PURPOSE:Several drugs such as insulin, propranolol, levodopa, glucagon and clonidine have been used for pharmacological growth hormone(GH) provocative test, and each medical center chooses different combinations of drugs during GH provocative tests. In this study, authors compared three drugs insulin(RI), clonidine(C), and propranolol-levodopa(P-L) in terms of GH secretory ability to select the most effective drug. METHODS:Study patients consisted of 63 children with idiopathic growth hormone deficiency, who were diagnosed 'H deficiency'in the department of pediatrics, Kyungpook National University Hospital between January, 1995 and December, 1995. Peak values of GH by each drug were analyzed and following results were obtained. RESULTS:Numbers of patients who showed peak GH values of < or = 5ng/mL, 6-9ng/ mL or > or = 10ng/mL were 23, 22 and 18 respectively in GH provocative test using RI, 48, 12 and 3, respectively in GH provocative test using P-L, 55, 8 and 0, respectively in GH provocative test using C. The numbers of patients showing peak growth hormone values over 6ng/mL were more significantly in GH provocative test using RI than those using P-L or C(P<0.05). CONCLUSION: Among drugs authors have been using in GH provocative tests, RI was more effective in stimulating growth hormone secretion than P-L or C. Authors feel that RI should be included in GH provocative tests for the diagnosis of growth hormone deficiency.
Child ; Clonidine* ; Diagnosis ; Glucagon ; Growth Hormone* ; Gyeongsangbuk-do ; Humans ; Insulin* ; Levodopa ; Pediatrics ; Propranolol

BACKGROUND: The blunted tip of a reusable with multiple uses can cause problems with the passing procedure in arthroscopic Bankart repair. This study assessed the advantage of Scorpion with a 70° arthroscope in arthroscopic Bankart repair compared to hook typed suture passer. METHODS: Scorpion in 19 patients, the hook type suture passer (conventional group) in 18 patients were used. All patients underwent the same procedure except for the type of suture passer used. Another different point of the procedure were telescopes and the number of portals used; three arthroscopic portals (posterior, anterorsuperiorlateral, and mid-anterior) and a 30° arthroscope in the conventional group, but two portals and a 70° arthroscope as well as the 30° one in the Scorpion group. The surgery time and the surgical complications including an iatrogenic axillary nerve injury were recorded. RESULTS: The Scorpion group showed a significant decrease in surgery time compared to the conventional group. In contrast to the conventional group, Scorpion provided an easy estimation of the exit of suture passing, no iatrogenic labral injury during the passing procedure with straight movement and the sharp tip of the knife installed. Iatrogenic supraspinatus injuries could be avoided when making an accessory anteosuperiorlateral portal due to the 70° arthroscope. CONCLUSIONS: In arthroscopic Bankart repair, the use of the Scorpion suture passer and a 70° arthroscope can reduce the surgery time, avoid unnecessary supraspinatus injury, and avoid iatrogenic axillary nerve damage through the relatively easy and precise suture passing and saving of the anterosuperior portal.
Arthroscopes* ; Arthroscopy ; Humans ; Scorpions* ; Sutures* ; Telescopes

No abstract available.
Humans ; Hyalin* ; Hyaline Membrane Disease* ; Infant, Newborn

Wallerian degeneration is well known as the anterograde degeneration of axon and their accompanying myelin sheath from injury to the proximal portion of the axon or its cell body. The most common cause of wallerian degeneration is cerebral infarction. Authors experienced three patients with old hemispheric infarct with typical wallerian degeneration in the brain stem, which was demonstrated by magnetic resonance imaging (MRI) in two cases and CT in one case. This report demonstrates the wallerian degeneration in the corticospinal tract on the MRI and CT with the brief review of the literatures.
Axons ; Brain Stem ; Brain* ; Cell Body ; Cerebral Infarction ; Humans ; Magnetic Resonance Imaging* ; Myelin Sheath ; Pyramidal Tracts ; Wallerian Degeneration*

No abstract available.
Adenocarcinoma*

Migration of the fixation device to a part of the body is well known complication of fracture treatment. However, few reports of this complication have appeared in the literature. The present report concerns two instances of the migration of a K-wire and a Steinmann pin from the acromioclavicular joint, respectively, into the neck. It appears that if wires and pins are used for fixation, the lateral ends should be bent to prevent medial migration, and as soon as the desired therapeutic results have been obtained, these must be subsequently removed.
Acromioclavicular Joint ; Fixatives ; Neck

Transient synovitis of the hip in children is a non-specific inflammatory and self-limited condition. It is also the most common cause of painful hip in children under ten years of age. Despite of the benign prognosis, there are many difficulties in distinguishing it from other diseases of the hip joint. It remains a common diagnostic problem for clinician because the clinical symptoms, physical findings, and conventional radiography is not pathognomonic of the condition. The authors paid attention to the increase of effusion in the affected hip and studied the value of the hip ultrasonography in 24 cases of transient synovitis from August 1985 to July 1987. The results are summerized as follows : 1. The ratio of male to female was 7 to 1, average age was 7.9 yrs, average hospitalization period was 4.5 days. 2. In simple X-ray studies, no bony change was detectable except for soft tissue signs in 68% of the cases. 3. Capsule-to-bone distance in sagittal ultrasonographic section revealed abnormal increase in 87.5% of the affected hip. 4. Average capsule-to-bone distance of affected hip joint was 7.50 mm, while that of the normal hip was 4.26 mm. 5. As shown in the above studies, ultrasonography can be considered good noninvasive technique in detection and follow-up of hip effusion. So, it is thought to be a valuable method in the diagnosis of transient synovitis of the hip in children.
Child ; Diagnosis ; Female ; Follow-Up Studies ; Hip Joint ; Hip ; Hospitalization ; Humans ; Male ; Methods ; Prognosis ; Radiography ; Synovitis ; Ultrasonography

BACKGROUND: We investigated the effectiveness of fibular strut allograft augmentation of proximal humerus fractures to prevent varus deformity in patients over the age of 65 years with insufficient medial support. METHODS: We analyzed the clinical and radiological outcomes of locking plate fixation with adjunct fibular strut allograft augmentation in 21 patients with proximal humeral fractures. The inclusion criteria were age (65-year-old or older); presence of severe medial comminution; inadequate medial support; and those who could participate in at least a one year follow-up. The average age was 76.4 years. We analyzed each patient's Constant score, our indicator of clinical outcome. As radiological parameters, we analyzed time-to-bone union; restoration of the medial hinge; difference between the immediately postoperative and the last follow-up humeral neck-shaft angles;; and anatomical reduction status, which was assessed using the Paavolainen method. RESULTS: A successful bone union was achieved in all patients at an average of 11.4 weeks. We found that the average Constant score was 74.2, showing a satisfactory outcome. The average difference in the humeral neck-shaft angles between the immediately postoperative time-point and at the final follow-up was 3.09°. According to the Paavolainen method, the anatomical reduction was rated excellent. The medial hinge was restored in 14 of 21 patients. Although we did not find evidence for osteonecrosis, we found that a single patient had a postoperative complication of screw cut-out. CONCLUSIONS: Fibular strut allografting as an adjunct treatment of proximal humeral fractures may reduce varus deformity in patients with severe medial comminution.
Allografts ; Congenital Abnormalities* ; Follow-Up Studies ; Humans ; Humerus* ; Methods ; Osteonecrosis ; Postoperative Complications ; Shoulder Fractures ; Transplantation, Homologous

Electron microscopy (EM) can provide a valuable contribution to light microscopy (LM) in the interpretation of fine needle aspiration cytology (FNAC) specimen, especially in the diagnosis of the tumor. However, considerable care in processing the specimen is mandatory to recover the cells and avoid altering the fine structures. We experienced a case of malignant melanoma in 33-yrs-old female, diagnosed by EM study of FNAC specimen from the axillary mass, who was initially thought as dissem- inated carcinomatosis on LM study. The technique of EM study on FNAC specimen consisted of washing the needle and syringe in 2.5% glutaraldehyde after a rapid stain (Diff-Quik), which was used to obtain a preliminary diagnostic impression and to assure the adequacy of the EM specimen. After centrifugation in the steps of fixation and dehydration, the sediment was made into an epon block and examined. The whole processing time of EM study can be shortened within 7 or 8 hours, and results can be available within 48 to 72 hours. Our experience suggests the EM study on FNAC can be a useful diagnostic method in the diagnosis of difficult FNAC cases.
Behcet Syndrome* ; Biopsy, Fine-Needle ; Carcinoma ; Centrifugation ; Dehydration ; Diagnosis ; Female ; Glutaral ; Histiocytoma, Malignant Fibrous ; Humans ; Lung ; Melanoma ; Microscopy ; Microscopy, Electron ; Needles ; Nephrotic Syndrome* ; Syringes

It has been increasingly clear that the defence against Mycobacterium leprae(M. leprae) appears mainly to depend on cell-mediated rather than humoral immune mechanism. Nevertheless, the M. leprae is not only capable of producing specific humoral antibody, but also stimulating the formation of a variety of autoantibodies, since mycobacteria are known to exert adjuvant effect. Although the exact role of the autoantibodies in the pathogenesis of leprosy is not known, it is remarkable that the prevalence of autoantibodies has been reported different by several investigators, suggesting the possibility of geographical or racial difference. This study was undertaken to investigate the prevalence of some autoantibodies in Korean patients with leprosy. Eighty patients with leprosy registered at the Department of Dermatology, Seoul National University Hospital entered this study from February, 1977 through October, 1978, The diagnosis was made by clinical, histological, bacteriological and immunological assessments and the patients were classified according to the Ridley-Jopling scale. All patients were under anti leprosy chemotherapy with DDS (Diaminodiphenylsulfone) for various periods at the time of study. Venereal Disease Research Laboratory (VDRL) test was performed in 80 patients and the sera displaying reactive VDRL were subjected to re-examination by Treponema Pallidum Hemagglutinin Assay (TPHA). Rbeumatoid factor was sought by means of latex fixation test in 66 patients. Antinuclear antibody (ANA) was detected by means of latex agglutination reaction in 61 patients using polysterene latex complexed with calf thymus deoxyribonucleoprotein. Cryoprotein was detected as described elsewhere. Four of the 80 patients(5%) showed reactive VDRL, while rheumatoid factor and antinuclear antibody were not detectable in all cases. Cryoprotein was detected in 15 patients (27. 3 %). Compared with other reports on the prevalence of autoantibodies in Caucacian and African patients, we found a much lower frequency. This result may be expained partly by the racial or geographic difference in the pattern of leprosy as suggeste4 by Turk.
Agglutination ; Antibodies, Antinuclear ; Autoantibodies* ; Dermatology ; Diagnosis ; Drug Therapy ; Hemagglutinins ; Humans ; Latex ; Latex Fixation Tests ; Leprosy* ; Mycobacterium ; Prevalence* ; Research Personnel ; Rheumatoid Factor ; Seoul ; Sexually Transmitted Diseases ; Thymus Gland ; Treponema pallidum