No abstract available.
Graves Disease* ; Insulin*

Congenital lipoid adrenal hyperplasia, the most severe form of congenital adrenal hyperplasia, is caused by mutations in the steroidogenic acute regulatory protien (StAR). It is characterized by failure of synthesis of all three classes of adrenal steroids and massive accumulation of lipids and cholesterol in the adrenal cortex. The computed tomography (CT) unequivocally delineated massively enlarged adrenal glands of fat-tissue attenuation, enabling early diagnosis and replacement therapy. We report a case of congenital lipoid adrenal hyperplasia, in which CT established that lipoid deposition at the adrenal cortex disappeared after the adrenal hormone replacement therapy.
Adrenal Cortex ; Adrenal Glands ; Adrenal Hyperplasia, Congenital ; Cholesterol ; Early Diagnosis* ; Hormone Replacement Therapy ; Hyperplasia* ; Steroids

PURPOSE: In determining image quality of mammography,many factors are related. Selection of film and screen is one of them. Authors took phantom images of nine film-screen combinations under properly controlled conditions and compared them to evaluate their image qualities. In addition, KVp, mAs and surface dose were evaluated at each combination to deterrhine proper exposure conditions. MATERIALS AND METHODS: Using phantom,images of nine film-screen combinations composed of Fuji MI-NC, UM-MA, UM-MH films and Fuji Fine,Medium, Kodak Min-R screeens were taken. Phantom(Ackermann Mammochip Phantom) was composed of simulations for microcalcifications, fibers, nodules, lymph nodes, breast tissue and breast cancer masses. For phantom of 4.5 cm compressed breast equivalent, 28 KVp was used. For 1.5 and 3.0 cm equivalant phantoms, 24 KVp and 26 KVp was used. At each KVp, mammographic images were taken at various mAs. Among images taken by this process, best images were selected and then, according to scoring method, comparison of image quality for each combination was done. With dosimation strip, surface doses for various conditions were evaluated. RESULTS: Combination of Fuji UM-MA film and Fuji Fine screen showed best image quality regardless of KVp or phantom thickness. For the best image, 10 mAs with 26 KVp was most ideal while mAs with 24 KVp was optimal for equivalent phantom of 3.0 cm thickness breast. At this condition, surface dose was less than other combinations when combinations involving UM-MH films were used. On the other hand,when combinations involving MI-NC films were used, surface dose was higher than others. CONCLUSION: Using phantom, image quality of film-screen combinations could be evaluated and compared. Such process can contribute to best quality image with decreased exposure and can play a role in quality asurance program.
Breast ; Breast Neoplasms ; Lymph Nodes ; Research Design

This intervention study was performed to assess the effect of spirulina on lipid metabolism, antioxidant capacity, and immune function in elderly Koreans. The subjects were 6 male and 6 female people between the ages of 60 and 75, who were given spirulina supplements of 7.5 g/day for 24 weeks. Dietary intake, anthropometric measurements and biochemical assessment for plasma lipid levels, antioxidant status and immune function were measured before and throughout the intervention period. Before entering the study, the subjects were in relatively good health. Their nutrient intake was satisfactory, and anthropometric indices and plasma nutrient levels were within the normal range. Spirulina supplementation for 24 weeks did not affect dietary intake and anthropometric parameters. However, considerable changes were observed in blood lipid profiles, antioxidant capacity, and immune indices. The plasma concentrations of triglycerides, total- and LDL-cholesterol decreased from 4 weeks of the supplementation period. The antioxidant capacity improved, as shown in increasing TAS and decreasing TBARS after supplementation. Improved immune function was also observed as the PBL lymphocyte proliferation rate and plasma C3 levels increased. The above effects of spirulina supplementation did not differ between mild hypercholesterolemic (cholesterol > or =200mg/d1) and normochole-sterolemic (cholesterol <200 mg/dl) subjects. This study provided evidence that spirulina could be used as dietary supplementation in nutritionally vulnerable groups to improve nutritional and health status and to prevent chronic disease such as hyperlipidemia or oxidation-prone diseases. further studies in this area with various population groups are warranted.
Aged ; Chronic Disease ; Dietary Supplements ; Female ; Humans ; Hyperlipidemias ; Clinical Trial ; Lipid Metabolism* ; Lymphocytes ; Male ; Plasma ; Population Groups ; Reference Values ; Spirulina* ; Thiobarbituric Acid Reactive Substances ; Triglycerides

PURPOSE: The purpose of this study was to compare the rehabilitation nursing services what nurses recognize to be important and what they do in practice of the industrial workers. METHOD: The subjects were 150 nurses who were working at the industrial hospital. The questionnaire was made up with 43 items about the perception on importance and performance of rehabilitation services. RESULT: The highest services in the perception on importance and performance subscale were physical and therapeutic services. The highest difference between perception on importance and performance was the social and occupational services. The perception on importance of rehabilitation services had positive correlation with performance. The group take care of general patients had a higher level of perception on importance than the other group, and level of performance had significant difference with age and position. CONCLUSION: We need to develop the strategy for promoting the performance of services that recognize it will be important services, but not to do. Further study on system for promoting the nurse practitioner who responsible for rehabilitation nursing.
Humans ; Nurse Practitioners ; Occupational Health ; Surveys and Questionnaires ; Rehabilitation Nursing

Mauriac syndrome consists of a triad of poorly controlled diabetes, profound growth retardation and hepatomegaly. We experienced a case of Mauriac syndrome in an 18-year-old girl who had poorly controlled diabetes mellitus, short stature, hepatomegaly and central obesity. Also at the time of examination, she had complications of diabetic cataract and nephropathy. Fourteen years prior to admission, she was diagnosed as diabetes mellitus at a hospital. Thereafter, she had been managed with irregular insulin injection. On physical examination at admission, her height was 135cm(<3 percentile) and her weight was 39kg(<3 percetile). She was short and obese. The liver was 5 cm palpable below the right subcostal margin. Her sexual maturation was Tanner stage I. On ophthalmologic examination, the cataracts were observed on both eyes and diabetic retinopathy was absent. Diabetic nephropathy could not be confirrned by kidney biopsy due to her mother's refusal. We studied the hormonal, radiographic and histological abnormalities. The hormonal study was normal and the bone age was by delayed as much as 10 years. The liver biopsy revealed glycogen accumulation in hepatocyte. She was consistent with Mauriac syndrome. She was managed by strict diabetic control with insulin therapy, diabetic diet and intensive education. She was discharged with well controlled blood glucose. Five months later, growth acceleration and sexual maturation have not been observed, but hepatomegaly subsided. (J Korean Pediatr Soc 2000;43-837-841)
Acceleration ; Adolescent ; Biopsy ; Blood Glucose ; Cataract ; Diabetes Mellitus* ; Diet, Diabetic ; Diabetic Nephropathies ; Diabetic Retinopathy ; Disulfiram ; Education ; Female ; Glycogen ; Hepatocytes ; Hepatomegaly ; Humans ; Insulin ; Kidney ; Liver ; Obesity, Abdominal ; Physical Examination ; Sexual Maturation

BACKGROUND & PURPOSE: Thymic tumors are frequently found in patients with myasthenia gravis(MG); the patients with thymoma seem to be more associated with severe MG. This study was performed to analyse the clinical characteristics of thymic tumor-associated MGs and to compare the patients with invasive and noninvasive thymomas. METHODS: We retrospectively reviewed the medical records of 305 MG subjects(M:F = 112:193, age = 30.4 ? 8.1 years) who had been diagnosed to have MG from January 1986 to June 1996, and analysed the clinical characteristics of MG subjects with thymic tumors. Forty seven patients were confirmed to have thymic tumor by the postoperative histopathologic findings(thymic tumor(TT) group) and 191 were known to have nonneoplastic thymus by chest CT or postoperative histopathologic findings(nonneoplastic thymus(NN) group). RESULTS: The incidence of thymic tumor-associated MG was 25.2%. The male to female ratio for the TT and the NN groups were 1:1 and 1:2, and the mean age of onset were 42.9 ? 11.2 years and 28.3 ? 17.5 years, respectively. When we evaluated the disease severity by Osserman's classification, 85% of the TT group and 51% of NN group were severely affected(Iib, III, IV). The generalization of symptoms occurred in 98% of the TT group and 66% of the NN group. The disease severity and the clinical outcome were not significantly different between the MGs with invasive thymoma, noninvasive thymoma and thymic carcinoma. CONCLUSION: Compared with those of MGs with nonneoplastic thymus, the thymic tumor-associated MGs showed several different clinical phenotypes, as in the followings; they showed no sex predominance, the onset age was older, more common generalization of myasthenic symptoms, and more patients were severely affected. The severity and outcome were not different between the MGs with thymic tumor.
Age of Onset ; Classification ; Female ; Generalization (Psychology) ; Humans ; Incidence ; Male ; Medical Records ; Myasthenia Gravis* ; Phenotype ; Retrospective Studies ; Thymectomy ; Thymoma ; Thymus Gland ; Thymus Neoplasms ; Tomography, X-Ray Computed

Plexiform neurofibromas (PNFs) represent an uncommon variant (30%) of neurofibromatosis type 1 (NF-1), in which neurofibromas arise from multiple nerves as bulging and deforming masses involving connective tissue and skin folds. We report the case of a 17-year-old man with known NF-1 presenting with bilateral occipital neuralgia that began in his late adolescence. His chief complaint was radiating pain in the occiput induced by protective helmet wear when riding alpine skiing. Craniofacial magnetic resonance imaging (MRI) confirmed the presence of fusiform masses arising from the bilateral greater occipital nerves. Histopathological examination of the biopsy samples showed PNFs. After surgical treatment, the patient's symptoms completely improved. Unlike cutaneous neurofibromas, PNFs have different clinical characteristics and have the risk of malignant mutations. Correct diagnosis and adequate surgical treatment are necessary for PNFs.

PURPOSE: Neonatal jaundice is one of the most common problems in our country leading to hospitalization. Agar is low cost, low risk, and easily fed orally; it can bind bilirubin in the intestine, decreasing its enterohepatic circulation, thereby decreasing serum bilirubin levels. At present, however, the effectiveness of agar in the prevention and treament of neonatal jaundice is quite conflicting and controversy. Recently we have read Caglayan's 'Superiority of Oral Agar and Phototherapy Combination in the Treatment of Neonatal Hyperbilirubinemia'. The result was very hopeful and attractive enough, and which gave us a motivation to study if it was really of value. METHODS: From May 1995 to April 1996, a total 50 term neonates admitted in nursery of Dong-Eui Medical Center with the capillary serum bilirubin levels greater than 10mg/ dl were enrolled in the study. Those with pathologic causes and breast fed infants were all excluded. The neonates were randomly devided into two groups; 25 of conventional phototherapy alone (P group) and 25 of oral agar plus conventional phototherapy combination (A+P group). The study was terminated when the capillary serum bilirubins were decreased to 8mg/dl. Pastagar B (Pasteur Institute 64946) 500mg in 10ml distilled water were fed four times a day using 10ml syringes prior to bottle feeding. Capillary serum bilirubin levels were measured daily at 10:00 a.m. with heel pad samples. Daily stool frequency and adverse effects of treatment were observed closely. RESULTS: 1) The decrement of the serum bilirubin levels at first 24 hours of therapy was significantly different between P and A+P groups showing as 1.7+/-1.2 and 2.4+/-1.0mg/dl respectively (p<0.05). 2) Mean time for bilirubin to decrease to 8mg/dl was shorter in A+P group than in P group showing as 45.7+/-20.8 and 57.5+/-32.3 hours each other, but those differences were statistically insignificant (p>0.05). 3) No adverse effects such as rashes or abdominal pains were observed during treatment. Differences of mean stool frequency were significant between P and A+P groups showing as 3.7+/-1.2 and 4.7+/-2.0 times per day respectively (p<0.05). CONCLUSION: The agar plus conventional phototherapy combination was superior to conventional phototherapy alone at first 24 hours of therapy in neonatal hyperbilirubinemia, but further more careful researches would be necessary for using it routinely in the treatment of neonatal hyperbilirubinemia in future.
Abdominal Pain ; Agar* ; Bilirubin ; Bottle Feeding ; Breast ; Capillaries ; Enterohepatic Circulation ; Exanthema ; Heel ; Hope ; Hospitalization ; Humans ; Hyperbilirubinemia, Neonatal* ; Infant ; Infant, Newborn ; Intestines ; Jaundice, Neonatal ; Motivation ; Nurseries ; Phototherapy* ; Syringes ; Water

PURPOSE: To analyze the related sonographic findings and to determine the value of sonography in establishing the diagnosis of acute osteomyelitis in infants. MATERIALS AND METHODS: The sonographic findings of eleven infants aged 10 days-4 months (mean, 45 days) with acute osteomyelitis were retrospectively evaluated. The involved bones were the femur (n=5), humerus (n=2), tibia (n=2), rib(n=1), sternum(n=1), and calcaneus(n=1). Discontinuity or destruction of cortical margins, echotexture of the metaphysis and epiphysis, the presence of subperiosteal hypoechoic lesion, adjacent soft tissue swelling, distension of the joint capsule, the echotexture of joint effusion, and dislocation or subluxation of the involved joint were evaluated. The sonographic findings were compared with the plain radiographic (n=12) and MR (n=5) findings, with special attention to the identification of the metaphyseal or epiphyseal bony lesions and the involvement of adjacent joints. RESULTS: The sonographic findings of osteomyelitis were cortical discontinuity or destruction (n=12), hypoechoic lesions with an echogenic rim in the metaphysis (n=12), subperiosteal hypoechoic lesions (n=8), soft tissue swelling (n=9), a distended hip joint, with echogenic fluid (n=5), ill-demarcated echogenic lesions in the capital femoral epiphysis (n=5), and a subluxated hip joint (n=3). Plain radiographs revealed well or ill-defined osteolytic lesions in the metaphysis, accompanied by cortical destruction (n=8), new periosteal bone formation (n=3) and reactive sclerosis (n=2). Abnormality of the femoral epiphyses and joint involvement were not detected on plain radiographs, and in four cases no abnormality was noted. MR imaging showed that at T1WI, affected bony lesions were of low signal intensity and enhanced, with high signal intensity at T2WI. In all cases, both metaphyseal and epiphyseal lesions were demonstrated at MRI, but in one of the three cases in which an epiphyseal lesion was seen at MRI, this was not detected at US. CONCLUSION: Sonography is not only more sensitive than radiography in evaluating metaphyseal bony lesions but also useful in assessing concomitant joint and epiphyseal involvement of acute osteomyelitis in infants. Sonography is, therefore, a useful additional diagnostic tool for the early detection and management of acute osteomyelitis in infants.
Diagnosis ; Dislocations ; Epiphyses ; Femur ; Hip Joint ; Humans ; Humerus ; Infant* ; Joint Capsule ; Joints ; Magnetic Resonance Imaging ; Osteogenesis ; Osteomyelitis* ; Radiography ; Retrospective Studies ; Sclerosis ; Tibia ; Ultrasonography*