No abstract available.
Breast Neoplasms* ; Breast*

No abstract available.
Hematoma*

The Duodenal diverticulum is the rare cause of the common bile duct obstruction. We experienced a case of the diverticulum of the second portion of duodenum in a 59-year-old male, who complained recurrent attacks of right upper abdominal pain and fever since 16 months prior to admission. Duodenoscopic finding and UGI study revealed a typical duodenal diverticulum just side to the papilla of Vater. Diverticulectomy and cholecystectomy was performed and after than, he has been free front above mentioned symptoms. We reported a case of duodenal diverticulum which caused recurrent common bile duct obstruction.
Abdominal Pain ; Cholecystectomy ; Common Bile Duct* ; Diverticulum* ; Duodenum ; Fever ; Humans ; Male ; Middle Aged

Primary biliary cirrhosis, a chronic, progressive, and often fatal cholestatic liver disease, is characterized by destruction of intrahepatic bile ducts, portal inflammation and scarring, and the eventual development of cirrhosis and liver failure. We reviewed four cases of primary biliary cirrhosis primarily suspected with peritoneoscopic liver biopsy specimens. All patients were female and their age ranged from 29 to 50 years(median age: 43.8 years). Presenting symptoms were typically pruritus and/or upper abdominal discomfort. On physical examination, interus was presented in 3; hepatomegaly in 3; chronic liver disease stigmata in one. Co-existing autoimmune diseases such as Hashimoto' thyroiditis and Sjoegren' syndrome were found in 2 cases. Biochemical tests of liver function revealed a cholestatic pattern. An antimitochondrial-antibody test was positive in 2 out of 3 patients(75%). Increase levels of serum immunoglobulins, especially of IgM, were evident in 3 cases. Histologic staging(Ludwig et al.) disclosed stage I lesion in one, stage III in two, and stage IV in the remaining one.
Female ; Humans ; Biopsy

An unusual case of intraspinal peripheral neuroepithelioma arising from the cauda equina is reported. The patient, a 21-year old female, suffered from low back pain with radiation to the posterior aspect of both legs. Myelographic, computed tomographic scan and magnetic resonance imaging studies of lumbosacral spine showed the intradural extramedullary mass lesion on the L3-S1 level which was excised surgically, but recurred rapidly. It could be diagnosed by the histopathologic findings. The postoperative radiotherapy and chemotherapy were administered. We report this rare case with review of the literatures.
Cauda Equina* ; Drug Therapy ; Female ; Humans ; Leg ; Low Back Pain ; Magnetic Resonance Imaging ; Neuroectodermal Tumors, Primitive, Peripheral* ; Radiotherapy ; Spine ; Young Adult

BACKGROUND/AIMS: There is considerable variance in individual susceptibility to hepato-toxic effects of ethanol as evidenced by the finding that only about 10-20% of alcoholics develop alcoholic liver cirrhosis. The aims of this study were, 1) to get the data on the genetic polymorphisms of three major ethanol-metabolizing enzymes (ADH, CYP2E1, ALDH) in normal Korean adults, and to search for the specific genotypes influencing alcohol drinking behavior by the comparison of allele frequencies between healthy control group and heavy drinker group with or without liver disease, 2) to investigate the influence of the genetic polymorphisms of these enzymes on the susceptibility to alcoholic liver disease by the comparison of allele frequencies between heavy drinker group without liver disease and alcoholic liver cirrhosis group. METHODS: Healthy control group included 53 healthy males in military service without evidence of liver disease or alcoholism. Heavy drinker group without liver cirrhosis included 29 males who had been drinking 80g or more of alcohol daily for more than ten years but did not have any clinical evidence of liver disease. Alcoholic cirrhosis group included 43 male patients who had drunk 80g or more of alcohol daily for more than ten years and had clinical evidences of overt cirrhosis. Subjects with hepatitis B surface antigen or anti-hepatitis C antibody were excluded. Genotypes of the three enzymes were determined by PCR (polymerase chain reaction) and restriction fragment length polymorphism (RFLP) with genomic DNAs extracted from peripheral leukocytes. RESULTS: 1) In healthy Korean males, allele frequency of ADH22, ADH31, CYP2E1 c2 and ALDH22 was 81%, 94%, 30% and 14%, respectively. 2) The absence of ALDH22 or CYP2E1 c2 allele were significant risk factors for being a heavy drinker (odds ratio,' 0.09, 0.42, respectively). 3) Although it was not associated with the polymorphism of each ethanol-metabolizing enzymes, the susceptibility to alcoholic liver cirrhosis was significantly associated with combined genotypes of ADH2(22) & ADH3(1+1)& CYP2E1 B or C. COMCLUSION: Genetic polymorphisms of ethanol-metabolizing enzyrnes are significantly associated with the suseptability to alcoholic liver disease as well as alcohol drinking behavior.
Adult ; Alcohol Drinking ; Alcoholics* ; Alcoholism ; Alleles ; Cytochrome P-450 CYP2E1 ; DNA ; Drinking ; Ethanol ; Fibrosis ; Gene Frequency ; Genotype ; Hepatitis B Surface Antigens ; Humans ; Leukocytes ; Liver Cirrhosis ; Liver Cirrhosis, Alcoholic* ; Liver Diseases ; Liver Diseases, Alcoholic ; Male ; Military Personnel ; Polymerase Chain Reaction ; Polymorphism, Genetic* ; Polymorphism, Restriction Fragment Length ; Risk Factors

BACKGROUND/AIMS: Imrnortalized human fetal liver cell lines established by transfecting simian virus 40 T gene wae found to lose differentiated liver cell functions in successive long-term culture. Butyrate, known as a differentiation-promoting agent for a variety of cancer cell lines, is produced in the colon by bacterial flora and selectively transported into the liver though the portal blood flow. Therefe, butyrate might play a role in the maintenance of differentiation in hepatocytes in vivo. In thepresent study, the effects of butyrate on cell growth and differentiation in human fetal liver cell lines was investigated. METHODS: Human fetal liver cell lines imrnortalized by SV 40 T antigen were treated with sodium butyrate (1mM), and cell growth rate after butyrate treatment were nmsured by the number of viable cells, determined by trypan blue dye exclusice method. The effects of sodium butyrate on the hepatocyte-specific differentiatian were assessed by albumin and alfa-fetoprotein (AFP) mRNA expression, analyzed using reverse-transcription polymerase chain reaction, and were also by the increment of albumin secretion into culture media, determined by a competitive inhibition ELISA. RESULTS: Treatment with sodium butyrate resulted in a cessation of cellular proliferation and alterations in cellular morphology (increased cell size and polygonal change in shape). The level of albumin mRNA after sodium butyrate treatment was elevated by about two times as compared to that of control. In contrast, AFP mRNA expression were dennstrated neither before nor after sodium butyrate treatment. The average amount of albumin released in the medium was less than 6pghnl/10'cells/2days in the absence of sodium butyrate, and increased to 17 p g/ml/10'cells/2days at day 2, 21ugfml 10'cells/2days at day 4 in the presence of sodium butyrate, and these levels thereafter were over 10 times higher than that in the absence of sodium butyrate until day 10. CONCLUSION: These mults indicate that treatment of immcetalized fetal liver cell lines with butyrate leads to inhibition of cellular proliferation and promotion of adult hepatocyte-specific differentiation.
Adult ; Antigens, Viral, Tumor ; Butyrates ; Butyric Acid* ; Cell Line* ; Cell Proliferation ; Cell Size ; Colon ; Culture Media ; Enzyme-Linked Immunosorbent Assay ; Hepatocytes ; Humans* ; Liver* ; Polymerase Chain Reaction ; RNA, Messenger ; Simian virus 40 ; Sodium* ; Trypan Blue

BACKGROUND/AIMS: Lens culinaris agglutinin-A reactive alpha-fetoprotein (AFP L3) has been reported to be highly specific for the diagnosis of hepatocellular carcinoma (HCC). The present study was to evaluate the clinical usefulness of AFP-L3 for the diagnosis of HCC in the patients either with chronic liver disease or with HCC in complete remission who showed significant increment of serum AFP level and no mass lesion in the liver on ultrasonography. METHODS: A total numer of 34 patients (24 with chronic liver disease, 10 with HCC in complete remission) were enrolled, who showed significant increment of serum AFP level and no mass lesion in the liver on ultrasonography. Serum AFP L3 levels were analysed by AFP differentiation kit L. Abdominal spiral CT or ultrasonogram was performed at 1-3 month intervals and all of the patients were followed up for more than 6 months. RESULTS: Among 24 patients with chronic liver disease, two were positive (higher than 15%) for AFP L3; however, HCC was not detected in these patients, while HCCs were detected in two of 22 patients negative for AFP L3 during followe-up. Eight of the 10 patients with HCC in complete remission were positive for AFP L3; recurrent HCCs were detected in 7 of those 8 patients as well as in the rest 2 patients negative for AFP L3 during follow-up. The overall sensitivity and specificity of AFP L3 measurement for the detection of HCC within 6 months of follow-up were 63.6% and 87.0%, respectively. The positive and negative predictive value for HCC in patients with chronic liver disease were O% and 90.9% and for recurrent HCC in HCC patients in remission were 87.5% and ON, respectively. CONCLUSION: The measurement of AFP L3 is suggested to be useful for the diagnostic strategy in patients either with chronic liver disease or hepatocellular carcinoma in complete remission, who showed progressive increment of serum AFP level and no mass lesion in liver on ultrasonogram.
alpha-Fetoproteins* ; Carcinoma, Hepatocellular ; Diagnosis* ; Follow-Up Studies ; Humans ; Lens Plant* ; Liver Diseases* ; Liver* ; Recurrence ; Sensitivity and Specificity ; Tomography, Spiral Computed ; Ultrasonography*

The diagnostic importance of finding an appendicolith in the plain x-ray of the abdomen has been well documented. However, most of the papers so far published have stressed x-ray findings of the preoperative abdomenin acute appendicitis. In the present study we have attempted to correlate incidences of appendicoliths insurgical specimen and plain x-ray of the abdomen. The materials were 37 surgical specimens of the appendix removed for acute appendicits at St. Mary's Hospital, St. Paul's Hospital, Kang Nam Hospital, Holy Family Hospital and Our Lady of Mercy Hospital of Catholic Medical College during the period of 6 months from August 1980. Each surgical specimen was subjected to soft tissue radiography to detect calcified appendicolith. Then the preoperative x-raysof abdomen were retrospectroscopically analysed for the presence of radiographically demonstrable appendicoliths.Our study revealed that in as many as 32% of 37 surgical specimens one or more calcified appendicoliths were demonstrated radiographically whereas only one of these was identified as such in the preoperative x-ray film ofthe abdomen. Such a great discrepancy between the incidences of appendicoliths in the surgical specimen andpreoperative x-ray films of the abdomen are ascribed to (1) relative smallness of appendicoliths (87% of the stones measured less than 1cm in diameter in radiographs of surgical specimen in our series), (2) overlapping of these small stones on the right iliac bone and (3) underpenetrating of the iliac bone area in x-ray films of theabdomen. For improving detctability of appendicoliths therefore it is recommended that the technique of radiography of plain abdomen should be such that a small appendicolity overlying the iliac bone can be brought outof trabecular shadows.
Abdomen ; Appendicitis ; Appendix ; Humans ; Incidence ; Radiography ; X-Ray Film

Prior to 1988, endometrial cancer was clinically staged but there was the considerable discrepancy between clinical and aetual stage. FIGO surgical staging classification of endometrial cancer(I988) provides the advanatage of recognizing the true disease distribution and extension, and more rational treatraent can be accomplished. This retrospective study was based on a clinical review of 73 patients with endometrial carcinoma from l982 through 1991 who underwent primary surgical evaluation. A11 cases were restaged ueing the newly adopted FIGO surgical staging. The distribution of FIGO clinical staging was as follows:85 patients(89.1%) were with stage I, 5(6.9%) with stage II, 2(2.7%) with stage III and 1(l.3%) with stage IV. Surgical restaging according new FlG0 classification reveald 56(76.7%) patients with stage I, 1(1.4%) with stage II, 14(19.2%) with stage III and 2(2.7%) with stage IV. Surgery upstaged 12.3% of clinical stage I patients, In clinical stage II patients, 80.0% was doenstaged. There wes no stage changing in cliaical stage III and IV patients. The acturial survival rates for surgical stages I a, I b, I c, and III were 80.0%, 77.2%, 68.4A%, and 35.0% respectively. By using FIGO surgical staging, the initial extent of endometrial cancer can be more accurately evaluated and we may predict prognosis and survival relatively well.
Classification ; Endometrial Neoplasms* ; Female ; Humans ; Prognosis ; Retrospective Studies ; Survival Rate