GH concentration in plasma decline with age. GH and GH response to GHRH are influenced by sex hormones, thereby changing around the menopause. In several aspects, features of aging resemble those of a state of GH deficiency. It has been argued the declining GH function, along with other factors, might be a causal factor in osteoporosis. The purpose of this study was to investigate that postmenopausal osteoporosis in ovariectomized rat could be prevented by rhGH. Fifty-four Sprague-Dawley rats(weight 140-200g) were devided 3 groups. Group 1(n=18) was sham operation; Group 2(n=18) was ovariectomized and received subcutaneous injection with 0.05 cc normal saline; Group 3(n=18) was ovariectomized and received subcutaneous injection with 0.2 IU rhGH. Group 2 and 3 were injected daily, 6 day per week. Each group was devided three subgroups(n=6) and were sacrificed at 6 week, 10 week, 14 week, respectively. Group 2 showed a significant increase in body weight, femur length, serum IGF-1 level, serum PICP and ICTP level at 6 weeks, 10 weeks, 14 weeks and a significant decrease in ash weight of tibia, width of bony spicules, at 14 weeks than Group 1. Group 3 demonstrated a significant increase in body weight, femur length, serum IGF-1, serum PICP and ITCP levels and a insignificant decrease in ash weight of tibia and width of bony spicules, at 6 weeks, 10 weeks, 14 weeks than Group 1. At 14 weeks, Group 3 showed a significant increase in serum IGF-1, Serum PTH, Serum PICP. From these data, we conclude that although rhGH administration leads to an activation of bone turnover and more stimulation of bone formation, it does not prevent a bone loss in ovariectomized rat.
Aging ; Animals ; Body Weight ; Female ; Femur ; Gonadal Steroid Hormones ; Humans* ; Injections, Subcutaneous ; Insulin-Like Growth Factor I ; Menopause ; Osteogenesis ; Osteoporosis* ; Osteoporosis, Postmenopausal ; Ovariectomy ; Plasma ; Rats* ; Rats, Sprague-Dawley ; Tibia

Many agents for the treatment of osteoporosis are broadly classified as inhibitors of bone resorption and stimulators of bone formation. Many pharmacological derivatives of bisphosphonates are used in the treatment of osteoporosis by inhibiting osteoclast-mediated bone resorption. Although the pamidronate, derivative of bisphosphonates, has a potent antiresorptive activity, there are only a low reports about prevention and treatment of postmenopausal osteoporosis using it. The purpose of this study is to evaluate the changes of bone metabolism and bone mass after pamidronate administration during the early period of estrogen deficiency. Ninty-five Sprague-Dawley rats (weight 233-243 g) were divided into 3 groups. Group 1(n=28) was performed sham operation. Group 2 (n=25) was both ovariectomized and intravenously injected with 0.5 cc normal saline. Group 3 (n=42) was both ovariectomized and intravenously injected with 0.1 mg/kg pamidronate. During the first 8 weeks normal saline or pamidronate was intravenously injected twice a week(q 3 day or q 4 days). After 4 weeks of observation without injection the experiental animals were sacrificed at postoperative 12 weeks. There were statistically significant decrease in the body weight and the weight of uterus in group 1 compared with group 2, 3. There was statistically significant decrease in the bone mass of the spine, proximal femur, proximal tibia in the group 2 compared with group 1, 3. The difference of bone mass between group 1 and 3 was statistically insignificant. Serum osteocalcin and PICP concentration were significantly increased in group 2 and 3 compared with group 1. But there was no statistical significance between group 2 and 3 in serum osteocalcin and PICP concentration. Serum ICTP concentration was significantly decreased in group 1 and 3 compared with group 2, but the difference between group 1 and 3 was insignificant. These results suggests that the administration of the pamidronate during the early period of estrogen deficiency can inhibit bone resorption and prevent trabecular bone loss of the spine, proximal femur and proximal tibia metabolically.
Animals ; Body Weight ; Bone Resorption ; Diphosphonates ; Estrogens ; Female ; Femur ; Humans ; Metabolism ; Osteocalcin ; Osteogenesis ; Osteoporosis* ; Osteoporosis, Postmenopausal ; Ovariectomy ; Rats* ; Rats, Sprague-Dawley ; Spine ; Tibia ; Uterus

BACKGROUND: Sex steroid hormones are believed to play an important role in the genesis and growth of uterine myoma. Several studies suggest a possible role of insulin-like growth factor(IGF) as a mediator of estradiol in uterine myama. We have recently demonstrated that some IGF binding proteins(IGFRPs) messenger ribonucleic acid(mRNA) expressions in myoma are dependent on the in vivo esttogen status. The purposes of this study are to evaluate the in vitro effects of sex steroid hormones including estrogen on the IGFBPs gene expression in tissues from uterine myoma and adjacent normal myometrium. METHODS: Tissues from myoma and adjacent normal myometrium of patients with uterine myoma during early proliferative phase of menstrual cycle were cultured in the absence(control) and presence of 17b-estradiol(10M/L) or/and progesterone(10M/L) for 3 days. The IGFBPs mRNA expressions in these explants were analyzed by Nothern blot using specific human complementary deoxyribonucleic acid(cDNA) probes. RESULTS: The addition of 17b-estradiol, progesterone alone and in combination to conditioned media of explants from myoma and adjacent normal myornetrium did not result in any changes in the expression of IGFBP-2, IGFBP-4, IGFBP-5, and IGFBP-6 mRNA. With progesterone addtion, lGFBP-3 rnRNA expression was significantly reduced in myoma explant but not in adjacent ncemal myometrium explant. There was no significant change in the IGFBP-3 mRNA expression with 17b-estradiol and with the combination of both 17b-estradiol and progesterone. CONCLUSION: 17b-estradiol does not affect IGFBPs gene expression in the myoma and adjacent normal myometrium explant regardless of the presence of progesterone in vitro. However progesterone alone induces a decrease in IGFBP-3 synthesis in myoma explant.
Animals ; Culture Media, Conditioned ; Estradiol ; Estrogens ; Female ; Gene Expression ; Gonadal Steroid Hormones ; Humans* ; Insulin-Like Growth Factor Binding Protein 2 ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor Binding Protein 4 ; Insulin-Like Growth Factor Binding Protein 5 ; Insulin-Like Growth Factor Binding Protein 6 ; Insulin-Like Growth Factor Binding Proteins ; Leiomyoma* ; Menstrual Cycle ; Mice ; Myoma ; Myometrium* ; Progesterone ; RNA, Messenger*

BACKGROUND/AIMS: The endoscopic mucosal resection has now been adopted for a useful modality in both curative therapy and accurate diagnosis of early gastric cancer. A retrospective study was done to evaluate the indication and the limitation of endoscopic mucosal resection of early gastric cancer. METHODS: We studied 20 cases of early gastric cancer treated by endoscopic mucosal resection in Chungnam National University Hospital from November, 1995 to July, 1997. RESULTS: 1) The size affected the curability: 83. 3% of lesions less than 2 cm and 50. 0% of those larger than 2 cm were resected completely. 2) The depth of cancer invasion affected the curability: 87. 5% of lesion confined to mucosa were resected completely, while all of submucosal cancers were resected incompletely. 3) Among fourteen cases resected completely, three cases of lesions larger than 2 cm were residual cancer and two of those less than 2 cm were recurred locally. CONCLUSIONS: To be a curative therapy by endoscopic mucosal resection of early gastric cancer, we think that careful selection of the lesion, that is lesion less than 2cm and confined to mucosa, is necessary
Chungcheongnam-do ; Diagnosis ; Mucous Membrane ; Neoplasm, Residual ; Retrospective Studies ; Stomach Neoplasms*

Objectives: ：The purpose of this study is to evaluate the effect of a school-based social skills training program on the social decision-making of children and adolescents and to assess plan for effective school-based mental health services. Methods: ：It was performed school-based social skills training (n=46, 7 sessions) in elementary and middle school students. Evaluations were conducted before and after the application of the program using a ultimatum game and dictator game, in order to identify changes. Results: ：Before social skills training program (SSTP), the younger students showed higher acceptance rates of unfair offers than the older students in ultimatum game (UG) [at 9:1 offers 0.79±0.08>0.55±0.12 (p=0.001); at 8:2 offers 0.81±0.11>0.59±0.11 (p=0.001)]. the rejection rates of unfair offers in UG significantly increased after SSTP[at 9:1 offers 0.64±0.19→0.43±0.18 (p=0.001) ; at 8:2 offers 0.67±0.16→0.54±0.16 (p=0.046) ; at 7:3 offers 0.83± 0.20→0.65±0.12 (p=0.001)]. the rejection rates of unfair offers in UG significantly increased at happy and at neutral facial expression of proposers after SSTP[happy facial expression condition, at 9:1 offers 0.89±0.12→0.68±0.19 (p=0.001) ; at 8:2 offers 0.82±0.19→0.72±0.14 (p=0.001) ; at 7:3 offers 0.99±0.07→0.92±0.17 (p=0.040] [neutral facial expression condition, at 9:1 offers 0.71±0.20→0.54±0.13 (p=0.001) ; at 8:2 offers 0.61±0.18→0.52±0.06 (p=0.001) ; at 7:3 offers 0.91±0.13→0.83±0.12 (p=0.001)]. the amount of money offered as a proposer in dictator game significantly increased after SSTP [3989.1±1952.3→4742.5±371.1, (p=0.012)]. Conclusion ：The social skills training program positively influences the social decision-making. The school-based social skills training program can be expected to have positive results in school-based mental health services. Future investigation is needed to validate the long term effects of this program.

Objectives: ：The purpose of this study was to identify the change in the reasons for referrals before and after the COVID-19 outbreak among students who were referred to the one hospital-linked Wee center in Dalseo-gu, Daegu. Methods: ：324 students who were referred to one hospital-linked Wee center for personal counseling from January 1, 2019 to December 31 were included. In the initial session of individual counseling, 3 of the chief reasons among 27 emotional and/or behavioral problems were indicated. This reason was divided into before and after COVID-19 to determine whether there is a difference, and whether there is a difference between before and after COVID-19 depending on the school level. Results: ：The most frequent emotional and/or behavioral problem was ‘interpersonal problems’ in both pre- COVID-19 and post- COVID-19 groups. In post- COVID-19 group, ‘anxiety’ was significantly increased, whereas ‘conduct problems,’ ‘impulsivity’ and ‘inattention’ were significantly decreased. In elementary students group, only ‘conduct problems’ was significantly decreased after COVID-19 and the same result was shown in middle and high school students group. Conclusions ：The study showed that after COVID-19 pandemics in Daegu the difference of students’ problems was noted, and internalizing problems seem to increase rather than externalizing problems. This result calls upon schools to plan for students’ further mental health care measures.

PURPOSE: The goals of cranioplasty are to protect the brain from trauma and restore normal cranial contour with as few complication as possible. In patient who suffered from cranial defect, the most satisfactory form of cranioplasty may be archived with autogenous bone grafts. We report on the treatment of large frontal bone defect using pericranial flap and split-rib graft. METHODS: A 29-year-old male was referred to our department. He was involved in an automobile accident resulting in large frontal bone and sinus defect and skull basal defect. The reconstruction was undertaken using galeal frontalis myofascial flap and split-rib cranioplasty using bicoronal incision. RESULTS: The postoperative course was successful. For 9 months follow up period, there was no complication about hematoma, infection, CSF leakage and washboard deformity. He was pleased with the results even when absolute symmetry was not achieved. CONCLUSION: We experienced large frontal bone and sinus defect and skull basal defect patient and successfully treated with split-rib graft and galeal frontalis myofascial flap.
Adult ; Automobiles ; Brain ; Congenital Abnormalities ; Follow-Up Studies ; Frontal Bone ; Hematoma ; Humans ; Male ; Skull ; Transplants

Background: This study was conducted on the experiences, limitations, and factors necessary for increasing participation in emergency care outside a medical institution for physicians working in a tertiary hospital. Methods: This study was conducted by analyzing data from 150 physicians working in a tertiary hospital. The physicians’ intent to participate in emergencies outside the medical institution was measured as frequencies and percentages, and chi-square test was performed. Multi-logistic regression was used to determine factors affecting the physicians’ willingness to participate emergencies outside the medical institution. Results: Out of 103 respondents, 52 (50.5%) said that they do not want to participate in future emergency situations. Among them, 38 (73.1%) said that legal burden associated with medical accidents dissuaded them from intervening in future emergencies. Also, 33 (63.5%) said that ‘a firm guarantee of exemption from legal responsibility’ was needed to convince them to participate in emergency patient care. There were no meaningful results in the analysis of factors affecting future participation in emergency care. Conclusion It was found that the reason they do not participate in emergency care is because they feel that they bear the risk of legal liability. We suggest that providing more legal immunity could be a way to encourage doctors to step up in emergency situations. At the same time, it is recommended that a more suitable environment be provided for physicians in such situations, so that they can be able to fulfill their ethical duties in emergency medical care.

Delirium is a common symptom in patients with terminal cancer. The prevalence increases in the dying phase. Delirium causes negative effects on quality of life for both patients and their families, and is associated with higher mortality. However, some studies reported that it tends to remain unrecognized in palliative care setting. That may be related with difficulties to distinguish the symptom from others with overlapping characteristics such as depression and dementia, and a lack of knowledge regarding assessment and diagnostic tools. We suggest that accurate recognition with validated tools and early diagnosis of the symptom should be highly prioritized in delirium management in palliative care setting. After diagnosing delirium, it is important to identify and address reversible precipitants such as medication, dehydration, and infection. Non-pharmacological interventions including comfortable environment for the patient and family education are also essential in the management strategy. If such interventions prove ineffective or insufficient to control hyperactive symptoms, pharmacologic interventions with antipsychotics and benzodiazepine can be considered. Until now, low levels of haloperidol remains the standard treatment despite a lack of evidence. Atypical antipsychotics such as olanzapine, quetiapine and risperidone reportedly have similar efficacy with a stronger sedating property and less adverse effect compared to haloperidol. Currently, delirium medications that can be used in palliative care setting require more clinical trials, and thus, clinical guidelines are not sufficiently available. We suggest that it is warranted to develop clinical guidelines based on well-designed clinical studies for palliative care patients.
Antipsychotic Agents ; Benzodiazepines ; Dehydration ; Delirium* ; Dementia ; Depression ; Diagnosis* ; Early Diagnosis ; Education ; Haloperidol ; Humans ; Mortality ; Palliative Care* ; Prevalence ; Quality of Life ; Quetiapine Fumarate ; Risperidone

Neuronal migrational disorders of the brain represent abnormalities in the formation of the neocortex caused by faulty migration of the subependymal neuroblasts. The neuroblasts normally migrate between the sixth and 15th gestational week and in doing so form the six-layered neocortex. When the migration does not occur in a normal fashion the resultant brain anomalies include lissencephaly, pachygyria, schizencephaly, hemimegalencephaly, heterotopia, and polymicrogyria. Neuronal heterotopia is a collection of nerve cells in abnormal locations as a result of arrest of their radial migration, improper formation, or destruction of the radial glial fiber. We reported a case of neuronal heterotopia with brief review of related literatures.
Agenesis of Corpus Callosum ; Brain ; Lissencephaly ; Malformations of Cortical Development ; Neocortex ; Neuronal Migration Disorders ; Neurons*