BACKGROUND/AIMS: Although the only therapy of proven benefit for chronic hepatitis C is interferon alpha, the rate of sustained response after treatment with interferon is less than 25%. A 6-month course of combination therapy with interferon and ribavirin was associated with higher rate of long-term response than either interferon or ribavirin alone. Pilot studies suggested that combination of interferon and ursodeoxy-cholic acid (UDCA) resulted in higher biochemical response than interferon alone. We investigated the rates of end of treatment response(ETR) and sustained response(SR) of combination therapy of interferon e2a, ribavirin and UDCA and compared it with interferon a 2a alone. METHODS: Ninty-five naive patients with chronic hepatitis C who have been positive for anti-HCV by 3rd generation EIA and HCV RNA by RT-PCR and had elevated level of ALT over 6 months were included. They were assigned to three groups. Thirty seven patients in group 1 were treated with interferon a 2a (3MU thrice weekly) in combination with ribavirin (600mg/day) and UDCA (600mg/day) for 6 months. Twenty nine patients in group 2 were treated with the same dose of interferon a 2a alone for 6 months. Changes of ALT and HCV RNA were observed over 12 months (average 3029 mos) after the end of treatment in both groups. Twenty nine patients in group 3 were observed over 12 months without antiviral treatment. HCV genotypes were tested by Innop-Lipa in 24 patients in group 1. RESULTS: In group 1, not only ETR (68%) but also 12 month SR rate (54%) was significantly higher than group 2(31%, 21% respectively). There was no difference in relapse rate between two groups. The level of ALT became normalized and HCV RNA negative within 1 month after treatment in most responders in group l. Genotype 1b was associated with lower ETR and SR than non-lb, although not significant stastistically. CONCLUSION: Both the ETR and 12 month SR rate were significantly higher after combination treatment of interferon a 2a, ribavirin and UDCA than interferon e 2a alone in chronic hepatitis C. It is suggested that this combination is preferable to interferon alone in the treatment of naive patients with chronic hepatitis C.
Genotype ; Hepatitis C, Chronic* ; Hepatitis, Chronic* ; Humans ; Interferon-alpha* ; Interferons* ; Recurrence ; Ribavirin* ; RNA

Persistent trigeminal artery is an embryonic remnant of the anastomotic channel linking the internal carotid artery and the basilar artery. Cases of vertebrobasilar insufficiency caused by the persistent trigeminal artery with internal carotid artery stenosis has been described previously, but vertebrobasilar insufficiency entirely due to in situ stenosis of the persistent trigeminal artery has not been reported. A 71-year-old man presented with frequent dizzy episodes. The brain MRI showed no parenchymal lesions. MR angiography showed poor visualization of vertebrobasilar system. He was diagnosed as having vertebrobasilar insufficiency. Cerebral angiography revealed that there was complete occlusion at the vertebrobasilar junction, and the basilar artery was supplied by the persistent trigeminal artery which had severe stenosis at its origin. There was no stenosis of the internal carotid artery of both sides. We believe that this is the first report of vertebrobasilar insufficiency due to stenosed persistent trigeminal artery, without internal carotid artery stenosis.

The early postpartum period is crucial toward in recovery form childbirth and attainment of the maternal role. Maternal role attainment is a complex social and cognitive process of stimulus-response accomplished by learning. Helping for maternal role attainment is one of nursing goals in the early postpartum period. Based on King's conceptual framework for nursing, this study was planned as descriptive correlation study to determine the significant differences of the degree of nursery room nurses' role performance according to several variables of personal, interpersonal, and working system of nurses in nursery room, The purpose of this study was to contribute to the planning of nursing care to help maternal role attainment of the early postpartum period of mothers and to the development of relevant nursing theory, The data were collected from R3b. 3 to 28 by questionnaires with 273 nurses in nursery room. The instruments for this study were consisted of four parts: 21 questions for roll performance of nurse ; 37 questions for personal system of nurse including 31 questions for role perception of nurse ; 65 questions for interpersonal system including 63 questions for job stress of nurse ; 18 questions for working system of nurse. The toes to measure role performance and role perception, and job stress of nurse were tested for internal reliability. Cronbach's Alphas were 0.9612, 0.9058, and 0.9649. The data were analysed by using in S.A.S. computerized program and included percentage, t-test, ANOVA, Pearson Correlation Coefficient, and Duncan multiple range test. The conclusions obtained from this study are summarized as follows : 1. The mean score of the items of role performance was 2.12(SD=0.55) in Likert's 4 points scale. 2. The degree of role performance was significantly different according to role perception(p=0.0001), age(p=0.006), educational background(p=0.002), and certificate of midwife(p=0.03) among variables of personal system of subjects. 3. The degree of role performance was significantly different according to job stress(p=0.0001) and numbers of children(p=0.006) among variables of interpersonal system of subjects. 4. The degree of role performance was significantly different according to having opportunities for baby(p=0.03), the degree of flexibility to bring baby to mother's room(p=0.046), the scope of visitor for baby(p=0.016), the degree of flexibility of visiting for baby(p=0.049), the degree of participation of nurse in establishing visiting rules(p=0.017), existence and/or nonexistence of rules for breast feeding(p=0.010), existence and/or nonexistence of education for breast feeding(p=0.009), existence and/or nonexistence of breast feeding room(p=0.013), concret methods for breast feeding(p=0.003), working place(p=0.0001), and career(p=0.019) among variables of personal system of subjects.
Breast ; Breast Feeding ; Education ; Humans ; Learning ; Mothers* ; Nurseries* ; Nursing ; Nursing Care ; Nursing Theory ; Parturition ; Pliability ; Postpartum Period* ; Statistics as Topic ; Toes ; Child Health ; Surveys and Questionnaires

The accuracy of fine needle aspiration cytology (FNAC) of the lymph node was investigated through a review of 176 FNAC cases and the corresponding biopsies. We chose 157 FNAC cases after the exclusion of 19 inadequate ones. Sensitivity of malignancy was 94.0%, specificity 100%, false negativity 6.0%, and false positivity 0.0%. The overall diagnostic accuracy was 96.8%. Sensitivity of metastatic carcinoma was 98.0% and that of malignant lymphoma was 87.9%. False negative cases included one metastatic carcinoma and four malignant lymphomas. The aspirates of metastatic carcinoma with false negativity exhibited a diffuse smear of keratin debris without viable cells, which led to the difficulty in differentiation from benign epithelial cyst. The cases of malignant lymphoma with false negative diagnosis were two Hodgkin diseases, one Lennert's lymphoma, and one peripheral T cell lymphoma in the histologic sections. On the analysis of 39 cases of tuberculosis, 17 cases (43.6%) were diagnosed as tuberculosis, 4 (10.3%) as granulomatous lymphadenitis, 3 (7.7%) as necrotizing lymphadenitis, and 15 (38.5%) as reactive hyperplasia or pyogenic inflammation. Sensitivity of tuberculosis was 53.9%. In conclusion, lymph node FNAC is an excellent non-invasive diagnostic tool for the diagnosis of metastatic carcinoma. The diagnostic accuracy of malignant lymphoma could be improved with flow cytometry or polymerase chain reaction for antigen receptor genes. For the FNAC diagnosis of tuberculosis, AFB stain, culture, and PCR would be helpful as adjuvant techniques.
Biopsy ; Biopsy, Fine-Needle ; Diagnosis ; Flow Cytometry ; Hyperplasia ; Inflammation ; Lymph Nodes ; Lymphadenitis ; Lymphoma ; Lymphoma, T-Cell, Peripheral ; Polymerase Chain Reaction ; Receptors, Antigen ; Sensitivity and Specificity ; Tuberculosis

Milk of calcium located in the breast is typically a benign entity. However, carcinoma may incidentally arise adjacent to or even within milk of calcium. Consequently, the characteristics of all observed calcific particles should be carefully analyzed. In this study, we report a case of carcinoma presented as malignant microcalcifications mixed within milk of calcium in a breast.
Breast Neoplasms/*chemistry/radiography ; Calcium Carbonate/*analysis ; Carcinoma, Ductal/*chemistry/radiography ; Female ; Humans ; Mammography ; Middle Aged

Congenital adrenal hyperplasia is inherited disorder of adrenal steroidogenesis. 21-hydroxylase deficiency is the most commone enzymatic defect and is divided into classic and late-onset or nonclassic forms. Both classic non-classic 21-hydrozylase deficiencies are inherited in a recessive manner as allelic variants. But it is rare that happened in twin infants. Chief complaints of affected twins in our case were ambiguous genitalia, hyperpigmentation and dehydrations. They were revealed into hyponatremia, hyperkalemia and increased amount of serum progesterone, 17-hydroxyprogesterone and urinary 17-ketosteroid excretion and were administered with DOCA, 9alpha-fluorohydrocortisone, hydrocortisone to control the electrolyte imbalance. And now, both of them are going to normal ratio of weight gain and body growth.
17-alpha-Hydroxyprogesterone ; Adrenal Hyperplasia, Congenital* ; Desoxycorticosterone Acetate ; Disorders of Sex Development ; Humans ; Hydrocortisone ; Hyperkalemia ; Hyperpigmentation ; Hyponatremia ; Infant ; Progesterone ; Steroid 21-Hydroxylase* ; Twins* ; Weight Gain

The results of alpha-acetyldigoxin(Dioxanin(R)) administration in 21 patients with congestive heart failure were as follows. Alpha-acetyldigoxin is a new oral preparation of cardiac glycoside derived from lanatosid C. 1. For rapid digitalization in 2-3 days, the initial dose was 1.2 to 2.6mg (average 1.96mg). For medium-fast digitalization in 4 days, the loading dose was 2.0 to 3.2mg (average 2.7mg). For slow digitalization 0.1 to 0.4mg was required for 5 to 6 days without loading dose. The maintenance dose was 0.1 to 0.4mg (average 0.33mg) daily. 2. The therapeutic effect of acetyldigoxin was excellent in 15 cases (71%), good in 4 cases (20%) and stationary in 2 cases (9%). 3. Side effects were observed in 2 cases with usual dosage regimen. One accidental case who took single dose of 4mg(20 tablests) developed supraventricular tachycardia with varying degree of atrioventricular block, ventricular bigeminy and premature beat but recovered completely after 6 days.
Acetyldigoxins* ; Atrioventricular Block ; Cardiac Complexes, Premature ; Estrogens, Conjugated (USP)* ; Heart Failure* ; Humans ; Tachycardia, Supraventricular

No abstract available.
Leukemia, Myelogenous, Chronic, BCR-ABL Positive*

The incidence of thyroid cancer is steadily increasing in many countries including Korea. Especially in Korea, the incidence of thyroid cancer is very rapidly increasing during several decades; from 2005 Annual Report of the Korea Center Cancer Registry, thyroid cancer ranked the fifth among all cancers (incidence rate was 8.9%). Moreover the incidence of thyroid cancer was 16.7% in female and now thyroid cancer was reported the most common cancer in Korean female. Among several thyroid cancers, papillary thyroid cancer (PTC) is rapidly increasing due to the increased detection of papillary thyroid microcarcinoma (PMC). Until now, PMC showed little significant differences among clinical characteristics or prognosis compared with PTC, thus the optimal treatment strategy of PMC remains controversial. Therefore, to establish the optimal treatment and follow up program about thyroid cancer, we should investigate clinical characteristics, prognosis and predictive factors of PMC more closely.
Carcinoma, Papillary ; Factor IX ; Female ; Humans ; Incidence ; Korea ; Prognosis ; Thyroid Gland ; Thyroid Neoplasms

We deacribe herein a case of Darier-White disease occurring to a 50-year-old man who had a characteristic lesions limited to the sun exposed area and no skin lesion in the sun protected area for 40 years. The akin lesions recurred in summer time and aggravated after sun exposure and disappeared spontaneously in winter time. Histologic findings from the neck lesions revealed hyperkeratosis, parakeratosis, supirabasal lacunae, acantholytic cells, villi, corps ronds and grains.
Edible Grain ; Darier Disease ; Humans ; Middle Aged ; Neck ; Parakeratosis ; Skin ; Solar System*