No abstract available.

To elucidate the complex of insulin-like growth factor binding proteins (IGF-BPs) in short stature patients, we carried out a prospective study on three patients who were diagnosed as complete GH deficiency at the department of pediatrics from July 1992 to June 1993. The results were summarized as follows: 1) Two circulating IGFs complexed to specific binding protein existed in normal serum. Binding activity was found to be in the 150,000 molecular weight area (the large complex) and 50~60,000 molecular weight area (the small complex). 2) Binding activity for the large complex was seen to be dependent on advancing age, level of large IGF-BP3 complex peacked at the age of 15~16 years. 3) The binding activity for large complex diminished in three GH deficient patients and increased after hGH injection to near or above normal level. 4) Increased growth rate after GH treatment in GH deficient patient was closely related with increasing level of the large IGF-BP3 complex. Therefore we suggest that the large IGF-BP3 complex is regulated by GH. Estimating its serum level is useful for screening of GH deficiency and the monitoring of response to GH therapy.
Carrier Proteins ; Growth Hormone* ; Humans ; Insulin-Like Growth Factor Binding Proteins ; Insulin-Like Growth Factor I* ; Mass Screening ; Molecular Weight ; Pediatrics ; Prospective Studies

No abstract available.

No abstract available.
Dupuytren Contracture*

OBJECTIVE: To evaluate whether the basal serum luteinizing hormone (LH) levels in the presence of normal serum follicle stimulating hormone (FSH) are useful as a prognostic indicator of ovarian response to controlled ovarian hyperstimulation (COH). METHODS: From January 1997 to January 1999, 91 infertile women with tubal factor who had undergone in vitro fertilization and embryo transfer (IVF-ET) were enrolled in the present study. COH was performed using long protocol of gonadotropin-releasing hormone (GnRH) agonist. All patients included in this study had blood samples drawn on cycle day 2 or 3 prior to COH for measurement of basal FSH and LH. Women who had other infertility factors or high basal FSH levels (> or = 8.5 mIU/ml) were excluded from this study. The results of COH and IVF-ET were compared between two groups according to the level of basal LH (low LH group [< 3mIU/ml] vs. control group [> or = 3mIU/ml]). RESULTS: Patient's characteristics were comparable in both groups except basal LH level. The number of ampules and duration of exogenous gonadotropins required were significantly higher in the low LH group than those in the control group (p<0.001; p<0.005, respectively). The number of follicles > or = 14mm diameter on the day of human chorionic gonadotropin (hCG) injection was significantly less in the low LH group than that in the control group (p<0.001). The serum estradiol level on the day of hCG injection was also significantly lower in the low LH group, with 1115.5 +/- 380.9 pg/ml compared with 1340.6 +/- 403.0 pg/ml in the control group (p<0.005). There were significantly lower numbers in oocytes retrieved, oocytes fertilized and embryos frozen in the low LH group than those in the control group (< 0.001; < 0.001; <0.005, respectively). However, there was no difference in the fertilization rate between the two groups. The clinical pregnancy rate per cycle seemed to be lower in the low LH group, but the difference did not achieve significance (26.2% vs 39.7%). There were no differences in the miscarriage rate and multiple pregnancy rate between the two groups. CONCLUSION: This study demonstrates that the low basal LH levels ( < 3 mIU/ml) could be predictive of low ovarian response to COH and poor IVF results.
Abortion, Spontaneous ; Chorionic Gonadotropin ; Embryo Transfer ; Embryonic Structures ; Estradiol ; Female ; Fertilization ; Fertilization in Vitro ; Follicle Stimulating Hormone ; Gonadotropin-Releasing Hormone ; Gonadotropins ; Humans ; Infertility ; Lutein* ; Luteinizing Hormone* ; Oocytes ; Pregnancy ; Pregnancy Rate ; Pregnancy, Multiple

PURPOSE: To evaluate the diagnostic value of radiologic studies in the Cushing's disease MATERIALS AND METHODS: We analyzed retrospectively the CT(n=19, dynamic CT was not perfomed), MR (n=23, dynamic MR in 2 cases), and the results of inferior petrosal sinus sampling(IPSS)(n=13) in 25 patients(19 women, 6men, age range 16-58, mean 32.2) with pathologically-confirmed ACTH secreting pituitary adenoma. We analyzed the radiologic findings and determined how accurately each method could detect and lateralize the lesion within the pituitary gland. The results were compared with the surgical findings and with each other. RESULTS: Seven patients(28%) out of 25 had macroadenomas and the lesions were detected and correctly diagnosed by CT and MR in all. Eighteen patients(72%) had microadenoma. In patients with microadenoma the sensitivity was 38.5%(5/13) in CT, 64.7%(11/17) in MR, 90.9%(10/11) in IPSS. In two patients with dynamic MR, in whom the conventional Gd-enhanced MR showed false negative results, the lesions were detected as low signal intensity mass and correctly lateralized. Considering the results of both MR and IPSS, the sensitivity increased up to 94.1%(17/18). CONCLUSION: Considering the invasiveness of IPSS, Gd-enhanced MR, preferably dynamic, seems to be an imaging modality of choice in Cushing's disease. Combined use of IPSS in selected patients further increases the accuracy of diagnosis and lateralization.
ACTH-Secreting Pituitary Adenoma ; Diagnosis ; Female ; Humans ; Pituitary Gland ; Retrospective Studies

TO know the causative agent of asptic meningitis. we performed and cerebrospinal fluid study on 24 children who had been admitted to the department of Pediatrics.. Asam Medical Center form Jume. 1991 to July 1991. In the 10 cases of them. CSF virus culture was done Special Reference Laboratory, Japan The most of the patients were young infants, and 15 cases of them were under 3 months of age. The male to female ratio was 1:1.4 We observed the main symptoms as fever 100%. irritability 67%, vomiting 17%. poor feeding 13%, seizure 8%. In the 4 cases among the 10 cases with virus culture, Coxsackievirus B5 was cultured. We concluded that the causative agent of this epidemic aseptic meningitis in 1991 was Coxsakievirus B5.
Cerebrospinal Fluid ; Child ; Female ; Fever ; Humans ; Infant ; Japan ; Male ; Meningitis ; Meningitis, Aseptic* ; Pediatrics ; Seizures ; Vomiting

MELAS syndrome is a rare but distinct clinical entity belonging to a group of mitochondrial encephalomyopathies characterized by the tetrad of mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes. We experienced a case of MELAS syndrome in an 8 year-old boy who showed headache, pain of the eyeball, vomiting, stroke-like episodes such as visual disturbance and dysarthria, myoclonic seizure, confusion, and walking disturbance. His serum lactate level was elevated up to 48 mg/dl. MRI findings showed high signal intensities T2-weighted image and low signal intensities in T1-weighted image in the right thalamus and parietooccipital lobe and bilateral symmetric high signal intensity in T1-dweighted image in the basal ganglia. We have seen the dispersed ragged-red fibers with modified Gomori trichrome staining on light microscope, and abundant and dysmorphic mitochondria on electon microscope in the specimen of muscle biopsy. esis of SLE.
Basal Ganglia ; Biopsy ; Child ; Dysarthria ; Headache ; Humans ; Lactic Acid ; Magnetic Resonance Imaging ; Male ; MELAS Syndrome* ; Mitochondria ; Mitochondrial Encephalomyopathies ; Seizures ; Thalamus ; Vomiting ; Walking

Angiodysplasia of small bowel is uncommon and frequently undiagnosed and presents a taxing surgical problem. It is usually diagnosed for unexplained gastrointestinal bleeding. For the surgeon, the main technical problem is that the lesion is impalpable, and invisible to the naked eye, so it usually cannot be identified unless bleeds actively at the time of surgery. Arteriography gives a little information about wax and wane pattern of bleeding in the lesion. Endoscopy is often unfruitful because the majority of lesions are submucosal and rarely exceed a few millimeters in diameter. Transillumination of the intestinal wall from inside of the lumen to the outside in a dark room can define the precise vascular anatomy of the wall. The delicate lesion of the angiodysplasia can be identified by this transillumination method. We described a simple intraoperstive endoscopic translllumination technique used successfully to identify an angiodysplasia in the small bovwel prior to the bowel resecion. This report summarized our experience and review of literature.
Angiodysplasia* ; Angiography ; Endoscopy ; Hemorrhage ; Taxes ; Transillumination*

No abstract available.
Child* ; Hepatitis B, Chronic* ; Hepatitis, Chronic* ; Humans ; Interferon-alpha*