No abstract available.

PURPOSES: To evaluate the effect of hormone replacement therapy(HRT) on serum insulin-like growth factors(IGFs) levels and to investigate if changes in serum IGFs reflect changes in BMD after HRT in postmenopausal women. MATERIAL & METHODS: IGF-I and IGF-II were measured by radioimmunoassay after Bio-spin P-10 seperation in sera obtained every 3 months from postmenopausal women who was taking premarin alone (premarin group; n=17) or premarin-medroxyprogesterone acetate(MPA group; n=42) for 1 year. Also, bone mineral density(BMD) were determined before and 1 year after HRT by dual energy X-ray absorptiometry(DEXA). All statistics were performed by Paired t-test, student's t-test, repeated measures ANOVA test, Pearson's coefficient. RESULTS: HRT increased BMD of the lumbar spine and proximal femur in both premarin group and MPA group, but any difference in degreee of increase in BMD was not noted between premarin group and MPA group. Compared with pretreatment levels, serum IGF-I levels decreased at 3, 6 and 12 months after therapy only in latter group whereas serum IGF-II levels increased at 6 and 12 months after HRT in both groups. Changes in serum IGF-I and IGF-II levels during therapy did not show any difference by the bone response to HRT. Changes in serum IGF-II levels after HRT did not correlated with the 1 year changes in BMD at any skeletal sites studied, but changes in serum IGF-I levels from pretreatment to 6 months after HRT was negatively correlated with change in BMD of Ward's triangle. CONCLUSION: HRT influences serum IGF levels in postmenopausal women and changes in serum IGF-I levels may predict the changes in BMD of Ward's triangle after HRT.
Bone Density* ; Estrogens, Conjugated (USP) ; Female ; Femur ; Hormone Replacement Therapy* ; Humans ; Insulin-Like Growth Factor I ; Insulin-Like Growth Factor II ; Postmenopause ; Radioimmunoassay ; Spine

No abstract available.
Humans ; Pregnancy, Twin* ; Twins*

BACKGROUND: This study was conducted to investigate the reason why H. pylori infected people develop different patterns of gastric diseases and in some infected patients have peptic ulcers, but the others have not. METHODS: We analyzed 177 cases of H. pylori positive patients who were confirmed by histologic evaluation of gastric endoscopic biopsy specimens from January 1998 to July 1998 in Health Promotion Center of one medical college hospital. Among these 177 cases, 63 cases(35.6%) were peptic ulcer patients and 114 cases(64.4%) were non ulcer patients. We analyzed the difference of sociodemographic findings, alcohol and smoking habit, past history, family history, drug history, emotional factors, body mass index and serum biochemical profiles between ulcer and non ulcer patients. RESULTS: 1. There were no differences of age, sex and occupation between peptic ulcer and non ulcer patients. 2. Heavy smoking (p<0.001), heavy drink (p=0.011), past history of upper gastrointestinal disease (p<0.001), fatigue (p<0.001) and depressive mood (p=0.001) were significantly more frequent in H. pylori positive peptic ulcer patients than non ulcer patients. 3. We found several related factors that might affect peptic ulcer development in H. pylori infected patients through logistic regression analysis of variables. These factors were heavy smoking (odds ratio 5.91, 95% CI 2.54-13.78), past history (odds ratio=4.24, 95% CI 1.72-10.42), depressed mood (odds ratio 2.76, 95% CI 1.15-6.63), and fatigue (odds ratio 2.42, 95% CI 1.03-5.69). CONCLUSION: We conclude that past history, heavy smoking, depressed mood, and fatigue are related factors of peptic ulcer disease in H. pylori positive patients.
Biopsy* ; Body Mass Index ; Fatigue ; Gastrointestinal Diseases ; Health Promotion ; Humans ; Logistic Models ; Occupations ; Peptic Ulcer* ; Risk Factors ; Smoke ; Smoking ; Stomach Diseases ; Stomach* ; Ulcer

Endocrine adrenal tumors are uncommon but clinically significant because they can be managed successfully by surgical therapy. During pregnancy, adrenal tumors can be a cause of death for both mother and baby, unless they diagnoses antenatally and managed properly. To investigate clinical characteristics of endocrine adrenal tumors, we analyzed 26 cases of adrenal tumor diagnosed and managed in Chung Ang Gil Hospital including cases associated with pregnancy and also a rare case of paraganglioma in liver. 1) There were 7 cases of Cushing's syndrome among which two cases were due to Cushing's disease and five cases were due to adrenal adenoma. Six cases were managed successfully by appropriate surgery. Another one case was associated with pregnancy but the patient expired due to sudden development of pulmonary edema and hypotension during preoperative preparation.2) Among 9 cases of primary aldosteronism, 8 cases were aldosterone-producing adenoma(APA) and 1 case was idiopathic hyperaldosteronism(IHA). In differential diagnosis between APA and IHA, diagnostic accuracy of postural study and adrenal CT was 86%, 78% respectively. In each one case of APA and IHA, adrenal venous aldosterone sampling was used for the differential diagnosis. Six cases of APA were managed by appropriate surgery. One patient with APA who refuses surgery and one patient with IHA were placed on spironolactone with good response.3) Among 10 cases of pheochromocytoma, seven cases were from adrenal gland and three cases were paragangliomas including one case originating from liver and two cases from abdominal ganglia. One patient with pheochromocytoma was diagnosed in 1st trimester of pregnancy and she was successfully treated by surgery.We observed 26 cases of endocrine adrenal tumors which were successfully managed except one case. We think that it is important to pay attention to adrenal tumor for early diagnosis particulary when associated with pregnancy. Paraganglioma in liver, although very rare, should be included in the differential diagnosis of space occupying lesion in liver.
Adenoma ; Adrenal Glands ; Aldosterone ; Cause of Death ; Cushing Syndrome ; Diagnosis ; Diagnosis, Differential ; Early Diagnosis ; Ganglia ; Humans ; Hyperaldosteronism ; Hypotension ; Liver ; Mothers ; Paraganglioma ; Pheochromocytoma ; Pregnancy ; Pulmonary Edema ; Spironolactone

OBJECTIVE: To investigate the influence of laparoscopic surgery on the pregnancy rate of infertile women with endometriosis. MATERIALS & METHODS: Retrospective analysis was performed in 33 infertile patients with endometriosis and infertility who had operative laparoscopy at Seoul National University Hospital from January 1991 to February 1998. We investigated the pregnancy rate during the 12 months following conservative laparoscopic surgery. RESULTS: The overall rate of spontaneous intrauterine pregnancy rate (IUP) during the 12 months was 48.5% (16/33). Most of spontaneous pregnancy occurred during the 3 months after surgery (12/16). There was no correlation between spontaneous pregnancy rate and the revised American Fertility Society (rAFS) classification or laparoscopic findings. The rate of IUP was 50% (7/14) for patients with stage I or II endometriosis and 47.4% (9/19) for the patients presenting stage III or IV endometriosis. CONCLUSION: Conservative laparoscopic surgery may be an effective treatment for infertile patients with endometriosis and most of spontaneous pregnancy occurred during the 3 months after surgery .
Classification ; Endometriosis* ; Female ; Fertility ; Humans ; Infertility ; Laparoscopy* ; Pregnancy Rate* ; Pregnancy* ; Retrospective Studies ; Seoul

PURPOSE: To report a case of retinal detachment with a giant retinal tear, which was treated with perfluorocarbon liquid as an intraocular substitute. CASE SUMMARY: A 37-year-old woman with a dislocated lens and a giant retinal tear underwent vitrectomy and lensectomy and was instructed to maintain a supine position after the operation. Perfluorocarbon liquid (Perfluoro-N-octane, C8F18) was used as a substitute in the vitreous cavity for 17 days. After 17 days, the perfluorocarbon liquid was removed and intraocular lens scleral fixation was performed. After removal of the perfluorocarbon liquid, the corneal endothelium was stable without other complications (including corneal edema, elevated intraocular pressure, ocular hypotony, macular pucker), and the best corrected visual acuity after intraocular lens scleral fixation was 0.4. CONCLUSIONS: Perfluorocarbon liquid is a useful surgical material in patients with a dislocated lens and retinal detachment with a giant retinal tear who have difficulty maintaining a prone position.
Adult ; Corneal Edema ; Endothelium, Corneal ; Female ; Fluorocarbons ; Humans ; Intraocular Pressure ; Lens Subluxation ; Lenses, Intraocular ; Ocular Hypotension ; Prone Position ; Retinal Detachment ; Retinal Perforations ; Retinaldehyde ; Supine Position ; Visual Acuity ; Vitrectomy

The objective of this retrospective study was to evaluate whether the transvaginal ultrasonographic analysis of endometrial pattern and thickness could predict the stage of menstrual cycle. Endometrial pattern and thickness were observed in those patients receiving infertility work up from April, 1 f94 to July, 1998 at Seoul National University Hospital. The study group was 185 patients with normal regular menstrual cycles. Among them, 44 patients received endometrial biopsy, and the date of endometrium was compared with the observed endometrial pattern and thickness. The observed endometrial pattern was presence or absence of central cavity echogenicity, triple line sign, endometrial hypoechogenicity, ring sign, endometrial hyperechogenicity and posterior acoustic sonic enhancement. The results were as follows; Central cavity echogenicity was seen throughout menstrual cycle. Triple line sign was observed in 81.1% of patients during early secretory phase. However, in mid to late secretory phase, triple line sign was appeared in only 6.8%. The percentage of positive endometrial hypoechogenicity was highest in early secretory phase. In contrast to hypoechogenicity, positive endometrial hyperechogenicty was highest in mid to late secretory phase. Ring sign was observed in 73.5% of the patients during early secretory phase with peak incidence. Posterior acoustic enhancement was seen in 72.7% of the patients during late secretory phase The sensitivity and specificity of being a secretory phase if the patients showed hyperechogenic endometrium, were 84.2%, 83.3% respectively. The sensitivity and specificity of being a secretory phase if the patients showed posterior acoustic enhancement were 93.8%, 58.3% respectively. Endometrial thickness was not correlated with endometrial dating. In conclusion, transvaginal ultrasonographical delineation of the endometrial pattern might to useful tool in predicting endometrial status during normal menstrual cycle. But, endometrial thickness could not predict the endometrial dating.
Acoustics ; Biopsy ; Endometrium ; Female ; Humans ; Incidence ; Infertility ; Menstrual Cycle* ; Retrospective Studies ; Sensitivity and Specificity ; Seoul

PURPOSE: The purpose of this study was to identify the frequency and status of mentally ill patients who registered in a community health center (CHC) but they could not be accessed. METHODS: A total of 233 mentally ill individuals who were registered to a CHC in B Metropolitan City participated in this survey. Data were collected from December 1 to 31, 2010 and analyzed. RESULTS: There were 140 (60.1%) community dwelling mentally ill patients who had been registered to that CHC but were not accessible. The major reasons of this inaccessibility were patients' rejection to be accessed (27.1%) and the wrong or missing address in hospital's discharge note (22.9%). The nursing problems of the subjects were rejection of medication (93.4%); poor personal hygiene (85.8%); violence including harassment of family member(s), assault, property destruction, threat with weapon (38.7%); and so on. Among 159 cases of referrals and requests for help immediate action with patient's compliance were only 8.8%. CONCLUSION: The findings show that mentally ill patients who had registered to the CHC but were not able to be accessed failed to be managed properly. This would become risk factors of social problems which threat to the community as well as individuals. Thus, we need to prepare programs for this population to make them take medicine at a minimum.
Community Health Centers ; Compliance ; Humans ; Hygiene ; Mentally Ill Persons ; Referral and Consultation ; Rejection (Psychology) ; Risk Factors ; Social Problems ; Violence ; Weapons

No abstract available.