Background
: There have been bone mass studies for the treatment of osteoporosis, nonetheless, little attention has been paid to the management of osteopenia. This study was to evaluate the effects of estrogen, alendronate and their combination on bone mineral density and bone metabolism in the postmenopausal women with osteopenia.

Methods : A total of 150 healthy regional patients with osteopenia from Busan were enrolled in prospective randomized clinical trial and randomly assigned to receive conjugated equine estrogen (group I), alendronate (group II), or combination of the two (group III). Assessments included BMD of L2-4 spines and femur neck by DEXA and markers of bone turnover including serum osteocalcin, total alkaline phosphatase and urine Deoxypyridnoline (Dpd). BMD and markers of bone turnover were re-evaluated at 6 and 12 months after the treatment.

Results : BMD of the lumbar spines increased significantly at 12 months after treatment in the three groups (P＜0.05). BMD of the femur neck increased at 12 months after treatment in the three groups, but significantly in group III (P＜0.05). Serum osteocalcin decreased at 12 months after treatment in the three groups, but only significantly in group III. Urine Dpd decreased at 12 months after treatment in three groups, but significantly in group, II and III (P＜0.05). Serum total alkaline phosphatase decreased at 12 months after treatment in only group III (P＜0.05). There was more favorable benefit for group III in BMD of the lumbar spines and serum osteocalcin and urine Dpd at 12 months after treatment compared to group, II and III (P＜0.05).

Conclusion : These results indicated a favorable benefit of conjugated equine estrogen, alendronate, or combination of the two in BMD and important markers of bone turnover. The combined treatment with conjugated equine estrogen and alendronate was more effective in postmenopausal women with osteopenia. Long-term studies are required to confirm these results.

Background
: The herbicides used in Vietnam were later found to be extremely contaminated with 2,3,7, 8-tetrachlorodibenzo-ρ-dioxin (TCDD). The carcinogenecity of the product was for all cancers combined. The risk of soft tissue sarcoma, lung cancer, and lymphoma, chloracne, peripheral neuropathy and other diseases were found to be increased. Although many veterans exposed to herbicides had chronic skin diseases with variable clinical features, there were few researches about herbicides-related skin diseases. The purpose of this study was to investigate the characteristics of herbicides-related skin diseases and to provide epidemiologic information.

Methods : This study has been reviewed in the clinical findings of 127 veterans with skin diseases exposed to herbicides who visited Kosin University Gospel Hospital during the 5 years from January of 1997 to December of 2001.

Results : The age distribution was in the range of 47∼68 years. The mean age was 54.6 years old. All patients were male. In the duration, 34 patients (26.8%) developed skin diseases for 6∼10 years, 21 patients (16.5%) for 16∼20 years, and 21 patients (16.5%), 25 years. In the incidence, seborrheic dermatitis was the most frequently observed in 45 patients (35.4%) followed by eczematous dermatitis in 41 patients (32.3%), xerotic eczema in 23 (18.1%) and pruritic dermatoses in 21 (16.5 %). In the incidence ratio of skin diseases with systemic diseases, chronic urticaria was the most highly observed with 100% (1/1) followed by fungal infection in 70% (7/10), other diseases in 66.6% (6/9), seborrheic dermatitis in 64.4% (29/45), eczematous dermatitis in 56.1% (23/41), and xerotic eczema in 52.2% (12/23). Sixty eight patients had skin diseases with systemic disease. Hypertension and diabetes were most frequently observed with 24 and 23 patients, respectively. The order of incidence was as follows: liver disease, gastroduodenal ulcer, peripheral neuropathy, chronic gastroenteritis, and hyperlipidemia. Mycosis fungoides was found in 4 cases and monoclonal T cell γ receptor gene rearrangement was detected in 2 cases (50%).

Conclusion : Skin diseases among veterans exposed to herbicides used in Vietnam were chronic and showed variable clinical features. It was difficult to confirm the relationship between skin diseases and herbicides, but further researches are required to seek guidelines for the evaluation of skin diseases.

Background
: Many endoscopists generally use topical pharyngeal anesthesia as a premedication for upper gastrointestinal endoscopy. However, the use of topical pharyngeal anesthesia for upper GI endoscopy has been debated since its inception. The purpose of this study was to compare the effect of no premedication to the effect of a lidocaine premedication.

Methods : One hundred consecutive examinees scheduled for diagnostic upper endoscopy, divided into two group 50, were randomly assigned to receive topical lidocaine spray or without. The test group involved subjects not using topical pharyngeal anesthesia and the control group involved subjects using it without sedation. The collected data included intubation time (seconds), procedure time (minutes), pulse rate, blood pressure, the difficulty of the endoscopy (VAS), anxiety (STAI), and discomfort. Examinees were also asked whether they would agree to another endoscopy if their doctor thought it was medically necessary.

Results : In the response to the amount of cough, belching, bloating or the degree of difficulty in endoscopic procedure, there was no statistically significant difference between the test group and the control group. The intubation time was significantly different comparing the no-premedication group versus lidocaine premedication group. However, the procedure time was not significantly different. In the normotensive group, the changes of systolic blood pressure during endoscopy were significantly higher in the test group than in the control group.

Conclusion : Evaluating all variables, there was no statistically significant difference between the test group and the control group.