PURPOSE: Osteoporosis is generally regarded as disease of women and there are extensive data about post-menopausal osteopotosis, but there is relatively little information concerning the osteoporosis in aging male. We aimed to determine the relationships between age ,androgen and bone mineral density (BMD) in elderly korean men. MATERIALS AND METHODS: We evaluated the sex hormones and BMD of 82 elderly men between May 1999 and April 2000. Serum free testosterone (FT), total testosterone (TT), DHT, LH, FSH and Prolactin were measured by RIA. BMD at anteroposterior L2-4, femoral neck, ward's triangle, femoral trochanter and femoral shaft were determined by dual-energy X-ray absorptiometry. We defined group I as free testosterone <10ng/dl and group II as 10ng/dl. RESULTS: Serum LH and FSH increased with age. There was a significant decrease in serum FT with age, but T concentrations remained unchanged. There were significant declines with age in BMD at femoral neck, Ward's triangle, femoral trochanter, femoral shaft. Serum FT were significantly correlated to BMD at anteroposterior L2-4, femoral neck, Ward's triangle, femoral trochanter, femoral shaft. After controlling for age, serum FT were significantly correlated to BMD at femoral trochanter, femoral shaft. Mean BMD was significantly lower in group I than group II at anteroposterior L2-4, femoral shaft. CONCLUSIONS: We suggest that FT is a male osteoporotic marker in man older than 50 years and bone mineral density should be considered for diagnosis of male osteoporosis associated with PADAM, especially when FT is lower than 10ng/dl.
Absorptiometry, Photon ; Aged ; Aging* ; Bone Density* ; Diagnosis ; Female ; Femur ; Femur Neck ; Gonadal Steroid Hormones ; Humans ; Male* ; Osteoporosis ; Prolactin ; Testosterone

A multiple regression analysis using ordinary least square (OLS) is frequently used for the projection of healt expenditure as well as for the identification of factors affecting health care costs. Data for the analysis often have mixed characteristics of time series and cross section. Parameters as a result of OLS estimation, in this case, are no longer the best linear unbiased estimators (BLUE) because the data do not satisfy basic assumptions of regression analysis. The study theoretically examined statistical problems induced when OLS estimation was applied with the time series cross section data. Then both the OLS regression and time series cross section regression (TSCS regression) were applied to the same empirical data. Finally, the difference in parameters between the two estimations were explained through residual analysis.
Health Care Costs ; Health Expenditures*

Divergent placement of the femoral interference screw has been described as a major pitfall in single incision endoscopic reconstruction of the anterior cruciate ligament. This study reviews the radiographic results in 30 consecutive endoscopic single-incision ACL reconstructions using interference screw fixation to find a method to reduce the divergent femoral screw fixation. We measured the angles which were determined by a line through axis of femoral bone block and axis of interference screw in anteroposterior and lateral view of knee(APD/LD),through axis of femoral tunnel and axis of tibial tunnel in the full extension-anteroposterior view(AFT),through the longitudinal axis of distal femoral shaft and axis of femoral tunnel in the anteroposterior and lateral view(APFT/LFT). Average LD(4.96+/-62degrees) was significantly larger than average APD(1.303+/-13degrees) (P=0.008). Significant correlation was present between APD and APFT(g=-0.3882, P=0.034), between LD and LFT(gamma=0.6933, P=0.000) and other variables had no significant correlation. The femoral divergence in the anteroposterior plane occurred in the case with small angle between longitudinal axis of femoral shaft and that of femoral tunnel, and vice versa in lateral plane. During drilling of femoral tunnel, more than 90 flexion causes LFT to increase and the risk of femoral divergence increases. Therefore, in the anteroposterior plane, angle between femoral tunnel and longitudinal axis of femoral shaft shoud be made as large as possible and flexion of knee should not be more than 90 during drilling of femoral tunnel.
Anterior Cruciate Ligament Reconstruction* ; Anterior Cruciate Ligament* ; Axis, Cervical Vertebra ; Knee ; Patellar Ligament*

OBJECT: In order to compare several Obstetric characteristics and outmmes of teenage pregnancy. METHODS: The 10 year clinical records of 11,583 women undergoing Cesarean section and delivery were reviewed in the department of Obstetrics and Gynecology, Incheon Christian Hospital from July 1, 1989 to June 30, 1999. There were seventy-eight pregnancies under age 20 and we compared them with two hundred pregnancies aged 20-29 who were randomly chosen during the same periods as the control group. RESULT: The following results were obtained. The proportion of birth by teenagers increased from 0.5% of all birth in 1989 to 2.61% in 1999. The most of cases were in high teen group, age 14- 19.The majority(50.5%) were in the age of 19. Seventy two cases(92.3%) had no previous pregnant history. Six cases had one previous pregnant history. The frequencies of prenatal care were significantly lower than that of the control group(p<0.05). The mean gestational period was 36+4weeks, and showed significant difference between the study group and the control group(39+3 weeks). The incidence of preterm labor was significantly different between the two proups(p<0.05). But the incidence of postterm delivery were not significantly different between the two groups. The mean weight gain of pregnant teenagers revealed 10.64kg, significantly less profound than the control group. The matemal weight gain of control group revealed 12.95kg, respectively. The mean birth weight(2.54kg) of infant was significantly less profound than the control group. The incidence of birth of small for gestational age(birth weight 1,500-2,499gm ; 14.5%) was significantly increased among study group than the control group(1%). The rate of abdominal delivery(21.8%) were not significantly decreased than the control group(47%). The incidence of cephalopelvic disproportion and malpresentation for cesarean section were somewhat higher than the control group, and were statistically significant(p<0.05). During the antepartun period, anemia, pyelonephritis, and preterm labor occurred more frequently in the teenage pregnancy than the control group, but not statistically significant. Among postpartum complications, incidence of anemia(51.3%) increased significantly. The perinatal mortality, intrauterine growth retardation, congenital anomaly occurred more frequently than the control group. CONCLUSION: These results show that pregnancy of teenage will be comeout high risk and complications. And then we will be more concern and study about teenage pregnancy.
Adolescent ; Anemia ; Cephalopelvic Disproportion ; Cesarean Section ; Female ; Fetal Growth Retardation ; Gynecology ; Humans ; Incheon ; Incidence ; Infant ; Obstetric Labor, Premature ; Obstetrics ; Parturition ; Perinatal Mortality ; Postpartum Period ; Pregnancy ; Pregnancy in Adolescence* ; Prenatal Care ; Pyelonephritis ; Weight Gain

Spinal dimensions (anterior, mid, and posterior height of the vertebral body) and shape variation (wedge compression, biconcave, and crush ratio) were obtained from plain radiographs of healthy Korean men and women. The purpose of this study was to define vertebral fracture from normal spinal morphometry of Korean men and women and to compare spinal dimension between men and women. Healthy 100 men and 100 women were included in this study. Plain lateral radiographs of thoracic and lumbar vertebrae were taken with standard method. Quantitative morphometry (anterior, mid, and posterior height of the vertebral body) was performed with plain radiographs. Spinal shape variations (wedge compression, biconcave, and crush ratio) were calculated from morphometric data. Spinal dimensions and shape variation of Korean men and women were presented, and morphometric cut-off vaiues for vertebral fracture were evaluated(mean-3xSD). Spinal dimensions of men were greater than women in all level (p<0.01). Wedge compression ratios (T6, 7, 8, 9, 12, L5 level) and biconcave ratios (T12, Ll, 4, 5 level) and crush ratios (Tll, L4, L5 level) were different between men and women (p<0.01). Spinal dimensions and shape variation from quantitative morphometry can be used in objective definition of vertebral fracture which can be used in medicolegal problem, workers compensation and medical insurance.
Female ; Humans ; Insurance ; Lumbar Vertebrae ; Male ; Spine ; Workers' Compensation

There have been much limitations and errors in evaluating prostatic conditions by traditional radiologic methods due to its location and anatomical structure. However recent introduction and improvement of the ultrasonography have been enabled us to visualize boundary of the prostate clearly and differentiate the variable findings within the prostate. Transrectal or transurethral ultrasonography of the prostate is popular nowadays, however we performed suprapubic ultrasonography of which merits are traumatic to the patients, easy to perform and it requires no adjustments or additions to basic ultrasound equipment. In order to evaluate ultrasonogram of the prostate in patients with prostatic diseases and normal adults and compare preoperative volume of the prostate on ultrasonographic estimation with postoperative volume, 31 patients with prostatic diseases and 40 normal adults under the age 60 were studied with suprapubic ultrasonography. The results obtained were as follows. 1. On ultrasonographic picture of the prostate, normal adults showed symmetrical or triangular or elliptical appearance and there were numerous fine homogenous spots within the prostate. BPH patients showed symmetric, round or oval shapes and its margin was smooth and numerous fine spots were seen within the prostate as normal adults. The prostatic size enlarged and elevated to the bladder base. Advanced prostatic cancer patients showed dyssymmetric irregular appearance. The prostate of acute prostatitis patients resembled normal prostate but prostatic size enlarged. 2. The mean prostatic volume of normal adults on ultrasonographic estimation was 21.30+/-24.80 cm3 and there were no differences of the prostatic volume between ages. 3. The mean prostatic volume of 21 BPH patients on ultrasonographic estimation was 46.2+/-17.2 cm3 and majority patients were in 33.49-61.56 cm3. 4. Comparisonal studies between preoperative ultrasonographic prostatic volume and resected prostatic volume showed correlation coefficient 0.98 (P<0.005) and mean error rate 17.58+/-8.1%. Most cases showed preoperative prostatic volume was larger than the postoperative volume which was probably due to inadequate removal of tissue and surgical capsule. As results of the above, the suprapubic ultrasonography was helpful in differential diagnosis of the prostatic diseases and estimation of the prostatic size.
Adult ; Diagnosis, Differential ; Humans ; Prostate ; Prostatic Diseases* ; Prostatic Neoplasms ; Prostatitis ; Ultrasonography ; Urinary Bladder

BACKGROUND: Since the initial report on anesthesia for the renal transplantation from Peter Bent Brighan Hospital in 1962, the anesthesia for kidney transplantation has been reviewed and discussed by many authors. We have performed 200 renal transplantations from August 1990 to October 1996. No cadaveric donor was used and all except two cases was the first graft. METHODS: Anesthetic procedures in the recipients were as follows; 1) The recipient was dialysed within 24 hrs prior to operation. 2) Premedication was done as glycopyrrolate and fentanyl, or glycopyrrolate and diazepam. 3) Thiopental and vecuronium, or thiopental and succinylcholine were used for anesthetic induction. 4) N2O-O2-relaxant (vecuronium) with halothane or isoflurane were used for maintenance. 5) Neostigmine or pyridostigmine were also used to antagonize against the relaxant. 6) CVP was maintained around 10~17 cmH2O. RESULTS: The results were as follows; 1) The mean ages of donors and recipients were 35.3 and 37.4, respectively. The ratio of male to female of donors and recipients was 1.6 : 1 and 1.6 : 1, respectively. 2) One hundred and ten cases (55.0%) were living unrelated donors and 90 cases (45.0%) were living related donors. 3) Overall graft and patient survival rate was 96.9 and 98.0 at 1 year, 94.1 and 95.1 at 3 years. CONCLUSIONS: Most patients with renal failure have several common problems that are of significance to anesthesiologists, including anemia, bleeding tendency, electrolyte imbalance, acidosis, hypertension, hyper- or hypovolemia, and previous therapy with steroids and immunosuppressants, etc. Therefore anesthesiologists should keep in mind the risk factors above mentioned for the anesthetic management of patients with renal failure.
Acidosis ; Anemia ; Anesthesia ; Cadaver ; Diazepam ; Female ; Fentanyl ; Glycopyrrolate ; Halothane ; Hemorrhage ; Humans ; Hypertension ; Hypovolemia ; Immunosuppressive Agents ; Isoflurane ; Kidney Transplantation* ; Male ; Neostigmine ; Premedication ; Pyridostigmine Bromide ; Renal Insufficiency ; Risk Factors ; Steroids ; Succinylcholine ; Survival Rate ; Thiopental ; Tissue Donors ; Transplants ; Unrelated Donors ; Vecuronium Bromide

Repeat cesarean section is one of the leading causes to make increasing a rate of cesarean section. Trial of labor TOL after cesarean section is attempt to reduce the rate of repeat cesarean section. Trial of labor has been well established as a safe alternative in carefully selected women with transverse scars in the lower uterine segment. This study was based on 104 cases of delivery with prior cesarean birth at the Chonbuk National University Hospital from January, 1991 to June, 1997. The results were as follows: 1) Among 1400 cases with previous cesarean delivery, trial of labor was done in 104 cases (7.4%). Among 104 cases, vaginal birth was successfully completed in 96 cases (92.3%). 2) Among 28 cases with PGE2, vaginal tablet, vaginal delivery was done in 23 cases (82.1%). 3) Among 22 cases with more than 4 of Bishop score, vaginal delivery was done in 21 cases (95.5%), and among 6 cases with less than 3 of Bishop score, vaginal delivery was done only 2 cases (33.3%). 4) There was no matemal death or uterine rupture in the cases of trial of labor, But in 2 cases, uterine dehiscence was observed in 4 cases and postpartal bleeding (more than 400ml) was developed. 5) In the cases of cesarean section, mean of hospital day was 7 days and medical fee was about 400,000 won. In the cases of vaginal birth after cesarean section, mean of hospital day was 2.6 days and medical fee was about 100,000 won. In condusion, vaginal birth after cesarean section is safe and effective alternative to elective repeat cesarean section and also the use of PGE, vaginal tablet is so effective to increase success rate of vaginal delivery. After all, positive these trials might decrease cesarean rate and increase maternal health and quality of medical care.
Cesarean Section ; Cesarean Section, Repeat ; Cicatrix ; Dinoprostone ; Fees, Medical ; Female ; Hemorrhage ; Humans ; Jeollabuk-do ; Maternal Health ; Parturition ; Pregnancy ; Prostaglandins E ; Trial of Labor ; Uterine Rupture ; Vaginal Birth after Cesarean* ; Vaginal Creams, Foams, and Jellies

Concepts regarding the evaluation and management of the infertile male have evolved during the past decade primarily because of the development of new methodology. Nevertheless, the causes of male infertility is often obscure, and the clearly defined causes are infrequent or rare. Testicular biopsy findings are basic and very important in evaluating the causes of infertility. The testis biopsy findings of 30 azoospermic patients were evaluated and it was observed in aspect of testicular size and past history. Following results were obtained. 1. Among the 91 patients who underwent semenalysis, 30 cases (33%)were azospermia. 2. In testicular biopsy findings hypospermatogenesis was the most frequent finding and the more severe hypospermatogenesis was the more atrophic the seminiferous tubule is and showed frequent Leydig cell hyperplasia. 3. Testicular biopsy findings revealed no specific correlation between small testis and normal testis patients. 4. In aspect of past history 2 epididymal tubercu1osis patients showed normal biopsy findings which suggest obstruction of sperm route and one cryptorchism and one varicocele patients showed hypospermatogenesis. 5. By testicular biopsy most of the cause of infertility was testicular and 3 cases were posttesticular.
Azoospermia ; Biopsy* ; Cryptorchidism ; Humans ; Hyperplasia ; Infertility ; Infertility, Male ; Male ; Oligospermia ; Seminiferous Tubules ; Spermatozoa ; Testis* ; Varicocele

No abstract available.
Animals ; Horns* ; Pregnancy*