No abstract available.
Endocarditis*

Adult* ; Humans ; Respiratory Distress Syndrome, Adult*

No abstract available.
Malingering*

BACKGROUND: Osteoporosis results from bone loss due to menopause [estrogen(E) deficiency] and aging. Initial skeletal effect of menopause is accelerated bone resorption with an increase in seurm calcium(Ca) and compensatory but inadequate bone formation. Secretion of parathyroid hormone(PTH) is suppressed at this time. Postmenopausal osteoporosis results in fractures predominantly of trabecular bone, i.e., vertebra. With aging, secondary hyperparathyroidism by low serum Ca and vitamin D deficiency superim poses. Senile osteoporosis produces hip fractures, area of cortical bone. The aim of this study was to- examine the association of vitamin D[25(OH)D] and intact(i) PTH with bone mineral density(BMD) after controlling for suggested confounding factors, and the possibility of low serum vitamin D and high serum iPTH concentration could impact bone loss in Korean postmenopausal women. METHODS: Data from 188 postmenopausal Korean women aged 42 to 69 were analyzed through BMD, serum 25(OH)D, iPTH, Ca, phosphorus(P), alkaline phosphatase(ALP) and clinical characteristics. Factors affecting BMD was determined by Pearson correlation and the relationship between lumbar and femoral neck BMD and vitamin D[25(OH)D] and iPTH was assessed by multiple regression analysis after adjus- ting for suggested confounding factors. RESULTS: Lumbar and femoral neck BMD, serum Ca, P were decresaed and serum iPTH was increased with aging. In Pearson`s correlation, significant contributing factors to lumbar BMD was age, height, weight, menarche, year since menopause(YSM) and ALP. And significant contributing factors to femoral neck BMD was age, height, weight, menarche, YSM and iPTH. No relationship could be demonstrated between serum vitamin D[25(OH)D] and lumbar and femoral neck BMD. How ever, after controlling for potential confounding factors, a correlation was found between vitamin D[25(OH)D] and both of lumbar (p=0.013) and femoral neck BMD(p=0.077). iPTH was inversely related to femoral neck BMD(p=0.004) only in multiple linear regression. CONCLUSION: Serum vitamin D[25(OH)D] was influencing both of vertebral and femoral neck BMD, which suggests a significant role of vitamin D deficiency in the pathogenesis of postmenopausal osteo- porosis. In age related remodeling and loss of bone, increased serum iPTH might have additive role in cortical bone of femur. These findings suggest that vitamin D is very important for optimal bone health and a deleterious effect of increased iPTH on cortical bone loss. Adequate calcium and vitamin D status have to be maintained to prevent osteoporosis in postmenopausal Korean women.
Aging ; Bone Density* ; Bone Resorption ; Calcium ; Female ; Femur ; Femur Neck ; Hip Fractures ; Humans ; Hyperparathyroidism, Secondary ; Linear Models ; Menarche ; Menopause ; Osteogenesis ; Osteoporosis ; Osteoporosis, Postmenopausal ; Parathyroid Hormone* ; Spine ; Tolnaftate ; Vitamin D Deficiency ; Vitamin D* ; Vitamins*

No abstract available.
Humans ; Otitis Media* ; Otitis*

Acute pulmonary edema associated with direct current shock is a rare complication. Pulmonary edema with an increase in heart size following direct current shock have been previously reported and confirmed. The cause of this complication is unknown. This is not due to a sudden increase in the cardiac output with the establishment of sinus rhythm. It has been most commonly noted in the presence of mitral or aortic valvular diseases or ventricular dysfunction. It is likely that acute alteration or disparities in atrial or ventricular mechanical function consequent to electrical discharge precipitate pulmonary congestion. This is a case report of acute pulmonary edema following cardioversion with direct current shock which caused ventricullar fibrillation during tonsillectomy. He was treated with oxygen, iuretics, digitalis, steroid, dopamine and PEEP (positive end expiratory pressure). The patient recovered uneventful ventilation.

Capnogram, monitoring of end-tidal CO2, has been a popular tool for assessment of ventilatory status during modern anesthesia. A normal curve on capnogram suggests normal CO2 production, adequate circulation, and adequate ventilation. Level of end-tidal CO2. is different from that of arterial CO2 even in normal individual. The difference is originated from alveolar dead space gas which dilute concentration of CO2 from normal alveoli. In clinical situation, the major factor which determines alveolar dead space is low pulmonary blood flow. Decrease of alveolar capillary perfusion from low cardiac output is the most important cause of low measure of end-tidal CO and large difference between arterial CO2 and end-tidal CO2 concentration in perioperative period. To understand the effect of cardiac output on end-tidal CO2 tension and the difference between arterial CO2 tension and end-tidal CO2 tension, We measured cardiac output before and dutiag administration of nitroglycerine and sodium nitropruside for relieve of myocardial load before aortic clamping in 30 male patients undergoing aortic recontructive surgery under endotracheal anesthesia for repair of infrarenal aortic obstruction. We also measured arterial CO2 tension, and end-tidal CO2 tension at the time of 10% decrease(phasel), 15% decrease(phase2)and 20% decrease(phase3) of cardiac output respectively. Measured values were statistically analyzed to evaluate correlation between cardiac output and end-tidal CO2 tension. The results are as follows: 1) Decreases of cardiac output brought about significant decrease in end-tidal CO2 in all phases compared to control value(p<0,05). 2) Decreases of cardiac output brought about significant increase in the difference between arterial- end-tidal CO2. tension in all phases compared to control value(p<0.05). 3) Changes in cardiac ourput correlated with changes in end-tidal CO2 tension significantly(p=0.0001, r=0.61, slope=2.01). 4) Changes in cardiac ourput correlated with changes in differences between arterial-end-tidal CO2 tension significantly(p=0.0001, r=-0.59, slope=-1.63). In conclusion we suggest that measurement of end-tidal CO2 tension, especially difference between arterial and end-tidal CO2 tension, may be a useful indicator for detection of cardiac output change during operation.
Anesthesia ; Capillaries ; Cardiac Output* ; Cardiac Output, Low ; Constriction ; Humans ; Male ; Nitroglycerin ; Perfusion ; Perioperative Period ; Sodium ; Ventilation

No abstract available.
Mass Screening* ; Uterine Cervical Neoplasms*

No abstract available.
Alleles* ; Base Sequence* ; Clone Cells* ; Cloning, Organism* ; HLA-DR Antigens

No abstract available.
Adult* ; Fistula* ; Humans