Sine the success of human growth hormone (GH) synthesis by DNA recombinant technology, these GH products are widely used in the treatment of children with growth hormone deficiency. Recently, methionyl-GH has been produced in the yeast, Saccaromyces cerevisiae 2150, by the use of a DNA recombinant method in Korea. The purpose of this study was to investigate the clinical efficacy, side effect and immunogenicity of this GH product during therapy of 3year in 22 children with naive GH deficiency. The subjects of this study are aged 4.5~17.9 years, diagnosed by the failure of plasma GH to respond to insulin induced hypoglycemia, arginine and/or clonidine loading and height below -2 standard deviation of mean for their chronological age. Each subjcct received GH 0.45IU/kg/week, intramusculary in 3 devided dose, During treatment, vital signs, height and body weight checked before and every 3 months. Blood count urinalysis, blood chemistry, bone age and measurement of thyroid hormone were performed before, every 3months in year 1, and every 6 months in year 2 and 3. Assay of antibody against GH were performed before, year 1,2 and 3. The height velocity was significantly increased from an average baseline level of 2.9+/-1.1cm/year to 7.9+/-1.9cm/year after the first year, 6.6+/-1.1cm/year during the second year, and 5.9+/-1.2cm/year during the third year of GH treatment. The height standard deviation score for chronological age was decreased from an average baseline of 3.5+/-1.3 to 2.9 1.2 after the first year, 2.7 +/-1.1 during the second year, and 2.5+/-1.2 during the year of GH treatment. The increment in height age was significantly increased from an average baseline of 0.6+/-0.2 year to 1.3+/-0.3 year in year 1, 1.1+/-0.3 year in year 2, and 1.0+/-0.2 year in year 3. The increment in bone age was significantly increased from an average baseline of 0.6+/-0.2 year to 1.2+/-0.2 in year 1, 1.3+/-0.3 year in year , 2, and 1.1+/-0.3 year in year 3. Antibody against hGH was observed in 3 of the 22 patients(13.5%) in year 1 and 1 and in 2 of the 17 patients(17.7%) in year 3. And unwanted side effects were not observed in any of the 22 patients. These results suggest that this yeast derived recombinant methionyl growth hormone appears to be a safe very effective product for treating of children with GH deficiency.
Arginine ; Body Weight ; Chemistry ; Child* ; Clonidine ; DNA ; Growth Hormone* ; Human Growth Hormone ; Humans ; Hypoglycemia ; Insulin ; Korea ; Plasma ; Thyroid Gland ; Urinalysis ; Vital Signs ; Yeasts*

No abstract available.
Anxiety* ; Arachnoid*

Many authers insisted that the fracture-dislocation of the vertebral column with locked facet, bilateral dislocation of articular facets which resistant to closed reduction, were necessary to posterior stabilization with anterior decompression. But using Harrington-Distraction rod, we experienced that the acceptable reduction of locked facet and posterior impinged bony fragments without anterior decompression, were obtained.
Decompression ; Dislocations ; Spine

A review of 15 cases of the modified Bristow operation for recurrent anterior shoulder dislocation from Jan. 1983 to Dec. 1988 was presented. Using arthroscopy, we could examined the pathologic feature of the recurrent anterior dislocation of the shoulder. The results are as following. 1. The ages at the initial dislocation were ranged from 15 to 26 years and operated from 19 to 61 years. 2. The most common injury mechanism of the dislocation was sports injury (5 cases) and followings were traffic accident, military training, hanging with one hand. 3. The 10 cases were dislocated above 10 times before operation and 3 were dislocated above 10 times per year. 4. Bony lesions were detected on routine X-ray at 8, that is A-P and lateral view, Hill-sach's view, Stryker-notch view and West point view, Hermoddson view, and apical obique view. 5. Arthroscopic examination was done at 7 cases and could detect the pathologic lesion more exactly. 6. All were treated with modified Bristow method 7. Mean follow up periods were 2 year and 4 monthes. 8. The range of motion was not limited but external rotation was done about 18. 9. Excellent results were obtained by Rowe's grading system, mean 88.8.
Accidents, Traffic ; Arthroscopy ; Athletic Injuries ; Dislocations ; Follow-Up Studies ; Hand ; Humans ; Methods ; Military Personnel ; Range of Motion, Articular ; Shoulder Dislocation ; Shoulder

STUDY DESIGN: The treatment of a stable fracture around thoracolumbarjunction is a controversial subject. OBJECTIVES: To evaluate the result from long term follow-up of the stable spinal fracture around thoracolumbar junction according to the operation, osteoporosis and in situ extension bar, respectively. SUMMARY OF BACKGROUND DATA: The thoracolumbar junction is a transitional zone in which the kyphotic angle of thoracic spine is continued to the lordotic angle of lumbar splne. So it is prone to be injured biomechanically, and the stability of the spine around thoracolumbar junction is not determined yet. METHODS: We studied retrospectively 105 cases of the stable fracture around thoracolumbar junction from January 1985 to December 1995. The criteria of the stability were a compression fracture by Denis F., a bursting fracture without involvement of posterior column, a neural enchroachment of bony fragment below 30%, fracture without subluxation or dislocation in spinal junction. RESULTS: The most common cause was traffic accident and, the first lumbar vertebrate was common site. Below 30% of initial compression, the progression was not exceded 5% in operative group. But in nonoperative group, anterior compression was more progressed than initial compression over 5%. The degree of anterior compression was affected by osteoporosis and in situ extension bar just after injury. CONCLUSIONS: We suggest an anterior compression abode 30% in spinal body of thoracolumbar junction for an additional operative indication. The prognosis may be affected by osteoporosis and in situ extension bar.
Accidents, Traffic ; Dislocations ; Follow-Up Studies* ; Fractures, Compression ; Osteoporosis ; Prognosis ; Retrospective Studies ; Spinal Fractures ; Spine ; Vertebrates

The diagnosis and treatment of avascular necrosis of femoral head advanced, after Freud issued examples of bilateral avascular necrosis of femoral head (AVN) in 1926. But still not fixed in treatment and diagnosis. Recently early diagnosis and treatment produced good result. Whole body bone scan, intraosseous pressure mornitoring, intramedullary venography, C-T, or MRI, Selective femoral angiography also used in early diagnosis. Selective femoral angiography was performed for 56 patients, who has suspected as AVN by sumple X-ray and WBBS in order to estimate. How the femoral angiographic finding exist in AVN. In the control group femoral angiography performed to 5 person with normal stage of clinical and radiologic finding. So the result are as following l. All cases in the control group were not observed terminal branch of superior and inferior capslar branch. 2. In AVN the alteration of vasculature appeared 22 patients among 56 patient. 3. The altered vasculature presented 87.5% in traumatic group and 31.5% in nontraumatic group. 4. Collateral circulation was 22.2% in the cases of patients under 6 moths of the time interual between etiological events and clinical symptoms, 89.5% over 6 months. 5. Collateral circulation received 86.8% from inferior gluteal artery two cases from superior gluteal artery, and three cases form obturator artery. 6. Clinical tolerance was supposed to in well developed collateral circulation. According to the above results, Vascular alteraion were noted very much in traumatic group and development of collateral circulation were related promote clinical tolerance. Selective femoral angiography was not effective to assist early diagnosis and treatment of AVN for it could not detect terminal branch of superior and inferior capsular artery that reflected intraossous vasculsture. We need the new nethod of angoigraphy in order to early diagnosis.
Angiography ; Arteries ; Collateral Circulation ; Diagnosis ; Early Diagnosis ; Head ; Hip ; Humans ; Magnetic Resonance Imaging ; Moths ; Necrosis ; Phlebography

No abstract availalbe.

STUDY DESIGN: Ninty eight patients with multilevel spinal stenosis who were treated with posterior decompression and instrumented posterolateral fusion were reviewed retrospectively. All patients were divided two groups by pathologic level and surgery level. One is complete level decompression group (whole pathologic levels were decompressed) and the other is limited level decompression group (less than pathologic levels were decompressed). SUMMARY OF BACKGROUND DATA: Many patients with spinal stenosis haute multilevel pathology, which is very difficult problem to make surgical strategy for determination of decompression level. METHOD: Patients were reviewed using combination of clinical records, follow-up examinations and radiographs. Posterior decompression and instrumented posterolateral fusion were performed in all patients using pedicle screw fixation (TSRH 49 cases, Diapason 37 cases, CCD 12 cases) and either autogenous bone graft alone or autograft with allograft. The average follow-up period was 19.7 months. RESULTS: In the clinical results by the criteria of Kirkalldy-Willis, there was no difference between complete level decompression group and limited level decompression group. By the bone graft mothorts, fusion rate was no difference between autograft alone group and autograft with allograft group, but fusion periods were more shorter in autograft alone group than in autograft with allograft group(P>0.05). CONCLUSION: In multilevel spinal stenosis, the segments that associated with neurologic symptoms or seyeie stenosis on radiograph must be decompressed but the segments that not associated with neurologic symptoms and mild stenosis on radiograph do not need preventive decompression.
Allografts ; Autografts ; Constriction, Pathologic ; Decompression ; Follow-Up Studies ; Humans ; Neurologic Manifestations ; Pathology ; Retrospective Studies ; Spinal Stenosis* ; Transplants*

In orper to measure the levels of high density lipoprotein cholesterol in psoriasis, 60 psoriatic patients and 30 healthy subjects were included in this study. Lopez-Virells methos was applied for measuring the serum level of high density lipoprotein cholesterol. The results were obtained as follows. The level of serurn HDL cholesterol was 58. 39+17. 40 mg/dl in psoratcs and 50.3+0.31 mg/dl in healthy subjects and 50. 43+ 10. 31 mg/dl in healthy subjects. No significant differences were noted between psoriatics & healthy subjects. 2. The level of serum HDL cholesterol was 56. 40+19. 10 mg/dl in male group of psoriatics and 60. 00+15.47 mg/dl in female group of psoriatics and 48.3+9. 50 mg/dl in healthy male group and 52.60 -10.59 mg/dl in healthy female group. No significant differences of serum HDL cholesteol levels were noted in both sexes.3. The mean value of serum HDL cholesterol by age groups of 10, 20, 30, 40, and 50 years old with psoriasis were 50. 70 mg/dl, 61. 97 mg/dl, 57. 44 mg/dl, 49. 11 mg/dl and 70. 36 mg/dl, respectively and those of healthy groups were 57. 25 mg/ dl, 45. 17 rng/dl, 50. 97 rng/dl, 48. 07 mg/dl and 46. 98 mg/dl, respectively.
Cholesterol, HDL* ; Female ; Humans ; Male ; Middle Aged ; Psoriasis*

No Abstract Available.
Cataract*