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

The fracture of the upper end of the femur is unique in orthopedics because it is endemic to an elderly population with special problem. In trochanteric fractures open reduction and internal fixation, with a hip nail used to maintain reduction, have become the standard treatment protocol for the elderly. Unlike fractures of the femoral neck, nonunion and avascular necrosis is rare but more frequently complicated by fatal sequele, such as pneumonia, thromboembolic disease, and decubitus ulceration. In order to achieve early ambulation of a patient with a trochanteric hip fracture, two conditions must be met: The implant used for fixation must be strong enough to withstand loadings exerted upon it during fracture healing, and the fracture itself must be rendered stable in a suitably reduced position. The treatment of the fracture of the femoral neck has a long and frustrating history. As recently as 20 years ago McCarroll remarked that this fracture must be considered “unsolved” until the incidence of aseptic necrosis and nonunion could be diminished or abolished. But now with adequate reduction, impaction, accurate internal fixation with newer devices, and carefully supervised postoperative care the fracture of the femoral neck can be expected to heal at least 90 per cent of the patients. A lower incidence of recognizable aseptic necrosis has been reported under these circumstances. X-ray films of 94 cases of hip nailing for hip fractures were collected in the Department of Orthopedic Surgery of Seoul National University Hospital. Twenty seven cases considered to be failed in hip nailing were analysed radiologically, and following results were obtained. 1. The incidence of failed hip nailing was most frequent in the fifties with average age of 54. 6 years, which seemed somewhat younger than that of the hip fracture. There was no sexual difference. 2. Hip nailings were failed in 23 cases of the femoral neck fractures and in 4 cases of the trochanteric fractures, which revealed respectively 52.3% and 8.2% of failure. Among these the technical failure was 22.7% in femoral neck fractures and 6.1% in trochanteric fractures. 3. Among the various fixation devices, Smith-Petersen nail or hip screws which has no side plate to fix the shaft rigidly showed high failure rates. 4. In all cases the etiology of the failed hip nailing was functional, such as failure of reduction, failure of fixation, penetration of the head, avaseular necrosis, infection, and inadequate postoperative management. 5. Most cases of femoral neck fractures which was not achieved near anatomical reduction was failed in fixation. 6. Too long or short nails showed high failure rates. In view point of this, hip nail should fix the lateral cortex, calcar femorale and center of subchondral bone, even in the trochanteric fracture. So devices such as heavy compression sliding nail or multiple pinning were more desirable to achieve complete fixation. 7. When, in the fresh fractures of the femur neck cannot be reduced to an anatomical or slightly overcorrected position, endoprosthesis should be considered seriously. When the joint is abnormal, the total hip arthroplasty can reduce morbidity and mortality, and also shorten the hospitalization.
Aged ; Arthroplasty, Replacement, Hip ; Clinical Protocols ; Early Ambulation ; Femoral Neck Fractures ; Femur ; Femur Neck ; Fracture Healing ; Head ; Hip Fractures ; Hip ; Hospitalization ; Humans ; Incidence ; Joints ; Mortality ; Necrosis ; Orthopedics ; Pneumonia ; Postoperative Care ; Pressure Ulcer ; Seoul ; X-Ray Film

Amiodarone, an antiarrhythmic drug, may exert pulmonary toxicity in some patients but the pathogenesis is not clear. This study was carried out to investigate the pathogenetic mechanism of pulmonary injury induced by amiodarone at dose of 100 mg/kg/day given to rats by intraperitoneal injection for 3 weeks. And the preventive effects of concomitantly injected steroid (10 mg/kg/day) on amiodarone induced pulmonary injury was also studied using bronchoalveolar lavage, light microscopy and transmission electron microscopy. The results obtained were summarized as follows: Mild lymphocytosis of bronchoalveolar lavage fluid was found in all experimental groups. Intracytoplasmic lamellar body formation was found in all types of pulmonary cells and type II pneumocytes revealed the earliest abnormal lamellar body formation. The capillary endothelial cells showed cellular swelling and detachment from underlying basement membrane at early phase of experiment and the edema of alveolar wall and interstitium were noted. Interstitial fibrosis and proliferation of type II pneumocytes were noted at late phase. The lungs of steroid injected groups revealed accumulation of lamellar bodies in all types of pulmonary cells but interstitial fibrosis was not occurred. These findings support the concept that amiodarone is responsible for a drug-induced phospholipidosis and directly toxic to pulmonary endothelial and epithelial cells. And steroid may regress the progression of amiodarone induced pulmonary injury.
Rats ; Animals

The present study was undertaken to evaluate the anthelmintic effects of fenbendazole against intestinal nematode; Ascaris lumbricoides, hookworm and Trichuris trichiura, and to compare the efficacy in fenbendazole, oxantel-pyrantel pamoate and placebo by means of double blind method. Out of 114 subjects harbouring Ascaris lumbricoides, hookworm and Trichuris trichiura, 36 cases were treated with single dose of fenbendazole, 38 cases with oxantel-pyrantel pamoate, and the remaining 40 cases had received the placebo. The results were as follows: In the group treated with fenbendazole (30-50 mg/kg), the cure rates were 83.9 percent in 31 subjects with Ascaris lumbricoides and 83.3 percent in 18 subjects with hookworm, and only 28.6 percent in 28 subjects with T. trichiura respectively. In the group treated with a single dose of oxantel-pyrantel pamoate (10 mg/mg), the cure rates were 96.7 percent in 30 subjects with A. lumbricoides, 95.2 percent in 21 subjects with hookworm, and 54.6 percent in 33 subjects with T. trichiura. Egg reduction rate was 85.7 percent in T. trichiura cases. On the other hand, the egg negative conversion rates in placebo group were 9.7, 8.3 and 33.3 percent in Ascaris, Trichuris and hookworm infections respectively. The above results showed that fenbendazole was highly effective against Ascaris and hookworm. However, incomparisom with oxantel-pyrantel pamoate, fenbendazole was less effective in regards of A. lumbricoides, hookworm and T. trichiura infections.
parasitology-helminth-nematoda ; chemotherapy ; Ascaris lumbricoides ; hookworm ; Trichuris trichiura ; fenbendazole ; oxantel-pyrantel pamoate

The author observed clinical study and response of -interferon treatment of 43 cases of chronic hepatitis who were admitted to Department of Pediatrics Pusan National University College of Medicine during the period of 4 year 6 months from Jenuary, 1988 to Jun, 1992. The results were as follows: 1) Of 43 patients with chronic hepatitis, CPH was 17 cases (39.5%) and CAH was 26 cases (60.5%). 2) Of 43 patients, chronic hepatitis caused by HBV was 37 cases (86.0%) 2 cases were by Wilson's disease, 1 case was by glycogen storage disease and in the 3 cases, the cause was undetermined and CPH by HBV and CAH were 14 cases (82.4%), 23 cases (88.5%) respectively. 3) A peak frequency (46.5%) of chronic hepatitis occurred between 6 to age and male predominated in a propotion of 3.5:1. 4) On the clinical manifestation, jaundice and hepatomegaly was higher frequency on CAH than on CPH. 5) On the laboratory findings, CAH had higher serum ALT and direct bilirubin level than CPH. 6) On effect of -interferon treatment for patients of CAH, serum ALT and AST levels normalized in 81.8% of patients, negative conversion of HBeAg was 38.5%, Anti-HBe serocoversion was 7.7%, negative conversion of HBsAg was 7.7% and the clearnce of HBV-DNA from seum showed 60.0%. 7) The HBeAg seroconversion (28.6%) on children of HBsAg(+) mother showed lower reponse than HBeAg seroconversion (50.0%) of HBsAg(-) mother after -interferon treatment for patients of CAH.
Bilirubin ; Busan ; Child* ; Glycogen Storage Disease ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens ; Hepatitis B, Chronic* ; Hepatitis, Chronic* ; Hepatolenticular Degeneration ; Hepatomegaly ; Humans ; Jaundice ; Male ; Mothers ; Pediatrics

BACKGROUND/AIMS: Lamivudine, an oral nucleoside analogue, effectively inhibits hepatitis B virus replication and reduces hepatic necroinflammation in patients with chronic hepatitis B. This study investigated the effect and safety of 12 week lamivudine therapy in Korean patients with chronic hepatitis B (CHB). METHODS: In an open clinical trial, 113 patients with CHB were enrolled. They received 100 mg of lamivudine orally once daily for 12 weeks, and they were followed until 2 weeks after cessation of lamivudine. HBV DNA (by bDNA assay), liver enzymes, creatine phosphokinase, creatinine and CBC were checked at 0, 2, 4, 8, 12 and 14 weeks. Compliance and side effects were evaluated at the same time. RESULTS: After receiving lamivudine 100 mg, serum HBV DNA levels fell rapidly, remaining in 94.3% below baseline values at 2 weeks and 99.8% below baseline values at 12 weeks. Serum HBV DNA was cleared in 75.2% and alanine aminotransferase level (ALT) was normalized in 64.8% at 12 weeks. Cumulative percentage of HBeAg clearance (defined by clearance of serum HBV DNA and HBeAg) was 14.4%. Clearance of HBV DNA was more frequent in patients with lower pretreatment serum HBV DNA and higher ALT. During the treatment periods, adverse effects were negligible and transient. Two weeks after cessation of lamivudine, serum HBV DNA reappeared in 70.6% of responders. CONCLUSION: It is suggested that lamivudine is effective and safe in the treatment of CHB in Korean patients, but further study for adequate duration of treatment is needed because of high recurrence after 12 weeks therapy.
Alanine Transaminase ; Compliance ; Creatine Kinase ; Creatinine ; DNA ; Hepatitis B e Antigens ; Hepatitis B virus ; Hepatitis B, Chronic* ; Hepatitis, Chronic* ; Humans ; Lamivudine* ; Liver ; Recurrence

To build and to manipulate clinical data in one of the important works in the hospital. In order to accurately append the data and to quickly find and display the informations as the user need, we developed a software program running on the personal computer. Our system largely consists of four parts; registration of the clinical and departmental data, retrieving tool of articles in the medical journal, collection of special data for clinical survey and display system of the various reports. In our experiences, we consider the key factors for systemic management of clinical rearch data base as the follows; work analysis for data processing, design of data base, coding and classification of basic data and technique of registeration. Of these standarized coding system of the orthopedic diseases appeare to be of it most importance.
Classification ; Clinical Coding ; Humans ; Microcomputers ; Orthopedics ; Running

Fractures of the shaft of the radius and ulna occur commonly in children and are usually treated by closed reduction and plaster cast immobilization. Anatomic reduction is seldom necessary because of the remodelling potential in the child under 10 years of age, whereas the bones of children older than 10 years of age have less capacity to remodel and the diaphyseal fracture is unstable. In case of either unacceptable reduction or unstable fractures in adolescent patients, an operative treatment is required. In five children older than 12 years of age for whom conservative treatment had hailed, we treated a closed intramedullary nailing using a distal radial and proximal ulnar approach, and followed up for 1 year or more. All fractures healed within 6 weeks. No nonunion, cross-union or refrature occured. Another advantages of this method are negliable cosmestic defect and easy removal of the internal fixation device under local anesthesia. We think that closed intramedullary nailing with rush pin is a safe and reliable method to treat unstable forearm fracture in children older than 12 years of age.
Adolescent ; Anesthesia, Local ; Casts, Surgical ; Child ; Forearm ; Fracture Fixation, Intramedullary ; Humans ; Immobilization ; Internal Fixators ; Methods ; Radius ; Ulna

62 cases of the fracture of the pelvis admitted to the orthpedic department of Wonju Christian Hospital during past 5 years from 1975 to 1979 were reviewed and clinical results were obtained as follows: 1. Males were frequent than females and almost 3rd to 4th decades of life. 2. The causes of injury were traffic accident, coal minor accident, and falling. 3. Stable type is the most common in this series and among the unstable types, lateral compression type is the most common and then straddle type and vertical shear type. 4. The most common complication is uro-genital injury. 5. The residual complications at the end of treatment remained in some cases, Arthritis of sacroiliac joint, Impotence, Urethral stricture, Low back pain, etc. 6. All of the cases were treated conservatively and their results were somewhat good except 4 cases. 7. Surgical treatment would be considered, if necessory, to decrease the complications and reduce hospital days.
Accidental Falls ; Accidents, Traffic ; Arthritis ; Coal ; Erectile Dysfunction ; Female ; Gangwon-do ; Humans ; Low Back Pain ; Male ; Pelvic Bones ; Pelvis ; Sacroiliac Joint ; Urethral Stricture

The authors performed the interfascicular nerve grafting in the gap of injured nerves using the microsurgical technique to obtain the accurate coaptation of the fascicles. The authors experienced the 33 cases(26 patients) of the interfascicular nerve grafting in the median(11), ulnar(9), radial(2), common peroneal(3) and digital(8) nerves at the Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University from Jan. 1980 to June 1984. The patients were followed up from 12 to 26 months (average 20 1/2 months). The following results were obtained; 1. The shorter the length of the donor nerve and the younger the age of the patients are, the better the recovery of the nerve function is. 2. The medial and lateral cutaneous nerves of forearm as donor nerve are suitable as well as the sural and superficial radial nerves. 3. The end result of each patient was evaluated by Seddon's classification. The excellent motor recovery was 72.0% (18/25) and the excellent sensory recovery was 81.8% (27/33). 4. The interfascicular nerve grafting is an excellent method in treating the widely separated,severed peripheral nerve injury.
Classification ; Forearm ; Humans ; Methods ; Peripheral Nerve Injuries ; Peripheral Nerves ; Radial Nerve ; Tissue Donors ; Transplants