OBJECTIVE: This study investigated changes of Biochemical Markers of Bone turnover in Pre-, Peri-and Postmenopausal Women METHOD: The levels of Urinary deoxypyridinoline(Dpd), serum total alkaline phosphatase(TALP), osteocalcin(OC), serum calcium(Ca++) and phosphorus(P) were determined. Bone mineral density(BMD) were also measured by dual energy X-ray absorptiometry (DEXA) RESULTS: There were negative correlation between Biochemical markers of bone turnover and BMD, Biochemical markers of bone turnover in osteoporosis group were significantly higher than normal groups. Biochemical marker of bone turnover except serum calcium increased after menopause and remains elevated in late postmenopausal and elderly women. An increased bone turnover rate to sustained serum calcium in constant level is related to a high rate of bone loss in postmenopausal women and to a decreased bone mass in elderly women. CONCLUSION: Bone turnover increased not only at the time of menopause but also in the elderly women. This subsequent abnormalities of bone resorption and formation in the elderly women suggest their potential role in osteoporosis.
Absorptiometry, Photon ; Aged ; Biomarkers* ; Bone Resorption ; Calcium ; Female ; Humans ; Menopause ; Osteoporosis

No abstract available.
Pregnancy*

PURPOSE: MRI is known to be an effective imaging modality of the aorta and its role is steadily increasing in the evaluation of acquired aortic diseases including aortic dissections and aortic aneurysms. However, differentiation of the aortic dissections with thrombosed false lumen from the aortic aneurysm with mural thrombus in MRI has not been easy. Therefore, the authors tried to find the characteristic MR featrses which would to differentiate the two diseases. MATERIALS AND METHODS: MR images of 6 patients with thrombosed aortic dissection and 7 patients with thrombosed aortic aneurysms were reviewed retrospectively and compared in regand to shape and extent of thrombus, dimension of aorta, and luminal flow signal. RESULTS: Thrombosed aortic dissections showed sharply demarcated crescent shaped aortic wall thickening of even thickness involving long segment of the aorta, whereas thrombosed aortic aneurysms showed irregular aortic wall thickening of uneven thickness localized in the short dilated segment of the aorta. Characteristically aortic aneurysm with mural thrombus showed eccentric intraluminal slow flow signal. In contrast to the signal void of the true lumen in aortic dissections, the residual lumen of the aortic aneurysm with mural thrombus revealed intraluminal signal due to slow flow. CONCLUSION: Familiarity to these MRI findings of thrombosed aortic dissections and aortic aneurysms may lead to the accurate differential diagnosis in majority of cases.
Aorta ; Aortic Aneurysm* ; Aortic Diseases ; Diagnosis, Differential* ; Humans ; Magnetic Resonance Imaging* ; Phenobarbital ; Recognition (Psychology) ; Retrospective Studies ; Thrombosis

Acute myocardial infarction after a bee sting is a very rare process. Among proposed mechanisms, vasospasm of the coronary artery is the most probable mechanism. Many mediators are included in the venom of wasps, and those mediators have vasoconstrictive properties and may constrict the coronary artery. Furthemore, those mediators have thrombogenic properties that lead to thrombogenesis in the coronary artery and aggravate myocardial ischemia. Epinephrine, commonly used in the management of anaphylactic shock, may further aggravate myocardial ischemia. We experienced two cases of acute myocardial infarction after a bee sting. In the first case, we could find no underlying abnormalities of the coronary vessel because the patient died during coronary angiography. In the second case, the electrocardiogram showed inferior wall myocardial infarction, but only mild stenosis of the right coronary artery was seen in coronary angiography.
Anaphylaxis ; Bees* ; Bites and Stings* ; Constriction, Pathologic ; Coronary Angiography ; Coronary Vessels ; Electrocardiography ; Epinephrine ; Humans ; Inferior Wall Myocardial Infarction ; Myocardial Infarction* ; Myocardial Ischemia ; Venoms ; Wasps

BACKGROUNDs: A retrospective study was performed to define objective radiologic parameters in diagnosing epiglottitis on soft-tissue lateral neck radiographic study. METHODS: Parameters of soft-tissue structures(epiglottis width, third vertebral body width, ratio of epiglottic width to third vertebral body width) in 30 adult patients compared with those of age and sex-matched controls with foreign body in throat whose radiographic reading was normal. RESULTS: Epiglottis width of more than 11mm, ratio of epiglottis width(EW) to the third vertebral body width(C3W) of more than 0.5 were, respectively, found to be 100% sensitive and specific in differentiating between patients with and without epiglottitis. CONCLUSION: These preliminary results suggest that EW/C3W ratio of more than 0.5, EW of more than 11mm, respectively, may be useful in the diagnosis of epiglottitis in adult patients.
Adult* ; Diagnosis* ; Epiglottis ; Epiglottitis* ; Foreign Bodies ; Humans ; Neck ; Pharynx ; Retrospective Studies

The case of a patient with acute onset of flank pain is presented. Initial therapy was directed toward relief of pain believed to be caused by renal calculi. The flank pain did not responded to analgesics. An abdominal ultrasonogram showed that multiple hyperechogenic masses were in the parenchyma of both kidney, and an abdominal CT showed that multiple high-density masses, presumed to be angiomyolipomas, were located in both kidneys and in the perirenal hematoma around the left kidney. Vital signs were stable, and there was no evidence of anemia. On the seventh hospital day, angiographic tumor embolization was performed. Cases such as this should remind emergency physicians to carefully consider alternate diagnoses to renal calculi in patients with flank pain who have atypical clinical features or an atypical course.
Analgesics ; Anemia ; Angiomyolipoma* ; Diagnosis ; Emergencies ; Flank Pain ; Hematoma ; Humans ; Kidney ; Kidney Calculi ; Rupture, Spontaneous* ; Tomography, X-Ray Computed ; Ultrasonography ; Vital Signs

OBJECTIVE: Placental oxidative stress is known to be a factor that contributes to pregnancy failure. The aim of this study was to determine whether selenium could induce antioxidant gene expression and regulate invasive activity and mitochondrial activity in trophoblasts, which are a major cell type of the placenta. METHODS: To understand the effects of selenium on trophoblast cells exposed to hypoxia, the viability and invasive activity of trophoblasts were analyzed. The expression of antioxidant enzymes was assessed by reverse-transcription polymerase chain reaction. In addition, the effects of selenium treatment on mitochondrial activity were evaluated in terms of adenosine triphosphate production, mitochondrial membrane potential, and reactive oxygen species levels. RESULTS: Selenium showed positive effects on the viability and migration activity of trophoblast cells when exposed to hypoxia. Interestingly, the increased heme oxygenase 1 expression under hypoxic conditions was decreased by selenium treatment, whereas superoxide dismutase expression was increased in trophoblast cells by selenium treatment for 72 hours, regardless of hypoxia. Selenium-treated trophoblast cells showed increased mitochondrial membrane potential and decreased reactive oxygen species levels under hypoxic conditions for 72 hours. CONCLUSION: These results will be used as basic data for understanding the mechanism of how trophoblast cells respond to oxidative stress and how selenium promotes the upregulation of related genes and improves the survival rate and invasive ability of trophoblasts through regulating mitochondrial activity. These results suggest that selenium may be used in reproductive medicine for purposes including infertility treatment.
Adenosine Triphosphate ; Anoxia ; Antioxidants ; Gene Expression ; Heme Oxygenase-1 ; Infertility ; Membrane Potential, Mitochondrial ; Mitochondria ; Oxidative Stress ; Placenta ; Polymerase Chain Reaction ; Pregnancy ; Reactive Oxygen Species ; Reproductive Medicine ; Selenium* ; Superoxide Dismutase ; Survival Rate ; Trophoblasts* ; Up-Regulation

Drug-induced toxic epidermal necrolysis (TEN) is a bullous erythematous disease that is characterized by the appearance of scaled lesions and large sheets of pilling on the skin. A caseof TEN occured in a 10 month old female patient. The characteristic skin lesions of TEN developed after oral administration of carbamazepine for a partial seizure. Thig case consists of prodrome of malaise, fever, anorexia, and conjunctivity followed by erythema & flaccid bullae formation. Diagnosis was confirmed by histologic findings. This patient was treated with a massive systemic corticosteroid, antibiotics, fluid and electrolytes, and topical measures. Authors experienced an extremely rare case of TEN dur to carbamazepine, So report it with a brief review of literature.
Administration, Oral ; Anorexia ; Anti-Bacterial Agents ; Carbamazepine ; Diagnosis ; Electrolytes ; Erythema ; Female ; Fever ; Humans ; Infant ; Seizures ; Skin ; Stevens-Johnson Syndrome*

Self expandable metallic stent is a good alternative of percutaneous transhepatic biliary drainage because it can eliminate numerous problems caused by external drainage catheter, such as tube dislodgement, bile leakage and psychotic problems. Authors analyzed initial results of self expandable metallic stents used in the patients with malignant biliary obstruction to evaluate the efficacy of the procedure and to find the technical problems in the procedure. Self expandable metallic stents were inserted in 14 patients: three with recurrent stomach cancer: there with gallbladder cancer: seven with Klatskin tumor: one with common duct cancer. Gianturco type stent was used in 9 cases ans Wallstent was used in 2 cases. In remaining three cases, both Z-stent and Wallstent were used in the same patient. The average period of follow up was 104 days (4-409). In 13 cases, the patency of the bile duct was restored by the stent (technical success: 92.9%). Occlusions of the stent were found in two cases, after two and 13 months, respectively. Causes of failure and stent occlusion were associated duodenal obstruction, tumor overgrowth and shortening of Wallstent. In remaining 11 patients, one patient was lost to follow up an 10 patients did not show recurrent jaundice until death or last follow up. There was no major complication related to the procedure. The insertion of self expandable metallic stent is a safe procedure and call eliminate major disadvantages of PTBD. Overstenting, overlapping land evaluation of associated GI tract obstruction is crucial for obtaining technical success and long-term patency.
Bile ; Bile Ducts ; Catheters ; Drainage ; Duodenal Obstruction ; Follow-Up Studies ; Gallbladder Neoplasms ; Gastrointestinal Tract ; Humans ; Jaundice ; Klatskin Tumor ; Lost to Follow-Up ; Self Expandable Metallic Stents* ; Stents ; Stomach Neoplasms

Self expandable metallic stent is a good alternative of percutaneous transhepatic biliary drainage because it can eliminate numerous problems caused by external drainage catheter, such as tube dislodgement, bile leakage and psychotic problems. Authors analyzed initial results of self expandable metallic stents used in the patients with malignant biliary obstruction to evaluate the efficacy of the procedure and to find the technical problems in the procedure. Self expandable metallic stents were inserted in 14 patients: three with recurrent stomach cancer: there with gallbladder cancer: seven with Klatskin tumor: one with common duct cancer. Gianturco type stent was used in 9 cases ans Wallstent was used in 2 cases. In remaining three cases, both Z-stent and Wallstent were used in the same patient. The average period of follow up was 104 days (4-409). In 13 cases, the patency of the bile duct was restored by the stent (technical success: 92.9%). Occlusions of the stent were found in two cases, after two and 13 months, respectively. Causes of failure and stent occlusion were associated duodenal obstruction, tumor overgrowth and shortening of Wallstent. In remaining 11 patients, one patient was lost to follow up an 10 patients did not show recurrent jaundice until death or last follow up. There was no major complication related to the procedure. The insertion of self expandable metallic stent is a safe procedure and call eliminate major disadvantages of PTBD. Overstenting, overlapping land evaluation of associated GI tract obstruction is crucial for obtaining technical success and long-term patency.
Bile ; Bile Ducts ; Catheters ; Drainage ; Duodenal Obstruction ; Follow-Up Studies ; Gallbladder Neoplasms ; Gastrointestinal Tract ; Humans ; Jaundice ; Klatskin Tumor ; Lost to Follow-Up ; Self Expandable Metallic Stents* ; Stents ; Stomach Neoplasms