PURPOSE:Noonan syndrome(NS) is characterized by short stature, congenital heart disease, and typical facies. Recombinant human growth hormone(GH) has been reported to improve growth rate in a similar fashion to that seen in Turner syndrome. We investigated the clinical characteristics and growth reponses to GH therapy in children with NS. METHODS:The cases of sixty seven patients with NS were reviewed retrospectively. Ten of the 65 patients were assessed height, weight and pubertal stage every 3 months during GH therapy. RESULTS:Webbed neck(70%), delayed development(59.7%), low set posterior hairline(56.7%), eye abnormalities(56.7%) and mental retardation(55.2%) were the leading clinical characteristics. Short stature below the 3rd percentile was presented in 73.8 %. Growth patterns in NS children were variable and the evaluation of their growth must be individualized. The increments of height SDS were significant in children with GH therapy(height SDS:from -2.8+/-.6 to -2.3+/-.9, growth velocity:from 4.4+/-.8 cm to 9.2+/-.9 cm during first year, and 6.1+/-.1 cm during second year) (P<0.05). CONCLUSION: This study characterized the clinical profiles in Korean children with NS, which should be further extended with more children with NS. Additionally, the significant increase in final adult height after GH therapy in children with NS should be observed.
Adult ; Child* ; Facies ; Heart Defects, Congenital ; Humans ; Noonan Syndrome* ; Retrospective Studies ; Turner Syndrome

PURPOSE:Noonan syndrome(NS) is characterized by short stature, congenital heart disease, and typical facies. Recombinant human growth hormone(GH) has been reported to improve growth rate in a similar fashion to that seen in Turner syndrome. We investigated the clinical characteristics and growth reponses to GH therapy in children with NS. METHODS:The cases of sixty seven patients with NS were reviewed retrospectively. Ten of the 65 patients were assessed height, weight and pubertal stage every 3 months during GH therapy. RESULTS:Webbed neck(70%), delayed development(59.7%), low set posterior hairline(56.7%), eye abnormalities(56.7%) and mental retardation(55.2%) were the leading clinical characteristics. Short stature below the 3rd percentile was presented in 73.8 %. Growth patterns in NS children were variable and the evaluation of their growth must be individualized. The increments of height SDS were significant in children with GH therapy(height SDS:from -2.8+/-.6 to -2.3+/-.9, growth velocity:from 4.4+/-.8 cm to 9.2+/-.9 cm during first year, and 6.1+/-.1 cm during second year) (P<0.05). CONCLUSION: This study characterized the clinical profiles in Korean children with NS, which should be further extended with more children with NS. Additionally, the significant increase in final adult height after GH therapy in children with NS should be observed.
Adult ; Child* ; Facies ; Heart Defects, Congenital ; Humans ; Noonan Syndrome* ; Retrospective Studies ; Turner Syndrome

BACKGROUND: Better effect of antiemetic drugs can be obtained by combination of multiple antiemetic drugs that have different mechanisms of action. However, if the combined drugs have similar mechanisms of action, the incidence of side effects may be increase. This study was conducted to evaluate the ability of using combination therapy consisting of metoclopramide and dexamethasone in control of postoperative nausea and vomiting. METHODS: Sixty adult female patients undergoing major gynecological operation under the general anesthesia were randomly divided into two groups according to administered drugs. The patients received a single IV dose of metoclopramide (10 mg, Group I) or metoclopramide plus dexamethasone (10 mg 8 mg, Group II) when as operator sutured the skin wound. The incidences of nausea and vomiting were assessed during the first 12, 24, and 48 hours after recovery from anesthesia. RESULTS: There were no prominent incidences of postoperative nausea and vomiting between two groups within postoperative 12 hours. But there were significantly increased incidences of nausea and vomiting in Group I (26.7%, 13.3%) compared to Group II ( 8.0%, 3.2%) during postoperative 24 hours and 48 hours. CONCLUSIONS: Combination therapy of metoclopramide with dexamethasone seemes to have no synergic effect in control of postoperative nausea and vomiting.
Adult ; Anesthesia ; Anesthesia, General ; Antiemetics ; Dexamethasone* ; Female ; Gynecologic Surgical Procedures ; Humans ; Incidence ; Metoclopramide* ; Nausea ; Postoperative Nausea and Vomiting* ; Skin ; Vomiting ; Wounds and Injuries

A 23 year-old female with skeleto-dentoalveolar protrusion of maxilla, minor broken contact points between anterior teeth, and missing of lower 1st molars, has been treated with multibanded edgewise technique. After treatment of 14 months, she has gained functional overbite-overjet relationship and facial harmony due to the retraction of upper anterior teeth. Root resorption was slight. Especially, us ing the space of missed lower 1st molars instead of extracting lower premolars, expected and favorable results were obtained.
Adult* ; Bicuspid ; Female ; Humans ; Maxilla ; Molar ; Prognathism* ; Root Resorption ; Tooth ; Young Adult

19 years old female had untreated Veau classification class II cleft palate with ectopic eruption of upper right lateral incisor and congenital missing of lower lateral incisors. Upper left lateral incisor, left first molar aid lower left first molar were root restswithperiapicalpathologiclesions. So all root rests were extracted and prosthodontic rehabilitation after orthodontic treatment was planned. She was treated by means of multibanded system with face bow. After 23 months all orthodontic correction were achieved and, as soos as debanding procedure was done she was referred to oral surgeon and prosthodontist for surgical operation and bridge construction.
Classification ; Cleft Palate* ; Female ; Humans ; Incisor ; Molar ; Prosthodontics ; Rehabilitation ; Tooth* ; Young Adult

No abstract available.
Orbit*

Multidirectional shoulder instability is often difficult to diagnose and treat and can be cause of significant disability. Nonoperative rehabilitations and life tyle modifications are the primary treatments. Hiwever, the inferior capsular shift procedure, performed either from an anterior or posterior approach, as described by Neer and Foster, is recommended for symptomatic multidirectional instability that is unresponsive to nonoperative therapy. Twenty-seven shoulders in twenty-seven patients with inferior and multidirectional instability were managed with Neer s inferior capsular shift, through anterior or posterior approach depending on the direction in which the shoulder is most unstable. All of the patients were followed up for an average of 3 years (range one to seven years). The postoperative range of motion of the shoulders was well maintained except 1 patient. Three patients had recurrence of symptomatic and disabling multidirectional instability, but twenty-four (89%) of the shoulders continued to function well with no instability, no pain, no recurrence and no remarkable limitation of motion.
Humans ; Range of Motion, Articular ; Recurrence ; Shoulder*

No abstract available.
Cholesterol* ; Granuloma*

The ankle is a complex structure supporting the entire musculoskeletal system during standing and walking. The injuries to the ankle joint result in a severe functional disturbance because of complex anatomical characteristics around the ankle joint. 284 patients of the ankle fracture that were treated in orthopedic Dept. Capital Armed Forced General Hospital from march 1985. to march 1988. were analized in clinical and radiological aspects. The following results were obtained: 1. The main cause of the injuries was falling from a height and the other were sports injury and slipping down in order. 2. The most common type by Lauge-Hansen classification was supination-external rotation type(122 case, 42.9%). 3. 211 case(74.3%) were treated with open reduction and internal fixation, and 73 case(25.7%) were treated with closed reduction. Poor outcome seemed closely related to the severity of the injury and degree of fracture displacement. 4. Accurate reduction and rigid internal fixation of the lateral malleolus with shortening was important factor. 5. Classification of Lauge-Hansen was useful in the diagnosis and treatment of the ankle fractures.
Accidental Falls ; Ankle Fractures ; Ankle Joint ; Ankle ; Arm ; Athletic Injuries ; Classification ; Clinical Study ; Diagnosis ; Hospitals, General ; Humans ; Musculoskeletal System ; Orthopedics ; Walking

About 40% of patients with diabetes mellitus develops to diabetic nephropathy, and these patients show increment of glomerular filtration rate and renal volume at early phase. 99mTc-DMSA SPECT (single photon emission computed tomography) can measure a functional renal volume because 99mTc- DMSA it is taken up by the viable proximal tubular cells located in the renal cortex. To evaluate the renal volume in early diabetic nephropathy, we compared functional renal volume between diabetic patients and control, renal transplantation donor. 99mTc-DMSA was injected intravenously and SPECT was done after 2 hours in 15 diabetic patients, 18 renal transplantation donors, and 2 patients with end stage renal disease due to chronic glomerulonephritis. In diabetic patients with creatinine clearance more than 30ml/min and proteinuria, right and left renal volume were 247+/-22ml/BSA(m2), 256+/-37ml/BSA (m2), which were greater than those of diabetic patients with normal renal function and without proteinuria, or renal transplantation donors(P<0.05). In conclusion, we measured the functional renal volume by 99mTc-DMSA SPECT. Renal volume of diabetic patients with proteinuria were larger than the volume of control group or diabetic patients with normal renal function and without proteinuria. 99mTc-DMSA SPECT was thought to be useful test a for the measurement of functioning renal volume.
Creatinine ; Diabetes Mellitus* ; Diabetic Nephropathies ; Glomerular Filtration Rate ; Glomerulonephritis ; Humans ; Kidney Failure, Chronic ; Kidney Transplantation ; Proteinuria ; Succimer ; Technetium Tc 99m Dimercaptosuccinic Acid* ; Tissue Donors ; Tomography, Emission-Computed, Single-Photon*