The results of hepatic portojejunostomy performed in 34 patients with biliary atresia between May 1989 and December 1997 were analyzed. These patients were divided into three groups based on age of surgery; group 1 (< or =60 days, n = 11); group 2 (61~90 days, n = 14), and group 3 (>90 days, n = 9). Jaundice was cleared in 22 cases (64.7%). There was no significant difference of jaundice-free rate according to the age at operation between group 1, 2, 3. After a mean follow-up period of 33.9 month (range 18days-105.7 month), there were eleven deaths from hepatic failure(6), esophageal varix bleeding even though anicteric(2), sepsis by cholangitis(1), heart failure(1) and renal failure(1). Two of group 1 and 3 had received liver transplantation. With follow-up of average 33.9 months (18days-106months, one follow-up loss), 5-year cumulative survival rate by Kaplan-Meier method was 65.9%. The 5-year survivals of group 1, 2, 3 were 63.6%, 77.9%, 41.4%. There was no significant difference of survival rates according to the age at operation between group 1, 2, 3. Moreover, two cases of group 3 survived more than 5 years. Therefore, hepatic portojejunostomy can be considered as a primary surgical modality for biliary atresia in a patient of 90 days or more. Early detection of esophageal varix and possible sclerotherapy is necessary for long term survival.
Biliary Atresia* ; Chungcheongnam-do* ; Esophageal and Gastric Varices ; Follow-Up Studies ; Heart ; Hemorrhage ; Humans ; Jaundice ; Liver Transplantation ; Sclerotherapy ; Sepsis ; Survival Rate

Neurotoxicity in the workplace may occur with exposure to scores of chemicals. Although large acute outbreaks of the occupational neurological disease are rare, the incidence of occupational neurotoxicity in its subtler aspects is unknown. A working knowledge of both the major occupational neurotoxic solvents and the tools used by clinical neurologists and neurotoxicologists to evaluate neurotoxicity in working population is a necessity for the occupational physician. To investigate the effects of carbon disulfide(CS2) on the peripheral nerve system using the nervous conduction study, 105 male workers working in the spinning room of a viscose rayon factory were examined and compared with a sex and age matched, unexposed 105 male controls using t-test analysis. 72.4% of CS2-exposed workers complained of neurological symptoms, and the abnormal cases in nerve conduction study were 48.6%. The abnormal cases of nerve conduction study increased in number according as the age and duration of exposure increased. In this study, asymptomatic workers were confirmed to have subclinical neuropathy by nerve conduction study. Also as there were abnormal cases even in its duration of exposure below 4 years, nerve conduction study turned out to be ways of discovering of early peripheral neuropathy. In nerve conduction study, the amplitude, velocity, F-wave latency and H-reflex of the motor and sensory nerves in both upper and lower extremities were significant different between CS2-exposed workers and the controls. From the pathological viewpoint, both segmental and axonal degenerations were assumed in this study.
Axons ; Carbon Disulfide* ; Carbon* ; Disease Outbreaks ; H-Reflex ; Humans ; Incidence ; Lower Extremity ; Male ; Neural Conduction ; Peripheral Nerves ; Peripheral Nervous System Diseases* ; Solvents

Vivax malaria, which was once thought to be eradicable since more than 20 years ago, has made a dramatic resurgence since 1993 in the northern parts of Kyeonggi-do in the background of 0.13 of the annual parasite incidence in the population of 956,773 and 2 positives (0.07%) of asymptomatic parasitaemia among the 2,937 residents of mass blood survey in the area in 1969. The majority of the cases were soldiers infected in several counties located within 5 km from the Demilitarized Zone (DMZ) in 1994. Since then, malaria cases have increased and have tended to expand toward eastern and southern areas. Korean malaria is characterized by asymptomatic parasitaemia with long prepatent period, so malaria cases, including those manifesting as general fever should be treated with a combination of chloroquine and pyrimethamine to prevent the completion of sporogonic cycle in the mosquitoes. For the most effective control of vector mosquitoes, residual insecticides should be applied in the military houses and animal shelters with thermal fogging, including the control of the pre-stages of physiological age of the mosquitoes within 25 km from the DMZ. It is strongly suggested that military uniforms be treated with 0.5% permethrin complex (permethrin 39%+cyfluthrin 1%) or permethrin formulation. Further genetic studies are desired to determine the subspecies of Plasmodium vivax because Korean strain of malaria is likely to be a complex form of Plasmodium vivax vivax and Plasmodium vivax hibernans.
Animals ; Chloroquine ; Culicidae ; Fever ; Gyeonggi-do ; Humans ; Incidence ; Insecticides ; Korea* ; Malaria* ; Malaria, Vivax ; Military Personnel ; Parasites ; Permethrin ; Plasmodium vivax ; Pyrimethamine ; Weather

No abstract available.
Follow-Up Studies* ; Occupational Diseases*

No abstract available.
Follow-Up Studies* ; Intermittent Urethral Catheterization*

No abstract available.
Arthritis, Rheumatoid* ; Humans ; Scleroderma, Localized*

Ossification of the ligamentum flavum (OLF) has been recognised as a definite clinical entity as an ossification of the posterior longitudinal ligament. It has been known that the incidence of OLF is high in Japan and OLF usually occurs in the thoracic and lumbar region. Recently OLF has received considerable attention as a cause of myelopathy. OLF is quite distinct from “hypertrophy” of the ligamentum flvum. We experienced 2 cases of OLF with neurological symptom, which were treated by decompressive laminectomy and removal of the ossified ligamentum flavum. So remarkable symptomatic improvement was obtained.
Incidence ; Japan ; Laminectomy ; Ligamentum Flavum ; Longitudinal Ligaments ; Lumbosacral Region ; Spinal Cord Diseases ; Spine

No abstract available.
Tibia*

Pleomorphic (undifferentated) carcinoma is a rare histologic type of carcinomas of the gallbladder and an atypical carcinoid is thought to be an intermediated type between carcinoid tumor and small cell carcinoma. Dense core "neurosecretory" granules can be found in the above mentioned tumors. We experienced a case of a double tumor of the gallbladder in a 51-year old male patient. Grossly, a large solid mass, about 5.0 cm in diameter, was found in the fundic portion and the neck portion also had a small 1.5 cm-sized polypoid mass. Microscopically, these lesions had features of pleomorphic carcinoma and atypical carcinoid, respectively. Immunohistochemically, they manifested reactivity for neuron specific enolase. Ultrastructural study revealed neurosecretory granules in the cytoplasms of tumor cells of the fundic and neck masses. Although light microscopic features of these tumor masses are quite different, we consider that these tumors represent a spectrum of neuroendocrine differentiation.
Male ; Humans

Pleomorphic xanthoastrocytoma is histologically characterized by marked cellular pleomorphism of lipid-laden neoplastic astrocytes and bizarre giant cells showing mitotic figures and high cellularity. Inspite of its ominous-looking microscopic features, howerver, the prognosis is usually favorable. This tumor develops mainly in the supratentorial area of young people and frequently involves the leptomeninges. We experienced a case of pleomorphic xanthoastrocytoma in 18 year-old-male. In addition to the cellular pleomophism, the prominent reticulin fibers surround the individual tumor cells or the tumor cells nests. Immunohistochemical staining and electron microscopy revealed glial fibrillary acidic protein(GFAP) expression and pericytoplasmic basal lamina in the tumor cells.