BACKGROUND: The relation between clinical characteristics and a change of thymid functions in patients with hyperemesis gavidarum(HO) has not been well described. In order to clarify this characteristics, we evaluated thyroid function in patients with HG and compared the relationship to clinical characteristics of gestational thyrotoxicosis and hyperemesis. METHODS: From March, 1991, to April, 1997, 20 patients were admitted to the department of obstetrics in Chonbuk National University Hospital because of HG. We examined clinical characteristics of patients with HG(age, marrital age, levels of educations, obstetrical history, gestational duration, vomiting duration, degree of weight loss, infant's birth weights, duration of pregnancy). Thyroid functions, liver functions and serum electrolytes was measured. Also, we compared to the clinical characteristics of patients with HG according to thyroxine concentration. RESULTS: An increased free thyroxine concentration was observed m 65% of 20 pregnancies complicated by severe HG. The level of serum ALT was greater in thyrotoxicosis patients(91.2+-76.6 IU/L, mean +-SD) than normothyroxemic patients(20.3+-12.7 IU/L, P=0.027). Also, increased level of serum AST was observed in patients with HG. In patients with thyrotoxicosis, the long durations of vomiting was observed. CONCLUSIONS: Increased free thyroxine concentration is found in severe HG. Because the relatively higher risk for thyrotoxicosis, patients with severe hyperemesis, they must be evaluated about thyroid functions.
Birth Weight ; Electrolytes ; Humans ; Jeollabuk-do ; Liver ; Obstetrics ; Pregnancy ; Thyroid Gland* ; Thyrotoxicosis ; Thyroxine ; Vomiting ; Weight Loss

No abstract available.
Endocrine Cells* ; Fetus* ; Humans* ; Immunohistochemistry*

It is generally accepted that ectopic bone should be removed after full maturation. Removal of immature ectopic bone was attempted combined with immidiate postoperative irradiation to suppress its recurrence. The authors report two cases immature heterotropic bone resection around elbow joint followed by 2000 Rad midplane irradiation given in ten fractions over fourteen days. The results obtained are as follows: 1. There was no evidence of recurrence after removal of immature ectopic bone. 2. Improved range of joint motion was observed during 3 months and 6 months posteroperatively.
Elbow Joint ; Joints ; Osteogenesis ; Recurrence

Six cases of lunate dislocation were treated in the departments of orthopaedic surgery, Hangang Sacred Heart Hospital and Kangnam Sacred Heart Hospital, Hallym College during the period from March 1, 1978 to August 31, 1982. The results were as follows; l. Among the total 6 cases, two cases had lunate dislocation only and the other four had associated injuries of the same wrist joints. 2. Marupulative reduction was successful in only one case. Five cases were treated by open reduction, and for four of them internal fixation was tried. 3. Postoperative roentgenograms showed acceptable reductions in all cases except one which redislocation occurred. This case showed lunate dorsiflexion instability and was treated with extensor carpi radialis longus tenodesis. 4. The cases with pure lunate dislocation yielded better functional recovery than those with associated carpal injuries.
Dislocations ; Heart ; Tenodesis ; Wrist Joint

BACKGROUND: The prevalence of ovat hyperthyroidism ar hypothyroidism has been estimated up to 5% in the general populatian. Subclinical hyperthyroidism and subclinical hypothyroidism have pevalences of approximately 1% and 6%, ectively. The prevalence of hypothyroidism may be associated with excessive intake of iodine in iodine sufficient areas. Therefore, we assumed the prevalence of thyroid dysfunction in Karea might be different from those af Western cauntries. However, thete have been no surveys to examine the prevalence of thyroid dysfunction in Karea. We performed the study to investigate the prevalence of thyrotoxicosis and hypothyroidism in Korean adults. METHODS: This study was performed in 15019 subjects (8275 men, 6744 women; between 17 and 87 years of age) visited in health promotion center of Samsung Medical Center for 12 months in 1996. Serum T3, T4, and TSH concentrations were measured with RIA or IRMA using commercial kits. History of thyroid dysfunction and current medication were obtained from medical records. The criteria for thyrotoxicosis were TSH level below than 0.30 mU/L and increased T3 or T4 levels (T3 > 3.1 nmol/L or T4 > 152 nmol/L). Patients who had TSH level above than 5.0 mU/L and T4 level below than 77 nmol/L met the criteria for hypothyroidism. RESULTS: The prevalence of thyrotoxicosis was 5.5/1000 population (men 3.6/1000, women 7.7/1000) with peak prevalence in fifth decade. The prevalence of previously undiagnosed thyrotoxicosis was 4.0/1000 (men 2.9/1000, women 5.3/1000). The prevalence of hypothyroidism was 2.8/1000 population (men 1.1/1000, women 4.9/1000) with peak prevalence in seventh decade. The prevalence of previously undiagnosed hypothyroidism was 1.6/1000 (men 0.6/1000, women 2.S/1000). The prevalence of subclinical thyrotoxicosis was 12.4/1000 population (men 11.8/1000, women 13.0/1000). The prevalence of subclinical hypothyroidism was 18.2/1000 population (men 11.2/1000, women 26.7/1000) which frequency was increased with age. CONCLUSION: Although the prevalence of thyrotoxicosis and hypothyroidism was not significantly different from those of other countries, it was lower than expected and female preponderance is not significant. The prevalence of subclinical thyrotoxicosis and subclinical hypothyroidism was lower than those of other countries. The prevalence of subclinical hypothyroidism was higher in women and old ages. (J Kor Soc Endecrinol 14:301~313, 1999)
Adult ; Female ; Health Promotion ; Humans ; Hyperthyroidism ; Hypothyroidism* ; Iodine ; Male ; Medical Records ; Prevalence* ; Thyroid Gland ; Thyrotoxicosis*

Multiple endocrine neoplasia (MEN) Ila is an inherited disease characterized by the development of medullary thyroid carcinoma, pheochromocytoma and hyperparathyroidism. It has been shown to be associated with germ-line mutatians in the RET proto-oncogene. Presymptomatic screening of medullary thyroid carcinoma in MEN IIa families enables the early diagnosis of this tumor with its significant morbidity, We describe a 19-year-old woman fmm a MEN IIa family who was founded by DNA analysis to be a gene carrier of MEN IIa and then was diagnosed, using a pentagastrin stimulation test, as having presymptomatie medullary thyroid carcinoma She underwent thyroidectomy and histologic examination confirmed medullary thyroid carcinoma. It is cancluded that direct genetic analysis for mutations in the RET proto-oncogene should be the diagnstlc test of choice for identifying family members at risk for MEN IIa and thyroidectomy on the basis of genetic analysis is a rational course of action.
DNA ; Early Diagnosis ; Female ; Genes, vif ; Humans ; Hyperparathyroidism ; Male ; Mass Screening* ; Multiple Endocrine Neoplasia ; Multiple Endocrine Neoplasia Type 2a* ; Pentagastrin ; Pheochromocytoma ; Proto-Oncogenes ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy ; Young Adult

BACKGROUND: An increase in oxidative stress has been suggested to play major roles in the complications of diabetes. The bulk of the experimental data favors enhanced free radicals in diabetes and antioxidant defense mechanisms may be reduced in diabetes. Melatonin, the major secretory product of the pineal gland has been shown to be a potent and specific hydroxyl radical scavenger. The purpose of our study was to determine the antioxidative effeet of melatonin in streptozotocin-induced diabetic rats. METHODS: Sprague-Dawley rats weighing 200-240 g were divided into 3 groups: normal controls(n-7), diabetic contmls(n-9), melatonin-treated diabetic animals(n-9). Diabetes was induced by intraperitoneal injection of streptozotoein(55 mg/kg body weight) and melatonin(6 mg/kg body weight) was orally administered for 20 days. At day 20 after streptozotocin administration, blood was collected for the assay of glucose, albumin and cholesterol. Erythrocyte membrane lipid peroxidation was determined by malonyldialdehyde(MDA) reactivity. RESULTS: 1) The MDA resctivity of erytbrocyte membrane in melatonin-treated diabetic animals (meanstandard deviation: 5.52+-1.52nmol/ml packed cells) were lower(p<0.05) than that in diabetic controls(7.68+-1.16nmol/mL packed cells). But, there was no significant difference between melatonin-treated diabetic animals and normal contls(4.93+-1.19 nmol/mL packed cells). 2) There were no significant differences of blood glucose and body weight between diabetic controls and melatonin-treated diabetic animals. CONCLUSION: These results show the antioxidative effect of melatonin in streptozotocin-induced diabetic rats. Further clinical and long-term experimental studies are needed to assess the effect of melatonin on development and progression of diabetic complications.
Animals ; Blood Glucose ; Body Weight ; Cholesterol ; Defense Mechanisms ; Diabetes Complications ; Erythrocyte Membrane ; Free Radicals ; Glucose ; Hydroxyl Radical ; Injections, Intraperitoneal ; Lipid Peroxidation ; Melatonin* ; Membranes ; Oxidative Stress ; Pineal Gland ; Rats* ; Rats, Sprague-Dawley ; Streptozocin

When a surgeon fails to save intracranial segement of the facial nerve and can not identify the proximal segment of the facial nerve due to severe adhesion or severe brain stem compression by the tumor, the interpositional graft has no place in helping this patient. Hypoglossal-facial nerve (XII-VII) direct side to end anastomosis is the effective facial reanimation technique used in such a case. This technique compensates for the drawbacks of classical XII-VII anastomosis, and the bothersome strong mass movement and hemiparalysis of the tongue. We recently experienced a case where XII-VII direct side-to-end anastomosis was applied. We report our case with literature review.
Brain Stem ; Facial Nerve ; Facial Paralysis ; Humans ; Hypoglossal Nerve ; Tongue ; Transplants

BACKGROUND: Low levels of serum vitamin D is associated with several lung diseases. The production and activation of matrix metalloproteinases (MMPs) may play an important role in the pathogenesis of emphysema. The aim of the current study therefore is to investigate if vitamin D modulates the expression and activation of MMP-2 and MMP-9 in human lung fibroblasts (HFL-1) cells. METHODS: HFL-1 cells were cast into three-dimensional collagen gels and stimulated with or without interleukin-1beta (IL-1beta) in the presence or absence of 100 nM 25-hydroxyvitamin D (25(OH)D) or 1,25-dihydroxyvitamin D (1,25(OH)2D) for 48 hours. Trypsin was then added into the culture medium in order to activate MMPs. To investigate the activity of MMP-2 and MMP-9, gelatin zymography was performed. The expression of the tissue inhibitor of metalloproteinase (TIMP-1, TIMP-2) was measured by enzyme-linked immunosorbent assay. Expression of MMP-9 mRNA and TIMP-1, TIMP-2 mRNA was quantified by real time reverse transcription polymerase chain reaction. RESULTS: IL-1beta significantly stimulated MMP-9 production and mRNA expression. Trypsin converted latent MMP-2 and MMP-9 into their active forms of MMP-2 (66 kDa) and MMP-9 (82 kDa) within 24 hours. This conversion was significantly inhibited by 25(OH)D (100 nM) and 1,25(OH)2D (100 nM). The expression of MMP-9 mRNA was also significantly inhibited by 25(OH)D and 1,25(OH)2D. CONCLUSION: Vitamin D, 25(OH)D, and 1,25(OH)2D play a role in regulating human lung fibroblast functions in wound repair and tissue remodeling through not only inhibiting IL-1beta stimulated MMP-9 production and conversion to its active form but also inhibiting IL-1beta inhibition on TIMP-1 and TIMP-2 production.
Collagen ; Emphysema ; Enzyme-Linked Immunosorbent Assay ; Fibroblasts* ; Gelatin ; Gels ; Humans ; Interleukin-1beta ; Lung Diseases ; Lung* ; Matrix Metalloproteinase 9 ; Matrix Metalloproteinases ; Polymerase Chain Reaction ; Reverse Transcription ; RNA, Messenger ; Tissue Inhibitor of Metalloproteinase-1 ; Tissue Inhibitor of Metalloproteinase-2 ; Trypsin ; Vitamin D* ; Wounds and Injuries

BACKGROUND: Although cardiopulmonary resuscitation(CPR) is a very effective therapy in cardiac arrest, it is hard to prove the true effectiveness of CPR. Several studies about out-of-hospital and emergency department CPR exist, but only a few reports about in-hospital CPR are available. This study was designed to investigate in-hospital cardiac arrest, to analyze the result of CPR, and to evaluate the problems associated with in-hospital CPR. METHODS: A clinical analysis of 71 cases of in-hospital CPR announcement from January 2000 to August 2000 was performed. The initial rhythm on cardiac arrest, return of spontaneous circulation(ROSC), and the survivals were analyzed in the case of the 46 true cardiac arrest patients. RESULTS: During 8 months, there were 71 cases of in-hospital CPR announcement. Among them, there were 46 cases of true cardiac arrest and 25 cases of non-cardiac arrest. Of the 46 true cardiac-arrest cases, 27(58.7%) experienced ROSC, 15(32.6) survived for over 24 hours, and 7(15.2%) survived to be discharged. The initial rhythms on cardiac arrest were 30 cases(65.2%) of asystole, 14(30.4%) of PEA(pulseless electrical activity), and 2(4.3%) of ventricular fibrillation, with ROSC being 17 cases(56.7%), 9(64.3%) and 1(50.0%) cases and discharged survivors being 4 cases(13.3%), 3(21.4%) and 0(0.0%) cases, respectively. CONCLUSION: Extraordinarily high proportions of asystole and PEA were seen in the initial rhythm of cardiac arrest, and those were associated with high survival rates. Although further study is needed to evaluate the course leading to this high proportion of asystole and PEA, this result suggests that if the EMS system in the hospital is activated promptly and systematically, a better outcome will be achieved in case of cardiac arrest with asystole and PEA.
Cardiopulmonary Resuscitation* ; Emergency Service, Hospital ; Heart Arrest ; Humans ; Peas ; Survival Rate ; Survivors ; Tertiary Care Centers* ; Ventricular Fibrillation