Biochemical markers of bone turnover has received increasing attention over the past few years, because of the need for sensitive and specific tool in the clinical investigation of osteoporosis. Bone markers should be unique to bone, reflect changes of bone loss, and should be correlated with radiocalcium kinetics, histomorphometry, or changes in bone mass. The markers also should be useful in monitoring treatment efficacy. Although no bone marker has been established to meet all these criteria, currently osteocalcin and pyridinium crosslinks are the most efficient markers to assess the level of bone turnover in the menopausal and senile osteoporosis. Recently, N-terminal telopeptide (NTX), C-terminal telopeptide (CTX) and bone specific alkaline phosphatase are considered as new valid markers of bone turnover. Recent data suggest that CTX and free deoxypyridinoline could predict the subsequent risk of hip fracture of elderly women. Treatment of postmenopausal women with estrogen, calcitonin and bisphosphonates demonstrated rapid decrease of the levels of bone markers that correlated with the long-term increase of bone mass. Factors such as circadian rhythms, diet, age, sex, bone mass and renal function affect the RESULTS of biochemical markers and should be appropriately adjusted whenever possible. Each biochemical markers of bone turnover may have its own specific advantages and limitations. Recent advances in research will provide more sensitive and specific assays.
Aged ; Alkaline Phosphatase ; Biomarkers* ; Calcitonin ; Circadian Rhythm ; Diet ; Diphosphonates ; Estrogens ; Female ; Hip ; Humans ; Kinetics ; Osteocalcin ; Osteoporosis ; Treatment Outcome

CT guided percutaneous fine-needle aspiration (FNA) of the liver for both cytologic and histologic examination has great value in diagnosing liver malignancy. From March, 1986 to April, 1990, 62 patients with the clinical impression of liver mal- ignancy underwent CT guided percutaneous FNA biopsy. Of these, 43 cases were revi- ewed for this study, 19 were reported to be liver cell carcinoma, 2 were adenocarcinoma, 11 were reported as anaplastic cell present, and the rest (11 cases) were negative (9) or necrotic (2). Among the 11 cases of the last group, 9 were diagnosed as liver cell carcinoma and 2 were necrotic histologically. Retrospective review, in order to clarify the cause of cytologic diagnostic error, of both cytologic and histologic slides of all cases showed discordance of 23% between these diagnoses and sensitivity is 93.9% and specificity is 90.9%. The reasons were as follows ; 1) the lack of awareness of tumor cells of well differentiated liver cell carcinoma (4 cases), 2) missed tumor cells due to too scanty cellularity (1 case), 3) improper smear (2 cases) and no tumor cell in the cytologic smears (3 cases). In such cases, at the initiation of FNA, a correct diagnosis of liver malignancy could only be made by a combination of cytologic and histologic examinations. However after three years' exper- ience we can conclude that cytomorphologic features of liver cell carcinoma are sufficiently distinctive from other liver malignancies to be diagnostic.
Adenocarcinoma ; Biopsy ; Biopsy, Fine-Needle ; Carcinoma, Hepatocellular ; Diagnosis ; Diagnostic Errors ; Humans ; Liver ; Nephrotic Syndrome* ; Retrospective Studies ; Sensitivity and Specificity

No abstract available.
Hematologic Neoplasms* ; L-Lactate Dehydrogenase* ; Lactic Acid*

Two cases of folliculitis decalvans are reported. One case is a 51 year-old woman showing the lesion first on the left occipital scalp and then, 4 years later, on the left mandibular area. The other case, a 57 year-old woman. showed the lesion typically encircled with pustules and crusts for the 20 years on the vertex area.
Female ; Folliculitis* ; Humans ; Middle Aged ; Scalp

Winging of the scapula is characterized clinically by a prominence of the vertebral border and inferior angle of the scapula. Trauma, neuritis, neural injury during surgical procedure and many other causes may develop winging of scapula. When pain and functional impairment persist, surgical intervention may become appropriate. We report two cases of winged scapula. One case was serratus anterior palsy due to blunt trauma, which was treated by transfer of teres major and pectoralis minor elongated with a tensor fascia strip. Another case was trapezius muscle palsy due to iatrogenic spinal accessary nerve injury, which was treated by transfer of the levator scapulae, rhomboid major and rhomboid minor muscle. In the former case, there was no weakness nor deformity of affected shoulder. In the later case, there was some residual pain and limitation of motion.
Congenital Abnormalities ; Fascia ; Neuritis ; Paralysis ; Scapula* ; Shoulder ; Superficial Back Muscles

No abstract available.
Precursor Cell Lymphoblastic Leukemia-Lymphoma*

No abstract available.
Fracture Fixation, Intramedullary*

In Korea, slipped capital femoral epiphysis is a rare disease. In which the capital femoral epiphysis migrate posteriorly and inferiorly against the neck portion. Sometimes it should be differentiated from other conditions that separate the femoral capital epiphysis. We have experienced a rare case of separation of capital femoral epiphysis due to an osteosarcoma in the proximal femoral metaphysis in the 15 years of old girl.
Epiphyses ; Female ; Humans ; Korea ; Neck ; Osteosarcoma ; Rare Diseases ; Slipped Capital Femoral Epiphyses

OBJECTIVES: Breast cancer has been the most prevalent female cancer in South Korea since 2001. Early detection of this disease is the most effective strategy for reducing mortality. The objective of this study was to identify factors which could predict advanced stage at diagnosis of breast cancer. METHODS: Participants who were initially diagnosed with breast cancer and referred to the Stress Clinic of the Breast Cancer Center at Kyungpook National University Hospital were included. Through a semi-structured interview, the authors investigated psychosocial variables such as the extent of marital and family functioning and emotional-economic family burden as well as sociodemographic and health behavior-, health characteristic- and cancer-related variables. RESULTS: Data were collected from 219 participants. One hundred and twenty(54.8%) subjects were diagnosed with advanced-stage breast cancer. Variables that were significantly different between the advanced-stage and early-stage groups included : monthly breast self examination(p<0.000), annual mammographic screening(p< 0.000), mode of tumor detection(p<0.000), nature of the first symptoms(p<0.000), time to treatment after di-agnosis(p<0.000), overloaded economic and family burden(p=0.018), marital functioning(p<0.000) and family functioning(p<0.00). Logistic regression analysis indicated that irregular annual mammography screening(OR=7.431 ; 95% CI 2.407-22.944) or a lack of screening(OR=25.299 ; 95% CI 7.855-81.482) and a dysfunctional marital relationship(OR=4.772 ; 95% CI 2.244-10.145) were significantly associated with advanced stage at diagnosis of breast cancer. CONCLUSIONS: We reconfirmed screening behavior to be a risk factor for delayed diagnosis of breast cancer. Our findings also emphasized the importance of psychosocial factors such as marital functioning in early detection of breast cancer. Psychiatric consultation in the area of martial functioning could be beneficial for increasing early detection in breast cancer.
Breast ; Breast Neoplasms* ; Delayed Diagnosis* ; Diagnosis ; Female ; Gyeongsangbuk-do ; Humans ; Korea ; Logistic Models ; Mammography ; Marriage* ; Mass Screening ; Mortality ; Psychology* ; Risk Factors ; Time-to-Treatment

The Wolff-Parkinson-White (W-P-W) syndrome and variants are called the pre-excitation sydrome. The prevalence has been estimated 0.15 pereent. Advances in electrophysiological mapping and increasing sophistication of surgical techniques have been resulted in an increasing role for definitive surgical treatment. The anesthetic management of patients with this syndrome is aimed at avoiding tachyarrhythmias. Anesthesia for surgical ablation of accessory conducting pathways was successfully performed under general balanced technique with fentantyl, vecuronium, isoflurane which were avoid of sympathetic stimulation.
Accessory Atrioventricular Bundle ; Anesthesia ; Humans ; Isoflurane ; Prevalence ; Tachycardia ; Vecuronium Bromide ; Wolff-Parkinson-White Syndrome