OBJECTIVE: To evaluate the effects of estrogen replacement therapy and pamidronate on the bone metabolism in the postmenopausal women. METHODS: This prospective randomized clinical trial examined the effects of oral pamidronate and conjugated equine estrogen, in combination and seperately, on biochemical markers of bone turnover in 140 women with low bone mass. Treatment included pamidronate (group I, n=50), or conjugated equine estrogen (group II, n=50), conjugated equine estrogen plus alendronate (group III, n=40) for 12 months. Biochemical markers of bone turnover were also measured at months 6 and 12 months. RESULTS: Serum osteocalcin and urinary deoxypyridinoline in Group I, Group II and Group III decreased signifiantly at 12 months of treatment (p<0.05). But total alkaline phosphatase decreased significantly during the treatment in Group III, but not in Group I and Group II. CONCLUSION: The combined treatment with pamidronate and conjugated equine estrogen is more effective in postmenopausal women with osteoporosis by decreasing bone biochemical markers.
Alendronate ; Alkaline Phosphatase ; Biomarkers ; Estrogen Replacement Therapy* ; Estrogens* ; Female ; Humans ; Metabolism* ; Osteocalcin ; Osteoporosis ; Postmenopause ; Prospective Studies

No abstract available.
Pregnancy*

No abstract available.
Humans ; Pregnancy, Twin* ; Twins*

BACKGROUND: It is well known that a lacunar infarction has characteristic clinical features and a relatively good prognosis. However, the significance of lesions in the parent artery of patients with lacunar syndrome as regard to the prognosis remains unsettled. METHODS: Using the data of consecutive patients with their first ischemic stroke and were followed longer than 1 year, were divided the patients by their clinical features and the results of the work-up was as follows; (1) mismatching [MM] group; lacunar syndrome and the presence of parent arterial lesion, (2) large artery artherosclerosis [LAD]; non-lacunar syndrome and the presence of parent arterial lesion, (3) no determined etiology [NE]; non-lacunar syndrome without parent arterial lesion, and (4) small artery disease [SAD]; lacunar syndrome without parent arterial lesion. Patients with a potential source of embolism were excluded from this study. The prognosis and recurrence rate of patients with the MM group were compared with those of other groups. RESULTS: A total of 176 patients were included; 56 LAD, 62 SAD, 22 MM and 36 NE groups. An unstable hospital course was more frequently found in LAD than in the other groups. The recurrence rate of the MM group (23%) was significantly higher than that of SAD (2%), but was similar to that of patients with non-lacunar syndrome (LAD 16%, NE 28%). CONCLUSIONS: Among patients with lacunar syndrome, the prognosis of those with parent arterial lesions was different from those without lesions. Therefore, a systematic work up of the stroke mechanism may be important in patients with lacunar syndrome.
Arteries ; Embolism ; Humans ; Parents* ; Prognosis ; Recurrence ; Stroke ; Stroke, Lacunar*

PURPOSE: To evaluate the levels of vascular endothelial growth factor (VEGF) in the vitreous of patients with proliferative diabetic retinopathy (PDR) and to find any correlation between clinical and fundus findings, grade of PDR, post-operative complications and surgical outcomes. METHODS: Using ELISA, the vitreous concentration of VEGF was measured in 74 patients with PDR who had undergone vitrectomy and in 13 control patients. RESULTS: The pre-operative levels of VEGFin the vitreous of the PDR patients was significantly increased compared with those of the control and with the post-operative levels. The pre-operative VEGF concentration in the vitreous of the PDR patients was correlated with the duration of diabetes and the severity of proteinuria, but not with the type of diabetes, level of HbA1c, hypertension and BUN/creatinine levels. The severity of PDR was also correlated with pre-operative VEGF levels, especially in NVD, NVE and NVI, but was not correlated with vitreous hemorrhage and fibrous proliferation elsewhere. There was negative correlation with the severity of retinal detachments. The vitreous levels of VEGF in PDR were significantly lower in those who had received previous laser photocoagulation than in those who did not. The VEGF levels were also significantly elevated in patients who developed NVI or NVG in the post-operative period. The changes of visual acuity after vitrectomy in the PDR patients were not correlated with vitreous levels of VEGF. CONCLUSIONS: These results show that VEGF is related to intraocular angiogenesis, progression of PDR and post-operative complications such as NVI or NVG, and that panretinal photocoagulation could prevent the progression of PDR.
Diabetic Retinopathy* ; Enzyme-Linked Immunosorbent Assay ; Humans ; Hypertension ; Light Coagulation ; Proteinuria ; Retinal Detachment ; Vascular Endothelial Growth Factor A* ; Visual Acuity ; Vitrectomy* ; Vitreous Hemorrhage

Occult bronchial foreign body is that long-standing foreign body lodge in bronchial tree. A 63-year-old male was admitted our hospital complaining of a cough. Chest computerized tomography and bronchoscopy showed collapse of right middle lobe and foreign body in the bronchus intermedius. After open thoracotomy and bronchotomy, foreign body was removed and collapsed middle lobe was ventilated. Herein we report a case of middle lobe syndrome caused by occult foreign body in the bronchus intermedius.
Bronchi* ; Bronchoscopy ; Cough ; Foreign Bodies* ; Humans ; Male ; Middle Aged ; Middle Lobe Syndrome* ; Thoracotomy ; Thorax

To identify acanthocephala found in 'Changran-pickles' and 'Myungran-pickles' each organ was measured in permanent slides. In the present report, the results obtained were as follows: 1. Morphology of male worms: Worms possessed 18-19 longitudinal rows, with 4 hooks per row, which became smaller towards the base of proboscis. Each worm contained two testis and six cement glands arranged linearly. Body 22.0 by 0.8-0.6 mm and 15.0 by 0.6-0.4 mm, proboscis 284.8 by 227.6 microgram and 524.9 by 151.4 microgram, proboscis sheath 1570.7 by 72.7 microgram and 751.9 by 280.4 microgram, lemnisci length 2566.7 and 1085.6, testis 2202.9-1860.5 by 737.0-575.7 microgram and 1033.8-981.1 by 463.1-351.6 microgram, cement glands 940.2 by 441.2 microgram and 610.0 by 369.1 microgram. 2. Morphology of female worms: Worms possessed 14-18 longitudinal rows, with 6-10 hooks per row and become smaller toward the base of proboscis. Each worm contained an uterine bell and uterus in the posterior portion and the eggs filled the body cavity. Body 14.0~51.0 mm by 0.7-0.5~2.2-1.4 mm, proboscis 466.1-268.9 microgram by 259.9-252.0 microgram, proboscis sheath 1550.7-506.0 by 298.8-231.1 microgram, lemnisci length 1325.7-473.1 microgram, eggs 112.4 by 28.5 microgram~51.7 by 14.0 microgram. In this present study, the acanthocephala collected in 'Changran-pickles' and 'Myungran-pickles' were identified as Echinorhynchus gadi by morphological features.
Acanthocephala/anatomy & histology/classification/*isolation & purification ; Animals ; Female ; Fish Diseases/*parasitology ; Fishes ; Helminthiasis, Animal/*parasitology ; Korea ; Male ; Seafood/*parasitology

PURPOSE: To evaluate the usefulness and radiologic findings of CT in the diagnosis of orbital blow-outfracture. MATERIALS AND METHODS: Forty-four patients with orbital blow-out fractures diagnosed by clinicalfindings and CT were evaluated retrospectively. On CT images, we evaluated the site and frequency of fracture,herniation of orbital fat, extraocular muscle abnormality, intraorbital hematoma, and intrasinus hemorrhage. RESULTS: Forty-eight sites of orbital wall fractures were seen. Of these, 25(52.1%) were observed at the medialwall and 18(37.5%) at the inferior wall. Combined fracture of the medial and inferior wall was seen in fivecases(10.4%), and orbital fat herniation to adjacent sinuses in 25. Associated extraocular muscle abnormalitieswere seen at the medial rectus (n=20) and inferior rectus muscle(n=18). Intrasinus hemorrhage was seen in 15cases, and intraorbital hematoma in five. CONCLUSION: CT is a useful diagnostic modality for the evaluation oforbital blow-out fracture and associated soft tissue abnormalities.
Diagnosis ; Hematoma ; Hemorrhage ; Humans ; Orbit* ; Orbital Fractures* ; Retrospective Studies

BACKGROUND: The surgical treatment of pectus carinatum is usually a modified Ravitch operation that consists of complete costal cartilage resection and sternal wedge osteotomy. We tried a simple and easy technique that is resection of only deformed, protruded costal cartilage and pre-sternal compression with using a stainless steel bar and this is done without sternal osteotomy. Therefore, we performed partial cartilage resection and pre-sternal compression with a stainless steel bar and we observed the effects and the efficiency of treatment. MATERIAL AND METHOD: From July, 2006 to June, 2008, 10 patients with pectus carinatum underwent our modified technique of pectus carinatum surgery. The effects of surgery and the complications were reviewed. RESULT: 5 patients with only pectus carinatum underwent our modified technique of pectus carinatum surgery. 5 patients with pectus carinatum and pectus excavatum underwent our modified technique of pectus carinatum surgery and Nuss surgery. The mean patient age was 13.4+3.3 years old. The mean operation time was 137.6+22.9 minutes for the pectus carinatum patients and 234.0+36.5 minutes for the pectus carinatum and pectus excavatum patients. The mean length of hospitalization was 11.8+1.0 days. The Haller pectus index of pectus carinatum was 2.10+/-0.21 preoperatively and this was increased to 2.53+/-0.07 postoperatively. The only complication was simple partial wound disruption in 1 patient. CONCLUSION: We performed partial cartilage resection and pre-sternal compression with a stainless steel bar in 10 patients with pectus carinatum and its effects were good. Our modified technique of pectus carinatum is easy and simple as compared with the Ravitch operation. But removal of the stainless steel bar has not yet been performed for these patients and long-term follow up is needed to accurately evaluate the effects of this surgery in many surgical cases.
Cartilage ; Follow-Up Studies ; Funnel Chest ; Hospitalization ; Humans ; Osteotomy ; Stainless Steel ; Thoracic Wall

A mediastinal mass and 2 lung masses on the lower lobes were detected by chest CT in a 44-year old woman. The mass on the left lower lobe was diagnosed as an adeno type of cancer by preoperative lung biopsy. But the preoperative lung biopsy exam for the mass on the right lower lobe couldn't perform because of patient's noncooperation. Removal of the mediastinal mass, left lower pulmonary lobectomy and wedge resection of the right lower pulmonary lobe were done. The histopathologic diagnosis of the resected mediastinal mass was mature cystic teratoma and both lung masses were the adeno type of cancer with the same histopathologic patterns. We experienced a rare case of lung adeno cancer together with mediastinal mature cystic teratoma.
Biopsy ; Female ; Humans ; Lung ; Lung Neoplasms ; Teratoma ; Thorax