BACKGROUND/AIMS: The emergence of lamivudine-resistant mutant hepatitis B virus (HBV), with aminoacid substitution in the YMDD motif of DNA polymerase, has been reported in the long-term lamivudine use group. However there is no report about the emergence of mutant viruses during the short-term lamivudine therapy. The objective of this study was to investigate the emergence of YMDD mutant HBV during short-term lamivudine therapy. METHODS: We evaluated twenty-eight chronic hepatitis B patients who were HBeAg and HBV DNA positive and treated with lamivudine 100mg p.o. daily for 12 weeks. First, we investigated the emergence of YMDD mutants by nested polymerase chain reaction (PCR) method developed by Chayama et al in 19 patients who lost HBV DNA during lamivudine therapy but showed HBV DNA re-emergence 2 weeks after the end of therapy. Second, DNA subcloning and sequencing of HBV DNA polymerase including YMDD motif was undertaken in one patient's serial blood samples at 0, 8, 12 weeks to confirm the results of nested PCR. RESULTS: YMDD motif mutation was detected in 17(90%) out of 19 patients at the end of therapy and the type of mutations were YIDD only. At the end of therapy, mutant was predominant in 5 patients, both mutant and wild type were similar in proportion in 3 patients, and wild type was predominant in 9 patients. When we carried out nested PCR serially with samples of 0, 2, 4, 8, 12, 14 weeks after initiation of therapy in 5 patients who were mutant predominant at 12 weeks, YIDD mutant began to be detected from 2 weeks in 4 patients and from 4 weeks in one patient. However, rapid turnover from mutant to wild type happened after the end of therapy, so only wild type was detected in 3 patients and wild type became predominant in 2 patients at 2 weeks after the end of therapy. All the sequencing results of serial blood samples in one patient were consistent with nested PCR data. CONCLUSIONS: The presence of YMDD motif HBV polymerase mutant may be possible before administration of lamivudine in Korean chronic hepatitis B patients. Nested PCR assay would be an useful method to detect YMDD mutant.
DNA ; Hepatitis B e Antigens ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis B, Chronic ; Hepatitis* ; Humans ; Lamivudine* ; Polymerase Chain Reaction

PURPOSE: This study was performed to examine the serial alteration of the optic nerve in chronic ischemia-induced brain injury of albino rat, which might be an experimental model of ischemia-induced optic nerve disease and vasogenic glaucoma in human. METHODS: We ligated bilateral common carotid arteries so that the brain and optic nerve had permanent ischemic injuries. Serial alteration of the optic nerve was studied on postoperative 1 day, 3 day, 5 day, 1 week, 2 week, 4 week and 9 week. After fixing the brain by perfusing formaline through the left ventiricle, we dissected the brain and optic nerve and then made specimen for Hematoxilin-Eosin (HE) stain to observe the histopathology of the optic nerve. Kluiver-Barrera (KB) stain was performed to qualify the myelin injury and optic nerve injury status. RESULTS: The HE stain specimen showed increased spaces in the nerve fiber layer and increased number of vacuoles three days after the operation. The optic neve injury became augmented with time. The KB stain showed better-defined configuration of HE stain. CONCLUSIONS: We were able to notice that optic nerve injury was induced by the bilateral common carotid ligation in this chronic ischemic experimental model, which might be an help to the studies of ischemic optic nerve disease, neurodefensive mechanism, and the hemodynamic mechanism of glaucoma in human.
Animals ; Brain ; Brain Injuries ; Carotid Arteries* ; Carotid Artery, Common ; Formaldehyde ; Glaucoma ; Hemodynamics ; Humans ; Ligation ; Models, Theoretical* ; Myelin Sheath ; Nerve Fibers ; Optic Nerve Diseases ; Optic Nerve Injuries ; Optic Nerve* ; Rats* ; Vacuoles

No abstract available.
Gastroenterology*

PURPOSE: Carnitine plays a key role in the oxidation of fatty acids by facilitating their transport. As very low birth weight(VLBW) infants receiving total parenteral nutrition(TPN) with limited oral intake are likely to be carnitine-deficient state, they require exogenous supplementation of carnitine, however, effects of it remains controversial. To demonstrate effects of parenteral camitine supplementation on fat metabolism, weight gain and clinical outcome. We analyzed plasma levels of biochemical markers, changes of weight, and incidence of complications in 23 VLBW infants receiving TPN. METHOD: We randomly assigned 23 VLBW infants(<32 wks of gestational age) receiving TPN to carnitine-supplemented(100mg/kg per day) group(n=10) and control(n=13). Plasma total (TC), free(FC), and acyl carnitine(AC) levels and serum cholesterol, triglyceride and free fatty acid levels were measured before and 2 weeks after carnitine supplementation. RESULT: Decrements in TC for 2 weeks were significantly lower in carnitine group(41.6umol/l->32.3umol/l) than control group(46.3umol/l->25.2umol/l)(p<0.05). Changes of FC and AC were similar in both groups. Levels of cholesterol and triglyreride were similar in both groups. Days of regaining birth weight were faster in carnitine group than control group(15.3+/-3.4 vs 20. 8+/-11.1 days)(p<0.05). Rate of weight gain for two weeks were significantly faster than carnitine group than control group(p<0.05). No significant differences in clinical outcome were found. CONCLUSIONS: Carnitine supplementation in VLBW infants receiving TPN has an supportive nutritional regimen in that it reduces decrement in carnitine level and facilitate weight gain.
Biomarkers ; Birth Weight ; Carnitine* ; Cholesterol ; Fatty Acids ; Humans ; Incidence ; Infant* ; Infant, Very Low Birth Weight* ; Metabolism ; Parenteral Nutrition, Total ; Parturition ; Plasma ; Triglycerides ; Weight Gain

No abstract available.
Prune Belly Syndrome*

No abstract available.
Prune Belly Syndrome*

This study is to understand and to explain how nursing students experience in the clinical nursing practice using grounded theory approach. Ten nursing students were participated in the study. Seven of them were junior students at the junior college of nursing, and the rest were the senior students at the university. The data were collected by in-depth individual interviews by investigators during May and June in 1995. The results of the study were as follows: Twenty-eight concepts and 9 categories were emerged by the constant comparative analysis. The 9 categories include 'the need of role model', 'non-educational practical setting', 'knowledge deficit', 'emotional changes','the attitudes of clinical practice','fatigue','skepticism','pride', and'the product of clinical practice'. The core category which encompasses all 9 categories was emerged as 'the process of formulating the nursing view'. Five hypotheses were derived from the analysis. 1) The desirable role model would enhance to pride of nursing in students. 2) Non-educational practical setting would increase skepticism of nursing in students. 3) Knowledge deficit would negatively affect on experience of clinical practice. 4) The pride of clinical practice would formulate a positive nursing view. 5) The skepticism of clinical practice would formulate a negative nursing view. The results of this study are to use as basic data for students attending clinical experience.
Humans ; Nursing* ; Research Personnel ; Students, Nursing*

No abstract available.
Ear, Middle* ; Eustachian Tube*

No abstract available.

No abstract available.
Noise* ; Organ of Corti*