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.

Implant supported removable partial denture (ISRPD) using the implants enables favorable rehabilitation by complementing biomechanical limitations of the conventional removable partial denture (RPD). However, continuous recall check is necessary for evaluation of the mechanical and biological complications to ensure good long-term prognosis of ISRPD. This clinical report describes the complication and management in patient of Kennedy class I edentulism with ISRPD using healing abutment. The wear and fracture of healing abutment occurred at 36 months after delivery. So, healing abutment was replaced by connecting Locator® abutment for altering into the implant retained partial overdenture.
Complement System Proteins ; Denture, Overlay ; Denture, Partial, Removable* ; Humans ; Prognosis ; Rehabilitation

PURPOSE: The purpose of this study was to evaluate cell toxicity due to ion release caused by galvanic corrosion as a result of contact between base metal and titanium. MATERIALS AND METHODS: It was hypothesized that Nickel (Ni)-Chromium (Cr) alloys with different compositions possess different corrosion resistances when contacted with titanium abutment, and therefore in this study, specimens (10 x 10 x 1.5 mm) were fabricated using commercial pure titanium and 3 different types of Ni-Cr alloys (T3, Tilite, Bella bond plus) commonly used for metal ceramic restorations. The specimens were divided into 6 groups according to the composition of Ni-Cr alloy and contact with titanium. The experimental groups were in direct contact with titanium and the control groups were not. After the samples were immersed in the culture medium - Dulbecco's modified Eagle's medium[DMEM] for 48 hours, the released metal ions were detected using inductively coupled plasma mass spectrometer (ICP-MS) and analyzed by the Kruskal-Wallis and Mann-Whitney test (P<.05). Mouse L-929 fibroblast cells were used for cell toxicity evaluation. The cell toxicity of specimens was measured by the 3-{4,5-dimethylthiazol-2yl}-2,5-diphenyltetrazolium bromide (MTT) test. Results of MTT assay were statistically analyzed by the two-way ANOVA test (P<.05). Post-hoc multiple comparisons were conducted using Tukey's tests. RESULTS: The amount of metal ions released by galvanic corrosion due to contact between the base metal alloy and titanium was increased in all of the specimens. In the cytotoxicity test, the two-way ANOVA showed a significant effect of the alloy type and galvanic corrosion for cytotoxicity (P<.001). The relative cell growth rate (RGR) was decreased further on the groups in contact with titanium (P<.05). CONCLUSION: The release of metal ions was increased by galvanic corrosion due to contact between base metal and titanium, and it can cause adverse effects on the tissue around the implant by inducing cytotoxicity.
Alloys ; Animals ; Corrosion* ; Dental Alloys ; Fibroblasts ; Ions ; Metal Ceramic Alloys ; Mice ; Nickel ; Plasma ; Titanium*

PURPOSE: The purpose of this study was to evaluate cell toxicity due to ion release caused by galvanic corrosion as a result of contact between base metal and titanium. MATERIALS AND METHODS: It was hypothesized that Nickel (Ni)-Chromium (Cr) alloys with different compositions possess different corrosion resistances when contacted with titanium abutment, and therefore in this study, specimens (10 x 10 x 1.5 mm) were fabricated using commercial pure titanium and 3 different types of Ni-Cr alloys (T3, Tilite, Bella bond plus) commonly used for metal ceramic restorations. The specimens were divided into 6 groups according to the composition of Ni-Cr alloy and contact with titanium. The experimental groups were in direct contact with titanium and the control groups were not. After the samples were immersed in the culture medium - Dulbecco's modified Eagle's medium[DMEM] for 48 hours, the released metal ions were detected using inductively coupled plasma mass spectrometer (ICP-MS) and analyzed by the Kruskal-Wallis and Mann-Whitney test (P<.05). Mouse L-929 fibroblast cells were used for cell toxicity evaluation. The cell toxicity of specimens was measured by the 3-{4,5-dimethylthiazol-2yl}-2,5-diphenyltetrazolium bromide (MTT) test. Results of MTT assay were statistically analyzed by the two-way ANOVA test (P<.05). Post-hoc multiple comparisons were conducted using Tukey's tests. RESULTS: The amount of metal ions released by galvanic corrosion due to contact between the base metal alloy and titanium was increased in all of the specimens. In the cytotoxicity test, the two-way ANOVA showed a significant effect of the alloy type and galvanic corrosion for cytotoxicity (P<.001). The relative cell growth rate (RGR) was decreased further on the groups in contact with titanium (P<.05). CONCLUSION: The release of metal ions was increased by galvanic corrosion due to contact between base metal and titanium, and it can cause adverse effects on the tissue around the implant by inducing cytotoxicity.
Alloys ; Animals ; Corrosion* ; Dental Alloys ; Fibroblasts ; Ions ; Metal Ceramic Alloys ; Mice ; Nickel ; Plasma ; Titanium*

0.05). Amnesia during local injection was observed in eight patients (34.8%). Compared with the preoperative anxiety score, the intraoperative anxiety score was decreased.CONCLUSION: In this study, we found cardiovascular and respiratory stability in intravenous sedation using dexmedetomidine with pethidine, in plate and screw removal, after orthognathic surgery. Furthemore, intravenous sedation using dexmedetomidine with pethidine shows adequate analgesic and sedative effects.]]>
Amnesia ; Anxiety ; Arterial Pressure ; Blood Pressure ; Dexmedetomidine ; Heart Rate ; Humans ; Hypnotics and Sedatives ; Meperidine ; Orthognathic Surgery ; Oxygen

BACKGROUND AND OBJECTIVES: Left transradial coronary angiography may result in damage of both radial arteries in patients who experienced right radial access. In some patients, the left radial artery has been used as a graft. We investigated whether graft angiography using right radial access is feasible in patients with bypass surgery to preserve the left radial artery as a future graft. SUBJECTS AND METHODS: A total of 109 consecutive patients with bypass surgery who had undergone right radial access underwent graft angiography via the same access. RESULTS: Sixteen (15%) patients were excluded because of the presence of a severely tortuous right subclavian artery. Bypass graft angiography via right radial or brachial access was completed successfully in 90 (97%) out of 93 patients. In 3 (3%) of patients, femoral access was needed to complete the angiography. Saphenous vein grafts were cannulated selectively in 150 (90%) of 167 grafts with satisfactory image quality and not found even on the aortogram in the other 17 (10%) grafts. Ninety-two (89%) out of 103 left mammary grafts were cannulated selectively or semi-selectively using a modified Simmons catheter, resulting in satisfactory image quality. The other 11 (11%) grafts were visualized non-selectively using a Judkins Left catheter, and resulting in acceptable image quality in 10 (91%) grafts. There were no procedure-related complications. CONCLUSION: Graft angiography via right radial access can be performed reliably in most patients that lack severe subclavian tortuosity.
Angiography ; Catheters ; Coronary Angiography ; Coronary Artery Bypass ; Humans ; Mammary Arteries ; Radial Artery ; Saphenous Vein ; Subclavian Artery ; Transplants

Nephrotic syndrome is a relatively rare complication of malignancy. A few cases of nephrotic syndrome accompanying Hodgkin's disease, non-Hodgkin lymphoma, leukemia and other malignancies have been reported since the first case of the nephrotic syndrome associated with extrarenal malignancy was reported in 1922. Hodgkin's disease and solid tumors are known to be the most common malignancies accompanying nephrotic syndrome. The pathologic findings of kidney in patients with Hodgkin's disease commonly show minimal change nephropathy. Membranous glomerulonephropathy is the most common pathologic feature in patients with solid tumors. Although membranous glomerulonephropathy related to small cell lung cancer has rarely been reported in Korea, minimal change nephropathy accompanying small cell lung cancer has never been reported. We present here a case of a 70 year-old male with minimal change nephropathy that was related to small cell lung cancer. We detected small cell lung cancer during the diagnosis work-up of nephrotic syndrome. We suggest that nephrotic syndrome can be a manifestation of underlying malignancy.
Glomerulonephritis, Membranous ; Hodgkin Disease ; Humans ; Kidney ; Korea ; Leukemia ; Lymphoma, Non-Hodgkin ; Male ; Nephrosis, Lipoid ; Nephrotic Syndrome ; Small Cell Lung Carcinoma

BACKGROUND/AIMS: It has been acknowleged that diverse factors such as Hepatitis B or C virus, alcohol, food carcinogens, and environmental or genetic factors are involved in hepatocellular carcinogenesis. In the molecular biologic aspect, suppression of tumor suppressor gene or amplification of oncogene, abnormal regulation of cell cycle-related proteins, abnormal apoptosis mechanism, and diverse growth factors are reported to be factors that contribute to hepatocellular carcinogenesis. In this study, the genetic difference between hepatocellular carcinoma tissue and surrounding non-hepatocellular carcinoma tissue has been investigated to identify genes that are deleted, diminished, amplified, or newly developed in hepatocellular carcinoma using differential gene expression. METHOD: We studied each of 12 biopsy samples of hepatocellular carcinoma and surrounding non-hepatocellular carcinoma tissues obtained during surgical resections. Random arbitrarily primed-polymerase chain reaction (RAP-PCR) was applied for differential gene expression. The genes that are deleted, diminished, or amplified, newly developed in hepatocellular carcinoma are cloned, sequenced, and then identified by BLAST search, some genes are characterized by eletrophoresis motility shift assay (EMSA) and in situ hybridization. RESULTS: We identified the various, diverse genes classified as tumor suppressor genes, oncogenes, growth factor genes, and some kinds of transcription factors. Some of these genes were identified to be repressed, deleted or diminished, others were amplified, or newly developed in hepatocellular carcinoma tissues. CONCLUSIONS: RAP-PCR is a good method in the identification of the gene associated with hepatocellular carcinoma. The result in this study shows that so many genes are different between hepatocellular carcinoma and surrounding non- hepatocellular carcinoma tissues, and that the genes related with hepatocellular carcinogenesis may be predicted. Further studies are necessary for analyzing the relationship bet
Apoptosis ; Biopsy ; Carcinogenesis ; Carcinogens ; Carcinoma, Hepatocellular* ; Clone Cells ; Gene Expression* ; Genes, Tumor Suppressor ; Hepatitis B ; In Situ Hybridization ; Intercellular Signaling Peptides and Proteins ; Oncogenes ; Transcription Factors

To determine the distinction of primary ovarian carcinoma from metastatic ovariancarcinoma, the author studied total 40 cases of malignant tumors(13 primary ovarian carcinomas:7 serous, 4 mucinous, and 2 endometrioid, 7 metastatic ovarian adenocarcinomas,10 gastric adenocarcinomas and 10 colonic adenocarcinomas) using primary antibody to CEA,CK7, CK20 and CK18. The results were summerised as follows: The expression of CK7was demonstrated in all(7) serous and 3 out of 4 mucinous adenocarcinoma, and 1 out of10 each gastric and colonic adenocarcinoma. The CK20 positivity was seen in 4 out of 10cases of colonic adenocarcinoma and 3 out of 7 cases of metastatic adenocarcinoma. Allprimary ovarian carcinoma and gastric adenocarcinoma were negative for CK20 except forfocal positivity in only 1 ovarian mucinous adenocarcinoma. All types of serous andendometrioid adenocarcinoma were negative for CEA. But, the vast majority of mucinousadenocarcinoma, metastatic adenocarcinoma, gastric and colonic adenocarcinoma were positivefor CEA. The CK18 may not be helpful to differentiate the primay or metastatic carcinomabecause all cases examined were positive for CK18 except for 1 ovarian mucinous carcinoma.Immunostainning for CK7 may be helpful on differential diagnosis of primary andmetastatic ovarian carcinoma, especially mucinous adenocarcinoma and metastatic gastric andcolonic adenocarcinoma. The CK20 may be a useful marker for differential diagosis inprimary and metastatic ovarian carcinomas. The CEA may be of value on differential diagnosisof mucinous and nonmucinous(serous and endomerioid) ovarian carcinomas, and metastaticcolonic adenocarcinoma and endometrioid carcinoma.In conclusion, immunohistochemical study for CEA, CK7, and CK20 may be helpful indifferential diagnosis between primary and metastatic ovarian carcinoma.
Adenocarcinoma ; Adenocarcinoma, Mucinous ; Colon ; Diagnosis ; Diagnosis, Differential* ; Female ; Immunohistochemistry ; Mucins ; Neoplasm Metastasis ; Ovary

Heterotopic pregnancy describes the rare coexistence of intrauterine and extrauterine gestations. The commonly accepted incidence is 1:30,000 but the actual number is significantly higher. This condition remains difficult to diagnose and potentially dangerous to both mot- her and fetus. The incidence has risen after wider use of ovulation induction and the adve- nt of techniques of assisted reproduction. We report a case of simultaneous intrauterine pregnancy and tubal pregnancy.
Female ; Fetus ; Incidence ; Ovulation Induction ; Pregnancy ; Pregnancy, Heterotopic* ; Pregnancy, Tubal ; Reproduction