No abstract available.
Rickets*

No abstract available.
Ghrelin* ; Prader-Willi Syndrome*

No abstract available.
Ghrelin* ; Prader-Willi Syndrome*

No abstract available.
Adrenal Hyperplasia, Congenital* ; Genetic Association Studies*

To evaluate the changes of Doppler echocardiographic parameters of left ventricular(LV) filling in hypertensive subjects, 34 patients(M : F=17 : 17) with and without LV hypertrophy and 19 healthy, age-matched control subjects(M : F=10 : 9) were examined by M-mode, 2 dimensional and Doppler echocardiography. From the Doppler recording, A2 D(time from second heart sound to the onset of early diastolic mitral flow), peak velocity at early diastole(E) and late diastole(A), ratio of E to A velocity, diastolic filling times, early diastolic deceleration rate(EDDR) and flow velocity integral(FVI) were measured. In the patients without LV hypertrophy, A2 D only was significantly prolonged(127+/-21 vs 83+/-24 msec P<0.01) as compared with the normal subjects, but the patients with LV hypertrophy had more prolonged A2 D(149+/-31 vs 83+/-24 msec P<0.01), higher late diastolic peak velocity(A : 0.58+/-0.17 vs 0.47+/-0.09m/sec, P<0.01) and lower E/A velocity ratio(0.95+/-0.19 vs 1.24+/-0.29, P<0.01) than the normal subjects. There was a significant correlation between A2 D and LV muscle mass index in entire patients with hypertension(r=0.42P<0.01). These data suggest that A2D is the earliest parameter indicating abnormality of LV diastolic function and E/A ratio is not likely to be a definite index of LV diastolic dysfunction but rather be a reliable index of LV hypertrophy in hypertensive patients with preserved LV systolic funtion.
Deceleration ; Echocardiography* ; Echocardiography, Doppler ; Heart Sounds ; Humans ; Hypertrophy

BACKGROUND AND OBJECTIVES: The relationship of cold pressor, hyperventilation and exercise test responses to circadian patterns and types of angina in vasospastic angina have still not been known. The aim of this study was to identify subgoups of patients who have similar clinical features and provocation test response. MATERIALS AND METHODS: Twenty-one consecutive patients with pure vasospastic angina were studied. Six exercise tests were performed in the early morning, late morning, and late afternoon in consecutive days, and 2 hyperventilation tests and 2 cold pressor tests in the early morning. Circadian distribution and types of angina(at rest, on physical activity or both) were evaluated by clinical history, clinical records and ambulatory ECG recordings during admission and follow-up periods(mean 19+/-9 months). RESULTS: Three patterns of circadian distribution of anginal attacks were identified during all observation periods together(morning and night: MN n=, morning and afternoon or evening: M+/E n=, morning, night and afternoon and/or evening: MN+/E n=1). Exercise test was positive in 36%(40/111) without circadian variation, hyperventilation test in 66%(23/35) and cold pressor test in 6%(2/33). Neither hyperventilation test nor cold pressor test was related to circadian patterns, types or activity of angina, or numbers of spastic artery. But positive exercise test increased significantly in patients with angina on physical activity(43% vs 21%, p<0.05), high activity(57% vs 18%, p<0.01), multivessel spasm(50% vs 27%, p<0.05 ) and circadian patterns of M+/E and MN+/E(29%, 55% vs 4%, p<0.05, p<0.01). All patients with MN had rest angina and single vessel spasm. All 6 patients with M+/E had angina both at rest and on physical activity and 5 single vessel spasm. Eight of 11 patients with MN+/E had angina both at rest and on physical activity and 8 multivessel spasm. CONCLUSION: These findings suggest that hyperventilation test is highly sensitive in vasospastic angina without any relationship to clinical features, but exercise test response is related well to circadian patterns of angina attacks which are associated with characteristic clinical features.
Arteries ; Electrocardiography ; Exercise Test ; Follow-Up Studies ; Humans ; Hyperventilation ; Motor Activity ; Muscle Spasticity ; Spasm

PURPOSE: In Korea, Lung cancer is the Second most common prevailing malignancy among male population next to stomach cancer. Although CT scan and MRI is widely used in the staging of lung cancer, plain chest x-ray still plays an important role in screening and diagnosis. Our intention was to review the confusing radiographic features which result in delayed diagnosis of lung cancer. MATERIALS AND METHODS: Of the 160 patients with lung cancer evaluated by us, 62 patients(39%) with delayed diagnosis had average diagnostic duration of 5.1 months compared with 2.1 months for those without delay. We reviewed the plain chest x-ray findings of those 62 patients. RESULTS: The diagnosis of lung cancer was delayed more than half of the cases under the impression of intrathoracic tuberculosis. Upon reviewing the roentgenologic findings in patients with diagnostic delay, central type appeared as a small hilar or mediastinal mass with or without obstructive pneumonia. Peripheral type appeared as an ill-defined pulmonary nodule, a nodule hidden by overlapping structures, or as a lung cancer associated with pulmonary tuberculosis. Some cases were misinterpreted as extranodal spread of malignancy. CONCLUSION: To solve above mentioned problems, we recommend proper understanding of natural history of lung cancer, incorporation of high kVp technique in chest radiographs, routine acquisition of lateral chest radiograph to increase diagnostic accuracy, and appropriate use of CT scan in cases of difficult diagnosis.
Delayed Diagnosis* ; Diagnosis ; Humans ; Intention ; Korea ; Lung Neoplasms* ; Lung* ; Magnetic Resonance Imaging ; Male ; Mass Screening ; Natural History ; Pneumonia ; Radiography, Thoracic ; Stomach Neoplasms ; Thorax ; Tomography, X-Ray Computed ; Tuberculosis ; Tuberculosis, Pulmonary

PURPOSE: Differential diagnosis of sexual precocity is important. Sexual precocity, defined as the appearance of secondary sexual characteristics before the age of 8 years in girls and 9 years in boys, was studied to evaluate the sex incidence and etiology of sexual precocity. METHODS: We reviewed the etiology and age incidence of precocious puberty in 14 boys and 89 girls examined between 1994. 11. 1-2002. 7. 31 at Samsung Seoul Hospital. All underwent standard anthropometric measures. They were assigned to diagnostic categories on the basis of clinical assessment, endocrine evaluation, radiologic imaging, and pelvic ultrasonography. RESULTS: In 89 girls, 27 had idiopathic precocious puberty, 3 had precocious puberty with organic brain lesion, 12 had gonadotropin-independent precocious puberty, 44 had premature thelarche, 2 had premature menarche, 1 had premature adrenarche. The majority of idiopathic precocious puberty girls(78%) were aged between 7-7.9 years. In 14 boys, 2 had idiopathic precocious puberty, 3 had precocious puberty with organic brain lesion, 6 had gonadotropin-independent precocious puberty, 3 had gynecomastia. CONCLUSION: Sexual precocity occurs more frequently in girls than boys. Premature thelarche is the most common form of sexual precosity. In boys, majority of central precocious puberty had organic brain lesion, so brain imaging study should be performed. In girls, majority of idiopathic precocious puberty were aged between 7-7.9 years. Reexamination of the age limit for defining when puberty should be considered precocious in Korean girls is necessary.
Adolescent ; Adrenarche ; Brain ; Diagnosis, Differential ; Female ; Gynecomastia ; Humans ; Incidence* ; Male ; Menarche ; Neuroimaging ; Puberty ; Puberty, Precocious* ; Seoul ; Ultrasonography

To evaluate the hypotensive effect of dilevalol which has a nonselective blocking action on beta receptors with selective beta2 agonist actcvity, We performed a prospective clinical study for 8 weeks in 31 patients with essential hypertension(mean age : 52+/-9, mean sitting blood pressure : 158/101mmHg) without concomitant heart failure, coronary heart disease, conduction disturbance or renal impairment. The daily dose of dilevalol was 200-400mg. The results were as follows ; 1) After 8 weeks of treatment with dilevalol, average sitting systolic and diastolic blood pressures reduced to 138+/-8mmHg(13%), 84+/-5mmHg(17%) respectively(p<0.01, 0.01). 2) After 8 weeks of treatment with dilevalol, 28(90%) out of the 31 hypertensives showed good hypotensive effect ie, : sitting diastolic blood pressure decreased to below 90mmHg. 3) Pulse rate decreased slightly from pretreatment average of 75+/-8 beats per minute to 70+/-6 beat per minute at the end of 6 weeks of treatment but went back to pretreatment value lastly. 4) Average body weight, serum levels of total cholesterol, HDL cholesterol, triglyceride, AST, ALT, BUN, creatinine, sodium and potassium were not significantly changed from the pretreatment values. 5) A few side effects in order of frequency were epigastralgia, fatigue, cold extremities and dizziness. These results suggest that dilevalil may be used as an effective first line monotherapeutic antihypertensive agent in mild to moderate hypertensives without significant limitations.
Blood Pressure ; Body Weight ; Cholesterol ; Cholesterol, HDL ; Coronary Disease ; Creatinine ; Dizziness ; Extremities ; Fatigue ; Heart Failure ; Heart Rate ; Humans ; Hypertension* ; Labetalol* ; Potassium ; Prospective Studies ; Sodium ; Triglycerides

A 67-year-old man noted a 4×6cm sized, erythematous, erosive, oozing patch on the penile shaft, which resisted conservative therapy for three years. Histopathologic examination revealed typical findings of extramammary Paget's disease. Interestingly, nests of Paget's cells in some hair follicular structures were shown in the middermis. The lesion was excised by microscopically controlled excision, using the fresh-tissue technique. There were histologically involved areas extending to quite a distance beyond the clinically normal appearing skin. Mohs micrographic surgery might offer the unique advantage of effective surgical treatment with microscopically controlled tumor free borders in the extramammary Paget's disease.
Aged ; Hair ; Humans ; Mohs Surgery ; Paget Disease, Extramammary* ; Skin