PURPOSE: To evaluate mammographic and sonographic breast parenchymal changes and the risk of breast cancer in women on hormonal replacement therapy (HRT). MATERIAL AND METHODS: The study group consisted of 50 patients examined with serial mammograms and/or ultrasonograms during HRT. The control group consisted of 50 patients examined with serial mammogram for a routine health check. Mammographic parenchymal changes in both the study and control groups and so- nographic findings of 27/50 patients in study group were evaluated. RESULTS: Follow-up mammogram of the control group showed no interval change or slight evolution of parenchyma with increasing age, but the study group showed increasing parenchymal densities. Most frequently encountered finding on SOhogram in 11 women treated by estrogen alone, was ductal dilatation (7cases ;64%), whereas in 16 women treated by estrogen and progesteron it was ductal epithelial hyperplasia (8 cases; 50%). Overall, four breast cancers developed;one infiltrating ductal carcinoma and three ductal carcinoma in situ. CONCLUSION: HRT causes the changes of breast parenchyma on mammogram and sonogram of postmenopausal women, and increases the risk of developing breast cancer. Therefore, careful and regular examination should be followed in those on postmenopausal HRT.
Breast Neoplasms ; Breast* ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Dilatation ; Estrogens ; Female ; Follow-Up Studies ; Humans ; Hyperplasia ; Ultrasonography

Introduction: Several investigators demonstrated that routine nasogastric decompression after abdominal surgery was unnecessary and can be safely eliminated. Some authors suggested that early feeding could be tolerated by the majority of patients after elective colorectal surgery. PURPOSE: The aim of our study was to prospectively assess the safety and tolerability of early oral feeding after colorectal surgery. METHODS: This trial included 69 patients who underwent an colon or rectal operation between April 1997 and August 1998. Patients were randomized after the operative procedure into one of two groups. Group 1: early oral feeding-all patents received a clear liquid diet on the first postoperative day followed by a regular diet as tolerated. Group 2: delayed feeding-all patients were treated in the traditional way with feeding only after the resolution of their postoperative ileus. Both groups had intraoperative nasogastric tubes that were removed at the end of surgery. The patients were monitored for vomiting, nasogastric tube reinsertion, time of regular diet consumption, complication, and length of hospitalization. The nasogastric tube was reinserted if two or more episodes of vomiting of more than 100 ml occurred in the absence of bowel movement. RESULTS: Sixty-nine consecutive patients were studied, 34 patients in group 1 (12 males and 22 females, mean age 58.1+/-12.7), and 35 patients in group 2 (16 males and 19 females, mean age 58.5+/-12.7). Significant differences were not noted in age and type of procedures. No significant differences were seen in rates of vomiting and overall complications. However, early feeding group well tolerated a regular diet (postoperative period to take regular diet of group 1: 5.4+/-4.0 days, group 2 : 8.1+/-4.6 days, p=0.013), and were discharged from hospital significantly earlier than the delayed feeding group(group 1: 14.0+/-5.1 days, group 2: 19.1+/-8.6 days, p=0.004). CONCLUSION: Early feeding after colorectal surgery is successfully tolerated by the majority of patients and led to earlier hospital discharge.
Colon ; Colorectal Surgery* ; Decompression ; Diet ; Female ; Hospitalization ; Humans ; Ileus ; Male ; Prospective Studies ; Research Personnel ; Surgical Procedures, Operative ; Vomiting

Authors reviewed mammographic ultrasonographic and MRI findings a patient with breast cysticerocosis, which was operated and pathologically proved. Mammography showed a 1 cm sized round radioopaque lesion with curvilinear calification, which was located near the pectoralis major muscle. Ultrasonograiphic findings showed heterogenous hypoechoic cystic lesion with internal hyperechoic nodule and posterior acoustic shadowing. T2Wl and proton density MR image showed low signal intensity with cresentic high signal intensity portion. 2D-FLASH dynamic MRI showed intermediate signal intensity and peripheral signal void area, which was not enhanced with Gd-DPTA. The possibility of cysticercosis can be considered be considered when a cytic lesion is discovered near the pectoralis muscle in a patient living in an endemic area.
Acoustics ; Breast* ; Cysticercosis* ; Humans ; Magnetic Resonance Imaging ; Mammography ; Pectoralis Muscles ; Protons ; Shadowing (Histology)

PURPOSE: To analyze the dynamic MR imaging of breast fibroadenoma according to the histologic type for differentiation from breast carcinoma. MATERIALS AND METHODS: Dynamic MR images of 26 lesions from 22 breasts in 19 patients showing atypical clinical features or film mammogram and ultrasound manifestations were performed. We analyzed the speed and the maximal amount of contrast enhancement and the patterns, such as shape, border, and internal signal intensity, among the histologic types during five minutes after contrast injection. RESULTS: The speed and maximal amount of contrast enhancement of fibroadenoma were in descending order of myxoid, sclerotic, glandular, and calcified types. Among these, the value of maximal amount of contrast enhancement of myxoid and sclerotic type were more than 700 NU, but only myxoid type was enhanced more than 700NU within the first 1 minute after contrast injection, similar to the findings of carcinoma. In general, fibroadenoma showed the tendency of smooth surface(69%), well-defined border(88%) with safety rim, and internal homogeneous signal intensity(65%). However, sclerotic type of fibroadenoma had relatively high incidence of heterogeneous internal signal intensity(78%) after Gd-DTPA injection. CONCLUSION: Dynamic MR imaging of atypical breast fibroadenoma mimicking breast malignancy was very useful in differentiation it from carcinoma and had the benefit of classifying fibroadenoma according to its histologic types.
Breast Neoplasms ; Breast* ; Fibroadenoma* ; Gadolinium DTPA ; Humans ; Incidence ; Magnetic Resonance Imaging* ; Ultrasonography

BACKGROUND: The present study investigated the efficacy and safety of vildagliptin-metformin treatment compared to those of glimepiride-metformin treatment for type 2 diabetes. METHODS: In a randomized, open-label, comparative study, 106 patients with type 2 diabetes were enrolled. The primary endpoint was a reduction in HbA1c from baseline and secondary endpoints included fasting plasma glucose (FPG) or 2-hour postprandial glucose (2h-PPG) reduction from baseline, as well as HbA1c responder rate and HbA1c reduction according to baseline HbA1c category. RESULTS: Comparable HbA1c reduction was observed with a mean+/-standard deviation change from baseline to the 32-week endpoint of -0.94+/-1.15% in the vildagliptin group and -1.00+/-1.32% in the glimepiride group. A similar reduction in 2h-PPG (vildagliptin group 3.53+/-4.11 mmol/L vs. the glimepiride group 3.72+/-4.17 mmol/L) was demonstrated, and the decrements in FPG (vildagliptin group 1.54+/-2.41 mmol/L vs. glimepiride group 2.16+/-2.51 mmol/L) were not different between groups. The proportion of patients who achieved an HbA1c less than 7% at week 32 was 50.1% in the vildagliptin group and 56.0% in the glimepiride group. An average body weight gain of 2.53+/-1.21 kg in the glimepiride group was observed in contrast with the 0.23+/-0.69 kg weight gain noted in the vildagliptin group. A 10-fold lower incidence of hypoglycemia was demonstrated in the vildagliptin group, in addition to an absence of severe hypoglycemia. CONCLUSION: Vildagliptin-metformin treatment provided blood glucose control efficacy comparable to that of glimepiride-metformin treatment and resulted in better adverse event profiles with lower risks of hypoglycemia and weight gain.
Adamantane ; Blood Glucose ; Body Weight ; Diabetes Mellitus, Type 2 ; Fasting ; Glucose ; Humans ; Hypoglycemia ; Incidence ; Metformin ; Nitriles ; Plasma ; Pyrrolidines ; Sulfonylurea Compounds ; Weight Gain

Inflammatory mediators, such as oxidants, TNF-alpha, and IL-6, play a major role in the systemic response to bum injury It has been known that a continuing inflammatory response cause a sepsis and subsequent multiple organ failure. Recent studies have shown that burn patients receiving recombinant human growth hormone(rhGH) therapy have an improvement of the general condition, but the mechanism by which rhGH exerts its effects has not been clearly understood. The aim of this study was to evaluate the effect of rhGH on the early bum injury. Female Sprague-Dawley rats were divided into four groups : control group, bum group, burn plus rhGH treated group, and rhGH only treated group. Animals were killed at 30min., 3, 6, 24, and 48 hours after treatment. Histology and biochemical changes including malondialdehyde(MDA) content, tissue reduced glutathione(GSH) and catalase activity in the lung and liver, and plasma TNF-alpha and IL-6 levels were examined. Lung histology in the bum plus rhGH treated group showed decreased inflammtory response such as neutrophil and lymphocyte infiltrations, interstitial thickening, and edema compared with the bum group. Liver histology in the bum group revealed mild neutrophil and lymphocyte infiltrations, vacuolization .of hepatocytes, disrupted lobular structures, and dilated sinusoids. But liver histology of the bum plus rhGH was similar to control group. Lung and liver MDA in the burn plus rhGH and rhGH only treated groups were decreased with time compared with the burn group. Lung and liver GSH and catalase activities in the bum plus rhGH and GH only treated groups remained significantly increased compared with the bum group for the 48-hours period. Plasma TNF-alpha levels in the bum group remained elevated for the 48-hours period compared with the bum plus rhGH and rhGH only treated groups. Plasma IL-6 levels in the burn group were significantly increased only at first compared with the bum plus rhGH and rhGH only treated groups. These results suggested that rhGH showed inhibitory effects on the inflammatory cell infiltration and lipid peroxidation in the lung and liver after bum injury. Increased GSH levels and catalase activities seemed to be associated with the antioxidant effect of rhGH. But the inhibitory effect of rhGH on plasma TNF- and R-6 levels was not clearly demonstrated.
Animals ; Antioxidants ; Burns ; Catalase ; Edema ; Female ; Hepatocytes ; Human Growth Hormone* ; Humans* ; Interleukin-6* ; Lipid Peroxidation* ; Liver ; Lung ; Lymphocytes ; Multiple Organ Failure ; Neutrophils ; Oxidants ; Plasma* ; Rats* ; Rats, Sprague-Dawley ; Sepsis ; Tumor Necrosis Factor-alpha*

No abstract available.
Intussusception*

BACKGROUND: The obese patients increased recently in Korea due to excessive energy intake and decreased physical activity. We are well known that obesity is associted with an increased risk of cardiovascular disease, angina pectoris, hypertension, but not known to influence of weight gain to change in cardio-vascular risk factors. Once, the study of obesity are many but the study of influence of weight gain are small in Korea. This study investigated to influence of weight gain in cardio-vascular risk factors. METHODS: We gatherd case and control group among persons who has taken twice medical examination except disease person from October 1990 to October 1995 at SungAe General hospital. In our study, total 167 case, compare weight gain group(>3kg) with control group to change in cardiovascular risk factor. RESULTS: Sex, age, smoking history, obesity index were not statistically significant difference between two group in the first medical examination. systolic blood pressure, diastolic blood pressure, fasting blood sugar, HDL, total cholesterol/HDL were not statistically significant difference between two group for weight gain. Total cholesterol and triglyceride, LDL were stastistically significant increased. CONCLUSIONS: Weight gain was increased of total cholestrol and triglyceride, LDL, so weight control was important.
Angina Pectoris ; Blood Glucose ; Blood Pressure ; Cardiovascular Diseases ; Cholesterol ; Energy Intake ; Fasting ; Hospitals, General ; Humans ; Hypertension ; Korea ; Motor Activity ; Obesity ; Risk Factors* ; Smoke ; Smoking ; Triglycerides ; Weight Gain*

No abstract available.

OBJECTIVES: To study the distributions of pH and gas values in umbilical arterial(UA) blood of normal newborns following uncomplicated pregnancies and vaginal births. Methods: In 457 consecutive normal term infants who were born between March 1995 and June 1998, we examined the UA pH and blood gas values obtained immediately following delivery. Maternal inclusion criteria were defined as an uncomplicated singleton pregnancy and a normal full term spontaneous vaginal delivery. And also neonatal inclusion criteria were defined as a normal intrauterine growth appropriate for gestational age without any malformations and Apgar score of 7 or more at both one and five minutes after birth. Umbilical artery blood samples were collected at each birth and were evaluated for pH, carbon dioxide pressure (PaCO2), oxygen pressure (PaO2) and actual bicarbonate. RESULTS: Histogram of UA pH value resemble normal distribution curve. The lowest UA pH was 7.04 and the 10th percentile value was 7.23. The median UA pH was 7.31 and 5% was below 7.20. The lowest UA PaO2 was 4.6mmHg and the 10th percentile value was 11.5mmHg. The highest UA PaCO2 was 67.2mmHg and the 90th percentile value was 56.5mmHg. The lowest bicarbonate value was 13.2mmol/L and the 10th percentile value was 18.4mmol/L. CONCLUSION: The distributions of the UA pH and gas values of the collective of normal newborns were illustrated. None of the UA pH was below 7.0.
Apgar Score ; Blood Gas Analysis* ; Carbon Dioxide ; Gestational Age ; Humans ; Hydrogen-Ion Concentration ; Infant ; Infant, Newborn* ; Oxygen ; Parturition ; Pregnancy ; Umbilical Arteries*