Almost all colorectal carcinomas have been thought to develop from pre-existing adenomas. However, some colorectal carcinomas can arise directly from normal flat mucosa, and usually form infiltrative mass at the early stage. The carcinogenesis of this infiltrative carcinoma may be different from the well-known adenoma-carcinoma sequence, which usually forms a polypoid mass. The purpose of this study is to investigate the different expression of various oncogenes in polypoid carcinoma and infiltrative carcinoma. We performed immunohistochemical staining on p53, bcl-2, c-erbB-2 and MIB-1 in 29 polypoid carcinomas arised from adenomas, and 21 infiltrative carcinomas. The average tumor size of infiltrative carcinomas (5.5 cm) was larger than that of polypoid carcinomas (3.1 cm), and the polypoid carcinomas were differentiated more than the infiltrative carcinomas. The results of p53, bcl-2, c-erbB-2, and MIB-1 antisera immunoreactivity in the polypoid carcinoma were 79%, 17%, 21%, and 100%, and those in the infiltrative carcinoma were 71%, 29%, 29%, and 100%, respectively. However the diffuse positivities of p53 and MIB-1 antisera were slightly higher in the infiltraive carcinomas (62%, 76%) than in the polypoid carcinomas (55%, 41%) (p=0.63, 0.01). And the results of p53 and c-erbB-2 immunoreactivity in the adenomas were 52% and 17%, respectively, which is significantly lower than that in the polypoid carcinoma(p=0.03, 0.74). The immunoreactivty of bcl-2 in the adenoma was 72%, which was significantly higher than that in the polypoid carcinoma (17%) (p<0.01). In summary, we did not show the significant difference in expression of p53, bcl-2, c-erbB-2, and MIB-1 proteins between polypoid and infiltrative carcinomas. However, the tendency of infiltrative carcinomas having a more aggressive nature suggests another carcinogenetic mechanism is involved in the colorectal carcinogenesis.
Adenoma ; Carcinogenesis ; Colorectal Neoplasms* ; Immune Sera ; Ki-67 Antigen ; Mucous Membrane ; Oncogenes

BACKGROUND/AIMS: Combined esophageal variceal ligation and sclerotherapy has been hypothesized to be more effective for the control of bleeding esophageal varices than ligation alone. The present study was to compare the combined therapy with ligation alone in terms of variceal eradication, rebleeding, complication and survival rates in patients with bleeding esophageal varices. METHODS: Thirty-eight patients with bleeding esophageal varices were randomly assigned to receive ligation alone in 20 patients or the combined therapy in 18 patients. The clinical and endoscopic characteristics of patients in the ligation group were similar to those of patients in the combination group. In the combination group, 1-3 mL of ethanolamine was injected proximal to each ligated site. Treatments were repeated every 2- to 3-month until varices were eradicated. RESULTS: No significant differences were found between the ligation and combination groups in variceal eradication rates (70% vs. 72%), numbers of endoscopic sessions required to achieve eradication (3.5+/-0.33 vs. 3.3+/-0.31), rebleeding rates (30% vs. 28%) or 2-yr cumulative survival rates (95% vs. 75%). There were significantly more complications in the combination group (25% vs. 89%, p=0.001). CONCLUSION: Ligation alone is recommended rather than the combined ligation and sclerotherapy because of its lower complication rates.
Esophageal and Gastric Varices* ; Ethanolamine ; Hemorrhage* ; Humans ; Ligation* ; Sclerotherapy* ; Survival Rate ; Varicose Veins

BACKGROUND/AIMS: Combined esophageal variceal ligation and sclerotherapy has been hypothesized to be more effective for the control of bleeding esophageal varices than ligation alone. The present study was to compare the combined therapy with ligation alone in terms of variceal eradication, rebleeding, complication and survival rates in patients with bleeding esophageal varices. METHODS: Thirty-eight patients with bleeding esophageal varices were randomly assigned to receive ligation alone in 20 patients or the combined therapy in 18 patients. The clinical and endoscopic characteristics of patients in the ligation group were similar to those of patients in the combination group. In the combination group, 1-3 mL of ethanolamine was injected proximal to each ligated site. Treatments were repeated every 2- to 3-month until varices were eradicated. RESULTS: No significant differences were found between the ligation and combination groups in variceal eradication rates (70% vs. 72%), numbers of endoscopic sessions required to achieve eradication (3.5+/-0.33 vs. 3.3+/-0.31), rebleeding rates (30% vs. 28%) or 2-yr cumulative survival rates (95% vs. 75%). There were significantly more complications in the combination group (25% vs. 89%, p=0.001). CONCLUSION: Ligation alone is recommended rather than the combined ligation and sclerotherapy because of its lower complication rates.
Esophageal and Gastric Varices* ; Ethanolamine ; Hemorrhage* ; Humans ; Ligation* ; Sclerotherapy* ; Survival Rate ; Varicose Veins

BACKGROUND: The HBV-PCR assay seems to be potentially valuable diagnostic tool for the evaluation of variable serologic status. However, the selection of the primer for HBV-PCR test may be very important because they can influence the HBV-PCR positivity. METHODS: We compared the results of primer HBV1/2 including famous 1896 and 1899 mutation sites with those of primer PHBV1/2 at precore/core region. HBV-PCR was tested in 87 HBsAg-positive patients using two sets of primers. The results were evaluated according to the primers and also compared the results with the clinical diagnosis and the alanine aminotransferase (ALT) level. RESULTS: The positive rate of PHBV primer was higher than HBV primer including mutation sites (nucleotide 1896 and 1899) in HBeAg-negative patients. According to the clinical diagnosis, the sensitivity of PHBV primer was higher than that of HBV primer in chronic hepatitis patients. There was no significant correlation between ALT level and HBV-PCR results. CONCLUSIONS: It is important that the selection of primer in HBV-PCR is important, because the primer including mutation sites may result in false negative results. PHBV primer used in this study could be useful for the detection of HBV-DNA by HBV-PCR.
Alanine Transaminase ; Diagnosis ; Hepatitis, Chronic ; Humans ; Polymerase Chain Reaction*

No abstract available.

No abstract available.

Bezafibrate, a fibric acid derivative related to clofibrate, is being used increasingly in the treatment of hypertriglycemia. It is relatively well tolerated at usual dosage, and has a low incidence of adverse reactions. But we had recently observed a reversible deterioration of renal function requiring hemodialysis, presumed to be caused by bezafibrate treatment in a patient with diabetic nephropathy. A 55 year old man was admitted with complaints of general weakness and painful lower extremities. He had taken bezafibrate (200 mg every 12 hours) for the previous 4 months because of hypertriglycemia. After admission, the drug was withdrawn, and he was treated conservatively management with hydration and diuretics for bezafibrate induced rhabdomyolysis. Nevertheless, his symptom was not improved, so he was taken even hemodialysis. These findings suggested that bezafibrate should be admistered with great caution to patient with renal insufficiency. When it is admistered, CK, LDH, aldolase, and sGOT levels have to be checked for early detection of potential side effect.
Aspartate Aminotransferases ; Bezafibrate* ; Clofibrate ; Diabetic Nephropathies ; Diuretics ; Fructose-Bisphosphate Aldolase ; Humans ; Incidence ; Lower Extremity ; Middle Aged ; Renal Dialysis ; Renal Insufficiency ; Rhabdomyolysis*

This is a clinical observation of congenital anomalies in 97newborn infants associated with hydramnios. These infants were born at severance Hospital, Wonju Christian Hospital and Jeonju Presbyterian Hospital from Jan. 1966 to Aug. 1975. The results were as follows: 1. The frequency of hydramnios was 86 cases in 25,566 deliveries in that period, which was 0.34%. 40infants (41.2%) has congenital anomlies of 97 infants associated with hydramnios by adding twin babies. 2. Hydramnios was associated with high incidence of prematurity and low-birth-weight infant. Who also has high incidence of anomalies 3. The incidence of associating anomalies was 77.8%(75 cases) and multiple anomaly was noticed in 37.5%(15 cases)of these infants. The most common organ involved with these anomalies was central nervous system in 32.0% (24 cases). 13 cases of anencephaly was included. 4. The perinatal mortality rate was 46.4%(45cases) and 60.0%(27cases) of these were associated with congenital anomalies. 20 (60.0%) of 33 live-births with congenital anomalies were died in neonatal period.
Anencephaly ; Central Nervous System ; Gangwon-do ; Humans ; Incidence ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Jeollabuk-do ; Perinatal Mortality ; Polyhydramnios* ; Protestantism ; Twins

PURPOSE: This survey was intended to investigate the awareness and application of the asthma guideline among pediatricians. Insight into the feasibility in the guidelines can guide implementation strategies in the future and, if necessary, support the revision of the previous guideline. METHODS: This self-administered survey study was conducted with the data on 10 items of questionnaire about knowledge and implementation of Korean childhood asthma guideline. The data was analyzed using SPSS WINDOW 8.0. RESULTS: A total of 141 doctors out of 500 participants in the pediatric refresh course responded the questionnaire. Ninety-five percent of the responders were aware of guideline, but differences were found between the asthma management policies in the guideline and their habitual practice patterns. As far as the prescription of inhaled corticosteroid, approximately half of the responders followed the guideline. For peak flowmeter use, 57% of the responders never prescribed peak flowmeter and only 5% of the responders used peak flowmeter frequently. The barriers pediatricians face when applying the guideline in the practice were habitual management pattern, time limitation, low compliance, lack of knowledge and economic burden. CONCLUSION: The guideline for diagnosis and management of childhood asthma seemed to be recognized widely, however, the role of the guideline to change pediatricians habitual practice was limited. These data clearly indicate a need for further educational programs directed to both physicians and patients. Finally the development of more practical evidence- based guideline is needed
Asthma* ; Compliance ; Diagnosis* ; Flowmeters ; Humans ; Prescriptions ; Surveys and Questionnaires

Focal nodular hyperplasia (FNH) is a benig nepithelial tumor of the liver. The etiology of FNH is unknown, but recent evidence suggests that FNH may represent a localized, hyperplastic response to a pre-existing vascular malformat ion. There is a high probability of as sociat edlesions , most commonly hepatic hemangiomas, meningioma, as trocytoma, and arterial dysplasia in various organs . In the present report we describe a FNH with aberrant lymphatics in a 24-year-old woman. In operation field, lymphatics were located on the site of falciform ligament. Histologically, aberrant lymphatics were composed of well vas cularized complex lymphatic channels and the mass were typical FNH. In this case, the role of aberrant lymphatics in the development of FNH was unclear . But as the FNH frequently as sociated with ot her anomalies , we think the aberrant lymphatic as such anomaly that have not been reported.
Carcinoma, Hepatocellular* ; Female ; Focal Nodular Hyperplasia ; Hemangioma ; Humans ; Ligaments ; Liver ; Meningioma ; Young Adult