BACKGROUND: Understanding the differentiation and migrating character of the tympanic membrane, external auditory canal as well as cholesteatoma pathogenesis needs knowledge about epithelial generation center. OBJECTIVE: We investigated the distribution of the epithelial generation center in the tympanic membrane and external auditory canal using 5-bromo-2-deoxyuridine(BrdU) immunohistochemistry. MATERIALS AND METHODS: BrdU was injected into peritoneum of 10 Mongolian gerbils and gerbil's temporal bones were obtained and serial section was done. Anti-BrdU antibody immunohistochemical stain was done. RESULTS: The labeling index was highest at posterosuperior quadrant of pars tensa, higher at malleus handle attached area and annulus region. On pars flaccida, labeling index was high at entire area. The labeling index of deep meatal skin was higher than that of lateral meatal skin, especially near annulus area. According to results, epithelial generation centers are thought to be on pars flaccida, posterosuperior quadrant of pars tensa, malleus handle attached area and annulus region. CONCLUSION: These findings are similar to those of human tympanic membrane and external auditory canal, and gerbils can be used as a animal model for study of normal human tymapnic membrane, external auditory canal and cholesteatomas.
Bromodeoxyuridine ; Cholesteatoma ; Ear Canal* ; Gerbillinae* ; Humans ; Immunohistochemistry ; Malleus ; Membranes ; Models, Animal ; Peritoneum ; Skin* ; Temporal Bone ; Tympanic Membrane*

No abstract available.

No abstract available.
Radiation Oncology*

OBJECTIVE: This study was aimed to investigate of newborn babies sex ratio in Seoul Seong Ae hospital and review of future problem. METHODS: We reviewed retrospectively the 21,332 cases of deliveries in women visiting at Seoul Seong Ae hospital from Jannuary 1994 to December 2003 (10 year's period). We investigated 1st baby and 2nd baby sex ratio and in case of 3rd baby, subdividing then into tree groups (first and second are female, first and second are male, first and second are male and female). We arranged the data at the base of childbirth registers and patients' obligation records. RESULTS: The results were as follows, 1. The total sex ratio in last 10 years was 111.2:100 (male:female). 2. 1st baby sex ratio was 109.2:100. 3. 2nd baby sex ratio was 110.6:100. 4. 3rd baby sex ratio was 133:100. CONCLUSION: These findings suggest that unbalance of sex ratio in 3rd baby is extremely serious trend in this country and is expected a tremendous social problems in early 21th century.
Female ; Humans ; Infant, Newborn* ; Male ; Parturition ; Retrospective Studies ; Seoul* ; Sex Ratio* ; Social Problems

PURPOSE: This study was conducted to identify potential dangers involved in procedure and evaluate complications of percutaneous endoscopic gastrostomy (PEG) comparing to surgical gastrostomy (SG). METHODS: A retrospective study of 66 children with feeding gastrostomy between 1994 and 2002 was done. RESULTS: Of 66 children, 23 (mean age 29 months) had PEG and 43 (mean age 49 months) had SG. 31 cases of SG group had fundoplication for gastroesophageal reflux disease. PEG groups were followed up with an average 13 months and SG groups with 21 months. Major complications occurred in 33% of PEG group (8/23) and 55% of SG group (24/43). Major complications were significantly lower in PEG group than SG group and minor complications, too (p<0.05). Of major complications, aspiration pneumonia was the most common but paralytic ileus was significantly higher in SG group than PEG group. 8 patients died of underlying disease but not related to gastrostomy. Removals of stomata were done in 5 of PEG group and 3 of SG group. GER recurred in 25% of SG group with fundoplication and newly developed in 17% of SG group. GER persisted in 17% and newly developed in 5% of PEG group. CONCLUSION: The gastrostomy was a significant procedure with the potential to produce complications. PEG is recommended as an initial procedure in children requiring a feeding gastrostomy but should be considered a major undertaking.
Child* ; Fundoplication ; Gastroesophageal Reflux ; Gastrostomy* ; Humans ; Intestinal Pseudo-Obstruction ; Mortuary Practice ; Pneumonia, Aspiration ; Retrospective Studies

Eleven children with gastroesophageal reflux disease underwent fundoplication. Eight had neurological impairment, two hiatal hernia and one had history of esophageal repair for esophageal atresia. The most common and significant symptom was vomiting (81.8%), followed by recurrent respiratory infections (72.7%) and failure to thrive (72.7%). The most common diagnostic tool was 24 hour esophageal pH study, which showed a pH less than 4 for more than 10% of the total recorded time in 6 among 9 patients. Nissen fundoplication was performed in 10 patients. Thal fundoplication was carried out in one patient with esophageal atresia. Stamm gastrostomy was added for nutritional and/or swallowing problem in all 8 patients with neurological impairment. The median follow up period was 13 months. There were one late death of unrelated cause and one recurrence. The quality of life after antireflux surgery was greatly improved. Antireflux surgery should be done if indicated, and a simultaneous gastrostomy be considered in a patient with neurological impairment.
Child ; Deglutition ; Esophageal Atresia ; Failure to Thrive ; Follow-Up Studies ; Fundoplication ; Gastroesophageal Reflux* ; Gastrostomy ; Hernia, Hiatal ; Humans ; Hydrogen-Ion Concentration ; Quality of Life ; Recurrence ; Respiratory Tract Infections ; Vomiting

Diaphragm injuries are very important because, if both thoracic and abdominal viscera are damaged, a combination of shock and acute respiratory distress may develop. It can be highly lethal. This evaluation was based on the reviews of 17 cases of traumatic diaphragm injuries treated at the Department of Cardiovascular Surgery, Seoul Adventist Hospital during 5 years from March 1993 to February 1997. The mean age of the patients was 37.2 years and sex ratio was 3.2:1 with male dominance. Blunt trauma(N=5, Rt.=4, Lt.=1) was 29.5%, penetrating trauma(N=12, Rt.=5, Lt.=7) was 70.5%. Dyspnea(76%) was the most common symptom. Blunt trauma(9.8 3.7 Cm) was larger than the penetrating trauma(3.2 1.3 Cm)(P<0.05) in the size(mean SD) of the injury. All of the patients had associated injuries and repaired immediatley with thoracic approach 11 cases(64%), abdominal approach 3 cases(18%) and thoracoabdominal approach 3 cases(18%). 5 cases of penetrating diaphragmatic trauma was diagnosed on the operation of other organ injury. Now we suggest that diaphragmatic injury should be suspected in all patients with penetrating as well as blunt injury of the chest and abdomen to protect the patient from its late complications.
Abdomen ; Diaphragm ; Humans ; Male ; Seoul ; Sex Ratio ; Shock ; Thorax ; Viscera ; Wounds, Nonpenetrating

The double pylorus is a rare condition consisting of a double communication between gastric antrum and duodenal bulb. Some investigators postulate that the doubling of the pyloric channel is a congenital phenornenon, but others believe that it is an acquired lesion. A 72 year-old-man was admitted to this hospital because of epigastric pain for 1 month. Upper G-I series revealed thickened rnucosal folds of pylorus and duodenal bulb and dilated, deformed duodenal bulb filled with barium materials. Endoscopic findings also showed two ovoid large openings of the pyloric channel divided by smooth thickened septum and multiple gastroduodenal ulcers. We thought that this case was an acquired lesion. The relevant literatures on the subject were reviewed.
Barium ; Duodenal Ulcer ; Humans ; Peptic Ulcer ; Pyloric Antrum ; Pylorus* ; Research Personnel ; Stomach Ulcer

Juvenile idiopathic arthritis (JIA) can develop extra-articular manifestations, including growth retardation, osteopenia and chronic uveitis. However, pleuropulmonary involvement is rare. Approximately 40% of patients with JIA have abnormal pulmonary function tests without pulmonary symptoms, with the commonest abnormality in carbon monoxide diffusing capacity, but clinically evident pulmonary parenchymal disease in JIA is extremely uncommon. We describe a 15-year-old male with JIA who presented with dyspnea due to interstitial lung disease.
Adolescent ; Arthritis ; Arthritis, Juvenile Rheumatoid* ; Bone Diseases, Metabolic ; Carbon Monoxide ; Dyspnea ; Humans ; Lung Diseases ; Lung Diseases, Interstitial ; Lung* ; Male ; Respiratory Function Tests ; Uveitis

Acromegaly and hyperprolactinemia have been described in association with polyostotic fibrous dysplasia. The pathogenic mechanisms of this endocrinopathy are not clear. We experienced a 19-year-old male with hypersecretion of GH, hyperprolactinemia and fibrous dysplasia. He was referred for evaluation of suspected acromegaly. He had no skin pigmentation. Plasma GH, PRL, somatomedin-C, LH, FSH, testosterone, estradiol, progesterone, T3, T4, TSH and cortisol were measured. Among those, the levels of plasma GH, PRL and somatomedin-C were high. Serum alkaline phosphatase was increased. OGTT did not suppress plasma OH concentration and GH showed paradoxical response to TRH and LHRH. GH was suppressed after a test-dose of somatastatin and bromocriptine. Brain MRI demonstrated a mass lesion in sella turcica and another mass lesions in nasal cavity and posterior occipital bone. Whole body bone scan revealed increased uptake in skull, nasal bone, both 9th posterior rib, both femurs, both tibias, left scapular and pelvic bone. These fmdings were consistent with bone tumor such as fibrous dysplasia. We report a case with incomplete MeCune-Albright syndrome including acromegaly, hyperprolactinemia and polyostotic fibrous dysplasia.
Acromegaly ; Alkaline Phosphatase ; Brain ; Bromocriptine ; Estradiol ; Femur ; Fibrous Dysplasia, Polyostotic ; Glucose Tolerance Test ; Gonadotropin-Releasing Hormone ; Humans ; Hydrocortisone ; Hyperprolactinemia ; Magnetic Resonance Imaging ; Male ; Nasal Bone ; Nasal Cavity ; Occipital Bone ; Pelvic Bones ; Plasma ; Progesterone ; Ribs ; Sella Turcica ; Skin Pigmentation ; Skull ; Testosterone ; Tibia ; Young Adult