BACKGROUND: Recently the number of elderly gallstone patients has increased, in Korea. The aim of this study is to analyze and to measure the risk factors associated with operation on elderly gallstone patients. METHODS: We reviewed the medical records of 206 gallstone patients who had been admitted and operated on in the department of general surgery. Konkuk University Hospital, between January, 1993 and December, 1999. The patients were divided into 2 groups, over and under age 65. In each group, analysis was done on sex distribution, the ratio according to location of gallstone, duration of hospital stay, duration of general anesthesia and operative mortality, and then the above factors of each group were compared. RESULTS: 1) The ratio of common bile duct stones in patients over age 65 was two times of that in patients under age 65(48%,24%) 2) The overall operative mortality was 1.9% and has no correlation with old age. 3) Severe coexisting disease may seem the risk factor for operative mortality. CONCLUSION: In the diagnosis and management of gallstones in the elderly, the possibility of common bile duct stone should be suspected. And in order to reduce the operative mortality, careful preoperative evaluation and treatment of coexisting disease should be done.
Aged ; Anesthesia, General ; Common Bile Duct ; Diagnosis ; Gallstones* ; Humans ; Korea ; Length of Stay ; Medical Records ; Mortality ; Risk Factors ; Sex Distribution

BACKGROUND: The regurgitative valvular heart diseases are important underlying diseases that result in congestive heart failure, and the prevalence increase with the increasing age. Early detection and management of the regurgitative valvular heart disease could decrease the morbidity and mortality rate of the elderly. METHODS: We reviewed medical records of 425 patients who visited KonKuk University Medical Center ChungJu Hospital for the echocardiography between April 1994 to September 2000. 281 out of 425 patients were diagnosed with regurgitative valvular heart disease, and they were analyzed according to their age, sex, underlying disease, and accompaniment of congestive heart failure. Also the relationships between the regurgitative valvular heart disease and fractional shortening(FS), and also with ejection fraction(EP) were analyzed. RESULTS: There were 281 patients diagnosed with regurgitative valvular heart disease. Greatest number of patients was diagnosed with MR, followed by AR, TR and PR, accordingly. The prevalence of regurgitative valvular heart disease increased as the age increased. The prevalence of regurgitative valvular heart disease in male patients were 74% and for female patients, 62%. For patients with hypertension, it was 59%, and for DM patients it was 60%. For patients with past history of ischemic heart disease, or congestive heart failure, the prevalences of regurgitative valvular heart disease were high. FS for the patients with regurgitative valvular heart disease was 28.91% compared 32.69% for the patients without regurgitative valvular heart disease. EF for the patients with regurgitative valvular heart disease was 54% compared to the 60% for without regurgitative valvular heart disease. The FS for patients with symptomatic regurgitative valvular heart disease was 23.86% compared to 27.7% for asymptomatic group. The EF for symptomatic regurgitative valvular heart disease was 46.2% compared to 52.3% for asymptomatic group. CONCLUSION: When 2D-echocardiography was performed on elderly patients who were older than 65 years of age, most of them featured degenerative structural changes in valves and deterioration of valvular functions resulting in regurgitative valvular heart disease. When patients had any symptoms or underlying diseases, the decrease in cardiac function and high prevalence of regurgitative valvular heart disease were apparent. Therefore in elderly patients, even if they are asymptomatic or without any underlying diseases, aggressive diagnostic approaches and early intervention may delay the progress of valvular heart disease.
Academic Medical Centers ; Aged* ; Chungcheongbuk-do ; Early Intervention (Education) ; Echocardiography ; Female ; Heart Failure ; Heart Valve Diseases* ; Humans ; Hypertension ; Male ; Medical Records ; Mortality ; Myocardial Ischemia ; Prevalence

BACKGROUND: The hypertension is known to be the most important risk factor for the intracerebral hemorrhage. We analyzed other risk factors associated with hypertension that may contribute in the episode of hypertensive intracerebral hemorrhage. METHODS: Medical records of 100 patients with hypertensive intracerebral hemorrhage between January 1995 and December 2000 were reviewed and analyzed for age, sex, serum total cholesterol level, regular management of hypertension, systolic and diastolic blood pressure, arrhythmia and left ventricular hypertrophy in ECG. RESULTS: 1) Mean age was 64.1+/-11.3 years old and there were 35 males and 65 females. 2) Mean systolic and diastolic blood pressure were 176.9+/-35.9 mmHg and 106.3+/-20.7 mmHg. 3) Mean serum total cholesterol level was 182.6+/-46.4 mg/dL. 35.5% of the patients had serum total cholesterol levels less than 160 mg/dl and 33.4% were between 160-199 mg/dL. 4) Only 16% of the patients had any kind of treatment for hypertension. CONCLUSION: The high blood pressure and the treatment for hypertension were most important risk factors for hypertensive intrace- rebral hemorrhage. Also, 68.9% of the patients with hypertensive intracerebral hemorrhage had normal to low serum total cholesterol level. Thus low to normal serum total cholesterol level could be a risk factor of hypertensive intracerebral hemorrhage.
Arrhythmias, Cardiac ; Blood Pressure ; Cerebral Hemorrhage ; Cholesterol ; Electrocardiography ; Female ; Hemorrhage ; Humans ; Hypertension ; Hypertrophy, Left Ventricular ; Intracranial Hemorrhage, Hypertensive* ; Male ; Medical Records ; Risk Factors

Pfeiffer Syndrome is as rare as Apert syndrome in the Western population. This condition is very rare in the Asian population and has not been previously reported in Korea. The authors report with a review of literature the case of a newborn baby with Pfeiffer syndrome, manifested by bicoronal craniosynostosis, broad thumbs, and big toes. The infant also had bilateral syndactyly of the fingers and toes, mild proptosis, choanal hypoplasia and maxillary hypoplasia.
Korea ; Infant, Newborn ; Humans ; Female ; Acrocephalosyndactylia/*diagnosis/genetics/radiography/surgery

BACKGROUND: The angiotensin converting enzyme(ACE) is a key component of the renin-angiotensin system thought to be important in the pathogenesis of hypertension and cadiovascular diseases. Deletion polymorphism in the ACE gene may be a risk factor for myocardial infarction. The insertion/deletion(I/D) polymorphism of the ACE detected by PCR analysis appears to be associated with hypertension in Koreans and its nucleotide was subcloned into T-vector and its nucleotide sequences were determined. We also examined an association between hypertension and genetic variance of ACE. METHODS AND RESULTS: We identified the angiotensin I-converting enzyme genotype in 127 hypertensive and 189 normotensive Korean subjects. The distribution of ACE genotype II, ID, DD were 39.2%, 40.2%, 20.6% respectively and the frequency for ACE alleles I and D were 0.593 and 0.407, respecively in all subjects. The frequency of D allele in Korean males is higher than that of Korean females(male; 0.438 : female; 0.267), and the frequency of I allele in Korean females is higher than that of Korean males(female; 0.733 : male; 0.562). Genotype distributions of angiotensin I-converting enzyme genes in Korean normal adult population were different from that of Caucasians(P<0.001). There were no significant differences in genotype frequency between the hypertensive control group(n=127) and the normotensive group(n=189). CONCLUSIONS: We observed significant differences of ACE genotype distribution between the male group and the female group in total(P=0.001) and in hypertensive Korean subjects(P=0.013).
Adult ; Alleles ; Angiotensins* ; Base Sequence ; Female ; Gene Frequency* ; Genotype* ; Humans ; Hypertension ; Male ; Myocardial Infarction ; Peptidyl-Dipeptidase A* ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Renin-Angiotensin System ; Risk Factors

BACKGROUND: During coronary angiography, some electrocardiographic changes occured due to contrast media, which do life threatening influences. METHODS: We compared the electrocardiographic changes which were induced by injection of three radiopaque contrast media during selective coronary angiography in 49 patients with chest pain. One of the contrast media was high osmolar ionic(Urografin_76) and the another was low osmolar ionic(Hexabrix) and the last was non-ionic(Ioversol). Electrocardiograms were obtained before, during and after selective coronary angiography. RESULTS: The changes of S-T segment or T were decreased in non-ionic group rather than high osmolar or ionic group. And there was significant Q-Tc interval prolongation among all three groups except comparision of low osmolar ionic contrast dye and non-ionic contrast dye in left coronary angiography. CONCLUSION: Non-ionic low osmolar contrast media was safer than high osmolar or ionic contrast medial because of lesser change of Q-Tc interval during selective coronary angiography.
Chest Pain ; Contrast Media* ; Coronary Angiography* ; Diatrizoate Meglumine ; Electrocardiography* ; Humans ; Ioxaglic Acid ; Osmolar Concentration

No abstract available.
Acromegaly* ; Osteoarthropathy, Primary Hypertrophic*

OBJECTIVE: Many studies have investigated paraspinal muscle changes after posterior lumbar surgery, including lumbar fusion. However, no study has been performed to investigate back muscle changes after pedicle based dynamic stabilization in patients with degenerative lumbar spinal diseases. In this study, the authors compared back muscle cross sectional area (MCSA) changes after non-fusion pedicle based dynamic stabilization. METHODS: Thirty-two consecutive patients who underwent non-fusion pedicle based dynamic stabilization (PDS) at the L4-L5 level between February 2005 and January 2008 were included in this retrospective study. In addition, 11 patients who underwent traditional lumbar fusion (LF) during the same period were enrolled for comparative purposes. Preoperative and postoperative MCSAs of the paraspinal (multifidus+longissimus), psoas, and multifidus muscles were measured using computed tomographic axial sections taken at the L4 lower vertebral body level, which best visualize the paraspinal and psoas muscles. Measurements were made preoperatively and at more than 6 months after surgery. RESULTS: Overall, back muscles showed decreases in MCSAs in the PDS and LF groups, and the multifidus was most affected in both groups, but more so in the LF group. The PDS group showed better back muscle preservation than the LF group for all measured muscles. The multifidus MCSA was significantly more preserved when the PDS-paraspinal-Wiltse approach was used. CONCLUSION: Pedicle based dynamic stabilization shows better preservation of paraspinal muscles than posterior lumbar fusion. Furthermore, the minimally invasive paraspinal Wiltse approach was found to preserve multifidus muscles better than the conventional posterior midline approach in PDS group.
Humans ; Muscles ; Psoas Muscles ; Retrospective Studies ; Spinal Diseases

Vertebral hemangioma is relatively common, but rarely extends into the epidural space and causes neurological deficits. This case report describes a 69-year-old woman with vertebral hemangioma extending into the epidural space causing spinal cord compression. The patient presented with low back pain and progressive weakness of the left lower extremity over a period of 1 year. Radiologic findings revealed a dural encasing vertebral hemangioma with spinal cord compression at the T11 level. After T11 vertebroplasty, the lesion was subtotally removed by T10-11 total laminectomy. The patient regained motor power of the left lower extremity postoperatively. And no further tumor growth was observed at last follow-up. This combination of intraoperative vertebroplasty and decompressive laminectomy offers a viable treatment modality for a dural encasing vertebral hemangioma with epidural extension causing cord compression.
Aged ; Epidural Space ; Female ; Hemangioma ; Humans ; Laminectomy ; Low Back Pain ; Lower Extremity ; Spinal Cord ; Spinal Cord Compression ; Vertebroplasty

PURPOSE: To compare clinical and radiological results between vertebroplasty and conservative treatment in osteoporotic compression fractures of thoracolumbar spine. MATERIALS AND METHODS: 34 patients were reviewed with at least 1 year follow up. Vertebroplasty was used in 14 and conservative treatment was done in 20 fractures. These groups were compared by clinical results which were evaluated by the scoring system according to pain, mobility and analgesic usage at preoperative, postoperative 1 month and postoperative 1 year. And also compared by the increment of kyphosis and loss of vertebral body height in lateral films at the same time. We compared duration of hospitalization between two groups. RESULTS: Vertebroplasty group showed statistically significant less pain and mobility than conservative treatment (p<0.05), but there was no differences in analgesic usage at postoperative 1 year while significant difference at 1 month. In radiological comparison, vertebroplasty showed less increment of kyphosis and loss of body height significantly (p<0.05). Also vertebroplasty group had shorter hospitalization stay significantly (p<0.05). CONCLUSION: Our retrospective analysis demonstrated that vertebroplasty provided significant pain relief, improvement of motion and reduction of analgesic usage and also provided considerable spinal stabilization that prevented further kyphosis and collapse.
Body Height ; Follow-Up Studies ; Fractures, Compression* ; Hospitalization ; Humans ; Kyphosis ; Osteoporosis ; Retrospective Studies ; Spine ; Vertebroplasty*