PURPOSE: As growth hormone was reported to improve cavernosal nerve regeneration, we studied the action mechanism of growth hormone(GH) on the regeneration of nitric oxide synthase(NOS)-containing penile nerves after unilateral cavernous nerve neurotomy in rats. MATERIALS AND METHODS: Male rats were divided into three groups: sham operation(n=10); unilateral neurotomy of a 5mm segment of the cavernous nerve(n=10) and unilateral neurotomy with GH injection(n=10). Electrostimulation of the intact cavernous nerve was performed at 1 and 3 months after operation. Nicotinamide adenine dinucleotide phosphate(NADPH) diaphorase staining was used to identify nNOS in penile nerve fibers of the mid-shaft segment. The gene expression for nNOS, insulin like growth factor(IGF)-I and nerve growth factor(NGF) were investigated in corporal tissue by reverse transcriptase-polymerase chain reaction(RT-PCR) using specific oligonucleotide primers. RESULTS: Electrostimulation in the GH-treated group revealed a greater maximal intracavernosal pressure and a shorter latency period than in those given neurotomy alone at 3 months after operation. One month after unilateral neurotomy, both neurotomy alone and the GH-treated groups showed a significant decrease in NOS-containing nerve fibers in the dorsal and intracavernosal nerves on the side of neurotomy, however mRNA expression of nNOS and IGF-I showed a significant increase in GH-treated group. At 3 months, the number of NOS-containing nerve fibers in the neurotomy alone group did not increase while the GH-treated group showed a significant increase. CONCLUSIONS: These results show that GH significantly enhances the regeneration of NOS-containing fibers in the dorsal and intracavernosal nerves after unilateral cavernous nerve injury via IGF-I.
Animals ; DNA Primers ; Gene Expression ; Growth Hormone* ; Humans ; Insulin ; Insulin-Like Growth Factor I ; Latency Period (Psychology) ; Male ; NAD ; Nerve Fibers ; Nerve Regeneration ; Nitric Oxide ; Rats* ; Regeneration* ; RNA, Messenger

BACKGROUND: This study was conducted to examine if basal luteinizing hormone (LH) levels could be useful for screening central precocious puberty (CPP) in girls. METHODS: A total of 90 girls under the age of 8 years were included in this study. They underwent the gonadotropin-releasing hormone (GnRH) stimulation test at Good Gang-An Hospital from March 2008 to December 2012 for evaluation of premature sexual development. Patients were classified into two groups: the pubertal response group of patients who had 5 IU/L peak LH levels in the GnRH stimulation test, and the prepubertal response group of patients who had LH levels <5 IU/L. Chronological and bone ages, height, weight, body mass index, gonadotropin response to GnRH stimulation, and basal levels of LH, follicle-stimulating hormone, and estradiol were studied in both groups. The relationship between basal LH and peak-stimulated LH was evaluated using Spearman's correlation. To determine the optimal cut-off values of basal LH levels for differentiating between two groups, the receiver operating characteristic (ROC) curves were analyzed. RESULTS: When the correlation between basal LH levels and peak LH after GnRH stimulation was analyzed in all subjects (N=90), basal LH levels had a statistically significant positive correlation with peak stimulated LH levels (rs=0.493, p<0.001). The cut-off level of optimal basal LH was 0.1 IU/L, according to the ROC curves. Its sensitivity was 73.3%, and its specificity was 77.8%. CONCLUSION: The study results showed that serum basal LH levels are useful for screening CPP in girls.
Body Weight ; Estradiol ; Female* ; Follicle Stimulating Hormone ; Gonadotropin-Releasing Hormone ; Gonadotropins ; Humans ; Lutein* ; Luteinizing Hormone* ; Mass Screening* ; Puberty, Precocious* ; ROC Curve ; Sexual Development

BACKGROUND: This study was conducted to examine if basal luteinizing hormone (LH) levels could be useful for screening central precocious puberty (CPP) in girls. METHODS: A total of 90 girls under the age of 8 years were included in this study. They underwent the gonadotropin-releasing hormone (GnRH) stimulation test at Good Gang-An Hospital from March 2008 to December 2012 for evaluation of premature sexual development. Patients were classified into two groups: the pubertal response group of patients who had 5 IU/L peak LH levels in the GnRH stimulation test, and the prepubertal response group of patients who had LH levels <5 IU/L. Chronological and bone ages, height, weight, body mass index, gonadotropin response to GnRH stimulation, and basal levels of LH, follicle-stimulating hormone, and estradiol were studied in both groups. The relationship between basal LH and peak-stimulated LH was evaluated using Spearman's correlation. To determine the optimal cut-off values of basal LH levels for differentiating between two groups, the receiver operating characteristic (ROC) curves were analyzed. RESULTS: When the correlation between basal LH levels and peak LH after GnRH stimulation was analyzed in all subjects (N=90), basal LH levels had a statistically significant positive correlation with peak stimulated LH levels (rs=0.493, p<0.001). The cut-off level of optimal basal LH was 0.1 IU/L, according to the ROC curves. Its sensitivity was 73.3%, and its specificity was 77.8%. CONCLUSION: The study results showed that serum basal LH levels are useful for screening CPP in girls.
Body Weight ; Estradiol ; Female* ; Follicle Stimulating Hormone ; Gonadotropin-Releasing Hormone ; Gonadotropins ; Humans ; Lutein* ; Luteinizing Hormone* ; Mass Screening* ; Puberty, Precocious* ; ROC Curve ; Sexual Development

Genitourinary gangrene is an uncommon, potentially lethal disorder characterized by the abrupt onset of a rapidly progressive necrotizing soft tissue infection caused by the synergistic action of various organisms that spread along fascial planes, causing subfascial soft tissue necrosis and destruction. Many factors, debilitating condition such as carcinoma, diabetes and alcoholism, contribute to the development and perpetuate the course of Fournier's gangrene. In our two cases , predisposing causes were as follow ; chronic liver disease, diabetes mellitus, chronic alcoholism, perianal abscess. The patients were hemodynamically unstable and extensive necrosis was noted. After aggressive debridement of the wound and triple antibiotic therapy, general condition became improved and then we performed split thickness skin grafts and the results of reconstructive surgery were satisfactory.
Abscess ; Alcoholism ; Debridement ; Diabetes Mellitus ; Fournier Gangrene* ; Gangrene ; Humans ; Liver Diseases ; Necrosis ; Skin ; Soft Tissue Infections ; Transplants ; Wounds and Injuries

PURPOSE: Many different scoring systems have been proposed for assessing the severity of atopic dermatitis. The SCORAD (SCORing Atopic Dermatitis) is one of the best validated systems, but is too complicated and time-consuming for routine clinical use. The aim of this study is to evaluate the Three Item Severity (TIS) score in routine clinical practice and to investigate the correlation with SCORAD and quality of life. METHODS: The study was done on 69 cases of atopic dermatitis randomly selected by SCORAD severity in Kangdong Sacred Heart Hospital pediatric allergy clinic from March 2003 to August 2003. Patients were from three months old to 15 years old. A trained pediatrician assessed the TIS score and simultaneous 10 item questionnaire about quality of life (QOL) was checked. RESULTS: According to the SCORAD, there were 21 (30.4%) mild cases, 26 (37.7%) moderate cases and 22 (31.9%) severe cases out of total 69 patients. According to the TIS score, 21 (30.4%) cases were 0-2 point, 16 (23.2%) were 3 point, 11 (16.0%) were 4-5 point and include 21 (30.3%) were 6-9 point. In QOL score, 21-30 points were most common (36.2%). There was significant positive correlation between TIS score and SCORAD (Spearman's rs= 0.86, P< 0.01). There was significant positive correlation between TIS score and QOL (Spearman's rs=0.89, P< 0.01). CONCLUSION: The TIS score is a reliable and simple scoring system for atopic dermatitis. It is particularly suitable in general practice, for routine clinical use.
Adolescent ; Child* ; Dermatitis, Atopic* ; General Practice ; Heart ; Humans ; Hypersensitivity ; Quality of Life ; Surveys and Questionnaires

PURPOSE: The rising prevalence of childhood obesity may be due to an energy imbalance between food intake and energy expenditure. Recently, consumption of beverages in children has increased. The aim of this study is to provide useful information for the prevention and the control of childhood obesity by assessment of variable beverage consumption. METHODS: Fight hundred seventy seven children(M : F=1 : 1.02, mean age; 9.7 years) from two primary schools in Seoul in May 2003 were enrolled. Body mass index(BMI) was calculated and the degree of obesity was classified into normal, overweight and obese groups by BMI percentile. Parental BMI, socio-economic factor, 3-day dietary intake, calory intake and beverage intake were examined by questionnaires. We researched beverages and classified them into six categories, milk, other milk products, soda, sports beverage, other beverage. RESULTS: The prevalence of obesity was 7.2%. The parental BMI of the obese group were higher than those of the other groups. There was no significant difference in birth weight, or parents' intellectual and economic levels between the obese group and the other groups. There was no significant difference in daily total calory intake between the obese group and the other groups. The obese group of 7-9 year-old-males was higher than the other groups in sodas, and sports beverages intake. The obese group of 10-12 year-old-males was higher than the other groups in total beverage intake and other beverage intakes. The obese group of 10-12 year-old-females was higher than the other groups in other milk products. CONCLUSION: Excessive intake of beverages is associated with childhood obesity. Efforts to decrease intake of beverages may be important approaches to counter the rise in the prevalence of obesity.
Beverages* ; Birth Weight ; Body Mass Index ; Child ; Eating ; Energy Metabolism ; Fast Foods ; Humans ; Milk ; Obesity ; Overweight ; Parents ; Pediatric Obesity* ; Prevalence ; Surveys and Questionnaires ; Seoul ; Sports

PURPOSE: Recently, the bispectral index monitor has been promoted as an objective measure of sedation depth during pediatric procedural sedation in the emergency department (ED). However, rectal administration of thiopental sodium for pediatric procedural sedation has not been validated. METHODS: Patients aged one to seven years and undergoing primary closure procedures for simple facial and hand laceration in the ED were enrolled. Procedural sedation was performed by rectal administration of thiopental sodium. The bispectral index score and the Ramsay Sedation Scale were recorded every 10 minutes during sedation. The investigator and treating physician were blinded to bispectral index scores, which were later correlated with the Ramsay Sedation Scales values. Receiver operator characteristic (ROC) curves were conducted to determine the ability of the bispectral index score to discriminate various thresholds of sedation depth. RESULTS: One hundred thirty paired measurements were obtained from 12 patients. The Spearman's correlation coefficient for paired measurements, was -0.906 (95% confidence interval: [-9.8] ~ [-8.1], p<0.001). ROC curve analysis demonstrated a high discriminatory power for bi-spectral index scores in predicting the level of sedation, with areas under the curve at least 0.95 for all Ramsay Sedation Scale thresholds. CONCLUSION: Bispectral index monitoring can serve as a useful, objective measure of sedation depth in pediatric procedural sedation with rectal administration of thiopental sodium in the ED.
Administration, Rectal ; Consciousness Monitors* ; Emergencies* ; Emergency Service, Hospital* ; Hand ; Humans ; Lacerations ; Research Personnel ; ROC Curve ; Thiopental* ; Weights and Measures

Although autoimmune liver diseases are common in Western countries, only sporadic cases have been reported in Korean children. Autoimmune hepatitis, primary biliary cirrhosis, autoimmune cholangiopathy and primary sclerosing cholangitis are major classes of liver diseases currently considered autoimmune. The overlap syndrome has features associated with both autoimmune hepatitis and other liver diseases. We treated a case of the overlap syndrome that included auoimmune hepatitis and cholangiopathy in a 12 year-old boy. Considering that these entities, autoimmune liver diseases or overlap syndromes, are potentially treatable diseases in children, a high index of suspicion is needed for the appropriate diagnosis.
Child* ; Cholangitis, Sclerosing ; Diagnosis ; Hepatitis* ; Hepatitis, Autoimmune ; Humans ; Liver Cirrhosis, Biliary ; Liver Diseases ; Male

The therapeutic efficacy and significance of intraprostatic fosfomycin injection in treating patients with chronic prostatitis were reviewed. During the last 6 years, 350 patients were treated with intraprostatic fosfomycin injection for chronic prostatitis, and among them, 218 patients who could be followed up at least for 3 months were analysed. As for chronic prostatitis, when a patient's WBC count of EPS per high power field remains invariable below 15 for at least 3 months, he is said to be cured. Intraprostatic injection was performed once or twice in all patients and 153 (70.2%) cases were responsive to this treatment. But eleven patients recurred immediately within 3 months after the response. Therefore, final cure rate reached 65.1% (142/218): Adverse effects were rare, if any, they were just trivial symptoms such as mild suprapubic pain or discomfort, transient hematuria and hemospermia. These facts demonstrate that intraprostatic fosfomycin injection has much advantage in patients with chronic prostatitis as treatment modality compared with ordinary method.
Fosfomycin* ; Hematuria ; Hemospermia ; Humans ; Prostatitis*

Purpose: This study aimed to evaluate and compare the accuracy of the size of the posterior malleolar fragment measured using lateral plain radiography and three-dimensional computed tomography (3DCT) in patients with ankle trimalleolar fractures. Materials and Methods: This study enrolled 80 patients (80 ankles) with ankle trimalleolar fractures and analyzed the size of the posterior malleolar fragments using plain radiography and 3D-CT. The articular involvement of the posterior malleolar fragments was measured as a percentage of the articular surface in the sagittal length of the tibial plafond using lateral plain radiography, and the articular surface area was directly measured using 3D-CT. In addition, we classified the patients into three groups based on the morphology of the posterior malleolar fracture, according to the Haraguchi classification method, and evaluated and compared the accuracy of the size of the posterior malleolar fragments. Results: The mean articular involvement of the posterior malleolar fragments on plain radiography was 27.6% (range, 6.0%-53.1%), which was significantly higher than the mean of 21.9% (range, 4.7%-47.1%) measured using 3D-CT (p=0.004). In the analysis, according to the fracture morphology, the mean difference between the two methods was the largest for type I fractures at 9.1% (range, 1.8%-19.5%) and the smallest for type II fractures at 1.1% (range, –7.7% to 8.8%). Conclusion The articular involvement of posterior malleolar fragments measured using plain radiography showed low accuracy and significantly higher values than the actual articular involvement. Therefore, careful evaluation using 3D-CT is crucial for accurate analysis and optimal treatment in patients with ankle trimalleolar fractures.