No abstract available.
Child* ; Humans ; Peak Expiratory Flow Rate*

PURPOSE: Most children who have been treated for craniopharyngioma eventually develop multiple pituitary hormone deficiencies as well as growth hormone deficiency(GHD). However, some of them may grow normally or even have accelerated growth velocity despite GHD postoperatively. This study was undertaken to evaluate several factors influencing change in growth velocity after surgery for craniopharyngioma in patients with GHD. METHODS: Fifteen patients operated on for craniopharyngioma had a pharmacological assessment of hypothalamic-pituitary function and at least two standard GH provocation tests. All patients had multiple pituitary hormone deficiencies including GHD after surgery. Patients were classified in two groups according to their growth rate during the first postoperative year. Group 1 consisted of 6 children with normal growth velocity or more than 2 standard deviation score(SDS) above the normal mean, and group 2 consisted of 9 children with decreased growth velocity more than 2 SDS below the normal mean. RESULTS: Height velocity was 8.3+/-.2 cm/year in group 1 and 2.8+/-.3 cm/year in group 2 during the first year. During the second year, height velocity was 4.4+/-.3 cm/year and 3.3+/-.4 cm/year, respectively. Body mass index(BMI) change between before and after surgery was 0.83+/-.4 kg/m2 in group 1 and 0.03+/-.3 kg/m2 in group 2 but there was no difference between both groups. However, BMI changes was correlated positively with height SDS change for 1 year following surgery in 15 patients(P<0.05, r=0.601). Prolactin levels before surgery were not significant difference between group 1 and group 2. However, there was a significant positive correlation between prolactin levels before surgery and height SDS change(P<0.01, r=0.671). Postoperative IGF-1 levels were low in all patients except one, who showed decreased growth rate. CONCLUSION: In this study, there were no significant differences in height velocity, BMI, prolactin, and IGF-1 levels between normal growth group and growth failure group after surgery. Further studies are needed to find out any other growth promoting factors related to growth without growth hormone.
Child* ; Craniopharyngioma* ; Growth Hormone* ; Humans ; Insulin ; Insulin-Like Growth Factor I ; Obesity ; Prolactin

No abstract available.
Humans ; Outpatients* ; Silicon Dioxide*

PURPOSE: This study was undertaken to identify the frequencies and the risk factors of microvascular complications in subjects with type 1 diabetes mellitus METHODS: The frequencies and their relation to risk factors of microvascular complications were analyzed in 29 type 1 diabetes mellitus subjects with duration of disease more than 5 years. Microvascular disease was defined as the presence of either retinopathy, microalbuminuria or neuropathy. RESULTS: The overall prevalence rate of microvascular disease was 8/29(27.6%). Retinopathy has developed in 3 patients(10.3%), microalbuminuria in 7 patients(24.0 %) and neuropathy in 5 patients(17.2%). The mean HbA1C was significantly higher in the patients with microvascular complications(11.6+/-.2% in microvascular complication group vs 9.3+/-.6% in control group). CONCLUSION: In childhood onset type 1 diabetes mellitus, poor glycemic control is an important risk factor for microvascular complications.
Diabetes Mellitus, Type 1* ; Humans ; Prevalence ; Risk Factors*

PURPOSE: The purpose of this study was to evaluate clinical manifestation, etiology and prognosis of hypocalcemic infants who were admitted with seizure. METHODS: We reviewed medical records of 32 infants admitted at the Asan Medical Center with hypocalcemic seizure retrospectively. We classified patients into vitamin D deficiency group(n=7, 21.9%), transient hypoparathyroidism group(n=4, 12.5%), relative hypoparathyroidism with hyperphosphatemia group(n=16, 50%), and others(n=5, 15.6%) according to the laboratory results. RESULTS: Of the 32 patients, 29 patients were improved. There were no differences in gestational age and birth weight among the three groups. In the vitamin D deficiency group, age of onset was later than those of the transient hypoparathyroidism group and relative hypoparathyroidism with hyperphosphatemia group(51.6+/-2.7 vs 8.3+/-.5, 8.2+/-.6 days). In the age when all laboratory results were normalized, transient hypoparathyroidism group was younger than those of vitamin D deficiency group and relative hypoparathyroidism group(33.2+/-4.6 vs 93.6+/-8.5, 77.1+/-2.4 days). In the total treatment period, relative hypoparathyroidism with hyperphosphatemia group was longer than those of vitamin D deficiency group and transient hypoparathyroidism group(68.9+/-3.5 vs 42.0+/-5.0, 25.0+/-4.3 days). Others included two 22q11.2 deletion syndrome patients, a congenital hypoparathyroidism, a pseudohypoparathyroidism, and an early neonatal hypocalcemia. CONCLUSION: Transient hypoparathyroidism and hyperphosphatemia were major causes of neonatal hypocalcemia. And high calcitonin and peripheral organ resistance to parathyroid hormone act on hypocalcemia. In infants after one month, vitamin D deficiency was also an important cause of hypocalcemia. Most of the patients were improved within 1-2 months after proper management, but relative hypoparathyroidism with hyperphosphatemia group needed longer treatment. So, it is necessary to perform a systematic study for several complex causes that explain above fact.
Birth Weight ; Calcitonin ; Chungcheongnam-do ; DiGeorge Syndrome ; Gestational Age ; Humans ; Hyperphosphatemia ; Hypocalcemia ; Hypoparathyroidism ; Infant* ; Medical Records ; Parathyroid Hormone ; Prognosis ; Pseudohypoparathyroidism ; Retrospective Studies ; Seizures ; Vitamin D Deficiency

PURPOSE: This study was undertaken to determine whether the clinical presentation of patients with central precocius puberty(CPP) varies according to the etiology, whether this permits the differentiation between idiopathic and organic forms and to examine whether LH determination in a single timed blood sample after GnRH administration is sufficient to diagnose CPP. METHODS: This study included 33 girls with signs of breast development, of whom 23 were diagnosed as definite central precocious puberty. Sixteen patients had idiopathic CPP; the remaining 7 patients had organic CPP. Ten patients were classified as non-CPP. Potential clinical and laboratory predictors of CNS abnormalities were assessed and GnRH stimulation test was done. RESULTS: The age of onset in patients with organic CPP was 4.11+/-2.08 years, whereas the age in patients with idiopathic CPP was 7.25+/-1.34 years. This parameter is the only one showing statistical significance. We compared sensitivities and specificities at 0, 15, 30, 60, 90 and 120 min which yielded sensitivities of 8.7%, 87.0%, 91.3%, 87.0%, 73.9%, 60.9%. CONCLUSION: It is impossible to exclude a central nervous system lesion in patient with central precocious puberty without performing central nervous system imaging. However, this study indicates earlier the onset of disease, higher the possibility of presence of CNS lesion. According to the mean GnRH stimulated LH levels and sensitivity at each times, a single blood sample obtained for LH determined after GnRH administration at 30 min can be used to diagnose the central precocious puberty.
Age of Onset ; Breast ; Central Nervous System* ; Female ; Gonadotropin-Releasing Hormone* ; Humans ; Luteinizing Hormone ; Puberty, Precocious*

Cytomegalovirus retinopathy(CMV)is a necrotizing retinitis which can occur as a late manifestation of the Acquired immunodeficiency syndromde(AIDS), which rapidly increases in number after original description of the disease in 1981 by Gottliebet al. We experienced a patient, who complained of decreased visual acuity of the left eye only we initially diagnosed the patient as CMV retinitis, and during the course of treatment, finally diagnosed the patient as CMV retinitis with AIDS, and the patient was subdivided into Group IV, Subgroup C by center for disease control classification system To our knowledge, for about 10% of the patient of the CMV retinopathy, AIDS was diagnosed like same manner as we did, but we couldn't find any report in korea, so we report this case with a review of literatures.
Centers for Disease Control and Prevention (U.S.) ; Classification ; Cytomegalovirus Retinitis ; Cytomegalovirus* ; Ganciclovir ; Humans ; Korea ; Retinitis ; Visual Acuity

The purpose of this study was to investigate the effect that three resin indexing materials had on the distortion of split cast in the procedures of solder indexing and block fabrication. The specimen had two cylinders and connecting bar. Two cylinders were a reference cylinder and a test cylinder that were machined precisely and placed on metal base. The total of specimens wee 30 and they were divided into 3 groups according to the resin indexing materials : Acrylic solder , G-C Pattern resin , Z-100 . The relative coordinates (X, Y, Z) of centroids of both cylinders were measured by using 3-D coor dinates measuring machine. The value of indexing distortion was obtained after application of indexing material, and the value of the block distortion was obtained after fabrication of soldering block, and the value of total distortion was a value sum of indexing distortion and block distortion. Intercentroidal linear distortion({{{{ SQRT {X'^2 + Y'^2 +Z'^2 }- SQRT {X^2 + Y^2 +Z^2} }} }}) and global distortion {{{{rm SQRT {(X'-X)^2 +(Y'-Y^)2 +(Z'-Z^)2} }} }} were calculated from data of coordinates of centroids at each mea s u r ing stages. The results of this study were as belows ; 1. The intercentroidal distance between the split casts was reduced by indexing distortion and increased by block distortion. 2. The indexing global distortion between the split casts was smaller than block global distortion. 3. The intercentoidal linear distortion and the global distortion were no significant difference between indexing materials.
Abstracting and Indexing as Topic

Although the ultrasonography has been regarded as a important procedure in the diagnosis of intraabdominalabscess, there were relatively few papers concerning the ultrasonographic findings of periappendiceal abscess.Nineteen cases of surgically proven periappendiceal abscess caused by perforated appendicitis were studied byultrasonography at the Kyung Hee University Hospital during last 34 months. The results were as follows; 1.Diagnostic accuracy of the real-time ultrasonography was 94.7%(18/19). There were only one false positive and onefalse negative. 2. The location of abscesses were ; periappendiceal 68.4%(13/19), pelvic 21.0%(4/19), subhepatic5.3%(1/19) and subphrenic 5.3%(1/19) in order of frequency. 3. Variable echo-patterns of abscesses wereencountered. But irregular, thick walled, posteriorly reinforcing, echo-free or mixed echo-patterns were mostcommon.
Abscess ; Appendicitis ; Diagnosis ; Ultrasonography

One of the serious and challenging problems confronting orthopaedic surgeons is an open un-united fracture of tibia. Especially, there are some difficulties in getting bone union on the condition of combining soft tissue defect with infection. In the management of infected un-united fracture of tibia with significant soft tissue loss we attempted a two-stage reconstruction : the first stage consisted of radical sequestrectomy, soft tissue reconstruction, and external fixation, and the 2nd stage consisted of various types of bone grafting and bone fixation. Fifteen patients with open infected un-united fractures of tibia treated with staged reconstruction from September 1982 to August 1987 at Department of Orthopaedic Surgery, Dae-Jeon's St. Mary's Hospital, Catholic University Medical College, were analyzed in clinical aspects and the results of treatment obtained were as follows : 1. Satisfactory bone union was obtained in an average of 6 months after bone graft with a range of 4 months to 12 months. 2. The duration from the injury to bone union was 13 months on an average with a range of 8 months to 19 months. 3. The soft tissue rer.onstruction at the first stage were performed with local flap in 11 cases and muscular flap in 2 cases and musculocuteneous flap in 2 cases. 4. The time interval between 1st stage and 2nd stage was from 1.5 months to 3 months. 5. At the 2nd stage, bone graft were performed with autogenous cancellous bone graft in 11 cases, vascularized osteocutaneous fibular graft in 2 cases and ipsilateral vascularized fibular transference in 2 cases. In summary, a two-stage reconstruction for open infected un-united fracture of tibia is a advisable procedure that leads to bone union with satisfactory return of function.
Bone Transplantation ; Fractures, Open ; Humans ; Surgeons ; Tibia ; Transplants ; United Nations