PURPOSE:Craniopharyngioma is one of the most common causes of organic growth hormone deficiency leading to pituitary hormonal insufficiency. However, some growth hormone(GH)-deficient children with craniopharyngioma may grow normally or even show accelerated growth. This study was designed to evaluate several factors associated with growth of patients with craniopharyngioma. METHODS:Forty children operated on for craniopharyngioma were evaluated for their pituitary function, serum insulin like growth factor-I(IGF-I), serum insulin like growth factor binding protein-3(IGFBP-3) and serum prolactin levels. We also observed their growth status and corresponding changes with or without GH treatment. RESULTS:Among 40 patients, one had normal pituitary hormonal status and one had isolated GHD(GH deficiency). The other patients showed multiple pituitary hormone deficiency including GH(98%), LH, FSH(75%), TSH(65%), ACTH(62%), and ADH(38%) deficiencies. Patients with GHD were categorized into 2 groups. Group 1 consisted of children who showed normal growth, thus had not received GH treatment(n=14) and Group 2, those who showed subnormal growth(n=25). Patients in Group 2 were subdivided into Group 2A, when the patients had not received GH treatment in spite of subnormal growth(n=9) and Group 2B, when GH treatment had been added later on(n=16). There were no differences in the age at diagnosis of GHD, initial height standard deviation score(Ht SDS), body mass index(BMI), peak GH concentration between Group 1 and Group 2. Height velocities in Group 1, 2A, and 2B were 8.1+/-.2 cm/yr, 2.4+/-.2 cm/yr, 2.7+/-.2 cm/yr during the first year of endocrinologic follow-up, 7.1+/-.8 cm/yr, 1.2+/-.1 cm/yr, 7.6+/-.7 cm/yr during the second year, 5.9+/-.0 cm/yr, 2.8+/-.9 cm/yr, 7.3+/-.7 cm/yr during the third year, respectively. BMI changes during the first year of endocrinologic follow-up and postoperative prolactin levels were not significantly different between Group 1 and Group 2A. Postoperative IGF-I and IGFBP-3 levels in Group 1 were significantly higher than those in Group 2A(P<0.05). Both IGFBP-3 and prolactin levels correlated significantly with height velocity in Group 1 and 2A(P=0.004 r=0.64 and P= 0.035 r=0.74 , respectively). CONCLUSION: In this study, growth in children with craniopharyngioma was likely to be associated with IGF-I, IGFBP-3 and prolactin levels. Further studies are needed to unravel other growth promoting factors related to GH independent growth.
Child* ; Craniopharyngioma* ; Diagnosis ; Follow-Up Studies ; Growth Hormone ; Humans ; Insulin ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor I ; Prolactin

Postoperative colonoscopy is an effective tool for management of colonic adenomas. Authors analyzed the pattern of colonic adenomas detected during follow-up colonoscopy after colorectal cancer surgery and evaluated the characteristics of adenornas, risk groups, and effective fo1low-up schedule. Study group were 222 patients and colonoscopy was performed 389 times. Patterns of adenornas were analyzed by variables as age, sex, preoperative serum CEA level, location of primary colorectal cancer, Borrmann type, Duke's stage, histologic differentiation, DNA ploidy, recurrence and histology. Metachronous adenomas were detected in 79 patients(35.6%) and both metachronous and syachronous adenomas were observed in 29 cases(13.1%). High risk variables for adenomas were male, old age and presence of synchronous adenoma. There were 2 patients with maligant change of adenomas. Yearly follow-up by complete colonoscopy over 3 years or more is recommended and follow-up interval should be shortened in the high risk groups.
Adenoma* ; Appointments and Schedules ; Colon ; Colonic Neoplasms ; Colonoscopy ; Colorectal Neoplasms* ; DNA ; Follow-Up Studies ; Humans ; Male ; Ploidies ; Recurrence

This study was done to identify the reality in doing the intradermal skin test of injectional antibiotics and to serve a basis to the clinical and educational situations. For the study, the survey was done to the staff nurses who are working at one of the selected 39 hospitals in the capital area, from January 6 to Feburary 8 in 1997. The data analysis was done by mean, standard deviation, Fisher's exact test, t-test, ANOVA through running SAS computer program. The results of the study were as follows : 1.The dilution ratio of the antibiotics was mostly 1 : 10 regardless of what kind of antibitics. Making the contrast was done only for the suspended to the antibiotics. Mostly the reaction was detected after 15 to 20 minutes from its diameter of redness and wheals. Most of the respondents answered they do the intradermal skin test only once for the same antibiotics. 2. In the education on the skin test the 66.7% from the respondents had exposed to the education mostly through the new nurses orientation. The 85.4% from them answered the need of the continuous education which had a significant difference in the number of beds(p=.046). The had experiences of detecting positive reactions(98.3%), and of anaphyaxis(49.5%) which had a significant difference in experience(p=.002) and in their age groups(p=.000). 3. The average score of the confidence on the intradermal skin test was 3.32 form 4-point scale. Also it had a significant difference from the number of beds(p=.010), the year of experiences(p=.016), and their age groups(p=.046). 4. From the general characteristics of respondents, the infection methods had a significant difference in the amounts of injection, whether adopting the contrast pairing, and the repeatable skin tests for the same antibiotics. 5. Only 15 from 39 hospitals had their protocol about the intradermal skin test provided by nursing department which differs in its contents from that provided by the medical information center. From the results of the study, it is suggested that the continuous education on the intradermal skin test and its unified protocol should be provided. Also it is recommended that the drug manufacturer should notice about its anaphylactic cautions and pack its extra skin test use.
Anti-Bacterial Agents* ; Surveys and Questionnaires ; Education ; Information Centers ; Nursing ; Running ; Skin Tests* ; Skin* ; Statistics as Topic

Background & PURPOSE:Since the 1970's the rate of breast-feeding has decreased significantly. The Korean National Institute of Health reported that the rate of breastfeeding was 68.9% in 1982 and 14.1% in 1997. There are many influencing factors including: the lack of education and information on breast feeding, lack of faith in breast feeding, increment of the rate of working, lack of encouragement by supporters in difficult situations, and nurses' low level of knowledge about breast feeding. Such a lack of knowledge and support of breast-feeding at home by family members create another dilemma to the problem of breast-feeding. If problems arise and family members are unable to provide assistance due to the deficiency of knowledge, mothers show a tendency to abandon breast-feeding. The purpose of this research is to find out the rate of breast-feeding practice by time sequence of 1 week, 6 weeks and 12 weeks after birth and influencing factors on breast-feeding practice centered on the postpartal women who were 3discharged from one hospital, which is located in Seoul and provides simple breast-feeding education and continuous postnatal telephone consultation. Methodology: The subjects of this research were 54 women who gave birth in a hospital located in Seoul from 1 March 2000 to 31 April 2000. After birth the subjects were educated individually about breast-feeding and telephone consultations were conducted. On the 1st week, 6th week, and 12th week, the subjects were surveyed about their breast-feeding practice rates and methods by telephone. Results: 1) Complete breast-feeding rate: Within one week after birth, the subjects showed 64.2% complete breast-feeding rate. Within 6 weeks, 39.6%, and 12 weeks, 34.1%. 2)Partial breast-feeding rate: Within one week after birth, the subjects showed 32.1% partial breast-feeding rate. Within 6 weeks, 39.6%, and 12 weeks 15.1%. 3)Complete bottle-feeding rate Within one week after birth, the subjects showed 1.9% complete bottle-feeding rate. Within 6 weeks of giving birth 15.1%, and 12 weeks 17.0%. These results show that individual education about breast-feeding and continuous postnatal telephone consultation influenced on the practice of breast-feeding. On considering the reality of the hospital situation in which nurses could not operate education program due to the work-load, it is necessary to find out selectively those mothers who are unable to breast feed and provide education individually and continuous support by telephone follow up. Futhermore, the active role of lactation nurse specialist and their efficient management of breast-feeding for the successful practice is required.
Breast ; Breast Feeding ; Education* ; Female ; Follow-Up Studies* ; Humans ; Lactation ; Mothers ; Parturition ; Referral and Consultation ; Seoul ; Specialization ; Telephone*

No abstract available.
Humans

Tuberculosis of the duodenum is rare event in patients with pulmonary or intestinal tuberculoais. It is very difficult to diagnose duodenal tuberculosis because of inconaiatent symptoms and nonspecific duodenal lesioa. Although fiberoptic endoscopy has been used, there is the limitation of fiberoptic endoscopy ia diagnosingthis disease and the diagnoais require laparotomy with biopsy. Recently we experienced a case of duodenal tuberculosis with duodenoscopic findings of the submucosal tumor of duaidenum. We report a case with review of literatures.
Biopsy ; Duodenum* ; Endoscopy ; Humans ; Laparotomy ; Tuberculosis*

OBJECTIVE: To evaluate the effect of IL-10 on development of collagen-induced arthritis, on humoral and cellular immunity and on the endogenous production of IL-10 in DBA/1J mice. METHODS: DBA/1J mice were immunized with chicken type II collagen in Freund s complete adjuvant. Murine recombinant IL-10 was given intraperitoneally twice a week from the day of second immunization (week 3) in doses of 0.002ug, 0. 02ug and 0. 2ug for 3 different groups, respectively. Dexamethasone was injected in one group to suppress the arthritis development and this group was used as negative control group. Levels of anti-collagen antibodies, serum IL-10 and stimulation indices of splenic monocytes to collagen were measured at the end of study. RESULTS: The 0. 02ug IL-10 and 0. 2ug IL-10 treated groups developed earlier and more severe arthritis (week 6 and 8) compared to that of the control group while the 0. 002ug IL-10 group has shown similar course to the control group in terms of incidence and severity of arthritis, At week 10, all groups with or without IL-10 injections developed arthritis with similar degree of severity while dexamethasone group showed far less incidence and severity of arthritis. The serum levels of anti-collagen antibody, IL-10 and spleen monocyte stimulation indices to collagen antigen showed no difference among control group, IL-10 injected groups and dexamethasone injected group. CONCLUSION: This study shows IL-10 could worsen the arthritis in CIA with the dosage used in this study without significant influence on the level of anti-collagen antibodies or stimulation indices of spenic monocyte to collagen.
Animals ; Antibodies ; Arthritis ; Arthritis, Experimental* ; Chickens ; Collagen ; Collagen Type II ; Dexamethasone ; Immunity, Cellular ; Immunization ; Incidence ; Interleukin-10* ; Mice ; Monocytes ; Spleen

Acute arterial occlusion of the extremity may result from obstruction of an artery by embolism or by thrombosis in situ. This results in the sudden cessation of blood flow to an extremity. So immediate managements are required to prevent propagation of the clot and to restore blood flow to the ischemic extremity promptly. We report a case of a acute arterial occlusion which was developed during prolonged fasting. A 59-year-old male was transferred due to severe ischemic pain, coldness and loss of pulse in left lower extremity during fast. The arteriogram shows a complete obstruction of external iliac artery and non-visualization of femoral artery and popliteotibial artery in the left lower extremity. Selective intra-arterial urokinase thrombolytic therapy and percutaneous transluminal angioplasty resulted in recannulation of obstructed artery and relief of symptoms.
Angioplasty ; Arteries ; Embolism ; Extremities ; Fasting* ; Femoral Artery ; Humans ; Iliac Artery ; Lower Extremity* ; Male ; Middle Aged ; Thrombolytic Therapy ; Thrombosis ; Urokinase-Type Plasminogen Activator

PURPOSE: Ginseng has been reported to reduce blood glucose levels in diabetic animals and patients, and it is also reported to slow the aging process by acting as an anti-atherosclerotic agent or as an anti-oxidant. This study was designed to investigate whether ginseng and irbesartan can prevent the development of diabetic nephropathy in streptozotocin-induced diabetic rats. METHODS: Diabetes was induced in 7 week-old male Sprague-Dawley rats by intravenous injection of 60 mg/kg streptozotocin. Ginseng(1 g/kg/day) or irbesartan (20 mg/kg/day) was given to diabetic rats for 25 weeks. Blood glucose and body weight were checked weekly and urinary albumin excretion was evaluated every 6 weeks. At the end of the experiment, the kidneys were weighed and sliced for microscopic examination. Glomerular size and hyaline deposition were measured on light microscopy(on Masson' trichrome stain and PAS stain) and thickness of glomerular basement membrane(GBM) on electron microscopy. Renal histologic findings of ginseng or irbesartan treated rats were compared with those of normal control and diabetic control groups. RESULTS: The weight gain in diabetic rats was significantly reduced, and the final body weight of diabetic rats was lower than that of normal control rats. There was no significant difference in body weights between the diabetic control, ginseng, and irbesartan treated groups. Mean levels of blood glucose were significantly increased in diabetic rats compared to normal rats, but there was no significant difference in blood glucose among the three groups of diabetic rats. Urinary albumin excretion was increased in the diabetic groups compared to the normal control group, and it was significantly decreased in the irbesartan treated group compared to the diabetic control group at 13th week of treatment. At the end of the experiment, the kindeys of the diabetic rats were examined and showed significantly enlarged than those of the normal rats, and the ratio of kidney weight to body weight was decreased in the ginseng treated group compared to the diabetic control and irbesartan treated group. There was no significant difference in the size of glomerulus, the thickness of GBM, and glomerular hyaline deposition among the three diabetic groups. CONCLUSION: There was no significant hypoglycemic effect of ginseng in streptozotocin-induced diabetic rats. Renal hypertrophy was relatively milder in the ginseng-treated group, but there was no difference in findings of renal histology between the treatment groups.
Aging ; Animals ; Blood Glucose ; Body Weight ; Diabetic Nephropathies* ; Humans ; Hyalin ; Hypertrophy ; Hypoglycemic Agents ; Injections, Intravenous ; Kidney ; Male ; Microscopy, Electron ; Panax* ; Rats ; Rats, Sprague-Dawley ; Streptozocin ; Weight Gain

PURPOSE: The purpose of this study was to explore the experiences of young adults with hypertension, using phenomenology in order to describe the essence of such experiences and to understand them from the patients' point of view. METHODS: Participants in this study were 4 hypertension patients with ages ranging from 20 to 35 years old, living in Seoul city. Data were collected from in-depth interviews done from October to November in 2005. Colazzi method(1978) was used to analyze the data. RESULTS: The 12 themes were extracted in this study ; 'Discovery by accident', 'Denial of the diagnosis', 'A disease unworthy of the young men', 'Guilty feeling toward their parents', 'Fear of death', 'Unconvinced reason', 'Worry about the future', 'Attribute all symptoms to the disease', 'Will of not life-long medication', 'Concern for fertility problem', 'Not convinced with current treatment method', 'Becoming unimportant'. CONCLUSION: The results of this study show that the young adult with hypertension will be in a high risk group of non compliance, so helpful program for them should be developed and the nurses need to pay more attention to the psychosocial aspect of nursing.
Adult ; Compliance ; Fertility ; Humans ; Hypertension* ; Nursing ; Qualitative Research ; Seoul ; Young Adult*