Objectives: To report our experience of a patient in her 20s with multiple contiguous osteoporotic compression fractures.Summary of Literature Review: It is uncommon to develop multiple contiguous osteoporotic compression fractures at a young age. Materials and Methods: A 26-year-old woman was admitted with lower back pain. On radiologic examinations, compression fractures of L1, L2 and L5 were observed. Bone mineral density testing indicated severe osteoporosis. Secondary osteoporosis was suspected, and further examinations were performed. The patient was diagnosed with adrenocorticotropic hormone–independent Cushing’s syndrome.On abdominal computed tomography, a tumor suspected to be an adenoma was observed on the left adrenal gland. Tumor resection surgery was then performed. Results: Pathologic findings confirmed that the tumor was an adenoma. The lumbar fractures had healed at 3 months after the fracture. Conclusions If osteoporotic lumbar compression fracture occurs in a young patient, secondary osteoporosis should be suspected and the underlying cause must be found and treated.

PURPOSE: Some recent studies have demonstrated that finasteride, a well- known 5alpha-reductase inhibitor, can decrease prostate specific antigen (PSA) by approximately 50% during the first 1 year of treatment. We investigated how long-term treatment with finasteride and alpha-blockers impacts on the serum PSA level of men whose final diagnosis was benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: In a retrospective trial, we evaluated a total of 293 men with lower urinary tract symptoms (LUTS) that were suggestive of BPH. These men were divided into two treatment groups: group A was treated with alpha-blockers and group C was treated with a combination of finasteride and alpha-blocker. Comparisons of the two groups were performed by using independent t-tests. The changes in the PSA concentrations from baseline to the time of the final measurements were determined by repeated measures of ANOVA. RESULTS: There was no significant difference in the baseline PSA between the two groups. A statistically significant reduction in the PSA levels was observed at 2 years in C group (p<0.05), whereas any significant increase were not observed in group A (p>0.05). In group A, the repeatedly measured PSA levels were 2.67, 2.40, 2.41 and 2.42, respectively. In C group, these were 3.22, 2.09, 1.81 and 1.71 respectively. CONCLUSIONS: Our data showed that there was no clinically significant effect of long term treatment with alpha-blocker on the PSA levels. However, finasteride had significant effect on the serum PSA level during first two years of treatment.
Adrenergic Antagonists ; Diagnosis ; Finasteride* ; Follow-Up Studies* ; Humans ; Lower Urinary Tract Symptoms ; Male ; Oxidoreductases ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Hyperplasia* ; Retrospective Studies

Even the antituberculous drugs could cure the disease itself, it might not prevent progressive kyphosis and its sequelae. Therefore, radical curettage and anterior arthrodesis with autogenous strut bone graft has been used to prevent this deformity. From May 1982 to May 1989, twenty four cases of spinal tuberculosis treated with anterior arthrodesis were analysed about the progression of postoperative kyphosis. These cases were followed up for more than 1 year at least, and the following results were obtained; 1. Lumbar spine was most commonly involved. There was involvement of one disc space in 12 cases, only narrowing of disc space in 7 cases, and two disc spaces in 5 cases. 2. The degree of vertebral loss was under 1 in 15 cases, 0 (disc space narrowing only) in 7 cases, and over 1 in 2 cases. 3. Compared with immediate postoperative kyphotic angle, there was increase of kyphotic angle in 15 cases but most of them were under 10 degress. 4. Preoperative degree of vertebral loss of 15 incerased cases was 0.5 and that of 9 decreased of maintained cases was 0.2 in average. 5. Preoperative vertebral involvement of 15 increased cases was 1.3 and that of 9 decreased or maintained cases was 1.2 in average.
Arthrodesis ; Clinical Study ; Congenital Abnormalities ; Curettage ; Kyphosis ; Spine ; Transplants ; Tuberculosis, Spinal

PURPOSE: This study examined the effects of beraprost sodium on digital infrared thermal images in patients with peripheral arterial disease caused by type 2 diabetes mellitus. MATERIALS AND METHODS: Twenty-five diabetic patients with peripheral arterial disease were treated with beraprost sodium in a prospective, multicenter, cohort study from February 2013 to December 2014. Beraprost sodium (40 μg) was administered orally 3 times daily (120 μg/day) for 6 months. The visual analogue scale (VAS) and digital infrared thermal imaging (DITI) were performed to compare the blood flow improvement between before and after dosing. RESULTS: Among the 25 patients included in the evaluation, 22 patients completed the study. A significant increase in body temperature was observed in the front and left side, particularly in the plantar side in DITI compared to that before and after administration. An increase in body temperature was observed at the frontal part from 28.1℃±2.3℃ to 29.1℃±2.1℃ (p=0.021), at the left side from 27.8℃±2.4℃ to 28.6℃±1.9℃ (p=0.028), at the plantar part at 24.0℃±1.5℃, and at the plantar part at 27.1℃±2.4℃ (p < 0.01). The VAS decreased significantly from 5.4±1.3 to 2.7±2.0 after 6 months of treatment (p < 0.01). CONCLUSION: Beraprost sodium is a safe and easy-to use oral medication for diabetes peripheral arterial disease. It can be expected to increase the blood flow and decrease the lower extremity pain statistically after being taken for 6 months.
Body Temperature ; Cohort Studies ; Diabetes Mellitus, Type 2 ; Humans ; Lower Extremity ; Peripheral Arterial Disease* ; Prospective Studies ; Sodium*

Objectives: . The relationships among positional obstructive sleep apnea (POSA), obstructive sleep apnea (OSA), and periodic limb movements during sleep (PLMS) remain unclear. We investigated these relationships with respect to the severity of OSA and explored the underlying mechanisms. Methods: . We retrospectively reviewed 6,140 eligible participants who underwent full-night diagnostic polysomnography at four clinical centers over a 5-year period, utilizing event-synchronized analysis. We evaluated the periodic limb movement index (PLMI) and the periodic limb movement with arousal index (PLMAI). The impacts of POSA on the PLMI, PLMAI, and PLMS were analyzed in relation to the severity of OSA. Results: . The mean PLMI, the mean PLMAI, and the prevalence of PLMS were significantly lower in participants with severe OSA compared to the mild and moderate OSA groups. The mean PLMI among those with mild OSA exceeded that of control participants. Furthermore, the mean PLMI (4.8±12.7 vs. 2.6±9.8 events/hr, P<0.001), the mean PLMAI (0.9±3.7 vs. 0.5±3.3 events/hr, P<0.001), and the prevalence of PLMS (11% vs. 5.3%, P<0.001) were higher in patients with POSA than in those with non-positional OSA. This PLMS finding was particularly pronounced among those with severe OSA (odds ratio [OR], 1.554; 95% confidence interval [CI], 1.065–2.267) and was less evident in the mild (OR, 0.559; 95% CI, 0.303–1.030) and moderate (OR, 1.822; 95% CI, 0.995–3.339) groups. Conclusion . Patients with POSA, especially those with severe OSA, exhibit a comparatively high prevalence of PLMS. In cases involving prominent PLMS, the diagnosis and treatment of POSA and OSA should be considered.

PURPOSE: To evaluate the diagnostic performance of diffusion-weighted steady-state free precession (DW-SSFP) in comparison to diffusion-weighted echo-planar imaging (DW-EPI) for differentiating the neoplastic and benign osteoporotic vertebral compression fractures. MATERIALS AND METHODS: The subjects were 40 patients with recent vertebral compression fractures but no history of vertebroplasty, spine operation, or chemotherapy. They had received 3-Tesla (T) spine magnetic resonance imaging (MRI), including both DW-SSFP and DW-EPI sequences. The 40 patients included 20 with neoplastic vertebral fracture and 20 with benign osteoporotic vertebral fracture. In each fracture lesion, we obtained the signal intensity normalized by the signal intensity of normal bone marrow (SI norm) on DW-SSFP and the apparent diffusion coefficient (ADC) on DW-EPI. The correlation between the SI norm and the ADC in each lesion was analyzed using linear regression. The optimal cut-off values for the diagnosis of neoplastic fracture were determined in each sequence using Youden's J statistics and receiver operating characteristic curve analyses. RESULTS: In the neoplastic fracture, the median SI norm on DW-SSFP was higher and the median ADC on DW-EPI was lower than the benign osteoporotic fracture (5.24 vs. 1.30, P = 0.032, and 0.86 vs. 1.48, P = 0.041, respectively). Inverse linear correlations were evident between SI norm and ADC in both neoplastic and benign osteoporotic fractures (r = −0.45 and −0.61, respectively). The optimal cut-off values for diagnosis of neoplastic fracture were SI norm of 3.0 in DW-SSFP with the sensitivity and specificity of 90.4% (95% confidence interval [CI]: 81.0–99.0) and 95.3% (95% CI: 90.0–100.0), respectively, and ADC of 1.3 in DW-EPI with the sensitivity and specificity of 90.5% (95% CI: 80.0–100.0) and 70.4% (95% CI: 60.0–80.0), respectively. CONCLUSION: In 3-T MRI, DW-SSFP has comparable sensitivity and specificity to DW-EPI in differentiating the neoplastic vertebral fracture from the benign osteoporotic vertebral fracture.
Bone Marrow ; Diagnosis ; Diagnosis, Differential* ; Diffusion ; Diffusion Magnetic Resonance Imaging ; Drug Therapy ; Echo-Planar Imaging* ; Fractures, Compression* ; Fractures, Spontaneous ; Humans ; Linear Models ; Magnetic Resonance Imaging ; Osteoporotic Fractures ; ROC Curve ; Sensitivity and Specificity ; Spine ; Vertebroplasty

No abstract available.
Enoxacin* ; Humans ; Male* ; Urethritis*

We experienced a 61-year old man with Pneumocystis carinii pneumonia who had been diagnosed as having relapsed acute myelogenous leukemia(AML). He developed severe dyspnea in the nadir state after reinduction chemotherapy. His chest X-ray showed bilateral interstitial pneumonia in both lung fields. We started ventilator therapy and obtained sputum through the endotracheal tube. Typical P. carinii cysts were found in the sputum by Giemsa stain. No other organisms were found in thelavage sediments. From clinical observation and the presence of typical P. carinii cysts, the patient was diagnosed as having P. carinii pneumonia and was treated with sulfamethoxazole/trimethoprim and glucocorticoid. This was the first reported case of P. carinii pneumonia in an AML patient undergoing chemotherapy in Korea.
Azure Stains ; Drug Therapy ; Dyspnea ; Humans ; Korea ; Leukemia ; Leukemia, Myeloid, Acute* ; Lung ; Lung Diseases, Interstitial ; Middle Aged ; Pneumocystis carinii* ; Pneumocystis* ; Pneumonia ; Pneumonia, Pneumocystis* ; Sputum ; Thorax ; Ventilators, Mechanical

A 73-year-old male was admitted for unhealed wound. Eight months ago, the patient had been operated for excision of soft tissue mass on left distal thigh area in previous hospital and after 4 months from first operation, had been reoperated because of recurrence. The pathologic diagnosis of previous operation was simple cyst. In operating finding, the mass invaded the vastus lateralis fascia and had irregular margin and adhesion. We carried out simple excision with retaining 5 cm of free margin from the mass. The pathologic diagnosis of our hospital was malignant fibrous histiocytoma, and then the patient was performed radiation therapy. In 1 year follow-up, there was no significant finding either increasing mass size or metastasis. We misdiagnosed as simple cyst and then performed simple excision, however finally pathologic diagnosis confirmed as malignant fibrous histiocytoma. It is considered to operate a mass that preoperative proper evaluation and diagnosis are required.
Fascia ; Follow-Up Studies ; Histiocytoma, Benign Fibrous ; Histiocytoma, Malignant Fibrous ; Humans ; Male ; Neoplasm Metastasis ; Quadriceps Muscle ; Recurrence ; Thigh

STUDY DESIGN: Retrospective study of prospectively-collected data.OBJECTIVES: To evaluate the radiological outcomes of direct lateral lumbar interbody fusion (DLIF).SUMMARY OF LITERATURE REVIEW: DLIF, as a minimally invasive spinal surgical procedure, is useful for degenerative spinal diseases. However, few reports have evaluated the clinical and radiological outcomes of DLIF in Korea.MATERIALS AND METHODS: We analyzed 44 patients who underwent DLIF at our hospital from September 2015 to September 2017. Of these patients, 89 segments were included in this study. We measured preoperative and postoperative radiological values including the disc height, central canal area, height of the foramen, and segmental sagittal angle on magnetic resonance imaging. We also measured patients' visual analogue scale (VAS) and Oswestry Disability Index (ODI) scores as clinical parameters.RESULTS: Statistically significant improvements were found in the height of the left and right foramina (20.8% and 25.6%, respectively), the height of the intervertebral discs (86.0% and 84.3%, respectively), the cross-sectional area of the central nervous system (33.1%), lumbar lordosis, and the lumbar segmental angle (2.7° and 8.7°, respectively) after surgery. The VAS and ODI scores also showed significant improvements (65.7% and 67.7%, respectively) when compared with the preoperative level.CONCLUSIONS: DLIF was found to be effective for the treatment of diseases such as foraminal stenosis, degenerative spondylolisthesis, and adjacent segment diseases through indirect neuro-decompression of the bilateral foramina and central vertebrae.
Animals ; Central Nervous System ; Constriction, Pathologic ; Humans ; Intervertebral Disc ; Korea ; Lordosis ; Magnetic Resonance Imaging ; Retrospective Studies ; Spinal Diseases ; Spinal Fusion ; Spinal Stenosis ; Spine ; Spondylolisthesis