In 1,146 term neonates without perinatal problems who were born in Kwangju Christian Hospital, blood TSH levels were measured by immunoradiometric assay. In 397 term neonates among them, blood T4 levels were measured by radioimmunoassay in same specimens. 1) In normal neonates aged 3~5 days, 6~10 days, 11~20 days and 21~28 days, the TSH levels were 8.88+/-5.21(mean+/-SD), 9.44+/-5.16, 9.69+/-4.98, 11.96+/-3.75 IU/ml and the T4 levels were 11.41+/-2.79, 11.37+/-2.82, 11.19+/-2.63, 10.51+/-2.99 g/dl respectively. 2) No significant sex difference in TSH level was found in each age group, and TSH level did not correlate with birth weight. In neonates delivered by Cesarean section, TSH levels were lower than those of the normally delivered. 3) T4 levels did not differ between both sexes, and between types of delivery in each age group, and nor did it correlate with birth wweight 4) If the recall rate should be set at 0.2% of the total, TSH levels above 26.9 IU/ml would be required to recall for serum sampling. TSH level above 2 SD was 19.7 IU/ml. Cutoff points of T4 levels at 1.5 SD and 2 SD were 5.8 and 7.2 g/dl respetively, and the lowest 10th percentile was 7.4 g/dl.
Birth Weight ; Cesarean Section ; Female ; Gwangju ; Humans ; Immunoradiometric Assay ; Infant, Newborn* ; Mass Screening* ; Parturition ; Pregnancy ; Radioimmunoassay ; Sex Characteristics

An objective evaluation of the degree of respiratory impairment in children depends on the establishment of standards of normal function. In addition to sex and growth, various factors such as race and geography have been shown to be important determinants of lung function. The purposes of this paper are to report the result of lung function tests performed on a group of healthy children, to define the range of normal values, to provide a prediction formula of each parameter, and to compare the data with those of other investigators. Pulmonary function tests were performed on 198 healthy normal children in Kwangju between the ages of 5 and 15 years. The following variables were measured: vital capacity, forced vital capacity, one-second forced expiratory volume, peak expiratory flow, and maximal expiratory flow at 25%, 50% of expiratory vital capacity. Simple and complex prediction formulas for variables of PFT are presented according to sex, age, height, weight, and body surface area. 1) With increasing age, height and weight development increased in both sexes and their mean values in each age groups were more higer than those of Korean standard for children. 2) The correlation coefficients were 0.8 or more more in VC, FVC, FEV1 & more higher than that of PEFR, V25, V50. 3) Of the parameters examined, height had the heighest correlation coefficient in all pulmonary function test items. 4) The correlation coefficients by age, weight, body surface area were similar, but according to sex each parameters of PFT varied slightly. 5) Among complex prediction formulas, the correlation coefficients by 3 variables (age, height, and weight) and 2 variables (height and weight) were more higher than others. But disregarding age and weight, the correlation coefficients of height resembled that of simple regression equation. 6) Predicted values of pulmonary function test and correlation coefficients to the parameters were generally higher in boys than those of girls.
Body Surface Area ; Body Weight ; Child* ; Continental Population Groups ; Female ; Forced Expiratory Volume ; Geography ; Gwangju ; Humans ; Lung ; Peak Expiratory Flow Rate ; Reference Values ; Research Personnel ; Respiratory Function Tests* ; Vital Capacity

Ultrasonic evaluation of the pylorus was performed in a group of 22 infants clinically suspected of having Congenital Hypertrophic Pyloric Stenosis (CHPS), from march 1990 to July 1991. In every case the diagnosis of CHPS was confirmed by surgery. Ten normal babies served as the control group. 1) In CHPS group, the mean age on admission was 36.7 +/- 16.4 days, and male to female ratio was 19.3. In control group, the mean age was 33.7 +/- 18.7 days, with the sex ratio of 8 : 2, male predominating. 2) In CHPS group, the mean age of symptom onset was 18.6 +/- 12.7 days, the majority occurring between 2 to 3 weeks (13 cases : 59%). 3) The ultrasonographic measurements showed that the pyloric muscle thickness of CHPS group was 4.94 +/- 1.35 mm (mean+/-S.D), nearly four times greater than that of the control group with 1.30 +/- 0.17mm, whereas the pyloric canal length of CHPS group (18.03 +/- 1.84mm) was increased significantly, but only by 50%, compared with the control group (11.54 +/- 1.70). 4) In CHPS group, operative measurements of pyloric muscle thickness was 5.20+/-1.23mm, not significantly differing from the sonographic measurement, while pyloric canal length measured 22.13 +/- 3.45mm, significantly larger than ultrasonographic measurement. This indicates that the pyloric muscle thickness measured on preoperative ultrasonogram may provide more significant diagnostic value than the pyloric canal length. 5) If the diagnostic criteria for CHPS were taken as pyloric muscle thickness above 4mm and pyloric canal length above 16mm, 21 out of 22 cases (99.4%) were diagnosed correctly.
Diagnosis* ; Female ; Humans ; Infant ; Male ; Pyloric Stenosis, Hypertrophic* ; Pylorus ; Sex Ratio ; Ultrasonics ; Ultrasonography

BACKGROUND: The aim of this study is to evaluate the therapeutic effect of splenectomy in children with chronic idiopathic thrombocytopenic purpura(ITP) who do not respond to corticosteroids and intravenous immunoglobulin(IVIG). METHODS: Fifteen patients(7 boys and 8 girls) who were admitted to St. Mary's Hospital under the diagnosis of ITP from December 1990 to February 1997 were enrolled In this study. All had chronic forms(more than 6 months after diagnosis) and were refractory to corticosteroids(prednisolone 1~2mg/kg) and IVIG(400mg/kg for 5 days or 1 g/kg for 2 days). We you-finely employ pneumococcal vaccine in 13 patients before splenectomy slnce 1992. Antiplatelet antibody was examed in 10 patients. We measured platelet count at preoperative time, postoperative 1 day, 1 month, and 3 months or more. Hematologic results were analyzed according to Berchtold and McMillan's criteria (1) complete response(CR) >120 x 10(9)/l; (2) partial response(PR) >50 x 10(9)/l (3) no response(NR) < 50 x 10(9)/l. RESULTS: The median age at operation was 10 yr(6~16). The median time interval between diagnosis and splenectomy was 2 yr 2 mo(6 mo~5 yr 5 mo). Antiplatelet antibody was positive in 2 cases of 10 cases(20%). Of 15 cases, 12 cases were corticosteroid resistant and 3 cases were corticosteroid dependent. The postsplenectomy platelet count(median 407 x 10(9)/l of 1 day; 254 x 10(9)/l of 1 month; 227 x 10(9)/l of 3 months or more) was significantly higher than presplenectomy platelet count(median 9 x 10(9)/l)(P<0.05). All patients showed complete or parial response throughout the follow up period. Accessory spleen was found in 1 case and removed during operation. There were no serious complications following splenectomy except mild fever in 2 cases(14%). CONCLUSION: Splenectomy appears to be an effective and relatively safe treatment for patients with chronic ITP who have had inadequate response to conventional therapies.
Adrenal Cortex Hormones ; Blood Platelets ; Child ; Diagnosis ; Fever ; Follow-Up Studies ; Humans ; Platelet Count ; Purpura, Thrombocytopenic* ; Spleen ; Splenectomy*

No abstract available.
Alopecia* ; Dutasteride* ; Finasteride*

A 71-year-old man who had a laceration on his right fifth finger underwent an emergency explorative operation under brachial plexus block that was performed by using transaxillary artery technique.During axillary block, no elicitation of paresthesia was presented.Postoperatively he complained numbness on his right arm along the dermatome of 7th cervical nerve distribution.Two weeks later the evidence of nerve injury was found on EMG and NCV carried by the department of neurology. Observing closely for another two weeks, the symptoms and signs were gradually improved.On 42nd postoperative day, the patient complained no neurologic problems and the findings of EMG and NCV returned to normal.Considering the method of anesthesia, operation time, tourniquet time and patient position, we conclude that the direct needle injury and intraneural injection during axillary block are the highly suggestive causes of nerve injury.
Aged ; Anesthesia ; Arm ; Arteries ; Brachial Plexus ; Emergencies ; Fingers ; Humans ; Hypesthesia ; Lacerations ; Needles ; Neurology ; Paresthesia ; Tourniquets

A 71-year-old man who had a laceration on his right fifth finger underwent an emergency explorative operation under brachial plexus block that was performed by using transaxillary artery technique.During axillary block, no elicitation of paresthesia was presented.Postoperatively he complained numbness on his right arm along the dermatome of 7th cervical nerve distribution.Two weeks later the evidence of nerve injury was found on EMG and NCV carried by the department of neurology. Observing closely for another two weeks, the symptoms and signs were gradually improved.On 42nd postoperative day, the patient complained no neurologic problems and the findings of EMG and NCV returned to normal.Considering the method of anesthesia, operation time, tourniquet time and patient position, we conclude that the direct needle injury and intraneural injection during axillary block are the highly suggestive causes of nerve injury.
Aged ; Anesthesia ; Arm ; Arteries ; Brachial Plexus ; Emergencies ; Fingers ; Humans ; Hypesthesia ; Lacerations ; Needles ; Neurology ; Paresthesia ; Tourniquets

Seidel nail is one of locked humeral nail and Seidel himself reported excellent result in his preliminary report using his nail. But our early experience showed disappointing result with high rate of complications, So we reviewed our 16 cases of humeral shaft fracture with polytrauma treated with Seidel nail and studied anatomical fitness of the nail within the distal medullary space using CT scan. The most frequent complication was intraoperative fracture of the proximal humerus < 4 cases> and this seemed to be due to lateral placement of pilot hole. There were 3 cases of nonunion and these cases showed insufficient distal anchorage, either primarily or postoperatively. Anatomical fitness study showed insufficient spreading of nail flanges in 5 cases of distal canal width below 9mm and nonunion cases were in this group. Other problems of Seidel nail were technical difficulties due to occasionally incorrect proximal targeting device and frequent breakage of adaptor screw. Study of more cases may be needed to confirm the design problem of Seidel nail.
Humerus ; Multiple Trauma ; Tomography, X-Ray Computed

A 69-year old man presented with severe epigastric pain for 1 day. He had early gastric cancer at the antrum and underwent a distal subtotal gastrectomy and Billorth II gastrojejunostomy one month later without any post-operative complications. Radiologic examination revealed a large amount of retroperitoneal free air formation. Because of unremitting pain and unstable vital sign, exploratory laparotomy was followed. During the operation, a perforated duodenal diverticulum at the posterior wall of the 2nd portion of the duodenum was identified. He underwent diverticulectomy and primary closure. He was discharged on the 18th post operative day and has been followed up without any evidence of comlpication for several months.
Aged ; Diverticulum* ; Duodenum ; Gastrectomy* ; Gastric Bypass* ; Humans ; Laparotomy ; Stomach Neoplasms ; Vital Signs

No abstract available.
Dinoprostone* ; Membranes* ; Rupture* ; Suppositories*