The development of immuohistochemistry and the application of electron microscopy have revolutionized our understanding of the pathopysiology of pituitart adenoma. The clinical value of functional characterization of pituitary adenoma has been realized. Immunohistochemical stains using polyclonal antibodies to six pituitary hormones (GH, PRL, ACTH, TSH, FSH & LH) were performed to classify the pituitary adenoma and to investigate the relationship between the results of the immunohistochemical study and pared to the serum hormone level. The results are summarized as follows: The Most common clinical type of pituitary adenoma was prolactinoma and the second was nonfunctioning adenoma. However, the most common immunohistological type of pituitary adenoma was null cell adenoma, the second one, lactotrope adenoma and the third one, mixed sommatotrope & lactotrope adenoma. In the clinically nonfunctioning adenoma cases, null cell adenoma were present in 75%; gonadotrope adenoma and corticotrope adenoma were present in 25%, while the serum prolactin level was increased in ten of the twenty cases(50%) of the null cell adenoma. When the serum prolactin level was increased above the 150ng/ml, the tumor cells gave positive reactions in 95.2% of cases immunohistochemically. But in the cases of GH, FSH & LH, the tumor cells gave positive reactions in 100%, 75%, and 66.7%, respectively. In the case of increased serum prolactin level, more than 50% and 30% proportion of tumor cells showed positive reactions in the micro- and macroadenoma, respectively.
Adenoma

Colorecal cancer undergo relatively long preneoplastic processes before being invasive. Fecal occult blood test (FOBT) has been a useful tool to detect the advanced colorectal cancers with cost-effectiveness. However, the patient’s compliance to FOBT was poor because of low sensitivity and annual sampling. The sigmoidoscopy and colonoscopy have the ten-year preventive effect for the advanced cancer. Recently the DNA stool test for detection of mutations has showed excellent sensitivity and specificity. It has several adventages such as collection of samples and automated analysis. Virtual colonoscopy, especially CT colonograpy, can be a viable option for the colorecal cancer screening. In November 2001, the Korean Society of Coloproctology (KSCP) and the Natinal Cancer Center (NCC) developed the guidelines on screening and surveillance for early detection of colorectal cancers in Korea. Average-risk men and women should start colonoscopic examination with a 10-year interval at the age of 50. Individuals with increased risk such as those with a family or personal history of colorectal cancer or colorectal adenomas, or family history of familial adenomatous polyposis, hereditary non-polyposis colorectal cancer should consult their surveillance to the specialty-physicians. The ideal screening tools may change by age.
Adenoma ; Adenomatous Polyposis Coli ; Colonography, Computed Tomographic ; Colonoscopy ; Colorectal Neoplasms* ; Compliance ; DNA ; Early Detection of Cancer ; Female ; Humans ; Korea ; Male ; Mass Screening* ; Occult Blood ; Sensitivity and Specificity ; Sigmoidoscopy

BACKGROUND: Dizziness is a common complaint in patients presenting to the emergency room and that has various pathologic causes. This study investigate the clinical differences in dizziness between the central origin and the peripheral origin and to provides the clues far diagnosis and proper treatment. METHODS: We analysed 290 patients with dizziness during 12 months period prospectively, who visited in ED, Inha University Hospital from Jan. 1997 to Dec. 1997. We analysized sex ratio, characteristics of the dizziness, associated past illness, associated symptoms, severity, results of the special radiologic study, nystagmus type, and causes of central origin and peripheral origin dizziness. RESULTS: Male to female ratio was 1:1.4 in central origin(n=165) and 1:2.0 in peripheral origin(n=125). Most common age group was 11th decade in both groups. According to the characteristics of the dizziness, rotation sense was the main complaint of the peripheral origin dizziness. Most common past illness was hypertension in both groups. MRI has diagnostic priority than CT scan in central origin dizziness. Types of nystagmus has some significant differences between two groups. CONCLUSION: Dizziness may represented as a sign of significant pathological neurologic status especially in central origin. So we must precisely evaluate the patient history, neurologic examination of the inner ear and CNS, and special radiologic study incliding MRI.
Diagnosis ; Dizziness* ; Ear, Inner ; Emergency Service, Hospital ; Female ; Humans ; Hypertension ; Magnetic Resonance Imaging ; Male ; Neurologic Examination ; Prospective Studies ; Sex Ratio ; Tomography, X-Ray Computed

In Korea chronic liver diseases are the important medical issues because of their high incidence, poor prognosis and no available therapeutic resume. It is believed that the etiologic agent of most of chronic liver diseases in Korea is hepatitis B virus. To find out the incidence of positivity and to understand the autoantibodies in some of the chronic liver diseases in Korea, anti-smooth muscle antibody and anti-nuclear antibody tests were performed on 43 patient serum with chronic active hepatitis, 13 patient serum with chronic persistant hepatitis and 20 patient serum with liver cirrhosis, who diagnosed by liver biopsies. The results of the study are summarized as follows: 1) The positivity of anti-smooth muscle antibody in chronic active hepatitis was 93.0%, that in chronic persistant hepatitis 60.0% and that in liver cirrhosis 80.0%. 2) The positivity of anti-nuclear antibody in chronic active hepatitis was 18.6%, that in chronic persistant hepatitis 15.4%, that in liver cirrhosis 5.0%. 3) The test efficiency of anti-smooth muscle antibody to differentiate chronic active hepatitis from chronic persistant hepatitis and liver cirrhosis was 48.7%. The above results suggest that the antismooth muscle antibody may be related to the "necrosis of liver cells", and further studies are needed to fine out any relationship between the autoantibody and the disturbance of immune regulatory function if there is, as this study suggested.
Incidence

No abstract available.
Encephalitis* ; Encephalitis, Herpes Simplex*

When the non-union gap in a long bone is more than half of the diameter of the bone at that level, it presents a significant challenge to traditional bone grafting technique. Even if there are several good ways for this problem, such as shortening, traditional various bone grafting, electrical stimulation and free vascularized bone graft, most of these techniques have some difficulties to maintain the stability of fracture post-operatively, and we have to keep their extremities into a cast or external fixator so long. So we have attempted to treat the large osseus gap non-union in long bone with fixation of heavy duty or condylar plate on one side of fracture for fracture stability, a long tibial corticocancellous strut graft on the other side of fracture for fracture stability and rapid bony union, and extensive cancellous chip bone graft between the plate and tibial graft to enhance the bony union. We have experienced 9 cases of large osseus gap non-union in long bone with this technique from March 1981 to September 1986 at the department of orthopaedic surgery, St. Mary's hospital, Catholic University Medical College. 1. Their, 7 males and 2 females, average age was 38 years old, with a range of 24 to 53 years old. The distribution of the involved bone was 6 femur, 2 humerus, 1 radius and ulna with 1.4 years of average duration of non-union, ranged from 7 months to 2.4 years. The average gap from normal bone to normal bone was 4.8cm, with a range of 2.7cm to 7.4cm. The average number of previous surgical procedures was 4, with a range of 2 to 7. Four of the nine patients had quiescent osteomyelitis. 2. Post-operative immobilization with splint or cast was applied for 6 weeks for upper extremity and 8 weeks for lower extremity followed by active R.O.M. exercise and non-weight bearing crutch walking. 3. Five of the nine cases(55.6%) had completely bony union. This occured on an average 8 months post-operatively and was faster in the forearm bones and femur than in the humerus. An additional cancellous bone graft was done in two. But other two of the patients had subsequent amputation because of recurrent and uneontrollable osteomyelitis stirred up by the surgery. 4. This procedures was proved to be one of valuable adjuvant method in treatmqnt of large osseous gap non-union of long bones.
Amputation ; Bone Transplantation ; Electric Stimulation ; External Fixators ; Extremities ; Female ; Femur ; Forearm ; Humans ; Humerus ; Immobilization ; Lower Extremity ; Male ; Methods ; Osteomyelitis ; Radius ; Splints ; Transplants ; Ulna ; Upper Extremity ; Walking

Amipaque is a water soluble, non-ionic myelographic contrast media, and owing to its high diagnostic accuracy and safety, its use is gradually increasing. The authors studied the complications after Amipaque lumbermyelography in 61 patients with low back pain during the period from Jan. 1981 to Nov. 1981 in Chung Ang University Hospital. The results were as follows; 1. Total complication rate was 52%(32 of 61) and there was nosexual difference in its occurrence. 2. In total, no difference in complication rate was found between head-up positioned group with a degree of 30degrees (group I) after procedure and head-up positioned group with a degree of 70degrees (group II) but female patients had more complication rate in group I than in group II (75% vs 50%).Headache was more common in group I and nausea was more common in group II. 3. Headache was most common complicaiton (44%) and there was no sexual difference in its occurrence. 4. No significant difference in complication rate was found between patients proved to have HBP and patients to have not. 5. Complications were less common in patients with punctured level of L4-5 than in patients with L2-3 or L3-4 level puncture.
Contrast Media ; Female ; Headache ; Humans ; Low Back Pain ; Metrizamide ; Myelography ; Nausea ; Punctures ; Water

Recently, noninvasive prenatal test (NIPT) has been adopted as a primary screening tool for fetal chromosomal aneuploidy. The principle of NIPT lies in isolating the fetal fraction of cell-free DNA in maternal plasma and analyzing it with bioinformatic tools to measure the amount of gene from the target chromosome, such as chromosomes 21, 18, and 13. NIPT will contribute to decreasing the need for unnecessary invasive procedures, including amniocentesis and chorionic villi sampling, for confirming fetal aneuploidy because of its higher positive predictive value than that of the conventional prenatal screening method. However, its greater cost than that of the current antenatal screening protocol may be an obstacle to the adoption of this innovative technique in clinical practice. Digital polymerase chain reaction (dPCR) is a novel approach for detecting and quantifying nucleic acid. dPCR provides real-time diagnostic advantages with higher sensitivity, accuracy, and absolute quantification than conventional quantitative PCR. Since the groundbreaking discovery that fetal cell-free nucleic acid exists in maternal plasma was reported, dPCR has been used for the quantification of fetal DNA and for screening for fetal aneuploidy. It has been suggested that dPCR will decrease the cost by targeting specific sequences in the target chromosome, and dPCR-based noninvasive testing will facilitate progress toward the implementation of a noninvasive approach for screening for trisomy 21, 18, and 13. In this review, we highlight the principle of dPCR and discuss its future implications in clinical practice.
Amniocentesis ; Aneuploidy ; Chorionic Villi Sampling ; Chromosome Aberrations ; DNA ; Down Syndrome ; Female ; Mass Screening ; Plasma ; Polymerase Chain Reaction* ; Pregnancy ; Prenatal Diagnosis

Nine scaphoid non-unions, which were treated by through curettage of the scar tissue on pseudarthrosis, iliac bone grafts between the fragments and Herbert screws fixation, were analysed. The average follow up period from operation was 16.9 months. The interval between the fracture and the time of the operation ranged from 10 months to 48 months(average 21.6 months). Average union time was 14 weeks after operation. The initial radiologic cystic changes disappeared and overall clinical results were improved. Mean postoperative range of motion of the wrist was flexion 55 and extension 45°. Three of them had DISI deformity preoperatively which their scapholunate angles (mean 104°) has been corrected after reduction (mean 75°). In one case among three DISI deformities, partial radial styloidectomy and triscaphe fusion were added (to bone graft and Herbert screw fixation). A case of incorrect positioning of the screw and a case of neuroma were complicated. Treatment of scaphoid nonunion with curettage of the scar tissue and iliac bone graft and Herbert screw fixation seems to be encouraging to regain the normal anatomy of scaphoid and function of the wrist.
Cicatrix ; Congenital Abnormalities ; Curettage ; Follow-Up Studies ; Neuroma ; Pseudarthrosis ; Range of Motion, Articular ; Transplants ; Wrist

No abstract available.
Child* ; Fatty Liver ; Humans ; Hypercholesterolemia ; Incidence* ; Obesity