Autograft is frequently used to restore anatomic morphology and functional properties in bone defects. Disadvantages of the autograft are related to donor site morbidity and include the risk of wound infection, increased blood loss, and additional postoperative discomfort. Allograft and xenograft, which are currently employed as the most common alternative to autografts, encounter the complications. such as fracture, resorption, and nonunion secondary to immunologic rejection. Hydroxyapatite(HAp), a calcium phosphate ceramic, is a well known biocompatible artificial bone substitute without induction of systemic toxic and foreign body reactions. Bone conduction is usually occurred by the implanted HAp. Biodegradation of HAp is poor and the bone formation around HAp is slow and about more than 70% of the natural apatite in bone is composed of carbonate apatite that has carbonic radical(CO3) instead of hydroxyl radical(OH-) or Phosphate radical(PO4 ) of HAp. Carbonate apatite ahs been known as that the physicochemical properties are similar of the natural bony apatite. In vivo experiment, carbonate apatite demonstrates non-toxic reactions. In this study, the compostite consisted of carbonate apatite and type I collagen, which is the bony structural protein, was implanted in rabbit tibiae to evaluate possibility as an artificial bone substitute. Biodegradation rate of the composite, the rate and qiantity of the regenerative cortical and cancellous bone formation were investigated radiologically and histopathologically. HAp and the carbonate apatite coilagen composite(Ap-C) were applied in the dissected rabbit tibiae(7-8mm), and fixed by external fixators. Postoperative roentgenograms were taken 2, 4, 6, and 8 weeks after implantations. For histological ohservations, the rabbits were sacrificed and the specimens were obtained 2, 4, 6, and 8 weeks after operation. Radiological Lane scores of Ap-C were 1.16±0.92, 2.16±0.98, 3.33± 0.82, and 3.67±0.51 in 2. 4, 6 and weeks after operation, while the Lane score of HAp were 0.53±0.84, 0.83±0.75, 1.67±0.81, and 2.83±0.98 respectively. Ap-C demonstrated the faster degradation and more bone formation then HAp. Though physicochemical properties of carbonate apatite is similar to those of HAp, the carbonate apatite and type I collagen composite(Ap-C) revealed rather faster degradation and bone formation than HAp in both radiological and histological investigations.
Allografts ; Autografts ; Bone Conduction ; Bone Substitutes ; Calcium ; Carbon ; Ceramics ; Collagen Type I ; Collagen ; Durapatite ; External Fixators ; Foreign Bodies ; Heterografts ; Humans ; Osteogenesis ; Rabbits ; Tibia ; Tissue Donors ; Wound Infection

PURPOSE: Nutritional as well as genetic and hormonal factors play an important role in the bone mineralization during childhood and adolescence. There are several physical and metabolic changes in obese children, and these changes may influence on the mineralization of the skeleton. The studies about bone mineralization of obese children are rare and contradictory. This study was performed to evaluate the influence of childhood obesity on bone mineral density(BMD). METHODS: The BMD of 49 obese and 41 non-obese children were measured at lumbar spines(L2-L4) using dual energy X-ray bone absorptiometry. Then, the results were assessed and compared according to the degree of obesity and pubertal sex maturation. RESULTS: There were no significant differences in BMD between obese children and non-obese children(0.87+/-.19 g/cm2 vs 0.81+/-.13 g/cm2). BMD increased according to the Tanner' pubertal staging, and the most marked increment was observed at overt puberty. No sex difference in BMD was seen in both obese and non-obese children. BMD was highly correlated with age, height, weight and body mass index(BMI), but there was no significant correlation between BMD and osteocalcin. CONCLUSION: BMD of obese children was not significantly different from that of non-obese children, and BMD also was not changed according to the degree of obesity. These findings suggest that BMD is not influenced by obesity in children.
Adolescent ; Bone Density* ; Calcification, Physiologic ; Child* ; Humans ; Obesity* ; Osteocalcin ; Pediatric Obesity ; Puberty ; Sex Characteristics ; Sexual Maturation ; Skeleton

BACKGROUND: Cryosurgery for epidermal pigment lesions such as Becker's nevus and nevus spilus could be inexpensive, simple and effective, but has not been published much in detail. OBJECTIVE: We evaluated the clinical efficacy according to its determinants, complications and recurrence rate of the cryosurgery, and compared with those of pigment laser. METHODS: Hard chalk dry ice were applied on the lesions of 17 patients with Becker's nevus, 8 patients with nevus spilus and 6 patients with congenital nevocytic nevus. Two freeze-thaw cycles per lesion were employed, freezing time was chosen arbitarily depending on the characteristics of each lesion. Nineteen patients of the above 31 patients were also treated with PLDL(xenon flashlamp -pumped dye laser: 2.5-3.0J/cm2) or PLTL (Q-Switched alexandrite laser: .5-8.5J/cm2). Accessible patients were evaluated by direct interview or phone. RESULTS: 1. The clinical efficacy of the cryosurgery was better in nevus spilus than in Becker's nevus or congenital nevocytic nevus. 2. In nevus spilus, the clinical efficacy of the cryosurgery was similar to that of pigment laser, while cryosurgery was more effective than laser surgery in Becker's nevus. 3. The most common complication was transient perilesional hyperpigmentation, which could be removed with chemical peeling or dermabrasion. CONCLUSION: Cryosurgery for epidermal pigment lesions was an inexpensive, simple and effective procedure. In some cases, cryosurgery showed better results than pigment laser, and its efficacy may be improved by adjunctive laser treatment. The rate of recurrence after cryosurgery was lower than that of laser surgery. Cryosurgery would be recommendable for treating epidermal pigment lesions.
Calcium Carbonate ; Cryosurgery* ; Dermabrasion ; Dry Ice ; Freezing ; Humans ; Hyperpigmentation ; Laser Therapy ; Lasers, Dye ; Lasers, Solid-State ; Nevus* ; Recurrence

No abstract available.
Hemolytic-Uremic Syndrome*

The syndrome of inappropriate ADH secretion is a disorder characterized by hyponatremia which results from water retention attributable to ADH release. The hallmark of SIADH is hyponatremia due to water retention, in the presence of urinary osmolality above plasma osmolality. The SIADH was initially described by Schwartz et al (1957). This syndrome, first recognized in patients with bronchogenic carcinoma, has now been observed in a variety of other illnesses. Recently, we encountered a 59 year-old female with small cell lung cancer, also she had SIADH. Thus, we present a case and review the literature on the subject.
Carcinoma, Bronchogenic ; Female ; Humans ; Hyponatremia ; Inappropriate ADH Syndrome* ; Osmolar Concentration ; Plasma ; Small Cell Lung Carcinoma* ; Water

Proximal cerebrospinal fluid shuntmalfunction due to ventricular catheter occlusion remains the most common sourceof the shunt problem. The position of the hole-bearing segment of the catheter affects the long term patency of the ventricular catheter of a cerebrospinalfluid shunt.Placementof thissegmentnear thechoroidplexus or injured ependyma increases the probability of obstruction. Accurate locationof ventriculoperitoneal(V-P)shunt tip inrelation to foramen Monro canbe well establishedby plain radiographyregardless of agesor sizes and shapes of head dueto the fact that foramen Monro tothe spatial matrix of the skull is constant. Of 147patients who underwentV-P shunt operations, 49(33.3%)patients had more thanone operations. Radiologicgradingof theventricularcatheterposition is compared betweensingle operatedgroup andreoperated group.Single operated group showed excellentin 33.6%, good41.8%, poor 24.4%of accuracy rateof catheter tip position. Incases ofreoperation, placement ofcatheter tipresulted in excellent 12.5%, good21.8%, and poor 65.6%.These results indicatethat accurate location of ventricular catheter tip affects favorably to the patency of V-P shunt.
Catheters ; Cerebrospinal Fluid ; Ependyma ; Head ; Skull ; Ventriculoperitoneal Shunt*

BACKGROUND: Frontal hair line dose not exist in the same form for a lifetime, and each individual has a different form of frontal hair line. But, the study of the change of the frontal hair line still dose not exist. OBJECTIVE: The objective of this study of the change of frontal hair line was to analyze whether the change of age, puberty, and the family history of androgenic alopecia was related to the change of frontal hair line. METHOD: This study held a survey which consists of male and female students of each class from middle school to high school. In this survey, the shape of frontal hair line was classified into the egg shape, square shape, and M shape. RESULT: 1. When the age increased, the egg shape type of frontal hair line decreased, and the square type of frontal hair line increased. Especially, men were more salient. 2. During puberty, the egg shape type of frontal hair line decreased, and the square shape type of frontal hair line increased. 3. Before puberty, the m shape type of frontal hair line did not exist, but during puberty the M shape type of frontal hair line appeared. 4. Statistically, the family history of androgenic alopecia of the relationship of the change of the egg shape type decreased, the square shape increased. CONCLUSION: This study shows that frontal hair line is related to the change of age, and existence of puberty.
Adolescent* ; Alopecia ; Female ; Hair* ; Humans ; Korea* ; Male ; Ovum ; Puberty

BACKGROUND: Clinically apparent thyroid nodule is a very common disease in adults. Patients are often treated with thyroxine in order to reduce the size of the nodule, but the efficacy of thyroxine-suppressive therapy with thyroxine remains uncertain. We investigated the efficacy of thyroxine-suppressive therapy and the hormonal characteristics during thyroxine therapy to find out whether such measurement could be used to determine the effectiveness of this therapy in patients with benign solitary thyroid nodule proved by aspiration biopsy. METHODS: In this study, 54 patients were randomly assigned to receive L-thyroxine (Group I, n=24) or placebo (GroupII, n=30) for 1 year. High resolution ultrasonography (10MHz) was used to measure the size of the nodules at six month intervals. Thyroid hormones and thyroglobulin assay and FNA (fine needle aspiration) was done at the same time. The dose of thyroxine was 200ug/day. Patients were followed at 6 month intervals. RESULTS: The results were as follows: 1) 13 (54.1%) out of 24 Group I patients after adequate TSH suppression had a statistically significant reduction of nodule size and before-to-after nodule volume ratios were significantly different between the Group I and Group II patients. 2) In the responders among Group I patients, the before-to-after therapy ratio of the nodule volume was not related to the pretreatment nodule size, thyroid hormones and thyroglobulin levels. CONCLUSION: Thus we concluded that an adequate suppressive dose of L-thyroxine significantly altered the volume of the benign solitary thyroid nodules 12 months later.
Adult ; Biopsy, Needle ; Humans ; Needles ; Thyroglobulin ; Thyroid Gland* ; Thyroid Hormones ; Thyroid Nodule* ; Thyroxine* ; Ultrasonography

PURPOSE: The objective of this study is to report our initial experience about the feasibility, effectiveness, and safety of transobturator tension-free vaginal mesh (Prolift(TM)) and concomitant tension-free vaginal tape (TVT) as a treatment of female anterior vaginal wall prolapse associated with stress urinary incontinence (SUI). MATERIALS AND METHODS: We reviewed the charts of patients who underwent Prolift(TM) and TVT between April 2009 and March 2010. All patients had a physical examination and staging of cystocele. According to the International Continence Society system 2, 5 and 3 women had stage grade II, III and IV respectively. All the patients underwent pelvic examination 1, 3, 6 month and 1 year after operation and anatomical and functional outcomes were recorded. An anatomic cure after intervention was defined as stage 0 and an improvement was defined as stage I. Anatomic failures were defined as stage II or higher on the last physical examination. RESULTS: The mean follow-up was 7.1 (1-11) months. Overall success rate of cystocele repair was 90%. The anatomical cure rate of cystocele was 50%. The cystocele repair improved 4 patients, but failed in 1. SUI was cured in all patients. No significant complications including bladder or vessel injury and mesh related erosion occurred. The postoperative complication was transient voiding difficulty (2 cases). CONCLUSIONS: These preliminary results suggest that Prolift(TM) and TVT offer a safe and effective treatment for female anterior vaginal wall prolapse and SUI. However, a long-term follow up is necessary in order to support the good result maintenance.
Cystocele ; Female ; Follow-Up Studies ; Glycosaminoglycans ; Gynecological Examination ; Humans ; Physical Examination ; Postoperative Complications ; Prolapse ; Suburethral Slings ; Urinary Bladder ; Urinary Incontinence

BACKGROUND/AIMS: Spontaneous rupture of hepatocellular carcinoma (HCC) is a rare but life-threatening complication. Although the prevalence rate and mortality of HCC has been reportedly high in Korea, studies on ruptured HCC are limited. The aim of this study was to determine the clinical characteristics and prognostic factors of ruptured HCC. METHODS: Among 886 cases with HCC that had been diagnosed at Chonnam National University Hospital from January 2002 to December 2007, 62 cases (7.0%) with ruptured HCC were studied retrospectively regarding their clinical characteristics and prognostic factors. RESULTS: Transarterial embolization was performed in 56 cases (90.3%) to control bleeding, with a hemostasis success rate of 89.3%. The survival time after the rupture of HCC was 8.0+/-1.7 months (mean+/-SD), although it was longer in HCC cases that were first diagnosed in a ruptured state or ruptured with a small amount of bleeding than in those that ruptured during follow-up after diagnosis or with a large amount of bleeding, respectively. The 30-day mortality rate in patients with a ruptured HCC was 43.5%, and the early deaths were independently associated with the presence of hepatic encephalopathy (odds ratio, OR=44.7; 95% confidence interval, CI=1.9-1051.1; P=0.018), serum bilirubin >3.0 mg/dL (OR=36.7; 95% CI=1.3-1068.5; P=0.036), and the massive or diffuse type of tumor morphology (OR=53.5; 95% CI=3.0-964.2; P=0.007). CONCLUSIONS: The prognosis in patients with ruptured HCCs was poor with a 30-day mortality of 43.5%. The early deaths after the rupture of HCC were associated with elevated serum bilirubin levels, hepatic encephalopathy, and the massive or diffuse type of tumor morphology.
Adult ; Aged ; Aged, 80 and over ; Carcinoma, Hepatocellular/*diagnosis/mortality/therapy ; Clinical Chemistry Tests ; Data Interpretation, Statistical ; Female ; Humans ; Liver Neoplasms/*diagnosis/mortality/therapy ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Rupture, Spontaneous/diagnosis ; Severity of Illness Index ; Survival Rate ; Tomography, X-Ray Computed ; Treatment Outcome