PURPOSE: This study was undertaken to determine whether the clinical presentation of patients with central precocius puberty(CPP) varies according to the etiology, whether this permits the differentiation between idiopathic and organic forms and to examine whether LH determination in a single timed blood sample after GnRH administration is sufficient to diagnose CPP. METHODS: This study included 33 girls with signs of breast development, of whom 23 were diagnosed as definite central precocious puberty. Sixteen patients had idiopathic CPP; the remaining 7 patients had organic CPP. Ten patients were classified as non-CPP. Potential clinical and laboratory predictors of CNS abnormalities were assessed and GnRH stimulation test was done. RESULTS: The age of onset in patients with organic CPP was 4.11+/-2.08 years, whereas the age in patients with idiopathic CPP was 7.25+/-1.34 years. This parameter is the only one showing statistical significance. We compared sensitivities and specificities at 0, 15, 30, 60, 90 and 120 min which yielded sensitivities of 8.7%, 87.0%, 91.3%, 87.0%, 73.9%, 60.9%. CONCLUSION: It is impossible to exclude a central nervous system lesion in patient with central precocious puberty without performing central nervous system imaging. However, this study indicates earlier the onset of disease, higher the possibility of presence of CNS lesion. According to the mean GnRH stimulated LH levels and sensitivity at each times, a single blood sample obtained for LH determined after GnRH administration at 30 min can be used to diagnose the central precocious puberty.
Age of Onset ; Breast ; Central Nervous System* ; Female ; Gonadotropin-Releasing Hormone* ; Humans ; Luteinizing Hormone ; Puberty, Precocious*

No abstract available.
Frontal Sinus*

We report a case of clinical features corresponding to Eosinophilia-Myalgia syndrome, with no causal relationship with L-tryptophan. Since the epidemic of L-tryptophan associated Eosinoghilia-Myalgia Syndrome in 1989, only 2% of the cases were found not to be related to L-tryptophan in America. We believe that this is the first case report of Eosinophilin-Myalgia Syndrome not related to L-tryptophan in Korea.
Americas ; Electrodiagnosis ; Eosinophilia-Myalgia Syndrome* ; Korea ; Tryptophan*

No abstract available.
Adult* ; Humans ; Tibia*

No abstract available.
Advanced Cardiac Life Support*

We report the clinical features in one patients with episodic positional vertigo and apogeotropic direction changing horizontal positional nystagmus that does not fatigue, beating to the right with the head turned to the left and beating to the left with the head turned to the right. This syndrome probably represents a horizontal semicircular canal variant of benign positional vertigo. Free-floating debris and Cupula attached debris in one horizontal semicircular canal may explain many of the clinical and oculographic findings.
Fatigue ; Head ; Humans ; Nystagmus, Physiologic ; Semicircular Canals ; Vertigo*

No abstract available.
Acute Kidney Injury* ; Humans ; Pancreatitis*

PURPOSE: To evaluate the outcome of ductal carcinoma in situ (DCIS) patients who underwent surgery followed by radiation therapy (RT). MATERIALS AND METHODS: We retrospectively reviewed 106 DCIS patients who underwent surgery followed by postoperative RT between 1994 and 2006. Ninety-four patients underwent breast-conserving surgery, and mastectomy was performed in 12 patients due to extensive DCIS. Postoperative RT was delivered to whole breast with 50.4 Gy/28 fx. Tumor bed boost was offered to 7 patients (6.6%). Patients with hormonal receptor-positive tumors were treated with hormonal therapy. RESULTS: The median follow-up duration was 83.4 months (range, 33.4 to 191.5 months) and the median age was 47.8 years. Ten patients (9.4%) had resection margin <1 mm and high-grade and estrogen receptor-negative tumors were observed in 39 (36.8%) and 20 (18.9%) patients, respectively. The 7-year ipsilateral breast tumor recurrence (IBTR)-free survival rate was 95.3%. Resection margin (<1 or > or =1 mm) was the significant prognostic factor for IBTR in univariate and multivariate analyses (p < 0.001 and p = 0.016, respectively). CONCLUSION: Postoperative RT for DCIS can achieve favorable treatment outcome. Resection margin was the important prognostic factor for IBTR in the DCIS patients who underwent postoperative RT.
Breast ; Breast Neoplasms ; Carcinoma, Ductal* ; Carcinoma, Intraductal, Noninfiltrating* ; Estrogens ; Follow-Up Studies ; Humans ; Mastectomy ; Mastectomy, Segmental ; Multivariate Analysis ; Recurrence ; Retrospective Studies ; Survival Rate ; Treatment Outcome*

Severe neurologic complication after epidural anesthesia is very rare. We experinced a case of cauda equina syndrome following epidural anesthesia with 2% lidocaine 20 ml, alkalinized with sodium bicarbonate and 1: 200,000 epinephrine added in female patient underwent abdominal hysterectomy. She complained hypoesthesia of buttock, perineum, left leg and weakness of left leg. She also suffered from urinary retension and defecation difficulty and abdominal discomfort 2 days after epidural block. In MRI taken 4 days after block, spinal stenosis (L4-5) and mild disc bulging (L3-4) were noted. She was treated with medication, bladder training and physical therapy and recovered slowly but gradually, finally discharged 2 months after block with mild weakeness of left leg. We suggest the causative factors are the temporary neural compression due to spinal stenosis and the spinal cord ischemia due to vascular spasm because of added epinephrine.
Anesthesia, Epidural* ; Buttocks ; Cauda Equina* ; Defecation ; Epinephrine ; Female ; Humans ; Hypesthesia ; Hysterectomy ; Leg ; Lidocaine ; Magnetic Resonance Imaging ; Perineum ; Polyradiculopathy* ; Sodium Bicarbonate ; Spasm ; Spinal Cord Ischemia ; Spinal Stenosis ; Urinary Bladder

PURPOSE: To investigate the incidence and characteristics of vertical deviation in the intermittent exotropia. METHODS: Fifty consecutive intermittent exotropes over age of 5 were prospectively studied. Patients with any significant ocular and neurologic abnormalities or orbital anatomic abnormalities, definite oblique dysfunction with A or V pattern were excluded. Ophthalmologic evaluation included visual acuity, ocular movements, measurements of angle of deviation by prism cover test, Bielschowsky head tilt test, stereoacuity test, and fundus observation for torsion by indirect ophthalmoscopy. RESULTS: We found that 27 children(54%) had concomitant hypertropia in primary position. Mean amount of hypertropia was 4.81 PD(range: 2~20 PD). Thirty nine children(78%) showed positive Bielschowsky head tilt test. No objective torsion was observed. No inferior oblique overaction was found except for only 2 patients. All subjects had good visual acuity and stereopsis. CONCLUSIONS: The incidence of vertical deviation in the intermittent exotropia is much higher than expected. All of the vertical deviations show positive Bielschowsky head tilt test.
Depth Perception ; Exotropia* ; Head ; Humans ; Incidence ; Ophthalmoscopy ; Orbit ; Prospective Studies ; Strabismus* ; Visual Acuity