Growth hormone (GH) deficiency is caused by congenital or acquired causes and occurs in childhood or adulthood. GH replacement therapy brings benefits to body composition, exercise capacity, skeletal health, cardiovascular outcomes, and quality of life. Before initiating GH replacement, GH deficiency should be confirmed through proper stimulation tests, and in cases with proven genetic causes or structural lesions, repeated GH stimulation testing is not necessary. The dosing regimen of GH replacement therapy should be individualized, with the goal of minimizing side effects and maximizing clinical improvements. The Korean Endocrine Society and the Korean Society of Pediatric Endocrinology have developed a position statement on the diagnosis and treatment of GH deficiency. This position statement is based on a systematic review of evidence and expert opinions.

PURPOSE: The purpose of this study was to assess the impact of the core materials, thickness and fabrication methods of veneering porcelain on prosthesis fracture in the porcelain fused to metal and the porcelain veneered zirconia. MATERIALS AND METHODS: Forty nickel-chrome alloy cores and 40 zirconia cores were made. Half of each core group was 0.5 mm-in thickness and the other half was 1.0 mm-in thickness. Thus, there were four groups with 20 cores/group. Each group was divided into two subgroups with two different veneering methods (conventional powder/liquid layering technique and the heat-pressing technique). Tensile strength was measured using the biaxial flexural strength test based on the ISO standard 6872:2008 and Weibull analysis was conducted. Factors influencing fracture strength were analyzed through three-way ANOVA (alpha< or =.05) and the influence of core thickness and veneering method in each core materials was assessed using two-way ANOVA (alpha< or =.05). RESULTS: The biaxial flexural strength test showed that the fabrication method of veneering porcelain has the largest impact on the fracture strength followed by the core thickness and the core material. In the metal groups, both the core thickness and the fabrication method of the veneering porcelain significantly influenced on the fracture strength, while only the fabrication method affected the fracture strength in the zirconia groups. CONCLUSION: The fabrication method is more influential to the strength of a prosthesis compared to the core character determined by material and thickness of the core.
Alloys ; Dental Porcelain* ; Prostheses and Implants ; Tensile Strength

BACKGROUND: Neck circumference, as a predicator of obesity, is a well-known risk factor for obstructive sleep apnea and cardiovascular diseases. However, little research exists on neck length associated with these factors. This study explored the association of neck length with sleep and cardiovascular risk factors by measuring midline neck length (MNL) and lateral neck length (LNL). METHODS: We examined 240 patients aged 30 to 75 years who visited a health check-up center between January 2012 and July 2012. Patients with depressive disorder or sleep disturbance were excluded from this study. MNL from the upper margin of the hyoid bone to the jugular notch and LNL from the mandibular angle to the mid-portion of the ipsilateral clavicle were measured twice and were adjusted by height to determine their relationship with sleep and cardiovascular disease risk factors. RESULTS: Habitual snorers had shorter LNL height ratios (P = 0.011), MNL height ratios in men (P = 0.062), and MNL height ratios in women (P = 0.052). Those snoring bad enough to annoy others had shorter MNL height ratios in men (P = 0.083) and women (P = 0.035). Men with objective sleep apnea had longer distances from the mandible to the hyoid bone to the mandible (P = 0.057). Men with metabolic syndrome had significantly shorter LNL height ratios (P = 0.021), and women with diabetes, hyperlipidemia, and metabolic syndrome had shorter MNL height ratios (P < 0.05). CONCLUSION: This study shows that a short neck by measuring the MNL is probably associated with snoring. In addition, MNL is related to cardiovascular disease risk factors in women.
Anthropometry ; Cardiovascular Diseases ; Clavicle ; Depressive Disorder ; Female ; Humans ; Hyoid Bone ; Hyperlipidemias ; Male ; Mandible ; Neck* ; Obesity ; Risk Factors* ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive ; Snoring

Syphilis is a chronic systemic infectious disease caused by the bacterium Treponema pallidum. Gastric involvement and nephrotic syndrome are uncommon but well documented complications of syphilis, but the co-occurrence of these two complications in the same patient is extremely rare. Thus, because of their nonspecific presentation, suspicion of gastric syphilis (GS) and nephrotic syndrome is essential for diagnosis. Patients should be investigated thoroughly and a diagnosis made based on clinical, endoscopic, and histological findings, in order to initiate appropriate therapy. We report of a 34-year-old male patient with a history of epigastric pain and a diagnosis of GS and syphilis-associated membranous glomerulonephritis confirmed by gastroscopy and kidney biopsy, who was treated successfully with penicillin G benzathine. This case report provides information on the typical features of GS that should help raise awareness of this rare disease entity among clinicians, resulting in earlier diagnosis and administration of appropriate therapy.
Adult ; Biopsy ; Communicable Diseases ; Diagnosis ; Gastroscopy ; Glomerulonephritis, Membranous* ; Humans ; Kidney ; Male ; Nephrotic Syndrome ; Penicillin G Benzathine ; Rare Diseases ; Stomach ; Syphilis* ; Treponema pallidum

BACKGROUND/AIMS: Carnitine and vitamin complex (Godex(R)) is widely used in patients with chronic liver disease who show elevated liver enzyme in South Korea. The purpose of this study is to identify the efficacy and safety of carnitine from entecavir combination therapy in Alanine aminotransferase (ALT) elevated Chronic Hepatitis B (CHB) patients. METHODS: 130 treatment-naive patients with CHB were enrolled from 13 sites. The patients were randomly selected to the entecavir and the complex of entecavir and carnitine. The primary endpoint of the study is ALT normalization level after 12 months. RESULTS: Among the 130 patients, 119 patients completed the study treatment. The ALT normalization at 3 months was 58.9% for the monotherapy and 95.2% for the combination therapy (P<0.0001). ALT normalization rate at 12 months was 85.7% for the monotherapy and 100% for the combination group (P=0.0019). The rate of less than HBV DNA 300 copies/mL at 12 months was not statistically significant (P=0.5318) 75.9% for the monotherapy, 70.7% for the combination and it was. Quantification of HBsAg level was not different from the monotherapy to combination at 12 months. Changes of ELISPOT value to evaluate the INF-gamma secretion by HBsAg showed the increasing trend of combination therapy compare to mono-treatment. CONCLUSIONS: ALT normalization rate was higher in carnitine complex combination group than entecavir group in CHB. Combination group was faster than entecavir mono-treatment group on ALT normalization rate. HBV DNA normalization rate and the serum HBV-DNA level were not changed by carnitine complex treatment.
Adult ; Alanine Transaminase/blood ; Antiviral Agents/*therapeutic use ; Carnitine/*therapeutic use ; DNA, Viral/analysis ; Drug Therapy, Combination ; Enzyme-Linked Immunospot Assay ; Female ; Guanine/*analogs & derivatives/therapeutic use ; Hepatitis B Surface Antigens/blood ; Hepatitis B e Antigens/blood ; Hepatitis B virus/genetics ; Hepatitis B, Chronic/*drug therapy ; Humans ; Interferon-gamma/metabolism ; Male ; Middle Aged ; Mitochondria/physiology ; Treatment Outcome ; Vitamin B Complex/*therapeutic use

No abstract available.
Adult ; Carcinoma, Hepatocellular/radiography/radionuclide imaging/ultrasonography ; Granuloma, Plasma Cell/pathology/*radiography/radionuclide imaging ; Humans ; Liver Diseases/pathology/*radiography/radionuclide imaging ; Liver Neoplasms/radiography/radionuclide imaging/ultrasonography ; Magnetic Resonance Imaging ; Male ; Tomography, X-Ray Computed

PURPOSE: The purpose of this study was to compare the effect of 3 chairside polishing methods and laboratory polishing methods on surface roughness and C. albicans adhesion of polyamide denture base. MATERIALS AND METHODS: Using contact profilometer, the surface of polyamide specimens (25x15x2 mm) was studied after conventional polishing without finishing and after chiarside polishing with 2 chiarside polishing kits and chairside-pumice polishing following finishing with tungsten carbide bur. To evaluate the adhesion of C. albicans, C. albicans suspension was overlayed on the test specimen. And the specimens were incubated for 2 hours. Imprint culture method was achieved and counted the colony on the agar plate. Polished polyamide were evaluated using a scanning electron microscope. The statistics were conducted using one-way ANOVA and in case of difference, Scheffe test and Tamhane's T2 test were used. RESULTS: Surface roughness (Ra) of surfaces polished with 2 chairside polishing kits had higher than conventional polishing and pumice polishing. The highest roughness value was 0.32 +/- 0.10 microm, and the lowest was 0.02 +/- 0.00 microm. The adhesion of C. albicans on the specimens polished with chairside polishing group and pumice polishing group were increased than conventional polishing group (P<.01). CONCLUSION: Conventional laboratory polishing was found to produce the smoothest surface and the lowest adhesion of C. albicans. Two groups polished with Chairside polishing kits were similar with respect to surface roughness. Surface of the specimen polished with pumice is significantly smoother than 2 chairside polishing groups, but the result of C. albicans adhesion is that group polished with pumice was similar with 2 chairside polishing groups (P>.01).
Agar ; Candida ; Candida albicans ; Denture Bases ; Dentures ; Electrons ; Nylons ; Silicates ; Tungsten ; Tungsten Compounds

Most bronchogenic cysts originate in the mediastinum, while 15% to 20% occur in the lung parenchyma. According to the literature, most intrapulmonary cysts occur in the lower lobes. But, they are rarely located in an extrathoracic site, such as subdiaphragmatic retroperitoneal area. We describe a paraesophageal intra-abdominal bronchogenic cyst, first considered as gastric submucosal tumor. Resection was successfully realized by laparoscopy. A 20-year-old female was admitted to our hospital with incidentally detected gastric submucosal tumor. At operation, there was a 2.5x2 cm sized cystic tumor that was isolated from the gastric wall. We performed tumor resection laparoscopically. The postoperative course was uneventful and the patient was discharged on the second postoperative day. Histological examination reported a bronchogenic cyst. We, herein, report this case.
Bronchogenic Cyst ; Female ; Humans ; Laparoscopy ; Lung ; Mediastinum ; Young Adult

Diffuse large B cell lymphoma is the most common type of non-Hodgkin's lymphoma, representing approximately one-third of all cases and involving the gastrointestinal tract in about 18%. With the development of modern chemotherapeutic regimens and advances in medical care, the prognosis for malignant lymphoma can be excellent. However, because of the aggressive adjuvant therapy required, complications such as bowel perforation may be fatal. In cases of chemotherapy for malignant lymphoma, we should keep in mind the possibility of perforation of the bowel after chemotherapy. Early detection is important to save patients.
Gastrointestinal Tract ; Humans ; Lymphoma ; Lymphoma, B-Cell ; Lymphoma, Non-Hodgkin ; Prognosis

A spermatic cord leiomyoma is an uncommon disease. A leiomyoma can originate anywhere, including the genitourinary system, where smooth muscle is present. 70 and 30% of spermatic cord leiomyomas are benign and malignant, respectively. The preoperative diagnosis of a leiomyoma is difficult; the only definite diagnostic method is histological confirmation. A retroperitoneal lipoma probably constitutes the largest group of solid abdominal tumors. However, their etiology is unknown and the symptoms insidious, and recurrences and sarcomatous changes frequently occur. The clinical diagnostic methods are the clinical symptoms, a physical examination and radiological evaluations, such as intravenous urography, computed tomography and angiography, and so on, but an abdominal CT scan provides the most useful information. A fifty-six-old man presented with a five-month history of a suddenly enlarging right inguinal mass. He had undergone a right inguinal hernia operation, with medication for hypertension. Herein, a rare case of a huge retroperitoneal lipoma, with a spermatic cord leiomyoma, is reported.
Angiography ; Diagnosis ; Hernia, Inguinal ; Hypertension ; Leiomyoma* ; Lipoma ; Muscle, Smooth ; Physical Examination ; Recurrence ; Retroperitoneal Space ; Spermatic Cord* ; Tomography, X-Ray Computed ; Urogenital System ; Urography