BACKGROUND: Many reports have shown that hormone replacement therapy(HRT) in postmenopausal women decreases lipoprotein(a)[Lp(a)]. However these had small numbers of subjects, short duration of therapy, or comparisons of only a few regimens. The influences of progesterone on Lp(a) and lipids, administered with estrogen, are controversial. METHODS: Five hundred and fifty-one postmenopausal women were divided into 4 groups : group A ; 0.625mg conjugated equine estrogen(CEE)(m=140), group B ; 0.625mg CEE plus 5mg medroxyprogesterone acetate(MPA)(m=97), group C ; 0.625mg CEE plus 10mg MPA(n=109), and group D ; 2mg estradiol valerate(E2) plus 0.5mg norgestrel(N)(n=134) and group E ; control(n=71). Lp(a) and lipids levels were measured before and 12 months after HRT. RESULTS: Estrogen replacement therapy(ERT) for 12 months lowered Lp(a) level by 37.1%. The addition of progesterone attenuated the Lp(a)-lowering effect of estrogen and decreased by 27.7%, 29.6%, and 30.3% in groups B(p<0.05), C(p<0.05), and D(p<0.0001) respectively. High density lipoprotein cholesterol(HDL-C) was increased markedly in group A(16.5%), increased moderately in groups B(10.8%) and C(11.3%), and not changed in group D. Low density lipoprotein cholesterol was decreased by 10.9%, 13.7%, 11.3%, and 17.6% in groups A, B, C, and D respectively. CONCLUSIONS: Reduction of Lp(a) with estrogen replacement therapy may be one of mechanisms for cardioprotective effect in postmenopausal women. The combined therapy of estrogen and progesterone may reveal different effects on heart due to adverse actions of progesterone on Lp(a) and HDL-C. The variations in the androgenic potency of progesterone may explaine inconsistent results on HDL-C in previous studies.
Cholesterol, LDL ; Estradiol ; Estrogen Replacement Therapy ; Estrogens ; Female ; Heart ; Hormone Replacement Therapy* ; Humans ; Lipoprotein(a)* ; Lipoproteins ; Medroxyprogesterone ; Progesterone*

Hepatoid carcinoma is a rare type of malignant tumor resembling hepatocellular carcinoma that arises in extrahepatic sites.(stomach, lung, ovary, pancreas, bladder and renal pelvis). Hepatoid carcinoma of the ovary is an extremely rare ovarian tumor, first described by Ishikura and Scully in 1987. Histologically it is important to differentiate this entity from other oxyphil tumors of the ovary as it requires aggressive treatment. We have experienced a case of hepatoid carcinoma of the ovary in 69-year-old postmenopausal woman, who has been treated with operation and adjuvant Taxol - cisplatin chemotherapy. We present this case with brief review of literatures.
Aged ; Carcinoma, Hepatocellular ; Cisplatin ; Drug Therapy ; Female ; Humans ; Lung ; Ovary ; Paclitaxel ; Pancreas ; Pregnancy* ; Primary Ovarian Insufficiency* ; Urinary Bladder

The foreign bodies in the upper GI tract are produced chiefly by accidental swallowing and rarely produce symptoms. But it is recommended to remove the foreign bodies if they produce symptoms or retained in GI tract for long duration, and if they have the possibilities of producing complications. Nowadays the development of therapeutic endoscopy enables the removal of the foreign bodies easily. We have reviewed 88 cases of foreign bodies diagnosed by endoscopy from January, 1980 to July 1990 and had the following results. 1) The most common foreign bodies were coins and bezoars, common with the ages under 10 years and over 50 years. 2) The foreign bodies were found in the upper gastrointestinal tract in the order of stomach, esophagus and duodenum. 3) The esophageal stricture especially by lye was the most common underlying cause of upper gastrointestinal foreign bodies. 4) The symptoms and complications were more common with esophageal foreign bodies. 5) By therapeutic endoscopy, the success rate for removal of foreign bodies was 98%.
Bezoars ; Deglutition ; Duodenum ; Endoscopy* ; Esophageal Stenosis ; Esophagus ; Foreign Bodies* ; Gastrointestinal Tract ; Lye ; Numismatics ; Stomach ; Upper Gastrointestinal Tract*

Infantile myofibromatosis is the most common of the juvenile fibromatoses and an unusual mesenchymal disorder characterized by the proliferation of tumors in the skin, muscle, bone and viscera. There are two forms of the disease: solitary and multicentric. A benign course with spontaneous regression is seen in most patients, but poor prognosis can be associated with the multicentric form, in which visceral organs may be involved. It usually presents in early childhood. We report a case of infantile myofibromatosis arising in the left sole of a female new born. Physical examination showed a firm, red colored 2x4cm sized tumor. Histological examination revealed a spindle cell tumor in the dermis with fascicles of plump spindle cells with a whorled arrangement.
Dermis ; Female ; Fibroma ; Humans ; Myofibromatosis* ; Physical Examination ; Prognosis ; Skin ; Viscera

Myxoinflammatory fibroblastic sarcoma (MIFS) is a rare neoplasm that is frequently located in the distal extremities. Emerging evidence suggests that MIFS can also affect the proximal limbs, trunk, and scalp, and aggressive clinical courses have been noted. We report a case of MIFS that occurred suddenly in the patient’s forearm and grew rapidly within 2 weeks. A level of Ki-67 was observed in the patient’s lesion, which constitutes a considerable finding compared with most MIFS cases. The patient underwent surgical tumor removal, and no evidence of recurrence was noted. We highlight this case in view of its sudden occurrence and rapid local progression, which contradicts the usual features of this disease, suggesting that this clinical course might be attributable to the high Ki-67 value.

OBJECTIVES: This research was performed to identify family violence by male adolescencts, and to examine the characteristics of male adolescent delinquents in terms of domestic viloence. METHODS: We surveyed 677 male adolescents including 238 delinquents from BBS(Big brothers and sisters) in Pusan, 209 criminal adolescents from adolescent correctional institution in Pusan, 230 high school students through questionnaire, MMPI(Minnesota Multiphasic Personality Inventory), and PBI(Parental Bonding Instrument), and then compared these three groups by Chi-square test, T-test, and Anova. RESULTS: In most cases, male delinquent adolescents were placed in poorer socio-economic conditions than those of students, but in better socio-economic conditions than those of criminal adolescents. In general, the assaulters were senior family members, physically stronger than sufferers, and have bad brotherliness. Compared with normal students, the serious problem of violence including violence to the ancestors in delinquent and criminal adolescents. On results of MMPI and PBI test, there were significant difference between violent group and non-violent group on the Sc score and Passive aggressive index in adolescent delinquents and parental overprotection in normal students. CONCLUSION: Generally the characteristics of family violence by male delinquent adolescents were intermediate between those of criminal adolescent and students, these results were same as those of previous socio-psychiatric study, and so the intervention in criminal adolescents is needed for the pre-vention of family violence.
Adolescent* ; Busan ; Criminals ; Domestic Violence* ; Humans ; Male ; MMPI ; Parents ; Surveys and Questionnaires ; Siblings ; Violence

PURPOSE: The present study assessed the diagnostic significance of digital infrared thermal imaging (DITI) in determining the inflammatory state of patients with nonspecific orbital inflammation. METHODS: The present study included 11 patients diagnosed with nonspecific orbital inflammation between December 2009 and March 2011 and who were followed-up for more than 6 months. All patients were all diagnosed based on computed tomography (CT), magnetic resonance image (MRI) and tissue biopsy. The grade of eyelid swelling was classified as 5 and severe compared with the temperature of location. The temperature of the upper eyelid, caruncle, medial conjunctiva, lateral conjunctiva, lower eyelid, cornea and lateral orbit were measured with DITI. RESULTS: When comparing the normal eye with the diseased eye in patients with nonspecific orbital inflammation, the temperature of the upper eyelid and cornea were statistically significant (p = 0.003, p = 0.038, respectively, Mann-Whitney test). The correlation between the grade of eyelid swelling and the temperature of location was most highly related in the temperature of the upper eyelid (Spearman's correlation coefficient, r = 0.55, p = 0.008) and cornea (Spearman's correlation coefficient, r = 0.45, p = 0.037). CONCLUSIONS: DITI may aid in evaluating the inflammatory state of nonspecific orbital inflammation. In particular, the temperature of the upper eyelid and cornea can be very useful indicator. Future studies, including larger study population are necessary in order to confirm DITI as a diagnostic tool which can assess the results of medical treatment by comparing temperature before and after treatment.
Biopsy ; Conjunctiva ; Cornea ; Eye ; Eyelids ; Humans ; Inflammation ; Magnetic Resonance Spectroscopy ; Orbit

PURPOSE: We postulated that the success rate for subclavian venous catheterization could be enhanced by improving body positioning. The purpose of this study was to determine the optimal positioning. The ideal position should result in the largest antero-posterior diameter of the subclavian vein and the shortest depth from the skin to the subclavian vein. METHODS: We used 7.5MHz linear probe. Eighteen adult volunteers underwent ultrasound imaging of the right subclavian vein while supine in the following eight positions: NP/PO/AT, NP/PO/AN, NP/PX/AT, NP/PX/AN, LP/PO/AT, LP/PO/AN, LP/PX/AT, LP/PX//AN (neutral head position, NP; head turned to left, LP; on pillow, PO; off pillow, PX; arm traction, AT; neutral arm position, AN). We checked the antero-posterior diameter of the subclavian vein and the depth from skin to the subclavian vein in each position. Statistical significance was determined using Wilcoxon's signed rank test. RESULTS: The antero-posterior diameter of the subclavian vein in NP/PX/AN position is largest and in LP/PO/AN position is smallest (p=0.01). The difference of the depths from skin to the subclavian vein in each positions is not significant statistically. CONCLUSION: There was no statistically significant effect of head position on the antero-posterior diameter of the subclavian vein or on the depth from the skin to subclavian vein. Arm traction did not result in an increase in the anteroposterior diameter. Positioning on the pillow likewise conferred no advantage in the antero-posterior diameter. The most optimal position for subclavian venous catheterization was the neutral head position without pillow between the scapulas and without the arm retracted position.
Adult ; Arm ; Catheterization* ; Catheterization, Central Venous ; Catheters* ; Head ; Humans ; Scapula ; Skin ; Subclavian Vein ; Traction ; Ultrasonography ; Volunteers

Cancer of the gastric stump, first described by Balfour in 1922, is defined as the cancer detected more than 5 years after surgery for a benign disease. We experienced a case of cancer found at the gastric stump after gastrojejunostomy in a 53 years old male patients, proven pathologically as a early cancer. He visited to our hospital with the chief complaint of epigastric pain and indigestion for 1 Months. On past history, he has been received gastrojejunostomy due to duodenal ulcer obstruction, 23 years ago, Gastrofiberscopy was done, and we could find the early gastric cancer lesions at the anterior wall of gastric angle as type Ilc+III and antrum as type IIa. The microscopic finding of the multiple endoscopic biopsies at the gastic angle and antrum revealed the adenocarcinoma of signet ring cell type infiltrated to the level of submucosa. And so, we could diagnose these lesions as a early gastric cancer in the gastric stump after gastrojejunostomy. He was treated with subtotal gastrectomy and discharged with cured condition. Therefore, we report this case with a literature review.
Adenocarcinoma ; Biopsy ; Duodenal Ulcer* ; Dyspepsia ; Gastrectomy ; Gastric Bypass* ; Gastric Stump* ; Humans ; Male ; Middle Aged ; Stomach Neoplasms

Subcutaneous emphysema is a complication of the pneumoperitoneum necessary to perform laparoscopy and will be seen more often as laparoscopic techniques are applied to a growing number of intraabdominal procedures. We report a case of subcutaneous emphysema and hypercarbia without pneumothorax or pneumomediastinum during laparoscopic cholecystectomy, which was treated by multiple puncture with 18G needle on emphysematous site. The suspected cause is inadvertent subcutaneous insufflation of carbon dioxide through the trocar sites by increased intra-abdominal pressure for the establishment of pneumoperitoneum. Immediate recognition, evaluation, and treatment of subcutaneous emphysema is necessary since this can be life-threatening complication.
Carbon Dioxide ; Cholecystectomy, Laparoscopic* ; Insufflation ; Laparoscopy ; Mediastinal Emphysema ; Needles ; Pneumoperitoneum ; Pneumothorax ; Punctures ; Subcutaneous Emphysema* ; Surgical Instruments