PURPOSE:There were many controversies whether constitutional delay of growth and puberty(CDGP) is simple varient of normal growth pattern, or one of the cause of growth disturbance induced by the disturbance of growth hormone secrtion or its function. So we studied about the difference in serum peak growth hormone level after insulin, L-dopa provocation test, and serum IGF-I leve between constitutional delay of growth and puberty(CDGP) and familial short stature(FSS). METHODS:Measurement of serum peak growth hormone and insulin like growth factor-I(IGF-I) level after insulin, L-dopa provocation test were performed in 33 children with costitutional delay of growth and puberty (CDGP). Two groups of children with familial short stature (FSS) whose height were below 10 percentile for chronologic age of Korean national height standards were included as control groups. RESULTS: 1)There were no significant difference of serum peak growth hormone level between children with CDGP and children with FSS and these results were similar in both sex. 2)The mean serum IGF-I level of children with CDGP were 125.69+/-4.06 ng/ml(71.53-189.34ng/ml) in male, 157.7+/-3.17ng/ml(81.9-279.2ng/ml) in female. Both results were significantly lower to those of FSS children by chronologic age group because the mean serum IGF-I level of FSS children were 190.19+/-7.97ng/ml (87.64-297.6ng/ml) in male, 205.47+/-15.87ng/ml(61.7-433.1ng/ml) in female. But compared to FSS children by bone age of 72-96 months, there were no significant difference noted because the mean serum IGF-I level of children with FSSwere130.47+/-0.27ng/ml(63.24-198.2ng/ml)inmale,162.35+/-9.43ng/ml(54.9-217.53 ng/ml) in female. CONCLUSIONS:The results of this study showed that the serum peak growth hormone level after insulin, L-dopa provocation test with children of CDGP revealed no significant difference with those of FSS children in both sex. Serum IGF-I level of CDGP children was lower significantly to those of FSS children by chronologic age group, but no much difference with FSS children of bone age group.
Adolescent ; Child* ; Female ; Growth Hormone* ; Humans ; Insulin* ; Insulin-Like Growth Factor I ; Levodopa* ; Male ; Puberty*

PURPOSE: The aims of this study were to investigate the frequencies and role of hepatitis B virus(HBV) precore and core promotor mutations in children with chronic hepatitis B infection. METHODS: Sera from 46 children with chronic hepatitis B infection were analyzed by direct sequencing of polymerase chain reaction product of HBV DNA. In this study, the patients were divided into vertical and non-vertical groups according to the mode of HBV transmission. Statistical analysis was performed by using Fisher's exact test. RESULTS: Forty-six adr type of HBV DNA were analyzed. The mutations in HBV precore region were observed in 12(26.1Yo) of 46 cases. The GA mutation of nucletide(nt) 1896 was observed in 5 cases(10.9Yo). The frequency of mutations in HBV precore region of the non-vertical group (6/16; 37.5Fo) was higher than that of the vertical group(6/30; 20M), but there was no statistical significance. The mutation in HBV core promotor region was observed in 40(87.0%) of 46 cases. The A-->T mutation of nt 1762 or G-->A mutation of nt 1764 were observed in 24(52.2%) of 46 cases, and 23 cases revealed combined mutation at both positions 1762 and 1764. The frequency of mutations in HBV core promotor region of the vertical group(28/30; 93.3Yo) was higher than that of the non-vertical group(12/16; 75.0M), but there was no statistical significance. The frequencies of mutations in HBV precore and core promotor regions of the HBeAg negative patients was higher than that of HBeAg positive patients, but there was no statistical significance. Also there were no significant correlations between the frequencies of mutations in HBV precore and core promotor regions and AST, ALT level or the level of HBV DNA. CONCLUSION: These observations suggest that mutations in HBV precore and core promotor regions were frequently detected in children with chronic hepatitis B infection. There were no statistical significant differences in the frequencies of mutations in HBV precore and core promotor regions between vertical and non-vertical transmission groups. (J Korean Pediatr Soc 2000; 43:779-791)
Child* ; DNA ; Hepatitis B e Antigens ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis B, Chronic* ; Hepatitis* ; Hepatitis, Chronic* ; Humans ; Polymerase Chain Reaction ; Promoter Regions, Genetic

PURPOSE: The aims of this study were to investigate the frequencies and role of hepatitis B virus(HBV) precore and core promotor mutations in children with chronic hepatitis B infection. METHODS: Sera from 31 children with chronic HBV infection were analyzed by direct sequencing of polymerase chain reaction amplification of HBV DNA. RESULTS: Twenty-nine adr type were analyzed. The mutations in HBV precore region were observed in 8(27.6%) of 29 cases. The G->A mutation of nucleotide 1896(A1896; stop codon) were observed in 4 cases(13.8%). The mutations in HBV core promotor region were observed in 27 (93.1%) of 29 cases. The G(1764)->A mutation(A1764) was observed in 14 cases(48.3%), and among these 12 cases combined with a A to T change at nucleotide 1762(T1762). The mutations in HBV precore region were obsereved in 4(21%) of 19 cases of HBeAg positive group and 9(90%) of 10 cases of HBeAg negative group. A1896 mutation was observed in 2 cases in both HBeAg positive and negative group, respectively. The mutations in HBV core promotor region were observed in 18(94.7%) of 19 cases of HBeAg positive group and 9(90%) of 10 cases of HBeAg negative group. T1762 mutation were observed in 6(31.6%) of 19 cases of HBeAg positive group and 6(60%) of 10 cases of HBeAg negative group(P=0.14). A1764 mutation was obsereved in 7 (36.8%) of 19 cases of HBeAg positive group and 7(70%) of 10 cases of HBeAg negative group (P=0.089). A1896 mutation was observed in 2(18.2%) of 11 cases in increased AST/ALT group and 2(11.1%) of 18 cases in normal AST/ALT group. A1764 and T1762 mutations were higher (61.1%) in AST/ALT increased group than those(27.3%) in AST/ALT normal group, but there was no statistical significance(P=0.077). CONCLUSION: Mutations in the precore and core promotor regions can be frequently detected in children with chronic HBV infection. T1762 and A1764 mutations were observed more frequently in HBeAg negative group and in AST/ALT increased group but there was no statistical significance.
Child* ; DNA ; Hepatitis B e Antigens ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis B, Chronic* ; Hepatitis* ; Hepatitis, Chronic* ; Humans ; Polymerase Chain Reaction ; Promoter Regions, Genetic

BACKGROUND: We can usually see the yawning at induction of anesthesia, however, it has not been studied as such an indicator of anesthesia. The yawning is one means of changing arousal level, and a sign or marker that such a change is occurring, although its functions are not well understood. The purpose of the present study was to evaluate the yawning whether it could be used as an indicator of induction of anesthesia, using its property as a marker of changed arousal level. METHODS: In 60 adult patients, group 1 was done propofol target controlled infusion (TCI) with Stelpump software, while group 2 was done thiopental TCI similarly. Clinical indicators of induction of anesthesia were measured as follows: loss of verbal control (LOV), loss of eyelash reflex (LOE), the yawning. In addition, the occurrence of apnea (OOA) were measured, too. We assessed the hypnosis levels of indicators of induction of anesthesia including the yawning and demonstrate their effect site concentrations and elapsed time. Furthermore, we compared the incidences of yawning and apnea between both groups. RESULTS: Clinical indicators of induction occurred in the order of LOV > LOE > the yawning >> OOA in both groups. With respect to BIS, the yawning showed the lowest BIS and the highest effect site concentrations except OOA in both groups. The incidence of the yawning in group 2 was higher than in group 1 (about 82 vs 63%). On the contrary, the incidence of apnea in group 1 was higher than in group 2 (about 79 vs 53%). CONCLUSIONS: As far as the yawning could be shown, we could observe, it approximated most closely to their clinical impression of the 'true' induction in terms of the hypnosis level and its effect site concentration.
Adult ; Anesthesia* ; Apnea ; Arousal ; Humans ; Hypnosis ; Incidence ; Propofol ; Reflex ; Thiopental ; Yawning*

Morphometry of nuclei of the benign and malignant prostatic lesions was performed to study the relationship between nuclear size and shape and the prognosis of prostatic adenocarcinoma. Fifty one cases of prostatic adenocarcinoma and 13 cases of benign prostatic hyperplasia were included to evaluate area, perimeter, Dmax, Dmin, and 5 form factors of the nuclei by image analyzer (Zeiss Ibas 2000) using hematoxylin-eosin stained slides. All analytic factors of nuclear size and shape were significantly different between benign lesions and adenocarcinomas. Increased nuclear size was associated with nu- clear irregularity, presence of metastasis, advanced clinical stage, and high Gleason's grade and score of prostatic adenocarcinoma. On Kaplan-Meier method, survival was decreased with older age, no hormonal treatment, stage D, high Gleason's grade and stage as well as with larger size and irregular shape of the nuclei. In conclusion, morphometry of nuclei of the prostate can be a helpful tool to differentiate between benign and malignant lesions. Nuclear morphology is thought to be associated with prognosis of prostatic adenocarcinoma.
Adenocarcinoma ; Breast ; Fibroadenoma ; Hepatitis B e Antigens* ; Hepatitis B Surface Antigens* ; Hepatitis B* ; Hepatitis* ; Neoplasm Metastasis ; Prognosis ; Prostate ; Prostatic Hyperplasia

BACKGROUND: There has been reports which suggest that non-specific symptom of patients with mitral valve prolapse is associated with autonomic dysfunction. METHODS: To assess autonomic dysfunction of patients, we examined five cardiovascular reflex tests in 25 asymptomatic MVP patients(identified as MVP group), 25 symptomatic MVP patients(identified as MVP syndrome group) and 25 control group. RESULTS: In the five cardiovascular autonomic function tests, abnormalities of Valsalva ratio were detected in 1(4%) control group, 7(28%) MVP group, 9(36%) MVP syndrome group, heart rate response to deep breathing in 0(0%), 2(8%), 4(16%) respectively, immediate heart rate response to standing in 0(0%), 2(7.4%), 2(8%) respectively and in postural hypotension, there were no abnormal group. Abnormalities of blood pressure response to sustained handgrip were only detected in 2(8%) MVP syndrom group. According to the five categories of cardiovascular autonomic functon tests, normal in 24(96%) and early damage in 1(4%) were detected in control group. In the MVP group, normal 17(68%), early damage 6(24%) and definite damage 2(8%) were noted. In the MVP syndrome group, normal 9(36%), early damage 13(52%), definite damage 1(4%) and combined damage 2(8%) were detected. In case of heart rate response to deep breathing, we found significant differences between control and MVP syndrome group(p=0.043), and between MVP and MVP syndrome group(p=0.0043). In case of heart rate response to standing, between control and MVP syndrome group(p=0.0009), between MVP and MVP syndrome group(p=0.001), the differences were noted. In case of blood pressure response to standing, between control group and MVP group(p=0.0019), between MVP and MVP syndrome group(p=0.0075), we found significant differences. Resulting from our study, heart rate response to deep breathing and standing, blood pressure response to standing were of considerable value in assessing the autonomic dysfunction of patients with mitral valve proapse. CONCLUSION: We found autonomic dysfunction in addition to increased autonomic tone and responsiveness which have been already known previously in mitral valve prolapse. And autonomic dysfunction was more severe in symptomatic patients with mitral valve prolapse than asymptomatic ones.
Blood Pressure ; Heart Rate ; Humans ; Hypotension, Orthostatic ; Mitral Valve Prolapse* ; Mitral Valve* ; Reflex ; Respiration

PURPOSE: We report a case of stromal keratitis, corneal infiltration, anterior uveitis, central retinal artery occlusion and optic neuropathy in a patient with herpes zoster ophthalmicus. CASE SUMMARY: A 73-year-old man who was hospitalized for pain and vesicles on his left face was referred to our clinic with sudden onset visual disturbance in his left eye. His best corrected visual acuity in the right eye was 0.8 and light-perception in his left eye. Relative afferent pupillary defect was found in his left eye. Slit-lamp examination showed anterior uveitis secondary to herpes zoster ophthalmicus presented with stromal keratitis. Fundus examination showed retinal hemorrhage, vitreous opacity, cherry-red spot in the fovea and optic disc swelling. Delayed arterial filling and arteriovenous transit time were observed on fluorescence angiography. He was treated with topical antiviral and steroid eye drops for stromal keratitis and anterior uveitis. He was also treated systemically with an intravenous antiviral agent and oral steroid, but visual acuity did not improve. CONCLUSIONS: Stromal keratitis, corneal opacity, anterior uveitis, central retinal artery occlusion and optic neuropathy can be complications of herpes zoster ophthalmicus.
Aged ; Corneal Opacity ; Fluorescein Angiography ; Herpes Zoster Ophthalmicus* ; Humans ; Keratitis ; Ophthalmic Solutions ; Optic Nerve Diseases ; Pupil Disorders ; Retinal Artery Occlusion ; Retinal Hemorrhage ; Uveitis, Anterior ; Visual Acuity

BACKGROUND: Activated fibrinolysis during cardiopulmonary bypass(CPB) is one of the causes of post CPB coagulopathy. Antifibirinolytics such as tranexamic acid have been administered prophylactically before CPB to decrease postCPB bleeding. However, their routinely application has been challenged as regarding it's thrombotic complication. This study was performed to evaluate the effect of tranexamic acid administered before CPB by thromboelastography. METHODS: 50 open heart surgical patients were randomly selected and devided into two groups, control(N=25) and tranexamic acid group(N=25). In tranexamic acid group. 125mg of tranexamic acid were singly infused before vena caval and aortic cannulation. All of parameters of thromboelastography (TEG) and fibrin degradation products measured before and after CPB were compared between two groups. RESULTS: There were no significant differences in fibrinolytic indexes of TEGs between control group and tranexamic group afte CPB. And there were also no changes in fibrinolysis index between before and after CPB in both groups. The concentration of FDP did not changed after CPB in both groups. CONCLUSIONS: It may be considered that prophylactic administration of tranexamic acid before CPB to reduce post-CPB bleeding would not be recommended routinely.
Catheterization ; Fibrin Fibrinogen Degradation Products ; Fibrinolysis* ; Heart* ; Hemorrhage ; Humans ; Thoracic Surgery* ; Thrombelastography ; Tranexamic Acid*

During hemorrhagic shock, liver is susceptible to ischemia and decreased hepatic energy charge results in decreasing arterial ketone body ratio(AKBR). Reperfusion after hemorrhagic shock can greatly amplify the generation of toxic oxygen metabolites. As a result, the fluxes of these highly toxic metabolites can overwhelm the endogenous antioxident defense mechanisms and lead to tissue injury. In order to observe the effect of glutathione(GSH) on the AKBR in hemorrhagic shock, dogs(n=16) were anesthetized with 1% enflurane in 02. We pretreated glutathione (100 mg/kg) intravenously before hemorrhagic shock in glutathione (GSH) group (n=8). Shock was induced with bleeding and mean arterial pressure was maintained 50 mmHg for 30 minutes. Recovery from shock was done with transfusion of preserved blood and maintained for 30 minutes. We measured arterial ketone bodies and ketone body ratio before, during and after shock, and compared them to control group (n=8) which was not pretreated with glutathione. AKBR during and after hemorrhagic shock in GSH group (0.8 and 1.0) were higher than those in control group (0.5 and 0.8). Light microscopic examination of liver biopsy revealed less portal degeneration during and after hemorrhagic shock in GSH group than control group. Pharmacologic modulation of hepatocytic function with glutathione before hemorrhagic shock has shown some beneficial effect with protection of decreased AKBR and histological change during and after hemorrhagic shock.
Animals ; Arterial Pressure ; Biopsy ; Defense Mechanisms ; Dogs* ; Enflurane ; Glutathione* ; Hemorrhage ; Ischemia ; Ketone Bodies ; Liver ; Oxygen ; Reperfusion ; Shock ; Shock, Hemorrhagic*

Hepatitis C virus (HCV) is a major cause of chronic hepatitis, liver cirrhosis and hepatocellular carcinoma. HCV core protein has been shown to modulate various cellular signaling pathways including the nuclear factor κB (NF-κB) pathway which is associated with inflammation, cell proliferation and apoptosis. However, there have been conflicting reports about the effect of HCV core protein on NF-κB pathway, and the mechanism by which the core protein affects NF-κB activity remains nuclear. In this study, the functional interaction of HCV core protein and IκB kinase γ (IKKγ) was investigated using the expression plasmids of core and the components of IKK complex. The data revealed that HCV core protein activates NF-κB. Also, HCV core protein up-regulated the phosphorylation and degradation of IκBα. The activating effect of HCV core protein on NF-κB was synergistically elevated by IKKγ. It was noticed that the N-terminal IKKβ binding site, C-terminal leucine zipper, and zinc finger domains of IKKγ are not necessary for its synergistic effect. HCV core protein and IKKγ appeared to activate NF-κB by up-regulating the IKKβ activity resulting in the degradation of IκBα. As expected, HCV core protein induced the expression of NF-κB-targeted pro-inflammatory genes such as iNOS, IL-1β and IL-6 in the transcription level. These results suggest that HCV core protein induces NF-κB through the interaction with IKKγ and may play a critical role in the development of inflammation and related liver diseases.
Apoptosis ; Binding Sites ; Carcinoma, Hepatocellular ; Cell Proliferation ; Hepacivirus* ; Hepatitis C* ; Hepatitis* ; Hepatitis, Chronic ; Inflammation ; Interleukin-6 ; Leucine Zippers ; Liver Cirrhosis ; Liver Diseases ; Phosphorylation ; Phosphotransferases ; Plasmids ; Zinc Fingers