Spinal dimensions (anterior, mid, and posterior height of the vertebral body) and shape variation (wedge compression, biconcave, and crush ratio) were obtained from plain radiographs of healthy Korean men and women. The purpose of this study was to define vertebral fracture from normal spinal morphometry of Korean men and women and to compare spinal dimension between men and women. Healthy 100 men and 100 women were included in this study. Plain lateral radiographs of thoracic and lumbar vertebrae were taken with standard method. Quantitative morphometry (anterior, mid, and posterior height of the vertebral body) was performed with plain radiographs. Spinal shape variations (wedge compression, biconcave, and crush ratio) were calculated from morphometric data. Spinal dimensions and shape variation of Korean men and women were presented, and morphometric cut-off vaiues for vertebral fracture were evaluated(mean-3xSD). Spinal dimensions of men were greater than women in all level (p<0.01). Wedge compression ratios (T6, 7, 8, 9, 12, L5 level) and biconcave ratios (T12, Ll, 4, 5 level) and crush ratios (Tll, L4, L5 level) were different between men and women (p<0.01). Spinal dimensions and shape variation from quantitative morphometry can be used in objective definition of vertebral fracture which can be used in medicolegal problem, workers compensation and medical insurance.
Female ; Humans ; Insurance ; Lumbar Vertebrae ; Male ; Spine ; Workers' Compensation

No abstract available.
Fetal Death*

No abstract available.
Laryngectomy* ; Lung*

Computerized tomography has been used in the evaluation of the intracranial lesions. Recently the usage of computerized tomography has progressively widened in many fields of clinical practice. In orthopedics computerized tomography has been tried in the diagnosis and the determination of treatment of tumors, spinal disorders, hip disorders and knee problem. Four problem cases in which concentric reduction could not be obtained after closed reduction of hip dislocations were evaluated by computerized tomography from Apr, 1, 1983 to Mar. 31, 1984 in the Capital Armed Forces General Hospital and following conclusiions were obtained: 1. Open reduction revealed that muscles(adductor and pyriformis muscles), joint capsule and osteocartilaginous loose bodies (femoral and acetabular) were interposed to hinder concentric reduction. Large posterior acetabular fragment induced instability and redislocation of the hip. 2. When there were 2-3 mm lack of symmetry of the two femoral heads or any abnormal findings(breakage of Shenton's line etc.) in plain roentgenography, computerized tomography was recommanded, and muscles, osteocartilaginous loose bodies and instability were found. 3. Computerized tomography is an easy simple method and has a great diagnostic value in the evaluation of asymmetry and instability after closed reduction of traumatic hip dislocations.
Acetabulum ; Arm ; Diagnosis ; Head ; Hip Dislocation ; Hip ; Hospitals, General ; Joint Capsule ; Knee ; Methods ; Muscles ; Orthopedics ; Radiography

PURPOSE: The purpose of this study was to analyse the characteristics of acalculous cholecystitis (AC) compared with those of calculous cholecystitis (CC), and also to find the relationship of preoperative radiologic findings to the classification of pathological degree of inflammation of the gallbladder in AC. METHODS: Between March 1996 and June 2000 a total of 163 patients undergoing cholecystectomy for cholecystitis were divided into group AC (21 patients) and group CC (142 patients) and retrospectively studied by analyzing clinical data. RESULTS: The incidence of AC among cholecystitis cases was 12.9%. there was male preponderance in group AC whereas female preponderance in group CC (P<0.036). The pulse rate (P<0.02) and white blood cell count (P<0.003) were significantly elevated in group AC. Possible etiological factors were found in 6 cases (28%) in group AC. The rates of preoperatively observed pericholecystic fluid collection in US (P<0.033) and dilatation of the gallbladder in CT (0.012) were significantly higher in group AC than in group CC. Additionally, the rate of tube drainage during surgery was significantly higher in group AC than group CC (P<0.02). Finally, wall thickness (P<0.05), dilatation (P<0.05) of the gallbladder in CT and the total sum of findings in CT (P<0.01) and US (P<0.05) were strongly related to the degree of inflammation of the gallbladder. CONCLUSION: The majority of AC patients exhibit nonspecific clinical findings, often delaying diagnosis; however, if it develops, AC tends to display more acute and inflammatory characteristics than calculous cholecystitis. laparoscopic surgery cannot be sucessful in cases of delayed diagnosis. US, CT and scintigram are useful diagnostic tools if we interpretate each finding in relation to the severity of inflammation.
Acalculous Cholecystitis* ; Cholecystectomy ; Cholecystitis* ; Classification ; Delayed Diagnosis ; Diagnosis ; Dilatation ; Drainage ; Female ; Gallbladder ; Heart Rate ; Humans ; Incidence ; Inflammation ; Laparoscopy ; Leukocyte Count ; Male ; Retrospective Studies

OBJECT: In order to compare several Obstetric characteristics and outmmes of teenage pregnancy. METHODS: The 10 year clinical records of 11,583 women undergoing Cesarean section and delivery were reviewed in the department of Obstetrics and Gynecology, Incheon Christian Hospital from July 1, 1989 to June 30, 1999. There were seventy-eight pregnancies under age 20 and we compared them with two hundred pregnancies aged 20-29 who were randomly chosen during the same periods as the control group. RESULT: The following results were obtained. The proportion of birth by teenagers increased from 0.5% of all birth in 1989 to 2.61% in 1999. The most of cases were in high teen group, age 14- 19.The majority(50.5%) were in the age of 19. Seventy two cases(92.3%) had no previous pregnant history. Six cases had one previous pregnant history. The frequencies of prenatal care were significantly lower than that of the control group(p<0.05). The mean gestational period was 36+4weeks, and showed significant difference between the study group and the control group(39+3 weeks). The incidence of preterm labor was significantly different between the two proups(p<0.05). But the incidence of postterm delivery were not significantly different between the two groups. The mean weight gain of pregnant teenagers revealed 10.64kg, significantly less profound than the control group. The matemal weight gain of control group revealed 12.95kg, respectively. The mean birth weight(2.54kg) of infant was significantly less profound than the control group. The incidence of birth of small for gestational age(birth weight 1,500-2,499gm ; 14.5%) was significantly increased among study group than the control group(1%). The rate of abdominal delivery(21.8%) were not significantly decreased than the control group(47%). The incidence of cephalopelvic disproportion and malpresentation for cesarean section were somewhat higher than the control group, and were statistically significant(p<0.05). During the antepartun period, anemia, pyelonephritis, and preterm labor occurred more frequently in the teenage pregnancy than the control group, but not statistically significant. Among postpartum complications, incidence of anemia(51.3%) increased significantly. The perinatal mortality, intrauterine growth retardation, congenital anomaly occurred more frequently than the control group. CONCLUSION: These results show that pregnancy of teenage will be comeout high risk and complications. And then we will be more concern and study about teenage pregnancy.
Adolescent ; Anemia ; Cephalopelvic Disproportion ; Cesarean Section ; Female ; Fetal Growth Retardation ; Gynecology ; Humans ; Incheon ; Incidence ; Infant ; Obstetric Labor, Premature ; Obstetrics ; Parturition ; Perinatal Mortality ; Postpartum Period ; Pregnancy ; Pregnancy in Adolescence* ; Prenatal Care ; Pyelonephritis ; Weight Gain

Tissue expansion in breast reconstruction is a invaluable alternative surgical procedure. the advent of permanent expander prosthesis eliminated a second operative procedure for removal of the expander and replacement with another permanent implant. When we consider the choice of method for breast reconstruction, we have to take account of the extent of mastectomy, past-medical history of the patient, timing of operation, and patient's motivation. It is still accepted that autogenous Breast reconstruction is the best choice of the mothed. As autogenous breast reconstruction increase in popularity, however, it requires longer operation time, more complicated technique, and careful attention to donor site. Autogenous breast reconstruction is also not good candidate for the patients who have diabetes, vascular disease, smoking, obesity, previous history of cesarean section, or further pregnancy planning. We have performed 10 immediate breast reconstructions after modified radical mastectomy using the permanent expander prosthesis, manufactured by Mentor corporation. Among these cases, 8 patients underwent cesarean section and 2 patients pregnancy. Although this method has advantages of simple technique, minimal morbidity, and low cost, it has some limitations for orientals. First, it is inevitable in superior fullness of the reconstructed breast because of round shape of the expander. Second, it is difficult to get ptotic breast because of thick and inelastic characteristics of oriental skin. Third, the ratio of expander base to projection is not appropriate for orientals because of their smaller chest size. We experienced 2 cases of spontaneous deflation for its manufactural defect itself. In our experience, we would like to suggest that new type of permanent expander prosthesis should be innovated.
Breast* ; Cesarean Section ; Female ; Humans ; Mammaplasty* ; Mastectomy ; Mastectomy, Modified Radical ; Mentors ; Moths ; Motivation ; Obesity ; Pregnancy ; Prostheses and Implants* ; Skin ; Smoke ; Smoking ; Surgical Procedures, Operative ; Thorax ; Tissue Donors ; Tissue Expansion ; Vascular Diseases

In many cases the breast reconstruction surpasses the goal of a normal breast mound appearance in clothing and achieves a result that, in time, may look almost normal in the unclothe state. Breast reconstructions with autologous transverse rectus abdominis myocutaneous (TRAM) flaps are well known to produce the most aesthetically excellent results. the pedicled to TRAM flap cannot be used in high risk patient such as obese or smoking patients due to partial flap necrosis. But, the free TRAM flap have more robust blood supply and less donor site morbidity than the pedicled TRAM flap and is therefore the currently preferred technique in western. However, the free TRAM flaps has a problem related to the anastomotic failure which has been reported as high as 6% to 10%. Moreover many Korean women have smaller sized breast than western women and have no risk factors compromising flap circulation. So the single pedicled TRAM flap can be safely used for breast reconstruction without any flap necrosis. 60% of the elevated flap area has a sufficient volume to mold a new breast that matches with the contralateral breast and the unneccessary distal portion of the flap that has the marginal circulation can be resected. In this study we review our 20 consecutive cases of breast reconstruction using the pedicled TRAM flap and have a conclusion that the pedicled TRAM flap produce an aesthetically acceptable new breast in Korean mastecotmy patients without any flap necrosis or donor site morbidity.
Breast* ; Clothing ; Female ; Fungi ; Humans ; Mammaplasty* ; Necrosis ; Rectus Abdominis* ; Risk Factors ; Smoke ; Smoking ; Tissue Donors

BACKGROUND: Lidocaine is a well known antiarrhythmic agent. However, recent reports indicate that indocaine has myocardial protective effects on acute myocardial ischemia and reperfusion. The exact mechanism of myocardial protection of lidocaine is still not clearly understood. In this study we intended to assess the effects of lidocaine on high energy phosphate metabolism in cats subjected to myocardial ischemia-reperfusion by using 31P MR spectroscopy. Effect of lidocaine on size of infarct will also be evaluated by 2, 3, 5-triphenyltetrazolium chloride(TTC) staining. METHODS: Twenty-seven cats were used for this study. The animals were divided into three groups : for group 1(n=10) and group 2(n=7), animals were subjected to a 90 min of LAD occlusion followed by a 90 min of reperfusion ; for group 3(n=10), a 20 min of occlusion followed by a 90 min of reperfusion. In group 2 and group 3, lidocaine(5mg/kg/hr) was infused continuously during the occlusion and reperfusion periods with an initial bolus injection(1mg/kg) before ligation of LAD. In-vivo MR spectroscopy was performed on a 4.7T Biospec System(Bruker, Switzerland). A home-made surface coil(diameter : 1.5cm) was used to receive31p signals from the myocardium underwent ischemic and reperfusion damage. RESULTS: Decrease of PCr during ischemic period was not different between each groups : PCr showed less than 30% of the baseline value at L-30 in group 1 and group 2 and at L-20 in group 3. More than 90% recovery of PCr was achieved at R-30 in group 2 and group 3, whereas less than 50% of PCr was recovered in group 1. Decrease of ATP during ischemic period was less pronounced in group 2 than in group 1 : in group 2 ATP depleted down to 25% of the baseline at L-90, whereas in group 1 ATP decreased to 50% of the baseline. Recovery of ATP during reperfusion period was not signiflcant in all three groups. On TTC staining, evidence of infarct was seen in all cases of group 1 : the area of infarct was 12.3+/-2.7% of the left ventricular mass and 23.9+/-6.1% of the area at risk. On the contrary, there was no evidence of infact in any case of group 2 and group 3. CONCLUSION: In this study, we found that lidocaine has myocardial protecitve effects on ischemia-reperfusion in cats. Lidocaine improves high energy phosphorous metabolism during ischemia and reperfusion as well as reduces infarct size.
Adenosine Triphosphate ; Animals ; Cats* ; Ischemia ; Lidocaine* ; Ligation ; Magnetic Resonance Spectroscopy ; Metabolism ; Myocardial Ischemia ; Myocardium ; Polymerase Chain Reaction ; Reperfusion ; Reperfusion Injury

PURPOSE: Foot infections are common complications in patients with diabetes. The patients are usually immune-compromised; therefore the pathogens could be resistant to narrow spectrum antibiotics. Those drugs, however, are categorized as specially managed antibiotics, and access are difficult without confirming of the pathogens. Our aim was to analyze the common pathogens in diabetic foot infection and figure out the proper antibiotics. MATERIALS AND METHODS: We studied 68 patients treated with diabetic foot infection. The pathogens which caused the infection and their sensitivity to initial antibiotics were analyzed. We also investigated the change of the antibiotics after the confirming of the culture result and average time to get the result. RESULTS: Among the 68 patients, 56 (82%) received cephalosporin and beta-lactam antibiotics. Only 12 (18%) who were confirmed the drug resistant pathogens from previous culture, were treated with broad spectrum antibiotics such as vancomycin and tazoperan. Average culture study time was 6 days. Methicillin-resistant staphylococcus aureus (MRSA) was cultured in 19 patients (28%), Methicillin-resistant coagulase negative staphylococcus (MRCNS) in 11 patietns (17%), pseudomonas in 11 patients (17%). Total 44 (65%) including 3 of other antibiotics resistant pathogen needed broad spectrum antibiotics. Thirty two patients (47%) were resistant to initial antibiotics.irt follow up culture, 2 MRSA and 2 MRCNS were found. The antibiotics resistant pathogens were confirmed in 48 (71%) patients at last. CONCLUSION: Diabetic patients with foot infection need proper antibiotics from initial treatment. The proper broad spectrum antibiotics should assigned to the patients from the first time without the confirming of the culture results.
Anti-Bacterial Agents ; Coagulase ; Diabetic Foot ; Follow-Up Studies ; Foot ; Humans ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Pseudomonas ; Staphylococcus ; Vancomycin