No abstract available.
Arteries*

No abstract available.
Mucocutaneous Lymph Node Syndrome*

BACKGROUND/AIMS: Although interferon-a(IFNa) is currently the most effective antiviral agent for treating patients with chronic hepatitis C, its efficacy is not always reliable. Factors suggested to infruence outcome of IFN-a therapy for chronic hepatitis C are histological activity, level of viremia and HCV genotype, etc. The aim of this study was to determine the relationship between several pretreatment factors and response to IFN-a therapy in patients with chronic HCV infection. METHODS: Fifty-four patients with chronic HCV infection(47 with chronic hepatitis and 7 with liver cirrhosis) who received IFN-a(2a or 2b) therapy(3 6 MU, three times a week, for 3 12 months) were included. Level of serum HCV RNA(50 patients), HCV genotype(27 patients) and IgM anti- HCV(21 patients) during pretreatment period were assayed. RESULTS: Overall, 19(35%) subjects achieved sustained response(SR), 12(22%) had transient response(TR) and 23(43%) did not respond (nonresponse;NR). Mean age of patients with SR, TR and NR was 46+ 10, 51+ 7.5 and 54+ 9.7 years, respectively(p<0.05 between SR and NR). Among 30 patients with biopsy-proven chronic hepatitis, 13(43%) achieved SR;but only one(14%) in 7 patients with liver cirrhosis. Mean serum HCV RNA level(X10' copies/ml) was higher in nonresponders(7,7+ 13.0) compared with SR(2.3+ 2. 7) or TR(3.1+ 4.9), although statistically insignificant HCV genotyping in 27 patients revealed type la in 5(18.5%), 1b in 14(52%), 2a in 5(18.5%), 2b in 1(3.7%) and 4 in 2(7%), respectively. In non-1b patients, SR rate was significantly higher than 1b patients(69.2% vs. 21.4%, p=0.03). Although IgM anti-HCV was positive in 12(57%) among 21 patients studied, the positive rate and the titer of IgM anti-HCV was not significantly different in three groups. CONCLUSION: Our results suggest that in patients with chronic hepatitis C, infection with genotype 1b, old age, high serum HCV RNA level and the presence of cirrhosis would predict poor response to IFN therapy.
Fibrosis ; Genotype ; Hepatitis C, Chronic ; Hepatitis, Chronic ; Humans ; Immunoglobulin M ; Interferons* ; Liver ; Liver Cirrhosis ; RNA ; Viremia

We herein describe a case of a 55-year-old healthy woman with localized primary thymic amyloidosis presented as a mediastinal mass, found incidentally by chest radiography. Computed tomography revealed a 4.1 cm soft tissue lesion with nodular calcification in the left anterior mediastinum. The resected specimen was a well-defined lobulating mass with calcification. Microscopically, the mass was consisted of amorphous eosinophilc hyalinized substances involving the thymus and intrathymic lymph nodes. These eosinophilic substances showed apple-green bi-refringence under polarized light after staining with Congo red. In immunohistochemical study, they were positive for kappa and lambda light chains and negative for amyloid A. There was no evidence of systemic amyloidosis in clinical investigations. A final diagnosis of localized primary thymic amyloidosis was made.
Amyloid ; Amyloidosis ; Congo Red ; Eosinophils ; Female ; Humans ; Hyalin ; Light ; Lymph Nodes ; Mediastinum ; Middle Aged ; Thorax ; Thymoma ; Thymus Gland

Wilms' tumor is the most common intra-abdominal malignant tumor of childhood. There has been a progressive improvement in the over all survival rate of children with Wilms' tumor since the introduction of radiotherapy and nephrectomy. Survival has continued to improve with the addition of chemotherapy, initially actinomycin D, and later vincristine. This paper reviewed 34 patients with Wilms' tumor seen between 1965 and 1979 with special references to the significant factors in diagnosis as well as the influence of age, stage of disease and treatment on the prognosis. The usefulness of three modalities of treatment was discussed. A cure rate of 64.9% in the intensive multimodaliy treatment group was calculated by the Life Table Method.
Child ; Dactinomycin ; Diagnosis ; Drug Therapy ; Humans ; Life Tables ; Nephrectomy ; Prognosis ; Radiotherapy ; Survival Rate ; Vincristine ; Wilms Tumor*

Chronic infection with HCV represents second most common cause of end-stage liver diseases and hepatocellular carcinoma in Korea. The introduction of new agents and regimens for the treatment of chronic hepatitis C, such as pegylated forms of interferon-alpha (Peg-IFN) and combination with oral ribavirin has resulted in substantial improvement in sustained virologic response (SVR) rates. SVR rate of Peg-IFN and ribavirin combination therapy can be 40-46% of individuals infected with genotype 1 and approximately 75-85% with genotype 2 and 3. Peg-IFN/ribavirin combination therapy represents current standard therapy of chronic hepatitis C. This article reviews the treatment objectives, outcomes, optimal regimens, efficacy and predictors of response, monitoring during treatment, adverse events, retreatment of persons who failed to respond to previous treatments, and treatment of special patient groups in chronic hepatitis C.
Drug Therapy, Combination ; English Abstract ; Hepatitis C, Chronic/*drug therapy ; Humans ; Interferon Alfa-2a/administration & dosage ; Interferon Alfa-2b/administration & dosage ; Polyethylene Glycols/administration & dosage ; Ribavirin/administration & dosage

9 classic hemophilacs in Severance Hospital, Yonsei University from Dec. '77 to Aug. '79 were reviewed and analysed and the following results were obtained. 1. Intracranial hemorrhage is required the most immediate emergent therapy in hemophiliacs and computerized transverse axial tomogarhy may be essential for the accurate and noninvasive diagnosis and for the effective emergency treatment. 2. To conserve supplies of therapeutic materials and to decrease the possibility of transmitting hepatitis and other diseases with blood products, it is desirable to reduce the amount of blood products with the use of epsilone aminocaproic acid, and epsilone aminocaproic acid may be useful in extraction and/or other non-dental injury with hemophiliacs.
Aminocaproic Acid ; Diagnosis ; Emergencies* ; Emergency Treatment ; Equipment and Supplies ; Hemophilia A* ; Hepatitis ; Intracranial Hemorrhages

No abstract available.
Korea*

Hypoglycemia due to non-islet cell tumor is usually associated with hypersecretion of big insulin-like growth factor II (IGF-II). This big IGF-II cannot form ternary IGF complex, and is biologically more active in peripheral tissue, inducing increased glucose utilization and hypoglycemia. A 57-year-old man developed severe hypoglycemia due to hepatocellular carcinoma. To control hypoglycemia, the patient required continuous glucose infusion. The circulating levels of cortisol and free T4 were in the normal range. The plasma levels of insulin, C-peptide, IGF-I, IGF binding protein-3 (IGFBP-3), and total IGF-II levels were decreased. Radioimmunoassay of IGF-II revealed that big IGF-II immunoreactivity markedly increased compared to that of normal control. In this patient, it was strongly suggested that big IGF-II might be a cause of severe intractable hypoglycemia.
C-Peptide ; Carcinoma, Hepatocellular ; Glucose ; Humans ; Hydrocortisone ; Hypoglycemia* ; Insulin ; Insulin-Like Growth Factor I ; Insulin-Like Growth Factor II* ; Middle Aged ; Plasma ; Radioimmunoassay ; Reference Values

BACKGROUND: Precutaneous mitral balloon valvuloplasty(PMV) is known to produce shortterm hemodynamic and symptomatic improvement in selected patients with restenosis after previous surgical commissurotomy. METHODS: To evaluated the long-term efficacy of PMV and identify the risk factors for restenosis after this procedure in patients with mitral restenosis after previous surgical commissurotomy, we obtained 30.4+/-13.0 months(range, 6-53) follow-up data in 19 patients with restenosis after previous surgical commissurotomy on whom PMV was successfully performed since April, 1988. RESULTS: There were 10 females and 9 males with mean age of 42.7+/-8.7(range, 28-59). 11 patients were in atrial fibrillation. Restenosis occurred in 8 patients(42%) during follow-up. Median value for restenosis by Kaplan-Meier survival analysis was 40 months. Restenosis by univariate analysis correlated with smaller valve area after PMV and short interval from previous surgical commissurotomy to restenosis. Mitral valve area after PMV and echoscore were found to be the determinant predictors of restenosis by Cox proportional hazard analysis. For mitral valve area after PMV, patients with post-PMV valve area less than 1.6cm2have relatively high risk for restenosis than those with post-PMV valve area more than 1.6cm2. CONCLUSION: Half of the patients who underwent PMV due to restenosis after previous surgical commissurotomy maintained optimal result up to 40 months. Poorer long-term outcome can be predicted in patients with unfavorable valve morphology or post-PMV valve area less than 1.6cm2.
Atrial Fibrillation ; Balloon Valvuloplasty* ; Echocardiography* ; Female ; Follow-Up Studies* ; Hemodynamics ; Humans ; Male ; Mitral Valve ; Risk Factors