To evaluate the morphogenesis of the human thyroid, a histologic study was made based on 100 normal thyroids of human embryos and fetuses ranging in age from 4 to 42 weeks of gestation. The embryos were serially sectioned and fetuses were examinated as an individual organ. 1) The first sign of thyroid primordium was the spherical proliferation of median ventral pharyngeal wall at the 4th week of development. 2) At the 6th week of gestation, the thyroid differentiated into two lobes that were connected by an isthmus, and was on the way of migration to the definite position from the foramen cecum. 3) The developing thyroid consisted of two cell cords, solid nests or interconnecting complex pattern until 14th week of gestation, when the entire portion of thyroid was replaced by follicles of variable size. 4) At the 9th week, the first follicle was recognizable at the periphery of the gland. 5) At the 14th week, follicles were partly filled with faintly eosinophilic colloid. 6) After the 18th week of gestation, lobulation of the thyroid parenchyme was a prominent feature. 7) After the 24th week, large follicles with rich colloid content are distributed through both superificial and deep portions. And after the 34th week, maturation reached the general pattern of adult thyroid. 8) The ability of thyroglobulin synthesis which was confirmed by PAP method, was first recognized at the 10th week of gestation.
Adult ; Male ; Female ; Humans

BACKGROUND: Osteoporosis is an important health concern among the postmenopausal women. Therefore, it is necessary to find out acceptable screening tools for osteoporotic patients. The purpose of this study was to evaluate the Risk Index by OSTA as a screening test for osteoporosis. METHODS: The study population was 322 naturally caused menopausal women in Korea. Their was of femoral neck and lumbar spine BMD measured by DEXA. Risk Index by OSTA, based on weight and age, was calculated and the sensitivity and specificity for osteoporosis and osteopenia were evaluated. To find out the proper cut-off point for osteoporosis and osteopenia among the postmenopausal women in Korea, we also compared the sensitivity and specificity of each Risk Index value. RESULTS: The mean age and ages at menopause were 59.1(+/-6.2) and 50.7 (+/-2.7) years, respectively. The prevalence of osteoporosis was 9.6% with femoral neck BMD. For oeteoporosis, using a cut-off point of -1 yielded a sensitivity of 74.3% and a specificity of 52.2% with femoral neck BMD. Using a cut-off of -2 yielded a sensitivity of 87.3% and a specificity of 70.9%. The ROC curve showed an AUROC 0.88 for Risk Index in identifying osteoporosis. CONCLUSION: The Risk Index is an acceptable, simple and useful method in the diagnosis of osteoporosis with a Risk Index of -2 in Korean postmenopausal women.
Bone Diseases, Metabolic* ; Diagnosis ; Female ; Femur Neck ; Humans ; Korea ; Mass Screening* ; Menopause ; Osteoporosis* ; Prevalence ; ROC Curve ; Sensitivity and Specificity ; Spine

The amplification of c-myc oncogene was evaluated in 42 cases of ovarian carcinomas to correlate with clinical parameters. Using oligonucleotide primers, sequences from the c-myc exon-3 gene and from a control gene, tissue plasminogen activator (tPA), were amplified simultaneously by polymerase chain reaction (PCR). After the products of differential PCR (d-PCR) were electrophoresed, slot blot hybridization was performed, and hybridized with P32 dATP-labeled myc and tPA oligonucleotide probes and then autoradiographed. The signal intensities of the two products were quantitated by densitometry and the ratios of two products (c-myc/tPA) were measured. The ovarian carcinomas showed significantly increased amplification of c-myc oncogene Oligonucleoti compared to normal control group (p<0.05). 15 of 42 cases (35.7%) showed various degrees of the MYC gene amplification up to 27 folds in various histologic types of ovarian carcinomas. No significant differences of the MYC gene amplification according to histologic subtypes, tumor action) grades and clinical stages of ovarian carcinomas were present.
Densitometry ; DNA Primers ; Genes, myc ; Oligonucleotide Probes ; Oncogenes* ; Polymerase Chain Reaction* ; Tissue Plasminogen Activator

To analyze the improvement of shouder function after arthroscpic subacrominal decompression and open repair for complete rotator cuff tear, we performed a prospective study in 14 patients using self evaluation form from the American Shouder and Elbow Society(ASES). All patients were treated with arthrscopic biplanar subacromial decompression and open repair by use of bony trough and followed for more than 1 year from November 1994 to June 1996 in Dankook university hospital. All patients were assessed preoperatively and at final follow-up using the standardised method of research committee of American shoulder & elbow surgeons. Tears of the rotator cuff were divided into medium(8 shoulders), large(3 shoulders) and massive(3 shoulders). Most of the patients were heavy laborers. Average age was 56.2 years (51-73 years). There were 9 male and 5 female patients. The dominant arm was affected in 8 shoulders. Postoperative abduction brace was used in all cases and passive range of mortion exercise was started from postoperative third day. At average follow-up of 17 months, average pain scores decreased to 0.8+/-1.1 from 6.9+/-2.3. Scores of ASES evaluation form increased to 87.3+/-12.2 from 35.8+/-16.3(p<0.05). As to the range of mortion, only internal rotation improved from T12 to T8(p<0.05). Thirteen patients achieved excellent or good result. Twelve patients returned to initial occupations. Arthroscopy is helpful to define the tear size which may affect the surgical approach and open repair by use of bony trough and tunnel is useful to recovery of shoulder function.
Arm ; Arthroscopy ; Braces ; Decompression* ; Diagnostic Self Evaluation ; Elbow ; Female ; Follow-Up Studies ; Humans ; Male ; Occupations ; Prospective Studies ; Rotator Cuff* ; Shoulder

BACKGROUND/AIMS: When stools containing altered blood are the sole evidence for acute gastrointestinal bleeding, the bleeding source is uncertain. Because the absorption of blood products via the small intestine is responsible for azotemia after gastrointestinal bleeding, patients with colorectal bleeding rarely become azotemic. Therefore the blood urea nitrogen to creatinine ratio (BUN/Cr ratio) is believed to reliably discriminate upper gastrointestinal bleeding (UGIB) from lower gastrointestinal bleeding (LGIB). This study was conducted to evaluate the BUN/Cr ratio for distinguishing an upper versus lower source of gastrointestinal bleeding. METHODS: Charts of patients who were admitted to Maryknoll hospital with the diagnosis of gastrointestinal bleeding from August 1994 to August 2000, were retrospectively reviewed for source of bleeding, initial blood urea nitrogen (BUN), creatinine (Cr), BUN/Cr ratio, hemoglobin, and hematocrit. RESULTS: A total of 298 patients were eligible for inclusion, 210 (70%) of whom were male. A total of 168 (56%) patients had an UGIB. Gastric ulcer disease (42%) and esophageal varices (27%) were the most common causes of UGIB, whereas malignant neoplasm was etiologic in 29% of LGIB episodes. The mean standard deviation BUN/Cr ratio was significantly higher in UGIB than LGIB (34.1+/-12.9 vs. 12.2+/-; p<01). CONCLUSIONS: The BUN/ Cr ratio may be a useful tool in distinguishing upper from lower sources of gastrointestinal bleeding, especially in patients with an uncertain source that could be upper or lower in origin.
Absorption ; Azotemia ; Blood Urea Nitrogen ; Creatinine ; Diagnosis ; Esophageal and Gastric Varices ; Hematocrit ; Hemorrhage* ; Humans ; Intestine, Small ; Male ; Retrospective Studies ; Stomach Ulcer ; Urea*

A 12-year-old boy developed cholestatic hepatitis with Steven-Johnson syndrome following the use of amoxicillin. The skin lesion and general condition were improved over 2 weeks, but jaundice was gradually aggrevated. We performed liver biopsy, on 30th hospital day, which showed cholestatic hepatitis. The patient improved gradually and liver function was normalized 5 months later.
Amoxicillin ; Biopsy ; Child ; Hepatitis* ; Humans ; Jaundice ; Liver ; Male ; Skin

No abstract available.
Drainage* ; Pancreatic Pseudocyst*

Porencephaly is a rare congenital anomaly characterized by a cavitary hole extending from the cerebral mantle to the ventricle of the brain and covered by leptomeningeal membrane. It is now generally believed that the porencephaly represents a fetal or neonatal destructive process of the neural tissue. Authors experienced an autopsy case of bilateral porencephaly in a 35-day-old Korean male infant who died of sepsis. The brain weighed 150 gms and morphologically well formed except for two large symmetric defects at the fronto-parietal region. These defects were characterized by cleft-like shape, covering the entire cerebral mantle with resultant direct communication between ventricular cavity and leptomeninges. Thin leptomeningeal trabeculae were covering the cavity. There was a smooth transition between ependyma and roof of the defects. There are focal, microscopic cerebral infarct and abscess without connection with the cavitary lesion. The remaining central nervous system was unremarkable.
Infant ; Male ; Female ; Infant, Newborn ; Humans

Eight neonates with transient tricuspid insufficiency are presented which was confirmed clinical and two dimensional echocardiographic assessment. We found that two dimensional Doppler echocardiography was very useful in the detection of transient tricuspid insufficiency during neonatal age as noninvasive method. Transient tricuspid insufficiency is a clinical disorder in the newborn period caused by myocardial dysfunction, secondary to asphyxia with or without hypoglycemia and associated with right ventricular overloading caused by pulmonary hypertention. The clinical diagnosis was based on a history of perinatal distress, distinctive murmur, ECG changes, biochemical abnormalities and myocardial imaging. 1) The sex ratio of TTI was 1:1. 2) The average gestational age was 34 weeks and mean body weight was 2.06 Kg, respectably. 3) Major symptoms were dyspnea, cyanosis, and tachypnea. 4) Tricuspid regurgitation was detected from the lst day to the 4th day of the life and was improved from the 7th day to the 30th day of the life. 5) The peak velocity through tricuspid valve ranged from the 2.7 m/sec to 4.0 m/sec and the estimated right ventricular pressure ranged from 39 mmHg to 74 mmHg. 6) Associated diseases were neonatal hyperbilirubinemia (100%), prematurity (87.5%), atrial right to left shunt (87.5%), patent ductus arteriosus (75%), hyaline membrane disease (25%), and transient tachypnea of newborn (12.5%).
Asphyxia ; Body Weight ; Cyanosis ; Diagnosis ; Ductus Arteriosus, Patent ; Dyspnea ; Echocardiography* ; Echocardiography, Doppler ; Electrocardiography ; Gestational Age ; Humans ; Hyaline Membrane Disease ; Hyperbilirubinemia, Neonatal ; Hypoglycemia ; Infant, Newborn ; Sex Ratio ; Tachypnea ; Transient Tachypnea of the Newborn ; Tricuspid Valve ; Tricuspid Valve Insufficiency ; Ventricular Pressure

BACKGROUND AND OBJECTIVES: Nitric oxide (NO) reduces the intracellular Ca2+ concentration ([Ca2+]i) in smooth muscle cells, whereas the effect of NO on [Ca2+]i in endothelial cells is still controversial. Therefore, the effect of NO on the [Ca2+]i, and its mechanism in mouse aortic endothelial cells (MAEC) and human umbilical vein endothelial cells (HUVEC) were examined. MATERIALS AND METHODS: In primary cultured MAEC and HUVEC, cells were loaded with fura 2-AM and [Ca2+]i and measured using a microfluorometer. RESULTS: The NO donor, sodium nitroprusside (SNP), reduced the [Ca2+]i in 72% of the cells tested (n=100). In the remaining cells, the effect of SNP was biphasic, or the [Ca2+]i was increased. In addition, the membrane-permeable cGMP, 8-bromo cGMP, decreased the [Ca2+]i. The effects of SNP and 8-bromo cGMP were inhibited by the soluble guanylate cyclase inhibitor, 1H-[1,2,4] oxadiazole[4,3-a]quinoxalin-1-one (ODQ), and the cGMP-dependent protein kinase inhibitor, KT5823, respectively. In contrast, in the presence of 8-bromo cGMP or ODQ, SNP increased the [Ca2+]i. CONCLUSION: These results suggest that NO inhibits the [Ca2+]i through a cGMP-dependent mechanism and increases the [Ca2+]i through a cGMP-independent mechanism.
Animals ; Cyclic GMP ; Endothelial Cells* ; Endothelium ; Guanylate Cyclase ; Human Umbilical Vein Endothelial Cells ; Humans ; Mice ; Myocytes, Smooth Muscle ; Nitric Oxide ; Nitroprusside ; Protein Kinases ; Tissue Donors