PURPOSE: This study was undertaken to determine whether the clinical presentation of patients with central precocius puberty(CPP) varies according to the etiology, whether this permits the differentiation between idiopathic and organic forms and to examine whether LH determination in a single timed blood sample after GnRH administration is sufficient to diagnose CPP. METHODS: This study included 33 girls with signs of breast development, of whom 23 were diagnosed as definite central precocious puberty. Sixteen patients had idiopathic CPP; the remaining 7 patients had organic CPP. Ten patients were classified as non-CPP. Potential clinical and laboratory predictors of CNS abnormalities were assessed and GnRH stimulation test was done. RESULTS: The age of onset in patients with organic CPP was 4.11+/-2.08 years, whereas the age in patients with idiopathic CPP was 7.25+/-1.34 years. This parameter is the only one showing statistical significance. We compared sensitivities and specificities at 0, 15, 30, 60, 90 and 120 min which yielded sensitivities of 8.7%, 87.0%, 91.3%, 87.0%, 73.9%, 60.9%. CONCLUSION: It is impossible to exclude a central nervous system lesion in patient with central precocious puberty without performing central nervous system imaging. However, this study indicates earlier the onset of disease, higher the possibility of presence of CNS lesion. According to the mean GnRH stimulated LH levels and sensitivity at each times, a single blood sample obtained for LH determined after GnRH administration at 30 min can be used to diagnose the central precocious puberty.
Age of Onset ; Breast ; Central Nervous System* ; Female ; Gonadotropin-Releasing Hormone* ; Humans ; Luteinizing Hormone ; Puberty, Precocious*

PURPOSE:There is a clear sexual dimorphism in circulating concentration of leptin in adulthood. However, we don' know when such dimorphism begins and how much pubertal development influences on it. So we examined body composition and circulating concentrations of leptin according to Tanner stage(TS). METHODS:We examined 112 children(M; 56, F; 56, Age; 8.5-17 yr) to evaluate the relationship of leptin and body composition. Body composition was determined by bioelectric impedence measurements(BIA) and by anthropometry. Leptin was measured by human specific RIA. Leptin level was analysed according to TS, body mass index(BMI), fat mass(FM), and lean body mass. RESULTS:BMI and free FM was correlated with TS in both sexes. FM was closely correlated with TS in girls but not in boys(M; r=0.08, P=0.54. F; r=0.73, P>0.001). Leptin levels increased in girls with advanced TS(r=0.355, P<0.01), but decreased in boys(r=-0.339, P<0.01). A strong exponential relationship was observed for leptin levels with BMI, FM, and percentage body fat as determined by BIA. There was significant sexual dimorphism of leptin level at TS VI/V. Because leptin level was significantly related FM, leptin level was normalized to FM(Leptin/FM). Leptin/FM of females(0.67+/-.27 ng/mL/kg) was also significantly higher then that of males(0.31+/-.15 ng/mL/kg)(P<0.001). CONCLUSION: These data suggest that plasma leptin levels increase in girls and decrease in boys after TS II as pubertal development proceeds; they show a significant gender difference, especially late puberty, even after adjustment for FM. Sexual dimorphism in leptin during puberty reflects not only differential changes in body composition but also different leptin resistance; reference ranges of leptin could be modified by TS and gender.
Adipose Tissue ; Adolescent* ; Anthropometry ; Body Composition* ; Child* ; Female ; Humans ; Leptin* ; Plasma ; Puberty ; Reference Values

PURPOSE:There is a clear sexual dimorphism in circulating concentration of leptin in adulthood. However, we don' know when such dimorphism begins and how much pubertal development influences on it. So we examined body composition and circulating concentrations of leptin according to Tanner stage(TS). METHODS:We examined 112 children(M; 56, F; 56, Age; 8.5-17 yr) to evaluate the relationship of leptin and body composition. Body composition was determined by bioelectric impedence measurements(BIA) and by anthropometry. Leptin was measured by human specific RIA. Leptin level was analysed according to TS, body mass index(BMI), fat mass(FM), and lean body mass. RESULTS:BMI and free FM was correlated with TS in both sexes. FM was closely correlated with TS in girls but not in boys(M; r=0.08, P=0.54. F; r=0.73, P>0.001). Leptin levels increased in girls with advanced TS(r=0.355, P<0.01), but decreased in boys(r=-0.339, P<0.01). A strong exponential relationship was observed for leptin levels with BMI, FM, and percentage body fat as determined by BIA. There was significant sexual dimorphism of leptin level at TS VI/V. Because leptin level was significantly related FM, leptin level was normalized to FM(Leptin/FM). Leptin/FM of females(0.67+/-.27 ng/mL/kg) was also significantly higher then that of males(0.31+/-.15 ng/mL/kg)(P<0.001). CONCLUSION: These data suggest that plasma leptin levels increase in girls and decrease in boys after TS II as pubertal development proceeds; they show a significant gender difference, especially late puberty, even after adjustment for FM. Sexual dimorphism in leptin during puberty reflects not only differential changes in body composition but also different leptin resistance; reference ranges of leptin could be modified by TS and gender.
Adipose Tissue ; Adolescent* ; Anthropometry ; Body Composition* ; Child* ; Female ; Humans ; Leptin* ; Plasma ; Puberty ; Reference Values

Fractures of the proximal humerus occur more frequently in older patients but are seen in all ages and emerge epiphyseal separations. The objectives of treatment are restoration of all involved structures to normal anatomical state and a completely functional limb in the shortest time possible. One part and two part fractures were indicated in conservative treatment and surgical treatment in most of three, four part fractures. The results of treatment of forty four cases according to Neer's classification were analysed at the Department of Orthopedic Surgery, Chonbuk National University Hospital from Mar. 1978 to Dec.1985. The results were as follows. 1. The prevalent age distribution was third and fifth decade(48%) . 2. The most common cause of injury was slip down(14 cases, 32%). 3. The most frequent cases of the fractures in Neer's classification were two part fractures(22 cases, 50%). 4. Thirty one cases(71%) were treated by conservative treatment, twelve cases(27%) by open reduction and 1 case(2%) by prosthesis. 5. Good results were in 23 cases(52%) of one and two part fractures, fair in 17 cases(39%) and poor in 4 cases(9%) of two, three and four part fractures.
Age Distribution ; Classification ; Clinical Study ; Extremities ; Humans ; Humerus ; Jeollabuk-do ; Orthopedics ; Prostheses and Implants ; Shoulder Fractures

Fiber-reinforced composite(FRC) was developed as a structural component for dental appliances such as prosthodontic framework. FRC provides the potential for fabrication of a metal-free, excellent esthetic prostheses. It has demonstrated success as a result of its simple fabrication, natural colour, and marginal integrity, and fracture resistance of veneering composite resin and the FRC material. Although it has lots of merits, clinical and objective data are insufficient. The purpose of this study was to evaluate the fracture strength and marginal fitness of fiber-reinforced composite bridge in the posterior region for clinical application. Sixteen bridges of each group, Targis/Vectris(R), Sculpture-fibrekor(R)and In-Ceram, were fabricated. All specimens were cemented with Panavia 21 to the master dies. Strength evaluation was accomplished by a universal testing machine (Instron). The marginal fitness was measured by using the stereoscope (X50). The results were as follows. : 1.The fracture strength according to the materials was significantly decreaed in order In-Ceram(238.81+/-82). Targis Vectris(176.25+/-18.93), Sculpture-Fibrekor(120.35 +/-20.08) bridges. 2.FRC resin bridges were not completely fractured, while In-Ceram bridges were completely fractured in the pontic joint. 3.The marginal accuracy was significantly decreased in order Targis/Vectris (60.71micrometer), Sculpture-Fibrekor(73.10micrometer). In-Cream Bridge(83.81micrometer). 4.The fitness of occlusal sites had a lower value than the marginal sites(P<0.001), and the marginal gaps of inner site of the pontic were greater than that of outer sites of the pontic. Fiber reinforced composite bridges are new, esthetic prosthesis and can be clinically used in anterior regions and short span bridges. However, caution must be exercised when extrapolating laboratory data to the clinical situation because there are no long term clinical data regarding the overall success of the FRC.
Denture, Partial, Fixed ; Joints ; Prostheses and Implants ; Prosthodontics

No abstract available.
Fetal Blood* ; Growth Hormone* ; Humans ; Infant, Newborn* ; Insulin-Like Growth Factor I* ; Somatomedins* ; Umbilical Cord*

Citrin deficiency caused by the SLC25A13 gene mutations is associated with both neonatal-onset type II citrullinemia (CTLN2), also known as neonatal intrahepatic cholestasis caused by citrin deficiency and adult-onset CTLN2. Neonatal-onset CTLN2 is an autosomal recessive disorder characterized by poor growth, intrahepatic cholestasis, and increased serum citrulline. A 16-days old infant with hyperammonemia was referred for evaluation of increased plasma citrulline diagnosed using tandem mass spectrometry. Blood amino acid analysis showed significant elevation of citrulline. Mild elevation in serum galactose levels had been found. DNA analysis of the SLC25A13 gene in this patient showed two novel compound heterozygous mutations, c.221C>T in exon4 and c.1645C in exon16 (p.[Ser74Phe]+[Gln549X]). We suggest that infants with a high serum citrulline level on a tandem mass screening test are candidates for gene analysis and blood amino acid analysis for neonatal-onset CTLN2.
Calcium-Binding Proteins ; Cholestasis, Intrahepatic ; Citrulline ; Citrullinemia ; DNA ; Galactose ; Heterozygote ; Humans ; Hyperammonemia ; Infant ; Infant, Newborn ; Mass Screening ; Organic Anion Transporters ; Plasma ; Tandem Mass Spectrometry

Indirect composite resin are used as an popular effective esthetic material in prosthetic dentistry, often with metallic substructure that provides support for restorations. Recently, new indirect composite resins as a substitute of ceramic have been developed. These resins provide good esthetics, with a wide range of hue and chroma. And the flexural strength of those is in the range of 120-150MPa, which is higher than that of feldspathic ceramic, and similar tot hat of Dicor. Although it has many merits, one of the major clinical problems of composite resins is the bond failure between metal and resin due to insufficient interfacial bond strength. The purpose of this study was to evaluate shear bond strength of the reinforced indirect composite resin to dental alloys. Three different composite resin systems(Artglass . Sculpture , Targis ) as test groups and ceramic(VMK 68 ) as control group were bonded to Ni-Cr-Be alloy(Rexillium III ) and gold alloy(Dave 4). All specimens were stored at 37degrees C distilled water for 24 hours and the half of specimens were thermocycled 2000 times at temperature from 5degrees C to 60degrees C. The shear bond strengths of reinforced indirect composite resins to dental alloys were measured by using the universal testing machine, and modes of debonding were observed by stereoscope and scanning electron microscope. The results were as follows : 1. The shear bond strengths of reinforced indirect composit resins to dental alloys were approximately half those of ceramic to dental alloys(P<0.01). 2. There was no significant difference between the shear bond strength of several reinforced indirect composite resins to metal. 3. Alloy type did not affect on the shear bond strengths of resin to metal, but the shear bond strengths of ceramic to gold alloys were higher than those of ceramic to Ni-Cr alloys(P<0.05). 4. The shear bond strenghts of Artglass and Targis to gold alloys were significantly decreased after thermocycling treatment(P<0.01). 5. Sculpture showed cohesive, adhesive, and mixed failure modes, but Artglass and Targis showed adhesive or mixed failures. And ceramic showed cohesive and mixed failures.
Adhesives ; Alloys ; Ceramics ; Composite Resins* ; Dental Alloys* ; Dentistry ; Esthetics ; Gold Alloys ; Sculpture ; Water

Cystoid macular edema (CME) is a relatively common cause of temporary or permanent visual impairment after cataract extraction. Fluorescein angiography is indispensable to diagnose the CME. Intravenous fluorescein angiography is asscciated with a high incidene of minor adverse effects but a very low incidence of life-threatening serious reactions. There are no reports of oral fluorescein causing a senous reaction, and minor adverse effects are uncommon. We had Performed the oral fluorescein angiography in 30 consecutive cases (31 eyes) to detect the CME after cataract extraction. Two eyes (6.45%) had definite evidence of CME on the fluorograms. The typical angiogram of CME were obtained at 30 or 40 minutes after they had taken the fluorescein sodium. A dose of 20mg/Kg body weight produced good quality angiograms in 71% of the patients. There was no serious reaction but a mild pruritus was noted in one patient(3.3%). Therefore, we have concluded that the oral fluorescem agniography is very useful method because the oral fluorogram may avoid the adverse effect that could occur in intravenous fluorescein injection and be comparable in quality with those produced by intrvenous fluorescein.
Body Weight ; Cataract Extraction* ; Cataract* ; Fluorescein Angiography* ; Fluorescein* ; Humans ; Incidence ; Macular Edema* ; Pruritus ; Vision Disorders

BACKGROUND: Intrathecal neostigmine produces antinociceptive effects in many pain tests. Comparisons of pre- versus postinjury drug interventions have been made using the formalin test as a model for central sensitization. The purpose of this study was to compare behavioral antinociceptive responses with spinal fos-like immunoreactivity (FLI) in an intrathecal neostigmine injection between pre- versus post-formalin administration in a rat pain model. METHODS: Sprague-Dawley rats (250 300 g) were prepared with a PE 10 indwelling intrathecal catheter to receive either saline or neostigmine. The formalin test was performed on the second day after surgery with 5% 100microl. All rats were randomly divided into one of five groups; Sham, basal, control, pretreatment or posttreatment group. The Sham group (n = 4) received a dry needle at the hindpaw and the basal group (n = 6) received saline 100microl at the hindpaw. Saline 20microl was injected intrathecally after the formalin test in the control group (n = 8). Neostigmine (7.5microgram/10microl in volume) was administered intrathecally 7 minutes before the formalin test in the pretreatment group (n = 8) and 7 minutes after the formalin injection in the posttreatment group (n = 8). Pain related behavior was quantified by counting the incidence of flinches of the injected hindpaw for 60 minutes. Two hours after injection of formalin, animals were perfused with PBS and the spinal cords were removed immediately. The effect of pre- versus posttreatment with the neostigmine on c-Fos protein in the cord was examined by immunohistochemistry using specific antibodies. Immuno-positive cells in laminae I-II and III-V in the lumbar enlargement were calculated. RESULTS: Intraplantar formalin injection produced a biphasic appearance of the flinch behavior (phase 1 = 0 5 minutes, phase 2 = 20 60 minutes) in the control, pretreatment and postreatment groups. In the pretreatment group, rats showed less remarkable phase 1 and 2 responses than other groups. Flinches of phase 1 were 2.3 2.1, 33.2 7.6 (P< 0.05 vs. basal), 10.0 6.6 and 33.0 13.4(P< 0.05 vs. basal) in basal, control, pre- and posttreatment groups respectively. Flinches of phase 2 were 0.3 0.5, 224.5 66.4 (P< 0.05 vs. basal), 120.6 151.3 and 187.5 76.8 (P< 0.05 vs. basal) in basal, control, pre- and posttreatment groups respectively. Similarly, the pretreatment group virtually inhibited formalin-induced expression of FLI (P< 0.05 vs. control, posttreatment) in the laminae I-II ipsilateral to injection. The posttreatment group inhibited formalin-indeced expression of FLI (P< 0.05 vs. control) in the laminae III-V ipsilateral to injection. CONCLUSIONS: Pretreatment of intrathecal neostigmine inhibits nociceptive behaviors and FLI in the laminae I-II following formalin injection in rats, suggesting that pretreatment plays an important role in the development of plasticity in this model.
Analgesics ; Animals ; Antibodies ; Catheters ; Central Nervous System Sensitization ; Formaldehyde* ; Immunohistochemistry ; Incidence ; Needles ; Neostigmine* ; Pain Measurement* ; Plastics ; Rats ; Rats, Sprague-Dawley ; Spinal Cord