Growth hormone (GH) deficiency is caused by congenital or acquired causes and occurs in childhood or adulthood. GH replacement therapy brings benefits to body composition, exercise capacity, skeletal health, cardiovascular outcomes, and quality of life. Before initiating GH replacement, GH deficiency should be confirmed through proper stimulation tests, and in cases with proven genetic causes or structural lesions, repeated GH stimulation testing is not necessary. The dosing regimen of GH replacement therapy should be individualized, with the goal of minimizing side effects and maximizing clinical improvements. The Korean Endocrine Society and the Korean Society of Pediatric Endocrinology have developed a position statement on the diagnosis and treatment of GH deficiency. This position statement is based on a systematic review of evidence and expert opinions.

Drug-induced sleep endoscopy (DISE) is used to identify areas of upper airway obstruction, which occurs when patients with obstructive sleep apnea (OSA) snore. DISE enables effective diagnosis and appropriate treatment of the obstruction site. Among surgical treatment methods for OSA, maxillomandibular advancement surgery (MMA) is performed to move a jaw forward; the surgery has a high success rate for OSA treatment. In DISE, anesthetics such as propofol and midazolam must be administered to induce snoring while the patient is deeply sedated for an accurate diagnosis to be made. When inducing deep sedation in a patient with OSA, airway obstruction may increase, causing oxygen saturation to drop; airway interventions are necessary in such cases. Effective DISE and MMA surgery can be performed by administering propofol through target-controlled infusion while monitoring the bispectral index (BIS).
Airway Obstruction ; Anesthetics ; Deep Sedation ; Diagnosis ; Endoscopy* ; Humans ; Jaw ; Midazolam ; Oxygen ; Propofol ; Sleep Apnea, Obstructive* ; Snoring

Formaldehyde (FA) used for preserving the body for anatomy dissection is harmful to the human body. In many countries, for the purpose of protecting the health of workers in the industrial field, the maximal allowable air concentration of FA has been set. The threshold limit values of time weighted average (TLV-TWA) and short-term exposure limit (TLV-STEL) of FA recommended by Ministry of Employment and Labor (MOEL) of Korea are less than 0.5 and 1 ppm, respectively. In the United States and Europe, TLV-TWAs of FA are recommended at between 0.3 and 2 ppm. In this study, we compared the air concentration of FA to domestic and foreign standards of FA in an anatomy laboratory equipped dissecting tables with inbuilt exhaust and an air diffuser/return system. We installed ten elevated dissection tables, 18 air diffusers on the ceiling, and 10 air returns at the bottom of both side walls. The concentration of FA was measured at five sites in the anatomy laboratory and above the cadavers on the dissecting tables at a height of 1.5 m from the floor using a Formaldemeter. The average concentration of FA in the anatomy laboratory (five sites) was 0.31 ppm (0.45 mg/m³), range 0.21 to 0.41 ppm (0.26~0.51 mg/m³). The average concentration of FA above the cadavers was 0.45 ppm (0.56 mg/m³), range 0.31 to 0.64 ppm (0.39~0.80 mg/m³). The average TWA of FA in the anatomy laboratory was 0.19 ppm (0.24 mg/m³), range 0.13 to 0.26 ppm. The average TWA of FA above the cadavers was 0.28 ppm (0.35 mg/m³), range 0.19 to 0.40 ppm. The anatomy laboratory dissecting tables equipped with inbuilt exhaust and air diffuser/return system met the criteria of the FA concentration recommended by MOEL of Korea and most foreign countries. This study was the first evaluation of the air concentration of FA in an anatomy laboratory equipped dissecting tables with inbuilt exhaust and an air diffuser/return system in Korea. We expect it will be not only used as a standard of comparison for anatomy laboratories, but as a reference for design and construction to improve air quality in Korean Medical Colleges.
Cadaver ; Employment ; Europe ; Formaldehyde* ; Human Body ; Korea ; Threshold Limit Values ; United States ; Ventilation

BACKGROUND: To prepare for possible emergency situations during dental treatment, it is helpful to know how often and what kinds of emergencies may arise. This study set out to evaluate the incidences, causes, treatments, and outcomes of emergency situations in the outpatient clinic of a dental teaching hospital in Korea. METHODS: We retrospectively reviewed the records of patients who had experienced an emergency situation and emergency response team activated in a selected outpatient clinic between November 2004 and November 2013. Specific information about the emergency cases was collected, including the patient characteristics and the frequency, types, treatments, and outcomes of the emergency situations. RESULTS: We identified 35 instances of emergency situations in 2,890,424 patients (incidence = 0.012 per 10,000 outpatients). The number of cases was as follows: 10 (28.6%) in the Department of Periodontics, 10 (28.6%) in the Department of Oral and Maxillofacial Surgery, 6 (17.1%) in the Department of Oral and Maxillofacial Radiology, 4 (11.4%) in the Department of Prosthodontics, 2 (5.7%) in the Department of Conservative Dentistry, 2 (5.7%) in the Department of Pediatric Dentistry, and 1 (2.9%) in the Department of Orthodontics. Three (8.6%) of the emergency situations arose before treatment, 22 (62.9%) during treatment, 7 (20.0%) after treatment, and 2 (5.7%) in a patient's guardian. CONCLUSIONS: In accordance with the growing elderly population and more aggressive dental procedures, the number of emergency situations may increase in the future. We recommend that clinicians keep in mind airway management and the active control of emergency situations.
Aged ; Airway Management ; Ambulatory Care Facilities* ; Dentistry ; Emergencies* ; Emergency Medical Services ; Hospital Rapid Response Team ; Hospitals, Teaching* ; Humans ; Incidence ; Korea* ; Orthodontics ; Outpatients* ; Pediatric Dentistry ; Periodontics ; Prevalence ; Prosthodontics ; Retrospective Studies* ; Surgery, Oral

Cystic lesions or progressive cystic changes in adenocarcinoma of the lung have rarely been reported. We report a case of lung adenocarcinoma that progressed from ground-glass opacities (GGOs) and consolidations or nodules to extensive cystic lesions during 12 months in a young adult patient. A 29-year-old male was initially diagnosed with primary lung adenocarcinoma by transbronchial lung biopsy of the right lower lobe and lung to lung metastasis in both lungs according to imaging findings. The initial chest computed tomography (CT) scans showed multifocal GGOs, consolidations, and nodules in both lungs. Despite treatment with palliative chemotherapy, the patient's follow-up CT scans showed multiple, cystic changes in both lungs and that the lesions had progressed more extensively. He died of hypoxic respiratory failure one year after his diagnosis.
Adenocarcinoma ; Adult ; Biopsy ; Follow-Up Studies ; Humans ; Lung ; Lung Neoplasms ; Male ; Neoplasm Metastasis ; Respiratory Insufficiency ; Thorax ; Young Adult

No abstract available.
Gastrointestinal Hemorrhage ; Intussusception

Animals ; Bisphosphonate-Associated Osteonecrosis of the Jaw ; Diphosphonates ; Humans ; Ilium ; Imidazoles ; Macrophages ; Maxillary Sinus ; Membranes ; Osteonecrosis ; Periosteum ; Rabbits ; Sodium Chloride ; Transplants

BACKGROUND: Bronchiectasis (BE) remains a rare respiratory disease in Korea. This retrospective study was done to investigate the potential pathogenic microorganisms (PPMs) that cause in patients with BE, through the use of sputum specimens. METHODS: One hundred eleven adult patients, who had undergone chest computed tomography (CT), sputum gram stain/culture, and BE detected by chest CT, were included in this study. Sputum adequacy was determined by using Murray-Washington classification. RESULTS: The mean (+/-SD) age of patients was 60.9 (+/-14.0). The number of PPMs was 167 (67%) in the total 248 isolated organisms. The most frequent PPMs were P. aeruginosa (23.4%), K. pneumoniae (10.5%), and S. aureus (8.4%). The proportion of adequate sputum (AS) was 25.8% in the total sputum specimens. The patients with AS were 41 (37%) and the patients with inadequate sputum (IS) were 70 (63%). The proportion of P. aeruginosa was higher in AS compared to that of IS (44% vs. 19%, p=0.004). The BE score was also higher in P. aeruginosa (+) patients compared to that of P. aeruginosa (-) patients (10.8 vs. 7.6, p=0.001). CONCLUSION: Although the proportion of AS in the total sputum was low, PPMs were isolated in most patients with BE. It is likely that P. aeruginosa was isolated in AS and AS patients had higher BE scores.
Adult ; Bacteriology ; Bronchiectasis ; Humans ; Korea ; Pneumonia ; Retrospective Studies ; Sputum ; Thorax

Background: DNA prevalence and type distribution of human papillomavirus (HPV) varies geographically. We investigated HPV prevalence and type distribution in Korean women using the MyHPV DNA chip testing. Methods: A total of 2,368 women from five regions of the country underwent Pap smear examination and MyHPV chip testing. Results: Overall HPV positivity was 15.8% and 78.4% in women with normal and abnormal cytology, respectively. High-risk HPV infection was strongly correlated with cytological atypia. In women with abnormal cytology, the five most common HPV types were 16, 58, 18, 52, and 56/53, and HPV16 was significantly the most common type in most geographical regions. After HPV16, HPV58, and 52 were the next most frequently detected types. Women with normal cytology, in contrast, showed heterogeneity in HPV type distribution. High-grade intraepithelial lesions infected with HPV16, 18, 31 or 45 are more likely to progress to carcinoma. Conclusions: The HPV chip test can provide useful data regarding HPV positivity and type. The most common HPV type in Korean women with abnormal cytology is HPV16, with HPV58 and 52 being frequently present. Our data may have important implications for vaccination programs and the development of cervical screening.
Cervix Uteri ; DNA ; Female ; Genotype ; Humans ; Mass Screening ; Oligonucleotide Array Sequence Analysis ; Population Characteristics ; Prevalence ; Republic of Korea ; Vaccination ; Vaginal Smears

BACKGROUND: Welders tend to be exposed to a variety of hazards including metal fumes, toxic gases, electricity, heat, noise, and radiation such as ultraviolet and infrared light. Noxious gases generated during welding include carbon monoxide, ozone, and nitrogen oxide. Although the effects of metal fumes have been well studied, few reports have investigated the influence of noxious gas exposure in welders. CASE REPORT: We encountered a patient who developed non-cardiogenic pulmonary edema within a day after fairing up a steel plate with an oxygen/LPG torch. The patient was a 43-year-old female who complained of dyspnea which became exacerbated the following morning. Her chest X-ray and chest CT scan showed an extensive ground glass opacity which was more prominent in the both upper lungs. Both her symptoms and chest X-ray findings improved. We attributed the patient's symptoms to non-cardiogenic pulmonary edema caused by nitrogen dioxide exposure, by reasoning that: 1) the patient's clinical course and radiologic findings suggested pulmonary edema 2) the event happened following fairing work with oxygen/LPG torch that usually induces a high concentration of nitrogen dioxide, and 3) the other possible causes of pulmonary edema could be excluded. CONCLUSION: Nitrogen dioxide-induced pulmonary edema should be considered in oxygen torch contrary to arc welding.
Adult ; Carbon Monoxide ; Dyspnea ; Electricity ; Female ; Gases ; Glass ; Hot Temperature ; Humans ; Lung ; Nitrogen Dioxide ; Nitrogen* ; Noise ; Oxygen* ; Ozone ; Pulmonary Edema* ; Steel ; Thorax ; Tomography, X-Ray Computed ; Welding