To elucidate the biologic significause of hepatocyte B core antigen (HBcAg) expression and its relation to the natural course of hepatitis B virus (HBV) infection, we tried to correlate the patterns of HBcAg with the HBV replication state and with disease activity in 40 needle biopsies performed on hepatitis B surface antigen (HBsAg) carriers aged from 15 to 46 years. In 32 of 40 cases, HBcAg was present in the hepatocyte nucleus (nHBcAg), in the cytoplams (cHBcAg) or in both (mixed). Pure nHBcAg was seen only in minimal hepatitis, but a diffuse pattern of expression of cytoplasmic HBcAg and mixed cytoplasmic and nuclear expression of HBcAg were seen in active hepatitis. There was also a good correlation between liver HBcAg and serum HBeAg. Cases in which HBcAg expression were observed were positive for serum HBeAg (81%) and the cases negative for HBcAg were all positive for serum anti-HBe.
Biopsy

Nezelof's syndrome(combined immunodeficiency with immunoglobulin) is a hereditary primary immunodeficiency characterized by recurrent chronic pulmonary infections, oral and cutaneous candidiasis, failure to thrive, chronic diarrhea, skin infection, urinary tract infection, gram-negative sepsis, severe progressive varicella infection, lymphopenia, diminished lymphoid tissue, abnormal structure of the thymus, and presence of normal or increased levels of one or more of the major immunoglobulin classes, but with impaired antibody synthesis. We experienced a case of Nezelof's syndrome in 5-month-old boy who complained cough, poor feeding, vomiting and diarrhea in first admission day and discharged with recovered general condition in 38th admission day and then died of recurrent bacterial and fungal infections and malnutrition in 15-month-old age. He had no thymic shadow in chest X-ray and immunologic abnormalities including decreased lymphocyte count, decreased T cell count and function, normal number of B cell count and immunoglobulins with funtional impairment in antibody synthesis. We report a case of Nezelof's syndrome with brief review of related literatures.
Candidiasis, Cutaneous ; Cell Count ; Chickenpox ; Cough ; Diarrhea ; Failure to Thrive ; Humans ; Immunoglobulin Isotypes ; Immunoglobulins ; Infant ; Lymphocyte Count ; Lymphoid Tissue ; Lymphopenia ; Male ; Malnutrition ; Sepsis ; Skin ; Thorax ; Thymus Gland ; Urinary Tract Infections ; Vomiting

BACKGROUND: The nucleus tractus solitarius (NTS), the region of the brain stem in which primary baroreceptor afferents teminate, is critically important in the normal regulation of arterial pressure (AP). In the NTS, excitatory amino acids such as L-glutamate serve as the main neurotransmitter in the regulation of AP. However, the function of GABA in the NTS has not been established. To test the function of GABA, we applied GABAergic agents to the NTS. METHODS: The experiments were conducted on adult male Sprague-Dawley rats weighing 300-500g. A cannula (PE-50 tubing filled with heparinized saline) was inserted into the femoral artery for recording of AP and heart rate(HR). Another cannula was inserted into the femoral vein for administration of nitroprusside or phenylephrine. After rats were placed on a sterotaxic instrument, the dorsal surface of the medulla was exposed, and with the aid of a surgical microscope, the NTS was visualized. Drug injections were made into the NTS using single- or three-barreled grass micropipettes pulled to an outer diameter of 80-100(micro)m and connected to a 1(micro)l Hamilton syringe. RESULTS: The follwing results were obtained in this experiment. Injection into the NTS of 10 or 20 nmol nipecitic acid, a selective inhibitor of GABA untake, produced an increase in AP. The pressor responses evoked by two doses of nipecotic acid were not significantly different. Injection of GABA(A) agonist, musciml(5 pmol in 80 nl artificial CSF) and GABA(B) agonist, baclofen (20 pmol in 80 nl) into the NTS of urethane-anesthetized rats prodused an increase in AP of 16.6+/-1.3 and 27.6+/-1.5 mmHg, respectively. Thus the pressor response to GABA(B) agonist was greater than to GABA(A) agonist. On the other hand, microinjection of GABA(A) antagonist, bicuculline and GABA(B) antagonist, phaclofen into the NTS decreased AP by approximately 13.4+/-1.0 and 20.9+/- mmHg, respectively. Thus injection of nipecotic acid into the NTS was greater in control group compared with the muscimiol or baclofen groups. The AP changes caused by i.v. injection of nitroprusside or phenylephrine were smallest in control group and greatest in the baclofen group. When calculated as baroreflex sensitivity, the change was greatest in control group and smallest in the baclofen group. CONCLUSION: From these results it was concluded that GABA in the NTS plays an important role in the regulation of AP, especially through GABA(B) receptors, and have an inhibitory effect on baroreceptor reflex.
Adult ; Animals ; Arterial Pressure ; Baclofen ; Baroreflex ; Bicuculline ; Blood Pressure ; Brain Stem ; Catheters ; Excitatory Amino Acids ; Femoral Artery ; Femoral Vein ; GABA Agents ; gamma-Aminobutyric Acid* ; Glutamic Acid ; Hand ; Heart ; Heparin ; Humans ; Male ; Microinjections ; Neurotransmitter Agents ; Nitroprusside ; Phenylephrine ; Poaceae ; Pressoreceptors ; Rats ; Rats, Sprague-Dawley ; Solitary Nucleus* ; Syringes

No abstract available.
Constriction, Pathologic* ; Stents*

BACKGROUND: In Korea, the prevalence of tuberculosis and hepatitis is high, and combined therapy with rifampicin and pyrazinamide is used in tuberculosis, so drug induced hepatitis is not only problem of tuberculosis therapy but also cause of treatment failure. However most of recent reports on drug induced hepatitis during antituberculosis medication have dealt with its pathogenesis and have stressed the biochemical, and histopathological aspects of the disorder, whereas this study was designed primarily to provide information on the clinical features. METHOD: The subjects of study were 1414 patients treated with antituberculosis drugs on the department of chest medicine at National Medical Center during the 5-year 6-month period from January 1, 1988, to June 30, 1993. Retrospective analysis of clinical features for the 29 patients who developed drug induced hepatitis was done. RESULTS: 1) The incidence of antituberculosis drug induced hepatitis was 2.1%. 2) Male to female ratio of antituberculosis drug induced hepatitis was 2:1, but case rates among males and females were not significantly different. 3) Rates of drug induced hepatitis according to age distribution shows the most common incidence between 35 to 49 year old age group, but rates among groups of age were not significantly different. 4) Drug induced hepatitis was most common in the case of moderate advanced Pulmonary tuberculosis(rate is 2.78%), but rates among types of tuberculosis were not significantly different. 5) 18 cases(62%) of antituberculosis drug induced hepatitis patients had no signs or symptoms. In remaining cases, they were nausea, vomiting, jaundice, hepatomegaly, icteric sclera, right upper quadrant -tenderness in order 6) 22 cases(76%) of antituberculosis drug induced hepatitis cases had occurred within the first month. 7) The duration of abnormal liver function was 28±5(Mean±SD), ranged from 5 days to 180 days. 8) One case of antituberculosis drug induced hepatitis died. 9) The levels of abnormal GOT ranged from 64 to 1055U/L and GPT from 68 to 931U/L. CONCLUSION: There are no decided predisposing factors of antituberculosis drug induced hepatitis, so it should be done biochemical monitoring as week as close monitoring for overt signs or symptoms of hepatitis to avoid the development of irreversible hepatic reaction, especially at the treatment of the first month.
Age Distribution ; Causality ; Female ; Hepatitis* ; Hepatomegaly ; Humans ; Incidence ; Jaundice ; Korea ; Liver ; Male ; Nausea ; Prevalence ; Pyrazinamide ; Retrospective Studies ; Rifampin ; Sclera ; Thorax ; Treatment Failure ; Tuberculosis ; Vomiting

No abstract available.

PURPOSE: To evaluate the value of helical CT in patients with endoscopically and pathologically proven early gastric cancer. MATERIALS AND METHODS: Helical CT scans(5-mm section thickness, 5-mm/sec table speed) were obtained in 45 patients with pathologically proven early gastric cancer. CT findings were retrospectively reviewed by two independent radiologists without surgical or pathologic information. Detection rate, depth of invasion, and lymph node staging were evaluated. RESULTS: The overall detection rate was 52% ; there was no significant difference in the rates between observer A(55%) and B(49%). The detection rate was higher in the anterior bodywall(100%) and antrum(63%) than in the posterior body wall(42%) and antrum(53%). The detection rate of the depressed type(63%) was higher than that of the elevated type(38%). Submucosal stripe was seen in 45% of mucosallesions and in 32% of submucosal lesions, though the stripe was not a reliable indicator for depth of invasion.Lymph node metastasis was detected in only one of eight patients. None was found to have distant metastasis. CONCLUSION: Helical CT is of little help in the evaluation of endoscopically evident early gastric cancer and the routine use of helical CT is not recommended in early gastric cancer.
Humans ; Neoplasm Metastasis ; Retrospective Studies ; Stomach Neoplasms* ; Tomography, Spiral Computed*

Perforated appendicitis with an abscess formation is known to be the most common cause of tender mass in right lower abdomen. The differential diagnosis of a tender mass in right lower abdomen, however, is broad and includesvarious intraabdominal and intrapelvic lesions in origin. Preoperative accurate diagnosis is essential in order toavoid unnecessary surgery or complications resulting from delayed surgery. The purpose of this pictorial essay isto illustrate examples of various causes and methods to differentiate them with ultrasonography and CT.
Abdomen* ; Abscess ; Appendicitis ; Diagnosis ; Diagnosis, Differential ; Ultrasonography ; Unnecessary Procedures

PURPOSE: Adiponectin is an adipocyte-derived plasma protein with various metabolic effects that include increasing insulin sensitivity, antiatherogenic, and antiinflammatory properties. The purpose of this study was to investigate the association of cord plasma adiponectin levels with body size, ponderal index, and gender in newborns and also age and body mass index in their mothers. METHODS: The cord blood was obtained from 99 healthy newborns (male 46, female 53, gestational age of 32-41 weeks) and the concentrations of adiponectin were analyzed by a radioimmunoassay kit. Anthropometric parameters of the newborns including birth weight and length were measured. Maternal weight and height were identified, and their body mass index was calculated. RESULTS: The cord plasma adiponectin levels of the newborns whose gestational age was longer than 39 weeks were significantly higher compared with those of gestational age shorter than 39 weeks (15.0+/-9.9 vs 8.4+/-8.9 microgram/mL, P=0.001). The cord plasma adiponectin concentrations were positively correlated with gestational age and length at birth of the newborns. There was no correlation between cord plasma adiponectin levels and sex, birth weight or ponderal index of the newborns. Any significant correlation was not found between cord plasma adiponectin levels and maternal age or body mass index. CONCLUSION: These findings indicate that cord plasma adiponectin concentrations are positively associated with gestational age and length at birth of neonates. However there is no correlation between cord plasma adiponectin levels and maternal age or body mass index.
Adiponectin* ; Birth Weight* ; Body Mass Index ; Body Size ; Female ; Fetal Blood* ; Gestational Age ; Humans ; Infant, Newborn* ; Insulin Resistance ; Maternal Age ; Mothers ; Parturition* ; Plasma ; Radioimmunoassay

Infantile digital fibromatosis(IDF) is a rare, benign fibrous tumor, first described in 1965 by Reye. IDF may occur single or multiple lesions exclusively on the fingers or toes, rare occurrence outside the digit have been reported. This tumor grow slowly and may adhere to the deeper tissue, and may lead to deformity of the digit, but do not distant metastasis or dissemination. There is a marked tendency for recurrence after surgical excision. Up to now, only 6 cases have been reported in the literature showing spontaneous regression. We experienced a case of infantile digital fibromatosis located on hypothenar area at birth. Also that spontaneous regressed at 13 months of age. We reported a case of IDF showing spontaneous regression with brief review of related literature.
Congenital Abnormalities ; Fibroma* ; Fingers ; Neoplasm Metastasis ; Parturition ; Recurrence ; Toes