BACKGROUND/AIMS: Hepatocytes on the hepatic lobule mipate from portal zone to centrilobular mea as the DNA synthesis within it. And also, the xenobiotic reactions reveal characteristic differences associated with zone specific metabolism in the liver acinus. In this study, the zonal distribution of ethylnitrosourea (ENU)-induced hepatic precancerous lesion was stereologically investigated. METHODS: Nine B6C3F1 mices were given I.p. injection of ENU (60 ug/pn body weight) when the pups were 15 days old prior to sacrifices at 8 weeks of life. All the 150 consecutive sections, 3 p m in thickness, were stained with hematoxylin and eosin and identified the basophilic precancerous lesions with 80-165 p m diameter in equatorial plane by the Zeiss microprojector. And then the distances from the center of selected foci to terminal hepatic vein or portal vein branches were estimated under the microscopic fields. As a control group, the same estimations were performed from the random points by the appointments of random digit table. RESULTS: Mean distance between ENU-induced 52 hepatocellular foci and the nearest terminal hepytic vein was 181.15+112.39 p m (Mean+ SD), but that of randomly selected 104 points was 291.73+157.98pm (Mean+5D) (Students t-test, p<0.0005). Substantially, 52.7% of ENU-induced 52 hepatocellular foci were within 300 p m from the terminal hepatic vein, but randomly selected 104 points were only 50.9% (Shapiro Wilk W test, w=0.819857, p=0.048038). Mean distance from ENU-induced 52 foci to portal vein was 398.85+149.98pm (Mean+SD), but that from the randomly selected 104 points was 315.87+145.79 pm (Mean+SD)(Students t-test, p<0.0005). CONCLUSION: Stereologically, ENU-induced mice liver cell foci distribute non-randomly to Zone III, centrilobular zone of mouse hepatic acini where promote invasion toward terminal hepatic veins.
Animals ; Appointments and Schedules ; Basophils ; Cholestasis ; DNA ; Eosine Yellowish-(YS) ; Ethylnitrosourea ; Fluconazole ; Hematoxylin ; Hepatic Veins ; Hepatocytes ; Liver ; Metabolism ; Mice* ; Portal Vein ; Veins

Purpose: Following the outbreak and global spread of the coronavirus disease 2019 (COVID-19), an increasing number of people have turned to cycling. This study aims to investigate the epidemiology of bicycle-related injuries before and after the emergence of the COVID-19. Methods: In this retrospective study, we collected medical records of those patients who visited the emergency room for orthopedic injuries related to bicycle accidents. The “COVID-19 period” consisted of the patients identified from April 1 to November 31 in the year 2020, while the “pre-COVID-19 period” consisted of those identified during the same months of the year 2019. Results: A total of 519 patients were identified. The bicycle-related injuries increased by 5.1% during the COVID-19, in comparison to the pre-COVID-19 period. Among these, 76.3% were men. The highest incidence of the injuries was seen for 10– 19 years of age during the pre-COVID-19, and for 50– 59 years of age during the COVID-19 period. Overall, upper limb injuries were the commonest, consisting of 32.2% of all injuries. The shoulder injuries were the commonest in the pre-COVID-19, while the knee injuries were the commonest in the COVID-19 period. Assessing the severity of the injuries, contusion (81.8%) was the commonest. Of the injuries requiring hospital admissions, hip injuries had the highest incidence at 76.5%. Conclusion During the COVID-19, the total number of bicycle-related injuries did not increase significantly. In the bicycle-related injuries, the middle-age group had the highest proportion during the COVID-19 period. More efficient prevention strategies for middle-aged riders are necessary.

Purpose: Following the outbreak and global spread of the coronavirus disease 2019 (COVID-19), an increasing number of people have turned to cycling. This study aims to investigate the epidemiology of bicycle-related injuries before and after the emergence of the COVID-19. Methods: In this retrospective study, we collected medical records of those patients who visited the emergency room for orthopedic injuries related to bicycle accidents. The “COVID-19 period” consisted of the patients identified from April 1 to November 31 in the year 2020, while the “pre-COVID-19 period” consisted of those identified during the same months of the year 2019. Results: A total of 519 patients were identified. The bicycle-related injuries increased by 5.1% during the COVID-19, in comparison to the pre-COVID-19 period. Among these, 76.3% were men. The highest incidence of the injuries was seen for 10– 19 years of age during the pre-COVID-19, and for 50– 59 years of age during the COVID-19 period. Overall, upper limb injuries were the commonest, consisting of 32.2% of all injuries. The shoulder injuries were the commonest in the pre-COVID-19, while the knee injuries were the commonest in the COVID-19 period. Assessing the severity of the injuries, contusion (81.8%) was the commonest. Of the injuries requiring hospital admissions, hip injuries had the highest incidence at 76.5%. Conclusion During the COVID-19, the total number of bicycle-related injuries did not increase significantly. In the bicycle-related injuries, the middle-age group had the highest proportion during the COVID-19 period. More efficient prevention strategies for middle-aged riders are necessary.

OBJECTIVES: For many years, inflammatory bowel disease has been thought to have a strong psychosomatic component, but recent prospective studies show no evidence of correlation between various psychologic factors and the disease activity. However, chronic renal disease still places unique stresses on the hemodialysis patients, with consequent emotional reactions. The aims of this study are to investigate the psychologic factors of ulcerative colitis and hemodialysis patients using MMPI scales, which are objective psychological test, thus give aid to psychological understanding of these patients. MOTHODS: We investigated 23 ulcerative colitis patients in remission followed at outpatient department of Hanyang University Hospital and 25 patients receiving hemodialysis between June, 1994 and August, 1995. Twenty students were selected for normal control group. We utilized T-score of each MMPI scale for analyzing characteristics of each group and regard T-score over 70 or below 40 as abnormal. RESULTS: The average T-scores of each MMPI scale in ulcerative colitis, hemodialysis patients & normal control group were within normal range between 40 and 70, except for T-score of Es scale in hemodialysis patient group(34.5). The results of comparison between each MMPI scale of two patients & normal control group were as follows. 1) L scale was significantly elevated in ulcerative colitis & hemodialysis patients group compared with that of normal control group. F scale was significantly elevated in hemodialysis patients compared with that of ulcerative colitis patients & normal control group (p<0.01). 2) Hs(p<0.01), D, Pt(p<0.05) and Sc(p<0.01) scales were significantly elevated in hemodialysis patients compared with those of ulcerative colitis patients & normal control group. 3) Es scale was significantly lower in hemodialysis patients compared with that of ulcerative colitis patients & normal control group(p<0.01). CONCLUSION: The result presented in this study reflects emotional disturbances, functional impairment, stressful life condition, excessive hypochondriacal thinking, depressed mood and egocentric tendency of hemodialysis patients compared with ulcerative colitis patients & normal control group. This result also reflects the projective tendency, hostility, difficulty in rapport formation, psychologic disturbance, obssesive and rigid personality, anxiety and retiredness of hemodialysis patients compared with ulcerative colitis patients & normal control group. On the other hand, we can't find any statistically significant differences between ulcerative colitis and normal control group.
Affective Symptoms ; Anxiety ; Colitis, Ulcerative* ; Hand ; Hostility ; Humans ; Inflammatory Bowel Diseases ; MMPI* ; Outpatients ; Psychological Tests ; Reference Values ; Renal Dialysis* ; Renal Insufficiency, Chronic ; Thinking ; Ulcer* ; Weights and Measures

BACKGROUND/AIMS: Most liver diseases lead to a pathobiochemical reaction termed liver fibrosis. Hepatic fibrosis is not a uniform phenomenon and it comprises increased deposition of the liver connective tissue components(collagen, noncollagenous glycoprotein, proteoglycan) in the intercellular space, leading to disturbances of intrahepatic blood flow and hindrance of exchange processes between blood and cells, Fibrosis can be determined by morphological examination o f the liver, but this approach cannot be used to assess accurately the activity of collagen synthesis at any given point in time, Thus, the development of biochemical markers of hepatic fihrosis might allow a promising diagnostic approach for the identification and quantitation of this process, Aminoterminal procollagen III pn) peptide(PIIINP) and carboxytermina1 procollagen I propeptide(PICP) are known as the most widely used parameter for evaluating liver fibrosis, but it is diAicult to find previous report discribing the correlation ot each other. To elucidate the clinical significance of the corretation of PICP(x) and PIIINP(y) concentrations in patients with chronic liver diseases, radioimmunoassay was employed in this investigation. METHODS: Sera tested were obtained from pathologically proven 43 patients;4 cases of fatly liver, 11 cases of chronic persistent hepatitis, 13 cases of chronic active hepatitis, l5 cases of liver cirrhosis. All the patients except 4 cases ot fatty liver were shown positivity of HBsAg. PICP and PIIlNP radioimmunoassay kits(Farrnos Diagnostica, Oulunsalo, Finland) wcre purchased for this study. RESULTS: In the patients among the three groups of chronic active hepatitis, liver cirrhosis, chmnic persistent hepatitis, the correlations were significant in orders(y= - 10.27 +0.l3938x, r=0.92286, p=0.000007;y=-1.185+0.06611x, r=0.73656, p=0.001737;y=1.1174+0.03273x, r=0.56879, p=0.067849). Four cases of fatty liver reveal no signiticant correlation (y=4,8671- 0,0079x, r= 0.1959, p=0.804054). CONCLUSION: 0n the basis of these data, we s st that the correlation of each showed a significant increase with heightening degree of inflammation, activity of diseases and fibrosis.
Biomarkers ; Collagen ; Connective Tissue ; Extracellular Space ; Fatty Liver ; Fibrosis ; Glycoproteins ; Hepatitis ; Hepatitis B Surface Antigens ; Hepatitis, Chronic ; Humans ; Inflammation ; Liver Cirrhosis ; Liver Diseases* ; Liver* ; Procollagen* ; Radioimmunoassay

PURPOSE: To study the concentration of vascular endothelial growth factor (VEGF) in the aqueous humor before and after intracameral injection of bevacizumab in eyes with neovascular glaucoma, and to detect the duration of an anti-VEGF effect of bevacizumab in the anterior chamber. METHODS: In this prospective interventional case series, 1.25 mg of bevacizumab was injected into the anterior chamber of five eyes in five neovascular glaucoma patients. Aqueous humor samples were obtained just before intracameral injection of bevacizumab and two weeks after injection. The concentrations of VEGF in the aqueous humor were measured using ELISA. To investigate corneal endothelial damage after intrecameral bevacizumab injection, specular microscopy was performed before injection and two weeks after injection. Slit lamp photo and iris fluorescent angiography was performed to determine the regression of iris neovascularization. RESULTS: After injection, substantial regression of neovascularization or fluorescein leakage was seen in all treated eyes. The VEGF concentrations in the aqueous humor in eyes with NVG were 1181.8+/-1248.3 pg/mL before intracameral injection of bevacizumab. Two weeks after injection, the VEGF concentrations decreased to 33.2+/-12.2 pg/mL (p=0.04, Wilcoxon signed rank test). There were no significant changes in IOP or corneal endothelial cells. CONCLUSIONS: Intracameral bevacizumab injection can remarkably reduce iris neovascularization in neovascular glaucoma patients. VEGF levels were significantly decreased two weeks after injection and corneal toxicity was not observed during short term follow-up.
Adult ; Aged ; Aged, 80 and over ; Angiogenesis Inhibitors/*administration & dosage ; Antibodies, Monoclonal/*administration & dosage ; Aqueous Humor/*metabolism ; Eye ; Glaucoma, Neovascular/*drug therapy/*metabolism ; Humans ; Injections ; Middle Aged ; Osmolar Concentration ; Prospective Studies ; Vascular Endothelial Growth Factor A/antagonists & inhibitors/*metabolism

BACKGROUND/AIMS: Increasing the susceptibility of young populations to HAV infection could result in an outbreak in a high-risk group. The author investigated the characteristics of hepatitis A outbreaks among Korean military personnel to obtain the fundamental data for determining the necessity for selective HAV vaccination. METHODS: A case was defined as a person who had an onset of an illness compatible with acute viral hepatitis A between 4 February and 6 April 1998. RESULTS: A widespread outbreak of hepatitis A affected 102 military personnel. The epidemic curve indicated a common-source exposure in the initial stage. At the end of the first month of the initial onset, the occurrence was specific to the location of the military post. Investigation suggested that contamination most likely occurred prior to the local distribution of food. The mean age was 23 years. The overall attack rate was 91 cases per 10000 persons at risk. All cases were jaundiced. The most frequently reported symptoms included icteric sclerae, dark urine, anorexia, malaise and fatigue, nausea, fever, abdominal pain, headache, upper respiratory symptoms, vomiting, itching, diarrhea, light-colored stools, myalgia, arthralgia, and skin rash. The laboratory test showed the serum total bilirubin of 5.5 mg/dL, AST of 344 IU/L, and ALT of 868 IU/L (mean value). CONCLUSION: All patients were clinically apparently diseased with jaundice and were completely recovered. The outbreak was food borne common-source exposure. The changing epidemiology hepatitis A in Korea calls for the economic evaluation of costs and benefits for selective HAV vaccination in high risk adult groups including military personnel.
Abdominal Pain ; Adult ; Anorexia ; Arthralgia ; Bilirubin ; Cost-Benefit Analysis ; Diarrhea ; Disease Outbreaks ; Epidemiologic Studies* ; Epidemiology ; Exanthema ; Fatigue ; Fever ; Headache ; Hepatitis A* ; Hepatitis* ; Humans ; Jaundice ; Korea ; Military Personnel* ; Myalgia ; Nausea ; Pruritus ; Sclera ; Vaccination ; Vomiting

BACKGROUND/AIMS: Chronic HBV infection is associated with a wide spectrum of clinical manifestations, including asymptomatic carrier state, chronic hepatitis, liver cirrhosis, and hepatocellular carcinoma. Genotypically, HBV genomes have been classified into seven groups, designated A to G. Several studies have suggested recently that HBV genotypic differences influence the severity of liver disease and clinical outcomes. The distribution of HBV genotypes in Korea and its clinical relevance are poorly understood. We investigated the prevalence of HBV genotypes in Korea and the association between the distinct genotypes and the severity of liver disease. METHODS: A total of 214 HBV-DNA positive serum samples, were used for the genotyping. All patients were HBV-bDNA positive chronic HBsAg carriers. 199 patients were histologically verified with liver cirrhosis (6), chronic hepatitis (192) and fatty liver (1). The other patients were clinically diagnosed with liver cirrhosis (13) or hepatocellular carcinoma (2). HBV genotype was determined by PCR using type-specific primers. RESULTS: Genotyping was possible in all patients. Out of 214 patients, 213 (99.5%) were HBV genotype C. Only one (0.5%) was genotype A. The patient with genotype A had minimal hepatitis as diagnosed by liver biopsy. CONCLUSIONS: These results indicate that almost all chronic HBV infections are genotype C in Korea. HBV genotypic difference therefore does not influence the clinical outcome of HBV infection in Korea. Because genotype C may be associated with more severe liver disease, the predominance of genotype C in Korea may result in more severe outcomes than in other countries where other genotypes are predominant.
Biopsy ; Carcinoma, Hepatocellular ; Carrier State ; Epidemiology ; Fatty Liver ; Genome ; Genotype* ; Hepatitis A ; Hepatitis B Surface Antigens ; Hepatitis, Chronic ; Humans ; Korea* ; Liver ; Liver Cirrhosis ; Liver Diseases ; Polymerase Chain Reaction ; Prevalence

Herpes simplex virus esophagitis and candidal esophagitis can be found in immunocompromised patients. But it rarely occurs in immunocompetent patients. Diagnosis is usually established with an upper gastrointestinal endoscopy. The lesions of herpes simplex virus esophagitis involves the squamous mucosa, where the earlist manifestation is a vesicle, rarely. We report a case of herpes simplex virus esophagitis who, being immunologically healthy, presented with substernal pain and dysphagia and showed vesicle formation on endoscopy. The patient also showed whitish patch and spot on esophageal mucosae. The patient showed loss of symptom and improvement of endoscopic finding after conservative management and antifungal therapy.
Deglutition Disorders ; Diagnosis ; Endoscopy ; Endoscopy, Gastrointestinal ; Esophagitis* ; Herpes Simplex* ; Humans ; Immunocompromised Host ; Mucous Membrane ; Simplexvirus*

BACKGROUND: Hepatocellular carcinoma(HCC) has characteristic differences in both viral profiles and the most frequently occurring age in each country. It also has clinically distinct features between adult patients of the age under 65 and senile patients over 65 years. Herein we investigate differences in clinical features of the patients with HCC of the three different age groups : young patients (group 1) below 45 years of age; most frequently occurring age (45 - 65 year) (group 2); and elderly patients (group 3) above 65 years of age. METHODS: The 371 HCC patients hospitalized and followed-up from 1986 to February 1997 have been analyzed. At the time of diagnosis there was no significant difference among the three groups in alcohol intake, cigarette smoking, sex, family history of liver disease, mean values of aminotransferases, Child-Pugh class, tumor location, TNM stage, tumor size, varix grade, metastasis, abdominal pain, ascites, encephalopathy, fever, or jaundice. RESULTS: In the younger group HCC showed (1) a high incidence of HBsAg positivity (group 1, 95.3%; group 2, 78.6%; group 3, 25%; p<0.001) ; (2) a low positive rate of anti-HCV (group 1, 0%; group 2, 7.7%; group 3, 44.4; p<0.001); (3) a low incidence of NBNC(group 1, 4.9%; group 2, 14.1%; group 3, 30.4%; p<0.01); (4) a high incidence of diffuse type (group 1, 40.5%; group 2, 29.5%; group 3, 11.9%; p<0.05); (5) a higher levels of serum AFP (group 1, 4,180 ng/mL; group 2, 3,224 ng/mL; group 3, 2,025 ng/mL; between group 1 and group 3, p<0.05). But three different levels of AFP (<20 ng/mL, 20-400 ng/mL, >400 ng/mL) showed no differences among the three age groups (p=0.23766). (6) The overall survival rates did not differ statistically among the three groups (mean survival: group 1, 12 months; group 2, 18 months; group 3, 15 months; p=0.4635, log rank test). CONCLUSION: These data support the younger patients with HCC are the most frequently associated with HBV contrarily to the elderly patients the more frequently associated with HCV or NBNC rather than HBV. This suggests, in turn, that the onset of HCC occurs one or two decades later in those with adult-acquired HCV than it does in lifelong HBV patients after neonatal vertical infection.
Abdominal Pain ; Adult ; Aged ; Ascites ; Carcinoma, Hepatocellular* ; Clonorchis sinensis ; Diagnosis ; Eosinophilia ; Fever ; Hepatitis B Surface Antigens ; Humans ; Incidence ; Jaundice ; Liver Diseases ; Neoplasm Metastasis ; Smoking ; Survival Rate ; Transaminases ; Varicose Veins