No abstract available.
Hospitals, General* ; Humans ; Inpatients* ; Sleep Initiation and Maintenance Disorders*

PURPOSE:Varying clinical phenotypes are associated with the chromosome 22q11.2 microdeletion syndrome. The endocrine manifestation are latent or overt hypoparathyroidism, thyroid dysfunction and short stature. This study was undertaken to investigate frequencies of endocrine abnormalities and short stature in patients with the chromosome 22q11.2 microdeletion syndrome. METHODS:Forty three unrelated patients were diagnosed having chromosome 22q11.2 microdeletion syndrome. Chromosomal microdeletion was confirmed by fluorescent in situ hybridation (FISH) with DNA probe (22q11.2 LSI TUPLE1 from Vysis). Serum total calcium and intact parathyroid hormone (PTH) were measured in all patients. Thyroid function tests including free thyroxine(T4), thyroid stimulating hormone (TSH) and thyroid autoantibodies were performed in all patients. Insulin-like growth factor-1 (IGF-1) was measured in 10 patients. Height, weight and body mass index were compared with chronological age in all patients. RESULTS:Seven patients (16%) had an overt hypoparathyroidism, presenting with hypocalcemic tetany. Thirteen patients (31%) showing hypocalcemia with normal PTH were regarded as having latent hypoparathyroidism since their PTH secretion response was blunted. Out of 2 patients with thyroid diseases, one patient had Graves disease and the other had Hashimoto thyroiditis. Five patients (12%) were below the 3rd percentile in height at evaluation. The BMI was below the 5th percentile in 23% of patients. CONCLUSION: Twenty patients (47%) presented with overt and latent hypoparathyroidism. Interestingly, autoimmune thyroid diseases such as Graves disease and Hashimoto thyroiditis were associated in patients with chromosome 22q11.2 microdeletion, indicating predisposition to autoimmune disorders. Therefore, a careful endocrine and growth evaluation is needed in these patients.
Autoantibodies ; Body Mass Index ; Calcium ; DNA ; Graves Disease ; Hashimoto Disease ; Humans ; Hypocalcemia ; Hypoparathyroidism ; Parathyroid Hormone ; Phenotype ; Tetany ; Thyroid Diseases ; Thyroid Function Tests ; Thyroid Gland ; Thyrotropin

CT was found to be highly accurate in predicting tumor size and assessing invasion of the surroundingstructures and distant metastasis. Also CT played an important role for determination of operability of esophagealcarcinoma. The CT findings with barium esophagogram in 21 patients with histologically proven esophageal carciomawere reviewed from Feb. 1985 to Feb. 1986 at the department of Radiology, Yonsei University ,College of Medicine.The results were as follows: 1. Number of patients in each stages were: 2 in stage 1, 6 in stage 2, 4 in stage 3,and 9 in stage 4. 2. Peak age distribution was in its 6th decasedes as 9 patiens (42.9%). Overall mean age was 60.8 years. Number of male patients were 19 and 2 of female. 3. Histologic types of esohageal carcinoma were 19cases of epidermoid (90.5%) and 2 cases of adenocarcinoma(9.5%). 4. The tumor location was 1 case in upper, 14cases(66.7%) in middle and 6 cases in lower one-third. 5. Various types of esophageal carcinoma were as follows: 3cases of fungating, 4 cases of infiltrating, 5 cases of ulcerofungating, and 9 cases of ulceroinfiltrating type.6. Average length of involvement in each stages were 4cm in stage 1, 5.5cm in stage 2, 8.8cm in stage 3, and 8.3cmin stage 4. The involved length was longer in advanced cases. In 11 cases(52.4%), the involved length was between4 and 8cm. 7. Angle of periaortic fat plane obliteration of the aortic circumference were as follows: Below 45degrees( 7 cases 33.3%), 45degrees-90degrees (3 cases 14.3%), over 90 degrees(11 cases, 52.4%). 8. Method oftreatment of esophageal carcinoma were as follows: Only radiotherapy in 11 cases(52.4%), radiotherapy withoperation in 5 cases, only operation in 1 cases, and no treatment in 4 cases. 9. Distant metastatic sites were:brain in 1, pericardium in 5, liver in 5, trachea in 2, bronchus in 9, and distant lymph node in 5 cases.
Age Distribution ; Barium ; Bronchi ; Female ; Humans ; Liver ; Lymph Nodes ; Male ; Methods ; Neoplasm Metastasis ; Pericardium ; Radiotherapy ; Trachea

Cutarieous manifest,ations and systemic complications were observed in 521 patient., with diabetes mellitus. The results were as follows: Total 70, 8% of patients had complications', In 16. 5%, cutaneous manifestation were observed. Systemic complications were observed in 27 6%, Both eutaneous manifestations and systemic complications were observed in 26 7% 2 The cutaneous mariifestations observed in 43 2%, were cutaneous infection, pruritus, shin spot, diabetic foit, peripheral edema, diahetic bulla, foot gangrene and rutieosis in the order of frequency, 3, The cutaneous manifestations were much more observed in patients with systemic complications than without them(p<0 05), and with longer duration more than 10 years history, 4. It seems to be no relationship between the cutancous manifestations and fasting blood sugar level.
Blood Glucose ; Diabetes Mellitus* ; Edema ; Fasting ; Foot ; Gangrene ; Humans ; Pruritus ; Statistics as Topic*

C-erbB-2 oncoprotein has been known to act as growth factor receptor responsible for the regulation of cellular growth, proliferation and differentiation and has been demonstrated in a number of cancers by immunohistochemical as well as matrix blotting techniques. Breast and ovarian cancer patients, whose tumor cells have amplification or overexpression of this oncoprotein, have been suggested to have worse prognosis. Yet, there are only a few studies on c-erbB-2 oncoprotein expression in transitional cell carcinoma(TCC) of the bladder. The aim of this study was to examine c-erbB-2 oncoprotein expression in bladder cancer to assess its potential as a useful prognostic marker in transitional cell carcinoma of the bladder. Deparaffinized tumor specimens from 42 patients with TCC of the bladder and 3 normal bladder tissue specimens were utilized. C-erbB-2 oncoprotein expression was detected by immunohistochemical analysis and then correlated with conventional prognostic variables such as histologic tumor grade, stage and DNA ploidy. In addition, we related the expression of c-erbB-2 oncoprotein to indicators of cellular proliferative activities such as proliferating cell nuclear antigen(PCNA), mean number of silver nucleolar organizer regions(AgNORs) per nucleus, flow cytometric S-phase fraction(CPF) and proliferation index(PI). The incidence of c-erbB-2 oncoprotein expression in Ash grade IV TCC of bladder was higher than that in Ash grade II and III (Chi-square test, p<0.05). The incidence of positive immunoreaction was higher in cases with muscle invasion and metastasis than in superficial tumors with statistical significance(p<0.05). In addition, statistical significant correlation was noted between c-erbB-2 oncoprotein expression and PCNA expression rate. But there were no significant differences in c-erbB-2 oncoprotein expression to DNA ploidy, PI nor SPF by flow cytometry and mean number of AgNORs per nucleus. The results of this study suggests that the c-erbB-2 oncoprotein together with other predictive parameters may serve to provide a phenotypic profile which permits more accurate forecasting of bladder cancer behavior and may prove to be useful in the future as an important guide to specific anti-tumor therapy.
Breast ; Carcinoma, Transitional Cell* ; DNA* ; Flow Cytometry ; Forecasting ; Humans ; Incidence ; Neoplasm Metastasis ; Nucleolus Organizer Region* ; Ovarian Neoplasms ; Ploidies* ; Prognosis ; Proliferating Cell Nuclear Antigen* ; Silver ; Urinary Bladder Neoplasms ; Urinary Bladder*

Background: Hyperglycemia during cardiopulmonary bypass may increase the incidence and severity of neurologic deficits that may result from cerebral ischemia. Moderate hyperglycemia has been noted to occur in pediatric patients undergoing cardiac surgery despite measures such as eliminating dextrose from the CPB clear pump priming solution and from the intra-operative iv fluids. To ameliorate the hormonal and hemodynamic stress responses during cardiac surgery in neonates, infants and children, high dose fentanyl anesthesia is widely used. The authors wished to determine prospectively whether fentanyl dosage is associated with reduced blood glucose or not in pediatric patients undergoing cardiac surgery. METHODS: Twenty four pediatric patients undergoing cardiac surgery were allocated randomly into 3 groups who received 25 g/kg fentanyl, 50 g/kg fentanyl or 75 g/kg fentanyl before CPB. The changes of plasma glucose and insulin levels were observed after sternotomy, on bypass, 30 min after bypass, off bypass, and the end of the operation. RESULTS: Blood glucose levels were not increased after sternotomy, but significantly increased at bypass to the end of the operation in all fentanyl dosage groups. Plasma insulin level increased, but statistically not significant. Different fentanyl dosage (25~75 g/kg) is not associated with differences in blood glucose level. CONCLUSION: At a dosage of 25~75 g/kg fentanyl anesthesia during pediatric open heart surgery were associated with no differences and below 250 mg/dl of blood glucose level and no significant changes in insulin level.
Anesthesia ; Blood Glucose* ; Brain Ischemia ; Cardiopulmonary Bypass ; Child ; Fentanyl* ; Glucose ; Heart* ; Hemodynamics ; Humans ; Hyperglycemia ; Incidence ; Infant* ; Infant, Newborn* ; Insulin* ; Neurologic Manifestations ; Plasma ; Prospective Studies ; Sternotomy ; Thoracic Surgery*

Epiblepharon is frequently encountered n oriental eyelid, especially in children. It is characterized by a horizontal fold of redundant skin and abundant orbicularis muscle near lid margin, which the lashes vertically, or posteriorly towards the eye. Surgical therapy of epiblepharon in correcting the trichiasis includes lid bracing sutures, burried sutures, skin resection, a Hotz procedure or its modification, and a Jones procedure. In our opinion, these procedures are not sufficient, because these procedures will not correct the epicanthal folds. Epicanthal folds have been a one of the characteristics of Asian over 50 percents of population in Japan and South Korea, and it either reduce the aesthetic result of the double-eyelid procedure or make the correction of the entropion and epiblepharon difficult. Although many surgical procedures are available to eliminate epicanthal folds, scarring on the medial canthus is in still and obstacle for surgeons to overcome. From January of 1998 to October of 1998, we used half z-plasty procedures in 5 cases to correct epicanthal folds in epiblepharon. There were few complications in our series. We believe that half z-plasty can get a good result in the correction of epibolepharon and oriental epicanthal folds.
Asian Continental Ancestry Group ; Braces ; Child ; Cicatrix ; Entropion ; Eyelids ; Humans ; Japan ; Korea ; Skin ; Sutures ; Trichiasis

Pigmented villonodular synovitis and synovial chondromatosis are known as a poup of interrelated tumorous disorders that involve the lining of the joints, hursa and tendon sheath. Pigmented villonodular synovitis consists of proliferatin synovia1 tissue containing histiocytes, librohlasts, multinucleated giant cells, and capillaries that can destroy dense fihrous tissue, form soft tissue masses, and invade bone. Synovial chondromatosis consists of hyaline cartilage nodules within the synovium and synovial joint cavities, develop multiple loose fragments of cartilage within the joint. They may represent a reactive inflammatory process or henign neoplasm and usually occur in latge synovial joints, including the knee, hip and ankle. There are some reports stating that pigmented villonodular synovitis has coexisted with synovial chondromatosis. but none have reported that they occurred simultaneously in a large single joint. This is a report on a diagnosed and arthroscopicully treated pigmented villonodular synovitis and synovial chondromatosis that occurred simultaneously in the same ankle joint.
Ankle Joint* ; Ankle* ; Capillaries ; Cartilage ; Chondromatosis, Synovial* ; Giant Cells ; Hip ; Histiocytes ; Hyaline Cartilage ; Joints ; Knee ; Synovial Membrane ; Synovitis, Pigmented Villonodular* ; Tendons

No abstract available.
Scrub Typhus*

Current using strabismic angle measurement techniques require examiners experience and subjective decision. The accuracy between observers and intra-observer is limited by the minimum eye movement that the examiner can detect with naked eye. Horizontal strabismic angles with 35 comitant strabismus patients were measured using precise digital signals converted by digital frame grabber and image processing software in a 32 bit microcomputer. Strabismic angle calculated using digital method was compared with that of prism-cover method. The slope of the regression line was 1.1054; the Y-intercept was 1.3870PD. The coefficiency of variation to verify its reproducibility for measurements of total variability in 35 strabismic patients was 3.71%. The strabismic angle measurement with digital frame grabber seems to be relatively precise and clinical application will be available in measuring horizontal and vertical strabismic angel.
Eye Movements ; Humans ; Microcomputers ; Strabismus