HBV DNA Levels, Aminotransferase and Histological Activity in Young Male Patients with HBeAg Positive Chronic Hepatitis B / 대한간학회지

BACKGROUND/AIM: A significant correlation between HBV DNA and liver damage was found in precore mutant strains but there was no significant association between viral replication and liver damage in HBeAg positive patients. Laboratory tests are often requested to predict hepatitis activity (grade) and fibrosis (stage) in HBeAg positive chronic hepatitis B. We assessed ALT, AST, and HBV-branched DNA to find which is the best for predicting hepatitis activity and fibrosis. METHODS: Routine biochemical liver function tests and HBV DNA in sera were assessed in 119 young patients positive with HBsAg and HBeAg. The mean age of patients was 21+/-2 years. All patients were male. By logistic regression analysis the relationships between laboratory data, hepatitis activity, fibrosis, or risk of chronic active hepatitis were analyzed. RESULTS: There was a significant correlation between aminotransferase (AST, ALT) and hepatitis activity/ fibrosis. A significant inverse relationship between the HBV bDNA and hepatitis activity was demonstrated (Pearson's correlation coefficient: lobular activity,-0.305; porto-periportal activity, -0.410). But HBV bDNA was not correlated with severity of fibrosis. AST and HBV bDNA was the important test for predicting the more severe hepatitis activity (lobular activity and porto-periportal activity: score> or =3, respectively) CONCLUSION: The higher AST, but the lower HBV bDNA, in sera shows the more severe hepatitis activity. AST and HBV bDNA could be helpful for assessing the hepatitis activity in young male patients with HBeAg positive chronic hepatitis B if proper reference values are used.

A Case of Hematogenous Tuberculosis of Skeletal Muscle / 대한내과학회지

Tuberculosis infection of skeletal muscle is rare even in countries in which tuberculosis is a relatively common disease. Because tuberculosis of muscle is almost always secondary to underlying tuberculosis of the bone or adjacent joint, hematogenous tuberculosis of skeletal muscle is extremely rare. Therefore, We report a case of hematogenous tuberculosis of skeletal muscle with the review of literatures. A 79-year-old man presented with a history of left shoulder pain, edema, fever and chill. MRI showed inflammatory changes of infraspinatus and deltoid muscle. The histopathology of skeletal muscle showed granulomas surrounded by epithelioid cells and Langhans' giant cells. Mycobacterium tuberculosis was grown from the specimens of sputum, pleural fluid and muscle tissue. The patient improved on anti-tuberculosis treatment.

Comparison of I-131 Scintigraphy , T1-201 Scintigraphy , and Serum Thyroglobulin in the Postoperative Follow-Up of Differentiated Thyroid Cancer / 대한핵의학회잡지

To evaluate the utility of I-131, T1-201 scintigraphy, and serum thyroglobulin(Tg) in the follow-up of differentiated thyroid cancer, we compared retrospectively the data from 33 patients who underwent total or subtotal thyroidectomy. I-131 scintigraphy was performed after optimal endogenous TSH stimulation (TSH>50microgram/ml). Total 41 cases of I-l3l and T1-201 scintigraphy pairs were examined. Concomitant serum thyroglobulin levels were measured for 41 pairs of scan. Tg-off levels(that measured after discontinuation of the thyroid hormone) higher than 40ng/ml were considered positive, and Tg-on levels(that measured during the thyroid hormone replacement) higher than 5ng/ml were considered positive. The concordance rates between I-131 therapeutic scintigraphy and T1-201 scintigraphy was 48% in the 38 case of total scan pairs(59% in the 17 cases of postoperative preablation group, and 38% in the 21 cases of postoperative postablation group), Of 17 studies before the I-131 ablation therapy (preablation group), 7 showed positive I-131 therapeutic scintigraphy despite of negative T1-201 scintigraphy. Among patients with negative I-131 therapeutic scintigraphy, no patients had abnormal T1-201 uptake. However, of 21 studies which were done after radioiodine therapy(postablation group) 6 had abnormal uptake on T1-201 scintigraphy which were not seen on I-131 therapeutic scintigraphy, and Tg-off levels also elevated in this 4 of 6 cases. As a result, I-131 therapeutic scintigraphy showed highest positive rate at postoperative preablation follow-up study in differentiated thyroid cancer patients. T1-201 scintigraphy may be useful in postablation studies, and the use of the combined modalities(T1-201 and Tg levels) provides a higher diagnostic yield.

Usefulness of Tc-99m MIBI Scan in the Postoperative Follow Up Of Well-Differentiated Thyroid Cancer / 대한핵의학회잡지

To evaluate the clinical utility of Tc-99m MIBI scan in the detection of residual thyroid tissue or metastatic lesion in postoperative thyroid cancer patients, we compared Tc-99m MIBI scan with I-131 diagnostic and therapeutic scan in 30 postoperative well-differentiated thyroid cancer patients. Thyroglobulin levels of both on and off thyroid hormone medication and antithyroglobulin antibody were tested [Tg(on), Tg(off)l Positive rates for I-131 diagnostic and Tc-99m MIBI scan were 81% and 68% respectively. Concordance between I-131 diagnostic and Tc-99m MIBI scan was observed in 15 cases; 12 positive and 3 negative respectively Among the 6 cases with negative I-131 diagnostic scan and positive Tc-99m MIBI scan, 4 were positive in the therapeutic I-131 scan. We concluded that Tc-99m MIBI scan maybe a useful complementary modality to the currently established method of I131 scan and serum thyroglobulin level in the detection of recurrent or metastatic thyroid cancer, especially in the case of negative I-131 diagnostic scan.

A Case of Bartter's Syndrome in an Adult / 대한신장학회잡지

Bartter's syndrome is characterized by hypokalemia and secondary hyperaldosteronism without edema or hypertension. Its pathogenesis is obscure and the characteristic renal potassium wastage is difficult to treat. We experienced a case of Bartter's syndrome in 47 year-old diabetic female. She had felt dizziness, muscle weakness and cramping for about two years. During diagnostic evaluation, hypokalemic metabolic alkalosis and hyperreninemic hyperaldosteronism were discovered. The patient denied ingestions of laxatives, diuretics, licorice and she had no nausea, vomiting, diarrhea or edema. She had normal blood pressure. The patient improved with potassium supplements and spironolactone therapy along with oral hypoglycemic agent. So we report this case with the review of literature.

The Study of Chromosomal Aberration in NSCLC Patients which Developed after Administration of Chemotherapeutic Agents / 대한암학회지

PURPOSE: Except hormonal agents and biologic response modifier, the biologic effects of chemotherapy and radiotherapy as anti-cancer therapy have the mechanism of DNA injury. They cause not only cancer cell necrosis, but also infertility, bone marrow suppression, secondary malignancy, and individual death. There are many reports to human genome or chromosomal injuries by radiation but few by chemotherapy. Therefore this study is designed for systemic evaluation of the frequency of chromosomal damage by chemotherapy. MATERIALS AND METHODS: We performed evaluation of chromosomal aberration, sister chromatid exchange, and mitotic index were examined in 3 patient with NSCLC. Two of them were stage IIIb and the other one was stage IV. Venous blood was taken from patients before chemotherapy and one day after last administration of combination chemotherapy. Microscopic examination for chromosomal aberration, chromatid aberration, and SCEs was done after cell culture and FPG stain. RESULTS: The incidence of chromatid break was 3 before chemotherapy and 26 after chemotherapy. The incidence of SCEs was 9.85 1.93 before chemotherapy and 40.47 7.12 after chemotherapy. CONCLUSION: Incidence of chromatid break and SCEs increased after combination chemotherapy.