BACKGROUND/AIMS: Chronic hepatitis C virus (HCV) infection is often associated with extrahepatic autoimmune disease, and autoantibodies such as anti-nuclear antibody (ANA) or anti-smooth muscle antibody (ASA). The presence of autoantibodies may make discrimination between chronic hepatitis C with autoimmune features and type 1 autoimmune hepatitis difficult. We studied the prevalence of autoantibodies in patients with chronic HCV infection and their clinical significance. MATERIALS AND METHODS: ANA, ASA, anti-mitochondrial antibody (AMA), anti-microsomal antibody (AmA), rheumatoid factor (RF), anti-cardiolipin antibody (aCL) and lupus anti-coagulant (LA) were tested in 116 patients (80 chronic hepatitis C, 36 liver cirrhosis). Genotypes of HCV were determined in 25 patients by INNO LiPA. RESULTS: The overall prevalence of autoantibody was 65.5%. The most common autoantibody was aCL (34.5%), followed by ANA (25%), RF (18%), LA (15.5%), ASA (6.9%), anti-microsomal antibody (6%) and AMA (1%). The positive rate of either ANA or ASA was 30.2%, but both were positive in 1.7% only. There was no difference in the demographic features, biochemistry, HCV genotypes and disease status between autoantibody-positive and autoantibody-negative patients. CONCLUSIONS: Autoantibodies were commonly found in patients with chronic HCV infection. But, the presence of autoantibodies may be a non-specific finding in chronic hepatitis C infection without clinical significance.
Autoantibodies* ; Autoimmune Diseases ; Biochemistry ; Discrimination (Psychology) ; Genotype ; Hepacivirus ; Hepatitis C, Chronic* ; Hepatitis, Autoimmune ; Hepatitis, Chronic* ; Humans ; Liver ; Prevalence* ; Rheumatoid Factor

Ten feet from 6 idiopathic congenltal clubfoot patients which had failed to respond to conservative mearsured were treated by aggreasive posteromedial release during infancy with generally good results. A modltication of Denis-Browne splint by splitting both aides and using dial lock to hold the foot still ln correeted position was found quite useful for post-operative maintenance.
Clubfoot ; Foot ; Humans ; Splints

No abstract available.
Shoulder Fractures*

Hepatocellular carcinoma (HCC) is one of the most frequent and malignant diseases worldwide. Epidemiological studies have clearly demonstrated that chronic hepatitis B virus (HBV) infection is a major etiological factor in the development of HCC. The pathogenesis of HBV-associated HCC has been studied extensively, and the molecular changes associated with malignant transformation have been identified. The predominant carcinogenic mechanisms of HBV-associated HCC are chronic inflammation and the effects of cytokines in the development of fibrosis and liver cell proliferation. An important role is also played by the integration of HBV DNA into host cellular DNA, which disrupts or promotes the expression of cellular genes that are important in cell growth and differentiation. Especially, HBx protein is a transactivating protein that promotes cell growth, survival, and the development of HCC. Continued investigation of the mechanisms underlying hepatocarcinogenesis will refine our current understanding of the molecular and cellular basis for neoplastic transformation in the liver. Prevention of HBV infections and effective treatments for chronic hepatitis B are still needed for the global control of HBV-associated HCC. This review summarizes the current knowledge on the mechanisms involved in HBV-associated hepatocarcinogenesis.
Carcinoma, Hepatocellular* ; Cell Proliferation ; Cytokines ; DNA ; Fibrosis ; Hepatitis B virus ; Hepatitis B, Chronic ; Inflammation ; Liver ; Trans-Activators

To know the effect of the intravitreal silicone oil affecting the visual evoked potentials (VEPs), we reviewed 19 patient's charts retrospectively. All patients had received pars plana vitrectomies with intravitreal silicone oil injection. The oil was removed after a few months of intravitreal silicone oil. The eyes showing operative or postoperative complication were excluded in this study. The VEPs and visual acuity were tested one day before and two weeks after intravitreal silicone oil removal. The changes of VEPs and visual acuities between the pre- and post-silicone oil removal were analized. And the changes of VEPs according to the changes of the visual acuities in the pre- and post-silicone oil removal were analized with student t-Test and Spearman corelation. The VEPs amplitudes decreased significantly (p=0.03) after silicone oil removal, and the latencies increased slightly but statistically not significant. The findings suggested that intravitreal surgery itself may influence the VEPs. After removal of intravitreal silicone oil, no significant relationship was found between the changes of VEPs and those of visual acuities.
Evoked Potentials, Visual* ; Humans ; Postoperative Complications ; Retrospective Studies ; Silicone Oils* ; Visual Acuity* ; Vitrectomy

A questionnaire on a variety of ophthalmic topics was made up and sent to 150 members of the Korean Society of Cataract and Refractive Surgery-[KSCRS] in May, 1996. Forty percent [60/150] responded within the deadline in June, 1996. As the contents of the questionnaire were almost identical to the ones prepared in the USA [1994, 1995] and in Japan [1994], the answer to the questionnaire could be compared with those gathered from the USA and Japan. Over half of the respondents [57%] were in their forties. The average number of operations done per month was 26. Cataract operation accounted for over 60% of the total operations in 34% of KSCRS members. And more than 76% of the cataract operation were done using phacoemulsification technique in 31% of the respondents. There were no difference in the preferred method of local anesthesia for the cataract surgery in Korea compare to the USA or Japan. And there was less likelihood of using peribulbar anesthesia and no suture technique in Korea compared to the USA. Sixty-one percent of the Korean ophthalmic surgeon implanted the intraocular lenses even before the patients were younger than 20 years old whereas, 82% of ophthalmic surgeon in Japan did only when the patients were older than 20 years of age. For radial keratotomy as a means of correcting myopia, 91% of the Korean respondents were not performing the procedure any more, while 45% of the American respondents abandoned it. Fifty four percent of the Korean respondents and 46% of the American respondents have been doing excimer laser photorefractive keratectomy. There was no statistical difference between the two. From the answers to the qustionnaire, we found that our results did not differ significantly from those of the USA or Japan and we believe that these results reflect the present trends of cataract and refractive surgeries in Korea.
Anesthesia ; Anesthesia, Local ; Cataract* ; Surveys and Questionnaires ; Humans ; Japan ; Keratotomy, Radial ; Korea ; Lasers, Excimer ; Lenses, Intraocular ; Myopia ; Phacoemulsification ; Photorefractive Keratectomy ; Refractive Surgical Procedures* ; Suture Techniques ; Young Adult

BACKGROUND: Single pass lead VDD pacing preserves atrioventricular synchrony with a single lead system which incorporates floating atrial electrodes. The objectives of this study were to measure whether different body postures and physical activities cause significant changes of the atrial electrogram amplitudes and to evaluate the effectiveness of its atrial sensing, ventricular sensing and pacing. METHOD: Prospective study was done in 7 patients with high degree AV block and normal sinus node function in whom a single lead VDD pacing system was implanted. The P wave amplitude was been measured in different condition during follow-up period. RESULTS: 1) During follow-up period, the P wave amplitude showed variation with changes in posture and respiration, but there was no consistent increase or decrease in amplitude. The lowest P wave amplitude was above the minimal atrial sensing value of 0.2 mV. 2) The percentage of atrial synchronous ventricular pacing recorded in Holter ECG and during Treadmill exercise test was more than 99%. 3) Atrial oversensing or VA cross sensing were not observed in any of the patients. CONCLUSIONS: Despite floating atrial electrode, the single pass lead VDD pacing maintains reliable atrial sensing and ventricular pacing in different body position and physical activity, so it may offer an excellent alternative in patients with high grade AV block and intact sinus node function.
Atrioventricular Block ; Electrocardiography ; Electrodes ; Electrophysiologic Techniques, Cardiac ; Exercise Test ; Follow-Up Studies ; Humans ; Motor Activity* ; Posture ; Prospective Studies ; Respiration ; Sinoatrial Node

BACKGROUND: Single pass lead VDD pacing preserves atrioventricular synchrony with a single lead system which incorporates floating atrial electrodes. The objectives of this study were to measure whether different body postures and physical activities cause significant changes of the atrial electrogram amplitudes and to evaluate the effectiveness of its atrial sensing, ventricular sensing and pacing. METHOD: Prospective study was done in 7 patients with high degree AV block and normal sinus node function in whom a single lead VDD pacing system was implanted. The P wave amplitude was been measured in different condition during follow-up period. RESULTS: 1) During follow-up period, the P wave amplitude showed variation with changes in posture and respiration, but there was no consistent increase or decrease in amplitude. The lowest P wave amplitude was above the minimal atrial sensing value of 0.2 mV. 2) The percentage of atrial synchronous ventricular pacing recorded in Holter ECG and during Treadmill exercise test was more than 99%. 3) Atrial oversensing or VA cross sensing were not observed in any of the patients. CONCLUSIONS: Despite floating atrial electrode, the single pass lead VDD pacing maintains reliable atrial sensing and ventricular pacing in different body position and physical activity, so it may offer an excellent alternative in patients with high grade AV block and intact sinus node function.
Atrioventricular Block ; Electrocardiography ; Electrodes ; Electrophysiologic Techniques, Cardiac ; Exercise Test ; Follow-Up Studies ; Humans ; Motor Activity* ; Posture ; Prospective Studies ; Respiration ; Sinoatrial Node

We investigated whether symptom-free period(mean response time) could be prolonged when diltiazem, one of the calcium-channel blocker, as a adjuvant was administered with botulinum toxin in blepharospasm and hemifacial spasm. The patients were 10 blepharospasms and 20 hemifacial spasms who had been treating with botulinum toxin injection in our hospital. When they received only botulinum toxin for treatment of blepharospasm and hemifacial spasm, their mean response times were 126.94 +/- 42.74 and 167.32 +/- 52.90 days, respectively. After start combination therapy of diltiazembotulinum toxin, mean response times were prolonged to 163.83 +/- 53.07 (p=0.0446) in patients with blepharospasm, on the other hand, 154.21 +/- 43.36(p=0.2156) days in patients with hemifacial spasm. This study suggests that a combination treatment of diltiazem and toxin may be effective especially when the mean response time is decreased due to antibody production and the local complications are possibly expected in some patients. Present study is meaningful in that it provides a new treatment modality for blepharospasm and hemifacial spasm.
Antibody Formation ; Blepharospasm* ; Botulinum Toxins* ; Diltiazem* ; Hand ; Hemifacial Spasm* ; Humans ; Reaction Time

BACKGROUND: The cardiac troponin I (cTnI), one of the subunits of the troponin regulatory complex, binds to actin and inhibits interactions between actin and myosin. cTnI is highly sensitive and specific marker for myocardial injury and is useful in diagnosis and detection of reperfusion in acute myocardial infarction (AMI). In this study, we measured the serum concentration of cTnI according to serial time after chest pain in patients with AMI and compared serum concentration of cTnI with CK-MB and echocardiographic data to evaluate the significance of measuring serum concentration of cTnI in AMI. SUBJECTS AND METHODS: The study was carried out on 16 patients with first attack of AMI within 6 hours of chest pain. All patients were performed thrombolytic therapy and reperfusion was confirmed by coronary angiography. Blood samples for measuring of CK-MB and cTnI were collected at 4-h intervals during the first 24 h, 12-h intervals until 48 h, and 24-h intervals until fourth days after hospitalization. Echocardiography were performed before thrombolytic therapy in all patients. RESULTS: 1) The mean age of subjects was 63.6+/-11.5 years (range:44 - 84 years) and 11 patients were men and 5 patients were women. The site of infarction was anterior in 11 patients and inferior in 5 patients. 2) The peak concentrations of CK-MB and cTnI were reached from 4-h to 12-h after admission in all patients (7.3+/-2.6-h, and 9.0+/-3.1-h, respectively), but there was no significant difference in peak time. 3) Serum concentration of CK-MB was normalized at 72-h after admission, but cTnI was remained in increased state until 96-h after admission. The numbers of the patients with above cutoff value of CK-MB and cTnI at different time after admission were significantly different after 72-h (p<0.05). 4) The peak cTnI and sigma cTnI level were significantly correlated with peak CK-MB and sigma CK-MB level, respectively (r 2 =0.7955, p<0.0001 and r 2 =0.6378, p=0.0002, respectively). 5) The ejection fraction was not correlated with peak cTnI concentration (r 2 =0.0948, p=0.2461) and sigma cTnI (r 2 =0.1867, p=0.0946). 6) The wall motion score index was not correlated with peak cTnI concentration (r 2 =0.2135, p=0.0716), but significantly correlated with sigma cTnI (r 2 =0.2540, p=0.0465). CONCLUSION: The serum concentration of cTnI was useful in late diagnosis of AMI and cTnI release in patients with AMI was correlated with myocardial infarct size.
Actins ; Chest Pain ; Coronary Angiography ; Delayed Diagnosis ; Diagnosis ; Echocardiography ; Female ; Hospitalization ; Humans ; Infarction ; Male ; Myocardial Infarction* ; Myosins ; Reperfusion ; Thrombolytic Therapy ; Troponin I* ; Troponin*