The apparent acute hepatitis A was occuring among adolescene and young adults during last several years. So here we present the clinical manifestations and laboratory finding and risk factors of 72 patients with acute hepatitis A who were referred to our community hospital.

Seventy-two Patients, 6 to 40 years of age(mean ; 22±8 years) with hepatitis A identified by testing their sera for IgM anti-HAV antibody. Medical records for patients with HAV infection were retrospectively reviewed for symptoms, signs, and laboratory values.

The prevalence of hepatitis A have been increased recently, especially during last 2 years. The probable exposures to HAV included food- or waterborne source, household, foreign travel, day care centers. The clinical symptoms are not distinguishable from hepatitis due to other agents. The mean laboratory tests included total bilirubin 6.0mg/dl, AST/ALT 1064.0±1123.4mIU/mL, 1561.7±1203.0mIU/ml, respectively. All 72 patients experienced complete clinical and biochemical recovery within 6 months after onset of illness.

Abrupt increase of hepatitis A was occuring among the adolescents and young adults recently. Improved sanitation has brought our countries shifting a nearly universal asymptomatic infection in children to a less common but more significant disease expression in adults.

Tumor lysis syndrome(TLS) has been broadly defined as the metabolic abnormalities that occur after rapid tumor breakdown. The purpose of this study was to evaluate the types or degrees of metabolic abnormalities and clinical characteristics in patients with high-grade non-Hodgkin's lymphoma(NHL) who developed clinical TLS.

Patients were considered to have 'clinical TLS' if two of the following metabolic abnormalities occurred within 4 days of treatment : a 25% increase in the serum phosphate, potassium, uric acid, urea nitrogen concentrations, or a 25% decline in the serum calcium concentration and one of the following : a serum potassium level greater than 6.0mEq/L, a creatinine level greater than 2.5mg/dL, a calcium level less than 6.0mg/dL, the development of a life-threatening arrhythmia, or sudden death.

Clonical TLS occurred in 15 patients with advanced high-grade NHL, and these patients were associated with elevated lactate dehydrogenase(LDH) and β₂-mivtonlonulin(MG)levels. Pre-treatment TLS occurred in 10 patients(66.7%) and post-treatment TLS in 5 patients(33.3%). Most of these patients showed metabolic abnormalities including hyperuricemia, hyperphosphatemia, hypocalcemia, or acute renal insufficiency. They were treated with adequate hydration combined with allopurinol and recovered in 4 patients. In remained 11 patients, hemodialysis was required and the metabolic parameters returned to normal levels without any significant complications.

It is important to remember that patients with advanced high-grade NHL who have more increased serum LDH or β₂-MG level be carefully monitored. Further investigations of elucidating risk factors and diagnostic criteria on clinical TLS will be required.

The production of basic fibroblast growth factor(bFGF), which is known to have strong angiogenic activity in gastric cancer, was evaluated.

Using Alkaline phosphoatase-labelled, synthetic oligonucleotide probe of bFGF genes, the expression of the gene was evaluated with in situ hybridization method in 9 fresh advanced gastric cancer tissues.

In situ Hybridization of bFGF mRNA showed positive reaction in 8 of 9 patients.

In view of profuse expression of angiogenic growth factor, future therapeutic targeting for angiogenesis could be reasonable in patients with gastric cancer.

The aim of this study is to obtain the basic knowledge for safer clinical use of oxymetazoline, one of nasal decongestants, by observing changes of ciliary activity and histopa-thologic findings after topical application of oxymetazoline to the cultured human basak mucosa.

The nasal mucosa, obtained from the inferior tubinates in healthy non-smokers without any nasal symptoms or signs, was cultured and then, exposed to oxymetazoline solu-tion at different concentrations from 0.0123% to 0.25%, containing no preservatives. Ciliary activity was observed under an inverted microscope and the histopathology of the mucosa was examined by light microscopy 1,3,6,12,24 and 48 hours after exposure, respectively.

Oxymetazoline impaired ciliary activity and induced mucosal injury at dose- and time-dependent patterns. Once the ciliary activity disappeared, it was not restored at least for the next 48 hours. Furthermore, these functional and morphologic changes resulted from applying oxymetazoline at the concentration of clinical use.

Oxymetazoline as a topical vasoconstrictor should be administered for the minimal period even at clinical dose.

On previous reports about the relationship between herpes simplex virus(HSV) & erythema multiforme(EM), subjective specimens were taken from target lesions and papules of herpes-associated EM or recurrent EM of unknown etiology. PCR-positive specimen were found in target lesion of idiopathic EM and even drug induced EM. But biopsy was actually performed when the clinical finding is atypical and so diagnosis is not certain with only clinical finding. In non-classic type of erythema multiforme without herpes associated history or recurrent episode, we try to evaluate the clinical and histopathologic findings and to detect the DNA of herpes simplex virus.

We clinically and histopathologically observed the 29 cases of non-classic type of erythema multiforme through the clinical photographics, clinical charts and telephone visiting. And we also tested 29 paraffin-embedded tissues from non-classic type of erythema multiforme by PCR with two nested primer pairs.

The results are as follows :

1) There are not specific difference according to age and sex.

2) The most frequent clinical type was the diffuse type(55.2%), followed by the acral type(24.1%) and central type(20.7%).

3) The major cause was idiopathic(72.4%), followed by the drug(27.6%).

4) There were various findings in clinical manifestation, including maculopatch, palulopla-que, wheal-like papule, vesicle-bullae, purpuric macule and papule and urticaria.

5) Histologically, we observed necrotic keratinocyte(48.3%) and spongiosis, exocytosis and vacuolization of basal cell in most cases. Eosinophilic infiltration, pigmentary incontinence and RBC extravasation were also seen.

6) The HSV positive specimens were fund in 2 cases(6.9%).

Although herpes simplex virus infection is a major contributing factor to most cases of erythema multiforme, our data supports the finding that it is not so important in non-classic type of erythema multiforme.

We studied to determine the usefulness of dynamic magnetic resonance imaging(MRI) in the preoperative evaluation of invasion of colorectal cancer and to compare its usefulness with the conventional CT. To observe the enhancement pattern of colorectal wall after iv administration of Gd-DTPA between normal and cancerous wall.

Twenty patients with colon cancer and 8 patients with rectosigmoid cancer, who were diagnosed between October 1997 and June 1998 by barium enema, colonoscopic biopsy were evaluated. The patients population consisted of 16 men and 12 women, with ages ranging from 46 to 68 years(mean 61years). Preoperative staging was done by conventional CT and dynamic MRI. All MR images were performed with 1.5T superconducting magneting unit(Vision, Siemens, Erlangen, Germany). 2D-FLASH(Fast Low-Angle Shot) sequence was used for the dynamic and delayed images(TR/TE/NEX/FA=72.5-117.3/4.1/1/80°), and acquisition time of 13-15sec.

For the dynamic images, five MR images were obtained with a single breath hold. Precontrast images(axial, or sagittal or coronal) was obtained first, and then dynamic MR images were obtained at 30, 60, 90, 120sec after intravenous injection of 0.1mmol/kg Gd-DTPA. Ten to fifteen delayed images were also obtained with the interval of 4-5 minutes with a single breath hold. Preoperative staging of CT and MRI were decided with a consensus by two radiologists. Pathologic staging were done by TNM classification.

The dynamic MR image-determined stage of colorectal cancer correlated with histopathologic findings in 2 of 3 pT2 tumor(67%), 19 of 21 pT3(90%), and 4 of 4 pT4 tumors(100%). MRI correctily diagnosed tumor deposits of involved lymph nodes in 16 patients, overall accuracy was 57%(16/28%). And the signal intensities after IV Gd-DTPA administration between the cancerous wall and normal wall ws not significantly different at the 30, 60, and 90 seconds MR images with the indifferent Student t-test(p>0.05).

Dynamic MRI has a role for the preoperative assesment of colorectal carcinoma.