Epidemiological Comparison of viral hepatitis-hepatocellular carcinoma(HCC) and non viral hepatitis-hepatocellular carcinoma(HCC) / 한국역학회지

BACKGROUND: Korea is one of high incidence areas of Hepatocellular carcinoma (HCC) and major etiologic factor is hepatitis B virus (HBV). In future incidence of HBV related HCC may decrease and non viral hepatitis HCC (Non-B,C HCC) relatively increase because of widely used vaccination for HBV. To evaluate epidemiological characters of Non-B,C HCC, We divided HCC by viral or non-viral feature and compared each others. METHODS: 185 patients firstly diagnosed HCC and 455 normal subjects included from January 1997 to December 2000 and divided into 3 groups, HBV group (positive HBsAg), HCV group (positive anti-HCV Ab) and Non-B,C group (both negative HBsAg and anti-HCV Ab). RESULTS: 136 cases were HBV group (73.5%), 19 cases were HCV group (10.3%) and 27 cases were Non-B,C group (14.6%). Mean age of Non-B,C group at diagnosis was higher than HBV group (64.1+/-7.1 vs 55.6+/-7.7). Non-B,C HCC were more associated with alcohol abuse and rural residence (p<0.01). There was no difference of family history of liver disease, coexistence rate of liver cirrhosis and occupation. CONCLUSION: Non-B,C HCC tended to be older in mean age than HBV HCC and more associated with alcohol abuse and rural residence. This characteristics of Non-B,C HCC supposed to be from difference in alcohol consumption and environment.

The Study of 46 Cases of Tsutsugamushi Disease in Young-Dong Region in Gang-Won-Do / 감염과화학요법

BACKGROUND: Although the incidence of tsutsugamushi disease has been increasing in Korea, epidemiological and clinical characteristics of tsutsugamushi disease in Young?dong province have not been reported. METHODS: We retrospectively reviewed the medical records of 46 patients of tsutsugamushi disease who admitted at Gangneung Asan hospital from 1997 to 2001. RESULTS: Incidence of tsutsugamushi disease in Young-dong province had been increasing since 1999. Most patients were infected during agricultural work. The incidence of women was higher than that of men (65.2%). Characteristic laboratory finding was elevation of AST and ALT, hypoalbuminemia and thrombocytopenia. Despite fever, leukocytosis was found only in 20% of patients. Course of disease was relatively good in most patients, but complications such as pneumonia, acute renal failure, and shock developed in 26% of patients. In one case with acute renal failure and another case with pneumonia, the patients' condition aggravated in spite of doxycycline therapy, thus, hemodialysis and mechanical ventilator care were done respectively. Consequently, both patients recovered completely without chronic complication. Old age (>65 years), longer duration from onset of symptoms to admission (>10 days), hypoalbuminemia at admission(<2.6 g/dL) and leukocytosis could be used as a marker for prediction of complications. CONCLUSION: Incidence of tsutsugamushi disease increased in Young?dong region. Old age, delayed admission, hypoalbuminemia and leukocytosis could be used as marker for prediction of complications.

The Study of 46 Cases of Tsutsugamushi Disease in Young-Dong Region in Gang-Won-Do / 감염과화학요법

BACKGROUND: Although the incidence of tsutsugamushi disease has been increasing in Korea, epidemiological and clinical characteristics of tsutsugamushi disease in Young?dong province have not been reported. METHODS: We retrospectively reviewed the medical records of 46 patients of tsutsugamushi disease who admitted at Gangneung Asan hospital from 1997 to 2001. RESULTS: Incidence of tsutsugamushi disease in Young-dong province had been increasing since 1999. Most patients were infected during agricultural work. The incidence of women was higher than that of men (65.2%). Characteristic laboratory finding was elevation of AST and ALT, hypoalbuminemia and thrombocytopenia. Despite fever, leukocytosis was found only in 20% of patients. Course of disease was relatively good in most patients, but complications such as pneumonia, acute renal failure, and shock developed in 26% of patients. In one case with acute renal failure and another case with pneumonia, the patients' condition aggravated in spite of doxycycline therapy, thus, hemodialysis and mechanical ventilator care were done respectively. Consequently, both patients recovered completely without chronic complication. Old age (>65 years), longer duration from onset of symptoms to admission (>10 days), hypoalbuminemia at admission(<2.6 g/dL) and leukocytosis could be used as a marker for prediction of complications. CONCLUSION: Incidence of tsutsugamushi disease increased in Young?dong region. Old age, delayed admission, hypoalbuminemia and leukocytosis could be used as marker for prediction of complications.

Clinical Features of Simple Bronchial Anthracofibrosis which is not Associated with Tuberculosis / 결핵

BACKGROUND: Bronchial anthracofibrosis (BAF) is a dark black or brown pigmentation of multiple large bronchi associated with a fibrotic stenosis or obliteration that is incidentally found during a diagnostic bronchoscopy. Some reporters have suggested endobronchial tuberculosis or tuberculous lymphadenitis as a possible cause of BAF. However, some BAF patients do not have any medical history of tuberculosis. The aim of this study was to elucidate the clinical features of simple BAF patients, which were not associated with tuberculosis. METHODS: We reviewed the patients' charts retrospectively and interviewed all BAF patients who were followed up for 1 year or more. Among the 114 BAF patients, 43 patents (38 %) had no associated tuberculosis, cancer and pneumoconiosis. The clinical characteristics, radiological findings and associated pulmonary diseases of these patients were evaluated. RESULTS: Most patients were non-smokers, old aged, housewifes who resided in a farming village. The common respiratory symptoms were dyspnea, cough and hemoptysis. The predominant X-ray findings were a multiple bronchial wall thickening(89%), bronchial narrowing or atelectasis (76%) and a mediastinal lymph node enlargement with/without calcification (78%). Pulmonary function test usually showed mild obstructive ventilatory abnormalities but no patient showed a restrictive ventilatory pattern and the patients were frequently affected with chronic bronchitis(51%), post-obstructive pneumonia(40%) and chronic asthma(4%). CONCLUSION: Because BAF is frequently associated with chronic bronchitis and obstructive pneumonia as well as tuberculosis, a careful clinical evaluation and accurate differential diagnosis is more essential than empirical anti-tuberculous medication.

A Case of Primary Biliary Cirrhosis in Association with Sjorgen's Syndrome Developing Features of Systemic Lupus Erythematosus / 대한류마티스학회지

Primary biliary cirrhosis (PBC)is a chronic inflammatory disease characterized by fibrous obliteration of intrahepatic bile ductules.Although the etiopathogenesis of PBC remains unclear,several studies suggest that a disordered immune response may be involved.This disease is commonly associated with various autoimmune diseases,such as Sjogren's syndrome,scleroderma, rheumatoid arthritis,Hashimoto's thyroiditis,polymyositis,and pernicious anemia.More than 80%of cases with PBC are accompanied by at least one autoimmune disorder,and 40%by two or more. Sjogren's syndrome,defined by dry eyes and xerostomia,may be found in 69 to 81%of PBC patients. However, concurrent coexistence of PBC and systemic lupus erythematosus (SLE)has been rarely described in the literature.We report a 46-year-old female with PBC and Sjogren's syndrome who also satisfied a classification criteria of SLE.