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

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

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: 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

BACKGROUND/AIMS: We investigated the electromyography (EMG) findings and demographic, clinical, and laboratory features that may predict the development of malignancy in patients with idiopathic inflammatory myopathy (IIM). METHODS: In total, 61 patients, 36 with dermatomyositis and 25 with polymyositis, were included. Patients were divided into those with and without malignancies, and comparisons were made between the groups in terms of their demographic, clinical, laboratory, and EMG findings. RESULTS: The frequencies of malignancies associated with dermatomyositis and polymyositis were 22% and 8%, respectively. Patients with malignancies showed a significantly higher incidence of dysphagia (odds ratio [OR], 21.50; 95% confidence interval [CI], 3.84 to 120.49), absence of interstitial lung disease (ILD; OR, 0.12; 95% CI, 0.01 to 0.98), and complex repetitive discharge (CRD) on the EMG (OR, 26.25; 95% CI, 2.67 to 258.52), versus those without. After adjustment for age, dysphagia and CRD remained significant, while ILD showed a trend for a difference but was not statistically significant. Multivariate analysis revealed that the CRD conferred an OR of 25.99 (95% CI, 1.27 to 531.86) for malignancy. When the frequency of malignancy was analyzed according to the number of risk factors, patients with three risk factors showed a significantly higher incidence of malignancy, versus those with fewer than two (p = 0.014). CONCLUSIONS: We demonstrated for the first time that CRD on the EMG was an additional independent risk factor for malignancy in IIM. Further studies on a larger scale are needed to confirm the importance of CRD as a risk factor for malignancy in IIM.
Action Potentials ; Adult ; Aged ; Dermatomyositis/complications/*diagnosis/physiopathology ; *Electromyography ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Muscle, Skeletal/*innervation/pathology ; Neoplasms/*etiology ; Odds Ratio ; Polymyositis/complications/*diagnosis/physiopathology ; Predictive Value of Tests ; Retrospective Studies ; Risk Factors

This study was performed to investigate the association between hair mineral levels and nutrient intakes, age, and BMI in female adults who visited a woman's clinic located in Seoul. Dietary intakes were assessed by food frequency questionnaire and mineral levels were measured in collected hairs, and the relationship between these was examined. The average daily nutrient intakes of subjects were compared to those of the KDRIs, and the energy intake status was fair. The average intake of calcium in women of 50 years and over was 91.35% of KDRIs and the potassium intake was greatly below the recommended levels in all age groups. In the average hair mineral contents in subjects, calcium and copper exceeded far more than the reference range while selenium was very low with 85.19% of subjects being lower than the reference value. In addition, the concentrations of sodium, potassium, iron, and manganese in the hair were below the reference ranges in over 15% of subjects. The concentrations of sodium, chromium, sulfur, and cadmium in the hair showed positive correlations (P < 0.05) with age, but the hair zinc level showed a negative correlation (P < 0.05) with age. The concentrations of sodium, potassium, chromium, and cadmium in the hair showed positive correlations (P < 0.05) with BMI. Some mineral levels in subjects of this study showed significant correlations with nutrient intakes, but it seems that the hair mineral content is not directly influenced by each mineral intake. As described above, some hair mineral levels in female adults deviated from the normal range, and it is considered that nutritional intervention to control the imbalance of mineral nutrition is required. Also, as some correlations were shown between hair mineral levels and age, BMI, and nutrient intakes, the possibility of utilizing hair mineral analysis for specific purposes in the future is suggested.
Adult ; Body Mass Index ; Cadmium ; Calcium ; Chromium ; Copper ; Energy Intake ; Female ; Hair ; Humans ; Iron ; Manganese ; Potassium ; Surveys and Questionnaires ; Reference Values ; Selenium ; Sodium ; Sulfur ; Zinc

BACKGROUND/AIMS: The usefulness of 18F-fluoro-2-deoxyglucose (FDG)-PET in detecting primary cancer, lymph node metastasis, and distant metastasis were studied in the gastric cancer patients. METHODS: The subjects were 392 gastric cancer patients who received FDG-PET and an abdominal CT test prior to surgery. The results of FDG-PET and CT were compared with the surgical and pathologic results. RESULTS: The primary site detection rate of FDG-PET was 74.4%, 50.3% in early gastric cancer and 92.0% in advanced gastric cancer. Detection rate was higher when tumors were larger than 3.5 cm, had deeper depth of invasion, and at a later stage (p<0.05, respectively). In multivariate analysis, tumor size, spread of tumor cells beyond the muscle layer (> or =T2), and lymph node metastasis were statistically significant factors in primary site detection rate. The sensitivity, specificity, and positive predictive value of FDG-PET to lymph node metastasis were 59.6%, 88.8%, and 81.1% respectively, sensitivity being lower compared to CT while specificity and positive predictive value were higher. Sensitivity, specificity, and positive predictive value to distant metastasis were, respectively, 66.7%, 99.2%, and 88.0%, similar to CT. In 21 of the 392 patients (5.4%), synchronous double primary cancers were detected. CONCLUSIONS: In gastric cancer, usefullness of FDG-PET is limited to the advanced stage. Diagnostic value of this test was not superior to CT. However, FDG-PET may be useful in detecting synchronous double primary cancers.
Aged ; Female ; Fluorodeoxyglucose F18/chemistry/*diagnostic use ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; Positron-Emission Tomography ; Predictive Value of Tests ; ROC Curve ; Radiopharmaceuticals/chemistry/*diagnostic use ; Retrospective Studies ; Stomach Neoplasms/*diagnosis/radionuclide imaging ; Tomography, X-Ray Computed