No abstract available.
Child* ; Down Syndrome* ; Humans ; Hypothyroidism* ; Incidence*

PURPOSE: This study was done to determine how a hospital life guidance movie enhanced the understanding of hospital life by elderly in-patients. METHOD: A non-equivalent control group post-test design was used for the study. The experimental group watched a movie on guidance for hospital life while an in-patient control group read corresponding guidance booklets. The understanding and satisfaction from the respective programs for the two groups were surveyed with a questionnaire. The data were analyzed using SPSS. RESULTS: The group which watched the movie had a better understanding of hospital life than the group which read the booklets. The patients who watched the movie also expressed more satisfaction with their guide program than the patients who only read the booklets. Understanding of hospital life had relevance to satisfaction with the given program. CONCLUSION: The results of this study suggests that a movie on hospital life provides better guidance which helps the prospective patients understand and adapt better to their hospital life. Therefore, this type of movie is considered to be an effective medium to provide guidance to elderly in-patients.
Aged ; Humans ; Pamphlets ; Patient Admission ; Patient Education as Topic ; Questionnaires

Desmoid tumors are defined as aggressive overgrowth of fibrous sheets and musculoaponeurotic structures. Although desmoid tumors are generally known as a benign neoplasm, it's aggresive local invasiveness and frequent recurrence indicate it's position lying between the benign and malignancy. The association of desmoid tumor and familial adenomtous polyposis(FAP) was first made in 1923 by Nichols. In 1951, Gardner reported the familial occurrence of intestinal polyposis, osteomas, fibromas, and epidermal or sebaceous cyst. Desmoid tumors are common in patients with FAP and Occur in 3.5~29% of patients with FAP whereas the incidence in the gerenal population is 2~5/1,000,000 person years. Surgical resection of desmoids in patients with FAP has been controversial because unresectability and recurrence are more common than cure. Palliative and curative resections have a high morbidity. Surgery should be reserved for those patients with symptomatic mesenteric desmoids. If a small mesenteric desmoid is encountered incidentally and is easily resectable, it should be resected. If surgery has been less than satisfactory in the treatment of these patients, several different medical approaches can be combined with or without surgical resection with mixed result. Authors report a case of unresectable mesenteric desmoid tumor, developing after surgery of FAP and literatures were reviewed
Deception ; Epidermal Cyst ; Fibroma ; Fibromatosis, Aggressive* ; Humans ; Incidence ; Intestinal Polyposis ; Osteoma ; Recurrence

To develop an animal model of nephrolithiasis similar to the pattern of human renal stone disease, we adopted a protocol of administration of stone substrates along with induction of renal tubular injuries. Male Wister rats fed with 3% ammonium oxalate containing chows with or without additional 40 mg/kg/day of gentamicin for 8 days were compared with those fed with normal chows. On dissecting microscopic examination, rats receiving oxalate and gentamicin showed more crystals and plaques than rats receiving oxalate only, both in 15 days and 22 days after feeding, and most of the crystals were located at renal papilla. Average score of crystal abundance was 0.4, 1.15, respectively in rats receiving oxalate only and oxalate plus gentamicin after 15 days of feeding, and 0.9 and 1.55, respectively after 22 days. Little crystals were found in rats fed with normal chow with or without gentamicin. Urinary excretion of tubular epithelial brush border enzyme, gamma-glutamyl transpeptidase(GGT), was increased by gentamicin administration whereas creatinine clearance rate was not changed. Urinary excretion of oxalate was unchanged, but calcium and uric acid was markedly decreased in rats fed with oxalate and formed crystals, and citrate and magnesium excretion was also decreased. These results indicate that administration of oxalate along with inducing renal tubular damages by subcutaneous injection of gentamicin seems to form crystals and plaques in the kidney more rapidly and abundantly than feeding with oxalate alone.
Animals* ; Calcium ; Citric Acid ; Creatinine ; Gentamicins ; Humans ; Injections, Subcutaneous ; Kidney ; Magnesium ; Male ; Microvilli ; Models, Animal* ; Nephrolithiasis* ; Oxalic Acid ; Rats ; Uric Acid

The Kallmanns syndrome is the most common form of isolated hypogonadotropic hypogonadism in which anosmia or hyposmia resulting from agenesis of hypoplasia of the olfactory lobes is associated with LHRH deficiency, This syndrome is genetically heterogeneous and can be trans-mitted as an X-linked, autosomal dominant or autosomal recessive trait. The hypogonadotropic hypogonadism results in absent or incomplete pubertal development and may be associated with anosmia or hyposmia, mid-line defect(color blindness, cleft-lip or
Blindness ; Cryptorchidism ; Epiphyses ; Femur Neck ; Gonadotropin-Releasing Hormone ; Growth Plate ; Head ; Humans ; Hypogonadism ; Kallmann Syndrome ; Male ; Olfaction Disorders ; Olfactory Cortex ; Slipped Capital Femoral Epiphyses

Bochdalek hernia through Bochdalek foramen, defect at the posterolateral side of the diaphragm is one of the congenital diaphragmatic hernias. It usually occurs in infants, but very rare in old age and also on the right side. We experienced the right-side Bochdalek hernia including kidney herniation in 68 years old man man ifested by hemoptysis. CT scan revealed diaphragmatic defect and herniated liver, colon and kidney. Thoracotomy was performed and the 10 cm-sized large defect was closed with patch. After then, the patient has been well without symptom.
Aged ; Colon ; Diaphragm ; Hemoptysis ; Hernia* ; Hernia, Diaphragmatic ; Humans ; Infant ; Kidney* ; Liver ; Thoracotomy ; Tomography, X-Ray Computed

BACKGROUND: Idiopathic Central Diabetes Insipidus in children or adolescents requires a frequent follow-up regimen using serial brain MRI and CSF examinations especially if an isolated pituitary stalk thickening or loss of a hyperintense signal in the posterior pituitary lobe is observed. Although a detailed description has not been made in adults who had Idiopathic Central Diabetes Insipidus, the clinical course of a Central Diabetes Insipidus in children or in adolescents can not be applied to adults because a follow-up study is so invasive and expensive. In this report, we evaluated the clinical course of Idiopathic Central Diabetes Insipidus in adults. METHODS: The diagnosis of Idiopathic Central Diabetes Insipidus was based on the presenting clinical symptoms, the water deprivation test, biochemical studies and a brain MRI. We measured the urine specific gravity, urine and plasma osmolarity, electrolytes, and daily urine amount and we also performed an anterior pituitary evaluation. Patients had contrast-enhanced MRI and biochemical studies every 4 to 12 months. RESULTS: The patients included 8 females and 4 males. Their ages ranged from 20 to 76 years and their mean age was 45+/-17 years. Tumor markers in the CSF were not detected any of the patients. An anterior pituitary evaluation showed that four patients had hyperprolactinemia, and five patients had impaired secretory responses of Growth Hormone to an insulin induced hypoglycemia. Nine of the 12 patients had thickening of the pituitary stalk, seven had lacked the hyperintense signal of a normal neurohypophysis. The abnormalities of MRI disappeared in 3 patients by the 4th, 27th and 36th month follow up periods, respectively. The follow up duration was between 8 months and 11 years 3 months and the mean follow up duration period was 50.6+/-45.5 months. Clinical symptoms were corrected by DDAVP administration. Other symptoms were absent. CONCLUSION: In our study, of Idiopathic Central Diabetes Insipidus in adults there were no observed germinomas or other disease that were observed. Therefore this disorder may have a benign course.
Adolescent ; Adult* ; Brain ; Child ; Deamino Arginine Vasopressin ; Diabetes Insipidus, Neurogenic* ; Diagnosis ; Electrolytes ; Female ; Follow-Up Studies ; Germinoma ; Growth Hormone ; Humans ; Hyperprolactinemia ; Hypoglycemia ; Insulin ; Magnetic Resonance Imaging ; Male ; Osmolar Concentration ; Pituitary Gland ; Pituitary Gland, Posterior ; Plasma ; Specific Gravity ; Biomarkers, Tumor ; Water Deprivation

BACKGROUND: Insulin induced hypoglycemia has been used to assess the adrenocortical function, but may be hazardous. The standard rapid ACTH stimulation test has been advocated as a substitute but is sometimes insensitive. In this study, low dose (1ug) rapid ACTH stimulation test was compared to insulin induced hypoglycemia and standard dose (250ug) rapid ACTH stimulation. METHODS: 27 patients (14 men and 13 women) with pituitary disease and definite adrenocortical dysfunction (14 patients were confirmed by insulin induced hypoglycemia) and 23 controls (pituitary control: 3 men and 7 women, confirmed by insulin induced hypoglycemia, normal control: 8 men and 5 women) were studied. All subjects underwent rapid ACTH stimulation test with 2 different level of stimulation (1 and 250ug). Serum cortisol levels were measured at 0, 30 and 60 min after each dose of ACTH injection. A normal response was defined as a peak cortisol value of 497nrnol/L (18ug/dL) or above, RESULTS: During rapid ACTH stimulation study in controls, the peak serum cortisol level was significantly lower (690+-25lnmol/L (25.0+-9.1ug/dL) vs. 933+-257nmol/L (33.8+-9.3ug/dL); p< 0.01) and the peak appeared earlier (30min. vs. 60min) after the administration of low dose ACTH than after standard dose. However, the serum cortisol level at 30min was not different. In patient group, each serum cortisol level at 30min and 60min had no difference between low and standard dose (p>0.1). None of these 27 patients showed normal response to low dose stimulation, but 2 of 27 did to standard dose. In controls, 19 of 23 showed normal response to low dose, and all of 23 did to standard dose (sensitivity 100% vs 92.5%, specificity 82.5% vs 100%). The results of low and high dose stimulation test agreed with those of insulin induced hypoglycemia (Kendalls g= 0.50 vs 0.92, p<0.01 vs 0.001). CONCLUSIONS: The results of a low dose (1ug) rapid ACTH stimulation test showed good correlation with those of the standard dose (250ug) rapid ACTH stimulation test and insulin induced hypoglycemia. Thus it may be used in screening for the diagnosis of adrenal insufficiency.
Adrenal Insufficiency ; Adrenocorticotropic Hormone* ; Diagnosis ; Female ; Humans ; Hydrocortisone ; Hypoglycemia ; Insulin ; Male ; Mass Screening ; Pituitary Diseases ; Sensitivity and Specificity

PURPOSE: to investigate the effect of amniotic membrane transplantation (AMT) on corneal epithelial healing. METHODS: A 4-mm epithelial debridement was made in central rabbit cornea. Then, human amniotic membrane was transplanted (AMT group) or a contact lens was applied (contact lens group). The contralateral eyes were unwounded as controls. After surgery 5-bromo-2'-deoxyuridine (BrdU) was injected via ear vein. Each corneal tissue including the limbus was obtained on postoperative 12, 24 and 48 hours. Proliferating cell nuclear antigen (PCNA) in limbal and peripheral corneal epithelium and keratinocyte growth factor (KGF) in limbal stroma were immunolocalized by immunohistochemical method. Incorporation of BrdU in limbal and peripheral corneal epithelium was visualized by indirect immunofluorescent method. RESULTS: AMT group significantly accelerated the expression of PCNA and BrdU at limbal and peripheral corneal epithelial cells. The expression of PCNA and BrdU showed a peak at 24hr in both groups and increased in limbal epithelial cells more than peripheral corneal epithelial cell in AMT group. The expression of KGF on limbal keratocyte increased in AMT group more than contact lens group and coincided wiht the expression pattern of PCNA and BrdU. The number of keratocyte in significantly decreased in contanct lens group compared wiht AMT group. CONCLUSION: AMT enhanced corneal epithelial wound healing in vivo by stimulating limbal epithelial proliferation which is indirectly mediated in part by upregulating the expression of KGF, which is a potent epithelial mitogen secreted by limbal keratocytes.
Amnion* ; Bromodeoxyuridine ; Cornea ; Debridement ; Ear ; Epithelial Cells* ; Epithelium, Corneal ; Fibroblast Growth Factor 7 ; Humans ; Proliferating Cell Nuclear Antigen ; Veins ; Wound Healing

Among the four-hundred patients with cerebral aneurysms confirmed by cerebral angiography, we divided them into two age groups, one with ages 39 years or younger(young-aged group: 51 patients, 12.8%), and another with ages 65 years or older(old aged group: 45 patients, 11.3%). A comparison was undertaken in regard to clinical characteristics and overall outcome in two groups. In young-aged group, the female-to-male ratio was 2.2: 1 whereas, women was predominant by five times more in old aged group. Anterior communicating artery aneurysm was the most common site(43.1%) in young-aged group, unlike to old aged group where posterior communicating artery was the most common site(33.3%). The most common symptom was headache in both groups, and the hypertension was more frequent in young-aged group(45.5%) than old-aged group(33.3%). Surgery was performed in 43 patients(84%) in younger group, and 37 patients(82.2%) in elderly group. Young-aged group showed more favorable outcome(91%) than old-aged group(70%).
Aged ; Arteries ; Cerebral Angiography ; Female ; Headache ; Humans ; Hypertension ; Intracranial Aneurysm* ; Prognosis