Although methotrexate(MTX) has been known to have many side effects, especially toxicity on the hemopoietic cells and the liver, it has been used as a potent anticancer drug and for the treatment of psoriasis or rheumatoid arthritis. The severity of hepatotoxicity varies from mild fatty change to chronic active hepatitis(CAH) and cirrhosis. We experienced two cases of MTXinduced CAH in patients with psoriasis, which prompted us to report in view of the absence of biopsy proven MTX hepatotoxicity in the Korean literature. Microscopically, the liver showed a distorted lobular architecture with portal fibrous expansion, piecemeal necrosis and bridging necrosis/fibrosis. The hepatic lobules revealed fatty changes of hepatocyte, focal hepatocytolysis, delicate collagen deposits along the space of Disse and the characteristically marked polyploid nuclear change of hepatocytes.
Biopsy

To evaluate the tissue expression rate and pattenr of HBsAg and HBcAg in tumors and peritumoral livers, an immunohistochemical study was undertaken on 47 surgically resected hepatocellular carcinomas(HCCs). The results are as follows. 1. Patient's sera were positive for HBsAg in 40 cases(85.1%). In the remaining 7 cases, the tumor and peritumoral liver expressed neither HBcAg nor HbSaG, suggesting that they were caused by other etiologies than hepatitis B virus. 2. The peritumoral liver had HBsAg and HBcAg in 95.0% and 27.5% among the 40 cases, respectively. But the tumor expressed HBsAg in 50.0% and HBcAg in none. 3. The expression of HBsAg within the tumor and both HBsAg and HBcAg in the peritumoral liver tended to be more frequent in the pretreated cases before surgery. 4. Edmondson-Steiner grade IV tumors revealed a lower expression rate of HBsAg than the low grade tumors(p<0.05). Incases with cirrhosis at peritumoral tissues, HBcAg was less frequently found than in those without cirrhosis. The majority of tissue HBsAg and HBcAg was represented as groups of positive cells. These results suggest that, during the development and progression of HCCs, the HBcAg containing cells are repeatedly removed and the HBcAg negative cells are selected, because cellular expression of HBcAg is the target of host immune response.
Carcinoma, Hepatocellular

The purpose of this study was to investigate the effect that three resin indexing materials had on the distortion of split cast in the procedures of solder indexing and block fabrication. The specimen had two cylinders and connecting bar. Two cylinders were a reference cylinder and a test cylinder that were machined precisely and placed on metal base. The total of specimens wee 30 and they were divided into 3 groups according to the resin indexing materials : Acrylic solder , G-C Pattern resin , Z-100 . The relative coordinates (X, Y, Z) of centroids of both cylinders were measured by using 3-D coor dinates measuring machine. The value of indexing distortion was obtained after application of indexing material, and the value of the block distortion was obtained after fabrication of soldering block, and the value of total distortion was a value sum of indexing distortion and block distortion. Intercentroidal linear distortion({{{{ SQRT {X'^2 + Y'^2 +Z'^2 }- SQRT {X^2 + Y^2 +Z^2} }} }}) and global distortion {{{{rm SQRT {(X'-X)^2 +(Y'-Y^)2 +(Z'-Z^)2} }} }} were calculated from data of coordinates of centroids at each mea s u r ing stages. The results of this study were as belows ; 1. The intercentroidal distance between the split casts was reduced by indexing distortion and increased by block distortion. 2. The indexing global distortion between the split casts was smaller than block global distortion. 3. The intercentoidal linear distortion and the global distortion were no significant difference between indexing materials.
Abstracting and Indexing as Topic

In this article, the statement of ethical statement about animal experiment was omitted.

Since it was reported that incipient enamel caries can be recovered, previous studies have quantitatively evaluated that enamel artificial caries have been remineralized with fluoride, showing simultaneously the increase of width of surface layer and the decrease of width of the body of legion. There is, however, little report which showed that remineralization could occur without fluoride. In addition, the observations on the change of hydroxyapatite crystals also have been scarcely seen. In this study, enamel caries in intact premolars or molars was induced by using lactic acidulated buffering solutions over 2 days. Then decalcified specimens were remineralized by seven groups of solutions using different degree of saturation (0.212, 0.239, 0.301, 0.355) and different pH (5.0, 5.5, 6.0) over 10 days. A qualitative comparison to changes of hydroxyapatite crystals after fracturing teeth was made under SEM (scanning electron microscopy) and AFM (atomic force microscopy). The results were as follows: 1. The size of hydroxyapatite crystals in demineralized area was smaller than the normal ones. While the space among crystals was expanded, it was observed that crystals are arranged irregularly. 2. In remineralized enamel area, the enlarged crystals with various shape were observed when the crystals were fused and new small crystals in intercrystalline spaces were deposited. 3. Group 3 and 4 with higher degree of saturation at same pH showed the formation of large clusters by aggregation of small crystals from the surface layer to the lesion body than group 1 and 2 with relatively low degree of saturation at same pH did. Especially group 4 showed complete remineralization to the body of lesions. Group 5 and 6 with lower pH at similar degree of saturation showed remineralization to the body of lesions while group 7 didn't show it. Unlike in Group 3 and 4, Group 5 and 6 showed that each particle was densely distributed with clear appearance rather than crystals form clusters together.
Bicuspid ; Dental Enamel* ; Durapatite* ; Fluorides ; Hydrogen-Ion Concentration* ; Lactic Acid* ; Microscopy, Atomic Force ; Microscopy, Electron, Scanning ; Molar ; Tooth

In gastrointestinal tract CMV has been implicated in inducing mucosal inflammatory and ulcerative lesions. More recently, increasing number of patients with CMV-associated gut lesions have been reported primarily in immunocompromised patients or occasionally in normal hosts. The colon is the most common site of the infection, although it might occur in other gastrointestinal tract such as esophagus, stomach, duodenum and terminal ileum. The diagnosis of CMV infection can often be difficult and must await serological conversian or viral cultures. (continue...)
Colon ; Cytomegalovirus* ; Diagnosis ; Duodenum ; Esophagus ; Gastrointestinal Tract ; Humans ; Ileum ; Immunocompromised Host ; Stomach ; Stomach Ulcer* ; Ulcer

BACKGROUND AND OBJECTIVES: Recently, there has been an increase in olfactory disorders due to many etiologies. Many therapeutic methods have been tried with some favorable results. Some of the therapeutic methods are functional endoscopic sinus surgery (FESS), oral and topical steroids, and other pharmacologic therapies (vitamin A, aminophylline, zinc sulfate, etc). In this study, we tried to find out the transition of olfactory recovery in patients with olfactory disturbance. MATERIALS AND METHODS: Sixty-one patients with olfactory disturbance were studied. There were 25 patients who had chronic sinusitis with nasal polyp, 10 patients who had chronic sinusitis without nasal polyp, 12 patients who had upper respiratory infection, 5 patients who had congenital disorder, 4 patients who had head trauma, and 5 patients who had nasal septal deviation. Chronic sinusitis was treated by functional endoscopic sinus surgery, nasal septal deviation was treated by septoplasty and others were treated by drug therapy and topical steroid. The degree of olfactory disturbance and recovery was scored with a KVSS test (Korean Version of Sniffin Sticks test) prior to treatment and also three and six months after the treatment. RESULTS: Twenty-one patients with chronic sinusitis with nasal polyp (84%) showed improvement of olfaction on the third postoperative month, and 6 months later (p<0.01). Seven patients with chronic sinusitis without nasal polyp (70%) also showed improvement of olfaction (p<0.01). But seven patients with upper respiratory tract infection (58%) did not show significant improvement of olfaction, and it would be necessary to follow up these patients longer. Patients with congenital disorder, nasal septal deviaton, and head trauma did not show significant improvement of olfaction. CONCLUSION: The mentioned test can aid in investigating the etiology of olfactory disturbance, and in accurately assessing the degree of the olfactory disturbance.
Aminophylline ; Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Craniocerebral Trauma ; Drug Therapy ; Follow-Up Studies ; Humans ; Nasal Polyps ; Nasal Surgical Procedures ; Respiratory Tract Infections ; Sinusitis ; Smell ; Steroids ; Zinc Sulfate

BACKGROUND/AIMS: The most effective method of improving survival in patients with HCC is early diagnosis and curative hepatic resection. However, longterm survival after curative resection remains low because of high recurrence rate after resection. The purpose of the study is to assess the prognosis and the efficacy of the various treatment modalities on recurrent HCC after curative resection. METHODS: The clinical records of 50 patients with recurrent HCC were reviewed retrospectively who underwent curative surgery in Yonsei University, Severance Hospital from Jan. 1987 through Oct. 1994. The cummulative recurrent rate after resection, the response rate of treatment after resection, the median progression free survival and the survival after recurrence according to the treatment modalities were evaluated. RESULTS: The cummulative recurrent rate after resection was 3.9% at 3 month, 8.3% at 6 month, 14.1% at 12 month, 21.5% at 24 month, 23.4% at 36 month and 24.4% at 60 month. The response rate of treatment after recurrence was 23.7% (9 patients). The median progression free survival of the patient with reoperation and hepatic embolization was 13.9 months, that of conservative treatment group was 6.8 months and that of no treatment group was 4 months(p = 0.004). The survival after recurrence of HCC was 19.7 months in reoperation and hepatic embolization group, 11.4 months in multimodality group, 16.9 months in conservative treatment group and 8.4 months in no treatment group(p=0.0998). CONCLUSION: Reoperation and hepatic embolization for HCC after curative resection was effective in improving progression free survival, but overall survival were not significantly different according to the treatment modalities. This results proposed that reoperation and hepatic embolization for recurrent HCC after curative resection improve progression free survival.
Carcinoma, Hepatocellular* ; Disease-Free Survival ; Early Diagnosis ; Humans ; Prognosis* ; Recurrence ; Reoperation ; Retrospective Studies

BACKGROUND/AIMS: Recently, nucleotide sequences from a novel virus, termed hepatitis G virus (HGV), were identified in serum from a patient with cryptogenic hepatitis and suggested as agent of non A-E hepatitis. HGV has been isolated from patients with various liver diseases but clinical implications of this new agent remain largely unresolved. In Korea, the etiology of substantial fraction of hepatitis has remained undefined and there has been no report concerning HGV. METHODS: To determine the infection rate of HGV, RT-PCR of 5 UTR of HGV was performed, and to understand the clinical implication of HGV, medical records of 115 patients with various liver diseases were reviewed. Of 115 patients, 63 were male and 52 were female. Their mean age was 44 years (19-74) and their mean AST and ALT were 121.3+278.7 IU/L and 172.2+253.3 IU/L, respectively. Of 115 patients, 58 (50.4%) had no specific cause of liver diseases, 37 (32.2%) were infected with hepatitis B and/or C virus and 20 (17.4%) had non-viral identifiable liver diseases. RESULTS: 1. HGV RNA was detected in 15 (13.0%) patients of 115 patients. 2, Among the 15 HGV RNA positive cases, 7 were male and 8 were female. Their mean age was 48 years (19-72) and their mean AST and ALT were 71.9+45.2 IU/L, 97.4+66.8 IU/I respectively. 3. HGV RNA was detected in 8(13.8%) of 58 patients without obvious causes of their liver diseases and in 7 (18.9%) of 37 patients infected with HBV and/or HCV. However, HGV RNA was not detected fram 20 patients with non-viral liver diseases such as alcoholic liver diseases, autoimmune hepatitis, PBC, or fatty liver. 4. HGV RNA was detected in 5 (19.2%) of 26 patients with acute hep- atitis, in 6 (9.4%) of 64 patients with chronic hepatitis, in 1 (14.3%) of 7 patients with liver cirrhasis, and iB 3 (27.3%) Of 11 pafients with hepatocellular caIcinoma. 5. These was no slatistically significant difference in sex, age, history of transfusion, serum ALT level, etiologies and status of liver diseases between HGV RNA positve and negative group. CONCLUSIONS: the prevalence of HGV infection is quite high among the patients who have no specific cause of acute or chronic liver diseases and HGV can be coinfected with HBV and/ar HCV infection in Korea.
Base Sequence ; Fatty Liver ; Female ; GB virus C* ; Hepatitis B ; Hepatitis* ; Hepatitis, Autoimmune ; Hepatitis, Chronic ; Humans ; Korea ; Liver Diseases* ; Liver Diseases, Alcoholic ; Liver* ; Male ; Medical Records ; Polymerase Chain Reaction* ; Prevalence ; RNA*

The diffuse form of supravalvar aortic stenosis represents a surgical challenge when the ascending aorta, aortic arch, proximal descending thoracic aorta and arch arteries are involved. It can be treated by a variety of surgical approaches. We report a case of severe diffuse supravalvar aortic stenosis combined with an aortic valve anomaly and occlusion of the right coronary artery ostium in a 14-year-old boy with Williams syndrome. We enlarged the aortic root (Nick's procedure), ascending aorta, aortic arch, proximal descending thoracic aorta, and innominate artery with patches and replaced aortic valve with 19 mm St. Jude valve. Deep hypothermic circulatory arrest and retrograde cerebral perfusion were used during repair of the arch and arch artery.
Adolescent ; Aorta ; Aorta, Thoracic ; Aortic Stenosis, Supravalvular* ; Aortic Valve* ; Arteries ; Brachiocephalic Trunk ; Circulatory Arrest, Deep Hypothermia Induced ; Coronary Vessels ; Humans ; Male ; Perfusion ; Williams Syndrome