No abstract available.
Blood Platelets* ; Platelet Activating Factor* ; Progesterone*

No abstract available.
Bone Density* ; Female ; Lactation* ; Postpartum Period*

OBJECTIVES: The purpose of this study was to observe the changes of lipid levels during 4 years of hormone replacement therapy (HRT) in postmenopausal women. We also tried to determine whether lipid changes were different according to the treatment regimen and baseline lipid values. METHODS: A total of 108 postmenopausal women were treated with cyclic combined HRT (n=60), continuous combined HRT (n=19), and conjugate estrogen (n=29) alone. Serum total cholesterol, HDL-cholesterol, LDL-cholesterol and triglyceride were measured before and after HRT every year. RESULTS: After 4 years of HRT, HDL-cholesterol level raised significantly (10.1%, p=0.001), but total cholesterol and LDL-cholesterol levels were not changed (1,1%, -0.1%). Triglyceride level significantly raised at first year (22.2%, p=0.001) and maintained over three year, but the level became similar to the baseline value at fourth year. The changing patterns of HDL-cholesterol, LDL-cholesterol and triglyceride were not different among cyclic HRT, continuous HRT and estrogen alone treatment group but total cholesterol levels at fourth year were significantly different according to the treatment regimen (-12.7% in continuous HRT, -0.3% in estrogen alone, and 7.3% in cyclic HRT, p=0.02). HRT had more favorable effect in women with baseline hypercholesterolemia compared to women with baseline normocholesterolemia since the reducing effects on total-cholesterol and LDL-cholesterol and the raising effect on HDL-cholesterol were greater. CONCLUSION: Postmenopausal HRT had a more beneficial effect on lipid profile in women with Hypercholesterolemia. This finding may suggest that those women could be the best candidates for HRT.
Cholesterol ; Estrogens ; Female ; Follow-Up Studies* ; Hormone Replacement Therapy* ; Humans ; Hypercholesterolemia ; Triglycerides

Gastric hemangioma in the neonatal period is a very rare cause of upper gastrointestinal bleeding. We present a case of hemangioma limited to the gastric cavity in a 10-day-old infant. A huge, erythematous mass with bleeding was observed on the lesser curvature side of the upper part of the stomach. Surgical resection was ruled out because the location of the lesion was too close to the gastroesophageal junction. Medical treatment with intravenous H₂ blockers, octreotide, packed red blood cell infusions, local epinephrine injection at the lesion site, application of hemoclip, and gel-form embolization of the left gastric artery did not significantly alter the transfusion requirement. Hemostasis was achieved with endoscopic argon plasma coagulation (APC). After two sessions of APC, complete removal of the lesion was achieved. APC was a simple, safe and effective tool for hemostasis and the ablation of gastric hemangioma without significant complications.
Argon Plasma Coagulation* ; Argon* ; Arteries ; Epinephrine ; Erythrocytes ; Esophagogastric Junction ; Hemangioma* ; Hemorrhage ; Hemostasis ; Humans ; Infant ; Infant, Newborn* ; Octreotide ; Stomach

PURPOSE: Gallbladder (GB) wall thickening can be found in various conditions unrelated to intrinsic GB disease. We investigated the predisposing etiologies and the outcome of acalculous GB wall thickening in children. METHODS: We retrospectively analyzed 67 children with acalculous GB wall thickening who had visited our institute from June 2010 to June 2013. GB wall thickening was defined as a GB wall diameter >3.5 mm on abdominal ultrasound examination or computed tomography. Underlying diseases associated with GB wall thickening, treatment, and outcomes were studied. RESULTS: There were 36 boys and 31 girls (mean age, 8.5+/-4.8 years [range, 7 months-16 years]). Systemic infection in 24 patients (35.8%), acute hepatitis in 18 (26.9%), systemic disease in 11 (16.4%), hemophagocytic lymphohistiocytosis in 4 (6.0%), acute pancreatitis in 3 (4.5%), and specific liver disease in 3 (4.5%) predisposed patients to GB wall thickening. Systemic infections were caused by bacteria in 10 patients (41.7%), viruses in 5 patients (20.8%), and fungi in 2 patients (8.3%). Systemic diseases observed were systemic lupus erythematosus in 2, drug-induced hypersensitivity in 2, congestive heart failure in 2, renal disorder in 2. Sixty-one patients (91.0%) received symptomatic treatments or treatment for underlying diseases. Five patients (7.5%) died from underlying diseases. Cholecystectomy was performed in 3 patients during treatment of the underlying disease. CONCLUSION: A wide range of extracholecystic conditions cause diffuse GB wall thickening that resolves spontaneously or with treatment of underlying diseases. Surgical treatments should be avoided if there are no definite clinical manifestations of cholecystitis.
Acalculous Cholecystitis ; Bacteria ; Child* ; Cholecystectomy ; Cholecystitis ; Female ; Fungi ; Gallbladder* ; Heart Failure ; Hepatitis ; Humans ; Hypersensitivity ; Liver Diseases ; Lupus Erythematosus, Systemic ; Lymphohistiocytosis, Hemophagocytic ; Pancreatitis ; Retrospective Studies ; Ultrasonography

PURPOSE: The aim of this study was to investigate the clinical features and extraintestinal manifestations (EIMs) of Crohn disease (CD) in Korean pediatric patients. METHODS: The medical records of 73 children diagnosed with CD were retrospectively reviewed. Data regarding baseline demographic and clinical characteristics, including CD phenotype at diagnosis based on the Montreal classification, and clinical features and course of EIMs were investigated. RESULTS: Fifty-two (71.2%) of the patients were males. The mean age of the patients was 12.5 years. The mean follow-up period was 3.4 years. The disease location was ileal in 3 (4.1%) of the patients, colonic in 13 (17.8%), ileocolonic in 56 (76.7%). The clinical behavior was inflammatory in 62 (84.9%) of the patients, stricturing in 8 (11.0%), and penetrating in 3 (4.1%). Perianal abscesses or fistulas were found in 37 (50.7%) of the patients. EIMs observed during the study period were anal skin tag in 25 patients (34.2%), hypertransaminasemia in 20 (27.4%), peripheral arthritis in 2 (2.7%), erythema nodosum in 2 (2.7%), vulvitis in 1 (1.4%), uveitis in 1 (1.4%), and pulmonary thromboembolism in 1 (1.4%). CONCLUSION: Perianal diseases and manifestations were present in more than half of Korean pediatric CD patients at diagnosis. Inspection of the anus should be mandatory in Korean children with suspicious CD, as perianal fistulas, abscesses, and anal skin tags may be the first clue to the diagnosis of CD.
Abscess ; Anal Canal ; Arthritis ; Child* ; Classification ; Colon ; Crohn Disease* ; Diagnosis ; Erythema Nodosum ; Fistula ; Follow-Up Studies ; Humans ; Male ; Medical Records ; Phenotype ; Pulmonary Embolism ; Retrospective Studies ; Skin ; Uveitis ; Vulvitis

Autoimmune pancreatitis or IgG4-related sclerosing cholangitis often involves the liver. Most common lesion involving the liver is shown as mass or masses often referred as inflammatory pseudotumor. Inflammatory pseudotumor usually needs to be discriminated with malignancy. Here we report a case of IgG4-related sclerosing cholangitis with liver involvement presented as a mass. It was proven by biopsy and did not show any evidence of autoimmune pancreatitis. The mass infiltrated around the portal tract and portal vein thrombosis was also present.
Biopsy ; Cholangitis, Sclerosing* ; Granuloma, Plasma Cell ; Liver* ; Pancreatitis ; Venous Thrombosis

Duodenal variceal bleeding in patients with portal hypertension due to cirrhosis or other causes is uncommon. We report on a case of a 55-year-old male with an ectopic variceal rupture at the distal fourth part of the duodenum who presented with massive hematochezia and shock. Shortly after achievement of hemodynamic stability, due to the limitation of an endoscopic procedure, we initially attempted to find the bleeding focus by abdominal computed tomography, which showed tortuous duodenal varices that drained into the left gonadal vein. He was treated with first-line balloon-occluded retrograde transvenous obliteration (BRTO), resulting in a favorable long-term outcome without rebleeding three years later. This case suggests that BRTO may be a first-line therapeutic option for control of ruptured duodenal varices, especially at a distal location.
Balloon Occlusion ; Duodenal Diseases/*diagnosis/radiography/therapy ; Embolization, Therapeutic ; Gastrointestinal Hemorrhage/therapy ; Humans ; Male ; Middle Aged ; Tomography, X-Ray Computed

In order to define osteoporosis on the basis of bone mineral measurements, one must define an acceptable normal range or fracture threshold. It is clear that the normal range cannot be compared between different ethnic groups. We have measured spinal bone mineral density (BMD) by dual photon absorptiometry in 277 women without spinal fracture, aged 30-91 years, and in 53 women with asymptomatic spinal fracture to provide such a database for normal Korean women. Peak bone mass at the 3rd decade was 1.24 g/cm2. BMD from age 40-69 was strongly correlated with age (r = -0.7) and the annual decrease averaged 0.018gm/cm2. The rate of annual loss slowed by 50% in women after 70% years of age. Fracture threshold was evaluated at the 90th percentile for spinal BMD in patients with vertebral fractures. The fracture threshold of the vertebra was 0.94 g/cm2. Approximately 50% of normal women over 50 years of age had values below this threshold. These findings suggest that the way of developing low bone mass in Korean women is to peak high and lose fast.
Adult ; Age Factors ; Aged ; Asian Continental Ancestry Group ; *Bone Density ; European Continental Ancestry Group ; Female ; Fractures, Bone/etiology ; Humans ; Korea ; Menopause/metabolism ; Middle Aged ; Osteoporosis/*metabolism ; Spine/*chemistry

We investigated the immune response induced by the Francisella (F.) tularensis live vaccine strain (LVS) and the Pohang isolate. After the Balb/c mice were infected intradermally (i.d) with 2 x 10(4) cfu of F. tularensis LVS and Pohang, respectively, their blood and organs were collected at different times; 0, 3, 6, 24, 72, 96, 120 and 168 h after infection. Using these samples, RT-PCR and ELISA analysis were carried out for the comparative study of the cytokines, including TNF-alpha, INF-gamma, IL-2, IL-4, IL-10 and IL-12. In the Pohang-infected mice at 120 h, the liver showed a 53 times higher level of TNF-alpha and a 42 times higher level of IFN-gamma than the respective levels at the early time points after infection. The levels of TNF-alpha and IFN-gamma induced by LVS were 5 times lower than those induced by the Pohang isolate. Also, the organs from the Pohang-infected mice showed higher levels of TNF-alpha, IFN-gamma, IL-10 and IL-12 than the levels in the LVS-infected mice. The blood from the Pohang-infected mice at 120 h revealed about a 40 times increased level of IFN-gamma, and IL-10 was also increased by 4 times at 96 h compared to an early infection time point, while IL-4 was not induced during the whole infection period. These results suggest that F. tularensis may induce a Th1-mediated immune response to in vivo infection and the Pohang isolate has a higher capacity than the LVS to induce an acute immune response in Blab/c mice.
Animals ; *Bacterial Vaccines ; Cytokines/*biosynthesis ; Francisella tularensis/immunology/isolation & purification/*pathogenicity ; Humans ; Interferon-gamma/genetics/metabolism ; Interleukins/genetics/metabolism ; Korea ; Liver/microbiology/pathology ; Mice ; Mice, Inbred BALB C ; Polymerase Chain Reaction ; Tularemia/*diagnosis/*immunology ; Tumor Necrosis Factor-alpha/genetics/metabolism