Recombinant human parathyroid hormone 1-34 (rHPTH; 1-34, teriparatide) increases bone mass and increases osteoporotic fracture by stimulating new bone formation. It was approved in the United States for treatment of osteoporosis in men and women, and its effectiveness and safety was proved. Mild hypercalcemia was observed, but persistent and severe hypercalcemia was not observed in the studies of teriparatide. In this case, severe hypercalcemia was developed from patient having gait disturbance who was treated with vitamin D, calcium and teripartide for two months to treat osteoporosis after subtrochanteric fracture. Hypercalcemia was resolved with discontinuation of teriparatide. Severe hypercalcemia is not a common complication of teriparatide and monitoring of serum calcium level is routinely not recommended. But it is necessary to pay close attention to patients who were treated with teriparatide, especially in immobilized patients.
Calcium ; Female ; Gait ; Humans ; Hypercalcemia ; Male ; Osteogenesis ; Osteoporosis ; Osteoporotic Fractures ; Parathyroid Hormone ; Teriparatide ; United States ; Vitamin D

Recombinant human parathyroid hormone 1-34 (rHPTH; 1-34, teriparatide) increases bone mass and increases osteoporotic fracture by stimulating new bone formation. It was approved in the United States for treatment of osteoporosis in men and women, and its effectiveness and safety was proved. Mild hypercalcemia was observed, but persistent and severe hypercalcemia was not observed in the studies of teriparatide. In this case, severe hypercalcemia was developed from patient having gait disturbance who was treated with vitamin D, calcium and teripartide for two months to treat osteoporosis after subtrochanteric fracture. Hypercalcemia was resolved with discontinuation of teriparatide. Severe hypercalcemia is not a common complication of teriparatide and monitoring of serum calcium level is routinely not recommended. But it is necessary to pay close attention to patients who were treated with teriparatide, especially in immobilized patients.
Calcium ; Female ; Gait ; Humans ; Hypercalcemia ; Male ; Osteogenesis ; Osteoporosis ; Osteoporotic Fractures ; Parathyroid Hormone ; Teriparatide ; United States ; Vitamin D

OBJECTIVE: Peripheral neuropathy is characterized by hyperalgesia, spontaneous burning pain, and allodynia. The purpose of this study was to investigate the effect of rolipram, a phosphodiesterase-4-specific inhibitor, in a segmental spinal nerve ligation model in rats. METHODS: Both the L5 and L6 spinal nerves of the left side of the rats were ligated. Phosphodiesterase-4 inhibitor (rolipram) and saline (vehicle) were administered intraperitoneally. We measured mechanical allodynia using von Frey filaments and a nerve conduction study. RESULTS: The mechanical allodynia, which began to manifest on the first day, peaked within 2 days. Multiple intraperitoneal injections of rolipram ameliorated the mechanical allodynia. Furthermore, an intraperitoneal administration of rolipram improved the development of pain behavior and nerve conduction velocity. CONCLUSION: This study suggests that the phosphodiesterase-4 inhibitor, rolipram, alleviates mechanical allodynia induced by segmental spinal nerve ligation in rats. This finding may have clinical implications.
Animals ; Burns ; Cyclic Nucleotide Phosphodiesterases, Type 4 ; Hyperalgesia ; Injections, Intraperitoneal ; Ligation ; Neural Conduction ; Peripheral Nerve Injuries ; Peripheral Nervous System Diseases ; Rats ; Rolipram ; Spinal Nerves

OBJECTIVE: Lateral cephalometric radiographs have been the main form of resource for assessing two dimensional anteroposterior airway changes. The purpose of this study was to evaluate the three dimensional volumetric change in the upper airway space in Class III malocclusion patients who underwent mandibular setback surgery. METHODS: Three dimensional cone-beam computed tomographs (CBCT) and their three dimensional reconstruction images were analyzed. The samples consisted of 20 adult patients (12 males and 8 females) who were diagnosed as skeletal Class III and underwent mandibular setback surgery. CBCTs were taken at 3 stages - Baseline (1.8 weeks before surgery), T1 (2.3 months after surgery), and T2 (1 year after surgery). Pharyngeal airway was separated according to the reference planes and reconstructed into the nasopharynx, the oropharynx and the hypopharynx. Measurements at Baseline, T1, and T2 were compared between groups. RESULTS: The result showed the volume of the pharyngeal airway decreased significantly 2.3 months after surgery (p < 0.001) and the diminished airway did not recover after 1 year post-surgery. The oropharynx was the most decreased area. CONCLUSIONS: These findings suggest that mandibular setback surgery causes both short-term and long-term decrease in the upper airway space.
Adult ; Cone-Beam Computed Tomography ; Humans ; Hypopharynx ; Male ; Malocclusion ; Nasopharynx ; Oropharynx ; Orthognathic Surgery

BACKGROUND: This study evaluated the shoulder girdle muscle characteristics of elite archery athletes and provides suggestions for archery training programs. METHODS: This study enrolled 15 cases of high level archery athletes (7 males, 8 females) and 30 cases of (15 males, 15 females) sex, age-matched, healthy, non-athletic individuals. We measured peak torques of flexion (FL), extension (EX), abduction (ABD), adduction (ADD), external rotation (ER) and internal rotation (IR) of both shoulders at an angular velocity of 30°/sec, 60°/sec, and 180°/sec. The peak torques and peak torque ratios of FL/EX, ABD/ADD, and ER/IR of the two groups were compared. RESULTS: The archer group had a greater peak torque of IR and ADD, but only in the left shoulder (p < 0.05). In the same group, both shoulders had greater peak torque of EX and lower peak torque of FL. The peak torque ratios of FL/EX of both shoulders were significantly lower in the archer group at all three angular velocities (p < 0.05). The peak torque ratios of ABD/ADD were significantly greater in only the left shoulder of the archer group (p < 0.05). CONCLUSIONS: The prominent characteristics of the shoulder girdle muscles of an elite archer are stronger adductor muscles of the bow shoulder and stronger extensors of both shoulders, as compared to healthy, non-athletic individuals. These muscle groups of the shoulder probably contribute a major role in maintaining the accuracy and stability during archery shooting. Hence, a training program that selectively enhances the adductor and extensor muscles could prove helpful in enhancing the archery skills of the athlete.
Athletes ; Education ; Humans ; Male ; Muscles ; Shoulder ; Torque

Background: Previous studies reported that waist circumference can be a more important risk factor of chronic diseases than body mass index.Abdominal obesity is known to be associated with physical activity and lifestyle. Recent studies have found a high prevalence of abdominal obesity and low physical activity levels in Korean women. The purpose of this study was to investigate the effects of physical activity and lifestyle on abdominal obesity in Korean middle-aged women. Methods: We collected data from the 7th Korea National Health and Nutrition Examination Surveys in 2016 and 2017, and 2,274 women aged 45–65 years were evaluated. Logistic regression analysis was used to examine the association between abdominal obesity and many factors after adjusting for confounding variables with significant correlations. Results: The results showed that the mean waist circumference was 80.20±9.05 cm and the prevalence of abdominal obesity was 28.8% in the population. The low physical activity group had the largest population (48.5%). Abdominal obesity was associated with moderate and high physical activity levels (odds ratio [OR], 0.791; 95% confidence interval [CI], 0.651–0.962; P=0.019), sedentary time (≥5 h; OR, 1.495; 95% CI, 1.173–1.906;P=0.001), and weekend sleep duration (<7 h/d; OR, 1.406; 95% CI, 1.127; P=0.003). Conclusion In the Korean middle-aged women, a statistically significant correlation was found between physical activity and abdominal obesity.

PURPOSE: Although guidelines indicate that routine dissection of the central lymph nodes in patients with thyroid carcinoma should include the right para-oesophageal lymph nodes (RPELNs), located between the right recurrent laryngeal nerve and the cervical oesophagus and posterior to the former, RPELN dissection is often omitted due to high risk of injuries to the recurrent laryngeal nerve and the right inferior parathyroid gland. MATERIALS AND METHODS: We retrospectively identified all patients diagnosed with papillary thyroid carcinoma who underwent total thyroidectomy with central lymph node dissection, including the RPELNs, between January 1, 2009 and December 31, 2013 at the Thyroid Cancer Center of Yonsei University College of Medicine, Seoul, Korea. RESULTS: Of 5556 patients, 148 were positive for RPELN metastasis; of the latter, 91 had primary tumours greater than 1 cm (p<0.001). Extrathyroidal extension by the primary tumour (81.8%; p<0.001), bilaterality, and multifocality were more common in patients with than without RPELN metastasis; however, there were no significant differences in age and sex between groups. A total of 95.9% of patients with RPELN metastasis had central node (except right para-oesophageal lymph node) metastasis, and the incidence of lateral neck node metastasis was significantly higher in patients with than without RPELN metastasis (63.5% vs. 14.3%, p<0.001). Forty-one patients underwent mediastinal dissection, with 11 patients confirmed as having mediastinal lymph node metastasis with RPELN metastasis on pathological examination. CONCLUSION: RPELN metastasis is significantly associated with lateral neck and mediastinal lymph node metastasis.
Adult ; Aged ; Carcinoma/pathology/*surgery ; Carcinoma, Papillary/pathology/*surgery ; Esophageal Neoplasms/*secondary/surgery ; Female ; Humans ; Incidence ; *Lymph Node Excision ; Lymph Nodes/pathology/*surgery ; Lymphatic Metastasis/pathology ; Male ; Middle Aged ; Recurrent Laryngeal Nerve/pathology ; Republic of Korea/epidemiology ; Retrospective Studies ; Thyroid Neoplasms/pathology/*surgery ; *Thyroidectomy ; Treatment Outcome ; Young Adult

Matrix metalloproteinases (MMPs) have been implicated in tissue development and re-modeling. Dynamic morphological changes of tooth germs reflect involvement of these enzymes during odontogenesis. The present study was performed to investigate expression and localization of MMP-2 and MMP-9, which have been known to have type IV collagenase activities, in rat tooth germs at different developmental stages. MMP-2 expression was increased gradually in the tooth germs from cap to crown staged germs at both transcription and translation levels. The localization of this molecule was detected in secretory ameloblasts and preameloblasts. The strong immunoreactivities were occasionally seen along the basement membrane between ameloblasts (or preameloblasts) and odontoblasts (preodontoblasts). However, weak reactivity was detected in odontoblasts and reduced enamel epithelium. The level of MMP-9 expression in the tooth germs was higher in cap stage than in crown staged germs at both transcription and translation levels. They were strongly expressed in both ameloblasts and odontoblasts. Even though reduced enamel epithelium after enamel formation and inner enamel epithelium at the cap stage exhibited weak reactivity, strong reactivity was detected in dental follicles and perifollicular tissues surrounding cap staged germs. These results suggested that MMP-2 may involve degradation of the basement membrane during hard tissue formation, whereas MMP-9 might be involved in remodeling of follicular tissues.
Ameloblasts ; Animals ; Basement Membrane ; Collagenases ; Crowns ; Dental Enamel ; Dental Sac ; Epithelium ; Matrix Metalloproteinases ; Molar ; Odontoblasts ; Odontogenesis ; Rats ; Tooth Germ

OBJECTIVE: Alcoholic neuropathy is characterized by allodynia (a discomfort evoked by normally innocuous stimuli), hyperalgesia (an exaggerated pain in response to painful stimuli) and spontaneous burning pain. The aim of the present study is to investigate the effect of rolipram, a phosphodiesterase 4 inhibitor, against alcohol-induced neuropathy in rats. METHODS: Allodynia was induced by administering 35% v/v ethanol (10 g/kg; oral gavage) to Spraue-Dawley rats for 8 weeks. Rolipram and saline (vehicle) were administered intraperitoneally. Mechanical allodynia was measured by using von Frey filaments. Somatosensory evoked potential (SEP) was proposed as complementary measure to assess the integrity of nerve pathway. RESULTS: The ethanol-induced mechanical allodynia began to manifest from 3 week, and then peaked within 1 week. Beginning from 3 week, latency significantly started to increased in control group. In rolipram treated rats, the shorter latency was sustained until 8 weeks (p<0.05). The mechanical allodynia, which began to manifest on the 3 weeks, intraperitoneal injections of rolipram sustained statistical difference until 8 weeks, the final week of the study (p<0.05). CONCLUSION: This study suggests that rolipram might alleviate mechanical allodynia induced by alcohol in rats, which clearly has clinical implication.
Alcoholic Neuropathy ; Alcoholics ; Animals ; Burns ; Cyclic Nucleotide Phosphodiesterases, Type 4 ; Ethanol ; Evoked Potentials, Somatosensory ; Humans ; Hyperalgesia ; Injections, Intraperitoneal ; Rats ; Rolipram

PURPOSE: The purpose of this study was to determine the significant factors for risk estimate of aspiration and to evaluate the efficiency of the dysphagia assessment tool. METHODS: A consecutive series of 210 stroke patients with aspiration symptoms such as cough and dysphagia who had soft or regular diet without tube feeding were examined. The dysphagia assessment tool for aspiration was compared with videofluoroscopy using Classification and Regression Tree (CART) analysis. RESULTS: In CART analysis, of 34 factors, the significant factors for estimating risk of aspiration were cough during swallowing, oral stasis, facial symmetry, salivary drooling, and cough after swallowing. The risk estimate error of the revised dysphagia assessment tool was 25.2%, equal to that of videofluoroscopy. CONCLUSION: The results indicate that the dysphagia assessment tool developed and examined in this study was potentially useful in the clinical field and the primary risk estimating factor was cough during swallowing. Oral stasis, facial symmetry, salivary drooling, cough after swallowing were other significant factors, and based on these results, the dysphagia assessment tool for aspiration was revised and complemented.
Adult ; Aged ; Cough ; Deglutition ; Deglutition Disorders/complications/*diagnosis ; Facial Asymmetry ; Female ; Fluoroscopy/methods ; Humans ; Inhalation ; Male ; Middle Aged ; Risk Assessment ; Stroke/*complications/radiography/therapy