BACKGROUND: Most mutations in the reverse transcriptase (RT) gene of the hepatitis B virus (HBV) are related to resistance to antiviral agents. Cross-sectional studies on the mutations of this gene are rare. Thus, we analyzed the mutation patterns of RT genes and their biochemical parameters. METHODS: From 2009 to 2012, 301 blood specimens from patients with chronic hepatitis B at Daegu Catholic University Medical Center were retrospectively analyzed for the RT gene sequence of HBV, ALT, hepatitis B e antigen (HBeAg), and HBV DNA. The mutation patterns of the RT gene were compared with the biochemical parameters. RESULTS: Of the 301 patients, 100 (33.2%) had no RT gene mutations. The remaining showed the following mutation patterns: rtM204I/V (50.2%), rtL180M (39.2%), and rtA181T/V (19.6%). Combined mutations were found in 146 cases (48.5%). Of these, the combination of amino acid changes at rt180+rt204 (49.3%) was most frequently detected, followed by rt181+rt236 (11.0%) and rt173+rt180+rt204 (9.6%). In the mutated group, HBV DNA and HBeAg positive rates were significantly higher (P<0.05 for both). Phenotypic analysis showed that lamivudine resistance was most frequently detected (34.6%), followed by adefovir resistance (15.6%). Multidrug resistance was detected in 48 cases (15.9%). The adefovir-resistant group had a higher proportion of cases with HBV loads greater than 2,000 IU/mL. CONCLUSIONS: We found correlations between the mutation status of the RT domain and biochemical parameters such as HBV DNA and HBeAg positive rate. The presence of RT gene mutations could therefore be utilized to predict clinical status.
Adenine/analogs & derivatives/therapeutic use ; Antiviral Agents/therapeutic use ; DNA, Viral/analysis ; Drug Resistance, Multiple, Viral ; Drug Resistance, Viral ; Hepatitis B e Antigens/blood ; Hepatitis B virus/*enzymology/isolation & purification ; Hepatitis B, Chronic/drug therapy ; Hospitals, University ; Humans ; Lamivudine/therapeutic use ; Mutation ; Organophosphonates/therapeutic use ; Phenotype ; RNA-Directed DNA Polymerase/*genetics ; Republic of Korea ; Retrospective Studies

PURPOSE: This study aimed to find out the difference in between the anatomic properties children with intermittent exotropia and children with orthophoria. METHODS: The intermittent exotropia group consisted of 35 patients who had an angle of deviation of more than 15 prisms. The control group consisted of 35 orthophoric children with comparable age and sex ratio. From the view of skull AP, we compared the diameter, interlateral wall distance, and intermedial wall distance of the orbital rim. Also we compared the intercanthal distance, interlateral canthal distance of eyelids, and interpupillary distance. RESULTS: The average values of interpupillary distance, intercanthal distance, and interlateral canthal distance of exotropic group were 54.23+/-1.85 mm, 34.75+/-1.66 mm, and 78.25+/-4.21 mm, respectively. Compared to those of control group, which were 53.59+/-1.21 mm, 33.56+/-1.54 mm, and 76.68+/-3.23 mm, respectively, there was no significant difference (P>0.05). The average values of the diameter, interlateral wall distance and the intermedial wall distance of the orbital rim were not significantly different between two groups (p>0.05). CONCLUSIONS: Our results showed that the anatomic properties including orbital rim size and orbital exodeviation did not seen to influence the development of intermittent exotropia.
Child ; Exotropia* ; Eyelids ; Humans ; Orbit ; Sex Ratio ; Skull

Esophageal varices(EV) are present in 40% and 60% of Child-Pugh A and C patients, respectively when cirrhosis is diagnosed. EV bleeding is a life-threatening complication of liver cirrhosis with a high probability of recurrence. Treatment to prevent first EV bleeding or rebleeding is mandatory. In small EV with high risk of bleeding, nonselective beta-blockers should be used for the prevention of first variceal bleeding. For medium to large EV, nonselective beta-blockers or endoscopic variceal ligation (EVL) may be recommended to high risk varices. But, nonselective beta-blockers are the first treatment option to non-high risk varices and EVL is an alternative when nonselective beta-blockers are contraindicated or not tolerated. For the prevention of rebleeding, a combination of nonselective beta-blockers and EVL may be the best option. A great improvement in the prevention of variceal bleeding has emerged over the last years. However, further therapeutic options that combine higher efficacy, better tolerance and fewer side effects are needed.
Adrenergic beta-Antagonists/therapeutic use ; Esophageal and Gastric Varices/drug therapy/*prevention & control ; Gastrointestinal Hemorrhage/*etiology ; Humans ; Ligation ; Portasystemic Shunt, Transjugular Intrahepatic ; Sclerotherapy

Superficial gastritis has been classified as a type of chronic gastritis, since a report of Schindler in GASTRLTIS, 1947. Howev~er, Benedict reported that superficial gastritis is only acute gastritis or shows normal mucosa histologically. The com mon endopical findings of chronic superficial gastritis were adherent mucus, edema, redness. The common redness which were encounterd are patchy redness and comb-like redness(Kammrotung). We studied the relationship between the redness of superficial gastritis and acute inflammatory changes histologically. Each case of superfieial gastritis was biopsied to redening and non-redening mucosa respectively. We collected 24 cases with 48 biopsy specimens. The results are as follows: Acute inflammatory changes were found only one case in redness and none in non-redness groups. There was no difference in acute inflammatory changes in two groups. The degree of mucosal atrophy were 62.5%, 66.7% in normal mucosa, 12.5%, 16.7~% in mild atrophy, 25%, 12.5% in moderate atrophy, 0%, 4.l% in severe atrophy with respect to redness and non-redness mucosa respectively. There was no difference in degree of mucosal atrophy in two groups. Mucosal atrophies were higher in older ages above 41 years old than below 40 and with increasing age, there was increasing tendency of mucosal atrophy. In conclusion, There was no relationships between mucosal redness and acute in flammatory changes histologically and also between mucosal redness and degree of atrophy.
Adult ; Atrophy ; Biopsy ; Edema ; Gastritis* ; Humans ; Mucous Membrane ; Mucus

Liver cirrhosis has distortion of the hepatic architecture and the formation of regenerative nodules due to progressive hepatic fibrosis. Treatment of underlying etiology can slow or reverse the progression of liver fibrosis. Early stage is characterized by asymptomatic phase, termed 'compensated cirrhosis' follwed by the development of complications of portal hypertension and/or liver dysfunction, termed 'decompensated cirrhosis'. The quality of life and survival of patients with cirrhosis can be improved by prevention and treatment of these complications. This review discuss the complication and its management in patients with liver cirrhosis.
Fibrosis ; Humans ; Hypertension, Portal ; Liver ; Liver Cirrhosis ; Liver Diseases ; Quality of Life

The ankle, which at times bears up to five times the body weight, is the most congruous joint of the lower extremity. Recently, importance of early joint motion and weight bearing after anatomical reduction & rigid internal fixation of the displaced ankle fracture was emphasized. Therefore, we studied prospectively, fifty-two patients with displaced ankle fractures admitted to the Department of Orthopedic Surgery, Severance hospital during a period of 4 years from January 1985 to December 1988. In fifty-two patients, group I (24 cases)were treated with early joint motion and weight bearing without cast immobilization and group II (28 cases) were treated with cast immobilization for long duration after open reduction and rigid internal fixation. The result of an average 15 months follow up of these patients were as follows. l. In displaced ankle fracture, early recovry of joint motion was obtained in early joint motion and weight bearing group after accurate anatomical reduction and rigid internal fixation. 2. In clincal evaluation, 95.8% resulted to satisfactory in group I, whereas 85.8% in group II. 3. In radiologic evaluation, 95.8% resulted to satisfactory in group I, whereas 82.1% in group II. 4. In lateral malleolar fracture, accurate reduction and fixation with plate and screws was important. 5. Syndesmotic ligament should be repaired and weight bearing was allowed without removal of transfixing screw. 6. Reduction of lateral malleolus made reduction and fixation of medial malleolus easy, and thus maintaining talar tilt angle. 7. Anatomical repair of deltoid ligament was needed for stability of ankle joint and prevention of local degenerative change.
Ankle Fractures ; Ankle Joint ; Ankle ; Body Weight ; Follow-Up Studies ; Humans ; Immobilization ; Joints ; Ligaments ; Lower Extremity ; Orthopedics ; Prospective Studies ; Weight-Bearing

No abstract available.
Follow-Up Studies* ; Pneumonectomy*

OBJECTIVE: Recently, the incidence of elderly primipara is increasing. Thus, impact of old age on pregnancy outcomes became important. Our purpose was to assess the effect of maternal age on pregnancy outcomes. METHODS: 73 cases of the elderly primipara over 35 years at the department of obstetrics and gynecology, Chon-ju presbyterian medical center, from Jan. 1, 1995 to Dec. 31, 1998, were compared with 73 cases randomly chosen young primiparas during same period. RESULTS: Elderly primipara had higher rate of infertility and spontaneous abortion history, antenatal complications, cesarean section, poorer neonatal outcome than young primipara. CONCLUSION: The pregnancy outcome of elderly primipara is considered to be less favorable than those of young primipara. Careful antenatal and intrapartal care should be performed for the elderly primipara. We think that many clinical study of congenital anomaly in elderly primipara will be necessary.
Abortion, Spontaneous ; Aged* ; Cesarean Section ; Female ; Gynecology ; Humans ; Incidence ; Infertility ; Jeollabuk-do ; Maternal Age ; Obstetrics ; Pregnancy Outcome ; Pregnancy* ; Protestantism ; Statistics as Topic*

Injury of the ankle ligaments is one of the most common sports-related injuries. Although there are some debates as to the best initial treatment for an acute tear of a lateral ligament, persistent functional instability of the ankle develops in approximately 20% of patients regardless of the type of initial treatment. In these patients, late reconstruction of the lateral ankle ligaments may become necessary. Among 13 cases which have been operated with Larsen procedure using peroneus brevis tendon from March 1991 to February 1993, the 11 cases followed up over 1 year were examined clinically and radiologically. We introduced the clinical analysis and results with the brief review of the literatures. 1. The indication of surgical treatment was the ankle instability which had differences over 10° in talar tilting angle or over 3mm in anterior displacement compared wit the uninjured site. 2. The postoperative results were 5 cases in excellent and 4 in good. 3. The Larsen procedure was considered a good method to anatomically and simply stabilize both the ankle and subtalar joint and to fix tendon depending on the type of instability.
Ankle ; Collateral Ligaments ; Humans ; Ligaments ; Methods ; Subtalar Joint ; Tears ; Tendons

The aim of this study was to evaluate the appropriateness of some kinds of surgery and admission, such as cesarean section (C/S), cholecystectomy, and pediatric pneumonia. For appropriateness evaluation, we ourselves developed some criteria, which were included in the category of explicit and linear criteria, with the assistance of specialists of relevant clinical field. The evaluation of appropriateness was performed by two family physicians. The major findings were as follows: 1. For ceserean section, 77.6% of deliveries were determined to be 'appropriate', but the level of appropriateness was not significantly different among hospitals between hospital groups by size. The most frequent indication of C/S was repeated operation, followed by cephalopelvic disproportion(CPD). The labor trials for vaginal delivery among repeated C/S and CPD cases were performed in 24.5% of pertinent deliveries. 2. About 73.8% of cholecystectomy cases was appropriate to one of the surgical indications, without significant differences among hospitals. Of surgical indications, 'sufficiently frequent and intense symptom recurrence' was the most frequent, and 'confirmed acute cholecystitis' was the second. 3. Of children admitted due to pneumonia, only 57.4% of cases satisfied admission criteria, and the level of appropriateness of admission was different among hospitals. The common reasons for admission were 'failure to initial treatment', 'suspected bacterial pnermonia', 'young infant', etc. We could find that there were differences of quality among hospitals in some procedures, especially in the pediatric pneumonia and labor trial before C/S, which suggested that the implementation of quality assurance activities would be necessary in this country. In this study, we used some simple and primitive research tools and the numbers of subjects and tracer procedures were limited. So advanced studies with plentiful subjects and more representative diseases or procedures should be tried.
Cesarean Section* ; Child ; Cholecystectomy* ; Female ; Humans ; Physicians, Family ; Pneumonia* ; Pregnancy ; Specialization ; Trial of Labor ; Utilization Review