PURPOSE:Decreased bone mineral density(BMD) has been reported in girls with Turner syndrome. Estrogen therapy is recommanded to improve sexual infantilism and decreased BMD. Short stature is also characteristic finding in patients with Turner syndrome. Treatment modality for short stature has included estrogen, anabolic steroids and growth hormone(GH). Recently GH therapy in GH deficient children could increase BMD in addition to improve short stature. We observed the treatment effects on bone mineral density in patients with Turner syndrome. METHODS: Bone Mineral Density in second to fourth lumbar spine area were measured by dual energy X-ray absorptiometry in 56 girls with Turner syndrome, before and after growth hormone and/or estrogen. All Turner girl was confirmed by clinical and chromosomal examination. RESULTS: 1) There was no significant difference in BMD according to karyotype. 2) The mean BMD of untreated Turner syndrome was 0.752+/-0.122g/cm2. 3) The mean BMD before and after GH treatment were 0.620+/-0.028g/cm2, 0.793+/-0.093g/cm2 respectively. The mean BMD before and after estrogen treatment were 0.761+/-0.125g/cm2, 0.918+/-0.141g/cm2 respectively. In combined group, the BMD were 0.752+/-0.087g/cm2 and 0.939+/-0.134g/cm2. Growth hormone was also effective to improve BMD as well as estrogen. But the changes of BMD were more significant in estrogen and combined group(p<0.05). 4) A significant positive correlation was found between age and BMD(p<0.05). CONCLUSIONS:Estrogen therapy can accelerate epiphysial maturation and compromise final height. Growth hormone therapy in Turner girls was effective for improvement bone mineral density as well as growth improvement. But growth hormone and estrogen combined therapy or Estrogen therapy is more effective to improve bone mineral density in Turner syndrome. Estrogen replacement can be delayed for a while on growth hormone treatment and the appropriated time of estrogen therapy should be elucidated.
Absorptiometry, Photon ; Bone Density* ; Child ; Estrogen Replacement Therapy ; Estrogens ; Female ; Growth Hormone ; Humans ; Karyotype ; Sexual Infantilism ; Spine ; Steroids ; Turner Syndrome*

No abstract available.
Acoustics* ; Vocal Cord Paralysis* ; Vocal Cords*

This study was carried out to evaluate the effects of stevia (Stevia rebaudiana Bertoni) leaf powder on soybean milk quality. Soybean milk was prepared with the addition of 0.1 g (SP1), 0.2 g (SP2), 0.3 g (SP3), 0.4 g (SP4) of stevia leaf powder. The pH of soybean milk added with stevia leaf powders ranged from 7.90 to 7.98, whereas that of control was 7.88. The viscosity of soybean milk added with stevia leaf powder was 11.13~12.71 cp while that of control was 11.09 cp. Soymilk added with stevia leaf powder yielded values of Hunter L (59.40~64.94), a (-7.63~-6.45), and b (18.71~19.63), whereas that of control were 67.45, -4.74 and 20.13, respectively. There was decrease upon addition of stevia leaf powder. During storage, the pH, viscosity, L, and b values were decreased continuously. According to sensory evaluation, taste, and flavor of SP3 were better than the other groups. Quality characteristics between control and SP3 showed no significant differences. Therefore, this study showed the possibility of substituting 0.3 g of stevia leaf powder instead of sugar for creating a standard quality soybean milk with low calories. Upon the results of this study, it may be assumed that there are consequences positive responses to health-oriented consumers when using stevia leaf powder.
Hydrogen-Ion Concentration ; Milk* ; Powders ; Soybeans* ; Stevia* ; Viscosity

OBJECTIVES: The purpose of this study is to compare public stigma against mental patients and mental patients' perceived stigma. METHODS: 549 members of general populations participated in the survey which included questions regarding prejudice and discrimination against mental mental patients, while 377 mental patients participated in the survey which included questions regarding perceived prejudice, experienced discrimination and a coping orientation to social stigma. RESULTS: The mental patients perceived prejudice more compared to public prejudice toward the mental patients. And they experienced discrimination less compared to public's practice of discrimination against mental patients. Also mental patients used passive-avoidance coping orientation against social stigma. CONCLUSION: This study concluded that consumer empowerment program for mental patients is just important as anti-stigma campaign.
Discrimination (Psychology) ; Humans ; Mentally Ill Persons* ; Power (Psychology) ; Prejudice ; Social Stigma

Over the past 30 years, there has been an increase in the incidence of multifetal pregna-ncies, primarily because of the introduction of ovarian stimulants for ovulation induction and assisted reproductive technology ( ART ) in infertile patients. It is well established that multifetal pregnancies are associated with an increased frequency of the maternal complications and gre-ater perinatal morbidity and mortyality. The adverse outcome of multifetal pregnancies is dire-ctly proportional to the number of fetuses, primarily as an consequence of prterm delivery. Re-duction in the number of fetuses in multifetal pregnancies has been proposed as a way to impr-ove the perinatal outcome in this situation. Therefore, selective fetal reduction ( SFR ) is sugges-ted as a therapeutic option for continuation of pregnancy with fetuses mature enough to survi-ve. In this paper, we report our infertility clinic experiences with 6 patients who carried mult- ifetal pregnancies including 1 quintuplet, 1 quadruplet, and 4 triplets. from January, 1991 to May, 1996, transabdominal SFR was accomplished by fetal intrathoracic KCl injection at 9~10 weeks of gestation. After the prcedure, 4 patients remained as twin pregnancies, and 2 patients as single pregnancy. There have been 3 sets of twin deliveries and the 2 sets of single delivery. One case was aborted. Two patients were delivered after 37 weeks of gestation, 2 patients were at 35 weeks, and 1 patient at 24 weeks. All babies have been healthy after birth in patients after 35 weeks gestation. There was no fetal anomaly related to the procedure in the 6 cases. We concluded that transabdominal SFR is a rather safe and useful procedure that may improve the outcome of multifetal pregnancies.
Fetus ; Humans ; Incidence ; Infertility ; Ovulation Induction ; Parturition ; Pregnancy Reduction, Multifetal* ; Pregnancy* ; Pregnancy, Twin ; Quadruplets ; Quintuplets ; Reproductive Techniques, Assisted ; Triplets ; Twins

BACKGROUND: This study aimed to explore the associations of social-demographic, health-behavioral, and woman-specific factors with the non-screening status of the cervical cancer screening test in Korean adult women. METHODS: This study was a cross-sectional analysis of 9,698 Korean adult women aged 20 years or more who participated in the Korea National Health and Nutrition Examination Surveys V (2010–2012). Rao-Scott chi-square tests and survey logistic regression analyses were employed respectively to analyze the difference in the non-screening status of the cervical cancer screening test by each characteristic and to explore the factors related to the non-screening status. RESULTS: The rate of the non-screening status of the cervical cancer screening test was 53.5% over the previous 2 years. In the survey logistics regression analysis, age, marital status, educational levels, income levels, residential area, occupation, private health insurance, smoking, alcohol, obesity, menstrual status, pregnancy experience, and hormone replacement therapy were significantly associated with the non-screening status of the cervical cancer screening test. CONCLUSION On the basis of the results of this study, some social-demographic, health-behavioral, and woman-specific characteristics of Korean adult women seem to affect the non-screening status of the cervical cancer screening test. Therefore, appropriate health policies need to be designed, implemented, monitored, and evaluated to reduce the non-screening status of the cervical cancer screening test of them.

Succinylcholine(SCC) is well known to elevate the serum potassium level and to threaten life in some cases. In order to minimize the elevation of serum potassium following SCC, several attempts have been made such as SCC tamming and pretreatment with pancuronium or lidocaine or diazepam. Our study was undertaken to evaluate the change of serum potassium following induction in 60 patients divided into 7 different groups; group l. SCC 1mg/kg; group ll. SCC 2 mg/kg, grouplll, SCC 1mg/kg after SCC 10mg; group IV, SCC 1mg/kg after pancuronium 0.015mg/kg, group V. Pnacuronium 0.1mg/kg; group VI, SCC 1mg/kg after Lidocaine 1mg/kg; grou VII, SCC 1mg/kg after Diazepam 0.2mg/kg. The results were as follows: 1) Serum potassium were increased 0.14mEq/L in group l and 0.17 mEq/L in group ll. 2) Serum potassium were decreased in group lll, VI and VII than their control values but they were not statistically significant. 3) The decrease in serum potassium was most significant in group IV and V.
Calcium ; Diazepam ; Humans ; Lidocaine ; Pancuronium ; Potassium ; Succinylcholine

Direct puncture and embolization of the transverse sinus (TS) for treatment of dural arteriovenous fistula (DAVF) is typically performed with coils with or without glue. We report a case of DAVF at the left TS that was treated with Onyx embolization via direct puncture of the TS. A 75-year-old woman presented with tremor, festinating gait, and dysarthria. A left TS-DAVF with retrograde superior sagittal sinus and cortical venous reflux (Cognard type IIa+b) was identified on cerebral angiography, and both TSs were occluded with thrombi. We considered that achieving complete cure by transvenous embolization via the femoral vein or transarterial embolization via occipital feeders would be difficult. Thus, we performed a small craniotomy at the occipital bone to puncture the TS. The midportion of the TS was directly punctured with a 21-G microneedle under fluoroscopic guidance. We inserted a 5-F sheath into the TS. A microcatheter was then navigated into the affected sinus. Coils were placed through the microcatheter to support Onyx formation by reducing the pressure of shunting flow. Onyx embolization was performed with the same microcatheter. The DAVF was almost completely occluded except for the presence of minimal shunting flow to the proximal TS. After 1 week, time-of-flight magnetic resonance angiography showed complete resolution of DAVF. The patient showed resolved tremor and markedly improved mental status at 1-month follow up. Direct puncture and embolization of the TS using coils and Onyx is effective and feasible method for the treatment of DAVF when other approaches seem difficult.
Adhesives ; Aged ; Central Nervous System Vascular Malformations ; Cerebral Angiography ; Craniotomy ; Dysarthria ; Female ; Femoral Vein ; Follow-Up Studies ; Gait Disorders, Neurologic ; Humans ; Magnetic Resonance Angiography ; Methods ; Occipital Bone ; Punctures ; Superior Sagittal Sinus ; Tremor

The symptoms and signs of acute pulmonary arteries thrombosis are nonspecific. So clinical suspicion is the most important in the diagnosis. Treatment of pulmonary thromboembolism include anticoagulant, thrombolytic agent, or surgical intervention. We experienced a case of recurrent pulmonary thromboembolism without coagulation defect and any risk factor except old age and obese. Initially we treated with heparin, but clinical symptoms were aggravated. After we changed to urokinase (total 330 million IU/2 days), the pulmonary arteries obstruction were resolved and clinical symptoms were improved without any complications. So we report this clinical experience with review of articles.
Diagnosis ; Heparin ; Pulmonary Artery ; Pulmonary Embolism* ; Risk Factors ; Thrombosis ; Urokinase-Type Plasminogen Activator*

This study was understand in order to examine the effect of hardness on stress-causing factors, defined in this study as burnout in nursing. The subjects were 248 nurses working in three general hospitals in Taejon. The instruments used for this study were a survey of general characteristics, modified Health-Related Hardiness Scale(HRHS) (25 items), job stress scale (63 items), and burnout scale(20 items). Analysis of data was done through the mean, percentage, Person correlation coefficient, and stepwise multiple regression done with a SAS program. The results of this study are as follows. 1) The average item score for the job stress was high at 4.44. In the subcategories, the highest degree of stress was night duty(5.11), and work overload(4.70), responsibility for extra affairs(4.70), conflict in nurse-doctor relationships(4.69), and low reward (4.63) in that order. 2) In the stepwise multiple regression analysis, hardiness(11.55%) was a significant determinant of burnout along with job stress(17.24%) and job duration(12.94%). The results of this study show that hardiness has an effect on psychological distress caused by stress.
Daejeon ; Hardness ; Hospitals, General ; Humans ; Nursing ; Reward