PURPOSE:The natural course of Hashimoto' thyroiditis (HT) is so dynamic that the disease progresses to overt hypothyroid or spontaneous recovery. The authors reviewed the clinical course of this disease and analysed the possible predicting factors regarding remission. METHODS:Thirty nine patients with HT (38 girls and 1 boy) were studied retrospectively. Of these patients, 30 were followed for more than 2 years. The possible remission factors were analyzed at initial diagnosis and during follow-up period. RESULTS:The mean age at the diagnosis was 11.8+/-.1 years. Initial thyroid function was euthyroid in 38.5%, compensated hypothyroid in 35.9%, overt hypothyroid in 23.1%, and hyperthyroid in 2.6% of patients. Antithyroglobulin antibody (ATA) was positive in 94.7%, and antimicrosomal antibody (AMA) was positive in 74.4%. The overall remission rate was 53.3% during the follow-up period (51+/-7 months). Initial goiter size, thyroid function status, and autoantibody titer had no relation to the remission rate statistically. Follow-up autoantibody titers in remission group were marginally lower than those in nonremission group (P<0.1), and follow-up AMA titer was significantly higher than initial titers in nonremission group (P<0.05). CONCLUSION: We could not find any predictable remission factors from the initial clinical and autoantibody status. But, during follow-up period, patients with lower autoantibody titers showed slight higher remission, and those with increasing AMA titer showed less remission. Above results suggest that we should monitor antithyroid antibody titer as well as thyroid function regularly.
Adolescent* ; Child* ; Diagnosis ; Female ; Follow-Up Studies ; Goiter ; Humans ; Retrospective Studies ; Thyroid Gland* ; Thyroiditis*

STATEMENT OF PROBLEM: Screw loosening has been a common complication and still reported frequently. PURPOSE: The purpose of this study was to evaluate abrasion of the implant fixture and TiN coated abutment screw after repeated delivery and removal with universal measuring microscope. MATERIAL AND METHODS: Implant systems used for this study were Osstem and 3i. Seven pairs of implant fixtures, abutments and abutment screws for each system were selected and all the fixtures were perpendicularly mounted in liquid unsaturated polyesther with dental surveyor. After 20 times of repeated closing and opening test, the evaluation for the change of inner surface of implant and TiN-coated abutment screw, and weight loss were measured. Mann-Whitney test with SPSS statistical software for Window was applied to analyze the measurement of weight loss. RESULTS: TiN-coated abutment screws of Osstem and 3i showed lesser loss of weight than non-coated those of Osstem and 3i (P < .05, Mann-Whitney test). CONCLUSION: Conclusively, TiN coating of abutment screw showed better resistance to abrasion than titanium abutment screw. It was concluded that TiN coating of abutment screw would reduce the loss of preload with good abrasion resistance and low coefficient of friction, and help to maintain screw joint stability.
Collodion ; Friction ; Joints ; Tin ; Titanium ; Weight Loss

Photodynamic therapy(PDT) is a treatment modality by highly reactive oxygen intermediates generated through the interaction of light with a photosensiziter. It has been shown to be an effective treatment for various cutaneous and noncutaneous malignancies. It is efficient for the curative and palliative treatment of epithelial skin tumor in situ or early invasive lesions. In effect, it is a useful alternative treatment for the lesions located on anatomically difficult areas or the large-sized lesions. We treated a case of Bowen's disease arising on the plantar area and 3rd and 4th toewebs of left forefoot in a 61-year-old man with PDT using the hematoporphyrin derivative, porfirmer sodium(Photofrin, Russia) as a photosensitizer and gold vapor laser as a visible light source. The outcome showed partial clinical improvement after about 2 months' follow-up.
Bowen's Disease* ; Follow-Up Studies ; Hematoporphyrin Derivative ; Humans ; Lasers, Gas ; Light ; Middle Aged ; Oxygen ; Palliative Care ; Photochemotherapy* ; Skin

Cardiac tamponade with pleural and pericardial effusion is a rare but life-threatening complication of umbilical venous catheterization in the newborn. It requires a timely diagnosis and urgent treatment, such as pericardiocentesis, to save lives of affected patients. Recently, we experienced a 7 day-old, very low birth weight infant, who developed a cardiac tamponade with pleural and pericardial effusions complicated by umbilical venous catheterization. The patient was successfully treated with pleural and pericardial drainages. Here, we report this case with a review of literature, since there has been no such previous case reported in Korea.
Cardiac Tamponade* ; Catheterization ; Catheters ; Diagnosis ; Humans ; Infant, Newborn* ; Infant, Very Low Birth Weight ; Korea ; Pericardial Effusion* ; Pericardiocentesis ; Pleural Effusion

PURPOSE: We investigated properness of growth hormone stimulation test (GHST) to diagnose growth hormone deficiency (GHD) in comparison with clinical characteristics. METHODS: For twenty five GHD children classified by GHST criteria during the recent 5 years, clinical characteristics and laboratory findings were correlated retrospectively through medical records. RESULTS: Seventeen were idiopathic GHD and 8 were secondary GHD. 1) Among the idiopathic type, 8 had complete GHD (maximal stimulated GH <5 ng/mL), and the others had partial form (GH >5, and <10 ng/mL). For this group, IGF-1, height SDS, and degree of delayed bone age were not correlated with maximal stimulated GH level, while the IGFBP-3 and growth velocity before GH treatment were significantly correlated (P<0.05). Growth velocity was significantly increased from 5.1 to 8.6 cm/yr during treatment (P<0.0001). 2) Variable results were obtained in 5 patients with multiple GHST. One idiopathic patient changed from non GHD to complete GHD during 5 years. One patient operated for craniopharyngioma showed from non to partial, then non GHD. Diffuse brain atrophy patient showed from partial to complete GHD. Two secondary form patients showed from non to partial GHD. 3) Three patients among idiopathic type showed growth velocity more than 5 cm/yr even without GH treatment. CONCLUSION: IGFBP-3 and growth velocity before treatment might be possible indicators to predict maximal stimulated GH level. In view of the variable results from multiple GHST, auxological and biological data should also be considered in diagnosis.
Atrophy ; Brain ; Child ; Craniopharyngioma ; Diagnosis ; Growth Hormone* ; Humans ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor I ; Medical Records ; Retrospective Studies

PURPOSE: We compared body growth, blood cell counts, and chemistry among infants receiving soy-based formula (SF), breast milk (BM), and casein-based formula (CF). METHODS: Full-term neonates delivered at our hospital from June 2001 to August 2003 were recruited and divided into 3 feeding groups (BM=20, SF=19, CF=12) according to the parents wishes. Breast feeding or artificial formulae were given during the initial 3 months of age; thereafter, weaning foods were added freely. Height, weight, head circumference, skin-fold thickness, and mid-arm circumference were measured at birth and 1, 2, 4, 5, 12, and 36 months of age. Cell counts and blood chemistry were analyzed at 5, 12, and 36 months of age. RESULT: At 5 months of age, body weight was the lowest in the SF group; the height was similar among all groups. Thereafter, there were no differences in height or weight among the groups until 36 months of age. Hemoglobin was the lowest in the BM group at 5 and 12 months of age (P<0.05). At 5 months of age, serum cholesterol, BUN, phosphates, and K+ were significantly lower in the SF group; thereafter, all chemical parameters were similar until 36 months of age. CONCLUSION: Infants fed with SF showed normal growth during the first 3 years of life as compared to infants fed with BM and CF. Low values of serum phosphates and K+ at 5 months of age in the SF group, despite the high mineral content, suggest that further investigation is needed for effective mineral absorption.
Absorption ; Blood Cell Count ; Body Weight ; Breast Feeding ; Cell Count ; Cholesterol ; Head ; Hemoglobins ; Humans ; Infant ; Infant, Newborn ; Milk, Human ; Parents ; Parturition ; Phosphates ; Soy Milk ; Weaning

PURPOSE: The purpose of this study was to investigate screw joint stability and sagittal fit between internal connection implant fixtures of two different manufacturers and customized abutments. MATERIALS AND METHODS: Internal connection implant systems from two different manufacturers (Biomet 3i system, Astra Tech system) were selected for this study (n=24 for each implant system, total n=48). For 3i implant system, half of the implants were connected with Ti ready-made abutments and the other half implants were connected with Ti CAD-CAM custom ones of domestic-make (Myplant, Raphabio Co., Seoul, Korea) and were classified into Group 1 and Group 2 respectively. Astra implants were divided into Group 3 and Group 4 in the same way. Micro-CT sagittal imaging was performed for fit analysis of interfaces and preloading reverse torque values (RTV) were measured. RESULTS: In the contact length of fixture-abutment interface, there were no significant differences not only between Group 1 and Group 2 but also between Group 3 and Group 4 (Mann-Whitney test, P>.05). However, Group 2 and Group 4 showed higher contact length significantly than Group 1 and Group 3 in abutmentscrew interface as well as fixture-screw one (Mann-Whitney test, P<.05). In addition, RTV was lower in CAD-CAM custom abutments compared to ready-made ones (Student t-test, P<.05). CONCLUSION: It is considered that domestically manufactured CAD-CAM custom abutments have similar fit at the fixture abutment interface and it could be used clinically. However, RTV of CAD-CAM custom abutments should be improved for the increase of clinical application.
Computer-Aided Design* ; Joints ; Seoul ; Torque

BACKGROUND: Venous regurgitation into the infusion line and subsequent occlusion frequently occurs during blood pressure (BP) measurement. The purpose of this study was to obtain the pattern and the actual range of peripheral venous pressure (PVP) change during NIBP measurement before and during enflurane anesthesia. METHODS: Adult size NIBP cuff was placed on the same arm on which IV infusion set was placed. PVP waveforms during BP measurement were recorded from 6 subjects. PVPs were measured before induction and at 30 min after induction of enflurane anesthesia (n=19). As the PVP waveform during NIBP measurement was biphasic in shape, values of baseline PVP (BEFORE), first peak (PEAK1), notch between two peaks (NOTCH), second peak (PEAK2) were measured. Timed control data were obtained from six volunteers. RESULTS: PEAK2 was always higher than PEAK1. Range of peak PVP was 12-130 mmHg (57.6 2.5 mmHg, mean S.E.) and PVP change was augmented during enflurane anesthesia (p<0.05). Enflurane anesthesia accentuated correlationship between mean arterial pressure and PVP. CONCLUSION: Our observation showed that peak PVP occurred during deflation phase and its range of variation was substantial. Changes in the pattern and the autoregulation of PVP by enflurane needs further investigation.
Adult ; Anesthesia* ; Arm ; Arterial Pressure ; Blood Pressure* ; Enflurane* ; Homeostasis ; Humans ; Venous Pressure* ; Volunteers

OBJECTIVE: To evaluate the incidence, the time of detection, classification, and risk factors of thyroid dysfunction in very low birth weight (VLBW) and sick infants in order to help with the diagnosis and treatment of thyroid dysfunction in the neonatal intensive care unit (NICU). METHODS: We reviewed the medical records of 78 infants, who were admitted for more than 1 month in the NICU at Chungbuk National University Hospital from July 2004 through June 2006. In these infants, at least to 2 thyroid function tests were performed, a initial screening whthin 2 weeks of age and a repeated thyroid function test after 2 weeks of age. RESULTS: 1) The study infants were divided into 2 groups, VLBW (birth weight < 1,500 g) and NVLBW (birth weight > or =1,500 g). 2) In the VLBW groups (n=48), 24 infants (50%) showed thyroid dysfunction. Six infants (12.5%) were detected at initial screening test and all had transient hypothyroxinemia. The remaining 18 infants (37.5%) were detected at repeated tests, most commonly detected at 4~8 weeks of age (n=8). Their types of thyroid dysfunction were primary hypothyroidism (PH) with a delayed marked TSH rise (n=3), PH with a delayed mild TSH rise (n= 7), euthyroid sick syndrome (ESS, n=8), and central hypopituitary hypothyroidism (HH, n=1). 3) In the NVLBW groups (n=30), 11 infants (36.7%) showed thyroid dysfunction. Three infants (10%) were detected at initial screening test, while 8 (26.7%) were detected at repeated tests. Their types of thyroid dysfunction were PH (n=5), ESS (n=3), transient hyperthyrotropinemia (n=2), and HH (n=1). 4) Among 35 infants with thyroid dysfunction, 20 infants (57.1%) were treated with thyroxine. CONCLUSION: Thyroid dysfunction was very common in sick infants in the neonatal intensive care unit, especially in the very low birth weight infants. Often, they were not detected at the initial screening test, but detected at later repeated tests. The repeated thyroid function test need to be performed in infants at risk for late detection of thyroid dysfunction after 2~4 weeks of age.
Chungcheongbuk-do ; Classification ; Diagnosis ; Euthyroid Sick Syndromes ; Humans ; Hydrogen-Ion Concentration ; Hypothyroidism ; Incidence ; Infant ; Infant, Newborn ; Infant, Very Low Birth Weight ; Intensive Care, Neonatal ; Mass Screening ; Medical Records ; Risk Factors ; Thyroid Function Tests ; Thyroid Gland* ; Thyroxine

PURPOSE: In this study we attempted to find the value of mast cell index as a diagnostic purpose of the interstitial cystitis (IC) MATERIALS AND METHODS: We compared clinical symptoms and the mast cell index in the IC and chronic cystitis patients. 16 cases of the IC patients, determined by Parson's criteria, were monitored. Under the spinal anesthesia and bladder overdistension with pressure of 60-80cmH2O, bladder wall was checked under cystoscopy. The biopsies of the bladder mucosa and detrusor muscle were obtained. The mast cell index was estimated under light microscope(x400 magnification) after it was stained with toluidine blue. RESULTS: In the IC patients, there was significant correlation between the bladder capacity and mast cell index(p <0.01). Seven patients with 100-199ml bladder capacity range had mast cell index of 62.94+/-3.66, and 8 patients in 200-299ml range had 44.78+/-9.12 mast cell index. In relation between the frequency of nocturia and mast cell index, frequency of 1-2 nocturia patients had mast cell index of 53.75+/-11.45(8 cases), 3-4 nocturia had 44.82+/-8.42(5 cases), 4 or more nocturia had 60.13+/-17.94 mast cell index(3 cases). 10 patients with urgency had 46.41+/-10.29 mast cell index, while 6 patients with no urgency problem had 61.73+/-9.92. 9 patients with lower abdominal pain had mast cell index of 51.37+/-11.79, while 7 patients with lower abdominal pain had 53.16+/-11.79. In comparison between the IC and chronic cystitis, there was significant difference between them. In IC, mast cell index was 52.09+/-12.49 and in chronic cystitis, mast cell index was 23.51+/-7.10(p <0.01). CONCLUSIONS: In this study, the results were showed that there is no direct correlation of mast cell index with nocturia, urgency and lower abdominal pain in IC patients, however there is inverse relationship between mast cell index and the bladder capacity, and we also found significant mast cell index differences between the IC and chronic cystitis. Therefore, we suggest that mast cell index is one of the pathological characteristics of IC and useful method to diagnose the interstitial cystitis.
Abdominal Pain ; Anesthesia, Spinal ; Biopsy ; Cystitis ; Cystitis, Interstitial* ; Cystoscopy ; Humans ; Mast Cells* ; Mucous Membrane ; Nocturia ; Tolonium Chloride ; Urinary Bladder