BACKGROUND: T cell mediated immune destruction is an important mechanism of liver injury in patients with chronic hepatitis C. Serum levels of soluble interleukin-2 receptor(sIL-2R) seem to serve as a marker for the T cell activation and progressive liver injury, This study examined serum levels of sIft-2R and hepatitis C virus (HCV) RNA in patients with chronic HCV infection to determine the correlation with the severity of chronic hepatocellular damage. METHODS: Serum levels of sIft-2R in 73 patients with HCV infection (chronic hepatitis 52, liver cirrhosis 9, hepatocellular carcinoma 12) and 40 healthy controls were measured by sandwich enzyme immunoassay (CELLFREE, T Cell Sciences, USA). HCV RNA was quantified by QUANTIPLEX(TM) HCV RNA 2.0 assay (Chiron, USA) with duplication. This assay is a sandwich nucleic acid hybridization procedure using branched DNA amplification for the quantitation of HCV RNA. RESULTS: The sIL-2R levels of 52 patients with chronic hepatitis (591.4+/-238.7U/mL), 9 with liver cirrhosis(949.4+/-721.9 U/mL), and 12 with hepatocellular carcinoma (1,167.4+/- 554.4 U/mL) were significantly higher than those of healthy controls(370.8+/-71.8 U/mL) (p<0.001). A progressive and significant increase occurred in sIL-2R levels with chronic hepatitis C, liver cirrhosis and hepatocellular carcinoma (HCC) in order (p(0.001). The HCV RNA was detected in all patients and the means of HCV viral load were 3.3 MEq/mL in chronic hepatitis, 2.8 MEq/mL in cirrhosis, and 3.7 MEq/mL in HCC. There was no significant correlation between HCV RNA and the severity of liver injury in chronic HCV infection. There were no correlations among sIL-2R, HCV RNA and serum ALT. CONCLUSIONS: These results suggest that chronic hepatocellular injury by HCV progress mainly by T cell mediated immune response, not by direct cytopathic injury. Also, sIL-2R can be useful as a marker in monitoring the patients with HCV infection at high risk of getting HCC.
Carcinoma, Hepatocellular ; DNA ; Fibrosis ; Hepacivirus* ; Hepatitis C* ; Hepatitis C, Chronic* ; Hepatitis* ; Hepatitis, Chronic* ; Humans ; Immunoenzyme Techniques ; Interleukin-2* ; Liver ; Liver Cirrhosis ; Nucleic Acid Hybridization ; RNA ; Viral Load

BACKGROUND: T cell mediated immune destruction is an important mechanism of liver injury in patients with chronic hepatitis C. Serum levels of soluble interleukin-2 receptor(sIL-2R) seem to serve as a marker for the T cell activation and progressive liver injury, This study examined serum levels of sIft-2R and hepatitis C virus (HCV) RNA in patients with chronic HCV infection to determine the correlation with the severity of chronic hepatocellular damage. METHODS: Serum levels of sIft-2R in 73 patients with HCV infection (chronic hepatitis 52, liver cirrhosis 9, hepatocellular carcinoma 12) and 40 healthy controls were measured by sandwich enzyme immunoassay (CELLFREE, T Cell Sciences, USA). HCV RNA was quantified by QUANTIPLEX(TM) HCV RNA 2.0 assay (Chiron, USA) with duplication. This assay is a sandwich nucleic acid hybridization procedure using branched DNA amplification for the quantitation of HCV RNA. RESULTS: The sIL-2R levels of 52 patients with chronic hepatitis (591.4+/-238.7U/mL), 9 with liver cirrhosis(949.4+/-721.9 U/mL), and 12 with hepatocellular carcinoma (1,167.4+/- 554.4 U/mL) were significantly higher than those of healthy controls(370.8+/-71.8 U/mL) (p<0.001). A progressive and significant increase occurred in sIL-2R levels with chronic hepatitis C, liver cirrhosis and hepatocellular carcinoma (HCC) in order (p(0.001). The HCV RNA was detected in all patients and the means of HCV viral load were 3.3 MEq/mL in chronic hepatitis, 2.8 MEq/mL in cirrhosis, and 3.7 MEq/mL in HCC. There was no significant correlation between HCV RNA and the severity of liver injury in chronic HCV infection. There were no correlations among sIL-2R, HCV RNA and serum ALT. CONCLUSIONS: These results suggest that chronic hepatocellular injury by HCV progress mainly by T cell mediated immune response, not by direct cytopathic injury. Also, sIL-2R can be useful as a marker in monitoring the patients with HCV infection at high risk of getting HCC.
Carcinoma, Hepatocellular ; DNA ; Fibrosis ; Hepacivirus* ; Hepatitis C* ; Hepatitis C, Chronic* ; Hepatitis* ; Hepatitis, Chronic* ; Humans ; Immunoenzyme Techniques ; Interleukin-2* ; Liver ; Liver Cirrhosis ; Nucleic Acid Hybridization ; RNA ; Viral Load

BACKGROUND: Several studies have demonstrated that quantitation of hepatitis B virus (HBV) DNA in sera of HBsAg-positive patients is more useful test for the assessment of infectivity and for the evaluation of disease status than previously utilized numerous serological markers and qualitative polymerase chain reaction for the detection of HBV DNA. We tried to measure serum HBV DNA using a branched DNA (bDNA) signal amplification assay, which is recently introduced and known to be a simple and nonradioisotopic method. METHODS: Total forty patients with HBsAg were randomly selected and serum HBV DNA was measured with duplication using bDNA signal amplification assay (QUANTIPLEXTM HBV DNA ASSAY, Chiron, USA). Quantitation was determined from a standard curve and expressed as HBV DNA equivalents/mL (Eq/mL; 1 Eq = 1 molecule of the primary HBV DNA standard). Serum HBeAg, aspartate aminotransferase (AST), alanine aminotransferase (ALT) , and soluble interleukin-2 receptor (sIL-2R) were compared with HBV DNA. RESULTS: Serum HBV DNA was quantitated in 13 patients (32.5%) (range 6.4x106-7.4x109 Eq/mL, mean 1.8x109 Eq/mL, CV 8.1%). All eleven patients (100%) with both HBsAg and HBeAg an4 2 of 29 patients (6.9%) with HBsAg but not with HBeAg showed measurable HBV DNA (p < 0.001). In addition, serum levels of AST, ALT, and sIL-2R were significantly higher in HBV DNA measured patients compared with those of unmeasured patients. CONCLUSIONS: Above results show that more than half the HBsAg-positive patients do not have enough HBV DNA which is measurable with boNA signal amplification assay but all of HBeAg-positive patients and some of HBeAg-negative patients do. In addition, HBV DNA quantitation might be correlated with the disease activity in HBsAg-positive patients because serum levels of AST, ALT, and sIL-2R are higher in patients measured with HBV DNA than unmeasured.
Alanine Transaminase ; Aspartate Aminotransferases ; Branched DNA Signal Amplification Assay* ; DNA ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Humans ; Interleukin-2 ; Polymerase Chain Reaction

In order to investigate electrolyte changes in serum and urine diuretic therapy, we studied 98 patients with hypertension not optimally controlled by previous treatment. After we divied the patients into three gorups in randomized trial, group A were given Amiloride 10mg/day, group B were given Dihydrochlorothiazide 50mg/day, group C were given Amiloride 5mg/day combined with Dihydrochlorothiazide 25mg/day for 7 days. Blood pressure and electrolyte changes in serum and urine after diuretic theraphy for 7 days were as follows. 1) Serum sodium concentrations were not significantly changed in all three groups(P>0.05). 2) Serum potassium concentrations were increased in group A and C (P<0.05), but there were no significant changes in group B(P<0.05). 3) Urinary sodium exceretions were increased in all three groups(P<0.05). 4) Urinary potassium excretion were decreased in group A and C (P<0.05), but there were increased in group B (P<0.05). 5) Blood pressure were decreased in all three groups(P<0.05).
Amiloride ; Blood Pressure ; Diuretics* ; Electrolytes* ; Humans ; Hydrochlorothiazide ; Hypertension* ; Potassium ; Sodium

Informed consent (IC) should be a form of communication between a physician and patient in which information regarding all options of a medical procedure and the patient's preference is shared. The aim of this study was to create a standard for communication by IC for physicians. The IC standard was developed based on an analysis of a dialogue in our previous experience with a medical communication program and a review of the literature. The dialogue pattern of the IC standard had the following six elements: opening; orientation; disclosure of information; conforming and complementing; shared decision making; and closing. Factors that influenced effective IC-based communication included preparation, attitude, empathy, listening, a psychosocial factor, nonverbal communication, explanation, and understanding. The IC communication standard will be useful in improving the quality of communication between a physician and patient in obtaining IC. It will also be used as a guideline for communication educators and medical students. Innovative strategies and rigorous studies are needed to improve IC counseling to establish effective patient-centered interviews.
Complement System Proteins ; Counseling ; Decision Making ; Disclosure ; Empathy ; Humans ; Informed Consent* ; Nonverbal Communication ; Psychology ; Students, Medical

The rhabdomyosarcoma of the prostate is very rarely encountered in the western literature, and only a few reports have been published in Korea. The authours recently experienced two cases of rhabdomyosarcomas of the prostate in 35-year-old and 51-year-old males who had suffered from gross hematuria and difficulty of urination. Microscopic studies showed embryonal type of rhabdomyosarcoma in two cases. The clinical and pathological features of the distinctive prostatic rhabdomyosarcoma are described, and a brief review of the literature is made.
Male ; Humans

Agenesis of the dorsal pancreas is one of the rare congenital anomalies of the pancreas. Six cases of them have been reported. We have experienced an autopsy case of agenesis of the dorsal pancreas associated with fetal death in the uterus. Grossly, the body and tail of the pancreas and uncinate process were not found and those were partially replaced by adipose tissue. No abnormality was noted in the other organs. Microscopically, pancreatic tissue with autolytic change was identified only in the head portion of the pancreas.

Interleukin-6(IL-6) is a multifunctional cytokine, and deregulated IL-6 gene expression has been implicated as being involved in the pathogenesis of a number of diseaaes. So we measured the serum level of IL-6 to find a relationahip between uterine cervical cancer and serum IL-6 level. The serum levels of IL-6 were meesured m 54 patients adrnitted to the Severance hospital, from August, 1992 to February, 1993, of whom 27 patients were diagnosed as invasive cancer of cervix, 17 as CIN, and also utilizing 10 patiente diagnosed as uterine myoma as a control group for matched age and parity. The average serum level of IL-6 in invasive cancer, CIN, and uterine myoma were respectively 30.33pg/ml, 37.27pg/ml, and 12.45pg Jml. In 22% af cervical cancer patients (6 of 27), and 27% of CIN patients (4 of 17) studied blood levels of II-6 were detected whereas only 10% of uterine myoma (1 of 10) shorved the same result. However, the difference does not seem to be statistically significant, There was no statistically significant difference among any of the groups, and age and stage did not show any significant cmrelation, and the results need furt,ber investigations.
Cervix Uteri* ; Female ; Gene Expression ; Humans ; Interleukin-6* ; Leiomyoma ; Parity ; Uterine Cervical Neoplasms

Pulmonary histiocytosis X is a rare granulomatous disorder of unknown etiology that alters the interstitium of the lung. When confined to the lung, it is known as primary pulmonary histiocytosis X or eosinophilic granuloma of the lung. The chest radiograph shows characteristic nodular, reticular, and cystic abnormalities, which are most apparent in the upper and middle lung zones, but spare the costophrenic angles, The CT demonstrates innumerable small cysts with thin walls, and fine nodules. Recently we experienced pathologically proven primary pulmonary histiocystosis X in 35 years old male patients who had recurrent pneumothorax.
Eosinophilic Granuloma ; Histiocytosis, Langerhans-Cell* ; Humans ; Lung ; Male ; Pneumothorax ; Radiography, Thoracic

The trichofolliculoma is a rare tumor of the hair follicle occuring most often on the head and neck. We have experienced a case of 24-year-old female who had a small, dome-shaped, tan brown firm nodule on the nose. Under the clinical impression of a granuloma, an excisional biopsy of the nodule was done. Microscopically the lesion was composed of a large central cystic hair follicle with many srhall but well differenciated secondary hair follicles branching from the wall. Well developed secondary hair follicles were often grouped and were surrounded by a prominent stroma.
Female ; Humans ; Biopsy