No abstract available.
Thyrotropin*

Between January 1994 and February 1996 lumbar fusion was carried out in eight patients who had degenerative lumbar disease by a technique of translaminar facet screw fixation. The goal of instrumentation is to confer immediate stability to unstable segments and lower the pseudarthrosis rate. However, transpedicular systems can carry a risk of neural damage and require a high standard surgical skills. Therefore, the purpose of this study was to determine the efficacy and safety, and to introduce the simple fusion technique. We usually used this technique for the patients who had been planned single level fusion without definite preoperative instability. Preoperative diagnosis were isthmic spondylolisthesis in one, spinal stenosis in three and laterally herniated lumbar discs in four in which postoperative instability was expected without performing fusion. A single-level fusion was perfomed in all patients. Fusion levels were L2-3 in two, L3-4 in one, L4-5 in four and L5-Sl in one. The average follow-up period was 20 months, ranging from 12 to 36 months. Overall clinical satisfaction including excellent and good result was obtained in all cases. The fusion rate was evaluated radiographically and all were solidly fused. The time to fusion ranged from 3 to 10 months at an average of 5.4 months. There were no significant complications including nerve root injury, and screw loosening or breakage. Although this study was retrospective and the number of cases were small, translaminar facet screw fixation for degenerative lumbar disease is simple and readily available, and provides sufficient rigid stabilization.
Diagnosis ; Follow-Up Studies ; Humans ; Pseudarthrosis ; Retrospective Studies ; Spinal Stenosis ; Spine* ; Spondylolisthesis

No abstract available.
Child* ; Humans ; Tuberculosis*

Background : It is not easy to diagnose sporadic medullary thyroid carcinoma(MTC) before surgery and this might lead the patient reoperation and/or lowered chance of definite cure. Methods : The prevalence of sporadic MTC in Korean was studied in patients with thyroid nodules. A prospective study of 1048 consecutive patients with thyroid nodules was performed. In all patients, measurements of basal serum calcitonin, thyroid hormones, TSH, anti-thyroglobulin antibody and anti-thyroperoxidase antibody were undertaken along with technetium-99m thyroid scintigraphy and fine needle aspiration cytology. In patients with elevated basal calcitonin levels, calcium stimulated calcitonin level was determined. Results: Two patient had markedly elevated calcitonin levels(over 3,200 pg/mL and 1,763 pg/ mL) and another one slightly elevated calcitoni#n(71.9 pg/mL). Fine needle aspiration cytology was suggestive of MTC in one and nodular hyperplasia in the other two. They underwent surgery and histological examination revealed MTC in those two with markedly elevated calcitonin levels. The patient with slightly elevated calcitonin, who was on the maintenance hemodialysis due to chronic renal failure, had nodular hyperplasia. Conclusion: MTC was found in 0.19% of patients with thyroid nodules, which was not different with the previously reported prevalence in Europe. Routine measurements of serum calcitonin might be of value to detect sporadic MTC; however, the cost-effectiveness of routine measurement of serum calcitonin is not clear, considering the relatively low prevalence of MTC in Koreans.
Biopsy, Fine-Needle ; Calcitonin ; Calcium ; Carcinoma, Medullary ; Europe ; Humans ; Hyperplasia ; Kidney Failure, Chronic ; Mass Screening ; Prevalence ; Prospective Studies ; Radionuclide Imaging ; Renal Dialysis ; Reoperation ; Thyroid Gland ; Thyroid Hormones ; Thyroid Nodule

BACKGROUND: Melanin pigment plays a major role in the expression of normal human skin color as well as in the photoprotection against ultraviolet damage. Melanin produced in melanocytes is transferred via dendrites to surrounding keratinocytes, and this anatomical relationship is termed as epidermal melanin unit. The rates of pigment synthesis and transfer by melanocytes appear to be influenced by ultraviolet light, though the precise factors regulating human epidermal pigmentation remain unelucidated. It has been reported that keratinocytes in vitro release factors that could modulate melanocyte behavior. Ultraviolet irradiation was also been known to enhance the release of various kinds of cytokine from keratinocytes in vivo and in vitro. OBJECTIVE: We postulated that keratinocytes rather than melanocytes could play a primary role in UVB-induced pigmentation, and keratinocytes, when irradiated with UVB, release substances that could modulate or stimulate melanin synthesis from melanocytes. The fact that keratinocytes are located efficiently for direct sunlight irradiation at the top of melanocytes, that they release various biological factors known to simulate melanin synthesis from melanocytes and that they constitute the majority of epidermal cells supported this possibility. To investigate this possibility, we evaluated the effect of supernatant from UVB-irradiated cultured keratinocytes on the growth, melanin content, and tyrosinase activity of human melanocytes. METHODS: Human cultured keratinocytes were irradiated with UVB(30, 60, or 120mj/cm2)once, and after 24 hours, supernatant of the keratinocytes were collected and added to a growth medium of melanocytes for 5 days in concentration of 15, 25 or 35%, We observed numeric and morphologic changes as well as melanin content and tyrosinase activity in situ of cultured human melanocytes. RESULTS: 1. When cultured melanocytes were incubated with supernatant of non-irradiated keratinocytes, the number of melanocytes, amount of melanin and tyrosinase activity increased in groups added with 25% or35% concentration of supernatant. 2. The number of melanocytes incubated with 15% or 25% concentrations of supernatant from cultured keratinocytes irradiated with UVB increased in both 30 and 60mj/cm2 of UVB irradiated groups and decreased in 120mJ/cm2of UVB irradiated groups. 3. The melanin content of melanocytes incubated with 15% concentration of supernatant from UVB-irradiated cultured keratinocytes increased in 120mJ/cm2 of UVG irradiated groups. 4. The tyrosinase activity of melanocytes incubated with 15% concentration of supernatant from UVB-irradiated cultured keratinocytes increased in 120mJ/cm2 of UVB irradiated groups and the tyrosinase activity of melanocytes incubated with 25% concentration of supernatant from UVB-irradiated cultured keratinocytes increased with 35% supernatant concentration of supernatant from UVB-irradiated keratinocytes, the tyrosinase activity increased in 30mJ/cm2of UVB irradiated groups. CONCLUSION: The above results suggest that UVB-irradiated kerationcytes release soluble or photoactivated factors which could modulate the growth and melanization of melanocytes, and that keratinocytes play an important or primary role in the regulation of UVB induced pigmentation.
Biological Factors ; Dendrites ; Humans* ; Keratinocytes* ; Melanins* ; Melanocytes* ; Monophenol Monooxygenase* ; Pigmentation ; Skin ; Sunlight ; Ultraviolet Rays

Mitral valvular orifice area is important for the evaluation of prognosis and treatment of patients with mitral valvular stenosis. Until recently, Gorlin's formula using cardiac catheterization has been utilized in the measurement of mitral valve area, but it is invasive and impractical to examine repeatedly. Recently 2-Dimensional echocardiography appeared to be a practical and useful substitute in measurement of valve area and also it is economical and has no risk to patients. In 31 patients with mitral valvular stenosis examined at the echocardiography room of Busan national University Hospital from March 1982 to March 1983, we measured the mitral valve area with 2-Dimensional echocardiography and evaluated its relationship with the left ventricular functions measured on M-mode echocardiogram. Among many parameters on M-mode measurements EF slope, excursion amplitude and the ratio of left atrial dimension to aortic root dimension were rather helpful for the assessment of severity of mitral valvular stenosis than other parameters. And each relationship with the valve area showed correlation coefficient of 0.60, 0.05 and -0.58, respectively.
Busan ; Cardiac Catheterization ; Cardiac Catheters ; Constriction, Pathologic* ; Echocardiography* ; Humans ; Mitral Valve* ; Prognosis ; Ventricular Function, Left

Fifty percents of patient with achondroplasia present neurological disturbances of varying degree. Congenital narrowing of the spinal canal in achondroplastics seems to be the main cause of the cord disturbance, and there are several other causes such as prolapse of intervertebral discs, spondyloarthitic degenerative manifestations and wedging of vertebral body. Surgical treatment of the cord disturbance consist of anterior decompression with fusion and posterior decompression. We experienced L1-2 disc herniation in achondroplasia with rapid progression of neurologic symptoms and treated with posterior decompression. Two years after operation, the patient had good result.
Achondroplasia ; Decompression ; Humans ; Intervertebral Disc ; Neurologic Manifestations ; Prolapse ; Spinal Canal

Tuberculosis of the esophagus is rare. We experienced four patients with esophageal tuberculosis proven by esophagoscopic biopsy or surgical specimens. Case 1 was a patient with primary esophageal tabereulosis, case 2 was a patient with teberculous esophagobronchial fistula and case 3,4 were patients with esoyhageal perforation due to tuberculous traetion diverticulum of the esophagus. The clinical, radiological and esapbagoscopic findings may be nonspecific in diagnosis of esophageal tuberculosis. Therefore early diagnosis should be rested on a high index of suapieion and a cautious attention.
Biopsy ; Diagnosis ; Diverticulum ; Early Diagnosis ; Esophagus* ; Fistula ; Humans ; Tuberculosis

Biliary atresia (BA) is a major cause of extrahepatic biliary obstruction in children. Malnutrition is a significant clinical problem in children with BA. BA may induce the malabsorption of fat and fat-soluble vitamins, resulting in cholestasis and an impaired nutritional status. For the treatment of BA, it is most important to reconstruct the bile flow as early as possible by performing a Kasai portoenterostomy. After the Kasai operation, growth and nutrition are restored, but to follow normal growth and development, it is necessary to evaluate the nutritional status and support. Therefore, the purpose of nutritional support in children with BA is to normalize growth and development, prevent further liver damage and deterioration of the patient's nutritional status, avoid vitamin and mineral deficiencies, and improve the quality of life of patients.
Avitaminosis ; Bile ; Biliary Atresia* ; Child ; Cholestasis ; Growth and Development ; Humans ; Liver ; Malnutrition ; Miners ; Nutritional Status ; Nutritional Support* ; Quality of Life ; Vitamins

A case of pretibisl myxederna in typical Graves disease was described. A 50-year-old woman revealed diffuse toxic goiter, exophthalmos, and pretibial myxedema. From light and electron microscopic findings, large amount of acid mucopolysaccharides were deposited in the stroma and fibroblssts. In spite of elevation of TBII (a kind of thyroid stimulatory factors, negative direct immunofluorescence of lesional skin and no response. of pretibial myxedema to the treatment with antithyroid drug (propylthiouracil) suggested stimulstory factors of fibroblasts might be different from those of thyroid gland.
Exophthalmos ; Female ; Fibroblasts ; Fluorescent Antibody Technique, Direct ; Glycosaminoglycans ; Goiter ; Graves Disease* ; Humans ; Middle Aged ; Myxedema* ; Skin ; Thyroid Gland