A Case of Primary Hyperparathyroidism Caused by Solitary Parathyroid Adenoma That was Not Detected by Both Ultrasonography and Sestamibi Scan

Thanks to advances in assay techniques and routine measurements in serum chemical analysis, primary hyperparathyroidism has become far more frequently detected, and the number of asymptomatic patients has substantially increased. In the majority of patients (85%), a solitary adenoma is the underlying cause of primary hyperparathyroidism. Surgical excision is the treatment of choice for most cases of primary hyperparathyroidism; this procedure has a relatively high success rate. In the past decade, improvements in preoperative imaging have played a major role in a targeted operative approach, which allows for minimally invasive surgery to be performed. The success of parathyroid surgery depends on the accurate preoperative localization of parathyroid adenoma. In this study, we report the case of a 54 year-old woman with primary hyperparathyroidism who presented with left buttock and leg pain. For localization of the parathyroid lesion, an ultrasonography and a 99mTc-sestamibi scan were initially performed, but these attempts failed to localize the lesion. We then carried out contrast-enhanced CT; thereafter, a single parathyroid adenoma was detected. Therefore, in patients with negative results on both ultrasonography and 99mTc-sestamibi scan, contrast-enhanced CT may prove helpful for preoperative parathyroid localization.

The effect of bisphenol A on cell apoptosis pattern in the spinal cord of chick embryos / 대한주산의학회잡지

OBJECTIVE: To investigate the effects of bisphenol A (BPA) on cell death pattern in neuronal development of chick embryos. MATERIALS AND METHODS: We planned to compare the cytokinetic features in the normal chick embryo and those with BPA. Fifteen eggs were divided into three GROUPS: the control group, BPA 50 microgram/g egg group and BPA 200 microgram/g egg group. Embryos were incubated for 56 hours (Hamburger & Hamilton stage 16) and then we injected BPA into embryos. The embryos were sectioned by 3 micrometer thickness at the level of wing buds and stained at 72 hours after incubation (HH stage 18). We observed cell death in the spinal cord using terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL) method. RESULTS: The TUNEL-positivity markedly increased in proportion to the doses of BPA. The number of TUNEL-positive cells per section was 15.2+/-2.14 in the control group, 34.6+/-3.44 in the BPA 50 microgram/g egg group, 87.6+/-4.32 in the BPA 200 g/g egg group. Furthermore the contour of spinal cord was deformed as the doses of BPA raised. CONCLUSION: BPA causes neuronal cell death and exerts cytotoxic effect on early chick embryos. It suggests that BPA might have an effect on cytogenesis during neural tube development.

A study on biocompatability of resin cements for all-ceramic crown / 대한치과보철학회지

STATEMENT OF PROBLEM: Resin cements were used widely on all ceramic crowns, but the influence of resin cements on biocells was not understood clearly. PURPOSE: This study was investigated to evaluate the biocompatibility of resin cements for allceramic crowns. MATERIAL AND METHOD: The resin cements used in this study were Panavia F (Kuraray Co., Ltd. Japan), Variolink II (Vivadent Ets., Schann / Liechtenstein), and Bistite II(Bistite dual cure resin cement-clear, Tokuyama Soda Co., Japan). The viability of normal human oral keratocytes, gingival fibroblast, and gingival fibroblast immortalized by Human Papilloma virus 16 was measured in vitro for evaluation of cytotoxicity on resin cements, and the response of pulp tissue was analyzed and evaluated with light microscope after application of cements at cutting edge of incisors. RESULTS: The normal human oral keratocytes was the most sensitive to toxicity of resin cement, and toxicity of cements was higher in Bistite II than in Variolink II. The cell viability of immortalized gingival fibroblast did not affected by type of cement and cultivation period, but there was a tendency that cytotoxicity in Bistite II was higher than in Variolink II. The cell viability of gingival fibroblast was similar to that of immortalized gingival fibroblast regardless of cement type, but Bistite II showed more toxic than others after 5 days cultivation. The responses of pulp tissue according to cement type were similar after 2 days cultivation, but revealed high toxicity in Bistite II after 10 days cultivation. CONCLUSION: Variolink II was more biocompatible than any other resin cements used in this study.

The Study On The Color Stability Of Composite Resin / 대한치과보철학회지

The purpose of this study was to investigate the color stability of composite resins used widely as esthetic restorative material.Surefil(Dentsply,U.S.A.),Esthet X(Dentsply,U.S.A.),Filtek P60(3M,U.S.A.),Filtek Z250(3M,U.S.A.),Synergy Compact(Coltene,Switzerland),and Synergy Duo(Coltene,Switzerland)were chosen for this study.Thirty six specimens(7mm x2mm) of each composite resin were fabricated and polished after polymerization.Treatment conditions designed for this study were thermocycling,methylene blue staining,and filtered coffee staining. The color changes before and after treatment were measured by colorimeter(colorimeter,Model Tc-6Fx,Tokyo Denshoku Co.)and analyzed. The followings were drawn from this study: 1.The color changes of Filtek Z250,Surefil,Filtek P60 and Esthet X after thermocycling for 3 weeks were greater than those of the others. 2.The color changes of Surefil and Esthet X after methylene blue staining and those of Surefil, Filtek Z250 and Filtek P60 after coffee staining were great. 3.The color changes of Synergy Duo and Synergy Compact after thermocycling and coffee staining were relatively lesser than those of other composite resins.

Birth Defects Monitoring Systems Utilizing Public and Private Medical Resources in Incheon / 대한산부인과학회잡지

OBJECTIVE: To discover the etiology of birth defects and low birth weight, it is necessary to establish epidemiological birth defects monitoring system in Korea. Our aim was to develop new practical model in Incheon to establish birth defects monitoring system to evaluate the incidence rate and patterns of birth defects in Korea. METHODS: Public health center and private hospitals and clinics participated in this monitoring system. Web based reporting system have been built. Trained nurses actively collected the records obtained from delivery units in the participating hospitals during 2 years (first year: December 1st, 1998-November. 31, 1999; second year: January 1 st, 2000-December 31 th, 2000). RESULTS: Through this monitoring system at 1 st year and 2 nd year, we observed 25 birth defect cases from 2482 births, 28 birth defect cases from 3490 births including live births and stillbirths. The incidence of birth defect per thousand person was 10.1, 8.0 respectively. At 1st year, the highest proportion of birth defects was 28.0% in musculoskeletal system. The proportion of birth defects in gastrointestinal system, cardiovascular system and cleft lip & cleft palate were 20.0%, 12.0%. 12.0%. At 2 nd year, the highest proportion of birth defects was 21.4% in gastrointestinal system The proportion of birth defects in cardiovascular system and musculoskeletal system were 17.9% and 14.3%. CONCLUION: In conclusion, we could build population-based monitoring system for birth defects successfully in Yonsu gu, Incheon. To establish population-based monitoring system for birth defects in Korea, it is necessary to organize the reporters of public health center and private hospitals and clinics, to build an available reporting system, and to extend participating centers for birth defects monitoring systems.

Clinical Analysis of Atypical Glandular Cells of Undetermined Significance (AGUS) on Pap Smear according to Menopausal Status / 대한산부인과학회잡지

OBJECTIVE: To evaluate the clinical significance of AGUS including histologic results and diagnostic modalities according to menopausal status. METHODS: One hundred and four patients with AGUS were identified. Corresponding biopsies were available for 87 of these cases. The evaluation for histologic results and diagnostic modalities was made according to menopausal status. RESULTS: Among the 87 patients with AGUS, the number of premenopausal and menopausal patients were 46 (52.9%) and 41 (47.1%), respectively. Over all, 70 (80.5%) of 87 patients were found to have important histologic findings and of them, premenopausal and menopausal patients with invasive diseases were 19 (41.3%) and 31 (75.6%) respectively. There were significant differences in pathologic findings between premenopausal and menopausal patients indicating more invasive lesions in menopausal than premenopausal patients (p=0.002). For the evaluation of diagnostic modality, the second arm was significantly more needed for menopausal than premenopausal patients (p=0.018). CONCLUSION: AGUS on pap smear represents a cytologic diagnosis associated with high incidence of underlying preinvasive and invasive lesions, especially in postmenopausal patients. Thus aggressive work-up is recommended to rule out the potential pathologic conditions in endocervix, endometrium and rarely extrauterine lesions such as gastrointestinal, tubal, ovarian or breast in patients otherwise unexplained AGUS after careful first arm work-up.

STRESS ANALYSIS OF ABUTMENT FOR DISTAL EXTENSION REMOVABLE PARTIAL DENTURE BY CLASP DESIGN AND IMPRESSION METHOD / 대한치과보철학회지

This study was performed to investigate the effects of impression method and design of the retainer on the stress of abutment tooth in distal extension RPD. Three different types of direct retainer such as Akers clasp. RPI clasp, and wrought wire clasp were designed . Stress on the abutment tooth was measured and analyzed with strain gauge method. Impressions were anatomic impression technique and functional impression technique. The following conclusions were drawn from this syudy. 1.The stress at the abutment tooth on all RPD was decreased in functional impression except RPI clasp retained RPD. 2.The stress at the abutment tooth on RPI clasp retained RPD was the most smallest in anatomic impression 3.While load is increase the stress at the abutment tooth was increased, but the change of stress at the buccal side of abutment tooth was not too much in functional impression.

Establishing Web-Based Birth Defects Monitoring Systems in Incheon / 대한의료정보학회지

Problems of birth defects and low birth weight are important issues of public health because most infant mortality are caused by these two. To discover the etiology of birth defects and low birth weight, it is necessary to establish epidemiological birth defects monitoring system in Korea. With the rapid growing of internet usage in korea, the computer network has become the popular means of communicating and sharing of information. Our aim was to develop web-based reporting and database management system in Incheon to establish birth defects monitoring system to evaluate the incidence rate and patterns of birth defects in Korea. Public health center and private hospitals and clinics participated in this monitoring system. Web based reporting system have been built and operated during 2 years (first year: December 1st, 1998-November. 31, 1999; second year: January 1st, 2000 - December 31th, 2000). Trained nurses actively collected the records obtained from delivery units in the participating hospitals. During first and second year, the incidence rate of birth defect per thousand person was 10.0 and 8.0 respectively. In conclusion, we could build web-based monitoring system for birth defects successfully in Yonsu gu, Incheon. It could be a model of national standard for population-based monitoring system for birth defects in Korea.

Staining Resistance of The Soft Denture Liners / 대한치과보철학회지

This study was investigated to compare the staining resistance of soft denture liners. Specimens wee made of Coe-soft. Coe-Comfort, Soft-liner, Visco-gel, and were stored in 1% methyleneblue solution for 24 hours. The amounts of color change before and after treatment with mono-poly and thermocycling were measured by colorimeter(TC-6FX, Tokyo Denshoku Co. Ltd, Japan) for evaluation of staining resistance. The following conclusions were drawn from this study. 1. The staining resistance of Visco-gel was increased, but there was no changer of staining resistance in Coe-soft, Coe-comfort, and Soft-liner after treatment with monopoly. 2. The staining resistance of the Coe-comfort was the least in all soft denture liners. 3. The staining resistance of Visco-gel and Soft-liner were decreased after thermocycling.

A Clinical Study of Nulliparous Women Aged 40 Years and Older / 대한주산의학회잡지

OBJECTIVE: Our purpose was to compare the pregnancy outcomes of nulliparous women aged 40 years and older with those of nulliparous women under 35 years of age. METHODS: From January 1989 to December 1998 total 57,563 deliveries were seen in Gachon Gil Medical Center. Among them we experienced 59 cases of nulliparas at 40 years and older. These women were compared with 188 young nulliparas under 35 years of age as the control group. The statistical analysis was performed using Chi-square tests, and statistical significance was defined as p<0.05. RESULTS: The incidence rate of elderly nulliparas aged 40 years and older was increased from 0.04% in 1989 to 0.30% in 1998. The age distribution was from 40 years to 45 years. The gravidity of eldery nulliparas was 2.2 in comparison with 1.6 in control group. The incidence of uterine myoma, gestational DM, IUGR and oligohydramnios was significantly high rate in elderly nulliparas. There was significantly high rate of cesarean section in elderly nulliparas(88.1%) in comparison with control group(40.4%). The reasons of cesarean section were her demand(39.0%), CPD(15.3%) and breech presentation(13.6%) in decreasing order. The preterm delivery rate was 10.2% in elderly nulliparas in comparison with 4.3% in the control group. Placenta accreta and uterine atony were significantly high in elderly nulliparas and mean estimated blood loss was also high. There was no difference in 5-minute Apgar score between both group, but there were more cases of neonatal intensive care unit admission in neonates of elderly nulliparas(6.8% vs 0%). CONCLUSION: The incidence of elderly nulliparas is continuously increasing. The elderly nulliparas and their babies are at greater risk than young women. Therefore all elderly nulliparas aged 40 years and older can be regarded as high risk patients and they must be managed with careful attention.

Clinical and Radiological Analysis of THR Using AML Prosthesis / 대한정형외과학회잡지

We had replaced 159 hips in 130 patients with cementless porous-coated AML porsthesis at Kwang Ju Christian Hospital between April 1987 and Feb. 1992. Among them, 100 cases(80 patients) could be analyzed clinically and radiologically with an average follow-up of 38.5 months(range 10 months to 74 months). The purpose of this study was to evaluate the relationships of initial fit, follow up stability and clinical results. The results were as follows. 1. The average postoperative Harris hip score was 90 points(preop. 42) at the follow-up of 1 year or more, the pain score 41 points(preop. 15). 2. When the surgical fit of stem was achieved properly, fixation by bone ingrowth could be expected. Simultaneously adequate fit of acetabular cup provided stable fixation. 3. The incidence of thigh pain was high in patients with an unstable implant of stem and the hip pain was more common in group of a definitely unstable cup. 4. Stress shielding was seen in 44 cases(44%). Of the 44 cases, 38 cases(86%) revealed in bone ingrowth. In conclusion, this study showed good clinical result of THR using AML prosthesis at the average follow-up of 38.5 months and it seemed to be influenced by initial fit significantly. But long-term follow-up is needed for accurate clinical and radiological evaluation.

A case of congenital hypertrophic pyloric stenosis in two siblings

Congenital hypertrophic pyloric stenosis is the most common intra-abdominal disease required surgery during the first few months of life. The expression of pyloric stenosis is dependent upon the genetic influence of ancestors affected with the disease, as well as unknown environmental influences in the postnatal period. Pyloric stenosis has been reported in multiple sibs in a family, which suggests the genetic influence on the expression of this disease. Until now, the genetic influence is thought a sex-modified polygenic or multifactorial background which facilitates the expression of a common dominant gene. We experienced a case of congenital hypertrophic pyloric stenosis in a two siblings. The siblings suffered projectile vomiting for 2~4 days at 16 days old of age and 15 days old of age. After we confirmed the diagnosis by upper gastrointestinal series and abdominal sonogram, the Fredet-Ramstedt pyloromyotomy was done successfully. This case suggests the genetic influence on the expression of this disease.

A Case of Kasabach-Merritt Syndrome

No abstract available.