BACKGROUND: E2/nonstructural protein 1 (E2/NSl) glycoprotein of hepatitic C virus (HCV) is most variable region of HCV and appears to cause positive selection of escape mutants, which may play a role in the mechanism of persistent viral infection. We analyzed the sequence diversity of E2/NSl of HCV from twelve Koreans. METHODS: The nucleotide and deduced amino acid sequences of the putative E2/NSl region of HCV were determined by analysis of twelve independent amplified CDNA clones obtained from Korean patients with chronic hepatitis and primary hepatocellular carcinoma, using dideoxynucleotide chain termination method. RESULTS: High level of variations in both nucleotide and amino acid sequences were observed in the hypervariable region 1 and 2 (HVR1 and HVR2). Sequences of HVR1, situated at the nucleotide positions from 1478 to 1552 (amino acid positions : from 383 to 407), showed from 27.8 to 94.4% diversity at the nucleotide level and from 25.0 to 87.5% diversity at the amino acid level. 4 few amino acid residues (amino acid positions: 384, 388, 389 405, 406) within HVR1 were highly conserved in most cases. Sequences of HVR2, situated at the nucleotide positions from 1736 to 1774 (amino acid positions from 469 to 481). Two groups of highly conserved amino acid sequences were observed in the HVR2 of twelve Korean cases, indicating that there are type specific conservation in the HVR2 region. 4 large part of the eave lope region located at the nucleotide positions from 1832 to 1892 (amino acid positions : from 501 to 521) was highly conserved, to show 100% Identity of amino acid sequences. The positions of six putative N-glycosylation sites were highly conserved. The percent diversities of nucleotide of E2/NSl was from 60.4% to 92.7% and the percent diversities of amino acid of E2/NSl was from 57.6% to 95.5% among twelve Korean HCV clones. CONCLUSION: Extensive genetic variations including two hypervariable regions were clustered and interspersed with highly conserved nucleotides sequences in E2/NSl region of HCV isolated from Koreans.
Amino Acid Sequence ; Carcinoma, Hepatocellular ; Clone Cells ; DNA, Complementary ; Genetic Variation ; Glycoproteins ; Hepacivirus* ; Hepatitis C* ; Hepatitis* ; Hepatitis, Chronic ; Humans ; Nucleotides ; United Nations

BACKGROUND: E2/nonstructural protein 1 (E2/NSl) glycoprotein of hepatitic C virus (HCV) is most variable region of HCV and appears to cause positive selection of escape mutants, which may play a role in the mechanism of persistent viral infection. We analyzed the sequence diversity of E2/NSl of HCV from twelve Koreans. METHODS: The nucleotide and deduced amino acid sequences of the putative E2/NSl region of HCV were determined by analysis of twelve independent amplified CDNA clones obtained from Korean patients with chronic hepatitis and primary hepatocellular carcinoma, using dideoxynucleotide chain termination method. RESULTS: High level of variations in both nucleotide and amino acid sequences were observed in the hypervariable region 1 and 2 (HVR1 and HVR2). Sequences of HVR1, situated at the nucleotide positions from 1478 to 1552 (amino acid positions : from 383 to 407), showed from 27.8 to 94.4% diversity at the nucleotide level and from 25.0 to 87.5% diversity at the amino acid level. 4 few amino acid residues (amino acid positions: 384, 388, 389 405, 406) within HVR1 were highly conserved in most cases. Sequences of HVR2, situated at the nucleotide positions from 1736 to 1774 (amino acid positions from 469 to 481). Two groups of highly conserved amino acid sequences were observed in the HVR2 of twelve Korean cases, indicating that there are type specific conservation in the HVR2 region. 4 large part of the eave lope region located at the nucleotide positions from 1832 to 1892 (amino acid positions : from 501 to 521) was highly conserved, to show 100% Identity of amino acid sequences. The positions of six putative N-glycosylation sites were highly conserved. The percent diversities of nucleotide of E2/NSl was from 60.4% to 92.7% and the percent diversities of amino acid of E2/NSl was from 57.6% to 95.5% among twelve Korean HCV clones. CONCLUSION: Extensive genetic variations including two hypervariable regions were clustered and interspersed with highly conserved nucleotides sequences in E2/NSl region of HCV isolated from Koreans.
Amino Acid Sequence ; Carcinoma, Hepatocellular ; Clone Cells ; DNA, Complementary ; Genetic Variation ; Glycoproteins ; Hepacivirus* ; Hepatitis C* ; Hepatitis* ; Hepatitis, Chronic ; Humans ; Nucleotides ; United Nations

PURPOSE: To analyze the variable MRI features and clinical significance of intracranial cavernous realformation. MATERIALS AND METHODS: Forty patients(mean age 35.4) with cavernous malformation were evaluated by MRI. Eleven patients were surgically confirmed. Cavernous malformations were divided into four categories on the basis of the MR imaging characteristics, especially on T2-weighted image. Type I lesion was defined as an extralesional subacute hemorrhage outside the low signal rim, type II as an intralesional hemorrhage surrounded by low signal rim, type III lesion as an intralesional thrombosis with variegated central core surrounded by low signal rim, and type IV lesion as a focal old hemorrhagic core with small low signal intensity. Type IV was further divided into IVa and IVb, whether the lesion has small iso- or hypersignal central core (IVa) or not (IVb). Follow-up MRI was evaluated in 12 patients who were managed conservatively. Follow-up intervals ranged from 2 weeks to 29 months (mean 6months). RESULTS: Total 80 lesions were detected in 40 patients. Multiple lesions were noted in 10 patients. The topography of the cavernous malformations was supratentorial in 75% and infratentorial in 23%. There were 10 lesions in type I, 15 in type 11, 21 in type III, 14 in type IVa, and 20 in type IVb. Type I lesions mainly showed mass effect and edema. Type III lesions showed minimal contrast enhancements in 7 lesions on delayed images. Type II lesions showed the characteristics of both type I and type III lesions. On follow up images, decrease in size in 5, change of type in 7, rebleeding in 2 and no change in 12 lesions were demonstrated. Hemorrhage, edema and mass effect were combined in the cases of rebleeding. On follow-up study, the estimated risk of bleeding was 32.3%/person-year and 13.7%/lesion-year. CONCLUSION: Cavernous realformations show as variable appearance, on MR imaging suggesting variable stages of evolution. The MR morphologic classification and evaluation of secondary findings are helpful to predict natural course and possibility of rebleeding of the lesion.
Classification ; Edema ; Follow-Up Studies ; Hemorrhage ; Humans ; Magnetic Resonance Imaging* ; Thrombosis

No abstract available.
Myelodysplastic Syndromes* ; Neutrophils* ; Pyoderma Gangrenosum* ; Pyoderma*

No abstract available.
Humans ; Siblings*

Fine needle aspiration cytology of the salivary lesions was performed on 221 patients at Soonchunhyang University Hospital for 10 years. Of 221 aspirates, 6 aspirates(2.7%) were inadequate, 116 cases(52.5%) were non-neoplastic lesions, 76(34.4%) cases were benign neoplasms and 23 cases(10.4%) were malignant neoplasms. The cytologic diagnoses could be correlated with histologic findings in 58 cases. FNAC correctly discriminated between neoplastic and nonneoplastic lesions in fifty-seven lesions and failed in a case, and overall accuracy, sensitivity, and specificity were 98.3%, 98.0%, and 100.0%. FNAC correctly discriminated malignant neoplasms from benign neoplastic/non- neoplastic lesions in fifty-three cases and failed in five cases, and overall accuracy, sensitivity, and specificity were 91.3%, 72.7%, and 95.7%. Among three false negative cases, two mucoepidermoid carcinomas were misdiagnosed as mucocele and benign neoplasm, and an acinic cell carcinoma were misdiagnosed as Warthin's tumor. Two false positive cases were a Warthin's tumor misdiagnosed as squamous cell carcinoma and a pleomorphic adenoma misinterpretated as suggestive of malignancy. In conclusion, diagnostic accuracy of FNAC of salivary lesions is high, and the possibilities of low grade mucoepidermoid carcinoma and acinic cell carcinoma should be considered on hypocellular smears with mucoid or fluidy background.
Adenoma

In modem medical industries as in others, it has been emphasized by many experts such as Dr. Mayer and Dr. Donabedean that there should be quality assurance activities applying statistical knowledges in the processes of medical management and medical staff themselves for the better medical care and customer satisfaction. Three of our quality assurance programs for the purpose of shortening the treatment time In the department of emergency medicine in Keimyung University, Dong-San Medical Center had been carried out during the period of June 94 through December 95. Our methodology was mainly the process emphasized ; finding the causes of delaying factors in various processes related to the works of nurses, doctors, laboratory services, radiology services etc. in the emergency room, holding various meetings among the related groups with genuine discussions, notifying the new results in each step, encouraging the positive ones and also applying the new leadership technics. During the period of June 94 through December 95(for 1.5 years), the average E.R. patient treatment time from registrations to dispositions had been reduced by about 2 hours (from 5 hours 3 minutes to 2 hours 5 minutes) and its variations among the different specialities had been narrowed down to significant degree (p<0.05) revealing the preprogram base line standard deviation of 2.43 to 1.28 in post program through continuous quality assurance programs. It was also noted that the successful results of Q/A program have been closely related to the fact that the process should be designed and redesigned repeatly as needed and that all the participants related were actively involved in the planning and redesigning processes.
Emergency Medicine ; Emergency Service, Hospital ; Humans ; Leadership ; Medical Staff ; Modems

As the incidence of acute myocardial infarction been increasing with prolongation of life spans, improvement in foods and life styles in Korea, rapid diagnosis and treatment is critical in survival of acute myocardial infarction patient. Most of the acute myocardial infarction result from atherosclerotic plaque forming thrombus and occlusion of coronary artery. Because early thrombolytic therapy is important to maintain the left ventricular function and survival rate, there have been many trials to reperfuse the occluded coronary artery. We have studied the many aspects of acute myocardial infarction such as sex, age, infarction site, chief complaints, change of ECG, change of serum enzyme, time delay on emergency room arrival, and compared the effectiveness of thrombolytic therapy. Total number of patient was 212, and males were 141(66.5%) and females were 71(33.5%). The most common infarction site was ant, fuel wall(102 cases,48%)of the heart and the most common chief complaint was chest pain(204 cases,97%). Among the 106 patients who received thrombolytic therapy, 101 patients(95%) had survived and 5 patients(5%) had died. Among the 64 patients who didn't receive thrombolytic therapy, 56 patients (87.5%) were alived and 8 patients(12.5%) were dead.
Ants ; Coronary Vessels ; Diagnosis* ; Electrocardiography ; Emergency Service, Hospital ; Female ; Heart ; Humans ; Incidence ; Infarction ; Korea ; Life Style ; Life Support Care ; Male ; Myocardial Infarction* ; Plaque, Atherosclerotic ; Survival Rate ; Thorax ; Thrombolytic Therapy ; Thrombosis ; Ventricular Function, Left

A clinical study was made on 52 patients (55 organs) with renal injuries in Capital Armed Forces General Hospital during the period from January, 1980 to May, 1982. Emphasis was placed on comparison of the expectant and early surgical management. Following results were obtained: 1. The nonpenetrating injuries were 45 cases (86.5%), penetrating, 7 cases (13.5%) and the most common cause of nonpenetrating injuries was traffic accident in 23 cases (44.2%) and the most common cause of penetrating injuries was gunshot in 6 cases (11.6%). 2. As to the management of nonpenetrating injuries, the expectant management was performed in 32 cases (71.1%) and early surgical management in 13 cases (28.9%). 3. All cases of penetrating injuries were managed with early surgical intervention. 4. As to the early surgical management in nonpenetrating injuries, nephrectomy was performed in 6 cases (46.2%), simple closure in 6 cases (46.2%) and partial nephrectomy in I case. 5. As to the early surgical management in penetrating injuries, nephrectomy was performed in 5 cases (71.4%), simple closure in 1 case and partial nephrectomy in I case. 6. In group of expectant management, gross hematuria disappeared at 2.7 days on an average. 7. In nonpenetrating injuries, complication were 6 cases (18.8%) after expectant management, while none, after early surgical management. 8. In penetrating injuries, complication were 2 cases (28.6%) after early surgical management. 9 As to the management of complication in nonpenetrating injuries, nephrectomy was performed in 4 cases (66.7%), deroofing of cyst in 1 case and expectant management in 1 case. 10. As to the management of complication in penetrating injuries, incision and drainage was performed in 1 case and colostomy in 1 case.
Accidents, Traffic ; Arm ; Colostomy ; Drainage ; Hematuria ; Hospitals, General ; Humans ; Nephrectomy ; Wounds, Nonpenetrating

Cerebrotendinous xanthomatosis-is a very rare, automsomal recessive disorder which characterized by xanthomatous deposits in multiorgan system. The main clinical features include pyramidal, cerebellar and brain stem dysfunction, juvenile cataracts, dementia and xanthomas, especially on Achilles tendon and other tissues. We experienced a patient, 43 year old male who showed cataract, mild cerebellar dysfunction and multiple xanthomas as well as recently developed right hemiparesis. The tendinous xanthomatosis was confirmed pathologically and the brain CT scan showed cortical atrophy, demyelination and multifocal cerebromalacia, which correlated with neurologic manifestation of this patient and with neuropathologic findings of cerebrotendinous xanthomatosis. The EEG showed generalized slowing of background activities.
Achilles Tendon ; Adult ; Atrophy ; Brain ; Brain Stem ; Cataract ; Cerebellar Diseases ; Cerebral Infarction* ; Dementia ; Demyelinating Diseases ; Electroencephalography ; Encephalomalacia ; Humans ; Male ; Neurologic Manifestations ; Paresis ; Tomography, X-Ray Computed ; Xanthomatosis ; Xanthomatosis, Cerebrotendinous*