephaly, diagnosed postnatally and one case of alobar holoprosencephaly, diagnosed antenatally in our hospitals.
Fetal Development ; Holoprosencephaly* ; Mesoderm ; Notochord ; Prenatal Diagnosis ; Prognosis ; Prosencephalon ; Ultrasonography

Majority of .hepatocellular carcinoma is evolved from a well differentiated cancerous condition such as hypetptastic lesions eg; adenomatous hyperplasia in cirrhotic liver or de no vo carcinogenesis and prolifenation along with dedifferentiation. Adenomatous hyperplasia is may be seen in severe acute hepatic injury, like svhmassive hepatic necrosis, or in chronic liver diseases, particularly liver cirrhosis and it has recently attracted much interest from both clinicians and pathologists because it is regarded as a precursor lesion of hepatocObdar carcinoma. Hepatic. denomatous hyperplasia resembling focal nodular hyperplasia might have developed from localized vascular changes associated with chronic liver disease, pre-existing arterial malformation and early stage of angiogenesis in hepatocarcinogenesis. .fie present a patient who developed hepatocellular carcinoma after hepatic artery ligation.
Carcinogenesis ; Carcinoma, Hepatocellular* ; Focal Nodular Hyperplasia ; Hepatic Artery* ; Humans ; Hyperplasia ; Ligation* ; Liver ; Liver Cirrhosis ; Liver Diseases ; Necrosis

No abstract available.
Ceruloplasmin* ; Cholesterol, HDL* ; Copper* ; Humans ; Infant, Newborn* ; Iron* ; Zinc*

BACKGROUND/AIMS: Acute suppurative cholangitis is associated with significant mortality. It is best managed by drainage of biliary tree such as endoscopic, percutaneous or surgical, We evaluated the role of emergency endoscopic nasobiliary drainage(ENBD) in the acute suppurative cholangitis. METHODS: For 55 patients with acute calculous cholangitis, who did not respond to conservative management and the stone could not be removed from bile duct by endoscopic papillotomy due to poor condition or bleeding tendency, ENBD tube(7.5Fr) was inserted at proximal side of obstruction. ENBD was done at 39.4 hours (mean) after arrival to hospital. RESULTS: ENBD was successful in all patients (100%). All patients responded with striking improvement of the abdominal pain, fever and stabilized vital signs within 3 days. After patients conditions were stabilized clinically, common bile duct stones were removed successfully by endoscopic sphincterotomy or surgery. No patients died of acute suppurative cholangitis. CONCLUSION: These results show that ENBD is a simple, safe, and effective measure for the initial control of acute suppurative cholangitis due to cholelithiasis.
Abdominal Pain ; Bile Ducts ; Biliary Tract ; Cholangitis* ; Cholelithiasis ; Common Bile Duct ; Drainage* ; Emergencies* ; Fever ; Hemorrhage ; Humans ; Mortality ; Sphincterotomy, Endoscopic ; Strikes, Employee ; Vital Signs

A study carried out to evaluate the bleeding control and prophylactic effect of rebleeding using emergency endoseopic sclerotherapy in patients with hleeding gastric varices. 42 patients with gastric variceal bleeding were admitted to the Yeungnam University Hospital from May, 1983 to August, 1992. Patients were randomly classified into control group, 20 patients treated with conservative management, and sclerotherapy group, 22 patients treated with emergency endoscopic sclerotherapy. The two group were analysed with age, sex, etiology of liver cirrhosis, nature of bleeding episode, hematocrit on admitting day, amount of sclercsants used, rebleeding episodes, complications, and mortality. There were no significant differences in the severity of underlying liver disease and hematocrit on admission between two groups. Blood transfusion were performed in 19 cases of control group and 21 cases in sclerotherapy group(p>0.05). The amounts of transfusion were 7. 7units in control group and 6.1 units in sclerotherapy group(p<0,05). Rebleeding were developed in 65% and 18% of the patiehts with control and sclerotherapy group, respectively(p<0.05). Chest pain and mild fever were observed after endoscopic sclerotherapy. These results suggest that the endoscopic sclerotherapy is effective method in hemostasis of bleeding gastric varices and short-term prevention of rebleeding, but mortality rate was not decreased compared to control group. Development of more effective methods to treat gastric variceal bleeding is required.
Blood Transfusion ; Chest Pain ; Emergencies ; Esophageal and Gastric Varices* ; Fever ; Hematocrit ; Hemorrhage* ; Hemostasis ; Humans ; Liver Cirrhosis ; Liver Diseases ; Mortality ; Sclerotherapy*

Pure primary hepatic rhabdomyosarcoma in adult is very uncommon. There have been only five previous case of primary rhabdomyosarcoma of the adult liver. A case of hepatic ihabdomyosarcoma was diagnosed in a 52 year-old female. She was admitted to the hospital due to the epigastric pain and weight loss. A CT scan of the abdomen showed a large hypodense mass with focal calcification occupies most of the both lobes of the liver. The liver biopsy showed massive liver tumor composed entirely of oval shaped cells showing light microscopic and immunohistochemical evidence of rhabdomyoblastic differentiation. We report a case of hepatic rhabdomyosarcoma with review of literature.
Abdomen ; Adult ; Biopsy ; Female ; Humans ; Liver* ; Rhabdomyosarcoma* ; Tomography, X-Ray Computed ; Weight Loss