Background: Discontinuing growth hormone (GH) treatment during the transition to adulthood has been associated with adverse health outcomes in patients with childhood-onset growth hormone deficiency (CO-GHD). This study investigated the metabolic changes associated with interrupting GH treatment in adolescents with CO-GHD during the transition period. Methods: This study included 187 patients with CO-GHD who were confirmed to have adult GHD and were treated at six academic centers in Korea. Data on clinical parameters, including anthropometric measurements, metabolic profiles, and bone mineral density (BMD) at the end of childhood GH treatment, were collected at the time of re-evaluation for GHD and 1 year after treatment resumption. Results: Most patients (n=182, 97.3%) had organic GHD. The median age at treatment discontinuation and re-evaluation was 15.6 and 18.7 years, respectively. The median duration of treatment interruption was 2.8 years. During treatment discontinuation, body mass index Z-scores and total cholesterol, low-density lipoprotein, and non-high-density lipoprotein (HDL) cholesterol levels increased, whereas fasting glucose levels decreased. One year after GH treatment resumption, fasting glucose levels, HDL cholesterol levels, and femoral neck BMD increased significantly. Longer GH interruption (>2 years, 60.4%) resulted in worse lipid profiles at re-evaluation. The duration of interruption was positively correlated with fasting glucose and non-HDL cholesterol levels after adjusting for covariates. Conclusion GH treatment interruption during the transition period resulted in worse metabolic parameters, and a longer interruption period was correlated with poorer outcomes. GH treatment should be resumed early in patients with CO-GHD during the transition period.

OBJECTIVES: This study was conducted to evaluate a relationship between the blood concentrations of toxic metals and the blood pressure in people living near the copper smelter. METHODS: The study included 570 adults living within 4km of the smelter. We compared systolic and diastolic blood pressure between tertiary groups for blood cadmium, mercury and lead levels, respectively. Multiple regression analysis was performed to identify risk factors affecting systolic and diastolic blood pressures. RESULTS: In male subjects, there is a significant difference in the mean of systolic and diastolic blood pressure between tertiary groups of blood cadmium and mercury levels, but in women, there was no significant difference in the mean systolic and diastolic blood pressures in all tertiary groups of heavy metals. The results of multiple regression analysis showed that age, BMI, and cadmium concentration in men were risk factors for blood pressure. CONCLUSIONS: Residents living near the Janghang smelter showed high concentrations of blood lead and cadmium, suggesting that they were exposed to high concentrations of heavy metals released from the smelter in the past. Such exposure may have caused some blood pressure increase. Especially, the concentration of cadmium in the case of men and the concentration of mercury in blood in the case of women were found to be significantly related to the increase of blood pressure. The local population should be advised to make efforts to reduce exposure to environmental contaminants, in order to minimize cardiovascular disease, and to pay close attention to any health problems possibly related to toxic metal exposure.
Adult ; Blood Pressure* ; Cadmium ; Cardiovascular Diseases ; Copper* ; Female ; Humans ; Korea* ; Male ; Metals* ; Metals, Heavy ; Risk Factors

STUDY DESIGN: A case report and review of literature OBJECTIVE: Mostly operative treatment for pyogenic spondylits has been performed via anterior approach, which is often followed by greater morbidity and late sequelae. Efficacy of percutaneous drainage and posterior lumbar interbody fusion (PLIF), which are increasingly applied with favorable results, as an alternative of anterior surgery was investigated. MATERIAL AND METHOD: A case of pyogenic L4-5 spondylitis with psoas abscess but without neurologic deficit in a 66-year old lady was reviewed. Percutaneous drainage under fluoroscopic guide was performed. 7 weeks later, curettage of disc space and posterior lumbar interbody fusion using autogeous graft was performed to get rid of dead space and achieve stability. Administration of antimicrobial agents followed. RESULTS: Infection was controlled successfully. Clinical features including ambulatory function improved. Solid fusion was achieved. SUMMARY: In treating pyogenic spondylitis with moderate abscess, percutaneous drainage and posterior lumbar interbody fusion seemed to be one of alternatives of anterior surgery.
Abscess ; Aged ; Anti-Infective Agents ; Curettage ; Drainage* ; Humans ; Neurologic Manifestations ; Psoas Abscess ; Spondylitis* ; Transplants

PURPOSE: To Investigate the patterns and to document the clinical and technical significances of the leg injuries of drivers of short-fronted vehicles in frontal collision accidents. MATERIALS AND METHODS: Twelve cases of jammed leg injury were chosen from hospitals in the Chungcheong Province area and investigated in terms of nature of the accident, distribution of injuries, methods and duration of treatment and final sequelae. RESULTS: The patients had multiple injuries on the lower extremities, such as, fractures of the femoral shaft, tibial shaft, foot and ankle and soft tissue injuries, requiring an average 8.3 surgical procedures and 7 months admission, and from which permanent sequlae resulted, though associated injuries of the head, chest, abdomen were not significant. CONCLUSION: "Jammed leg injury" seemed to be related with the design of short-fronted vehicles. As these injuries can cause considerable functional and socioeconomic loss with long treatment periods and permanent residual sequelae. Preventive measures appear to be necessary, possibly involving vehicle design modification.
Abdomen ; Ankle ; Foot ; Head ; Humans ; Leg ; Leg Injuries ; Lower Extremity ; Multiple Trauma ; Soft Tissue Injuries ; Thorax

BACKGROUND: Ventrlcular tachyarrhythmias are major cause of sudden cardiac death in patients after myocardial infarction and their accurate detection seems to be important in prevention of sudden cardiac death. Clinical findings, treasmill test, holter monitoring and coronary angiography have been used to search for high risk group in sudden cardiac death. Recently electrographysiologic stimulation has been to this, but it is not practical, because of high cost and invasiveness. Signal averaged electrocardiogram(SAECG) may be helpful in prediction of high risk group in sudden cardiac death. So we try to know the values of SAECG in Korean patients without heart disease. RESULTS: 1) The mean value and standard deviation of Time domain analysis is as follows ; fQRS : 106.8+/-12.3ms, RMS : 36.2+/-21.5(micro)V, LAS : 27.2+/-8.1ms. 2) The mean value and standard deviation of Spectral turbulence analysis is a follows ; LSCR : 58.6+/-3.9, ISCM : 95.2+/-0.8, ISCSD : 71.8+/-15.7, SE : 6.9+/-1.8. CONCLUSION: There was no significant difference between male and female. Time domain analysis shows significant differences among each hour but spectral turbulence analysis did not. Spectral turbulence analysis shows high specificity.
Coronary Angiography ; Death, Sudden, Cardiac ; Electrocardiography* ; Electrocardiography, Ambulatory ; Female ; Heart Diseases* ; Heart* ; Humans ; Male ; Myocardial Infarction ; Sensitivity and Specificity ; Tachycardia

BACKGROUND: To provide some fundamental physiological basis for the physical training of pilots to improve orthostatic intolerance, cardiorespiratory responses to the symptom-limited maximal exercise loading were studied in pilots and non-pilots, and the results were compared. METHOD: Cardiorespiratory reponses to the symptom-limited maximal exercise loading by Bruce protocol was studied in 11 pilots and 11 matched controls (non-pilots). RESULTS: Comparisons of various data at maximal exercise in the pilots with those in the controls revealed that RR, VE/M2, VE/VO2, VE/VCO2, VT/VC and VE/MVV as well as HR, VO2, O2 pulse and AT showed no significant difference. CONCLUSION: The fact that the aerobic power in the pilots is not superior to that in the controls seems to emphasisze the necessity of aerobic endurance training along with muscular strength training to improve orthostatic tolerance of pilots flying modern high-performance aircrafts.
Aircraft ; Diptera ; Orthostatic Intolerance ; Resistance Training

The position of interventricular septum, which was measured by transitional zone of EKG, was compared with that measured by 2-D echocardiography in 51 patient. 1) The position of interventricular septum measured by 2-D echocardiography was very similar to that measured by transitional zone of EKG. 2) Extensive AMI (Anterior Myocardial Infarction) and LBBB showed moderate differences between two method. 3) RBBB and replaced mitral valve state showed severe differences between two methods. Transitional zone of EKG was helpful to define the position of interventricular septum except extensive AMI, bundle branch block and replaced mitral valve state.
Bundle-Branch Block ; Echocardiography ; Electrocardiography* ; Humans ; Mitral Valve

The cranium can be thought of a as shallow, rigid sphere of contrast volume. There are three main components within the intracranial space : brain, cerebrospinal fluid and blood. Intracranial volume and pressure are maintained constantly by Monroe-Kellie doctrine. Also intracranial pressure is influenced by a number of physiologic factors and it will be changed with intracranial lesion. Now we were look for the possible factors that influence the intracranial pressure with continuous intracranial pressure monitoring. At the same time we studied the possibility of the relationship between factors that influence ICP and ADL(Ability of Daily Life) in 43 severe brain lesions(33 cases ; intracerebral hematoma, 10 cases ; head injury). In cases of higher GCS, smaller hematoma, lower amplitude of ICP, lesser frequency of A-wave and lower elastance, the ICP were lowed. Ninety percent of cases that GCS is over 12 was belong to ADL I and II, but only nineteen percent of cases that GCS is under 7 was belong to ADL I and II. No case of internal capsule involved group was belong to ADL I but forty-eight percent of cases whose hematoma volume is under 10ml was belong to ADL I. Fifty percent of cases whose hematoma volume is under 10ml was belong to ADL I and no case that hematoma volume is over 20ml was belong to ADL I. Cases that PCO2 is in the range of 25mmHg-29mmHg were not belong to ADL I. In cases of higher amplitude of ICP, higher frequency of A-wave and higher elastance, the patient's ADL was grave. And in cases of ICP was progressively increased, the prognosis was also grave. Consequently we are able to guess that patient's prognosis will be influenced by initial GCS, internal capsule involvement, hematoma volume, PCO2, amplitude of ICP, frequency of A-Wave, brain elastance and curve of ICP.
Activities of Daily Living ; Brain ; Cerebrospinal Fluid ; Head ; Hematoma ; Internal Capsule ; Intracranial Pressure* ; Prognosis* ; Skull

From Jun, 1983 to Sep, 1986, we operated 127 cases of spontaneous intracranical parenchymal hematoma. Among them, 88 cases were operated by stereotaxic evacuation of hematoma with computed B.R.W. system and 39 cases by free-hand craniectomy and leucotomy. We compared results of both methods. Results are as followings : 1) Nearly 90%(112 cases) were over 40 years old. 2) Prevalence of both sex were nearly same. 3) Hypertension cases on admission were 93 cases(73.2%). 4) Favorite anatomical locations were putamen(55 cases ; 43.3%), thalamus(32 cases ; 25.2%), subcortical(29 cases ; 22.8%), pontine, cerebellum in frequency. 5) Amount of removed hematoma were mostly 10-30ml and upper most case was 145ml. 6) Irrigation with urokinase were done in cases. 7) Surgical complication were 7 cases(5.5%) : 6 cases of reblecding : 1 case of ventriculitis. 8) Mortality of total cases were 26.0%(33 cases). 9) Comparative results between B.R.W. group and F.H.C. group were as followings ;(tab)B.R.W. group(tab)(tab)F.H.C. group(tab)(newline)Mortality(tab)13.60%(tab)(tab)28.20%(tab)(newline)(tab)AD(tab)DC(tab)AD(tab)DC(newline)Glasgow coma scale(tab)11.23+/-3.14(tab)12.72+/-3.87(tab)8.56+/-3.33(tab)10.97+/-4.93(newline)Motor power(tab)2.59+/-1.14(tab)3.44+/-1.27(tab)3.05+/-1.21(tab)3.32+/-1.53(newline)Motor of Putaminal Hx(tab)2.38+/-0.85(tab)3.13+/-1.00(tab)3.20+/-0.94(tab)3.00+/-1.41(newline)
Adult ; Cerebellum ; Coma ; Hematoma* ; Humans ; Hypertension ; Mortality ; Prevalence ; Psychosurgery ; Urokinase-Type Plasminogen Activator

Histopathological diagnosis of brain stem glioma should be performed for the purpose of the determination of its management and clinical course, but its surgical biopsy has been followed by high mortality and morbidity. We performed the tissue sampling for histological examination with BRW stereotaxic system under local anesthesia successfully.
Anesthesia, Local ; Biopsy* ; Brain Stem* ; Brain* ; Diagnosis ; Glioma* ; Mortality