PURPOSE: This study was undertaken to determine whether the clinical presentation of patients with central precocius puberty(CPP) varies according to the etiology, whether this permits the differentiation between idiopathic and organic forms and to examine whether LH determination in a single timed blood sample after GnRH administration is sufficient to diagnose CPP. METHODS: This study included 33 girls with signs of breast development, of whom 23 were diagnosed as definite central precocious puberty. Sixteen patients had idiopathic CPP; the remaining 7 patients had organic CPP. Ten patients were classified as non-CPP. Potential clinical and laboratory predictors of CNS abnormalities were assessed and GnRH stimulation test was done. RESULTS: The age of onset in patients with organic CPP was 4.11+/-2.08 years, whereas the age in patients with idiopathic CPP was 7.25+/-1.34 years. This parameter is the only one showing statistical significance. We compared sensitivities and specificities at 0, 15, 30, 60, 90 and 120 min which yielded sensitivities of 8.7%, 87.0%, 91.3%, 87.0%, 73.9%, 60.9%. CONCLUSION: It is impossible to exclude a central nervous system lesion in patient with central precocious puberty without performing central nervous system imaging. However, this study indicates earlier the onset of disease, higher the possibility of presence of CNS lesion. According to the mean GnRH stimulated LH levels and sensitivity at each times, a single blood sample obtained for LH determined after GnRH administration at 30 min can be used to diagnose the central precocious puberty.
Age of Onset ; Breast ; Central Nervous System* ; Female ; Gonadotropin-Releasing Hormone* ; Humans ; Luteinizing Hormone ; Puberty, Precocious*

This experiment was aimed to investigate the contractile responses of the fermoral artery to the electrical stimulation and the inhibitory effects of verapamil and papaverine on the electrical stimulation of the fermoral artery in the control (n=46) and the diabetic rabbits(n=40). Diabetic rabbits were made by and administration of alloxan (100 mg/kg) intravenously and sacrified 8 weeks later. Femoral arterial rings 3 mm in length were taken and mounted on the force-displacement transducer for the measurements of isometric tension. All experiments were done in the aerated (95% O2 with 5% CO2)biological chamber filled with Kreb's solution and the initial tension of 1.5g was applied to the rings. After 1 hour of equilibrium of the rings, the contractile responses of the electrical stimulation on the femoral arterial rings were taken without vasoactive drugs and then, under verapamil and papaverine solution. And we compared the morphologic findings of the vessels in the two groups in relation to the functional changes by transmission electron miroscopy. The results are as follows: 1. The contractile responses in the presence of verapamil or papaverine solutions to the electrical stimulation were lowed significantly in the fermoral arterial rings of the diabetic rabbits compared with that of the control rabbits (verapamil; 10M~10M: p<0.01, papaverine; 10M & 10M: p<0.01). 2. Transmission electron microphotographs showed many morphological differences of the femoral arteries between the control and the diabetic rabbits. These were irregularities of the internal elastic lamina and the hypertrophy of the cytoplasms of the smooth muscle cells. And also, there were many vacuoles in the cytoplasm of the endothelial cells, lateral to the internal elastic laminaes, and between the smooth muscle cells in the diabetic rabbit femoral artery. By this study, we found that the contractile responses of the femoral arterial rings to the electrical stimulation were decreased in the diabetic rabbits, and the vasodiatory effects of verapamil and papaverine on the electrically stimulated femoral arterial rings were also lowered in the diabetic rabbits compared with the control rabbits. These changes of the vasular responses of the diabetic vessel may be associated with morphological changes manifested by transmission electron microscopy or any other functional derangement of the vessels.
Alloxan ; Arteries ; Cytoplasm ; Electric Stimulation* ; Endothelial Cells ; Femoral Artery ; Hypertrophy ; Microscopy, Electron, Transmission ; Myocytes, Smooth Muscle ; Papaverine ; Rabbits ; Transducers ; Vacuoles ; Vasodilator Agents* ; Verapamil

Fiber-reinforced composite(FRC) was developed as a structural component for dental appliances such as prosthodontic framework. FRC provides the potential for fabrication of a metal-free, excellent esthetic prostheses. It has demonstrated success as a result of its simple fabrication, natural colour, and marginal integrity, and fracture resistance of veneering composite resin and the FRC material. Although it has lots of merits, clinical and objective data are insufficient. The purpose of this study was to evaluate the fracture strength and marginal fitness of fiber-reinforced composite bridge in the posterior region for clinical application. Sixteen bridges of each group, Targis/Vectris(R), Sculpture-fibrekor(R)and In-Ceram, were fabricated. All specimens were cemented with Panavia 21 to the master dies. Strength evaluation was accomplished by a universal testing machine (Instron). The marginal fitness was measured by using the stereoscope (X50). The results were as follows. : 1.The fracture strength according to the materials was significantly decreaed in order In-Ceram(238.81+/-82). Targis Vectris(176.25+/-18.93), Sculpture-Fibrekor(120.35 +/-20.08) bridges. 2.FRC resin bridges were not completely fractured, while In-Ceram bridges were completely fractured in the pontic joint. 3.The marginal accuracy was significantly decreased in order Targis/Vectris (60.71micrometer), Sculpture-Fibrekor(73.10micrometer). In-Cream Bridge(83.81micrometer). 4.The fitness of occlusal sites had a lower value than the marginal sites(P<0.001), and the marginal gaps of inner site of the pontic were greater than that of outer sites of the pontic. Fiber reinforced composite bridges are new, esthetic prosthesis and can be clinically used in anterior regions and short span bridges. However, caution must be exercised when extrapolating laboratory data to the clinical situation because there are no long term clinical data regarding the overall success of the FRC.
Denture, Partial, Fixed ; Joints ; Prostheses and Implants ; Prosthodontics

No abstract available.

No abstract available.
Empyema* ; Typhoid Fever* ; Urinary Bladder*

No abstract available.
Heart Diseases* ; Heart*

BACKGROUND: Blunted perception of dyspnea, which may be related to the increased mortality, has been demonstrated in patients with a history of near-fatal asthma and in the elderly. OBJECTIVE: The purpose of this study was to evaluate the relationship between the perception of dyspnea and the severity of asthma. METHOD: Baseline spirometry and Borg score change(A Borg score) during breathing through an inspiratory muscle trainer were measured in 27 consecutive asthma patients and 11 normal subjects. RESULTS: The baseline Borg score was negatively related to FEV1 A Borg score was significantly lower in asthmatics than in controls at high level of loads. A Borg score was lower in severe asthma than in mild asthma. A Borg score was positively related to the baseline FEV1. Seventy-five percent of severe asthma, 62.5% of moderate one, and 9.1% of mild one showed impaired dyspnea perception. Dyspnea perception was related to age(r, = -0.49, p<0.001). CONCLUSION: Three quarters of patients with severe asthma showed impaired dyspnea perception to inspiratory resistive load. Dyspnea perception was related to asthma severity and age.
Aged ; Asthma ; Dyspnea* ; Humans ; Mortality ; Respiration ; Spirometry

Familial adenomatous polyposis (FAP) is an hereditary autosomal dominant disease characterized by development of hundreds to thousands of adenomatous polyps in the colon and rectum. The common symptoms are bloody stool, diarrhea, and abdominal pain. The average age at onset of symptoms is 33 years. Because of inevitable progression to malignancy, it is necessary to remove the entire colonic and rectal mucosa. Current surgical options are total proctocolectomy with permanent ileostomy, trans-abdominal colectomy with ileorectal anastomosis (IRA), and restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA). Recently IPAA can give optimum control of colorectal polyposis in FAP patients with an acceptable incidence of postoperative complications and satisfactory functional results. We experienced one case of FAP who had malignacy in the remained rectum after subtotal colectomy. IPAA was done and the result was satisfactory.
Abdominal Pain ; Adenomatous Polyposis Coli* ; Adenomatous Polyps ; Colectomy* ; Colon ; Diarrhea ; Humans ; Ileostomy ; Incidence ; Mucous Membrane ; Postoperative Complications ; Proctocolectomy, Restorative ; Rectum*

A case of xanthogranulomatous oophoritis is presented in a patient who had a 3-month history of intrapelvic mass protruding into the vagina. The sonographic findings are a well defined mass shadowing lower echogenicity than the echo of the uterus at the posteosuperior aspect of the uterus. The CT findings are an enhancing solid mass with central necrosis containing a multiseptated cystic component.
Female ; Humans ; Necrosis ; Oophoritis* ; Shadowing (Histology) ; Ultrasonography ; Uterus ; Vagina

Fifteen women with symptomatic uterine myomas, diagnosed by clinical examination and confirmed by pelvic ultrasonography, were treated with intranasal insufflation of Nafarelin acetate, 200 micrograms, twice a day, for a total treatment period of 6 months. Treatment was evaluated with respect to subjective symptoms, changes in myoma size and uterine volume, variations in blood estradiol, FSH, LH and CA 125, and side effects. The following results were obtained: 1. All patients showed a marked reduction(p<0.001) in uterine volume. Before treatment volume measured 312.3+/-24.2cm3, after 12 weeks volume was 132.4+/-40.6cm3, and after 24 weeks it was 123.6+/-48.3cm3. 2. Blood estradiol and LH levels were decreased significantly(p<0.05) after treatment. The FSH level was decreased, but not significantly. 3. Blood CA 125 levels were increased 6 cases(40.0%) before treatment. The levels were normalized in all 6 cases after treatment. 4. Symptoms of uterine myoma disappeared or decreased. 5. Minor side effects, such as hot flushes, headache, general myalgia and fatigue, and vaginal dryness were encountered frequently although none necessitating discontinuation of treatment, These data suggest that Nafarelin acetate is useful for the treatment of uterine myoma. However, appropriate indications should be selected in the treatment of uterine myoma because the possible regrowth of uterine myoma after treatment limits the use of GnRH agonist.
Estradiol ; Fatigue ; Female ; Gonadotropin-Releasing Hormone* ; Headache ; Humans ; Insufflation ; Leiomyoma* ; Myalgia ; Myoma ; Nafarelin ; Ultrasonography