Thirty one free vascularized fibula bone grafts were performed for treatment of osteonecrosis of the femoral head in 26 patients, 24 men and 2 women aged from 16 to 48(mean:32 years). Twenty one patients had unilateral disease. Five patients had bilateral disease underwent staged bilateral free vascularized fibula grafts three months apart. Associated etiological factors included alcohol(9 patients), steroid(7 patients), and trauma(one patient). The condition was considered idiopathic in the remaining 9 patients. Radiologic staging by Ficat included stage 1 in one hip, stage II in 15 hips, stage III in 14 hips, and stage IV in one hip. A skin island flap was used for monitoring purpose for the grafted fibula. One monitoring, flap was necrotized due to vascular occlusion but the fibula bone graft was left in place to use as a nonvascularized bone graft. Average follow-up period was 21 months in 31 hips. Pain was relieved in 28 hips(93.3 percent) and aggravated in 2 hips(6.7 per cent). On radiographic evaluation, 26 hips(86.7 per cent) demonstrated excellent preservation of the femoral head contour. Progressive collapse of the femoral head (greater than 1-2 mm) occurred in 2 hips, i mm depression in one hip with stage III and 2 mm collapse in one hip with stage IV. In conclusion, the free vascularized fibula bone graft is an excellent treatment modality for preserving the femoral head and relieving symptoms in cases of the osteonecrosis of the femoral head.
Depression ; Female ; Fibula* ; Follow-Up Studies ; Head* ; Hip ; Humans ; Male ; Osteonecrosis* ; Skin ; Transplants

We report a case of secondary anetoderma due to pilomatricoma. A 15-year-old girl presented with a soft, 1.5 × 1.5cm in size, atrophic, pinkish and bulged-out lesion overlying the palpable subcutaneous mass on the left upper arm for several months. Histologic examination revealed the reduced number of dermal elastic fibers overlying a typical pilomatricoma.
Adolescent ; Anetoderma* ; Arm ; Elastic Tissue ; Female ; Humans ; Pilomatrixoma*

We report a case of secondary anetoderma due to pilomatricoma. A 15-year-old girl presented with a soft, 1.5 × 1.5cm in size, atrophic, pinkish and bulged-out lesion overlying the palpable subcutaneous mass on the left upper arm for several months. Histologic examination revealed the reduced number of dermal elastic fibers overlying a typical pilomatricoma.
Adolescent ; Anetoderma* ; Arm ; Elastic Tissue ; Female ; Humans ; Pilomatrixoma*

No abstract available.
Blood Donors* ; Chungcheongnam-do* ; Humans

PURPOSE: Diagnosis of a hemodynamically significant patent ductus arteriosus (PDA) that should be treated is difficult to determine by clinical and echocardiographic examination. The purpose of this study is to clarify the usefulness of diastolic flow velocity (DFV) of the left pulmonary artery (LPA) determined by echocardiography in the assessment of significant PDA in preterm infants. METHODS: Clinical and echocardiographic findings, including DFV in LPA, of PDA were evaluated at 24 hours, 48-72 hours of age and after indomethacin treatment in thirty-nine infants ranging from 25 to 34 gestational weeks of age. DFVs of the study group (N=13) with significant PDA were compared with those of healthy control group (N=26) without significant PDA. RESULTS: DFVs in healthy preterm infants were high in the first few days and were significantly decreased after spontaneous ductal closure. DFVs in preterm infants with significant PDA who underwent indomethacin treatment were significantly higher than that of healthy control infants. After indomethacin treatment, DFVs in this study group remained high with continuing significant PDA and markedly decreased with disappearance of significant PDA. Until ductus arteriosus closed, DFVs showed a significant correlation with the magnitudes of ductal shunt. A cutoff value for DFV of 30 cm/sec showed a sensitivity of 77% and a specificity of 92% as a predictor of significnat PDA in preterm infants. CONCLUSION: Measurement of DFV in LPA by echocardiography is a useful method for assessing the significnat PDA which may require treatment in preterm infants.
Diagnosis* ; Ductus Arteriosus ; Ductus Arteriosus, Patent* ; Echocardiography ; Humans ; Indomethacin ; Infant ; Infant, Newborn ; Infant, Premature* ; Pulmonary Artery* ; Sensitivity and Specificity

Cushing's syndrome associated with nodular adrenal glands will be divided into four main categories: adrenal adenoma, adrenal carcinoma, primary pigmented nodular adrenal dysplasia (PPNAD) and macronodular adrenal hyperplasia(MAH). The term macronodular adrenal hyperplasia is restricted to the presence of multiple nodules visible to the naked eye, ranging in size from 0.5 to 7.0 cm. We report a case of Cushings syndrome caused by bilateral macronodular adrenal hyperplasia (MAH). A 45-year-old man presented with Cushingoid features, hypertension and diabetes mellitus. Urine free cortisol was 449.9 mmol/day(27-276) and were not suppressed after administration of low-dose and high-dose dexamethasone. Plasma ACTH was very low(1.87 pmol/L(18)) and was not stimulated by administration of ovine CRH. In abdominal CT, both adrenal glands were markedly enlarged and nodular in appearance. Pituitary MRI showed no abnormal finding. Bilateral adrenalectomy was done. Histologic examination revealed multiple nodules and internodular hyperplasia. This case and other reports suggested that because of variable biochemical, radiologic and pathologic findings, macronodular adrenal hyperplasia represents a heterogeneous group of patients with varying degrees of adrenal autonomy.
Adenoma ; Adrenal Glands ; Adrenalectomy ; Adrenocorticotropic Hormone ; Cushing Syndrome ; Dexamethasone ; Diabetes Mellitus ; Humans ; Hydrocortisone ; Hyperplasia ; Hypertension ; Magnetic Resonance Imaging ; Middle Aged ; Plasma ; Tomography, X-Ray Computed

Background: Whole body scan using 131-iodine is performed to detect local recurrence or metastasis after thyroidectorny in differenciated thyroid cancer patients. The sensitivity of this procedure is related to the dose of radiopharmaceutical administered. It was reported that 131I posttreatment whole body scan demonstrate foci of tracer uptake not previously observed in diagnostic scan in 10~30% of cases. Posttreatment scans were most likely to reveal new foci in young patients(<45) and patients who had previously received radioactive iodine therapy. Method: We observed the frequency of discordant posttreatment scans and analysed the clicnical significance in 33 differenciated thyroid cancer patients who were admitted for radioiodine ablation from June, 1995 to April, 1996. Results: In 7 cases(21.2%), post treatment scan demonstrated cme or more foci of uptake and revealed less sites of uptake than diagnostic scan in 3 cases(9.1%). In one case with elevated thyroglobulin level and negative diagnostic scan, post treatment scan revealed new uptake sites with thyroid bed and cervical 1ymph node. The sites of discordant uptake were cervical lymph nodes in 4 cases and rnediastinal lymph node in one case, lung in one case, thyroid bed and cervical lymph nodes in one case, 3 cases of 7 pts(43%), demonstrated ane or more foci of uptake in post treatment scan, had history of previous radioiodine treatent. Conclusion: Post treatment scan confirmed uptake into remnant and metaststic tissues identified on the corresponding low dose diagnostic scans. Scanning after high dose radioiodine treatment frequently demonstrated one or more foci of uptake, especially in patients with previous radioiodine treatment, which were not visualized on the diagnostic low dose scan. Treatment scan may be useful for detection of remnant tissue or metastatic lesion in patients with elevated thyroglobulin and negative diagnostic scan.
Humans ; Iodine ; Lung ; Lymph Nodes ; Methods ; Neoplasm Metastasis ; Recurrence ; Thyroglobulin ; Thyroid Gland ; Thyroid Neoplasms ; Whole Body Imaging

The trial of external quality assessment for inborn error of metabolism was performed in 2003. A total 10 specimens for neonatal screening tests were distributed to 43 laboratories with a response rate of 83%. All the control materials were sent as a filter paper form. Each laboratory replied the test result as the screening items they were doing as a rountine test at the reception of the specimen among PKU screening, neonatal TSH, neonatal T4(total/free), galactosemia screen, homocytinuria screen and histidinemia screen. The mean, SD, and CV were analyzed.
Galactosemias ; Infant, Newborn ; Korea* ; Mass Screening ; Metabolism* ; Neonatal Screening

Background: The shelf life policies for central supply department (CSD) sterilized items and other devices should be determined by the healthcare facility's infection control program. We investigated effect of the sterility integrity of the CSD sterilized packs by wrapping-materials, storage period and environment to modify and extend current shelf-life. Methods: The first phase study was from May to October in 2000 and the second phase study was planned to extend further the shelf-life of the sterile packs from April 2001 to June 2002. Six hundred and fourty packs containing small gauze with four wrapping materials(100 times and 50 times washed two-ply reusable cotton, disposable craft paper, and disposable new pouch bag) and the 104 returned set after their shelf-life were stored on the top or middle of shelves or closed cabinets and storage durations from 1 to 20 weeks in the first phase study. The test packs were collected weekly and cultured in the laboratory. Five hundred seventy-six test packs were prepared with three wrapping materials (except 50 times washed cotton and returned set) and stored in the same location as the First phase study and collected and cultured monthly after three months storage (from July 2001) for one year in the second phase study. The temperature and relative humidity was monitored whenever the test pack was collected. Results: The gauze in the test packs were not contaminated until 154 days in the first study phase and until 423 days in the second phase study. The temperature and relative humidity of storage locations were 25.9degrees C and 55.2% in the first phase study and 26.0degrees C and 45.9% in the second phase study, respectively. Conclusions: There was no difference in the sterility integrity of the test packs with different wrapping materials. storage locations and environments. and storage durations. It was possible to extend shelf-life from two weeks to three and six months in the study hospital.
Delivery of Health Care ; Humidity ; Infection Control ; Infertility

PURPOSE: This study aimed to investigate body shape perception, weight control behaviors and eating habits of adolescent girls in urban, suburban and rural areas of Korea to obtain basis for establishing adequate weight control program for adolescent. METHODS: From May 2002 to November 2002, a cross-sectional questionnaire survey and physical examination were conducted to examine body shape perception, weight control behaviors, eating habits and health status of 2,891 adolescent girls and 891 boys in Seoul, Ansan and Paju. RESULTS: The proportion of underweight adolescent girl was decreased in rural area than in urban area. 46.3% of girls considered themselves to be somehow or very obese. Notably 3.2% of underweight girls considered themselves obese. 57.9% were unsatisfied with their own body shape. The proportion of dissatisfaction increased with age and body mass index (BMI), but there were no differences among area. The experiences of weight control increased by age, BMI and dissatisfaction of own body shape. The eating attitudes test-26 (EAT-26) score of girls was significantly higher than that of boys. The girls with high risk of eating disorder were 10.9%. And risk factors of eating disorder were living in urban area, severe stress for weight control excessive expenditure for appearance and think themselves unhealthy. CONCLUSION: The findings of this study demonstrate that there were serious impairment of body shape perception of adolescent girls and unhealthy, inadequate weight control behaviors were widely done. Therefore adequate weight control program for adolescent girl should be established promptly.
Adolescent ; Body Image ; Body Mass Index ; Eating ; Feeding and Eating Disorders ; Feeding Behavior ; Female ; Health Expenditures ; Humans ; Korea ; Physical Examination ; Surveys and Questionnaires ; Risk Factors ; Thinness ; Weight Loss ; Weight Perception