BACKGROUND/AIMS: The purpose of this study was to evaluate the effectiveness of lamivudine treatment in patients with chronic liver disease caused by chronic infection of hepatitis B virus (HBV). METHODS: Thirty-ive patients with chronic infection of HBV were included in this study who were diagnosed at Hanyang University Hospital from January 1998 to January 1999. They received 150mg of lamivudine per oral once daily for 6 months with follow-p of liver function test, serum HBV DNA and serologic markers for hepatitis B virus every two months. Lamivudine was well tolerated. Eight patients underwent liver biopsies before entering the study and follow-p biopsies were done at 5 patients. RESULTS: Out of all 35 patients, chronic hepatitis patients histologically confirmed were 8, chronic hepatitis patients clinically diagnosed were 25 and liver cirrhosis patients clinically diagnosed were 2. The mean age was 35.7 years. Male-female ratio was 2.2:1. There was no hepatitis B surface antigen (HBsAg) negative seroconversion. The HBeAg loss rate was 26.9%(7/26) and HBeAg seroconversion rate was 10.7%(3/28) at the end of follow-p. Ten patients were anti-Be positive prior to treatment, 3 of them became anti-Be negative at the end of follow-p. Five patients underwent follow-p liver biopsies, in which histologic improvements were shown in 4 cases. Serum replicative HBV DNA by bDNA assay was decreased in all patients and HBV DNA was undetectable in 52.9%(9/17) at the end of treatment. Out of the 15 patients with abnormal alanine aminotransferase (ALT) levels at baseline, ALT level in 7 patients(46.7%) was normalized at treatment completion. Pretherapy ALT level was the only predictive factor for loss of HBeAg by stepwise logistic regression analysis(odds ratio : 1.0208) (95% Confidence Interval : 1.0023 ~ 1.0396) (p value=0.0271). CONCLUSIONS: Lamivudine induced sustained suppression of HBV replication during treatment in all patients. In treating patients with lamivudine, who had chronic liver disease due to chronic infection of HBV, the improvement of liver function test and suppression of viral replication appeared early and was sustained during the 6months treatment. This, in turn, may induce histological improvement as well. Pretherapy ALT level was the only predictive determinant for HBeAg loss during lamivudine therapy, and that should be kept in mind in selecting patients for treatment.
Alanine Transaminase ; Biopsy ; Branched DNA Signal Amplification Assay ; DNA ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Hepatitis B* ; Hepatitis* ; Hepatitis, Chronic ; Humans ; Lamivudine* ; Liver ; Liver Cirrhosis ; Liver Diseases ; Liver Function Tests ; Logistic Models ; Prospective Studies*

OBJECTIVES: The purpose of this study was to evaluated the difference of depressive symptoms and attention between estrogen user and non-user in postmenopausal women. METHODS: 30 Estrogen users and 30 non-users were participated in this study. They were all menopausal for at least 1 year and have 12 or more education years. We used BDI(Beck Depression Inventory), digit span and digit symbol to evaluate depressive symptoms and attention in both groups. We also measured the plasma estradiol level and identified the correlation between estradiol level and BDI, digit span and digit symbol. RESULTS: The demographic data was not different between both groups. Estrogen users scored higher than non-users in digit span(forward) and lower than non-users in BDI. The correlation between estradiol level BDI, digit span and digit symbol was not significant. CONCLUSION: Estrogen replacement therapy was effective in alleviation depressive symptoms but ineffective in improving attention in postmenopausal women.
Depression* ; Education ; Estradiol ; Estrogen Replacement Therapy* ; Estrogens* ; Female ; Humans ; Plasma

BACKGROUND/AIMS: As a tumor marker, alpha-etoprotein is widely used. Diagnositic cut-ff value is known as 400 ng/mL in sera. This study is aimed to determine the clinical features of hepatocellular carcinoma (HCC) with reference to serum AFP levels in Korean patients. METHODS: From May 1990 to March 1998, 367 patients diagnosed as HCC, hospitalized and followed-p at Hanyang University Hospital, have been retrospectively analyzed with special reference on serum AFP level at time of diagnosis. The differences in clinical, hematological, and radiological features of HCC, as well as the survival rate in the two groups have been compared. Group 1 (N=182) was defined as an AFP level lower than 400 ng/mL, group 2 (N=185) was defined as an AFP level greater than 400 ng/mL. Comparisons were made by student's t test or chi-quare test. Survival rate was calculated from the time of diagnosis by Kaplan-eier method. Survival curves were also compared using log-ank test. P values less than 0.05 were considered significant. RESULTS: The patients with serum AFP levels above 400 ng/mL showed (1) a lower mean age; (2) a higher level of AST; (3) a higher level of AST/ALT ratio; (4) a high incidence of liver cirrhosis; (5) a high incidence of portal vein thrombosis; (6) a high incidence of positive HBsAg; (7) a low incidence of anti-CV; (8) a low incidence of small HCC but high incidence of large HCC; (9) a high incidence of more advanced TNM stage; (10) a low incidence of single nodular type and high incidence of diffuse type. CONCLUSIONS: Depending on the value of AFP, HCC has some clinical features. In hepatocellular carcinoma, high levels of AFP represent young age, HBV infection more than HCV infection and advanced disease state.
Carcinoma, Hepatocellular* ; Diagnosis ; Hepatitis B Surface Antigens ; Humans ; Incidence ; Liver Cirrhosis ; Retrospective Studies ; Survival Rate ; Venous Thrombosis

BACKGROUNR/AIMS: Heterogeneity of liver cell populations within the hepatic lobules can affect xenobiotic reaction. In this study, we attempt to clarify the stereological distribution of the y-GTP positive foci in hepatic lobule initiated by diethylnitrosamine and promoted by phenobarbital. METHODS/METERIALS: To the five Sprague-Dawley rats, one day after birth, diethylnitrosamine (0.15 pmole/pn) was intraperitoneally injected and by the weaning at four weeks of life, 0.035% phenobarbital in drinking water was fed for four weeks, at which time the rats were sacrified to obtain the livers. Livers were fixed in fresh cold ethanol acetic acid. Ihe 200 cotmecutive tissue sections were stained by histochemistry for y-GIP and countastained with toluidine blue ar HkE. Employing Zeiss microprojector, y-GTP foci wae traced. And then the largest cross-sectian (size class: 65-165 pm in diameter) of 52 y-GTP foci were selected. Using microscopic grid, distances fiom center of y-GlP foci to nearest centtal vein and bile ductule was measured. As a control group, out of 52 random points determined by rareken digit table, the distances were measured by the same romr. RESULT: the diameter Aom the central points of y-GIP positive foci to the neatest bile ductules was measured as 0.234620+0.14899mm (mean+SD) and the diameter from random points to the neatest bile ductules was measured as 0.303080+0.19582mm (mean+SD). Y-GTP positive foci located within 0.3mm diameter fram bile ductules were counted as 73.1% of 52 foci, whereas that of random points were only 55.8%. Accoring to Aequency table analysis by Shapiro-Wilk W test, there was significant difference by W-value (0.812065) and p-value (0.0144866). CONCLUSION: Stereologically, y -GTP positive foci initiated by diethylnitros;unine, promoted by phaxkarbital in neonatal Spague-Dawley rats were non-rarxlanly distributed in peripcetal atea (Rappaport zone I) in hepatic lobule during hepatocarcinogenesis.
Acetic Acid ; Animals ; Bile ; Diethylnitrosamine ; Drinking Water ; Ethanol ; Liver* ; Parturition ; Phenobarbital ; Population Characteristics ; Rats* ; Rats, Sprague-Dawley* ; Tolonium Chloride ; Veins ; Weaning

BACKGROUND: Perfusion scintigraphy with dipyridamole have been reported to be useful for diagnosis of coronary artery disease and the assessment of the presence and extent of myocardium at ischemic risk, especially in patients who can not undergo dynamic exercise testing. Dipyridamole, pharmacologic coronary vasodilator, also induces fall in blood pressure and rise in heart rate. The purpose of this study was to answer the question if dipyridamole induced peripheral hemodynamic responses were related to chest pain, ST changes on EKG, scintigraphic defect or extent of coronary stenosis. METHODS: Dipyridamole 99mTc-MIBI myocardial scintigraphy and coronary angiography on 43 subjects who were suspected to have coronary artery disease. The peripheral hemodynamic response was graded as absent(group 0) if there was a < or =10mm fall in systolic blood pressure (SBP) and/or < or =10 beats/min rise in geart rate(HR) ; moderate(group 1) if there was >10 but < or =20mm fall in SBP and/or >10 but < or =20 beats/min rise in HR ; and marked (group 2) if there was >20mm fall in SBP and/or >20 beats/min rise in HR. RESULTS: The overall diagnostic sensitivity and specificity for coronary artery disease of dipyridamole perfusion scintigraphy were 68%, 83% while per vessel sensitivity and specificity for coronary artery disease were 66%, 97%. The numbers of induced chest pain and ischemic ST changes among hemodynamic subgroups, were 40%, 40% in group 0, 33%, 27% in group 1 and 50%, 40% in group 2 without significant difference in each hemodynamic subgroups. Either the numbers of diseased coronary arteries or the numbers of patients demonstrationg reversible scintigraphic defects were not statically different among each subgroups. CONCLUSION: Although the peripheral hemodynamic response dose not always correlate with its central coronary effect but dipyridamlole 99mTc-MIBI myocardial perfusion scintigraphy is an useful test for diagnosis of coronary artery disease.
Blood Pressure ; Chest Pain ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Stenosis ; Coronary Vessels* ; Diagnosis ; Dipyridamole* ; Electrocardiography ; Exercise Test ; Heart Rate ; Hemodynamics* ; Humans ; Myocardial Perfusion Imaging ; Myocardium ; Perfusion Imaging ; Sensitivity and Specificity

BACKGROUND/AIMS: Hepatocarcinogenesis of microscopically altered foci could be shown to be progressed into a trabecular pattern of hepatocellular carcinoma. And it is reported that down-regulation of TGF beta II receptor and up-regulation of TGF alpha and c-myc reveal the progression of diethylnitrosamine-induced foci into liver cell cancer. Up-regulation of TGF beta II receptor, however, causes apoptosis of foci. To determine characteristic morphology and growth kinetics of putatively precancerous y glutamyl transpeptidase (GGT) positive foci and hyperplastic nodules, a stereological quantification was attempted in the Peraino's neonatal rat model initiated by diethylnitrosamine and promoted by phenobarbital. MATERIALS/METHODS: Fifteen Sprague-Dawley rats were I.p. injected with 0.15 pmole/g of body weight of diethylnitrosamine mixed in corn oil at one day after birth. From weaning at 4 weeks of life, the rats were continuously fed 0.035% phenobarbital in drinking water and sacrified 5 rats at each time point of 8 weeks, 16 weeks, and 32 weeks. Teklad standard diet was fed after weaning. The livers obtained were fixed in freshly prepared, cold ethanol-acetic acid (99:1 vo1%). For the GGT histochemical staining, Rutenberg's method was modified, and counterstained with H & E or toluidine blue. For the stereological analysis GGT positive foci and nodules were traced in 200 consecutive tissue sections and quantified the 3 dimensional volumes by computer assisted planimetry. Either spheroidal or non-spheroidal morphology was determined by parabola 2nd degree equation ' y=ax+bx+c (sphere a=-P,). RESULTS: Thirty nine (55.71%) out of 70 representative lesions were nonspheroidal. Especially at 8 weeks, the 28 out of 40 GGT positive foci were irregular, nonspheroidal shape. Later times, however, GGT positive foci and reprogrammed nodular lesions were become spheroidal. Lilliefors probabilities test for spheroidal frequency was statistically significant (p<0.05). CONCLUSION: Stereologically non-spheroidal characteristics of the early GGT positive foci limit growth kinetic estimation by 3 dimensional volume quantitation but permit in later times in spheroidal, GGT positive foci and reprogrammed nodules showing fade-out of GGT activity. In other words, GGT positive foci may be clonally selected for growing into hyperplastic nodules and hepatocellular carcinoma or regressed by apoptosis.
Animals ; Apoptosis ; Body Weight ; Carcinoma, Hepatocellular ; Corn Oil ; Diet ; Diethylnitrosamine ; Down-Regulation ; Drinking Water ; gamma-Glutamyltransferase* ; Kinetics ; Liver ; Models, Animal ; Parturition ; Phenobarbital ; Rats ; Rats, Sprague-Dawley* ; Tolonium Chloride ; Up-Regulation ; Weaning

PURPOSE: This study was conducted in order to determine the most cost-effective strategy, in terms of interval and age range, for liver cancer screening in the high-risk population of Korea. MATERIALS AND METHODS: A stochastic model was used to simulate the cost-effectiveness of liver cancer screening by combined ultrasonography and alpha-fetoprotein testing when varying both screening intervals and age ranges. The effectiveness of these screening strategies in the high-risk population was defined as the probability of detecting preclinical liver cancer, and cost was based on the direct cost of the screening and confirmative tests. Optimal cost-effectiveness was determined using the incremental cost-effectiveness ratio. RESULTS: Among the 36 alternative strategies, one-year or two-year interval screening for men aged between 50 and 80 years, six-month or one-year interval screening for men aged between 40 and 80 years, and six-month interval screening for men aged between 30 and 80 years were identified as non-dominated strategies. For women, identified non-dominated strategies were: one-year interval screening between age 50 and 65 years, one-year or six-month interval screening between age 50 and 80 years, six-month interval screening between age 40 and 80 years, and six-month interval screening between age 30 and 80 years. CONCLUSION: In Korea, a one-year screening interval for men aged 50 to 80 years would be marginally cost-effective. Further studies should be conducted in order to evaluate effectiveness of liver cancer screening, and compare the cost effectiveness of different liver cancer screening programs with a final outcome indicator such as quality-adjusted life-years or disability-adjusted life-years.
Adult* ; alpha-Fetoproteins ; Cost-Benefit Analysis ; Female ; Humans ; Korea ; Liver Neoplasms* ; Male ; Mass Screening* ; Republic of Korea* ; Ultrasonography

The mainly used polymeric material for the denture is PMMA because of its cost and easiness to handle. So it was widely used material among dentists for past decades. But the acrylic-based denture materials have several common weak points such as shrinkage after curing and lack of strength. In order to solve these problems, we adapted one of hybrid system using acrylic polymer and vinyloligosilsesquioxane(POSS). POSS, which is a well known expandable monomer during polymerization process, may eventually suppress volumetric shrinkage. And the hybrid system makes it possible for the polymer to be stable in various severe conditions. Eight different kinds of samples were designed and synthesized. Each samples were characterized with dynamic mechanical analyser(DMA) to confirm their thermodynamic properties, fractured to analyze the cross-sectional morphology of the samples. And elongation, flexural and impact tests were also executed to evaluate the mechanical properties of the samples. From the results, hybrid composites had well defined crosslinked network structure compared to the widely used denture materials, and the mechanical strength improved without changing any surface condition as increment with POSS ratio in hybrid system. Fractured morphology showed homogeneous surfaces in spite of mutli component system, therefore we can conclude that the adoption of the POSS brought the reinforcement of the denture resin.
Dentists ; Dentures* ; Humans ; Polymerization ; Polymers ; Polymethyl Methacrylate ; Thermodynamics

ELISA has been used for the diagnosis of toxoplasmosis, but it is being gradually replaced by a rapid diagnostic test (RDT). We compared and analyzed ELISA and RDT results using the sera collected during 4 consecutive years from residents of Gyodong-do (Island), Incheon-city, Korea. Sera from 921, 993, 940, and 838 adult residents were collected on a yearly basis (2010–2013). ELISA was performed by using a crude extract of T. gondii RH strain antigen and IgG/IgM RDT mounted with recombinant fragment of major surface antigen (SAG1), GST-linker-SAG1A, were applied to the sera. Comparison between groups was analyzed by the Student’s t-test. The positive seroprevalence surged from 14.7% (135/921, 2010), 23.1% (231/993, 2011), 23.6% (222/940, 2012), and 32.1% (269/838, 2013) by ELISA. In contrast, RDT showed a more moderate increasing trend from 21.7% (200/921, 2010), 25.5% (253/993, 2011), 28.9% (272/940, 2012) and 33.1% (277/838, 2013). Discrepancies between ELISA and RDT were noted near the cut-off value. At the OD 0.15–0.24 range, RDT could detect 16.1% (169/1051) more positives, which suggests an early or acute toxoplasmosis, but at the OD 0.25–0.34 range, ELISA could detect 35.9% (92/256) more positives of possible chronic infections. Over the OD > 0.35 ELISA and RDT agreed in the majority of the cases. This surge in seroprevalence may be caused by the organic agriculture in addition to eating behavior or increase in pets among Koreans. These facts may be applied on a full-scale national survey using RDT to supplement ELISA to define the characteristics of the infection.
Adult ; Antigens, Surface ; Diagnosis ; Diagnostic Tests, Routine* ; Enzyme-Linked Immunosorbent Assay* ; Feeding Behavior ; Follow-Up Studies* ; Humans ; Incheon* ; Korea* ; Organic Agriculture ; Seroepidemiologic Studies* ; Toxoplasma ; Toxoplasmosis*

BACKGROUND: The aims of our study was to explore the effectiveness of 1 year treatment of lamivudine in Korean patients with chronic liver disease caused by chronic infection of HBV. METHODS: Thirty patients with chronic infection of HBV were included in this study who were diagnosed at Hanyang University Hospital from January 1998 to August 1999. They received 150mg of lamivudine per oral once daily for 1 year with follow-up of liver function test, serum HBV-bDNA and serologic markers for hepatitis B virus every two months. RESULTS: The mean values of ALT, AST, and GGT decreased significantly after 6 months treatment, but after 10-12 months treatment, 6 out of 30 cases(20%) tended to flare-up or return to pretreatment state. Nevertheless, their levels revealed no statistically significant changes after 12 months. No case show disappearance of HBsAg. HBeAg seroconversion occurred in 10 among 27 patients(37%). The mean of HBV-bDNA decreased from 1,776.0 pg/mL(2.5-17,000) to 10.8 pg/mL (2.5-67) after 6 months, but tended to rise to 317.9 pg/mL(2.5-5,900) after 12 months. After 10-12 months treatment, 11 cases out of 30 showed breakthrough or incomplete suppression of HBV DNA replication. Stepwise-logistic regression analysis proved the high baseline ALT was the only predictable factor for loss of HBeAg by lamivudine with an odds ratio of 1.0518(95% confidence interval: 1.0052-1.1007)(p=0.0291). CONCLUSION: Treatment of lamivudine showed improvement in normalization of ALT and reduction of HBV-bDNA after 6months. But after 10-12 months treatment, one third cases of them tended to flare-up or return to pretreatment state. And the group with high baseline ALT is not only suitable for indication of lamivudine therapy but also predictable factor of disappearance of HBeAg after 12months treatment with lamivudine.
DNA ; DNA Replication ; Follow-Up Studies ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Hepatitis B* ; Hepatitis B, Chronic ; Hepatitis Viruses ; Hepatitis* ; Humans ; Lamivudine* ; Liver Diseases ; Liver Function Tests ; Odds Ratio ; Prospective Studies*