OBJECTIVE: The purpose of this study was to evaluate the performance of OSTA (Osteoporosis Self assessment Tool for Asian) in Korean peri- and postmenopausal women. DESIGN AND METHODS: Total 1488 peri- and postmenopausal women over 45 years were included from Menopause Clinic in Chung-Ang University Hospital. Femoral neck BMD was measured by using DEXA (Lunar DPXIQ #7055). Three categories of bone status were defined by BMD based on the WHO definition. OSTA index values were calculated by using only 2 components such as age and weight. Three risk categories (high, medium, low) were classified according to index values. RESULTS: Seven hundred thirty women tested comprising 49.1% of all subject had low BMD (10.6% osteoporosis, 38.5% osteopenia respectively). The combined medium and high risk groups had a high prevalence (447/557=80.3%) of low bone mass. The medium and high risk groups had 85.5% of a high specificity, and 61.2% of a good sensitivity for identifying low bone mass. The medium and high risk groups also had 87.9% of a high sensitivity, and 68.5% of a good specificity for identifying osteoporosis. CONCLUSION: OSTA is a simple tool and easy to use, because it requires only age and weight. The OSTA risk tool performed well for identifying low bone mass, especially osteoporosis in Korean peri- and postmenopausal women.
Bone Diseases, Metabolic ; Female ; Femur Neck ; Humans ; Menopause ; Osteoporosis* ; Prevalence ; Self-Assessment* ; Sensitivity and Specificity

No abstract available.
Endometriosis* ; Female

OBJECTIVE: The purpose of this study was to evaluate the relationship between parathyroid hormone (PTH), vitamin D status, bone mineral density (BMD) and bone turnover markers in Korean postmenopausal women. METHODS: The subjects were 263 healthy postmenopausal women recruited in Seoul, Korea. The research was performed from January to March, 1999. Serum PTH level was measured with immunoradiometric assay (IRMA). Serum 25 (OH) vitamin D concentration was measured by radioimmunoassay (RIA) for the evaluation of vitamin D nutritional status. The averages of BMD were attained from the 2nd and 3rd lumbar spine. Two serum levels of bone turnover markers such as osteocalcin and N- telopeptide were also measured by IRMA and enzyme linked immunosorbent assay (ELISA) respectively. RESULTS: Severe, moderate, mild vitamin D deficiency and normal vitamin D status groups were found in 16 (6.1%), 94 (35.7%), 127 (48.3%), and 26 (9.9%) subjects respectively. Among the four groups, no significant differences were found in terms of age, weight, height, bady mass index (BMI). The serum vitamin D levels were 3.18 +/- 1.5 ng/ml, 7.8 +/- 1.4 ng/ml, 13.9 +/- 2.7 ng/ml 25.2 +/- 1.3 ng/ml in severe, moderate, mild, vitamin D deficiency and normal vitamin D status group respectively. Serum PTH levels were 28.6 +/- 14.9 pg/ ml, 22.7 +/- 10.4 pg/ml, 19.5 +/- 12.9 pg/ml, 15.1 +/- 10.3 pg/ml in severe, moderate, mild vitamin D deficiency and normal vitamin D, respectively, and a siginificant difference was found (p<0.05). In comparison with the normal vitamin D group, PTH concentration level was significantly increased by 90.1%, 50.4%, 29.4%, in severe, moderate, mild vitamin D deficiency groups respectively (p<0.05). The serum PTH concentration and 25 (OH) vitamin D were inversely related (r=-0.219, p<0.05). The correlations between the serum PTH level and other factors, such as age, weight, height, BMI, BMD, and bone turnover markers, were insignificant. CONCLUSION: Korean postmenopausal women showed an increase in serum PTH levels in case of vitamin D deficiency, and about 90% of women were suffering from vitamin D deficiency. Therefore, it is recommendable to prescribe the supplemental vitamin D for the most of Korean postmenopausal women.
Bone Density ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Immunoradiometric Assay ; Korea ; Nutritional Status ; Osteocalcin ; Parathyroid Hormone* ; Radioimmunoassay ; Seoul ; Spine ; Vitamin D Deficiency ; Vitamin D* ; Vitamins*

The respiratory system is one of the most important body systems particularly from the viewpoint of occupational medicine because it is the major route of occupational exposure. In 2013, there were significant changes in the specific criteria for the recognition of occupational diseases, which were established by the Enforcement Decree of the Industrial Accident Compensation Insurance Act (IACIA). In this article, the authors deal with the former criteria, implications of the revision, and changes in the specific criteria in Korea by focusing on the 2013 amendment to the IACIA. Before the 2013 amendment to the IACIA, occupational respiratory disease was not a category because the previous criteria were based on specific hazardous agents and their health effects. Workers as well as clinicians were not familiar with the agent-based criteria. To improve these criteria, a system-based structure was added. Through these changes, in the current criteria, 33 types of agents and 11 types of respiratory diseases are listed under diseases of the respiratory system. In the current criteria, there are no concrete guidelines for evaluating work-relatedness, such as estimating the exposure level, latent period, and detailed examination methods. The results of further studies can support the formulation of detailed criteria.
Alveolitis, Extrinsic Allergic/economics/pathology ; Asbestosis/economics/pathology ; Asthma/economics/pathology ; Humans ; Lung Diseases/*economics ; Occupational Diseases/*economics ; Occupational Exposure ; Pneumoconiosis/economics/pathology ; Pulmonary Disease, Chronic Obstructive/economics/pathology ; Republic of Korea ; Workers' Compensation/*economics

Pituitary adenomas are frequent intracranial tumors with generally benign prognosis but acute hemorrhage into tumor with necrosis is a severe complication and can potentially result in fatal outcome, if not diagnosed or treated early. While many precipitating factors have been known, even a mild blunt force shown in this case could play a role in the catastrophic complication of the pituitary adenoma. We report a rare forensic case of post-traumatic apoplexy sustained in a preexisting pituitary adenoma with a mild blunt force to the face.
Adenoma

We present a rare case of abdominal compartment syndrome due to a bulimic attack in a 19-year-old female patient with bulimia nervosa. She was admitted to our emergency room with complaints of progressive abdominal pain following bulimia. Computed tomography showed dilated stomach with food and air pressed other visceral organs and major abdominal vessels. Decompression using nasogastric tube or gastric lavage tube failed. At laparotomy, we performed gastrotomy and decompression was performed. After decompression, she fell into hypovolemic shock due to bleeding in the intra-gastric and peritoneal cavity. Twelve hours after the operation, the patient died due to refractory hypovolemic shock from uncontrolled bleeding following decompression of abdominal compartment. It should keep in mind that binge-eating habits in patients with bulimic nervosa could cause abdominal compartment syndrome due to gastric distension and this may be a potentially fatal condition.
Abdominal Pain ; Bulimia ; Bulimia Nervosa ; Compartment Syndromes ; Decompression ; Emergencies ; Female ; Gastric Lavage ; Hemorrhage ; Humans ; Intra-Abdominal Hypertension ; Laparotomy ; Peritoneal Cavity ; Reperfusion Injury ; Shock ; Stomach ; Young Adult

OBJECTIVE: Our purpose was to evaluate and compare the Le Fort colpocleisis and conventional total vaginal hysterectomy in the uterine prolapse patients in the medically compromised or elderly patients. METHODS: This study was to analyze the data from 16 patients with uterine prolapse undergone Le Fort colpocleisis at the department of obstetrics and gynecology, Chung-ang university hospital from January 1991 to December 2000, and 36 patients with uterine prolapse undergone total vaginal hysterectomy from January 1999 to December 2000. We compared the age of patients, operation time, type of anesthesia, estimated blood loss, changes in hemoglobin, duration of hospitalization, occurrence of febrile morbidity, and medical complications based on the medical records. RESULTS: The mean operation time of 16 patients undergone Le Fort colpocleisis with uterine prolapse was 51+/-18 minutes, the estimated blood loss was 175+/-134 cc, hemoglobin change was 1.72+/-1.14 mg/dl, the mean days of hospitalization was 7.2+/-2.8 days, and the febrile illness occurred in 2 patients. In this group, general anesthesia was used in 10 patients (75%), local anesthesia in 4 patients (25%), and spinal and epidural anesthesia in 1 case respectively. The mean operation time of 11 patients undergone total vaginal hysterectomy with uterine prolapse was 86+/-29 minutes, the estimated blood loss was 366+/-154 cc, hemoglobin change was 2.36+/-1.22 mg/dl, the mean days of hospitalization was 7.8+/-1.6 days, and the febrile illness occurred in 3 patients. General anesthesia was done in total vaginal hysterectomy group and vulva hematoma was developed in 1 case postoperatively. There are significant difference (p<0.01) between the Le Fort colpocleisis and total vaginal hysterectomy in operational time, estimated blood loss, and type of anesthesia, but no significant difference in days of hospitalization, febrile morbidity. CONCLUSION: The assessment of Le Fort colpoclesis in uterine prolapse offers signinficant benefits in elderly or compromised patients and the method is safe for operation.
Aged ; Anesthesia ; Anesthesia, Epidural ; Anesthesia, General ; Anesthesia, Local ; Female ; Gynecology ; Hematoma ; Hospitalization ; Humans ; Hysterectomy, Vaginal* ; Medical Records ; Obstetrics ; Prolapse* ; Uterine Prolapse ; Uterus* ; Vulva

The present study was conducted to investigate the effect of iron-enriched cereal supplement and nutrition education program on nutritional status and life style of children. Elementary school students (n = 170) aged of 11 years old at Seoul were participated. Subjects were supplemented with iron-enriched cereal for breakfast and provided with 2 sessions of nutrition education during 3 months. Intake of carbohydrate, iron, sodium, zinc, vitamin A, vitamin B1, vitamin B2, vitamin C, niacin, and folic acid was significantly increased after cereal supplement. Caloric intake was similar to KDRIs during both before and after cereal supplement. There was no improvement on exercise and dietary habits after nutrition education. Male students tended to sleep later, wake up early, and ate snack less than female. Cereal supplement was effective on improving nutritional status, but short-term nutrition education had no effect on modification of life style. Thus, further studies are required to develop long-term education program effective on improving life style and eating habits in children.
Ascorbic Acid ; Breakfast* ; Edible Grain* ; Child ; Eating ; Education* ; Energy Intake ; Female ; Folic Acid ; Food Habits ; Humans ; Iron ; Life Style* ; Male ; Niacin ; Nutritional Status* ; Riboflavin ; Seoul ; Snacks ; Sodium ; Thiamine ; Vitamin A ; Zinc

A 36-year-old male patient with no remarkable medical history was admitted to our hospital for a health check up. On chest radiography, bilateral aortic notches at the level of aortic arch were shown suggesting aortic arch anomaly without any clinical symptoms. Two aortic arches were almost same-in-size on suprasternal view of transthoracic echocardiography. In addition, multidetector computed tomography showed balanced type double aortic arch forming a complete vascular ring which encircled the trachea and esophagus. The trachea was slightly compressed by the vascular ring whereas the esophagus was intact. Nevertheless, the pulmonary function test was normal. The patient was discharged from hospital with instructions for periodic follow-up.
Adult ; Aorta, Thoracic ; Echocardiography ; Esophagus ; Follow-Up Studies ; Humans ; Male ; Multidetector Computed Tomography ; Respiratory Function Tests ; Thorax ; Trachea

OBJECTIVE: Preimplantation genetic diagnosis (PGD) is reserved for couples with a risk of transmitting a serious and incurable disease, and hence avoids the undesirable therapeutic abortion. In this study, we evaluated the efficacy of PGD for Duchenne muscular dystrophy (DMD) cases by the fluorescent PCR with polymorphic linked markers and the conventional duplex-nested PCR methods. METHODS: Biopsy of one or two blastomeres was done from the embryos fertilized by ICSI on the third day after fertilization. We performed two cases of PGD-DMD by the duplex-nested PCR for the causative mutation loci and the SRY gene on Y chromosome. The triplex fluorescent PCR for the mutation loci, the SRY gene and the polymorphic microsatellite marker on X chromosome was applied for two cases of PGD-DMD. RESULTS: By the duplex-nested PCR, successful diagnosis rate was 95.5% (21/22), but we could not discriminate the female embryos whether normal or carrier in this X-linked recessive disease. However, the triplex fluorescent PCR method showed 100% (27/27) of successful diagnosis rate, and all female embryos (n=17) were distinguished normal (n=10) from carrier (n=7) embryos. Unaffected and normal embryos were transferred into mother's uterus after diagnosis. A healthy normal male was achieved after PGD with the duplex-nested PCR method and a twin, a male and a female, were delivered with triplex fluorescent PCR method. The normality of dystrophin gene was confirmed by amniocentesis and postnatal genetic analysis in all offsprings. CONCLUSION: The fluorescent PCR with polymorphic marker might be useful in improving the specificity and reliability of PGD for single gene disorders.
Abortion, Therapeutic ; Amniocentesis ; Biopsy ; Blastomeres ; Diagnosis ; Dystrophin ; Embryonic Structures ; Family Characteristics ; Female ; Fertilization ; Genes, sry ; Humans ; Male ; Microsatellite Repeats ; Muscular Dystrophy, Duchenne* ; Polymerase Chain Reaction* ; Pregnancy ; Preimplantation Diagnosis* ; Prostaglandins D ; Sensitivity and Specificity ; Sperm Injections, Intracytoplasmic ; Twins ; Uterus ; X Chromosome ; Y Chromosome