The chronic active or aggressive hepatitis B, in which periportal inflammation(piecemeal necrosis) is conventionally accepted as the pattern of progression to cirrhosis', implies little concern with intralobular necroinflammation as a process responsible for aggravation and progression. Some published observations, however, refer to episodes of acute necrotizing bouts(subacute hepatic necrosis) have been reported". For technical reasons, relatively few sequential biopsy studies of chronic hepatitis B are available and particularly, initial acute hepatitis B is barely documented since biopsies are now rarely perfomed in acute stages of hepatitis4. Moreover, most published sequential studies are complicated by therapeutic intervention. The availability of Korean sequential biopsy specimens and the increasing interest in parenchymal changes in the evolution of hepatitis B encouraged the description of the progression of acute and chronic hepatitis B to cirrhosis. During the long-term follow-up study, acute bouts of intralobular parenchymal necroinflammation are observed whenever the stage of aggravation is caught and the biopsy is possible. Whatever the result of these studies, the observation presented suggests a major role of parenchymal changes in the evolution of chronic hepatitis B and this experience focuses on the important lesions of the lobular parenchyma in classification and evaluation of chronic hepatitis'. Seven patients are selected on the basis of elevated S-ALT level, and submit to repated needle biopsies during a 6-month period". Of these, 2 cases show chronic active hepatitis with early cirhosis constantly, and in 5 cases CAH appear 1 or 2 times in each case during the follow-up period. In clinical follow-up after the sequential biopsies, these 7 patients were all healthy at least for an average of 18.6 years ranging from 14 to 27 years, except for one who developed into HCC without complication of cirrhosis. Thus, while the sample size of this study is small, continuous piecemeal necrosis seems not to be a pattern of progression to cirrhosis. In conclusion, acute and chronic hepatitis B experienced in Korea appear to progress to cirrhosis by means of repeated acute episodic bouts of intralobular necroinflammation, and the conventional concept that continuous progress by piecemeal necrosis seems not to hold true.
Biopsy ; Biopsy, Needle ; Classification ; Fibrosis* ; Follow-Up Studies ; Hepatitis B ; Hepatitis B, Chronic* ; Hepatitis, Chronic* ; Humans ; Korea ; Necrosis ; Sample Size

No abstract available.

Primary ampullary carcinoma is one of rare gastrointestinal malignancies which can be diagnosed by ERCP and endoscopic biopsy. However, sometimes it is difficult to comfirm the diagnosis when the tumor is not exposed out of orifice of ampulla. Recently, we diagnosed early stage ampullary carcinoma using endoscopic sphincetrotomy for the exposure of tumor in 54 year old woman ia whom ERCP revealed rather impacted stone like filling defect in distal common bile duct. we describe a case of papillary adenocarcinoma of the ampulla of Vater diagnosed by edoscopic sphincterotomy.
Adenocarcinoma, Papillary ; Ampulla of Vater* ; Biopsy* ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct ; Diagnosis ; Female ; Humans ; Middle Aged ; Sphincterotomy, Endoscopic*

Along with traditional goal of 'straightening teeth', today's orthodontics put more and more emphasis on facial esthetics. Naturally, the importance of soft tissue, which dictates one's facial form, is noticed. There have been many cephalometric studies on growth of hard tissue; however, only a few on that of soft tissue. In Korea, various methods of sampling, measuring and analysing were used to study soft tissue changes, and yet, soft tissue changes along with process of normal growth have not been studied. The author carried out this study as a part of semi-longitudinal study on craniofacial growth and development of Korean children from ages of six to seventeen. 409 boys and 436 girls who'd had no systemic disease for the last three years and shown normal developmental and occlusal status were chosen as subjects. Cephalometric X -rays were taken of each subject, and facial form, lip position & form, nose form, and lip thickness were measured, Mean values and standard deviations were calculated according to age and gender, and figures and tables were drawn accordingly. The following results were obtained: 1. In respect to facial form, boys showed growth for longer period compared to girls. Also, lower face showed higher growth rate than upper face. 2. There was not much change in thickness of upper and lower lips with age; however , they appeared more prominent compared to caucasian children. 3. Nose grew horizontally with age. 4. Horizontal thickness of lower face increased with age, and upper lip thickness at nose base[A-Sn(FH)] showed more growth than anywhere else.
Child* ; Esthetics ; Female ; Growth and Development* ; Humans ; Korea ; Lip ; Nose ; Orthodontics

Sclerosing cholangitis is cholestatic disease, characterized by progressive fibrotic inflammation and obliteration af intrahepatic bile ducts and extrahepatic bile ducts and sometimes associated with ulcerative colitis. The pathogenesis of this disease is not understood well. In this disease, however, have been proposed infectious agent, endotoxin of bacteria and immunological event. In Europe and U.S.A., the incidence of sclerosing cholangitis associated with ulcerative colitis was between 2,4 and 4.0 percent. The association is strongest in patients with pancolitis, with a prevalenee of 5.5 percent, compared with patients with disease confined to the distal colon, with a prevalence of 0.5 percent. But, in Korea, it has not been reported sclerosing cholangitis associated with ulcerative colitis. A 30-year old man was diagnosed as an ulcerative colitis 9 years ago and has been followed up, intermittently. Recently, he has experienced hematochezia and dizziness. Colonoscopy showed active ulcerative colitis(pancolitis), blood chemistry elevated alkaline phosphatase and y-GTP. ERCP and liver biopsy specimen revealed sclerosing cholangitis. we concluded that this case was a sclerosing cholangitis as a complication of ulcerative colitis and the first case report of primary sclerosing cholangitis with ulcerative colitis in Korea, Hence, we reported a case of primary sclerosing cholangitis with ulcerative colitis with a review of literatures.
Adult ; Alkaline Phosphatase ; Bacteria ; Bile Ducts, Extrahepatic ; Bile Ducts, Intrahepatic ; Biopsy ; Chemistry ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis, Sclerosing* ; Colitis, Ulcerative* ; Colon ; Colonoscopy ; Dizziness ; Europe ; Gastrointestinal Hemorrhage ; Humans ; Incidence ; Inflammation ; Korea ; Liver ; Prevalence ; Ulcer*

Sclerosing cholangitis is cholestatic disease, characterized by progressive fibrotic inflammation and obliteration af intrahepatic bile ducts and extrahepatic bile ducts and sometimes associated with ulcerative colitis. The pathogenesis of this disease is not understood well. In this disease, however, have been proposed infectious agent, endotoxin of bacteria and immunological event. In Europe and U.S.A., the incidence of sclerosing cholangitis associated with ulcerative colitis was between 2,4 and 4.0 percent. The association is strongest in patients with pancolitis, with a prevalenee of 5.5 percent, compared with patients with disease confined to the distal colon, with a prevalence of 0.5 percent. But, in Korea, it has not been reported sclerosing cholangitis associated with ulcerative colitis. A 30-year old man was diagnosed as an ulcerative colitis 9 years ago and has been followed up, intermittently. Recently, he has experienced hematochezia and dizziness. Colonoscopy showed active ulcerative colitis(pancolitis), blood chemistry elevated alkaline phosphatase and y-GTP. ERCP and liver biopsy specimen revealed sclerosing cholangitis. we concluded that this case was a sclerosing cholangitis as a complication of ulcerative colitis and the first case report of primary sclerosing cholangitis with ulcerative colitis in Korea, Hence, we reported a case of primary sclerosing cholangitis with ulcerative colitis with a review of literatures.
Adult ; Alkaline Phosphatase ; Bacteria ; Bile Ducts, Extrahepatic ; Bile Ducts, Intrahepatic ; Biopsy ; Chemistry ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis, Sclerosing* ; Colitis, Ulcerative* ; Colon ; Colonoscopy ; Dizziness ; Europe ; Gastrointestinal Hemorrhage ; Humans ; Incidence ; Inflammation ; Korea ; Liver ; Prevalence ; Ulcer*

BACKGROUND/AIMS: Apoptosis via Fas/FasL system is thought to be involved in the development of hepatocyte death in viral hepatitis B. In chronic hepatitis C, sFas/sFasL system was reported to control liver injury induced by Fas/FasL mediated apoptosis. To determine the role of sFas/sFasL system in chronic hepatitis B, we analyzed serum sFas/sFasL in 58 HBV patients and 29 healthy controls. METHODS: HBV patients were categorized into two groups; normal ALT (< or =40 IU/L) and elevated ALT (>40 IU/L). Serum sFas/sFasL levels in HBV patients were measured by ELISA and was compared with those in 29 healthy controls. Serum ALT levels, histological activity, and Fas/FasL expression of liver were compared. RESULTS: Chronic hepatitis B patients with elevated ALT had significantly higher serum sFas levels than those in healthy controls (P<0.01). Serum sFasL levels, however, were significantly lower than those in healthy controls (P<0.01). Patients with moderate to marked degree of inflammation and fibrosis had significantly higher serum sFas levels than those in healthy controls (P<0.05). Serum sFasL levels had no correlation with the hepatic histological activity. Serum sFas/sFasL levels also had no significant correlation with the Fas/FasL expression of liver. CONCLUSIONS: Serum sFas/sFasL levels play a possible role in the pathogenesis of chronic hepatitis B. These results suggest that serum sFas levels might serve as a marker for estimating the degree of hepatic histological activity.
Adult ; Antigens, CD95/analysis/*blood ; Fas Ligand Protein/analysis/*blood ; Female ; Hepatitis B virus/isolation & purification ; Hepatitis B, Chronic/*diagnosis ; Humans ; Male ; Middle Aged

The thalidomide tragedy in the 1960s has resulted in a perpetuation of a certain perception amongst physicians and pregnant women that the use of medication during pregnancy is a potential teratogen. Consequently, physicians hesitate in prescribing medication to pregnant women. In addition, pregnant women often refuse medication despite therapeutic necessity because of this existing perception. Recently there have been frequent adverse pregnancy outcomes related to the recurrence of chronic diseases, such as hypertension and diabetes, following pregnancy in older women. And there are lots of unnecessary termination of pregnancy due to the of information of medication exposed to medication following over 50% of unintended pregnancy. In light of this, better dissemination of information regarding the safe usage of medication for pregnant women is required. This would not only be cost-effective in terms of medical expenditure, but also prove beneficial for the treatment of diseases. In addition, Korea needs to adapt to the increasing changes of the international information system regarding supporting the safe usage of medication during pregnancy. An example of this is shown by the recent changes to the labeling of medication by the United States Food and Drug Administration. The new labeling includes information on the risk of usage, rather than just an arbitrary alphabetic classification of B, C, D, or X. Furthermore, this information is limited in Korea because of the lack of research, which in turn is due to several limitations on ethics and methodology, as well as present regulations on the research of pregnant women. From this, we can learn that government support is critical for the establishment of research so that we can alter the perception that all medication is harmful to pregnant women.
Chronic Disease ; Classification ; Ethics ; Female ; Health Expenditures ; Humans ; Hypertension ; Information Systems ; Korea ; Pregnancy ; Pregnancy Outcome ; Pregnant Women* ; Recurrence ; Social Control, Formal ; Thalidomide ; United States Food and Drug Administration

Sarcoidosis is a multisystem granulomatous disorder commonly affecting young adults. Diagnosis is confirmed by evidence of non-caseating granuloma in more than one organ. A case is presented where the diagnosis was made on a bone marrow biopsy, the first case in Korea. A 54-year-housewife was admitted because of multiple variable sized, skin papules and macules, who showed pancytopenia and evidence of liver cirrhosis on ultrasound. We performed skin biopsy and bone marrow biopsy, which showed non-caseating granulomas. The chest CT, opthalmologic examination was performed and showed the involvement of sarcoidosis of mediastinal lymph nodes and uvea. Multiple joints of both hands and feet also seemed to be involved in view of simple X-ray. By this case, we emphasize the significance of bone marrow biopsy in the sarcoidosis with pancytopenia.
Biopsy ; Bone Marrow* ; Diagnosis ; Foot ; Granuloma ; Hand ; Humans ; Joints* ; Korea ; Liver Cirrhosis ; Liver* ; Lymph Nodes ; Pancytopenia ; Sarcoidosis* ; Skin* ; Tomography, X-Ray Computed ; Ultrasonography ; Uvea* ; Young Adult

An isolated aneurysm of the iliac artery is a very rare disease that can occur as the result of atherosclerotic degeneration, mycosis, trauma, medial necrosis, fibrodysplasia, or Marfan syndrome. This abnormality is often asymptomatic, and it has a potential risk of rupture. Since patients with chronic renal failure on hemodialysis have many comorbid conditions, the risk of rupture is increased. Here, we report the case of an isolated common iliac artery aneurysm that was caused by atherosclerosis in a patient on hemodialysis, and we review the relevant literature.
Aneurysm ; Atherosclerosis ; Humans ; Iliac Aneurysm ; Iliac Artery ; Kidney Failure, Chronic ; Marfan Syndrome ; Necrosis ; Rare Diseases ; Renal Dialysis ; Renal Insufficiency ; Rupture