PURPOSE: As the use of hormone replacement therapy for the menopausal women increases, some caution is advised, since there is an increased risk of breast cancer. Accordingly, the importance of regular mammography has been addressed. This cross-sectional study analyzed the effects of different hormone therapies on mammographic density. MATERIALS AND METHODS: Sixty-seven postemenopausal women who had completed one year of hormone therapy and had undergone follow-up mammography, were divided into two groups : Group I : continuous conjugated equine estrogen, 0.625 mg, plus continuous medroxyprogesterone acetate, 2.5 mg (n=48), Group II : continuous conjugated equine estrogen 0.625 mg (n=19). The mammograms were read by two radiologists. RESULTS: With regard to the radiologists involved, interobserver reliability (kappa) was 0.70 and intraobserver reliability (kappa) was 0.51 and 0.67. Before hormone therapy, factors related to decreased mammographic density were age and number of full term pregnancies (p<0.05). After one year of hormone therapy, body fat showed a significant increase (p<0.05), but in spite of this, increased mammographic density induced by hormone therapy remained significantly high (p<0.05). Compared with Group II, Group I showed a significant increase in mammographic density (p<0.05). In Group I, mammographic density increased from P2 to DY pattern in two cases, but there was no such change in Group II. CONCLUSION: The increase of mammographic density seen in Group II was much more significant statistically than that seen in Group I. The mammograms of women who have undergone continuous combined hormone therapy should therefore be interpreted very cautiously.
Adipose Tissue ; Breast Neoplasms ; Cross-Sectional Studies ; Estrogen Replacement Therapy* ; Estrogens* ; Female ; Follow-Up Studies ; Hormone Replacement Therapy ; Humans ; Mammography ; Medroxyprogesterone Acetate ; Pregnancy

BACKGROUND AND AIMS: Cigarette smoking induces an inflammatory response in the airways, which may play a key role in the pathogenesis of chronic obstructive pulmonary disease. Interleukin-6 (IL-6) is one of the cytokines that plays an important role in inducing bronchial inflammation. The aim of this study was to determine if the level of the pro-inflammatory cytokine, Interleukin-6 , is increased when the bronchial epithelial cells are exposed to a cigarette smoke extract (CSE) and an extract from stop smoking-aiding cigarettes, and examined the safety of these commercially available stop smoking-aiding cigarettes. METHOD: Bronchial epithelial cells were exposed to CSE from cigarette and stop smoking-aiding cigarettes for 24 hours. ELISA was used to measure the IL-6 levels in the supernatant from each condition. The IL-6 mRNA levels were measured by Taqman Real time RT-PCR. N-acetyl-L-cysteine(NAC) was added to each condition to determine if NAC can inhibit the release of IL-6 from the bronchial epithelial cells when they are exposed to CSE from cigarette and stop smoking-aiding cigarettes. RESULT: When bronchial epithelial cells were exposed to a CSE from cigarettes and stop smoking- aiding cigarettes, each type of CSE stimulated IL-6 production from the bronchial epithelial cells. The IL-6 mRNA level in the Bronchial epithelial cells was also elevated and NAC was found to inhibit the release of IL-6 from bronchial epithelial cells when they were exposed to the CSE from cigarettes and stop smoking-aiding cigarettes. CONCLUSION: Commercially available stop smoking-aiding cigarette can induce bronchial inflammation and can be harmful to smokers. Therefore, the safety of these cigarettes for smoking cessation should be evaluated.
Cytokines ; Enzyme-Linked Immunosorbent Assay ; Epithelial Cells* ; Inflammation ; Interleukin-6* ; Pulmonary Disease, Chronic Obstructive ; RNA, Messenger ; Smoke ; Smoking ; Smoking Cessation ; Tobacco Products*

Coronary artery anomalies are diagnosed in 0.6 to 1.5% of patients who undergo coronary angiography (CAG). They may present with life threatening conditions but are generally asymptomatic. Recognition and adequate visualization of the anomaly is essential for correct management of the condition. However, in some cases the exact orifice and course of an anomalous coronary vessel cannot be selectively identified by CAG. In this report, a 54-year-old man was admitted to the hospital with acute inferior myocardial infarction and had an anomalous origin of the left circumflex coronary artery (LCX) from the first diagonal branch (D1). In CAG, the right CAG showed no significant stenosis and fortunately we found an anomalous origin of the LCX from the D1. The course of LCX was precisely established by 64-slice multi-detector computed tomography.
Constriction, Pathologic ; Coronary Angiography ; Coronary Vessel Anomalies ; Coronary Vessels ; Glycosaminoglycans ; Humans ; Inferior Wall Myocardial Infarction ; Middle Aged ; Myocardial Infarction

The concept of cellular reprogramming was developed to generate induced neural precursor cells (iNPCs)/dopaminergic (iDA) neurons using diverse approaches. Here, we investigated the effects of various nanoscale scaffolds (fiber, dot, and line) on iNPC/iDA differentiation by direct reprogramming. The generation and maturation of iDA neurons (microtubule-associated protein 2-positive and tyrosine hydroxylase-positive) and iNPCs (NESTIN-positive and SOX2-positive) increased on fiber and dot scaffolds as compared to that of the flat (control) scaffold. This study demonstrates that nanotopographical environments are suitable for direct differentiation methods and may improve the differentiation efficiency.
Cellular Reprogramming ; Nanofibers ; Neurons ; Tyrosine

PURPOSE: The following study has been carried out to find the symptoms of hypoglycemia and the symptoms of transient focal neurologic deficit, which were complained by insulin dependent diabetes mellitus patients and their parents. METHODS: The subjects of this study were 16 insulin dependent diabetic patients who were admitted to the pediatric department of Samsung Medical Center. From the 28 possible symptoms of hypoglycemia, the patients and their parents were asked to choose the symptoms they were experiencing through questionnaires, and the mean score was obtained by dividing the frequency of each symptom manifestation by 4 levels. RESULTS: Of the 16 patients, there were 6 males and 10 females and their average age was 13 years. The complaints raised by insulin dependent diabetic patients and their parents regarding the symptoms of hypoglycemia were relatively similar. However the frequency of observed symptoms such as pounding heart, dizziness and trembling was higher in the complaints of patients, and the mean score of objective symptoms such as slurred speech, odd behaviors, aggressiveness was much higher in the complaints of parents. During symptoms of hypoglycemia, three cases were seen throwing fits of convulsions due to neurologic deficit. CONCLUSION: It is thought that parents can offer a reasonably accurate information on the symptoms of hypoglycemia in insulin dependent diabetic patients, and particularly, behavioral changes in young children with diabetes mellitus is considered as an important characteristic for testing hypoglycemia.
Child* ; Diabetes Mellitus ; Diabetes Mellitus, Type 1* ; Dizziness ; Female ; Heart ; Humans ; Hypoglycemia ; Insulin ; Male ; Neurologic Manifestations ; Parents* ; Surveys and Questionnaires ; Seizures

PURPOSE: The aim of this study is to investigate the effects of high humidification of nearly 100% on insensible water loss and total fluid requirement in very low birth weight infants during their first week of life. METHODS: We retrospectively compared twenty-five infants (GA 28.1+/-1.7 wk, and BW 970+/-186 g) who were cared for in a double walled incubator with high humidification with 24 infants (GA 27.6+/-2.2 wk, and BW 972+/-186 g) who were in a double walled incubator without raised humidity during the first week of their life. We analyzed the changes in body weight, total fluid intake, insensible water loss, urine output, input of sodium and potassium, serum levels of sodium and potassium, and the incidence of complications during the hospitalization in the high humidified group and the control group. RESULTS: High humidification during the first week of life in very low birth weight infants reduced insensible water loss and total fluid requirement. However the imbalance of serum electrolyte or oliguria did not increase. The high humidification group (n=25) acquired more physiologic weight loss during the first two weeks of life than the control group (n=24) but gained more weight than the control group (n=24) on the third month of life. Infants nursed with high humidification showed an increased tendency toward spontaneous closure of the patent ductus arteriosus and a decreased tendency toward surgical ligation of the patent ductus arteriosus and intraventricular hemorrhage without the evidence of an increase in infection. No significant differences were noted in the incidence of patent ductus arteriosus, bronchopulmonary dysplasia and retinopathy of prematurity. CONCLUSION: The high humidification of nearly 100% and fluid restriction therapy during the first week of life were effective in the fluid and electrolyte management of very low birth weight infants.
Body Weight ; Bronchopulmonary Dysplasia ; Ductus Arteriosus, Patent ; Hemorrhage ; Hospitalization ; Humans ; Humidity ; Incidence ; Incubators ; Infant ; Infant, Newborn ; Infant, Very Low Birth Weight* ; Ligation ; Oliguria ; Potassium ; Retinopathy of Prematurity ; Retrospective Studies ; Sodium ; Water Loss, Insensible ; Weight Loss

PURPOSE: Congenital adrenal hyperplasia(CAH), which is classified into salt-wasting, simple virilization and non-classic type according to clinical features, is difficult to detect in early stages. Failure to diagnose it in the initial state may lead to life-threatening adrenal crisis, inappropriate male sex assignment in the genetic female, acceleration of skeletal maturation and subsequent short stature. Therefore, we studied the variables increasing the 17-hydroxyprogesterone(OHP) values for more specific and sensitive diagnosis of CAH. METHODS: We classified 3,532 newborns into variable factors; gestational age, birth weight, gender, delivery type, sampling date and stress. Then, we analysed the relationships between 17-OHP values and variable factors. RESULTS: The mean value of 17-OHP was 4.21+/-0.03ng/ml. There were significant differences among the variable factors except gender. The mean value of male was 4.26ng/ml, and that of female was 4.15ng/ml(P=0.10). The mean value of 17-OHP in vaginal delivered newborn was higher than C-section delivered ones(4.71ng/ml, 3.34ng/ml, P=0.0001). It was also higher in low birth weight(P=0.0001), in prematurity(P=0.001), those sampled within 4 days(P=0.0001), stressful condition and ventilator care-assisted(P=0.004). CONCLUSION: 17-OHP value in neonatal screening is influenced by several variables such as vaginal delivery, ventilator management, low birth weight, sampling date and prematurity. If the 17-OHP value is increased, we have to consider the variables influencing the increase in value and follow up with time interval or analysis of genetic mutations.
17-alpha-Hydroxyprogesterone* ; Acceleration ; Adrenal Hyperplasia, Congenital* ; Birth Weight ; Diagnosis ; Female ; Follow-Up Studies ; Gestational Age ; Humans ; Infant, Low Birth Weight ; Infant, Newborn* ; Male ; Mass Screening* ; Neonatal Screening ; Parturition ; Ventilators, Mechanical ; Virilism

PURPOSE: Congenital adrenal hyperplasia(CAH), which is classified into salt-wasting, simple virilization and non-classic type according to clinical features, is difficult to detect in early stages. Failure to diagnose it in the initial state may lead to life-threatening adrenal crisis, inappropriate male sex assignment in the genetic female, acceleration of skeletal maturation and subsequent short stature. Therefore, we studied the variables increasing the 17-hydroxyprogesterone(OHP) values for more specific and sensitive diagnosis of CAH. METHODS: We classified 3,532 newborns into variable factors; gestational age, birth weight, gender, delivery type, sampling date and stress. Then, we analysed the relationships between 17-OHP values and variable factors. RESULTS: The mean value of 17-OHP was 4.21+/-0.03ng/ml. There were significant differences among the variable factors except gender. The mean value of male was 4.26ng/ml, and that of female was 4.15ng/ml(P=0.10). The mean value of 17-OHP in vaginal delivered newborn was higher than C-section delivered ones(4.71ng/ml, 3.34ng/ml, P=0.0001). It was also higher in low birth weight(P=0.0001), in prematurity(P=0.001), those sampled within 4 days(P=0.0001), stressful condition and ventilator care-assisted(P=0.004). CONCLUSION: 17-OHP value in neonatal screening is influenced by several variables such as vaginal delivery, ventilator management, low birth weight, sampling date and prematurity. If the 17-OHP value is increased, we have to consider the variables influencing the increase in value and follow up with time interval or analysis of genetic mutations.
17-alpha-Hydroxyprogesterone* ; Acceleration ; Adrenal Hyperplasia, Congenital* ; Birth Weight ; Diagnosis ; Female ; Follow-Up Studies ; Gestational Age ; Humans ; Infant, Low Birth Weight ; Infant, Newborn* ; Male ; Mass Screening* ; Neonatal Screening ; Parturition ; Ventilators, Mechanical ; Virilism