No abstract available.
Hepatitis B, Chronic/*drug therapy ; Humans

Microspherocytosis is known as a hallmark of hereditary spherocytosis (HS) which is one of the most common hemolytic anemias with a prevalence of one per 5000, and is inherited as Mendelian dominant. In this disorder, the patient's red cells become spheroidal, osmotically less resistant in the peripheral circulation, and are selectively trapped in the spleen, but survive normally after splenectomy. The exact mechanism for the formation of microspherocytosis has not been elucidated, although extensive investigations demonstrate that HS red cells are intrinsiclly defective and the patient's spleen does "condition" the metabolically abnormal red cells. The authors report here, one case of severe microspherocytosis in which changes in facial bone structure and transfusion dependency are noted, and an early splenectomy is indicated.
Human ; Infant ; Male ; Spherocytosis, Hereditary/surgery* ; Splenectomy*

The index on myocardial contractility of pure mitral regurgitation(MR) after mitral valve replacement is believed to be useful in determining proper operation time before irreversible myocardial damage by volume overload. Thus the authors examined pre and post-operative echocardiographic results of 20 cases of pure MR patients who had been admitted to Pusan National University hospital and compared the usefulness of each index. Pre and post-operative echocardiographic results were as follows respectively ; 1) Left ventricular internal dimension in diastole(LVIDd) were 6.49+/-0.19cm and 5.51+/-0.17cm. 2) Left ventricular internal dimension in systole(LVIDs) were 4.26+/-0.12 and 3.79+/-0.18cm. 3) Ejection fraction were 71.28+/-1.57% and 59.24+/-3.05%. 4) Fractional shortening(FS) were 34.09+/-1.18% and 27.21+/-1.84%. 5) Mean Vcf were 1.53+/-0.08cm/sec and 1.18+/-0.09cm/sec. 6) Left ventricular end-diastolic volume index(EDVI) were 196.35+/-18.33cc/m2 and 98.46+/-9.96cc/m2. 7) Left ventricular end-systolic volume index(ESVI) were 55.28+/-5.12cc/m2 and 41.88+/-6.07cc/m2. 8) Left ventricular end-systolic wall stress/ESVI(ESS/ESVI) were 2.3+/-0.21 and 3.91+/-0.83. ESS/ESVI showed significantly(p<0.05) elevated postoperative change, LVIDd, LVIDs, EF, FS, EDVI, ESVI revealed significantly(p<0.05) reduced postoperative change whereas Mean Vcf had no postoperative change. After examining correlation between preoperative and postoperative results of each index, it is believed that LVIDd, LVIDs, and ESS/ESVI were useful prognostic indices but were unrelated to postoperative ejection phase indices such as EF, FS, and MEan Vcf. Especially in case of LVIDd>6cm, LVIDs>4cm, and ESS/ESVI<2, the prognosis was poor due to myocardial damage by mitral regurgitation.
Busan ; Echocardiography ; Humans ; Mitral Valve Insufficiency* ; Mitral Valve* ; Prognosis ; Stroke Volume

Verrucous hemangioma is a variant of a capillary, cavernous, or mixed hemangioma which undergoes a reactive proliferative epidermal change. Most verrucous hemangiomas appear on the lower extremities, and most are present at birth or appear during childhood. We observed two patients who showed typical clinical and histopathological findings of verrucous hemangioma. Treatment was done by wide surgical excision and skin graft. The first rnale patient had a good therapeutic result but the second female patient had a recurrence at one month post-operative.
Capillaries ; Female ; Hemangioma* ; Humans ; Lower Extremity ; Parturition ; Recurrence ; Skin ; Transplants

There were 105 patients with multiple rib fracture or flail chest who had underwent surgical rib fixation using Judet's strut from Aug. 1989 to Aug. 1995. They were 86 men and 19 women, and the age distribution was from 17 to 77(mean 48+/-12). The most common cause of accident was a traffic accident(81%). The mean number of rib fracture was 5.5 and the distribution of patient were flail chest(72, 64.7%), severe displaced rib Fracture(18, 17.1%), traumatic chest wall deformity(10, 95%) and others(5, 4.7%). The operative mortality was 1 patient(0.96%) and the incidence of postoperative complication were 13 patients(12.3%). The duration of perioperative artificial ventilator therapy was 90.5+/-22.6 hours. Our method allowed shorter duration of an artificial ventilation and decreased a functional sequelae. We find this technique to be better than previously published methods, since it provides better stabilization and immobilization of the ribs and thus obviates the need for artificial ventilation and prevents post-traumatic chest deformity.
Age Distribution ; Congenital Abnormalities ; Female ; Flail Chest* ; Humans ; Immobilization ; Incidence ; Male ; Mortality ; Postoperative Complications ; Rib Fractures* ; Ribs* ; Thoracic Wall ; Thorax ; Ventilation ; Ventilators, Mechanical

It is generally considered that enteral feeding is superior to parenteral nutritional support. Thus enteral meal should be given whenever patients have proper gastrointestinal function to take enteral feeding. Because the morbidity and mortality for surgical jejunostomy have been reported as high as 50% and 10% respectively, direct percutaneous endoscopic jejunostomy has been developed to reduce the morbidity and mortality. A 55-year-old male patient, who was suffering from dysphagia and oropharyngeal aspiration, was transferred to the division of gastroenterology to be done permanent enteral feeding. His stomach was resected (subtotal gastrectomy with billroth II anastomosis) due to peptic ulcer hemorrhage 10 years before. We performed direct percutaneous endoscopic jejunostomy without any complication. Herein, we report a successful case.
Deglutition Disorders ; Enteral Nutrition ; Gastrectomy* ; Gastroenterology ; Gastroenterostomy ; Humans ; Jejunostomy* ; Male ; Meals ; Middle Aged ; Mortality ; Nutritional Support ; Peptic Ulcer Hemorrhage ; Stomach

Primary biliary cholangitis is a chronic inflammatory autoimmune liver disease that is characterized by a positive antimitochondrial antibodies test and progressive destruction of the small intrahepatic bile duct. Ankylosing spondylitis is a chronic, systemic, inflammatory disease of the spine and the sacroiliac joints. The association between these two is very low. This paper reports a rare case who had ankylosing spondylitis and developed primary biliary cholangitis.

BACKGROUND: De novo methylation and transcriptional silencing of p16 gene is one of the main pathways in inactivation of p16 gene in colon neoplasm. But there has been no study about that in Korea yet. The aims of this study were to determine p16 methylation status and its association with clinicopathologic parameters and stage of colon cancers and adenomas in patients of Korea. METHODS: We examined p16 methylation of sixty primary colon cancer tissues and thirty colon adenoma tissues using methylation specific PCR after bisulfite modification of the DNA samples. RESULTS: In colon cancer group, 30 patients were male and the others were female, and the average age was 59.7+/-12.5 years. Three cases were in Dukes' stage A, 24 in B, 26 in C, and 7 in D respectively. p16 gene was methylated in 20% (12 of 60) of colon cancers. There was no significant correlation between methylation status of p16 gene and clinicopathologic variables of colon cancers including patient's age, sex, tumor location, size, and differentiation. In Dukes' stage C and D, methylation was positive in 24.2% (8/33 cases) comparing 14.8% (4/27 cases) in Dukes' A and B, but there was no significant difference statistically (p=0.52). In colon adenoma group, there were 15 simple adenomas, and 15 advanced adenomas (>or=1cm, including villous component, or high grade dysplasia). The p16 gene was methylated in 16.7% (5 of 30) of colon adenomas; in 3 cases of simple adenoma and in 2 cases of advanced adenoma. There was no significant correlation between p16 methylation status and clinicopathological variables in colon adenoma. CONCLUSION: The p16 gene was methylated in 20% of colon cancers and 16.7% of colon adenomas in the present series, suggesting that the methylation of p16 tumor suppressor gene might be expressed in similar rate in colon cancer/adenoma in Korea, and play a role in colorectal tumorigenesis in its early stage.
Adenoma* ; Carcinogenesis ; Colon* ; Colonic Neoplasms* ; Colorectal Neoplasms ; DNA ; Female ; Genes, p16 ; Genes, Tumor Suppressor* ; Humans ; Korea ; Male ; Methylation* ; Polymerase Chain Reaction

There have been many reports that colon cancer responds poorly to chemotherapy. Several classes of matrix metalloproteinases(MMPs) have been implicated in the process of invasion of epithelial and endothelial basement membranes in several steps of tumor invasion and metastasis. This study was performed to determine the biologic behavior and the histopathological characteristics of a 5-FU resistant colon cancer cell line. METHODS: We performed several biologic assays including liver colonization assay, cell adhesion assay, invasion assay and zymogram for protease activity using parental HT29 cell and 5-FU resistant HT29 cell (HT29-FU cell). RESULTS: In liver colonization assay, HT29-FU cell revealed a 2.5-fold increase in the liver weight and tumor burden compared with HT29 cell. HT29-FU cell showed moderate increase in adhesion and invasion assays in comparison to HT29 cell. HT29-FU cell revealed increased activity of MMPs and serine protease. Xenograft tumors of HT29-FU cell formed moderately differentiated adenocarcinoma with more glandular formations of mucin. CONCLUSION: The increased expression of MMPs in 5-FU resistant colon cancer cell can explain poor prognosis. These are potentially poor prognostic indicators in 5-FU resistant colon cancer. Consequently, it can be suggested that modulation of MMPs is needed to prevent invasion and metastasis in colon cancer by using inhibitors of these enzymes.
Adenocarcinoma ; Basement Membrane ; Biological Assay ; Biomarkers* ; Cell Adhesion ; Cell Line* ; Colon* ; Colonic Neoplasms* ; Drug Therapy ; Fluorouracil* ; Heterografts ; HT29 Cells ; Humans* ; Liver ; Matrix Metalloproteinases ; Mucins ; Neoplasm Metastasis ; Parents ; Prognosis ; Serine Proteases ; Tumor Burden

BACKGROUND/AIMS: Idiopathic portal hypertension (IPH) is defined as portal hypertension with splenomegaly and hypersplenism in the absence of cirrhosis or obstruction of portal vein or hepatic vein. It has been recently suggested that hypercoagulable state and thromboembolic event of small portal veins have an important role in the pathogenesis of IPH. In this study, we evaluated the clinical and pathological characteristics of IPH. METHODS: We reviewed clinical, endoscopic, radiologic and liver biopsy findings of 10 cases of IPH retrospectively. RESULTS: The tests for antithrombin III deficiency, protein C deficiency, protein S deficiency, resistance to activated protein C, lupus anticoagulant, antiphospholipid antibodies, anticardiolipin antibodies were normal. Pathologic findings revealed portal vein dilatation (10/10), loss of portal vein (6/10), portal vein sclerosis (1/10), dilated megasinusoids (9/10), dilation of terminal hepatic vein (8/10), narrowing of terminal hepatic vein (2/10), hairline fibrous septa (1/10), and regenerative nodule (1/10). CONCLUSIONS: The pathologic finding of IPH showed various manifestations of obliterative portal venopathy although there was no hypercoagulable state.
Antibodies, Anticardiolipin ; Antibodies, Antiphospholipid ; Antithrombin III Deficiency ; Biopsy ; Dilatation ; Fibrosis ; Hepatic Veins ; Hypersplenism ; Hypertension, Portal* ; Liver ; Lupus Coagulation Inhibitor ; Portal Vein ; Protein C ; Protein C Deficiency ; Protein S Deficiency ; Retrospective Studies ; Sclerosis ; Splenomegaly