BACKGROUND: Osteoporosis and resultant fracture seems to be the most common skeletal disease, affecting female exclusively. Osteoporosis increases exponentially with menopause and age. Therefore the demographic data seems to be the most important & fundamental for the study of osteoporosis epidemiology. METHODS: This study was to analyzed population projection from 1960 to 2060. We evaluated the demographic change of female, postmenopausal and elderly geripausal population in South Korea using Korean statistical information service database as basic fundamental data for osteoporosis epidemiology. RESULTS: According to population projection, the total female population will be exceeds the total male population since 2015 and maximize up to 2030. In 2030, nearly half of female will become postmenopausal and one fourth of women elderly will be geripausal. Of total female population in 2060, the proportion of postmenopausal women will be increased up to 59.8%. CONCLUSIONS: According to population projection in South Korea, six of ten women in 2060 will be postmenopausal and seven of ten postmenopausal women geripausal. As expected to increase proportion of elderly women, dramatic rise of osteoporosis and osteoporotic fracture also expected. Health providers pay more attention to postmenopausal and geripausal women health care.
Aged ; Demography ; Epidemiology ; Female ; Population Forecast ; Humans ; Information Services ; Korea ; Male ; Menopause ; Osteoporosis ; Osteoporotic Fractures ; Women's Health

The QTc interval is a complex quantitative trait and a strong prognostic indicator of cardiovascular mortality in general, healthy people. The aim of this study was to identify non-genetic factors and quantitative trait loci that govern the QTc interval in an isolated Mongolian population. We used multiple regression analysis to determine the relationship between the QTc interval and non-genetic factors including height, blood pressure, and the plasma lipid level. Whole genome linkage analyses were performed to reveal quantitative trait loci for the QTc interval with 349 microsatellite markers from 1,080 Mongolian subjects. Among many factors previously known for association with the QTc interval, age, sex, heart rate, QRS duration of electrocardiogram and systolic blood pressure were also found to have influence on the QTc interval. A genetic effect for the QTc interval was identified based on familial correlation with a heritability value of 0.31. In a whole genome linkage analysis, we identified the four potential linkage regions 7q31-34, 5q21, 4q28, and 2q36.
Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Blood Pressure/genetics ; Body Height/genetics ; Cardiovascular Diseases/*genetics/mortality/pathology/*physiopathology ; Child ; Child, Preschool ; Chromosomes, Human/genetics ; *Electrocardiography ; Female ; *Genome-Wide Association Study ; Heart Rate/genetics ; Humans ; Male ; Microsatellite Repeats/*genetics ; Middle Aged ; Mongolia/epidemiology ; Quantitative Trait Loci/*genetics ; Sex Factors

The authors regret an error in discussion, the authors wrote that "We also performed an additional linkage analysis using only the adult population (> or = 20 years old)(Table 7, Figure 2 and 3)." In this sentence, Table 7 should be changed to Table 6.

PURPOSE: The purpose of our study was to compare the diagnostic value of contrast-enhanced spiral CT scanning and pulmonary angiography in detecting central and peripheral pulmonary embolism (PE) in pigs. MATERIALS AND METHODS: Experiments were performed in a porcine model of acute pulmonary embolism. Five pigs underwent contrast-enhanced spiral CT and pulmonary angiography after central venous administration of embolic material (Konyak). Three thoracic radiologists read the films and the results were compared with the findings of pathologic specimens. RESULTS: Of 85 cases of PE detected pathologically, 78 (91.8 %) were visible with spiral CT and 65 (76.5 %) with pulmonary angiography. Sensitivity and specificity for the detection of central emboli were 95 % and 100 %, respectively, with spiral CT, and 89 % and 100 %, respectively, with pulmonary angiography. Sensitivity and specificity for the detection of peripheral emboli were 88 % and 99 %, respectively, with spiral CT, and 64% and 100 %, respectively, with pulmonary angiography. CONCLUSION: Contrast-enhanced spiral CT is a very useful method for the diagnosis of both peripheral and central pulmonary embolism. Compared to pulmonary angiography its sensitivity and specificity are high.
Angiography ; Diagnosis ; Pulmonary Embolism* ; Sensitivity and Specificity ; Swine ; Tomography, Spiral Computed*

PURPOSE: The purpose of our study was to compare the diagnostic value of contrast-enhanced spiral CT scanning and pulmonary angiography in detecting central and peripheral pulmonary embolism (PE) in pigs. MATERIALS AND METHODS: Experiments were performed in a porcine model of acute pulmonary embolism. Five pigs underwent contrast-enhanced spiral CT and pulmonary angiography after central venous administration of embolic material (Konyak). Three thoracic radiologists read the films and the results were compared with the findings of pathologic specimens. RESULTS: Of 85 cases of PE detected pathologically, 78 (91.8 %) were visible with spiral CT and 65 (76.5 %) with pulmonary angiography. Sensitivity and specificity for the detection of central emboli were 95 % and 100 %, respectively, with spiral CT, and 89 % and 100 %, respectively, with pulmonary angiography. Sensitivity and specificity for the detection of peripheral emboli were 88 % and 99 %, respectively, with spiral CT, and 64% and 100 %, respectively, with pulmonary angiography. CONCLUSION: Contrast-enhanced spiral CT is a very useful method for the diagnosis of both peripheral and central pulmonary embolism. Compared to pulmonary angiography its sensitivity and specificity are high.
Angiography ; Diagnosis ; Pulmonary Embolism* ; Sensitivity and Specificity ; Swine ; Tomography, Spiral Computed*

BACKGROUND: Chronic Myelogenous Leukemia (CML) is the first proven disease in which gene abnormality, t(9;22)(q34;q11) can cause the disease to occur in humans. Recently, targeted therapy with STI571 (GleevecTM), signal transduction inhibitor for BCR-ABL kinase was developed and can induce cytogenetic remission in patients with CML. Hypermetaphase-FISH (HMF)/Interphase-FISH (I-FISH, Fluorescence in situ hybridization) aiming specific chromosomal abnormalities are unambiguous quantitative molecular genetic methods for individual Philadelphia (Ph1) chromosome positive cells. We evaluated the change of Ph1 chromosome in CML patients during STI571 therapy using HMF/I- FISH. METHODS: Twenty one patients with CML were treated with STI571 which was provided from Norvatis pharmaceutical company as Expanded Access Program for Compassionate Use from May 2001 at the doses of 200-600 mg/day orally. Median age of this cohort was 37 years old and median follow up duration was 113 days (48~165 days). HMF or I-FISH using bone marrow or peripheral blood were performed on the sample at baseline, day 14, day 28 and then monthly. RESULTS: Complete cytogenetic responses which were assessed by HMF/I-FISH counting several hundreds cells were found in 8 of 21 patients. Among them, 4 of 10 chronic phase, 2 of 2 accelerate phase and 2 of 8 blastic crisis patients achieved cytogenetic complete response. One patient with blastic crisis was relapsed after achieving cytogenetic complete response. Grade III-IV thrombocytopenia and neutropenia were noticed in 8 and in 7 patients respectively, but there were no major bleeding episodes nor neutropenic fever. CONCLUSION: BCR-ABL tyrosine kinase inhibitor, STI571 was tolerable for patients with CML. The majority of patients achieved hematologic remission and 8 out of 21 patients achieved complete cytogenetic response regardless of their disease stage. Cytogenetic response of Ph1 chromosome can be quantified accurately with HMF/I-FISH.
Adult ; Bone Marrow ; Chromosome Aberrations ; Cohort Studies ; Compassionate Use Trials ; Cytogenetics ; Fever ; Fluorescence ; Follow-Up Studies ; Fusion Proteins, bcr-abl ; Hemorrhage ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive* ; Molecular Biology ; Neutropenia ; Philadelphia Chromosome* ; Phosphotransferases ; Signal Transduction ; Thrombocytopenia ; Imatinib Mesylate

BACKGROUND: Embryonic lethal abnormal vision (ELAV)-like protein HuR is known to stabilize mRNA through binding AU-rich elements in the 3'-untranslated region. Recent studies show that HuR expression is associated with the expression of several genes including cyclooxygenase-2 (COX-2). HuR exists predominantly in the nucleus, but cytoplasmic translocation of HuR is thought to be more important for its activity. COX-2 is a well-known enzyme that promotes tumor growth. METHODS: To evaluate the correlation of HuR and COX-2 expression, we analyzed expression of HuR and COX-2 in 91 cases of breast cancer using immunohistochemistry. RESULTS: Nuclear and cytoplasmic expression of HuR was seen in 76 (83.5%) and 19 (20.9%) of 91 cases respectively. COX-2 immunoreactivity was seen in 54 (59.4%) cases. Cytoplasmic HuR expression showed significant correlation with COX-2 expression (p=0.001). Nuclear HuR showed no correlation with COX-2 expression or other clinicopathological parameters. COX-2 expression is significantly associated with tumor grade (p=0.028). COX-2 (p=0.092) and cytoplasmic (p=0.569) and nuclear HuR (p=0.247) expression showed no correlation with survival. CONCLUSIONS: These results suggest that cytoplasmic HuR expression is associated with COX-2 expression in breast cancer and cytoplasmic location of HuR might contribute to the stabilization of COX-2 mRNA.
Breast Neoplasms

BACKGROUND: We reviewed the guidelines for the transfusion of red cells, platelets, and fresh frozen plasma (FFP) of the Korean Society of Blood Transfusion and modified the previous guidelines for transfusions at our hospital. We evaluated the appropriateness of the current hospital transfusions with these algorithms based on these guidelines. METHODS: The medical records of 266 transfusion episodes of patients receiving transfusions of red cells (144), platelets (61), and FFP (61), were reviewed retrospectively at Ewha Womans University Mokdong Hospital during 2002. RESULTS: Inappropriateness rates for transfusion episodes were 2.8% for red cells, 4.9% for platelets, and 44.3% for FFP. 144 red cell transfusions comprised 73 episodes (50.7%) in acute blood loss and 71 (49.3%) in chronic anemia. Among them, 2 episodes in each condition were assessed as inappropriate, respectively. 61 platelet transfusions comprised 32 episodes (52.5%) for a prophylaxis in marrow failure and 13 (21.3%) for active bleeding and 6 (9.8%) for acute disseminated intravascular coagulation (DIC) and 10 (16.4%) for others. Among them, 3 episodes for clinical bleeding were assessed as inappropriate. Out of 61 FFP transfusions, 34 episodes (56%) (16 liver disease with complications, 11 acute DIC, and 7 others) were assessed as appropriate and 27 episodes (44%) (8 liver diseases without complications, 10 surgical procedures and 9 others) were assessed as inappropriate. CONCLUSIONS: We modified our previous guidelines for transfusions according to the transfusion guidelines proposed by the Korean Society of Blood Transfusions. These guidelines could be easily applied to evaluate the appropriateness of transfusions performed at our hospital and to specify the cases of inappropriate transfusions.
Anemia ; Blood Transfusion ; Bone Marrow ; Dacarbazine ; Disseminated Intravascular Coagulation ; Female ; Hemorrhage ; Humans ; Liver Diseases ; Medical Records ; Plasma* ; Platelet Transfusion ; Retrospective Studies

BACKGROUND: This study was designed to compare the effects of remifentanil, alfentanil, and fentanyl on the hemodynamic changes, sedation, and analgesia when administered with small doses of midazolam in patients undergoing a retrobulbar block for cataract surgery. METHODS: Sixty patients scheduled for cataract surgery were divided into 4 groups (n = 15 for each group). Firstly, group C received 5 ml of a normal saline solution, 3 min before a retrobulbar block. Next, group R received remifentanil 0.3g/kg. Furthermore, group A received a 4.5g/kg dose of alfentanil, 90 s before a retrobulbar block, and group F received fentanyl 0.6g/kg, 210 s before a retrobulbar block. All solutions were mixed with normal saline to a 5 ml volume. In group R, A, and F, midazolam (0.5 mg for patients over the age of 65 years; 1.0 mg in patients under the age of 65 years) was injected 3 min before the retrobulbar block. RESULTS: The systolic blood pressure in patients significantly increased at 1 or 2 minutes after a retrobulbar block in group C and at 1 minute in group F. For group R, the systolic blood pressure decreased significantly at 3, 4, 5, and 10 minutes, and at 2, 3, 4, 5, and 10 minute in group A. The mean OAA/S scale during a retrobulbar block significantly declined in groups R and A. The VAS score for pain was significantly lower in groups R and A, whereas the VAS anxiety index was significantly lower in groups R, A, F compared to group C (P 0.05). CONCLUSIONS: We found that the combination of remifentanil or alfentanil with midazolam showed better hemodynamic stability, sedative, and analgesic effects compared to fentanyl with midazolam in the retrobulbar block for cataract surgery.
Alfentanil* ; Analgesia* ; Anxiety ; Blood Pressure ; Cataract* ; Fentanyl* ; Hemodynamics* ; Humans ; Midazolam ; Sodium Chloride

PURPOSE: To evaluate the efficacy of fat-suppressed gadolinium-enhanced MR imaging in differentiating acutefrom chronic ligament tears of anterior cruciate ligament. MATERIALS AND METHODS: MR images of 22 patients witharthroscopically proven complete tear of the anterior cruciate ligament were retrospectively reviewed. Theinterval between injury and MR examination was one day to seven years. When ligament tear was detected on MR imagewithe three months of injury, the case was considered acute;if detected after three months had elapsed, it wasjudged to be chronic. The extent of contrast enhancement was graded as 1, 2 or 3; grade 1, enhancement wasconfined to the expected ligament region; grade 2, enhancement extended to the joint capsule; grade 3, enhancementextended beyond the joint capsule. The grades of contrast enhancement correlated with the acute and chronic stagesof ligament tears. Associated bone bruise and/or adjacent soft tissue edema were also evaluated. RESULT: Among15 patients with acute ligament tear, nine (60%) showed grade 3 enhancement; among seven in whom tearing waschronic, four (57%) showed grade 1 enhancement. Bone bruising was present in 100% of acute tears (15/15) and 29%of chronic tears (2/7). Soft tissue edema was associated in 87% of acute tears (13/15) and 29% of chronic tears(2/7). CONCLUSION: Fat-suppressed gadolinium-enhanced MR imaging could help differentiate acute from chronictears of anterior cruciate ligament, as well as bone bruising and tissue edema.
Anterior Cruciate Ligament* ; Cartilage ; Contusions ; Edema ; Humans ; Joint Capsule ; Ligaments ; Magnetic Resonance Imaging* ; Retrospective Studies