No abstract available.
Densitometry* ; Osteoporosis*

BACKGROUND: Thoracoscopic sympathectomy seems to be a safe therapeutic procedure without a severe complication. Hypotension has been often reported as one of postoperative complications, but intraoperative changes in blood pressure (BP) were not studied. However, authors' past experience of thoracic sympathectomy told that intraoperative BP reduction could be observed only when measured in ipsilateral arm. During general anesthesia, BP reduction might be a crucial, which could be associated with complication. Authors conducted this study to establish whether BP reduction is confined to ipsilateral arm, or is systemic phenomenon in thoracoscopic sympathectomy. METHODS: Twenty healthy, male and female patients scheduled for one stage thoracoscopic thoracic sympathectomy were prepared for this study. Without premedication, invasive BP monitoring was taken place in bilateral radial arteries. General anesthesia was induced with low dose of fentanyl, propofol and vecuronium. Endotracheal intubation was done with double lumen tube and anesthesia was maintained with variable concentrations of isoflurane in 100% oxygen. Sympathetomies were done for T2~3 during one lung ventilation. BP and palmar temperature were recorded at arrival, after one lung ventilation, after sympathectomy, 5 min, 10 min, after two lung ventilation. BPs and temperatures were analyzed by time and groups. RESULTS: Concurrent with initiation of sympathectomy, BP was reduced only in ipsilateral radial artery. Mean BP decrement was almost 11% (right side: 80 +/- 11 mmHg -> 71 +/- 15 mmHg; left side: 80 +/- 14 mmHg -> 71 +/- 9 mmHg; both of p<0.05). It was accompanied with ipsilateral palmar temperature elevation (right side: 1.28 degrees C; left side: 1.19 degrees C; both of p<0.05). CONCLUSION: Conclusively, BP reduction in thoracic sympathectomy is a change confined to ipsilateral arm, which seems because of peripheral vasodilation.
Anesthesia ; Anesthesia, General ; Arm* ; Arterial Pressure* ; Blood Pressure ; Female ; Fentanyl ; Humans ; Hyperhidrosis* ; Hypotension ; Intubation, Intratracheal ; Isoflurane ; Lung ; Male ; One-Lung Ventilation ; Oxygen ; Postoperative Complications ; Premedication ; Propofol ; Radial Artery ; Sympathectomy* ; Vasodilation ; Vecuronium Bromide ; Ventilation

No abstract available.
Idiopathic Pulmonary Fibrosis*

Retrospective analysis of survival rates was undertaken in the patients of 58 cases treated with conventional radiation therapy for malignant salivary gland tumors between January 1975 and December 1984 in Korea Cancer Center Hospital (KCCH). They were patients whose long-term follow-up was possible and who had refused surgery or had had recurrences postoperatively. Out of 58 patients, 25 patients (43.1%) had mucoepidermoid carcinomas and 24 patients (41.3%) adenoid cystic carcinoma. Total actuarial survival rates at 5 years and 10 years were 68.2% and 31.8% respectively, but disease-free survival rates, 43.2% and 13.0%, respectively. According to TNM stage, the survival rates at 5 years were 86.5% in T1, 40.0% in T2 + T3, and 0% in T4. In terms of histologic types, 5 years disease-free survival rate of adenoid cystic carcinomas (40.1%) was lower than that of mucoepidermoid carcinomas (49.8%) but overall survival rate (77.3%) was much higher than that of mucoepidermoid carcinomas (51.5%). Therefore, we concluded that the patients, who had had disease after failure of treatment, could survive during a certain period of time and their alive times were 2 years on the average. There was a difference in survival rates in the mucoepidermoid carcinomas in terms of histological grade of differentiation and it was a arbiter in prognosis: 5 YSR of low-grade was 78.8% and higher 2 times than that of high-grade. There was no difference in survival rates according to location and sex. The number of patients having minor salivary gland tumors was 6 cases and their actuarial 5 YSR was 32.3%. Consequently, prognostic factors which influence the survival rates of patients with malignant salivary gland tumors are thought to be 1) histological ubtypes 2) T and N staging (AJCC) 3) histological grade, especially in mucoepidermoids.
Carcinoma, Adenoid Cystic ; Carcinoma, Mucoepidermoid ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Korea* ; Prognosis ; Recurrence ; Retrospective Studies ; Salivary Glands* ; Salivary Glands, Minor ; Survival Rate

BACKGROUND: Physical activity and calcium nutriture with reproductive endocrine status are primary controller of bone remodelling activity. There are differences in impact of exercise on early menopausal bone ; late menopausal bone. There are possibility of different effect of calcium intake on bone mass among different life stage. The aim of this study was to elucidate whether the relation between lifestyle and bone mineral density varied with life stages. METHODS: We examined bone mineral density and took questionnaires related to lifestyle of 1,698 women aged 49~54 years old who lived in ulsan from July 1999 to Dec. 1999. We selected 731 healthy subjects without medical conditions or lifestyle factors known to affect bone metabolism. RESULTS: In 6~10 years postmenopausal women, those with calcium intake of more than 600 or 800mg /day showed significantly greater BMD. In postmenopausal women , those daily consumption of milk showed greater BMD. But it is not significantly. In premenopausal women with regular menstruation, those who took regular exercise showed significantly greater BMD than those who did not. Working hours is not related with BMD. CONCLUSIONS: Our study showed that the relation between calcium intake or physical activity and BMD differed with life stages. It was suggested that life stages should be taken into consideration to perform lifestyle modifications for the prevention and management of osteoporosis.
Bone Density* ; Calcium* ; Female ; Humans ; Life Style ; Menopause ; Menstruation ; Metabolism ; Milk ; Motor Activity* ; Osteoporosis ; Ulsan ; Surveys and Questionnaires

No Abstract Available.
Female ; Hormone Replacement Therapy* ; Humans ; Life Style* ; Osteoporosis*

PURPOSE: Purpose: To compare the diagnostic accuracy of ferumoxides-enhanced MR with that of combined CT during arterial portography (CTAP) and CT hepatic arteriography (CTHA) in the preoperative detection of hepatocellular carcinoma (HCC). MATERIALS AND METHODS: For preoperative evaluation, 20 patients with HCC underwent ferumoxides-enhanced MR and combined CTAP and CTHA. The MR protocol included fat-suppressed respiratory-triggered fast spin echo, T2*-weighted fast multiplanar gradient-recalled acquisition in the steady state, proton density-weighted fast multiplanar spoiled gradient-recalled echo, and breath-hold in-phase T1-weighted fast multiplanar spoiled gradient-recalled echo. In all patients, laparotomy was performed. The presence or absence of HCC was confirmed by pathologic examination in the resected liver and by intraoperative ultrasonography of remaining liver, or by follow up. Images were reviewed by three radiologists working independently; regarding the presence or absence of HCC in each segment, each observer assigned one of five confidence levels. A receiver operating characteristic (ROC) curve was fitted to these confidence ratings, and the diagnostic accuracy of each modality was evaluated by calculating the Az value (area under the ROC curve) and compared with that of other modalities. The sensitivity and specificity of each modality in the detection of HCC were also calculated and compared, and using a κstatistic, inter-observer agreement for each modality was assessed. RESULTS: In 28 of 160 liver segments, 30 HCCs were present. For ferumoxide-enhanced MR the mean Az value was 0.958, and for combined CTAP and CTHA this value was 0.948. The difference was not statistically significant. The mean sensitivities of ferumoxide-enhanced MR and combined CTAP and CTHA were 92.9% and 90.9%, respectively, the difference being statistically insignificant. The mean specificities of these modalities were, respectively, 98.9% and 93.6%. The difference was statistically significant. For both ferumoxide-enhanced MR and combined CTAP and CTHA, interobserver agreement was excellent. CONCLUSION: In the preoperative detection of HCC, ferumoxide-enhanced MR imaging of the liver showed a diagnostic accuracy similar to that of combined CTAP and CTHA. Its specificity, however, was higher.
Angiography* ; Carcinoma, Hepatocellular* ; Follow-Up Studies ; Humans ; Iron ; Laparotomy ; Liver ; Liver Neoplasms ; Magnetic Resonance Imaging ; Portography* ; Protons ; ROC Curve ; Sensitivity and Specificity ; Ultrasonography

OBJECTIVE: To analyze the incidence of gestational diabetes mellitus (GDM) and its clinical implication of glycosuria identified in 2nd trimester pregnancy. METHODS: This study included pregnant women who had undertaken the 50 g oral glucose tolerance test (50 g OGTT) between 24 and 28 weeks gestation and delivered at term (N=704). Blood and urine sample were collected and analyzed for glucose level, one hour after 50 g OGTT. We applied women to 100 g OGTT if their blood glucose level after 50 g OGTT were more than 140 mg/dL. We compared blood glucose level, rate of GDM, birth weight and number of macrosomia at different urine glucose levels. Urine glucose level were measured by urine dipstick test and grouped to trace, 1+, 2+, 3+, and 4+, which were corresponding to 100, 250, 500, 1,000, 2,000 mg/dL. RESULTS: Women with glycosuria after 50 g OGTT were 258/704 (36.6%). Mean blood glucose levels were 117+/-23 mg/dL, 128+/-20 mg/dL, 135+/-23 mg/dL, 132+/-17 mg/dL, 139+/-25 mg/dL, 153+/-45 mg/dL, mean birth weight 3.29+/-0.40 kg, 3.25+/-0.40 kg, 3.27+/-0.41 kg, 3.34+/-0.35 kg, 3.28+/-0.41 kg, 3.33+/-0.40 kg, and numbers of macrosomia (> or =4.0 kg) 20 (4.5%), 3 (4.8%), 1 (1.8%), 2 (4.2%), 3 (6.7%), 0 (0%) at glycosuria level of negative, trace, 1+, 2+, 3+ and 4+ respectively. Glycosuria level was correlated significantly with blood glucose level (P=0.000), but not with birth weight and macrosomia (P=0.838, 0.881). The rate of GDM was 7/55 (12.7%), 2/48 (4.7%), 7/45 (15.6%), 8/48 (16.7%) in glycosuria level of 1+, 2+, 3+, 4+ and their relationship was statistically significant (P=0.000, AUC=0.734, 95%CI 0.638-0.830). In the cut off value of glycosuria 1+ or greater, sensitivity and positive predictive value were 72.7 and 12.2%. CONCLUSION: Glycosuria correlates well with blood glucose level and GDM prevalence but not with birth weight.
Birth Weight ; Blood Glucose ; Diabetes, Gestational ; Female ; Glucose ; Glucose Tolerance Test ; Glycosuria ; Humans ; Incidence ; Pregnancy ; Pregnant Women ; Prevalence