No abstract available.
Leukoencephalopathies*

No abstract available.
Primary Myelofibrosis*

No abstract available.
Child* ; Humans ; Infant*

Eleven cases of juvenile diabetes mellitus who were admitted Seoul National University Hospital from Jan., 1969 to Aug., 1978 were aha1yzed. The mean age of onset was 7 and female to male ratio was 8 to 3 with female preponderance. Four had family history of diabetes, although none had diabetic sibling. Polyuria and polydipsia were noted in all cases as initial symptoms, and symptoms of weight loss (6 cases), disturbances in consciousness (5), generalized weakness (5), anorexia (4) and enuresis (3) were noted in the order of frequency. Leucocytosis was noted in 5 cases, but only 2 among the 4 who had infection revealed leucocytosis, The mean blood glucose level was 320 mg% and serum osmolality was 293 mOsm/L. There was no significant difference in the level of blood sugar and serum osmolality according to the consciousness status. Eight episodes of ketoacidosis occured in 5 cases. Three episodes developed due to discontinuance of insulin and three episodes accompanied infection. The mean blood glucose level was 495 mg% and serum osmolality was 300 mOsm/L in ketoacidosis. The consciousness cleared in average 20 hours and ketonuria disappeared in average 26 hours after the administration of insulin (average 5 units/kg of body weight). At discharge, the average dose of insulin needed was 1.2 U/kg/d. Six patients were followed from 6 months to 6 years. Two developed pulmomary tuberculosis during the period of follow up.
Age of Onset ; Anorexia ; Blood Glucose ; Consciousness ; Diabetes Mellitus* ; Enuresis ; Female ; Follow-Up Studies ; Humans ; Insulin ; Ketosis ; Male ; Osmolar Concentration ; Polydipsia ; Polyuria ; Seoul ; Siblings ; Tuberculosis ; Weight Loss

No abstract available.

Retinoblastom is the most common intraocular malignancy in childhood and the survival rate has recently been raised by an adequate method of examination and treatment. We report a case that a child having bilateral retinoblastoma treated with enucleation, external beam irradiation, and chemotherapy is diagnosed as an osteosarcoma of the distal radius 9 years after the initial treatment, and died. This case shows the regular examinations for long bone of the extremities are necessary in a child survived after the treatment of bilateral retinoblastoma.
Child ; Drug Therapy ; Extremities ; Humans ; Osteosarcoma* ; Radiotherapy ; Radius ; Retinoblastoma* ; Survival Rate ; Survivors*

The positive predictability of anti-HCV ELISA is low, especially, in blood donors and in healthy populations. False positive anti-HCV results pose some difficulties in medical practice and in blood screening. The aim of this study was to identify the factors associated with true hepatitis C virus (HCV) infection among anti-HCV ELISA-positives. A case-control analysis was conducted using 354 subjects who were positive for anti-HCV ELISA. All subjects were tested for true HCV infection using the reverse transcriptase polymerase chain reaction (RT-PCR). Tests for serum alanine aminotransferase (ALT), fasting glucose, HBsAg, anti-HBc antibody, alpha-fetoprotein, platelet count and ultrasound of liver were also performed. Epidemiological data were obtained by self-administered questionnaires. Out of 354 subjects, 202 (57.1%) were positive for HCV by RT-PCR and 152 were negative and used as the control group. In multivariate analysis, blood transfusion (odds ratio, OR 2.3, 95% confidence interval, CI 1.3-4.0), elevated ALT (OR 2.2, 95% CI 1.2-4.3) and higher anti-HCV ELISA ratios (more than 3; OR 1.7, 95% CI 1.3-2.1) were associated with true HCV infection. Thrombocytopenia was also associated with the presence of HCV in univariate analysis. These results suggest that a history of blood transfusion, elevated ALT and a high score on anti-HCV ELISA ratios are associated with true HCV infection among anti-HCV ELISA-positives.
Adult ; Blood Donors ; Enzyme-Linked Immunosorbent Assay* ; False Positive Reactions ; Female ; Hepatitis C/epidemiology ; Hepatitis C/diagnosis* ; Hepatitis C/blood ; Hepatitis C Antibodies/blood* ; Hepatitis C-Like Viruses ; Human ; Male ; Middle Age ; Multivariate Analysis ; Predictive Value of Tests ; Reverse Transcriptase Polymerase Chain Reaction ; Risk Factors

OBJECTIVES: Chronic HBsAg carriers are the principal source of infection for other susceptible people, and are themselves at high risk of developing serious liver diseases. In Korea, it has been estimated that 65-75% of the HBsAg positives remained as persistent carriers. Additionally, familial clustering of HBV infection has frequently been observed among carriers. Some would become progressive, chronic hepatitis patients, and others would not. The aim of this study was to evaluate the association between various factors, such as the duration of infection, type of virus, mutation of precore/core region in HBV, major histocompatibility class-I, and developing chronic liver diseases among familial HBV carriers. METHODS: Chronic carrier status was identified by repeated serological tests for HBsAg at intervals of six months or more. A familial chronic carrier was defined when the disease was observed in a family member over two generations. Two families were recruited, among which a total of 20 chronic HBsAg carriers(11 carriers in No.1, and 9 in No.2 family) were identified. Data on the general characteristics and liver disease status were collected. Identification of the HBV-DNA was successful only for 13 subjects among the 20 carriers. Analysis of viral DNA in terms of subtype, pre-core and core region mutations was carried out. The type of major histocompatibility class-I for the 13 subjects was also analysed. RESULTS & CONCLUSIONS: Seven of 10 chronic HBV carriers of the 1st generation and one of 10 of the 2nd generation were clinical patients with chronic hepatitis, the others, three of the 1st and nine of the 2nd generation, were asymptomatic carriers. This data indicates that the duration of HBV carriage is one of the major factors for disease severity. The subtype of HBsAg analysed using HBV-DNA identified in 13 carriers were adr, and the pattern of precore nonsense mutation in HBV-DNA was identical among family members, which means that the same virus strains were transmitted between the family members. The association between the precore or core mutations in HBV-DNA and the disease severity was not observed. While it was suggested that a specific type of MHC class-I may be related to disease progression.
Codon, Nonsense ; Disease Progression* ; DNA, Viral ; Family Characteristics ; Hepatitis B Surface Antigens ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Hepatitis, Chronic ; Histocompatibility* ; Humans ; Korea ; Liver Diseases ; Serologic Tests

No abstract available.
Cystadenocarcinoma, Mucinous* ; Female* ; Humans ; Mucins*

BACKGROUND: Diabetic patients have more chance of requiring surgery than non-diabetic population. Glycemic and metabolic controls are key points in the perioperative diabetic management. A variety of methods have been proposed for the management of diabetics perioperatively, but their effectiveness is still controversial. This study was done to investigate whether diabetic patients are managed appropriately in perioperative period. METHODS: Among diabetic patients referred to anesthesiologic outpatient clinic from August 1997 to September 2002, 85 patients were randomly selected Diabetic duration, medication for diabetic control, concurrent illness and referral surgical department was recorded. In preoperative routine laboratory findings, HbA1c, fasting glucose and postprandial glucose were checked Perioperative glucose control protocols applied to patients were investigated RESULTS: Patients received 1.32 operation per person. Diabetic duration was 12.2 +/- 7.2 years, thirty nine patients had take oral hypoglycemic agent and thirty one patients had received insulin. Mean HbA1c was 8.0 +/- 1.6%, thirty four patients showed above 8.0%. Alberti's regimen was used in fifty five patients and insulin was omitted in fifty six patients. Two patients received insulin of half of usual dose in the morning. Alberti's regimen in major surgery and no insulin in minor surgery were preferred. The composition of Alberti's regimen and target blood glucose level varied. During operation, blood glucose was checked only in fourty four cases. Five of seven postoperative hypoglycemic patients were not checked glucose level during operation. Mortality rate was 7% and major cause of death was sepsis. All of the mortality cases had diabetic cardiovascular and nephrologic complications. CONCLUSIONS: We concluded there is a pitfall in managing diabetic patients requiring surgery. There must be a consensus between surgeon and anesthesiologist about perioperative management of diabetics. Perioperative glucose level should be checked as often as feasible, and insulin supply be continued during operation.
Ambulatory Care Facilities ; Blood Glucose ; Cause of Death ; Consensus ; Diabetes Mellitus ; Fasting ; Glucose ; Humans ; Insulin ; Mortality ; Perioperative Period ; Referral and Consultation ; Retrospective Studies* ; Sepsis ; Surgical Procedures, Minor