No abstract available.

BACKGROUND: Recently authentic human growth hormone(hGH) has produced in the E coli K-12, W3110 by recombinant DNA tecbnology in Korea In this paper, the clinical efficacy and immunogenicity of this GH was shdied in 38 children with growth hormone deficiency during therapy of 1 year. METHODS: The subjects of this study were aged 4.9-13.9 years, diagnosed by failure of plasma GH to respond to insulin-induced hypoglycemia, arginine and/or L-dopa loading and height below -2 standard deviation of mean for their chronological age. Each patient received GH 0.5-0.7IU/kg/week subcutaneously in 6-7 divided doses. During treatment, vital signs, height, body weight and bone age were checked every 3 months. Complete blood count, urinalysis, blood chemistry and thyroid hormone were checked before and every 6 months. The measurement of serum IGF-1 level and antibody against hGH were performed before and every 6 months during therapy of I year. RESULT: The height velocities significantly increased from 3.3 +/- 1.5cm/year to 10.1 +/- 2.5 and 9.0 +/- 1.8cm/year at 6 and 12 months of therapy, respectively. The height standard deviation score for chronological age were significantly improved from -2.141.50 to -1.74 +/- 1.43 and -1.54 +/- 1.38 at 6 and 12 months of therapy with increasing ratio of bone age to chronological age from 0.72 +/- 0.15 at pretreatment to 0.76 +/- 0.15 at 6 month, 0.79 +/- 0.16 at 12 month of therapy. The plasma IGF-1 level significantly increased during treatment. One of 36 patients(2.8%) showed positive antibody against hGH after 1 year of treatment. During therapy of 1 year, unwanted and remarkable clinical side effect were not observed in all subjects. CONCLUSION: These results indicate that this E. coli derived authentic recombinant growth hormone is very effective in stimulating linear growth in children with growth hormone deficiency.
Arginine ; Blood Cell Count ; Body Height ; Chemistry ; Child* ; DNA, Recombinant ; Escherichia coli ; Growth Hormone* ; Human Growth Hormone ; Humans* ; Hypoglycemia ; Insulin-Like Growth Factor I ; Korea ; Levodopa ; Plasma ; Thyroid Gland ; Urinalysis ; Vital Signs

No abstract available.

BACKGROUND: Nitrous oxide is a safe analgesics which has analgesic and sedative effects without loss of consciousness. The advantage of Nitrous oxide is that it has a rapid onset time and that we can modulate duration of its action. The purpose of this experiment is to obtain the safe and effective concentration of Nitrous oxide in Emergency Department as use of analgesics and sedative drugs. METHODS: Twenty volunteers were investigated according to double blind method. Nitrous oxide was administrated to volunteer subjects at different concentrations ; 33%, 50%, 67% each. Then we evaluated the Pain score, Blood pressure, Heart rate, Respiratory rate, Oxygen saturation and its side effects. RESULTS: Pain Score were 8.4+/-2.1 at 33%, 6.1+/-1.5 at 50%, and 3.65+/-2.2 at 67% of Nitrous oxide. Pain Score is decreased significantly following administration of Nitrous oxide at concentration of 50%, 67%(P<0.05). There was no difference between preadministration group and postadministration group. While no remarkable change in systolic blood pressure, heart rate, and oxygen saturation. Respiratory rate showed significant increase when 679o of Nitrous oxide was administrated. There was no side effect in administration of 33% of Nitrous oxide. When 50% of Nitrous oxide was administrated, there were dizziness 5(25%), paresthesia 2(10%), nausea 1(5%), palpitation 1(5%) and hyperethesia 1(5%). At 679o of Nitrous oxide, there were nausea 7(35%), dizziness 6(30%), paresthesia 5(25%), headache 5(25%), diplopia 2(10%), dysphoria 2(10%), salivation 1(5%), dyspnea 1(5%), nystagmus 1(5%), tinnitus 1(5%) and euphoria1 (5%). Incidence of side effect increased as the concentration of Nitrous oxide was increased. CONCLUSION: We can conclude that safe and effective concentration of Nitrous oxide is 50% as analgesics and sedative drugs in the emergency department.
Analgesics ; Blood Pressure ; Diplopia ; Dizziness ; Double-Blind Method ; Dyspnea ; Emergency Service, Hospital ; Headache ; Heart Rate ; Hemodynamics* ; Hypnotics and Sedatives ; Incidence ; Nausea ; Nitrous Oxide* ; Oxygen ; Paresthesia ; Respiratory Rate ; Salivation ; Tinnitus ; Unconsciousness ; Volunteers

BACKGROUND: Flow cytometric study has been used to measure the DNA content of solid tumors for the last decade. DNA ploidy is an important property commonly measured by flow cytometry. The possibility to study archival paraffin-embedded tumors has hastened an appreciation of prognostic utility of this method. The aim of this study is to look for biologic prognostic indicator for survival time of patients with small cell carcinoma of lung in addition to the well known clinical prognostic factors. METHOD: DNA ploidy was measured by flow cytometric method using tumor cells isolated from paraffin embedded tissue. To evaluate the prognostic significance, DNA ploidy of small cell lung cancer was analysed in 42 patients who died after receiving anticancer chemotherapy. RESULTS: 1) Mean survival time of all patients was 190(+/-156) days. Survival time was shortened, when TNM stage and PS scale were advanced. 2) 62% of all patients was DNA aneuploidy. DNA ploidy had nothing to do with advance of TNM stage and PS scale. 3) Mean survival time of aneuploid tumor was significantly shorter(138+/-90 days) than that of diploid tumors(272 +/- 197 days).(p <0.001) 4) To exclude the influence of clinical prognostic factors such as TNM stage and PS scale, the analysis was restricted to subgroups of identical stage. We were able to find the same tendency. CONCLUSION: DNA ploidy is an independent prognostic factor in small cell lung cancer.
Aneuploidy ; Carcinoma, Small Cell ; Diploidy ; DNA* ; Drug Therapy ; Flow Cytometry ; Humans ; Lung ; Paraffin ; Ploidies* ; Small Cell Lung Carcinoma* ; Survival Rate

No abstract available.
Gardnerella vaginalis* ; Gardnerella*

A 39-year-old hairdresser developed sodium bromate poisoning after drinking a cup of hair neutralizer in a suicide attempt. This is the first case of visual loss afteringestion of sodium bromate. Only few cases are as a cause of acute renal failure reported in medical literature. She presented 1 day later with anuria, required hemodialysis. Sensorineural hearing loss, often a characteristic finding, was developed.
Acute Kidney Injury* ; Adult ; Anuria ; Deafness* ; Drinking ; Hair ; Hearing Loss, Sensorineural ; Humans ; Poisoning* ; Renal Dialysis ; Sodium* ; Suicide

We experienced two cases of Boerhaave syndrome (spontaneous esophageal rupture). The first patient was a 62-year-old male who presented epigastric pain after several violent vomitings associated with alcohol ingestion. Diagnosis was done early and promptly in our emergency center and then definitive treatment was done only after 12hrs from onset of his symptom and he was discharged in relatively good condition 256ays after his admission. The second patient was a 44-year-old male who was transfered to our emergency center with chest pain, dyspnea and fever after vomitings associated with autobicycle accident. Diagnosis was delayed due to initial trauma oriented evaluation and incidious develpement of typical clinical findings and then he was managed conservatively but he died of multiple organ failure due to sepsis. We report these cases with literature review.
Adult ; Chest Pain ; Diagnosis ; Dyspnea ; Eating ; Emergencies ; Esophageal Perforation* ; Fever ; Humans ; Male ; Middle Aged ; Multiple Organ Failure ; Sepsis

Spontaneous renal allograft rupture is an uncommon complication of renal transplantation, but it represents a life-threatening emergency that requires prompt recognition and treatment. The incidence of spontaneous renal allograft rupture is variable and range between 3.6 and 9.6 percent of all transplants. In the majority of cases the rupture is associated with acute rejection episodes and with renal vein thrombosis. Most frequently, the allograft rupture occurs within the first 2 weeks of transplantation. in addition, most ruptures reported have occurred in cadaveric renal allograft. Debate on the management of such allograft salvage versus transplant nephrectomy. It appears that the recent trend is toward performing surgical repair of the graft if the rupture is secondary to rejection and oo evidence of renal vein thrombosis ; otherwise, graft nephrectomy be done. We report a case of spontaneous renal allograft rupture due to renal vein thrombosis occurred in a 21-year-old woman 6 days after transplantation. Unusual severe localized pain, swelling over at allograft site, and hypotension, a triad frequently seen in renal allograft rupture, were present. Management by graft nephrectomy was inevitable because of the patient's downhill course.
Allografts* ; Cadaver ; Emergencies ; Female ; Humans ; Hypotension ; Incidence ; Kidney Transplantation ; Nephrectomy ; Renal Veins ; Rupture ; Rupture, Spontaneous* ; Thrombosis ; Transplants ; Young Adult

Progression of coronary artery disease after angioplasty seemed to be an important determinant of the long term efficacy of percutaneous transluminal coronary angioplasty(PTCA). In fifty seven patients who underwent coronary angiography beyond 1 month of PTCA, progression of coronary artery disease was evaluated and clinical and angiographic variables that might predict the progression after PTCA were sought. At the time of the repeat study, restenosis(>50% loss of PTCA gained diameter or >50% diameter stenosis) was found in 35 patients(61%) and progression(increasing >20% obstruction in coronary diameter or newly occurred total occlustion) was found in 20 patients(35%). Progression occurred similarly both in patients with restenosis(12 of 3, 35%) and in patients without restenosis(8 of 22, 36%). Within 6 months of PTCA, restenosis was found in 82%(23 of 28) and progression in 36%(10 of 28) and beyond 6 months, restenosis in 41%(12 of 29) and progression in 34%(10 of 29). Progression tended to occur more commonly in the artery which was dilated(10 of 60,17%) than in the artery that was not dilated(10 of 111, 9%), but this observation did not reach statistical significance. The influence of the risk factors on the progression was evaluated and progression appeared to be correlated with the initial extent of coronary artery disease and high low-density lipoprotein/high-density lipoprotein cholesterol ratio at follow-up study. Furthermore, the low-density lipoprotein/high-density lipoprotein cholesterol ratio at follow-up study was significantly higher in patients with progression in nondilated artery than that of those without progression, but there was no significant difference between patients with progression in dilated artery and patients without progression. In this study, we found that the incidence of progression was not rare within 6 months of PTCA as beyond 6 months. In addition, the incidence of progression in dilated vessels was not significantly higher than that in nondilated vessels, but high low-density lipoprotein/high-density lipoprotein cholesterol ratio was associated only with progression in non-dilated vessels, so trauma in dilated artery during PTCA might predispose the patients with low risk to the progression of coronary artery disease. Conclusively, PTCA may accelerate the progression of coronary artery disease. And the consistent relation between PTCA and progression of coronary artery disease requires further evaluation with more patients and prospective protocol.
Angioplasty ; Angioplasty, Balloon, Coronary* ; Arteries ; Cholesterol ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Vessels* ; Follow-Up Studies ; Humans ; Incidence ; Lipoproteins ; Risk Factors