To examine the management status of patients with rheumatoid arthritis (RA) taking glucocorticoids treated at a tertiary hospital rheumatology Practice.

A retrospective chart review was performed on 114 RA patients who were noted to be taking glucocorticoids during the period of 2000.7 to 2003.7, and who had been followed up for at least one year period. Use of bone densitometry and use of prescription medication for osteoporosis management were assessed.

Thirty one % of patients underwent bone densitometry, and 34% of patients received prescription medication for osteoporosis management. Sixty-six percent of patents who underwent bone densitometry showed osteoporosis with T score of less than 2.5, Osteoporosis medication was prescribed most often in the prednisolone exposure group of at least 7.5mg/d for at least 6 months. Factors associated with not receiving management for osteoporosis included male sex, young age, and premenopausal woman.

The use of bone densitometry and prescription medication for osteoporosis were suboptimal. Interventions to improve detection and prevention of glucocorticoid induced osteoporosis are necessary.

Of all the chronic pain syndromes postherpetic neuralgia ranks the most refractory to treatment. The eight postherpetic neuralgia patients have been treated with nerve blocks or neurolysis and obtained good result. We evaluate the therapeutic effect of nerve blocks for postherpetic neuralgia and reviewed the pathology, clinical consideration, treatments and prevention.

Eight patients with established postherpetic neuralgia enrolled in pain clinic of Mokdong Hospital of Ewha Womans University from March,2004 to December. Average age at 58 and about 63% of patients were over 68 years. Affected area of forehead was two patients. They have been treated with stellate ganglion block (SCB), two times supraorbital and supratrochlear nerves blocks and neurolysis with absolute alcohol. Face affected patient has was one and has been treated with 5 times SGB, 2 times supraorbital and supratrochlear nerves blocks, infraorbital and mental nerves blocks, and then 2times maxillary and mandibular nerves blocks. Chest affected two patients were treated with intercostal nerve blocks. Thoracic wall affected one patient received 2 times thoracic epidural blocks and thoracic nerve block. Scapalur and thoracic wall affected patient has been treated with SGB and 2 times thoracic epidural block. The chest and thoracic wall affected patient received 10 times intercostal blocks,2 times thoracic epidural blocks,3 times thoracic root block and neurolysis of intercostal nerves with absolute alcohol. The injected agents were 1% mepibacaine or 0.25% mercain heavy and methylprednisolone succinated, and at weekly intervals the agents were injected.

All patient having been treated with nerve blocks were free of pain at 3-9 months.

Although no controlled trial has been done of nerve blocks to treat postherpetic neuralgia, this technique is safe in experienced hands and, if effected, may be repeated. It suggested that local anesthetics and steroid are the effective components in nerve blocks. Data on the relief of acute pain with nerve blocks, however cannot be extrapolated to predict the prevention of postherpetic neuralgia. The best way to prevent herpes zoster becasuse of post herpetic neuralgia is so difficult to treat.

The advances in surgical techniques and stabilizing devices have made the off-pump coronary artery bypass (OPCAB) popular, and good results have been published. We analyzed the early results of OPCAB performed in our hospital.

Between January 2004 and December 2004, 23 patients underwent OPCAB. There were 14males and 9 females with mean age of 62.6±10.3years. Preoperative diagnoses were unstable angina in 13(57%), acute myocardial infarction in 9(39%), and stable angina in 1(4%). Preoperative angiographic diagnoses were three-vessel disease in 12 (52%), two-vessel disease in 8(35%), one-vessel disease in 1(4%), and left main disease in 2(9%).

The mean number of grafts was 2.6±0.9 per patient. Vessels accessed were left anterior descending artery in 23, diagonal branch in 14, obtuse marginal branch in 9, right coronary artery in 12, and posterior descending artery in 1. Left internal mammary artery were used in 22 patients and bilateral internal mammary arteries were used in 1 patient. There was no operative mortality. Postoperative complications were cerebral vascular accident in 1, postoperative bleeding which required operative management in 2, arrhythmia including atrial fibrillation in 5, and minor operative wound problem in 1. Pre-discharge graft patency was evaluated in 11 patients. One internal mammary artery graft was occluded in 11 internal mammary artery graft evaluated. The patency rate was 91%. Seventeen saphenous vein grafts were patent in 19 saphenous vein grafts and the patency rate was 89%.

Our result of OPCAB is promising and OPCAB is suggested to be the ideal technique with less morbidity and mortality.

Chronic prostatitis is difficult to treat and unintelligible disease with multi-factorial etiology, various pathophysiology and several clinical manifestations rather than simple single disease. Therefore, it is thought to be important successful treatment and courtesy call that grasp whether some elements influence incidence of disease. The authors wished to search factors which influence the development and the progress of chronic prostatitis.

From January, 2004 to October, 184 patients who undergo diagnosis as chronic prostatitis were selected, and chose healthy 40 men for comparative analysis to control group. Subjects were investigated for the status of profession and form of work, driving, motorcycle or bicycle utilization, drinking, smoking and sex, and the style of behavior and diet.

Average age of chronic prostatitis(CP) group and control group was no difference. The classification of specific profession did not show relevant difference, but sedentary desk workers were much excellently than CP group(40.0%) by control group(53.8%)(p<0.05). Driver's ratio more than 1 day 1 hour was high in CP group than control group(22.5%) by 28.3%(p<0.05). A person who ride motorcycle or bicycle did not show relevant difference(p>0.05). A person who ejaculate more than once a week through any manner, was less CP group(51.1%) than control group(62.5%), but showed high ratio by person with ejaculation less than 1-2 time a month and daily ejaculation in CP group(p<0.05). A person who drinks more than once a week was many in CP group(p<0.05), and also a person who drink more than 1 bottle of soju expressively high ratio show in CP group(p<0.05), In dietary life habit, CP group showed high ratio by salty food preference degree(p<0.05).

Some factors look that have important effect in disease change for the worse progress of chronic prostatitis. Therefore, it is thought should be gone side by side that reform this detecting eating habit and lifestyle that can exacerbate the disease along with general medication in treatment.

Although chronic prostatitis is extremely frequent, there had been very vague analyses and solutions with regard to this disease and the treatment is still challenging. An antibiotic is usually given for a longer period of time, 4-12 weeks. For years, the cranberry(Vaccinium macrocarpon) has been widely used to prevent and treat urinary tract infections, because cranberry has been shown to interfere with bacterial adherence to urothelium. The main objective of this investigation was to verify whether or not the cranberry juice is capable of the complementary therapy for chronic prostatitis.

The selected subjects were 69 patients diagnosed with NIH-category IIIb chronic prostatitis between the periods of March to October, 2004. The first-line treatment was daily 3 times intake of levofloxacin 100mg for 4 weeks. Randomly selected 34 patients were prescribed with 150ml of cranberry juice intake, two times a day for 12 weeks and the remainder 35 patients were managed conservatively only after ceasing the antibiotic. The patients were reevaluated 4 and 12 weeks later.

At the baseline stage, NIH-CPSI scores were 25.8±7.4 and 25.4±7.0 for the cranberry juice group and the conservative group. 4 weeks after the antibiotic treatment, they were 16.91±4.5 and 17.8±4.8 and thus implied the improvements without difference between the two groups(p>0.05). For the conservative group, there were 6 patients who experienced deteriorations 8 to 12 weeks later and as the NIH-CPSI scores reached 19.2±7.3, thus there were no significant improvements compared to baseline(p>0.05). Within the cranberry juice group, there was no patient with symptoms worsened and the NIH-CPSI scores at 12 weeks reached 13.5±3.9 with significant improvements compared to baseline(p<0.05). All the patients did not experience any side effects due to the cranberry juice intake.

Under the present circumstances of proposing the distinctive standard and providing a suggestion to replace the antibiotics for the treatment of chronic prostatitis, the short timed and limited use of the antibiotics accompanied by the cranberry juice demonstrated sufficient possibility and effectiveness. Thus the cranberry juice could be appointed as the complementary therapy in chronic prostatitis without serious adverse effects.