PURPOSE:Insuline-like growth factor I(IGF-I) is polypeptide mitogen and mediate growth effect of growth hormone(GH). It's serum level is regulated by GH. The aim of this study is to evaluate whether -2 standard deviation of IGF-I level in normal short stature after insuline and L-dopa stimulation test has any diagnostic significance in GH deficiency. METHOD:We included 64 children with GH deficiency(complete GH deiciency 18 cases, partial GH deficiency 46 cases). Their height was below 10 percentile of korean children's standard growth chart. Control group was 175 children whose test results were normal after insuline and L-dopa stimulation test. Serum growth hormone level was measured by IRMA(immunoradiometric assay) with "Daiichi" kit(Japan) and serum IGF-I level was measured with 125I RIA kit (U.S.A). RESULTS: 1)Serum IGF-I level in normal stimulation test result group was increased with the age and the level was higher in female than that of male. 2)Using the cut-off value of -2SD of IGF-I level in control group, sensitivity was 17.2%, specificity was 98.86%, positive predictive value was 84.62%, negative predictive value was 76.55%, and test accuracy was 76.99%. Sensitivity and test accuracy was 44.44% and 93.26% in th complete GH deficiency, respectively. 3)Serum IGF-I level was significantly correlated with peak GH level with insuline stimulation test in control and GH deficiency group(Y=0.018889X+11.32 r= 0.23930 P=0.0014, Y=0.008592X+4.189 r=0.28141 P=0.0267). But serum IGF-I level was was not correlated with peak GH level with L-dopa stimulation test(Y= 0.005609X+13.88 r=0.06625 P=0.3823, Y=0.008293X+2.98 r=0.20895 P=0.1031). CONCLUSION: Serum IGF-I level in GH deficiency group was lower than that of control group and had wide variation of normal range. Based upon above results IGF-I level has limited clinical value in the diagnosis of GH deficiency.
Child ; Diagnosis ; Female ; Growth Charts ; Growth Hormone* ; Humans ; Insulin ; Insulin-Like Growth Factor I* ; Levodopa ; Male ; Reference Values ; Sensitivity and Specificity

PURPOSE: Hepatitis B virus(HBV) with various mutations has been reported. The aims of this study were to investigate the frequency and manifestation of HBV pre-S/S mutations in children with chronic hepatitis B infection. METHODS: Sera from 17 children with chronic hepatitis B infection were analyzed by direct sequencing of polymerase chain reaction amplification of HBV DNA. Results: Seventeen cases of adr type were analyzed. The deletions in HBV pre-S region were observed in 3(17.6%) of 17 cases. Of 3 deleted cases, 2 had an in-phase deletion in the pre-S1 region spanning 18 bp. Another case had a 18 bp and 3 bp deletions in the pre-S1 region. Many point mutations in HBV pre-S region were detected in all cases and these mutations were observed more frequently in the pre-S2 region than the pre-S1 region. Six point mutations in the pre-S1 region were observed. Eight point mutations in pre-S2 region were observed. Point mutations in the S region were detected in 14(82.4%) of 17 cases. Among these, mutations of the "a" determinant were detected in 4(23.5%) of 17 cases. Mutations at codon 130 and at codon 146 were noted in 2 cases. Combined mutations at codon 124, 126, 146 and at 130, 131, 136, 146 were noted in the other 2 cases. Mutations except "a" determinant region included at codon 3, 29, 73, 120, 184, 214, 226, 227. CONCLUSION: These observations suggest that deletion and point mutations in HBV pre-S1, pre- S2 regions and point mutations in HBV S region are frequent in the children with chronic hepatitis B infection.
Child* ; Codon ; DNA ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis B, Chronic* ; Hepatitis* ; Hepatitis, Chronic* ; Humans ; Point Mutation ; Polymerase Chain Reaction

Background: The serum levels of total insulin-like growth factor (IGF)-I and IGF binding protein (IGFBP)-3 reflect endogenous growth hormone (GH) secretion in healthy children. Free form of IGF-I which is suggested to have more potent biological action than complex form of IGF-I. The aim of this study is to investigate the serum levels of free IGF-I and its clinical value in healthy children. METHODS: Serum levels of total IGF-I and IGFBP-3 were determined in 494 healthy children (248 boys and 246 girls) by RIA and IRMA. Serum level of free IGF-I was determined in 206 healthy children (103 boys and 103 girls) by IRMA. RESULTS: The free IGF-I level increased with age in both sex. The free IGF-I level increased continuously between 7 and 15 years of age in boys, but decrement was noted after 14 years of age in girls. Serum total IGF-I level also increased with age in similar pattern of that of free IGF-I. There were no significant differences of mean values of the ratio of free IGF-I/total IGF-I in relation to age in both sex. And there were significant correlations between the level of free IGF-I and total IGF-I and the ratio of total IGF-I/IGFBP-3, respectively. CONCLUSION: In healthy children, serum free IGF-I increased with age in both sex and high free IGF-I level may play an important role in pubertal growth spurt. Our results suggest that the increased serum free IGF-I level in puberty may reflect changes in total IGF-I rather than IGFBP-3. But free IGF-I does not have more clinical value than total IGF-I because of no significant differences of mean values of the ratio of free IGF-I/total IGF-I in relation to age.
Carrier Proteins ; Child ; Growth Hormone ; Humans ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor I ; Puberty

Over the past 30 years, there has been an increase in the incidence of multifetal pregna-ncies, primarily because of the introduction of ovarian stimulants for ovulation induction and assisted reproductive technology ( ART ) in infertile patients. It is well established that multifetal pregnancies are associated with an increased frequency of the maternal complications and gre-ater perinatal morbidity and mortyality. The adverse outcome of multifetal pregnancies is dire-ctly proportional to the number of fetuses, primarily as an consequence of prterm delivery. Re-duction in the number of fetuses in multifetal pregnancies has been proposed as a way to impr-ove the perinatal outcome in this situation. Therefore, selective fetal reduction ( SFR ) is sugges-ted as a therapeutic option for continuation of pregnancy with fetuses mature enough to survi-ve. In this paper, we report our infertility clinic experiences with 6 patients who carried mult- ifetal pregnancies including 1 quintuplet, 1 quadruplet, and 4 triplets. from January, 1991 to May, 1996, transabdominal SFR was accomplished by fetal intrathoracic KCl injection at 9~10 weeks of gestation. After the prcedure, 4 patients remained as twin pregnancies, and 2 patients as single pregnancy. There have been 3 sets of twin deliveries and the 2 sets of single delivery. One case was aborted. Two patients were delivered after 37 weeks of gestation, 2 patients were at 35 weeks, and 1 patient at 24 weeks. All babies have been healthy after birth in patients after 35 weeks gestation. There was no fetal anomaly related to the procedure in the 6 cases. We concluded that transabdominal SFR is a rather safe and useful procedure that may improve the outcome of multifetal pregnancies.
Fetus ; Humans ; Incidence ; Infertility ; Ovulation Induction ; Parturition ; Pregnancy Reduction, Multifetal* ; Pregnancy* ; Pregnancy, Twin ; Quadruplets ; Quintuplets ; Reproductive Techniques, Assisted ; Triplets ; Twins

The gene ftsH encodes a membrane-bound and ATP-dependent protease that is involved in a variety of cellular functions including heat-shock and stress response. Streptococcus pneumoniae DNA encompassing most part of the ftsH gene was cloned in Escherichia coli and sequenced. Due to the unsuccessful cloning as seen in other pneumococcal promoters, the 5'-end of the gene including the upstream promoter region was amplified by inverse polymerase chain reaction and then sequenced by cyclic sequencing. The amino acid sequence that is deduced from the 1,959 bp-long ftsH gene is very similar to FtsH of several gram-positive bacteria and E. coli within the region responsible for the AAA (ATPase associated with diverse cellular activities) function. Except for the N-terminal domain that contains a short extracellular region between two mernbrane-spanning segments, pneumococcal FtsH shows striking sequence similarity to that of a closely related species Lactococcus lactis within the conserved cytoplasmic domain where two ATP-binding motifs, the AAA Signature motif, and a zinc-binding motif are found.
Amino Acid Sequence ; ATP-Dependent Proteases ; Base Sequence* ; Clone Cells* ; Cloning, Organism* ; Cytoplasm ; DNA ; Escherichia coli ; Gram-Positive Bacteria ; Lactococcus lactis ; Polymerase Chain Reaction ; Promoter Regions, Genetic ; Streptococcus pneumoniae* ; Streptococcus* ; Strikes, Employee

No abstract available.
Goiter*

No abstract available.
Exostoses*

PURPOSE: This research was conducted to compare the effects of an obesity control program on knowledge of obesity, diet habit, exercise habits, and weight loss of children in a pediatric and adolescent psychiatric hospital. METHODS: A non-equivalent control group non-synchronized design was used for this study. Eighteen patients were participated in the experimental group and seventeen were participated in the control group. For 8 weeks, the experimental group received the interventions for fifty minutes weekly, which were consisted of knowledge of obesity, diet habit, and exercise habits and weight loss, while the control group received the usual care during the same period. The outcome variables were measured before and after the program. Data were analyzed using t-test with SPSS/WIN 18.0. RESULTS: The experimental group showed more significant improvement in knowledge of obesity, diet and exercise habits than the control group, but weight loss was not different between the groups. CONCLUSION: To be more effective obesity control program, nurses should collaborate with other staffs including doctors and social workers, and consistently educate the families of the patients.
Adolescent* ; Child* ; Diet ; Food Habits ; Hospitals, Psychiatric* ; Humans ; Obesity* ; Social Workers ; Weight Loss

PURPOSE: Osteoporosis and growth failure have been known one of the serious side effects of corticosteroid therapy especially in children. This study was designed to evaluate the effect of long-term administration of steroids on bone mineral density(BMD) in children with nephrotic syndrome and its relationship to cumulative steroid dose, the duration of therapy and sex. Meathods : The BMD of the spine and arm were measured by dual energy x-ray absorptiometry in 24 children with biopsy-proven minimal change nephrotic syndrome who have been revealed steroid dependent and/or frequent relapse in its clinical course and in age- and sex-matched healthy controls. The mean duration of steroid therapy was 37+/-29.8 months and the mean cumulative steroid doses was 12.8+/-7.7g/m2. RESULTS: 1) The BMD at arm was 0.57+/-0.06g/cm2 in patient group and 0.59+/- 0.06g/cm2 in control group. The BMD at spine was 0.68+/-0.1g/cm2 in patient group and 0.76+/-0.1g/ cm2 in control group. Compared with control group significant decrease in BMD was detected in patient group at arm(p=0.011) and spine(p<0.01). The bone loss at spine and arm was -10.6+/-7.44% and -3.7+/-5.5%, respectively. The bone loss was more prominant at spine(p<0.01). 2) Bone loss at arm was significantly correlated to the total cumulative dose of steroid(Y=-0.0029-0.294X, r=-0.4148, p=0.0434), but was not correlated to the duration of steroid(Y=-2.15-0.04X, r=0.1396, p=0.4619). At spine, there were no significant correlation between bone loss and the cumulative steroid doses(Y=-8.47-0.178X, r=-0.19397, p=0.363) and the duration of steroid therapy (Y=-9.75-0.025X, r=0.09081, p=0.6332). CONCLUSIONS: The long-term use of steroid can induce significant bone loss at the both site of arm and spine. To minimize the extent of corticosteroid-induced bone loss, BMD measurement using dual energy x-ray absorptiometry in children with nephrotic syndrome would be helpful.
Absorptiometry, Photon ; Arm ; Bone Density* ; Child* ; Humans ; Nephrosis, Lipoid* ; Nephrotic Syndrome ; Osteoporosis ; Recurrence ; Spine ; Steroids

PURPOSE: The prevalence of renal anomalies in Turner syndrome (TS) has been reported varies from 33% to 60%. In order to clarify the true incidence of renal malformations in Korean TS, and the incidence of renal anomalies according to the karyotype, we have a plan to study this subject. METHODS: We evaluated 51 patients with TS diagnosed by karyotype in Inje University Busan Paik Hospital and Youngnam University from January 1995 to March 2005. The study population was divided into two groups according to the cytogenetic results as classic group (45,X karyotype) and variant group (mosaicism and structural aberration). RESULTS: Of the 51 patients, the karyotype showed 45,X in 26 (51.0%) patients, mosaicism in 17 (33.3 %) patients and structural aberration in 8 (15.7%) patients. Of the 26 patients with 45,X karotype, 12 (46.2%) had renal anomalies, while these were found in 7 (28.0%) of the 25 patients with mosaicism/ structural aberration. The renal anomalies included 9 cases of horseshoe kidney, 7 cases of abnormal renal collecting system, 2 cases of single kidney and 1 case of malrotation. CONCLUSION: The incidence of renal anomalies in Korean TS was 37.3%. The incidence of renal anomalies of the patients with 45,X karotype was higher than that of the patients with mosaicism/structural aberration, but the difference was not statistically significant. We recommend that renal ultrasonography or IVP for investigation of renal anomalies should be done as a screening procedure for the better quality of life in patients with TS.
Busan ; Child* ; Cytogenetics ; Humans ; Incidence* ; Karyotype* ; Kidney ; Mass Screening ; Mosaicism ; Prevalence ; Quality of Life ; Turner Syndrome* ; Ultrasonography