Relationship between Weight, Body Mass Index and Bone Mineral Density of Lumbar Spine in Women

OBJECTIVES: This study aims to identify a relationship between bone mineral density (BMD) of lumbar spine, and the weight and body mass index (BMI) in women. METHODS: The subjects were 1,143 females who visited the public health center. BMD (T-score), height and weight were measured and age, menopause, diabetes and hypertension, exercising status and smoking status were inquired by interview. RESULTS: Among the subjects, 362 (31.7%) were in the normal group and 781 (68.3%) were in the abnormal group. As the result of the logistic regression analysis with BMI (Model I), the odds ratio of getting into the abnormal BMD group as age increases by 1 year marked 1.044 (95% CI = 1.009-1.080). The odds ratio of getting into the abnormal BMD group due to menopause was 2.663 (1.516-4.679) and the odds ratio according to lack of walking exercise was 2.597 (1.878-3.591). The odds ratio with 1 kg/m2 of BMI increase was 0.909 (0.862-0.959). In the logistic regression analysis with weight (Model II), the odds ratio of getting into the abnormal BMD group as age increases by 1 year marked 1.044 (1.009-1.080). The odds ratio of getting into the abnormal bone density group due to menopause was 2.575 (1.472-4.507) and the odds ratio according to lack of walking exercise was 2.598 (1.881-3.587). The odds ratio with 1 kg of weight increase was 0.963 (0.942-0.984). The Akaike's information criterion (AIC) values of Model I and Model II were 1196.18 and 1197.14 respectively, indicating Model I has the better compatibility of regression analysis model. CONCLUSION: Weight, BMI and BMD had a positive correlation. However, the coefficient of correlation between weight and BMD was higher than the coefficient between BMI and BMD, which means low weight is much more likely to be related to osteoporosis with no other factor considered. On the other hand, under the condition considering age, height, menopause and walking exercise smoking status, low BMI is much more compatible as a risk factor for osteoporosis.

Identification of Target Genes in the Endometrial Carcinomas with Microsatellite Mutator Phenotype / 대한산부인과학회지

OBJECTIVE: Recent molecular genetic studies have revealed that two major types of genomic instabilities, chromosomal instability and microsatellite instability (MSI), exist in the endometrial carcinomas. Tumors with microsatellite mutator phenotype (MMP) are caused by defects in DNA mismatch repair genes. MMP tumors are believed to progress by accumulating frameshift mutations in coding microsatellite sequences of various cancer related genes including tumor suppressor genes, apoptosis related genes and DNA repair genes. Thus, the identification of the specific target genes in the MMP endometrial carcinomas is important for the elucidation of molecular pathogenesis of endometrial carcinomas. METHODS: We classified the MMP endometrial carcinomas and evaluated the frameshift mutations of the 11 genes containing coding microsatellite sequences by using 34 endometrial carcinomas and 4 MMP endometrial carcinoma cell lines. RESULTS: MSI was found in 6 of 34 endometrial carcinomas. In the endometrial carcinoma tissues, frequent mutations were found in TAF1B (68%), HT001 (50%), SLC23A1 (50%) and ACVR II (50%) in the MMP endometrial carcinoma tissues. The other 7 genes were infrequently mutated. Mutations of these target genes were more frequent in MMP endometrial carcinoma cell lines. CONCLUSION: we identified specific target genes in MMP endometrial carcinomas. These data demonstrate the mechanism of tumor progression in the MMP endometrial carcinomas.

Total Hip Arthroplasty for Fused Hips / 대한정형외과학회잡지

The conversion of the fused hip to THA may be used for patients with painful pseudoarthrosis, and malposition of the arthrodesed hip. It may also be used for patients with disabling pain in the ipsilateral knee, contralateral hip or lower back. Nineteen fused hips have been converted to total hip arthroplasty from January 1985 to December 1993. They were followed up for an average of 6 years. The causes of the fused hip were post-traumatic osteoarthritis (8 cases), tuberculous arthritis (6 cases), ankylosing spondylitis (3 cases) and rheumatoid arthritis (2 cases). The results of THA were satisfactory in all cases. The average Harris hip score after THA was improved from 56 to 84.1. The results of THA were best in patients with tuberculous arthritis and poorest in patients with ankylosing spondylitis. The average range of motion after THA is as follows: flexion 82 degree, abduction 28 degree, adduction 16 degree, external rotation 27 degree and internal rotation 13 degree. The average leg length discrepancy improved from 3 cm to 1.5 cm. The conversion of the fused hip to THA improves the patient s quality of life, so it is a useful treatment for the fused hip.

A Case of metastatic choriocarcinoma diagnosed at 34th week of pregnancy / 대한산부인과학회잡지

Choriocarcinoma associated with a normal pregnancy is rare. Especially, choriocarcinoma coexistent with a viable pregnancy is even rarer and commonly presents with widespread metastatic disease. We experienced a patient at 34th week of pregnancy with dyspnea and sputum production due to pulmonary metastasis of choriocarcinoma. The serum B-hCG level was extremely elevated and the placenta had multifocal choriocarcinoma. After vaginal delivery, the patient was successfully treated with combination chemotherapy (EMA-CO). The patient is receiving follow up with monthly measurement of hCG values. We report one case of metastatic choriocarcinoma with viable pregnancy with review of literature.