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*

PURPOSE:Varying clinical phenotypes are associated with the chromosome 22q11.2 microdeletion syndrome. The endocrine manifestation are latent or overt hypoparathyroidism, thyroid dysfunction and short stature. This study was undertaken to investigate frequencies of endocrine abnormalities and short stature in patients with the chromosome 22q11.2 microdeletion syndrome. METHODS:Forty three unrelated patients were diagnosed having chromosome 22q11.2 microdeletion syndrome. Chromosomal microdeletion was confirmed by fluorescent in situ hybridation (FISH) with DNA probe (22q11.2 LSI TUPLE1 from Vysis). Serum total calcium and intact parathyroid hormone (PTH) were measured in all patients. Thyroid function tests including free thyroxine(T4), thyroid stimulating hormone (TSH) and thyroid autoantibodies were performed in all patients. Insulin-like growth factor-1 (IGF-1) was measured in 10 patients. Height, weight and body mass index were compared with chronological age in all patients. RESULTS:Seven patients (16%) had an overt hypoparathyroidism, presenting with hypocalcemic tetany. Thirteen patients (31%) showing hypocalcemia with normal PTH were regarded as having latent hypoparathyroidism since their PTH secretion response was blunted. Out of 2 patients with thyroid diseases, one patient had Graves disease and the other had Hashimoto thyroiditis. Five patients (12%) were below the 3rd percentile in height at evaluation. The BMI was below the 5th percentile in 23% of patients. CONCLUSION: Twenty patients (47%) presented with overt and latent hypoparathyroidism. Interestingly, autoimmune thyroid diseases such as Graves disease and Hashimoto thyroiditis were associated in patients with chromosome 22q11.2 microdeletion, indicating predisposition to autoimmune disorders. Therefore, a careful endocrine and growth evaluation is needed in these patients.
Autoantibodies ; Body Mass Index ; Calcium ; DNA ; Graves Disease ; Hashimoto Disease ; Humans ; Hypocalcemia ; Hypoparathyroidism ; Parathyroid Hormone ; Phenotype ; Tetany ; Thyroid Diseases ; Thyroid Function Tests ; Thyroid Gland ; Thyrotropin

BACKGROUND: According to the 1992 version of ACLS guideline, adenosine is recommended as the first line drug far the treatment of paroxysmal supraventricular tachycardia(PSYT). But adenosine is not used frequently in our country, despite currency proven effect and safety. Therefore we tried to compare the efficacy and safety of adenosine with verapamil for the treatment far PSVT. MATERIALS AND METHODS: We prospectively reviewed charles of PSVT patients admitted to YongDong Severance Hospital from Jan. 1995 to Dec. 1996. These patients were randomly divided into two groups. The flat group was given 6mg of adenosine initially, and another 12mg was given within 5 minutes if fast dose failed. The other group was given 5mg of verapamil initially, and if failed, 10mg was given within 10 minutes. The results were analyzed by Chi-square test and student-t method. RESULTS: In converting PSVT to normal rhythm, adenosine and verapamil showed similar results and there was no difference between the two Groups in frequency of side elects, but serious arrhythmia such as ventricular fibrillation and ventricular tachycardia was not seen in the adenosine group. CONCLUSION: Adenosine not only showed comparable effect and safety, but also had shorter action time than verapamil. Therefore we recommand adenosine, as a safe and effective fort line drug for PSVT.
Adenosine* ; Arrhythmias, Cardiac ; Humans ; Prospective Studies ; Tachycardia, Supraventricular* ; Tachycardia, Ventricular ; Ventricular Fibrillation ; Verapamil*

No abstract available.
Stomach Neoplasms*

No abstract available.
Family Practice* ; Fatigue* ; Humans ; Pilot Projects* ; Prospective Studies*

To evaluate the possible functional role of serum during the process of parturition, 15 serum samples were collected and analyzed for the nickel concentrations in each 3 groups(Group 1 for the period during parturition, Group 2 for the period from delivery of fetus to delivery of placenta, and Group 3 for the period after delivery of placenta) of normal, uncomplicated full term vaginal delivery and one control group composed of healthy unmarried women in 3rd decades of age. Data revealed that average serum nickel concentration of Group 2(26.6 microgram/l) and Group 1(22.2 microgram/l) were significantly higher than that of Control group(13.7 microgram/l), but Group 3's(13.8 microgram/l) was almost same as Control group's. There were significant negative correlation between age and serum nickel concentration in group 2, and a tendency of higher nickel concentration in women who have no previous experiences of pregnancy than who have previous experiences of pregnancy, although it was not significant. These result could be indicative of close causal relationship between serum nickel concentration and the entire process of parturition.
Female ; Fetus ; Humans ; Nickel* ; Parturition ; Placenta ; Pregnancy ; Single Person

Migration of roundworms, Ascaris lumbricoies, into the biliary tract is a relatively common cause of biliary symptoms in endemic areas, but the number of reported gallbladder ascariasis was scanty even in these areas. Some diagnostic methods might provide suggestive informations, but there are no pathognomonic clinical features for biliary ascariasis, so it is discovered usually after surgical exploration, which is especially the case of gallbladder ascariasis. A young female patient with 4 months' history of right upper quadrant pain which did not respond to medical control and was aggravated recently, presented normal level of peripheral blood leukocyte count with no eosinophilia, normal liver function test, normal serum amylase level and subjectively no febrile sense. Abdominal ultrasonogram disclosed a long, thick, linear, non-motile echogenic structure, not accompanied by acoustic shadowing, within the gallbladder. The intra-and extra-hepatic bile ducts were not dilated and the pancreas was revealed as normal echogenecity and contoru. Endoscopic retrograde cholangiopancreatography was performed immediately thereafter, and it showed a thin linear filling defect in the gallbladder. Cholecystectomy was performed under the impression of gallbladder ascariasis. A mummified Ascaris lumbricoides was found in the lumen of the gallbladder. There was no stones and the histologic examination of the gallbladder revealed chronic cholecystitis.
Acoustics ; Amylases ; Ascariasis* ; Ascaris ; Ascaris lumbricoides ; Bile Ducts ; Biliary Tract ; Cholangiopancreatography, Endoscopic Retrograde ; Cholecystectomy ; Cholecystitis ; Eosinophilia ; Female ; Gallbladder* ; Humans ; Leukocyte Count ; Liver Function Tests ; Pancreas ; Shadowing (Histology) ; Ultrasonography

Migration of roundworms, Ascaris lumbricoies, into the biliary tract is a relatively common cause of biliary symptoms in endemic areas, but the number of reported gallbladder ascariasis was scanty even in these areas. Some diagnostic methods might provide suggestive informations, but there are no pathognomonic clinical features for biliary ascariasis, so it is discovered usually after surgical exploration, which is especially the case of gallbladder ascariasis. A young female patient with 4 months' history of right upper quadrant pain which did not respond to medical control and was aggravated recently, presented normal level of peripheral blood leukocyte count with no eosinophilia, normal liver function test, normal serum amylase level and subjectively no febrile sense. Abdominal ultrasonogram disclosed a long, thick, linear, non-motile echogenic structure, not accompanied by acoustic shadowing, within the gallbladder. The intra-and extra-hepatic bile ducts were not dilated and the pancreas was revealed as normal echogenecity and contoru. Endoscopic retrograde cholangiopancreatography was performed immediately thereafter, and it showed a thin linear filling defect in the gallbladder. Cholecystectomy was performed under the impression of gallbladder ascariasis. A mummified Ascaris lumbricoides was found in the lumen of the gallbladder. There was no stones and the histologic examination of the gallbladder revealed chronic cholecystitis.
Acoustics ; Amylases ; Ascariasis* ; Ascaris ; Ascaris lumbricoides ; Bile Ducts ; Biliary Tract ; Cholangiopancreatography, Endoscopic Retrograde ; Cholecystectomy ; Cholecystitis ; Eosinophilia ; Female ; Gallbladder* ; Humans ; Leukocyte Count ; Liver Function Tests ; Pancreas ; Shadowing (Histology) ; Ultrasonography

Heat stroke is defined as a core body temperature that rises above 40 degrees C accompanied by central nervous system abnormalities such delirium, convulsions or coma. Despite treatment with optimal cooling, heat stroke causes deaths by complications including rhabdomyolysis, renal failure, hepatic dysfunction, disseminated intravascular coagulation syndrome, acute respiratory distress syndrome, bowel ischemia, myocardial injury, and multiple organ failure. In some cases of survival, heat stroke it can cause irreversible CNS damage. Therefore, if exertional heat stroke is properly diagnosed in the emergency room, we must initiate early and aggressive treatment in order to prevent the multiorgan failure and high mortality associated with this condition. To our knowledge, case reports in the literature are rare describing that patients with multiple organ dysfunction and fulminant pneumonia following exertional heat stroke. This study reports on a relevant case, as well as findingsfrom the literature. The case history is presented of a 20- year-old man who presented with exertional heat stroke with sustained hyperpyrexia ongoing after the first day of admission despite optimal treatment including intensive fluid resuscitation. On the 3rd day of admission, chest infiltrated lesions were discovered. From the high-resolution computed tomography results, multifocal consolidations were discovered in both lungs. Blood cultures revealed Staphylococcus hominis. Treatment with proper antibiotics was begun after identifying the blood culture. The patient fully recovered and was discharged on the 10th day after admission.
Anti-Bacterial Agents ; Body Temperature ; Central Nervous System ; Coma ; Delirium ; Disseminated Intravascular Coagulation ; Emergencies ; Heat Stress Disorders ; Heat Stroke ; Hot Temperature ; Humans ; Lung ; Multiple Organ Failure ; Myocardial Ischemia ; Pneumonia ; Renal Insufficiency ; Respiratory Distress Syndrome, Adult ; Resuscitation ; Rhabdomyolysis ; Seizures ; Staphylococcus hominis ; Thorax