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.

No abstract available.
Bronchiolitis* ; Humans

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

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*

The ultimate goal of periodontal therapy is directed to arresting the progression of the disease, and regenerating the fibrous attachment. In order to achieve such treatment aim, the plaque and calculus must be eliminated and the physiological conditions of the root surface must be changed to facilitate the attachment and migration of the new fibroblasts, The method of changing the proper root surface conditions to promote the healing of periodontal tissue involves mechanical procedures, such as scaling and root planing, and chemical procedures such as tetracycline-HCl. However, the formation of a long junctional epithelium was most frequently observed type of healing. Thus, the aim of this study was to examine in vitro the influence of surface conditioning of dentin by TC-HCl on human gingival epithelial cell attachment. Human gingival epithelial cells were obtained from healthy retromolar pad area(under the age 23 years). Seventy two teeth extracted from severe periodontitis were used as study material. To evaluate the epithelial cell attachment to dentin, the prepared specimen was divided to four groups. For the control group, only scaling and root planing were carried out, and for the test group, 1 to 3, the concentration of the TC-HCl was 50, 125 and 250mg/ml, respectively. After cell cultivation time of 1-, 3-. 24 hour, for the indirect quantitative assessment of gingival epithelial cell attached to dentin sample, the absorbance of epithelial cell unattached to dentin was measured. The results were as follows; 1. There was no statistically significant difference between scaling and root planing group and TC-HCl 50mg/ ml, 125mg/ml and 250mg/ml group about absorbance of unattached epithelial cell to dentin sample(p>0.5). 2. As time passes, the absorbance of unattached gingival epithelial cell to dentin sample was decreased statistically significant(p<0.05). 3. There was no statistically significant difference among the TC-HCl group(p>0.05) We concluded that there was similar effect on gingival epithelial cell attachment between TC-HCl conditioning on root surface and only scaling and root planing treatment
Calculi ; Dentin ; Epithelial Attachment ; Epithelial Cells* ; Fibroblasts ; Humans ; Periodontitis ; Root Planing ; Tooth

PURPOSE: The aim of this study was to determine whether differences exist in the presentation, clinical course, and outcome of Graves' disease between prepubertal children and adolescents. METHODS: A retrospective chart review of 14 prepubertal(PREPUB, 7.2+/-0.9 yr) and 38 pubertal (PUB, 12.4+/-1.5 yr) children with Graves' disease between January 1989 and November 1995 at St. Mary's Hospital and Kangnam St. Mary's Hospital was undertaken. RESULTS: There were no significant differences in T3, T4, TSH between two the groups at diagnosis. The PUB group had significantly higher titers of antimicrosomal antibody(positive dilution factor 11,727.3+/-22,888.4) than did the PREPUB group(2,111.5+/-2,285.0, P<0.001). The PREPUB group had significantly higher titers of TSH-binding inhibitory immunoglobulin(TBII, 62.5+/-39.6) than did the PUB group(44.9+/-10.4, P<0.05) before treatment started. The duration(months) of medical therapy before thyroid function tests were normalized was longer in the PREPUB group than in the PUB group(T3: 6.8+/-5.0 vs. 5.4+/-13.2, T4: 2.3+/-1.9 vs. 2.1+/-2.2, TBII: 26.7+/-24.0 vs. 20.8+/-12.1), especially that of TSH was significantly longer in the PREPUB group(14.6+/-11.0 vs. 6.8+/-7.8, P< 0.05). Total length of medical therapy was significantly longer in the PREPUB group than the PUB group(52.3+/-19.3 vs. 37.9+/-16.3 months, P<0.01). During three years of antithyroid drug therapy, in the PREPUB group, the remission rate was lower and the relapse rate was higher than in the PUB group. Total length of treatment correlated negatively with chronological age(P=0.03). CONCLUSION: Prepubertal children require longer medical therapy to achieve a remission than do pubertal children. But there is an obvious need for more studies because of the small number of patients and the short duration of the follow-up.
Child ; Adolescent ; Male ; Female ; Humans