During past 4 years, 15 patients over 50 years of age with secundum atrial septal defect underwent surgery in our hospital. The ages ranged from 50 to 70 years with a mean of 59.7 years. Before operation, 8 were in functional class II, 7 in class III (New York Heart Associasion classification). Thirteen patients had pulmonary hypertension, 8 had right-to-left shunt and 6 had atrial fibrillation. Pulmonary function test showed decreased %VC and FEV_1.0% with a mean of 74% and 65%, respectively. Cardiothoracic ratio ranged from 48 to 77 with a meam of 60%. Preoperative laboratory data showed significant inverse correlations between CTR and %VC and between pulmonary arterial pressure and %VC. The defects were closed directly in 6 patients and closed using patches in 9. All patients survived the operation. Postoperatively, antithrombotic agents were administered to the patients with patch closure. After operation, all but one improved to functional class I and no patients had embolic episode.

OBJECTIVES: We compared the effectiveness of bisphosphonates combined with activated vitamin D administered for therapy of aromatase inhibitor-induced osteoporosis after a breast cancer operation and primary postmenopausal osteoporosis through propensity score matching. METHODS: Forty-eight postmenopausal patients with estrogen receptor-positive early breast cancer, who had postoperative adjuvant treatment with aromatase inhibitors and whose T-score of bone mineral density (BMD) decreased below −2.5 (AI group), and 48 patients of primary postmenopausal osteoporosis (PO group) enrolled in this retrospective observational study. They were administered monthly risedronate or minodronate, and daily alfacalcitol or eldecalcitol were combined. Their BMD (L2–4, L-BMD), serum-corrected calcium, serum phosphate, tartrate-resistant acid phosphatase 5b (TRACP-5b), bone alkaline phosphatase (BAP), estimated glomerular filtration rate, urine calcium/creatinine ratio, intact-parathyroid hormone, and 25-hydroxy vitamin D were measured before treatment and until 24 months. RESULTS: L-BMD values increased with time compared with the baseline values in each group, and there was no significant difference in the groups. Percentage value of TRACP-5b decreased rapidly after 6 months and maintained low level until 24 months in both groups. Percentage value of BAP in the AI group decreased continuously until 24 months. In contrast, the percentage change in the PO group plateaued after 6 months. CONCLUSIONS: It is suggested that monthly oral bisphosphonate combined with activated Vitamin D is an effective therapy to increase BMD in the aromatase inhibitor-induced osteoporosis after breast cancer operation. Monitoring of kidney function and concentration of Ca in blood and urine may be necessary.
Acid Phosphatase ; Alkaline Phosphatase ; Aromatase Inhibitors ; Aromatase ; Bone Density ; Breast Neoplasms ; Breast ; Calcium ; Diphosphonates ; Estrogens ; Female ; Glomerular Filtration Rate ; Humans ; Kidney ; Observational Study ; Osteoporosis ; Osteoporosis, Postmenopausal ; Propensity Score ; Retrospective Studies ; Risedronate Sodium ; Vitamin D ; Vitamins