BACKGROUND: Bone age measurements have clinical significance in estimation of growth status and prediction of final adult height. Mostly used methods of bone age measurements are Tanner Whitehouse method(TW2) and Greulich-Pyle method(OP). TW2 is known to be more accurate method in determining the bone age, compared to GP. But GP is being used more widely despite some shortcomings, because TW2 is time consuming and need special training. In this study, we observed the correlation between GP and TW2 to evaluate which bone age among three portions of hand and wrist[metacarpals and phalanges(GP1), carpal bones(GP2), distai radius and ulna (GP3)], measured by GP, was more correlated with the bone age, measured by TW2. METHODS: Left hand/wrist radiographs were taken from 100 prepubertal children with normal growth. These radiogrphs were reviewed by two pediatric endocrinologists independently. Bone ages using TW2 were measured at first, and then GP1, GP2, and GP3 were measured. These bone ages had been compared with TW2, using SAS computer program. RESULTS: The mean chronological age of 100 children was 10.0+/-2.5 years(5 years to 14.7 years range, 63 males and 37 females). The bone age by TW2 was 9.0+/- 2.6 years(2.3 to 13.6 years). The bone age by GP1, GP2, and GP3 were 8.8+/-2.5 years, 8.7+/-2.9 years, and 8.3+/-2.8 years, respectively. Bone ages by TW2 were significantly closer to the chronological age than those by GP. The Pea~rson correlation coefficients of GP1, GP2, and GP3 in eomparison to TW2 were 0,87(p=0.0001), 0.94(p=0.0001), and 0.91(p=0.0001), respectively, There are significant correlatkm between bone ages by TW2 and GP. Bone ages by GP2 and GP3 were statistically significantly different from those by TW2(P<0.01). Bone ages by GP1 has no statistical difference with that by TW2(P=0.64). CONCLUSION: TW2 method is more accurate than GP method in determining the bone age, but it needs time-consuming and laborious efforts. We suggest that the use of GP method for the metacarpals and phalanges can result in a considerable saving of time with no significant loss of accuracy and reproducibility.
Adult ; Age Determination by Skeleton ; Child ; Hand ; Humans ; Male ; Metacarpal Bones ; Radius ; Ulna

Development of supervoltage treatment machine may minimize skin reaction by skin-sparing effect, but skin damage is still one of “the dose limiting factor” in radiation therapy. In spite of these importance, systemic histopathologic studies of skin in similar conditions which used in clinical treatment has not been performed so far. 60 mice were irradiated with conventional fraction (200x5/wk) and whole abdominal field (2x3 cm, from symphysis pubis to xyphoid process). Used machine was 250 KV, 24 mA. orthovoltage x-ray machine. Histopathological changes of acute skin reaction at the level of total irradiation dose were analyzed and possible mechanism of later chronic changes were investigated. Obtained results are as follows 1. In 1,000 rad irradiated group, only mild epidermal edema is noted. 2. In 2,000 rad irradiated group, slightly decreased number and size of hair follicles and appendages, dermal edema and scanty infiltration of inflammatory cells are visible. 3. In 3,000 rad irradiated group, marked increased capillary congestion and prominent infiltration of inflammatory cells are observed. 4. In 4,000 rad irradiated group, vascular wall thickening with proliferation of endothelial cells are prominent. Dermal thinning and hyalinization are newly developed. 5. In 5,000 rad irradiated group, complete desquamation of epidermis is not seen, despite of acceleration of all above mentioned changes.
Acceleration ; Animals ; Capillaries ; Edema ; Endothelial Cells ; Epidermis ; Estrogens, Conjugated (USP) ; Hair Follicle ; Hyalin ; Mice* ; Pubic Bone ; Skin*

BACKGROUND: Doxylamine succinate(DS) is an antihistamine commonly used as an over-the-counter medication to relieve insomnia and frequently involved in overdoses. Its overdoses are dominated by anticholinergic effect. Recently it was revealed that DS had a direct effect on muscle, while its exact mechanism is not clear yet. We evaluated the patients with rhabdomyolysis induced by DS overdose for patients disposition based upon clinical decision, especially by creatinine phosphokinase(CPK). METHODS: We reviewed retrospectively the medical records of patients admitted by DS overdose from Jan. 1998 to Oct. 1999. Seventy and nine cases of DS overdose were evaluated with respect to age and sex distribution, amount ingested, clinical symptomatology, time from ingestion to visit, pattern of CPK, amount of bicarbonate used as therapy, complication and prognosis, especially in patients complicated rhabdomyolysis. RESULTS: Rhabdomyolysis, diagnosed as more than 1,000I. U/L of CPK, has been noted in 25(31.6%) of 79 cases of DS overdose visited to our emergency department(ED). In patients diagnosed rhabdomyolysis, the number of man was 10 cases(40%) and the number aged between 20 and 40 years was 22 cases(88%). The average time from DS ingestion to ED visit was 459 minutes. The amount of DS ingested was 500-5,000mg(mean, 1,980mg). 13(52%) cases ingested less than 2,250mg of DS. The initial levels of CPK(range, 48-14900I. U/L; normal range, 26-200I. U/L) after admitting to our emergency department were normal in 15 cases(60%) of rhabdomyolysis patients. The range of peak CPK levels after ingestion was 607 to 412,500I. U/L(mean, 33,550I. U/L). Its peak time was 6 to 96 hours(mean, 28.96 hours). In 14 cases(67%) of 21 visiting within 24 hours after ingestion, peak time of CPK ranged 12 to 24 hours after ingestion. The amount of bicarbonate used as therapy of rhabdomyolysis ranged 100 to 2,740mEq(mean, 656mEq) and all patients was discharged after improvement without other complication including acute renal failure. CONCLUSIONS : Although patients ingested less than 2,250mg of DS, emergency physicians should observe them more than 24 hours after DS ingestion with CPK follow-up after gastric irrigation and charcoal administration.
Acute Kidney Injury ; Charcoal ; Creatinine ; Doxylamine* ; Eating ; Emergencies ; Emergency Service, Hospital ; Follow-Up Studies ; Gastric Lavage ; Humans ; Medical Records ; Prognosis ; Reference Values ; Retrospective Studies ; Rhabdomyolysis* ; Sex Distribution ; Sleep Initiation and Maintenance Disorders ; Succinic Acid*

No abstract available.
Diagnosis* ; Magnetic Resonance Imaging* ; Spinal Stenosis*

The Acknowledgements was published incorrectly.

No abstract available.
Liver* ; Retrospective Studies*

No abstract available.
Spondylolisthesis*

Myoglobin has been shown to be elevated in the serum after myocardial infarction. Myoglobin is one of the first to appear in the serum and its quantification may thus be used in the diagnosis of the early phase of acute myocardial infarction. The purpose of this study was to clarify the time course of myoglobin elevation in the early phase of acute myocardial infarction. We compared this with the time course of serum CPK and obtained following results: 1) Serum myoglobin becomes significantly elevated at 4 hours following onset of chest pain and apears earlier than CPK. 2) Serum myoglobin time curve peaks at 8 hours, whereas the CPK time surve peaks at 16 hours following onset of chest pain. 3) Mearsurement of serum myoglobin in the early phase of acute myocardial infarction can serve as valuable aid in diagnosis of myocardial infarction with other findings.
Chest Pain ; Diagnosis ; Myocardial Infarction* ; Myoglobin*

Aortic root diameter by two dimensional and M-mode echocardiography in predicting prosthetic aortic valve size preoperatively was measured in 10 adult patients undergoing aortic valve replacement. Correlation of aortic root diameter measured by two dimensional echocardiography and actual prosthetic valve size implanted by aortic valve replacement was excellent. Correlation coefficient was statistically significant (r=0.91, P<0.001). Correlation of aortic root diameter measured by M-mode echocardiography and actual prosthetic valve size was also excellent. Correlation coefficient was statistically significant (r=0.86, P<0.001). This study demonstrates that aortic root diameter by two dimensional and M-mode echocardiography can accurately predict prosthetic aortic valve size in patient undergoing aortic valve replacement.
Adult ; Aortic Valve* ; Echocardiography* ; Humans

PURPOSE: The purpose of this study is to find what medical students think the reward for their future work should be and whether they would keep their ideals or abandon them for prestige and wealth by analyzing the book reports of Cronin's The Citadel. METHODS: Participants were 50 medical students of junior class. A month before the classroom lecture, the book and digital video disk were provided. Students had discussions in groups of seven and wrote book reports which include answers of three questions. RESULTS: Regarding what should be the reward for the medical doctor, two-thirds of students (66.7%) answered with spiritual compensation, while one-third (33.3%) chose material reward. In the situation presented to Manson, three-fifths (60.0%) answered they would keep their ideals (idealist), while the remaining two-fifths (40.0%) decided they would abandon them. Less than one-third of students (30.0%) answered they would reveal the corruptions of the doctor's society, while two-thirds (64.0%) would not. CONCLUSION: The larger number of idealists who prefer spiritual reward rather than a material reward represents the innocence of youth as in portrayed in The Citadel.
Adolescent ; Compensation and Redress ; Humans ; Medicine in Literature ; Reward ; Students, Medical