No abstract available.
Anencephaly* ; Autopsy*

BACKGROUND: Osteoporosis results from bone loss due to menopause [estrogen(E) deficiency] and aging. Initial skeletal effect of menopause is accelerated bone resorption with an increase in seurm calcium(Ca) and compensatory but inadequate bone formation. Secretion of parathyroid hormone(PTH) is suppressed at this time. Postmenopausal osteoporosis results in fractures predominantly of trabecular bone, i.e., vertebra. With aging, secondary hyperparathyroidism by low serum Ca and vitamin D deficiency superim poses. Senile osteoporosis produces hip fractures, area of cortical bone. The aim of this study was to- examine the association of vitamin D[25(OH)D] and intact(i) PTH with bone mineral density(BMD) after controlling for suggested confounding factors, and the possibility of low serum vitamin D and high serum iPTH concentration could impact bone loss in Korean postmenopausal women. METHODS: Data from 188 postmenopausal Korean women aged 42 to 69 were analyzed through BMD, serum 25(OH)D, iPTH, Ca, phosphorus(P), alkaline phosphatase(ALP) and clinical characteristics. Factors affecting BMD was determined by Pearson correlation and the relationship between lumbar and femoral neck BMD and vitamin D[25(OH)D] and iPTH was assessed by multiple regression analysis after adjus- ting for suggested confounding factors. RESULTS: Lumbar and femoral neck BMD, serum Ca, P were decresaed and serum iPTH was increased with aging. In Pearson`s correlation, significant contributing factors to lumbar BMD was age, height, weight, menarche, year since menopause(YSM) and ALP. And significant contributing factors to femoral neck BMD was age, height, weight, menarche, YSM and iPTH. No relationship could be demonstrated between serum vitamin D[25(OH)D] and lumbar and femoral neck BMD. How ever, after controlling for potential confounding factors, a correlation was found between vitamin D[25(OH)D] and both of lumbar (p=0.013) and femoral neck BMD(p=0.077). iPTH was inversely related to femoral neck BMD(p=0.004) only in multiple linear regression. CONCLUSION: Serum vitamin D[25(OH)D] was influencing both of vertebral and femoral neck BMD, which suggests a significant role of vitamin D deficiency in the pathogenesis of postmenopausal osteo- porosis. In age related remodeling and loss of bone, increased serum iPTH might have additive role in cortical bone of femur. These findings suggest that vitamin D is very important for optimal bone health and a deleterious effect of increased iPTH on cortical bone loss. Adequate calcium and vitamin D status have to be maintained to prevent osteoporosis in postmenopausal Korean women.
Aging ; Bone Density* ; Bone Resorption ; Calcium ; Female ; Femur ; Femur Neck ; Hip Fractures ; Humans ; Hyperparathyroidism, Secondary ; Linear Models ; Menarche ; Menopause ; Osteogenesis ; Osteoporosis ; Osteoporosis, Postmenopausal ; Parathyroid Hormone* ; Spine ; Tolnaftate ; Vitamin D Deficiency ; Vitamin D* ; Vitamins*

During 1 year and 9 month period, from September, 1980 to June, 1983, retrospective study was performed on 35 patients with Mitral Valve Prolapse at Kyung Hee University Medical Center. And the following results were obtained; 1) The mitral valve prolapse syndrome presents with various cardiovascular symptoms including dyspnea(63%), palpitation(49%), chest pain(34%), syncope and dizziness(11%). 2) Of 35 patients with MVP, 17 cases were isolated MVP, 13 cases were associated with cardiovascular disorders and 5 cases were associated with non-cardiovascular disorders. 3) Electrocardiographic abnormalities were found in 20 patients with MVP. The most common abnormality was ST-T change and atrial fibrillation, VPB, RBBB, first degree A-V block and W-P-W syndrome were also noted. 4) QTc interval prolongation was more common in serverely symptomatic patients with MVP. 5) 18 cases in 35 patients showed systolic click or murmur on phonocardiography. 6) Of 35 patients with MVP, 19 patients demonstrated prolapse of the anterior leaflet, 11 patients demonstrated prolapse of posterior leaflet and 5 patients demonstrated prolapse of the both leaflets. 7) There were severe derangement on echocardiography in severely symptomatic patients were MVP.
Academic Medical Centers ; Atrial Fibrillation ; Echocardiography ; Electrocardiography ; Humans ; Mitral Valve Prolapse* ; Mitral Valve* ; Phonocardiography ; Prolapse ; Retrospective Studies ; Syncope ; Thorax

No abstract available.
Epidermolysis Bullosa* ; Epidermolysis Bullosa, Junctional*

BACKGROUND: Exercise testing is an importnat diagnostic and prognostic procedure in the assessment of patients with ischemic heart disease. But standard ST-segment depression criteria was not high enough to estimate coronary srtery disease. Recently, the heart rate adjustment of ST segment depression, ST segment/heart rate slope and index, have been proposed as a more accurate criteria for diagnosing significant coronary artery disease. The objective of this study was to compare the discriminating power of proposed ST segment/heart rate slope and index with that of a standard method of assessing exercise-induced ST segment depression for estimating coronary artery disease. METHODS: Sixty nine patients with ischemic heart disease were studied with exercise treadmill testing and coronary angiography. Computer-measured ST-segment amplitudes were obtained and analysis of the heart rate-adjusted ST segment depression(ST/HR slope and big up tri, Delta ST/HR index) was done. The sensitivity, specificity, and extent of coronary artery disease on each criteria were compared. RESULTS: 1) The sensitivity of big up tri, Delta ST/HR index partition of 1.6uV/beats/min was slightly higher(83%) and the specificity of ST/HR slope partition of 2.4uV/beats/min was higher(87%) than the standard exercise electrocardiographic criteria. 2) Early onset of ischemic ST-segment depression, profound ST-segment depression(> or =2mm), and downsloping ST-segment were associated with more extensive coronary artery disease. 3) On ST/HR slope, no CAD was 1.7+/-0.26uV/beats/min, one vessel disease was 2.6+/-0.34 uV/beats/min, two vessel disease was 2.7+/-1.36uV/beats/min, one vessel disease was 2.8+/-0.35uV/beats/min, and on big up tri, Delta ST/HR index, no CAD was 1.8+/-0.38uV/beats/min, one vessel disease was 2.8+/-1.36uV/beats/min, two vessel disease 3.4+/-1.44uV/beats/min, and three vessel disease was 3.7+/-2.95uV/beats/min. The increment of ST/HR slope and big up tri, Delta ST/HR index were associated with the coronary artery disease and its severity, but the correlations were not high enough. CONCLUSION: The heart rate adjustment of ST segment depression was not high enough for improved detection of coronary artery disease, compared with standard ST-segment depression criteria. But these indexes can be improved the clinical usefulness of the treadmill exercise test for coronary aretry disease.
Coronary Angiography ; Coronary Artery Disease* ; Coronary Vessels* ; Depression* ; Electrocardiography ; Exercise Test ; Heart Rate* ; Heart* ; Humans ; Myocardial Ischemia* ; Sensitivity and Specificity

The apoptosis, a distinctive type of individual cell necrosis, has been considered to play a complementary but opposite role to mitosis in the regulation of animal cell populations. It can be initiated or inhibited by a variety of environmental stimuli, physiologically and pathologically. Apoptosis seems to appear in either non-neoplastic or neoplastic tissues, even malignant tumors in the state of untreatment or irradiation. This study was carried out to investigate the spontaneous occurrence of apoptosis in squamous carcinomas of the uterine cervix and its mechanisms. Light microscopically, noted were the condensation and fragmentation of individual tumor cells with formation of apoptotic bodies that were frequently phagocytosed by nearby intact tumor cells. They were commonly seen in the neighbourhood of coagulative necrosis. Electron microscopically (TEM and SEM), noted were nuclear condensation, margination toward the nuclear membrane and fragmentation of membrane-bounded apoptotic bodies that were well preserved. The intracellular apoptotic bodies were phagosomes and reduced to electron-dense lysosomal residual bodies. The conclusion obtained was as follow: Apoptosis was found in all cases of squamous carcinoma of the uterine cervix, of which the frequency was higher in tumors of poor differentiation than those of well to moderate differentiation. The process of the apoptosis is considered to pass through the step of formation of the apoptotic bodies, phagocytosis by adjoining tumor cells or histiocytes, and then degradation as lysosmal residual bodies.
Animals

Although sacrococcygeal mass is rare and usually found in infants or children, adolescent or adult patients with protruding mass in sacrococcygeal region occasionally come to us simply for a cosmetic problem. In this situation, even though there is no definite neurological deficit, it should be evaluated whether or not the underlying bony pathology or dural defect exists. Few cases about the sacrococcygeal mass have been reported in adults. We reviewed our cases including preoperative evaluation methods and postoperative diagnosis. From March, 1993 to February, 1997, we experienced 6 adult patients with sacrococcygeal mass and no neurological abnormality. Preoperative evaluation were made by plain X-ray, myelogram, computed tomography(CT), and magnetic resonance imaging (MRI), as needed. Postoperative diagnoses were 2 meningoceles, 2 lipomyelomeningoceles, 1 desmoid tumor, and 1 teratoma. From our experiences, CT or MRI is essential to evaluate the sacrococcygeal mass preoperatively. These methods can visualize the precise anatomic location and extent of the mass, its relation to the spinal cord, and associated bony abnormalities. MRI is superior to CT, especially in defining the nature of the mass and involvement of the spinal cord. Conclusively, even a simple mass in the sacrococcygeal region in adults needs MRI or CT evaluation, and MRI is the most valuable method of evaluating the mass preoperatively and provides important information to establish a treatment plan.
Adolescent ; Adult* ; Child ; Diagnosis ; Fibromatosis, Aggressive ; Humans ; Infant ; Magnetic Resonance Imaging ; Meningocele ; Pathology ; Sacrococcygeal Region* ; Spinal Cord ; Teratoma

Acute colonic pseudoobstruction was first reported in 1948 by Sir H. Ogilvie. It is characterized by an acute, abrupt right-sided colonic distention in the absence of physical reasons for obstruction. If untreated, it may progress to cecal perforation, peritonitis, and death. Although primary cases have been reported, 87 percent of cases were secondary results of medical or surgical conditions. The most common medical conditions were infections, cardiac disease, and neurologic problems. In surgical conditions, cesarean section has been reported as the most common cause of Ogilvie's syndrome. In 1995, the first case of Ogilvie's syndrome complicated after a cosmetic surgical procedure(abdominoplasty) was reported by Bradley et al. We report a case of Ogilvie's syndrome complicated after breast reconstruction with TRAM flap that developed in the postoperative third day in 35-year old woman. The complications are primarily related to decreased flap perfusion. No reference of intestinal pseudoobstruction was found in the literature conducted in regard to complications of TRAM flap breast reconstruction.
Adult ; Breast* ; Cesarean Section ; Colon ; Colonic Pseudo-Obstruction ; Female ; Heart Diseases ; Humans ; Intestinal Pseudo-Obstruction ; Mammaplasty* ; Perfusion ; Peritonitis ; Pregnancy

The obstructive sleep apnea syndrome can occur due to various etiologies in children. In otherwise healthy children, adenotonsillar hypertrophy is the leading cause of childhood obstuctive sleep apnea. Obstructive sleep apnea caused by adenotonsillar hypertrophy can lead to a variety of symptoms and sequelae such as behavioral disturbance, enuresis, failure to thrive, developmental delay, cor pulmonale, and hypertension. So if obstructive sleep apnea is clinically suspected, proper treatment should be administered to the patient after diagnostic examinations. More than 80% improvement is seen in symptoms of obstructive sleep apnea caused by adenotonsillar hypertrophy in children after tonsillectomy and adenoidectomy. However, when it is impossible to treat the patient using surgical methods or residual symptoms remained after tonsillectomy and adenoidectomy, additional treatments such as weight control, sleep position change, and continuous positive airway pressure (CPAP), should be considered. This paper reports a case using weight control and Auto-PAP to control mild sleep apnea and snoring, which in long-term follow-up were not resolved after tonsillectomy and adenoidectomy for severe obstructive sleep apnea.
Adenoidectomy ; Adenoids ; Child ; Continuous Positive Airway Pressure ; Enuresis ; Failure to Thrive ; Follow-Up Studies ; Humans ; Hypertension ; Hypertrophy ; Palatine Tonsil ; Pulmonary Heart Disease ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive* ; Snoring ; Tonsillectomy

No abstract available.
Animals ; Cloning, Molecular* ; Interleukin-2* ; Mice*