No abstract available.
Polycystic Kidney Diseases*

Among the panents who visited Ewha Womens Universty Hospital from Dec 1988 to Oct 1989, the authors investigated the presence of posterior vitreous detachment(PVD) in 181 eyes Wlth nomal fundus flnd1ngs and 160 eyes wlth diabetic retinopathy. In normal eyes, the incidence of complete PVD increased with age but that of partlal PVD was not related to age. In non prolderative diabetic retinopathy, complete PVD was 15.6% and partial PVD was 5.6%, And in proliferative diabetic retinopathy, complete PVD was 8.6% and partial PVD was 41.4%. It is suggested that there is a close relationship between proliferative diabetic retinopathy and partial PVD.
Diabetic Retinopathy* ; Female ; Humans ; Incidence ; Vitreous Detachment*

BACKGROUND: Glycemic profile has traditionally been with the use of HbAlc over a 2 to 4 month period. Recently, serum fructosamine is highly sensitive to acute metabolic deterioration(period 2 to 3 weeks), and is suitable for automation, allowing multiple assays with minimal effort. In some report, despite evidence suggesting a reduction in serum albumin level with increasing age, serum fructosamine was strongly correlated with HbAlc in elderly diabetic patients. This study was conducted to define the correlation between fructosamine and other parameters in elderly diabetic patients. METHODS: The study group consisted of 56 elderly patients(age range : 66-85 years, group A) and 58 adult patients(age range: 18-64 years, group B), who were stable over recent 2 months in fasting glucose values and serum albumin levels. Fructosamine was measured in 114 diabetic patients. The measured levels were related to HbAlc and fructosamine/albumin index(FAI). RESULTS: 1) There was significant correlation between HbAlc and fructosamine in all diabetic patients(r=0.705, p=0.0001). The correlation between HbAlc and fructosamine was stronger in group A than in group B [group A: r=0.831, group B: r=0.367, p=0.0001](p<0.05). 2) The correlation between HbAlc and FAI was significantly stronger compared to that between HbAlc and fructosamine in elderly diabetic patients(p<0.05). 3) Glycation ratio provides a vector-like insight into the recent trend of glycemia, and Glycation ratio was stable in all diabetic patients. CONCLUSIONS: Our study suggests that correlation between HbAlc and fructosamine in elderly daibetic patients was significantly lower in adult diabetic patients. Further studies are needed to determine the ultimate values of this test in the clinical management of elderly patient with diabetes.
Adult ; Aged* ; Automation ; Fasting ; Fructosamine* ; Glucose ; Humans ; Serum Albumin

No abstract available.
Splenomegaly*

BACKGROUND: Measurement of bronchodilator response is necessary to establish reversibility of airflow obstruction that was helpful to estimate the diagnosis, treatment, and prognosis in obstructive airway disease. An useful index should be able to detect the bronchodilator response more sensitively not related with degree of airflow obstruction and also be independent of initial FEV1. METHOD: Sensitivities of bronchodilator response in each group classified by degree of airflow obstruction in FEV1, FVC, FEF25~75%, Isovolume FEF25~75%, sGaw were studied and correlation coefficients were calculated between initial FEV1 and reversibilities expressed as absolute, %initial, %predicted, %possible in FEV1. RESULT: Sensitivities of bronchodilator response were 61.5% in FVC, Isovolume FEF25~75% and sGaw, in severe group, and 56.3% in Isovolume FEF25~75% and sGaw, in moderate group, and 62.5% in FEV1 and sGaw and 50.0% in FVC and Isovolume FEF25~75%, in mild group, and 60.0% in sGaw and 58.0% in Isovolume FEF25~75% in total patients. Correlation coefficients between initial FEV1(L) and absolute, % initial, % predicted, % possible were 0.15, -0.22(p<0.05), 0.02, 0.24(p<0.05) and correlation coefficients between initial FEV1(% predicted) and absolute, % initial, % predicted, %possible were 0.06, -0.28(p<0.05), 0.08, 0.39(p <0.05). CONCLUSION: Volume related parameters were more sensitive index not related with degree of airway obstruction and the change in FEV1 expressed as % predicted was the least dependent on initial FEV1 and reversibilities, expressed as % initial or as % possible(predicted minus initial FEV1)were correlated with initial FEV1.
Airway Obstruction ; Diagnosis ; Humans ; Inpatients* ; Prognosis

BACKGROUND AND AIMS: Endoscopic ultrasonography (EUS) is a useful diagnostic method for diagnosing local invasion and lymph node metastasis of primary gastric lymphoma including mucosa-associated lymphoid tissue (MALT) lymphoma, but the role of follow-up EUS after histologic regression of MALT lymphoma has not been well established until now. Therefore the usefulness of EUS in initial and follow up studies after Helicobacter pylori eradication therapy was investigated. METHODS: From January 1995 to October 1998, nineteen MALT lymphoma patients were investigated. All but four patients underwent EUS exam at diagnosis and 3~23 months thereafter. 17 patients recieved H. pylori eradication therapy and 2 patients recieved operations without medical treatment. RESULTS: 16 of the 17 patients (94%) were cured of H. pylori infection after antimicrobial therapy. but on the histologic criteria, 13 of the 16 cases (81%) who were cured of H. pylori infection showed complete regression of MALT lymphoma. Histologic regression of MALT lymphoma was observed 6 weeks to 23 months after H. pylori eradication. In follow up EUS exam, gastric wall abnormalities returned to normal in 9 cases (69%) and remained abnormal in 4 cases (31%) among the completely regressed 13 cases. CONCLUSIONS: Considerable portion (31%) of follow up EUS exam showed persistent abnormalities of gastric wall such as thickening of mucosa and/or submucosa after histologic regression of MALT lymphoma. To evaluate the usefulness of EUS, follow up EUS exam with regular interval for longer periods after histologic regression is needed.
Diagnosis ; Endosonography* ; Follow-Up Studies ; Helicobacter pylori ; Humans ; Lymph Nodes ; Lymphoid Tissue ; Lymphoma* ; Lymphoma, B-Cell, Marginal Zone ; Mucous Membrane ; Neoplasm Metastasis

Multiple biliary papillomatosis are extremely rare, fifty one cases have been reported in the literature. Clinical symptoms are associated with obsructive jaundice and cholangitis. Malignant transformation into adenocarcinoma had been described. We report a case of multiple papillomatosis in the entire biliary ductal system with malignant transformation, in which endoscopic retrograde cholangiopancreatography and peroral choledochoscopy showed multiple polypoid lesicons. The endoscopic sphincterotomy and the intraductal biopsy confirmed the histologic diagnosis of multiple papillomatosis and adenocarcinoma.
Adenocarcinoma* ; Biopsy ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis ; Diagnosis ; Jaundice ; Papilloma* ; Sphincterotomy, Endoscopic

BACKGROUND/AIMS: The protective role of HBV-specific CD8+ cells is dependent on their ability to efficiently migrate to the infected liver, where they may exert an effector function. The migratory behavior of CD8+ cells is influenced by their expression of different chemokine receptors. This study was intended to analyse the pattern of chemokine receptor expression of HBV specific CD 8+ cells in chronic B viral infection. METHODS: We analysed the CCR5 and CCR3 profile of HBV-specific CD8+ cells isolated from the blood and liver of patients with different patterns of HBV infection. Purified T cells were stained directly ex vivo, or after antigen-specific stimulation, using HBV peptide-specific HLA tetramers and monoclonal antibodies to CD8, CCR5 and CCR3, with analysis by flow cytometry. RESULTS: In patients with chronic hepatitis B characterised by low levels of virus (serum HBV DNA <0.5pg/mL) and minimal liver inflammation, analysis of circulating and intrahepatic CD8+ cells demonstrated that liver infiltrating Tc18-27-specific cells were preferentially CCR5+ (up to 80% of HBV-specific CD8+ cells), in contrast to cells of the same specificity within the circulating compartment (up to 35% of HBV-specific CD8+ cells). Furthermore, CCR3 was expressed by about 10% of Tc18-27+ cells infiltrating the liver, but was absent from circulating cells. Following HBV-specific stimulation in vitro the CCR5 expression of circulating Tc18-27-specific cells was up-regulated, to levels found in liver infiltrating cells, whereas CCR3 expression was unchanged. CONCLUSIONS: The chemokine receptor profile of HBV-specific CD8+ cells is influenced by the anatomical site of these cells, and the clinical pattern of disease. The ability of circulating HBV-specific CD8+ cells of patients with low replicating virus to upregulate CCR5 suggests that these cells may respond to increases in virus replication by efficiently migrating into the infected liver.
CD8-Positive T-Lymphocytes/immunology/*metabolism ; English Abstract ; Hepatitis B Virus/immunology ; Hepatitis B, Chronic/*immunology/pathology ; Human ; Liver/pathology ; Receptors, CCR5/metabolism ; Receptors, Chemokine/*metabolism ; T-Cell Antigen Receptor Specificity

Tetralogy of Fallot (TOF) assumes its' most severe form when accompanied by pulmonary atresia (PA). Preserving the patent ductus arteriosus to maintain pulmonary blood flow is life-saving for patients with this congenital heart disease. Milrinone, a selective phosphodiesterase III inhibitor, is a potent vasodilator. Here, we report the successful use of milrinone for a newborn infant with TOF and PA for keeping the ductus arteriosus open and thereby maintaining pulmonary circulation. Milrinone is a useful drug because of its inotropic, lusitropic, and pulmonary vasodilating effects, in addition to its ability to keep the ductus arteriosus open and its relatively mild side-effects. Case series and comparative studies will be needed in the future to verify the effectiveness of this drug.
Cyclic Nucleotide Phosphodiesterases, Type 3 ; Ductus Arteriosus ; Ductus Arteriosus, Patent ; Heart Diseases ; Humans ; Infant, Newborn ; Milrinone ; Pulmonary Atresia ; Pulmonary Circulation ; Tetralogy of Fallot

BACKGROUNDS/AIMS: Hepatitis B virus(HBV) specific cytotoxic T lymphocyte (CTL) response is believed to play a major role in virus control and liver damage in chronic hepatitis B(CHB). We performed this study to evaluate whether HBV specific CTL could be visualized directly by tetrameric HLA-A2/core 18-27 complex(T c18-27) in the peripheral blood and liver of patients with CHB. On the basis of our results we clarified patients intrahepatic compartmentalization and correlation with HBV specific CTL and viral replication or liver damage. METHODS: We stained peripheral blood mononuclear cells of 33 HLA-A2 + and 8 HLA-A2 patients with CHB with cychrome conjugated anti-CD8 mAb and phycoerythrin conjugated T c18-27. Among these we analysed intrahepatic lymphocyte of 11 HLA-A2 + patients. We compared the frequency of T c18-27 specific CD8+ cells with serum HBV-DNA levels or alanine aminotransferase(ALT) levels. RESULTS: The frequency of circulating T c18-27 specific CD8+ cell was higher(9-101 cells per 50,000 CD8+ cells) than background level in 14 among 33 patients. The frequency of intrahepatic T c18-27 specific CD8+ cells was 12-2100 cells per 50,000 CD8+ cells in 8 out of 11 patients whose liver was obtained This was 17.4-150 times higher than circulating T c18-27 specific CD8+ cells. The frequency of circulating T c18-27 specific CD8+ cells was increased in 10 out of 18 patients with serum HBV DNA level <0.5 pg/mL and ALT < 40 IU/L. It was increased in just 4 out of 15 patients with HBV DNA level > 800 pg/mL and ALT >70 IU/L. The frequency of intrahepatic T c18-27 CTL tended to be lower in high levels of serum HBV DNA and was not correlated with liver inflammation. CONCLUSION: This study provess that if HBV-specific CTLs are barely detectable in the peripheral blood of CHB, much more HBV-specific CTLs are in the liver and most HBV-specific CTLs are infiltrated in the liver. Also, in the presence of an effective HBV specific CD8 response the inhibition of viral replication can be independent of liver damage.
CD8-Positive T-Lymphocytes/immunology ; DNA, Viral/analysis ; English Abstract ; HLA-A2 Antigen/analysis/*immunology ; Hepatitis B Virus/genetics/*immunology ; Hepatitis B, Chronic/*immunology/virology ; Human ; T-Lymphocytes, Cytotoxic/*immunology ; Viral Core Proteins/*immunology