Duodenal gastrointestinal stromal tumors (GISTs) are uncommon and a relatively small subset of GISTs whose optimal surgical procedure has not been well defined. Because submucosal spread and local lymph node involvement is infrequent in GISTs, wide margins with routine lymph node dissection may not be required. Various techniques of limited resection for duodenal GISTs have been described depending on the site and the size of the tumors. In this study, we report two cases of GIST involving the third and fourth portion of the duodenum successfully treated by segmental duodenectomy with end-to-end duodenojejunostomy. This technique should be considered as a treatment option for GIST located at the third and fourth portion of the duodenum.
Duodenum ; Gastrointestinal Stromal Tumors ; Lymph Node Excision ; Lymph Nodes

No abstract available.
Facial Nerve*

PURPOSE:There were many controversies whether constitutional delay of growth and puberty(CDGP) is simple varient of normal growth pattern, or one of the cause of growth disturbance induced by the disturbance of growth hormone secrtion or its function. So we studied about the difference in serum peak growth hormone level after insulin, L-dopa provocation test, and serum IGF-I leve between constitutional delay of growth and puberty(CDGP) and familial short stature(FSS). METHODS:Measurement of serum peak growth hormone and insulin like growth factor-I(IGF-I) level after insulin, L-dopa provocation test were performed in 33 children with costitutional delay of growth and puberty (CDGP). Two groups of children with familial short stature (FSS) whose height were below 10 percentile for chronologic age of Korean national height standards were included as control groups. RESULTS: 1)There were no significant difference of serum peak growth hormone level between children with CDGP and children with FSS and these results were similar in both sex. 2)The mean serum IGF-I level of children with CDGP were 125.69+/-4.06 ng/ml(71.53-189.34ng/ml) in male, 157.7+/-3.17ng/ml(81.9-279.2ng/ml) in female. Both results were significantly lower to those of FSS children by chronologic age group because the mean serum IGF-I level of FSS children were 190.19+/-7.97ng/ml (87.64-297.6ng/ml) in male, 205.47+/-15.87ng/ml(61.7-433.1ng/ml) in female. But compared to FSS children by bone age of 72-96 months, there were no significant difference noted because the mean serum IGF-I level of children with FSSwere130.47+/-0.27ng/ml(63.24-198.2ng/ml)inmale,162.35+/-9.43ng/ml(54.9-217.53 ng/ml) in female. CONCLUSIONS:The results of this study showed that the serum peak growth hormone level after insulin, L-dopa provocation test with children of CDGP revealed no significant difference with those of FSS children in both sex. Serum IGF-I level of CDGP children was lower significantly to those of FSS children by chronologic age group, but no much difference with FSS children of bone age group.
Adolescent ; Child* ; Female ; Growth Hormone* ; Humans ; Insulin* ; Insulin-Like Growth Factor I ; Levodopa* ; Male ; Puberty*

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

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

PURPOSE:This study was performed to investigate the status of cardiac structure and function and to assess their alterations after growth hormone(GH) treatment in children with growth hormone deficiency(GHD). METHODS:Interventricular septal thickness and left ventriclular posterior wall thickness, ejection fraction(EF), fractional shortening(FS), systolic time interval(STI) of left ventricle were measured by two-dimensional and M-mode echocardiography in sixteen children with GHD and age, sex matched sixteen children with GH normal short stature as control. The measure were done before GH treatment and at 6 and 12 months of GH treatment, respectively. RESULTS: 1)Left ventricular posterior wall thickness in GHD group was significantly thinner than that of control group(P<0.05). 2)Interventricular septal thickness and left ventricular posterior wall thickness were increased with GH treatment from 10.4+/-1.7mm, 8.1+/-1.8mm before GH treatment to 11.0+/-0.9mm, 8.7+/-0.7mm and 11.2+/-1.7mm, 9.7+/-1.8mm at 6 and 12 months of GH treatment, respectively. The increment of left ventricular posterior wall thickness after 12 months GH treatment revealed statistic significance(P<0.05). 3)There was no significant alterations of EF, FS, STI of left ventricle after GH treatment at 6 months and 12 months, respectively. CONCLUSION: Left ventricular posterior wall thickness in GHD group was significantly thin compared to that of control group(P<0.05). GH treatment in GHD children for 12 months, resulted statistically significant increase(P<0.05) in posterior wall thickness. There is no evidence of hypertrophic cardiomyopathy after GH treatment. But we could not exclude the possibility of these alterations were induced by an increased overall body size and body surface area after GH treatment. To clarify the exact alterations of cardiac structures and function in children with GHD after GH treatment, long term follow-up studies should be necessary.
Body Size ; Body Surface Area ; Cardiomyopathy, Hypertrophic ; Child* ; Echocardiography ; Follow-Up Studies ; Growth Hormone* ; Heart ; Heart Ventricles ; Humans

To investigate the correlation between urinary growth hormone(GH) level and peak serum GH level, urinary GH value measured by overnight collection of urine for 10 hours and serum GH value in response to GH provocation test using insulin and L-dopa were measured in 9 cases of GH complete deficiency(GCD), 19 cases of GH partial deficiency(GPD) and 40 cases of GH normal short stature(GHN). Urinary GH values were measured by the EIA method using PICOIA HGH plate(Joo Woo Pharmaceutical Co., Japan). Urinary GH was expressed in terms of nanograms per gm creatinine(ng/gCr). Serum GH was measured by immunoradiometric assay using "Daiichi kit"(Je Il Pharmaceutical Co., Japan). Wilcoxon ranked sum test and student's t-test were used to assess the significance of differences between the groups of the patients. The correlation between urinary GH level and peak serum GH level was assessed by the parametric Pearson correlation test. The correlation between peak serum GH level in GH provocation test using insulin and urinary GH level measured by overnight 10 hours collection method showed statistically significant results in all the patients(Y=0.464072X +9.208044, r=0.48987, p=0.0001) and in the GH deficiency groups(GCD+GPD) (Y=0.924659X +9.2385509, r=0.80437, p=0.0001). In case of L-dopa stimulation test, urinary GH values were also positively correlated with peak serum GH level when all the patients were participated(Y=0.572988X +8.312993, r=0.58212, p=0.0001). In contrast, no correlation was found when patients were confined to GH deficiency group(GCD+GPD)(Y=0.127712X +8.3129939, r=0.08044, p=0.6841).
Dihydroxyphenylalanine ; Growth Hormone ; Humans ; Immunoradiometric Assay ; Insulin ; Levodopa ; Methods

Disc herniation is commonly thought to be disease of young and middle aged adult and the backache during adolescence and childhood frequently mislead the doctor to suspect other conditions such as epiphysitis, spondylolysis, and infection of vertebral column, etc. During the period of 1967~1977, 26 cases of juvenile disc herniation were collected at Catholic Medical College and the authors analysed these cases and the results are as follows. 1. The incidence was 3.4% of all disc herniation. 2. There was no sex predilection. 3. The clinical symptoms do not differ from that of the adult cases, but sensory disturbance and motor weakness appear less frequently. 4. Good result was obtained after the surgical removal of the involved disc. 5. The etiology of the disc herniation in childhood and adolescence is thought to be superimpositon of trauma over the preceding degenerative changes in disc.
Adolescent ; Adult ; Back Pain ; Humans ; Incidence ; Middle Aged ; Spine ; Spondylolysis

27 Colles' fracture were treated with closed reduction and percutaneous k-wire fixation under the C-arm fields, from July 1980 to September 1984 at the Department of Orthopedic Surgery of Eul Ji Hospital. The average duration of the follow up was 4.9 Months. A prospective study was made and evaluated under the subjective and objective criteria of Gartland and Werley, and the objective criteria of Scheck. The results of this study were as follows: 1. The incidence was high in 4th and 5th decade as 66. 5%, not significant between females and males, 45% of the cause of injury was falling accident. 2. In 27 cases, showed the satisfactory result about 92.6%, but, in the eomminuted intraarticular fracture group, 2(15.4%) out of 13 cases showed unsatisfactory result. 3. Better result was obtained with more secure reduction and skillful technique, in certain case, considered that the open reduction and internal fixation with k-wires would be better than percutaneous k-wire fixation. 4. In the aspect of hand motion and the concept of improved anatomical restoration and maintenance would lead to improved function, ideal method was percutaneous k-wire fixation and casting after closed reduction under the C-arm fields.
Accidental Falls ; Colles' Fracture ; Female ; Follow-Up Studies ; Hand ; Humans ; Incidence ; Intra-Articular Fractures ; Male ; Methods ; Orthopedics ; Prospective Studies

With a ordinary goniometer, we measured the range of active motion of the wrist flexion, extension, ulnar and radial deviation in 120 normal adult subjects ranging in age from 20 to 49 years old. Normal limits were determined for the male and female groups, for the age groups, and for the right and left sides, respectively. The data were compared with the axial angles in roentgenograms that described by T.E. Keats in 1966. And we have undertaken a study of the correlation between the range of motion and the axial angles. The results were as following: 1. Range of active motion (degrees±standard deviation) Rexion; 73.9 ±6.386. extension; 65.9 ±5.164 unlar deviation; 28.3 ±5.124 radial deviation; 18.6±2.556 2. Axial angles (degrees±standard deviation) P-A view;73.8±3.985 lateral view;79.7±4.777 3. Males had a smaller range of motion than female in wrist joint. 4. The right side showed a smaller range of motion than the left. 5. There were no correlations between the range of motion and the axial angles.
Adult ; Female ; Humans ; Male ; Range of Motion, Articular ; Wrist Joint ; Wrist