Increase of AST and ALT is a common biochemical finding in patients with multiple trauma. So it is difficult to make a decision for appropriate operation timing and to predict prognosis with consideration of parenchymal liver disease. We studied patients with multiple trauma who admitted to orthopedic department with increased AST & ALT and patients who had hepatitis from Jan. 1993 to Dec. 1993. The patients were checked AST & ALT on admission day and followed by the 3rd, 5th, 9th day, second and third week. We checked the relation of changed level of these enzymes and severity of injury, combined abdominal trauma, head trauma and the presence of HBs Ag/Ab. We concluded as followed: 1) Traumatized patients had high AST than ALT during first 3 days but hepatitis patients had higher ALT than AST during throughout admission days. High ALT in hepatitis patients had statistically significance compare to traumatized patients. 2) Traumatized patients with high AST were decreased more rapidly than ALT and showed normalized enzymatic level by 3rd week. 3) The AST level was higher in severely injured patients and it was statistically significant within first 3 days. But ALT was not correlated with the severity of injury. 4) In patients with abdominal injury, AST was higher than ALT and AST had significance but ALT had none. 5) There is no specific correlation between these enzyme level in neurosurgical problem and the presence of HBsAg/Ab.
Abdominal Injuries ; Craniocerebral Trauma ; Hepatitis ; Humans ; Liver Diseases ; Multiple Trauma ; Orthopedics ; Prognosis

BACKGROUND/AIMS: Despite of increasing numbers of reports on intraductal papillary mucinous tumor (IPMT), there is still difficulty in its' diagnosis, treatment and prediction of prognosis. The purpose of this multicenter study was to evaluate the clinico-pathological features of IPMT in Korea and suggest the prediction criteria of malignancy in IPMT. METHODS: We retrospectively reviewed the clinico-pathological data of 208 patients who underwent operations with IPMT between 1993 and 2002 at 28 institutes in Korea. RESULTS: Of the 208 patients with a mean age of 60.5+/-9.7 years, 147 were men and 61 were women. 124 patients underwent pancreatoduodenectomy, 42 distal pancreatectomy, 17 total pancreatectomy, 25 limited pancreas resection. Benign cases were 128 (adenoma (n=62), borderline (n=66)) and malignant cases were 80 (non-invasive (n=29), invasive (n=51)). A significant difference in 5-year survival was observed between benign and malignant group (92.6% vs. 65.3%; p=0.006). Of the 6 factors (age, location, duct dilatation, tumor appearance, main duct type, and tumor size) that showed the statistical difference in univariate analysis between benign and malignant group, we found three significant factors (tumor appearance (p=0.009), tumor size (p=0.023), and dilated duct size (p=0.010)) by multivariate analysis. CONCLUSION: Although overall prognosis of IPMT is superior to ordinary pancreatic cancer, more curative surgery is recommended in malignant IPMT. Tumor appearance (papillary), tumor size (> or =30 mm) and dilated duct size (> or = 12 mm) can be used as preoperative indicators of malig-nancy in IPMT.
Academies and Institutes ; Diagnosis ; Dilatation ; Female ; Humans ; Korea* ; Male ; Mucins* ; Multivariate Analysis ; Pancreas* ; Pancreatectomy ; Pancreatic Neoplasms ; Pancreaticoduodenectomy ; Prognosis ; Retrospective Studies