PURPOSE:Cardiovascular morbidity has recently been demonstrated to potentially reduce life expectancy in growth hormone deficiency(GHD). The aim of this study was to evaluate cardiovascular abnormalities and atherosclerotic changes in adults with childhood-onset GHD in whom GH treatment had been stopped at the achievement of final height. METHODS:Nine patients with childhood-onset GHD(7 idiopathic and 2 organic), with an age of 24.0+/-.0 year, were studied. Clinical characteristics of subjects were determined and blood pressure, body mass index(BMI), and serum concentrations of lipids were measured. Structural and functional evaluation of cardiovascular system was performed by M-mode echocardiography and linear phase array imaging transducer. RESULTS:BMI of patients was 27.3+/-.7 mg/m2, and four patients(44%) were overweight(BMI 25-30 mg/m2), but none was obese(BMI >30 mg/m2). The percentage of patients who had total cholesterol > or = 200 mg/dL, triglyceride > or = 150 mg/dL, LDL cholesterol > or = 140 mg/dL, and HDL cholesterol < or = 40 mg/dL were 56%, 44%, 33 %, and 44%, respectively. Interventricular septum thickness(IVST), left ventricular posterior wall thickness(LVPWT), left ventricular end-diastolic internal diameter (LVID), left ventricular mass index(LVMI) of patients were 6.4+/-2.1 mm(SDS -1.5+/-1.1), 6.3+/-1.2 mm(SDS -2.1+/-0.8), 44.9+/-4.3 mm(SDS -1.0+/-0.9), and 85.4+/-94.8 g/m2 (SDS -0.5+/-6.8), respectively. The number of patients whose IVST, LVPWT, LVID, and LVMI were decreased(<-2SD) were 4(44%), 5(56%), 1(11%), and 6(67%), respectively. Carotid artery intima-media thickness(IMT) was 0.86+/-0.22 mm, and it was increased(>2SD) in 3 patients(33%). Three out of four patients with IVST lower than -2SD had increased carotid artery IMT, whereas none of five patients with IVST higher than -2SD had increased carotid artery IMT. There were no differences in echocardiographic findings between groups according to sex, age, duration of disease, duration after GH discontinuation, BMI, and severity of dyslipidemia. CONCLUSION: Decreases in IVST, LVPWT, and LVMI, and an increase in carotid artery IMT were observed in a significant number of patients with childhood-onset GHD. These findings support the need of GH replacement after completion of growth and careful evaluation of cardiovascular changes in patients with childhood-onset GHD.
Adult* ; Blood Pressure ; Cardiovascular Abnormalities* ; Cardiovascular System ; Carotid Arteries ; Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Dyslipidemias ; Echocardiography ; Growth Hormone* ; Humans ; Life Expectancy ; Transducers ; Triglycerides

PURPOSE:Improved adult final height(FH) is a major goal in the treatment of children with short stature due to growth hormone deficiency(GHD). The purpose of this study was to evaluate final height in idiopathic and organic GHD children after long-term growth hormone(GH) treatment. METHODS:Twenty five(16 males and 9 females) patients with GHD(14 idiopathic and 11 organic GHD) were included. GHD was diagnosed by two or more GH provocation tests(peak GH level <10 ng/mL). All subjects had multiple pituitary hormone deficiencies, and aged 10.7+/-.5(5.5-14) years at the start of GH treatment. The patients were treated with GH 0.45-0.7 IU/kg/week in 3-7 divided doses for 6.9+/-.8(5.2-10) years. Treatment was ended when growth velocity reached lower than 2 cm/year and/or bone age reached 16 years. Standard auxologic measurements were performed at the start of GH treatment and at every 6 month after initial GH treatment. RESULTS:FH was 166.9+/-.8 cm, which was not significantly lower than target height(167.1+/-.9 cm) and predicted adult height(169.1+/-5 cm). FH SDS was significantly improved to -0.8+/-.5 compared with -3.4+/-.0 of height SDS at the start of GH treatment. The largest height increment was observed in the first year of GH treatment, with a gradual decrease in the following years. There was no difference in FH and FH SDS between idiopathic and organic GHD. Unwanted serious adverse events were not observed in all patients during GH therapy. CONCLUSION: Early diagnosis and continuous treatment with optimal doses of GH to near adult height improve the outcome in children with short stature due to idiopathic and organic GHD.
Adult ; Child* ; Early Diagnosis ; Growth Hormone* ; Humans ; Male

No abstract available.
Child* ; Humans ; Joints* ; Tuberculosis, Osteoarticular*

The word "Delayed" in the legend of Figure 2 should have been written as "Controls."

No abstract available.
Bronchiolitis* ; Humans

No abstract available.

BACKGROUND: Careful manipulation of hair grafts is essential for a good yield of transplanted hair. OBJECTIVE: The aim of this study was to evaluate some of the factors responsible for poor graft yield, such as dehydration of the graft and the temperature and duration of preservation. METHODS: First, for the dehydration study, isolated single hair follicles were left on dry gauze for 0, 5, 10, 20, and 30 minutes at room temperature. Secondly, to evaluate the effect of preservation temperature and time on the hair graft, follicles were preserved in saline for 5 minutes as a control, then for 6, 24, and 48 hours both at room temperature and at 4℃, respectively. Viability of preserved follicles was judged based on organ culture. RESULTS: Elongation of hair folliciles was seen in 96%, 94%, 94%, 83%, and 68% for 0-, 5-, 10-, 20-, and 30-minute air-exposed groups, respectively. Survival was seen in 95%, 92%, 40% and 34% at room temperature and 96%, 94%, 76% and 50% at 4℃ for follicles preserved in saline for 5 min (control), then for 6, 24, and 48 hours, respectively. CONCLUSION: We suggest that, alone with careful manipulation of hair units, high survival can be achieved with the avoidance of graft dehydration and preservation of the grafts at low temperatures if the operation time extends for more than 6 hours.
Dehydration* ; Hair Follicle ; Hair* ; Organ Culture Techniques ; Transplants*

PURPOSE: The aim of this study was to examine the sensitivity and specificity of the influenza rapid antigen test, in comparison with reverse transcription polymerase chain reaction (RT-PCR), according to the time of the test from symptom onset and the clinical manifestations in the patients tested for suspected infection of the influenza A (H1N1) at a second hospital. METHODS: A total of 529 pediatric patients, aged between 6 and 12 years old, who visited the emergency department from October 1, 2009 to December 31, 2009, received the influenza rapid antigen test and RT-PCR. We examined the sensitivity and specificity of the influenza rapid antigen test in comparison with RT-PCR according to the time of the test from symptom onset (<24 hours, 24 to 48 hours, 48 to 72 hours, >72 hours) and clinical manifestations (fever, cough, rhinorrhea.nasal obstruction, sore throat, gastrointestinal symptoms, and general symptoms) in a retrospective study based on hospital charts. RESULTS: The sensitivity of the influenza rapid antigen test at elapsed times of less than 24 hours, 24 to 48 hours, and 48 to 72 hours after the onset of the symptoms was 53.9%, 61.4%, and 62.1% respectively. When the elapse time was greater than 72 hours, the sensitivity was 31.6%; thus, the sensitivity of the influenza rapid antigen test tended to decrease with elapsed time. The sensitivity of the test was 79% in patients presenting with gastrointestinal symptoms, which was the highest, but there was no statistical difference according to the clinical manifestations of the patients. CONCLUSION: Our study suggests that more accurate results might be gained when the influenza rapid antigen test is performed within 72 hours after symptom onset.
Aged ; Child ; Cough ; Emergencies ; Humans ; Influenza, Human ; Pharyngitis ; Polymerase Chain Reaction ; Retrospective Studies ; Reverse Transcription ; Sensitivity and Specificity

The purpose of this study was to evaluate the effect of stroke on hypothalamic-pituitary axis using dexamethasone suppression test. The effects were evaluated according to age, sex, type, size, and lesion site of stroke. There tests were performed in 62 patients with stroke(cerebral infarction, 42 cases : intracerebral hemorrage, 20 cases) and 21 disabled controlled patients without intracranial diseases at Yeungnam University Hospital from June 1992 to June 1993. The results summarized as follows. 1. Cerebral infarction showed significantly higher frequency of DST non-suppression in stroke patients than control (p<0.05). 2. Patients with left hemisphere stroke showed more frequent abnormal neuroendocrine test results (p<0.01). 3. Patients with large infarction revealed strongly non-suppressed DST results(p<0.01). 4. Significantly higher basal cortisol level in patients with cerebral infarction was noted(p<0.01). 5. There are no statistical significance between DST results and sex, age, motor impairment, type of cerebral infarction.
Cerebral Infarction ; Dexamethasone* ; Humans ; Hydrocortisone ; Infarction ; Stroke*

PURPOSE: Bronchial asthma is a disorder that is characteized by symptoms of reversible airway obstruction and increased responsiveness of the bronchus and to quantify the degree of br onchial hyperresponsivenes can be very helpful in determing the severity of disease and the prognosis. But the Methacholine provocation test is not always easy to be performed in all patients. Thus we designed this trial to know the relationship between the degree of bronchial hype rresponsiveness by Methacholine and the severity of asthma symptoms, pulmonary function te st and atopic findings. METHODS: Methacholine provocation test was performed on 60 clinically stable asthma patients who visited the pediatric allergy clinic of Taegu Fatima Hospital from July, 1992 to June, 1 993. All patients were free of URI for at least 6 weeks and medications were withhold for 2 weeks for corticosteroid or beta receptor agonist and at least 2 days for theophylline. All subjects ha d FEV1 more than 70% of predicted value, and more than 20% of reversible obstruction. Disease severity score(DSS) was compared by the number of asthmatic attacts, clinical picture, therapeutic medications and the Airway reactivity score(ARS) was measured on the number of nonspecipic irritants provoking the bronchial hyperresponsivess. Methacholine provocation test was performed as follows; Normal saline was inhaled 5 times by tidal breath through De Vilbiss 646 inhaler and FEV1 was measured as baseline. According to Chai standardized method, Mathacholine was diluted to 0.075-25mg/ml concentration and inhaled 5 times and accumulated Methacholine was graded 0.375-225.0 Breath Units(One BU = 1 inhalation of 1 mg/ml). PD20 was determined to the concentration at which the FEV1 faIled to 20% below the baseline. RESULTS: 1) PD20 were distributed variably between 0.375 BU and 225.0 BU 2) Bronchial hyperresponsiveness was high on asthma with allergic rhinitis(p<0.05). 3) Bronchial hyperresponsiveness by Methacholine provocation test had significant correlation both DSS(r= -0.473; p<0.01) and ARS(r= -0.32; p<0.05). 4) Bronchial hyperresponsiveness by Methacholine provocation test had significant correlation to baseline FEV1/FVC ratio(r= -0.63; p<0.01). 5) Bronchial hyperresponsiveness by Methacholine provocation test had no statistical significant correlation to serum IgE value(r= -0.24; p<0.05). CONCLUSIONS: The severity of bronchial hyperresponsiveness by Methacholine provocation t est had significant correlation with DSS and ARS, and there was a close relation BHR to the baseline FEV1/FVC1 ratio too. Thus exact history about clinical pictures, medications, provocating irritants in asthmatic patients and baseline FEV1/FVC ratio can be very helpful in assessing the bronchial hyperresponsiveness.
Airway Obstruction ; Asthma* ; Bronchi ; Daegu ; Humans ; Hypersensitivity ; Immunoglobulin E ; Inhalation ; Irritants ; Methacholine Chloride* ; Nebulizers and Vaporizers ; Prognosis ; Respiratory Function Tests ; Theophylline