PURPOSE: Nowadays pharmacologic provocation tests and physiologic tests are usually used to determine growth hormone(GH) deficiency in short stature. But this method has many problems. We know GH stimulates the release and synthesis of insulin-like growth factor-I(IGF-I) and measuring the level of IGF-I is relatively simple. So we measured plasma IGF-I to watch the correlation with the GH levels and to determine it may replace the complicated stimulation tests. METHODS: At the department of Pediatrics in Dong San Hospital from Dec. 1996 to Aug. 1998, childrens who visited for evaluation of short stature and measured GH and IGF-I simultaneously were reviewed. After clonidine and insulin administration, exercise and sleep, we measured their peak GH level and IGF-I level by the immunoradiometric assay(IRMA) kit. RESULTS: The ratio of boys and girls were 22 to 31 and the cases below 3 rd percentile were 26 which was the most. With phamacologic provocation test, there were 43 cases whose level of peak GH below 7 ng/mL(group I) but with combined phamacologic provocation and physiologic tests there were 27 cases of group I. The mean IGF-I level showed correlation with aging in both male and female(r=0.53, P<0.05). The relationship between peak GH and IGF-I level are found when we tested both phamacologic and physiologic combined tests. The mean IGF-I level did not correlate with height percentile. CONCLUSION: Measuring the IGF-I value was useful to detect GH deficient children but combined tests were more helpful.
Aging ; Child* ; Clonidine ; Female ; Growth Hormone ; Humans ; Insulin ; Insulin-Like Growth Factor I* ; Male ; Pediatrics ; Plasma

Hemifacial spasm (HFS) is due to the vascular compression of the facial nerve at its root exit zone (REZ). Microvascular decompression (MVD) of the facial nerve near the REZ is an effective treatment for HFS. In MVD for HFS, intraoperative neurophysiological monitoring (INM) has two purposes. The first purpose is to prevent injury to neural structures such as the vestibulocochlear nerve and facial nerve during MVD surgery, which is possible through INM of brainstem auditory evoked potential and facial nerve electromyography (EMG). The second purpose is the unique feature of MVD for HFS, which is to assess and optimize the effectiveness of the vascular decompression. The purpose is achieved mainly through monitoring of abnormal facial nerve EMG that is called as lateral spread response (LSR) and is also partially possible through Z-L response, facial F-wave, and facial motor evoked potentials. Based on the information regarding INM mentioned above, MVD for HFS can be considered as a more safe and effective treatment.
Decompression ; Electromyography ; Evoked Potentials, Auditory, Brain Stem ; Evoked Potentials, Motor ; Facial Nerve ; Hemifacial Spasm ; Intraoperative Neurophysiological Monitoring ; Microvascular Decompression Surgery ; Vestibulocochlear Nerve

PURPOSE: Cryopreservation of hematopoietic stem cells is one of the essential components in autologous and peripheral blood stem cell transplantation. Cryopreservation of hematopoietic stem cell, the conventional method involves controlled-rate freezing by a programmed freezer in medium that contains 10% dimethyl sulfoxide (DMSO) as cryoprotectant, followed by storage in liquid nitrogen freezer. We compared the differences between different methods of cryopreservation and cryoprotectants on viability and colony forming capacity of hematopoietic stem cells. METHODS: Mononuclear cells separated using Ficoll-Hypaque from cord blood, peripheral blood and bone marrow were frozen with programmed freezer at 196degrees C or placed in a 70degrees C freezer without programmed freezer in both 10% and 20% DMSO. We measured cell viability using trypan blue dye exclusion method and colony forming capacity with methyl cellulose media at 7, 30 and 90 days after thawing. RESULTS: Cell viability of cord blood, peripheral blood and bone marrow was higher in the groups with programmed freezer compared with rapid freezing and storing in a 70degrees C freezer. Also as the storage time passed, the decrease in viability of hematopoietic cells was much less in the groups of controlled-rate freezing by a programmed freezer. The number of colony in cord blood and bone marrow was higher with programmed freezer and that of peripheral blood was higher with rapid freezing and storage in a 70degrees C freezer. Comparing the differences between different concentraions of DMSO, cell viability was similar or slightly higher in 20% DMSO groups than 10% DMSO groups, but the number of colony was higher in 10% DMSO groups. CONCLUSION: These results suggested that conventional cryopreservation method using programmed freezer with 10% DMSO was more effective in the cryopreservation of hematopoietic stem cells.
Bone Marrow ; Cell Survival ; Cryopreservation* ; Dimethyl Sulfoxide ; Fetal Blood ; Freezing ; Hematopoietic Stem Cells* ; Methylcellulose ; Nitrogen ; Peripheral Blood Stem Cell Transplantation ; Stem Cell Transplantation ; Trypan Blue

Hepatic myelopathy is a rare neurological complication of chronic liver disease, and is characterized by a progressing spastic paraparesis without any sensory loss. However, a few recent reports suggest that involvement of the sensory system is also possible in hepatic myelopathy. We present a patient with hepatic myelopathy, who had impaired proprioception and a delayed cortical response of somatosensory evoked potentials. This supports the hypothesis that hepatic myelopathy may involve the sensory system as well as the motor system.
Evoked Potentials, Somatosensory ; Humans ; Liver Diseases ; Paraparesis, Spastic ; Proprioception ; Spinal Cord Diseases

Rapid canine retraction, first introduced by Liou, is a distraction osteogenesis applied to the periodontal ligament tissue. Rapid tooth movement was facilitated by establishing minimal bony resistance on the distal surface of the canine by socket preparation and by osteogenesis on the mesial side in response to the periodontal distraction. Since undesired buccal tipping or extrusion of the canine during retraction tends to occur, it is crucial to maintain the firm path of movement and the axis of the canine during retraction. In order to improve the predictability of the canine movement, lingually extended distraction screws with heavy labial guiding wires were designed. Prefabricated plastic canine models for the estimation of socket depth and miniscrew implants for anchorage reinforcement were also devised. Applying these devices to a female patient with Class II anterior protrusion, the whole treatment was effectively finished in 13 months. Loss of vitality or periodontal problems did not occur throughout treatment, and stable occlusion was maintained during 10 months of retention. This case report demonstrates that a predictable rapid canine retraction can be achieved through the use of this modified technique.
Axis, Cervical Vertebra ; Female ; Humans ; Osteogenesis ; Osteogenesis, Distraction ; Periodontal Ligament ; Plastics ; Tooth Movement

Microvascular decompression (MVD) is a widely used surgical intervention to relieve the abnormal compression of a facial nerve caused by an artery or vein that results in hemifacial spasm (HFS). Various intraoperative neurophysiologic monitoring (ION) and mapping methodologies have been used since the 1980s, including brainstem auditory evoked potentials, lateral-spread responses, Z-L responses, facial corticobulbar motor evoked potentials, and blink reflexes. These methods have been applied to detect neuronal damage, to optimize the successful decompression of a facial nerve, to predict clinical outcomes, and to identify changes in the excitability of a facial nerve and its nucleus during MVD. This has resulted in multiple studies continuously investigating the clinical application of ION during MVD in patients with HFS. In this study we aimed to review the specific advances in methodologies and clinical research related to ION techniques used in MVD surgery for HFS over the last decade. These advances have enabled clinicians to improve the efficacy and surgical outcomes of MVD, and they provide deeper insight into the pathophysiology of the disease.

Histiocytic necrotizing lymphadenitis (Kikuchi's disease) is a cause of benign lymphadenitis, most commonly affecting young women and usually presenting as a painless or painful cervical lymphadenopathy sometimes associated with fever and leukopenia. Less frequent symptoms include weight loss, nausea, vomiting, and night sweats. We experienced two cases of histiocytic necrotizing lymphadenitis in an 11-year-old boy and a 13-year-old boy. They presented cervical lymphadenopathy with fever in one patient and without fever in the other patient. Lymph node enlargement did not respond to antibiotics. We performed surgical biopsy of cervical lymph node which was consistent with histiocytic necrotizing lymphadenitis. In one patient CD8 T cells and CD68 histiocytes were shown in immunohistochemical stain. So we report two cases of histiocytic necrotizing lymphadenitis with brief review of the related literature.
Adolescent ; Anti-Bacterial Agents ; Biopsy ; Child ; Female ; Fever ; Histiocytes ; Histiocytic Necrotizing Lymphadenitis* ; Humans ; Leukopenia ; Lymph Nodes ; Lymphadenitis ; Lymphatic Diseases ; Male ; Nausea ; Sweat ; T-Lymphocytes ; Vomiting ; Weight Loss

Bone marrow necrosis is a rare complication of a variety of diseases affecting the marrow. The cause and incidence are unknown, and reports of treatment response are rare. We describe a case of relapsed acute mixed type leukemia with bone marrow necrosis. The patient was a 10 year old female diagnosed with acute mixed type leukemia four years ago. She had been on second remission state for 1 year, presented with severe back pain, tenderness in lower extremities, low-grade fever and general weakness. Her level of serum lactic dehydrogenase on admission was increased. Bone marrow aspiration from both posterior iliac crest showed marrow necrosis. Subsequent examination showed the same feature. Hip MRI showed heterogenous low signal intensity in both iliac bone on T-1 weighted image and heterogenous high signal intensity on T-2 wieghted image. Remission induction therapy was started but she expired on 59th hospital day due to the complication of sepsis.
Back Pain ; Bone Marrow* ; Child ; Female ; Fever ; Hip ; Humans ; Incidence ; Leukemia* ; Lower Extremity ; Magnetic Resonance Imaging* ; Necrosis* ; Oxidoreductases ; Remission Induction ; Sepsis

No abstract available.
Cohort Studies* ; Daegu* ; Humans ; Infant ; Infant Mortality* ; Infant*

BACKGROUND: Bone mineral density (BMD) is influenced by genetic, hormonal, and environmental factors. Long-term antiepileptic drug (AED) use also causes osteopenia or osteoporosis that have been most extensively described in institutionalized patients. But, the mechanism of these abnormalities is unclear. The objective of this study is to determine the effect of AED on bone density and to explain the pathophysiologic mechanisms by analyzing bone related factors. METHODS: We prospectively examined BMD by dual-energy X-ray absorptiometry in 45 patients with epilepsy. We measured the serum calcium, phosphorus, protein, alkaline phosphatase (ALP), bone specific ALP, vitamin D and osteocalcin to analyze the factors that influence bone metabolism. RESULTS: BMD was significantly lower in the patient group than in the control group (p<0.05). 13% of patients had osteopenia and 3% of patients had osteoporosis. The level of bone specific ALP was higher in the patient group, but the level of vitamin D was not different, implying that BMD is decreased by the direct effect of antiepileptic drugs. There was a weak negative correlation and marginal significance between BMD and the duration of therapy in the patient group (r=-0.407, p<0.05). CONCLUSIONS: Long-term antiepileptic drug therapy in patients who have seizures causes significant bone loss in the lumbar spine even in the absence of vitamin D deficiency. In addition, the degree of bone mineral density was weakly related with the therapeutic duration of antiepileptic drugs. The regular evaluation of BMD in patients with long-term antiepileptic drugs might be helpful to prevent decreases in BMD.
Absorptiometry, Photon ; Alkaline Phosphatase ; Anticonvulsants* ; Bone Density* ; Bone Diseases, Metabolic ; Calcium ; Drug Therapy ; Epilepsy ; Humans ; Metabolism* ; Osteocalcin ; Osteoporosis ; Phosphorus ; Prospective Studies ; Seizures ; Spine ; Vitamin D ; Vitamin D Deficiency