Parathyroid hyperplasia is a pathologic finding that can be found in hyperparathyroidism. Unlike parathyroid adenoma, treatment of parathyroid hyperplasia is still quite controversial. In addition, the relative merits of two alternative surgical approaches-subtotal parathyroidectomy versus total parathyroidectomy with autotransplantation have not been clearyly elucidated. The records of 10 patients who had parathyroid hyperplaisa and who underwent parathyroid surgery at the Department of Surgery, Hanyang University Hospital, between April 1992 and April 2003 were retrospectively reviewed. The 10 patients were comprised of 3 males and 7 females. The age distribution was between 29 and 73 years. The presenting clinical manifestations were associated with bone pain in 8 patients, muscle weakness in 4, headache in 4, gastrointestinal symptoms in 3, renal symptoms in 3 and psychologic symptoms in 2. The serum parathyroid hormone level was elevated in all patients. The serum alkaline phosphatase level was elevated in seven among the ten patients. Histopathologic findings revealed chief cell hyperplasia in all patients. Postoperative transient hypocalcemia occurred in 5 patients and they were supplied with oral calcium and calcitriol for several months. There were no major complications. The results indicate that a subtotal parathyroidectomy can be performed without mortality or morbidity and provides good control of primary parathyroid hyperplasia, A total prathyroidectomy with autotransplantation can be performed without mortality or morbidity and provides good contril of secondary and tertiary parathyroid hyperplaisa.
Age Distribution ; Alkaline Phosphatase ; Autografts ; Calcitriol ; Calcium ; Female ; Headache ; Humans ; Hyperparathyroidism ; Hyperplasia* ; Hypocalcemia ; Male ; Mortality ; Muscle Weakness ; Parathyroid Hormone ; Parathyroid Neoplasms ; Parathyroidectomy ; Retrospective Studies ; Transplantation, Autologous

No abstract available.
Prune Belly Syndrome*

No abstract available.
Ectromelia*

Fetal bilateral renal agenesis is a lethal congenital anomaly. An early and reliable prenatal diagnosis is extremely important as it may offer options for pregnancy termination as early as possible. The criteria for the ultrasonographic diagnosis of bilateral renal agenesis are severe oligohydramnios, nonvisualization of the bladder, and the empty renal fossa. However, severe oligohydramnios makes it difficult to diagnose the disease because of poor sonographic resolution. We present two cases of bilateral renal agenesis, one is diagnosed by ultrasonography after amnioinfusion at 24 weeks gestation, the other is diagnosed postnatally after term delivery.
Diagnosis ; Female ; Oligohydramnios ; Pregnancy ; Prenatal Diagnosis ; Ultrasonography ; Urinary Bladder

The humerus is anatomically and phyelologically unique, such as, firstly, it is a non weight bearing bone, secondly, it has greatest range of motion, thirdly, when at rest while the person is standing, the axis of bone hangs vertically and is influenced by gravity, and conservative methods usually used in treatment. However, in the event of closed reduction failure, open fracture, multiple fracture, and old age, operative method may be employed. Authors reviewed and analzed 84 humeral shaft fractures which had been treated at the Department Orthopedic Surgery, Paik Hospital from Dec. 1979 to May 1988. The results were as follows : l. Among the 84 patients, male were 63 and female were 21. 2. The major causes of injury were a traffic accident. 3. The most frequent type and site of fracture was comminuted and middle one third. 4. The incident of radial nerve injury was 17 cases. 5. Of 84 cases, 22 cases were treated conservatively and 62 cases operatively. 6. The most common complication was non-union of 14 cases, of which 10 cases were treated with plate and bone graft and 4 cases with only bone graft.
Accidents, Traffic ; Female ; Fractures, Multiple ; Fractures, Open ; Gravitation ; Humans ; Humerus ; Male ; Methods ; Orthopedics ; Radial Nerve ; Range of Motion, Articular ; Transplants ; Weight-Bearing

BACKGROUND/AIMS: The efficacy of standard triple therapy (STT) in treating Helicobacter pylori infection has decreased. Many investigators have attempted to increase the eradication rate. We investigated the outcomes of concomitant therapy (CT) and STT combined with probiotics (STP) as a first-line treatment for H. pylori infection. METHODS: We reviewed the medical records of 361 patients who received either STP (n=286) or CT (n=75). The STP group received STT combined with a probiotic preparation for 1 week. The CT group received STT and metronidazole for 1 week. RESULTS: The intention-to-treat and per-protocol eradication rates were 83.6% (95% confidence interval [CI], 79.0 to 87.7) and 87.1% (95% CI, 81.2 to 89.7) in the STP group and 86.7% (95% CI, 78.7 to 93.3) and 91.4% (95% CI, 83.6 to 97.1) in the CT group (p=0.512 and p=0.324), respectively. The frequency of adverse effects was higher in the CT group (28.2%) than in the STP group (12.8%) (p=0.002). CONCLUSIONS: STP and CT are encouragingly efficacious as first-line treatments for H. pylori infection. Therefore, adding probiotics to STT may be a feasible option to avoid side effects.
Helicobacter pylori* ; Helicobacter* ; Humans ; Medical Records ; Metronidazole ; Probiotics* ; Research Personnel

The purpose of this study was to investigate any relationship between the geometric factors of synaptic contacts of muscle spindle afferent terminals and masseteric motor neurons in the trigeminal motor nucleus. Terminals from the masseteric muscle spindle afferents were stained with intra-axonal injection of HRP and were examined electronmi-croscopically with serial sections at the central and peripheral regions of trigeminal motor nucleus of the cat. The number of terminals examined were 76 in peripheral and 105 in central region. The results obtained were as follows. 1. Most of the labeled terminals showed simple synaptic connectivity. Each terminals in peripheral and central region made synaptic contact with 1 to 5 neuronal profiles. Two or three labeled terminals were occasionally seen to make synaptic contact with the same dendrite. 2. The average number of postsynaptic proximal dendrite per labeled terminal was higher in the central region than in the peripheral region. In contrast, that of postsynaptic distal dendrite per labeled terminal was higher in the peripheral region than in the central region. 3. The average diameter of postsynaptic dendrites in the central region was larger than that in the peripheral region. This imply terminals in the peripheral region contacted with further distal part of the distal dendrite than that in the central region. These results indicate that synaptic connectivity associated with the spindle afferents from masseteric muscle is different according to their geometric location within the trigeminal motor nucleus and suggest that there will be precise interrelationship between the morphology, pattern of synaptic connectivity and functions of muscle spindle afferents.
Animals ; Cats* ; Dendrites ; Motor Neurons ; Muscle Spindles* ; Neurons

A 63 year-old man was admatted to our hospital because of dulI epigastralgia. Upper G-I series reveaied the generalized thickened, tortuous mucosal folds in the stomach and duodenal bulb, Two ovold large pits on the antrum were observed endoscopically, Tha relevant literatures on the subject were reviewed.
Humans ; Middle Aged ; Pylorus* ; Stomach

This study was conducted to assess the risk of breast cancer by menstrual, reproductive, and lactational factors in Korean women. A total of 210 women living in Seoul aged 30 to 60 with a first diagnosis of breast cancer from 2 teaching hospitals in Seoul, and 249 control subjects, randomly selected from the female pensioners of Korean Medical Insurance Company living in Seoul were interviewed. There was a increasing risk with the decrease of age at menarche, and the adjusted odds ratio(OR) of early menarche(age 14 years or less compared with over 17 years) was 1.61(95% Confidence Interval [CI]: 0.95-2.74). The longer the interval between menarche and regular menstruation, the less risk of breast cancer(OR=0.31, 95% CI: 0.16-0.60). The effect of these menarche factors were more prominent among premenopausal women. The adjusted OR for the second category(25-29 years old) of the age at first pregnancy and the age at the first full term pregnancy, compared to the reference category( 24 years old), were 0.52(95% CI: 0.30-0.92) and 0.58(95% CI: 0.32-1.06), respectively. The late age at the last full term pregnancy had significant protective effect (OR=0.29, 95% CI: 0.10-0.88), and the age itself was important rather than the interval between the first and last full term pregnancy. Factors related to breast feeding(BF) had protective effect consistently. Among parous women, in referent to no BF, women with 1 year of BF had adjusted OR of 0.34(95% CI: 0.17-0.68), while those with 1-3 years of BF had 0.35(95% CI: 0.18-0.67), 3-5 years had 0.29(95% CI: 0.12-0.74), and more than 5 years had 0.06(95% CI: 0.02-0.17). Age at menarche with regular cycle have stronger effect on especially pre-menopausal breast cancer among Korean women. Recent increase in breast cancer incidence in Korea would be explained by delayed age at first pregnancy or delivery, earlier age at menarche and last delivery, and decrease in brest feeding.
Breast Feeding ; Breast Neoplasms* ; Breast* ; Case-Control Studies* ; Diagnosis ; Female ; Hospitals, Teaching ; Humans ; Incidence ; Insurance ; Korea* ; Menarche ; Menstruation ; Pensions ; Pregnancy ; Seoul

This etiology of Freiberg's disease, an idiopathic avascular necrosis of the second metatarsal head, has not been clarified. In 1979, Gauthier and Elbaz treated 53 cases of the advanced Freiberg's disease by a new technique, that is, dorsal closing wedge osteotomy, and their result was successful. Recently, in 1989, Zollinger identified that the load per surface area is concentrated at the dorsal rather than plantar surface of the second metatarsal head during walking by an experimental dynamic study, and this theory explained why the lesion of the disease is confined to the dorsal surface of the second metatarsal head, and provided a basic concept on the dorsal closing wedge osteotomy. The authors reviewed 5 cases of Freiberg's disease treated by dorsal closing wedge osteotomy from September 1989 to February 1994, and the average follow-up period was 2 years and 5 months(range, 12 to 50 months). The results were as follows; 1. All were female, and the average age at the time of operation was 29.4 years(range, 22 to 43 years). 2. All were pain-free at the last follow-up. 3. The range of motion(ROM) of the metatarsophalangeal joint was increased postoperatively; average ROM: preoperative, 33°/ postoperative 77°; mean gain of ROM, 44° So, dorsal closing wedge osteotomy is a recommendable procedure for the treatment of advanced Freiberg's disease.
Female ; Follow-Up Studies ; Head ; Humans ; Metatarsal Bones ; Metatarsophalangeal Joint ; Necrosis ; Osteotomy ; Walking