OBJECTIVE: This study is proposed to examine the relationship between bone loss after hormone replacement therapy for one year and initial bone markers. METHODS: One hundred postmenopausal women were studied for one year. At first visit, measurements were made of bone mineral density(BMD) at the lumbar spine and femoral neck, and of serum osteocalcin and urine deoxypyridinoline. After hormone replacement therapy was done for one year, BMD was rechecked. RESULTS: Serum osteocalcin was correlated with the rate of bone change(r=0.150, 0.262) and urine deoxypyridinoline was weakly correlated(r=-0.003, 0.038). The changes of femoral BMD in women with higher concentration of osteocalcin and deoxypyridinoline were significant different from those in women with normal concentration. At the lumbar spine, no significant differences were showed. In women with higher concentration of osteocalcin, the incidence of subjects with increased spine BMD was increased up to around 71.1%, which showed not significant increase compared with normal concentration of osteocalcin. And the incidence of increased spine BMD in women with higher concentration of osteocalcin was marked increased compared with the incidence of normal concentration. The level of the osteocalcin with increased spine BMD was 11.5+/-6.6 ng/ml, and the level with decreased spine BMD was 9.2+/-4.7 ng/ml, respectively. And the level of the deoxypyridinoline was 7.2+/-4.2 pmol/ mol cr in women with increased spine BMD and 7.2+/-2.7 pmol/ mol cr in women with decreased spine BMD, which was not statistically different. The concentration of deoxypyridinoline with increased and decreased in BMD in spine and femur was not statistically different. but the concentration of osteocalcin was 12.2 +/-5.5 ng/ml in significantly increased in BMD and 8.5 +/-4.5ng/ml in significantly decreased in BMD, which was showed significant different. CONCLUSION: Present study indicates that the serum osteocalcin more reflcets bone turnover changes at the menopause than deoxypyridinoline, however, the clinical utility of measurements of osteocalcin only to response to therapy is uncertain.
Bone Density* ; Female ; Femur ; Femur Neck ; Hormone Replacement Therapy* ; Humans ; Incidence ; Menopause ; Osteocalcin ; Spine

The great chain of sympathetic ganglia which extends from the base of the skull to the pelvis, including the suprarenal medulla, accounts for the origin of the ganglioneuroma which compound with the matured ganglion cells and neural elements. The ganglioneuroma is non-functioning tumor, but occasionally this tumor accompanies with hypertension and diarrhea and increased excretion of vanilmandelic acid in urine. Recently we experienced a housewife with the bilateral ganglioma which developed at both suprarenal medulla and after successful removal of the tumors hypertension was controlled.
Diarrhea ; Ganglia, Sympathetic ; Ganglion Cysts ; Ganglioneuroma* ; Hypertension ; Pelvis ; Skull ; Vanilmandelic Acid

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

BACKGROUND/AIMS: Transforming growth factor-a(TGF-a) is a polypeptide cytokine related to cell proliferation and transformation. TGF-a binds to EGF receptor and stimulating DNA synthesis in liver cell. The hepatitis B virus (HBV) by itself is also believed to play a role in the hepatic carcinogenesis. Recently, it was reported that TGF-a and HBV were synergistic in action with rapid appearance of hepatocelluar carcinoma in bitransgenic mice. Although TGF- a is thought to play an important role in hepatocarcinogenesis, its expression during the natural history of HBV hepatitis was poorly understood. This investigation was performed to elucidate the dynamic changes and istinct immunohistochemical staining patterns in the course of chronic HBV hepatitis with specific reference to hepatocelluar carcinoma and to explain the role of TGF-a in the pathogenesis of hepatocelluar carcinoma. MATERIALS/METHODS: Employing TGF-a monoclonal antibody, signal detection was carried out by peroxidase-conjugated streptavidin in deparaffinized liver tissue sections taken from HBsAg positive patients. All of the liver tissue sections were proven HBV DNA positive by in situ hybridization. Immunohistochemical staining was performed in the tissue sections obtained from four normal controls, six from patients with chronic persistent hepatitis, five with chronic active hepatitis, eight with liver cirrhosis and eleven with hepatocellular carcinoma. RESULTS: The patterns of TGF-a immunoreactivity were cytoplasmic-grain types in normal controls and chronic persistent hepatitis, honeycomb types in chronic active hepatitis, occasional cytoplasmic-flooding types in liver cirrhosis, and cytoplasmic-grape types in hepatocellular carcinoma. A Shapiro-Wilk W test for frequency table analysis for the expression of TGF-a in these different disease groups was statistically significant. CONCLUSION: These data suggest that step-wise distinct expression of TGF-a enhancement in HBV associated chranic liver diseases which eventually resulted in the development of hepatocellular carcinoma were conceivably due to dysregulation of liver cell cycles by both HBV and TGF-a during the persistent repetition of cell cycles.
Animals ; Carcinogenesis ; Carcinoma, Hepatocellular* ; Cell Cycle ; Cell Proliferation ; DNA ; Hepatitis ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Hepatitis, Chronic* ; Humans ; In Situ Hybridization ; Liver Cirrhosis* ; Liver Diseases ; Liver* ; Mice ; Natural History ; Receptor, Epidermal Growth Factor ; Streptavidin

OBJECTIVE: To determine if birth weight greater than 4000gm can be predicted by ultrasound measurement of abdominal circumference(AC) and if shoulder dystocia in macrosomic infants can be predicted by ultrasound measurement of the difference between the abdominal diameter(AD) and biparietal diameter(BPD). METHODS: A Retrospective study was performed of births occuring from March, 1998 to August, 1999 at department of Obstetrics and Gynecology, College of Medicine, Chung-Ang University. Among neonates of birth weight greater than 4000 gm, 50 cases in that ultrasound examination was done within 2 weeks before delivery were selected for macrosomic group and 50 cases were selected for control group during the same period, among neonate of birth weight from 3100gm to 3900gm. RESULTS: 1) Normal spontaneous vaginal delivery(NSVD) was 41 cases in control group and 30 cases in macrosomic group. Among NSVD, shoulder dystocia was 1 case in 41 cases of control group and was 7 cases in 30 cases of macrosomic group. 2) On ultrasound measurement, 6 cases had AC greater than 35 cm in control group and 45 cases in macrosomic group. Among 30 cases in NSVD was done in macrosomic group, difference between AD and BPD was 2.9 0.271 cm when shoulder dystocia was existed and was 2.1 0.409 cm when shoulder dystocia was not existed. Between the two groups, statistically significant difference was detected. 3) When AC(cutoff value of 35cm) was used for screening of macrosomia, sensitivity for macrosomia was 88.2% and specificity was 89.8% and when AD-BPD difference(cutoff value of 2.6cm) was used for prediction of shoulder dystocia, sensitivity for shoulder dystocia was 66.6% and specificity was 95.2%. CONCLUSIONS: In prenatal ultrasound measurement, AC measurement at third trimester of pregnancy will be a valuable indicator for macrosomia screening. The AD-BPD difference of shoulder dystocia group was greater than uncomplicated group in macrosomia and the AD-BPD difference cutoff value of 2.6cm was significant value statistically.
Birth Weight ; Dystocia* ; Female ; Gynecology ; Humans ; Infant ; Infant, Newborn ; Mass Screening ; Obstetrics ; Parturition ; Pregnancy ; Pregnancy Trimester, Third ; Retrospective Studies ; Sensitivity and Specificity ; Shoulder* ; Ultrasonography*

Subepithelial tumor (SET) is a protruding elevated mass covered with normal appearing mucosa, and is a relatively common finding during esophagogastroduodenoscopy. Recently, the incidence of asymptomatic small SETs is increasing due to esophagogastroduodenoscopy for national gastric cancer screening program in Korea. Unfortunately, the management of SETs is still controversial because the natural history of SETs is hardly known. There are only few studies about the natural history of SETs, especially in the stomach. According to studies, the overall rate of increased size of gastric SETs is 5.4~28%. Tumor size, age, non-upper area of the stomach, and detection of anechoic lesion or echogenic foci on endoscopic ultrasound (EUS) are related with size increase in gastric SETs. Gastrointestinal stromal tumors (GISTs) are one of the most important tumors, and the prognosis of GISTs is closely connected with tumor size, mitotic count, and organ location. Among them, tumor size is relatively easy to approach with esophagogastroduodenoscopy or EUS. Asymptomatic gastric SETs < or =2 cm show a benign clinical course and the malignant potential of them is nearly 0%, even if the gastric SETs are confirmed as GISTs. However, asymptomatic gastric SETs >2 cm, < or =5 cm might be considered for detailed pathologic diagnosis and treatment, if the possibility of GISTs cannot be ruled out. Well-designed, prospective studies are required for more accurate management of SETs.
Diagnosis ; Endoscopy, Digestive System ; Gastrointestinal Stromal Tumors ; Incidence ; Korea ; Mass Screening ; Mucous Membrane ; Natural History ; Prognosis ; Stomach ; Stomach Neoplasms ; Ultrasonography

No abstract available.
Child* ; Humans ; Typhoid Fever*

OBJECTIVE: To estimate the long-term skeletal responses to hormone replacement therapy(HRT) with or without active vitamin D(VD) by using short-term changes of bone markers in postmenopausal women (PMW). METHODS: Biochemical markers of bone formation(osteocalcin,OC) and (&) resorption(deoxypyridinoline, Dpd ) at 3 months & lumbar bone mineral density(BMD) at 1 year were measured in 64 natural PMW taking HRT(n=41) & HRT with calcitriol 0.25 microgram/day(n=23). The correlation of percent changes of bone markers after 3 months of Tx with those in lumbar BMD after 1 year was evaluated. RESULTS: 1. serum-OC & urine-Dpd showed decrease of 20.9% & 30.1% at 3months respectively & BMD increase of 3.8% after 1 year of Tx. 2. Among 58 PMW with decreased u-Dpd change, 49 (84.5%) revealed increase in BMD, while 40 (81.6%) among 49 PMW with decreased serum-OC change showed increased BMD. 3. Bone gainers showed significant decrease in changes of serum-OC(18.1% vs 9.2% p<0.05) & urine-Dpd(32.6% vs 20.4%, p<0.05) compared with those of bone losers. 4. No correlations of change of serum-OC (r=-0.174 p>0.05) & urine-Dpd (r=-0.091 p>0.05) at 3month with BMD changes at 1year were seen in total PMW, but urine-Dpd changes in HRT without active VD group revealed significantly inverse correlation(r=-0.376 p<0.05). CONCLUSION: Short-term changes of bone markers did not precisely predict the long-term changes of BMD in total PMW except urine- Dpd in HRT without active VD.
Biomarkers ; Bone Density* ; Calcitriol ; Estrogen Replacement Therapy* ; Female ; Humans ; Osteocalcin ; Vitamin D* ; Vitamins*

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*

PCR implication using the primers for gag, pol and rev genes in BLV (bovine leukemia virus) proviral DNA and syncytium assay were carried out for the Korean native goats experimentally infected with bovine leukemia virus to investigate pathogenesis of BLV in the goats, and to establish a model animal for BLV infection. The oligonucleotide primers used in PCR revealed very high specificity, The minimal amount of FLK-BLV cellular chromosomal DNA to detect the integrated BLV proviral DNA was 10 ng. The peripheral blood lymphocytes from the goat infected with BLV were examined at regular intervals by PCR amplification and syncytium assay. Pol or gag genes were detected in none of three infected goats at the 1st week post-infection (p.i.). At the 4th week p.i., one of three goats showed the amplified gag gene. Thereafter detection rates for the genes were increased, indicating that the BLV proviral genes were integrated in all of the lymphocytes from three goats, at the 16th weeks p.i., when it was evident in syncytium assay that the lymphocytes from all of three goats were infested with infective BLV. Investigating the tissues from the necropsied goats at the 8th month p.i., the amplified BLV proviral genes and infective BLV were detected in all of the peripheral lymphocytes from three infected-goats. Among various tissues examined, the amplified BLV proviral genes were observed in spleen and superficial cervical, mandibular and retropharyngeal lymph nodes, and the infective BLV, in superficial cervical and mandibular lymph nodes. It was assumed that the Korean native goat was quite susceptible to BLV infection, indicating that the goat could be a good model animal for BLV.
Animals ; Cattle ; Deltaretrovirus Infections ; DNA Primers ; DNA* ; Enzootic Bovine Leukosis* ; Genes, gag ; Genes, rev ; Giant Cells ; Goats* ; Leukemia ; Leukemia Virus, Bovine* ; Lymph Nodes ; Lymphocytes ; Polymerase Chain Reaction* ; Sensitivity and Specificity ; Spleen