No abstract available.
Humans

Frequent anomalies causing a left-sided appendix are situs inversus and malrotation. The ectopic position of the appendix frequently causes a delay or error in diagnosis because of atypical symptoms. A physical examination is of limited value unless dextrocardia is present. A left-sided appendix is a rare anomaly, but when other diseases are ruled out, it must be considered especially at the emergency department.
Appendicitis* ; Appendix ; Dextrocardia ; Diagnosis ; Emergency Service, Hospital ; Physical Examination ; Situs Inversus

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*

BACKGROUND: To evaluate the effect of preoperative fatty degeneration of deltoid and teres minor muscles on the clinical outcome in patient with reverse total shoulder arthroplasty (RTSA). METHODS: Nineteen patients with RTSA were enrolled. The mean follow-up period was 16.1 months. The fatty degeneration of three distinct parts in each deltoid and the teres minor muscle was measured using a preoperative magnetic resonance imaging. Postoperatively, the muscle strengths for forward elevation (FE), abduction (Abd), and external rotation (ER) were measured using a myometer at the last follow-up. The parameters for clinical outcome were Constant Score (CS) and Korean Shoulder Score (KSS). RESULTS: The number of cases was 10 in group 1 and 9 in group 2. The strength of FE and Abd were significantly higher in group 1 (p<0.001 and p<0.001, respectively), and the strength of ER was not different significantly between two groups (p=0.065). For the clinical outcome, both CS and KSS were higher in group 1 (p=0.002 and p=0.002, respectively). The number of patients in group A was 11, and group B was 8. Although there was not a significant difference in terms of FE and Abd between group A and B (p=0.091, p=0.238), ER was significantly higher in group A (p=0.012). We did not find a significant difference in the clinical scores (CS, p=0.177 and KSS, p=0.238). CONCLUSIONS: These findings suggest the importance of a preoperative evaluation of the fatty degeneration of deltoid and teres minor muscles for predicting postoperative strength and clinical outcome.
Arthroplasty* ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Muscle Strength ; Muscles* ; Shoulder*

No abstract available.

No abstract available.
Pemphigoid, Bullous*

Acquired tufted angioma is a benign, slowly progressive angioma with a characteristic histologic pattern, that was first described by Wilson Jones in 1979. We present herein a case of this rare disease developed in a 43 year old healthy woman. Routine biopsy specimens and an immunoenzymatic staining of factor 7IE showed compatible findings with those cases reported previously. The lesions were surgically excised, and during the two months of follow up, there was no sign of recurrence.
Adult ; Biopsy ; Female ; Follow-Up Studies ; Hemangioma* ; Humans ; Rare Diseases ; Recurrence

Pemphigua foliaceus is a rare, relatively mild and chronic variety of pemphigus which is characterized by superficial flaccid bullae which show acantholytic changes in the upper part of the epidermis histopathologically. We report herein five cases of pemphigus foliaceus. The patients had erythematous and crusted patches chiefly on face, chest and back areas, except for case 2 who had flaccid bullae on the upper extrimities. The diagnosis of all these patients were confirmed by immunofluorescence studies. Among these five patients, one was recognized as a rifampicin induced pemphigus foliaceus, and the other one revealed concurrent lesions of psoriasis.
Diagnosis ; Epidermis ; Fluorescent Antibody Technique ; Humans ; Pemphigus* ; Psoriasis ; Rifampin ; Thorax

PURPOSE: To evaluate the efficacy of vigabatrin and valproic acid add-on therapy in the treatment of uncontrolled partial-onset seizures through randomized active controlled parallel-group trial. METHODS: Criteria for entry included a requirement for three or more partial seizures per month despite the blood level of carbamazepine was within therapeutic range. During the 56-day baseline period, patients had at least 6 partial onset seizures. Vigabatrin or valproic acid were administered as the second drug in a randomized fashion. RESULTS: Forty one patients completed the trial(21 for vigabatrin, 20 for valproic acid). There is no statistically significant difference in age, age at onset, baseline seizure frequency, dose of carbamazepine, and serum level of carbamazepine between two groups. Two patients of vigabatrin-treated group and three patients of valproic acid treated group were dropped out because of side effects. The mean vigabatrin and valproic acid does were 2809 and 1490 mg, respectively. The percentage of patients achieving at least a 50% reduction in seizure frequency at the end of 8-week of add-on trial was 62% among vigabatrin-treated patients and was 50% for patients who received valproic acid(not statistically different). There was no significant difference in seizure reduction, percent seizure reduction, and truncated percent seizure reduction between two groups. The side effects were mild and transient neurotoxic symptoms in the patients who completed the trial(5 patients for vigabatrin, 10 patients for valproic acid). CONCLUSIONS: This trial indicates that vigabatrin and valproic acid are safe and effective in the treatment of intractable partial-onset seizures. The efficacy of vigabatrin as a new add-on antiepileptic drug is comparable to the previous valproic acid carbamazepine combination in the sense of seizure reduction and maybe even superior to that in the consideration of side effects
Carbamazepine* ; Humans ; Seizures* ; Valproic Acid* ; Vigabatrin*

Immunohistochemical study for c-erbB-2 oncoprotein was performed on paraffin sections of 76 primary breast carcinomas to determine the relationship between expression of c-erbB-2 and various clinicopathological prognostic indicators, including the expression of epidermal growth factor receptor (EGFR). Positive reaction for c-erbB-2 oncoprotein revealed an intense red granular staining predominantly located at the tumor cell membrane, with some cells exhibiting a weak cytoplasmic staining as well. The epithelial cells of the normal lobule and duct showed a negative reaction. Positive reaction for EGFR revealed a granular staining in the cytoplasm and the cell membrane of the tumor cells. Some tumors showed a positive EGFR staining in the epithelial cells of normal duct and lobule. Twenty six of 76 cases (34.2%) of primary breast carcinomas revealed a positive reaction for c-erbB-2 oncoprotein, and 28 cases (36.8%) were positive for EGFR. Expression of c-erbB-2 oncoprotein and EGFR was evident in 37.7% and 40.6% of 69 classic invasive ductal carcinomas, respectively. None of the other histological types showed a positive reaction. Expression of c-erbB-2 oncoprotein was strongly associated with tumor size(p=0.0015), histologic grade(.p=0.0175), vascular invasion(p=0.0043), and lymph node metastasis(p=0.0024), but not with age at diagnosis(p=0.1836). No significant association was found between expression of c-erbB-2 oncoprotein and EGFR. Co-expression of c-erbB-2 oncoprotein and EGFR was also strongly associated with tumor size (p=0.0029). These results suggest that c-erbB-2 oncoprotein is biologically distinct from EGFR, and may be used as a prognostic indicator of breast carcinoma due to its strong association with various clinicopathological prognostic factors.