PURPOSE: Growth hormone(GH) has not only growth promoting effect but also various metabolic effects. We evaluated GH effects by anthrometric data, biochmical data, electrolytes and simple CT in patients with Prader-Willi syndrome. METHODS: Nine children with Prader-Willi syndrome(PWS) were studied. The children were treated with GH(0.6U/kg/week) for 6 months. Before and after therapy we measured height, weight, waist, hip, and thigh. Blood sampling for eletrolytes, HgA1C, lipid profiles and other biochemistry were done in all patients before and after therapy. We also compared fat distribution with scan. RESULTS: Height standard deviation (SD) score increased from -0.7 to -0.5 and weight SD score decreased from 5.3 to 4.9. Body mass index(BMI) decreased from 28.2kg/m2 to 27.2kg/m2. But the changes in height, weight and BMI were not significant statistically. The waist/hip ratio decreased from 1.04 to 0.97(P<0.05), Thigh circumference had been decreased from 58.2+/-21.7cm to 49.9+/-6.9cm insignificantly. The visceral fat were decreased from 7,613+/-1,760 to 5,022+/-1,533 after GH therapy, and thigh muscle mass was increased from 6,358+/-1,616 to 7,175+/-2,155 (P<0.05). Total cholesterol and triglyceride decreased and HDL cholesterol increased after therapy although they were insignificant statistically. There were no differences in electrolytes, HgA1C, other biochemistry(Ca, P, protein, albumin, BUN, Cr) before and after therapy. CONCLUSION: In children with PWS, waist/hip ratio and fat mass were reduced and muscle mass was increased after GH therapy. There was tendency that total cholesterol and triglyceride decreased and HDL cholesterol increased after therapy. We confirmed that GH therapy had not only growth promoting effect but also metabolic effect on lipid and protein metabolism in children with PWS.
Biochemistry ; Child ; Cholesterol ; Cholesterol, HDL ; Electrolytes ; Growth Hormone* ; Hip ; Humans ; Intra-Abdominal Fat ; Metabolism ; Prader-Willi Syndrome* ; Thigh ; Triglycerides

No abstract available.
Antibody Formation* ; Humans*

sodium hyaluronate in beagle dogs. METHODS:In group 1, hGH(Eutropin, r-hGH) 0.29mg/kg was injected subcutaneously to 6 beagle dogs everyday for 7 days. In group 2, 1mg/kg in sustained- release formulation using sodium hyaluronate(SR-hGH), was injected subcutaneously to 6 beagle dogs. In group 3, 2mg/kg of the same formulation(SR-hGH) was injected subcutaneously to 6 beagle dogs. Blood samplings were done for the measurement of GH and IGF-1 concentrations with ELISA kit(Diagnostic Systems laboratories, Inc., USA) RESULTS:GH concentration in group 1 was below 0.5ng/ml before injection and elevated to 98.1+/-15.7 at 1 hr, 124.2+/-15 at 2 hr, 57.8+/-18.1 at 4 hr, 23.8+/-4.8 at 6hr, 10.8+/-3.7 at 8 hr, 2.8+/-1.6 at 10 hr, 1.0+/-0.7 at 12 hr, and 0.5+/-0.1ng/ml at 24hr after injection. Peak GH concentration was observed in 2 hr and thereafter decreased progressively and returned to basal level at 10 hr after injection. From the 2nd day GH concentration was measured only at 6 hr after daily GH injection, indicating the values of 20.9+/-8.7, 16.2+/-14.9, 23.1+/-8.5, 34.3+/-9.9, 16.1+/-7.0, and 21.8+/-13.0ng/ml at 2nd, 3rd, 4th, 5th 6th, and 7th day, respectively. GH concentrations in group 2(SR- hGH 1mg/kg) were 136.7+/-22.8 at 1hr, 149.3+/-29.9 at 2hr, 110.6+/-17.8 at 4hr, 103.7+/-18.2 at 6hr, 108.3+/-21.0 at 8hr, 91.4+/-21.4 at 10hr, 79.6+/-15.9 at 12hr, 23.7+/-8.3 at 24hr, 5.5+/-1.5 at 30hr, 0.7+/-0.2 at 48hr, 1.4+/-1.4 at 54hr, and 0.5+/-0.1ng/ml at 72hr after injection. GH concentration was elevated above the basal level for 72hr with the peak at 2hr after injection of SR-hGH of 1mg/kg. GH concentrations in group 3(SR-hGH 2.0mg/kg) were 196.7+/-45.2 at 1hr, 219.4+/-39.8 at 2hr, 198.1+/-38.0 at 4hr, 196.0+/-31.4 at 6hr, 179.2+/-28.3 at 8hr, 151.8+/-19.5 at 10hr, 141.3+/-23.1 at 12hr, 72.9+/-14.7 at 24hr, 43.7+/-14.2 at 30hr, 3.8+/-1.6 at 48hr, 1.6+/-0.5 at 54hr, 0.8+/-0.5 at 72hr, 0.5+/-0.1 at 78hr, and 0.5+/-0.2ng/ml at 120hr. Peak GH concentration occurred at 2hr after injection and remained high concentration till 72hr and returned to basal level thereafter. IGF-1 concentrations in group 1 changed from 190.5+/-68.1ng/ml before injection, to 326.4+/-96.2, 346.4+/-79, 391.4+/-86.9, 417.0+/-96.1, 422.1+/-92.0, 429.9+/-86.4, and 478.0+/-90.2ng/ml at 12hr, 30hr, 54hr, 78hr, 102hr, 126hr, and 150hr, respectively. IGF-1 concentrations in group 2 were 128.5+/-37.0 ng/ml before and 268.0+/-64.2, 307.6+/-63.1, 374.8+/-55.3, 335.5+/-39.4, 301.9+/-44.8, 288.5+/-42.5, 272.8+/-51.8, 273.9+/-46.0, 251.1+/-40.9, and 239.2+/-45.0ng/ml at 24hr, 30hr, 48hr, 54hr, 72hr, 78hr, 96hr, 102hr, 126hr, and 150hr, respectively after injection. Peak IGF-1 concentration was measured at 48hr and remained in high concentration till 150hr after injection. IGF-1 concentrations in group 3 were 116.0+/-68.9ng/ml before and 365.5+/-118.6, 400.0+/-135.1, 463.6+/-138, 450.2+/-140.0, 337.2+/-122.4, 301.4+/-113.4, 236.3+/-89.1, 226.3+/-75.5, 148.9+/-55.2, and 129.8 48.4ng/ml at 24hr, 30hr, 48hr, 54hr, 72hr, 78hr, 96hr, 102hr, 126hr, and 150hr, respectively after injection. Peak IGF-1 concentration was at 48hr and remained in high concentration till 150 hr after injection. There was no significant difference in IGF-I conc between group I and group 3. CONCLUSION: Sustained-release form(1mg or 2mg/kg) of hGH with sodium hyaluronate released GH for 72 hours with the peak level at 2 hours and higher concentration of IGF-I above baseline maintained for 150 hour after injection with peak level at 48 hour. There was no difference in IGF-1 concentration between SR-hGH 1mg/kg and 2mg/kg injection. So sustained release form 1mg/kg will be more effective for GH therapy as weekly injection mode. More extensive study is needed to permit for new therapeutic application.
Animals ; Dogs* ; Drug Delivery Systems ; Enzyme-Linked Immunosorbent Assay ; Growth Hormone* ; Hyaluronic Acid ; Insulin-Like Growth Factor I ; Sodium

No abstract available.
Pregnancy* ; Pyelonephritis*

Mullerian agenesis or dysgenesis, rare developmental anomaly presenting as primary amenorrhea, is characterized by absence of vagina and absence or rudimentary development of the uterus. Anatomic anomalies of the axial skeleton and kindney often accompany this psychologically devatating condition. There are various methods of surgical treatment for congenital absence of the vagina. The six cases reviewed in this paper were all treated with McIndoe technique. All of 6 women experienced satisfactory sexual activity and were satisfied with vaginal depth following vaginal creation using a split thickness skin graft technique. Despite the existence of several alternative methods, the McIndoe technique is a relatively simple and highly successful procedure and hence is still prefered by many surgeons.
Amenorrhea ; Female ; Humans ; Sexual Behavior ; Skeleton ; Skin ; Transplants ; Uterus ; Vagina*

PURPOSE:The incidence of glucose intolerance is increased in patients with Turner syndrome. Both noninsulin dependent diabetes mellitus and insulin dependent diabetes mellitus are increased. The purpose of this study was to investigate the impaired rate of carbohydrate metabolism in Turner syndrome after growth hormone treatment. METHODS:We investigated the incidence of carbohydrate intolerance and diabetes mellitus in 94 patients with Turner syndrome with NDDG and WHO criteria. The oral glucose tolerance test was performed in 78 patients. In 12 patients treated with growth hormone, the glucose tolerance test was performed before and after treatment. The insulin tolerance test was done in 20 patients. RESULTS:Only one patient had random plasma glucose level of more than 200 mg/dl. In results of the glucose tolerance test(n=78), 2 patients had glucose tolerance by NDDG criteria and 7 patients had it by WHO criteria. There was no change in glucose tolerance test results during growth hormone treatment. According to the results of the insulin tolerance test, we couldn't find any difference in insulin resistance between the growth hormone treatment group and the other treatments(oxandrolone, estrogen) group. CONCLUSION: The impaired rate of carbohydrate metabolism in Turner syndrome was much lower than in other reports. We observed that the impaired rate of carbohydrate metabolism did not increase after growth hormone treatment. However, the long-term effects in patients treated with growth hormone will be elucidated.
Blood Glucose ; Carbohydrate Metabolism* ; Diabetes Mellitus ; Glucose ; Glucose Intolerance ; Glucose Tolerance Test ; Growth Hormone* ; Humans ; Incidence ; Insulin ; Insulin Resistance ; Turner Syndrome*

The effects of oral premedication with diazepam and atropine were evaluated. We made three kinds of syrup which were composed of diazepam 0.3mg/0.5cc, diazepam 0.3 mg mixed with atropine 0.001 mg in 0.5cc and diazepam 0.3mg mixed with atropine 0.03mg in 0.5cc, respectively. The 1st was administered to Group l (n=21), the second to group ll (n=21) and the last to group lll (n= 24) one and half to two hours before induction of anesthesia. Each child received 0.5 cc/kg. On arrival at pediatric operating room, anxiety levels, vital signs, antisalivatory effect and side effects were checked. The attitude of children was evaluated just before induction of anesthesia. In group land lll, slight elevation of diastolic blood pressure was noticed. The satisfaotory levels, checked by anxiety level O, were 86% in group l, 90% in group ll and 79% in group lll. The altitudes in the operating rooms just before induction of anesthesia were satisfactory and cooperative in 77 %, 81%, and 87% of patients in group l, ll and lll, respectively. Antisalivatory effect was not good in group l, but satisfactory in 82% and 75% of cases in group ll and lll. But side effect was present in 25% of cases in group ll and lll, in spite of 10% in group l. So we can conclude that preoperative oral diazepam in a dose of 0.3mg/0.5cc/kg is very good for the reduction of anxiety and the additiopn of atropine may increase the incidence of side effects. Threefore we recommend parentreral belladonna alkaloids just before induction instead of preoperative oral medication.
Altitude ; Anesthesia ; Anxiety ; Atropine ; Belladonna Alkaloids ; Blood Pressure ; Child* ; Diazepam ; Humans ; Incidence ; Operating Rooms ; Premedication* ; Vital Signs

Bodycomposition measurement is useful in the diagnosis of pathology, assessment of disease process and response to treatement in many endoclonologic and metabolic diseases. The Techniques used currently are mostly indirect, often expensive, difficult and time-consuming. A new method for estimation of body composition, infrared interactance, is rapid, safe, noninvasive, and may be useful in research and clinical studies. Body composition was assessed in 51 children and adolescants with insulin-dependent diabetes mellitus by infrared interactance method using a Futrex 5000A body fat content analyzer. Percentage body fat of pubertal girls was 26.1+/-7.6%, significantly greater than prepubertal girls (17.9%, 0<0.01) and pubertal boys (19.9%, p<0.05). Body fat content was increased through puberty in girls. but not increased in boys. Our data do not explain why body fat of pubertal boys was not increased. There was no significant association of insulin dose and HbA1C level with percentage body fat. Thus, we had to attempt measure calorie intake, activity level and diet composition. Our data revealed that dietary carbohydrates may prompt fat deposition, but energy balance does not explain the differences between pubertal girls and boys. In conclusion, Body fat increased through puberty in girls, but the etiology of differences in pubertal girls and boys is not clear, and in view of potential adverse effect of fat depostion of long-term health, further larger case-contolled study will be necessary.
Adipose Tissue ; Adolescent* ; Body Composition* ; Child* ; Diabetes Mellitus, Type 1* ; Diagnosis ; Diet ; Dietary Carbohydrates ; Female ; Humans ; Insulin ; Metabolic Diseases ; Pathology ; Puberty

The purpose of this prospective study was to evaluate the diagnostic value of color Doppler scoring system in characterization of ovarian masses. We performed transabdominal or transvaginal color Doppler sonopaphy on 82 women with ovarian masses and analyzed the sonographic findings. Ovarian lesions were assessed by means of morphological and color Doppler scoring system by Kurjak. Tumors were characterized by ultrasonographic findings as benign or suspected of being malignant. Then the results of each scoring systems were correlated with histopathological findings. The results were as follows; Of 82 ovarian masses, 64 were benign lesions(13 mucinous cystadenomas, 16 endometriomas, 20 teratomas, 8 serous cystadenomas, and 13 other abnormalities), and 18 were malignant(12 cancers and 6 borderline tumors). The color Doppler scoring system was useful in distinguishing malignant from benign masses, with a sensitivity of 88.2%, compared with the morphological scoring system of 86.7%. The specificity of color Doppler and morphological scoring system were 95.4% and 92.5%, respectively. The sensitivity of combination of both scoring systems was 88.9%, with a specificity of 96.9%. In conclusion, color Doppler scoring system is a useful tool in predicting the malignancy of ovarian lesions especially combined with morphological scoring system.
Cystadenoma, Mucinous ; Cystadenoma, Serous ; Diagnosis* ; Endometriosis ; Female ; Humans ; Prospective Studies ; Sensitivity and Specificity ; Teratoma ; Ultrasonography

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