BACKGROUND: Primary hepatocellular carcinoma(HCC) is the second cause of cancer death in our country. Hepatitis B virus(HBV) and hepatitis C virus(HCV) are important risk factors for hepatocellular carcinoma. The mechanism of HCC development and the epidemiology in HCV infected individuals are still unclear. In this study, we investigated the epidemiolgical and clinical features of HCC in relation to viral infection. METHODS: We reviewed the medical records of 160 HCC patients retrspectively who had been admitted to one University Hospital located in Seoul between January 1991 and December 1995. Among these patients, 113 patients were positive for HBsAg(B group), 24 for anti-HCV(C group). We compared epidemiological and clinical data between B group and C guoup. RESULTS: Anti-HCV positivity was significantly higher in HBsAg negative patients than in HBsAg positive patients(53.3:1.7%, p<0.01). The mean age of patients in B group was significantly lower than that in C group(52:62yr, p<0.01). In C group, the proportion of Child-Pugh class B and C was significantly larger than that of B group(35.4: 75.0%, p<0.01). In C group, the proportion of transfusion history was significantly larger than that in B group(4.4: 16.7%, p<0.05), and the proportion of drug abuse hestory was significantly larger than that in B group (31.0:62.5%, p<0.01). In C group, the albumin, cholesterol, Gamma-glutamyl transferase leves were significantly lower than those in B group. In B group, the proportion of metastasis was significantly larger than that in C group(31.9:4.2%, p<0.01). Alpha fetoprotein levels greater than 400ng/ml are much more prevalent in group B significantly(67:39.1%, p<0.05). No significant differences in cumulative survival rate(1yr, 2yr) and median survival time were observed between the two groups. CONCLUSIONS: We ascertain that the HBV and HCV are inportant factors in HCC. In epidemiology and clinical features of HCC, there were some difference between the HBsAg and anti HCV positive group. Therefore, on primary health care settings, it is necessary to test for hepatitis C as well as hepatitis B in order to prevent and manage HCC and chronic liver desease.
alpha-Fetoproteins ; Carcinoma, Hepatocellular* ; Cholesterol ; Epidemiology* ; Hepatitis B ; Hepatitis B Surface Antigens* ; Hepatitis C ; Humans ; Liver ; Medical Records ; Neoplasm Metastasis ; Primary Health Care ; Risk Factors ; Seoul ; Substance-Related Disorders ; Transferases

No abstract available.
Emergencies* ; Emergency Service, Hospital* ; Humans

No abstract available.
Intussusception*

Os subfibulare is a accessory bone arround the lateral maleolus, but it is different from many other accessory bones in foot and ankle in its development related to trauma and frequent symptoms of ankle instability. Accessory bone is a developmental anomaly which fails to unite to main secondary ossification center and usually asymptomatic. But os subfibulare is developed by recurrent ankle sprains in younger age or non-union of avulsion fracture of anterior talofibular ligament and causes instability of ankle. We experienced two cases of symptomatic os subfibulare in adolecents and report them with review of literatures.
Ankle ; Ankle Injuries ; Foot ; Ligaments

No abstract available.
Seoul*

Cancer of the gastric stump, first described by Balfour in 1922, is defined as the cancer detected more than 5 years after surgery for a benign disease. We experienced a case of cancer found at the gastric stump after gastrojejunostomy in a 53 years old male patients, proven pathologically as a early cancer. He visited to our hospital with the chief complaint of epigastric pain and indigestion for 1 Months. On past history, he has been received gastrojejunostomy due to duodenal ulcer obstruction, 23 years ago, Gastrofiberscopy was done, and we could find the early gastric cancer lesions at the anterior wall of gastric angle as type Ilc+III and antrum as type IIa. The microscopic finding of the multiple endoscopic biopsies at the gastic angle and antrum revealed the adenocarcinoma of signet ring cell type infiltrated to the level of submucosa. And so, we could diagnose these lesions as a early gastric cancer in the gastric stump after gastrojejunostomy. He was treated with subtotal gastrectomy and discharged with cured condition. Therefore, we report this case with a literature review.
Adenocarcinoma ; Biopsy ; Duodenal Ulcer* ; Dyspepsia ; Gastrectomy ; Gastric Bypass* ; Gastric Stump* ; Humans ; Male ; Middle Aged ; Stomach Neoplasms

This experiment is designed to find differentially expressed genes in p388D1 cells that are specific for the serum deprived state. Serum starvation induces cells to enter the quiscent state in the cell cycle and is used to arrest cell growth or synchronize the cell cycle. Differential display and ribonuclease protection assay were used to identify quantitative change in gene expression. Nineteen genes that showed a differential expression in the differential display were cloned and 7 clones were verified by a ribonuclease protection assay. Among the 7 clones clone-16 showed same expression pattern in comparison with the differential display. Deduced amino acid sequences of clone-16 had N-glycosylation motif and seems to be a secretory protein. Getting a full sequence of clone-16 is critical for the characterization of it.
Amino Acid Sequence ; Cell Cycle ; Clone Cells ; Gene Expression ; Ribonucleases ; Starvation

BACKGROUND: Clinically apparent thyroid nodule is a very common disease in adults. Patients are often treated with thyroxine in order to reduce the size of the nodule, but the efficacy of thyroxine-suppressive therapy with thyroxine remains uncertain. We investigated the efficacy of thyroxine-suppressive therapy and the hormonal characteristics during thyroxine therapy to find out whether such measurement could be used to determine the effectiveness of this therapy in patients with benign solitary thyroid nodule proved by aspiration biopsy. METHODS: In this study, 54 patients were randomly assigned to receive L-thyroxine (Group I, n=24) or placebo (GroupII, n=30) for 1 year. High resolution ultrasonography (10MHz) was used to measure the size of the nodules at six month intervals. Thyroid hormones and thyroglobulin assay and FNA (fine needle aspiration) was done at the same time. The dose of thyroxine was 200ug/day. Patients were followed at 6 month intervals. RESULTS: The results were as follows: 1) 13 (54.1%) out of 24 Group I patients after adequate TSH suppression had a statistically significant reduction of nodule size and before-to-after nodule volume ratios were significantly different between the Group I and Group II patients. 2) In the responders among Group I patients, the before-to-after therapy ratio of the nodule volume was not related to the pretreatment nodule size, thyroid hormones and thyroglobulin levels. CONCLUSION: Thus we concluded that an adequate suppressive dose of L-thyroxine significantly altered the volume of the benign solitary thyroid nodules 12 months later.
Adult ; Biopsy, Needle ; Humans ; Needles ; Thyroglobulin ; Thyroid Gland* ; Thyroid Hormones ; Thyroid Nodule* ; Thyroxine* ; Ultrasonography

PURPOSE: We administered doxazosin gastrointestinal therapeutic system (GITS) to women with non-neurogenic voiding dysfunction to evaluate its therapeutic effects. MATERIALS AND METHODS: Women who had voiding dysfunctions for at least 3 mo were included. Inclusion criteria were age > or =18yr, an International Prostate Symptom Score (IPSS) > or =15, and a maximum flow rate (Qmax) <15mL/sec and/or postvoid residual (PVR) > or =150mL. Patients with neurogenic voiding dysfunction or anatomical bladder outlet obstruction were excluded. All patients were classified according to the Blaivas-Groutz nomogram. After 4 weeks, treatment outcomes were evaluated. RESULTS: Sixty-two patients were evaluated of mean age 53.8 (32-78)yr. According to the Blaivas-Groutz nomogram, 24 patients had no or mild obstruction (group A) and 38 had moderate or severe obstruction (group B). After treatment, mean IPSS decreased significantly and by more than 5 points in 42 (67.7%). Mean bother scores, Qmax, and PVR also changed significantly. Thirty-seven (59.7%) showed Qmax increases of more than 50%. No significant difference were observed between the groups in terms of IPSS, bother score, Qmax, PVR, micturition frequencies, or functional bladder capacity changes. Adverse effects related to medication were de novo stress urinary incontinence (SUI) (1 case) and underlying SUI aggravation (1 case). By satisfaction assessments, 16 patients (25.8%) were 'mainly satisfied', 31 (50%) were 'slightly satisfied', and 15 (24.2%) were 'dissatisfied'. CONCLUSION: Doxazosin GITS was found to be effective in female patients with voiding dysfunction regardless of obstruction grade. The alpha-adrenoceptor antagonists should be viewed as initial treatment option for women with a non-neurogenic voiding dysfunction.
Doxazosin* ; Female ; Humans ; Nomograms ; Prostate ; Urinary Bladder ; Urinary Bladder Neck Obstruction ; Urinary Incontinence ; Urination

PURPOSE: We tried to identify the overall incidence of microsatellite instability (MSI) and the utility of mismatch repair (MMR) protein expression in sporadic colorectal cancers in Korean. We also investigate the role of angiogenesis in colorectal cancers by MSI status. METHODS: A total 85 resected colorectal cancers were submitted for MSI study using PCR methods with 5 markers and immunohistochemistry (IHS) for hMLH1 and hMSH2. Expression of COX-2 and iNOS and microvessel density by IHS were correlated with various clinicopathologic prognostic factors. RESULTS: Among 85 cases of sporadic colorectal cancers, MSI was observed in 11 cases (12.9%) including 10 MSI-H and 1 MSI-L cases. Patients with MSI (+) showed female prevalence (1.75 : 1), low Dukes stage, mucinous histologic type, and Crohn-like lymphoid reaction than those with MSS. Overall sensitivity of hMLH1 and/or hMSH2 expression was 98.6% and specificity was 72.7%. iNOS expression was significantly correlated with COX-2 expression in tumor cells (P=0.006), however, they were not correlated with MSI status. High microvessel density was correlated with hMLH1 expression (P=0.025), COX-2 expression (P= 0.05), and Crohn-like lymphoid reaction (P=0.041). CONCLUSIONS: IHS for MMR proteins is a valuable substitute of MSI status and COX-2 related neoangiogenesis is thought to be related to inhibition of microsatellite unstable colorectal cancer progression via decreased microvessel density.
Colorectal Neoplasms* ; DNA Mismatch Repair ; Female ; Humans ; Immunohistochemistry ; Incidence ; Microsatellite Instability* ; Microsatellite Repeats* ; Microvessels* ; Mucins ; Polymerase Chain Reaction ; Prevalence ; Sensitivity and Specificity