PURPOSE: In some girls with central precocious puberty (CPP), growth velocity (GV) decreases below the age-appropriate normal range during gonadotropin-releasing hormone agonist (GnRHa) treatment. The purpose of this study was to investigate clinical and laboratory factors related to changes in GV during GnRHa treatment in girls with CPP. METHODS: We analyzed clinical and laboratory data of 49 girls (aged 7.8+/-0.5 years) with idiopathic CPP who were treated with GnRHa. GV, height standard deviation score (SDS), hormonal parameters, pubertal stage, chronological age and bone age (BA) were evaluated. RESULTS: GV during the first year of GnRHa treatment was 5.9+/-1.0 cm/yr and decreased significantly to 5.4+/-1.1 cm/yr during the second year of treatment (P = 0.005). GV during the third year (5.0+/-1.0 cm/yr) was not different from GV during the second year. During the second year of treatment, 8.2% and 36.7% of the girls had a GV < 4 cm/yr and < 5 cm/yr, respectively. Girls with relatively low GV during the second year of treatment (< 5 cm/yr) showed higher risk of advanced BA (> or = 11 yr) at 1 year (55.6% vs. 19.4%; odds ratio [OR], 5.2; P = 0.022). In multivariate logistic regression analysis, more advanced BA at 1 year (OR, 6.1; 95% confidence interval [CI], 1.57-23.87) and lower height SDS for BA at 1 year (OR, 0.24; 95% CI, 0.06-0.94) were associated with relatively decreased GV (< 5 cm/yr) during the second year of GnRHa treatment. CONCLUSION: GV during and after the second year of GnRHa treatment in girls with idiopathic CPP remains within the normal prepubertal range, and relatively low GV during GnRHa treatment is associated with more advanced BA and lower height SDS for BA.
Gonadotropin-Releasing Hormone ; Logistic Models ; Odds Ratio ; Piperazines ; Puberty, Precocious ; Reference Values

PURPOSE: In some girls with central precocious puberty (CPP), growth velocity (GV) decreases below the age-appropriate normal range during gonadotropin-releasing hormone agonist (GnRHa) treatment. The purpose of this study was to investigate clinical and laboratory factors related to changes in GV during GnRHa treatment in girls with CPP. METHODS: We analyzed clinical and laboratory data of 49 girls (aged 7.8+/-0.5 years) with idiopathic CPP who were treated with GnRHa. GV, height standard deviation score (SDS), hormonal parameters, pubertal stage, chronological age and bone age (BA) were evaluated. RESULTS: GV during the first year of GnRHa treatment was 5.9+/-1.0 cm/yr and decreased significantly to 5.4+/-1.1 cm/yr during the second year of treatment (P = 0.005). GV during the third year (5.0+/-1.0 cm/yr) was not different from GV during the second year. During the second year of treatment, 8.2% and 36.7% of the girls had a GV < 4 cm/yr and < 5 cm/yr, respectively. Girls with relatively low GV during the second year of treatment (< 5 cm/yr) showed higher risk of advanced BA (> or = 11 yr) at 1 year (55.6% vs. 19.4%; odds ratio [OR], 5.2; P = 0.022). In multivariate logistic regression analysis, more advanced BA at 1 year (OR, 6.1; 95% confidence interval [CI], 1.57-23.87) and lower height SDS for BA at 1 year (OR, 0.24; 95% CI, 0.06-0.94) were associated with relatively decreased GV (< 5 cm/yr) during the second year of GnRHa treatment. CONCLUSION: GV during and after the second year of GnRHa treatment in girls with idiopathic CPP remains within the normal prepubertal range, and relatively low GV during GnRHa treatment is associated with more advanced BA and lower height SDS for BA.
Gonadotropin-Releasing Hormone ; Logistic Models ; Odds Ratio ; Piperazines ; Puberty, Precocious ; Reference Values

PURPOSE: Recombinant human growth hormone is an effective therapy for short-statured children born small for their gestational age (SGA). This single-arm, multicenter, phase III clinical study of such children was designed to assess the efficacy and safety of treating them with recombinant human-growth-hormone (Eutropin(TM) Inj.) for 6 months. METHODS: Between 2005 and 2007, 30 treatment naive, prepubertal, short-statured SGA-born children were recruited as participants. Eutropin(TM) Inj. was administered for 6 months with a subcutaneous dose of 0.48 mg/kg/wk. The primary endpoint was the change in height velocity from the baseline to month 6. Various parameters were checked to obtain secondary outcome measures and to meet safety criteria. RESULTS: Height velocity significantly increased from 5.36 +/- 1.59 cm/yr at baseline to 10.66 +/- 2.03 cm/yr at month 6 (P < 0.0001). Secondary outcome measures (height velocity at month 3, height SDS for chronological age (CA), weight SDS for CA, bone maturation, and IGF-I and IGFBP-3 levels) were also significantly increased. Eutropin(TM) Inj. was well tolerated and safe over 6 months of treatment. CONCLUSION: The clinical efficacy and safety of Eutropin(TM) Inj. was demonstrated for the 6 month treatment of prepubertal children with short stature due to SGA. Further long-term study is needed.
Child ; Gestational Age ; Human Growth Hormone ; Humans ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor I ; Outcome Assessment (Health Care)

PURPOSE: The purpose of this study was to analyze clinical and radiological results after debridement arthroplasty during primary elbow arthroplasty. MATERIALS AND METHODS: This study involved 25 primary elbow osteoarthritis cases that were treated by debridement arthroplasty from January 1996 to December 2004 with at least a 2 year follow up (mean: 41.3 months). Mean patient age was 45.5 years. Clinical outcomes were analyzed using preoperative and postoperative ranges of motion, Mayo Elbow Performance Scores (MEPS), and Visual Analogue Scale scores. Radiologic analysis was based on plain radiographs. RESULTS: Average flexion-extension arc improved from 72degrees ROM preoperatively to 110.5degrees postoperatively (p<0.001). Mean MEPS was 89.5 points preoperatively and increased postoperatively (p<0.05). Humeral fenestration size decreased from 27% to 20.5%. Bony spurs of the olecranon and coronoid process recurred in 8 cases. Postoperative LOM was found to be associated with spur recurrence (p<0.05). CONCLUSION: Debridement arthroplasty may be recommendable for primary elbow osteoarthritis as it reduces pain and improves functional outcomes, including range of motion. Spur recurrence was found to be associated with a reduced range of motion.
Arthroplasty ; Debridement ; Elbow ; Follow-Up Studies ; Humans ; Olecranon Process ; Osteoarthritis ; Range of Motion, Articular ; Recurrence

Heme oxygenase-1 (HO-1), an inducible heme-degrading enzyme, is expressed by macrophages and endothelial cells in response to inflammatory stresses. It has been known to show strong immunosuppressive properties although its mechanisms are not completely understood. This study was designed to determine the effects of HO-1 modulation on collagen induced arthritis (CIA) model. CIA model was induced by subcutaneous injection of collagen on tail of DBA/1J mice. For evaluation of HO-1 effects, an inducer of HO-1, cobalt protoporphyrin IX (CoPPIX), or an inhibitor of HO-1, tin protoporphyrin IX (SnPPIX), were administered every other days into peritoneal cavity from day 1 to day 42 after CIA induction. The macrocopic clinical findings of CIA were evaluated and histo-pathologic findings and radiographic analysis were carried out. The expressions of TNF-alpha, IL-6, and VEGF which have important roles in pathogenesis of rheumatoid arthritis were observed by immuno-histochemical staining. Collagen on DBA/1J mice induced arthritis at knee joint and ankle joint. Administration of CoPPIX significantly aggravated the severity of arthritis while SnPPIX protected collagen induced arthritis. SnPPIX strongly suppressed inflammatory cell infiltration, swelling of synovial membrane, and erosion and destruction of bone on CIA mice. Furthermore subcutaneous injection of collagen also increased expression of TNF-alpha, IL-6, and VEGF which are important pro-inflammatory mediators in rheumatoid arthritis. SnPPIX suppressed expression of the pro-inflammatory mediators on CIA mice. Finally, we suggest that HO-1 mediates the expression of pro-inflammatory mediators and bone destruction during pathogenesis of CIA, which indicates modulation of HO-1 can be a new therapeutic target of rheumatoid arthritis.
Animals ; Ankle Joint ; Arthritis* ; Arthritis, Rheumatoid ; Cobalt ; Collagen* ; Endothelial Cells ; Heme Oxygenase-1* ; Heme* ; Injections, Subcutaneous ; Interleukin-6 ; Knee Joint ; Macrophages ; Mice ; Peritoneal Cavity ; Synovial Membrane ; Tail ; Tin ; Tumor Necrosis Factor-alpha ; Vascular Endothelial Growth Factor A

BACKGROUND: LB03002[somatropin(rDNA origin) for injectable suspension] is a sustained release formulation of human growth hormone to be administered by once-a-week subcutaneous injections. Less frequent administration could provide a considerable improvement on compliance and convenience. OBJECTIVE: To determine the efficacy and safety of a LB03002 administered in children with GHD once weekly for 6 months. DESIGN: Open-label, active-controlled, randomised, parallel group, phase II study. PATIENTS: A total of forty-two naive or previously treated, pre-pubertal children with GHD, confirmed by two different GH provocation tests, were randomised and received either LB03002(0.3 or 0.5 mg/kg/week) or Eutropin(TM)(daily rhGH, 0.3 mg/ kg/week divided 6 times a week) for 6 months. RESULTS: The pre-treatment(HV0) and 6-month annualised height velocity(HV6) are shown(mean+/-SD) in the table below: ----------------------------------------------------------------------- LB03002 LB03002 EutropinTM 0.3 mg/kg/week 0.5 mg/kg/week 0.3 mg/kg/week ----------------------------------------------------------------------- N 10 13 13 HV0 3.1+/-1.0 3.9+/-1.5 3.0+/-1.1 HV6 9.3+/-2.3 10.2+/-2.3 11.1+/-2.5 ----------------------------------------------------------------------- Mean IGF-I and IGFBP-3 levels were significantly elevated from baseline values in all the study groups. LB03002 at all dose groups was safe and well tolerated. No clinically relevant adverse events or abnormal laboratory parameters were observed and there were no remarkable differences between groups or changes over time within groups regarding parameters for glucose and lipid metabolism including fasting glucose and haemoglobin A1c. Injection site reactions were mostly mild to occasionally moderate and resolved within 2 to 3 days post-dose without intervention. CONCLUSIONS: Treatment with LB03002 by weekly administration of the doses tested in the study resulted in comparable safety and efficacy to daily rhGH in pre-pubertal children with GHD.
Child* ; Compliance ; Fasting ; Glucose ; Growth Hormone* ; Human Growth Hormone* ; Humans* ; Injections, Subcutaneous ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor I ; Lipid Metabolism

No abstract available.

Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is the term applied to arginine vasopressin (AVP) excess associated with hyponatremia without edema in the absence of physiologic or pharmacologic stimuli to AVP secretion. SIADH is associated with various conditions such as malignant tumors, infection, central nervous system disorders, and different pharmacological agents. The patient was 73-year-old female. She was admitted to the hospital because of persistent cough, dizziness, general weakness and confusion. On admission, her serum osmolality was 253 mOsm/kg, urine osmolality was 416 mOm/kg, and urine Na concentration was 159 mEq/L. Her Chest X-ray and CT scan of lung showed about 4x3.5 cm sized mass at posterior basal segment of left lower lobe of the lung, and CT-guided percutaneous needle aspiration revealed small round cell with clusters of malignant squamous cells. She was treated by salt restriction, hypertonic saline infusion and demeclocycline. We planned chemotherapy for advanced combined lung cancer, but she was discharged because of poor general condition and associated pneumonia without cancer chemotherapy. We report a rare case of SIADH in small cell cancer of lung combined with squamous cell cancer of lung.
Aged ; Arginine Vasopressin ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Central Nervous System Diseases ; Cough ; Demeclocycline ; Dizziness ; Drug Therapy ; Edema ; Female ; Humans ; Hyponatremia ; Inappropriate ADH Syndrome ; Lung Neoplasms* ; Lung* ; Needles ; Neoplasms, Squamous Cell* ; Osmolar Concentration ; Pneumonia ; Thorax ; Tomography, X-Ray Computed

The accumulation of fluid in the pericardium in an amount sufficient to cause serious obstruction to the inflow of blood to the ventricles results in cardiac tamponade. This complication may be fatal if it is not recognized and treated promptly. We report a case of cardiac tamponade caused by acute pancreatitis, which resolved after catheter drainage.
Cardiac Tamponade* ; Catheters ; Drainage ; Pancreatitis* ; Pericardium

PURPOSE: We planned to evaluate the toxicity and efficacy of DA-3030 to determine the recommended dose for phase III clinical trial based on the biologically active doses from phase I/II clinical trial. MATERIALS AND METHODS: Open non-randomized phase I/II study was carried out in 64 cancer patients with chemotheray-induced myelosuppression. After 1 cycle of control period (chemotherapy without DA-3030), DA-3030 was started 24 hours after the second cycle of chemotherapy to 4 groups of patients with the doses of 50 microgram/m2/day (step I), 100 microgram/m2/day (step II), 150 microgram/m2/day (step III), 200microgram/m2/day (step IV) by once-a-day subcutaneous administration for 10 days. RESULTS: Of the 64 enrolled patients, 46 patients were evaluable. Tmax reached after 2 hours of injection in step I and 4 hours in step II-IV. Terminal half life was 1.8 hours in step I and 3.2 hours in step II, 3.3 hours in step III, 3.0 hours in step IV. Area under the curve (AUC) and AUMC increased dose dependently from step I through step IV. Total clearance rate decreased in a dose dependent manner but the volume of distribution showed no differences between the steps.The mean nadir count of total WBC and neutrophil increased in all 4 steps of DA-3030 administration. Also the duration of leukopenia, equal to or less than 2,000/uL or neutropenia and the recovery time of WBC or neutrophil from nadir decreased with DA-3030 administration in all 4 steps. But no differece of DA-3030 effect was found among 4 steps. When we compared the clinical efficacy of DA-3030 with total WBC and neutrophil criteria, it was 58.3% and 58.3% in step I, 90.0% and 80.0% in step II, 91.7% and 91.7% in step III, 75.0% and 70.0% in step IV. Although the duration of antibiotics administration showed no difference between control and DA-3030 administration period in step I, it decreased with DA-3030 administration in step II-IV. Infection was found only in step I. Life-threatening side effect was not found in all steps. Only mild myalgia was found without any dose relationship. CONCLUSION: When we considered the efficacy, toxicity and pharmacokinetic parameters, we suggest that 100microgram/m2 is an appropriate dosage for the phase III clinical trial.
Anti-Bacterial Agents ; Drug Therapy* ; Half-Life ; Humans ; Leukopenia ; Myalgia ; Neutropenia* ; Neutrophils