PURPOSE: The aims of this study were to investigate the frequencies and role of hepatitis B virus(HBV) precore and core promotor mutations in children with chronic hepatitis B infection. METHODS: Sera from 46 children with chronic hepatitis B infection were analyzed by direct sequencing of polymerase chain reaction product of HBV DNA. In this study, the patients were divided into vertical and non-vertical groups according to the mode of HBV transmission. Statistical analysis was performed by using Fisher's exact test. RESULTS: Forty-six adr type of HBV DNA were analyzed. The mutations in HBV precore region were observed in 12(26.1Yo) of 46 cases. The GA mutation of nucletide(nt) 1896 was observed in 5 cases(10.9Yo). The frequency of mutations in HBV precore region of the non-vertical group (6/16; 37.5Fo) was higher than that of the vertical group(6/30; 20M), but there was no statistical significance. The mutation in HBV core promotor region was observed in 40(87.0%) of 46 cases. The A-->T mutation of nt 1762 or G-->A mutation of nt 1764 were observed in 24(52.2%) of 46 cases, and 23 cases revealed combined mutation at both positions 1762 and 1764. The frequency of mutations in HBV core promotor region of the vertical group(28/30; 93.3Yo) was higher than that of the non-vertical group(12/16; 75.0M), but there was no statistical significance. The frequencies of mutations in HBV precore and core promotor regions of the HBeAg negative patients was higher than that of HBeAg positive patients, but there was no statistical significance. Also there were no significant correlations between the frequencies of mutations in HBV precore and core promotor regions and AST, ALT level or the level of HBV DNA. CONCLUSION: These observations suggest that mutations in HBV precore and core promotor regions were frequently detected in children with chronic hepatitis B infection. There were no statistical significant differences in the frequencies of mutations in HBV precore and core promotor regions between vertical and non-vertical transmission groups. (J Korean Pediatr Soc 2000; 43:779-791)
Child* ; DNA ; Hepatitis B e Antigens ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis B, Chronic* ; Hepatitis* ; Hepatitis, Chronic* ; Humans ; Polymerase Chain Reaction ; Promoter Regions, Genetic

PURPOSE: The aims of this study were to investigate the frequencies and role of hepatitis B virus(HBV) precore and core promotor mutations in children with chronic hepatitis B infection. METHODS: Sera from 31 children with chronic HBV infection were analyzed by direct sequencing of polymerase chain reaction amplification of HBV DNA. RESULTS: Twenty-nine adr type were analyzed. The mutations in HBV precore region were observed in 8(27.6%) of 29 cases. The G->A mutation of nucleotide 1896(A1896; stop codon) were observed in 4 cases(13.8%). The mutations in HBV core promotor region were observed in 27 (93.1%) of 29 cases. The G(1764)->A mutation(A1764) was observed in 14 cases(48.3%), and among these 12 cases combined with a A to T change at nucleotide 1762(T1762). The mutations in HBV precore region were obsereved in 4(21%) of 19 cases of HBeAg positive group and 9(90%) of 10 cases of HBeAg negative group. A1896 mutation was observed in 2 cases in both HBeAg positive and negative group, respectively. The mutations in HBV core promotor region were observed in 18(94.7%) of 19 cases of HBeAg positive group and 9(90%) of 10 cases of HBeAg negative group. T1762 mutation were observed in 6(31.6%) of 19 cases of HBeAg positive group and 6(60%) of 10 cases of HBeAg negative group(P=0.14). A1764 mutation was obsereved in 7 (36.8%) of 19 cases of HBeAg positive group and 7(70%) of 10 cases of HBeAg negative group (P=0.089). A1896 mutation was observed in 2(18.2%) of 11 cases in increased AST/ALT group and 2(11.1%) of 18 cases in normal AST/ALT group. A1764 and T1762 mutations were higher (61.1%) in AST/ALT increased group than those(27.3%) in AST/ALT normal group, but there was no statistical significance(P=0.077). CONCLUSION: Mutations in the precore and core promotor regions can be frequently detected in children with chronic HBV infection. T1762 and A1764 mutations were observed more frequently in HBeAg negative group and in AST/ALT increased group but there was no statistical significance.
Child* ; DNA ; Hepatitis B e Antigens ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis B, Chronic* ; Hepatitis* ; Hepatitis, Chronic* ; Humans ; Polymerase Chain Reaction ; Promoter Regions, Genetic

Twenty three patients with locally invasive transitional cell carcinoma of the bladder(stage T2-T4N0M0) who refused to undergo radical cystectomy or were poor surgical candidates were included in this study. All patients received transurethral resection(TUR) of the tumor initially for the pathologic staging and debulking of tumor mass. Then, patients were treated with either one of the following two bladder preservation protocols. First trials consisted of initial 2 courses of MVAC(methotrexate, vinblastin, adriamycin and cisplatin) chemotherapy and followed by radiotherapy( 6480cGy) plus 2 courses of cisplatin. The other protocol was initial radiotherapy ( 6480cGy) with 2 courses of cisplatin and additional 2 courses of MCV(methotrexate, cisplatin and vinblastin) chemotherapy. There were 8 patients in T2, 13 in T3 and 2 in T4. Repeat biopsies were conducted 1 to 6 months after initiation of therapy. With a mean follow up of 17.1 months, other than two patients who underwent cystectomies, the survival rate without local recurrence or distant metastasis was 66.6% (14/21)-87.5 % ( 7/8) in T2. 63.6 % ( 7/11) in T3 and 0%(0/2) in T4. Bladder tumor recurrence and metastasis was observed in 3 patients respectively. One patient in stage T4 died at 20 months with multiple metastasis. The survival rate is closely correlated to initial stage. Patients with no residual mass after TUR seemed to be better in response than patients with residual mass. Side reactions such as neutropenia ( <2000/ mm3) were observed in 6(26.2% ) patients, radiation cystitis in 2(8.7% ) and radiation proctitis in 1(4.3%) The bladder preservation protocol in locally invasive bladder tumor has relatively satisfactory results but longer follow-up is necessary to determine the efficacy of current protocol in long term survival.
Biopsy ; Carcinoma, Transitional Cell ; Cisplatin ; Cystectomy ; Cystitis ; Doxorubicin ; Drug Therapy ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Neutropenia ; Proctitis ; Radiotherapy ; Recurrence ; Survival Rate ; Urinary Bladder Neoplasms* ; Urinary Bladder*

No abstract available.
Histiocytosis*

OBJECTIVE: This study analyze the standpoint of newspapers toward alternative medicine. METHODS: Through the content analysis of the articles selected by Korean Integrated News Database System(KINDS). With news items about alternative medicine in nine general dailies for six years between 1997 and 2002, this study was conducted to grasp the trend of the reports and provide investigation data to the alternative medicine communication. RESULTS: As social concerns about health drastically increase, many types of health information and common senses in medicine are recently pouring out through various media. Newspapers and TV are competitively presenting items and programs about health every day. Now anyone can approach information and common senses in medicine with ease if he or she wants. The problem is that reports and programs about health pouring out through each medium contain a great amount of wrong information that can have a bad influence on national health. If wrong information is delivered to the people, or medical consumers, through the mass media, they can suffer from very serious side-effects and aftereffects. If patients or caregivers misled by false information on health commit an error in judgement, they can make their disease worse or miss the proper moment for treatment and consequently meet an irrevocable misfortune. For this reason, they must be careful in dealing with information on health. CONCLUSION: In consideration of results, many type of health information are expected to grow in the future. Therefore it is important for information providers to maintain a sound policy which is scientific and objective in order to protect information consumers.
Caregivers ; Complementary Therapies* ; Hand Strength ; Humans ; Mass Media ; Periodicals

BACKGROUND: The aging of the patient population is one of rhe most important factirs influencing health care delivery. Currently 5% of the Korean population is elderly, defined as older than 65years of age, with this group projected to increase to 13.1% by the year 2021. Cardiovascular disease is the leading cause of death and of disability in the elderly age group. mong them, coronary heart disease is the most importane. METHOD: Study population composed of 216 patients who were admittied to the hospital with first acute myocardial infarction and they were divided into two groups according to the age(older than 65 years of age vs younger). Clonical features, risk factors of coronary heart disease, in-hospital outcome and complication were compared in elderly patients and others group. Results : 1) The risk factors of coronary heart disease is similar to younger patients but pattern of chest pain is less typical than younger patients. 2) Clinical presentation of elderly patients is similar to younger patients except Killip class on admission.(1.66vs 1.91,P=0.04) 3) In-hospital mortality of elderly patients in higher than younger patients. In addition to an increased incidence of death, recurrent ischemia, stroke, AV block, ventricular arrythmia, pulmonary edema occured more frequently with advanced age. 4) Especially in the thrombolytic therapy group, in-hospital death, reinfarction and recurrent ischemia is higher than primary PTCA group in elderly patients. CONCLUSIONS: Diagnosis of acute chest pain is difficult in elderly patients and in-hospital mortality and morbidity is higher than in younger patients. Thus more accurate diagnosis and discriminative therapeutic modality is needed.
Aged ; Aging ; Arrhythmias, Cardiac ; Atrioventricular Block ; Cardiovascular Diseases ; Cause of Death ; Chest Pain ; Coronary Disease ; Delivery of Health Care ; Diagnosis ; Hospital Mortality ; Humans ; Incidence ; Ischemia ; Myocardial Infarction* ; Pulmonary Edema ; Risk Factors ; Stroke ; Thrombolytic Therapy

Hepatitis C virus (HCV) is a major cause of chronic hepatitis, liver cirrhosis and hepatocellular carcinoma. HCV core protein has been shown to modulate various cellular signaling pathways including the nuclear factor κB (NF-κB) pathway which is associated with inflammation, cell proliferation and apoptosis. However, there have been conflicting reports about the effect of HCV core protein on NF-κB pathway, and the mechanism by which the core protein affects NF-κB activity remains nuclear. In this study, the functional interaction of HCV core protein and IκB kinase γ (IKKγ) was investigated using the expression plasmids of core and the components of IKK complex. The data revealed that HCV core protein activates NF-κB. Also, HCV core protein up-regulated the phosphorylation and degradation of IκBα. The activating effect of HCV core protein on NF-κB was synergistically elevated by IKKγ. It was noticed that the N-terminal IKKβ binding site, C-terminal leucine zipper, and zinc finger domains of IKKγ are not necessary for its synergistic effect. HCV core protein and IKKγ appeared to activate NF-κB by up-regulating the IKKβ activity resulting in the degradation of IκBα. As expected, HCV core protein induced the expression of NF-κB-targeted pro-inflammatory genes such as iNOS, IL-1β and IL-6 in the transcription level. These results suggest that HCV core protein induces NF-κB through the interaction with IKKγ and may play a critical role in the development of inflammation and related liver diseases.
Apoptosis ; Binding Sites ; Carcinoma, Hepatocellular ; Cell Proliferation ; Hepacivirus* ; Hepatitis C* ; Hepatitis* ; Hepatitis, Chronic ; Inflammation ; Interleukin-6 ; Leucine Zippers ; Liver Cirrhosis ; Liver Diseases ; Phosphorylation ; Phosphotransferases ; Plasmids ; Zinc Fingers

BACKGROUND: There has been reports which suggest that non-specific symptom of patients with mitral valve prolapse is associated with autonomic dysfunction. METHODS: To assess autonomic dysfunction of patients, we examined five cardiovascular reflex tests in 25 asymptomatic MVP patients(identified as MVP group), 25 symptomatic MVP patients(identified as MVP syndrome group) and 25 control group. RESULTS: In the five cardiovascular autonomic function tests, abnormalities of Valsalva ratio were detected in 1(4%) control group, 7(28%) MVP group, 9(36%) MVP syndrome group, heart rate response to deep breathing in 0(0%), 2(8%), 4(16%) respectively, immediate heart rate response to standing in 0(0%), 2(7.4%), 2(8%) respectively and in postural hypotension, there were no abnormal group. Abnormalities of blood pressure response to sustained handgrip were only detected in 2(8%) MVP syndrom group. According to the five categories of cardiovascular autonomic functon tests, normal in 24(96%) and early damage in 1(4%) were detected in control group. In the MVP group, normal 17(68%), early damage 6(24%) and definite damage 2(8%) were noted. In the MVP syndrome group, normal 9(36%), early damage 13(52%), definite damage 1(4%) and combined damage 2(8%) were detected. In case of heart rate response to deep breathing, we found significant differences between control and MVP syndrome group(p=0.043), and between MVP and MVP syndrome group(p=0.0043). In case of heart rate response to standing, between control and MVP syndrome group(p=0.0009), between MVP and MVP syndrome group(p=0.001), the differences were noted. In case of blood pressure response to standing, between control group and MVP group(p=0.0019), between MVP and MVP syndrome group(p=0.0075), we found significant differences. Resulting from our study, heart rate response to deep breathing and standing, blood pressure response to standing were of considerable value in assessing the autonomic dysfunction of patients with mitral valve proapse. CONCLUSION: We found autonomic dysfunction in addition to increased autonomic tone and responsiveness which have been already known previously in mitral valve prolapse. And autonomic dysfunction was more severe in symptomatic patients with mitral valve prolapse than asymptomatic ones.
Blood Pressure ; Heart Rate ; Humans ; Hypotension, Orthostatic ; Mitral Valve Prolapse* ; Mitral Valve* ; Reflex ; Respiration

We report a case of subcutaneous panniculitic T-cell lymphoma (SPTCL) which occurred in a 10-year-old Korean girl. Her disease presented as multiple erythematous subcutaneous nodules on the right cheek, left chest, abdomen, left flank, both calves, and left shin with systemic symptoms. She had a protracted course of multiple erythematous subcutaneous nodules for 2 months often with spiking fever. Histopathologic findings for the subcutaneous nodules revealed lobular panniculitis-like findings composed of atypical small, bland lymphocytes and histiocytes. Characteristically, atypical lymphocytes rimmed individual fat cells in a lace-like pattern and some histiocytes occasionally phagocytosed WBCs. Bone marrow findings revealed increased phagocytic histiocytes with engulfed hematopoietic cell. The immunophenotypic studies showed CD45RO (UCHLl)+, CD20-, CD4-, CD8+ and CD56+ (focal), lysozyme+, CD45 (LCA)+ and EBV-. She received three cycles of high-dose cyclophosphamide, adriamycin, vincristine, prednisolone (CHOP) and methotrexate, intrathecal methotrexate and one cycle of fludarabine, mitoxantrone and dexamethasone (FND) chemotherapy. She died of acute renal failure during multiple chemotherapy.
Abdomen ; Acute Kidney Injury ; Adipocytes ; Bone Marrow ; Cheek ; Child* ; Cyclophosphamide ; Dexamethasone ; Doxorubicin ; Drug Therapy ; Female ; Fever ; Glycogen Storage Disease Type VI ; Histiocytes ; Humans ; Lymphocytes ; Lymphoma, T-Cell* ; Lymphoma, T-Cell, Cutaneous ; Methotrexate ; Mitoxantrone ; Prednisolone ; T-Lymphocytes* ; Thorax ; Vincristine

Porphyromonas gingivalis is strongly implicated in the pathogenesis of adult periodontitis, the major cause of tooth loss in adults. Use of an antibacterial agent controlling P. gingivalis as a periodontal therapeutic agent has been rationalized. The present study was performed to observe the antibacterial effect of inorganic polyphosphates (polyP) on P. gingivalis. P. gingivalis 2561 was grown in half-strength brain-heart infusion broth containing hemin and vitamin K with or without polyP. Minimal inhibitory concentration (MIC) of polyP with various chain lengths was determined by measuring the absorbance of the grown cells at 540 nm. MIC of polyP for the bacterium was determined to be 0.05%. The effect of polyP with a chain length of 75 (polyP 75) was further examined. PolyP 75 added to the growing culture of P. gingivalis at its exponential phase was as effective in inhibiting the growth of P. gingivalis as polyP 75 added at the very beginning of the culture. More than 99% of the cells lost their viability determined by viable cell count when polyP 75 was added to the culture of growing P. gingivalis at the concentration of 0.06%, suggesting that polyP 75 has a bactericidal effect on the bacterium. Intracellular nucleotide release from the cells was increased by approx. 20% in the presence of polyP 75 but was not reversed by the addition of divalent cations like Ca++ and Mg++. Under the transmission electron microscope, only a small number of the growing P. gingivalis cells were actually lysed. However, the majority of the cells appeared to be atypical in their shape, demonstrating accumulation of highly electron-dense granules and bodies of condensed nucleic acid-like material in the cytoplasm. In the presence of polyP 75, the protein profile of P. gingivalis was changed as determined by SDS-polyacrylamide gel electrophoresis and immunoblot, and the proteolytic activity of the bacterium demostrated on the zymograms was decreased. The overall results suggest that polyP have a strong bactericidal activity against P. gingivalis in which lysis in relation to chelation may not play the major role but unknown mechanism that possibly affects the viability of the bacterium may be involved. PolyP may be used as an agent for prevention and treatment of periodontitis.
Adult ; Cations, Divalent ; Cell Count ; Chronic Periodontitis ; Cytoplasm ; Electrophoresis ; Hemin ; Humans ; Periodontitis ; Polyphosphates* ; Polyps ; Porphyromonas gingivalis* ; Porphyromonas* ; Tooth Loss ; Vitamin K