We report a 14-months-old infant who had obstructive jaundice caused by idiopathic fibrosing pancreatitis. Ultrasonography and abdominal computed tomography showed dilatation of the intrahepatic ducts, common bile duct, and the pancreatic duct. Diffuse swelling of the pancreas was also noted on CT. At laparotomy, the head portion of the pancreas revealed a stony hard consistency, and proliferation of fibrotic tissue was confirmed pathologically. Idiopathic fibrosing pancreatitis is a very rare disease entity in childhood, but should be considered in the differential diagnosis of obstructive jaundice in children who demonstrate bile duct and pancreatic duct dilatation and/or diffuse pancreas swelling.
Bile Ducts ; Child ; Common Bile Duct ; Diagnosis, Differential ; Dilatation ; Head ; Humans ; Infant ; Jaundice, Obstructive* ; Laparotomy ; Pancreas ; Pancreatic Ducts ; Pancreatitis* ; Rare Diseases ; Ultrasonography

After the clinical introduction of halothane, the problem of hepatotoxicity and mechanism has major implications for the practice of anesthesiology. This study was undertaken to investigate the liver function change after halothane anesthesia in 22 cases of electric burn patient. In this study, all cases had a great elevation of SGOT and SGPT levels, and previous experience of inhalation anesthesia, jaundice and who had not been transfused during this study. The following results were obtained: 1) Elevation of the SGOT and SGPT in electric burn patients may be influenced by damage of skeletal muscle and transaminase released into systemic circulation. 2) In the electric burn patients, elevation of the SGOT and SGPT does not enhance the susceptibility of the liver to injury by halothane.
Alanine Transaminase ; Anesthesia* ; Anesthesia, Inhalation ; Anesthesiology ; Aspartate Aminotransferases ; Burns, Electric* ; Halothane* ; Humans ; Jaundice ; Liver* ; Muscle, Skeletal

Cervical cancer and its precursors are caused principally, if not exclusively, by HPV infection and HPV DNA is found in more than 90% of cervical cancers. Cervical cytology is limited by its false negativity and this may be supplimented by other adjunctive test such as HPV test. It is therefore important to explore the use of HPV DNA detection as a primary or supplementary screening method and to determine whether HPV typing can be used as a predictor of a lesion's clinical behavior. Cervical cytology and Hybrid Capture test for HPV detection were performed in 450 asymtomatic wornen visited Health Care Center in Kangnam St. Mary's Hospital,and none of whom was believed to have current cervical disease. The Papanicolaou cytology results were classified by The Bethesda System : 333(74.%) women were classified to within normal limit, 19(4.2%) benign reactive change, 38(8.4%) ASCUS, 59(13%) low grade SIL, and only one woman high grade SIL. Twenty five of 450(5.6%) women showed HPV infection by Hybid Capture test. Among 98 wornen with abnormal Papanicolaou cytology, 16(16.3%) women showed HPV DNA positivity. (continue)
Delivery of Health Care ; DNA* ; Female ; Humans* ; Mass Screening* ; Papilloma* ; Uterine Cervical Neoplasms

Recently the change in medical informatics enabled us to use medical information whenever we want and wherever we are. There are many homepages on the web, which provide hospital information, medical counseling. Our multimedia center began its service as a internet Hospital in MIDAS Dongailbo, one of the major daily newspaper in Korea, on March 25th, 1997. The aim of this study is to examine the content and purpose of medical counseling on the web. The subjects consisted of 1,000 counsellings which were called 'Dongailbo Internet Hospital' for March, 25th, 1997 through October 30th, 1997. Many questioners wanted to know treatment principles, to make a diagnosis, and to know specific medical knowledges. The most common questions are as follows: general and unspecified, musculoskeletal, skin, digestive, respiratory, neurological problems.
Computer Communication Networks ; Counseling* ; Diagnosis ; Internet ; Korea ; Medical Informatics ; Multimedia ; Periodicals* ; Skin

Recently the change in medical informatics enabled us to use medical information whenever we want and wherever we are. There are many homepages on the web, which provide hospital information, medical counseling. Our multimedia center began its service as a internet Hospital in MIDAS Dongailbo, one of the major daily newspaper in Korea, on March 25th, 1997. The aim of this study is to examine the content and purpose of medical counseling on the web. The subjects consisted of 1,000 counsellings which were called 'Dongailbo Internet Hospital' for March, 25th, 1997 through October 30th, 1997. Many questioners wanted to know treatment principles, to make a diagnosis, and to know specific medical knowledges. The most common questions are as follows: general and unspecified, musculoskeletal, skin, digestive, respiratory, neurological problems.
Computer Communication Networks ; Counseling* ; Diagnosis ; Internet ; Korea ; Medical Informatics ; Multimedia ; Periodicals* ; Skin

Serum aspartate aminotransferase (AST) is a common enzyme for the evaluation of the hepatic, muscular and cardiac diseases and is produced also at kidney, brain, pancreas, lung, leukocytes, erythrocytes, etc. The elevation of its activity is usually caused by the necrosis of hepatocytes when there are not muscular injuries or myopathies. Recently, it is found that AST can exist as a macroenzyme by forming a complex with an immunoglobulin and this complex is erroneously considered to indicate the presence of liver disease as a result of elevation of AST activity on routine blood chemistry analysis. We experienced the patient with isolated AST elevation due to the formation of AST-mmunoglobulin complex confirmed by AST isoenzyme electrophoresis (EP).
Aspartate Aminotransferases ; Brain ; Chemistry ; Electrophoresis ; Erythrocytes ; Heart Diseases ; Hepatocytes ; Humans ; Immunoglobulins ; Kidney ; Leukocytes ; Liver Diseases ; Lung ; Muscular Diseases ; Necrosis ; Pancreas

Ten patients with muscle-invading bladder carcinoma (clinical stage T2-TsB Nx Mo, T.C.C.) who were not candidates for cystectomy were treated with combined cisplatin and external-beam radiotherapy From Mar. 1990 through Feb. 1992. Results of the combined therapy had been compared with those of the radiation therapy alone. Using this combined therapy, 5(71.4%) of 7 patients achieved partial remission with a mean follow-up of 10.8 months. Three patients died of unrelated causes. Partial remission following radialion therapy alone was 6 (60%) of 10 patients. Patients with complete remission was none in the two groups. All patients in the combined therapy group were nauseated on the day treatment was given and 7 patients developed total atopecia. The malaise associated with cisplatin therapy tended to increase with the number of courses. All patients refused further treatment on this account (mean amount of cisplatin received: 3 courses). Combined cisplatin and radiotherapy may be applied to patients unsuited for radical cystectomy. Tolerance to cisplatin and radiotherapy was poor due to relatively severe toxicity, poor performance status with old age and underlying medical disease. Refinement of this protocol, careful selection of patients and longer follow-up will be necessary to determine the real benefit of this alternative modality.
Cisplatin* ; Cystectomy ; Drug Therapy ; Follow-Up Studies ; Humans ; Radiotherapy* ; Urinary Bladder*

OBJECTIVE: The disintegration of extracellular matrix and basement membrane are important processes in the infiltration and metastasis of malignant tumors. We investigated the expressions of matrix metallo- proteinase-2 (MMP-2) and tissue inhibitors of metalloproteinases (TIMP-2) in tissues and sera from patients with cervical cancer, and compared the expressions of these enzymes with patient clinical status to determine the possibility of these enzymes being used as tumor biomarkers. METHODS : The expressions of MMP-2 and TIMP-2 were investigated in sixty cervical cancer tissues obtained from patients who were histologically confirmed having cervical cancer by immunohistochemical staining, and the expressions of the mRNAs of MMP-2 and TIMP-2 were confirmed by using RT-PCR. Also, the amounts of MMP-2 and TIMP-2 in sera obtained from each patient during treatment progress were measured using ELISA to determine the presence of a relationship between the expression levels of these enzymes and the clinical condition of the patient. RESULTS: In terms of the expression levels of MMP-2 and TIMP-2 by immunohistochemical staining, MMP-2 was shown to be positive in 46% (28/60) of the normal cervical tissues and in 75% (45/60) of the cervical cancer tissues, and the degree of expression of MMP-2 was also stronger in cervical cancer tissue than in normal cervical tissue. TIMP-2 was shown to be positive in 23% (14/60) and 27% (16/60) of normal cervical tissues and cervical cancer tissues, respectively, though these expressions were weak in nature. The mRNA of MMP-2 was more distinctly expressed in cervical cancer tissue than normal cervical tissue, but no difference could be seen in the case of TIMP-2. In terms of expressions as determined by ELISA, the positivity rate of MMP-2 in the normal control group and the cervical cancer group were 12% (7/54) and 76% (46/60), respectively, and the corresponding positivity rates of TIMP-2 were 22% (12/54) and 98% (59/60), respectively (p<0.05). MMP-2 expression reflected clinical condition in 57.5% of the patients, and TIMP-2 in 35%, however, MMP-2 expression increased in the presence of recurrent cervical cancer. CONCLUSIONS : MMP-2 and TIMP-2 are closely related with cervical cancer, and MMP-2 is believed a tumor biomarker that possibly reflects clinical status.
Basement Membrane ; Biomarkers ; Enzyme-Linked Immunosorbent Assay ; Extracellular Matrix ; Humans ; Matrix Metalloproteinase 2* ; Metalloproteases ; Neoplasm Metastasis ; RNA, Messenger ; Tissue Inhibitor of Metalloproteinase-2* ; Biomarkers, Tumor* ; Uterine Cervical Neoplasms*

OBJECTIVE: The toxicity and effectivity of intravenous paclitaxel and cisplatin as neoadjuvant chemotherapy were assessed in cervical cancer patients. METHODS: Thirty seven consecutive patients affected by FIGO stage IB2 to \\'a5\\'b1B were treated with paclitaxel 60 mg/m2 that was administered intravenously over a 3-hour period, followed by cisplatin 60 mg/m2, also administered intravenously. The chemotherapy was administered every 10 days and for three courses. The toxicity of the regimen in each cycle was determined according to the WHO toxicity criteria and in cases with grade 3 or 4 toxicity, chemotherapy was postponed for one week. The size of the tumor mass was measured prior to the neoadjuvant chemotherapy by means of pelvic examination and pelvic magnetic resonance imaging (MRI). The response to the treatment was determined 10 days after 3 cycles of chemotherapy by means of pelvic examination and pelvic MRI. Two weeks after the neoadjuvant chemotherapy was completed, the patients were either given an operation or radiation therapy, depending on their overall condition, the operational risks and personal willingness for an operation. RESULTS: A total of 37 patients were given a radical hysterectomy and enrolled in this study. Mild myalgia was the most common toxicity. Granulocytopenia was seen in four patients but there was no grade 3 or 4. Grade 1 neurotoxicities developed in four patients. Clinical responses occurred in 94.6% (35/37) of patients, including 35.1% (13/37) with a complete response, 10.8% (4/37) with a pathologically determined complete response, 59.5% (22/37) with a partial response, and 5.4% (2/37) showed stable disease. A down-staging response was seen in 75.7% (28/37) of those patients showing a response. CONCLUSIONS: The combination of paclitaxel with cisplatin for use in neoadjuvnant chemotherapy seems to be tolerated and very active in cervical cancer. Especially, every 10 days treatment did not delay the surgically or radologically optimal time. A larger number of cases need to be studied in order to confirm the efficacy of the treatment.
Agranulocytosis ; Cervix Uteri* ; Cisplatin* ; Drug Therapy ; Female ; Gynecological Examination ; Humans ; Hysterectomy ; Magnetic Resonance Imaging ; Myalgia ; Paclitaxel* ; Uterine Cervical Neoplasms

This study was designed to determine the attitude and degree of satisfaction of recipients toward the meal service program for elderly people. Nine hundred and eight elderly people(male: 301, female: 607) were interviewed by trained personnel. The results were as follows. Forty two percent of them had no income and 43.8% of the respondents were supported economically by the government. Their main reasons for attending the free congregated meal program was economic hardship(37.9%) The channels of becoming aware of the free meal program were through their friends(33.4%) and the meal service centers were located in the respondents residence area(36.0%) Thus any other advertisement from local government of official channels about the free meal program were not effective for the elderly 26.9% of the respondents felt inconvenience in visiting the meal service centers because they had some difficulty in walking, 53.5% of them however answered that they didn t have any complains and were quite satisfied with the meal service. The average satisfaction score for the free meal service was 63.4(maximum score 75) As for each evaluation item respondents were highly satisfied with volunteers attitude in meal serving(4.58+/-0.65: maximum 5 point) The evaluation score of females was generally lower than that of males(p<0.05) Oncemore, respondents who were in lowere socio-economic classes were marked by having significantly lower satisfaction scores for the meal service compared with higher scocio-economic classes. For the welfare of elderly people, meal service programs should be extended to more elderly persons and developed considering the elderlys ecological factors.
Aged* ; Surveys and Questionnaires ; Female ; Humans ; Local Government ; Meals* ; Volunteers ; Walking