Male osteoporosis is known to progress slowly and is less severe compared to female osteoporosis, and the incidence of lumbar compression fracture is considerably lower in male population. Hypogonadism which can develop from various causes including hypopituitarism is a common cause for secondary male osteoporosis. Hypopituitarism as a late complication of severe form of hemorrhagic fever with renal syndrome (HFRS) is known to occur occasionally but its clinical symptoms rarely appear. A 75-year-old male patient who had recovered from HFRS 13 years ago was admitted due to severe low back pain. He presented with gradually developed symptoms of hypogonadism and hypothyroidism resulting from hypopituitarism. MRI revealed collapsed pituitary gland and empty sella. This case presents with a male patient with multiple lumbar compression fractures due to severe osteoporosis secondary to hypogonadism, which resulted from hypopituitarism as a late complication of HFRS.
Aged ; Female ; Fever ; Fractures, Compression ; Hemorrhagic Fever with Renal Syndrome ; Humans ; Hypogonadism ; Hypopituitarism ; Hypothyroidism ; Incidence ; Low Back Pain ; Male ; Osteoporosis ; Pituitary Gland

PURPOSE: Breast cancer has been reported as the most common cancer of women in the United States, Western Europe and Korea and about 210,000 and 10,000 women in United States and Korea every year, respectively are diagnosed with it. Breast cancer is curable with an early diagnosis, and many researchers have made efforts to find a marker for this malady, heat shock protein (HSP) consists of 6 groups, it is highly preserved throughout both the prokaryotic and eukaryotic cells and it acts as a molecular chaperone that's involved in protein folding. HSPs have been recently reported to be related with breast cancer. In this study, we investigated the changes of expression of HSP60 in tissues and cell lines of breast cancer. METHODS: We obtained breast cancer tissues and normal tissues from breast cancer patients, and we purchased several cancer cell lines from American tissue culture correction. We treated the tissues and the cell lines of human breast cancer with heat shock protein. Proteins and mRNAs were isolated from the tissues and the cells and then we performed Western blotting, reverse transcriptase-Polymerase chain Reaction and fluorescence activated cell sorter analysis on them. RESULTS: On Western blot, HSP60 was more overexpressed in the tissues and the cell lines of breast cancer than in the normal breast tissues and cell lines. The expression of HSP60 showed 2 types of molecular weight differences in the tissues and cell lines of breast cancer, and specifically, low HSP60 was over-expressed in the cancer tissues. There was no difference between the breast cancer cell lines and the normal cell lines in the expressions of HSP60 mRNA, according to the treatment with heat shock. Also, there was no relationship between phosphorylation and the structural difference of HSP60 protein, according to HSP60 protein's molecular weight. The expression of HSP60 has been mostly reported at the mitochondria; however, in this study, it was more predominantly detected at the cytoplasm than at the mitochondria in the breast cancer cell lines. CONCLUSION: We conclude that HSP60 may be used as a diagnostic marker for breast cancer. Detailed investigation of the usefulness and significance of the HSP60 expression as a prognostic factor is required in further studies.
Blotting, Western ; Breast ; Breast Neoplasms ; Cell Line ; Chaperonin 60 ; Cytoplasm ; Early Diagnosis ; Eukaryotic Cells ; Europe ; Female ; Fibrinogen ; Fluorescence ; Heat-Shock Proteins ; Hot Temperature ; Humans ; Korea ; Mitochondria ; Molecular Chaperones ; Molecular Weight ; Phosphorylation ; Protein Folding ; Proteins ; RNA, Messenger ; Shock ; United States

PURPOSE: To investigate the recanalization rate after intravenous administration of recombinant tissue plasminogen activator (IV-tPA) for acute major arterial occlusion of the anterior cerebral circulation and to investigate the relationship between atrial fibrillation and recanalization. METHODS: From April 2005 to April 2006, 16 patients with acute major arterial occlusion of the anterior cerebral circulation were treated with IV-tPA. Recanalization was classified as good (as compared with an unoccluded contralateral vessel; thrombolysis in myocardial infarction (TIMI) classification grade II and III) and poor (TIMI grade 0 and I). The clinical and radiological parameters associated with recanalization were analyzed. The clinical outcomes were evaluated by use of the National Institute of Health Stroke Scale (NIHSS) at 3 months after treatment. RESULTS: Of all of the 16 patients, 11 patients (68.8%) showed good recanalization. Among these 11 patients, nine patients survived (81.8%). However, only one patient survived (20%, p = 0.036) of the other five patients who showed poor recanalization. The pretreatment NIHSS score and atrial fibrillation were significantly correlated with the recanalization rate. Atrial fibrillation was found in 8 of 16 patients (50.0%) as the cause of the cerebral embolic infarction. Among the patients with atrial fibrillation only three patients showed good recanalization (37.5%); patients without atrial fibrillation showed good recanalization (100%, p = 0.026). CONCLUSIONS: I.-tPA appears to be effective and safe as a recanalization method for acute major cerebral arterial occlusion in patients that do not have atrial fibrillation. Good recanalization was associated with a good clinical result. Atrial fibrillation is a significant associated factor of poor recanalization and high mortality.
Administration, Intravenous ; Atrial Fibrillation ; Classification ; Humans ; Infarction ; Mortality ; Myocardial Infarction ; Stroke ; Tissue Plasminogen Activator*

BACKGROUND AND PURPOSE: The enlargement of a hematoma occurs commonly in patients with spontaneous intracerebral hemorrhage (ICH) after hospitalization and can worsen the clinical outcome. We conducted this study to determine whether extravasation of a radiographic contrast agent is a predictor of hematoma enlargement occurring after admission in patients with spontaneous ICH. METHODS: We reviewed the clinical records and computerized tomography (CT) scan findings of 384 patients with spontaneous ICH admitted within 24 hours of ictus from 2002 to 2005. Only 71 patients with primary ICH in the basal ganglia or thalamus were included in the study. The first CT scan was preformed within 24 hours of onset and the second CT scan was preformed within 72 hours of onset. We compared patients with and without hematoma enlargement according to the radiological findings, clinical characteristics and laboratory data. RESULTS: Seventeen patients (23.9%) showed hematoma enlargement after admission. Extravasation of the radiographic contrast agent on a CT scan was seen in 23 patients (32.4%). The presence of contrast extravasation on a CT scan closely correlated with evidence of hematoma enlargement, as seen on a follow-up CT scan (p = 0.000). Other variables did not reach statistical significance for the independent association with hematoma enlargement. CONCLUSIONS: Due to a high risk for hematoma enlargement, patients with spontaneous ICH in the basal ganglia and thalamus, especially those with evidence of contrast extravasation on a CT scan, should be closely observed. Short term followup radiological studies are needed for the verification of hematoma enlargement.
Basal Ganglia ; Cerebral Hemorrhage* ; Follow-Up Studies ; Hematoma* ; Hospitalization ; Humans ; Thalamus ; Tomography, X-Ray Computed

OBJECTIVE: Recent clinical studies have demonstrated that intracisternal administration of recombinant tissue plasminogen activator(rt-PA) can facilitate the normal clearing of blood from the subarachnoid space. Urokinase, a first generation fibrinolytic agent, has been used to liquify such clots with some success. Therefore, recombinant tissue plasminogen activator, a second generation fibrinolytic drug that may be safer and more effective, is studied to evaluate its dosage to lyse clots in vitro and reactivity in the brain parenchyme. METHODS: Intracerebral hematomas were created by stereotactically injecting 2ml of clotted autogenous blood into the brain parenchyme of total 28 anesthetized adult cats (weighting 3.8 to 4.1kg). The control animals (group A) received 1ml of normal saline injected into the clots and the experimental animals received each 0.1mg of rt-PA (group B), 0.5mg of rt-PA (group C) and 1mg of rt-PA (group D) at 6 hours after the clot injection. RESULTS: 1. The amount of remained clots after lysing the hematomas were as follows: 1.80+/-0.17ml in group A, 1.65+/-0.23ml in group B, 0.61+/-0.37ml in group C and 0.52+/-0.34 in group D. The result indicated that hematomas in rt-PA treated groups (C & D) were lysed better than the control group. 2. At least 0.5mg of rt-PA should be required for the lysis of 2ml of hematomas. 3. Light microscopic examination revealed no histological evidence of hemorrhage in tissue sections from each brain. CONCLUSION: Recombinant tissue plasminogen activator may be safely and effectively employed for the lysis of intracerebral hematomas in animal model.
Adult ; Animals ; Brain ; Cats* ; Hematoma* ; Hemorrhage ; Humans ; Models, Animal ; Plasminogen ; Subarachnoid Space ; Tissue Plasminogen Activator* ; Urokinase-Type Plasminogen Activator

The management of unruptured aneurysm is controversial, and two main discussion points are its natural history and the role of endovascular coiling in the repair of this aneurysms. We reviewed our results of treatments using coil embolization for the unruptured intracranial aneurysms. We treated 106 unruptured aneurysms by endovascular coiling for the last 6 years. while 45 unruptured aneurysms were treated by clipping during same period. Seventy-six (71.7%) unruptured aneurysms were distributed in anterior circulation and 30 (28.3%) was in posterior circulation. Aneaurysms of paraclinoid carotid artery and vertebrobasilar artery was the most frequent location of endovascular coiling of UIAs and anticipated surgical difficulty was the most common reason for choosing coiling. Sixty-three (59.4%) aneurysms were smaller than 10 mm in maximum aneurysm size, 30 (28.3%) aneurysms were 11-20 mm, and 13 (12.2%) were over 21 mm. Complete embolization was achieved in 61 (57.5%) aneurysms, neck remnants in 35 (33.0%) aneurysms, incomplete embolization in 7 (6.7%), and attempted and failed was in three (2.8%). There were 9 procedural complications, 6 thromboembolisms, 2 aneurysm perforations and 1 coil migration. Three patients with thromboembolic complication and a coil migration patient remained in permanent neurologic deficit (morbidity : 3.8%). However, three thromboembolic complications and two aneurysm perforation recovered clinically well. In our series, small aneurysms (<10 mm) were involved larger number of preventive interventions of UIAs than large or giant size aneurysms. Although, over all morbidity and mortality of coil embolization for unruptured aneurysms in our series were low, the indications of repairing for small size unruptured aneurysms need to investigated further.
Aneurysm ; Arteries ; Carotid Arteries ; Embolization, Therapeutic ; Humans ; Intracranial Aneurysm ; Mortality ; Natural History ; Neck ; Neurologic Manifestations ; Thromboembolism

PURPOSE: In the current study, the relation between the clinicopathological parameters and levels of the amplification of the c-met and E-cadherin genes were investigated in patients with an advanced gastric carcinoma. METHODS: The levels of amplification of the c-met and E-cadherin genes in 44 advanced gastric carcinoma patients were retrospectively investigated using RT-PCR. The relationships between the levels of amplification of these genes and the clinicopathological parameters were evaluated using univariate and multivariate analyses. RESULTS: Seventeen (38.6%) and 13 (29.5%) of the 44 advanced gastric carcinoma patients were evaluated as having amplification of the c-met gene and down-regulation of the E-cadherin gene, respectivly. The amplification of c- met gene was significantly correlated with serosal invasion, lymph node metastasis and neural invasion, whereas the down-regulation of the E-cadherin gene was significantly correlated with the diffuse type of gastric carcinoma by Lauren's calssification, and neural invasion. CONCLUSION: The levels of the c-met and E-cadherin gene amplifications may be a powerful aids in evaluating the metastatic potential and prognosis in patients with advanced gastric cancer.
Cadherins* ; Down-Regulation ; Humans ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis ; Retrospective Studies ; Stomach Neoplasms*

OBJECT: In the treatment of coronary atherosclerosis, drug-eluting stents are effective in decreasing the rate of major adverse cardiac events and angiographic restenosis compared with bare metal stents. However, the benefits and safety of using these new devices in the cerebral vasculature have not been evaluated. To assess the effectiveness of drug-eluting stents in the cerebral vasculature, the authors analyzed clinical and angiographic results after percutaneous transluminal angioplasty and stenting in patients with vertebral artery origin stenosis. METHODS: Ninety-one patients with 99 vertebral origin stenoses treated with percutaneous endovascular balloon angioplasty and stent placement during a period of 5.1 years (September 1999-October 2004). Follow-up angiograms were obtained from 38 patients with 42 lesions (24 men, 14 women ; mean age, 61.9 yrs ; mean follow-up period, 9.1 months). We reviewed the clinical and radiological records of these patients. RESULTS: Bare stents were implanted in 30 lesions, while drug-eluting stents were implanted in 12 lesions, with a mean residual stenosis of 5.1 %. The overall rate of moderate-to-severe restenosis (> or =50%) was 31.0 % (13 of 42 cases). The restenosis rate in the bare stent group was 36.7 %, compared with 16.7 % in the drug-eluting stent group (p=0.282). Comparing the restenosis rate in stented lesions with reference diameters less than 3.5 mm (11 with bare stents, 12 with drug-eluting stents), the restenosis rates were 63.6 % in the bare stent-group and 16.7 % in the drug-eluting stent-group (p=0.029). CONCLUSION: Drug-eluting stents placed in vertebral artery origin stenosis have lower restenosis rate than bare stents, particularly in small-sized vessels.
Angioplasty* ; Angioplasty, Balloon ; Constriction, Pathologic ; Coronary Artery Disease ; Drug-Eluting Stents* ; Female ; Follow-Up Studies ; Humans ; Male ; Stents* ; Vertebral Artery*

OBJECT: In the treatment of coronary atherosclerosis, drug-eluting stents are effective in decreasing the rate of major adverse cardiac events and angiographic restenosis compared with bare metal stents. However, the benefits and safety of using these new devices in the cerebral vasculature have not been evaluated. To assess the effectiveness of drug-eluting stents in the cerebral vasculature, the authors analyzed clinical and angiographic results after percutaneous transluminal angioplasty and stenting in patients with vertebral artery origin stenosis. METHODS: Ninety-one patients with 99 vertebral origin stenoses treated with percutaneous endovascular balloon angioplasty and stent placement during a period of 5.1 years (September 1999-October 2004). Follow-up angiograms were obtained from 38 patients with 42 lesions (24 men, 14 women ; mean age, 61.9 yrs ; mean follow-up period, 9.1 months). We reviewed the clinical and radiological records of these patients. RESULTS: Bare stents were implanted in 30 lesions, while drug-eluting stents were implanted in 12 lesions, with a mean residual stenosis of 5.1 %. The overall rate of moderate-to-severe restenosis (> or =50%) was 31.0 % (13 of 42 cases). The restenosis rate in the bare stent group was 36.7 %, compared with 16.7 % in the drug-eluting stent group (p=0.282). Comparing the restenosis rate in stented lesions with reference diameters less than 3.5 mm (11 with bare stents, 12 with drug-eluting stents), the restenosis rates were 63.6 % in the bare stent-group and 16.7 % in the drug-eluting stent-group (p=0.029). CONCLUSION: Drug-eluting stents placed in vertebral artery origin stenosis have lower restenosis rate than bare stents, particularly in small-sized vessels.
Angioplasty* ; Angioplasty, Balloon ; Constriction, Pathologic ; Coronary Artery Disease ; Drug-Eluting Stents* ; Female ; Follow-Up Studies ; Humans ; Male ; Stents* ; Vertebral Artery*

BACKGROUND: Punch biopsy has been used frequently as a diagnostic method in dermatologic field. However dermatologist administrated antibiotics is routine for the prevention of wound infection. OBJECTIVE: The purpose of this study was to evaluate the efficacy of prophylactic antibiotics in punch biopsy. METHODS: Four hundred and one patients undergoing punch biopsy were studied prospectively. Patients were randomly split in to two groups: group I received prophylactic antibiotics after punch biopsy (197 patients), group II didn't receive any antibiotic after punch biopsy (204 patients). Wound infection was defined as a condition of erythema, edema, and pain or purulent discharge. RESULTS: Patients demographics and skin disease were similar between two groups. Biopsy site were infected in 3 patients of group I and 5 patients of groups II. Staphylococcus aureus, Staphylococcus epidermidis and Bacteroides fragilis were isolated from the infected biopsy site. There was no significant difference of infection rate between two groups. CONCLUSION: This result suggests that the routine use of prophylactic antibiotics after skin punch biopsy is unnecessary.
Anti-Bacterial Agents* ; Bacteroides fragilis ; Biopsy* ; Demography ; Edema ; Erythema ; Humans ; Prospective Studies ; Skin ; Skin Diseases ; Staphylococcus aureus ; Staphylococcus epidermidis ; Wound Infection