Urinary growth hormone (GH) excretion was quantitated in 12-hr overnight urine collections obtained from 13 children with complete growth hormone deficiency (CGHD). 6 children with partial growth hormone deficiency (PGHD), 5 children with short stature and normal GH provocation tests (NSC), and 5 normal control children (NC) to investigate whether the measurement of urinary GH can clearly separate the PGHD and CGHD groups from the NSC and NC groups. In addition, the urinary excretion of GH was measured in CGHD after sc injections of 0.1 IU/kg GH three times a week and daily in an attempt to determine the optimal replacement dose. The results were as follows. 1) The 12-hr urinary GH excretion cleary separated the CGHD (1.2+/-1.1 ng/12 hr; range, 0.3-3.1, n=13) and PGHD (3.7+/-2.4 ng/12 hr; range, 0.9-6.8 n=6) groups from the NSC (14.0+/-3.6 ng/12 hr; range, 8.5-18.2 n=5) and NC (12.7+/-5.8 ng/12 hr; range, 6.9-20.8, n=5) groups without any overlap. 2) There were significant difference in 12-hr urinary GH excretion between CGHD and PGHD, but the higher values in CGHD groups overlapped some of the lower values in PGHD group. 3) There were no differencies in 12-hr urinary GH excretion between NC and NSC. 4) A 12-hr urinary GH values less than 6.9 ng/12 hr suggested GH deficiency. 5) The CGHD patients who received o.1 IU/kg GH. sc. daily GH levels within the range of the mean +/-SD in NC. but those who received theree times a week had daily variable urinary GH levels. These results suggest that the measurement of 12-hr nocturnal urinary GH excretion monitering of GH therapy response.
Child ; Growth Hormone* ; Humans ; Urine Specimen Collection

PURPOSE: This study was aimed to evaluate the recurrence rate of a giant cell tumor (GCT) of the bone. MATERIALS AND METHODS: The medical records of fifty four patients who were diagnosed with a giant cell tumor of the bone between March 1980 and December 2008 were analysed retrospectively. Among 54 patients, 27 were men, remaining 27 were women with the mean age of 33.1 years (range, 13-67 years). The mean duration of follow-up was 67.1 months. RESULTS: Twenty-one patients (38.9%) had a local recurrence. The mean time to recurrence was 21.5 months (range, 2-59 months). The local recurrence rate of the upper extremities was higher than that of lower extremities. According to Campanacci classification, patients with a grade I diseae had lower recurrence rate than those with grade II or III disease. There was no significant differences in the recurrence rates based on cryotherapy, the filling of bone cement or bone grafts and surgical margin. CONCLUSION: To prevent local recurrence of GCT of bone, curettage of the tumor and elimination of the remaining cells are more important than adjuvant therapy.
Cryotherapy ; Curettage ; Female ; Follow-Up Studies ; Giant Cell Tumors ; Giant Cells ; Humans ; Lower Extremity ; Male ; Medical Records ; Recurrence ; Retrospective Studies ; Transplants ; Upper Extremity

No abstract available.
Urinary Bladder

PURPOSE: Pantothenate kinase-associated neurodegeneration (PKAN), also known as neurodegeneration with brain iron accumulation is an extremely rare degenerative disease. The present study reports a case of retinal pigmentary changes in PKAN. CASE SUMMARY: A 6-year-old girl presented with night blindness and developmental delay. Neurologic examination revealed toe gait and dystonia. Ocular examination showed retinal pigmentary change in the entire retina without optic atrophy. Brain magnetic resonance imaging showed iron deposits in the basal ganglia, the so-called "eye of the tiger" sign. Genetic tests confirmed a mutation in the gene encoding pantothenate kinase 2. Electroretinography demonstrated severe loss of rod and cone responses, prominently reduced in the rod response. The patient was diagnosed with PKAN and pharmacologic treatment started. CONCLUSIONS: In the case of systemic neurological abnormalities with pigmentary retinal change, PKAN should be considered as a differential diagnosis.
Basal Ganglia ; Brain ; Diagnosis, Differential ; Dystonia ; Electroretinography ; Gait ; Humans ; Iron ; Magnetic Resonance Imaging ; Neurologic Examination ; Night Blindness ; Optic Atrophy ; Pantothenate Kinase-Associated Neurodegeneration ; Phosphotransferases ; Phosphotransferases (Alcohol Group Acceptor) ; Retina ; Retinal Degeneration ; Retinaldehyde ; Toes

PURPOSE: When MRI and CT of the oral cavity utilize the traditional closed-mouth approach, direct contact between the tongue and surrounding structures may give rise to difficulty in recognizing the anatomy involved and demonstrating the possible presence of pathologic features. we describe a more appropriate scan technique, involving open-mouthed imaging, which may be used to demonstrate the anatomy of the oral cavity in detail. MATERIALS AND METHODS: Axial and coronal MR imaging and axial CT scanning were performed in 14 healthy volunteers, using both the closed and open-mouth approach. For the latter, a mouth-piece was put in place prior to examination. In all volunteers, open-mouth MR and CT examinations involved the same parameters as the corresponding closed-mouth procedures. The CT and MR images obtained by each method were compared, particular attention being paid to the presence and symmetry of motion artifact of the tongue and the extent of air space in the oral cavity. Comparative imaging analysis was based on the recognition of 13 structures around the boundaries of the mouth. For statistical analysis, Student 's t test was used and a p value < 0.05 was considered significant. RESULTS: Due to symmetry of the tongue, a less severe motion artifact, and increased air space in the oral cavity, the open-mouth method produced excellent images. The axial and coronal MR images thus obtained were superior in terms of demarcation of the inferior surface and dorsum of the tongue, gingiva, buccal surface and buccal vestibule to those obtained with the mouth closed (p<0.05). In addition, axial MR images obtained with the mouth open showed better demarcation of structures at the lingual margin and anterior belly of the digastric muscle (p<0.05), while coronal MR images of the base of the tongue, surface of the hard palate, soft palate, and uvula, were also superior (p<0.05). Open-mouth CT provided better images at the lingual margin, dorsum of the tongue and buccal surface than the closed-mouth approach (p<0.05). CONCLUSION: Open-mouth MRI and CT are both practical and useful for evaluation of the structures of the oral cavity. The images thus obtained are superior to those acqhired with the month closed.
Artifacts ; Gingiva ; Healthy Volunteers ; Humans ; Magnetic Resonance Imaging* ; Mouth* ; Palate, Hard ; Palate, Soft ; Tomography, X-Ray Computed ; Tongue ; Uvula ; Volunteers

PURPOSE: Currently, there are many developmental tests of scale and screening for infants and children. However, it has been questioned about the discriminating power and the correlation among developmental tests of scale and screening. So we comprared the Bayley Scales of Infant Development-II(BSID-II) and Korean Infant and Child Developmental Test(KICDT) in terms of correlations and agreement. METHODS: Seventy two infants were studied, who visited the pediatric outpatient clinic at Cheonan Soonchunhyang University Hospital between December 2002 and September 2003. They were classified into three groups, group A of 24 full term infants, group B of 24 preterm infants, and group C of 24 disabled full term infants. We performed both tests to the all infants. RESULTS: The mean scores of mental and psychomotor developmental indices of BSID-II of group A were higher than those of group B and group C, which was statistically significant. Also, the mean scores of personal-social, language and cognitive- adaptive fields of KICDT of group A were much higher than those of group B and group C. The correlation coefficients between BSID-II and KICDT were high in many indices. The kappa coefficient by Cohen between BSID-II and KICDT is 0.45(0.24-0.66). CONCLUSION: There was a reasonable corrrelation between BSID-II and Korean infant and child developmental test in infants younger than 12 months. The kappa coefficient by Cohen between BSID-II and KICDT is not so good in this study. Further study is needed to standardize the items of KICDT.
Ambulatory Care Facilities ; Child ; Child Development* ; Child* ; Chungcheongnam-do ; Humans ; Infant* ; Infant, Newborn ; Infant, Premature ; Mass Screening ; Weights and Measures*

OBJECTIVE: Bisphosphonates are the most commonly prescribed medications for the treatment of osteoporosis. This study was designed to analyze the rate of acute phase reaction (APR) following Zoledronate 5 mg administration in patients with osteoporosis who were treated with prior oral bisphosphonate for at least 2 weeks and to compare naive IV 5 mg Zoledronate. METHODS: Between July 2009 and October 2010, 27 patients with osteoporosis who were treated with prior oral bisphosphonate for at least 2 weeks, and maximum 52 weeks (average 18.5 weeks) and were between 42-and 85-year-old at the time of study participation. We prospectively evaluated APR, including fever, flu-like symptoms, headache, arthralgia, and myalgia, after 5 mg zoledronate by questionnaire. Additionally we assessed a visual analogue scale (VAS) by 4-point categorical scale. RESULTS: In this study of 27 patients with osteoporosis, the frequency of APR, flu-like symptom and myalgia were 14.8% and 7.4% and fever, arthralgia, and headache were 3.7% respectively. In VAS, all reactions were mild. The rate of APR rate in this study was statistically decreased compared to previous reports with zoledronate 5 mg IV in bisphosphonate-naive patients. CONCLUSION: Prior oral bisphosphonate administration for at least 2 weeks could significantly reduce the APR of IV zoledronate 5 mg.
Acute-Phase Reaction ; Aged, 80 and over ; Arthralgia ; Diphosphonates ; Fever ; Headache ; Humans ; Imidazoles ; Osteoporosis ; Prospective Studies ; Surveys and Questionnaires

PURPOSE: This study evaluated the efficacy of a water-soluble contrast enema (WCE) in predicting anastomotic healing after a low anterior resection (LAR). METHODS: Between January 2000 and March 2012, 682 consecutive patients underwent a LAR or an ultra-low anterior resection (uLAR) and were followed up for leakage. Clinical leakage was established by using physical and laboratory findings. Radiologic leakage was identified by using retrograde WCE imaging. Abnormal radiologic features on WCE were categorized into four types based on morphology: namely, dendritic, horny, saccular, and serpentine. RESULTS: Of the 126 patients who received a concurrent diverting stoma, only two (1.6%) suffered clinical leakage due to pelvic abscess. However, 37 patients (6.7%) in the other group suffered clinical leakage following fecal diversion (P = 0.027). Among the 163 patients who received a fecal diversion, 20 showed radiologic leakage on the first WCE (eight with and 12 without a concurrent diversion); 16 had abnormal features continuously until the final WCE while four patients healed spontaneously. Eleven of the 16 patients (69%), by their surgeon's decision, underwent a stoma restoration based on clinical findings (2/3 dendritic, 3/4 horny, 5/7 saccular, 1/2 serpentine). After stoma reversal, only 2 of the 11 (19%) complained of complications related to the rectal anastomosis. CONCLUSION: WCE is helpful for detecting radiologic leakage before stoma restoration, especially in patients suffering clinical leakage after an uLAR. However, surgeons appear to opt for stoma restoration despite the persistent existence of radiologic leakage in cases with particular features on the WCE.
Abscess ; Anastomotic Leak ; Colorectal Surgery ; Enema* ; Humans ; Rectal Neoplasms*

Malignant tumor originated from external auditory canal (EAC) is very rare with an annual incidence of around 1 per million. Pathologically, squamous cell carcinoma is incidentally most common, and adenoid cystic carcinoma, basal cell carcinoma, and melanoma follow in decreasing order. Due to the rarity of malignant tumor of EAC, there is no widely accepted treatment modality yet. But basal cell carcinoma, known to be less aggressive tumor, can be removed with a minimal safety margin and have better treatment results. Recently we experienced a case of basal cell carcinoma in the EAC, confined in the cartilaginous portion of EAC, presenting with intermittent otorrhea for several years. The patient was treated with a sleeve resection of the EAC with a safety margin reconstructed with a split-thickness skin graft. No tumor recurrence or complication was noted in the first postoperative year.
Aminocaproic Acids ; Carcinoma, Adenoid Cystic ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Ear Canal ; Humans ; Incidence ; Melanoma ; Recurrence ; Skin ; Transplants

Human seminal plasma (HSP)-induced hypersensitivity IS one of the serious complications associated with sexual intercourse The clinical manifestations of HSP-induced hypersensitivity may be induced by the release of mast cell-mediator by HSP however the effects of HSP on mast cell activity have not been Identified The purpose of this study is to determine If the pathogenesis of seminal plasma (SP)-induced hypeisensitivity IS mediated by mast cells or not To evaluate the reactions of mast cells to SP in VlVO the degranulations of skill mast cells changes of ear thickness, and cutaneous reactions were measured by morphometric method Ammals of normal or positive control groups were treated with phosphate buffered salme (PES) solution or compound 48/80 (2 5 mg/ml m PES) By light microscopy the degranuiations of mice ear mast cells were observed following treatments with HSP, rat semmal plasma (RSP), or compound 48/80 The degranulation rate (DR) of normal group treated with PES solution was 27 8% DR of those with HSP RSP, and compound 48/80 were 70 5% 90 1%, 96 0% respectively The ear swellings were noted m mice treated with HSP RSP, and compound 48/80 The cutaneous reactions m rat skin were noted when HSP or RSP or compound 48/80 were treated These results suggest that SP contains some substances activating skin mast cells and those increasing of vascular permeabilities In mice and I rats skin
Animals ; Capillary Permeability ; Coitus ; Ear ; Humans ; Hypersensitivity ; Mast Cells* ; Mice ; Microscopy ; Plasma ; Rats ; Semen* ; Skin*