No abstract available.
Humans ; Infant, Newborn* ; Membranes* ; Mortality* ; Mothers* ; Rupture*

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

BACKGROUND: E2/nonstructural protein 1 (E2/NSl) glycoprotein of hepatitic C virus (HCV) is most variable region of HCV and appears to cause positive selection of escape mutants, which may play a role in the mechanism of persistent viral infection. We analyzed the sequence diversity of E2/NSl of HCV from twelve Koreans. METHODS: The nucleotide and deduced amino acid sequences of the putative E2/NSl region of HCV were determined by analysis of twelve independent amplified CDNA clones obtained from Korean patients with chronic hepatitis and primary hepatocellular carcinoma, using dideoxynucleotide chain termination method. RESULTS: High level of variations in both nucleotide and amino acid sequences were observed in the hypervariable region 1 and 2 (HVR1 and HVR2). Sequences of HVR1, situated at the nucleotide positions from 1478 to 1552 (amino acid positions : from 383 to 407), showed from 27.8 to 94.4% diversity at the nucleotide level and from 25.0 to 87.5% diversity at the amino acid level. 4 few amino acid residues (amino acid positions: 384, 388, 389 405, 406) within HVR1 were highly conserved in most cases. Sequences of HVR2, situated at the nucleotide positions from 1736 to 1774 (amino acid positions from 469 to 481). Two groups of highly conserved amino acid sequences were observed in the HVR2 of twelve Korean cases, indicating that there are type specific conservation in the HVR2 region. 4 large part of the eave lope region located at the nucleotide positions from 1832 to 1892 (amino acid positions : from 501 to 521) was highly conserved, to show 100% Identity of amino acid sequences. The positions of six putative N-glycosylation sites were highly conserved. The percent diversities of nucleotide of E2/NSl was from 60.4% to 92.7% and the percent diversities of amino acid of E2/NSl was from 57.6% to 95.5% among twelve Korean HCV clones. CONCLUSION: Extensive genetic variations including two hypervariable regions were clustered and interspersed with highly conserved nucleotides sequences in E2/NSl region of HCV isolated from Koreans.
Amino Acid Sequence ; Carcinoma, Hepatocellular ; Clone Cells ; DNA, Complementary ; Genetic Variation ; Glycoproteins ; Hepacivirus* ; Hepatitis C* ; Hepatitis* ; Hepatitis, Chronic ; Humans ; Nucleotides ; United Nations

BACKGROUND: E2/nonstructural protein 1 (E2/NSl) glycoprotein of hepatitic C virus (HCV) is most variable region of HCV and appears to cause positive selection of escape mutants, which may play a role in the mechanism of persistent viral infection. We analyzed the sequence diversity of E2/NSl of HCV from twelve Koreans. METHODS: The nucleotide and deduced amino acid sequences of the putative E2/NSl region of HCV were determined by analysis of twelve independent amplified CDNA clones obtained from Korean patients with chronic hepatitis and primary hepatocellular carcinoma, using dideoxynucleotide chain termination method. RESULTS: High level of variations in both nucleotide and amino acid sequences were observed in the hypervariable region 1 and 2 (HVR1 and HVR2). Sequences of HVR1, situated at the nucleotide positions from 1478 to 1552 (amino acid positions : from 383 to 407), showed from 27.8 to 94.4% diversity at the nucleotide level and from 25.0 to 87.5% diversity at the amino acid level. 4 few amino acid residues (amino acid positions: 384, 388, 389 405, 406) within HVR1 were highly conserved in most cases. Sequences of HVR2, situated at the nucleotide positions from 1736 to 1774 (amino acid positions from 469 to 481). Two groups of highly conserved amino acid sequences were observed in the HVR2 of twelve Korean cases, indicating that there are type specific conservation in the HVR2 region. 4 large part of the eave lope region located at the nucleotide positions from 1832 to 1892 (amino acid positions : from 501 to 521) was highly conserved, to show 100% Identity of amino acid sequences. The positions of six putative N-glycosylation sites were highly conserved. The percent diversities of nucleotide of E2/NSl was from 60.4% to 92.7% and the percent diversities of amino acid of E2/NSl was from 57.6% to 95.5% among twelve Korean HCV clones. CONCLUSION: Extensive genetic variations including two hypervariable regions were clustered and interspersed with highly conserved nucleotides sequences in E2/NSl region of HCV isolated from Koreans.
Amino Acid Sequence ; Carcinoma, Hepatocellular ; Clone Cells ; DNA, Complementary ; Genetic Variation ; Glycoproteins ; Hepacivirus* ; Hepatitis C* ; Hepatitis* ; Hepatitis, Chronic ; Humans ; Nucleotides ; United Nations

Possible seasonal differences in serum Insulin-Like Growth Factor-I (IGF-I) concentrations have not been studied in newborn infants. Recently we demonstrated sea- sonal differences in bone mineral content (BMC) in newborn infants: lower BMC was present in summer vs. winter-born infants (J Pediatr Gastroenterol Nutr 1992; 15: 285). In a second stduy, higher serum osteocalcin, an index of bone formation, and lower BMC were found in summer vs. winter (J Pediatr Gastroenterol Nutr 1994; 19: 2207). We speculated that increased serum osteocalcin in summer could be an adaptive response to decreased bone mass. Since growth factors such as IGFs are local regulators of bone formation, we hypothesized that in summer-born infants, serum IGF-I will be higher than in winter, associated with high bone formation activity. Fifty-nine healthy, term appropriate for gestational age (AGA) infants were studied prospectively in winter (Jan-Mar, 29) and in summer (July-Sept., 30). Thirty infants were male, and 29 infants were female. Gestational ages and birth weights were not different by season(in summer, mean+SD, 39.61.1 wk, 3,471360 g,' in winter, 39.31.4 wk, 3,402 392 g). Cord serum IGF-I was measured by radioimmunoassay, modified from Furlanetto et al (1977), after acidification and sep-pack extraction of serum, and osteocalcin concentrations were determined by a kit radio-immunoassay. Cord serum IGF-I concentrations were not different by season of birth(summer vs. winter, 20.11.83 vs. 16.5 1.75 ng/mL, p=0.2). No gender differences were found: 18.21.8 vs. 18.2+1.8 ng/ mL in males vs. females. Serum osteocalcin was higher in summer vs. winter-born infants (8.22.3 vs. 4.951.58 ng/mL, p=0.009). BMC was different by season (87.2+ 14.5 vs. 94.1+16.4 mg/cm, p=0.02). Cord serum IGF-I was not related to serum osteocalcin and BMC. We conclude that serum IGF-I concentrations are not different by season or gender, and are not related to bone formation activity and BMC. Thus, IGF -I concentrations in serum are not seasonally regulated, nor associated with an index of bone formation activity.
Birth Weight ; Bone Density ; Female ; Gestational Age ; Humans ; Infant ; Infant, Newborn* ; Insulin-Like Growth Factor I ; Intercellular Signaling Peptides and Proteins ; Male ; Osteocalcin ; Osteogenesis ; Prospective Studies ; Radioimmunoassay ; Seasons*

The displacement of patellar components, such as dislocation or subluxation, causes polyethylene wear and further induces metallosis of the metal-backed patella. We compared two different patellar components, onset(Miller-Galante I) and inset(Whiteside-Ortholoc I)type, to understand the differences in patellar tracking according to their designs. Patellar prosthesis position in 43 primary total knee arthroplasties was evaluated with patellar tilt, patellar displacement from the center of the trochlear groove, medial placement, patellar thickness, and joint line height. For the MG(Miller-Galante I)group, the patellar displacement was laterally 50.0% and for the Ortholoc group, it was 33.3%. In the MG group, 4 cases of revision of the patellar component due to excessive polyethylene wear were performed, but there was no excessive wear of polyethylene in Ortholoc group. One of the primary factors which influence tracking of the patellofemoral joint is the difference in design between the patellar component and the femoral component. But in the opinion of the authors, the slope or lateral displacement of the patellar component have no correlation with each other under radiological measurements. However, the inset-type patellar component is a design that maintains the bony flange within the lateral flange, therefore relieving the shear stress and rotational forces loaded on the patellofemoral joint and protecting the metal-backing from exposure. Thereby, even if dislocation or subluxation of the patellar component should occur, polyethylene wear or metallosis caused by excessive wearing can be minimal.
Arthroplasty* ; Dislocations ; Joints ; Knee* ; Patella ; Patellofemoral Joint ; Polyethylene ; Prostheses and Implants

Fracture of intercondylar eminerce of the tibia indicate probable alteration of the cruciate ligament stability in the knee and occur from hyperextension injury of the knee and violent internal rotation of the tibia. Fracture of intercondylar eminence of the tibia has been classified by Meyer and Mckeever(1959, 1970) according to the degree of displacment and this classification is important as it pertains to the proper selection of treatment. The author studied 24 cases in 24 patients of fracture of the intercondylar eminerce of the tibia at the Department of Orthopedic Surgery of Severance Hospital during a 10 year period from Januaary, 1975 until December, 1984. The aim of this study was to find out incidence, cause and associated injury of the fracture of the intercondylar eminece of the tibia and was to asses the comparative results of the conservative and surgical treatment. The result of this study ase as follows ; 1. There is a predisposition for make in a ration of 3:1 and there is no age preponderance in occurance. 2.Majority of cause of injury was traffic accident(62.5%). 3.Isolated fracture of intercondylar eminence of the tibia was 15 cases (62.5%) associated knee joint injury shows 9 cases (37.5%). Among the associated knee joint injury, rupure of medial collateral ligament was 4 cases(44.4%), rupture of medial meniscus was 3 cases(33.3%) and rupture of lateral colateral ligament was 2 cases (22.2%). 4.By Meyer and Mckeever's classification, Type 2(41.7%) fracture of intercondylar eminence of the tibia was most common, and then Type 1(37.5%) and Type 3(20.8%) occured in order of frequency. 5. Type 1 and Type 2 fracture of the intercondylar eminence of the tibia resulted in good prognosis with only conservative treatment, and open reduction is not indicated. 6. Type 3 fracture of the intercondylar eminence of the tibia can be treated with conservative treatment if there is no associated injury of the knee joint.
Classification ; Clinical Study ; Collateral Ligaments ; Equidae ; Humans ; Incidence ; Knee ; Knee Joint ; Ligaments ; Menisci, Tibial ; Orthopedics ; Prognosis ; Rupture ; Tibia

No abstract available.
Femoral Neck Fractures* ; Femur Neck*

The posterior cruciate ligament in the stoutest ligamentous structure in the knee joint. Kennedy and Hawkins have confirmed its strenght to be about 2 times that of the anterior cruciate ligament or tibial collateral ligament. This would appear to offer the support that this ligament has a vital role to play in knee stabilization. But, in the past, non-surgical management was frequently elected either because of the belief that most kness with posterior cruciate insufficiency are asymptomatic or because it is difficult to access surgically. Recently, Hughston and Trickey reported good results after surgical repair of the rupture of the posterior cruciate ligament. And current trend is to repair it surgically. So, we analyzed the 36 cases of acute posterior cruciate ligament injuries, who were admitted and treated surgically in Severance Hospital between Jan. 1981 to Dec. 1985, and obtained the following results. 1. Single rupture of the posterior cruciate ligament largely results in good outcome. 2. When the rupture site is in the substane, we can obtain relatively good results with the augmentation using the medial head of the gastrocnemius. 3. When combined with medial or lateral compartment injuries, the chance of later instability and reconstruction is high.
Anterior Cruciate Ligament ; Clinical Study ; Head ; Knee ; Knee Joint ; Ligaments ; Medial Collateral Ligament, Knee ; Posterior Cruciate Ligament ; Rupture

Transmitral left ventricular diastolic inflow velocities determined by pulsed Doppler in 47 normotensives, 80 hypertensives and 44 age-matched hypertensives were measured to evaluate the effects of age and left ventricular hypertrophy on left ventricular diastolic fuction in normotensives and hypertensives. The results were as follows: 1) The peak E velocity in normotensives(77.82+/-13.53cm/sec) was significantly different from those of hyeprtensives(58.13+/-11.80cm, p<0.01) and age-matched hypertensives(59.31+/-10.94cm/sec, p<0.01). The peak E/A in normotensives(1.31+/-0.45) was significantly different from those of hypertensives(0.83+/-0.21,p<0.01) and age-matched hypertensives(0.83+/-0.20, p<0.01). 2)In normotensives, simple linear regression analysis revealed strong inverse correlations of peak E with age(r=-0.758, p<0.01), peak E/A with age(r=-0.748, p<0.01), but no significant correlation of peak E and peak E/A with LVMI(p>0.05). Stepwise regression analysis revealed that age was the most important correlate of peak E and peak E/A in normotensives(peak E: R
Heart Diseases ; Hypertrophy, Left Ventricular* ; Linear Models