Coincidence of Diagnosis of Osteoporosis at the Site of the Proximal Femur, Lumbar Spine and Distal Radius

PURPOSE: The purpose of this study is to evaluate correlation according to sites measured from women diagnosed with osteoporosis without other factors influencing osteoporosis. MATERIALS AND METHODS: Two hundred patients diagnosed with osteoporosis using dual-energy X-ray absorptiometry from January 2006 to January 2007 were evaluated. All patients were measured at the hip joint (Femur neck, Ward triangle, and great trochanter), lumbar spine body (L1-4), and distal radius. Results of measurements were then evaluated for determination of coincidence. RESULTS: Mean bone mineral density was lowest at Ward's triangle(-2.93+/-0.95) and radius midshaft(-2.95+/-1.21). The rate of disconcordance between hip joint and lumbar spine was 37%, between hip joint and distal radius, 34%, and, between the lumbar spine and distal radius, 38%. With increase in age, a greater decrease in bone mineral density was observed, and markedly decreased bone mineral density was observed between the ages of 60 and 70-years. CONCLUSION: Rate of disconcordance of bone mineral density among hip joint, lumbar spine, and distal radius was significant. To prevent further fracture, all sites (hip joint, lumbar spine, and distal radius) must inevitably be measured.

Clinicopathologic Characteristics and Prognosis of Early Stage Triple Negative Breast Cancer: Comparison with Non-triple Negative Group

PURPOSE: Triple negative breast cancer (estrogen receptor-negative, progesterone receptor-negative, and HER2/neu negative) is associated with high risk of recurrence and poor prognosis. We investigated the characteristics and prognosis of triple negative early-stage breast cancer. METHODS: We reviewed the records of 821 early-stage breast cancer patients treated at our hospital from 1995 to 2005. We studied the differences between a triple negative group compared with a non-triple negative group. RESULTS: Of 821 early-stage breast cancer patients, 200 (24.4%) were classified as triple negative. Large tumors (>2 cm) in the triple negative group were significantly more than those in the non-triple negative group (P=0.042). Histologic and nuclear grade of the triple negative group were significantly higher than those of the non-triple negative group (P<0.001). The median follow-up time is 50 months (1~135). There have been 50 local recurrences, 98 distant metastases, and 65 deaths. There were high rates of local recurrence in the triple negative group but no difference in 5-year disease free survival rates (P=0.178). The 5-year overall survival rate showed 85% in the triple negative group but 92.8% in the non-triple negative group (P=0.008). The relative risk for overall survival was 1.93 times higher in the triple negative group. CONCLUSION: Triple negative breast cancer patients in early stages have poor pathologic findings and prognoses. Careful treatment and follow-up are important and further investigation is necessary for triple negative breast cancer.

Calcific Tendinitis of the Gluteus Medius Tendon

PURPOSE: This study evaluated the clinical symptoms, diagnosis and management of calcific tendinitis around the insertion of the gluteus medius tendon. MATERIALS AND METHODS: Between February 2004 and December 2008, 9 patients (8 women and 1 man; mean age, 57 years; age range, 41~80) with a diagnosis of calcific tendinitis were enrolled in this study. All patients underwent radiography and sonography. The relationships between the clinical aspects, medication, the shape of calcification under radiography, thickening of the tendon, and the shape of calcification under sonography were analyzed. RESULTS: Type 1 (fluffy margin) under radiography had a shorter symptom duration and faster recovery than type 2 (well-defined and homogenous margin) (p=0.03). Tendon thickening and the shape of calcification (ovoid or amorphous) from the sonographic findings was not significantly related to the symptom duration and recovery time. Non-steroidal anti-inflammatory medication had no effect on the symptom duration or recovery time. CONCLUSION: Patients with calcific tendinitis around the gluteus medius tendon with a type 1 margin (fluffy margin) showed a shorter symptom duration and faster recovery than those with a type 2 margin. Non-steroidal antiinflammatory medication had no effect on the symptom duration or recovery time.

Comparison on New Bone Formation Between Ovariectomized Rats and Normal Rats After Graft of Alloplastic bone material / 대한치과보철학회지

PURPOSE OF STUDY: To compare on bone formation between ovariectomized rats and normal rats after graft of alloplastic bone material. MATERIAL AND METHODS: Twenty female rats were used in this study. They were divided into two groups by each ten rats. One group was ovariectomized and grafted alloplastic bone material. Other group was non-ovariectomized and grafted alloplastic bone material. After a healing time of 4 weeks, the animals were sacrificed and decalcified preparations were routinely processed for histologic evaluations. RESULTS: Ovariectomy group was significantly lesser bone formation compared with non-ovariectomy group. CONCLUSIONS: Ovariectomy acts as a negative factor in new bone formation.

The Impact of the Number and Size of Gallstone on the Suppuration of Gallbladder and Conversion Rate to Open from Laparoscopic Cholecystectomy / 한국간담췌외과학회지

BACKGROUND/AIMS: The progression of the inflammation to suppurative cholecystitis may depend on the number and size of gallstone. This is a comparative study of correlation between the nature of gallstone (number and size) and progression of suppurative cholecystitis and effect to the difficulty in surgery. METHODS: We analyzed 1,235 patients who were treated with laparoscopic cholecystectomy for the gallstone disease including acalculus cholecystitis and acute suppurative cholecystitis with or without gallstones. One hundred and twenty nine patients were acute suppurative cholecystitis. The patients were grouped four arms according to the size of stones as follows; group I has no stone, group II or =2 cm. Also the patients were grouped to four groups according to the number of stones; group A has no stone, 1 or =7. RESULTS: Conversion rate to open laparotomy was 17.1% (22/129). In case of suppurative cholecystitis, six patients were included in arm I, 57 patients in arm II, 35 patients in arm III, nine patients in arm IV. And six patients were included in group A, 44 patients in group B, three patients in group C and 54 patients in group D of laparoscopic cholecystectomy. Of the 22 patients who were converted to open cholecystectomy, one patient was included in arm I, 14 patients in arm II, four patients in arm III, three patients in arm IV. And one patient was included in group A, eight patients in group B, one patient in group C and 12 patients in group D of open conversion group. There was no statistical significance of the groups (p>0.05). The mean size of stones of the patients with suppurative cholecystitis (129 patients) and simple cholecystitis patients (312) was 0.97 versus 0.91 cm (p>0.05). There was no statistical difference of the number and size of gallstones between simple and suppurative cholecystitis (p>0.05). CONCLUSION: The number and size of gallstone for the patients who were treated by cholecystectomy was not contributing factors to develope suppurative cholecystitis and conversion to open from laparoscopic cholecystectomy.

Clinicopathological Analysis of Recurrent Gastric Cancer after Curative Resection

PURPOSE: Despite radical lymph node dissections and combined resections, experiences of recurrent gastric carcinomas are not infrequent. The prognosis of a recurrent gastric carcinoma has not improved despite the considerable recent progress in their treatment. This study was designed to investigate the correlation between the clinicopathological characteristics and recurrence patterns in gastric cancer following a curative resection. METHODS: The medical records of 1, 163 patients, who had undergone curative resection for primary gastric cancer, in Department of Surgery, Keimyung University School of Medicine, between January 1990 and December 1996, were retrospectively reviewed. The clinicopathological characteristics, relationship of each factor with the pattern of recurrence and the rate of recurrence were analyzed. RESULTS: Recurrent gastric cancer was confirmed in 350 patients (30.09%). The mean time interval to recurrence was 20.41+/-15.94 months. Of the patients with a recurrence, 231 (66.0%), 109 (31.1%) and 10 (2.9%) were early (0~2 years), intermediate (2~5 years) and late (more than 5 years) recurrences, respectively. 180 (51.4%), 90 (25.7%), 51 (14.6%) and 29 (8.3%) were peritoneal, loco-regional, distant and mixed recurrences, respectively. The recurrence patterns after a curative resection for a gastric carcinoma were related to the tumor location, differentiation, N-category and TNM stage. In a multivariate analysis, the size of tumor, Borrmann's classification, T-category, N-category, vascular invasion and Stage were found to be independent prognostic factors for a recurrence. CONCLUSION: Most recurrences of gastric carcinomas, following a curative resection, were found within 24 months. Therefore, the close follow up, with clinicopathological factors, is very important during this period, and might facilitate the early detection of a recurrence.

The Influence of Sevoflurane on the Autonomic Nervous System / 대한마취과학회지

BACKGROUND: Sevoflurane is a new inhalation anesthetic, which shows stable hemodynamic features, and does not have a pungent odor, so that it can be used as an inhalational induction agent. But mask ventilation can make patients anxious, and can stimulate the sympathetic nervous system. Therefore, we evaluated the effect of midazolam administered right before inhalation induction with sevoflurane on the autonomic nervous system using power spectral analysis. METHODS: We studied 28 patients undergoing elective surgery. They were assigned to one of two groups to receive either sevoflurane with midazloam (M group) or sevoflurane alone (S group). Anesthesia was induced with 6% sevoflurane and 0.03 mg/kg midazolam or 6% sevoflurane alone. Midazolam was administered immediately before induction with sevoflurane. An electrocardiogram was applied to all patients and connected to a computer, for power spectral analysis. Power values were recorded on arrival, pre-intubation, post-intubation and pre-incision, and compared between two groups. RESULTS: Power values at low frequency were lower, and the time to loss of eye lash reflex and induction were shorter in the M group than in the S group. CONCLUSIONS: The administration of midazolam before induction with sevoflurane reduced the activity of the sympathetic nervous system versus induction with sevoflurane alone.

An Anesthetic Experience of Intratracheal Double-Stents Insertion in an Infant / 대한마취과학회지

The management of airway during anesthesia is mandatory but it is very difficult in certain diseases, especially when a tracheoplasty and bronchoplasty is done. Tracheal stenosis is caused by congenital factors, trauma, physical compression, infection, intrabronchIal granuloma, tumor etc. Among those causes, congenital tracheobronchial stenosis is very rare and it accompanies pulmonary arterial sling and cardiovascular anomaly. Our anesthetic experience of succesful tracheal management during tracheobronchoplasty (3 times), bronchoscopic examination and bougienation (7 times), insertion of a single stent (1 time) and double stents into the trachea and the main bronchus (2 times) on a child who has a congenital complete circular tracheal cartilage and pulmonary arterial sling which caused tracheal stenosis will be reported, along with a literature review.