The authors performed a study of 32 patients who had undergone anterior lumbar interbody fusion using allograft with posterior pedicular instrumentation. The clinical outcomes were evaluated and the radiographs were analyzed with respect to graft subsidence, interspace collapse, graft collapse, sagittal angle and fusion status. In 71% of the levels there was a loss of disc space height during the follow-up, with 18% of the levels being narrower than their preoperative height at late follow-up. Significant(more than 3mm) subsidence and collapse were noted in three and four levels respectively. Approximately 84% of the 32 patients had satisfactory results and a radiological fusion was obtained in 88.2% of the 34 levels. We consider the pedicle screw fixation improves the retention of interspace distraction and the fusion rate of allograft in anterior lumbar interbody fusion.
Allografts* ; Follow-Up Studies ; Humans ; Spine ; Transplants

PURPOSE: This study was performed to compare the radiographic results of femoral tunnels made through the tibial tunnel and through the anteromedial portal. MATERIALS AND METHODS: From March 1996 to September 1997, fifty-five reconstructions of anterior cruciate ligament were performed. Group I (femoral tunnel through tibial tunnel) was composed of 30 cases and group II (femoral tunnel through anteromedial portal) was consisted 25 cases. On postoperative anteroposterior and lateral radiographs of knees, five angles were measured : APD/LD (angle between longitudinal axis of femoral bone block of patella tendon bone graft and that of interference screw in anteroposterior view/ lateral view), AFT (the angle between longitudinal axis of femoral tunnel and that of tibial tunnel in anteroposterior view), APFT/LFT (the angle between longitudinal axis of femoral tunnel and that of femoral shaft in anteroposterior view/ lateral view) and the graft tunnel mismatch was evaluated. RESULTS: Average APD was 1.30+/-3.13 degree in group I and 0.52+/-1.85 degree in group II (P>0.05), average LD was 4.97+/-7.62 degree and 1.48+/-3.30 degree (P<0,05), average AFT was 12.40+/-7.29 degree and 19.48+/-8.49 degree (P<0.05), average APFT was 15.33+/-6.95 degree and 14.32+/-7.33 degree (P>0.05), and average LFT was 36.57+/-5.20 degree and 39.64+/-6.48 degree (P>0.05), respectively. CONCLUSIONS: We concluded that making a femoral tunnel through the anteromedial portal decreased the divergence between the femoral interference screw and femoral bone block of patella tendon-bone autograft.
Anterior Cruciate Ligament Reconstruction* ; Anterior Cruciate Ligament* ; Autografts* ; Axis, Cervical Vertebra ; Knee ; Patella ; Patellar Ligament ; Transplants

PURPOSE: The purpose of the study was to identify the effect of a comprehensive education program on knowledge, self-efficacy for self-management, and coping style among newly diagnosed patients with breast cancer. METHODS: This study used a one group pretest-posttest design. Data were collected from April to September, 2010 at a cancer-specific hospital in Goyang, Korea. One hundred forty three women received a comprehensive education program consisting of 3 sessions composed of 8 themes was conducted by several experts (nurses, doctors, dietitians and clinical psychologists) for 3.5 hours a day for 3 days (1 day before and 2 days after the operation). RESULTS: This study showed that knowledge and self-efficacy for self-management significantly increased after education (p<.001). In terms of coping style, however, only the subscale, 'anxious preoccupation', significantly improved (p=.001) among 5 subscales of coping style after education. CONCLUSION: A comprehensive education program for newly diagnosed patients with breast cancer was effective for increasing the knowledge and self-efficacy for self-management of breast cancer, in addition to decreasing the coping style of 'anxious preoccupation'. However, it did not improve other coping style. Therefore, other strategies for improving coping style are needed.
Adaptation, Psychological ; Breast ; Breast Neoplasms ; Female ; Humans ; Korea ; Self Care ; Surveys and Questionnaires

BACKGROUND: The potential adverse effects of ketamine in neurosurgical anesthesia have been well established. However, the effects of ketamine on intracranial pressure (ICP) and hemodynamics during general anesthesia remain unclear. The purpose of this study was to assess the effects of ketamine on hemodynamics and ICP in anesthetized, ventilated rabbits. METHODS: Thirty rabbits were divided into three groups: Group 1 (n=10) received 1 ml/kg normal saline iv; Group 2 (n=10) received 0.5 mg/kg ketamine iv; Group 3 (n=10) received 1.0 mg/kg ketamine iv. After induction with thiopental, anesthesia was maintained with isoflurane and nitrous oxide in oxygen. During controlled ventilation, ICP, mean arterial pressure (MAP), cerebral perfusion pressure (CPP) and heart rate (HR) were measured. The ICP was measured using Ladd ICP monitoring system. All variables were evaluated at baseline and for 30 min following ketamine. RESULTS: In group 1, ICP, MAP, CPP and HR were unchanged over the course of the study. In group 2, ICP, MAP and CPP were unchanged. HR increased at 1, 3 and 5 min (p<0.01), 10 and 20 min (p<0.05) after injection. In group 3, ICP, MAP and CPP increased at 1 and 3 min (p<0.01) after injection. HR increased at 1, 3 and 10 min (p<0.01), 5 min (p<0.05) after injection. CONCLUSIONS: These results suggest that 0.5 and 1.0 mg/kg of ketamine don't significantly affect the hemodynamics and ICP in anesthetized, mechanically ventilated rabbits.
Anesthesia* ; Anesthesia, General ; Arterial Pressure ; Heart Rate ; Hemodynamics* ; Intracranial Pressure* ; Isoflurane ; Ketamine* ; Nitrous Oxide ; Oxygen ; Perfusion ; Rabbits* ; Thiopental ; Ventilation

No abstract available.
Tuberculosis* ; Tuberculosis, Lymph Node*

BACKGROUND: The safety and efficacy of ondansetron were evaluated for the prophylaxis of postoperative nausea and vomiting (PONV) after pelviscopic gynecologic procedure. We compared the effects of three doses of intravenous ondansetron, 1 mg, 4 mg, and 8 mg. METHODS: Eighty women were randomly allocated to one of 4 groups receiving 1 mg (group 1, n = 20), 4 mg (group 2, n = 20), 8 mg (group 3, n = 20) or normal saline (group 4, n = 20) at the end of pelviscopic operation. PONV were measured using a 4 point scale (0: none, 1: mild, 2: moderate, 3: severe) 1 hr, 2 hr, 6 hr, 12 hr, 24 hr after the operation and other side effects were checked. RESULTS: Over the 24 hr study period, group 2 and 3 showed a significant lower incidence of nausea (15%, 10%) and vomiting (5%, 5%) than in group 1 (nausea: 25%, vomiting: 5%) or group 4 (nausea: 40%, vomiting: 30%). Complete response rates of each group were 80%, 90%, 90% and 50% during first 2 hrs and 50%, 80%, 75% and 30% after 2 hrs after operation. Adverse events were minor, and ondansetron treated patients had profiles similar to those of the placebo. CONCLUSIONS: We concluded that ondansetron at 4 mg or 8 mg is a safe and effective prophylactic antiemetic for women requiring gynecologic pelviscopic surgery under general anesthesia.
Anesthesia, General ; Antiemetics ; Female ; Humans ; Incidence ; Nausea ; Ondansetron* ; Postoperative Nausea and Vomiting ; Vomiting

No abstract available.
Female ; Humans ; Pregnancy ; Pregnancy Trimester, Second* ; Pregnancy*

No abstract available.
Humans ; Male*

OBJECTIVES: This study investigated recent trends in the prevalence of obesity among Korean adolescents and explored socioeconomic disparities in obesity. METHODS: This study used annual self-reported data on height, weight, and socioeconomic information from the Korea Youth Risk Behavior Web-based Survey from 2006 to 2020. With a 95.8% response rate, the sample consisted of 818,210 adolescents. Obesity prevalence was calculated according to 4 socioeconomic indicators (household income, father’s educational attainment, mother’s educational attainment, and urbanicity). Socioeconomic inequality was quantified using the relative index of inequality (RII). RESULTS: The overall prevalence of obesity increased, doubling from 5.9% in 2006 to 11.7% in 2020. Boys and high school students showed a higher prevalence. The RIIs in household income and parental educational attainments significantly increased with time, indicating a growing inequality in obesity. Socioeconomic disadvantages had a greater influence on obesity among girls. The most recent RII values for boys were 1.25 for income, 1.79 for the father’s education, and 1.45 for the mother’s education, whereas the corresponding values for girls were 2.49, 3.17, and 2.62, respectively. CONCLUSIONS These findings highlight growing inequalities in adolescent obesity according to household income and parental educational attainments, especially for girls and middle schoolers.

Traumatic hemoperitoneum can still induce high mortality and morbidity rates, despite current method of intensive management. This study was performed to identify the independent prognostic factors in patients with traumatic hemoperitoneum. Two hundred thirty-six patients who underwent emergency operations because of traumatic hemoperitoneum at the Department of Surgery, Dong Kang General Hospital, Ulsan, from January 1986 to June 1994, were entered into this retrospective study. One hundred eighty-six patients were male, and fifty were female. The median age of the patients was 34 years (2 to 77 years). The modes of trauma were 131 motor-vehicle accidents, 43 fall down injuries, 30 stab injuries, 23 assaults, and 9 others . The common sites of injury were lthe iver and the spleen, followed by the mesentery, the stomach, the small bowels, the large bowels, the pancreas, the kidney, the diaphragm, and the retroperitoneum in order of frequency. Prognostic variables were identified from the perioperative parameters by using a univariate analysis(student t- test, chi-square test), and independent prognostic factors were determined by a multivariate stepwise logistic regression analysis, using the SPSS Win. Ver.5.0 PC package program. Statistical significance was present for p < 0.05. The overall postoperative morbidity and mortality rates were 34.3% and 19%, respectively. By using univariate analysis, the amount of bleeding, transfusion, and the immediate post-operative blood pressure were identified as significant prognostic factors for morbidity. Also age over 50, accompanying brain injury, time interval (less than 3 hrs), the systolic blood pressure on arrival (less than 100 mmHg), trauma score (less than 10), grade of liver injury (greater than IV), great vascular injury, total amount of resuscitative fluid (more than 4,000cc), the total amount of transfusion (more than 10 units), and the immediate postoperative systolic blood pressure (less than 100 mmHg) were identified as significant factors for mortality. Multivariate analysis demonstrated the following important independent prognostic factors : the total amount of transfusion for morbidity and mortality, and the post-operative blood pressure and trauma score for mortality. Our results suggest that early massive resuscitation, early operation to minimize the total amount of blood loss, and intensive immediate postoperative care to maintain blood pressure, are of utmost importance in multiple trauma patients with hemoperitoneum.
Blood Pressure ; Brain Injuries ; Diaphragm ; Emergencies ; Female ; Hemoperitoneum* ; Hemorrhage ; Hospitals, General ; Humans ; Kidney ; Liver ; Logistic Models ; Male ; Mesentery ; Mortality ; Multiple Trauma ; Multivariate Analysis ; Pancreas ; Postoperative Care ; Resuscitation ; Retrospective Studies ; Spleen ; Stomach ; Ulsan ; Vascular System Injuries