No abstract available.
Thyroid Gland*

Acute suppurative thyroiditis is uncommon in children. The relative rarity of thyroid infection is thought to reflect its complete fibrous encapsulation, generous vascular and lymphatic supply and high local iodine level. The bacterial involvement include the normal oropharyngeal microflora, and broad spectrum antibiotic therapy including anaerobic coverage should be utilized initially. We have experienced three cases of acute suppurative throiditis. All of them had painfull swelling on anterior cervical area and diagnosed by clinical and radiological features. Since two of them occured repeatedly, we report with brief review of literatures.
Child* ; Humans ; Iodine ; Thyroid Gland ; Thyroiditis, Suppurative*

Hyperglycemia is a well-recognized side effect of L-asparaginase in remission induction therapy of acute lymphocytic leukemia. Since hyperglycemia has preceded fatal diabetic ketoacidosis or hyperosmotic nonketotic coma in some patients, early detection and treatment of this complication are important. We determined retrospectively the risk of hyperglycemia in 117 patients with leukemia who had received L-asparaginase (& prednisolone). The results were as follows: 1) Twenty (17%) of the 117 patients developed hyperglycemia. 2) Of 47 female patients, 13 developed hyperglycemia, contrast with only 7 of 70 male patients(P<0.05). 3) All 2 obese patients developed hyperglycemia, contrast with 18 of 115 non obese patients (P<0.05). 4) Of 16 patients with a history of previous administration of L-asparaginase 6 (42%) developed hyperglycemia, contrast with only 14 (11%) of the remaining 101 patients (P<0.05). 5) Of the remaining factors analyzed-age, leukocyte counts, family history, dose of L-asparaginase-non had a statistically important influence on the development of hyperglycemia. 6) The mean glucose concentration at onset was 355+/-197.5mg/dl in patient who developed hyperglycemia with peak concentration of 404+/-253.6mg/dl. Hyperglycemia developed between 3 to 20 days after administration of L-asparaginase, and the duration of hyperglycemia was 6.90+/-5.54 days. Since hyperglycemia developed inevitably in a certain proportion of patients given L-asparaginase, we recommend blood glucose monitoring in patients with the risk factors.
Blood Glucose ; Child* ; Coma ; Diabetic Ketoacidosis ; Female ; Glucose ; Humans ; Hyperglycemia* ; Leukemia* ; Leukocyte Count ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Remission Induction ; Retrospective Studies ; Risk Factors*

No abstract available.
C-Peptide* ; Child* ; Diabetes Mellitus* ; Histocompatibility Testing* ; Humans ; Insulin* ; Islets of Langerhans*

Sixty-six cases of nontraumatic osteonecrosis of the femoral head were treated with multiple drilling using 9/64 inch Steinmann pin from May, 1992 to March, 1996. In this study, the results of the cases that were followed more than 2 years were analyzed. Thirty-three hips of 32 patients were included in this study. One case was lost to follow after the last follow-up at postop 19 months. Diagnosis was made by simple x-ray and MRI in all cases. The stage was classified according to the modified Fic.t classification. The extent of lesion was evaluated on coronal and sagittal images of MRI. Multiple drilling was performed with the patients on fracture table under C-arm control using 9/64 Steinmann pin held on a low speed power drill. Depending on the size of lesions, 4 to 13 holes were drilled into head from the lateral cortex of proximal femur. The average duration of follow-up was 30 months (range, 8-48 months). When a head collapsed or was converted to THRA for any reason, the case was determined to be a failure. There were 14 Ficat stage I, 16 stage IIA, I stage IIB and 2 stage III hips. The extent of lesion was ranging from 10 to 88% with an average of 49%. There were 7 cases of failure (overall success rate, 78%). In 4 cases, collapse of head was detected at postop 12, 14, 14 and 19 months and 3 of them were converted to THRA. Three cases were converted to THRA at postop 8, 21 and 41 months because of recurred pain without collapse on x-ray. Ectopic ossification around drill entry site was the only complication and was detected in 9 cases. Even though the follow-up period is short, multiple drilling of small diameter is very simple procedure and the short-term results were encouraging in early stage osteonectosis.
Classification ; Diagnosis ; Femur ; Follow-Up Studies ; Head* ; Hip ; Humans ; Magnetic Resonance Imaging ; Ossification, Heterotopic ; Osteonecrosis

Coronary artery disease (CAD) and peripheral vascular disease (PVD) are significant medical problems worldwide, including Korea. Although substantial progress has been made in prevention and treatment of these diseases, particularly CAD, there are still a large number of patients, who despite maximal medical treatment have substantial symptomatology, so are not suitable for mechanical revascularization. Therapeutic angiogenesis represents a novel, conceptually appealing, treatment option for these patients. Consequently, there are several different products in clinical trials looking at the various angiogenic growth factors. A number of small, mostly open-labeled phase I or I/II, studies have been conducted with adeno- and plasmid-based vascular endothelial growth factor (VEGF) and fibroblast growth factor (FGF) gene constructs in CAD and PVD. Although these studies have provided intriguing indications of the possibility of new vessel formation, and that these new vessels could be functional, these studies have been too small to allow definite conclusions on their potential efficacy to be drawn. Although, larger scale placebo-controlled studies of gene transfer are in progress. Future clinical studies will be required to determine the optimal dose, formulation, route of administration and combination of growth factors, as well as the requirement for endothelial progenitor cell, or stem cell supplementation, to provide effective and safe therapeutic angiogenesis. This exciting new field is reviewed, with special emphasis on clinical trials.
Angiogenesis Inducing Agents ; Cardiovascular Diseases* ; Coronary Artery Disease ; Fibroblast Growth Factors ; Genetic Therapy* ; Humans ; Intercellular Signaling Peptides and Proteins ; Korea ; Myocardial Ischemia ; Peripheral Vascular Diseases ; Stem Cells ; Vascular Endothelial Growth Factor A

Background. Ultimate goal for the treatment of the deformities in the lower extremities is to minimize the energy requirement and conserve the energy on walking and daily living. The normal energy saving mechanism is usually broken down in the patients with the deformities in the lower extremity, and they need more energy consumption. This is the reason why they feel fatigue frequently. It is well known that the deformity in the lower extremity cause excessive energy consumption. Objectives. There is no report that compared the energy consumption according to the deformities of the lower extremity. When we decide the priority of the treatment in cases of multiple deformities, it will be important to understand the energy demand according to each deformity. Therefore, it is the purpose of this study that assess the energy consumption according to the various types of lower extremity deformities. Method. We induced the multiple deformities in ten normal adults with the brace artificially. The induced deformities are as follows: Equinus deformity; mild (10degrees), moderate (20degrees), severe (30degrees), Knee flexion deformity; mild (10degrees), moderate (20degrees), severe (30degrees), Hip flexion deformity; mild (10degrees), moderate (20degrees), severe (30degrees). For the control group, same braces were applied without any deformity. Oxygen consumption was measured for the energy consumption with the Oxygen Consumption Meter (Morgan Oxylog II, Morgan Ltd. England). Heart rate was checked with the Telemonitor (Dynascope, Fukuda Ltd, Japan). We evaluated the inspired volume, oxygen rate, oxygen cost, and heart rate in each group and compared the data among the groups. Result. Energy consumption was higher in the hip deformity group, in the knee deformity group, and in the ankle deformity group in that order. Conclusion. When there are concomitant deformities in hip, knee and ankle, the priority of treatment may be hip, knee and ankle, in that order in terms of energy consumption.
Adult ; Ankle ; Braces ; Congenital Abnormalities* ; Equinus Deformity ; Fatigue ; Heart Rate ; Hip ; Humans ; Joints* ; Knee ; Lower Extremity* ; Oxygen ; Oxygen Consumption ; Walking

Uterine perforation is a serious complication in users of intrauterine devices for contraception. Authors encountered one case of displacement of Copper-T IVD into urinary blpossibly due to uterine perforation on insertion of the Copper-T IUD in a 28 year old 1-multipara, who experienced normal intrauterine pregnancy in the circumstances. This patient was in silent, asymptomatic condition and underwent cesarean section. And Copper-T IUD was removed under the cystotomy. So we report one case with brief review of literatures
Adult ; Asymptomatic Diseases ; Cesarean Section ; Contraception ; Copper* ; Cystotomy ; Female ; Humans ; Intrauterine Devices ; Pregnancy ; Urinary Bladder* ; Uterine Perforation

The author studied the functional derangement of blood-retinal barrier induced by destruction of the pigment epithelial cells of the retina. Sodium iodate, which was well known to exert a selectively destructive action to the retinal pigment epithelial cells, was injected to the rabbits intravenously(60mg/kg of body weight). Eyes were enucleated 2 days and 4 days after sodium iodate injection and examined by electron microscope. Some of the tissue were fixed in colloid lanthanum, to investigate the changes of the permeability of plasma membrane in accordance with cellular damages induced by sodium iodate. The permeability of the blood-retinal barrier was also studied after intravenous(200mg/kg) or intraocular(4 microgram/20ml of saline) injection of horseradish peroxidase(HRP). The results obtained were summarized as the following: Sodium iodate induced patchy areas of loss of pigment epithelial cells after 2 days, which were more widespread and severe after 4 days with regenerative activities. Loss of outer segment and mitochondrial swelling of the inner segment of visual cells were also noted after 4 days. Colloidal lanthanum penetrated into the mitochondria of pigment epithelial cells at 2 days after sodium iodate injection, which was extended to the mitochondria of inner segment of visual cells after 4 days. Intraocularly injected HRP appeared from the internal limiting membrane to Bruch's membrane after 2 days. Intravenously injected HRP appeared from the Bruch's membrane to ganglion cell layer after 2 days, which were extended to the vitreal cavity. The results suggested that the damage of the pigment epithelial cells induced by sodium iodate destroy blood-retinal barrier. HRP exudation is more extensive in direction of retina to choroid than choroid to retina.
Armoracia ; Blood-Retinal Barrier* ; Bruch Membrane ; Cell Membrane ; Choroid ; Colloids ; Epithelial Cells ; Ganglion Cysts ; Lanthanum ; Membranes ; Mitochondria ; Mitochondrial Swelling ; Permeability ; Rabbits ; Retina ; Retinal Pigment Epithelium* ; Retinaldehyde* ; Sodium

BACKGROUND: Several Studies from western institutes were done on the clinical characteristics and long-term prognosis of patients with variant angina. In these reports, 61-92% of patients had significant coronary artery disease, and survival without myocardial infarction at 1 year was approximately 70-83%. These results differ from our clinical experiences with Korean patients with variant angina;however, no detailed study has been reported in Korea. The purpose of this study was to describe the clinical characteristics and long-term follow-up data of our Korean patients with variant angina. METHODS: Two hundred four consecutive patients with variant angina(M/F;166/38, mean age 53+/-10 year) were included. The diagnosis of variant angina was made by spontaneous spasm in 53, positive intravenous ergonovine(iv Erg) provocation in 52, intracoronary acetylcholine(ic Ach) provocation in 55, simultaneous iv Erg and ic Ach provocation in 48 and bedside intravenous ergonovine with 2-dimensional echocardiography in 33. The clinical and angiographic characteristics were examined in 204 patients and mean 1.5 year(6 month to 3.5 year) follow-up could be done in 165 for the evaluation of long-trem prognosis. RESULTS: The Korean patients with variant angina were characterized by relatively low prevalences of significant coronary stenosis(25%), myocardial infarction and rate of cardiac death. Futhermore, survival and survival without myocardial infarction for the entire group were significantly better in our observation(1 year survival without myocardial infarction, 98%) than in other studies. During the follow-up period, 4(2%) out of 165 patients died, 1 developed myocarddial infarction and ventricular fibrillation occurred in 2. Three of 4 death caused by stopping medication abruptly. Thirteen patients were angina free after discontinued medications during the follow-up. CONCLUSION: The overall prognosis of variant angina may be better in Korean patients. We believe that less severe coronary atherosclerotic disease and a high rate of treatment with calcium blockers may have contributed to the lower rate of cardiac death and myocardial infarction on our patients compared with those in previous studies.
Academies and Institutes ; Calcium ; Coronary Artery Disease ; Death ; Diagnosis ; Echocardiography ; Ergonovine ; Follow-Up Studies* ; Humans ; Infarction ; Korea ; Myocardial Infarction ; Prevalence ; Prognosis ; Spasm ; Ventricular Fibrillation