BACKGROUND/AIMS: NAD glycohydrolase (NADase) is abundantly expressed in the liver. This expression is prominent in Kupffer cells. Since it was recognized that reticulendothelial function is impaired in liver cirrhosis, we assessed how these enzyme activities were altered in patients with liver cirrhosis. METHODS: Serum samples were obtained from 61 patients with liver cirrhosis (according to the criteria of Child-Pugh 15 were classified A, 24 were classified B, and 22 were classified C) and 16 healthy subjects. NADase activities were measured fluorometrically with [adenine-14C] NAD. The reaction mixture contained [adenine-14C] NAD and enzyme (patient serum). The reaction was stopped after a 30 to 480 min incubation by the addition of 50 L of 25% trichloroacetic acid. RESULTS: Serum NADase activities in 61 patients with liver cirrhosis were significantly lower than those in healthy subjects (33+/-14 vs. 55.6+/-13 p<0.001). Serum NADase activities in severe cirrhotic patients were significantly lower than those in mild to moderate cirrhotic patients (criteria of Child-Pugh, A: 40.6+/-6.4 vs. B: 38.6+/-13 vs. C: 21.8+/-14, p<0.001). NADase activities were correlated to prothrombin time (r = 0.69), and Apo A1 (r = 0.58) that were useful in identifying high-risk subjects for severe liver disease, but not asparate aminotransferase (AST) and alanine aminotransferase (ALT). Also, NADase activities reciprocally correlated with PGAA index (r = -0.78), Child-Pugh's score (r = -0.48), and serum alpha-2-macroglobulin (r = -0.72). CONCLUSIONS: NADase activities could be used as a single diagnostic marker for liver cirrhosis in addition to the Child-Pugh's score and PGAA index.
Alanine Transaminase ; Apolipoprotein A-I ; Humans ; Kupffer Cells ; Liver Cirrhosis* ; Liver Diseases ; Liver* ; NAD* ; NAD+ Nucleosidase* ; Prothrombin Time ; Trichloroacetic Acid

Familial adenomatous polyposis(FAP) is a rare hereditary disorder characterized by the development of hundreds to thounds polyps throughout the colon and rectum. Moreover, several extracolonic manifestations are seen. Recently, this disease is recognized as a adenomatous polyposis syndrome which can involve the entire astrointestinal tract. Several reports have demonstrated a high incidence of gastroduodenal polyps in patients with familial adenomatous polyposis. These colon polyps can be eventually developed as colon cancer, if not be treated. So early diagnosis is needed and prophylactic surgery should be erformed. We experienced a case of familial adenomatous polyposis with a large sentinel polyp on the sigmoid colon, presenting hematochezia and mucoid diarrhea. He was early treated before progression to carcinoma by total colectomy, rectal mucosectomy and J pouch ileoanal anastomosis.
Adenomatous Polyposis Coli* ; Colectomy ; Colon ; Colon, Sigmoid ; Colonic Neoplasms ; Colonic Pouches ; Diarrhea ; Early Diagnosis ; Gastrointestinal Hemorrhage ; Humans ; Incidence ; Polyps* ; Rectum

Medical Health IC card is a smart card built-in a microprocessor and a memory that stores individual health care information. The card is carried by the individual and presented to the medical doctor whin needed. Being connected with the existing networks, the card enables full automation of hospital management and formation of complete medical databases. Futhermore, the card links hospitals with nation-wide medical networks. The focus of this study is on what data should actually be stored in the card, and how the card to be used effectively in maternal-child and school health service. In this paper, existing literatures about prenatal care using medical health IC card were reviewed. and standardization efforts of medical IC card conducted by the ISO and Japanese Department of Health and Welfare were analyzed. This allowed us to pick the most suitable items based on the actual situation in Korea and how to systematically collect and record such data. As a result. we were able to present a standard that follows international standards and includes all additional information from maternal-child health care in major Korean hospitals, child health record published by the Korean pediatric society, and physical examinations done in elementary, middle and high schools in Korea. Also, The terminology of each item was standardized conforming to the Korean standard medical terminology.
Asian Continental Ancestry Group ; Automation ; Child ; Child Health ; Delivery of Health Care ; Humans ; Korea ; Memory ; Microcomputers ; Physical Examination ; Prenatal Care ; School Health Services*

PURPOSE: Nitric oxide (NO) synthesis has been known to be induced during interleukin-2 (IL-2) therapy. The present study was designed to elucidate mechanisms and roles of IL-2-induced NO synthesis in tumor cells. MATERIALS AND METHODS: Mechanisms of IL-2-induced NO synthesis were evaluated using in vitro culture systems of BALB/c mouse splenic lymphocytes and Meth-A tumor cells. Effects of IL-2-induced NO synthesis by Meth-A tumor cells on the tumor cell proliferation were also evaluated using an NO synthase inhibitor, N -monomethyl- L-arginine (MLA). RESULTS: Cultures of both lymphocytes alone and Meth-A tumor cells alone did not produce any significant amounts of nitrite, a stable metabolite of NO during IL-2 stimulation. In contrast, cocultures of lymphocytes and Meth-A tumor cells produced a large amount of nitrite during IL-2 stimulation. Addition of culture supernatants of lymphocytes incubated with IL-2 induced nitrite production in Meth-A tumor cell cultures. However, addition of culture supernatants of Meth-A tumor cells incubated with IL-2 did not induce nitrite production in lymphocyte cultures. Nitrite accumulation was markedly inhibited by addition of anti-interferon-y antibody, confirming the role of the cytokine in mediating tumor cell NO synthesis. MLA inhibited nitrite production by Meth-A tumor cells in a dose-dependent manner in the presence of culture supernatants of lymphocytes incubated with IL-2. Meth-A tumor cell nitrite production in the presence of increasing concentrations of MLA correlated inversely with tumor cell proliferation. CONCLUSION: NO synthesis can be induced by tumor cells by the secondarily released cytokines from lymphocytes during IL-2 stimulation. Autologous NO synthesized by tumor cells during IL-2 stimulation inhibits proliferation of tumor cells themselves.
Animals ; Arginine ; Cell Culture Techniques ; Cell Proliferation ; Coculture Techniques ; Cytokines ; Interleukin-2* ; Lymphocytes* ; Mice ; Negotiating ; Nitric Oxide Synthase ; Nitric Oxide*

Using IC cards with powerful information processing capabilities, high level of security, and multi media capabilities to create health IC cards has the following merits: comprehensive management of individual medical information, highly secure access to information that may be stored in separate location and/or institutes, increasing the compatability of difference used by various institutes. In this research ,we have categorized the information stored in the health IC card into the following main categories: basic personal information, emergency medical information, medical informatics, nursing information, welfare information. This was based on international ISO standards and specifics of Japan and south eastern Asia. These main categories are further divided into sub-categories and care was taken to ensure that the format of each sub-category is compatible with international standards while being suitable for Koran conditions of actual use. So, these categories conform to international standards and we will continue our efforts update the international standard to include additional categories needed in Korea and update the Korea standard to conform more closely with the international standards.
Academies and Institutes ; Access to Information ; Automatic Data Processing ; Emergencies ; Far East ; Humans ; Japan ; Korea ; Medical Informatics ; Nursing

Recent developments in computer and communication technology were studied in relation to medical information network systems, using computers and IC cards, to solve problems in community health. Trial use of health IC card systems for personal health data management are already in existence in some countries. The health IC card system provides good quality information to the doctors, the hospital, the patients, and the insurance organizations. Emergency medical information card systems that take advantage of advanced information-related technologies such as computers and communication systems, in order to improve their emergency medical care systems may have many advantages. Emergency medical information card can provide a way to protect people during medical emergencies by providing physicians with their vital medical information during the critical seconds of emergency care if being unable to provide your vital medical information. Before introducing these systems, recognition that an important problems such as standardization of the data and code for the medical information systems, defining the access and usage rights by user profiles and the types of data for the security and data protection must be considered. We studied the emergency medical information card systems to clarify their purpose, analyse their present status, standardize the data and codes and define the access and usage rights and present the ideal system, in view of community health care requirements. Here the results of the research are examined, and there is a discussion of what is needed to use the emergency medical card system in the future.
Community Health Services ; Computer Security ; Emergencies* ; Emergency Medical Services ; Human Rights ; Humans ; Information Services ; Information Systems* ; Insurance

PURPOSE: Mucormycosis is an opportunistic fungal infection caused by one of the ubiquitous fungi of the order Mucorales, occurring almost exclusively in immunocompromised hosts such as patients with diabetes, leukemia and lymphoma. Recently the incidence of mucormycosis is rising associated with the increasing predisposing factors such as cytotoxic drugs and immunosuppressive agents. Though mucormycosis is frequently fatal, there has been a dramatic improvement in outcome by early diagnosis and aggressive treatment. The aim of this study is to investigate the clinical characteristics of mucormycosis developed in leukemic children. METHODS: Clinical characteristics of mucormycosis was analyzed by retrospective review of 6 patients diagnosed as mucormycosis during chemotherapy of acute leukemia at the Seoul National University Children's Hospital from May 1990 to May 1995. Diagnosis was confirmed by the pathologic examination of the biopsy specimens from the involved site. RESULTS: 1) The age distribution ranged from 7 to 15 years. Three patients were male and 3 were female. 2) At the onset of mucormycosis all six patients were under the cytotoxic chemotherapy with resultant neutropenia. Four of 6 patients received large doses of corticosteroids and 2 of 6 patients were receiving broad-spectrum antibiotics intravenously. 3) Of the 6 cases of mucormycosis, 5 cases were of the type involving a particular body site(rhinocerebral in 3 patients, gastrointestinal in 1 and laryngeal in 1) and 1 case was of the disseminated type. In a case of rhinocerebral type, the orbit as well as paranasal sinuses were involved and in the case of disseminated type, the lung, skin and muscle were invaded by the fungi. 4) Except one case(gastrointestinal type) in which complete resection of lesion was possible, amphotericin B was administrated for at least two months in combination with rifampin. Surgical resection was done in 4 cases. In a case who expired during medical treatment and the other one who was almost cured with medical treatment alone, surgery was not done. 5) Of the 6 cases, mucormycosis was cured in 3 cases and recurred in 1 case despite initial improvement. Two cases expired -one who showed almost complete improvement but expired due to bacterial sepsis during the following chemotherapy, and the other who showed little improvement with persistent neutropenia and expired due to septic shock. CONCLUSIONS: In the immunocompromised patients including acute leukemia, mucormycosis should be considered as a possible complicating condition, and early diagnosis and aggressive treatment may improve the survival and outcome.
Adrenal Cortex Hormones ; Age Distribution ; Amphotericin B ; Anti-Bacterial Agents ; Biopsy ; Causality ; Child* ; Diagnosis ; Drug Therapy ; Early Diagnosis ; Female ; Fungi ; Humans ; Immunocompromised Host ; Immunosuppressive Agents ; Incidence ; Leukemia ; Lung ; Lymphoma ; Male ; Mucorales ; Mucormycosis* ; Neutropenia ; Opportunistic Infections ; Orbit ; Paranasal Sinuses ; Retrospective Studies ; Rifampin ; Seoul ; Sepsis ; Shock, Septic ; Skin

BACKGROUND/AIMS: In this study, we analysed the changes of matrix metalloproteinase-9 (MMP-9) expression in the gastric antral epithelium in respect to H. pylori eradication. METHODS: Twenty patients with H. pylori-positive chronic gastritis or peptic ulcer were studied. The expression of MMP-9 in the gastric antral biopsy specimens were compared before and after H. pylori eradication using immunohistochemical study. The positive rates and intensity of MMP-9 staining were evaluated at surface mucous cells and pyloric gland cells. RESULTS: The positive rate of MMP-9 staining in antral mucosal epithelial cells of H. pylori chronic gastritis is 63.8%. The positive rates of MMP-9 staining in the surface mucous cells and pyloric gland cells were 75.5% and 52.0% before H. pylori eradication, respectively. On the contrary, the rates were 85.5% and 82.0% after eradication. The MMP-9 overexpression in the pyloric gland cells were noticeably increased after H. pylori eradication. Strong positive staining of MMP-9 was increased significantly after H. pylori eradication in the pyloric gland cells. CONCLUSIONS: These results suggest that MMP-9 over-expression is associated with H. pylori infection as a host inflammatory response. The increased expression after H. pylori eradication indicates that MMP-9 may have a important role in remodeling or early tissue repairing process of gastric mucosa.
Adult ; Aged ; English Abstract ; Female ; Gastric Mucosa/*enzymology ; Gastritis/drug therapy/enzymology/microbiology ; Gelatinase B/*metabolism ; Helicobacter Infections/drug therapy/*enzymology/microbiology ; *Helicobacter pylori ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Peptic Ulcer/drug therapy/enzymology/microbiology ; Pyloric Antrum

The anisakiasis disease that is infected through various kinds of larvae of the anisakis family when sea fish ia eaten uncooked or half-cooked. Sinee Van Thiel, a Netherlander, found in 1960 that anisakis larvae parasitize upon the human intestinal tract of the patients who suffer from ahdomieal pain after eating herrings, there have been a number of similar reports in North America and Japan, and the clinical importance of anisakis larvae for the acute gastrontestinal infection is rising. In general, as raw sea fish is not regarded as a source of parasite infestation, the patients who had eaten it and suffered from acute abdominal pain and vomiting are considered as and to be treated of food poisoning. But it is highly possible that some of them suffer from the acute gastrointestinal symptom caused by anisakis larvae. Thereby we report on 7 examples of anisakiasis taken through endoscopic diagnosis of the patients who have the acute upper abdominal pain after eating raw sea fish.
Abdominal Pain ; Anisakiasis* ; Anisakis ; Diagnosis ; Eating ; Foodborne Diseases ; Humans ; Japan ; Larva ; North America ; Parasites ; Upper Gastrointestinal Tract* ; Vomiting

BACKGROUND: Helicobacter pylori colonizes the gastric surface epithelium and the mucus gel layer. It has been known that H. pylori infection decreased the gastric mucin expression. The aim of this study was to determine the effect of H. pylori eradication on mucin expression (MUC5AC, MUC6 and MUC1) in the gastric epithelium. METHODS: This study included 20 patients positive for H. pylori whom successful eradication was performed between March 1998 and December 1999. H. pylori status was determined by histology, rapid urase test and urea breath test. Gastric antral biopsy specimens were examined by immunohistochemistry for mucin (MUC5AC, MUC6 and MUC1) expression. The distribution of epithelial cells expressing MUC5AC was calculated at two sites (surface mucous cells, pyloric glands). Two scores system (weak-strong) was used to assess staining intensity. RESULTS: There was a gradient of MUC5AC expression, higher to lower from the surface to the glands. Increased MUC5AC expression in the surface mucous cell (p=0.013) and in the glands (p=0.008) was found after H. pylori eradication. MUC6 and MUC1 distribution was not changed after H. pylori eradication. CONCLUSION: MUC5AC expression was increased after H. pylori eradication. These results suggest that MUC5AC may relate in the pathogenesis of H. pylori.
Biopsy ; Breath Tests ; Colon ; Epithelial Cells ; Epithelium ; Gastric Mucins ; Helicobacter pylori* ; Helicobacter* ; Humans ; Immunohistochemistry ; Mucins* ; Mucus ; Urea