We experienced one case of severe pituitary dwarfism in a 16 years old male boy that magnetic resonance image(MRI) revealed transection of the pituitary stalk with the ectopic location of posterior pituitary gland and hypoplastic anterior pituitary gland. The serum growth horrnone(GH) response to clonidine and L-dopa revealed severe GH deficiency. The patient revealed normal response in TSH, prolactin and LH, FSH to TRH and LHRH respectively. So far, the primary cause of idiopathic pituitary dwarfism in many patients was due to hypoxic injury to hypothalmus by perinatal insults. In this patients, there was no history of perinatal insults and postnatal head trauma. We report a case of severe dwarfism due to hypogenesis of anterior pituitary gland.
Clonidine ; Craniocerebral Trauma ; Dwarfism ; Dwarfism, Pituitary ; Gonadotropin-Releasing Hormone ; Humans ; Levodopa ; Male ; Pituitary Gland ; Pituitary Gland, Anterior ; Pituitary Gland, Posterior ; Prolactin

Isolated heaptic tuberculous granuloma with no coexistent tuberculosis elsewhere in the body is extremely rare. We report a case of pathologically proven tuberculous granuloma in the liver followed with both IV bolus and portal CT scans. The lesion on preenhanced CT scan showed undefinable isodensity. After IV bolus injection, it showed poor enhancement with central low-density and surrounding hyperdenity due to compensatory hypervascularity of the left lobe of liver in early phase. It showed peripheral rim enhancement in late phase and in delayed phase showed relatively homogeneous but slightly decreased contract enhancement. On portal CT scan, it showed a hypodense portal defect similar to other hepatic mass lesions. During follow-up studies, it was a slowly growing mass which was more easily detectable by prtal CT scans than bolus CT scans.
Follow-Up Studies ; Granuloma* ; Liver ; Tomography, X-Ray Computed ; Tuberculosis

Authors compared early phase scan of the IV bolus CT (two phase incremental bolus dynamic CT) with late enhanecd scan similar to the conventional contrast enhanced CT for evaluation of the advantages of the IV bolus CT with two viewpoints of the pancreatic or peripancreatic mass and peripancreatic lymphadenopathy in 68 patients-28 cases of the pancreatic cancer, 6 cases of the pancreatitis and 34 cases of the pancreatic or peripancreatic metastasis. On the diagnosis of the pancreatic or peripancreatic mass, IV bolus CT could show the lesion(s) more easily in 41% (Grade II; 13/31) and much more easily in 34% (Grade III; 10/31) when compared with conventional contrast CT scan. The diagnosis of the peripancreatic lymph node involvement was also easy in 51%(Grade II; 20/39) and much easier in 37% (Grade III; 14/39). We thought that these differences were originated from the increase of the contrast between the lesion and normal portion because the early enhanced scans reflected the active blood flow change more exactly. Therefore IV bolus CT had advantages in comparison with the conventional drip infusion contrast CT in the diagnosis of the presence and pathologic extension of the pancreatic and peripancreatic lesion.
Diagnosis ; Infusions, Intravenous ; Lymph Nodes ; Lymphatic Diseases ; Neoplasm Metastasis ; Pancreatic Neoplasms ; Pancreatitis ; Tomography, X-Ray Computed

Authors compared early phase scan of the IV bolus CT (two phase incremental bolus dynamic CT) with late enhanecd scan similar to the conventional contrast enhanced CT for evaluation of the advantages of the IV bolus CT with two viewpoints of the pancreatic or peripancreatic mass and peripancreatic lymphadenopathy in 68 patients-28 cases of the pancreatic cancer, 6 cases of the pancreatitis and 34 cases of the pancreatic or peripancreatic metastasis. On the diagnosis of the pancreatic or peripancreatic mass, IV bolus CT could show the lesion(s) more easily in 41% (Grade II; 13/31) and much more easily in 34% (Grade III; 10/31) when compared with conventional contrast CT scan. The diagnosis of the peripancreatic lymph node involvement was also easy in 51%(Grade II; 20/39) and much easier in 37% (Grade III; 14/39). We thought that these differences were originated from the increase of the contrast between the lesion and normal portion because the early enhanced scans reflected the active blood flow change more exactly. Therefore IV bolus CT had advantages in comparison with the conventional drip infusion contrast CT in the diagnosis of the presence and pathologic extension of the pancreatic and peripancreatic lesion.
Diagnosis ; Infusions, Intravenous ; Lymph Nodes ; Lymphatic Diseases ; Neoplasm Metastasis ; Pancreatic Neoplasms ; Pancreatitis ; Tomography, X-Ray Computed

We performed IV bolus CT scan in 40 patients with final diagnosis of various hepatic masses in order to evaluate hemodynamic changes and differentiating characters of the lesions. Preenhanced, early and late phase post enhanced, and delayed CT scans were obtained with rapid IV bolus injection of contrast materials and table sliding method for pertinent scans. In hepatomas, early enhanced CT scan directly showed hypervascular change and active viable portion of the mass and late phase CT scan showed capsular enhancement. In addition, extracapsular invasion and post-embolization recurrence were more easily visualized. In hemangiomas, early and late enhancing types could be categorized according to the time of maximal enhancement. In metastatic liver malignancies and cholangiocarcinomas, specific findings were seen in early phase and delayed CT scans and not in conventional CT scan. In conclusion, IV bolus CT scan is a very useful CT method in demonstrating the characteristic hemodynamic patterns and in differential diagnosis of the hepatic masses.
Carcinoma, Hepatocellular ; Cholangiocarcinoma ; Contrast Media ; Diagnosis ; Diagnosis, Differential ; Hemangioma ; Hemodynamics ; Humans ; Liver ; Methods ; Recurrence ; Tomography, X-Ray Computed*

A case of myxoma of the breast was reported. A 25-year-old woman showed a lump in the left breast which was suddenly enlarged after the delivery of a baby. A tumor measuring 73.53cm was located in the upper outer quadrant of the breast. Fine needle aspiration cytology revealed scattered benign spindle shaped mesenchymal cells with abundant myxoid material. On excision, the tumor was partly solid, partly cystic and multilocular. Each nodule consisted of an abundant mucoid material with a few spindle or stellate mesenchymal cells. Pleomorphism and mitosis were absent. The mesenchymal cells showed immunoreactivities for S-100 protein, smooth muscle actin, and CD34. The myxoid stroma was positively stained with alcian blue and mucicarmine. These findings suggest that constituent cells derive from totipotential primitive mesenchymal cells.
Actins ; Adult ; Alcian Blue ; Biopsy, Fine-Needle ; Breast* ; Female ; Humans ; Mitosis ; Muscle, Smooth ; Myxoma* ; S100 Proteins

Accurate reproduction of intraoral tissue is essential in the fabrication of fixed prosthesis. This selection of impression material and method is very important. In this study, vinyl polysiloxane type impression material Panasil was used. Three impression methods ; one-step technique, individual tray technique, and individual tooth tray technique using the vinyl polysiloxane type bite registration material Futar Occlusion, were used to take horizontal and vertical impression. Improved stone models were fabricated. The amount of occlusal surface discrepaneies, interabutment distance discrepancies, amount of marginal defect were evaluated with the X-PLAN360d and photoscanning. The results were as follows. 1. There was no significant difference in occlusal surface according to the directions and techniques of impression taking. 2. There was no significant difference in interabutment distance discrepancies according to the directions and techniques of impression taking 3. There was no significant difference in marginal discrepancies according to the direction of impression taking but there was significant difference between one-step technique and individual tray technique, individual tooth tray technique (P<0.05). Taken together, these results suggest that individual tray technique and individual tooth tray technique are more accurate for impression taking than one-step technique.
Jaw Relation Record ; Prostheses and Implants ; Reproduction ; Siloxanes ; Tooth

BACKGROUND: This study intends to clear that the current cost reimbursement system of Korean medical insurance of health care. METHODS: By using insured medical record of Federation of Korean Medical Insurance Societies used in the demand tendency research of the type of services from feburary 1st to 28th of the year 1990, authors analyze the characterist,ic of components of charges per case in the type of health care facilities. RESULTS: The charge per case in the out-patient care of primary health care facility is 13,498 won, which is 54.6% by comparison with the secondary health care facility and 30.7 % by comparison wit,h the tertiary health care facility. Among these charges the amount of the cost for medical examinations and oral drugs are 73.9% in the primary health care facility and 71.8% in the secondary and 67.5% in the tertiary. Consequently, the services in the primary care are chiefly composed with the medical examinations and oral drugs. In addition to this point the author also finds that the charge per case is 3.5 times, the cost for oral drugs is 5.6 times larger than those of primary care, and therefore tertiary health care facility conduct various diagnostic examinations and prescript more expensive. CONCLUSIONS: There is a difference of basic medical cost ratio between primary, secondary and tertiary health care facility. These points can be lead to the presumption that the diseases under the structure of current medical insurance are overlapped irrespective of the charact.erisitcs of the type of health care facilites, and this is profitable to the tertiary health care facilities which can conduct various types of services. In conclusion, the frame a policy is needed to encourage primary care which are nothing but simple structure of charges.
Delivery of Health Care ; Humans ; Insurance* ; Medical Records ; Outpatients ; Primary Health Care

BACKGROUND: In patients with endometrial carcinoma, preoperative evaluation of exact staging has important prognostic and therapeutic implications. The incidence of pelvic and aortic lymph node involvement in endometrial carcinoma depends on grade of tumor differentiation and depth of myometrial invasion. MATERIAL AND METHOD: To evaluate whether MRI provides a preoperative assessment for staging of endometrial carcinoma, MRI was undertaken in 28 patients, a few weeks before operation. Myometrial invasion was devided in three categories, and involvement of cervix, adnexa, and pelvic cavity were classified. RESULTS: The results of MR imaging were compared with these of pathology. The preoperative MRI staging of endometrial carcinoma was correct in 22 out of 28 patients. In the evaluation of myometrial invasion, the MR imaging underestimated in 4 cases and overestimated in 1 case. CONCLUSION: In patients with endometrial carcinoma, MR imaging is very useful in the assessment of the depth of myometrial invasion, stromal invasion of cevix, lymphatic & pelvic metastases and extent of the lesion.
Cervix Uteri ; Endometrial Neoplasms* ; Female ; Humans ; Incidence ; Lymph Nodes ; Magnetic Resonance Imaging* ; Neoplasm Metastasis ; Pathology

The endoscopic variceal ligation(EVL) has been adopted as a new treatment for acute hemorrhage from esophageal varices that ranks the highest mortality rate in upper gastrointestinal tract bleedings. This treatment method has good effects for the urgent treatment and eradication of varices from acute variceal bleeding in repeated sessions. We enrolled 34 patients with an acute or chronic variceal bleeding episode at the time of admission in this study from Apr. 8, 1992 to June. 2, 1994. Among 34 patients, there were 31 males and 3 females, at ages between 45-66(mean: 52 years). The incidence of symptoms on admission was 10 in tarry stool, 9 in hematemesis 8 in ascites, 4 in hepatic encephalopathy and 3 in nonspecific symptoms. Varices were eradicated or reduced to grade I in 30(88.2%) of the 34 patients by 4-25 bands (mean: 10.8 bands) in 1-7 EVL sessions(mean: 3.1 sessions). After EVL, there are complicated by active bleeding in 3 patients, dysphagia in 3 patienta and transient chest discomfort in 5 patients but subsided during 24 hours. These results indicated that EVL is a safe method for treatment of bleeding from esophageal varices.
Ascites ; Deglutition Disorders ; Esophageal and Gastric Varices* ; Female ; Hematemesis ; Hemorrhage* ; Hepatic Encephalopathy ; Humans ; Incidence ; Ligation* ; Male ; Mortality ; Thorax ; Upper Gastrointestinal Tract ; Varicose Veins