Effects of the Combined Therapy with Raloxifene and Low-Dose Intermittent Fluoride for Two Years in Postmenopausal Women with Osteoporosis

OBJECTIVE: To compare the effects of raloxifene alone with a combination of raloxifene and fluoride in postmenopausal osteoporosis on bone mineral density, bone turnover and lipid profiles, at 2 year. METHOD: Fifty two women with postmenopausal osteoporosis (T-score < 2.5) were studied. Subjects were divided into two groups; Group I (n=23), treated with raloxifene and fluoride, and Group II (n=29), treated with raloxifene alone. Bone mineral density (BMD) at the lumbar spine and femur, osteocalcin, deoxypyridinoline and lipid profiles were measured at baseline and 2 years after treatment. RESULTS: BMD at the lumbar spine was increased in two groups, and BMD in Group I was increased more than that in Group II. Osteocalcin was increased in Group I, and was decreased in Group II. Deoxypyridinoline was decreased in two groups. Total cholesterol and LDL cholesterol were decreased in two groups, but HDL cholesterol and triglyceride showed no significant change in two groups. There were no significant differences between two groups in lipid profiles. CONCLUSION: The combined therapy with raloxifene and low- dose intermittent fluoride was more effective in postmenopausal women with osteoporosis than raloxifene alone, which would not influence on positive effect of raloxifene for lipid metabolism.

Psychological Characteristics of the Patients with Myofascial Pain Syndrome in Shipyard Work

OBJECTIVE: This study was conducted to analyze the psychological factors which influence myofascial pain syndrome and to evaluate whether the electromyographic study on the myofascial trigger point in shipyard workers satisfied the diagnostic criteria of myofascial pain syndrome. METHOD: We studied 61 patients who were employed in the shipbuilding industry and diagnosed myofascial pain syndrome. We investigated them using the Minnesota Multiphasic Personality Inventory (MMPI) and the visual analogue scale (VAS) and also obtained spontaneous electrical activity (SEA) by electromyographic study on myofascial trigger point. RESULTS: Mean VAS of subjects was 5.88. On the MMPI profile, the patients scored highest in psychopathic deviate, and then in hypochondriasis, depression and hysteria, in that order. The correlation of the VAS with results of electromyographic study and with the MMPI were not significant. In the electromyographic study, 19 patients out of 61 (31%) showed initial positive deflection on spontaneous electrical activities. CONCLUSION: This study suggested that considering the psychosocial aspect of myofascial pain syndrome, as well as organic aspects in hard manual labor such as shipyard work might be useful for treatment.

Changes of Bone Mineral Density, Lipid Profiles, and Biochemical Markers after Combination Therapy of Estrogen and Alendronate in Postmenopausal Osteoporosis

OBJECTIVE: To investigate the changes of bone mineral density (BMD), biochemical bone markers, and lipid profiles after combination therapy of continuous hormonal replacement therapy (c-HRT) and alendronate in postmenopausal osteoporosis. METHOD: We studied 89 women with postmenopausal osteoporosis (T-score<2.5) who visited at Department of Rehabilitation Medicine, Kosin Medical Center from August 1999 to March 2001. Subjects were divided into two groups; Group I (n=40), treated with estrogen and alendronate (10 mg/day), and Group II (n=49), treated with estrogen alone. BMD at the lumbar spine and femur, osteocalcin, urine deoxypyridinoline and lipid profiles were measured at baseline and 1-year after treatment. RESULTS: 1) BMD at the lumbar spine increased significantlyin two groups, and BMD in Group I increased significantly more than that in Group II. But, change of BMD on femoral neck was not significantly different. 2) Biochemical bone markers (osteocalcin and urine deoxypyridinoline) decreased significantly in two groups. 3) Total cholesterol and LDL cholesterol decreased significantly in two groups, but HDL cholesterol and triglyceride showed no significant change in two groups. There was no significant differences between two groups in lipid profiles. CONCLUSION: We concluded that combination therapy with c- HRT and alendronate in postmenopausal osteoporosis was more effective than c-HRT, which would not influence on positive effect of estrogen for lipid metabolism.