BACKGROUND/AIMS: In order to determine the relationship between the HBV precore mutant and the severity of liver disease in Korea, we performed liver biopsies in patients with HBV related chronic liver disease and compared the types of mutations and histologic findings in the same liver tissue simultaneously. METHODS: HBV DNA in liver tissues was amplified by polymerase chain reaction (PCR). The precore mutants were detected by PCR-SSCP(single strand conformation polymorphism), cloning the amplified PCR products and direct sequencing for them. RESULTS: 1. HBV DNA was detected in liver tissues of 28 cases among 30 patients with PCR. And with SSCP, the most cases were mixed type infections. 2. The HBV precore mutants were found in 12 cases among the total number of 28 cases(42.9%) and all mutations were G to A change at nucleotide 1896, creating a stop codon at codon 28. However, 10 cases among 12 mutants were associated with simultaneous another mutation at different positions or regions;9 cases at core gene region, 2 cases at nucleotide 1856(C to T change at codon 15), one case at core promoter, and one case with double mutations at nucleotide 1837 and 1846 respectively. Also, all HBV precore mutants were combined with wild type HBV sequence. 3. The relationship between HBV precore mutants and HBeAg status revealed that 4 cases from 13 HBeAg positive(30.8%) and 8 from 15 HBeAg negative or Anti-Hbe positive(53.3 %) were mutants. 4. In analysis of the types of mutants and histopathological findings of liver diseases, 6 among 15 chronic active hepatitis(40.0%), all 3 cases with hepatocellular carcinoma(100,0 %), 2 among 4 asymptomatic carriers with minimal histopathologic changes(50.0%) and a case with chronic lobular heaptitis(100.0%) showed precore region mutation. CONCLUSION: The patterns of HBV precore mutants in Korea could be summarized as followings. Firstly, most of the mutations are composed of G to A change at nucleotide 1896. Secondly, the most of the mutants at nuclmtide 1896 have been associated with simultaneous mutations at core promoter, core gene, and rarely at other positions, and manifested usua'ly mixed type viremic conditions. Thirdly, although precore mutation could be occurred in asymptomatic carrier, this type of mutation might be closely related with chronic or severe liver disease. However, it needs further investigations hereafter.
Biopsy ; Clone Cells ; Cloning, Organism ; Codon ; Codon, Terminator ; DNA ; Hepatitis B e Antigens ; Hepatitis B, Chronic* ; Hepatitis, Chronic* ; Humans ; Korea ; Liver Diseases ; Liver* ; Polymerase Chain Reaction ; Polymorphism, Single-Stranded Conformational

BACKGROUND: Keloids and hypertrophic scars are benign fibrous growths which usually occur in predisposed individuals after trauma. Numerous modalities have been used to treat keloids and hypertrophic scars, but the final results have been so far unsatisfactory. OBJECTIVE: The purpose of tlis study was to evaluate the effect of the combination of cryosurgery and intralesional corticoster oid for treatment of these scars. METHOD: Thirty patients, aged 17 to 45 years old, with keloids or hypertrophic scars(mean duration, 6.4 years) were treated using solid CO2 followed by intralesional injection of triamcinolone acetonide(13.3 mg/ml). Two freeze-thaw cycles per lesion were employed. Freezing time was chosen arbitrarily from 7 to 20 sec depending on the characteristics of each scar. RESULTS: The results are summarized as follows. 1. Excellent and good results were achieved in 57% of all subjects on average, 77% of those who were treated more than 3 times, and 48% of those treated less than twice. 2. The keloid of less than 2 years duration showed better results than older ones. 3. No recurrence was seen in 63% of patients, but partial recurrence in 21% of patients and complete recurrence in 10% were observed. Lesions on the trunk showed less improvement (p<0.05) and were more recurrent than other lesions. 4. There were complications in 9 patients, such as hyperpigmentation(6), hypopigmentation(1), infection(1) and telangiectasia(1). CONCLUSION: Cryosurgery and intralesional corticosteroid injections produced synergistic advantages. A cornbination of these modalities might be an effective treatment modality in keloids and hypertrophic scars.
Cicatrix ; Cicatrix, Hypertrophic* ; Cryosurgery* ; Freezing ; Humans ; Injections, Intralesional ; Keloid* ; Middle Aged ; Recurrence ; Triamcinolone

No abstract available.
Anemia, Neonatal* ; Fetal Blood* ; Infant, Newborn

BACKGROUND: Drug reactions are common problems in hospital inpatients and outpatients. Reliable diagnosis is essential but often difficult. OBJECTIVE: This study attempts to define the clinical features and causative drugs in the patients with drug eruptions, and to evaluate the diagnostic value of skin tests. METHODS: Sixty one patients with drug eruptions were reviewed clinically. In 18 patients, patch and prick tests were performed using suspected drugs. RESULTS: 1. The highest incidence of drug eruptions was observed in the third and forth decades(44.2%) and there was no sexual prodominence. 2. The most frequent latent peroid was 4 hours to 1 week(49.2%). 3. The common morphological features were exanthematous eruptions(57.3%), urticaria(14.8%) and fixed drug eruptoins(11.5%). 4. The major causative drugs were antibiotics(cephalosporin, ampicillin), antipyretics/anti-inflammatory analgesics(aspirin, piroxicam) and CNS depressants(diphenylhydantoin). 5. Clinical manifestations according to possible causative drugs were as follows; exanthematous eruptions by antibiotics, antipyretics/analgesics, herbs, CNS depressants, propylthiouracil and captopril; urticaria by antibiotics and herbs; fixed drug eruption by sulfonamide, antipyretics/analgesics and phenobarbital; acneiform eruptions by diphenylhydantoin and isoniazid; Stevens-Johnson syndrome by ampicillin, sulfonamide, aspirin and piroxicam, erythema nodosum by sulfonamide, and lichenoid drug eruptions by propylthiouracil. 6. Positivity to patch and prick tests was shown in 2 of the 18 patients and in 1 of 18 patients, respectively. CONCLUSIONS: The most frequent clinical feature of the drug eruptions were exanthematous in nature and the most common causative drugs were antibiotics, as suspected. To search for the causative drug of the drug eruption, the only usual methods of patch and prick tests were not sufficient in our study.
Acneiform Eruptions ; Ampicillin ; Anti-Bacterial Agents ; Aspirin ; Captopril ; Central Nervous System Depressants ; Diagnosis ; Drug Eruptions* ; Erythema Nodosum ; Humans ; Incidence ; Inpatients ; Isoniazid ; Outpatients ; Patch Tests ; Phenobarbital ; Phenytoin ; Piroxicam ; Propylthiouracil ; Skin Tests* ; Skin* ; Stevens-Johnson Syndrome ; Urticaria

The purpose of this study is to compare the quality of intraoperative salvaged blood with that of Citrate Phosphate Dextrose(CPD) stored blood in 32 patients having cardiac surgery involving cardiopulmonary bypass. 20 patients in the control group received one week cild CPD stored blood and 12 patients received autologous intraoperative salvaged blood which prepared and processed with the Hemonetics Cell Saver Plus autotransfusion device. 1) Salvaged blood had a higher hemoglobin concentration(l7.6 vs 13.1 g/dl, P<0.005), a higher 2.3-diphosphoglycerate concentration(3.1 vs 0.6 mmol/L, P<0.005), higher pH(7.6 vs 6.8, P<0.005) than CPD stored blood group. Salvaged blood had a lower ATP concentration was(47.7 vs 67.7 pmol/dl, P<0.005) than stored blood group. 2) Platelet count was l3.4 X 10(9)/L and WBC count was 5.09 X 10(9)/L in salvaged blood. 3) Salvaged blood volume was 1411+/-487.9 ml(range 580 to 2325 ml). Intraoperative salvaged blood had a superior oxygen carrying and delivery capacity, but modification of washing is required to lessen the platelet and white blood cell count in the salvaged blood.
2,3-Diphosphoglycerate* ; Adenosine Triphosphate* ; Blood Platelets ; Blood Transfusion, Autologous ; Blood Volume ; Cardiopulmonary Bypass ; Citric Acid ; Erythrocytes* ; Humans ; Leukocyte Count ; Oxygen ; Platelet Count ; Thoracic Surgery

Meigs' syndrome is defined as a hydrothorax with ascites and a pelvic tumor, both of which resolve on removal of the tumor. Pseudo-Meigs' syndrome is a variant not possessing the original tumor cell types described by Meigs. Both these syndromes should be considered in otherwise healthy women who present with either new or recurrent hydrothorax and ascites. Pseudo-Meigs' syndrome occurs with the clinical triad of (1)ascites, (2)pleural effusion and (3)Brenner tumors, struma ovarii, benign thecomas, extreme ovarian edema, uterine leiomyomas or other benign pelvic tumors. A case of Pseudo-Meigs' syndrome associated with Brenner tumor is presented with a brief review of literatures.
Ascites ; Brenner Tumor ; Edema ; Female ; Humans ; Hydrothorax ; Leiomyoma ; Meigs Syndrome ; Struma Ovarii ; Thecoma

No abstract available.
Bronchopulmonary Sequestration*

PURPOSE: The purpose of the study was to identify characteristics of nursing and caring concepts measured by nursing competencies or caring behaviors tools for general nurses working in acute care hospitals. METHODS: Five major nursing literature databases were used to identify the relevant tools. The study included 19 nursing competencies tools with a total of 843 measurement items and 12 caring behaviors tools with 334 items. According to the International Council of Nurses (ICN)'s Competencies Framework and 8Cs suggested by Roach (1987) and Pusari (1998), the measurement items were classified by two researchers independently first and in agreement finally. RESULTS: Competency of ‘key principles of care’ including sub-areas of the ICN Framework was most commonly found: on average 49.3% of nursing competencies items and 91.9% of caring behaviors items. 97.0% of the caring behaviors items were classified into one of six Cs: competence (27.5%), confidence (21.3%), compassion (17.1%), commitment (16.5%), communication (9.9%), or conscience (4.8%). CONCLUSION: Nursing competencies tools were more likely to measure ‘what to do’ focusing on tasks, while caring behaviors tools were to measure ‘how to do’ focusing on nurses' attitudes or values. Nursing practices should be evaluated with both nursing competencies and caring behaviors tools, considering that nursing and caring were differently conceptualized in the quantitative tools.
Clinical Competence ; Conscience ; Empathy ; International Council of Nurses ; Mental Competency ; Nursing Care ; Nursing* ; Professional Competence ; Surveys and Questionnaires

No abstract available.
Infant, Newborn ; Meconium Aspiration Syndrome

No abstract available.