No abstract available.
Adolescent* ; Humans

No abstract available.
Failure to Thrive*

No abstract available.
Addison Disease*

Primary hyperparathyroidism is a rare endocrine disease in children. It involves bone and joint, urinary tract, gastrointestinal tract and cardiovascular system. The main cause of these involvement is high level of PTH in serum, resulting in hypercalcemia.An 11 years old male patient who had complained of limping gait since last 18 months, showed typical laboratory and radiological findings of primary hyperparathyroidism. At the ultrasonography, computed tomography and radionuclide scanning, a well defined mass(10 X 15mm) was found on the posterior aspect of the right thyroid lobe. The mass was confirmed histologically as adenoma of parathyroid gland. The patient was successfully treated with subtotal parathyroidectomy and temporal administration of calcium and vitamin D.We report this case of primary hyperparathyroidism with brief review of the literatures.
Adenoma ; Calcium ; Cardiovascular System ; Child ; Endocrine System Diseases ; Gait ; Gastrointestinal Tract ; Humans ; Hyperparathyroidism, Primary ; Joints ; Male ; Parathyroid Glands ; Parathyroidectomy ; Thyroid Gland ; Ultrasonography ; Urinary Tract ; Vitamins

No abstract available.
Child* ; Humans ; Lung Diseases, Interstitial*

No abstract available.

The tibial pilon fracture has been described as difficult fracture to manage. We have reviewed 23 cases of tibial pilon fractures from Mar. 1987 to Feb. 1993 at our hospital. 1. The fractures were classified into five types according to the system of Ovadia and Beals and the methods of treatment were divided into two groups; 9 cases were treated with Ilizarov device(Group I). 6 cases out of Group I were type 3, 4 and 5. Other methods were performed in 14 cases(Group II). 8 cases out of Group II were type 3, 4, and 5. 2. In type 3, 4 and 5 fractures, there were 86 per cent good and fair radiographic results in Group I and 63 per cent good and fair results in Group II. 3. Satisfactory results were obtained by the treatment of Ilizarov method especially in type 3, 4 and 5 fractures. The advantages of Ilizarov device were its primary reduction with ligamentotaxis, easy open reduction due to proximal and distal stabilization, minimal soft tissue injury and minimal internal fixation.
Ilizarov Technique ; Soft Tissue Injuries

Primary biliary cirrhosis(PBC) is a chronic cholestatic liver disease of unknown origin. The small and medium sized intrahepatic bile ducts are destroyed by an inflammatory process, which, it has been suggested, is of the autoimmune type. It is strongly associated with the presence of antimitochondrial antibodies, predominantly IgM and IgG. The liver changes are classified into four stages, of which stage IV represents the development of cirrhosis, which required orthotropic liver transplantation in the longrun. The prevalence rates was reported 128 per millon in Sweden , but the disease is relatively rare in Oriental area. In medical treatment, long-term administration of ursodeoxycholic acid improves both clinical and biochemical signs, slows the progression of the disease and reduces the complication requiring liver transplantation. We report two cases of PBC, one with histologically proven cirrhosis, and the other with bile duct destruction consistent with stage III and hypothyroidism.
Antibodies ; Bile Ducts ; Bile Ducts, Intrahepatic ; Fibrosis ; Hypothyroidism ; Immunoglobulin G ; Immunoglobulin M ; Liver ; Liver Cirrhosis, Biliary* ; Liver Diseases ; Liver Transplantation ; Prevalence ; Sweden ; Ursodeoxycholic Acid

No abstract available.
Brain Stem Infarctions*

In recent years, there has been renewed interest in preoperative methods to reduce gastric acidity, thus lessening the risk of a serious pulmonary reactions following aspiration of gastric contents. Emergency obstetrical patients frequently have large volumes of gastric fluid. It is less commonly appreciated that patients fasting prior to elective surgery afterive in operating room with large gastric fluid volumes with a low pH. Prophylactic preoperative oral administration of antacids has been shown to reduce preoperative gastric acidity in significant percentage of patients, but aspiration of antacids can be associated with pulmonary complications, and there use may be associated with increased gastric volume. Preoperative adrpinistration of glycopyrrolate may decrease the frequency of surgical patients with a low gastric pH, and it appears that the volume of gastric fluid may be reduced by medication that relax the pylorus. However, none of these pharmacologic manuevers completely abolisbes the possibility of serious pulmonary damage with aspiration. Mendelson and Teabeat demonstrated the importance of pH in the etiology of acid aspiration and it is generally accepted that the critical pH is 2. 5 or less, i.e. the risk of aerious pulmonary reaction increases progressively as the pH of the aspirate falls below 2.5. A critical volume of acid aspirate is also necessary for widespread pulmonary damage to occur irrespective of a low gastric pH. The critical volume is rhesus monkeys has been shown to be 0.4 ml/kg, but the critical volume in man is less well difined. Several investigators have determined the patient to be at risk of serious pulmonary complications with aspiration if at least 25 ml of gastric fluid with a pH of 2.5 or less is aspirated. The present study was undertaken to investigate the effects on the volume and pH of gastric juice under general anesthesia. The 35 patients were studied, and were divided. into 4 group account to the kind of premedicants, N.P.O. time, weight, and obstetric patients Gastric juice, aspirated through a Levine tube, was examined for pH and. volume under general anesthesia.
Accidental Falls ; Administration, Oral ; Anesthesia, General* ; Antacids ; Emergencies ; Fasting ; Gastric Acid ; Gastric Juice ; Glycopyrrolate ; Humans ; Hydrogen-Ion Concentration* ; Macaca mulatta ; Operating Rooms ; Pylorus ; Research Personnel