No abstract available.
Child* ; Humans

Osteoporosis, a disease characterized by low bone mass and microarchitectural deterioration of bone tissue leading to enhanced bone fragility and fracture risk, is a major public health problem. The diagnostic methods for osteoporosis include simple radiography, bone scan, DXA (Dual energy X-ray Absortiometry) and biochemical markers of bone turnover. Optimal treatment and prevention of osteoporosis require modification of risk factors, particularly smoking cessation, adequate physical activity, and attention to diet, in addition to pharmacologic intervention. The estrogens and raloxifene both prevent bone loss in postmenopausal women, and the estrogens probably also decrease the risk of first fracture. There is good evidence that raloxifene prevents further fractures in postmenopausal women who already have had fractures and some evidence that estrogen does as well. Bisphosphonate prevents bone loss and reduces fractures in healthy and osteoporotic postmenopausal women and in osteoporotic men as well. Risedronate is more potent and has fewer side effects than alendronate and reduces the incidence of fractures in osteoporotic women. Calcitonin increases bone mineral density in early postmenopausal women and men with idiopathic osteoporosis, and also reduces the risk of new fractures in osteoporotic women. All of the agents discussed above prevent bone resorption, whereas teriparatide and strontium increase bone formation and are effective in the treatment of osteoporotic women and men. New avenues for targeting osteoporosis will emerge as our knowledge of the regulatory mechanisms of bone remodeling increases, although issues of tissue specificity may remain to be addressed.
Absorptiometry, Photon ; Alendronate ; Biomarkers ; Bone and Bones ; Bone Density ; Bone Remodeling ; Bone Resorption ; Calcitonin ; Diet ; Estrogens ; Etidronic Acid ; Female ; Humans ; Incidence ; Male ; Motor Activity ; Organ Specificity ; Osteogenesis ; Osteoporosis ; Public Health ; Raloxifene Hydrochloride ; Risk Factors ; Smoking Cessation ; Strontium ; Teriparatide ; Risedronate Sodium

No abstract available.
Fluoroimmunoassay* ; Immunoenzyme Techniques*

The development of tophi in th absence of prior episodes of gauty arthritis is unusual. We report a case of extensive tophi in a 31 year-old man, whose initial skin lesion had started without arthritis.
Adult ; Arthritis ; Gout* ; Humans ; Skin

No abstract available.
Cholesterol* ; Granuloma* ; Temporal Bone*

No abstract available.

PURPOSE: To evaluate the effects of oral Tamoxifen only versus L-Carnitine plus Tamoxifen in patients with Peyronie's disease. MATERIALS AND METHODS: All 45 patients with Peyronie's disease, diagnosed using accepted definitions, were randomized into two groups and treated for 3 months with Tamoxifen only(40 mg/day)(n=17) or a combination ofL-Carnitine(2 g/day) and Tamoxifen(40 mg/day)(n=28). A medical history was obtained, and a physical examination was performed. Plaque size, pain, erectile function(IIEF score), and penile curvature were assessed. Both before and after therapy, the differences between the 2 groups were compared using independent-sample t-test with p<0.05 considered significant. RESULTS: The mean age of the 45 patients was 52.1 years, and no severe adverse events occurred in either group. In the Tamoxifen only group, the mean decrease of plaque-length was 0.46+/-0.88 mm, and mean reduction in the pain rating scale was 0.44+/-0.53. In the L-Carnitine and Tamoxifen group, mean decrease of plaque-length was 1.57+/-0.92 mm, and mean reduction in the pain rating scale was 1.27+/-0.96. Based on IIEF scores, the improvement of erectile function was 0.88+/-0.64 in the Tamoxifen only group and 1.56+/-0.75 in the L-Carnitine and Tamoxifen group. The degree of penile curvature was also measured, and the reduction of curvature angle was 9.17+/-4.92 degrees in the Tamoxifen only group and 9.55+/-6.50 degrees in the L-Carnitine and Tamoxifen group. CONCLUSIONS: This study showed significantly greater improvements in plaque size, pain, erectile function, and curvature in patients with Peyronie's disease who were treated with L-Carnitine and Tamoxifen compared with those treated with Tamoxifen only.
Carnitine* ; Humans ; Male ; Penile Induration* ; Physical Examination ; Tamoxifen*

OBJECT: Accumulating evidence suggests a greater number of subcortical hyperintensities in the brain with bipolar disorder. We studied the Clinical correlates of subcortical hyperintensities on magnetic resonance imaging in patients with Bipolar Disorder. METHODS: Magnetic resonance images of the brain were obtained for 32 patients with bipolar disorder. The presence and location of hyperintensities were assessed. We compared clinical variables between with subcortical hyperintensities and patients without them. RESULTS: Seven Patients(21.8%) had subcortical hyperintensities, but among 8 patients who were or older, 5 patients(625) had them, Age and age of onset of patients with subcotical hyperintensities were significantly older than patients without them. Psychotic symptoms were more frequent in patients with hyperintensities. Patients without hyperintesities had more familial loading. CONCLUSION: Given the limitations of the study, our results should be seen as preliminary. This study, however, provides preliminary evidence supporting the notion that the onset, clinical feature and course of some bipolar disorders of late onset may be determined by underlying subcortical abnormalities, with such abnormalities being the consequence of factors related to aging or neurodegeneration(such as impaired cerebral circulation) rather than genetic factors which predispose to early-onset bipolar disorders.
Age of Onset ; Aging ; Bipolar Disorder* ; Brain ; Humans ; Magnetic Resonance Imaging*

No abstract available.
Animals ; Rats*

In our series with old electrical burn around the the wrist, there are several characteristics: for example, bad scarring in palm and volar aspect of wrist and distal forearm, large multiple defects of the flexor tendons, low median and ulnar nerve palsy, and occasionally insufficient blood supply. Between 1992 and 1995, we treated 8 cases of 7 patients with staged reconstruction. 4 patients with bilateral involvements had below-elbow amputee of contralateral upper extremity. The common approachs in each were soft tissue coverage, staged tendon reconstructiuon, and opponensplasty. The length of time between the injury and tendon reconstruction was 9 months on an average. Soft tissue coverage consisted of: 1. free tissue transfer (n=3), 2. abdominal (n=3) or groin (n=2). Total numbers of flexor tendon reconstruction were 26. Among them, staged reconstruction using silicone prosthesis were done in 18 tendons and primary tendon graft following tenolysis were done in 8 tendons. The time between first and second stage tendon reconstruction was 4.13 months. In all cases, opponen-splasty using extensor indicis proprius (n=4), extensor pollicis longus (n=2), and extensor digiti mini- mi (n=l), were performed. Good functional improvement of the hand were obtained in all cases. Patient s satisfaction were much better than the degree of functional improvement of the hand.
Amputees ; Burns* ; Cicatrix ; Forearm ; Groin ; Hand ; Humans ; Prostheses and Implants ; Silicones ; Tendons ; Transplants ; Ulnar Neuropathies ; Upper Extremity ; Wrist*