ABSTRACT
BACKGROUND: Patients with chronic obstructive pulmonary disease (COPD) are at increased risk for osteoporosis, which has implications for mobility and even mortality. The goal of this pilot study was to evaluate bone mineral density (BMD) and risk factors for osteoporosis in a limited number of men with COPD. METHODS: We checked BMD, FEV1(% of predicted) and investigated risk factors for osteoporosis in 44 male patients with COPD who visited our hospital from January to August 2002. RESULTS: Mean(+/-) age was 69+/-9 yrs, body mass index(BMI) 21+/- 3 kg/m2, FEV1 50+/- 18% of predicted, lumbar spine T-score -3.0+/- 1.2, lumbar spine Z-score -2.0+/-1.2, and lumbar spine BMD 0.76 +/-0.13 g/cm2. Osteoporosis(T-score below -2.5) was present in 27 patients(61.4%) and osteopenia(T-scorebetween -1 and -2.5) in 17(38.6%). None of the patients had normal BMD. There was no relationshipbetween BMD and FEV1(% of predicted). There were significant differences in smoking, alcohol consumption, exercise, cumulative steroid dose, BMI and BMD among the three groups according to FEV1(% of predicted) (group1 : > or =65%, group2 : 50-64%, group3 : < or =49%), except age. However, there were no significant differences in these variables between the osteopenia and osteoporosis groups, except BMI. Linear Regression(Stepwise) analysis showed that lumbar BMD was correlated with BMI & exercise. CONCLUSION: BMD is significantly reduced in men with COPD. There was no relationship between BMD and pulmonary function.
Subject(s)
Humans , Male , Alcohol Drinking , Bone Density , Bone Diseases, Metabolic , Mortality , Osteoporosis , Pilot Projects , Pulmonary Disease, Chronic Obstructive , Risk Factors , Smoke , Smoking , SpineABSTRACT
Concurrent hyperthyroidism and primary hyperparathyroidism in the same patient is rare. In most cases of concomitant hyperthyroidism and primary hyperparathyroidism, serum calcium levels are quite elevated. However, recently we diagnosed a patient who had hyperthyroidism [Triiodothyroxine 6.81 nmol/L (1.23-3.39), Free thyroxine 92.88 pmol/L (10.32-25.80), TSH 0.05 mU/L (0.2-7.0)] and primary hyperparathyroidism [parathyroid hormone 163 pg/mL (12-72)] with mild hypercalcemia 2.78 mmol/L (2.03-2.60)]. We treated this patient with propylthiouracil and pamidronate and normalized her thyroid function and serum calcium levels. We then performed subtotal thyroidectomy and removed two parathyroid glands and clipped one parathyroid gland using a hemoclip. The pathologic diagnosis was confirmed to be Graves' disease and parathyroid hyperplasia. The patient was healthy, and serum levels of PTH, calcium and phosphorus were normal after the operation.
Subject(s)
Humans , Calcium , Diagnosis , Graves Disease , Hypercalcemia , Hyperparathyroidism , Hyperparathyroidism, Primary , Hyperplasia , Hyperthyroidism , Parathyroid Glands , Phosphorus , Propylthiouracil , Thyroid Gland , Thyroidectomy , ThyroxineABSTRACT
Concurrent hyperthyroidism and primary hyperparathyroidism in the same patient is rare. In most cases of concomitant hyperthyroidism and primary hyperparathyroidism, serum calcium levels are quite elevated. However, recently we diagnosed a patient who had hyperthyroidism [Triiodothyroxine 6.81 nmol/L (1.23-3.39), Free thyroxine 92.88 pmol/L (10.32-25.80), TSH 0.05 mU/L (0.2-7.0)] and primary hyperparathyroidism [parathyroid hormone 163 pg/mL (12-72)] with mild hypercalcemia 2.78 mmol/L (2.03-2.60)]. We treated this patient with propylthiouracil and pamidronate and normalized her thyroid function and serum calcium levels. We then performed subtotal thyroidectomy and removed two parathyroid glands and clipped one parathyroid gland using a hemoclip. The pathologic diagnosis was confirmed to be Graves' disease and parathyroid hyperplasia. The patient was healthy, and serum levels of PTH, calcium and phosphorus were normal after the operation.
Subject(s)
Humans , Calcium , Diagnosis , Graves Disease , Hypercalcemia , Hyperparathyroidism , Hyperparathyroidism, Primary , Hyperplasia , Hyperthyroidism , Parathyroid Glands , Phosphorus , Propylthiouracil , Thyroid Gland , Thyroidectomy , ThyroxineABSTRACT
Obstructive jaundice primarily results from choledocholithiasis, neoplasm, inflammation and infection such as primary sclerosing cholangitis, postsurgical stricture, AIDS cholangiopathy, extrinsic compression of the biliary trees. However, obstructive jaundice secondary to foreign bodies is rare. Especially, shrapnel induced biliary obstruction is very rare and has never been reported in Korea. We report a patient who had biliary obstruction due to metal shrapnel. He had shrapnel injury 52 year ago during the Korean War. For a long time, he had had no symptoms. He was admitted to our hospital for epigastric pain and jaundice. Abdominal CT scan showed a metallic foreign body in the common bile duct. The patient underwent ERCP, and the shrapnel and several stones were successfully extracted with a basket.