Primary hyperparathyroidism is a rare endocrine disease in children. It involves bone and joint, urinary tract, gastrointestinal tract and cardiovascular system. The main cause of these involvement is high level of PTH in serum, resulting in hypercalcemia.An 11 years old male patient who had complained of limping gait since last 18 months, showed typical laboratory and radiological findings of primary hyperparathyroidism. At the ultrasonography, computed tomography and radionuclide scanning, a well defined mass(10 X 15mm) was found on the posterior aspect of the right thyroid lobe. The mass was confirmed histologically as adenoma of parathyroid gland. The patient was successfully treated with subtotal parathyroidectomy and temporal administration of calcium and vitamin D.We report this case of primary hyperparathyroidism with brief review of the literatures.
Adenoma ; Calcium ; Cardiovascular System ; Child ; Endocrine System Diseases ; Gait ; Gastrointestinal Tract ; Humans ; Hyperparathyroidism, Primary ; Joints ; Male ; Parathyroid Glands ; Parathyroidectomy ; Thyroid Gland ; Ultrasonography ; Urinary Tract ; Vitamins

BACKGROUND: Otitis media with effusion(OME) is a very common disease in pediatric age. However, a few literatures on epidemiologic study of otitis media with effusion are available in Korea due to the great variability of its diagnostic criteria and clinical features. The aim of this study is to provide the estimate of silent otitis media prevalence for preschool age. METHODS: The study population includes 329 children enrolled in 6 kindergartens in Kunsan city from April 1 to 10, 1995. Silent otitis media was diagnosed with otoscopy, pneumatic otoscopy and impedance audiometry by DANAC 40 model impedance audiometer from DANA JAPAN Co. RESULTS: The prevalence of silent otitis media with effusion was 14.5% and peak at 6 years of age(17.8%).The prevalence of silent otitis media with effusion according to sex were 11.8% in boys group, 17.9% in girls group. Nine cases(11.8%) involved bilaterally. Forty three cases(89.6 %) were asymptomatic cases. CONCLUSIONS: Among 329 preschool children, the prevalence of silent otitis media with effusion was 14.5%. The prevalence by sex showed slightly higher in girls group than boys group. OME involved unilateral site mostly and subjective symptoms were rare.
Acoustic Impedance Tests ; Child ; Child, Preschool* ; Electric Impedance ; Epidemiologic Studies ; Female ; Humans ; Japan ; Jeollabuk-do* ; Korea ; Otitis Media with Effusion* ; Otitis Media* ; Otitis* ; Otoscopy ; Prevalence*

Clear cell sarcoma of tendon and aponeurosis is a rare malignant tumor. It occurs chiefly in young adults, predominates in women and is most common in the regions of the foot and ankle. We report a case of clear cell sarcoma of tendon and aponeurosis in s 22-year-old man. he pstient had had a asymptomatic, normal skin colored, relativerly hard, dome shsped nodule on the anterior chest for 6 months. Histopsthologic findings revealed uniform pattern composed of compact nests of round or fusiform cells which had clear cytoplasm and were surrounded by delicate framework of fibrocollagenous tissue, and the individual tumor cell had a fairly regular appearance of possessing round to avoid vesicular nucleus with prominent basophilic nucleolus. One year after surgical excision and post operative radiotherapy, there was no recurrence.
Ankle ; Basophils ; Cytoplasm ; Female ; Foot ; Humans ; Radiotherapy ; Recurrence ; Sarcoma, Clear Cell* ; Skin ; Tendons ; Thorax* ; Young Adult

No abstract available.
Pyloric Stenosis*

No abstract available.
Pierre Robin Syndrome*

No abstract available.

Spontaneous spinal epidural hematoma is a rare entity. Various definitions for spontaneous epidural hematoma have been reported in the literature. The expression of nontraumatic spinal epidural hematoma seems to be less ambiguous and includes idiopathic hematomas and hematomas secondary to coagulopathy, vascular malformations, and tumors. We report three cases of nontraumatic spinal epidural hematomas observed from 1991 to 2000. The causes of the spinal epidural hematomas were not clear in two cases among them, but in the another one case, the cause was determined to be an acquired coagulopathy. We reviewed 24 cases reported in the Korean Journal of Neurosurgery and our three cases with particular emphasis on the various causes such as coagulopathy, vascular malformations and tumors. Among the 27 cases, numerous causes were detected such as three cases of vascular malformation, one case of anticoagulant treatment, five cases of combined lumbar disc herniation, two cases associated with pregnancy and postpartum, one case associated with hypertension, and one case associated with ossification of ligamentum flavum. No causes were detected in the ten cases. The authors reviewed the literature.
Hematoma ; Hematoma, Epidural, Spinal* ; Hypertension ; Ligamentum Flavum ; Neurosurgery ; Postpartum Period ; Pregnancy ; Vascular Malformations

INTRODUCTION: The fixation strength of transpedicular screw system in the vertebral hody relied on bone quality and anatomical characteristics of vertebral pedicle, designs of screw and types of connection(rod or plate) with screw. The purpose of this study is to verify the biomechanical nature of the transpedicular fixation in spine under various conditions with porcine vertebrae. MATERIAL AND METHOD: Fresh porcine vertebrae and the custom-made screws were used in this experiment. To reduce the errors caused by vertebral bodies of different size and quality, vertebral bodies having regular range of pedicular width(10.0 to 11.5mm) and hone density(more than 1.0 gm/cm2) were used. The pedicle screws were inserted in the same procedure and axial pull out test was performed with using the Material Testing System(lntron8511, Canton, USA). The experiments were performed in four types to assess the difference of strength accroding to designs of the screw hy using two group of screws. The first group of screw was designed according to the outer and inner diameter and the second group was designed according to the shape, pitch, and thread profile of screw. Experiment I was perfomed to evaluate the effect of screw diameters on the biomechanical pull-out strength hy using the first group of custom-made pedicle screw which fixed all other factors except the diameter of screw. Experiment I was to verify the effect of screw shape, experiment III to verify the effect of pitch and experiment IV to verify the effect of thread profile. RESULTS: The results of experiments were summarized as follows: Experiment I showed that the screw of larger outer diameter had greater holding strength. Experiment II showed that the holding strength of cylindrical shaped screw is superior to that of conical shaped screw. Experiment III showed that there is no statistical significance between different modes of pitch. Experiment IV showed that the holding strength of buttress shape of thread profile is superior to that of V-shape. CONCLUSION: It seemed that the fixation strength of the screw was more powerful with 1 mm increment of outer diameter in 4-7mm of outer diameter, 3mm of pitch and buttress shape of thread of the screw with the same operation technique.
Spine

No abstract available.
Otoacoustic Emissions, Spontaneous*

Reexpansion Pulmonary edema is the iatrogenic complication which develops in a lung that has been rapidly reinflated after varied period of collapse secondary to a pneumothorax or a pleural effusion of large volume. Its incidence is relatively low, but can sometimes lead to death. The prevention of this disease is known well, but the definite treatment method has not been known in severe case although there have been conventional ventilator therapy and some medications in mild case. Asynchronous differential lung ventilation is a new therapeutic modelity which is applied independently to bilateral lungs in respiratory failure patients secondary to ventilation-perfusion mismatch, preoperatively, intraoperatively or postoperatively. By asynchronous differential lung ventilation, we successfully treated a severe reexpansion pulmonary edema in 29 year old male patient. Therefore we suggest that asynchronous differential lung ventilation is the treatment of choice for severe reexpansion pulmonary edema.
Adult ; Humans ; Incidence ; Lung* ; Male ; Pleural Effusion ; Pneumothorax ; Pulmonary Edema* ; Respiration, Artificial ; Respiratory Insufficiency ; Ventilation* ; Ventilators, Mechanical