Changes of blood pressure, heart rate, ECG, respiration rate and pupil size by intracerebroventricular(ICV) infusion of hypertonic NaCl with 0.04 ml/min for 5 min(total 0.2ml) were observed in urethane-anesthetized rabbits. ICV infusion of 0.75M NaCl produced slight pressor effect (11mmHg) and did not affect other parameters. ICV infusion of 1.5M NaCl began to increase blood pressure from 2~3 min after the infusion and produced maximal increase(24mmHg) at 5~10 min. Then the pressor effect was recovered to the original level at 30~60 min. Change of heart rate by the infusion was not clear, but ST-segment of ECG was markedly depressed. Respiration rate increased about 1.5 times than the control in accordance with the pressor effect and the state was continued even after the recover of the pressor effect. Both pupils dilated markedly and light-reflex was lost. Changes of parameters by ICV infusion of 3.0M NaCl were similar to those by 1.5M NaCl and some rabbits caused severe arrhythmias and died. The purpose of present study is to investigate the mechansim(s) of the pressor effect induced by the ICV infusion of 1.5M NaCl. The pressor effect of 1.5M NaCl was attenuated by the continuous infusion of vasopressin antagonist(20microm/kg/min) but not affected by intravenous treatment with 2mg/kg phentolamine, 2mg/kg propranolol and 1mg/kg chlorisondamine. The pressor effect was not altered with ICV 0.12mg/kg phenoxybenzamine, 0.4mg diltiazem, 0.1mg/kg mecamylamine and 0.2mg/kg atropine. After ICV infusion of 25microg/kg/min of diazepam, however, the pressor effect was completely abolished and restored 3~4 hours after stopping diazepam infusion. The pressor effect was rather potentiated than inhibited in bilateral adrenalectomized or nephrectomized rabbits. Infusion of 2microg/kg/min of saralasin for 10 min in the bliateral adrenalectomized rabbit did not affect the pressor effect at all. These results suggest that hypertensive effect induced by ICV infusion of hypertonic NaCl is mediated by the increase of vasopressin secretion.
Arrhythmias, Cardiac ; Atropine ; Blood Pressure ; Chlorisondamine ; Diazepam ; Diltiazem ; Electrocardiography ; Heart Rate ; Infusions, Intraventricular* ; Mecamylamine ; Phenoxybenzamine ; Phentolamine ; Propranolol ; Pupil ; Rabbits* ; Respiratory Rate ; Saralasin ; Vasopressins

PURPOSE: Thyroid hormone is essential for normal growth and development. The aim of this study was to evaluate the factors affecting final adult height in patients with congenital hypothyroidism. METHODS: The study group was comprised of 42 patients who were diagnosed as congenital hypothyroidism and attained final adult height. Retrospectively, we reviewed medical records as to clinical and laboratory data. We analyzed the influence of various factors on final adult height(FAH) in patients with congenital hypothyroidism. RESULTS: The mean chronologic age at initiation of treatment was 5.85+/-4.32 years and the FAH deviation score(SDS) was -1.21+/-1.14. The age at initiation of treatment, the chronologic age, the mean dose of L-thyroxine of current treatment, and the bone age delay at initiation of treatment were negatively related to the FAH SDS(P<0.05). The height SDS at initiation of treatment and the height SDS at initiation of puberty were positively related to the FAH SDS(P<0.05). Analyzing according to etiology, the FAH SDS of dyshormonogenesis, thyroid aplasia, thyroid ectopia, and thyroid hypoplasia were 0.16+/-0.27, -1.15+/-0.97, -1.45+/-1.07, and -2.70+/-1.70 respectively(P<0.05). CONCLUSION: The younger the age at initiation of treatment and the chronologic age, and the more the mean dose of L-thyroxine of current treatment and the bone age delay at initiation of treatment, The higher the final adult height SDS. The higher the height SDS at initiation of treatment and the height SDS at initiation of puberty, the final adult height SDS were the higher.
Adolescent ; Adult* ; Congenital Hypothyroidism* ; Growth and Development ; Humans ; Medical Records ; Puberty ; Retrospective Studies ; Thyroid Dysgenesis ; Thyroid Gland ; Thyroxine

Local anesthesia for arthroscopic procedure of the knee is an increasinglv popular technique that avoids the use of general anesthesia and the associated risks of respiratory depression, aspiration, and postoperative sedation. Many authors, for example McGinty etc., Martin, Yoshiya etc., advocated local anesthesia as safe and efficient method for arthroscopic procedures of the knee. We performed arthoroscopy of the knee under local anesthesia on 150 patients for diagnostic and operative purposes between January l993 and December l996. The technique of local anesthesia that we used was that 20cc of 0.5%; bupivacaine with I:200,000 epinephrine was injected into superolateral portal of the knee joint and additional 10-20cc ot 1% lidocaine into the arthroscopic portals. Pnevmatic tourniquet wa, not applied in all cases. We analysed the 150 cases and the results were as follows; The diagnostic arthroscopy was performed in 50 cases and the operative arthroscopy was in 100 cases. The duration ot local anethesia was from 4 hours to 12 hours, with an average of 6 hours. In 35 cases arthroscopy was performed as outpatient procedure and average hospital stay excluding other problem was 5 days. No complication related to systemic toxicity by local anesthetics was observed. Conclusively arthroscopy of the knee under local anesthesia is safe and effective procedure to avoid the risks of general anesthesia but patients selection is very important.
Anesthesia, General ; Anesthesia, Local* ; Anesthetics, Local ; Arthroscopy* ; Bupivacaine ; Epinephrine ; Humans ; Knee Joint ; Knee* ; Length of Stay ; Lidocaine ; Outpatients ; Respiratory Insufficiency ; Tourniquets

OBJECTIVES: This study was designed to compare the ward atmosphere of an open ward and that of a closed ward as perceived by chronic schizophrenic patients, and to and out whether the perceived ward atmosphere is associated with their quality of life, and also to get some practical suggestions for treatment policies of open wards. METHODS: Fifty-two chronic schizophrenic inpatients were selected, 26 of them were in an open ward and the remaining 26 patients were in a closed ward, in Seoul National Mental Hospital. All the patients were asked to answer the whole items of Ward Atmosphere Scale (WAS) and SCL-90-R. Objective indicators and subjective indicators of their quality of life were scored during a face to face interview using portions of Lehman's Quality of Life Interview. The subjective indicators of quality of life were combined to a single 'global quality-of-life score' and then examined for associations with other variables. All the measures were compared between the two groups. Covariate adjustments were made as needed. RESULTS: The open ward patients reported significantly higher scores on 'support', 'autonomy' and 'practical orientation' subscales among WAS in comparison with closed ward patients. The open ward patients reported higher 'global quality-of-life score' compared with the closed ward patients. These differences were also significant following covariate adjustments for demographic, clinical and objective quality of life variables. Among the WAS subscales 'order and organization'(r=0.49, p <.05) was the highest correlate of 'globol quality-of-life score' in case of open ward patients, and 'support'(r=0.59, p<.01) was the highest correlate in case of closed ward patients. CONCLUSION: The open ward patients reported better satisfaction with life, and their reported satisfaction were associated with their higher ratings on WAS.
Atmosphere* ; Hospitals, Psychiatric ; Humans ; Inpatients ; Quality of Life* ; Seoul

PURPOSE: To investigate the relationship of MIS and cryptorchidism according to the descending level of testis into scrotum, we studied expression degree of MIS by immunohistochemical analysis using anti-human MIS polyclonal antibody in testicular specimen. MATERIALS AND METHODS: MIS were stained in excised testis by trauma on each 8 patients as control group and age-matched abdominal, inguinal and prepubic cryptorchidism. The expression were classified as score 1, 2, 3 and 4 according to stained degree of percentage in randomized 16 fields(x400) under the light microscope. RESULTS: Of the degree of MIS expression in control group, 87.5% were category 3 or more. The mean score was 3.13+/-0.62. 2. Of the degree of MIS expression in abdominal type cryptorchid testis group that underwent orchiectomies, 68.7% were category 1. The mean score, 1.31 +/- 0.48, showed significant difference compared to control group(p<0.05). 3. Of the degree of MIS expression in inguinal type,56.2% were category 3 or more. The mean score, 2.63+/- 0.81, showed no significant difference compared to control group(p>0.05). 4. Of the degree of MIS expression in prepubic type, 75.0% were category 3 or more. And the mean score, 2.88+/-0.62, showed no significant difference compared to control group(p>0.05). CONCLUSIONS: Expression of MIS is different according to descending level of testis and may play a role in physiologic changes of testicular descent.
Cryptorchidism* ; Humans ; Male ; Orchiectomy ; Scrotum ; Testis*

No abstract available.
Bony Callus* ; Fractures, Bone*

The metastasis of renal cell carcinoma to the ureteral stump is very rare and only a Few cases were reported. In most cases ureteral metastasis appeared after nephrectomy. We are presenting a case of metastatic renal cell carcinoma to the ureteral stump after radical nephrectomy in a 14 years old male with brief review and literature.
Adenocarcinoma* ; Adolescent ; Carcinoma, Renal Cell ; Humans ; Male ; Neoplasm Metastasis* ; Nephrectomy ; Ureter*

PURPOSE: Ovotesticular disorder of sex development (OTDSD) is rare condition and defined as the presence of both ovarian and testicular tissues in the same individual. We aimed to investigate clinical characteristics of patients and histologic findings of gonads at diagnosis of OTDSD and to characterize patients diagnosed with gonadal tumor. METHODS: We retrospectively reviewed the records of 20 patients histologically confirmed as OTDSD between 1980 and 2009 in Seoul National University Hospital. Age, chief complaints, karyotype, external and internal genital organs at diagnosis and gonadal histology were investigated. RESULTS: Age at histologic diagnosis of OTDSD was 5.1 years of age (0.1 - 28 yr). Chief complaints at diagnosis included wide spectrum of ambiguous genitalia including hypospadia and clitoromegaly (n = 15), inguinal mass (n = 3) and gynecomastia (n = 2). Thirteen cases (65%) showed 46,XX karyotype and 24 (61.5%) of 39 gonads histologically confirmed ovotestes. Testis was found in right (83.3%), in inguinal or scrotal area (84.2%) and ovary was in left (88.9%), in pelvis or abdomen (88.9%). Three cases (15%) were diagnosed with gonadal tumor, who all had undergone gonadectomy in the second decade due to belated identification of gonad (10 yr) despite early diagnosis, incidentally developed clitoromegaly (12.9 yr), and inguinal mass (28 yr) after surgical correction of clitoromegaly at 2.9 years of age. CONCLUSION: Patients with OTDSD had wide spectrum of ambiguous genitalia including hypospadia and clitoromegaly. This study provides the importance of early diagnosis and gonadectomy in patients with OTDSD considering increased risk for gonadal tumor in the second decade.

Primary antiphopholipid syndrome (APS) is a disease producing vascular thrombus with antiphospholipid antibody without association with autoimmune diseases as systemic lupus erythematosus. Retinal vein occlusion is a rare vascular manifestation in primary APS. We describe 2 cases of primary APS presenting with developing blurred vision. Each had central retinal vein occlusion and high titer of IgG anticardiolipin antibody.
Adult ; Antibodies, Anticardiolipin/analysis ; Antiphospholipid Syndrome/*complications/immunology ; Case Report ; Human ; Male ; Middle Age ; Retinal Vein Occlusion/*etiology/immunology

OBJECTIVE: To determine the incidence of HELLP (hemolysis, elevated liver enzymes and low platelet count) syndrome and assess the relationship between the maternal-fetal complications and the severity of HELLP syndrome, classified based on platelet count nadir. METHODS: We reviewed the maternal and neonatal charts of ten pregnancies complicated by HELLP syndrome, managed at Dankook University Hospital between January, 1995 and December, 2002. Women were divided into 2 groups as class I HELLP which had a maternal platelet nadir 50,000 and 100,000/mm3. We compared the maternal and fetal complications between class I and class II HELLP syndrome. But we did not analyze statistically due to small number of patients. RESULTS: There were four cases of class I HELLP and six cases of class II HELLP syndrome. The incidence of HELLP syndrome was 0.10% (10/10,238) in total deliveries and was 2.26% (10/443) in women with severe pre-eclampsia or eclampsia. The mean level of platelet counts nadir was 41,500/mm3 in class I and 64,000/mm3 in class II HELLP. The mean platelet recovery days (more than 100,000/mm3) were 6.0 and 4.2 days in each class. The mean values of the maximal aspartate aminotransferase (AST/SGOT), alanine aminotransferase (ALT/SGPT) and uric acid might show no differences, but there might be difference in lactate dehydrogenase (LDH) levels which were 5854 and 1388 IU/L in each class. All patients with class I HELLP syndrome showed maternal complications, but only one patient with class II HELLP showed maternal complications. There might be no differences in the mean gestational ages and birth weights. The neonatal complications were similar in each class. CONCLUSION: Our data suggest that patients with class I HELLP syndrome may be at increased risk for serious maternal complications, but the neonatal complications may be associated with gestational ages.
Alanine Transaminase ; Aspartate Aminotransferases ; Birth Weight ; Blood Platelets* ; Eclampsia ; Female ; Gestational Age ; HELLP Syndrome* ; Humans ; Incidence ; L-Lactate Dehydrogenase ; Liver ; Platelet Count* ; Pre-Eclampsia ; Pregnancy ; Uric Acid