It has been proven that the newborn screening programs for congenital hypothyroidism are very important for its early detection and the early treatment of congenital It has been proven that the newborn screening programs for congenital hypothyroidism are very important for its early detection and the early treatment of congenital hypothyroidism can ameliorate and possibly reverse its consequences. Treatment with L-thyroxine is started in case of suspicious hypothyroidism at the first visit. Serum concentration of total and free thyroxine become normal within 1week after start of therapy but TSH values become normal from 2 months to 6 months after L-thyroxine therapy. The possible explanations for prolonged TSH elevation in congenital hypothyroidism are poor compliance for therapy, an inadequate dose of L-thyroxine, elevated threshold for thyrotropin suppression and two novel mutations in the thyrotropin (TSH) receptor gene in a child with resistance to TSH. Authors have experienced two cases of prolonged TSH elevation with normal T3 and T4 levels till 18months and 27 months of age after optimal L-thyroxine therapy and literature were reviewed.
Child ; Compliance ; Congenital Hypothyroidism* ; Humans ; Hypothyroidism ; Infant, Newborn ; Mass Screening ; Thyrotropin ; Thyroxine

OBJECTIVE: To evaluate whether the basal serum luteinizing hormone (LH) levels in the presence of normal serum follicle stimulating hormone (FSH) are useful as a prognostic indicator of ovarian response to controlled ovarian hyperstimulation (COH). METHODS: From January 1997 to January 1999, 91 infertile women with tubal factor who had undergone in vitro fertilization and embryo transfer (IVF-ET) were enrolled in the present study. COH was performed using long protocol of gonadotropin-releasing hormone (GnRH) agonist. All patients included in this study had blood samples drawn on cycle day 2 or 3 prior to COH for measurement of basal FSH and LH. Women who had other infertility factors or high basal FSH levels (> or = 8.5 mIU/ml) were excluded from this study. The results of COH and IVF-ET were compared between two groups according to the level of basal LH (low LH group [< 3mIU/ml] vs. control group [> or = 3mIU/ml]). RESULTS: Patient's characteristics were comparable in both groups except basal LH level. The number of ampules and duration of exogenous gonadotropins required were significantly higher in the low LH group than those in the control group (p<0.001; p<0.005, respectively). The number of follicles > or = 14mm diameter on the day of human chorionic gonadotropin (hCG) injection was significantly less in the low LH group than that in the control group (p<0.001). The serum estradiol level on the day of hCG injection was also significantly lower in the low LH group, with 1115.5 +/- 380.9 pg/ml compared with 1340.6 +/- 403.0 pg/ml in the control group (p<0.005). There were significantly lower numbers in oocytes retrieved, oocytes fertilized and embryos frozen in the low LH group than those in the control group (< 0.001; < 0.001; <0.005, respectively). However, there was no difference in the fertilization rate between the two groups. The clinical pregnancy rate per cycle seemed to be lower in the low LH group, but the difference did not achieve significance (26.2% vs 39.7%). There were no differences in the miscarriage rate and multiple pregnancy rate between the two groups. CONCLUSION: This study demonstrates that the low basal LH levels ( < 3 mIU/ml) could be predictive of low ovarian response to COH and poor IVF results.
Abortion, Spontaneous ; Chorionic Gonadotropin ; Embryo Transfer ; Embryonic Structures ; Estradiol ; Female ; Fertilization ; Fertilization in Vitro ; Follicle Stimulating Hormone ; Gonadotropin-Releasing Hormone ; Gonadotropins ; Humans ; Infertility ; Lutein* ; Luteinizing Hormone* ; Oocytes ; Pregnancy ; Pregnancy Rate ; Pregnancy, Multiple

Plasma cholesterol is increased in normal aging in both rodents and humans. This is associated with reduced elimination of cholesterol and decreased receptor-mediated clearance of plasma low-density lipoprotein (LDL) cholesterol. The aims of this study were: (1) to determine age-related changes in plasma lipid profiles, and (2) to determine the effect of fenofibrate, an activator of peroxisome proliferator activated receptor alpha (PPAR alpha), on plasma lipid profiles in normal rats on a standard diet. Male Sprague-Dawley (SD) rats (n=15) were fed standard chow and water from 10 to 25 weeks of age. During that period, we measured daily food intake, body weight, fasting and random blood glucose levels, plasma total cholesterol (TC), triglycerides (TG), and free fatty acid (FFA) levels. At 20 weeks of age, all rats were randomly divided into two groups: a fenofibrate group (in which rats were gavaged with 300 mg/kg/day of fenofibrate) and a control group (gavaged with water). Fenofibrate treatment lasted 5 weeks. There were no significant changes in daily food intake, blood glucose, and plasma TG level with age. Body weight, plasma TC, and FFA levels were significantly increased with age. Fenofibrate significantly decreased plasma concentrations of TC and FFA, which had been increased with age. However, fenofibrate did not influence the plasma concentration of TG, which had not increased with age. These results suggest that fenofibrate might have a novel role in preventing age-related hypercholesterolemia in SD rats on a normal diet.
Aging ; Animals ; Blood Glucose ; Body Weight ; Cholesterol ; Diet ; Eating ; Fasting ; Fenofibrate ; Humans ; Hypercholesterolemia ; Lipoproteins ; Male ; Plasma ; PPAR alpha ; Rats ; Rats, Sprague-Dawley ; Rodentia ; Triglycerides ; Water

Influenza virus culture was performed in 149 patients with influenza-like illness who were admitted or visited to the Department of Pediatrics, Asan Medical Center from january, 1991 to March, 1991. The results were as follows; 1) Of the 149 patients, influenza virus were isolated in the 15 cases. 15 isolates were characterized by the WHO Collaborating Center for influenza: 7 cases were very similar to influenza A/Taiwan/1/86 (H1N1), 1 case was A/Beijing/353/89 (H3N2), 7 cases were B/Guangdon-g/55/89. 2) The age of 15 patients who were confirmed by viral isolation was between 11 months to 10 years. 3) The most common clinical symptoms were fever, vomiting, cough, nausea in deceasing order. 4) Of the total 149 patients, Reye syndrome occured in two patients and myositis occured in one: Influenza A/Taiwan/1/86 (H1N1) virus was isolated in one Reye syndrome patient.
Chungcheongnam-do ; Cough ; Fever ; Humans ; Influenza, Human* ; Myositis ; Nausea ; Orthomyxoviridae ; Pediatrics ; Reye Syndrome ; Seoul* ; Vomiting

We presented here a rare case of intestinal Behecet's disease simulating Grohn's disease. A 20 year old female complained of recurrence of oral ulcer, genital ulcer, arthralgia, erythema nodosum, abdominal pain and diarrhea, but she had no anal ulcer or anal fistulas. The colonoscopic examanation disclosed diffuse colonie involvement with multiple longitudinal ulcers and inflammatory pseudopolyposis. In hospital, she received ileocecectomy because of distal ilea perforation. Postoperative specimen showed multiple geographic ulcer on ileocecal region, creeping mesenteric fat and thickening of cecal wall. Pathological examination showed perivasculitis, transmural inflammation, fissuring, multiple lymph follicles which are compatible with intestinal Behect's disease. There were no granuloma sugges tive of Crohn's disease. Clinically, the patient met the international criteria of Behcet's disease. Punched out ulcer in the ileocecal region and pathological findings described above confirmed the diagnosis of intestinal Behcet's disease.
Abdominal Pain ; Arthralgia ; Colon* ; Crohn Disease ; Diagnosis ; Diarrhea ; Erythema Nodosum ; Female ; Fissure in Ano ; Granuloma ; Humans ; Inflammation ; Oral Ulcer ; Rectal Fistula ; Recurrence ; Ulcer* ; Young Adult

[Objective] It makes a through study on the popularization and usefulness plan of Moxa Combustion, therefore popularizing practical use of that.
[Methods] It was based on the established treatises and books, in order to studying about the literature of Moxa Combustion.
[Results & Conclusions] It makes a through study on the whole of Moxa Combustion, the results as follows.
1. We explained (illustrated) the origin, history, classification and mechanism (effect) of Moxa Combustion.
2. The study of standardization plan of Moxa Combustion for popularization.
The thermal stimulation of Moxa Combustion was decided the characteristic pattern of combustion temperature by moxa burning and that makes a measure to grasp the effective action of Moxa Combustion upon human body. Thereupon it is necessary to continue further studies by analyzing the characteristic pattern of combustion temperature by moxa burning and there clinical effects in practice.
3. The usefulness of Moxa Combustion.
The therapeutic effect of Moxa Combustion are hematopoiesis (increase the blood), analgesic function, increase the immunity, antioxidant activity, diuretic action, control of hormone (endocrine gland), suppression of carcinogenesis, increase the self involution (natural healing), decrease of GOT/GPT, glucose, cholesterol level.

OBJECTIVE: Many countries including U.S. have established their own Antenatal Screening Guideline suitable for their actual state to help Obstetricians detect pregnancy-related problems in clinical conditions. However, even investigations on the actual condition of Antenatal Screening in clinical conditions are not thoroughgoing enough in Korea. Therefore, this study was to survey the actual condition of Antenatal Screening in Obstetric Clinics in Korea. METHODS: Among 868 Obstetric Clinics, in which 100 or more cases of delivery were performed per annum according to an aggregate summary of the National Health Insurance Corporation in 2001, 848 clinics representing their correct address were selected to carry out a cross-sectional descriptive survey and understand the actual state of Antenatal Screening with literature review. RESULTS: Antenatal Screening Tests have been carried out in a diverse forms in Obstetric Clinics; some items (CBC, Urine analysis, VDRL test, ABO and Rh typing, HBs Ag and HBs Ab test, Triple test, Ultrasound, Rubella Ig M and Ig G test, Oral Glucose Tolerance test) of the test were performed as a basic test in 80% or higher of Obstetric Clinics; some items (Chlamydia test, PAPP-A, Chest X-ray, BUN, Creatinine, EKG, Cervix culture for Gonococcus) of the test were performed routinely in 10% or less of Obstetric Clinics or selectively in high-risk pregnant women; and some items (PAP smear, Blood chemistry, Nuchal translucency) of the test were performed on the basis of physician's experience or given conditions. CONCLUSION: According to the findings of this study, the role of Antenatal Tests as a screening test in clinical conditions is not evaluated properly under the current state. Thus, clinical assessment should be performed for each item of Antenatal Tests with respect to a screening test and systematic and efficient Antenatal Screening Guideline suitable for Korean conditions should be established in future studies.
Cervix Uteri ; Chemistry ; Creatinine ; Electrocardiography ; Female ; Glucose Tolerance Test ; Humans ; Korea* ; Mass Screening ; National Health Programs ; Pregnancy-Associated Plasma Protein-A ; Pregnant Women ; Prenatal Diagnosis* ; Rubella ; Thorax ; Ultrasonography

PURPOSE: The aim of this study was to compare the difference in acute stroke management between urban and rural areas, to investigate the factors affecting these differences, and to acquire basic information for establishing an efficient regional hub and spoke system for stroke patients. METHODS: This retrospective study was based on adult patients diagnosed with acute ischemic stroke from January 2012 to December 2012 at a regional cerebrovascular center. The term "acute" was defined as 24 hours from symptom recognized. The term "urban" was defined as the region within the boundary of a metropolitan area. The distance from the symptom onset location to the stroke center was calculated using a global positioning system. RESULTS: The rate of arriving at a stroke center within 3 hours after stroke recognition for acute ischemic stroke patients was much higher in urban areas compared to rural areas (27.5 vs. 19.2%, respectively; p-value=0.011). In stroke cases in rural areas, the distance from symptom onset location to a stroke center was determined as statistically significant through multivariate logistic regression analysis (Odds ratio (OR), 0.982; 95% Confidence interval (CI) 0.969-0.995). In contrast, the use of a public ambulance (OR, 4.258; 95% CI 2.233-8.118) and inter-hospital transfer (OR, 0.416; 95% CI 0.216-0.800) were the main prehospital delay factors in urban areas. CONCLUSION: For stroke cases in urban areas, it was important to directly visit a stroke center without transfer using a public ambulance. For rural areas, a new hub hospital and policies are necessary for reducing prehospital delay.
Adult ; Ambulances ; Emergency Medical Services ; Geographic Information Systems ; Humans ; Logistic Models ; Retrospective Studies ; Stroke*

During laparoscopic surgery, carbon dioxide (CO2) pneumothorax can develop due to a congenital defect in the diaphragm. We present a case of a spontaneous massive left-sided pneumothorax that occurred during laparoscopy-assisted gastrectomy, because of an escape of intraperitoneal CO2 gas, under pressure, into the pleural cavity through a congenital defect in the esophageal hiatus of the left diaphragm. This was confirmed on intraoperative chest radiography and laparoscopic inspection. This CO2 pneumothorax caused tolerable hemodynamic and respiratory consequences, and was rapidly reversible after release of the pneumoperitoneum. Thus, a conservative approach was adopted, and the remainder of the surgery was completed, laparoscopically. Due to the high solubility of CO2 gas and the extra-pulmonary mechanism, CO2 pneumothorax with otherwise hemodynamically stable conditions can be managed by conservative modalities, avoiding unnecessary chest tube insertion or conversion to an open procedure.
Carbon Dioxide* ; Carbon* ; Chest Tubes ; Congenital Abnormalities ; Conversion to Open Surgery ; Diaphragm ; Gastrectomy* ; Hemodynamics ; Laparoscopy ; Pleural Cavity ; Pneumoperitoneum ; Pneumothorax* ; Radiography ; Solubility ; Thorax ; United Nations

BACKGROUND AND OBJECTIVES: Pulmonary embolism (PE) is a disease with high mortality if left untreated. But, confirmative diagnosis is difficult because many diagnostic modalities are nonspecific. Pulmonary angiography, which is considered as the gold standard diagnostic tool, is invasive, costly, time-consuming, and not always available in small centers. Echocardiography is a non-invasive and available in the emergency room without significant time delay. We investigated the role of echocardiography as a screening test in patients with suspected PE. MATERIALS AND METHODS: (A) Retrospective study: We analyzed the recorded videotapes of transthoracic echocardiography in fifty patients with confirmed PE from Jan 1995 to Aug 1999. From the frequent echocardiographic findings of those patients, positive criteria were defined as followed ( 2 among 1-5 or only 6). (1) RV or pulmonary artery dilatation (RVEDA/LVEDA 0.6) (2) RV hypokinesis (3) paradoxical septal wall motion (4) pulmonary hypertension (5) TR (moderate degree or more) (6) Visible thrombus. Although the degree of TR was less than moderate, if the degree of pulmonary hypertension was more than moderate, we considered as PE. (B) Prospective study: From Nov 1999 to June 2000, patients with suspected pulmonary embolism underwent a transthoracic echocardiography and perfusion-ventilation lung scan or chest CT. We assessed echocardiographic findings, sensitivity and specificity of the previously defined echocardiographic positive criteria for PE. RESULTS: (A) Retrospective study: The sensitivity of echocardiography for PE was 74%. (B) Prospective study: The number of enrolled patients was thirty-four. In twenty patients the diagnosis was PE. The sensitivity of echocardiography was 75% but the specificity was 14%. CONCLUSION: Echocardiography may be used as a good screening test in patients who are clinically suspicious of pulmonary embolism.
Angiography ; Diagnosis ; Dilatation ; Echocardiography* ; Emergency Service, Hospital ; Humans ; Hypertension, Pulmonary ; Lung ; Mass Screening* ; Mortality ; Prospective Studies ; Pulmonary Artery ; Pulmonary Embolism* ; Retrospective Studies ; Sensitivity and Specificity ; Thrombosis ; Tomography, X-Ray Computed ; Videotape Recording