No abstract available.
Porphyrias, Hepatic*

PURPOSE: Thyroid disease is the most common endocrine disease in childhood. Thyroid hormone has critical effects on growth and development, especially in childhood. We survey the prevalence, sex and age distribution, symptoms and thyroid function states of thyroid diseases in childhood. METHODS: Three hundred ninety one children who were diagnosed as having thyroid disease at department of pediatrics, St. Mary's hospital from Jan. 1987 to Dec. 1998 enrolled in this study. RESULTS: 1) The ratio between male and female patients was 1: 5.3. Age distribution was puberty, school age and infancy in their order of frequency. 2) The results of thyroid function tests showed normal function in 210 cases (53.7%), increased function in 95 cases(24.3%), and decreased function in 86 cases (22%). 3) Simple goiter, Graves disease, and chronic lymphocytic thyroiditis were the most common diseases in euthyroid, hyperthyroid, and acquired hypothyroid state, respectively. 4) The most common sign and symptom was goiter in euthyroid(100%), hyperthyroid(98.8%) and acquired hypothyroid state(96.2%). Forty of 68 cases(58.8%) with congenital hypothyroidism were detected by neonatal screening. CONCLUSION: Simple goiter, chronic lymphocytic thyroiditis and Graves disease were common acquired thyroid diseases in childhood, and goiter is the most common clinical manifestation in acquired thyroid disease. Recently, increasing number of congenital hypothyroidism was detected by neonatal screening test.
Adolescent ; Age Distribution ; Child ; Congenital Hypothyroidism ; Endocrine System Diseases ; Female ; Goiter ; Graves Disease ; Growth and Development ; Hashimoto Disease ; Humans ; Infant, Newborn ; Male ; Neonatal Screening ; Pediatrics ; Prevalence ; Puberty ; Thyroid Diseases* ; Thyroid Function Tests ; Thyroid Gland*

Epinephrine ; Pulmonary Edema

OBJECTIVE: To investigate the role of ERK and PPAR gamma on the TGF-beta1 induced human endometrial stromal cell decidualization in vitro. METHOD: Endometrial stromal cells are cultured under the following condition: DMEM/F12 (10% FBS, 1 nM E2 and 100 nM P4). TGF-beta1 (5 ng/ml), Rosiglitazone (50 nM), and PD98059 (20 microgram) were added according to experimental purposes. Trypan-Blue and hematocytometer were utilized to count cell number. Enzyme-linked immunosorbent assay (ELISA) and western blotting were utilized to detect proteins. RESULT: TGF-beta1 inhibited proliferation of cultured human endometrial stromal cells and induced expression of PGE2 and prolactin. This effect was mediated by Smad and ERK activation. Administration of rosiglitazone, PPAR gamma agonist, prevented TGF-beta1 effect on cell proliferation. Furthermore, Rosiglitazone inhibited TGF-beta1 induced activation of ERK, consequently reduced PGE2 and prolactin production. CONCLUSION: TGF-beta1 induced decidualization of endometrial stromal cell through Smad and ERK phosphorylation. PPAR gamma acts as a negative regulator of human endometrial cell decidualization in vitro.
Blotting, Western ; Cell Count ; Cell Proliferation ; Dinoprostone ; Enzyme-Linked Immunosorbent Assay ; Humans* ; Peroxisome Proliferator-Activated Receptors* ; Phosphorylation ; PPAR gamma ; Prolactin ; Stromal Cells* ; Transforming Growth Factor beta1*

Pulmonary function tests were conducted in 60 male adults and 60 female adults at 20~79 years of age. They showed noevidenee of pulmonary disease on clinical symptoms, X-ray finidngs and past history. We wanted to evaluate the deterioration of pulmonary functional reserve in the aged. The results were as follows: 1) In males, FVC decreased significantly (p <0.01) from 4440+/-271.38 ml in 20~29 year-old subjects to 3090+/-445.75 ml 70~79 year-old subjects. The correlation coefficient with age was-0.6846. 2) In females, FVC decreased significantly (p<0.01) from 2097+/-479.42ml in 20~29 year-old subjects to 2142+/-233.13ml in 70~79 year-old subjects The correlation coefficient woth age was 0.6454. 3) In males, FEV, decreased significantly (p<0.01) from 4005+/-268.26 ml in 20~29 year-old subjects to 2373+/-326.36ml in 10~79 year-old subjects. The correlation coefficient with age was-0.8229. 4) In females, FEV1 decreased significantly (p<0.01) from 2586+/-519.00 ml in 20~29 yrar-old subjects to 1645+/-330.36ml in 70~79 year old subjects The correlation coefficient with age was 0.7013. 5) In males, FEV1/FVC decreased significantly (p<0.01) from 90.17+/-4.90% in 20~29 year-old subjects to 76.72+/-8.13% in 70~79 year-old subjects. The correlation coefficient with age was-0.5595. 6) In females, FEV1/FVC decreased significantly (p<0.01) from 88.66+/-6.58% in 20-29 year-old subjects to 76.80+/-9.32% in 70~79 year-old subjects. The correlation coefficient with age wae-0.4489.
Adult* ; Aging* ; Female ; Humans ; Lung Diseases ; Male ; Respiratory Function Tests

Central retinal artery occlusion occurs rarely as a complication of spine surgery under general anesthesia in prone position, but is quite tragic. The suggested causes are hypotension during anesthesia and increased external ocular pressure by headrest, sand bag or others. We experienced a case of left central retinal artery occlusion following cervical spine surgery under general anesthesia using a horseshoe headrest. The patient was 53 years old male whose medical history was non remarkable except dislocation of cervical spine. He was positioned prone after induction. The vital signs were stable during opreration. At the recovery room, he presented left visual field disturbance and investigations revealed that left central retinal artery occlusion occured. This case demonstrates that proper positioning of the head on an adequate head rest and contineous cautious inspection during surgical procedure are important to prevent retinal damage.
Anesthesia ; Anesthesia, General* ; Dislocations ; Head ; Humans ; Hypotension ; Male ; Middle Aged ; Prone Position* ; Recovery Room ; Retinal Artery Occlusion* ; Retinal Artery* ; Retinaldehyde ; Silicon Dioxide ; Spine* ; Visual Fields ; Vital Signs

BACKGROUND: Many studies indicated that the predictive accuracy of propofol TCI may be compromised by premedication with benzodiazepine which has been shown to reduce markedly the induction dose. This study was designed to examine the influence of midazolam premedication on certain parameters of treatment using the propofol TCI. METHODS: One hundred and sixty ASA I or II patients undergoing elective surgery were randomly allocated to two groups according to premedication: Group 1, glycopyrrolate 0.2 mg; Group 2, glycopyrrolate 0.2 mg and midazolam 0.07 mg/kg IM 1hr before induction. Each group divided to four subgroups (n=20 for each subgroup) according to expected target propofol concentration (4~7 microgram/ml for group 1 and 3~6 microgram/ml for group 2). Anesthesia induction within 3 min was considered as successful. Induction dose and time, success rate of induction, calculated concentration when successful induction, context sensitive decrement time when awakening concentration was 1.2 microgram/ml and side effects were checked. RESULTS: Successful induction rate was higher in group 2 (53.3% vs 77.8% at target concentration of 5 microgram/ml, P<0.05). Mean target concentration of propofol were lower in group 2 (5.18 vs 3.87 microgram/ml, P<0.05). Induction time and dose were decreased 48.4% and 36.8% at target concentration of 4 g/ml, respectively in group 2 (P<0.05). Vital signs, average pain score and incidence of pain showed no differences between groups, but incidence of apnea was significantly increased in group 2 (P<0.05). CONCLUSION: Group 2 showed better quality of propofol induction using a TCI in terms of induction time, induction dose and lower selected target without significant vital sign changes, but showed increased incidence of apnea compared with group 1.
Anesthesia ; Apnea ; Benzodiazepines ; Glycopyrrolate ; Humans ; Incidence ; Midazolam* ; Premedication* ; Propofol* ; Vital Signs

A Clinical study was carried out on 39 cases with congenital hypertrophic pyloric stenosis who were admitted to the department of Pediatrics, Catholic Medical College, during the 7 years 8 months from January 1971 to August 1978. The following results were obrained. 1. The age incidence was highest in the 2-4 weeks of age and 82.0% were under the 8 weeks. Af age Male to female ratio was 12:1. 2. The age at onset was within 3 weeks of age in the majority cases(69.2%). 3. In distribution of birth weight, the majority cases(75%) were 3.0~4.0kg. and 18 cases(46%) were first born bady. 4. In the body weight percentile on admission, the jahority cases(75.4%) were under the 25 percentile. 5. The kinds of feeding in order of frequency were breast(41.0%), bottle(30.8%) and mixed feeding(28.2%). 6. The average duration of symptoms prior to operation was 17 days. 7. On the physical examination, gastric peristaltic wave was observed in 30 cases(77%) and the pyloric tumor mass was palpated in 26 cases(67%). And Projectile vomitiong and dehydration were observed in all cases. 8. Barium meal X-ray study showed the string sign in 33 cases(88.9%).
Barium ; Birth Weight ; Body Weight ; Dehydration ; Female ; Humans ; Incidence ; Male ; Meals ; Pediatrics ; Physical Examination ; Pyloric Stenosis, Hypertrophic*

INTRODUCTION: There are three anatomic findings that correlate with a patient risk for developing anterior acromial impingement : acromial shape, anterior downsloping of the acromion. To analyze the effect of anterior and lateral downslopings and subacromial interval to the impingement syndrome retrospectively, the authors reviewed 32 patients who performed MRI of the shoulder joint in the Dankook university hoipital. MATERIALS AND METHODS: Eighteen males & fourteen females were reviewed and the average age was 46.6 years old. There were 23 cases of impingement syndrome and 9 cases of control group. The authors analyzed oblique coronal images and oblique sagittal images in shoulder MRI.
Acromion ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Retrospective Studies ; Shoulder Impingement Syndrome ; Shoulder Joint ; Shoulder

The effect of glucose-free bupivacaine were compared among thirty patients scheduled for urologic or orthopedic surgery. Different volumes of bupivacaine(2,3 and 4ml) were used for each group of patients. Patients were positioned in the supine position just after spinal tapping. The results are summarized as follows: 1) No statistical significance was found for each group of patients in age, height, and operation time. 2) The maximal height of sensory spread tended to increase as the amount of bupivacaine increased. It was T1-10 for the first group(2ml), T8-6 for the second(3ml), and T6-5 for the third(4ml). 3) The time to maximal cephalad spread of analgesia tended to increase as the amount of bupivacaine increased. It was 14 minutes for the first group, 16 minutes for the second and 19 minutes for the third. 4) The duration of analgesia by bupivacaine is considered to be slightly longer than that by tetracaine. 5) The degree of complete motor blockade at L1-2 was 80% for the first group, and 100% for the second by third group. Therefore, spinal anesthesia with glucose-free bupivacaine is considered to be satisfactory for lengthy operations of perianal or urologic procedures and lower extremity surgery.
Analgesia ; Anesthesia ; Anesthesia, Spinal* ; Bupivacaine* ; Glucose* ; Humans ; Lower Extremity ; Orthopedics ; Spinal Puncture ; Supine Position ; Tetracaine