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: It has been reported that younger patients with lung cancer have characteristic features that differ from those in older patients. The prognosis for young patients with this disease is controversial. This study aimed to determine the clinicopathological characteristics, the survival rate, and the risk factors associated with the overall survival rate in younger patients with lung cancer. METHODS: The records of 120 young(age≤40) patients with histologically confirmed lug cancer in the Korea Cancer Center Hospital(KCCH) between Jan. 1992 to 1998, 120 older(age>40) patients were randomly selected as the controls. RESULTS: More female patients(45.0% vs. 20.0%, p<0.001) and more adenocarcinoma cases(64.2% vs. 38.3%, p<0.001) were found in the younger group, when compared to the older patients. In NSCLC, advanced disease(stage III B and IV) was more common in the younger patients(90.2%) than in the older patients(62.7%) (p<0.001). The Median survival was 8.6 months in the younger patients and 12.2 months in the older(p=0.003). In a multivariate analysis, only the advanced-stage was an independent negative prognostic factor. CONCLUSION: Lung cancer in the younger age group presents with a more advanced stage resulting in a poor survival rate, which suggests that lung cancer in this population is more aggressive than in older patients.
Adenocarcinoma ; Female ; Humans ; Korea ; Lung Neoplasms* ; Lung* ; Multivariate Analysis ; Prognosis ; Risk Factors ; Survival Rate

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

While intussusception can occur at any age, the disease is most often seen in children and no etiologic factor can be seen in most cases of childhood intussusception. In contrast, the adult intussusception is rare and usually has an identifiable causes such as benign tumor, malignant tumor, sarcoma, Meckel's diverticulum and congenital anomaly. Especially, adult intussusception due to primary malignant lymphoma of small intestine is rare clinical condition. Here, we describe the case of a 49-year-old male patient with ileo-ileo-colic intussusception due to primary malignant lymphoma of the small intestine. The clinical, radiographic and pathologic findings are described with brief review of the literature.
Adult* ; Child ; Humans ; Intestine, Small* ; Intussusception* ; Lymphoma* ; Male ; Meckel Diverticulum ; Middle Aged ; Sarcoma

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