PURPOSE:This study was performed to investigate the status of cardiac structure and function and to assess their alterations after growth hormone(GH) treatment in children with growth hormone deficiency(GHD). METHODS:Interventricular septal thickness and left ventriclular posterior wall thickness, ejection fraction(EF), fractional shortening(FS), systolic time interval(STI) of left ventricle were measured by two-dimensional and M-mode echocardiography in sixteen children with GHD and age, sex matched sixteen children with GH normal short stature as control. The measure were done before GH treatment and at 6 and 12 months of GH treatment, respectively. RESULTS: 1)Left ventricular posterior wall thickness in GHD group was significantly thinner than that of control group(P<0.05). 2)Interventricular septal thickness and left ventricular posterior wall thickness were increased with GH treatment from 10.4+/-1.7mm, 8.1+/-1.8mm before GH treatment to 11.0+/-0.9mm, 8.7+/-0.7mm and 11.2+/-1.7mm, 9.7+/-1.8mm at 6 and 12 months of GH treatment, respectively. The increment of left ventricular posterior wall thickness after 12 months GH treatment revealed statistic significance(P<0.05). 3)There was no significant alterations of EF, FS, STI of left ventricle after GH treatment at 6 months and 12 months, respectively. CONCLUSION: Left ventricular posterior wall thickness in GHD group was significantly thin compared to that of control group(P<0.05). GH treatment in GHD children for 12 months, resulted statistically significant increase(P<0.05) in posterior wall thickness. There is no evidence of hypertrophic cardiomyopathy after GH treatment. But we could not exclude the possibility of these alterations were induced by an increased overall body size and body surface area after GH treatment. To clarify the exact alterations of cardiac structures and function in children with GHD after GH treatment, long term follow-up studies should be necessary.
Body Size ; Body Surface Area ; Cardiomyopathy, Hypertrophic ; Child* ; Echocardiography ; Follow-Up Studies ; Growth Hormone* ; Heart ; Heart Ventricles ; Humans

The aim of the present study is to demonstrate the usefulness of intraoperative fine needle aspiration (FNA) of pancreatic lesions in 30 patients. A conclusive diagnosis was done in 27 patients and the diagnoses of three patients were deferred. No complications followed the procedure. Based on histologic findings of the resected specimens in 20 cases and of cell blocks in 10 cases, the final diagnoses were adenocarcinoma in 19 cases, chronic pancreatitis in nine cases and tuberculosis in two cases. The sensitivity, specificity and diagnostic accuracy were 95%, 100% and 96% resepectively and there were no false positives. The smear of aspirate was stained with toluidine blue and examined by light microscope. The presence of there-dimensional clusters of disoriented cells and the increased nuclear/cytoplasmic ratio with large prominent nucleoli were the most helpful criteria for a diagnosis of malignancy in the pancreas. The intraoperative FNA of pancreatic lesions was considered as a simple, safe, and highly specific and sensitive tool in differentiating benign from malignant lesions. The intraoperative FNA can be recommended as the first tool of choice of intraoperative diagnostic procedure in lesions of the pancreas.
Child ; Male ; Female ; Humans ; Adenocarcinoma

In recent years, with increased number and higher speed of the automobiles, the incidence of the so-called whiplash injury has been increasing. The author had studied the clinical symptoms and signs, roentgenographic findings, associated injuries and treatment of the sixty four patients who had admitted to the Yonsei Medical Center under the diagnosis of the whiplash injury excluding the patients who had sustained an associated injuries those may cause neurologic symptoms and signs during the period of eight years from January, 1972 to December, 1979. and sumnerized the results as followings. 1. Among the sixty four patients, thirty one (48.4%) were male and thirty three (51.6%) were female. The most prevalent age were third and fourth decades (62.5%). 2. The causes were rear-end collision, falling of a car, front-end collision, falling of an airplane in an air-pocket and sudden deceleration of a car in the order of frequency. 3. The admission period were longest in the cases of falling of a car (13.3 days) and shortest in the cases of sudden deceleration of a car (9.4 days). 4. Fifty one (79.7%) were returned to the general activity in two weeks and fifty seven (89.1%) were out of the hospital in three weeks. 5. On admission. the patients were suffered from the symptoms and signs as followings, headache, limitation of the motion in neck, neckache, paresthesia, dizziness and dysphagia in the order of frequency. 6. Roentgenograms show loss of lordotic curve in twenty eight (43.7%) and prevertebral swelling in seven (10.3%). 7. Thirty six (56.3%) were associated with other injuries as followings; multiple contusion, teeth injuries, scalp laceration. There were thirteen cases (36.1%) of cerebral concussion. 8. In all the cases, we used analgegics and muscle relaxants until the neck pain subsided. We had performed cervical traction, hot packs in selected cases. Twelve (18.8%) needed cervical braces or Thomas collar at discharge.
Accidental Falls ; Aircraft ; Automobiles ; Braces ; Brain Concussion ; Clinical Study ; Contusions ; Deceleration ; Deglutition Disorders ; Diagnosis ; Dizziness ; Female ; Headache ; Humans ; Incidence ; Lacerations ; Male ; Neck ; Neck Pain ; Neurologic Manifestations ; Paresthesia ; Scalp ; Tooth Injuries ; Traction ; Whiplash Injuries

The simple chest X-ray study is essential in diagnosis of pulmonary tuberculosis, especially primary pulmonarytuberculosis. Authers analyzed the chest films and tuberculin tests of 521 cases which are suspected primarypulmonary tuberculosis coinically, from Jan. 1978 to Nov. 1982 at Seoul Red Cross Hospital. The results are asfollows; 1. Among the total 521 cases, the 115 cases of chst film reveal 245 probable pulmonary tuberculouslesions. 2. The coincidence of the parenchymal and lymphnodal involvement are observed in 40 cases (34.8%) with137 lesions(55.9%), parenchymal only in 23 cases (20.0%) with 25 lesions(10.2%) and lymphnodal only in 52 cases(45.2%) with 83 lesions(33.9%). 3. In observing the distribution of the 83 parenchymal lesions, the right lung istwo times as common as that of the left, being the highest in the RLL field with 41 lesions(49.4%), the lowest inthe LLL field with 3 lesions(3.6%). 4. In observing the distribution of the 162 lymphnodal lesions, there are 95lesions(58.6%) in the right and 67 lesions(41.4%) in the left, involving hilar nodes with 150 lesions(92.6%) andmediastinal nodes with 12 lesions(7.4%). The incidence of unilateral involvement is 13 cases (11.3%) and bilateral79 cases (68.7%). 5. Among the total 245 lesions, 141 lesions(57.9%) are smaller than rice in size, 120lesions(49.0%) are amophous in shape and 186 lesions(75.9%) are mainly calcific in density. According to theincrease of age, count and detection rate of the lesion on the chest film are increased. 6. Tuberculin testsshowed 26.1% negative rate in 115 tuberculous cases, and 51% positive rate in 406 negative chest cases.
Diagnosis ; Incidence ; Lung ; Red Cross ; Seoul ; Thorax ; Tuberculin ; Tuberculin Test ; Tuberculosis ; Tuberculosis, Pulmonary

Biliary ascariasis is a rare complication of intestinal ascaris infestation. Retrograde migration of the adult worm through the papilla of Vater causes biliary colic, and may give rise to pancreatic and biliary obstruction, choledocholithiasis, cholecystitis, cholangitis, hemobilia, and if the worm lodges in intrahepatic bile ducts, to liver absceases. In the past, treatment of biliary ascariasis has usually involved the direct removal of ascaris throagh a surgical choledochatomy and subsequent saline lavage of the common duct through an indwelling T tube. Recently, the worm in the bile duct can be seen by ERCP and it can be removed during the endoscopic procedure. A 55-year-old woman with intermittent colicky right upper quadrant abdominal pain was admitted to out hospital. Abdominai sonogram disclosed an echogenic structure within a mildly dilated common bile duct and a high ehogenic structure with acoustic shadowing in the distal common bile duct(CBD), which suggests a CBD stone. ERCP after obtaining the sonogram revealed a thick, long, linear, smooth filling defect in the CBD with a distal CBD stone. A distal CBD stone was removed by sphinctetotomy and lithotripsy, then we directly extracted ascaris with a tripod forcep without any complication.
Abdominal Pain ; Acoustics ; Adult ; Ascariasis* ; Ascaris ; Bile ; Bile Ducts ; Bile Ducts, Intrahepatic ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis ; Cholecystitis ; Choledocholithiasis ; Colic ; Common Bile Duct* ; Female ; Hemobilia ; Humans ; Lithotripsy ; Liver ; Middle Aged ; Shadowing (Histology) ; Surgical Instruments ; Therapeutic Irrigation

No abstract available.
Aorta, Thoracic* ; Blood Flow Velocity* ; Female ; Hypertension, Pregnancy-Induced* ; Pregnancy ; Umbilical Arteries*

Paraganglioma is a benign tumor arising in the paraganglion system scattered throughout the body, but its cytopathologic findings arenot well known. We experienced a case of paraganglioma of carotid body diagnosed by fine needle aspiration. The patient was a 30 year-old female who suffered from the left neck mass for 3 years. The mass was 3x3crn in size without pulsation or bruit. Cytologically, the smear revealed aggregated and singly scattered tumor cells having abundant pale cytoplasm and indistinct cell borders. Their nuclei were round to oval, but enlarged nuclei were occasionally observed. The nuclear membrane was smooth with fine clumping of chromatin. Differentiation from metastatic follicular carcinoma of the thyroid gland was difficult.
Adult ; Biopsy, Fine-Needle ; Carotid Body ; Chromatin ; Cytoplasm ; Female ; Glomerulosclerosis, Focal Segmental* ; Humans ; Neck ; Nephrotic Syndrome* ; Nuclear Envelope ; Paraganglioma ; Thyroid Gland

Rupture of Achilles tendon was first reported by Pare, 1575 and thereafter the cause and the diagnostic and therapeutic methods of the ruptured tendon have been described by many workers. Rupture of the Achilles tendon is often wrongly diagnosed and inadequately treated by the doctor who first sees it, with consequent problems of treatment and prognosis. In this paper 24 patients(25 cases)
Achilles Tendon ; Female ; Follow-Up Studies ; Humans ; Male ; Methods ; Prognosis ; Rupture ; Tendons

Congenital dislocations of the hip are all present at birth. Therefore if adequate examination of all newborn infants is done regularly, it should theoretically never be seen in adolescents or adults. Both the pathogenesis and management of congenital dislocation of the hip remain controversial topics. Closed reduction of simple congenital dislocations of the hip with retention in frog position was introduced by Lorenz. After this great efforts to receive these patients for treatment as early as possible were made by investigators. Also numerous surgical procedures and modifications have been used. Congenital dislocations of the hip were known to be uncommon in Korea. Nevertheless adolescents with untreated dislocations were not rarely met. The author studied congenital dislocation of the hip for sex incidence, X-ray findings, birth history, relation with combining anomaly and the results of treatment, In this study, 39 cases of congenital dislocation of the hip, treated at the Orthopedic Department of Severance Hospital during 7 years and 6 months from July, 1970 until December, 1977, were reviewed. The results of this study are as follows: 1. The annual number of the patients who were treated at Severance Hospital has not changed markedly. 2. The number of female patients was much greater than males. The ratio of female to male was 9 to 1. 3. The incidence of bilateral involvement was relatively low compared to the western coutries. 4. Congenital anomaly associated with congenital dislocation of hip occurred in about 7.8%. 5. The acetsbular index, C-E angle, Y-coordinate and height on affected hips are aggrevated according to the increment of age. 6. Closed reduction was satiafactory in 16 cases among 22 cases under the age of 3, but 4 cases were treated by operation. 7. Open reduction was performed in 8 cases, Salter's innominate osteotomy in 8 cases, Colonna's capsular arthroplasty in 2 cases, and supracondylar osteotomy in 2 cases.
Adolescent ; Adult ; Arthroplasty ; Clinical Study ; Dislocations ; Female ; Hip ; Humans ; Incidence ; Infant, Newborn ; Korea ; Male ; Orthopedics ; Osteotomy ; Parturition ; Reproductive History ; Research Personnel

The lumbosacral joint is an unstable area from an anatomical yiewpoint, while it is also a very mobile area in ordinary life, so that clinically major causes of low back pain originate in this joint The purpose of this study is to assess the differences in the efiicacy of the lumbosacral angles among low back pain patients. The following lumbosacial angles were measured and evaluated in 65 patients with only low back pain, in 70 patients with spondylolysis, and in 51 patients with spondylolisthesis. 1. Ferguson angle. 2. Sacrovertebral angle. 3. L-5 horizontal angle. 4. Meschan angle. 5. Line of weight bearing. 6. Wedging of the lumbar spine. 7. Interrelationship between slipping and wedging of the lumbar spine. The results are as follows: 1. The Ferguson angle was increased in spondylolisthesis, 2. The L-5 horizontal angle was increased in spondylolisthesis, meaning unstability of the lumbosacral joint. 3. There was no interrelationship between stability of the lumbosacral joint and the sacro-vertebral angle. 4. The Meschan angle indicated high sensitivity in spondylolisthesis, but the changes were also observed in some of the other back pain patients. 5. Most of the cases showed instability when judged by the line of weight bearing. This was especially true in spondylolisthesis. 6 The lumbar index was in 92.7% of simple low back pain patients, 82.2% in spondylolysis, and 80.2% in spondylolistheysis, The average wedging of the L-5 vertebra was significantly greater in spondylolysis and spondylolisthesis than in patients without slipping of the vertebral body. 7. The degrees of wedging and of slipping showed a statistically valid correlation, although their etiological relationship remains to be further investigated.
Back Pain ; Humans ; Joints ; Low Back Pain ; Spine ; Spondylolisthesis ; Spondylolysis ; Statistics as Topic ; Weight-Bearing