No abstract available.
Pneumocephalus*

No abstract available.
Humans

Adolescence is the period in which physical, mental and social maturation occurs and it is an important transit stage, changing from childhood to adulthood. This is a period in which important changes occur physically such as rapid growth in height and weight gain but significant differences in growth may occur for the same age. Therfore, the degree of sexual maturation may be an important indicator in evaluating growth in adolescence. Six thousand five hundred and eighty six male and female students from grade 4 to senior high from Seoul, district town and countryside were evaluated for sexual maturity using Tanner staging, weight, height and body mass index and compared for growth. There was a rapid growth in height of 6.7cm in boys between the ages of 11 and 14 years and 6.3 cm in height for girls between the ages of 10 and 12 years, showing earlier growth in height for girls. Growth in height according to sexual maturation showed the greatest growth during stages 2~3 for boys and girls. Boys grew an average of 18.94 cm and girls an average of 18.03 cm in height during the whole sexual maturation period. There was an increase of 5.5 kg in weight for boys during the same age as for growth in height, that is between 11 and 14 years of age. In girls, an average weight gain of 5.1 kg occurred between 11 and 13 years of age, slightly later than that of growth in height. Rapid gain in weight occurred during Tanner stages 2~3 for girls. Total gain of 20.70 kg for boys occurred during the whole sexual maturation period while girls gained total 19.73 kg. Body mass index increased gradually during the whole adolescent period. It was greater in boys during the ages of 9 and 12 years and greater in girls the age of 13 years and again in boys after 17 years of age. During the whole maturation period, boys gained 3.24 and girls, 4.05 of body mass index showing more gain in girls. Height, weight and body mass index showed normal variations during the sexual maturation index showed normal variations during the sexual maturation period and the results may bring an increased understanding that adolescent physical growth was closely related to sexual maturation.
Adolescent* ; Body Mass Index ; Female ; Humans ; Male ; Seoul ; Sexual Maturation* ; Weight Gain

PURPOSE: To evaluate the diagnostic role of a three-dimensional MR cholangiopancreatography(MRCP) over endoscopic retrograde cholangio- pancreatography(ERCP) in various extrah-epatic biliary disease. MATERIALS AND METHODS: MRCP and ERCP were performed in 45 consecutive patients with suspected extrahepatic biliary diseases. MRCP was obtained using a reverse fast imaging with a steady-state free precession (reverse FISP : PSIF) sequences, and then images were reconstructed by standard MIP algorithm. The predictability of biliary dilatation and level of obstruction of MRCP was evaluated using ERCP as a gold standard. The accuracy distinguishing malignant from benign lesions, and overall diagnostic accuracy were compared between MRCP and ERCP. RESULTS: The sensitivity, specificity and accuracy of MRCP in predicting biliary dilatation were 94.6%, 75.0% and 91.1%, respectively. The level of obstruction was accurate in 87.0% with MRCP. The sensitivity, specificity and accuracy MRCP and ERCP in distinguishing malignant from benign lesions were 76.2%, 87.5% and 82.2% and 71.4%, 83.3% and 77.8%, respectively. The overall diagnostic accuracy was 60.0% with MRCP and 55.6% with ERCP. CONCLUSION: 3D MRCP shows a good diagnostic value compared to that of ERCP, and can replace a ERCP.
Cholangiopancreatography, Endoscopic Retrograde* ; Dilatation ; Humans ; Sensitivity and Specificity

Localized fibrous mesothelioma of the liver is very rare benign tumor. It usually manifest large palpable hepatic mass in right upper quadrant area, and the prognosis is excellent by surgical resection. Contrast enhanced CT scan shows well defined hyperattenuating mass and celiac anglogram shows hypervascular mass. Recently we experienced 1 case of localized fibrous mesothelioma of the liver, and we report CT and anglographic findings of this tumor.
Liver* ; Prognosis ; Solitary Fibrous Tumor, Pleural* ; Tomography, X-Ray Computed

The purpose of this study is to evaluate the results of the reconstruction of acetabular bone defect with morselized bone graft in revision of failed acetabular cup, used screw fixed hemispherical cup or bipolar cup as a component. Forty five revisions of an acetabular component that had been performed in 42 patients between 1988 and 1993 at SNUH, and had followed more than two years were included in this study. The revised acetabulum was evaluated by Harris hip score, in terms of osseous union and resorption of the graft, the amount of the migration of the revised components. Cup angle change and radiolucency were also evaluated in screw fixed hemispherical cup. The mean Harris hip score was improved 54 to 87 in screw fixed hemispherical cup and 56 to 78 in bipolar cup. In screw fixed hemispherical cup, osseous union showed within 6 months is 91.3% (21 cases), the graft bone resorption less than 10% of the initial graft thickness is 73.9% (17 cases). In bipolar cup, osseous union within 6 months is 52.2% (12 cases), the graft bone resorption less than 10% of the initial graft thickness is 40.9% (9 cases). The failure of revised acetabular component was five in bipolar cup cases and one in screw fixed hemispherical cup cases. In conclusion, screw fixed hemispherical cup showed better clinical results, earlier graft osseous union, less graft bone resorption and lower failure rate than bipolar cup. There was no significant difference between pure allograft mixed with autograft in clinical and radiological results. So we recommend the technique used morselized allograft with screw fixed hemispherical cup, to reconstruct the acetabular bone defect in acetabular cup revision, though bipolar cup was used in staged operation in severe acetabular bone defect with was unable to fix the acetabular cup with screws.
Acetabulum ; Allografts ; Autografts ; Bone Resorption ; Hip ; Humans ; Transplants

To evaluate the possibility of the newly developed highly porous glass ceramics as a space-filler in the cavitary bone defect, we made the opening sized 1 × 0.5 cm on the medial aspect of the right proximal tibia of nine rabbits. We impacted the highly porous glass ceramics firmly to the medullary cavity of rabbit tibia through the opening. Each three were sacrificed at 4th, 8th, and 12th week and analyze in vivo reaction of the glass ceramics in rabbit tibia with radiological and histological methods. On radiological examination, radiolucent line was seen around impacted glass ceramics at 4th week, but this radiolucent line was obliterated gradually to 12th week. On histological examination, new bone formation with osteoblast was appeared at 4th week without foreign body reactions. At 8th week, newly formed bone infiltrated into the porous space between glass ceramics particles was noticed, and the surface of glass ceramics was tightly bound by newly formed bone with osteoblastic rim and mature bone, At 12th week, the amount of newly formed mature bone increased, though there was on evidence of resorption of glass ceramics particle. So, we suggest that the highly porous glass ceramics is one of the possible artificial bone graft substitutes, especially as a space-filler.
Ceramics ; Foreign Bodies ; Glass ; Osteoblasts ; Osteogenesis ; Rabbits ; Tibia ; Transplants

OBJECTIVE: We evaluated the effects and toxicities and cost effectiveness of iv etoposide-carboplatin- cyclophosphamide (ECC) combination chemotherapy against persistent or recurrent ovarian cancer who were previously heavily treated with one or more lines of chemotherapy which included platinum-paclitaxel- cyclophosphamide-topotecan based regimens. METHODS: Fifteen patients with a persistent or recurrent ovarian cancer, previously received first or more line chemotherapy, had been treated with ECC combination chemotherapy at Konsin Medical Center from September 2000 to October 2002. The ECC (iv etoposide-carboplatin-cyclophosphamide) combination chemotherapy consists of 100 mg/m2 etoposide iv and 500 mg/m2 cyclophosphamide iv in first day and 100 mg/m2 etoposide iv, 450 mg/m2 carboplatin iv in second day and 100 mg/m2 etoposide iv in third (and 4th-5th day if necessary) every 3-4 weeks. The response of patients was evaluated with the tumor marker (serum CA-125) and imaging studies (ultrasonogram, CT, MRI). The toxicities were defined according to the WHO toxicity criteria. RESULTS: The overall response rate by WHO criteria is 47%. In detail, partial response is 47%, Stable disease is 40% and progressive disease is 13%. The serologic CA-125 response rate is 64%, in detail serologic partial response is 64%, and serologic stable disease is 22% and serologic progressive disease is 14%. The median response duration is 9 months (4 to 12 months), the median time to response is 1 month (2 weeks to 2 months) and the median time to progression is 9 month (4 to 12 months). The most common side effect is nausea and vomiting and the bone marrow suppression is proved as a most serious side effect (grade 3 or more-13%). CONCLUSION: The iv etoposide-carboplatin-cyclophosphamide chemotherapy as a 2nd or more lines regimen against persistent or recurrent ovarian cancer is considerable.
Bone Marrow ; Carboplatin* ; Cost-Benefit Analysis ; Cyclophosphamide* ; Drug Therapy* ; Drug Therapy, Combination* ; Etoposide* ; Humans ; Nausea ; Ovarian Neoplasms* ; Vomiting

A 39-year-old female patient presenting with epigastric discomfort and jaundice was diagnosed as diffuse hilar cholangiocarcinoma with vascular tumor invasion. After preoperative management with percutaneous transhepatic biliary drainage and right portal vein embolization, the patient underwent modified hepatoligamentopancreatoduodectomy; this included extended right hepatectomy, caudate lobectomy, portal vein segmental resection, enbloc resection of hepatoduodenal ligament together with proper hepatic artery resection and with leaving a replaced left hepatic artery from the left gastric artery, and paraaortic lymph node dissection. Intraoperative frozen histologic examination revealed multiple paraaortic lymph node metastases, which was generally regarded as definite distant metastasis. There was no postoperative complication except for persistent drainage of ascites that occurred only during the immediate postoperative period. She did not receive postoperative adjuvant chemotherapy or radiotherapy. The patient is now living well 11 years 2months after surgery without recurrence. Although this patient revealed hilar vascular invasion and paraaortic lymph node metastasis, she survived more than 10 years without tumor recurrence. This implicate that aggressive surgical treatment of hilar cholangiocarcinoma can result in long-term survival even in the presence of paraaortic lymph node metastasis.
Adult ; Arteries ; Ascites ; Chemotherapy, Adjuvant ; Cholangiocarcinoma* ; Disease-Free Survival* ; Drainage ; Female ; Hepatectomy ; Hepatic Artery ; Humans ; Jaundice ; Ligaments ; Lymph Node Excision ; Lymph Nodes* ; Neoplasm Metastasis* ; Portal Vein ; Postoperative Complications ; Postoperative Period ; Radiotherapy ; Recurrence

We performed ERCP manometry of Sphincter of Oddi(SO) before and after endoscopic sphincterotomy(EST) for evaluation of the effect af EST on the SO. The subjects were postcholecystectomized common bile duct stone patients(n=l2) and EST was performed by major incision. The pressure gradient between common bile duct and duodenum before EST (8.6 + 3.9 mmHg) decreased significantly after EST(2.4 +1.7 mmHg). The length of SO before EST(8.8 + 0.8mmHg) decreased significantly after EST(2.5 + 0.8mm). But in each patient, the pressure gradient between common bile duct and duodenum remained in spite of the major incision. In conclusion, EST alters the function of the sphincter of the Oddi, but does not destroy its all protective function. The positive pressure in the bile duct is preserved in contrast to the absolute loss of pressure following surgical transduodenal sphincteroplasty.
Bile Ducts ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct ; Duodenum ; Humans ; Manometry* ; Sphincter of Oddi* ; Sphincterotomy, Endoscopic* ; Sphincterotomy, Transhepatic