BACKGROUND: With the rapid increase in the elderly population and the ensuing increase in osteoporosis and subsequent fractures, there has been a rise in socioeconomic costs. This study evaluated the relationship between osteoporosis and physical function in 66-year-old Korean women. METHODS: All of the 193 Korean women aged 66 years were recruited from life-transition health examinations from May to December, 2007. Background information was collected through a self-administered questionnaire; and height, weight, and waist circumference were measured. Bone mineral density of the lumbar spine was measured with the Dual Energy X-ray Absorptiometry and the 'timed up and go (TUG)' and 'one-leg balance (OLB)' tests were administered. Risk factors for osteoporosis were analyzed by correlation coefficients and binary logistic regression analysis. RESULTS: The prevalence of osteoporosis for 66-year-old women was 25.9%. A short stature and lower body mass index (BMI) were associated with osteoporosis of the lumbar spine. A longer time to complete the TUG test (>10 second) was associated with a 4-time higher prevalence of lumbar osteoporosis, which was not observed with the OLB test. CONCLUSIONS: One out of four 66-year-old Korean women had osteoporosis. A longer TUG time, short stature, and lower BMI were associated with osteoporosis.
Absorptiometry, Photon ; Aged ; Body Mass Index ; Bone Density ; Female ; Humans ; Korea ; Logistic Models ; Osteoporosis ; Prevalence ; Risk Factors ; Spine ; Waist Circumference

Preeclampsia is a syndrome of hypertension, proteinuria and generalized edema after the 20th week of gestation and usually abates within 48 hours of delivery. Patients with severe preeclampsia and eclampsia have changes consistent with low grade DIC. In severely ill patients with DIC, generalized but nonspecific signs of fever, hypotension, hypoxia and acidosis may be found. Any pattern of bleeding may be seen, but bleeding from wound or venipuncture site is common. A case is presented of acute respiratory distress resulting from DIC combined with right upper lobe atelectasis and hemothorax after right internal jugular vein cannulation. We report this case along with review of the literature.
Acidosis ; Anoxia ; Catheterization ; Dacarbazine* ; Eclampsia ; Edema ; Female ; Fever ; Hemorrhage ; Hemothorax ; Humans ; Hypertension ; Hypotension ; Jugular Veins ; Phlebotomy ; Pre-Eclampsia ; Pregnancy ; Proteinuria ; Pulmonary Atelectasis ; Wounds and Injuries

PURPOSE: The purpose of this study is to evaluate that sequential CT scans after oral contrast ingestion can show morphological and functional status of the biliary tree, especially for the gallbladder and assess whether the CT scans demonstrate other radiological informations than conventional oral cholecystography. MATERIALS AND METHODS: Thirty volunteers in third decades and eight patients with hepatobiliary disease were included for the study. CT scans were obtained 3, 6, 9, 12 hours after oral contrast ingestion and thirty minutes after fat meal in thiry volunteers. Conventional oral cholecystography was also obtained in all volunteers at 12 hours after oral contrast ingestion and after fat meal. We evaluate opacification of gallbladder, biliary tree, and duodenum by contrast media on CT scans and attenuation values of gallbladder, common hepatic duct and common bile duct in each artatomic area on CT and its sequential change. CT scans were performed 6 hours after oral contrast ingestion in eight patients with hepatobiliary disease. And gallbladder function was evaluated by opacification of gallbladder by contrast media in all patients. RESULTS: In thirty volunteers, opacified gallbladder by contrast media was seen in all cases in all sequential periods of time on CT scans, but in 22 cases on conventional oral cholecystography. Contrast-filled intrahepatic ducts were demonstrated in 3 cases at 3 hours after oral contrast ingestion and 11 cases at 6 hours and were not seen thereafter. Contrast-filled common hepatic duct was noted in 28, 18 and 4 cases respectively at 3, 6 and 9 hours after oral contrast ingestion and the CT attenuation values of common hepatic ducts had become progressively decreased. Contrast-filled common bile duct was noted in 28, 18 and 4 cases respectively at 3, 6 and 9 hours and the CT attenuation values of common bile ducts were not changed untill 9 hours but slightly increased at 12 hours. Contrast media was noted in 7, 5, 6 and 5 cases at 3, 6, 9, and 12 hours in cystic duct and 8, 3, 2, 5 cases in duodenum. Contrast-filled cystic duct and duodenum were noted in 24 cases and 19 cases respectively on CT scans after fat meal. The CT attenuation values of gallbladder were increased in sequential periods of time and the difference of density of gallbladder between 3 hours and 6 hours was statistically significant(p=0.0001). The CT attenuation values of gallbladder at 6 hours were heighter than that in 3 hours, statistically. Opacified gallbladder were noted in 2 cases of fatty liver(n=2), 1 case of alcoholic liver disease(n=1), in 1 case of liver cirrhosis(n=1). Patients of gallbladder stone(n=2) or hepatocellular carcinoma (n=2) had non-opacified gallbladder on CT scans. CONCLUSION: The CT scans after oral contrast ingestion can show the morphological and functional aspects of gallbladder better than conventional oral cholecystography and can also show biliary trees and other surrounding structures, so it is helpful method for assessment of not only gallbladder diseases but also other hepatobiliary diseases.
Alcoholics ; Bile Ducts* ; Bile* ; Biliary Tract ; Carcinoma, Hepatocellular ; Cholecystography ; Common Bile Duct ; Contrast Media ; Cystic Duct ; Duodenum ; Eating* ; Gallbladder Diseases ; Gallbladder* ; Hepatic Duct, Common ; Humans ; Liver ; Meals ; Tomography, X-Ray Computed ; Volunteers

Lichen planopilaris is believed to be a variant of lichen planus which is occasionally accompanied by classical lichen planus. A 68-year old male had asymptomatic skin colored or light violet colored papules and nodules on the occipital area followed by hair loss for 2 months. He had also violaceous pea to bean sized whitish scaly papules on the right lower extremity. Histopathological examination revealed the dilated follicles to be filled with horny material. There were also intense infiltrations of monocytes which were most prominent at the lower pole of the hair follicles on the scalp lesion. There was also hyperkeratosis, focal hypergranulosis and band-like infiltrations of lymphocytes at the dermo-epidermal junction on the lesion of the lower extremity. Direct immunofluorescence examination showed linear deposition of fibrin at the dermo-epidermal junction in the hair follicles. We had an opportunity to observe a man with lichen planopilaris who had loss of scalp hair which was accompanied by classical lichen planus on the lower extremity.
Aged ; Fibrin ; Fluorescent Antibody Technique, Direct ; Hair ; Hair Follicle ; Humans ; Lichen Planus ; Lichens* ; Lower Extremity ; Lymphocytes ; Male ; Monocytes ; Peas ; Scalp ; Skin ; Viola

No abstract available.
Carrier State*

Angioma serpiginosum is a rare acquired naevoid disorder, characterized by minute red or purple punta that are frequently arranged in serpiginous patterns in the lower extremities and buttocks. It usually begins in childhood and is more common in females. Histopathologically, thin-walled capillaries in the dermal papillae and the superficial reticular dermis are widely dilated without extravasation of red blood cells. We report a case of angioma serpiginosum on the lateral aspect of the right arm along the lines of Blaschko in a 36-year-old woman.
Adult ; Arm ; Buttocks ; Capillaries ; Dermis ; Erythrocytes ; Female ; Hemangioma* ; Humans ; Lower Extremity

Transjugular intrahepatic portosystemic shunt (TIPS) is an effective interventional procedure to relieve portal hypertension, which is a main mechanism for the development of complications of liver cirrhosis (LC), such as variceal hemorrhage, ascites, and hepatorenal syndrome. However, the high incidence of adverse events after TIPS implementation limits its application in clinical practice. Esophageal variceal hemorrhage is one of the major indications for TIPS. Recently, preemptively performed TIPS has been recommended, as several studies have shown that TIPS significantly reduced mortality as well as rebleeding or failure to control bleeding in patients who are at high risk of treatment failure for bleeding control with endoscopic variceal ligation and vasoactive drugs. Meanwhile, recurrent ascites is another indication for TIPS with a proven survival benefit. TIPS may also be considered as an effective treatment for other LC complications, usually as an alternative therapy. Although there are concerns about the development of hepatic encephalopathy and hepatic dysfunction after TIPS implementation, careful patient selection using prognostic scores can lead to excellent outcomes. Assessments of cardiac and renal function prior to TIPS may also be considered to improve patient prognosis.

This report is based on analysis of admissions to the department of pediatric at the Wonju Christian Hospital during the 3 3/4-year period from January 1989 to September 1993 with an Isolated ostium secundum ASD. Several methods of assessment of ASD size, namely, echographic, pulmonary-to-systemic flow ratio(Qp:Qs), and angiographic measures, were undertaken in a group of 37 patients, who were being evaluated for transcatheter closure of ASD; the results were compared with the operation diameter. The result of study was as follows : 1) The (Qp:Qs) ratio have no significant(p>0.01) correlation with the operation diameter(r= 0.342) 2) The angiographic size have a significant(p<0.01) correlation with the operation diameter (r=0.842) 3) The echo diameter has the best correlation with the operation diameter(r=0.935; p<0.01) The operation diameter can be estimated by the equation: 1.05 x echo diameter in millimeters+0.93mm. It is concluded that operation diameter of ASD can be estimated accurately by two-dimensional subcostal echo measurements, which in turn could be used for selection of device size for occlusion of the ASD.
Angiocardiography ; Echocardiography* ; Gangwon-do ; Humans

BACKGROUND: For pediatric anesthesia we frequently use rocuronium bromide, which is often associated with a localized withdrawal of the arm or generalized movements, that may cause harm to the patient. Lidocaine is said to be one of the better agents and reduce the incidence of movement associated with rocuronium injection in adults. The purpose of this study was to compare the effects on movement associated with rocuronium injection according to the method of lidocaine administration in children. METHODS: Two hundreds and four pediatric patients undergoing general anesthesia were randomly assigned to one of six groups (each group n = 34). Fifty seconds after the injection of thiopental sodium 5 mg/kg, the SM group was given mixture of rocuronium bromide 0.6 mg/kg and normal saline 0.05 ml/kg (same amount of 2% lidocaine 1 mg/kg) for 5-10 seconds. The LM 1.0 and LM 2.0 groups were given a mixture of rocuronium bromide 0.6 mg/kg and 2% lidocaine 1 mg/kg or 2 mg/kg, respectively. The LS 1.0, LS 1.5 and the LS 2.0 groups were given 2% lidocaine 1.0 mg/kg, 1.5 mg/kg, and 2.0 mg/kg respectively, 50 seconds after the injection of thiopental sodium, and rocuronium was given 5 seconds after the administration of lidocaine. Withdrawal movements after the injection of rocuronium were investigated. RESULTS: All of the SM group showed withdrawal movement and the LM 2.0, LS 1.0, LS 1.5, and LS 2.0 groups showed less withdrawal movement than the SM group. And the LS 1.0, LS 1.5, and LS 2.0 groups showed less movement than the LM 1.0 group. LS 2.0 group showed less withdrawal movement than LM 2.0 group. CONCLUSIONS: The sequential administration of lidocaine and rocuronium produced a better result than the administration of a mixture in terms of reducing withdrawal movement on rocuronium injection.
Adult ; Anesthesia ; Anesthesia, General ; Arm ; Child* ; Humans ; Incidence ; Lidocaine* ; Neuromuscular Blockade ; Thiopental

BACKGROUND: A light plane of general anesthesia is chosen for fetal safety during a cesarean section. Therefore an experience of wakefulness and pain perception is not infrequent and can be distressful to patients. The electroencephalogram-derived bispectral index (BIS) is a promising new method to assess anesthetic adequacy. This study was designed to assess the adequacy of general anesthesia and to evaluate the usefulness of the BIS in monitoring the awareness during a cesarean section. METHODS: Twenty one parturients undergoing general anesthesia for an elective caesarean section were examined. Anesthesia was induced with 4 mg/kg thiopental and 1 mg/kg succinylcholine, and then followed with a mixture of 50% N2O, 50% O2 and 0.8% enflurane at a flow of 4 L/min. Before administration of succinylcholine, a tourniquet was applied to the free arm and inflated to 250 mmHg. Responsiveness to verbal commands using the Tunstall isolated forearm technique was detected and the BIS was monitored throughout the study period. RESULTS: The incidence of responsiveness to verbal commands were 33% at the time of skin incision and fetal delivery respectively. BIS values of response to commands were significantly higher than that of no respose at both time points (p < 0.05). Fisher's exact test suggested that the BIS value less than 75 was related to unresponsiveness to verbal commands at time of skin incision (p < 0.05) and the BIS less than 85 at fetal delivery (p < 0.05). CONCLSIONS: These results suggest that adequate anesthesia is not provided with a mixture of 50% N2O, 50% O2 and 0.8% enflurane at a flow of 4 L/min at the time of skin incision and fetal delivery. In addition BIS could be a predictor of awareness during cesarean section under general anesthesia.
Anesthesia ; Anesthesia, General* ; Arm ; Cesarean Section* ; Consciousness Monitors* ; Enflurane ; Female ; Forearm ; Humans ; Incidence ; Pain Perception ; Pregnancy ; Skin ; Succinylcholine ; Thiopental ; Tourniquets ; Wakefulness