No abstract available.
Disability Evaluation*

No abstract available.
Laryngectomy* ; Rehabilitation* ; Voice*

No abstract available.
Carbon Disulfide* ; Carbon* ; Poisoning*

An epidemiological survey on the glycosuria was conducted on the senier students of middle and high school in Seoul, from March 1981 to March 1982. Selected examinee totalled to 254,835 of which 138,116 were male & 116,719 were female. The initial, second and third urine sugar test were done with Combur-test strip(r). Glucose tolerance test was performed on those who were found to have persistent glycosuria. The followings showed the results of the survey. Among the 254,835 examinees, 1,240 were found with initial positive glycosuria. The glycosuria positive rate revealed 0.52% for male, 0.44% for female. Its average was 0.49%. It also revealed that male students in high school had higher positive rate of glycosuria. 2) The persistent glycosuria positive rate revealed 11.58/100,000 for male, 15.42/100,000 for female and its average was 13.34/100,000. 3) Out of the 33 cases with the persistent glycosuria, 60.6% of them were diagnosed as diabetes mellitus. 4) The overall prevalence rate of diabetes was 7.85/100,000. The prevalence rate of male was5.79/100,000, and female was 10.28/100,000. Consequently the rate of male to female was 1:1.78, showing that rates were higher for females than males. The. survey also revealed that the prevalence rate of diabetes was increased with advancing grade. 5) The 70% of the total person who were diagnosed as diabetes, did not recognize of their disease by themselves till the survey was conducted. 6) The frequency of subjective diabetic symptoms were polydipsia, polyuria and polyphagia in order. *Combur-test(r)are registered trade marks of the Boehringer mannheim GmbH Company.
Child* ; Diabetes Mellitus* ; Female ; Glucose Tolerance Test ; Glycosuria* ; Humans ; Male ; Polydipsia ; Polyuria ; Prevalence* ; Seoul

PURPOSE:Craniopharyngioma is one of the most important intracranial tumors in pediatric age which causes multiple pituitary hormone deficiencies. We have studied clinical characteristics in patients with craniopharyngioma, focusing on changes of endocrine function, change of growth pattern, and change of body mass index before and after surgery. In addition, we wanted to know the effect of growth hormone therapy on growth velocity and body mass index, and to identify contributing factors for spontaneous growth in spite of growth hormone deficiency. METHODS:A total number of 17 patients who were diagnosed as having craniopharyngioma at the Department of Pediatrics, Asan Medical Center during the period of January, 1991 to December, 1997 were included in this study. Retrospectively, we reviwed medical records as to their endocrine function tests and auxoloogical data before, after surgery. RESULTS: 1)The number of patients of male and female were 9 and 8 respectively. Mean age was 7.3+/-4.3 years. 2)Preoperatively, 3 patients were thyroid hormone deficient, 3 patients were corticosteroid deficient, and 3 patients suffered from diabetes inspidus. 3)Postoperatively, GH and TSH deficiency were found in 100%, ACTH in 88.2%, ADH in 82.3%, and LH/FSH in 60%, 53% respectively. 4) Mean growth velocity in 14 GH deficient patients without growth hormone treatment for 2 years were 3.5+/-2.4cm/year during the 1st year and 3.1+/-1.7cm/year during the 2nd year. Although height standard deviation score(Ht. SDS) was decreasing trend as -0.24+/-2.19 at diagnosis, -0.94+/-1.73 at 1 year later, and -0.76+/-1.76 at 2 years later, it was not statistically significant. To our suprise, 4 out of 14 patients achieved greater growth velocity than nomal in spite of growth hormone deficiency during the 1st year after operation. 5) Although the mean body mass index of 14 GH deficient patients without GH treatment was increasing trend as 17.9+/-3.5 at diagnosis, 19.0+/-4.5 at 1 year later, and 19.9+/-4.8 at 2 year later, it was not statistically significant. 6) The mean Ht. SDS increased significantly in 7 patients treated with growth hormone(P<0.05) for 2 years, but change of body mass index was not significant. 7) Comparision of postoperative serum prolactin levels and changes of body mass index between spontaneous growth and stunted growth group did not reveal significant difference. CONCLUSION: Since most patients with craniopharyngioma become multiple pituitary hormone deficient after operation, it is important to predict and detect pituitary dysfunction to manage it effectively. Although patients with postoperative GH deficiency responded well to GH treatment, further study is needed to clarify what are the main contributing or prognostic factors for spontaneous growth without growth hormone treatment.
Adrenocorticotropic Hormone ; Body Mass Index ; Chungcheongnam-do ; Craniopharyngioma* ; Diagnosis ; Female ; Growth Hormone ; Humans ; Male ; Medical Records ; Obesity ; Pediatrics ; Prolactin ; Retrospective Studies ; Thyroid Gland

Purpose : As the recombinant human growth hormone has been widely available, a lots of parents having short statured children are interested in promoting growth of them whatever the etiologies of short stature they have. However, the growth hormone therapy for growth-promoting effect is only justified in well-established indications such as growth hormone deficiency, fumer syndrome, and chronic renal insufficiency. This study was undertaken to classify the children with chief complaint of short stature by its cause and giving the basic epidemiologic data for it so that the size of population in which growth hormone is indicated can be estimated. Methods : According to Ranke's etiologic classification, we categorized the 579 children who visited our pediatric endocrinology clinic with chief complaint of short stature during the period of March 1994 to August 1996. In this prospective study, history regarding growth was taken, physical examination and laboratory tests including bone age, thyroid function, blood chemistry were carried out. The auxological data were analyzed. Additional chromosomal study or growth hormone provocative tests were performed when needed. Results : Out of 579 patients, 360(62.2%) were classified as normal and 127(21.9%) were classified as normal variants which consist of familial [74(12.8%)], constitutional [48(8.5%)], and mixed familial & constitutional short stature[5(0.9%)]. Pathologic short stature was found in only 80(13.8%). Those are growth hormone deficiency(28), Tumer syndrome(16), intrauterine growth retardation(14) in order. Other etiologies list varieties of dysmorphism, skeletal dysplasia, chromosomal disorders. Conclusions : This results suggest the vast majority of children with chief complaint of short stature are normal or normal variants. Only 7.8% of children who visited our clinic were indicated for growth hormone therapy.
Chemistry ; Child* ; Chromosome Disorders ; Classification* ; Endocrinology ; Growth Hormone ; Human Growth Hormone ; Humans ; Parents ; Physical Examination ; Prospective Studies ; Renal Insufficiency, Chronic ; Thyroid Gland

Since the invasiveness and metastatic potential of the carcinoma and the proliferation of the tumor cells are the decisional factors in determining the prognosis of carcinoma, it has been a principal area of study to foresee these factors in early stage of the disease process. The purpose of the study was to propose a method to precisely determine the prognosis of tumor. The investigation was performed, using laminin, type IV collagen, and Ki-67 antibody, to reveal the invasiveness and proliferation of the squamous cell carcinoma which is the most prevalent cancer in the area of oral and maxillofacial complex. Frozen tissue sections, 6-8mum in thickness, were prepared from the surgical excision of fresh squamous cell carcinoma for the experimental group. The control group was composed of sections from the normal oral mucosa of the contralateral side. Following incubation in an appropriate primary antibody including laminin, type IV collagen and Ki-67, LSAB method was employed and the tissue sections were treated with DAB for light microscopic immurlohistochemistry. Semiquantitative analysis of the basement membrane was composed of five different positivity of laminin and type IV collagen according to the intensity of the staining. Mean number of Ki-67 positive cells per 2000 total cells in one slide were calculated along with the standard deviation. The obtained results were as follows : 1. In the basement membrane of normal oral mucosa, antibodies against laminin and type IV collagen showed regular thickened, continuous line. Positive reaction was also detected in the vascular walls. Ki-67 labelling index was 4.10+/- 0.80%, and the positive cells were distributed mainly in the basal and parabasal cell layers. 2. In basement membrane of the proliferating tumor adjacent to carcinoma, antibodies against laminin and type IV collagen showed irregular thin, discontinuous line. Ki-67 labelling index was 18.95+/-4.67%, and the parabasal cell layer exhibited increased number of positive cells. 3. In the basement membrane of the main proliferating tumor, antibodies against laminin and type IV collagen showed almost indistinct interrupted line and/or almost indistinct line. Ki-67 labelling index was 31.56+/-5.51%, and the parabasal and spinous cell layer indicated increased cell positivity. 4. Invasive islands showed almost negative reaction to the antibody against type IV collagen, and almost indistinct line of the laminin antibody was observed. Based upon these findings, the loss of laminin and type IV collagen and the Ki-67 labelling index were the highest in the basement membrane of invasive islands. Therefore, it is thought that invasive islands were more deeply involved, than main proliferating tumor, in the invasiveness and proliferation of tumor, and the more the invasiveness of the tumor, the more the cell proliferative activity.
Antibodies ; Basement Membrane ; Carcinoma, Squamous Cell* ; Collagen Type IV* ; Islands ; Laminin* ; Mouth Mucosa ; Prognosis

To investigate the properties and mechanism of PAF and TNF on the synthesis of prostaglandin E2 in human amnion, primary monolayer culture method was used for human amnion cell incubation. Amnion cells were incubated with various concentrations of PAF or TNF in Ca++ containing medium for various duration. Then PG E2 concentrations were measured by RIA and analyzed for the effect of PAF and TNF on PG E2 production according to their doses and incubation time. To test the role of Ca++ in E2 production, Ca++ free medium, Ca++ -channel antagonist and cyclo-oxygenase inhibitor were substituted or added in incubation medium. Following results were obtained. The synthesis of PG E2 was significantly enhanced by PAF of 10(-6) mol/L. The TNF also stimulated PG E2 synthesis at concentration of 10(-6)g/ml. The maximal level in PAF(10-6mol/L)-stimulated release of PG E2 was observed after 16 hours in incubation. The TNF(10(-6)g/ml)-induced PG E2 release was maximal after 24 hours of incubation. Combined application of PAF and TNF produced positive effect in PG E2 production. PAF or TNF stimulated-PG E2 production in Ca++ -free media was much lower than that of Ca++ -containing media. The PAF-stimulated PG E2 release was significantly inhibited by Ca++ -channel antagonist but TNF-stimulated PG E2 release was not effected by Ca++ -channel antagonist or cyclo-oxygenase inhibitor. It is strongly suggested us that both PAF and TNF enhance PG E2 release by amnion cell, although Ca++ -channel opening is essential only for PAF stimulation.
Amnion* ; Blood Platelets* ; Dinoprostone* ; Humans* ; Platelet Activating Factor* ; Prostaglandin-Endoperoxide Synthases ; Tumor Necrosis Factor-alpha*

PURPOSE:Although Hashimoto's thyroiditis is the most common cause of goiter in children and adolescents, it is not clear what proportion of patients become hypothyroid and which tests are the best predictors of this state. To determine whether these kinds of variations occur in the course of Hashimoto's thyroiditis and whether the size of the thyroid gland or immunologic markers correlate with the course or outcome of Hashimoto's thyroiditis are main objects of our study. METHODS:A total number of 48 patients who were diagnosed as having Hashimoto's thyroiditis at the Department of Pediatrics, Asan Medical Center during the period of January, 1992 to December, 1997 were included in this study. Retrospectively, we reviewed medical records as to their clinical and labaratory data. RESULTS:Thyroid function status at initial diagnosis of Hashimoto's thyroiditis were euthyroidism(33.3%), compensatory hypothyroidism(33.3%), overt hypothyroidism (27.1%), hyperthyroidism(8.3%) in order. Positivity of antithyroglobulin antibodies and antimicrosomal antibodies were 77.1% and 66.7% respectively. In 33 patients, 12(36.4 %) were on remission status after 3 years from initial diagnosis. Antithyroglobulin antibody titer was significantly decreased after 2-year follow up in remission group. Initial antithyroglobulin antibody titer and thyroid function status were not related to remission status after 3-year from diagnosis. CONCLUSION: About 36% of patients with Hashimoto's thyroiditis can be in remission after 3-year from diagnosis. Decrease of antithyroglobulin antibody titer is related to remission status. Further study is necessary to know what can be the predicting factors for early remission, for example, initial thyroid function status, initial antithyroid antibody titier, circulating immune complex, age, sex and size of thyroid.
Adolescent ; Antibodies ; Antigen-Antibody Complex ; Biomarkers ; Child ; Chungcheongnam-do ; Diagnosis ; Follow-Up Studies ; Goiter ; Humans ; Hypothyroidism ; Medical Records ; Pediatrics ; Retrospective Studies ; Thyroid Gland* ; Thyroiditis*

The purpose of this study is to analyze degree of geographic maldistribution of physicians and changes in the distributional pattern in Korea over the years 1980-1985. In assessing the degree of distribution and in identifying changes in the distribution pattern, the Gini index of concentration was used. The geographical units selected for computation of the Gini index in this analysis are districts (Gu), cities (Si), and counties (Gun). Locational data for 1980 and 1985 were obtained from the population census data in the Economic Planning Board and regular reports of physicians in the Korean Medical Association. The rates of physician located countries to whole physicians were 10.4% in 1980 and 9.6% in 1985. In term of the ratio of physicians per 100,000 population, rural area had 9.18 physicians in 1980 and 12.95 in 1985, 7.13 general practitioner in 1980 and 7.29 in 1985, and 2.05 specialists in 1980 and 5.66 in 1985. Only specialists of general surgery and preventive medicine were distributed over 10% in county and distribution of every specialists except chest surgery in county increased in 1985, comparing with that rates of 1980. The Gini index computed to measure inequality of physician distribution in 1985 indicate as follows; physicians 0.3466, general practitioners 0.5479, and specialists 0.5092. But the Gini index for physicians and specialists fell -15.40% and -10.42% from 1980 to 1985, indication more even distribution. The changes in the Gini index over the period for specialists from 0.3639 to 0.4542 for districts, from 0.2510 to 0.1949 for cities, and 0.5303 for countries indicate distributional change of 24.81%, -22.35%, and 10.65% respectively. The Gini indices for specialists of neuro-surgery, chest surgery, plastic surgery, ophthalmology, tuberculosis, preventive medicine, and anatomical pathology in 1985 were higher than Gini indices in 1980.
Censuses ; General Practitioners ; Humans ; Korea ; Ophthalmology ; Pathology ; Preventive Medicine ; Rural Population ; Socioeconomic Factors ; Specialization ; Surgery, Plastic ; Thorax ; Tuberculosis