BACKGROUND/AIMS: According to the recent research, mutations in the HBV pre-S region may have an impact on the progression of hepatitis B virus(HBV)-related liver disease. The aim of this study was to clarify the frequency and location of naturally occurring mutations in the pre-S region of HBV, and their possible effects on the clinical course of HBV-associated chronic liver diseases. METHODS: HBV DNA was extracted from the sera of 15 patients (8 with liver cirrhosis and 7 with hepatocellular carcinoma). The pre-S sequence was amplified via polymerase chain reaction, subcloning and sequenced. RESULTS: All patients had point mutations in the pre-S region. Nine of 10 mutation sites (90%) in the pre-S1 region, and 4 of 5 mutation sites (80%) in the pre-S2 region were identical in both liver cirrhosis and hepatocellular carcinoma. Deletions were detected in seven patients (4 with liver cirrhosis and 3 with hepatocellular carcinoma). Among the 4 patients with liver cirrhosis, three had deletion in 5'-end of the pre-S2 region and one spanning the 3'-end of the pre-S1 to 5'-end of the pre-S2 region. All 3 patients with hepatocellular carcinoma had deletions in 5'-end of the pre-S1 region, and two patients had simultaneous deletion spanning the 3'-end of the pre-S1 to the 5'-end of the pre-S2. CONCLUSION: The pre-S mutants were frequently detected in HBV-associated liver cirrhosis or hepatocellular carcinoma and the point mutations or deletions in the pre-S gene were clustered in specific regions.
Carcinoma, Hepatocellular* ; DNA ; Hepatitis B ; Humans ; Liver Cirrhosis* ; Liver Diseases ; Liver* ; Point Mutation ; Polymerase Chain Reaction

PURPOSE: To compare the effect of early versus late intravitreal injection of triamcinolone in patients with macular edema due to branch retinal vein occlusion (BRVO). METHODS: Twenty eyes of 20 patients with macular edema from BRVO, including 10 with duration after onset of < or =3 months and 10 with duration of >3 months, were treated using a single intravitreal triamcinolone injection (4 mg/0.1 ml). Best-corrected visual acuity and foveal thickness by optical coherence tomography were measured 1, 3, and 6 months post-injection. RESULTS: In patients that received treatment after a disease duration of < or =3 months, visual acuity and foveal thickness significantly improved from baseline over 6 months of follow-up. However, in those with a duration of >3 months, improvements in visual acuity and foveal thickness, though apparent at 1 month, were not maintained at 3 and 6 months post-triamcinolone. CONCLUSIONS: Intravitreal triamcinolone is more effective in patients with BRVO who are treated earlier.
Visual Acuity/drug effects ; Triamcinolone Acetonide/*administration & dosage/therapeutic use ; Treatment Outcome ; Tomography, Optical Coherence ; Retinal Vein Occlusion/*complications ; Middle Aged ; Male ; Macular Edema, Cystoid/chemically induced/*drug therapy/physiopathology ; Humans ; Glucocorticoids/*administration & dosage/therapeutic use ; Fovea Centralis/drug effects ; Female ; Drug Administration Schedule

Hepatic eosinophilic abscess is a very rare disease which has been reported in fascioliasis, and some gastrointestinal malignancy. We experienced 5 cases with hepatic eosinophilic abscesses which were caused by unknown etiology, confirmed by liver biopsy, from 1990 to 1994. The chracteristics of the cases including clinical menifestations, serologic findings, ultrasonography and abdominal computerizes tomogram(CT) were summerized. They had no characteristic findings except eosinophilia in clinical menifestations and they showed various ultrasonographic and CT findings which are different from the radiologic findings of liver abscesses by bacterial or amebic infection. We think that hepatic eosinophilic abscess must be included in differential diagnosis of all hepatic tumors.
Abscess* ; Biopsy ; Diagnosis, Differential ; Eosinophilia ; Eosinophils* ; Fascioliasis ; Liver ; Liver Abscess ; Rare Diseases ; Ultrasonography

OBJECTIVE: In this study, we aimed to investigate the predictors of clinical response to escitalopram (ESC) in obsessive-compulsive disorder (OCD) from the baseline clinical characteristics. In addition, we aimed to search the differences of prescription pattern between responders and non-responders to ESC. METHODS: Two hundred and twenty-three patients who met the DSM-IV criteria for OCD and visited at least once after the initiation of ESC prescription were included in this study. A primary outcome measure was the Clinical Global Impression-Improvement scale (CGI-I), which was scored at the time of retrospective chart review. Responders were defined as those with a CGI-I score of 1 or 2 at the final point of evaluation. Baseline clinical characteristics, prescription patterns, and adverse events were compared between responders and non-responders. We also examined the validity of the prediction model regarding treatment response to ESC. RESULTS: The OCD patients having aggressive obsessions and related compulsions showed significantly decreased response rate to ESC (odd ratio=0.285) in comparison with the OCD patients not having aggressive symptom dimension (p=0.002). The maximum dose of ESC prescription and rate of antipsychotics combination were higher in responders in comparison to the nonresponders. Among the adverse effects, sedation and constipation showed significantly different occurrence rate between responders versus non-responders. CONCLUSION: Aggressive obsessions and related compulsions seem to be associated with poor clinical response to ESC in OCD. Obsessive-compulsive symptom dimension should be considered when choosing a serotonin reuptake inhibitor for OCD.
Antipsychotic Agents ; Citalopram ; Constipation ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Obsessive Behavior ; Obsessive-Compulsive Disorder ; Outcome Assessment (Health Care) ; Prescriptions ; Retrospective Studies ; Serotonin

PURPOSE: The role of vascular and interventional radiology in trauma patients is evolving. Endovascular treatments are helpful in treating vascular injuries in trauma patients. In some situations, endovascular treatments are as effective or more effective than surgery, but less invasive. We performed this study to evaluate the efficacy of endovascular treatments in the trauma patients with vascular injury. METHOD: Between September 2000 and September 2003, a total of 10 consecutive trauma patients with vascular injury who received endovascular treatments were included in this study. RESULT: Of the 10 patients, the most common injured arteries were the iliac arteries (5 patients), and the most common associated injuries were pelvic (8 patients) and long bone (6 patients) fractures. Transarterial embolization was performed in 9 patients, and stent-graft placement in 1. Clinical success was achieved in all 10 patients. After endovascular treatments, 3 patients with fluid collections were treated with ultrasound-guided, percutaneous drainage. Two of 10 patients died of complications other than hemorrhage. CONCLUSION: This initial experience suggests that endovascular treatment for trauma patients with vascular injury is safe and effective, and that it can also reduce the unnecessary laparotomies in these difficult cases.
Arteries ; Drainage ; Hemorrhage ; Humans ; Iliac Artery ; Laparotomy ; Radiology, Interventional ; Stents ; Vascular System Injuries*

BACKGROUND/AIMS: Adenomatous polyp was a precancerous lesion and it's removal was the secondary prevention of colorectal cancer. So we evaluated: age, sex, gross findings (Yamada type, size, number), histologic types, the incidence of coexisting cancers. METHODS: We analyzed the 125 patients with colon polyps who underwent colonoscopic polypectomy from March 1993 to Febrary 1998 in Pusan Paik hospital Inje university. RESULTS: The male to female ratio was 1:0.43, and the polyps were most common in sixth decade. Abdominal pain was the most common symptom (34.4%). On occult blood examination, 25.5% of the patients with colorectal polyp had positive finding. According to Yamada classification, type IV is 49 patients (39.2%) and type III is 47 patients (37.6%). The most common size was 0.5 cm to 1.0 cm, and single polyp was noted in 68 cases (54.4%). Among patients with colon polyps, 6 cases had coexisting colon cancers, and 1 case was diagnosed as adenocarcinoma. Histologically, the numbers of adenomatous polyp and hyperplastic polyp were 74 (59.2%) and 17 (13.6%). Retention polyps were commom under the age of 20 years, but adenomatous polyps were common over the age of 40 years. Five cases diagnosed as adenomatous polyps on forceps biopsy were proven as nonadenomatous polyps on polypectomy sections. CONCLUSIONS: Among patients with colon polyps, 6 cases had coexisting colon cancers and 1 case was diagnosed adenocarcinoma but, did not reach statistical significance. The result of this study suggested that forceps biopsy results were different with polypectomy biopsy results, so we therefore recommands polypectomy as primary treatment for all colonic polyps.
Abdominal Pain ; Adenocarcinoma ; Adenomatous Polyps ; Biopsy ; Busan ; Classification ; Colon* ; Colonic Neoplasms ; Colonic Polyps ; Colonoscopy ; Colorectal Neoplasms ; Female ; Humans ; Incidence ; Male ; Occult Blood ; Polyps* ; Retrospective Studies* ; Secondary Prevention ; Surgical Instruments

Background: The study was planned to show the status of indoor microorganisms and the status of the reduction device in the military dog clinic. Methods: Airborne microbes were analyzed according to the number of daily patient canines. For identification of bacteria, sampled bacteria was identified using VITEK®2 and molecular method. The status of indoor microorganisms according to the operation of the ventilation system was analyzed. Results: Airborne bacteria and fungi concentrations were 1000.6 ± 800.7 CFU/m3 and 324.7 ± 245.8 CFU/m3. In the analysis using automated identification system, based on fluorescence biochemical test, VITEK®2, mainly human pathogenic bacteria were identified. The three most frequently isolated genera were Kocuria (26.6%), Staphylococcus (24.48%), and Granulicatella (12.7%). The results analyzed by molecular method were detected in the order of Kocuria (22.6%), followed by Macrococcus (18.1%), Glutamicibacter (11.1%), and so on. When the ventilation system was operated appropriately, the airborne bacteria and fungi level were significantly decreased. Conclusion Airborne bacteria in the clinic tend to increase with the number of canines. Human pathogenic bacteria were mainly detected in VITEK®2, and relatively various bacteria were detected in molecular analysis. A decrease in the level of bacteria and fungi was observed with proper operation of the ventilation system.

Background: The study was planned to show the status of indoor microorganisms and the status of the reduction device in the military dog clinic. Methods: Airborne microbes were analyzed according to the number of daily patient canines. For identification of bacteria, sampled bacteria was identified using VITEK®2 and molecular method. The status of indoor microorganisms according to the operation of the ventilation system was analyzed. Results: Airborne bacteria and fungi concentrations were 1000.6 ± 800.7 CFU/m3 and 324.7 ± 245.8 CFU/m3. In the analysis using automated identification system, based on fluorescence biochemical test, VITEK®2, mainly human pathogenic bacteria were identified. The three most frequently isolated genera were Kocuria (26.6%), Staphylococcus (24.48%), and Granulicatella (12.7%). The results analyzed by molecular method were detected in the order of Kocuria (22.6%), followed by Macrococcus (18.1%), Glutamicibacter (11.1%), and so on. When the ventilation system was operated appropriately, the airborne bacteria and fungi level were significantly decreased. Conclusion Airborne bacteria in the clinic tend to increase with the number of canines. Human pathogenic bacteria were mainly detected in VITEK®2, and relatively various bacteria were detected in molecular analysis. A decrease in the level of bacteria and fungi was observed with proper operation of the ventilation system.

BACKGROUND: Natural killer cells expanded from human peripheral blood (PB) have been used in cancer immunotherapy research. Although most research teams have access to human PB, it is necessary to find a source of blood that can be easily obtained. We have tested the possibility of using blood retained in a disposable platelet apheresis set as an alternative source, with special interest in expansion of NK cells for use in cancer immunotherapy research. METHODS: For expansion of NK cells, peripheral blood mononuclear cells (PBMCs) were isolated from an MCS+ platelet apheresis kit (Haemonetics, Braintree, USA) and PB from the same donor (n=7) and co-cultured with 100-Gy gamma ray-irradiated K562 cells expressing the 4-1BB ligand and membrane-bound IL-15 for three weeks in RPMI1640 medium in the presence of IL-2 and IL-15. Cytotoxicity was measured using WST-1 at 1:1, 2:1, and 4:1 effector-to-target (E:T) ratios for a period of four hours. RESULTS: Mean rate of expansion of NK cells was 1,097-fold and their purity was 94.4% from blood retained in a disposable platelet apheresis set; mean rate of expansion of NK cells was 953-fold and their purity was 92.0% from PB after a period of three weeks. No differences in cytotoxicity against K562, 697, Raji, and RPMI8226 were observed between NK cells expanded from two blood sources. CONCLUSION: Blood retained in a disposable platelet apheresis set is a useful and convenient source for expansion of NK cells for use in cancer immunotherapy research.
4-1BB Ligand ; Blood Component Removal ; Blood Platelets ; Humans ; Immunotherapy ; Interleukin-15 ; Interleukin-2 ; K562 Cells ; Killer Cells, Natural ; Tissue Donors

PURPOSE: Various tumor antigens can be loaded onto dendritic cells (DCs) to induce a potent cytotoxic T lymphocyte (CTL) response in DC-based immunotherapy against breast cancer. However, in the clinical setting, obtaining a sufficient number of autologous tumor cells as a source of tumor antigens is a laborious process. We therefore investigated the feasibility of immunotherapy using breast-cancer-specific CTLs generated in vitro by use of alpha-type 1 polarized DCs (alpha DC1s) loaded with ultraviolet B-irradiated cells of the breast cancer cell line MCF-7. MATERIALS AND METHODS: alphaDC1s were induced by loading allogeneic tumor antigen generated from the MCF-7 UVB-irradiated breast cancer cell line. Antigen-pulsed alphaDC1s were evaluated by morphological and functional assays, and the breast-cancer-specific CTL response was analyzed by cytotoxic assay. RESULTS: The alphaDC1s significantly increased the expression of several molecules related to DC maturation without differences according to whether the alphaDC1s were loaded with tumor antigens. The alphaDC1s showed a high production of interleukin-12 both during maturation and after subsequent stimulation with CD40L, which was not significantly affected by loading with tumor antigens. Breast-cancer-specific CTLs against autologous breast cancer cells were successfully induced by alphaDC1s loaded with apoptotic MCF-7 cells. CONCLUSION: Autologous DCs loaded with an allogeneic breast cancer cell line can generate potent breast-cancer-specific CTL responses. This may be a practical method for cellular immunotherapy in patients with breast cancer.
Antigens, Neoplasm ; Breast ; Breast Neoplasms ; CD40 Ligand ; Cell Line ; Dendritic Cells ; Humans ; Immunotherapy ; Interleukin-12 ; Lymphocytes ; T-Lymphocytes, Cytotoxic