Central diabetes insipidus is a rare disorder that can result as a consequence of diverse etiologies, including malformations, autoimmune, infiltrative(e.g. neoplastic or histiocytosis) or traumatic processes, as well as mutations in the gene encoding arginine vasopressin. Idiopathic central diabetes insipidus is a diagnosis of exclusion, one that has been made less frequently through the decades. Idiopathic central diabetes insipidus in children and adolescent requires a frequent follow-up regimen using serial brain MRI and CSF examinations especially if an isolated pituitary stalk thickening or loss of a hyperintense signal in the posterior lobe is observed. Also, so-called "idiopathic" central diabetes insipidus warrants close follow-up to determine the etiology, especially if anterior pituitary hormone deficiencies are detected. We report a case of idiopathic central diabetes insipidus with growh hormone deficiency and loss of a hyperintense signal in the posterior lobe. He is a 13 years old. We are scheduled to follow-up with serial contrast enhanced brain MRI and CSF evaluation for the early detection of an evolving occult hypothalamic-stalk lesion.
Adolescent ; Arginine Vasopressin ; Brain ; Child ; Diabetes Insipidus, Neurogenic* ; Diagnosis ; Follow-Up Studies ; Growth Hormone* ; Humans ; Magnetic Resonance Imaging ; Pituitary Gland

In children, snapping knee syndrome and joint pain with the loss of physiological hyperextension strongly suggests a diagnosis of a torn discoid meniscus. We performed arthroscopic meniscectomy to treat torn discoid lateral meniscus on 19 knees and open meniscectomy on 9 knees of 26 children(average age: 10.9 yrs) from September, 1983 to October, 1993 at Guro hospital. According to Ikeuchi's grading system', excellent results were obtained in 14, good in 11, fair in 2 knees and poor in 1 knee which was associated with osteochondritis dissecans. The knees treated by partial meniscectomy showed less Fairbank's radiologic changes than those by total meniscectomy during the average follow-up 4.2 years(minimum 1 year, maximum 7 year 11 months).
Arthralgia ; Child ; Diagnosis ; Follow-Up Studies ; Humans ; Knee ; Menisci, Tibial ; Osteochondritis Dissecans

No abstract available.
Child* ; Humans ; Humerus*

No abstract available.
Hemarthrosis* ; Knee*

Supracondylar fracture of humerus is the most common fracture about the elbow in children and much has been written about its treatment and the prevention of both Volkmann's ischemia with contracture and cubitus varus deformity. In a retrospective survey of 155 children with supracondylar frscture of the humerus, 63 cases were found to have sufficient clinical and retrospective data to classify the fracture. 1. The average age was 6.5 years ranged from 1 year 3 months to 14 years and sex ratio was 2.2: 1(M:F) 2. 62 cases(98.4%) were extension type and 1 case(1.6%) was flexion type. In extension type, displacement was posteromedial 30 cases(47.6%), posterolatera117 cases(26.9%), posterior 10 cases(15.9%) and undisplaced 5 cases(7.9%). 3. Fracture level was divided into 3 Groups. Trans-olecranon fractures were 47 cases(74.6%), proximal to olecranon fractures were 11 cases(17.5%) and distal to olecranon fractures were 5 cases(7.9%). According to age distribution lower age group involves the distal part and higher age group involves proximal part. 4. Transverse fractures were 39 cases(61.9%) and oblique fractures were 24 cases(38.1%). In oblique fracture, postero-anterial oblique fractures were 19 cases(30.2%), medio-lateral oblique fractures 3 cases(4.8%), and latero-medial 2 cases(3.2%). In oblique fractures redisplacements were more common in P-A oblique csse. 5. In the treatment of fracture, 31 cases(49.2%) were treated with closed reduction and percutaneous pinning, 26 cases(41.3%) were treated with closed reduction and splint immobilization, 3 cases(4.8%) were treated with open reduction and K-wire fixation, 3 cases(4.8%) were treated with skeletal traction. 6. Functional results according to degree of initial displacement was worse in some displaced(Grade II) cases, rather than total displaced (Grade IV) or displaced with rotation (Grade III) cases. 7. Complications in splint immobilzation method were cubitus varus deformity 2 cases, nerve injury 2 case, and in k-wire fixation method, nerve injury 5 cases and pin migration 1 case.
Age Distribution ; Child ; Clinical Study ; Congenital Abnormalities ; Contracture ; Elbow ; Humans ; Humerus ; Immobilization ; Ischemia ; Methods ; Olecranon Process ; Retrospective Studies ; Sex Ratio ; Splints ; Traction

To assess the clinico-pathological characteristics of patients with multiple primary colorectal cancer, 458 patients who underwent curative surgery and being followed-up at our institution between Jan. 1987 and Dec. 1993 were evaluated in this study. The median follow-up period was 42 months. Synchronous cancer was defined as distinct lesions separated by a distance of greater than 4cm with the invasion of the tumor below the muscularis mucosa at the time of diagnosis or within 6 months after initial treatment, and metachronous cancer was defined as the development of colon cancers more than 6 months after the initial treatment without evidence of the recurrence or metastases from primary tumor. There were 29 cases of multiple primary colorectal cancer(6.3%). Eighteen cases(3.9%) of them were synchronous, 11 cases(2.4%) were metachronous cancers. Seven cases(1.5%) were related to 5 hereditary non-polyposis colorectal cancer(HNPCC) families. During the follow-up period, 11 patients(2.4%) developed cancers in other organs. Adenomatous polyps were identified 14 cases of 29 patients with multiple primary colorectal cancers(48.3%), compared to 43 cases(10%) in 429 patients with solitary colorectal cancer(p<0.01). After initial curative surgery, there were 8 recurrences in 29 patients with multiple primary colorectal cancers(23.6%), compared to 100 recurrences in 429 patients with solitary primary colorectal cancer(23.3%)(p>0.05). In aspect of family history, there was close-relationship with this regarding in the group of multiple primary colorectal cancers. However, authors were unable to make analysis this regarding in the group of solitary primaries because of lack of the information. Conclusively, authors guess the frequent association of the adenomatous polyps in multiple primary colorectal cancers as the evidence of the adenoma-carcinoma sequence. In addition, authors emphasized the importance of the total colonoscopic examinations in pre-and post-operation in order to make diagnosis of the multiple primary colorectal cancers and paying attention as to the family history of colorectal cancer patients because we have good therapeutic results after operation of early stage in synchronous cancers and co-existent adenomatous polyps.
Adenomatous Polyps ; Colonic Neoplasms ; Colorectal Neoplasms* ; Diagnosis ; Follow-Up Studies ; Humans ; Mucous Membrane ; Neoplasm Metastasis ; Recurrence

We report a case of mycosis fungoides in a 37 year-old male patient who had relatively well defined, irregular, erythematous plaques covered with acales on the buttock, lower extremities, anterior chest and back. Histopathological findings showed epidermotropism and Pautrier microabscesses in the epidermis and infiltration of atypical lymphocytes in the upper dermis. Electron microscopic findings showed mycosis cells with convoluted nuclei and prominent nucleolei He had been received PUVA therapy combined with topical and systemic corticosteroid for 4 months. Skin lesions were improved markedly after treatment with total 262 joules/crn2 and then maintained with 14 joules/cm2 in every week.
Adult ; Buttocks ; Dermis ; Epidermis ; Humans ; Lower Extremity ; Lymphocytes ; Male ; Mycosis Fungoides* ; PUVA Therapy ; Skin ; Thorax

STATEMENT OF PROBLEM: A number of studies about the nano-treated surfaces of implants have been conducting along with micro-treated surfaces of implants. PURPOSE: The purpose of this study was to get information for the clinical use of nano-treated surfaces compared with micro-treated surfaces by measuring removal torque and analyzing histological characteristics after the placement of various surface-treated implants on femurs of dogs. MATERIAL AND METHODS: Machined surface implants were used as a control group. 4 nano-treated surface implants and 3 micro-treated surface implants [resorbable blast media surface (RBM), sandblast and acid-etched surface (SAE), anodized RBM surface] were used as experimental groups. Removal torque values of implants were measured respectively and the histological analyses were conducted on both 4weeks and 8weeks after implant surgery. The surfaces of removed implants after measuring removal torque values were observed by scanning electron microscopy (SEM) at 8 weeks. RESULTS: 1. Removal torque values of the nano-treated groups were lower than those of micro-treated groups. 2. Removal torque values were similar in the anodized RBM surface groups. 3. On the histological views, there was much of bone formation at 8 weeks, but there was no difference between 4 and 8 weeks, and between the types of implant surfaces as well. CONCLUSION: It is suggested that implant topography is more effective in removal torque test than surface chemistry. To get better clinical result, further studies should be fulfilled on the combined effect of surface topography and chemistry for the implant surface treatments.
Animals ; Dogs ; Femur ; Microscopy, Electron, Scanning ; Osteogenesis ; Titanium ; Torque

Twenty-nail dystrophy is an idiopathic nail dystrophy in which all twenty nails are uniformly and simultaneously affected with excess longitudinal ridging and loss of lustre. The pathogenesis is controversial, and the treatment is unsuccessful. It is thought to have a self-limiting and reversible nature when it develops in childhood, but in adults, it is unusual and exists persistently. We re-port here two cases of adult patients with dystrophy of all twenty nails, whose ages were 58 and 55. The disease had been present for one year and may be associated with alopecia areata in the 58 year old and an idiopathic condition in the 55 year old. Negative results were obtained on mycological studies. Biopsies taken from the nail bed revealed marked hyperkeratosis consistent with nail dystrophy.
Adult ; Alopecia ; Alopecia Areata ; Biopsy ; Humans

PURPOSE: We evaluated the correlation between the carcinogenesis of gallbladder and the expression of lysozyme, p53, c-erbB2 and CEA in gallbladder lesions. MATERIALS AND METHODS: Thirty cases of gallbladder lesions (containing 17 cases of GB carcinoma) were examined. We analyzed the clinicopathologic findings of the early (stage I & II) and advanced carcinoma (stage III, IV & V) and those of carcinoma with or without metaplasia in the tumor. We performed p53, c-erbB2 and CEA immunohistochemical staining and compared their findings with those of normal mucosa and preneoplastic lesions. We also performed lysozyme immunohistochemical staining and compared its finding with metaplastic and non-metaplastic lesions. RESULTS: There are two distinct genetic pathways in gallbladder cacinogenesis and metaplastic carcinoma was more frequent than non-metaplastic carcinoma. Metaplasia of gallbladder did not reveal any difference of the clinicopathologic findings and depth of invasion (Nevin stage). Lysozyme expression was found in all metaplastic lesions but non-expression did not indicate non-metaplastic lesions. p53 mutations and c-erbB2 alterations may have a role in the carcinogenesis of gallbladder carcinomas, especially, in a late event, and in an early and late events, respectively. The correlation of p53 and c-erbB2 expressions was found but which did not indicate that the co-expression was needed in the carcinogenesis. CEA immunohistochemical staining may be helpful in the differential diagnosis of benign lesions and precancerous and cancerous lesions of the gallbladder. CONCLUSION: These results suggest that p53 mutations and c-erbB2 alterations may have a role in the carcinogenesis of gallbladder carcinomas, especially, in a late event, and in an early and late events, respectively.
Carcinogenesis ; Diagnosis, Differential ; Gallbladder* ; Metaplasia* ; Mucous Membrane ; Muramidase