PURPOSE: Combined androgen blockade(CAB) is often used in the management of advanced adenocarcinoma of the prostate. Recent case reports indicated that hypogonadism from CAB therapy is associated with osteoporosis and related fracture. The effect of CAB on bone mineral density(BMD) has not been adequately studied in men with prostate cancer. In this study, the possibility, frequency and severity of osteoporosis following CAB in prostate cancer patient was investigated. MATERIALS AND METHODS: A total of 19 men with advanced prostate cancer receiving CAB were evaluated for the presence of osteoporosis defined as bone mass 2.5 standard deviation below peak bone mass of young normal men(T-score). The BMB of the femoral neck and lumbar spine were measured. The BMD was then compared to the age-matched control value and reported as the Z-score. BMD measurements were compared to duration of CAB and Gleason score. RESULTS: Osteoporosis occurred in 10 of 15 patients in lumbar spine, and 4 of 18 patients in femoral neck. Osteoporosis was unrelated to the type of the CAB(orchiectomy, or LHRH-agonist). CAB caused a decrease in mean BMD of lumbar spine and femoral neck. There is a negative linear relation between mean BMD and duration of CAB(lumber spine; R2=0.059, Y=-2.368-0.016X, p>0.05, femoral neck; R2=0.089, Y=-1.923-0.020x, p>0.05). There is a statistically significant negative linear relationship between Gleason score and mean T-score of femoral neck(lumbar spine; R2=0.391, Y=-0.08-0.371X, p<0.05, femoral neck; R2=0.517, Y=0.855-0.450x, p<0.005). CONCLUSIONS: Our study provide evidence for acceleration of osteoporosis among men whose prostate cancers were treated with CAB. This study indicates a need for bone mineral density determination at the onset of CAB and at periodic intervals there after to begin appropriate therapy, undefined at this point, for prevention of osteoporosis and its complications aggravated by this therapy.
Acceleration ; Adenocarcinoma ; Bone Density ; Femur Neck ; Humans ; Hypogonadism ; Male ; Neoplasm Grading ; Osteoporosis* ; Prostate* ; Prostatic Neoplasms* ; Spine

Fibrous dysplasia is a benign pathologic condition of bone and causes facial deformity as well as functional problems. The monostotic form of the disease is much more common(70-80 percent) than the polyostotic variety (20-30 percent). In craniofacial fibrous dysplasia, craniofacial involvement occurs in 10-30 percent of monostotic and 50 percent of polyostotic patients. Frontal, sphenoid, ethmoid, and maxilla bones are frequently involved. Jaw involvement may involve a solitary lesion, but nonetheless in more common in the maxilla than in the mandible. We report a case of mandible reconstruction of pan-craniofacial polyostotic fibrous dysplasia that do not involve maxilla. In operation, extensive hemimandibulectomy was done and fibular bone free flap was done for mandible reconstruction. Postoperative 6 months later, focal osteomyelitis was seen in mandible angle. We removed mini-plate and screw and illiac cancellous bone graft was performed. 3 months after second operation, wound healing was uneventful and we have a functionally and cosmetically good outcome.
Congenital Abnormalities ; Fibrous Dysplasia, Polyostotic ; Free Tissue Flaps ; Humans ; Jaw ; Mandible* ; Mandibular Osteotomy ; Maxilla* ; Osteomyelitis ; Transplants ; Wound Healing

OBJECTIVES: This study was designed to assess the relationship between alcohol use and stress. METHODS: The study subjects were 1,261 people who drink among the 2,565 people who lived in Gangneung. We investigated the sociodemographic characteristics, Short Form-12 (SF-12), Global Assessment of Recent Stress (GARS) and Alcohol Use Disorder Identification Test (AUDIT). RESULTS: In Problem drinking group the GARS was significantly positively associated with the AUDIT (p=0.02). In Social drinking group sex (p<0.001) and age (p=0.02) is significantly associated with the AUDIT. CONCLUSION: This study showed the significantly positively association between stress and alcohol use. We think that the intervention and active management of the stress can prevent the alcohol problem.
Drinking ; Gangwon-do

Malignant tumor originated from external auditory canal (EAC) is very rare with an annual incidence of around 1 per million. Pathologically, squamous cell carcinoma is incidentally most common, and adenoid cystic carcinoma, basal cell carcinoma, and melanoma follow in decreasing order. Due to the rarity of malignant tumor of EAC, there is no widely accepted treatment modality yet. But basal cell carcinoma, known to be less aggressive tumor, can be removed with a minimal safety margin and have better treatment results. Recently we experienced a case of basal cell carcinoma in the EAC, confined in the cartilaginous portion of EAC, presenting with intermittent otorrhea for several years. The patient was treated with a sleeve resection of the EAC with a safety margin reconstructed with a split-thickness skin graft. No tumor recurrence or complication was noted in the first postoperative year.
Aminocaproic Acids ; Carcinoma, Adenoid Cystic ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Ear Canal ; Humans ; Incidence ; Melanoma ; Recurrence ; Skin ; Transplants

No abstract available.
Prostatic Hyperplasia*

OBJECTIVE: The aim of this study was to evaluate the association between a variable number of tandem repeats polymorphism at the dopamine D4 receptor gene (DRD4) and the performance of children with attention deficit hyperactivity disorder (ADHD) in a continuous performance test (CPT). METHODS: This study included 72 ADHD children (mean age=9.39+/-2.05 years) who were recruited from one child psychiatric clinic. The omission errors, commission errors, reaction time and reaction standardization in the CPT were computed. The number of 48-base pairs tandem repeats in the exon III of DRD4 was analyzed in a blind manner. RESULTS: The homozygosity of the 4-repeat allele at DRD4 was significantly associated with fewer commission errors (t=2.364, df=28.685, p=0.025) and standard deviation of reaction time (t=2.351, df=24.648, p=0.027) even after adjusting for age. The results of analyses of CPT measured values among three groups showed that the group with higher frequency of the 4-repeat allele showed a lower mean score of commission errors (F=4.268, df=2, p=0.018). CONCLUSION: These results suggest a protective role of 4-repeat allele of the DRD4 polymorphisms on commission errors in the CPT in children with ADHD.
Alleles ; Attention Deficit Disorder with Hyperactivity ; Child ; Dopamine ; Exons ; Humans ; Minisatellite Repeats ; Reaction Time ; Receptors, Dopamine D4 ; Tandem Repeat Sequences

Tetramine toxicity due to sea snail ingestion is generally mild and has a good prognosis. Tetramine toxicity acts on the acetylcholine receptor, affecting the neuromuscular junction and autonomic nervous system. A 78-year-old female patient visited the emergency room with vomiting and dyspnea after eating sea snails. At the time of admission, the vital signs recorded were 140/80 mmHg-105/min-24/min-36.5。C, and 90% oxygen saturation. Arterial blood test revealed hypercapnia (pCO2 58.2 mmHg) and respiratory acidosis (pH 7.213, HCO3 - 22.5 mmol/L), whereas other blood tests showed no specific findings. Due to decreased consciousness and hypoxia, endotracheal intubation and mechanical ventilation were administered to the patient. Successful weaning was accomplished after 12 hrs, and the patient was discharged without any further complications. Although tetramine toxicity rarely results in acute respiratory failure due to paralysis of the respiratory muscle, caution is required whilst treating the patient.

Purpose: The purpose of this study is to compare the clinical features and complications of snake bite patients in urban and rural areas. Methods: A retrospective study was conducted on patients over 18 years of age who were hospitalized for snake bites from January 2013 to December 2019. Patients were categorized into urban and rural groups according to their respective locations at the time of the snake bite and the clinical characteristics and complications of the two patient groups were researched and compared. Results: Of the 77 snake bite patients, 44 patients were categorized into the rural group (57.1%). The rura1 group showed significant differences in old age (p=0.011), delayed hospital visits (p=0.010), far hospital distance (p<0.001), high local effect score (p<0.001), high traditional snake-bite severity grading scale (p=0.008) and use of large amounts of antivenins (p=0.026). There was a significantly higher incidence of acute kidney injury (p=0.030), rhabdomyolysis (p=0.026), and coagulopathy (p=0.033) in the rural group as well as a longer hospitalization period (p<0.011). Conclusion Snake bites that occurred in rural areas resulted in patients with more complications compared to urban areas due to farther distances from hospitals, causing a delay in antivenom treatment.

It was difficult to determine the clinical situations of Morgagni diaphragmatic hernias of adults on account of its rarity. The aim of this study was to propose diagnostic and therapeutic guidelines for adult Morgagni diaphragmatic hernias. A computerized `Korean study information co.' and `medical research information center' literature search of domestic articles published since 1950 was carried out. These 10 cases in addition to ours were analyzed. The average age at treatment was 68.7 years of age ranging from 51 to 83 years with 90.9% of patients being female. 18.2% of patients had symptoms immediately after trauma. 27.3% of patients were incorrectly diagnosed preoperatively. 90.9% of all treated Morgagni hernias were located on the right side just behind the sternum with hernia sacs. The most common contents of the hernias were the greater omentum and transverse colon. The preferred method of surgery was the trans-abdominal approach. The mortality rate of the hernias was 9.1%. Morgagni diaphragmatic hernias once diagnosed should be referred for surgical repair due to the risk of bowel perforation. The transabdominal approach or laparoscopic surgery is preferred in accurately diagnosed Morgagni diaphragmatic hernias prior to surgery.
Adult ; Colon, Transverse ; Female ; Hernia ; Hernia, Diaphragmatic* ; Humans ; Laparoscopy ; Mortality ; Omentum ; Sternum

Emergency physicians often have to treat patients suffering from testicular pain. Testicular torsion is a critical disease which can, in the worst situation, require orchiectomy. Testicular torsion is more common among neonates and adolescents than adults, and there are very few adults reported to have testicular torsion. There are several cases of testicular torsion among adults aged 20 to 40. However, there have been almost no reports of patients with testicular torsion over the age of 50. Patients over the age of 50 have a greater possibility of a delayed diagnosis. Therefore, they also have a greater possibility of requiring an orchiectomy. In our case, 57-year-old male patient complained of testicular pain that developed during his sleep after golf practice. After exploratory surgery, he was diagnosed as having testicular torsion. In conclusion, emergency physicians should consider the possibility of testicular torsion when older adults complain of testicular pain. Also, patients who suffer from intermittent testicular pain show higher rates of developing testicular torsion.
Adolescent ; Adult ; Aged ; Delayed Diagnosis ; Emergencies ; Golf ; Humans ; Infant, Newborn ; Male ; Middle Aged ; Orchiectomy ; Scrotum ; Spermatic Cord Torsion ; Stress, Psychological