BACKGROUND: Although lack of exercise is well known to be a risk factor of osteoporosis, it is unclear whether weight-bearing exercise has different effects on bone mineral density compared to non weight-bearing exercise, and the amount of exercise needed to prevent osteoporosis is not clearly defined. This study was performed to clarify the relations between the type and the amount of exercise with BMD. METHODS: This was a cross-sectional study of 3,661 women who had undertaken health screening including BMD measurement at Health Promotion Center of SNUH between May 1997 and March 1999. Information on sociodemographic characteristics, menarche, childbirth andexercise were gathered by means of self-reported questionnaire, and BMD was measured using DEXA. RESULTS: The number of women with lumbar osteoporosis were 601 (16.4%) and femoral neck osteoporosis 372 (10.2%). Lumbar osteoporosis occurred more frequently with increasing age and age at menarche, and in menopausal women, but less frequently with increasing fat-free mass in multiple logistic regression analysis. When adjusted for age, age at menarche, menopause and fat-free mass, lumbar osteoporosis was less common in women who exercised, but the type and the amount of exercise had no bearing. Especially, lumbar osteoporosis was least common in women engaging in moderate amount of exercise. Femoral neck osteoporosis decreased significantly only in weight-bearing exercise group and in women engaging in high amount of exercise. CONCLUSION: The results of this study suggest that lumbar osteoporosis can be prevented through exercise regardless of its type and amount, and high amount or weight- bearing exercise is most effective to prevent femoral neck osteoporosis.
Adult* ; Body Composition ; Bone Density* ; Cross-Sectional Studies ; Female ; Femur Neck ; Health Promotion ; Humans ; Logistic Models ; Mass Screening ; Menarche ; Menopause ; Osteoporosis ; Parturition ; Risk Factors ; Weight-Bearing ; Surveys and Questionnaires

Between 1989 and 1995, 14 patients with Kienbock's disease were treated with radial shortening or a radial wedge osteotomy. Clinical and radiological changes were classified according to Lichtman's stages and ulnar variance. Seven patients were male and seven were female. The mean age was 45 years, ranging from 29 to 64. The average follow-up period was 29 months, ranging from 12 to 61. Of the ten patients with negative ulnar variance who were treated by radial shortening, two cases were in Lichtman's stage II, six cases were stage III-a and two cases were stage III-b. Of the four patients with zero or positive ulnar variance who were treated by a radial wedge osteotomy, one case was stage 11 and three cases were stage III-a. The results were evaluated in terms of diminished wrist pain, increased grip strength, increased range of wrist motion and radiologic changes of the lunate. Wrist pain had diminished in all patients and grip strength had increased on average from 54% to 70% in the unaffected side. The range of arc of the wrist had increased on average from 59degrees preoperatively to 93 postoperatively. Sclerosis of the lunate improved in 43% of cases, cystic changes of the lunate improved in 57%, fragmentation of the lunate improved in 36% and the carpal height ratio increased in 50%. Of the 14 patients, 13 patients (93%) showed satisfactory results. One patient had an unsatisfactory result, according to Lichtman's criteria. These results suggest that radial shortening or a radial wedge osteotomy is recommended in patients with stage ll, III-a or III-b Kienb ck's disease, according to the ulnar variance. Early wrist pain reduction, increased range of motion and grip strength and improved avascularity of the lunate are all positive outcomes attainable with these treatment methods.
Female ; Follow-Up Studies ; Hand Strength ; Humans ; Male ; Osteonecrosis* ; Osteotomy* ; Range of Motion, Articular ; Sclerosis ; Wrist

Inability to tolerate discontinuation of mechanical ventilation or the need for reintubation has been reported .s much as 20% in mechanically ventilated patients. Many factors may be responsible for the .nsuccessful weaning outcome such as hypoventilation secondary to decreased respiratory c,nter output, respiratory muscle fatigue, impaired pulmonary gas exchange and excessive ventilatory requirements. We experienced a patient who was very difficult to wean from long term mechanical ventilation. The patient was 36 years old male with Guillain Barre syndrome. After 7 days admission, tracheostomy was taken and mechanical ventilation continued to 332 days. There was not any chance of pneumonia during the 11 months ventilation. His respiratory parameter improved to TV of 350 ml and VC of 1300 ml and he was able to breath himself without mechanical ventilator during day time. But he could not sleep without ventilator for fear of dying during sleep. We made him sleep with diazepam injection and carefully observed the patient with pulse oximetry and Sara capnography. We tried this method many times and the patient got the confidence that he cauld alive during sleep without mechanical ventilator. We could wean from long term mechanical ventilation during sleep by carefully observing patients respiratory pattern. Therefore we report here this successful weaning from long term ventilator in anxious and nervous patient.
Adult ; Capnography ; Diazepam ; Fatigue ; Guillain-Barre Syndrome ; Humans ; Hypoventilation ; Male ; Oximetry ; Pneumonia ; Pulmonary Gas Exchange ; Respiration, Artificial* ; Respiratory Muscles ; Tracheostomy ; Ventilation ; Ventilators, Mechanical ; Weaning*

No abstract available.
Humans* ; Placenta* ; Pregnancy*

Acute intermittent porphyria(AIP) is a rare hepatic disorder resulting from defects in the synthesis of heme. This occurs in approximately 0.01% of the general population and is even rare in black and orientals. Acute episode of this disease can be triggered by surgery, certain drug, pregnancy, mensturation, fasting and etc. We report a porphyrinogenic neuropathy occured after general anesthesia in a oriental woman who presented with abdominal pain and other typical sign and symptom. 56 year-old female patient was diagnosed as acute appendicitis for 2 days of constipation and abdominal pain and appendectomy was performed under general anesthesia at local clinic. Anesthesia was induced with penthothal and maintained with halothane, and she was recovered from anesthesia without event. After operation she experienced difficult swallowing and generalized weakness which were aggrevated day by day. Therefore she was transferred to our hospital on fourth postoperative day. Physical examination revealed Grade II motor weakness of Gxtremities and decreased deep tendon reflex. Neostigmine test and Jolly test were done under impression of myasthenia gravis but revealed negative. Guillian-Barre syndrome was difficult to rule out in this patient, but urinalysis revealed increased delta aminolevulinic acid and urine color changed dark under light. Therefore we diagnosed her as AIP. 6 days after appendectomy she complained severe dyspnea with vital capacity 350 ml and arterial blood gas analysis revealed PO2 of 56 mmHg and PCO2 of 44 mmHg under nasal oxygen 5 1/min inhalation. Therefore we diagnosed this peripheral neuropathy as AIP and report here with references.
Abdominal Pain ; Aminolevulinic Acid ; Anesthesia ; Anesthesia, General ; Appendectomy ; Appendicitis ; Blood Gas Analysis ; Constipation ; Deglutition ; Dyspnea ; Fasting ; Female ; Halothane ; Heme ; Humans ; Inhalation ; Middle Aged ; Myasthenia Gravis ; Neostigmine ; Oxygen ; Peripheral Nervous System Diseases ; Physical Examination ; Porphyrias ; Pregnancy ; Reflex, Stretch ; Urinalysis ; Vital Capacity

Adult Respiratory Distress Syndrome(ARDS) is defined as a syndrome of acute respiratory failure characterized by noncardiogenic pulmonary edema with severe hypoxemia caused by right to left intrapulmonary shunting secondary to atelectasis and air space filled with edema fluid. On the past respiratory failure was thought to be the most common cause of mortality of ARDS in the past but recent research suggests the importance of non-pulmonary organ failure. And this has been increasingly recognized as a major cause of death in patients who develope a acute lung injury. Therefore the prognosis of ARDS depends on the associated clinical disorders. But there are very few reports about the prognosis and predisposing factor of ARDS in korea. We performed a retrospective study on ARDS in association with sex prevalance, in 103 ARDS patients. Age distribution, associated disease and prognosis. The results were as follows l) ARDS occurred more frequantly in male.(male female=1.9: 1) 2) Common clinical disorders associcated with development of ARDS were sepsis(26%), pneumonia(16%), gastric aspiration(12%) and etc. 3) Overall mortality was 54%, but the mortality was high in trauma patient with 80%. 4) Mortality of ARDS increased by age.
Acute Lung Injury ; Adult* ; Age Distribution ; Anoxia ; Causality* ; Cause of Death ; Edema ; Humans ; Korea ; Mortality ; Prognosis* ; Pulmonary Atelectasis ; Pulmonary Edema ; Respiratory Distress Syndrome, Adult* ; Respiratory Insufficiency ; Retrospective Studies

PURPOSE: To investigate the prognostic role of apoptosis and to evaluate the relationship between apoptosis and apoptosis-related genes, as well as cell proliferation in renal cell carcinoma (RCC). MATERIALS AND METHODS: Apoptosis was detected by using the terminal deoxynucleotidyl transferase (TdT) mediated dUTP nick-end labeling (TUNEL) technique in 67 formalin-fixed and paraffin-embedded RCC specimens. Immunohistochemical stainings for p53 and retinoblastoma (Rb) proteins and proliferating cell nuclear antigen (PCNA) were also conducted simultaneously. RESULTS: The apoptotic index (AI) varied from 0.2% to 25.5%. The PCNA index (PI) ranged from 2.1% to 70.3%. The expression of p53 protein was found in 31 of 67 (46.3%) cases. Abnormal expression of Rb was seen in 23 of 67 (34.3%) cases. There was a statistically significant positive correlation between AI and increasingnuclear grade (p<0.001). A significant correlation was found between AI and PI (r=0.329, p<0.01). When comparing the AI with the expression of p53 and Rb proteins, there was no significant difference. In univariate survival analysis, nuclear grade, TNM stage, PI, expression of Rb and AI were significantly associated with shortened survival. However, TNM stage was the only independent prognostic factors by multivariate analysis. CONCLUSION: The present findings indicate that apoptosis in RCC is closely associated with cell proliferation, but not with the expression of p53 and Rb proteins. In multivariate analysis, the AI does not carry an independent prognostic significance.
Apoptosis* ; Carcinoma, Renal Cell* ; Cell Proliferation* ; DNA Nucleotidylexotransferase ; Genes, vif ; Multivariate Analysis ; Proliferating Cell Nuclear Antigen ; Retinoblastoma ; Retinoblastoma Protein

Nosocomial pneumonia is a common complication of mechanical ventilation. However the actual incidence of pneumonia associated with ventilator is not known. A total of 57 consecutive patients submitted to mechanical ventilation(MV) for mqre than 48 hours in ICU were studied to investigate the incidence, etiology and consequence of ventilator associated pneumonia. Pneumonia was diagnosed when new and persistent radiographic infiltration was detected together with more than two of the following criteria; (l) fever more than 38degrees C, (2) leukocytosis more than 12000/mm, (3) purulent sputum with s gram stain showing bacteria. The results are as following: l) Twenty-one(37.9%) patients developed bacterial pneumonia during mechanical ventilation 2) Ventilator associated pneumonia was developed after 4.6 days of machanical ventilation 3) The etiology of pneumonia were Gram(-) bacilli 65.8%, Gram(+) bacilli 31.7% and, Pseudomonas 27.9%, Streptococcus 16.5% and or, Staphylococcus 13.9%.
Bacteria ; Fever ; Humans ; Incidence* ; Leukocytosis ; Pneumonia* ; Pneumonia, Bacterial ; Pneumonia, Ventilator-Associated ; Pseudomonas ; Respiration, Artificial* ; Sputum ; Staphylococcus ; Streptococcus ; Ventilation ; Ventilators, Mechanical

Nosocomial pneumonia is a common complication of mechanical ventilation. However the actual incidence of pneumonia associated with ventilator is not known. A total of 57 consecutive patients submitted to mechanical ventilation(MV) for mqre than 48 hours in ICU were studied to investigate the incidence, etiology and consequence of ventilator associated pneumonia. Pneumonia was diagnosed when new and persistent radiographic infiltration was detected together with more than two of the following criteria; (l) fever more than 38degrees C, (2) leukocytosis more than 12000/mm, (3) purulent sputum with s gram stain showing bacteria. The results are as following: l) Twenty-one(37.9%) patients developed bacterial pneumonia during mechanical ventilation 2) Ventilator associated pneumonia was developed after 4.6 days of machanical ventilation 3) The etiology of pneumonia were Gram(-) bacilli 65.8%, Gram(+) bacilli 31.7% and, Pseudomonas 27.9%, Streptococcus 16.5% and or, Staphylococcus 13.9%.
Bacteria ; Fever ; Humans ; Incidence* ; Leukocytosis ; Pneumonia* ; Pneumonia, Bacterial ; Pneumonia, Ventilator-Associated ; Pseudomonas ; Respiration, Artificial* ; Sputum ; Staphylococcus ; Streptococcus ; Ventilation ; Ventilators, Mechanical

STATEMENT OF PROBLEM: There are two methods of color choice for the esthetic restoration. One is visual shade matching which draws a comparison between shade guide and teeth in dentist's own eye and the other is using a digital shade analysis system recently introduced. Although the visual shade matching has a lot of problems, decision of color by this visual shade matching and the ways of expression for the decided color are still applicable to clinical dentistry. PURPOSE: This study is designed to investigate shade guides used in the dental clinics and laboratories have the same value using ShadeEye-NCC(R). dental chroma meter (Shofu Inc., Kyoto, Japan) using shade guide are evaluated. MATERIAL AND METHODS: At the first experiment, eight Vita Lumin Vacuum shade guides (Vident Inc., California, USA) were collected from the dental clinics. A1 and B1 shade tabs are chosen and the colors are analyzed five times each in both tooth and porcelain modes by digital shade analysis system, ShadeEye-NCC(R). In the second experiment, twelve Vita shade guides using practically in the dental clinics and laboratories were collected and also A1 and B1 shade tabs are chosen and the colors of A1 and B1 are analyzed one time each in both tooth and porcelain modes by ShadeEye-NCC(R). RESULTS AND CONCLUSION: There were significant differences among eight shade guides in terms of shade (chroma), value and hue in both of A1 and B1 (P < .05). Shade guides using in present both dental clinics and laboratories did not show significant differences, except A1 in the porcelain mode, it showed significant differences (P < .05) in the shade even though the shade tab has the same name.
California ; Dental Clinics ; Dental Porcelain ; Dentistry ; Eye ; Quinolinium Compounds ; Tooth ; Vacuum