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Endocrine Function and Growth in Children with Craniopharyngioma (소아 두개인두종 환자에서 치료 전후의 뇌하수체 기능과 성장 및 체중 변화)

  • Chung, Yoo Mi;Shin, Choong Ho;Yang, Sei Won
    • Clinical and Experimental Pediatrics
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    • v.46 no.3
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    • pp.277-283
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    • 2003
  • Purpose : Craniopharyngiomas are often accompanied by severe endocrine disorders. Although there is universal growth hormone deficiency(GHD), the resulting growth pattern is very heterogeneous. We report the growth and endocrine outcome of 44 children with craniopharyngioma, with emphasis on initial symptoms, growth before and during growth hormone(GH) treatment and spontaneous growth in spite of GHD. Methods : We performed a retrospective study of 44 children treated at our centre between 1984 and 2002. Results : About 30% of patients had symptoms suggesting endocrine disorder at diagnosis. After surgery, multiple endocrinopathies were almost universal. Before GH therapy, height velocity was $8.00{\pm}2.71cm/yr$ in the normal growth group(n=11) and $1.79{\pm}1.10cm/yr$ in the subnormal growth group(n=7) during the first year and during the second year, $6.76{\pm}2.49cm/yr$ and $2.29{\pm}1.33cm/yr$, respectively. There was no difference of body mass index(BMI) change between before and after surgery in the two groups. Height standard deviation score(SDS) was $-1.46{\pm}0.74$ in the normal growth group and $-0.43{\pm}0.97$ in the subnormal growth group. Before GH treatment height SDS was $-1.31{\pm}1.25$ and BMI was $20.46{\pm}3.60$. During GH treatment, height SDS increased to $-0.60{\pm}1.37$ in the first, and to $-0.41{\pm}1.54$ in the second year(P<0.05), but BMI did not change significantly. Conclusion : The endocrine morbidity could develop in most children with craniopharyngioma before and after the operation and should be managed properly. Although all treated patients benefit from GH therapy, further studies are necessary to find out the possible mechanism of growth regulation in normally growing children, despite GH deficient.

Measurement of Bone mineral density According to Middle aged Women with Low Back Pain (중년여성의 요통에 따른 골밀도 측정)

  • Kang, Jeom-Deok;Kim, Jong-Bong
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.7 no.1
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    • pp.5-28
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    • 2001
  • Objectives: The objective of this study was to investigate analysis of bone mineral density according to Women with low back pain women. Methods: The data were collected from women who visited Physical Examination Center of a Catholic university hospital located in Daegu. Questionnaires were completed by 50 women during the period from July 20, 2000 to January 12, 2001. The sample was divided into three groups(the normal group of 16 cases and the osteopenia group of 12cases and the osteoporosis group of 22 cases). Bone mineral density(BMD) of lumbar spine was measured using energy absorptiometry. Results: The bone mineral density of the lumbar spine decreased with aging. The bone mineral density of the lumbar spine decreased with the serum Calcium and Phosphorus and Alkaline phosphatase increased. The mean bone mineral density of the lumbar spine of healthy women in age(50~59) was 0.87g/$cm^2$, the lumbar spine of women with low back pain in age(50~59) was 0.77g/$cm^2$. In the multiple regression of risk factors to bone mineral density(BMD) of lumbar spine were correlated with age, marriage existence, exercise time, the loving food of taste, calcium, bone mineral density standard T scores(p<0.05). The experience for LBP increased as weight increased(Odds ratio=999.000). The experience for LBP increased as number of Exercise decreased(Odds ratio=999.000). The experience for LBP increased as menopause existence increased(Odds ratio=999.000). The experience for LBP increased as serum Calcium and Phosphorus increased (Odds ratio=999.000). however all four variables had significant no relationship. The correlation in variables in relation to low back pain and bone mineral density, age showed contra-correlation with low back pain existence, Alkaline phosphatase(p<0.01). Weight showed contra-correlation with body mass index(BMI)(p<0.01). Exercise time showed correlation with number of exercise(p<0.01). The loving food of taste showed contra-correlation with Alkaline phosphatase(p<0.05). Bone mineral density showed correlation with menopause existence(p<0.05). Conclusions: Results from this study indicated that a statistically significant association between bone mineral density of the lumbar spin and age, marriage existence, exercise time, the loving food of taste, calcium, bone mineral density standard T scores. In logistic regression test, there were no related variables. The combination of bone mineral density measurement and assessment of the bone turnover rate by measuring biochemical would be helpful for the treatment of patients with risks of osteoporosis. The more precise study for risk factors to osteoporosis is essential.

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Effects on School Lunch Service Programme of Elementary School in Rural Area (농촌지역(農村地域) 국민학교(國民學校) 급식아동(給食兒童)과 성장발달(成長發達)과 식생활(食生活) 습관(習慣))

  • Park, Jin Wook;Lee, Sung Kook
    • Journal of the Korean Society of School Health
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    • v.5 no.2
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    • pp.74-90
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    • 1992
  • The purpose of this study is to know the effects on school lunch service programme of elementary school in rural area, by using the group consisting of the sixth year students in the schools that have provided them with the lunch for six years or longer(male student:312, & female student:324), while using the comparing group consisting of the sixth year students in the schools that have not provided them with the school lunch under their similar living condition(male student: 306 & female student:322). In addition, this study was carried out by examining all continued information about their height and weight shown in the developmetal record for six years from the 1st to 6th year, and by checking their eating habits on the basis of questionnaires. The result of this study is summarized as follows. As the result of comparing the values of their height and weight grown for 6 years, it was shown that the height of the male group provided with school lunch is 27.8 cm while the male group without lunch is 27.1 cm. And the female group provided with school lunch indicated the growing value of 29.9 cm while the group without lunch did 28.4 cm. Then, it appeared that both male and female groups provided with school lunch show higher growing values of 0.7 cm, respectively, and 1.5 cm than these groups without lunch. Also, the weight of the group without lunch was 14.8 kg. Moreover, the weight of the female group provided with school lunch was 16.9 kg while the group without lunch was 17.2 kg. Then, it was shown that the male group provided with school lunch indicates heavier growing value of 0.9 kg than the group without lunch while the female group without lunch does heavier value of 0.3 kg than the group provided with school lunch. It's figure showed that although this distribution according to percentile in the 1st year is similar to the standard regular curve it is positioned in the upper group(more thatn 70%) divided centering around 50% in the 6th year, of which distribution of children provided with school lunch was higher. When comparing the values of physical status in the 6th year, it was also shown that male children with school lunch are better than these children without lunch in jumping, throwing, chinning and lifting while female children are better than these children without lunch only in jumping, which were a significant difference. In addition, the group provided with lunch showed distribution of the higher physical grade. The result of analysis on their breakfast indicated that the children with every morning breakfast account for 67.6% of the group provided with school lunch while the group without lunch for 57.8%. Regarding the reason that they do not have the breakfast, the group with school lunch answered "Because of habits"(50.7%) while the group without lunch did "Because they have no appetite"(58.9%). When comparing the degree of preference for hot or salty food, it was apparent that these children with school lunch generally tend to prefer less hot or sailty food. With respect to the frequency and place of their eating between meals, it was shown that about 70.0% of both groups has the eating between meals, more than one time a day. Then, the group with school lunch had the eating between meals at home(45.2%) while the group without lunch did it in the process of returning to home(48.4%). Regarding the degree of their preference for a certain food, it was shown that more children of the group with school lunch do not prefer a food to others. Also, their eating attitude indicated that such children as eating the food with chat after completely swallowing food and with T.V watching are larger and lower among the group with school lunch, which showed a remarkable defference from the group without lunch. With respect to their sanitary habits such as hand washing and toothing, these children who always wash their hand before eating, accounted for 84.4 % of the group provided with school lunch while the group without lunch did for 63.6%, of which the female group with school lunch indicated a remarkable difference. The actual condition of their nutrition education showed that these children who answered "Received this education" accounted for 78.0% of the group with school lunch while the group without lunch accounted for 57.5%.

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Case report: Full mouth rehabilitation for patient with heavy occlusal force and excessive abrasion (강한 교합력과 과도한 마모를 보이는 환자의 전악수복 증례)

  • Park, Ji-Hee;Vang, Mong-Sook;Yang, Hong-So;Park, Sang-Won;Yun, Kwi-Dug;Lim, Hyun-Pil
    • The Journal of Korean Academy of Prosthodontics
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    • v.51 no.2
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    • pp.119-124
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    • 2013
  • Many of the patients with extensive abrasion need comprehensive restorative treatment. The abrasion is usually caused by attrition, besides of it, there are many reasons for it. The plan of treatment should be started on assessment of the type of attrition and the etiologic analysis. Patient with well-developed masticatory muscle, alveolar process, and high occlusal force and also with little muscle length difference between the stable and the contracted state should be carefully assessed for the vertical dimensional loss and the restoration should be carefully designed. Decrease of tooth length can be compensated by the growth of the alveolar bone height; therefore, consistency of the occlusal vertical dimension is maintained. Accordingly, a careless increase of the vertical dimension can produce muscle fatigue, depressed tooth and pain, and fracture of the restoration. In this case, the patient with multiple tooth abrasion and clenching habit, the edentulous maxillary area is restored with amalgam inserted RPD, and the dentulous area of the maxilla and mandible are treated with fixed restoration accompanying with the increase of vertical dimension. Consequently, we are going to report about the satisfying result in both functional and esthetic aspects.

Simultaneous Maxillo-Mandibular Distraction Osteogenesis in Hemifacial Microsomia: a Case Report (상하악에 동시 다발성 골신장술을 이용한 반안면왜소증의 치험례)

  • Kim, Il-Kyu;Park, Jong-Won;Lee, Eon-Hwa;Yang, Jung-Eun;Chang, Jae-Won;Pyun, Yeong-Hun;Ju, Sang-Hyun;Wang, Boon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.32 no.5
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    • pp.447-453
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    • 2010
  • The hemifacial microsomia is characterized by variable underdevelopment of the craniofacial skeleton, external ear, and facial soft tissues. So, patients with hemifacial microsomia have an occlusal plane canting and malocclusion with facial asymmetry. Distraction osteogenesis (DO) with an intraoral or extraoral device is a technique using tension to generate new bone with gradual bone movement and remodeling. DO has especially been used to correct craniofacial deformities such as a hemifacial microsomia, facial asymmetry, and mandible defect that could not adequately be treated by conventional reconstruction with osteotomies. It has a significant advantage to lengthen soft and hard tissue of underdeveloped site without bone graft and a few complication such as nerve injury or muscle contracture. A 13-years old girl visited our clinic for the chief complaint of facial asymmetry. She had a left hypoplastic maxilla and mandible, occlusal plane canting and malocclusion. We diagnosed hemifacial microsomia and lanned DO to lengthen the affected side. Le Fort I osteotomy, left mandibular ramus and symphysis osteotomy were performed. The internal distraction devices fixed with screw on maxillary and mandibular ramus osteotomy sites. External devices were adapted to lower jaw for DO on symphysis osteotomy site and to upper jaw for rapid maxillary expansion (RME). At 7days after surgery, distraction was started at the rate of 1mm per day for 13days, and after 4months consolidation periods, distraction devices were removed. Simultaneous multiple maxillo-mandibular distraction osteogenesis with RME resulted in a satisfactory success in correcting facial asymmetry as well as occlusal plane canting for our hemifacial microsomia.

Spermatogenesis of the Spiny Top Shell, Batillus cornutus (Lightfoot, 1786) (Gastropoda: Turbinidae) (소라, Batillus cornutus의 정자형성과정)

  • Jung, Gui-Kwon;Park, Jung-Jun;Lee, Jae-Woo;Lee, Jung-Sick
    • Development and Reproduction
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    • v.11 no.2
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    • pp.97-104
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    • 2007
  • This study describes the spermatogenesis and sperm ultrastructure of the spiny top shell, Batillus cornutus using light and electron microscopy. The spiny top shells were collected by divers in the coastal water of Wandogun, Cheollanamdo, Korea(N $34^{\circ}13'$, E $126^{\circ}47'$) at May 2003. Spiny top shells of $60.0{\sim}69.9\;mm$ in shell height were used in this study. The testis comprises many spermatogenic follicles which contains germ cells in different developmental stages. The primary spermatocytes in the pachytene stage were characterized by synaptonemal complexes. The early spermatids were characterized by appearance of Golgi complex, increased karyoplasmic electron density and tubular mitochondria. In early spermatid the mass of proacrosomal granules consists of numerous heterogeneous granules with high electron density. From the mid-stage of spermiogenesis the well-developed mitochondria aggregate posterior to the nucleus, and surround the proximal and distal centrioles. In this stage, proacrosomal granules are condensed and form a acrosome with thin envelope. During the late spermiogenesis, the acrosome begins to elongate and then became conical. The sperm consists of head, mid-piece and tail. The head comprises a round nucleus and a conical acrosome. Acrosomal rod of microfibrous is observed between nucleus and acrosome. Five mitochondria observed in mid-piece. And tail has the typical "9+2" microtubular system originates from the centrioles.

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VERTICAL DISTRACTION OSTEOGENESIS FOR IMPLANT INSTALLATION ON THE RECONSTRUCTED MANDIBLE WITH FREE FIBULAR FLAP (하악골 재건시 사용된 유리비골피판에서 임플란트 식립을 위한 수직적 골신장술)

  • Paeng, Jun-Young;Lee, Jin-Yong;Myoung, Hoon;Hwang, Soon-Jung;Seo, Byoung-Moo;Choi, Jin-Young;Lee, Jong-Ho;Choung, Pill-Hoon;Kim, Myung-Jin
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.28 no.6
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    • pp.579-585
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    • 2006
  • Introduction: The fibular free flap is now considered as the first choice for long mandibular discontinuity defect. In spite of its good bone quality for implant installation, its diameter is too narrow to rehabilitate the masticatory function with implant installation. In this report, distraction osteogenesis was used for the augmentation of bone to install the dental implant in the mandible which was reconstructed with a vascularized fibular free flap. Patients and Methods: Three patients undertook the vertical augmentation of grafted fibular bone and dental implants were installed. On the day 8 post-surgery, the activation of the distractor was started at the rate of 1 mm twice a day. The total amount of distraction was 15 mm in two patients and 12.5 mm in one patient. Twelve implants were installed in three patients. Dental implants were simultaneously installed during removal of the distraction device in two patients. In one patient, the implant installation was delayed after device had been removed. All three patients showed the symptoms of mild to severe postoperative infection during the activation and consolidation. However, the distracted site showed undisturbed bone regeneration. Conclusion: The distraction osteogenesis showed the reliable results for the vertical augmentation of fibular bone which was used for the mandibular reconstruction. However, the great tendency of postoperative infection must be considered and clinically controlled.

The Study on Correlations of Risser Sign with the Chronological Age, Bone Age, Menarche, and Adult Height Prediction according to TW3 Method (Risser 증후와 역연령, 골연령, 초경 시기 및 성인 예측신장 (AHP-TW3)과의 관계)

  • Koo, Eun Jin;Lee, Jin Hwa;Kim, Yun Hee
    • The Journal of Pediatrics of Korean Medicine
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    • v.31 no.4
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    • pp.31-38
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    • 2017
  • Objectives The purpose of this study was to find out the clinically reliable relationships between the Risser sign and chronological age, bone age, menarche, and adult height prediction (AHP) and to evidence the reliability of the Risser sign. Methods This study had been carried out with 50 children who had their growth checked in an oriental medical hospital from January 2015 to February 2017. We investigated Risser sign in AP X-rays with iliac crest, bone age, AHP for all 50 children and the timing of menarche from the 22 girls in the study subjects. We also investigated a correlation between the Risser stage and the other indicators to analyze statistical data. Results The mean chronological ages of Risser 1, 2, 3 and 4 were 11.2, 12.6, 14.4, and 15.5 years respectively for the boys and 10.8, 12.2, 13.8 and 14.8 years respectively for the girls. The mean bone ages of Risser 1, 2, 3 and 4 were 12.3, 13.6, 15.7 and 16.5 years respectively for the boys and 11.7, 13.8, 14.3 and 14.9 years respectively for the girls. We analyzed 22 girls' Risser stages in accordance with the duration from menarche. The result showed that in the first six months after menarche, all girls were in Risser 1 and 2; in the next six months, the girls were in Risser 2 on average; in the next 12 months, all girls were in Risser 3 and 4; after more than two years from menarche, all girls were in Risser 4. The mean remaining growth height of Risser 1, 2, 3 and 4 were 27.8, 17.3, 4.4 and 1.0 cm respectively for the boys and 14.5, 5.1, 3.1 and 1.1 cm respectively for the girls. The Risser stage was correlated strongly with chronological age (Spearman's rho=0.707 (boy), 0.841 (girl)), bone age (Spearman's rho=0.869 (boy), 0.875 (girl)), duration from menarche (Spearman's rho=0.909) and remaining growth height (Spearman's rho=-0.784 (boy), -0.878 (girl)). Conclusions This study showed that the Risser sign can be useful in assessing skeletal maturity and predicting remaining growth height based on the Risser stage and the other growth indicators.

IMPLANT INSTALLATION USING VERTICAL DISTRACTION OSTEOGENESIS AT A SEVERELY ATROPHIED EDENTULOUS MANDIBLE (심하게 위축된 하악골의 완전 무치악 환자에서의 수직 골신장술을 이용한 임플란트 치료)

  • Yeom, Hak-Ryol;Jeon, Seung-Ho;Kim, Yoon-Tae;Paeng, Jun-Young;Ahn, Kang-Min;Myung, Hoon;Hwang, Soon-Jung;Seo, Byoung-Moo;Choi, Jin-Young;Lee, Jong-Ho;Choung, Pill-Hoon;Kim, Myung-Jin
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.28 no.2
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    • pp.154-165
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    • 2006
  • Objectives : It is difficult to place implants at a severely atrophied edentulous mandible because of vertical and horizontal alveolar defect. The autogenous and allogenic bone graft and guided bone regeneration are useful, but there are some limitations such as the resorption and infection of the grafted bone, and insufficiency of soft tissue. Distraction osteogenesis has recently evolved a challenging technique to overcome major draws of conventional augmentation procedures, we, therefore, report the four applications of implant placement after vertical alveolar distraction osteogenesis. Patients and Methods : Four patients(all female, mean age: $60{\pm}6$ years) with severe alveolar ridge deficiencies at their anterior mandible were treated with vertical alveolar distraction osteogenesis by intraoral device(Track 1.5, 15 mm model, KLS Martin, Tuttlingen, Germany) and placement of implants (Branemark MK III, TiUnite). After the latency periods of 5, 7, 8 days, distraction rhythm and rate were $0.5\;mm{\times}2\;times/day$ in the case of good bone quality, and $0.25\;mm{\times}3\;times/day$ in the case of poor bone quality. After consolidation periods of mean fifteen weeks, five implants for each patients were placed at the interforaminal area. Results : On average, a vertical gain of $11.38{\pm}1.38\;mm$ was obtained by distraction. And all distraction zone showed complete ossification by panoramic radiography. There were no postoperative complications other than numbness of lower lip in one case. Total twenty implants in four patients were placed and their outcomes were satisfactory. Conclusion : It is a useful method to place five implants after vertical distraction osteogenesis of the severely atrophied mandible for the implant-supported fixed prosthesis.

Effects of Ethanol and Dietary Protein Levels on Calcium and Phosphorus Metabolism in Rats (알콜과 단백질수준이 흰쥐의 칼슘 및 인의 대사에 미치는 영향)

  • Koh, Jin-Bog;Han, Jae-Kum
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.18 no.2
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    • pp.229-237
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    • 1989
  • The effects of ethanol and dietary protein levels on the calcium and phosphorus metabolism were investigated in 15-week-old male rats. Rats were divided into 4 groups ; control group(16% protein, 16 PC) and 8%(8 PE), 16%(16 PE), and 24% protein groups (24 PE) to which was given 5% ethanol mixed with their drinking water. Body weigh gain, organ weight, hemoglobin content, and hematocrit value were not affected by either ethanol or dietary protein levels. Calcium concentrations in spleen were significantly decreased in the ethanol groups than those in control group. Calcium and Phosphorus levels in femur, serum, liver, kidney, and muscle were normal. Among ethanol treated groups, fecal excretions of calcium were a little more decreased, but urinary excretions, balances and apparent absorption rate of calcium were a little more increased in higher percentage of protein group than lower percentage. Urinary phosphorus excretions in the ethanol treated groups were significantly decreased compared with the control group. Among ethanol treated groups, phosphorus balance and apparent phosphorus absorption rate of 24 PE group were significantly higher than those of 8 PE and 16 PE groups.

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