The efficacy and safety of the combined preparation of Black Cohosh and St. John's wort in menopausal women / 대한산부인과학회지

OBJECTIVE: The aim of this study was to assess the efficacy and safety of the combined preparation of black cohosh and St. John's wort (GYNO-Plus(R)) in post menopausal women with symptoms. METHODS: A total number of 60 postmenopausal women with climacteric symptoms was allocated to take GYNO-Plus(R) for 3 months. And the change of the Kupperman menopausal index (KI), serum FSH and E2 level, bone densitometry (BMD), mammographic density, liver function test (LFT) and adverse effects were assessed. RESULTS: There was statistical difference in the decline of KI after 3 months treatment. But, there were no statistical differences in the change of serum FSH and E2 level, BMD, mammographic density, and LFT. There were nine adverse events in study, but two cases were directly related to the drug and they were resolved without any sequela. CONCLUSION: This study suggests that the combined preparation of black cohosh and St. John's wort is a safe, effective alternative treatment option for patients in whom hormone replacement therapy is either refused or contraindicated.

Effect of Triamcinolone Acetonide on Proliferative Vitreoretinopathy and Hepatocyte Growth Factor in a Rabbit Model

PURPOSE: To investigate the intravitreal level change of hepatocyte growth factor (HGF) in a rabbit model of proliferative vitreoretinopathy (PVR) and the effect of triamcinolone on PVR and intravitreal HGF concentration. METHODS: Experimental PVR was induced in 21 New Zealand white rabbits by performing a scleral laceration, followed by repair and intravitreal injection of 0.1 ml of autologous blood. Seven eyes (group A) were injected with a high -dose of triamcinolone (5 mg), 7 eyes (group B) with a low -dose of triamcinolone (1 mg), and 7 control eyes (group C) with only balanced salts solution (BSS), respectively. Intravitreal HGF levels were measured by ELISA test taken at 0, 3, 7, 14, 21, and 28 days after PVR induction. PVR grade was determined by serial indirect ophthalmoscopic examination at different time points mentioned. RESULTS: Elevated HGF levels were found in the vitreous peaking at 7 days after PVR -inducton in all 3 groups. The differences in HGF levels of treated groups A and B, and the control group C were statistically significant (p<0.001). The differences of PVR grades among the 3 groups were not statistically significant. However, gross and microscopic examinations of the control group C showed that proliferations and morphologic changes of retinal pigment epithelial cells were more prominent than in the treated groups. CONCLUSIONS: The intravitreal level of HGF varied with time in the rabbit PVR model. Also, our results suggest that intravitreal triamcinolone suppresses the expression of intravitreal HGF in the rabbit PVR model.

A Case of Pulmonary Hypertension and Left Vocal Cord Palsy in a Patient with Systemic Lupus Erythematosus / 대한류마티스학회지

There have been few case reports on the association of vocal cord palsy and pulmonary hypertension in a systemic lupus erythematosus (SLE) patient. Most cases had left vocal cord palsy caused by compression of left recurrent laryngeal nerve secondary to pulmonary hypertension, and only two cases in the literature were caused by vasculitis or inflammation of the right recurrent laryngeal nerve not related to pulmonary hypertension. Recently, we have experienced a 23-year-old female patient who presented hoarseness and multiple joint pain. She was diagnozed as SLE and left vocal cord palsy, and echocardiographic examination demonstrated enlargement of right atrium, right ventricle, and elevated right ventricular pressure (systolic pressure 47mmHg). She took high-dose glucocorticoid and calcium channel blocker. About one month later, there was significant improvement of hoarseness, arthritis, and cardiomegaly, and showed improvement of the left vocal cord palsy on the laryngoscopic examination. We report a case of left vocal cord palsy and pulmonary hypertension accompanied by SLE who experienced improvement of hoarseness after steroid treatment.

Acute monoarthritis associated with positively birefringent maltese cross appearing lipid spherules in a hyperlipidemic diabetic patient

A 63-year old man developed acute monoarthritis in the dorsum of the left foot. Polarized light microscopy of the synovial fluid from his third metatarsophalangeal joint revealed numerous positively birefringent lipid spherules with a maltese cross appearance. Positively birefringent lipid spherules can be found in association with acute, otherwise unexplained arthritis, and may induce synovial inflammation similar to that seen in other types of crystal-induced arthritis. We report a case of acute monoarthritis in which large numbers of positively birefringent lipid spherules were present in a hyperlipidemic diabetic patient.

A Case-Control Study on Risk Factors of Preterm Labor / 대한산부인과학회잡지

BACKGROUND: The prevention of preterm deliveries still remains a major problem in ob-stetrics. The cause of preterm labor is poorly understood. Our purpose was to determine the risk factors for preterm labor associated with specific clinical and environmental factors. METHODS: Using a case-control design, 54 women with preterm labor and 134 controls with term labor, who were admitted to the department of Obstetrics and Gynecology, Dan- kook University Hospital from January, 1996 to August, 1996. The study groups were inte- rviewed and their medical records were reviewed. RESULTS: 1. There were no significant differences of maternal age, maternal weight at 20 weeks of gestation and maternal weight gain at the time of delivery. 2. There were no significant differences between housewives and working women. But the physical workload of the preterm labor group was significantly higher than the control group ( 16.0% vs. 4.0% ). 3. There were no significant differences in the smoking habit of mother or her husba- nd. The passive smoking of the preterm labor group was significantly higher than the con- trol group ( 43.8% vs. 26.8% ). 4. In vaginal bleeding at pregnancy, the preterm labor group was significantly higher than the control group ( 15.7% vs. 2.3% ). Especially, the third trimester vaginal bleeding of the preterm labor group was significantly higher than the control group. 5. There were no significant differences in the number of previous fullterm deliveries, previous abortions, and living children between two groups. The experience of the previous preterm deliveries of the preterm group was significantly higher than the control group ( 11. 5% vs. 0.8% ). 6. There were no significant differences of medications, consumption of alcohol, coffee, tea, green-tea, cola and nutritional beverages, the experiences of coitus, defecation numbers and accidents during pregnancy between two groups. 7. There were no significant differences in the plasma concentrations of hemoglobin, hematocrit, white blood cells, and in the blood pressure, and the body temperature between two groups. CONCLUSION: The risk factors of preterm labor were severe physical workload, vaginal bleeding at pregnancy, especially, the third trimester vaginal bleeding, and the experience of previous preterm deliveries.