No abstract available.
Carcinoma, Squamous Cell*

BACKGROUND: Since 1983, vaccination for Hepatitis B virus(HBV) has been recommended for all neonates in Korea. Therefore, significant change of HBsAg positive rate is expected. The objective of this study is to investigate HBsAg positive rate of grade, junior high, and high schoolers in Kangwon Province. METHODS: From 1997 to 1999, total 120,220 subjects, who were born in 1981 to 1992, were enrolled in this study. HBsAg and anti-HBs were tested by reversed passive hemagglutination and passive hemagglutination, respectively. If their results had been vague, we perfomed enzyme-linked immunosorbent assay for confirmation. RESULTS: HBsAg positive rate of entire study group was 2.5%(3,045 out of 120,220). Those of schoolboys and schoolgirls were 2.6%(1,567 out of 60,076), 2.5%(1,478 out of 60,144), respectively. Significant statistical difference was not observed in comparison of HBsAg positive rate according to sex(p=0.09). HBsAg positive rate of grade schoolers was 1.4%(676 out of 48,871), which was significantly lower than that of junior high(3.2%, 557 out of 17,577) and high-schoolers(3.4%, 1,812 out of 53,772)(p< 0.01). From 1997 to 1999, HBsAg positive rate has significantly decreased from 2.8%(1,434 out of 50,434) to 1.9%(407 out of 20,991)(p< 0.01). HBeAg positive rate of HBsAg positive subjects was 62.9%(1,000 out of 1,590). CONCLUSION: HBsAg positive rate of grade-schoolers in Kangwon province Korea, tended to be lower than that of junior high, or high-schoolers, and is also thought to be lower than that of the past, which was caused by nationwide vaccination programme.
Enzyme-Linked Immunosorbent Assay ; Gangwon-do* ; Hemagglutination ; Hepatitis B ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens* ; Humans ; Infant, Newborn ; Korea ; Vaccination

BACKGROUND/AIMS: Bleeding still remains as one of the major medical problems in peptic ulcer diseases, despite of the advances in therapeutic options and endoscopic therapy. The aim of this study was to compare the clinical outcomes of bleeding peptic ulcer between two distinct periods in the past ten years. METHODS: We divided the among 10 years, we selected the two distinct periods; the first (1993~1995) and the second (2000~2002). The clinical and endoscopic characteristics in patients with bleeding peptic ulcer were compared between the two periods. We also analyzed the changes in the clinical outcomes as well. RESULTS: The age of patients during the second period was significantly older compare to the first period. In subgroup analysis, proportions of patients older than 60 years and of female patients were significantly higher in the second period. The percentage of the patients with co-morbid illness, such as diabetes mellitus, cardiovascular diseases, or users of non-steroidal anti-inflammatory drugs, was higher in the second period. Despite the decreasing the frequency of urgent surgery in the second period, there was no significant difference in the rate of re-bleeding and mortality between both periods. CONCLUSIONS: Despite the advances in therapeutic options in the second period, no significant difference was found in the prognosis of bleeding ulcer, compared to the first period. Old age, co-morbid illness, and increasing usage of NSAIDs has may contributed to this. Taken together, it might be more important to apply preventive measures to the patients who have risk factors for bleeding peptic ulcer.
Anti-Inflammatory Agents, Non-Steroidal ; Cardiovascular Diseases ; Diabetes Mellitus ; Female ; Hemorrhage* ; Humans ; Mortality ; Peptic Ulcer* ; Prognosis ; Risk Factors ; Ulcer

BACKGROUND/AIMS: The potential role of the cyclooxygenase (COX)-2 polymorphism has been reported in relation to the risk of gastrointestinal tract malignancies. Therefore, we investigated whether COX-2 polymorphisms are associated with the risk of gastric cancer (GC) in Korea, one of the areas with a high prevalence of this condition. METHODS: We evaluated the genotypic frequencies of COX-2-765 and -1195 in 100 peptic ulcer patients, 100 GC patients, and 100 healthy controls. The polymorphisms of the COX-2-765 and -1195 genes were analyzed by polymerase chain reaction and restriction fragment length polymorphisms. RESULTS: The frequencies of the COX-2-1195 GG, GA, and AA genotype were 20%, 60%, and 20% in intestinal-type GC and 8%, 48%, and 44% in diffuse-type GC, respectively (p=0.021). There were no significant differences in the frequency of COX-2-765 genotypes between intestinal-type GC and diffuse-type GC (p=0.603). Age- and sex-adjusted logistic regression analysis showed that the COX-2-1195 AA genotype was the independent risk factor of diffuse-type GC compared with the COX-2-1195 GG genotype (p=0.041; odds ratio, 6.22; 95% confidence interval, 1.077 to 35.870). CONCLUSIONS: The COX-2-1195 AA genotype may render subjects more susceptible to diffuse-type GC.
Gastrointestinal Tract ; Genotype ; Humans ; Korea ; Logistic Models ; Odds Ratio ; Peptic Ulcer ; Polymerase Chain Reaction ; Prevalence ; Prostaglandin-Endoperoxide Synthases ; Risk Factors ; Stomach Neoplasms

Drug-induced hepatotoxicity is injury to the liver as a result of drug exposure. Due to their unpredictable nature, drug-induced liver injuries pose a serious problem for clinicians, health agencies, and pharmaceutical firms. Albendazole is a benzimidazole with wide spectrum coverage as an antiparasitic drug. Very few cases of high-dose albendazole-induced hepatotoxicity have been reported so far, and no case in response to a single dose. A 25-year-old man presented to our hospital with dark urine. Twenty days prior to presentation, he took a tablet of albendazole (400 mg) as a prophylactic treatment for lumbricosis. Upon laboratory analysis, aspartate aminotransferase (AST) was 748 IU/L, alanine transaminase (ALT) was 939 IU/L, and total/direct bilirubin was 9.3/7.3 mg/dL. The patient was negative for viral markers (HAV, HBV, and HCV) and autoantibodies. Abdominal ultrasonography revealed no evidence of chronic liver damage. The pathology was compatible with drug-induced hepatotoxicity. The patient improved with conservative management only.
Adult ; Alanine Transaminase ; Albendazole ; Aspartate Aminotransferases ; Autoantibodies ; Benzimidazoles ; Bilirubin ; Biomarkers ; Drug-Induced Liver Injury ; Humans ; Liver

Up-to-date imaging modalities such as three-dimensional dynamic contrast-enhanced CT (3D CT) and MRI may contribute to detection of hypervascular nodules in the liver. Nevertheless, distinguishing a malignancy such as hepatocellular carcinoma from benign hypervascular hyperplastic nodules (HHN) based on the radiological findings is sometimes difficult. Multiple incidental liver masses were detected via abdominal ultrasonography (US) in a 65-year-old male patient. He had no history of alcohol intake and no remarkable past medical history or relevant family history, and his physical examination results and laboratory findings were normal. 3D CT and MRI showed numerous enhanced nodules with hypervascularity during the arterial phase. After US guided liver biopsy, the pathological diagnosis was HHN. To date, several cases of HHN have been reported in patients with chronic alcoholic liver disease or cirrhosis. Herein, we report on a case of HHN in a patient with no history of alcoholic liver disease or cirrhosis.
Abdomen/diagnostic imaging ; Aged ; Alcoholism/pathology ; Chronic Disease ; Diagnosis, Differential ; Focal Nodular Hyperplasia/*diagnosis ; Humans ; Imaging, Three-Dimensional ; Liver/diagnostic imaging/*pathology ; Liver Diseases/pathology ; Magnetic Resonance Imaging ; Male ; Tomography, X-Ray Computed ; Ultrasonography

BACKGROUND/AIMS: The association between Helicobacter pylori infection and nonsteroidal anti-inflammatory drugs (NSAIDs) or low-dose aspirin therapy as a risk factor for peptic ulcer bleeding (PUB) remains unclear. This study investigated the risk of PUB associated with H. pylori infection and NSAID or low-dose aspirin therapy in patients with PUD. MATERIALS AND METHODS: This case-control study investigated 340 patients with PUB between 2012 and 2016. The control group comprised age and sex-matched patients with endoscopically documented non-bleeding ulcers. Using logistic regression analysis, the adjusted odds ratio (AOR) was calculated for the risk of PUB. RESULTS: Of the patients investigated, 57.9% in the study group and 51.8% in the control group were diagnosed with H. pylori infection (P=0.106). Logistic regression analysis showed synergistic interaction between H. pylori infection and low-dose aspirin therapy. Multivariate analysis showed that low-dose aspirin (AOR 3.92, P < 0.001), NSAIDs (AOR 2.98, P=0.001), warfarin (AOR 14.57, P=0.011), gastric ulcer (compared with duodenal ulcer) (AOR 1.65, P=0.01), and smoking (AOR 1.97, P=0.004) increased the risk of PUB compared with the risk of PUD. CONCLUSIONS: Both NSAIDs and aspirin are independent risk factors for bleeding in patients with PUD. Additionally, low-dose aspirin therapy concomitant with H. pylori infection produced a synergistic effect. Therefore, H. pylori eradication may be crucial in aspirin users. Moreover, a proton pump inhibitor should be prescribed in patients with a history of bleeding ulcers who need long-term NSAID treatment.
Anti-Inflammatory Agents, Non-Steroidal ; Aspirin ; Case-Control Studies ; Helicobacter pylori ; Helicobacter ; Hemorrhage ; Humans ; Logistic Models ; Multivariate Analysis ; Odds Ratio ; Peptic Ulcer ; Proton Pumps ; Risk Factors ; Smoke ; Smoking ; Stomach Ulcer ; Ulcer ; Warfarin

BACKGROUND: We analyzed serologic data that were obtained from the Korea Association of Health from 1995 to 1999 to estimate the reliable prevalence of HBV in South Korea. METHODS: 603,375, 639,465, 621,476, 612,705 and 650,398 serum samples were annually tested for HBsAg. Of HBsAg positive persons whose serum samples were available, HBeAg positivity was checked. RESULTS: HBsAg positivities among subjects between 6 and 19 years old were 8.2%, 3.9%, 2.1%, 2.6% and 1.3%. HBsAg positivities among subjects above 20 years old were 8.9%, 6.4%, 5.9%, 5.4% and 5.4%. The positive rates of HBeAg were 39.8 to 62.9% among subjects between 6 and 19 years old, and 18.3 to 37.9% among persons above 20 years old, in each year. In both subgroups, HBsAg positivity in the latter year was significantly lower than that in the former year (p <0.001). It also showed that HBsAg positivities among subjects between 6 and 19 years old have been significantly lower than those among subjects above 20 years old, but those of HBeAg the exact reverse of HBsAg since 1996 (p < 0.001). CONCLUSIONS: It was observed that prevalence of HBV infection in the late 1990s, especially in the group between 6 and 19 years old, was conspicuously lower than that in the past. The nationwide vaccination programme might be one of the most important contributors to this tendency in Korea.
Adolescent ; Adult ; Age Distribution ; Aged ; Child ; Female ; Health Surveys ; Hepatitis B/blood/*diagnosis/*epidemiology ; Hepatitis B Surface Antigens/*analysis ; Hepatitis B Virus/*isolation & purification ; Hepatitis B, Chronic/blood/diagnosis/epidemiology ; Human ; Korea/epidemiology ; Male ; Middle Age ; Prevalence ; Risk Factors ; Serologic Tests/methods ; Sex Distribution

BACKGROUND: Long-term survival after surgical correction of mitral regurgitation is associated with preservation of left ventricular systolic function after operation. And mitral valve repair has been suggested to provide a better postoperative left ventricular systolic function. Accordingly, we intended to compare the operative results of mitral valve repair with those of mitral valve replacement and search for preoperative predictors of postoperative left ventricular systolic function. METHOD: The clinical features, echocardiographic measurements, and cardiac catheterization results of 75 patients operated between January 1984 and December 1994 for acquired pure mitral regurgitation were analyzed. RESULTS: Of the 75 patients, 39 patients had mitral valve repair, and 36 patients had mitral valve replacement. When the outcomes of mitral valve repair and mitral valve replacement were compared, left ventricular ejection fraction decreased significantly after surgery inboth groups but postoperative left ventricular ejection fraction was greater in valve repair group than in valve replacement group. Data analysis of preoperative variables showed that echocardiographic left ventricular end-diastolic diameter(p<.05), but not other clinical and echocardiographic variables, were predictors of postoperative left ventricular systolic function. CONCLUSION: After surgical correction of chronic organic mitral regurgitation, left ventricular dysfunction is frequent and valve repair decreases the severity of left ventricular dysfunction. And the most powerful predictor of postoperative left ventricular systolic function is preoperative left ventricular end-diastolic diameter measured by echocardiography.
Cardiac Catheterization ; Cardiac Catheters ; Echocardiography ; Humans ; Mitral Valve Insufficiency* ; Mitral Valve* ; Statistics as Topic ; Stroke Volume ; Ventricular Dysfunction, Left

BACKGROUND AND OBJECTIVES: Oxidative stress plays an important role in the pathogenesis of coronary atherosclerosis and spasm. We investigated whether the polymorphisms in two oxidative stress-related genes, paraoxonase and p22phox, are associated with risks of coronary artery spasm and stenosis. SUBJECTS AND METHODS: The study comprised of 116 patients with variant angina, 118 patients with coronary artery stenosis and 117 control subjects, who were all classified by coronary angiography. In all three groups, the genotype frequencies of the Q192R polymorphism of the paraoxonase gene and C242T polymorphism of the p22phox gene were analyzed, and the serum thiobarbituric acid-reactive substance concentrations measured. RESULTS: The frequency of the RR genotype of the paraoxonase Q192R polymorphism was significantly higher in patients with variant angina and coronary artery stenosis than in the control subjects (40.4% in variant angina and 37.8% in coronary artery stenosis vs. 24.7% in control, p=0.020 and 0.048, respectively). From the multivariate analysis, the odds ratio of the RR genotype was 2.240 for variant angina (95% confidence interval ; 1.012-4.956), and 2.333 for coronary artery stenosis (95% confidence interval ; 1.140-4.777), in relation to the control subjects. The thiobarbituric acid-reactive substance level was significantly higher in the RR type than in the QQ+QR types (RR vs. QQ+QR : 1.106+/-0.420 nmol/mL vs. 0.949+/-0.311 nmol/mL, p=0.028). There was no significant difference in the prevalence of the C242T polymorphism of the p22phox gene between the three groups. CONCLUSION: The RR genotype of the paraoxonase gene Q192R polymorphism was found to be an independent risk factor for both coronary spasm and stenosis.
Angina Pectoris ; Aryldialkylphosphatase* ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease ; Coronary Stenosis* ; Coronary Vessels* ; Genotype ; Humans ; Multivariate Analysis ; Odds Ratio ; Oxidative Stress* ; Polymorphism, Single Nucleotide ; Prevalence ; Risk Factors ; Spasm