PURPOSE:Insulin-like growth factors, IGF- I and IGF-II, are proteins that promote cellular growth and differentiation of the various organs including the kidney. These peptides circulate in serum bound to specific carrier proteins, called IGF binding proteins(IGFBPs). The IGFs are produced in most organs but liver is believed to be the principal source of circulating IGF-I. We studied the correlation of serum IGF-I and IGFBP-2 pattern with aging. METHODS:Sera were collected from 320 healthy population who were grouped according to age. IGF-I was seperated from IGFBPs by Sephadex G-50 acid chromatography. We measured serum IGF-I and IGFBP-2 by using radioimmuno-assay (RIA) and immunoradiometric assay (IRMA) respectively. RESULTS:Serum IGF-I levels were quite low in early childhood, rising slowly and reaching a peak during puberty and a significant decline(P<00.01) during adulthood. The age-dependent pattern of serum IGFBP-2 levels shows a pattern opposite to that of IGF-I which are high at birth, decline by late puberty and increase again with aging. CONCLUSION: Our results demonstrate the alteration of serum IGF-I and IGFBP- 2 pattern with aging. These data suggests that when these tests are performed in the clinic, their interpretation should be based upon age specific criteria.
Adolescent ; Aging* ; Carrier Proteins ; Chromatography ; Humans ; Immunoradiometric Assay ; Insulin-Like Growth Factor Binding Protein 2 ; Insulin-Like Growth Factor Binding Proteins ; Insulin-Like Growth Factor I ; Insulin-Like Growth Factor II ; Intercellular Signaling Peptides and Proteins ; Kidney ; Liver ; Parturition ; Peptides ; Puberty

OBJECTIVE: To estimate the long-term skeletal responses to hormone replacement therapy(HRT) with or without active vitamin D(VD) by using short-term changes of bone markers in postmenopausal women (PMW). METHODS: Biochemical markers of bone formation(osteocalcin,OC) and (&) resorption(deoxypyridinoline, Dpd ) at 3 months & lumbar bone mineral density(BMD) at 1 year were measured in 64 natural PMW taking HRT(n=41) & HRT with calcitriol 0.25 microgram/day(n=23). The correlation of percent changes of bone markers after 3 months of Tx with those in lumbar BMD after 1 year was evaluated. RESULTS: 1. serum-OC & urine-Dpd showed decrease of 20.9% & 30.1% at 3months respectively & BMD increase of 3.8% after 1 year of Tx. 2. Among 58 PMW with decreased u-Dpd change, 49 (84.5%) revealed increase in BMD, while 40 (81.6%) among 49 PMW with decreased serum-OC change showed increased BMD. 3. Bone gainers showed significant decrease in changes of serum-OC(18.1% vs 9.2% p<0.05) & urine-Dpd(32.6% vs 20.4%, p<0.05) compared with those of bone losers. 4. No correlations of change of serum-OC (r=-0.174 p>0.05) & urine-Dpd (r=-0.091 p>0.05) at 3month with BMD changes at 1year were seen in total PMW, but urine-Dpd changes in HRT without active VD group revealed significantly inverse correlation(r=-0.376 p<0.05). CONCLUSION: Short-term changes of bone markers did not precisely predict the long-term changes of BMD in total PMW except urine- Dpd in HRT without active VD.
Biomarkers ; Bone Density* ; Calcitriol ; Estrogen Replacement Therapy* ; Female ; Humans ; Osteocalcin ; Vitamin D* ; Vitamins*

The various and serious types of disaster occur everyday and everywhere on the earth. There is no doubt that it is very timely to discuss about the effectiveness and preparedness of disaster. The purpose of this study is to develop a curriculum on the disaster management through reviewing disaster concepts and the disaster management system. For the empirical relevance of the study, researchers participated in a couple or more disaster training program, reviewed references, and consulted to the experts working on action parts in the area. As a result, the 'Integrated Disaster Management System Model(IDMSM)' was designed, in which four dimensions were explained. Then the 'Disaster Curriculum Model(DCM)' was explored with its theoretical framework based on the system model. The developed curriculum is composed of four levels ; the introductory course, the fundamental course, the advanced course, and the expert course. From this DCM, basically the course-outlines of two subjects in the introductory course, 18 subjects in the fundamental course(5 of direct services, 13 of indirect services) were developed. Also each course-outline was explored by its course objective, learning objectives, contents, and its length. Finally to make the most of the results, suggestions are proposed. The governmental considerations on the policy should support the systematic and integrated educational program to practice, appointing [Disaster School] or [Disaster Training Center] of relevance and accountabilities. The further study should explore the higher levels of the DCM through interdisciplinary efforts, and develop the text materials. The further study should explore the higher levels of the DCM through interdisciplinary efforts, and develop the text materials.
Curriculum* ; Disasters* ; Education ; Learning

The purpose of this study is to verify severity of asthma in asthmatic patients through through the arterial blood gas analysis. Subjects were consisted of 103 patients (74 boys and 29 girls), between 2~13 years of ages. Clinically, asthmatic patients were classified into 6 groups, i, e., group 0(no rhonchi), group 1(rhonchi only), group 2(mild attack), group 3(moderate attack), group 4(severe attack), group 5(respiratory failure with disturbance of consciousness). PH kept normal range in the group 0, group 1, group 1 and group 3,but began decrease in the group 4.There was linear fall in Po2 and began decrease in the group 3. HCO3- maintained normal level through the whole range. BE showed acidemia on the whole, and began distinctive decrease in the group 4 and group 5, especially. Hypoxemia, hypercapnia and acidemia were common in patients in severe attacks with disturbance of consciousness.
Anoxia ; Asthma ; Blood Gas Analysis* ; Child* ; Consciousness ; Humans ; Hydrogen-Ion Concentration ; Hypercapnia ; Reference Values

The most common cause of small bowel obstruction is postoperative adhesion, and besides a hernia, metastatic or primary cancer and small bowel tumors are possible causes. Superior mesenteric artery (SMA) syndrome is a rare cause of upper gastrointestinal obstruction and is associated with debilitating conditions with marked weight loss. SMA syndrome results from the compression of the third part of the duodenum due to the narrowing of the aortomesenteric angle. We report a 28-year-old woman with SMA syndrome after acute gastroenteritis. Her stomach was severely dilated due to the duodenal obstruction and computed tomography showed the compression of the third portion of the duodenum by SMA. She was conservatively cared for and thus favorably improved.
Adult ; Duodenal Obstruction ; Duodenum ; Female ; Gastroenteritis ; Hernia ; Humans ; Mesenteric Artery, Superior ; Stomach ; Superior Mesenteric Artery Syndrome ; Weight Loss

Meigs' syndrome is defined as a hydrothorax with ascites and a pelvic tumor, both of which resolve on removal of the tumor. Pseudo-Meigs' syndrome is a variant not possessing the original tumor cell types described by Meigs. Both these syndromes should be considered in otherwise healthy women who present with either new or recurrent hydrothorax and ascites. Pseudo-Meigs' syndrome occurs with the clinical triad of (1)ascites, (2)pleural effusion and (3)Brenner tumors, struma ovarii, benign thecomas, extreme ovarian edema, uterine leiomyomas or other benign pelvic tumors. A case of Pseudo-Meigs' syndrome associated with Brenner tumor is presented with a brief review of literatures.
Ascites ; Brenner Tumor ; Edema ; Female ; Humans ; Hydrothorax ; Leiomyoma ; Meigs Syndrome ; Struma Ovarii ; Thecoma

We experienced a case of congenital rubella syndrome manifesting patent ductus arteriosus, petechiae, microcephaly, intrauterine growth retardation, and hepatomegaly in one-day-old female newborn infant. Congenital rubella syndrome was confirmed by positive results of anti-rubella IgM in the sera of patient. Anti-rubella IgM was negative in the sera of mother, while anti-rubella IgG was positive.
Ductus Arteriosus, Patent ; Female ; Fetal Growth Retardation ; Hepatomegaly ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Infant, Newborn ; Microcephaly ; Mothers ; Purpura ; Rubella Syndrome, Congenital*

PURPOSE: To determine whether subtraction images utilizing contrast media can improve the diagnostic performance of proximal caries diagnosis compared to conventional periapical radiographic images. MATERIALS AND METHODS: Thirty-six teeth with 57 proximal surfaces were radiographied using a size #2 RVG-ui sensor (Trophy Radiology, Marne-la-Vallee, France). The teeth immersed in water-soluble contrast media and subtraction images were taken. Each tooth was then sectioned for histologic examination. The digital radiographic images and subtraction images were examined and interpreted by three dentists for proximal caries. The results of the proximal caries diagnosis were then verified with the results of the histologic examination. RESULTS: The proximal caries sensitivity using digital subtraction radiography was significantly higher than simply examining a single digital radiograph. The sensitivity of the proximal dentinal carious lesion when analyzed with the subtraction radiograph and the radiograph together was higher than with the subtraction radiograph or the radiograph alone. CONCLUSION: The use of subtraction radiography with contrast media may be useful for detecting proximal dentinal carious lesions.
Contrast Media ; Dental Caries ; Dentin ; Dentists ; Diagnosis* ; Humans ; Radiography* ; Subtraction Technique ; Tooth

PURPOSE: To determine whether subtraction images utilizing contrast media can improve the diagnostic performance of proximal caries diagnosis compared to conventional periapical radiographic images. MATERIALS AND METHODS: Thirty-six teeth with 57 proximal surfaces were radiographied using a size #2 RVG-ui sensor (Trophy Radiology, Marne-la-Vallee, France). The teeth immersed in water-soluble contrast media and subtraction images were taken. Each tooth was then sectioned for histologic examination. The digital radiographic images and subtraction images were examined and interpreted by three dentists for proximal caries. The results of the proximal caries diagnosis were then verified with the results of the histologic examination. RESULTS: The proximal caries sensitivity using digital subtraction radiography was significantly higher than simply examining a single digital radiograph. The sensitivity of the proximal dentinal carious lesion when analyzed with the subtraction radiograph and the radiograph together was higher than with the subtraction radiograph or the radiograph alone. CONCLUSION: The use of subtraction radiography with contrast media may be useful for detecting proximal dentinal carious lesions.
Contrast Media ; Dental Caries ; Dentin ; Dentists ; Diagnosis* ; Humans ; Radiography* ; Subtraction Technique ; Tooth

BACKGROUND : Borame hospital nuns geriatric wards with 120 beds (40 beds for patients in Dept. of Internal Medicine, 40 for patients in Dept. of Orthopedics 40 for patients in Dept. of Neurology) from December 1996. We studied clinical characteristics of admissions to acute geriatric wards in Borame hospital in order to assess current status of geriatric wards in Korea. METHODS : 334 patients admitted from December 1996 to May 1997 were studied. By reviewing clinical records of these patients, we studied clinical characteristics of patients in geriatric wards retrospectively. RESULTS : 1) Age distribution: 8.6% of patients were over 85 years old. 16.4% of patients were between age of 80-84. 20.0% between 75-79, 31.3% between 70-74, 26.3% between 65-69, respectively. 2) Disease: 43% of patients have single disease, 67% of patients have multiple disease(23% of patients with 2 disease, 25% with 3 disease, 6% with 4 disease, 3% with over 5 disease respectively). 3) Mortality rate :Total mortality rates were 4.3% with 6.1% of patients in Internal medicine, 3.2% of patients in Neurology. These rates were much higher compared with mortality rates of 2.4% in general wards but similar to those (6.7%) in general wards in Internal medicine. 4) Causes of admission: Malignancies were most common causes of admissions in males, and then cerebrovascular diseases, infectious diseases, musculoskeletal diseases, in order. Musculoskeletal diseases were most common causes, and then diabetes mellitus, infectious diseases, cerebrovascular diseases. CONCLUSION : The elderly patients tend to have multiple diseases, longer hospital stays and higher mortality rates compared with younger patients in general wards. but differences of hospital stays and mortality rates are less than be expected.
Age Distribution ; Aged ; Aged, 80 and over ; Communicable Diseases ; Diabetes Mellitus ; Humans ; Internal Medicine ; Korea ; Length of Stay ; Male ; Mortality ; Musculoskeletal Diseases ; Neurology ; Orthopedics ; Patients' Rooms ; Retrospective Studies