Nowadays, to evaluate growth hormone(GH) deficiency-suspicious short stature, we usually use more than two kinds of provocative tests using various pharmacologic agents such as clonodine, L-dopa, insulin, etc. However, the importance of physiologic natural secretion of GH was recently approved. In the past, diagnosis of GH neurosecretory dysfunction was made by studying the 24-hour spantaneous GH secretion profile. But, because it is very clinically difficult, and so we measured and evaluated the mean GH concentrations of blood samples, obtained every 30 minutes during the first 3 hours' nocturnal sleep, instead of that. At the department of Pediatrics, Hanyang University Hospital from November, 1992 to February, 1994, we selected 34 GH deficiency-suspected children on the base of their growth data and bone age, etc. After GH stimulation with clonidine(100-150 ug/m2) and L-dopa(200-250 mg/m2), we measured their peak GH values by the immunoradiometric assay(IRMA) kit. And, we measured the mean GH concentrations of blood samples, obtained every 30 minutes during the first 3 hours noctumal sleep(22:OOPM-1:OOAM). RESULTS: 1. We analyzed the relationship between the mean of 3-hours' physiologic night-time surge of GH(X) and the phamacologically stimulated peak GH level(Y), except for the two neurosecretory dysfunction suspicious children. And so, for the 32 children, the relationship was Y=1.806X+ 3.177, r= 0.794, p<0.01. However, for all the tested children(34), the relationship is Y=1.709X+ 4.06, r=0.737, p<0.01. 2. We analyzed the relationship between the peak of 3-hours' physiologic night-time surge of GH(X) and the phamacologicaUy stimulated peak GH level(Y), except for the two neurosecretory dysfunction suspieious children. And so, for the 32 children, the relationship was Y=0.683X+ 3.686, r=737, p<0.01. CONCLUSION: For all the tested children(34), the relationship between the mean 3hr physiologic GH night time surge and stimulated peak GH value is Y=1.709X+4.06, r=0.737, p<0.01. The percentage of GH neurosecretory dysfunction is 5.8%(2/34). And, except for the two childrren, the relationship is more good, Y=1.806X+3.177, r=0,794, p<0.01. On the above relationship, the 3-hour GH night time-surge test might to give us some helpful information for the diagnosis of neurosecretory dysfunction.
Child* ; Diagnosis ; Growth Hormone* ; Humans ; Insulin ; Levodopa ; Pediatrics

Intrathecal administration of methotrexate(IT-MTX) has constituted the standard approach to prophylaxis and treatment of central nevous system(CNS) leukemia. We experienced a quadriplegia and motor aphasia in a 14-year-old boy following repeated IT-MTX for the prophylaxis of meningeal leukemia. He was diagnosed as ALL without CNS involvement and treated by CCG- 1882 protocol. IT-MTX was administered for CNS prophylaxis. The patient began complaining of urinary incontinence, motor aphasia and weakness in his right leg from 12 days after the 5th dose of the IT-MTX therapy. Even though the IT-MTX was discontinued, loss of muscle power progressed upward resulting in quadriplegia. The patient showed slow and partial recovery on right extremities over 3 months. We report this case with brief review of literature.
Adolescent ; Aphasia, Broca* ; Extremities ; Humans ; Leg ; Leukemia ; Male ; Methotrexate* ; Quadriplegia* ; Urinary Incontinence

The authors evaluated the clinical significance of the bilirubin values as screening test means for predicting the occurrence of neonatal jaundice earlier after birth, by using the transcutaneous bilirubinometry which is known to measure the bilirubin values in a noninvasive, accurate and simple way. The results obtained were as follows: 1. In comparison between the test group(showing the symptom of a jaundice within 72 hours after birth) and the control group, there were found no statistically significant differences in terms of sex, delivery type, birth weight, gestational age and mother's age, while being found statistically significant differences in terms of transcutaneous bilirubin at birth(TcBbirth), transcutaneous bilirubin at 24 hours after birth(TcB24hr), increase in transcutaneous bilirubin per hour during the first 24 hours after birth(TcBin/hr) and transcutaneous bilirubin at 72 hours after birth(TcB72hr)(p<0,05). 2. The correlation test using the Pearson's coefficient produced statistically significant correlationship between each transcutaneous bilirubin index (TcBbirth, TcB24hr, TcBin/hr and TcB72hr) and serum bilirubin concentration at 72 hours after birth(B72hr)(p<0.05), while the result of the correlation test using the Spearman's roh showed statistically significant correlationship only between TcB24hr or TcB72hr and B72hr(p<0.05). As it was, the correlationship between TcB72hr and B72hr was highest in both Pearsons coefficient and Spearman's roh tests, followed by that between TcB24hr and B72hr. 3. In view of the ROC graph, the most effective means of predicting the occurrence of the neonatal jaundice was TcB72hr followed by TcB24hr, TcBbirth and TcBin/hr in their order. In particular, TcB24hr was conceived to be useful as screening test for determining an early discharge from the nursery within 48 hours. On the other hand, since the negative predictive value of TcBbirth, and TcB24hr is higher, the possibility that those infants showing a lower value of these indices may well be free later from a serious neonatal jaundice even if they should be discharged earlier from the nursery. In conclusion, those four indices predicting the neonatal jaundice in a simple, quick and noninvasive manner using the transcutaneous bilirubinometry were considered to be effective screening test means whereby any serious neonatal jaundice developed earlier after delivery can be successfully predicted.
Bilirubin ; Birth Weight ; Gestational Age ; Hand ; Humans ; Infant ; Infant, Newborn ; Jaundice ; Jaundice, Neonatal* ; Mass Screening* ; Nurseries ; Parturition

This investigation was designed to categorize Angle's class III malocclusion groups through analyzing horizontal and vertical components of craniofacial skeleton in Angle's class III malocclusion. The material selected for this study consisted in standard lateral cephalogram of one hundred and fifty five children, seventy four boys and eighty one girls, aged 6 through 15 years, having Angle's class III malocclusion. On the basis of findings of this study, the following results were obtained. 1. In horizontal skeletal classifications, 16 groups were classified FMN-A-B, SE-FMN-A according to the Ba-SE-Me, Ba-SE/R. 2. The sequences that have relatively high frequency are as follow; a) Horizontal Group 1 b) Horizontal Group 3 c) Horizontal Group 5 d) Horizontal Group 9 e) Horizontal Group 4 3. In vertical skeletal classification, 8 groups were classified according to the PMV/PP, PMV/OP, PMV/MP. 4. The sequences that relatively high are as follows; a) Vertical Group 1 b) Vertical Group 3 c) Vertical Group 4 d) Vertical Group 8
Child ; Classification ; Female ; Humans ; Malocclusion* ; Skeleton*

Meckel-Gruber syndrome is a congenital disorder characterized by occipital encephalocele, bilateral multicystic kidneys with fibrotic changes of the liver and postaxial polydactyly. Other anomalies are frequently associated. This syndrome is a rare autosomal recessive disorder often resulting in neonatal death within a few hours of life and has the high recurrence(one in four) in future pregnancies. We present the case of Meckel-Gruber syndrome diagnosed by ultrasonography at 18 weeks` gestation with a brief literature review.
Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Encephalocele ; Liver ; Multicystic Dysplastic Kidney ; Polydactyly ; Pregnancy* ; Prenatal Diagnosis ; Ultrasonography*

Human cytomegalovirus (HCMV) isolated from Korean patients is different in the antigenic and genomic structure of gB from the laboratory-adapted strain. To dissect the reactivity to HCMV glycoprotein B (gB) domains, each domain gene of gB of HCMV SNUCH1, Korean isolate, was amplified from the extracted DNA of the virus-infected fibroblasts with the specific primers by polymerase chain reaction (PCR). Amplified DNA was cloned into pcDNA3. Immunofluorescent staining and western blot analysis revealed that the expressed gB in mammalian cells was immunoreactive and equivalent to the naturally expressed gB in virus-infected fibroblasts. The antigenic component reactive with monoclonal antibodies, MCMVA 57, 88, and 98 appeared at the D3 domain of gB molecule, and that with MCMVA 66 and 135 at the D2b domain. Antibody titer was measured with HCMV-infected fibroblasts and the domains of gB expressed in mammalian cells. There was no correlation between the antibody titer to the whole HCMV and neutralizing antibody titer, and between the antibody titer to whole HCMV and whole gB. It was more reasonable to use whole gB than whole HCMV in the comparison with the neutralizing antibody titer. D3 was representative domain in gB molecule in the anti-gB reactivity. Conclusively it is highly recommendable to use the representing isolates in Korea and its domains for the detection of antibody or the analysis of antigen in the aspect of immunological properties and molecular structures.
Antibodies, Monoclonal ; Antibodies, Neutralizing* ; Blotting, Western ; Clone Cells ; Cytomegalovirus* ; DNA ; Epitopes* ; Fibroblasts ; Glycoproteins ; Humans* ; Korea* ; Molecular Structure ; Polymerase Chain Reaction

PURPOSE: We conducted this study to find factors related to clinical aspects of patients with histiocytosis syndrome. METHODS: We performed a retrospective clinical study with chart review in twenty patients with histiocytosis syndrome from January 1987 to June 1997. RESULTS: The sex incidence revealed female predominance with a ratio of 1.2 : 1. Of twenty cases, fifteen were classified as class l, three cases as class ll, and two cases as class lll. The mean age of symptom onset was 7 and 9/12 years. Common clinical symptoms and signs at diagnosis were fever, mass, headache, pain on lower extremities, skin rashes and weight loss. The most common involved organ was the skeleton. Abnormal hematologic findings (hemoglobin;<10g/dL and/or white blood cell<4,000/mm3 and/or platelet<150,000/mm3) were found in four cases. Common findings on tissue biopsies were histiocytic proliferation and infiltration. Two patients with malignant histiocytosis (MH) and one patient of eosinophilic granuloma (EG) received chemotherapy. Among three patients who started chemotherapy, one patient was discharged freely, one patient died because of recurrence, and one patient had been treated with a maintenance regimen until now. CONCLUSION: The survival rate depends mainly on onset age, severity, Lahey's organ dysfunction score, histologic findings and sites of involved organs. But most patients had nonspecific symptoms before diagnosis. Therefore, early recognition and aggressive medical treatment before development of serious symptoms improved the prognosis.
Age of Onset ; Biopsy ; Diagnosis ; Drug Therapy ; Eosinophilic Granuloma ; Exanthema ; Female ; Fever ; Headache ; Histiocytic Sarcoma ; Histiocytosis* ; Humans ; Incidence ; Lower Extremity ; Organ Dysfunction Scores ; Prognosis ; Recurrence ; Retrospective Studies ; Skeleton ; Survival Rate ; Weight Loss

Septic pulmonary emboli(SPE) is derived from a variety of sources, including infected heart valves, peripheral sites of septic thrombophlebitis and infected venous catheters or pacemaker wires. In adult intravenous drug users, the most common cause of septic emboli is tricuspid valve endocarditis, but infective endocarditis in the non-complicated ventricular septal defect is a relatively rare condition in infants and children. Early detection, along with prompt administration of broad-spectrum antibiotics, is an important factor in the prognosis of patients with SPE. Unfortunately, initial clinical diagnosis is often difficult; a heart murmur may or may not be present and blood cultures may remain negative early in the course of infection. And so characteristic chest CT and chest radiographic findings are helpful in non-invasive diagnostic method for early detection. We experienced a case of pulmonary septic emboli associated with ventricular septal defect in a 6-year-old girl. The diagnosis was made on the basis of clinical features, echocardiography, chest x-ray and chest CT. We report this case with brief review related literatures.
Adult ; Anti-Bacterial Agents ; Catheters ; Child ; Diagnosis ; Drug Users ; Echocardiography ; Endocarditis ; Female ; Heart Murmurs ; Heart Septal Defects, Ventricular* ; Heart Valves ; Humans ; Infant ; Prognosis ; Radiography, Thoracic ; Thorax ; Thrombophlebitis ; Tomography, X-Ray Computed ; Tricuspid Valve

The aim of this narrative review is to describe treatment options for the posterior regions of the mandible and the maxilla, comparing short implants vs. longer implants in an augmented bone. The dental literature was screened for treatment options enabling the placement of dental implants in posterior sites with a reduced vertical bone height in the maxilla and the mandible. Short dental implants have been increasingly used recently, providing a number of advantages including reduced patient morbidity, shorter treatment time, and lower costs. In the posterior maxilla, sinus elevation procedures were for long considered to be the gold standard using various bone substitute materials and rendering high implant survival rates. More recently, implants were even placed without any further use of bone substitute materials, but the long-term outcomes have yet to be documented. Vertical bone augmentation procedures in the mandible require a relatively high level of surgical skill and allow the placement of standard-length dental implants by the use of autogenous bone blocks. Both treatment options, short dental implants, and standard-length implants in combination with vertical bone augmentation procedures, appear to result in predictable outcomes in terms of implant survival rates. According to recent clinical studies comparing the therapeutic options of short implants vs. long implants in augmented bone, the use of short dental implants leads to a number of advantages for the patients and the clinician.
Alveolar Ridge Augmentation ; Bone Substitutes ; Dental Implants ; Humans ; Mandible* ; Maxilla* ; Sinus Floor Augmentation ; Survival Rate

Cerebral gigantism(Sotos syndrome) is a growth disorder that consists of large size at birth, rapid early growth rate with accompanying advanced bone age, acromegalic features, and developmental delay. Clumsiness in the absence of other abnormal neurologic findings is common. The cause is unknown. We report here a case of 238/12-year-old Sotos syndrome with final adult height above 97 percentile, abnormal brain MRI findings(large ventricles, prominent trigone, prominent occipital horn & thining of corpus callosum), clumsiness, and some behavioral problems.
Adult ; Animals ; Brain ; Growth Disorders ; Horns ; Humans ; Magnetic Resonance Imaging ; Neurologic Manifestations ; Parturition ; Sotos Syndrome