BACKGROUND/AIMS: Hepatitis C virus(HCV) was known to most common etiologic agent of chronic liver disease in United states and Japan. Although hepatitis B virus(HBV) was well known to be a its major etiologic agent in Korea, it has been showed that HCV and HBV are associated with liver cirrhosis and hepatocellular carcinoma as major causative agent of chronic liver disease. Interferon alpha therapy is generally accepted as effective single agent for chronic hepatitis or to decrease the chronicity of acute hepatitis C. So, we evaluated the efficacy of interferon alpha in hepatitis C. METHODS: 46 patients who were positive for anti-HCV antibody and HCV RNA were included in this study. Liver biopsy was per formed on all patients and all of them were tested as negative for serum HBsAg, anti Hbe. Patients were divided into 2 groups . 30 patients received interferon therapy(treated group) and 16 patients received no therapy(untreated group). We compared the change of liver function test and HCV RNA before and after therapy between two groups. Treated group was subdivided into 5 groups according to response to interferon therapy '. Non-response, partial response, breakthrough, relapse and sustained response. RESULTS: 1) The mean age and sex distribution were 49.9 year old, male 19, female 11 in treated group and 48.7 years, male 12, female 4 in untreated group. 2) The number of patients with acute hepatitis, chronic persistent hepatitis, chronic active hepatitis and liver cirrhosis were 1, 2, 23, 4 in treated group and 0, 1, 12, 3 in untreated group, respectively. 3) The mean follow up period was 1.7 year and 2.3 years in treated and untreated group, respectively. 4) The activity of serum ALT before and after therapy were 195+ 134.6 IU/L, 87.4+ 40.5 IU/L and 186.7+ 106.4 IU/L, 157+ 87.1 IU/L in treated and untreated group, respectively. Serum ALT after therapy in treated group was significantly lower than untreated group(P<0.01). 5) The number of patients for patterns of reponse in treated group was non-response 5, partial response 8, breakthrough 1, relapse 4, sustained response 12 and there was no difference in age among them(P>0.05). 6) The case of negative conversion for HCV RNA in treated group was 12, but there was no case in untreated group. 7) Sex distribution of sustained response was 6(31% ) of 19 male, 6(54.5%) of 11 female and 12 patients(40.0%)(1 of 1 patients with acute hepatitis, 1 of 2 chronic persistent hepatitis, 10 of 23 chronic active heaptitis) included in sustained reponse, but any patients with liver cirrhosis had response. 8) Mean total dose and duration of interferon therapy was non-response 10353.6 million unit(MU)/5.8month(M), partial response 20025.06MU/6.4 M, breakthrough 36000.0MU/5.0M, relapse 11700.0MU/3.3M, sustained response 28100.0MU/6.6M, respectively. 9) 3 of 7 patients who were followed up over 1 year in sustained response and mean time to the relapse was 2.2 years. CONCLUSION: Our results showed that interferon alpha therapy is effective in patients with hepatitis C and further study and attempts should be performed to augument the efficacy of interferon alpha for the treatment of hepatitis C.
Biopsy ; Carcinoma, Hepatocellular ; Female ; Follow-Up Studies ; Hepatitis B ; Hepatitis B Surface Antigens ; Hepatitis C* ; Hepatitis* ; Hepatitis, Chronic ; Humans ; Interferon-alpha* ; Interferons* ; Japan ; Korea ; Liver ; Liver Cirrhosis ; Liver Diseases ; Liver Function Tests ; Male ; Recurrence ; RNA ; Sex Distribution ; United States

Authors reviewed and clinically analysed 34 cases of trasometatarsal joint injury treated at the Orthopedic department of Pusan National University Hospital during the period from January 1975 to December 1979, and following results were obtained. 1. The incidence was higher in male and the active age group of 20-40. 2. Among the causes, traffic accidents were 22 cases (64.7%) and crushing injuries in the industrial field were 6 cases (17.6%). 3. Fracure-dislocations were higher than simple dislocation. 4. According to the Wilsons Classifications, the injuries were classified as follows. First stage of supination (51), 11 cases (32.4%): First stage of pronation (P1), 8 cases (23.5%): Plantar-flexion alone (PF), 4 cases (11.8%): Second stage of supination (S2), 3 cases (8.8%): Second stage of pronation (P2), 2 casese (5.9%): And finally direct crushing injuries,were 6 cases (17.6%): 5. Associated injuries were fracture of the metatarsal bone in 15 cases (44.1%), fractures of the tarsal bone in 7 cases (20.6%) and severe soft tissue injuries in 6 cases (17.6%), 6. The operative treatments with early anatomical reduction were obtained better results than conservative treatment. 7. As complications, pain in 31 cases (91.2%), bony deformity in 26 cases (76.5%), motion limitation in 32 cases (94.1%), skin necrosis in 3 cases (8.8%) and traumatic arthritis in 23 cases (67.6%) were observed.
Accidents, Traffic ; Arthritis ; Busan ; Classification ; Clinical Study ; Congenital Abnormalities ; Dislocations ; Humans ; Incidence ; Joints ; Male ; Metatarsal Bones ; Necrosis ; Orthopedics ; Pronation ; Skin ; Soft Tissue Injuries ; Supination ; Tarsal Bones

No abstract available.
Thioacetamide*

Plesiomonas shigelloides with positive reactions of oxidase and indole production is a species of facultative anaerobic gram-negative bacilli. It is an inhabitant of fresh surface water and has been isolated from surface water, fresh water fish, oysters, and various animals. It is not considered to be a part of normal human intestinal flora. In human, P. shigelloides has been associated with gastroenteritis and extraintestinal infection. There have been no previous reports of extraintestinal disease due to P. shigelloides in Korea. Rare extraintestinal infections include neonatal meningitis and septicemia, cellulitis pyometra and acute cholecystitis. The patients may take fatal courses even though they receive antiboiotic therapy. We report a case of sepsis caused by P. shigelloides in a 60-year-old male with diabetes mellitus who had undergone subtotal gastrectomy 8 years before. The patient presented with diarrhea, abdominal cramps, high fever and jaundice. Enlargement of the gallbladder was noted in an abdominal ultrasonogram. He had a history of drinking surface water 5 days ago. P. shigelloides was isolated from his blood, but he recovered after cephalosporin and aminoglycoside infusion and supportive therapy. To our knowledge, this is the first report of septicemia due to P. shigelloides in Korea.
Animals ; Cellulitis ; Cholecystitis, Acute ; Colic ; Diabetes Mellitus ; Diarrhea ; Drinking ; Fever ; Fresh Water ; Gallbladder ; Gastrectomy ; Gastroenteritis ; Humans ; Jaundice ; Korea ; Male ; Meningitis ; Middle Aged ; Ostreidae ; Oxidoreductases ; Plesiomonas* ; Pyometra ; Sepsis* ; Ultrasonography ; Water

OBJECTIVES: Hemodynamic measurements of chronic portal hypertension were done to study the mechanisms that maintain high portal pressure despite well developed collateral circulations. METHODS: A prehepatic portal hypertensive rat model was produced by partial portal vein ligation. Cardiac output, organ blood flow and porto-systemic shunt were measured by radioisotope labeled microsphere methods, and vascular resistance was calculated by standard equation. RESULTS: There was a significant reduction in the weight of the liver and increase in the weight of the spleen in the portal stenotic rats. Porto-systemic shunting, representing development of the collateral circulations, was 96.7+/-0.6% in the portal stenosis group compared with 0.9+/-0.2% in the control group (p<0.01). Portal pressure was significantly increased in the portal stenosis group compared with the control group(12.8+/-1.4 vs. 6.5+/-0.6mmHg; p<0.01). Mean arterial pressure was significantly decreased in portal stenosis group compared with control group(101.4+/-2.5 vs, 129.9+/-3.9mmHg; p<0.01). In the portal stenosis group, cardiac output(135.7+/-8.0 vs. 111.0+/-4.2ml/min; p<0.01) and splanchnic organ blood flow (28.97+/-2.03 vs. 17.90+/-1.27ml/min, p<0.01) were significantly increased, with concomitant decrease in total peripheral vascular resistance(58.0+/-3.3 vs. 88.2+/-4.8 dyne sec/cm5 X 105; p<0.01) and splanchnic vascular resistance(2.54+/-0.20 vs. 5.47+/-0.33 dyne sec/cm5 X 105; p<0.01), However, the portal venous resistance was not significantly different in both groups of rats (3.57+/-0.31 vs. 3.03+/-0.38 dyne sec/cm5 X 105; p>0.05). CONCLUSION: The hemodynamic results of this study indicate that hyperdynamic status of systemic and splanchnic circulation was present in chronic portal hypertension and that the primary factor contributing to the persistently elevated portal venous pressure was the markedly increased portal venous inflow.
Animals ; Arterial Pressure ; Cardiac Output ; Collateral Circulation ; Constriction, Pathologic ; Hemodynamics* ; Hypertension, Portal ; Ligation ; Liver ; Microspheres ; Models, Animal* ; Portal Pressure ; Portal Vein* ; Rats* ; Splanchnic Circulation ; Spleen ; Vascular Resistance

Vibrio vulnificus infections occur between May and October, and most often involve men over age 40. V. vulnificus has been linked to two distinct syndromes: primary sepsis and primary wound infections. Primary sepsis occurs most commonly in patients with antecedent liver disease such as cirrhosis. Mortality approaches about 50 percent, with most deaths due to uncontrolled sepsis. We experienced a case of septicemia without dermatologic lesion by serovar type O1 V. vulnificus, and reported this case with a review of literature.
Fibrosis ; Humans ; Liver Diseases ; Male ; Mortality ; Sepsis* ; Skin* ; Vibrio vulnificus* ; Vibrio* ; Wound Infection

No abstract available.
Hemoptysis*

Cholestatic liver diseases are characterized by impairments of bile flows and accumulations of biliary constituents such as bile acids and bilirubin. The changes of phase I and II metabolism and the hepatobiliary transport system minimize cholestatic liver injury. These adaptive responses are transcriptionally regulated by several nuclear receptors. Recent studies have revealed that the pregnane X receptor (PXR) and the constitutive androstane receptor (CAR) are key nuclear receptors for regulating many of the adaptive responses noted in cholestasis. PXR and CAR coordinately regulate not only bile acid metabolism and transport, but also bilirubin clearance. PXR and CAR ligands may be useful in the future for the treatment of cholestatic liver disease.
Transcription Factors/metabolism/*physiology ; Receptors, Steroid/metabolism/*physiology ; Receptors, Cytoplasmic and Nuclear/metabolism/*physiology ; Humans ; Cholestasis/metabolism/*physiopathology

Drug-induced liver injury (DILI), including herbal and dietary supplement hepatotoxicity, is often passed lightly; however, it can lead to the requirement of a liver transplant or may even cause death because of liver failure. Recently, the American College of Gastroenterology, Chinese Society of Hepatology and European Association for the Study of the Liver guidelines for the diagnosis and treatment of DILI have been established, and they will be helpful for guiding clinical treatment decisions. Roussel Uclaf Causality Assessment Method scoring is the most commonly used method to diagnose DILI; however, it has some limitations, such as poor validity and reproducibility. Recently, studies on new biomarkers have been actively carried out, which will help diagnose DILI and predict the prognosis of DILI. It is expected that the development of new therapies such as autophagy inducers and various other technologies of the fourth industrial revolution will be applicable to DILI research.