Hepatocellular carcinoma (HCC) is malignant tumor frequently occurring in Koreans. There have been few reports regarding the cytologic findings of fine needle aspiration (FNA) of HCC. Most have suggested a diagnostic problem in the cytology distinguishing HCC from some benign hepatic lesions-for example, a regeneration nodule in cirrhosis and liver cell adenoma. In spite of its high frequency in Korea, no cytologic study has been reported, concerning the FNA of HCC. In an attempt to achieve cytologic criteria for the diagnosis of HCC, the authors studied retrospectively cytopathologic findings of 247 cases of HCC. These cases were confirmed either by histologic examination including lobectomy, biopsy, or cell block materiai, or, when tissue diagnosis was unavailable, by a high serum alpha-fetoprotein level (over 400 l. U.). All aspiration smears were stained by the Papanicolaou method. In each case, the smears were analyzed for cell patterns and various cytomorphology of the tumor cells. The smear background was assessed for the presence of tumor cell necrosis and inflammatory components and compared to that of metastatic carcinomas. The cell patterns were classified as trabecular, acinar, dispersed, and irregular. The cytologic parameters analyzed included the degree of nuclear atypia and the presence of mitoses, intranuclear cytoplasmic inclusions, nucleolar prominency, endotheiial lining, multinucleated giant cells, eosinophiic globules, bile, and Mallory body.Most of the FNA of HCC showed markedly cellular smears. The tumor cells were most frequently arranged in a trabecular pattern (80.3%). The irregular (12.6%), the acinar (5.5%), and the dispersed patterns (1.7%) followed in decreasing frequency. Individual hepatoma cells were larger than normal liver cells. However, they had morphologic features characteristic of the hepatic cells: the cells were round or polygonal, their cytoplasm was abundant and granular with eosinophilic or amphophilic stainability, and their nuclei were round to oval, located centrally, and tended to have prominent nucleoli. Anaplasia and pleomorphism of tumor cells were generally mild to moderate. These findings existed even in very well differentiated cases. Mitotic figures were present in about 85% of the cases. Prominent nucleoli were observed only in about half the cases. The frequency of other cytologic features was as follows: intranuclear cytoplasmic inclusion in 86.8%; endothelial lining in 56.1%: bile in 19.8%; and giant cells in 60.1%. Clear cells were often present in11.7%, Most aspiration smears of HCC displayed clean background without necrosis or inflammatory material in contrast to the dirty, necrotic background of metastatic cancers and cholangiocarcinomas. Based on the above mentioned features, it is suqqested that the cytologic critieria most important for the diagnosis of HCC include a markedly cellular smear, trabecular pattern, hepatocytoid appearance of tumor cells, endothelial lining, the presence of bile, giant cells, intranuclear cytoplasmic inclusions, and prominent nucleoli, Among these, trabecular pattern, endothelial lining, giant cells and clean smear background are points to be considered in differentiating HCC from metastatic and cholangiocellular carcinoma.
Adenoma, Liver Cell ; alpha-Fetoproteins ; Anaplasia ; Bile ; Biopsy ; Biopsy, Fine-Needle ; Carcinoma, Hepatocellular ; Child* ; Cholangiocarcinoma ; Cytoplasm ; Diagnosis ; Endothelial Cells ; Eosinophils ; Fibrosis ; Giant Cells ; Glomerulonephritis* ; Hepatocytes ; Humans ; Inclusion Bodies ; Korea ; Liver ; Mitosis ; Necrosis ; Regeneration ; Retrospective Studies

Recurrent epistaxis is not one of rare symptoms in children, the well-known causes of which are anatomical abnormalities of nasal cavity and systemic bleeding tendency. but, in the majority of cases of recurrent epistaxis, it is usually very difficult to find out their underlying causes, so that the treatment is only symptomatic control of nasal bleeding whenever epistaxis occurs, but it usually is impossible to manage against their underlying causes as a specific therapy. The authors considered the breakdown or weakness of vascular integrity of nasal capillary vessel wall as an important factor of recurrent epistaxis, and vitamin C, which has an important role for the synthesis of collagen fiber, could influence to the vascular integrity of nasal capillary vessels. To elucidate the relation between recurrent epistaxis and the status of vitamin C in the tissue of the patients, the authors performed urinary vitamin C loading test measuring urinary excretion of vitamin C with high-performance liquid chromatography by Sirota et al in 19 cases of control group and 32 cases of patients with recurrent epistaxis, whose underlying diseases were not identified. And also the authors administered 1.0 gm/day of vitamin C orally for the treatment of recurrent epistaxis and follow-up was done over 1 year from the beginning of treatment to evaluate the treatment response. The results were as follows: 1) The hemoglobin level was significantly decreased in patient group compared with that of control group (12.4+/-0.8 vs 9.0+/-3.2 gm/dl). 2) The results of urine loading test of vitamin C, expressed as the percent excreted ratio, revealed significantly decreased in the patient group compared to that of the control group (9.1+/-6.1% vs 13.6+/-7.9%). 3) After treatment with 1.0 gm/day of vitamin C orally, follow-up was possible in 23 cases of total 32 patients. Of the 23 patients, "excellent" therapeutic response were in 16 cases (69.6%), "good" response in 5 cases (21.7%), and "no response" only in 2 cases (8.7%). The overall treatment response were in 21 cases (91.3%). In conclusion, it seems that majority of the patients with idiopathic recurrent epistaxis in the deficient state tissue vitamin C so that administration of vitamin C will be one of the effective therapy.
Ascorbic Acid* ; Capillaries ; Child* ; Chromatography, Liquid ; Collagen ; Epistaxis* ; Follow-Up Studies ; Hemorrhage ; Humans ; Nasal Cavity ; Vitamins*

Between Feb. 1992 and Apr, 1995, the authors have performed arthroscopic abrasion arthroplasty in 78 knees of 76 patients with degenerative osteoarthritis. The followup period was between 24 and 58 months, with on an average of 41 months. All patients had Zarins grade IV articular cartilage change. The results were as follows. 1. Of the total 78 knees, results were excellent in 25(32%), good in 33(42A), fair in 12(17%), poor in 8(10%) knees respectively. 2, The best results were obtained patellofemoral abrasion arthroplasty. 3. The poor results were obtained in patients with the both femoral condyle, lesion. 4. The results were much better in young age group (below 40 years). Aroscopic abrasion arthroplasty is not a curative but palliative method. But it could be an appealing altemative to total knee arthroplasty or high tibial osteotomy or can be performed postoperated after these reconstructive proeedures.
Arthroplasty* ; Cartilage, Articular ; Follow-Up Studies ; Humans ; Knee* ; Osteoarthritis* ; Osteotomy

To investigate the correlation between urinary growth hormone(GH) level and peak serum GH level, urinary GH value measured by overnight collection of urine for 10 hours and serum GH value in response to GH provocation test using insulin and L-dopa were measured in 9 cases of GH complete deficiency(GCD), 19 cases of GH partial deficiency(GPD) and 40 cases of GH normal short stature(GHN). Urinary GH values were measured by the EIA method using PICOIA HGH plate(Joo Woo Pharmaceutical Co., Japan). Urinary GH was expressed in terms of nanograms per gm creatinine(ng/gCr). Serum GH was measured by immunoradiometric assay using "Daiichi kit"(Je Il Pharmaceutical Co., Japan). Wilcoxon ranked sum test and student's t-test were used to assess the significance of differences between the groups of the patients. The correlation between urinary GH level and peak serum GH level was assessed by the parametric Pearson correlation test. The correlation between peak serum GH level in GH provocation test using insulin and urinary GH level measured by overnight 10 hours collection method showed statistically significant results in all the patients(Y=0.464072X +9.208044, r=0.48987, p=0.0001) and in the GH deficiency groups(GCD+GPD) (Y=0.924659X +9.2385509, r=0.80437, p=0.0001). In case of L-dopa stimulation test, urinary GH values were also positively correlated with peak serum GH level when all the patients were participated(Y=0.572988X +8.312993, r=0.58212, p=0.0001). In contrast, no correlation was found when patients were confined to GH deficiency group(GCD+GPD)(Y=0.127712X +8.3129939, r=0.08044, p=0.6841).
Dihydroxyphenylalanine ; Growth Hormone ; Humans ; Immunoradiometric Assay ; Insulin ; Levodopa ; Methods

PURPOSE: Hepatitis B virus(HBV) with various mutations has been reported. The aims of this study were to investigate the frequency and manifestation of HBV pre-S/S mutations in children with chronic hepatitis B infection. METHODS: Sera from 17 children with chronic hepatitis B infection were analyzed by direct sequencing of polymerase chain reaction amplification of HBV DNA. Results: Seventeen cases of adr type were analyzed. The deletions in HBV pre-S region were observed in 3(17.6%) of 17 cases. Of 3 deleted cases, 2 had an in-phase deletion in the pre-S1 region spanning 18 bp. Another case had a 18 bp and 3 bp deletions in the pre-S1 region. Many point mutations in HBV pre-S region were detected in all cases and these mutations were observed more frequently in the pre-S2 region than the pre-S1 region. Six point mutations in the pre-S1 region were observed. Eight point mutations in pre-S2 region were observed. Point mutations in the S region were detected in 14(82.4%) of 17 cases. Among these, mutations of the "a" determinant were detected in 4(23.5%) of 17 cases. Mutations at codon 130 and at codon 146 were noted in 2 cases. Combined mutations at codon 124, 126, 146 and at 130, 131, 136, 146 were noted in the other 2 cases. Mutations except "a" determinant region included at codon 3, 29, 73, 120, 184, 214, 226, 227. CONCLUSION: These observations suggest that deletion and point mutations in HBV pre-S1, pre- S2 regions and point mutations in HBV S region are frequent in the children with chronic hepatitis B infection.
Child* ; Codon ; DNA ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis B, Chronic* ; Hepatitis* ; Hepatitis, Chronic* ; Humans ; Point Mutation ; Polymerase Chain Reaction

PURPOSE: The aims of this study were to investigate the frequencies and role of hepatitis B virus(HBV) precore and core promotor mutations in children with chronic hepatitis B infection. METHODS: Sera from 46 children with chronic hepatitis B infection were analyzed by direct sequencing of polymerase chain reaction product of HBV DNA. In this study, the patients were divided into vertical and non-vertical groups according to the mode of HBV transmission. Statistical analysis was performed by using Fisher's exact test. RESULTS: Forty-six adr type of HBV DNA were analyzed. The mutations in HBV precore region were observed in 12(26.1Yo) of 46 cases. The GA mutation of nucletide(nt) 1896 was observed in 5 cases(10.9Yo). The frequency of mutations in HBV precore region of the non-vertical group (6/16; 37.5Fo) was higher than that of the vertical group(6/30; 20M), but there was no statistical significance. The mutation in HBV core promotor region was observed in 40(87.0%) of 46 cases. The A-->T mutation of nt 1762 or G-->A mutation of nt 1764 were observed in 24(52.2%) of 46 cases, and 23 cases revealed combined mutation at both positions 1762 and 1764. The frequency of mutations in HBV core promotor region of the vertical group(28/30; 93.3Yo) was higher than that of the non-vertical group(12/16; 75.0M), but there was no statistical significance. The frequencies of mutations in HBV precore and core promotor regions of the HBeAg negative patients was higher than that of HBeAg positive patients, but there was no statistical significance. Also there were no significant correlations between the frequencies of mutations in HBV precore and core promotor regions and AST, ALT level or the level of HBV DNA. CONCLUSION: These observations suggest that mutations in HBV precore and core promotor regions were frequently detected in children with chronic hepatitis B infection. There were no statistical significant differences in the frequencies of mutations in HBV precore and core promotor regions between vertical and non-vertical transmission groups. (J Korean Pediatr Soc 2000; 43:779-791)
Child* ; DNA ; Hepatitis B e Antigens ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis B, Chronic* ; Hepatitis* ; Hepatitis, Chronic* ; Humans ; Polymerase Chain Reaction ; Promoter Regions, Genetic

PURPOSE: The aims of this study were to investigate the frequencies and role of hepatitis B virus(HBV) precore and core promotor mutations in children with chronic hepatitis B infection. METHODS: Sera from 31 children with chronic HBV infection were analyzed by direct sequencing of polymerase chain reaction amplification of HBV DNA. RESULTS: Twenty-nine adr type were analyzed. The mutations in HBV precore region were observed in 8(27.6%) of 29 cases. The G->A mutation of nucleotide 1896(A1896; stop codon) were observed in 4 cases(13.8%). The mutations in HBV core promotor region were observed in 27 (93.1%) of 29 cases. The G(1764)->A mutation(A1764) was observed in 14 cases(48.3%), and among these 12 cases combined with a A to T change at nucleotide 1762(T1762). The mutations in HBV precore region were obsereved in 4(21%) of 19 cases of HBeAg positive group and 9(90%) of 10 cases of HBeAg negative group. A1896 mutation was observed in 2 cases in both HBeAg positive and negative group, respectively. The mutations in HBV core promotor region were observed in 18(94.7%) of 19 cases of HBeAg positive group and 9(90%) of 10 cases of HBeAg negative group. T1762 mutation were observed in 6(31.6%) of 19 cases of HBeAg positive group and 6(60%) of 10 cases of HBeAg negative group(P=0.14). A1764 mutation was obsereved in 7 (36.8%) of 19 cases of HBeAg positive group and 7(70%) of 10 cases of HBeAg negative group (P=0.089). A1896 mutation was observed in 2(18.2%) of 11 cases in increased AST/ALT group and 2(11.1%) of 18 cases in normal AST/ALT group. A1764 and T1762 mutations were higher (61.1%) in AST/ALT increased group than those(27.3%) in AST/ALT normal group, but there was no statistical significance(P=0.077). CONCLUSION: Mutations in the precore and core promotor regions can be frequently detected in children with chronic HBV infection. T1762 and A1764 mutations were observed more frequently in HBeAg negative group and in AST/ALT increased group but there was no statistical significance.
Child* ; DNA ; Hepatitis B e Antigens ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis B, Chronic* ; Hepatitis* ; Hepatitis, Chronic* ; Humans ; Polymerase Chain Reaction ; Promoter Regions, Genetic

No abstract available.
Anemia, Aplastic* ; Hepatitis*

No abstract available.
Chorion* ; Chorionic Villi*

No abstract available.
Spinal Muscular Atrophies of Childhood*