To evaluate the potential contribution of high resolution ultrasonography(US) and 99mTc scintigraphy in the routine diagnosis of thyroid nodules, we performed thyroid function tests, US, thyroid scintigraphy, and fine-needle aspiration cytology (FNAC) in all 54 patients who initially visit our surgical department for thyroid masses from March 1995 to February 1996. The final diagnoses were made by either repeated FNAC (n=39) or thyroid operations (n=15). Final diagnoses were adenomatous goiters (n=41), simple cysts (n=3), follicular adenoma (n=1), papillary carcinomas (n=8), follicular carcinoma(n=1). The diagnostic impacts of US and 99mTc scintigraphy in all 54 patients were assessed and scored according to the following criteria: when the information provided by either test supported or confirmed (and/or gave some other information for management of thyroid nodules) the final diagnosis, it received a scores of 2 or 3 respectively, while a score 1 was given when the test itself was useless for the differential diagnosis. The scores of US were higher than those of scintigraphy in the diagnoses of adenomatous goiters, cysts, adenomas and carcinomas. However, after statistical analysis with Wilcoxon's signed rank test, US was statistically superior to scintigraphy only in diagnosing adenomatous goiters. These results indicate that current findings in US for differential diagnosis of thyroid nodules are not absolutely superior to those in scintigraphy, but have some benefits in detection of occult nodules in malignancy and differential diagnosis of adenomatous goiters.
Adenoma ; Biopsy, Fine-Needle ; Carcinoma, Papillary ; Diagnosis ; Diagnosis, Differential ; Goiter ; Humans ; Radionuclide Imaging* ; Thyroid Function Tests ; Thyroid Gland* ; Thyroid Nodule*

PURPOSE: Approximately 10% of the general population in western countries have gallstones. The compositions of gallstones, however, vary with location and ethnicity. The purpose of this study is to analyze the gallbladder stones of patients in Chungbuk and mainly to compare the compositions of the gallstones with those in other reports. METHODS: The patients in this study included gallbladder stone patients (N=318) who were operated on in Chungbuk National University Hospital from January 1992 to December 1997. By gross inspection of their cut surface structures, the gallstones were classified as pure cholesterol stones, mixed stones, brown stones, and black pigment stones. The chemical compositions of the stones (N=35) that were collected during January and February 1997 were analyzed using high- pressure liquid chromatography (HPLC). RESULTS: By inspection, 31 (9.7%) stones were classified as pure cholesterol stones, 54 (17%) as mixed stones, 27 (8.5%) as brown stones, and 206 (64.8%) as black pigment stones. The results of HPLC analysis were as follows; 5 (15%) stones had cholesterol contents higher than 90% of their composition, 5 (15%) stones 50 to 90%, and 25 (70%) stones less than 20%. CONCLUSION: Of the galldder stones of patients in Chungbuk 73.3% were pigment stones. This result was compatible with the HPLC results (70% of the stones have less than a 20% cholesterol content). The classification of the gallbladder stones of the patients in Chungbuk shows that the incidence of black pigment stones is very high while that of cholesterol stones is low. The difference is even greater when compared with the data in other papers published in Korea. The causes of the difference be remained to be clarified.
Cholesterol ; Chromatography, High Pressure Liquid ; Chromatography, Liquid ; Chungcheongbuk-do* ; Classification ; Gallbladder* ; Gallstones ; Humans ; Incidence ; Korea

Nonparasitic liver cysts are usually asymptomatic and require treatment when they are symptomatic. Hence, many treatment methods, such as percutaneous aspiration, aspiration followed by injection of sclerosing agents into the cyst, excision of the liver cyst, and hepatic resection have been suggested. Recently, the laparoscopic cholecystectomy has become popular, and this method has been challenged as a treatment for symptomatic nonparasitic liver cysts. To evaluate the feasibility of using and the disadvantages of laparoscopic treatment, we reviewed the medical records of 10 patients with a symptomatic nonparasitic liver cyst who were treated by laparoscopic unroofing at the Department of Surgery, Chungbuk National University Hospital. All patients were diagnosed by USG and abdominal CT. All patients had vague abominal discomfort, abdominal distension, or indigestion. The sizes of the liver cysts varied from 7 cm to 20 cm, and half of them were located in the right lobe, the other half in the left lobe. In 5 patients, the cysts were multiple. The mean operative time was 99.5 minutes, and mean hospital stay was 8 days. The follow up period was from 3 to 37 months. Two patients required a reoperation because of cyst infection and a rapidly growing cyst. Remaining cysts were identified in 4 among 8 patients, but they did not have any symptoms. In conclusion, laparoscopic unroofing is feasible as a first choice for treatment of a symptomatic liver cyst. However, in liver cyst that are located at the dome of right side or in a thickened wall, incomplete unroofing and residual cysts can be anticipated. In this case, we suggest that open cyst excision or unroofing may be better than laparoscopic unroofing.
Cholecystectomy, Laparoscopic ; Chungcheongbuk-do ; Dyspepsia ; Follow-Up Studies ; Humans ; Length of Stay ; Liver* ; Medical Records ; Operative Time ; Reoperation ; Sclerosing Solutions ; Tomography, X-Ray Computed

Apoptosis ; Bone Regeneration ; Calcium ; Calcium Phosphates ; Cell Cycle ; Cell Proliferation ; Ceramics ; Durapatite ; Gene Expression ; Microarray Analysis ; Oligonucleotide Array Sequence Analysis ; Osteoblasts ; Osteogenesis ; Signal Transduction

OBJECTIVES: The purpose of this preliminary study is to evaluate the effectiveness of a customized, three-dimensional, preformed titanium mesh as a barrier membrane for peri-implant alveolar bone regeneration. MATERIALS AND METHODS: Ten patients were recruited for this study. At the time of implant placement, all patients had fenestration or a dehiscence defect around the implant fixture. A mixture of particulate intraoral autologous bone and freeze-dried bone allograft was applied to the defect in a 1 : 1 volume ratio and covered by the preformed titanium mesh. A core biopsy specimen was taken from the regenerated bone four months postoperatively. Patients were followed for 12 months after the definitive prosthesis was placed. RESULTS: Satisfactory bone regeneration with limited fibrous tissue was detected beneath the preformed titanium mesh. Histologic findings revealed that newly formed bones were well-incorporated into the allografts and connective tissue. New growth was composed of approximately 80% vital bone, 5% fibrous marrow tissue, and 15% remaining allograft. All implants were functional without any significant complications. CONCLUSION: The use of preformed titanium mesh may support bone regeneration by maintaining space for new bone growth through its macro-pores. This preliminary study presents the efficacy of a preformed titanium mesh as a ready-to-use barrier membrane around peri-implant alveolar bone defect. This preformed mesh is also convenient to apply and to remove.
Allografts ; Alveolar Bone Loss ; Biopsy ; Bone Development ; Bone Marrow ; Bone Regeneration* ; Connective Tissue ; Humans ; Membranes ; Prostheses and Implants ; Surgical Mesh ; Titanium*

Tsutsugamushi fever is a serious febrile disease outwardly similar to malaria and various arboviral infections. The endemic area is Asia-Pacific. This disease are generally associated with disturbed habitats favoring large populations of vector larval trombiculid mites. Therapy with tetracycline, chloramphenicol or ciprofloxacin is currently recommanded. Unfortunately these drugs is suboptimal for children and pregnant women. Recently, azithromycin has been proven to be effective in therapy of scrub typhus. There is no evidence that azithromycin causes adverse reaction to developing fetus or children. We report four cases of tsutsugamushi fever in children successfully treated with azithromycin. This is the first report describing clinical application of azithromycin to tsutsugamushi fever in Korean children.
Azithromycin* ; Child* ; Chloramphenicol ; Ciprofloxacin ; Ecosystem ; Female ; Fetus ; Humans ; Malaria ; Pregnant Women ; Scrub Typhus* ; Tetracycline ; Trombiculidae

Hand, foot and mouth disease (HFMD) is a highly contagious viral infection affecting young children during the spring to fall seasons. Recently, serious outbreaks of HFMD were reported frequently in the Asia-Pacific region, including China and Korea. The symptoms of HFMD are usually mild, comprising fever, loss of appetite, and a rash with blisters, which do not need specific treatment. However, there are uncommon neurological or cardiac complications such as meningitis and acute flaccid paralysis that can be fatal. HFMD is most commonly caused by infection with coxsackievirus A16, and secondly by enterovirus 71 (EV71). Many other strains of coxsackievirus and enterovirus can also cause HFMD. Importantly, HFMD caused by EV71 tends to be associated with fatal complications. Therefore, there is an urgent need to protect against EV71 infection. Development of vaccines against EV71 would be the most effective approach to prevent EV71 outbreaks. Here, we summarize EV71 infection and development of vaccines, focusing on current scientific and clinical progress.
Animals ; Appetite ; Blister ; Child ; China ; Disease Outbreaks ; Enterovirus* ; Exanthema ; Fever ; Foot-and-Mouth Disease ; Hand ; Hand, Foot and Mouth Disease ; Humans ; Korea ; Meningitis ; Models, Animal ; Paralysis ; Seasons ; Vaccines*

Dentigerous cysts are common odontogenic cysts that are associated with the crown of the tooth and typically develop from single lesions. Bilateral and multiple dentigerous cysts are very rare and occur in patients with syndromic conditions. This paper presents a case report of a 15-year-old male patient that experienced non-syndromic bilateral dentigerous cysts that simultaneously occurred in all four dental quadrants around the unerupted third molars. Clinicians should confirm the extent of cystic lesions using a panoramic view and computed tomography, and should keep the possibility of bilateral dentigerous cysts in mind as a potential diagnosis, even in a non-syndromic patient.
Adolescent ; Crowns ; Dentigerous Cyst* ; Diagnosis ; Humans ; Male ; Molar, Third ; Odontogenic Cysts ; Tooth

Gallstone ileus is caused by mechanical obstruction of the gastrointestinal tract by the gallstone and accounts for 1~3% of all intestinal obstructions. Endoscopic sphincterotomy (EST) is the accepted treatment of choice for choledocholithiasis. Recognized complications of EST include bleeding, acute pancreatitis, retroperitoneal perforation. However, gallstone ileus is a rare complication of EST. A 70-year-old woman was admitted to our hospital with right upper quadrant pain. Abdominal ultrasound revealed single common bile duct (CBD) stone. ERCP was performed to remove the large CBD stone without mechanical lithotripsy. Nausea, vomiting and abdominal pain were developed after stone removal. Plain abdomen X-ray and computerized tomography represented marked dilatation of small bowel loops without definite obstructive lesion. Because the mechanical obstruction was sustained, explorolaparotomy was performed. On the operation, single stone was impacted at the distal ileum, narrowed by previous radiotheraphy. We reported a case of gallstone ileus after the removal of CBD stone following EST without lithotripsy.
Abdomen ; Abdominal Pain ; Aged ; Cholangiopancreatography, Endoscopic Retrograde ; Choledocholithiasis ; Common Bile Duct ; Dilatation ; Female ; Gallstones* ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Ileum ; Ileus* ; Intestinal Obstruction ; Lithotripsy ; Nausea ; Pancreatitis ; Sphincterotomy, Endoscopic* ; Ultrasonography ; Vomiting

Neuronal ceroid lipofuscinosis, which is also known as Batten-Bielschowsky disease, is a group of neuro degenerative disorders, associated with various progressive symptoms including seizures, dementia, visual loss and cerebral atrophy. We experienced a case of late infantile neuronal ceroid lipofuscinosis in a 6-year-old boy who had progressive myoclonic seizures, ataxia, rapid psychomotor deterioration and visual loss. Photic stimulation at 2 to 5 Hz elicited a discrete spike and wave discharges in the occipital region on an electroencephalogram. Magnetic resonance imaging of the brain showed generalized cerebral and cerebellar atrophy. An electron microscopic examination of the skin revealed characteristic curvilinear inclusion bodies. An optic fundoscopy revealed a devastated retina and severe optic atrophy. We report this case with the brief review of related literature.
Child ; Human ; Male ; Neuronal Ceroid-Lipofuscinosis/*diagnosis/pathology/physiopathology ; Support, Non-U.S. Gov't