The incidence and death rate of hepathocellular carcinoma (HCC) both rank third in Korea (death rate 21.3 per 100,000 in 2000) and HCC is a major health issue in Korea. HCC causes substantial morbidity and mortality and the results of treatments for advanced HCC are still disappinting. Considering the high incidence, death rate, and poor prognosis of HCC, it is necessary to establish a national screening program by evaluating the validity. The Korean Association for the Study of the Liver (KASL) and National Cancer Center (NCC) cooperatively developed and recently released HCC screening/surveillance recommendation. The target population is patients with chronic hepatits B and C and cirrhosis of any cause, over 30 years of age in male and 40 years of age in female. The surveillance tests consist of serum alpha-fetoprotein and abdominal ultrasonography at least every 6 months. Korean national program for the early detection of cancer will start the HCC screening/surveillance program in the low economic classes from 2003, based on KASL-NCC recommendations. The efficacy of this HCC survaillance program would be worthy of attention.
alpha-Fetoproteins ; Carcinoma, Hepatocellular* ; Early Detection of Cancer ; Early Diagnosis* ; Female ; Fibrosis ; Health Services Needs and Demand ; Humans ; Incidence ; Korea ; Liver ; Male ; Mass Screening* ; Mortality ; Prognosis ; Ultrasonography

No abstract available.

OBJECTIVES: Dysfunctional uterine bleeding(DUB) is defined as abnormal bleeding from the uterine endometrium unrelated to anatomic lesions of the uterus, and its incidence is 10-15% among gynecologic diseases. We conducted this study for understanding correlation between clinical aspecets and pathological findings of DUB. Methods: We conducted a retrospective review of 599 women with DUB who underwent endometrial biopsy with special regard to the relation between pathologic findings and presenting symtoms or complaints from Jan. 1988 to Dec. 1997. RESULTS: Age distribution of DUB was mainly 5th decade, mean age was 44.1years, among various bleeding patterns, intermenstrual bleeding was the most common pattern(31.6%) and the next was menorrhagia(25.0%). Histologic findings of endometrium were proliferative phase, 327 cases(54.6%), hyperplasia, 139 cases(23.2%), secretory phase, 74 cases(12.4%) in order of frequency, and there was no difference in distribution of histologic findings among various bleeding patterns. CONCLUSION: Compared to other previoius studies, our study showed more incidence of endometrial hyperplasia, especially at age group of 40 or more. So patients aged more than this age with abnormal uterine bleeding must undergo emdometrial biopsy for pathologic diagnosis. Patients who are diagnosed endometrial hyperplasia must be carefully followed up because there are possibilities of progression to endometrial carcinoma.
Age Distribution ; Biopsy ; Diagnosis ; Endometrial Hyperplasia ; Endometrial Neoplasms ; Endometrium ; Female ; Genital Diseases, Female ; Hemorrhage ; Humans ; Hyperplasia ; Incidence ; Metrorrhagia* ; Retrospective Studies ; Uterine Hemorrhage ; Uterus

There are many difficult problems and various methods in the treatment of difficult fractures of the femur. Form May 1991 to August 1994, 9 cases of difficult fractures of the femur were treated with Ilizarov external fixator. We obtained good result for all cases as follow : 1. There were 1 case of severely segmental and comminuted fracture with bone loss, 3 cases of infected nonunion after internal fixation(2 cases combined with bone loss), 2 cases of non-union after internal fixation and 3 cases of severely segmental and comminuted fractures. The traffic accident injury was in 6 cases and the falling down injury was in 3 cases. 2. The bone union was obtained in all cases and the duration of Ilizarov external fixator application was minimum 7.7 months up to 19 months with an average of 1.3 months and full weight bearing was possible in all cases after removal of the Ilizarov external fixator. 3. We experienced 9 complication; there were 6 cases of pin tract infection which were controlled by antibiotic injection at that site and there were three cases of limitation of motion of knee. So we conclude that the Ilizarov external fixation technique is one of the effective methods for the treatment of difficult fracture of the femur(ex. segmental, comminuted fracture, bone defect, osteomyelitis and nonunion) in spite of having experienced only few cases.
Accidental Falls ; Accidents, Traffic ; External Fixators ; Femur ; Fractures, Comminuted ; Knee ; Osteomyelitis ; Weight-Bearing

No abstract available.
Vincristine*

Aneurysm of the internal carotid artery is a rare disease and is known to be associated with congenital arterial anomalies such as neurofibromatosis type I (NF-I). NF-I is an autosomal dominant neurocutaneous disorder characterized by a variety of manifestations that involve the central and peripheral nervous systems, skin, vascular system, and skeleton. In particular, the involvement of vascular abnormalities in NF-I is well known. Any vessel may be affected by this condition, although the renal artery is most frequently involved. The vascular abnormality can be occlusive or an aneurysmal degenerative change. Therefore, symptomatic presentations might assume an indolent pathophysiologic course such as hypertension, or manifest as a catastrophic event such as arterial rupture that could result in sudden death. We report a rare autopsy case of an aneurysmal rupture of the internal carotid artery in a woman with suspected NF-I, who collapsed in her home.
Aneurysm ; Autopsy ; Carotid Artery, Internal ; Death, Sudden ; Female ; Glycosaminoglycans ; Humans ; Hypertension ; Neurocutaneous Syndromes ; Neurofibromatoses ; Neurofibromatosis 1 ; Peripheral Nervous System ; Rare Diseases ; Renal Artery ; Rupture ; Skeleton ; Skin

No abstract available.
Transplants*

BACKGROUND/AIMS: Hepatocellular carcinoma (HCC) is the 3rd most common cancer. The annual incidence is over 10,000 cases in Korea. While hepatitis B virus is major cause of Korean HCC, the impact of alcoholic liver disease is a rising trend. The 5-year survival rate of HCC is only 9.6%, mainly due late diagnosis, tumor biology and underlying chronic liver diseases. Because almost eighty percent of HCC is diagnosed in late, not early stages, a nationwide surveillance program to screen high risk groups (HBV or HCV carriers or liver cirrhosis, over 40 years old) was launched last year and a practice guideline, with special emphasis on advanced stage HCC was formulated. METHODS: Forty-five experts from KLCSG and the National Cancer Center participated in a special committee to develop a practice guideline for HCC. Based on scientific evidence, the consensus was made for diagnosis and treatment strategy after considering the medico-social situation in Korea. RESULTS: Required and optional tests and clinical (non-invasive) diagnosis criteria for HCC are identified. The first decision, based on both Child-Pugh score and modified UICC tumor staging, is to determine operability. The second decision, to determine resectability, is based on localization of the tumor and residual liver function. Chemoembolization or local ablation therapy is allowed for resectable tumors in certain conditions, such as at borderline risk or non-invasively diagnosed. Unresectable tumors are classified into either a group with inadequate residual liver functions or the another group with extensive or macrovascular invasion or distant metastases. Indications of liver transplantation, chemoembolization, local ablation, radiation therapy and chemotherapy for unresectable HCC are presented. CONCLUSIONS: This guideline is expected to be useful for clinical management of, and research for HCC patients.
Adult ; Carcinoma, Hepatocellular/*therapy ; English Abstract ; Humans ; Liver Neoplasms/*therapy ; Middle Aged

The purpose of this study was to evaluate the histologic difference that occured after trichloroacetic acid(TCA) chemical peel in an animal model that was pretreated with Tretinoin alone or Tretinoin-based combined pretreatment kit. Eight Hartley white guinea pigs were used in our study. The dorsal skin of the guinea pigs was divided into six equal squares(2x2 cm). Upper two areas of these six were not pretreated, middle two areas were pretreated for 4 weeks with Tretinoin alone and lower two areas were pretreated for 4 weeks with Tretinoin-based combined kit. Each guinea pig underwent chemical peel with 50% TCA. The wounded areas were biopsied at post-peeling 3 weeks and 6 weeks. The histology revealed that those animals pretreated with combined kit healed quicker than the animals pretreated with Tretinoin alone. This study implies that if patients are treated with Tretinoin-based-combined pretreatment kit before undergoing chemical peel, the pretreatment time will be shortened.
Animals ; Guinea Pigs* ; Guinea* ; Humans ; Models, Animal ; Skin ; Tretinoin* ; Wounds and Injuries

Two cases of ureteral fibrous polyp showing serpiginous filling defect on IVP are presented with characteristic radiologic features; easy flow of contrast medium around polyp. Prolapsed polyp in urinary bladder, and less ureteral obstruction or renal damage than in epithelial lesions. These rediologic findings enable to differentiation of ureteral fibrous polyps from malignant tumor, which is helpful for determining therapeutic approach.
Polyps* ; Ureter* ; Ureteral Obstruction ; Urinary Bladder