Obesity is associated with an impairment of the growth hormone secretion elicited by all stimuli known to date, but the basic mechanism of the alteration is unknown to date, but the basic mechanism of this alteration is unknown. To determine whether obesity is associated with a chronic state of tonic somatostatin secretion, several tests with growth hormone stimuli such as GHRH(1 microgram/kg), clonidine(150 microgram/m(2))and Regular insulin (0.1U/kg, subcutaneously), to obese subjects and normal control with or without pyridostigmine were undertaken, and the Somatomedin-c levels were measured in both obese subjects and matched controls. 1) The peak GH levels and AUC-GH after administration of GHRH, Clonidine or Regular insulin in obese group is less than those in control group. 2) Pretreatment with pyridostigmine increased the peak GH levels and AUC-GH significantly in obese group but the absolute values are less than those of normal group. 3) The Somatomedin-c levels are significantly higher in obese group than control. Our results lend support to the view that chronically high level of somatostatin decreases the responsiveness to GHRH and secretion itself.
Child* ; Clonidine ; Growth Hormone* ; Humans ; Insulin ; Obesity* ; Pyridostigmine Bromide ; Somatostatin

Background: There is growing interest in adult attention-deficit hyperactivity disorder (ADHD) because many ADHD children have symptoms that last through adulthood, and adult ADHD has a high risk of comorbid mental disorders. This study examined the prevalence and comorbidities of adult ADHD, with a focus on depression and pathological internet use among Korean college students. Methods: This study included 1358 college students, who were asked to complete self-reporting questionnaires on their characteristics, ADHD symptoms, and related clinical factors. The study analyzed associations between ADHD and depression, anxiety, pathological internet use, and problematic alcohol use. Results: The prevalence rate of ADHD among college students was 5.7%. A significant association was determined between ADHD symptoms and school satisfaction, depression, anxiety, and pathological internet use. Multivariate analysis showed that ADHD symptoms in college students were significantly associated with depression and pathological internet use. Conclusion The prevalence of ADHD among college students was similar to that of children and adolescents. Moreover, the risk of depression and pathological internet use was high in the ADHD group. Early screening and intervention for ADHD and comorbidities will be required to prevent the negative consequences of the condition and help students adapt in the future.

Dengue fever is an important health problem for international travelers to all endemic areas. The steadily increasing numbers of tourists visiting endemic areas raise the risk of exposure, and imported dengue cases are increasingly observed in nonendemic area. Dengue has a wide spectrum of clinical presentations, often with unpredictable clinical evolution and outcome. While most patients recover following a self-limiting, non-severe clinical course, a small proportion progress to severe disease such as dengue hemorrhagic fever or dengue shock syndrome. Therefore, it is important to suspect dengue fever in every febrile patient returning from the tropics. Whenever it is suspected, a quick diagnosis and adequate managements are essential to avoid complications. We report two cases of imported dengue fever in Korean children presenting with fever, headache, nausea, and rash.
Child ; Dengue ; Dengue Hemorrhagic Fever ; Exanthema ; Fever ; Headache ; Humans ; Korea ; Nausea ; Philippines

No abstract available.
Heart Septal Defects, Atrial*

BACKGROUND: Fibronectins(FN) are large, dimeric glycoproteins present in the plasma, loose connective tissues, and some basal lamina in vivo and synthesized by a number of cells in vitro, including lung fibroblasts, and alveolar macrophages. FN can affect the migration, proliferation, differention, and even apoptosis of various cell types, all considered necessary for organogenesis. This study was undertaken to detect the changes of localization and activity of FN, a glycoprotein molecule, in stages of lung differentiation in rats. MATERIAL AND METHOD: The experimental animals(Sprague-Dawley strain) were divided into 8 groups, a control group(adult male rats), and experimental groups of 17th day fetus, 20th day fetus, first day newborn, second day newborn, 3rd day newborn, 5th day new born, 7th day newborn. We used the immunohistological stain method with gold particle to obtain the data for distribution of FN in the alveoli, blood vessels, terminal bronchioles, alveolar macrophages and type II pneumocytes. This study revealed the FN reactions at the light and electron microscopic levels. RESULT: At 17th day fetal stage, FN reactions in fetal lung were strong on the blood vessels and moderate on the stroma. At 20th day fetal stage, FN reactions were strong on the blood vessels. After birth, FN reactions in alveolar basement membrane were maximum in the 5th and 7th day newborns. FN reactions in the blood vessels were observed to be moderate in first and second day newborns, but decreased in third day newborns. FN reactions in alveolar macrophages increased after birth. FN reactions in terminal bronchioles gradually increased after birth. 6. In type II pneumocytes, FN reactions were observed to be moderate in 1st and 3rd day newborns. CONCLUSION: Immunohistochemical analysis of rat lungs at various developmental stages revealed increased deposition of FN during the pseudoglandular stage of lung development, coinciding with the period of branching morphogenesis. Also, FN is released from type II pneumocytes. This observation, together with the strategic location of FN, suggests a role in airway formation.
Animals ; Apoptosis ; Basement Membrane ; Blood Vessels ; Bronchioles ; Connective Tissue ; Fetus ; Fibroblasts ; Fibronectins* ; Glycoproteins ; Humans ; Infant, Newborn ; Lung* ; Macrophages, Alveolar ; Male ; Morphogenesis ; Organogenesis ; Parturition ; Plasma ; Pneumocytes ; Rats*

OBJECTIVES: Early intensive interventions are very important for children with autism spectrum disorder. We examined the actual conditions of hospital-based early intensive interventions for autism spectrum disorder in Seoul, in order to help develop and implement an evidence-based early intensive intervention model for use in Korea. METHODS: Nine hospital-based institutes running an early intensive intervention program for children with autism spectrum disorder responded to a questionnaire in September 2014. They provided a brief introduction to their program, explained its theoretical bases, and reported the number of children, their age, intervention time, duration and so on. RESULTS: In the majority of the institutions, the intervention was provided for over 20 hours every week, and the theoretical bases included various applied behavioral analysis (ABA) methods and other therapies (language and occupational therapy). The therapist-child ratio ranged from 1:1 to 5:3. Various types of therapists were involved, including behavioral analysts, special education teachers and (or) language pathologists. There was only one clinic where the behavioral analyst was the main therapist. Usually, the intervention was terminated just before the child entered elementary school. The main merit of the hospital-based intervention in our survey was the effectiveness of the multi-disciplinary intervention plan and its other merits were the accuracy of the diagnosis, its ability to be combined with medicine, and so on. CONCLUSION: The current hospital-based early intensive intervention programs provide interventions for over 20 hours per week and employ multidisciplinary approaches. However, there are very few institutes for children with autism and very few intervention specialists and specialist education courses in the country. We need more educational programs for intervention therapists and have to try to develop policies which encourage the implementation of an evidence-based early intensive intervention program nationwide.
Academies and Institutes ; Autism Spectrum Disorder* ; Autistic Disorder* ; Child ; Diagnosis ; Education ; Education, Special ; Humans ; Korea* ; Running ; Seoul ; Specialization

Baclofen, a derivative of the inhibitory neurotransmitter gamma-aminobutyric acid (GABA), is used for the treatment of muscle spasm, intractable hiccups and multiple sclerosis. It is mostly excreted by glomerular filtration with a clearance that is proportional to creatinine clearance. Early hemodialysis is a treatment of the choice for baclofen-induced neurologic complication in renal failure patients. We experienced a 57-year-old hemodialysis patient with right arm muscle spasm who developed baclofen-associated encephalopathy by a single dose of oral baclofen (10 mg). He admitted to the hospital with the symptom of stuporous mental status with no specific focal neurologic signs. Brain CT imaging and blood biochemistry showed no specific abnormality. EEG revealed the typical metabolic encephalopathy findings, such as triphasic wave and frontal lobe syndrome with delta wave. After daily hemodialysis for 3 days, there was a complete recovery of an altered mentality. After one month later, the follow-up EEG showed normal finding with the resolution of abnormal waves. We report this case with a review of relevant literature. Baclofen should be used carefully, and rather recommended not to be administered in patients with renal failure.
Arm ; Baclofen ; Biochemistry ; Brain ; Brain Diseases, Metabolic ; Creatinine ; Electroencephalography ; Filtration ; Follow-Up Studies ; Frontal Lobe ; gamma-Aminobutyric Acid ; Hiccup ; Humans ; Middle Aged ; Multiple Sclerosis ; Neurologic Manifestations ; Neurotransmitter Agents ; Renal Dialysis* ; Renal Insufficiency ; Spasm ; Stupor

Baclofen, a derivative of the inhibitory neurotransmitter gamma-aminobutyric acid (GABA), is used for the treatment of muscle spasm, intractable hiccups and multiple sclerosis. It is mostly excreted by glomerular filtration with a clearance that is proportional to creatinine clearance. Early hemodialysis is a treatment of the choice for baclofen-induced neurologic complication in renal failure patients. We experienced a 57-year-old hemodialysis patient with right arm muscle spasm who developed baclofen-associated encephalopathy by a single dose of oral baclofen (10 mg). He admitted to the hospital with the symptom of stuporous mental status with no specific focal neurologic signs. Brain CT imaging and blood biochemistry showed no specific abnormality. EEG revealed the typical metabolic encephalopathy findings, such as triphasic wave and frontal lobe syndrome with delta wave. After daily hemodialysis for 3 days, there was a complete recovery of an altered mentality. After one month later, the follow-up EEG showed normal finding with the resolution of abnormal waves. We report this case with a review of relevant literature. Baclofen should be used carefully, and rather recommended not to be administered in patients with renal failure.
Arm ; Baclofen ; Biochemistry ; Brain ; Brain Diseases, Metabolic ; Creatinine ; Electroencephalography ; Filtration ; Follow-Up Studies ; Frontal Lobe ; gamma-Aminobutyric Acid ; Hiccup ; Humans ; Middle Aged ; Multiple Sclerosis ; Neurologic Manifestations ; Neurotransmitter Agents ; Renal Dialysis* ; Renal Insufficiency ; Spasm ; Stupor

PURPOSE: There is a long-standing debate about whether postoperative adhesive small bowel obstruction (SBO) is best managed operatively or nonoperatively. The aim of this study is to define predictive factors for surgical indication in the treatment of an adhesive SBO. METHODS: Medical records and laboratory data of 211 patients who had a SBO after a laparotomy from January 2000 to December 2008 were reviewed retrospectively. The patients were divided into two groups according to the modality of SBO treatment: operatively and nonoperatively. The laboratory data and clinical parameters were compared between the two groups and a statistical analysis was performed. RESULTS: A Mann-Whitney analysis revealed previous SBO history, amylase, erythrocyte sedimentation rate (ESR), creatine phosphokinase, drainage amount via a Levin tube to be significant factors associated with surgical management. A multivariate analysis showed drainage amount via a Levin tube of 500 mL/day or greater (P=0.007), amylase of 90 IU/L or greater (P=0.04), and ESR of 11 mm/hr or greater (P=0.03) to be independent predictive factors for surgery. CONCLUSION: Surgical management should be considered among adhesive SBO patients with elevated amylase (> or =90 IU/L) and ESR (> or =11 mm/hr) and with large drainage amount through the Levin tube (> or =500 mL/day).
Adhesives ; Amylases ; Blood Sedimentation ; Creatine Kinase ; Drainage ; Humans ; Laparotomy ; Medical Records ; Multivariate Analysis ; Retrospective Studies

PURPOSE: There is still much controversy about the prognosis of breast cancer developed in young women compared with old women. We performed this study to evaluate the pragnosis of the breast cancer in young women. MATERIALS AND METHODS: From 1985 to 1994, 1189 women received opetaticms for breast cancers at Severance Hospital. The study group included patients less than 36 years old who had unilateral, invasive and primary operable breast eancers (N=158). The control groups included patients between 36 and 50 years old (N=518) and those between 51 and 65 years old (N=269) who had the same conditions as the study group. The 5-year survival and 5-year disease-free survival rate for three groups were compared using Kaplan-Meier method and Log-rank method. To evaluate the age as an independent prognostic factor in premenopausal women Coxs proportional hazard model was used. RESULT: The overall 5-year survival rate and 5-year disease-free survival rate ot the study group were significantly lower than those of control groups (p<0.05). There was no significant difference in 5-year survival and S-year disease free survival between the two control groups. The Coxs propotional hazard model analysis revealed that the stage is the most important prognostic factor and the age was also an independent prognostic factor. CONCLUSION: The prognosis of breast cancer less than 36 year old was poorer than that of 36-51 year old and 51-65 year old, suggesting that the age may be an independent prognostic factor in premenopausal women. More aggessive adjuvant treatment is required for breast cancer patients less than 36 year old of age.
Adult ; Aged ; Breast Neoplasms* ; Breast* ; Disease-Free Survival ; Female ; Humans ; Middle Aged ; Prognosis ; Proportional Hazards Models ; Survival Rate