The prognosis of chronic hepatitis C is very variable. In some, the disease is progressive and cirrhosis can develop from chronic hepatitis C. Hepatitis C virus (HCV) may act as a trigger towards hepatocellular carcinoma in patients with cirrhosis. Interferon has been used for the treatment of chronic hepatitis C in abroad. 16 patients with chronic C liver disease were treated with alpha-interferon (alfa-2b : "Intron A" Schering Corp. Kenilworth, NJ). All patients were given alpha-interferon in subcutaneous doses of 3 million units three times weekly for 1 to 9 months. During therapy, CBC and ALT levels were checked weakly to monthly. After therapy,. patients were followed for 1 to 8 months. Among 16 patients treated with alpha-interferon, progressive decrease of ALT levels was observed in 14 (87.5%). In 11 patients (68.8%), ALT levels fell into the normal range during therapy, and in 9 of 11, within one month after therapy. 6 months after the completion of therapy in 4 of 9 patients (44.4%) whose ALT levels were in the normal range. alpha-interferon seems to have effect in controlling disease activity in patients with chronic hepatitis C. But the changes in the usage of alpha-interferon, dose and duration, long term follow up and more convenient and simple tests for HCV detection are recommended for the better effect and the exact evaluation on the effect of alpha-interferon therapy in patients with chronic hepatitis C.
Carcinoma, Hepatocellular ; Fibrosis ; Follow-Up Studies ; Hepacivirus ; Hepatitis C, Chronic* ; Hepatitis, Chronic* ; Humans ; Interferon-alpha* ; Interferons ; Liver Diseases ; Prognosis ; Reference Values

No abstract available.
Diagnosis* ; Liver Diseases* ; Liver*

Although Lamivudine and adefovir dipivoxil are efficacious drugs for preventing hepatocellular carcinoma (HCC) in chronic hepatitis B patients, their efficacy is far from completely satisfactory. The risk of liver cirrhosis and HCC begins to increase at an HBV DNA level of 10(4) copies/ml. Even with latent or past HBV infection, episomal covalently closed circular DNA(cccDNA) plays a key rolein the persistence, relapse and resistance of HBV in its natural course or during therapy. The annual incidence of HCC in YUMC is 1.8% and 4.7% patients/year in the antiviral treatment and control groups, respectively. The ability to achieve a high rate of sustained HBV suppression with low risk of drug resistance is the ultimate goal in the treatment of chronic HBV infection. The efficacy of universal immunization with striking reductions in the prevalence of HBV in localized countries needs to be spread worldwide. With hepatitis B immunization and effective antiviral therapy, global control of HBV infection and HBV-related complications, including HCC, are possible by the end of the first half of the 21st century.
Adenine ; Carcinoma, Hepatocellular ; Collodion ; DNA ; Drug Resistance ; Hepatitis B ; Hepatitis B, Chronic ; Hepatitis, Chronic ; Humans ; Immunization ; Incidence ; Lamivudine ; Liver Cirrhosis ; Organophosphonates ; Prevalence ; Recurrence ; Strikes, Employee

Among 85 patients with anti-HCV positive chronic liver disease, only 21.2% have past history of blood transfusion and over half the cases, they do not have any suspicious risk factors for HCV infection. 3 of 85 families show anti-HCV positive family members. On the other hand, 40 of 60 patients with HBsAg positive chronic liver disease show HBsAg positive family members. In Korea, HBV is transmitted mainly through vertical and intrafamilial infection but HCV disease might be rather horizontal and sporadic than vertical. To define the evident source of infection in sporadic hepatitis C, first of all, simple test with high sensitivity and specificity for diagnosis of HCV infection would be needed.
Blood Transfusion ; Diagnosis ; Epidemiology ; Hand ; Hepatitis B Surface Antigens ; Hepatitis C ; Humans ; Korea ; Liver Diseases ; Risk Factors ; Sensitivity and Specificity

No abstract available.
Clonorchis sinensis*

Paroxysmal Nocturnal Hemoglobinuria (PNH) is an uncommon hematologic disease characterized by an abnormal sensitivity of blood cells to the lytic action of serum complement. We experienced one case of PNH in Yeungnam University Hospital from May 1983 to May 1989. The patients was followed up without severe complications of 4 years since diagnosis with the only conservative treatments such as washed blood transfusion, adrenal corticosteroids, androgens, folate and iron preparation, intermittently.
Adrenal Cortex Hormones ; Androgens ; Blood Cells ; Blood Transfusion ; Complement System Proteins ; Diagnosis ; Folic Acid ; Hematologic Diseases ; Hemoglobinuria, Paroxysmal* ; Humans ; Iron

The positive rate for serum anti-Hbs was analized among 424 0f HA vaccinated and 2035 of non-vaccinated cases at the Yeungnam University Hospital, Computed Automated Med-screening Center. Most of them from Kyungbook province and they had the last HB vaccination in the periods of 3 to 42months prior to this study. The followings were obtained. 1. The positive rates for serum HBsAg were 0.7% in the vaccinees, 9.6% in the non-vaccinated and 8.0% in the whole cases. 2. The positive rates for serum ant-HBs were 66.3% in the vaccinees, 47.9% in the non-vaccinated and 51.6% in the whole cases. 3. The positive rates for serum anti-HBs were 51.4% in the cases with one time of vaccination and 68.6% in the cases with two times of vaccination. On the vasis of these findings the positive rate for serum anti-HBs among the vaccines was significantly higher than of non-vaccinated (P<0.05). The positive rate for serum anti-HBs shortly after vaccination was higher than that of present our study which was made relatively long period after vaccination. As the reason a natural decrease of the titers of the serum anti-HBs can be postulated as one of the contributing factors for the discrepancy. In order to keep to serum antibody of perfect protectivity against HBV, it may be better to check the serum anti-HBs just vaccination, follow up and take booster injection when it is needed.
Follow-Up Studies ; Hepatitis B Surface Antigens ; Vaccination* ; Vaccines

In recent years, an increasing number of drugs have been reported to cause direct esophageal damage. More than 30 cases on tetracyclines induced esophageal ulcer have been reported since the first description of tetracycline induced esophageal ulcer by Bokey and Hugh in 1975. In Korea, only one case of doxycycline-unduced esophageal ulcer has been reported. Authors have experienced 3 cases of esophageal ulcer probably caused by tetracyclines. The patients had taken their capsules just before going to bed with little fluid intake. About 6-8 hours later they had felt substernal burning sensation and epigastric discomfort. Gastrofiberscopy revealed relatively well demarcated circular ulcers on the mid esophagus. An esophagogram showed no apparent abnormality. Patients's symptoms became negligible with antacid treatment within 2-5 days. One of the causes of the esophageal ulcer is thought to be the delay in transit time of drugs and direct esophageal damage from mucosal contact when tablets are ingested in the recumbent position without an accompanying proper quantity of fluid. If only physicians endow patients with more concern about drug induced esophageal ulcer, they could find out more increasing number of drug induced esophageal ulcers by gastroscopic examination and thereby could prevent tetracycline induced esophageal ulcer.
Burns ; Capsules ; Esophagus ; Humans ; Korea ; Sensation ; Tablets ; Tetracycline ; Tetracyclines* ; Ulcer*

BACKGROUND/AIMS: Hepatitis C virus(HCV) was known to most common etiologic agent of chronic liver disease in United states and Japan. Although hepatitis B virus(HBV) was well known to be a its major etiologic agent in Korea, it has been showed that HCV and HBV are associated with liver cirrhosis and hepatocellular carcinoma as major causative agent of chronic liver disease. Interferon alpha therapy is generally accepted as effective single agent for chronic hepatitis or to decrease the chronicity of acute hepatitis C. So, we evaluated the efficacy of interferon alpha in hepatitis C. METHODS: 46 patients who were positive for anti-HCV antibody and HCV RNA were included in this study. Liver biopsy was per formed on all patients and all of them were tested as negative for serum HBsAg, anti Hbe. Patients were divided into 2 groups . 30 patients received interferon therapy(treated group) and 16 patients received no therapy(untreated group). We compared the change of liver function test and HCV RNA before and after therapy between two groups. Treated group was subdivided into 5 groups according to response to interferon therapy '. Non-response, partial response, breakthrough, relapse and sustained response. RESULTS: 1) The mean age and sex distribution were 49.9 year old, male 19, female 11 in treated group and 48.7 years, male 12, female 4 in untreated group. 2) The number of patients with acute hepatitis, chronic persistent hepatitis, chronic active hepatitis and liver cirrhosis were 1, 2, 23, 4 in treated group and 0, 1, 12, 3 in untreated group, respectively. 3) The mean follow up period was 1.7 year and 2.3 years in treated and untreated group, respectively. 4) The activity of serum ALT before and after therapy were 195+ 134.6 IU/L, 87.4+ 40.5 IU/L and 186.7+ 106.4 IU/L, 157+ 87.1 IU/L in treated and untreated group, respectively. Serum ALT after therapy in treated group was significantly lower than untreated group(P<0.01). 5) The number of patients for patterns of reponse in treated group was non-response 5, partial response 8, breakthrough 1, relapse 4, sustained response 12 and there was no difference in age among them(P>0.05). 6) The case of negative conversion for HCV RNA in treated group was 12, but there was no case in untreated group. 7) Sex distribution of sustained response was 6(31% ) of 19 male, 6(54.5%) of 11 female and 12 patients(40.0%)(1 of 1 patients with acute hepatitis, 1 of 2 chronic persistent hepatitis, 10 of 23 chronic active heaptitis) included in sustained reponse, but any patients with liver cirrhosis had response. 8) Mean total dose and duration of interferon therapy was non-response 10353.6 million unit(MU)/5.8month(M), partial response 20025.06MU/6.4 M, breakthrough 36000.0MU/5.0M, relapse 11700.0MU/3.3M, sustained response 28100.0MU/6.6M, respectively. 9) 3 of 7 patients who were followed up over 1 year in sustained response and mean time to the relapse was 2.2 years. CONCLUSION: Our results showed that interferon alpha therapy is effective in patients with hepatitis C and further study and attempts should be performed to augument the efficacy of interferon alpha for the treatment of hepatitis C.
Biopsy ; Carcinoma, Hepatocellular ; Female ; Follow-Up Studies ; Hepatitis B ; Hepatitis B Surface Antigens ; Hepatitis C* ; Hepatitis* ; Hepatitis, Chronic ; Humans ; Interferon-alpha* ; Interferons* ; Japan ; Korea ; Liver ; Liver Cirrhosis ; Liver Diseases ; Liver Function Tests ; Male ; Recurrence ; RNA ; Sex Distribution ; United States

BACKGROUND: Bupivacaine is a amide type local anesthetic agent, widely used for its excellent quality of analgesia and long duration of action. But unintended intravenous injection causes severe complication such as convulsion and cardiovascular collapse, which is known for its difficulty in resuscitation. With all the study, the exact mechanism is still unclear and there are much debate on the method of resuscitation. METHOD: We studied the effect of clonidine pretreatment on bupivacaine-induced cardiac toxicity and resuscitation in anesthetized dog. Twelve dogs were divided into two groups. : saline pretreatment group (control, N=6) and clonidine pretreatment group (clonidine group, N=6). The dogs were anesthetized with N2O-O2-enflurane and vecuronium. Thoracotomy was done in 4th or 5th intercostal space for open cardiac massage. After confirming stability of vital signs, we administered clonidine (10 mcg/kg) or saline, and then administered bupivacaine with the rate of 2 mg/kg/min. When the electeocardiogram showed asystole, 20 mcg/kg of epinephrine was administered via central venous line and open cardiac massage with the rate of 120 beat/min. was performed. We observed electrocardiogram (lead II), arterial blood pressure, heart rate, dose of infused bupivacaine to be required for QRS widening and arrest, required time and administered dose of epinephrine for resuscitation. RESULTS: Clonidine group showed significant decrease of heart rate after pretreatment (p<0.05). There was no significant difference in required dose for QRS widening between two groups. The dose administered for inducing arrest was less in clonidine group than control group (p<0.05). The time required for resuscitation was shorter in clonidine group than control group (p<0.05). The total dose of epinephrine required for resuscitation was less in clonidine group than control group (p<0.05). The blood concentration of catecholamine did not showed significant difference during the whole course of experiment. CONCLUSIONS: Above results demonstrated that clonidine, a central nervous system-mediated sympatholytic agent, facilitated cardiac arrest when bupivacaine was infused intravenously and cardiac rescucitation.
Analgesia ; Animals ; Arterial Pressure ; Bupivacaine ; Clonidine* ; Dogs* ; Electrocardiography ; Epinephrine ; Heart Arrest ; Heart Massage ; Heart Rate ; Injections, Intravenous ; Resuscitation* ; Seizures ; Thoracotomy ; Vecuronium Bromide ; Vital Signs