OBJECTIVE: To evaluate the relationship between the cross sectional area (CSA) and isokinetic strength of the back muscles in patients with chronic low back pain. METHOD: Data of twenty-eight middle-aged patients with chronic back pain were analyzed retrospectively. CSAs of both paraspinal muscles and the disc at the L4-L5 level were measured in MRI axial images and the relative CSAs (rCSA: CSA ratio of muscle and disc) were calculated. The degree of paraspinal muscle atrophy was rated qualitatively. Isokinetic strengths (peak torque, peak torque per body weight) of back flexor and extensor were measured with the isokinetic testing machine. Multiple regression analysis with backward elimination was used to evaluate relations between isokinetic strength and various factors, such as CSA or rCSA and clinical characteristics in all patients. The same analysis was repeated in the female patients. RESULTS: In analysis with CSA and clinical characteristics, body mass index (BMI) and CSA were significant influencing factors in the peak torque of the back flexor muscles. CSA was a significant influencing factor in the peak torque of total back muscles. In analysis with rCSA and clinical characteristics, BMI was significant in influencing the peak torque of the back flexors. In female patients, rCSA was a significant influencing factor in the peak torque per body weight of the back flexors, and age and BMI were influencing factors in the peak torque of back flexors and total back muscles. CONCLUSION: In middle-aged patients with chronic low back pain, CSA and rCSA were influencing factors in the strength of total back muscles and back flexors. Also, gender and BMI were influencing factors.
Back Pain ; Body Mass Index ; Body Weight ; Female ; Humans ; Low Back Pain ; Magnetic Resonance Imaging ; Muscle Strength ; Muscle Strength Dynamometer ; Muscles ; Muscular Atrophy ; Retrospective Studies ; Torque

OBJECTIVE: To evaluate the relationship between the cross sectional area (CSA) and isokinetic strength of the back muscles in patients with chronic low back pain. METHOD: Data of twenty-eight middle-aged patients with chronic back pain were analyzed retrospectively. CSAs of both paraspinal muscles and the disc at the L4-L5 level were measured in MRI axial images and the relative CSAs (rCSA: CSA ratio of muscle and disc) were calculated. The degree of paraspinal muscle atrophy was rated qualitatively. Isokinetic strengths (peak torque, peak torque per body weight) of back flexor and extensor were measured with the isokinetic testing machine. Multiple regression analysis with backward elimination was used to evaluate relations between isokinetic strength and various factors, such as CSA or rCSA and clinical characteristics in all patients. The same analysis was repeated in the female patients. RESULTS: In analysis with CSA and clinical characteristics, body mass index (BMI) and CSA were significant influencing factors in the peak torque of the back flexor muscles. CSA was a significant influencing factor in the peak torque of total back muscles. In analysis with rCSA and clinical characteristics, BMI was significant in influencing the peak torque of the back flexors. In female patients, rCSA was a significant influencing factor in the peak torque per body weight of the back flexors, and age and BMI were influencing factors in the peak torque of back flexors and total back muscles. CONCLUSION: In middle-aged patients with chronic low back pain, CSA and rCSA were influencing factors in the strength of total back muscles and back flexors. Also, gender and BMI were influencing factors.
Back Pain ; Body Mass Index ; Body Weight ; Female ; Humans ; Low Back Pain ; Magnetic Resonance Imaging ; Muscle Strength ; Muscle Strength Dynamometer ; Muscles ; Muscular Atrophy ; Retrospective Studies ; Torque

Ramsay-Hunt syndrome is caused by varicella zoster virus infection in the geniculate ganglion of the facial nerve. It is characterized by facial palsy, otic pain, and herpetic vesicles around the auricle and external auditory canal. Additionally, symptoms may develop related to other cranial nerve involvement, such as dizziness or hearing loss by the vestibulocochlear nerve being invaded. We report a rare case of a Ramsay-Hunt syndrome patient who developed dysphagia due to multiple cranial nerve involvement including the glossopharyngeal nerve and vagus nerve.
Cranial Nerves ; Deglutition Disorders ; Dizziness ; Ear Canal ; Facial Nerve ; Facial Paralysis ; Geniculate Ganglion ; Glossopharyngeal Nerve ; Hearing Loss ; Herpes Zoster Oticus ; Herpesvirus 3, Human ; Humans ; Vagus Nerve ; Vestibulocochlear Nerve

Oxidative radicals are regarded as a major factor in the pathogenesis of both acute and chronic pancreatitis. Because oxygen radicals react most readily with polyunsaturated fatty acids, resulting in peroxidation of lipids, several studies have been performed to determine the development of lipid peroxidation in pancreatitis. The purpose of this study was to evaluate the effects of free radicals and decision of the experimental model in acute necrotizing pancreatitis. Acute necrotizing pancreatitis was induced in 18 rats by retrograde injection into the bilopancreatic duct of 2%, 3%, and 5% sodium taurocholate. After a 12-hour observation time, the pancreas / the body weight, the serum amylase and the malondialdehyde content in tissue, as well as the reduced glutathione were measured in resected tissue samples. In addition, to determine the pathologic damage grade, tissue samples were examined by light microscopy. According to the amount of sodium taurocholate injected, the serum amylase and tissue malondialdehyde concentration were significantly increased. The reduced glutathione was significantly decreased, suggesting glutathione depletion due to oxidative stress. During the 12 hours after injection the pancreatic lesions were immediate and were characterized by interstitial edema, atrophy and extensive necrotic changes of the acinar cells, and hemorrhage. The pathologic damage grade increased according to the amount of sodium taurocholate injected. This study created an experimental model for studying the pathogenesis of acute necrotizing pancreatitis by using bile acid. In acute necrotizing pancreatitis, the increased levels of lipid peroxidation products in tissues and the change in glutathione metabolism suggest ongoing peroxidation of lipids due to an enhanced generation of oxygen radicals. Therefore, antioxidant treatment can reduce tissue damage, biochemical alterations, and extrapancreatic complications, thus improving the final outcome.
Acinar Cells ; Amylases ; Animals ; Atrophy ; Bile ; Body Weight ; Edema ; Fatty Acids, Unsaturated ; Free Radicals ; Glutathione ; Hemorrhage ; Lipid Peroxidation ; Malondialdehyde ; Metabolism ; Microscopy ; Models, Theoretical ; Oxidative Stress* ; Pancreas ; Pancreatitis ; Pancreatitis, Acute Necrotizing* ; Pancreatitis, Chronic ; Rats* ; Reactive Oxygen Species ; Sodium* ; Taurocholic Acid

The incidence of acute cholecystitis complicating endoscopic retrograde Cholangiopancreatography (ERCP) is rarely reported at 0.2% but is usually associated with a cystic duct obstruction caused by gallstones, gallbladder polyps, or cancer. However, acute cholecystitis with a gallbladder perforation after ERCP without a history of cystic duct obstruction can develop very rarely and has not yet been reported in Korea. We report a case of acute cholecystitis with gallbladder perforation and aggravation of a pancreatic pseudocyst after diagnostic ERCP in a man with a pancreatic cystic lesion. He has been successfully cured using only percutaneous transhepatic gallbladder drainage and antibiotics with no surgery.
Anti-Bacterial Agents ; Cholangiopancreatography, Endoscopic Retrograde ; Cholecystitis, Acute ; Cystic Duct ; Drainage ; Gallbladder ; Gallstones ; Incidence ; Korea ; Pancreatic Cyst ; Pancreatic Pseudocyst ; Polyps

Cerebral hemorrhage is one of the most common causes of dysphagia. In many cases, dysphagia gets better once the acute phase has passed. Structural lesions such as thyromegaly, cervical hyperostosis, congenital web, Zenker's diverticulum, neoplasm, radiation fibrosis, and retropharyngeal abscess must be considered as other causes of dysphagia as well. Retropharyngeal abscess seldom occur in adults and if it does so, a search for a prior dental procedure, trauma, head and neck infection is needed. The symptoms may include neck pain, dysphagia, sore throat, and in rare cases, dyspnea accompanied by stridor. We present a case and discuss a patient who had dysphagia and neck pain after a cerebral hemorrhage. Testing revealed a retropharyngeal abscess. The symptoms were successfully treated after the administration of antibiotics.
Adult ; Anti-Bacterial Agents ; Cerebral Hemorrhage ; Craniocerebral Trauma ; Deglutition Disorders ; Dyspnea ; Humans ; Hyperostosis ; Neck ; Neck Pain ; Pharyngitis ; Radiation Pneumonitis ; Respiratory Sounds ; Retropharyngeal Abscess ; Subarachnoid Hemorrhage ; Zenker Diverticulum

BACKGROUND AND OBJECTIVES: Congestive heart failure is one of the most frequent problems in cardiovascular patients. However, very little data concerning this syndrome in Korea was available. The objectives of this study were to evaluate the demographic and clinical characteristics, and the prognostic factors of patients hospitalized with congestive heart failure in Korea. SUBJECTS AND MEHTODS: Six university hospitals, fulfilling the protocol for clinical information of patients with heart failure, were prospectively engaged in this study. One thousand and forty seven patients, admitted between Jan.1. 1998 and Dec. 31. 2000 were enrolled. RESULTS: The cumulative survival rates at 3 and 6 month, and 1 and 2 years were 90.5, 87.5, 82 and 75.9%, respectively. Ischemic heart disease was the most frequent underlying disease (36.7%). Diabetes mellitus (OR : 1.626, 95% CI : 1.156-2.289, p=0.005), previous history of myocardial infarction (OR : 2.044, 95% CI : 1.488-2.808, p<0.0001), atrial fibrillation (OR : 1.516, 95% CI : 1.042-2.206, p=0.02), and cerebrovascular accident (OR : 2.187, 95% CI : 1.366-3.501, p=0.001) were the worse prognostic factors. CONCLUSION: Ischemic heart disease was the major cause of heart failure. The cumulative 1 year survival rate, of the patients of congestive heart failure was 82%. The poor prognostic factors were diabetes, old myocardial infarction, atrial fibrillation and cerebrovascular accident.
Atrial Fibrillation ; Diabetes Mellitus ; Epidemiology ; Estrogens, Conjugated (USP)* ; Heart Failure* ; Hospitals, University ; Humans ; Korea* ; Myocardial Infarction ; Myocardial Ischemia ; Prognosis ; Prospective Studies ; Stroke ; Survival Rate

BACKGROUND AND OBJECTIVES: Congestive heart failure is one of the most frequent problems in cardiovascular patients. However, very little data concerning this syndrome in Korea was available. The objectives of this study were to evaluate the demographic and clinical characteristics of hospitalized Korean patients with congestive heart failure. SUBJECTS AND METHODS: Six university hospitals that fulfilled the protocol for clinical information of the patients with heart failure, were prospectively engaged in this study. Six hundred and ninety patients, admitted between Jan. 1. 1998 and Dec. 31. 1999, were enrolled. RESULTS: Ischemic heart disease was the most frequent underlying disease (33.2%), with the other causes of heart failure being cardiomyopathy (23%), hypertensive heart disease (22%) and valvular heart disease (12.7%). Compared with ischemic cardiomyopathy, the patients with idiopathic dilated cardiomyopathy were younger (61.1+/-16.6 vs. 66.9+/-10.3, p<0.05), had less incidence of diabetes (16.8% vs. 32.2%) and smoked less (13.5+/-21.5 vs. 20.4+/-26.0 pack-year). The common aggravating factors were arrhythmia (22%), myocardial ischemia (21.7%) and infection (18.7%). Thirty nine (5.7%) patients died during the one year follow up period. Ischemic heart disease was the main underlying disease in the fatal cases (46.2%). CONCLUSION: Ischemic heart disease was the major cause of heart failure, and the leading cause of death in Korean patients with congestive heart failure.
Arrhythmias, Cardiac ; Cardiomyopathies ; Cardiomyopathy, Dilated ; Cause of Death ; Coronary Disease ; Epidemiology ; Estrogens, Conjugated (USP)* ; Follow-Up Studies ; Heart Diseases ; Heart Failure* ; Heart Valve Diseases ; Hospitals, University ; Humans ; Incidence ; Korea* ; Myocardial Ischemia ; Prospective Studies ; Smoke

BACKGROUND/AIMS: The bedside index of severity in acute pancreatitis (BISAP) is a new, convenient, prognostic multifactorial scoring system. As more data are needed before clinical application, we compared BISAP, the serum procalcitonin (PCT), and other multifactorial scoring systems simultaneously. METHODS: Fifty consecutive acute pancreatitis patients were enrolled prospectively. Blood samples were obtained at admission and after 48 hours and imaging studies were performed within 48 hours of admission. The BISAP score was compared with the serum PCT, Ranson's score, and the acute physiology and chronic health examination (APACHE)-II, Glasgow, and Balthazar computed tomography severity index (BCTSI) scores. Acute pancreatitis was graded using the Atlanta criteria. The predictive accuracy of the scoring systems was measured using the area under the receiver-operating curve (AUC). RESULTS: The accuracy of BISAP (> or = 2) at predicting severe acute pancreatitis was 84% and was superior to the serum PCT (> or = 3.29 ng/mL, 76%) which was similar to the APACHE-II score. The best cutoff value of BISAP was 2 (AUC, 0.873; 95% confidence interval, 0.770 to 0.976; p < 0.001). In logistic regression analysis, BISAP had greater statistical significance than serum PCT. CONCLUSIONS: BISAP is more accurate for predicting the severity of acute pancreatitis than the serum PCT, APACHE-II, Glasgow, and BCTSI scores.
Biological Markers/blood ; Calcitonin/*blood ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Pancreatitis/blood/*diagnosis ; Prognosis ; Prospective Studies ; Protein Precursors/*blood ; ROC Curve ; *Severity of Illness Index

BACKGROUND AND OBJECTIVES: Congestive heart failure is one of the most frequent problems in cardiovascular patients. The objectives of this study were to evaluate the demographic and clinical characteristics and prognostic factors of patients hospitalized with congestive heart failure in Korea. SUBJECTS AND METHODS: Nine university hospitals were involved, and gathered prospective clinical data on patients with heart failure. One thousand eight hundred and sixty four patients, admitted between Jan.1 1998 and Aug. 31 2003, were enrolled, and data from 1,759 patients were analyzed. RESULTS: The cumulative survival rates at 6 month, and 1 and 2 years were 90.8, 80.1 and 76.4%, respectively. Ischemic heart disease was the most frequent underlying disease (32.3%). Diabetes mellitus (OR: 1.682, 95%CI: 1.234-2.389, p=0.005), a previous history of myocardial infarction (OR: 2.521, 95%CI: 1.742-4.258, p<0.0001) and cerebrovascular accidents (OR: 2.020, 95%CI: 1.166-3.101, p=0.001) were the worst prognostic factors. CONCLUSION: Ischemic heart disease was the major cause of heart failure. The two year survival rate of patients with congestive heart failure was 76.4%. The factors relating to a poor prognosis were diabetes, a previous history of myocardial infarction and cerebrovascular accidents.
Diabetes Mellitus ; Estrogens, Conjugated (USP)* ; Heart Failure* ; Hospitals, University ; Humans ; Korea* ; Myocardial Infarction ; Myocardial Ischemia ; Prognosis ; Prospective Studies ; Stroke ; Survival Rate