PURPOSE:Craniopharyngioma is one of the most common causes of organic growth hormone deficiency leading to pituitary hormonal insufficiency. However, some growth hormone(GH)-deficient children with craniopharyngioma may grow normally or even show accelerated growth. This study was designed to evaluate several factors associated with growth of patients with craniopharyngioma. METHODS:Forty children operated on for craniopharyngioma were evaluated for their pituitary function, serum insulin like growth factor-I(IGF-I), serum insulin like growth factor binding protein-3(IGFBP-3) and serum prolactin levels. We also observed their growth status and corresponding changes with or without GH treatment. RESULTS:Among 40 patients, one had normal pituitary hormonal status and one had isolated GHD(GH deficiency). The other patients showed multiple pituitary hormone deficiency including GH(98%), LH, FSH(75%), TSH(65%), ACTH(62%), and ADH(38%) deficiencies. Patients with GHD were categorized into 2 groups. Group 1 consisted of children who showed normal growth, thus had not received GH treatment(n=14) and Group 2, those who showed subnormal growth(n=25). Patients in Group 2 were subdivided into Group 2A, when the patients had not received GH treatment in spite of subnormal growth(n=9) and Group 2B, when GH treatment had been added later on(n=16). There were no differences in the age at diagnosis of GHD, initial height standard deviation score(Ht SDS), body mass index(BMI), peak GH concentration between Group 1 and Group 2. Height velocities in Group 1, 2A, and 2B were 8.1+/-.2 cm/yr, 2.4+/-.2 cm/yr, 2.7+/-.2 cm/yr during the first year of endocrinologic follow-up, 7.1+/-.8 cm/yr, 1.2+/-.1 cm/yr, 7.6+/-.7 cm/yr during the second year, 5.9+/-.0 cm/yr, 2.8+/-.9 cm/yr, 7.3+/-.7 cm/yr during the third year, respectively. BMI changes during the first year of endocrinologic follow-up and postoperative prolactin levels were not significantly different between Group 1 and Group 2A. Postoperative IGF-I and IGFBP-3 levels in Group 1 were significantly higher than those in Group 2A(P<0.05). Both IGFBP-3 and prolactin levels correlated significantly with height velocity in Group 1 and 2A(P=0.004 r=0.64 and P= 0.035 r=0.74 , respectively). CONCLUSION: In this study, growth in children with craniopharyngioma was likely to be associated with IGF-I, IGFBP-3 and prolactin levels. Further studies are needed to unravel other growth promoting factors related to GH independent growth.
Child* ; Craniopharyngioma* ; Diagnosis ; Follow-Up Studies ; Growth Hormone ; Humans ; Insulin ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor I ; Prolactin

No abstract available.
Humans ; Urinary Retention*

Hemorrhagic fever with renal syndrome (HIFRS), scrub typhus, murine typhus and leptospirosis have been the principal acute febrile diseases in Korea. To evaluate the seroepidemiologic patterns of acute febrile illness, sera collected from 2,423 patients in 1996 were examined for antibodies against Hantaan virus, Orientia tsutsugamushi, Rickettsia typhi, and Borrelia burgdorferi by indirect immunofluorescent antibody technique (IFA) and macroscopic agglutination test for Leptospira interogans. Seropositive cases against O. tsutsugamushi, Rickettsia typhi, Leptispira interogans and Hantaan virus were 192 (7.9%), 193 (8.0%), 12 (0.5%) and 324 (13.4%), respectively. Male was more affected in HFRS and murine typhus contrasting to scrub typhus and leptospirosis in female. Most positive cases occurred during October and November for scrub typhus, and during November and December for HFRS. These results showed similar patterns with previous epidemical data for recent couple of years, and possibly implied no significant changes occurred in ecologic situations for acute febrile diseases in Korea.
Agglutination Tests ; Antibodies ; Borrelia burgdorferi ; Female ; Hantaan virus ; Hemorrhagic Fever with Renal Syndrome ; Humans ; Korea* ; Leptospira ; Leptospirosis ; Male ; Orientia tsutsugamushi ; Rickettsia typhi ; Scrub Typhus ; Typhus, Endemic Flea-Borne

Systemic lupus erythematosus (SLE) is a multisystemic disease that can involve the gastrointestinal tract, liver, and biliary system. Symptomatic pancreatic involvement, however, has rarely been reported. It may be part of the primary disease process, such as vasculitic or autoimmune etiology, or associated with drug therapy, in particular corticosteroid. We report here a lupus patient who developed severe pancreatitis within 30 hours of initiation of corticosteroid therapy; we also discuss the relation between pancreatitis and systemic lupus erythematosus.
Biliary Tract ; Drug Therapy ; Gastrointestinal Tract ; Humans ; Liver ; Lupus Erythematosus, Systemic* ; Pancreatitis*

No abstract available.
Intussusception*

We presented a case of wasp sting of 42 year old, farmer who got stung on the cornea directly. At the time of first examination, the patient had visual acuity of 0.02 in the right eye. Slit lamp examination revealed corneal epithelial desquamation and vesicle, striate keratitis, diffuse stromal edema and fine keratic precipitates on the corneal endothelium. The iris was depigmented and atrophic, and pupil was mydriatic and nonreactive. The lens was opaque at the center of anterior caspsule and fundus was not visualized. 4 months later, the corneal lesion was slightly improved. Clinical findings of iris and lens still unchanged.
Adult ; Bites and Stings* ; Cornea ; Edema ; Endothelium, Corneal ; Humans ; Iris ; Keratitis ; Pupil ; Visual Acuity ; Wasps*

We measured the axial length according to age in the eyeball of premature infants who were born at our hospital. Our patients were 36 weeks old below in conceptual age, 38 eyes in 19 males, 28 eyes in 14 females. total 66 eyes in 33 premature infants. And we examined the axial length using the A-mode of the LTZ/SSW-48. 7MHz for 1 month at each weeks. The results were as follows: 1. The mean axial length was 16.56mm (15.40-17.80) at 1st week of life. 16.82mm (15.43-17.95) at 2nd week, 17.01mm(15.71-18.01) at 3rd week, 17.04mm (15.72-18.24) at 4th week. 2. The mean axial length of 1st week was 16.77mm in male, 16.34mm in female; at 2nd week, 16.91mm in male, 16.72mm in female; at 3rd week, 17.09mm in male, 16.90mm in female; at 4th week, 17.12mm in male, 16.96mm in female and they did not show significant difference between male and female premature infants.
Biometry* ; Female ; Humans ; Infant, Newborn ; Infant, Premature* ; Male ; Ultrasonics*

Ever since Mixter and Barr demonstrated the relationship between disk protrusion and radicular pain nearly 50 years ago, there has been a swing toward mechanical explanations for all problems of this type. Murphy has proposed that inflammation rather than mechanical pressure is the basis of back pain and sciatica, and that the causal irritant is likely to be a chemical product of disk degeneration. That administration of steroids reduces the inflammatory process is well known. The present study was undertaken to acess our experience in using epidural steroid injection ofr patients suffering from diskogenic low back pain. Ten patients with the clinical diagnosis of sciatica and with post larninectomy sequelae were referred to the anesthesia department of Maryknoll hospital. Our routine epidural injection of the lumbar spine(L3-4) consists of 2ml of 2% xylocaine and 120mg of methylprednisolone(Depo medrol). Following the injection of Depo Medrol patients were encouraged to ambulate actively and were asked to evaluate their subsequent pain relief. Of the 10 patients studied, all patients experience pain relief within 10 minutes of the epidural injection. A follow up study of these patients was done between 5 and 10 months after injection. The results were as follows: 1) 3 patients: Complete relief. 2) 3 patients: moderate relief. 3) 3 patients: no relief. 4) 1 patient: technical failure.
Anesthesia Department, Hospital ; Back Pain ; Diagnosis ; Follow-Up Studies ; Humans ; Inflammation ; Injections, Epidural ; Intervertebral Disc Degeneration ; Lidocaine ; Low Back Pain ; Methylprednisolone ; Sciatica ; Steroids*

Patients with spinal cord injury are prone to the development of bladder calculi. Although bladder stones can by managed effectively, predictive and preventive measures remain a significant challenge for clinicians. We reviewed the medical records of the bladder stone formation group (81 patients) and the control group (153 patients) in the course of follow-up check after spinal cord injury. We analysed the risk factors of the Bladder stone formation including neurologic level and extent (completeness) of injury. method of bladder drainage management, presence of pyuria, specific organisms infecting the urinary tract, urine pH, residual and 24-hour urine volume, serum and 24-hour urine Ca, P, urio acid levels, renal function (BUN/cr./Ccr), and frequency of bladder irrigation. In Was found that most of the patients developing bladder calculi had neurologically complete lesions, indwelling catheters (suprapubic or urethral), large amount of residual urine, high urine pH, pyuria and bacteriuria.
Bacteriuria ; Catheters, Indwelling ; Drainage ; Follow-Up Studies ; Humans ; Hydrogen-Ion Concentration ; Medical Records ; Pyuria ; Risk Factors* ; Spinal Cord Injuries* ; Spinal Cord* ; Urinary Bladder Calculi* ; Urinary Bladder* ; Urinary Tract

Automated static perimeters, which are commonly used for early diagnosis and follow-up of glaucoma patients in Korea, are manufactured overseas, and their basic data were obtained from foreigners and normal values were set to meet them. Therefore, verification of validity of those data should precede their application to Koreans. We compared the mean normal values of standard indices of OCTOPUS 101 automated static perimeter with the values obtained from 140 eyes of 70 healthy Koreans using normal strategy(NS)and dynamic strategy(DS). Mean navlues of mean defect(MD), loss variance(LV), corrected loss variance(CLV), and short-term fluctuation(SF)were: 2.84+/-0.85dB, 2.15+/-0.54dB, 1.22+/-0.42dB, 1.43+/-0.22dBwith NS, and 2.05+/-0.81dB, 1.98 +/-0.58dB, 0.97+/-0.49dB, 1.43+/-0.24dB, repectively with DS. With NS, 114 of 140 eyes (81. 4%)were out of the normal range of MD. With DS, 67 of 140 eyes(47. 9%)were out of normal range of MD, and 2 of 140 eyes(1. 4%)were out of the normal range of SF. Values of the other indices were within normal range of both strategies. Statistical analysis of global indices showed that age was significantly correlated with LV, CLV and SF in NS(P<0.05), and that it was also correlated with LV and CLV in DS(P<0.05). These results suggest that both race and age should be taken into acoount in interpretation of visual fields on automated static perimetry.
Continental Population Groups ; Early Diagnosis ; Emigrants and Immigrants ; Glaucoma ; Humans ; Korea ; Octopodiformes* ; Reference Values ; Visual Field Tests ; Visual Fields*