Helicobacter pylori, loss of basement membrane, atrophy, type III intestinal metaplasia, adenomatous polyposis coli (APC) gene mutations and altered p53 function were believed as a factor to develop the gastric adenocarcinomas. To investigate the incidence and prevalence of Helicobacter pylori, intestinal metaplasia and atrophy, 120 gastrectomy specimens collected from patients with gastric adenocarcinoma (100 cases) and non-neoplastic conditions (20 cases) were studied. Intestinal metaplasia can be classified as type I (complete), type II (incomplete, sulfomucin-negative) and type III (incomplete, sulfomucin-positive) by Filipe and Jass. The incidence of intestinal metaplasia of gastric adenocarcinoma was 96% compared with the incidence of 75% in non-neoplastic conditions. The type I and type II were more common than type III and were present in both non-neoplastic conditions (75%) and adenocarcinoma (74%). In contrast, type III intestinal metaplasia was seen in only 20% of intestinal metaplasia-positive cases, all of which (22 of 22) were from patients with adenocarcinoma. The high specificity of type III intestinal metaplasia might be acceptable for screening purposes, but its sensitivity of 22% for gastric adenocarcinoma is low. Helicobacter pylori were detected in 96% of adenocarcinoma cases and 100% of non-neoplastic cases. Atrophy was detected in 50% of non-neoplastic cases and in 57% of adenocarcinoma cases. The data thus confirms a significant relation between incomplete sulfomucin-secreting intestinal metaplasia (type III) and gastric carcinoma, especially intestinal type (p<0.01). Thus, the type III intestinal metaplasia should be considered a risk factor and its presence in a biopsy specimen should prompt close surveillance.
Adenocarcinoma ; Adenomatous Polyposis Coli ; Atrophy ; Basement Membrane ; Biopsy ; Gastrectomy ; Helicobacter pylori ; Humans ; Incidence ; Mass Screening ; Metaplasia* ; Prevalence ; Risk Factors ; Sensitivity and Specificity

PURPOSE: For evaluation of the growth hormone and cortisol responses to insulin stimuli in children with short stature, the human growth hormone secretion and cortisol level was monitored 30 and 60 minutes after insulin infusion by intravenousely. METHODS: The inclusion criteria of children for this study were that the height was below 3 percentile compare with the same sex and age children, bone age was younger more than one year of chronologic age, and insulin and L-dopa induced growth hormone secretion was below 10ng/mL. There were 10 children compatible with this criteria(group A) and 11 children was selected for control group(group B). Serum concentration of growth hormone was determined just before intravenous infusion of 0.1U/kg insulin and then 30 and 60 minutes after insulin infusion. Serum level of cortisol was determined simultaneously with the growth hormone but skip the level of the 30 minutes after insulin infusion. Serum glucose level was monitored on every time sampling the blood for determined growth hormone and cortisol level. Serum level of growth hormone and cortisol were determined by radioimmunoassay. RESULTS :The serum glucose concentration were decrease to under 50% of baseline level on 30 minutes after insulin infusion in A and B group. The serum growth hormone level before insulin infusion was 2.5+/-1.78ng/mL and changed to 2.2+/-1.69 ng/mL on 60 minutes after insulin infusion in group A. In group B, the serum growth hormone level alteration before and on 60 minutes after insulin infusion was from 5.5+/-6.67ng/mL to 12.6+/-7.91ng/mL. The serum concentration of cortisol was changed from baseline level 10.7+/-7.10, 7.9+/-3.98microg/dL to 16.7+/-11.47, 26.1+/-3.59microg/ dL on 60 minutes after insulin infusion in group A and B respectively, but some cases in group A show a little increase in cortisol level. CONCLUSION: On the basis of this study, it is suggested that the deficiency of growth hormone secretion is related to cortisol concentration in peripheral blood. But for more detailed assessment of this association, follow up studies will be needed in more cases.
Blood Glucose ; Child* ; Growth Hormone* ; Human Growth Hormone ; Humans ; Hydrocortisone* ; Infusions, Intravenous ; Insulin* ; Levodopa ; Radioimmunoassay

Maintenance of normal rate of tear production and elimination is essential for the proper controlled envionment for the cornea and the conjunctiva. We analyzed tear turnover rates in normal subjects, which mainly depend on tear production. We scanned 65 eyes of 36 normal subjects after instillation of 2% fluorescein solution 1u into the lower conjunctival fornix, using fluorophotometer (Fluorotron Master). After instillation of fluorescein solution, we scanned the eyes every 3 minutes for 30 minutes to measure tear film fluorescence. We calculated the tear turnover rate using tear film fluorescence valuse. Mean tear turnover rates were 12.3+/-6.6 %/min in normal subjects, 12.7+/-6.9 %/min in men, and 11.7+/-6.6 %/min in women. Mean tear turnover rates of men did not differ significantly from those of women (p>0.05). Mean tear turnover rates of younger subjects(25 years old~40 years old) (16.2 +/-7.4 %/min) were found to be significantly higher than ghose of older subjects(41 years old~73 years old) (9.1+/-40 %/min) (p<0.05). The morning tear turnover rates (13.5+/-1.6 %/min) were found to be higher than those for the afternoon (10.2+/-4.9 %/min), but the differences were not significant(p>0.05). We think that this study might be useful to study the diagnosis and treatement of tear secretory system disorders.
Conjunctiva ; Cornea ; Diagnosis ; Female ; Fluorescein ; Fluorescence ; Humans ; Male ; Tears*

PURPOSE: We reviewed 5 years worth of experience with peritoneal drainage and dialysis in infants who underwent open heart surgery. The aim of this study was to investigate the effect of peritoneal drainage and peritoneal dialysis on fluid balance and several parameters of intensive care. METHODS: Six(10%) of 60 consecutive infants who underwent open heart surgery required peritoneal dialysis during peritoneal drainage. Simple peritoneal drainage was performed in the remaining 54 infants. The silicone rubber peritoneal dialysis catheter was inserted into the center of abdominal cavity just after operation, and subsequent peritoneal drainage was maintained during intensive care. RESULTS: Mean age of the study group was 0.48+/-0.21 years(M: F=32: 28). Early postoperative mortality amang the infants with congenital heart disease was 1.6%. Total amount of output was 7.0+/-2.28mL/kg/hr, urine output 5.14+/-2.9lmL/kg/hr, pleural fluid 0.80+/-0.5lmL/kg/hr, and peritoneal fluid 1.20+/-0.90mL/kg/hr. The ratio of output to intake(O/I) was 1.06. None of the complications required early termination of peritoneal drainage or peritoneal dialysis. Hemodynamics and pulmonary function were maintained steadily during postoperative intensive care. CONCLUSION: The early institution of peritoneal drainage and peritoneal dialysis in infants with congenital heart disease after cardiac operations not only removes fluid, thus easing fluid restriction, but may also improve cardiopulmonary function.
Abdominal Cavity ; Ascitic Fluid ; Catheters ; Dialysis ; Drainage* ; Heart Defects, Congenital* ; Heart* ; Hemodynamics ; Humans ; Infant* ; Critical Care ; Mortality ; Peritoneal Dialysis ; Silicone Elastomers ; Thoracic Surgery ; Water-Electrolyte Balance

PURPOSE: 2 TU of PPD HTZ3 has been substituted for 5 TU of PPD RT23 since 1998 in Korea without adequate evaluation. This study was undertaken to evaluate the tuberculin reactivity to 2 TU of PPD RT23 following intradermal BCG vaccination in neonates. The results were compared with the previous report generated with 5 TU of PPD RT23 in 1993. METHODS: Two hundred neonates born from October 1998 to April 1999 in Hanyang University Hospital were vaccinated with O.lmL of BCG(Institute Merieux, France) intradermally and tested for tuberculin response to 2 TU of PPD RT23 three months later. RESULTS: Among the total 200 infants, 31 showed no response on Mantoux test and the remaining 169 infants showed induration in diameter of 7.52.4rnm in bell shaped distribution(155 fullterm infants : 7.7+/-2.3mrn, l4 premature infants :.5.2+/- 2.2mm). When the diameter of induration was equal to or greater than 5 rnm considered for positive tuberculin response, the positive rate of tuberculin response in fullterm infants was 80.7%(146/181 infants) and significantlv greater than 52.6%(9/19 infants) in prernature infants(P=0.0119). CONCLUSION: Tuberculin reactivity to 2 TU of PPD RT23 on infants vaccinated with BCG during neonatal period appears to be lower than that to 5 TU of PPD RT23 reported previously, indicating that a new criteria for tuberculin reactivity to 2 TU of PPD RT23 should be established in future studies.
Humans ; Infant ; Infant, Newborn* ; Infant, Premature ; Korea ; Mycobacterium bovis* ; Tuberculin* ; Tuberculosis ; Vaccination*

We conducted a retrospective study of 20 penetrating keratoplasty (19patients) for corneal opacity due to herpes simplex keratitis from January 1992 to February 1997 at National Medical Center. We exaniined f requeuey of graft rejection and recurrence of herpetic keratitis after penetrating keratoplasty. The patients were grouped into control & treatinent, group according to the use of antivirial drug after penetrating keratoplasty and we examined the difference in rate of recurrence between two groups. The follow-up period was from 8 months to 68 months, mean follow-up period being 29.6 months. Graft rejection was seen in 3 eyes out of 20 eyes (15.0%) and recurrence was developed 3 eyes out of 20 eyes (15.0%). Recurrent herpetic keratitis developed in 15.4%(2 of 13) of the eyes in control group and 14.3% (1 of 7) of the eyes in treatment group. There was no statistically significant difference in recurrence rate between two groups (p)0.05). Postoperative prophylactic antiviral treatment is not associated with decreased rate of herpes simplex keratitis recurrence.
Corneal Opacity ; Follow-Up Studies ; Graft Rejection ; Herpes Simplex* ; Humans ; Keratitis, Herpetic* ; Keratoplasty, Penetrating* ; Recurrence ; Retrospective Studies

The authors have evaluated the effect of topically applied 1% cyclosporine A for four weeks after limbal allograft transplantation for ocular surface stability in severely ocular surface damaged rabbits. A total eleven severely damaged rabbits were subdivided into three groups of four limbal autograft (AUTO), three limbal allograft (ALLO), four limbal allograft with topical application of 1% cyclosporine A five times daily for four weeks (ALLO-C). We examined ocular surface smoothness, clarity, corneal vascularization before surgery and three months after surgery, and classified three grade (success, partial success, failure) according to result. In AUTO, three eyes were success, one eye was failure. In ALLO, one eye showed inferior graft detachment and one eye was success, two eyes were failire. In ALLO-C, no graft detachment detected and one eye was success, two eyes were partial success, one eye was failure. We knew that. ALLO-C show more effective ocular surface stability than ALLO. These result suggest ALLO-C can be used as alternative treatment of AUTO in ocular surface reconstruction. But, rnore study for duration and concentration of cyclosporin A will be need.
Allografts ; Autografts ; Cornea* ; Cyclosporine* ; Rabbits ; Transplants

Most of the malignant tumors of the pancreas are adenocarcinomas arising from the ductal epithelium. Primary leiomyosarcoma of the pancreas, even though it is the most common sarcoma of the pancreas, is very rare. We present a case of leiomyosarcoma of the pancreas, probably primary, with metastases to the stomach, lymph nodes, and abdominal wall. A 52-year-old woman visited the hospital with vague right upper abdominal pain and weigh loss of 6 kg for 2 months. The radiological and endoscopic examination revealed that she had a large heterogeneous mass, 11 cm in size, in the pancreatic body and tail, a 4 cm-sized mass in the paraaortic area, and a 3 cm-sized polypoid mass in the stomach. Histologically, they were all similar to one another and composed of markedly pleomorphic cells. Immunohistochemical and electron microscopic studies showed definite smooth muscle differentiation of the tumor cells. Two months later, the patient underwent an excision of a new 3 cm mass in the right lower abdominal wall, showing features of well differentiated leiomyosarcoma.
Abdominal Pain ; Abdominal Wall ; Adenocarcinoma ; Epithelium ; Female ; Humans ; Leiomyosarcoma* ; Lymph Nodes ; Middle Aged ; Muscle, Smooth ; Neoplasm Metastasis ; Pancreas* ; Sarcoma ; Stomach

No abstract available.
Apnea* ; Humans

Hirayama disease usually selectively involves lower cervical myotomes (C8, T1). Thus, patients usually manifest with atrophy and weakness of small hand muscle. Predominant isolated involvement of proximal arm is rarely reported in Hirayama disease. Here, we report a case of Hirayama disease who had focal weakness and wasting, mainly confined to right biceps brachii muscle, with prominent shifting of dural sac in C4-5 segment by dynamic flexion magnetic resonance imaging (dfMRI), which may explain this unusual distribution of the disease.
Amyotrophy, monomelic