Osteoporosis, a disease characterized by low bone mass and microarchitectural deterioration of bone tissue leading to enhanced bone fragility and fracture risk, is a major public health problem. The diagnostic methods for osteoporosis include simple radiography, bone scan, DXA (Dual energy X-ray Absortiometry) and biochemical markers of bone turnover. Optimal treatment and prevention of osteoporosis require modification of risk factors, particularly smoking cessation, adequate physical activity, and attention to diet, in addition to pharmacologic intervention. The estrogens and raloxifene both prevent bone loss in postmenopausal women, and the estrogens probably also decrease the risk of first fracture. There is good evidence that raloxifene prevents further fractures in postmenopausal women who already have had fractures and some evidence that estrogen does as well. Bisphosphonate prevents bone loss and reduces fractures in healthy and osteoporotic postmenopausal women and in osteoporotic men as well. Risedronate is more potent and has fewer side effects than alendronate and reduces the incidence of fractures in osteoporotic women. Calcitonin increases bone mineral density in early postmenopausal women and men with idiopathic osteoporosis, and also reduces the risk of new fractures in osteoporotic women. All of the agents discussed above prevent bone resorption, whereas teriparatide and strontium increase bone formation and are effective in the treatment of osteoporotic women and men. New avenues for targeting osteoporosis will emerge as our knowledge of the regulatory mechanisms of bone remodeling increases, although issues of tissue specificity may remain to be addressed.
Absorptiometry, Photon ; Alendronate ; Biomarkers ; Bone and Bones ; Bone Density ; Bone Remodeling ; Bone Resorption ; Calcitonin ; Diet ; Estrogens ; Etidronic Acid ; Female ; Humans ; Incidence ; Male ; Motor Activity ; Organ Specificity ; Osteogenesis ; Osteoporosis ; Public Health ; Raloxifene Hydrochloride ; Risk Factors ; Smoking Cessation ; Strontium ; Teriparatide ; Risedronate Sodium

No abstract available.
Thyroid Diseases* ; Thyroid Gland*

No abstract available.

The principal cause of avulsion fracture of anterior superior iliac spine is sudden powerful contraction of sartorius muscle in strenuous sporting activities. The condition usually occurs in young people in whom the apophysis has still not firmly united to the ilium. We presented the three cases of avulsion fracture of anterior superior iliac spine which occurred during sprinting in Physical Fitness Test.
Ilium ; Physical Fitness ; Spine ; Sports

A wedge shape compensating filter composed of aluminium was made to equalise the density of lung and mediastinum. Total 68 patients were taken chest tomograph with compensating filter and the radiographic findings were correlated with the pathologic, bacteriologic prove or the clinical course. This simple device was turned out to be very useful in certain disease categories, especially central type of bronchogenic carcinoma.
Carcinoma, Bronchogenic ; Humans ; Lung ; Mediastinum ; Thorax

The authors report their experience with 73 cases of unruptured cerebral aneurysms in a consecutive series of intracranial microsurgery for 380 cerebral aneurysms in 307 patients from September, 1975 through March, 1984. Multiple, symptomatic, and incidental aneurysms are included in this group of 73 unruptured aneurysms. There was no mortality among fifty nine of these cases who had surgery. The only morbidity was due to massive postoperative vasospasm in a patient with multiple aneurysms, that developed on the site of ruptured aneurysm. Discussed in this report are characteristics of three categories of unruptured cerebral aneurysm patients and the principles of the management of unruptured aneurysms. In conclusion, all symptomatic unruptured aneurysms should be clipped immediately upon definite diagnosis, while decision for the operation of multiple unruptured aneurysms and aneurysms detected incidentally should be made with discretion by the surgeon.
Aneurysm ; Aneurysm, Ruptured ; Diagnosis ; Humans ; Intracranial Aneurysm* ; Microsurgery ; Mortality

No abstract available.
Drainage* ; Lung Abscess* ; Lung* ; Pneumothorax* ; Suppuration*

After the introduction of the surgical microscope, microsurgical direct intracranial approach became a standard technique for the treatment of ruptured intracranial aneurysms with satisfactory results. Nevertheless, aneurysms of the anterior communicating artery present particular difficulties, because of their critical location, prevalence of local vascular anomalies, serious circulatory disturbances of the perforating vessels after the rupture of the aneurysm or vasospasm, and their marked tendency to fatal recurrent hemorrhage. The authors analyzed 102 cases of anterior communicating artery aneurysms surgically treated in the Department of Neurosurgery, Yonsei University Hospital from 1971 throught August 1981. Of the 102 cases, 84 operations were performed by microsurgical pterional approach. The analysis and evaluation was made with particular emphasis on the microsurgical treatment. The results of analysis were summarized as follows. 1) The anterior communicating artery aneurysms ruptured most frequently in the 5th decade(37.2%), and 81.7% of the patients were in their 30s to 50s. Anterior communicating artery aneurysms were more common in men than women(60:42). 2) Presenting symptoms and signs of rupture of the anterior communicating artery aneurysms were headache(98.6%), stiff neck(95.1%), brief lapse of consciousness(83.4%), vomiting(81.8%), hypertension(41.6%), and impaired conscious level(34.3%). 3) The prechiasmatic projection of the anterior communicating artery was slightly mjore frequent than the interhemispheric projection(43:39) in our series. The aneurysms were fed by the left anterior cerebral artery in 55.9% and by the right in 33.3%. Angiographic vasospasm was noted in 45.1% and the incidence of the multiple aneurysm was 8.8%. 4) The brain CT scan showed subarachnoid hemorrhage in 47.3%, hydrocephalus in 43.7%, and cerebral infarction in 27.3%. The aneurysms appeared as enhancing small lesions when the diameter of the aneurysm was larger was larger than 10mm. The actual size of the giant aneurysm was measured more precisely with the CT scan than by the angiogram. 5) Patients in Botterell's Grade I and II occupied 70.2% of the microsurgically treated cases. Majority of cases(82.1%) were operated in the second to fourth weeks after the last bleeding. 6) All of the 84 microsurgically treated cases were operated by pterional approach, and the gyrus rectus resection was frequently performed. Clipping of the aneurismal neck was possible in 82.1% of the series. 7) Fourteen cases of postoperative vasospasm, 4 cases of intracranial hematoma, and 7 cases of serious electrolyte imbalance were found as the major postoperative complications. Four patients died of these major complications. 8) Operative mortality of the microsurgical pterional approach was 4.8% and the morbidity 5.9%. Mortality rate of 9 premature rupture cases was 11.1%. Among the 18 cases which were operated on without the aid of microscope before 1975, the mortality rate was 16.7%, and the morbidity, 44.4%.
Aneurysm ; Anterior Cerebral Artery ; Arteries ; Brain ; Cerebral Infarction ; Hematoma ; Hemorrhage ; Humans ; Hydrocephalus ; Incidence ; Intracranial Aneurysm* ; Male ; Mortality ; Neck ; Neurosurgery ; Postoperative Complications ; Prevalence ; Rupture ; Subarachnoid Hemorrhage ; Tomography, X-Ray Computed

BACKGROUND: Scapular notching can happen at diverse location depending on implant design or operative technique, therefore, it is easily misdiagnosed. Thus, this study purposed to suggest a method helpful to assess scapular notching. METHODS: The subjects were 73 cases of reverse shoulder arthroplasty (RSA) for cuff tear arthropathy during the period from May 2009 to April 2014 and followed-up for over a year. There was medialized RSA in 22 cases, bone increased offset RSA (BIO-RSA) in 36 cases, and metal increased offset RSA (metal-RSA) in 15 cases. Scapular notching was not determined by bone defect at the inferior of glenosphere as Sirveaux's classification, but scapular notching at the site where the rotational route of the polyethylene of humeral implant met the scapular neck were examined. The results were compared with conventional method. RESULTS: By conventional method, scapular notching was observed in 10 cases (45.5%) in medialized RSA, 12 cases (33.3%) in BIO-RSA, and none in metal-RSA. By new method, it was observed in 9 cases (40.9%) in medialized RSA, 10 cases (27.8%) in BIO-RSA, and none of metal-RSA. The site of scapular notching was apart from glenoshpere in 18 cases, and at inferior of glenosphere in 1 case. Absorption of bone graft was observed in 4 (11.1%) out of 36 cases of BIO-RSA. CONCLUSIONS: It is hard to distinguish scapular notching from absorption of bone graft in BIO-RSA, and bone absorption at the lateral lower end of glenoid in medialized RSA. Thus, it is considered useful to assess scapular notching at the site where the rotational route of the polyethylene insert meets scapular neck.
Absorption ; Arthroplasty* ; Classification ; Neck ; Polyethylene ; Shoulder* ; Tears ; Transplants

The authors have reviewed and analyzed 105 cases of unruptured cerebral aneurysms in 94 patients from the medical records of 407 patients who had aneurysm sugery consecutively since the advent of microsurgery at the Department of Neurosurgery of Yonsei University. This study was done to define the clinical characteristics of intact intracranial aneurysms and to determine the principles of their management. There was no surgical mortality among 75 cases of intact intracranial aneurysms in 68 patients. Two cases of morbidity were not directly related to the surgery of intact aneurysms. As a result of the analysis of the cases, it was concluded that all symptomatic aneurysms should be treated immediately after the diagnosis, because they tend to be large in size and prone to rupture. If asymptomatic multiple unruptured aneurysms are accessible during surgery for a ruptured aneurysm, they should be treated at the same time. The decision for the treatment of unruptured aneurysms located opposite to ruptured ones or detected incidentally, should be made at the surgeon's discretion. The authors' belief is that intact intracranial aneurysms should be corrected regardless of their size when detected in young patients, in hypertensive patients, in hypertensive patients, or in patients with such high flow lesions as arteriovenous malformation.
Adult ; Aged ; Female ; Human ; Intracranial Aneurysm/surgery* ; Male ; Middle Age ; Postoperative Complications/etiology ; Prognosis ; Subarachnoid Hemorrhage/surgery