The use of recombinant DNA technology to produce human growth hormone has resulted in a marked increase in availability of Growth Hormone(GH) to treat short stature due to GH deficiency and other conditions, such as Turner syndrome, familial short stature, chronic renal insufficiency and intrauterine growth retardation (IUGR). But, the GH therapy may result in the adverse events such as sodium and water retention, pseudotumor cerebri, slipped capital femoral epiphysis, growth of nevi, recurrence of tumor. We experienced a case of severe hypertension associated with GH therapy in a 14-year-old male who presented high blood pressure up to 190/100 mmHg and normalized at 2-3 weeks after discontinuation of GH. Therefore, we think that the blood pressure should be carefully monitored during GH therapy.
Adolescent ; Blood Pressure ; DNA, Recombinant ; Fetal Growth Retardation ; Growth Hormone* ; Human Growth Hormone ; Humans ; Hypertension* ; Male ; Nevus ; Noonan Syndrome ; Pseudotumor Cerebri ; Recurrence ; Renal Insufficiency, Chronic ; Slipped Capital Femoral Epiphyses ; Sodium

Facial Asymmetry ; Female ; Genioplasty ; Humans ; Retrospective Studies ; Zygoma

Tumors of the parotid gland are the most frequently encountered salivary gland tumors. Knowledge of the histology and anatomy of the salivary gland is important when considering the histiogenesis of salivary gland tumors, requiring close cooperation between the pathologist and the surgeon. Most tumors are benign epithelial formations. Pleomorphic adenomas predominate. Superficial lobectomy is adequate treatment. When the tumor involves a deep lobe, total parotidectomy is indicated. Treatment of malignant tumors depends on the histology, its TNM stage and other factors. Total parotidectomy with lymph adectomy and radiotherapy are needed in case of high grade malignancy. In children, vascular neoplasias are the most frequent, followed by malignant tumors. Their histological features and treatment are the same as for adults. We reviewed 64 cases of the parotid tumors at Department of surgery, Dong-A University Hospital from July. 1990 to Jan. 1999 for the purpose of apprehension of parotid gland tumor by the clinical study and review. Over all sex ratio was 1: 1.13 (M: F), mean age was 38.9 years, mean size was 3.53cm. According to histologic findings of 64 cases, pleomorphic adenoma was 55 (85.9%), Warthin's tumor was 3 (4.7%), mucoepidermoid carcinoma was 3 (4.7%), squamous cell carcinoma was 2 (3.1%), acinic cell carcinoma was 1 (1,6%). Post op. facial nerve palsy 16 (25%), Frey's syndrome 11 (17.2%) cases were happened. Hence, the clinical manifestation of pain, tenderness, facial N. palsy suggest malignant tumors.
Adenoma, Pleomorphic ; Adult ; Carcinoma, Acinar Cell ; Carcinoma, Mucoepidermoid ; Carcinoma, Squamous Cell ; Child ; Facial Nerve ; Humans ; Paralysis ; Parotid Gland* ; Radiotherapy ; Salivary Glands ; Sex Ratio ; Sweating, Gustatory

PURPOSE: We wanted to report the our early experience with performing nephron-sparing radiofrequency ablation (RFA) of renal tumor. MATERIALS AND METHODS: Three percutaneous RFAs were performed under combined computed tomography (CT) and ultrasonogram guided, and two intraoperative ultrasonograpy-guided laparoscopic RFAs were performed since June 2004. The treatment indications were localized, small (<4cm), solid renal masses in elderly patients and also the same type masses in the patients with comorbid conditions. The follow-up studies included physical examination, CBC, serum creatinine, urine analysis and kidney CT, and these were performed at day 1, 1 week, 1 month, 3 months, 6 months and 1 year after ablation, and then semi-annually thereafter. The mean follow-up duration was 8.8 months (range: 5-12 months). RESULTS: All five patients underwent successful RFA without any serious events. One patient had a mild perinephric hematoma and another patients had mild gross hematuria postoperatively. With a mean follow-up of 8.8 months, none of the patients showed any residual tumor on follow-up contrast-enhanced CT after the final tumor ablation. Complete tumor ablation was achieved after a single treatment session in 80% of the patients and in 20% of patients after the subsequent ablation sessions. CONCLUSIONS: Percutaneous or laparoscopic RFA is a promising nephron-sparing treatment for selected patients with small renal mass. Contrast-enhanced CT performed immediately after ablation is a reliable method to exclude residual viable tumor. The ultimate role for this modality will continue to evolve and this warrants further studies.
Aged ; Catheter Ablation* ; Creatinine ; Follow-Up Studies ; Hematoma ; Hematuria ; Humans ; Kidney ; Laparoscopy ; Neoplasm, Residual ; Nephrons ; Physical Examination ; Tomography, X-Ray Computed ; Ultrasonography

Panner's disease, osteonecrosis of the capitellum of the elbow, was first reported by Panner in 1927. The disease occurs mainly in boys between 6 and 15 years old and shows unilateral distribution. Pain, stiffness, localized tenderness over the lateral condyle of the elbow, and decreased range of motion are the typical clinical symptoms. Conservative treatment is generally recommended for patients in the early stage of this disease. A few cases of Panner's disease have been reported and few are related to long-term follow-up results. To the best of our knowledge, all reported cases were over six years. Therefore, we report on a five-year-old boy diagnosed as Panner's disease that showed resorption and regeneration of the humeral capitellum with no limitation of motion over three years. The current study was exempted from review by the institutional review board because it was a single retrospective case report. Informed consent was obtained from the patient's guardian.
Child* ; Elbow ; Ethics Committees, Research ; Follow-Up Studies ; Humans ; Informed Consent ; Male ; Osteochondrosis ; Osteonecrosis ; Range of Motion, Articular ; Regeneration ; Retrospective Studies

The mainly used polymeric material for the denture is PMMA because of its cost and easiness to handle. So it was widely used material among dentists for past decades. But the acrylic-based denture materials have several common weak points such as shrinkage after curing and lack of strength. In order to solve these problems, we adapted one of hybrid system using acrylic polymer and vinyloligosilsesquioxane(POSS). POSS, which is a well known expandable monomer during polymerization process, may eventually suppress volumetric shrinkage. And the hybrid system makes it possible for the polymer to be stable in various severe conditions. Eight different kinds of samples were designed and synthesized. Each samples were characterized with dynamic mechanical analyser(DMA) to confirm their thermodynamic properties, fractured to analyze the cross-sectional morphology of the samples. And elongation, flexural and impact tests were also executed to evaluate the mechanical properties of the samples. From the results, hybrid composites had well defined crosslinked network structure compared to the widely used denture materials, and the mechanical strength improved without changing any surface condition as increment with POSS ratio in hybrid system. Fractured morphology showed homogeneous surfaces in spite of mutli component system, therefore we can conclude that the adoption of the POSS brought the reinforcement of the denture resin.
Dentists ; Dentures* ; Humans ; Polymerization ; Polymers ; Polymethyl Methacrylate ; Thermodynamics

The purpose of this study is to compare tensile bond strength between Cr-Co alloy and three denture base resins after surface treatment. Following the manufacturer's instructions, 180 bonded specimens were made from three denture base resins (Lucitone 199, Paladent 20, POSS resin) and three surface treatment methods(sandblasting, metal primer, silicoating). 20 samples were made in each group and a half was thermocycled 1000 times between 5 celsius degrees and 55 celsius degrees. The tensile bond strength was measured using an Instron with 5mm/min crosshead speed. Data was analyzed with one-way ANOVA, T-test and Duncan test. The results were as follows: 1. Samples with metal primer coating had significantly high tensile bond strength than the other surface treated groups (p<.05). Significantly low tensile bond strength was shown in sand blasted groups (p<.05). 2. No significant difference was observed in metal primer coating groups before and after thermocycling (p>.05). 3. Tensile bond strength was decreased in silicoated samples after thermocycling (p<.05). 4. Of the surface treated groups with metal primer,Lucitone 199 had the greatest bond strength and POSS resin and Paladent 20 were followed (p<.05). 5. Of the surface treated groups with silicoating, POSS resin and Lucitone 199 had greater bond strength than Paladent 20 (p<.05).
Alloys ; Computer Simulation ; Dental Alloys* ; Denture Bases* ; Dentures* ; Silicon Dioxide

BACKGROUND: To decide the optimal antibiotics and application of chest tube, examination of pleural fluid is fundamental in the management of empyema. Some criteria for drainage of pleural fluid have been recommended but some controversies have been suggested. Recently, newer radiologic methods including ultrasound and computed tomography scanning, have been applied to the diagnosis and management of pleural effusions. We undertook a retrospective analysis of 30 patients with pleural effusion who had CT scans of the chest in order to apply the criteria of Light et at retrospectively to patients with loculation and to correlate the radiologic appearance of pleural effusions with pleural fluid chemistry. METHOD: We analyzed the records of 30 out of 147 patients with pleural effusion undergoing chest CT scans. RESULTS: 1) Six of the pleural fluid cultures yielded gram negative organisms and three anaerobic bacterias and one Staphylococcus aureus and one non-hemolytic Streptococci. No organism was cultured in nineteen cases(63.0%). 2) The reasons for taking chest CT scans were to rule out malignancy or parenchymal lung disease(46.7%), Poor response to antibiotics(40.0%), hard to aspirate pleural fluid(10.0%) and to decide the site for chest tube insertion(3.3%). 3) There was no significant correlations between ATS stages and loculation but there was a tendency to Inoculate in stage III. 4) There was a significant inverse relationship between the level of pH and loculation(P<0.05) but there appeared to be no relationship between pleural fluid, LDH, glucose, protein, loculation and pleural thickening. 5) In 12 out of 30, therapeutic measures were changed according to the chest CT scan findings. CONCLUSION: We were unable to identify any correlations between the plerual fluid chemistry, ATS stages and loculations except pH, and we suggest that tube thoracotomy should be individualized according to the clinical judgement arid serial observation. All patients with empyema do not need a chest CT scan but a CT scan can provide determination of loculation, guiding and assessing therapy which should decrease morbidity and hospital stay.
Anti-Bacterial Agents ; Bacteria, Anaerobic ; Chemistry ; Chest Tubes ; Diagnosis ; Drainage ; Empyema* ; Glucose ; Humans ; Hydrogen-Ion Concentration ; Length of Stay ; Lung ; Pleural Effusion ; Retrospective Studies ; Staphylococcus aureus ; Thoracotomy ; Thorax* ; Tomography, X-Ray Computed* ; Ultrasonography

BACKGROUND: In 1987, the British Thoracic Society (BTS) subjected an extensive list of patient variables to statistical analysis in a prospective study of prognosis in 453 adults with communityacquired pneumonia and, subsequently published guidelines for management of severe community acquired pneumonia. It was hoped that those at risk of dying from community acquired pneumonia could be easily identified and treated appropriately, thereby reducing mortality. To date, severe community acquired pneumonia has not been well studied in Korea. Therefore, we studied retrospectively 10 patients dying of severe community acquired pneumonia in Dongsan Hospital to see clinical manifestations of .dying of severe community-acquired pneumonia. METHODS: Between July 1987 and july 1993, 498 patients were admitted to Keimyung University Dongsan Hospital with community acquired pneumonia, and 77 of them received intensive care. Of the 77 patients, 10 patients died. We reviewed medical records of these patients. RESULTS: 1) The mean age of the patients was 56.2 years(range, 25 to 75 years). There were 7 men and 3 women. Seven patients(70%) were older than 60years of age. 2) The clinical features on admission were as follows: tachypnea, hypoxemia, mental change, cyanosis, leukopenia, leukocytosis, azotemia, hypotension, hypoalbuminemia in order of frequency. Three patients had one abnormal physical finding, 3 patients had 2, 2 patients had 3, and 2 patients had none of these abnormal physical findings. All patients had at least one of the abnormal laboratory findings. 3) A potential bacterial pathogen was isolated in sputum culture from 2 patients. One was E.coli, the other Enterobacter species. Sputum stain were positive in eight cases (G(+)cocci in six, G(+)cocci and G(-)bacilli in two). 4) Features of respiratory failure were the main reasons for ICU transfer, but two patients were transferred only following a cardiac or respiratory arrest in the general ward. 5) The mean of 2.7 different antibiotics were given to the patients. The aminoglycoside and first generation cephalosporin were the most frequently prescribed antibiotics, followed by the third generation cephalosporin and vancomycin. The most frequently prescribed antibiotics combination was a 1st generation cephalosporin plus an aminoglycoside. 6) Save patients death(70%) occured after admission within the first five days, and a mean duration of hospitalization was 11.2 days. CONCLUSION: As the results show most death occured within the first days after admission and aged patients; consequently, an aggressive intensive treatment should be provided early to the patients with severe community acquired pneumonia, and we should pay more attention to the aged patients.
Adult ; Anoxia ; Anti-Bacterial Agents ; Azotemia ; Cyanosis ; Enterobacter ; Female ; Hope ; Hospitalization ; Humans ; Hypoalbuminemia ; Hypotension ; Critical Care ; Korea ; Leukocytosis ; Leukopenia ; Male ; Medical Records ; Mortality ; Patients' Rooms ; Pneumonia* ; Prognosis ; Prospective Studies ; Respiratory Insufficiency ; Retrospective Studies ; Sputum ; Tachypnea ; Vancomycin

OBJECTIVE: The risk factors of reoperation after microdecompression (MD) for lumbar spinal stenosis (LSS) are unclear. In this study, we presented the outcomes of MD for degenerative LSS and investigated the risk factors associated with reoperation. METHODS: A retrospective review was conducted using the clinical records and radiographs of patients with LSS who underwent MD. For clinical evaluation, we used the Japanese Orthopedic Association (JOA) scoring system for low back pain, body mass index, and Charlson comorbidity index. For radiological evaluation, disc height, facet angle, and sagittal rotation angle were measured in operated segments. Also the Modic change and Pfirrmann grade for degeneration in the endplate and disc were scored. RESULTS: Forty-three patients aged 69±9 years at index surgery were followed for 48±25 months. The average preoperative JOA score was 6.9±1.6 points. The score improved to 9.1±2.1 points at the latest follow-up (p<0.001). Seven patients (16.3%) underwent reoperation. Clinical and radiological factors except operation level and Pfirrmann grade showed a p-value >0.1. Patients with Pfirrmann grade IV and lower lumbar segment had a 29.1% rate of reoperation (p=0.001), whereas patients without these factors had a 0% rate of reoperation. CONCLUSION: Moderate disk degeneration (Pfirrmann IV) in lower lumbar segments is a risk factor of disk herniation or foraminal stenosis requiring reoperation after MD in LSS.
Asian Continental Ancestry Group ; Body Mass Index ; Comorbidity ; Constriction, Pathologic ; Follow-Up Studies ; Humans ; Intervertebral Disc Degeneration ; Laminectomy ; Low Back Pain ; Orthopedics ; Reoperation* ; Retrospective Studies ; Risk Factors ; Spinal Stenosis*