The Effect of Hormone Replacement Therapy and Related Factors on the Change of Bone Mineral Density in Early Postmenopausal Women in Ulsan-si, Korea

BACKGROUND: Hormone replacement therapy (HRT) has been used as a effective therapeutic strategy of postmenopausal osteoporosis. However, the studies on HRT are insufficient, particularly in early postmenopausal women in Korea. This study was designed as a community based clinical trial and was conducted for 1 year. METHODS: One hundred and forty early postmenopausal women aged 49 to 54 years who resided in Ulsan in Korea were enrolled in this study. The osteoporosis prone life style and general characteristics of the participants and their measured BMD were investigated. The therapy groups included 45 women who were assigned to one of the following regimens in 28 day cycles for 1 year: (1) conjugate equine estrogen (CEE), 0.625 mg/d daily, medroxyprogesterone acetate (MPA) 2.5 mg/d daily and calcium 500 mg/d daily (2) CEE 0.625 mg/d daily, MPA 10 mg/d for days 1 through 12 and calcium 500 mg/d daily. RESULTS: The women in the therapy groups had an average gain of 5.4%, 4.2%, 2.1%, 4.9% in BMD in the lumbar spine, femur total, femur neck and ward's area, respectively. HRT has significantly influenced the BMD after controlling age, month since menopause, alcohol intake, smoking, calcium intake, exercise, body mass index and baseline BMD. The baseline BMD and the BMI were factors that influenced the effect of HRT in BMD. CONCLUSION: HRT had positively influenced the BMD in Korean women. The baseline BMD and the BMI were predictors of the effect of HRT in BMD change.

Three Cases of High Signal Intensity by Brain Magnetic Resonance Imaging in CO2 arc Welders / 대한산업의학회지

We experienced three cases of high signal intensity observed by Brain Magnetic Resonance Imaging in CO2 arc welders of steel-frame manufacturing industry. Case 1 was a 35 years old man who has been an CO2 arc welder for 10 years, admitted a sudden onset of tonic clonic seizure. He complained fever, chilling and myalgia since 3 days before admission. On admission, in the test of manganese exposure indices, manganese concentrations of blood, urine and scalp hair were 5.17 microgram/dL, 22.00 microgram/l and 31.25 ppm respectively. Case 2 was a 35 years old man who has been an CO2 arc welder for 20 years. On admission, He complained fatigue, numbness and weakness of extremities, and decrease of libido. In the test of manganese exposure indices, manganese concentrations of blood, urine and scalp hair were 6.34 microgram/dL, 14.62 microgram/l and 57.87 ppm respectively. In neurologic examination, Palmo-mentis reflex and Myerson sign were observed. Case 3 was a 33 years old man who has been an CO2 arc welder for 16 years. On admission, He complainer loss of appetite, numbness of extremities, fatigue and decrease of attention. In the test of manganese exposure indices, manganese concentrations of blood, urine and scalp hair were 5.14 microgram/dL, 13.79 microgram/l and 50.08 ppm respectively. In neurologic examination, Myerson sign was observed. In brain magnetic resonance imaging, T1WI showed symmetrical high signal intensity in basal ganglia and midbrain of three cases. Authors argued that they were developed by manganese exposure, and we considered that follow up study would be necessary.