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

No abstract available.
Interleukin-6* ; Rabbits*

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

Purpose: This study was conducted to evaluate the validity and reliability of the Korean version of Nursing Student Perceptions of Dishonesty Scale (NSPDS). Methods: The English NSPDS was translated into Korean after going through a translation and reverse translation process. Data for this study were collected from 433 student nurses from 8 universities in Korea, who had clinical practice experience. The final data were evaluated using SPSS 20.0 and AMOS 22.0 for exploratory and confirmatory factor analysis. Reliability was tested using Cronbach's ⍺ and test-retest reliability. Results: The exploratory factor analysis showed that 15 items were deleted and 9 subscales were changed into 8 subscales, and the initial 67 items were reduced to 52 items. Confirmatory factor analysis was conducted with 8 subscales and 52 items. The standardized regression coefficients of all the items were statistically significant and between .66 and .93. Convergent validity confirmed that the critical ratio was greater than .85, and the average variance extracted was greater than .53. The criterion-related validity confirmed a negative correlation between student nurses’ ethical value and the Korean version of NSPDS. Reliability was confirmed with a Cronbach's ⍺ of .80~.95. The test-retest confirmed that the correlation coefficient showed significant positive correlations between .68 and .76 in the subscales. Conclusion The findings of this study suggest that the Korean version of NSPDS is an appropriate and reliable tool for identifying dishonesty perceptions among Korean student nurses.

Sodium nitrorusside (SNP) is used for induced hypotension to decrease bleeding in operation site by direct relaxation of vascular smooth muscles. It is known that the infusion of SNP increases plasma renin activity (PRA) and this activation of renin-angiotensin system is one of physiologic mechanism opposing the hypotensive action. Captopril, the renin-angiotensin converting enzyme inhibitor, could reduced the dose of SNP during induced hypotension through blocking of the cardiovascular effect of renin-angiotensin system. The present study investigates the effect of captopril on PRA, aldosterone, elecholamines and electroytes and whether the pretreatment with captoril can reduce the dose of SNP. Forty patients who needed the induced hypotension for maxillofacial reconstructive surgery were studied. They were pertained to ASA class I and II and classified to 4 groups. Ten patients were pretreated with captopril 3 mg/kg, 10 min. before induction. And ten patients were 1 mg/kg, the other ten patients were 0.5 mg/kg and remainder served as control group. Blood samples for analysis were drawn according to the time sequence of SNP infusion; Stage 1; after the induction and before SNP infusion Stage 2; 30 min. after SNP (when mean arterial pressure was 60-70 torr) infusion Stage 3; before stopping infusion of SNP Stage 4; 30 min. after stopping infusion of SNP The results were as follows: 1) The duration of anesthesia were not stastically different among four groups. 2) Total dose of SNP were significantly decreased in each captopril group. 3) PRA and each value of control group were significantly increased compared with stage l. But there were no significant increase in stages 2, 3, 4 compared with control group PRA. 4) Aldosterone level of all captopril groups were decreased in all stage compared with control group. 5) Epinephrine and norepinephrine were significantly incerased in control group and returned to control level after stopping of SNP infusuon. In captopril group 3 mg/kg, norepinephrine of stage 2.3.4 were not significantly increased than stage l. Epinephrine in captopril 3 mg/ kg group, there were no significant changes except for stage 2. 6) While sodium was decreased in stage 3,4 compared with stage 1 in control group, potassium and chloride were not changed. In summary, captopril can reduce significantly the total dose of SNP required to produce induced hypotension during operation.
Aldosterone* ; Anesthesia ; Arterial Pressure ; Captopril* ; Catecholamines* ; Electrolytes* ; Epinephrine ; Hemorrhage ; Humans ; Hypotension* ; Muscle, Smooth, Vascular ; Nitroprusside* ; Norepinephrine ; Plasma* ; Potassium ; Relaxation ; Renin* ; Renin-Angiotensin System ; Sodium*

No abstract available.
Adenocarcinoma* ; Diverticulum* ; Female* ; Humans ; Metaplasia*

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: Henoch-Schonlein purpura(HSP) nephritis has a variable range of prevalence from 25 to 50% among HSP patients and is a common cause of chronic glomerulonephritis in children. In our study, we evaluated the distribution and the association of the angiotensinogen(AGT) M235T polymorphism with the clinical manifestations, particularly proteinuria in children with HSP with or without nephritis. METHODS: The AGT M235T polymorphism was determined in children with HSP nephritis (n=33) or HSP without nephritis(n=28) who had been diagnosed at Busan Paik hospital from January 1996 to June 2001. The M235T polymorphism of the AGT gene was determined by PCR amplification of the genomic DNA. RESULTS: The M235T polymorphism of AGT gene frequency was MM:75%, MT:25%, TT:0% in HSP and MM:64%, MT:36%, TT:0% in HSP nephritis, there was no significant differences in the genotype and allele frequencies between the two groups. No significant differences in clinical manifestations at onset and last follow-up were seen between the two genotypes. When statistical analysis was done according to the presence of the M allele, the amount of 24-hour urinary protein excretion and the incidence of moderate to heavy proteinuria(>500 mg/m2/day) at onset and at last follow-up were higher in the MT genotype than in those of in the MM genotype but these difference were not statistically significant. CONCLUSION: We suggest a lack of association between M235T polymorphism of the AGT gene and clinical manifestations in children with HSP nephritis. However, further follow-up studies based on sufficient number of patients and long term follow up periods are necessary to confirm the role of M235T polymorphism of AGT gene in children with HSP nephritis.
Alleles ; Angiotensinogen* ; Busan ; Child* ; DNA ; Follow-Up Studies ; Gene Frequency ; Genotype ; Glomerulonephritis ; Humans ; Incidence ; Nephritis* ; Polymerase Chain Reaction ; Prevalence ; Proteinuria ; Purpura, Schoenlein-Henoch*

Kallmann syndrome (KS) is characterized by the association of hypogonadotropic hypogonadism and anosmia. Although the vast majority of KS cases are sporadic, some X-linked recessive (KAL1), autosomal dominant (FGFR1), and autosomal recessive (most commonly GNRHR) modes of inheritance have been described. Two boys were referred to our department because of cryptorchidism and the absence of puberty. Upon laboratory evaluation they were diagnosed with hypogonadotropic hypogonadism. Agenesis of the olfactory bulbs was detected in radiologic tests, and total deletion of the KAL1 gene was detected through multiplex ligation-dependent probe amplification (MLPA). Although cryptorchidism was diagnosed in the siblings, only the older brother suffered from sensorineural hearing loss and right renal agenesis, a feature that had been reported in X-linked KS. We describe herein the clinical heterogeneity of two affected brothers who carry a complete deletion in KAL1; this is the first case of familial Kallmann syndrome due to the complete deletion of the KAL1 gene reported in Korea.
Congenital Abnormalities ; Cryptorchidism ; Hearing Loss, Sensorineural ; Humans ; Hypogonadism ; Kallmann Syndrome ; Kidney ; Kidney Diseases ; Korea ; Male ; Multiplex Polymerase Chain Reaction ; Olfaction Disorders ; Olfactory Bulb ; Population Characteristics ; Puberty ; Siblings ; Wills