PURPOSE: To evaluate whether there are any differences in MR findings between the childhood and the adult moyamoya disease. MATERIALS AND METHODS: We compared the brain MR findings in 22 children (13 boys and 9 girls, 2-18 years of age) who had moyamoya disease with 15 adult patients (7 men and 8 women, 19-55 years of age). The MR findings were classified as parenchymal-(infarctions and intracranial hemorrhages) and vascular abnormalities (intracranial vascular patency and moyamoya vessels). The difference in each of these MR findings was analyzed using Chi-squaretest and Fisher's exact test (two-tailed). Out of 22 children, two children with normal MR finding were excluded from the statistical analysis. Moyamoya diseases were diagnosed angiographically in all adult patients. In children, they were diagnosed by MR imaging, MR angiography(6), and/or conventional cerebral angiography(18). RESULTS: In children, cerebral infarctions were observed in 20 of 22 patients (91%) (cortex 86%, periventricular white matter/centrum semiovale 32%, basal ganglia 10%). In two patients, there was no parenchymal abnormality. Intra-cranial hemorrhages were not demonstrated in any patients. In adults, intra-cranial hemorrhages(intracerebral hematoma, intraventricular hemorrhage, alone or combined) were demonstrated in 10 of 15 patients(67%). Cerebral infarctions with or without intracranial hemorrhage were detected in 10 of 15 patients(67%)(cortex 40%, periventricular white matter/centrum semiovale 53%, basal ganglia 20%). The difference in parenchymal abnormalities between the childhood and the adult moyamoya disease was statistically significant (p=0. 000164). There was no significant difference between the two groups with regard to the occlusive changes of the internal carotid and middle cerebral arteries or to moyamoya vessels(p> 0.01 ). CONCLUSION: This study could prove the fact that the principal clinical symptoms in the childhood moyamoya disease were due to cerebral infarction and those in the adult cases were due to infarction and intracranial hemorrhage. In addition, cortical infarction was more prevalent in children and infarction in periventricular white matter/centrum semivoale and basal ganglia was more frequentin adults. There was no significant difference in vascular abnormalities between the two groups.
Adult* ; Basal Ganglia ; Brain ; Cerebral Infarction ; Child* ; Female ; Hematoma ; Hemorrhage ; Humans ; Infarction ; Intracranial Hemorrhages ; Magnetic Resonance Imaging ; Male ; Middle Cerebral Artery ; Moyamoya Disease* ; Vascular Patency

In order to determine paternity by genetic testing, the Paternity Index (PI) and probability of paternity are calculated using likelihood ratio method. However, when it is necessary, additional testing can be performed to validate the genetic relationship. This research demonstrates autosomal short tandem repeat (STR) results of Jeju Island population in order to determine genetic relationship. Two notable cases showed that despite the acceptable PI value obtained from STR testing, average of 12 mismatches were found in total of 169 autosomal single nucleotide polymorphism typing. Such cases imply that cautious statistical approach is necessary when determining genetic relationship, especially within an isolated population group. Moreover, this would suggest that a further research and investigation are needed in order to understand the population structure of Korea.
Genetic Testing ; Humans ; Korea ; Microsatellite Repeats ; Oligonucleotide Array Sequence Analysis ; Paternity* ; Polymorphism, Single Nucleotide ; Population Groups

To elucidate the complex of insulin-like growth factor binding proteins (IGF-BPs) in short stature patients, we carried out a prospective study on three patients who were diagnosed as complete GH deficiency at the department of pediatrics from July 1992 to June 1993. The results were summarized as follows: 1) Two circulating IGFs complexed to specific binding protein existed in normal serum. Binding activity was found to be in the 150,000 molecular weight area (the large complex) and 50~60,000 molecular weight area (the small complex). 2) Binding activity for the large complex was seen to be dependent on advancing age, level of large IGF-BP3 complex peacked at the age of 15~16 years. 3) The binding activity for large complex diminished in three GH deficient patients and increased after hGH injection to near or above normal level. 4) Increased growth rate after GH treatment in GH deficient patient was closely related with increasing level of the large IGF-BP3 complex. Therefore we suggest that the large IGF-BP3 complex is regulated by GH. Estimating its serum level is useful for screening of GH deficiency and the monitoring of response to GH therapy.
Carrier Proteins ; Growth Hormone* ; Humans ; Insulin-Like Growth Factor Binding Proteins ; Insulin-Like Growth Factor I* ; Mass Screening ; Molecular Weight ; Pediatrics ; Prospective Studies

No abstract available.
Thyroid Gland* ; Thyroid Nodule*

Ocular flutter (OF) is a rare eye movement disorder with horizontal saccadic oscillations without inter-saccadic intervals. The OF can occur in various clinical settings. A 83-year-old female showed the OF in hyperosmolar hyperglycemic state (HHS) following malignant cerebral infarction. The pathophysiology of the OF is still unclear, but this case provides a new information that the OF can occur in the context of toxic-metabolic state such as HHS.

[Background] Over the last thirty years, majority of researches on clinical effectiveness of acupuncture have been explanatory (or experimental) randomized controlled trial. The benefits of acupuncture in clinical trials are stillcontroversial and most studies concluded that further control studies were required. Standardized combinations of acupuncture points for all the experimental subjects in various past studies have been criticized because such treatments do not reflect current routine clinical treatment.
[Objective] This paper aims to review pragmatic clinical trials on the effect of acupuncture treatment and to develop the ideal clinical research methodology of acupuncture study.
[Method] Clinical studies of acupuncture relevant with pragmatic or individualized trials were searched mainly in Pubmed and Science direct databases. All articles were fully reviewed by researchers, and data were evaluated by usage of a standardized form.
[Results & Suggestion] Pragmatic acupuncture researches were tried for various symptoms (eg. low back pain, hypertension, depression during pregnancy, sleep quality in HIV disease, chronic poststroke leg spasticity, headache, etc). Individualized acupuncture treatments based on oriental disease pattern diagnosis reflexes practical treatments which is more effective than unified and fixed acupuncture treatments without any theoretical basis of oriental medical philosophy.
[Conclusion] To overcome the controversies and limitations of past explanatory acupuncture trials, more individualized and tailored acupuncture trials with the theoretical basis of oriental medical diagnosis is highly recommended. Also clear definition and categorization of pattern identification should be established for further active clinical researches and applications of acupuncture.

BACKGROUND: The use of single donor platelets (SDPs) has been increased substantially worldwide. But in korea, SDPs are supplied only 11.5% of total platelets transfused and most of them collected in hospital blood center. Korean Red Cross blood center decided to supply and started collection of SDPs from registered and random repeat donors since January, 2000. METHODS: The utilization of platelets including SDPs was analyzed by mail survey from 33 hospitals and by statistical yearbooks of KRC, 2000. The necessity of SDPs and supplementary amounts of SDP in case of need was estimated. RESULTS: Total 483,611 units of platelets (692-80,414 units) and 12,150 units of SDP(0-3364 units) were utilized by 33 hospitals participated mail survey. The mean discard rate of platelets in the 33 hospitals was 1.5% (0%-15%). The total amounts of SDP collection in 19 hospitals among them were 10,031 units. About one third of 29 hospitals investigated, call for to use 100% of SDPs for patients. And most of the hospitals were cooperative using SDPs supplied from KRC. The amounts of SDP used in Big 5 hospitals, which is located in Seoul was 76.1% of total SDPs used in Korea. CONCLUSION: The relevant amount of supplied SDPs would be 80.000 unit/year, which is 50% of total supplied platelets by KRC. Efficient utilization of SDPs needs well organized collection, SDP stock control and supply system by regional groups of KRC blood center. In additionally, donor recruitment and maintenance for substantial supply of SDPs, and the supplementary support from the government is important.
Humans ; Korea ; Postal Service ; Red Cross* ; Seoul ; Tissue Donors*

473 patients who underwent orthopedic surgery of the upper extremities from July 1978 to August 1983 were studied and the results are as follows. 1) Among 473 patients 294 patients given general anesthesis. Axillary brachial piexus block(141 cases), intraveonus regional anesthesia(10 cases), interscalene block(2 cases) and continuous brachial plexus block were given to the rest of the patients. 2) 267 patients were male and 106 patients were female. Age distribution was from 2 to 74 years. 3) Physical status of the patients was A.S.A. (American Society of Anesthesiologists) class 2(52.5%), class 1(43.4%), class 3(4.4%) in the order. 47.2% of the patients underwent emergency operation. 4) There was a tendency that regional anesthesis has been increasing year by year. 5) The type of operations were open reduction(160cases), tendon repair(112cases), and surgery for neuropathy(65 cases). 6) The operations for upper arm, elbow, and forearm were performed mostly under general anesthesia, while regional anesthesia prevailled for hand, wrist, and digits operations. 7) Brachial plexus block was considered as a method of choice for upper extremity surgery, especially for emergency surgical procedures in patients with significant medical problems. 8) A new method was tried in which a flexible disaposable intravenous catheter was introduced into the neurovascular sheath in the axilla and used for injection of local anesthetic solutions to block the axillary brachial plexus. The catheter method constitutes an interesting alternative to the conventional needle techniques and offers a continuous axillary block and a method for postoperative pain relief.
Age Distribution ; Anesthesia, Conduction ; Anesthesia, General ; Arm ; Axilla ; Brachial Plexus ; Catheters ; Elbow ; Emergencies ; Female ; Forearm ; Hand ; Humans ; Male ; Needles ; Orthopedics ; Pain, Postoperative ; Tendons ; Upper Extremity* ; Wrist

The vasoactive effecs of ketamine on aortic and pulmonary arteries have not heen clearly characterized. Nevertheless, it has been recommended to avoid ketamine in systemic and pulmonary hypertension because of its tendency to increase systemic and pulmonary vascular resistance. This study was designed to investigate and compare the direct effects of ketamine on isolated rat aortic and pulmonary arteries, with or without intact endothelium. The optimal resting tension (Lmax) of each ring was searched hased on contractile responses to 3.7X10(6)M norepinephrine. Once the Lmax was Obtained, the peak developed tension was recorded as the control. Thereafter, in the second part of the experiments, prior to ketamine exposure, the endothelium was denuded which was confirmed pharmacologically using norepinephrine(3.7X10-6M) and acetylcholine(10(-6)M). In groups with intact endothelium, .3X10(3)M ketamine relaxed aortic and pulmonary artery ring by -10.3+/-5.6%, -17.8+/-4.4%, respectively. In groups without intact endothelium, 3X10(3)M ketamine relaxed aortic and pulmonary artery ring by -9.9+/-3.6%, -14.2+/-3.8%, respectively. It was statistically significant. In groups with or without intact endothelium, 0.1X10(3) M ketamine relaxed aortic and pulmonary artery ring. Hut it was statistically insignificant. We conclude that ketamine is a powerful aortic and pulmonary artery dilator in vitro and that is endothelium independent.
Animals ; Aorta* ; Endothelium ; Hypertension, Pulmonary ; Ketamine* ; Norepinephrine ; Pulmonary Artery* ; Rats* ; Vascular Resistance

A retrospective analyis was performed on 12,212 pediatric patients who had received operations from 1986 to 1988 in eight operating rooms, Seoul National University Childrens Hospital (SNUCH). The average distribution of the patient by department in descending order was pediatric surgery 24%, cardiothoracic surgery 17%, orthopedic surgery 16%, otolaryngology 13%, plastic surgery 11%, ophthalmology 10%, urology 8%, neurosurgery 3% and others 0.2%. Ophthalmology and urology share one operating room each other, why they have some limitations in performing operations. Total number of operations showed increasing tendency; 3,285 in 1986, 4,185 in 1987 and 4,742 in 1988, which were 27.4% increase in 1987 and 13.3% increase in 1988, compared with the previous year. The average age distribution in descending order was 42% in group between 2 and 5 years, 29% in group between 6 and 10 years, 13% in group between 1 month and 1 year, and over 10 years respectively and 3% in group under 1 month. The male to female ratio was 62% to 38%. Elective and emergency surgeries comprised 92.6% and 7.4%, respectively. Emergency pediatric surgery was the highest in number (16.4% of all surgeries and 48.9% of all emergency surgeries performed in the pediatric operating rooms). Pediatric operating room utility ratios for each departments increased year by year, especially utility ratios for ophthalmology and orthopedic surgery were 118% and 115%, respectively. The number of patients supported by medical insurance showed also increasing tendency; 72.5% in 1986, 74.1% in 1987 and 80.8% in 1988.
Age Distribution ; Child ; Emergencies ; Female ; Humans ; Insurance ; Male ; Neurosurgery ; Operating Rooms ; Ophthalmology ; Orthopedics ; Otolaryngology ; Retrospective Studies ; Seoul ; Surgery, Plastic ; Urology