PURPOSE:The project of the neonatal mass screening test for inborn errors of metabolism are just at the beginning in Korea and there was a few reports about the overall incidence and subtypes of congenital hypothyroidism. METHODS:In this study, we analysed the 97 cases of newborns with hyperthyrotropinemia who were detected by neonatal screening test to identify the incidence and early clinical manifestations of each subtypes of congenital hypothyroidism. Thyroid function were measured by thyrotropin(TSH) level, T4, T3, Free T4, Free T3, thyroglobulin, T3 resin uptake, TBII, TBG in serum, thyroid ultrasonography and 99mTc thyroid scan. We reanalysed the thyroid functions 1 week after discontinuance of L-thyroxine treatment for 1 year. RESULTS: 1) The time of neonatal screening test were between 3 and 7 days after birth in 46 cases(47.4%) and 8 and 14 days after birth in 35 cases(36.1%). Two cases (2.1%) were done neonatal screening test at the age of 2 days old. 2) The major cause of thyroid disorders were primary hypothyroidism in 45 cases of the total due to thyroid aplasia(7 cases), thyroid hypoplasia(17 cases), ectopic thyroid gland(12 cases) and dyshormonogenesis(9 cases). Other causes of thyroid disorders were TBG deficiency(11 cases), TBG dysfuction(1 case), transient hyperthyrotropinemia(28 cases) and transient hypothyroidism(12 cases). 3) Serum level of thyrotropin(TSH) at diagnosis were 223.5+/-229.6microU/ml in thyroid aplasia, 41.6+/-42.9microU/ml in thyroid hypoplasia, 52.4+/-55.6microU/ml in ectopic thyroid gland. TSH levels were significantly high in thyroid aplasia. T4 levels in thyroid aplasia are 1.7+/-2.0microg/dl and this is significantly lower than other types of thyroid disorders. T3 levels were within normal range except in thyroid aplasia and TBG deficiency. 4) Prolongation of physiologic jaundice was the most common clinical manifestation(33.3%) in patients with primary hypothyroidism and macroglossia, hypothermia, umbilical hernia and cold skin were the next commom clinical manifestations in order to present. 5) Osseous development was normal in 57 cases(82.6%) out of 69 cases who accomplished roentgenographic examination of knees. Only 12 cases(17.4%) showed retardation of osseous development, but there was no significant differences between types of thyroid disorders. 6) Most of the newborn(93.3%) with primary hypothyroidism started to treatment within 8 weeks of age. 7) Initial dosage of L-thyroxine was 10microg/kg/day and decreased 6 to 12 months after treatment. 8) There was significantly decreased thyroid uptake of 99mTc after 1 year follow-up in 5 cases of dyshormonogenesis. 9) The serum TSH levels returned to normal ranges within 6 month after treatment in transient hypothyroidism and transient hyperthyrotropinemia. CONCLUSIONS:Special attention should be paid to transient hyperthyrotropinemia and transient hypothyroidism because many of the congenital thyroid disorders showed transient type and it is necessary to establish the diagnostic guideline to early detect these transient types of congenital thyroid disorders.
Congenital Hypothyroidism ; Diagnosis ; Follow-Up Studies ; Hernia, Umbilical ; Humans ; Hypothermia ; Hypothyroidism ; Incidence ; Infant, Newborn ; Jaundice ; Knee ; Korea ; Macroglossia ; Mass Screening ; Metabolism, Inborn Errors ; Neonatal Screening* ; Parturition ; Reference Values ; Skin ; Thyroglobulin ; Thyroid Dysgenesis ; Thyroid Gland* ; Thyroxine ; Ultrasonography

The present study was undertaken to determine the pattern of infestation with the encysted larvae of digenetic trematodes in freshwater fish collected in both the natural and fish breeding ponds in Kyungpook Province, Korea. The fish collected in the two natural ponds, Nass-chil, and Sa-il, and three fish breeding ponds, Deok-dong, Mo-gok, and Seongryu-tunnel, were examined from July 1980 to August 1981. The data were compared with the results obtained from freshwater fish caught in the river Kumho by Hwang and Choi(1980). Ten species of fish caught in the ponds were examined for the presence of the larval trematodes. Seven species of the larvae, Clonorchis sinensis, Cyathocotyle orientalis, Echinochasmus species, Exorchis oviformis, Metacercaria hasegawai, Metagonimus yokogawai, and Metorchis orientails and two kinds of undetermined cyst A and B were found. The infestitation rate for Clonorchis sinensis metacercaria in the Korean shiner, Gnathopogon atromaculatus collected in the natural ponds was higher than the rate in the river Kumho by Hwang and Choi(1980), but lower in the fish collected in the breeding ponds. By contrast, the infestation rate in the flat bitterling, Paracheilognathus rhombea in ponds was higher, while there was no change of the rate in the southern top-mouthed minnow, Pseudorasbora parva. The intensity of infestation, expressed as the average number of Clonorchis sinensis metacercaria per gram of flesh, were lower than in the bullhead, Coreobagrus brevicorpus, and Gnathopogon atromaculatus in the ponds in 1981. The intensity was higher in Paracheilognathus rhombea, but no fluctuation in the intensity of infestation in Pseudorasbora parva was observed. The infestation rates and densities for the encysted larvae of digenetic trematodes except for Clonorchis sinensis varied from fish to fish. However, it was found that the rate and intensity of the larval trematodes from all the fish in the ponds was lower than from those in the rivers in Kyungpook Province, Korea.
parasitology-helminth-trematoda ; Clonorchis sinensis ; Cyathocotyle orientalis ; Echinochasmus species ; Exorchis oviformis ; Metacercaria hasegawai ; Metagonimus yokogawai ; Metorchis orientails ; Pseudorasbora parva ; Coreobagrus brevicorpus ; Gnathopogon atromaculatus ; Paracheilognathus rhombea ; Carassius carassius ; Coreoperca herzi ; Cyprinus carpio ; Lipomis macrochirus ; Moroco oxycephalus ; Zacco platypus ; epidemiology

No abstract available.

A 34-year-old woman presented with several intensely pruritic erythematous serpiginous thread-like skin lesions which began as a small papule on the epigastrium 4 months prior to her visit and was migrating to the left chest area. The laboratory examination showed eosinophilia and the total serum IgE level was slightly increased. Histopathologic examination revealed a pustular burrow in the epidermis with a larva-like cystic lesion apart from the burrow in the epidermis. The patient was treated with topical 10 % albendazole cream 3 times daily for 1 week without recurrence for 22 months up to now. We thought this was a rare case which was confirmed by a skin biopsy showing larva in the epidermis.
Adult ; Albendazole ; Biopsy ; Eosinophilia ; Epidermis ; Female ; Humans ; Immunoglobulin E ; Larva ; Larva Migrans* ; Recurrence ; Skin ; Thorax

No abstract available.
Enbucrilate* ; Facial Bones*

PURPOSE: To evaluate criteria for differentiating benign versus malignant solitary pulmonary nodules (SPNs) by analyzing their morphology and perinodular parenchymal changes on CT/HRCT. MATERIALS AND METHODS: We retrospectively reviewed the CT/HRCT in 99 patients with SPN. Sixty two cases were proved by surgery, PCNA, clinical follow up and etc. Thirty seven cases were diagnosed by typical benign calcification. We defined SPN as a discrete, single lesion in the lung with margins that are sharp enough to permit measurement of diameter. We excluded lesions more than 4cm in diameter and lesions with cavity from our study protocol. The study included 41 malignant nodules and 58 benign nodules. RESULTS: Mean diameter of malignant nodule was 2.9cm, benign nodule was 2.2cm. Peripheral location of nodule was 28 in malignant nodules, 50 in benign nodules. Typical benign calcification was observed in 37 tuberculoma and three hamartoma. Lobulated margin was noted in 32 malignant nodules and 14 benign nodules. Spiculated margin was observed in 17 malignant nodules and 20 benign nodules. Low attenuation within the nodule was observed in 14 malignant nodules and 12 benign nodules. Pleural tail was observed in 14 malignant nodules and 31 benign nodules. Air bronchogram was noted in 18 malignant nodules and 4 benign nodules. Juxta nodular tuberculosis was observed in 6 malignant nodules and 29 benign nodules. CONCLUSION: Malignant nodules were larger than benign nodules and more commonly demonstrated a Iobulated contour and air bronchogram (p<0.05). Benign nodules more commonly demonstrated low density in the nodule and associated with juxta nodular tuberculosis and peripheral location (p<0.05). Spiculated margin and pleural tail were not helpful to differentiate benign from malignant nodule.
Follow-Up Studies ; Hamartoma ; Humans ; Lung ; Proliferating Cell Nuclear Antigen ; Retrospective Studies ; Solitary Pulmonary Nodule* ; Tuberculoma ; Tuberculosis

PURPOSE: To evaluate criteria for differentiating benign versus malignant solitary pulmonary nodules (SPNs) by analyzing their morphology and perinodular parenchymal changes on CT/HRCT. MATERIALS AND METHODS: We retrospectively reviewed the CT/HRCT in 99 patients with SPN. Sixty two cases were proved by surgery, PCNA, clinical follow up and etc. Thirty seven cases were diagnosed by typical benign calcification. We defined SPN as a discrete, single lesion in the lung with margins that are sharp enough to permit measurement of diameter. We excluded lesions more than 4cm in diameter and lesions with cavity from our study protocol. The study included 41 malignant nodules and 58 benign nodules. RESULTS: Mean diameter of malignant nodule was 2.9cm, benign nodule was 2.2cm. Peripheral location of nodule was 28 in malignant nodules, 50 in benign nodules. Typical benign calcification was observed in 37 tuberculoma and three hamartoma. Lobulated margin was noted in 32 malignant nodules and 14 benign nodules. Spiculated margin was observed in 17 malignant nodules and 20 benign nodules. Low attenuation within the nodule was observed in 14 malignant nodules and 12 benign nodules. Pleural tail was observed in 14 malignant nodules and 31 benign nodules. Air bronchogram was noted in 18 malignant nodules and 4 benign nodules. Juxta nodular tuberculosis was observed in 6 malignant nodules and 29 benign nodules. CONCLUSION: Malignant nodules were larger than benign nodules and more commonly demonstrated a Iobulated contour and air bronchogram (p<0.05). Benign nodules more commonly demonstrated low density in the nodule and associated with juxta nodular tuberculosis and peripheral location (p<0.05). Spiculated margin and pleural tail were not helpful to differentiate benign from malignant nodule.
Follow-Up Studies ; Hamartoma ; Humans ; Lung ; Proliferating Cell Nuclear Antigen ; Retrospective Studies ; Solitary Pulmonary Nodule* ; Tuberculoma ; Tuberculosis

PURPOSE: High flow rate (FR) and pressure limit (PL) strategy with time-cycled pressure-limited (TCPL) ventilator is employed routinely in the neonates. Theoretical basis of this strategy is the two-compartment theory that the lung with acute respiratory failure consists of units with different compliance and resistance. But such constant pressure strategy has the risk of ventilator induced lung injury. We compared the ventilatory indices and clinical outcomes of two different strategies, high FR-constant pressure and low FR-constant FR in the ventilator care of the neonates with acute respiratory failure. METHODS: For the neonates born in our hospital and treated with mechanical ventilation from March to August in 1997, two different ventilator strategies were employed randomly with flow control ventilator. In the high-FR group, the FR was fixed at 10 L/ min and the PL was adjusted according to the arterial blood gas analysis (ABGA) results. In the low-FR group, the FR was adjusted to 10 mL/kg of tidal volume. Sixty neonates were enrolled, 32 in high-FR and 28 in low-FR group. Ventilatory indices and clinical outcomes were statistically cornpared in the two groups. RESULTS: Perinatal factors were not different in the two groups. Initial ventilator settings, ABGA results and ventilatory indices were not different. The tidal volume, fraction of inspired oxygen, peak inspired pressure and oxygenation index were higher and dynamic compliance was lower in the high-FR group compared to the low-FR group after 3 to 72 hours of ventilator care. In clinical outcomes, incidences of pulmonary interstitial emphysema, pneumothorax and chronic lung disease were significantly lower in the low-FR group. CONCLUSION: Low-FR with constant FR strategy resulted in better clinical outcomes in the ventilator care of neonates. We conclude that constant FR strategy prevents damage of the better compliant lung units and decreases the incidence of acute and chronic complications of ventilator care.
Blood Gas Analysis ; Compliance ; Emphysema ; Humans ; Incidence ; Infant, Newborn* ; Lung ; Lung Diseases ; Oxygen ; Pneumothorax ; Respiration, Artificial ; Respiratory Insufficiency* ; Tidal Volume ; Ventilator-Induced Lung Injury ; Ventilators, Mechanical

STUDY DESIGN: Changes of morphology and phenotype of cultured cells in media added lactate were observed. OBJECTIVES: To evaluate the effect of lactate on morphology and phenotype of cultured intervertebral disc cell. SUMMARY OF LITERATURE REVIEW: It was reported that lactate and pH were important factor in the degeneration of intervertebral disc. However the effect of lactate on morphology and phenotype of cultured intervertebral disc cell have not been studied. MATERIALS AND METHODS: Cells were dissociated enzymatically from rabbit nucleus pulposus. After attaining monolayer growth, the cells were incubated in media added 2mM or 5mM lactate. Total cell counts and morphological changes of the cells were periodically observed. Changes in cell phenotype were investigated by use of anti-collagen antibody stain. RESULTS: The cell groups added no lactate and 2mM lactate showed no difference in cell counts, morphology and phenotype. The cell group added 5mM lactate showed a reduction in final cell Counts and highel'ratio of fibroblastic cell in total population. Anti-collagen I Ab stained the Intra-and extra-cellular area of fibroblastic cells and intracellular area of chondrocytic cells. CONCLUSIONS: The current study suggests that high concentration of lactate inhibit intervertebral disc cell proliferation and accelerate morphological and phenotypical change to fibroblastic cell.
Cell Count ; Cell Proliferation ; Cells, Cultured ; Fibroblasts ; Hydrogen-Ion Concentration ; Intervertebral Disc* ; Lactic Acid* ; Phenotype*

No abstract available.
Animals ; Dietary Fats* ; Rats*