BACKGROUND: Osteoporosis is the most common metabolic bone disorder. Osteoporosis has emerged as a leading public health problem with elderly persons and its detection is important for prevention and treatment of fracture. this population-based study was conducted to evaluate the prevalence and risk factors of osteoporosis in the elderly women. METHODS: One hundred thirty eight women aged 60 years or older in rural area were investigated with questionnaires and measurements of height, weight. Bone mineral density(BMD) measurements of lumbar spine and femoral neck were made with dual energy X-ray absorptiometry(DEXA). The World Health Organization criteria for diagnosis of osteoporosis using the manufacturer's young adult population mean and our study young population mean have been applied. Our study's young adult population mean was derived using normal premenopausal 37 women aged 30~45 years. RESULTS: The prevalence of osteoporosis was 45.7% for lumbar spine, 13.0% for femoral neck by the manufacture's young adult mean and 63.0% and 34.8% by our study young adult population mean, respectively. Weight and smoking were associated with lumbar spine BMD. Age was associated with femoral neck BMD. CONCLUSION: Our data suggest that the prevalence of osteoporosis is dependant on reference population mean and measurement site.
Aged* ; Diagnosis ; Female ; Femur Neck ; Humans ; Osteoporosis* ; Prevalence* ; Public Health ; Surveys and Questionnaires ; Risk Factors ; Smoke ; Smoking ; Spine ; World Health Organization ; Young Adult

PURPOSE: Helicobacter pylori infection is known to be associated with acute or chronic abdominal pain and upper gastrointestinal bleeding in children. This study was performed to analyze the gastroduodenoscopic findings and the efficacy of triple therapy with omeprazole, amoxicillin and clarithromycin between one and two weeks of duration in children with H. pylori infection. METHODS: We have assessed retrospectively 60 patients presented with acute or chronic abdominal pain or upper gastrointestinal bleeding. H. pylori infection was confirmed by endoscopic biopsy and rapid urease test. Out of 60 patients, 30 patients were treated with a combination of omeprazole, amoxicillin, and clarithromycin for one week, and the other 30 patients were treated for two weeks with the same medication. Efficacy of treatment was assessed 4 weeks after the termination of treatment by using the 13C urea breath test. RESULTS: The 60 patients with the complaint of diffuse abdominal pain, epigastric pain, vomiting or hematemesis were included in this study. One-week treatment group (group I) consisted of 30 patients (14 male, 16 female) with mean age of 11.6+/-2.67 years. Two-week treatment group (group II) consisted of 30 patients (11 male, 19 female) with mean age of 10.7+/-4.17 years. In group I, H pylori were eradicated in 26 out of 30 patients (86.7%). In group II, H. pylori were eradicated in 26 out of 30 children (86.7%). Both groups did 13C urea breath test after 4 weeks after termination of the triple therapy. The eradication rates were same in both groups as 86.7%, 26 out of 30 patients in each group. The results of endoscopy were nodular gastritis 26 (43.3%), erosive gastritis 10 (16.7%), hemorrhagic gastritis 7 (11.7%), gastric ulcer 2 (3.3%) and normal finding 15 (25.0%). CONCLUSION: In this study, the nodular gastritis was most common endoscopic findings with H. pylori positive patients. The eradication rate of H. pylori with omeprazole, amoxicillin and clarithromycin was 86.7% and it would be highly effective as primary treatment with no significant differences in the eradication rate between one-week and two-week treatment groups. However, we should need more long-term follow-up data.
Abdominal Pain ; Amoxicillin ; Biopsy ; Breath Tests ; Child* ; Clarithromycin ; Endoscopy ; Follow-Up Studies ; Gastritis ; Helicobacter pylori* ; Helicobacter* ; Hematemesis ; Hemorrhage ; Humans ; Male ; Omeprazole ; Retrospective Studies ; Stomach Ulcer ; Urea ; Urease ; Vomiting

Radilogy plays an important role in evaluating patients with suspected adrenal gland pathology. Morphologicdelineation of adrenal gland is especially valuable in patients with clinical and/or biochemical evidence of adisturbance in adrenal function. Many diagnostic radiologic methods are avilable for demonstrating adrenallesions. CT overcomes many of the disadvantages of these other radiologic techniques. The high degree of spatialand density resolution allows precise demonstration of the normal adrenal glands as well as detection of bothsmall and large tumors in almost all patients. So CT of adrenal gland is an excellet nonivasive screening methodand definitive imaging technique. The authers have investigated the capability of CT to image the nomral size,location and shape of both glands. Knowledge of the range of normal is useful for optimal interpretation of CTscans in patients with suspected aderenal pathology. We reviewed CT scan of 150 cases without evidence of adrenaldisease. The following results were obtained: 1. There were 90 male and 60 female patients. 2. Their ages rangedfrom 20 to 60 years. 3. On CT, both gland were shown in 135 (90.0%), the right in 143(95.3%), the left in142(94.6%). 4. In the shape of adrenal glands, most of right adrenal gland was linear or comet shaped; 68(47.6%),most of left adrenal gland was inverted-Y shaped: 103(72.6%). 5. In the length of adrenal glands, theright was2.5+-0.77cm, the left was 2.9+-0.75cm. 6. In the width of adrenal glands, the right was 3.2+-0.74cm, the left was2.7+-0.57cm. 7. In the thickness of adrenal glands, the right was 0.5+-0.14cm, the left was 0.6+-0.16cm.
Adrenal Glands ; Female ; Humans ; Male ; Mass Screening ; Pathology ; Pheniramine ; Tomography, X-Ray Computed

We experienced the unusual C.T. finding of meningioma recently. Classical C.T. finding of meningioma reveals found homogenous high density or isodensity in the plain C.T. and homogenous marked enhancement in the postinfusion C.T. But, some of meningioma demonstrates atypical features such as irregular areas of nonenhancing mass, irregular ill-defined enhancing mass with large area of peritumoral edema, low density area within the mass representing necrosis and cystic change. C.T. finding that we experienced revealed ring-formed high density in the plain C.T. and homogenous strong enhancement in the postinfusion C.T.
Edema ; Meningioma* ; Necrosis

OBJECTIVES: Dementia has emerged as a leading public health problem in elderly persons, and its early detection is important for the treatment of curable cases, and in the educational support for other family members. Although dementia screening tests are available, they have not gained widespread use in community or primary care settings. Our goal was to validate the Time and Change (T and C) Test, -including its validity and reliability in patients, and to assess it as a simple, standardized method for the screening of dementia in the rural elderly. METHODS: The participants in this study comprised of 59 patients from an urban hospital and 405 persons from a rural community aged 65 years or older. The time test evaluated the understanding of clock hands indicating 11: 10, and the change test the ability to make 1, 000 Won from a group of coins, consisting of one 500, seven 100, and seven 50 Won coins. The T and C ratings were validated against a reference standard based on the physician? diagnosis of the patients. The convergent validity in relation to other cognitive measure, test-retest agreement, and inter-observer reliability were assessed. To assess the relationship between the Korean Mini-Mental State Exam (K-MMSE) and the T and C Test, the mean K-MMSE scores were compared with the results of the T and C Test in the elderly from a rural community. RESULTS: The T and C Test had a sensitivity and specificity of 73.0, and 90.9%, and positive and negative predictive values of 93.1, and 66.7%, respectively. The test-retest and inter-observer agreement rates were both 95%. The K-MMSE scores and T and C Test were significantly related in the elderly from a rural community (p< 0.01). The T and C Test was not influenced by the educational status. The Time and Change Tests took a mean of 6.3 and 12.7 seconds, respectively, to complete. CONCLUSION: The T and C Test is a simple, accurate and reliable, performance-based tool in the screening for dementia. Because it is quick, and easy-to-use, it is hoped the T and C Test will be used for the widespread cognitive screening of aging populations.
Aged* ; Aging ; Dementia* ; Diagnosis ; Educational Status ; Hand ; Hope ; Hospitals, Urban ; Humans ; Mass Screening* ; Methods ; Numismatics ; Primary Health Care ; Public Health ; Reproducibility of Results ; Rural Population ; Sensitivity and Specificity

PURPOSE: Doppler findings of pulmonary venous flow in large atrial septal defect(ASD) has been known to show a contiguous form rather than showing a form with two peaks in a cardiac cycle. The aim of this study was to find out the affecting variables in flow pattern change. METHODS: The present study was conducted on 16 isolated secondum ASD infants with defect diameters greater than 3 mm(L group), 10 infants with a defect diameter less than 3 mm(S group) and 11 infants with no structural abnormal findings(N group), among infants who visited the Pediatric Department of Soonchunhyang University Hospital and underwent a echocardiographic examination from April 2001 through June 2003. The echocardiographic examination included the midflow ratio of the pulmonary vein, calculated by division(numerator:the minimum velocity between S & D velocities, denominator: the mean value of S & D velocities). RESULTS: The mean ages of these three groups(L group, S group and N group) were 0.35+/-0.34 years, 0.22+/-0.22 years and 0.45+/-0.27 years, respectively. The midflow ratios were 0.76+/-0.20, 0.54 +/-0.11, 0.53+/-0.11 in groups, and significant difference between L group and the other two groups (P=0.002). The only affecting variable to midflow ratio is the defect area. And there is a significant causal relationship between them(P=0.003). CONCLUSION: The fact that Doppler findings of the pulmonary venous flow in a large sized atrial septal defect show a contiguous form is thought to be due to the unique hemodynamic characteristics of the ASD. The results of this study showed that such altered pattern ascertained as the defect size became larger.
Echocardiography ; Heart Septal Defects, Atrial* ; Hemodynamics ; Humans ; Infant* ; Pulmonary Veins

BACKGROUND: Tracheal extubation, as well as intubation, causes hypertension and tachycardia. The aim of this study was to compare the effect of verapamil, lidocaine to lidocaine-verapamil combination in attenuating the cardiovascular changes following tracheal extubation and emergence from anesthesia. METHODS: Eighty patients (ASA physical status 1) were randomly assigned to one of four groups (n=20 each) ; saline (control), 1 mg/kg lidocaine, 0.05 mg/kg verapamil and lidocaine-verapamil combination. These medication were given intravenously 2 min before tracheal extubation. Changes in blood pressure and heart rate were measured following tracheal extubation. RESULTS: Lidocaine, verapamil and their combination all attenuated the changes of heart rate and blood pressure. The inhibitory effect on changes of heart rate and blood pressure were miximum in group of the combination of lidocaine and verapamil. CONCLUSION: We conclude that the verapamil 0.05 mg/kg and lidocaine 1 mg/kg given iv concomitantly 2 min before tracheal extubation is a more effective prophylaxis than verapamil or lidocaine for attenuating the cardiovascular changes associated with tracheal extubation.
Airway Extubation* ; Anesthesia ; Blood Pressure* ; Heart Rate* ; Heart* ; Humans ; Hypertension ; Intubation ; Lidocaine* ; Tachycardia ; Verapamil*

This study aimed to develop and evaluate health educational information system on internet to train health center workers. Internet-based Public Health Manpower Training Program was developed based on the findings of the needs of health center worker. It consisted of E-mail based on-line lesson. The effects of developed Internet-based Public Health Manpower Training Program were assessed by questionnaires of users about legibility, readability, satisfaction, changes in level of knowledge, and practical uses, etc. Most users(94.3%) of Internet-based Public Health Manpower Training Program reported that they were satisfied with the programs, and 90% of users reported that the programs improved their performance in health education, consultation and medical examination. Knowledge levels of users were elevated after program participation(statistically non significant). Internet-based Public Health Manpower Training Program had positive effects on the performance of health center workers, and we expect this program to help the planning for public health manpower.
Community Health Centers ; Comprehension ; Education* ; Electronic Mail ; Health Education ; Information Systems ; Internet ; Public Health* ; Surveys and Questionnaires

OBJECTIVES: To evaluate the diagnostic value of quantitative ultrasound (QUS) in the prediction of osteoporosis as defined by dual energy x-ray absorptiometry (DEXA) in postmenopausal women. METHODS: Questionnaires and height and weight measurements were used in the investigation of 176 postmenopausal women. QUS measurements were taken on the right calcaneus while bone mineral density (BMD) measurements of the lumbar spine and femoral neck were made with DEXA. The areas under the curves (AUC) of the speed of sound (SOS) for osteoporosis in the lumbar spine and femoral neck were obtained through receiver operating characteristic (ROC) analysis and evaluated. A comparison was made, for osteoporosis in the lumbar spine and femoral neck, between the AUCs of the logistic model with clinical risk factors and SOS. RESULTS: Pearson's correlation coefficients of SOS and lumbar spine BMD, and of SOS and femoral neck BMD were 0.26 and 0.37. The AUC for the logistic model in its discrimination for lumbar spine osteoporosis was 0.764, and for SOS 0.605. The AUCs for the logistic model in its discrimination for femoral neck osteoporosis and for SOS were 0.890 and 0.892, respectively. CONCLUSIONS: These results suggest that the diagnostic value of QUS as a screening tool for osteoporosis is moderate for the femoral neck, but merely low for the lumbar spine and that the predictability provided by SOS is no better than that by the sole use of clinical risk factors in postmenopausal women.
Absorptiometry, Photon ; Area Under Curve ; Bone Density ; Calcaneus ; Discrimination (Psychology) ; Female ; Femur Neck ; Humans ; Logistic Models ; Mass Screening* ; Osteoporosis* ; Prevalence ; Questionnaires ; Risk Factors ; ROC Curve ; Spine ; Ultrasonography*

STUDY DESIGN: A retrospective study. PURPOSE: To determine the feasibility and effectiveness of revisional percutaneous full endoscopic discectomy for recurrent herniation after conventional open disc surgery. OVERVIEW OF THE LITERATURE: Repeated open discectomy with or without fusion has been the most common procedure for recurrent lumbar disc herniation. Percutaneous endoscopic lumbar discectomy for recurrent herniation has been thought of as an impossible procedure. Despite good results with open revisional surgery, major problems may be caused by injuries to the posterior stabilized structures. Our team did revisional full endoscopic lumbar disc surgery on the basis of our experience doing primary full endoscopic disc surgery. METHODS: Between February 2004 and August 2009 a total of 41 patients in our hospital underwent revisional percutaneous endoscopic lumbar discectomy using a YESS endoscopic system and a micro-osteotome (designed by the authors). Indications for surgery were recurrent disc herniation following conventional open discectomy; with compression of the nerve root revealed by Gadolinium-enhanced magnetic resonance imaging; corresponding radiating pain which was not alleviated after conservative management over 6 weeks. Patients with severe neurologic deficits and isolated back pain were excluded. RESULTS: The mean follow-up period was 16 months (range, 13 to 42 months). The visual analog scale for pain in the leg and back showed significant post-treatment improvement (p < 0.001). Based on a modified version of MacNab's criteria, 90.2% showed excellent or good outcomes. There was no measurable blood loss. There were two cases of recurrence of and four cases with complications. CONCLUSIONS: Percutaneous full-endoscopic revisional disc surgery without additional structural damage is feasible and effective in terms of there being less chance of fusion and bleeding. This technique can be an alternative to conventional repeated discectomy.
Back Pain ; Diskectomy ; Diskectomy, Percutaneous ; Follow-Up Studies ; Hemorrhage ; Humans ; Leg ; Magnetic Resonance Spectroscopy ; Neurologic Manifestations ; Recurrence ; Retrospective Studies