Purpose:Treatment of precocity with gonadotropin releasing hormone analogue (GnRHa) might theoretically exert a detrimental effect on the bone mass during pubertal development. We investigated the short-term changes in bone mineral density (BMD) during GnRHa treatment and the enhancement in the changes with the co-administration of GnRHa and human growth hormone (hGH). Methods:Forty girls with precocious or early puberty who were using GnRHa for more than 1 year were enrolled. Of them, 14 concurrently received hGH. Lumbar bone mineral density was measured before and after the treatment, and bone mineral density-standard deviation scores (BMD-SDSs) were compared according to chronologic age (CA) and bone age (BA), as well as according to the administration of GnRHa alone (Group I) or the co-administration of hGH and GnRHa (Group II). Results:BMDs before and after treatment were in the normal range according to CA but were significantly lower according to BA (P<0.05). During treatment, BMD-SDSs did not change according to CA but significantly increased according to BA (P<0.05). BMD-SDSs in group I did not change during treatment according to CA or BA, while those in group II increased significantly according to BA (P<0.05), but not according to CA. Conclusion:Lumbar BMD was adequate according to CA at initial manifestation of precocity but was lower if compared to BA, that is, BMD did not increase with BA. Because co-treatment with hGH significantly increased BMD-SDSs according to BA, hGH co-treatment could be considered during GnRHa therapy.
Kim, Su Jin;Cho, Joong Bum;Kwak, Min Jung;Paik, Kyung Hoon;Kwon, Eun Kyung;Jin, Dong-Kyu
Clinical and Experimental Pediatrics
/
v.51
no.7
/
pp.742-746
/
2008
Purpose : The objective of this study was to evaluate the effects and adverse side-effects of growth hormone (GH) therapy in children with Prader-Willi syndrome (PWS). Methods : Forty-one patients who had been treated with GH for more than two years (24 boys and 17 girls, mean age $7.3{\pm}3.3$ years during treatment initiation) were enrolled for this study. Results : After 2 years of GH therapy, the height and weight standard deviation scores (SDS) increased significantly ($-1.19{\pm}1.37$ vs. $-0.02{\pm}1.45$, and $1.02{\pm}2.42$ vs. $1.63{\pm}2.22$, P<0.002); however the percentage body fat decreased ($44.6{\pm}9.9%$ vs. $38.1{\pm}10.5%$, P<0.001). Further, no change was observed in the thyroid and serum glucose levels, but the total cholesterol level decreased. GH therapy did not impact glucose control in the patients with diabetes. The most common adverse effects of GH therapy were the progression of scoliosis and adenoid hypertrophy. Conclusion : GH therapy improved the height SDS and body composition in patients with PWS. However, GH should be used with caution in patients with scoliosis and adenoid hypertrophy.
There is a standard shoulder oblique method (Grashey method) available to view the shoulder joint. This method projects AP view of the shoulder joint so that the Humerus head's subuxation or joint degeneration can be easily visualized. However, in this view, the patients, with supine or sitting or erect position, have to keep their body obliquely. Whereas, the patients who are not well or operated, usually feel very uncomfortable to keep their body in this position and hence, we need other persons' help and much efforts will be needed to get the good quality shoulder joint view. Therefore, we thought of examining a method which shows the joint well by angling the tube to Medio-Lateral direction and without keeping the patients' one side upward in supine position. For this study, total 15 subjects with no history of neurological or psychiatric illness, were recruited for examinations. They consisted of 9 males and 6 females. Statistic group analysis was performed with ANOVA test. Scores of the evaluation of the experts were $1.10{\pm}0.54$ at $25^{\circ}$, $2.50{\pm}0.50$ at 30^{\circ}$, $2.85{\pm}0.36$ at $35^{\circ}$ and $2.33{\pm}0.47$ at $40^{\circ}$, respectively, and they were significant(p<0.05, Table 1). Joint space of the Humerus head and Scapula were well distinguished at $35^{\circ}$, $30^{\circ}$ and $40^{\circ}$ with the almost same score. However, the degree of distortion at $40^{\circ}$ was more severe than that at $30^{\circ}$. Ultimately, $30-35^{\circ}$ views were shown to yield good quality shoulder oblique images. In conclusion, this method may be very useful for the patients who are uncomfortable and for the emergency patients. In order to get similar or comparable view, the same X-tube angle is recommended to be used before and after the operation. Therefore, we hope that this new angled method seems to be efficient.
The study was conducted from May to September in 1994 to investigate applicability of the Hearing Handicap Inventory for the Elderly-Screening version(HHIE-S) in parallel with the pure-tone audiometer to the initial screening test of noise-induced hearing loss(NIHL) in some noise-exposed workers. Subjects were selected by systemic sampling that took every 10th person from 6, 700 workers taking the annual occupational health examination by the department of Health Maintenance of Dongsan Hospital Keimyung University in Taegu. The authors administered the pure-tone audiometric test and self-reported questionnaire of HHIE-S including items of sociodemographic and job-related variables concurrently. The final subjects analysed were 1,019(488 males and 531 females) excluding fourteen persons who had many missing values in their questionnaires. The reliability coefficients of HHIE-S scale by Cronbach's alpha were 0.84. In the univariate analysis of hearing handicap measured by the HHIE-S, work duration, military service and the hearing threshold loss at 1KHz and 4KHz by the initial audiometer were significant in males while age, work duration and hearing threshold loss at 1KHz and 4KHz were significant in females. In the stepwise linear regression analysis, hearing threshold loss at 1KHz and 4KHz, was the only selected variable explaining the hearing handicap in males and hearing threshold loss at 1KHz and 4KHz, age, and work duration were selected in females. In ROC curves for HHIE-S scores against NIHL as gold standard which was defined by the follow-up audiogram as more than 30dB of the average of 0.5/1/2KHz and 50dB at 4KHz, the optimal cutoff for the parallel HHIE-S appeared to be 8. The results suggest that HHIE-S appeared to have some reliability and validity in this data and might be used in screening NIHL in parallel with pure-tone audiometer in noise-exposed workers.
Purpose Acute pyelonephritis of growing kidneys may result in renal scarring. TGF-${\beta}1$, inflammatory cytokine, has been suggested to play an important role in promoting renal scarring through apoptosis, suppression of cellular proliferation and fibrosis. We observed the effects of a potent anti-inflammatory agent, methylprednisolone on apoptosis and renal scarring in experimentally induced acute pyelonephritic weaning rats. Materials and Methods: To induce ascending pyelonephritis a saline solution containing Escherichia coli type ATCC No. 25922, pili- form (107 bacteria/mL) was infused into the bladder through the 16-guage silicone cannula for 48 hours to 102 three-week-old Sprague-Dawley rats (50-60g). Experimental groups were divided into three groups according to the treatment protocols, group I (ceftriaxone only, n=3l), group II (methylprednisolone+ceftriaxone n=28), control group (n=43) was not treated. Histopathologic scores of inflammatory changes, fibrosis and tubular atrophy, the apoptosis index and TGF-${\beta}1$ expression score were observed at post-infection 1 and 3 week. Datas were analysed using ANOVA test and P value below 0.05 was interpreted as significant. Results: The mortality rate ($21.4\%$) of group II was not different to the control group ($41.9\%$) and group I ($32.3\%$). The inflammatory score of group II ($0.8{\pm}0.87$) at week 1 was significantly lower than those of the control group ($2.3{\pm}0.87$) and Group I ($1.7{\pm}0.79$) (P<0.05). Apoptosis index of group II ($2.9{\pm}2.15$) at week 1 was significantly lower than those of the control group ($10.0{\pm}1.95$) and group 1 ($8.3{\pm}2.53$) (P<0.05). TCF-${\beta}1$ expression score of group II ($0.8{\pm}0.72$) at week 1 was significantly lower than those of the control group ($1.9{\pm}0.68$) and group I ($1.8{\pm}0.60$) (P<0.05). The fibrosis score of group II ($1.1{\pm}1.10$) at week 3 was significantly lower than that of the group I ($1.8{\pm}0.83$) (P<0.05) Conclusion: Conclusion Combined treatment with methylprednisolone and ceftriaxone reduced inflammation, fibrosis, apoptosis and TGF-${\beta}1$ expression in acute pyelonephritic weaning rats, compared to ceftriaxone alone. Anti-inflammatory agent supplemented to antibiotics could prevent renal scarring more effectively. (J Korean Soc Pediatr Nephrol 2002 ; 6 : 75-84)
Acute phase patients who are unconscious and are suffering from cerebral infarction, cranial nerve disorders, or cerebral apoplexy are susceptible to aspiration pneumonia due to dysphagia. In these cases, a nasogastric tube is inserted to supply nutrients. Although bedside screening tests are administered during recovery after rehabilitation, clinical examinations may not be able to ascertain asymptomatic aspiration. Therefore, a video fluoroscopy swallowing study (VFSS) was performed in 10 patients with dysphagia after rehabilitation therapy; these patients had nasogastric tubes inserted, and a rehabilitation specialist assessed the degree of swallowing based on the patients' diet and posture. If aspiration or swallowing difficulties were observed, dysphagia rehabilitation therapy was administered. The patients were reassessed approximately 30-50 days after administration of therapy, based on the patients' condition. If aspiration is not observed, the nasogastric tube was removed. A functional dysphagia scale was used to analyze the VFSS images, and the scores were statistically calculated. The mean score of patients with nasogastric tubes was $49.79{\pm}9.431$, thereby indicating aspiration risk, whereas the group without nasogastric tubes showed a mean score of $11.20{\pm}1.932$, which indicated low risk of aspiration. These results demonstrated that a significantly low score was associated with nasogastric tube removal. Mann-Whitney's test was performed to assess the significance of both the groups, and the results were statistically significant with a P value <0.001. In conclusion, VFSS can effectively assess the movements and structural abnormalities in the oral cavity, pharynx, and esophagus. It can also be used to determine the aspiration status and ascertain the appropriate diet or swallowing posture for the patient. Therefore, VFSS can potentially be used as a reliable standard test to assess swallowing in order to determine nasogastric tube removal.
Physicochemical and sensory characteristics of commercial Oiji, Korean pickled cucumbers (six commercial and three traditionally made products) were investigated. Saltiness values for commercial and traditionally made products were 3.424-4.47 and 3.92-7,23%, and acidity and pH were 3.43-3.85 and 0.39-0.75%, respectively, Commercial products showed lower L and higher b values than traditionally made products. Redness of both products ranged from -1.47 to -3.71. Numbers of total microbial, lactic acid bacteria, and yeast in traditionally made products ($1{\times}10^{7}-1.3{\times}10^{9},\;4{\times}10^{6}-4.7{\times}10^{8},\;and\;1.3{\times}10^{6}-3{\times}10^{8}\;cfu/mL,\;respectively$), were higher than those of commercial products ($1{\times}10^{4}-2{\times}10^{7},\;1{\times}10^{4}-6{\times}10^{6},\;and\;1{\times}10^{4}-6{\times}10^{6}cfu/mL\;respectively$). Texture analysis revealed fracturability (2,103-3,010 g) and hardness (409-890 g) varied among the products above. Overall acceptability scores of commercial products C1 and C2 were highest at 7.6-8.0 compared to other products (p<0.05). From the principal component analysis, the first principal component (PC1, 79.94%) and the second principal component (PC2, 19.94%) could describe the majority of the variability. Commercial product C1, C2, C3, and C7 having high negative loadings on the PC2 axis are closely related to over-all acceptability, over-all taste, savory taste and hardness. From Pearson correlation analysis, hardness and chewiness correlated positively with saltiness, whereas over-all acceptability, positively correlated with savory and overall taste, respectively (p<0.05).
Lee Jae-Wook;Yeom Wook;Park Young-Woo;Shin Hwa-Kyun;Won Yong-Soon
Journal of Chest Surgery
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v.39
no.8
s.265
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pp.619-625
/
2006
Background: Peripheral arterial disease is frequently accompanied with systemic arteriosclerosis and more than half of the cause of deaths is due to the development of coronary arterial disease. Moreover, it is known that the most frequent cause of death after a bypass surgery of chronic arterial obstruction is heart related complications. Especially in patients with atherosclerotic arterial obstruction in the lower extremities who had no history of heart disease or had no presenting symptoms of ischemic heart disease showed a high rate of postoperative mortality and for this reason we suggest preoperative evaluation in these patients to evaluate whether or not coronary arterial disease is accompanied. Material and Method: Since Feb. 2001 to Oct. 2004, we analyzed 52 patients who were operated on for atherosclerotic arterial obstruction in the lower extremities, with the exception of patients with a past history of heart disease or symptoms of ischemic heart disease. They underwent on the same day a coronary and femoral angiography for evaluation of accompanying coronary arterial disease. Of among these patients, we compared those who received bypass surgery of the arteries of the peripheral extremities alone to those who underwent combined coronary artery bypass surgery. Result: 63% of the reported cases of atherosclerotic arterial obstruction in the lower extremities were accompanied with coronary arterial disease. Old age, hypertension, diabetes mellitus, smoking, and hypercholesterolemia are known risk factors for arteriosclerosis and of these, only old age and hypertension had statistically significance in patients with severe atherosclerotic arterial obstruction in the lower extremities accompanied with coronary arterial disease. Diabetes, smoking, and hypercholesterolemia showed no statistical significance in this group. With the increase in severity of the range and the degree of atherosclerotic arterial obstruction, coronary arterial disease is frequently accompanied and its severity also increased. Patients who received both peripheral artery and coronary artery bypass surgery showed no difference in the period of hospitalization and ICU stay period compared with patients who received bypass surgery of the arteries of the lower extremities alone. Conclusion: Patients with atherosclerotic arterial obstruction in the lower extremities without symptoms of ischem to evaluate coronary arterial disease for active treatment, especially in the patients with old age, hypertension and high AVD scores.
Background: Many types of tricuspid annuloplasty are used in surgical correction of functional tricuspid regurgitation (FTR). We evaluated the mid-term and long-term outcomes in patients treated with a posterior annular plication technique (a modified Davila technique) for FTR. Material and Method: Between January 1991 and August 2006, 58 adult patients (male, 22; female, 36) with FTR of grade 2/4 or more or with tricuspid annular dilatation of more than 5.0cm in diameter, even with an FTR of less than grade 2, had received a posterior annular placation. Preoperatively, 26 patients (44.8%) had a grade 3 or more FTR. All patients had received a mitral valve replacement, and 20 (34.5%) had concomitant aortic valve replacement. Result: During the mean follow-up period of $101.4{\pm}51.6$ months, FTR disappeared or remained trivial in 28 patients (49.1%), was grade $2{\sim}3$ (${\geq}$grade 2 and $2.66{\pm}0.73\;vs.\;0.82{\pm}0.89$; p<0.0001). Patients did not require a second surgery for FTR and did not show further FTR aggravation. Conclusion: The modified Davila posterior annular plication technique for FTR has reasonable mid-term and long-term results and is a useful surgical procedure.
Objectives : The purpose of this study was to provide some basic data for effective prevention and oral health education for oral health. For that purpose, a self-administered questionnaire was distributed to the boys of three high schools in Gyeonggi Province. Methods : The questionnaire consisted of items about the practice of oral health control and knowledge of decay according to grade, number of snacking, preferred taste, and toothbrushing. Total 487 questionnaires were put to analysis using the SPSS WIN 13.0 program. Results : 1. The biggest number of the boys brushed their teeth twice a day. The 10th graders brushed teeth three times a day, and the 11th and 12th graders tended to brush teeth twice a day(${\chi}^2$=18.21, p<.05). 2. As for the way of toothbrushing, 39.0% of the boys said they brushed teeth the way they felt like, being followed by those who said they brushed teeth turning the toothbrush up and down and brushing both the teeth and gums(32.6%). As for the number of snacking, those who had snacks three times a day or more brushed teeth turning the toothbrush up and down and brushing both the teeth and gums. Those who hardly had snacks more tended to brush teeth the way they felt like than those who had snacks(${\chi}^2$=21.28, p<.05). And as for preferred tastes, those who preferred a sweet and salty taste more tended to brush teeth the way they felt like than others. And those who preferred a hot taste brushed teeth turning the toothbrush up and down and brushing both the teeth and gums(${\chi}^2$=26.85, p<.01). 3. The respondents' percentage of correct answers for 'Decay is caused by bacteria' was 81.5%. Those who preferred a hot taste recorded the highest percentage of correct answers(${\chi}^2$=21.95, p<.00). 4. Their percentage of correct answers for 'Decay is accompanied by pain from the beginning' was 78.2%. The 12th graders had the highest rate of correct answers, and the 11th graders had the highest rate of wrong answers(${\chi}^2$=11.56, p<.00). 5. Their percentage of correct answers for 'Fluorine is helpful to the prevention of decay' was 75.4%. Those who hardly had snacks recorded the highest rate of correct answers(${\chi}^2$=10.05, p<.02). 6. Their percentage of correct answers for 'There is a way to supply fluorine into the waterworks' was 29.2%, which means the percentage of wrong answers was much higher. The percentage of wrong answers was the highest in the 11th grade(${\chi}^2$=7.06, p<.03). 7. The respondents' mean scores of knowledge of decay were 13.15 of total 18. While the 12th graders showed the highest level of knowledge of decay, the 11th graders were lower in the level of knowledge of decay than the other graders. And there were significant differences(F=5.41, p<.01) according to grade with no such differences according to the number of snacking and preferred taste. Conclusions : Oral health education should be applied to the boys all through their life to have a great effect, and it is important that they should always put the oral health education into practice to be a successful education.
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