Normal" spinal posture is generally accepted as moderate lordosis of the cervical and the lumbar sections ofspine and moderate kyphosis of the thoracic and sacrococcygeal sections. Among these normal range of the lumbarlordosis is less well defined. CT is very useful method to identified the bony structure and adjacent soft tissueof the spine, so it is very available method to detect accrate lumbar lordotic angle by using lateral Scanogram.Analysis and comparison of lumbar lordotic angles, crossing angle are drawn each parallel line to the superior endplate of body of 1st. lumbar vertebra and to the inferior end plate of the 5th. Lumbar vertebra, in 174 cases withbackache and 50 cases normal groups at Kangnam General Hospital Public Corporation, from Aug. 1985 to Jul 1986.Male and female were almostly same affected in backache group (1.1:1). And most lumbar lordotic angles were 10 degrees to 40degrees between all backache age group. On backache group, over all mean lumbar lordotic angleswere 24.7±8.9degrees but no significant difference at mean value of the each disease, such as HIVD, DegenerationSpondylosis or No Remarkable Finding group. On control group, over all mean ones were 29.2±8.0degrees. So,significant difference of lumbar lordotic angle between backache and control group, and most difference is at 5th.decade group(p<0.01).
Animals ; Back Pain ; Female ; Hospitals, General ; Humans ; Kyphosis ; Lordosis ; Methods ; Posture ; Reference Values ; Spine

Appendicitis is one of the most common condition causing an acute abdomen in young adult population. Two-hundreds and fifty-nine cases of acute appendicitis provened by surgery and pathology during recent 2 years in Han-ll Hospital were studied and analyzed by preoperative plain abdominal X-ray. One case of barium enema was also done. The results were as follows; 1. Male fo female sex ration was 1:1. 2. In age distribution, the most commonage group was from two to four decade. (75.3%) 3. The most common clinical symptom was classical abdominal pain as86.5%. 4. The positive radiographic findings were obtained 75.7% of all cases. 5. Common radiographic findings as follows; 1) Reflex ileus on RLQ (73.7%) 2) Obliteration of Rt. psoas line (41.3%) 3) Scoliosis of lumbar spine(21.2%) 6. The most common site of appendix was retrocecal in position. (84.2%) 7. One case of appendicolith and one case of appendiceal diverticulum were demonstrated.
Abdomen, Acute ; Abdominal Pain ; Age Distribution ; Appendicitis ; Appendix ; Barium ; Diverticulum ; Enema ; Female ; Humans ; Ileus ; Male ; Pathology ; Reflex ; Scoliosis ; Young Adult

BACKGROUND: Bioabsorbable plates and screws are commonly used to reduce maxillofacial bones, particularly in pediatric patients because they degrade completely without complications after bone healing. In this study, we encountered eight cases of a delayed foreign body reaction after surgical fixation with bioabsorbable plates and screws. METHODS: A total of 234 patients with a maxillofacial fracture underwent surgical treatment from March 2006 to October 2013, in which rigid fixation was achieved with the Inion CPS (Inion, Tampere, Finland) plating system in 173 patients and Rapidsorb (Synthes, West Chester, PA, USA) in 61 patients. Their mean age was 35.2 years (range, 15-84 years). Most patients were stabilized with two- or three-point fixation at the frontozygomatic suture, infraorbital rim, and anterior wall of the maxilla. RESULTS: Complications occurred in eight (3.4%) of 234 patients, including palpable, fixed masses in six patients and focal swelling in two patients. The period from surgical fixation to the onset of symptoms was 9-23 months. Six patients with a mass underwent secondary surgery for mass removal. The masses contained fibrous tissue with a yellow, grainy, cloudy fluid and remnants of an incompletely degraded bioabsorbable plate and screws. Their histological findings demonstrated a foreign body reaction. CONCLUSIONS: Inadequate degradation of bioabsorbable plates caused a delayed inflammatory foreign body reaction requiring secondary surgery. Therefore, it is prudent to consider the possibility of delayed complications when using bioabsorbable plates and surgeons must conduct longer and closer follow-up observations.
Absorbable Implants ; Follow-Up Studies ; Foreign Bodies* ; Foreign-Body Reaction* ; Humans ; Maxilla ; Maxillofacial Injuries ; Sutures

BACKGROUND: Neck and shoulder pain is fairly common among adolescents in Korea and results in significant health problem. The aims of this prospective study was to identify the effects of education, in terms of recognition of this issue and posture correction, on prevalence and severity of neck and shoulder pain in Korean adolescents. METHODS: A prospective, observational cohort design was used. The 912 students from two academic high schools in the city of Seoul were eligible for the current study and 887 completed this study. After a baseline cross-sectional survey, students listened to a lecture about cervical health, focusing on good posture, habits, and stretching exercises to protect the spine, and were encouraged by their teachers to keep the appropriate position. And follow-ups were conducted 3 months later, to evaluate the effect of education. RESULTS: The prevalence of neck and shoulder pain was decreased 19.5% (from 82.5 to 66.4%). The baseline mean usual and worst numeric rating scale were 19.9/100 (95% CI, 18.1-21.7) and 31.2/100 (95% CI, 28.7-33.2), respectively. On the follow-up survey, the mean usual and worst numeric rating scale were decreased significantly by 24.1 and 21.7%, respectively, compared with baseline (P < 0.01). Of the 570 students reporting neck and shoulder pain, 16.4% responded that they had experienced improvement during the 3 months. CONCLUSIONS: Education; recognition of this issue and posture correction, for cervical health appeared to be effective in decreasing the prevalence and severity of neck and shoulder pain at a 3 month follow-up.
Adolescent* ; Cohort Studies ; Cross-Sectional Studies ; Education* ; Exercise ; Follow-Up Studies ; Humans ; Korea ; Longitudinal Studies* ; Neck Pain ; Neck* ; Posture ; Prevalence* ; Prospective Studies ; Seoul ; Shoulder Pain* ; Spine

BACKGROUND AND OBJECTIVE: NT-proBNP, a sensitive and specific marker of congestive heart failure (CHF), is also useful in monitoring the effectiveness of treatment and in predicting prognosis. However, the usefulness of NT-proBNP for measuring the functional capacity as a component of the quality of life (QoL) in patients with CHF remains to be discovered. The Korean Activity Scale/Index (KASI) is a Koreanized tool for measuring the functional capacity in patients with cardiac diseases during daily activities, thus representing the physical domain of the QoL. The purpose of this study was to evaluate the relationship between NT-proBNP and the KASI. SUCJECTS AND METHODS: Between July, 2003 and September, 2003, the NT-proBNP levels were measured in 76 patients with CHF that visited the OPD or who were hospitalized. They were asked to fill out a self-administered questionnaire, from which their KASI scores were obtained. NYHA Fc and Heart Failure scores were also obtained from a history taking and physical examination conducted by the investigator. RESULTS: The level of NT-proBNP increased with increasing NYHA Fc (p<0.001 by Kruskall-Wallis test). The Spearman correlation coefficient between NT-proBNP and the KASI score was -0.730 (p<0.001), which was higher than that between the HF and KASI scores (rho=-0.557, p<0.001). The level of NT-proBNP also had a positive correlation with the HF score (rho=0.706, p<0.001). CONCLUSION: The level of NT-proBNP has a strong negative correlation with the KASI score, reflecting the functional capacity during daily activities. This suggests that NT-proBNP is useful in measuring the functional capacity as an element of the QoL in patients with CHF.
Estrogens, Conjugated (USP)* ; Heart Diseases ; Heart Failure* ; Humans ; Physical Examination ; Prognosis ; Quality of Life ; Research Personnel ; Surveys and Questionnaires

Fifty three years old, healthy female patient had presented an acute severe anemia after intestinal bleeding within 2 days. She was hemodynamically stable even during extreme hemodilution with hemoglobin (Hb) below 3 g/dL. However, her condition deteriorated dramatically after Hb nearly 2 g/dL. The patient died solely of anemia at a hemoglobin concentration of 1.2 g/dL. We presumed the hemoglobin concentrations below 2 g/dL are maximally life-threatening; this is the terminal hemoglobin threshold that the hemoglobin concentration could be an independent predictor of death.
Anemia ; Female ; Hemodilution ; Hemoglobins ; Hemorrhage ; Humans

BACKGROUND: Spinal anesthesia (SA) after epidural labor analgesia (ELA) can have advantages over augmentation of ELA due to its rapid onset and high-quality analgesia. However, unexpected side effects and diverse failure rates have been reported in women that received SA after ELA. We prospectively compared the effectiveness and side effects of SA after ELA versus SA only for intrapartum cesarean section. METHODS: The ELA/SA group received continuous epidural infusion at a rate of 10 ml/h for labor pain. In both groups, spinal anesthesia was induced with 10 mg of 0.5% hyperbaric bupivacaine and 15 microg of fentanyl using a pencil point needle. The rate of conversion to general anesthesia, the need for intraoperative analgesic supplements, and the incidence of high spinal block and hypotension were investigated. RESULTS: The rate of conversion to general anesthesia was higher in the ELA/SA group compared with the SA group (15.2 vs. 2.7%). Eighty percent of the conversion cases in the ELA/SA group were converted due to lack of sensory block. The need for intraoperative analgesic supplements and the rates of high spinal block and hypotension were comparable in the two groups. CONCLUSIONS: SA after ELA is associated with a high rate of conversion to general anesthesia during intrapartum cesarean section.
Analgesia* ; Analgesia, Epidural ; Anesthesia, General ; Anesthesia, Spinal* ; Bupivacaine ; Cesarean Section* ; Female ; Fentanyl ; Humans ; Hypotension ; Incidence ; Labor Pain ; Needles ; Pregnancy ; Prospective Studies

Primary extrapulmonary small cell carcinoma have been described in the esophagus, stomach, pancreas, salivary gland, paranasal sinus, small bowel, uterus, urinary bladder and skin. Primary small cell carcinoma of the esophagus has rarely been reported since McKeown had reported the first 2 cases of small cell carcinoma of the esophagus in 1952. Primary small cell cancer of esophagus is extremely aggressive tumor with grave prognosis. Because of the highly malignant potency, multimodality treatment including chemotherapy for the primary therapy is accepted generally. We experienced 2 cases of small cell carcinoma of the esophagus. One patient was a 57 year-old male without metastasis and we treated him with a multi-drug regimen (cisplatin and VP-16) being used in small cell carcinoma of the lung at our hospotal. But the other patient was a 67 year-old male with bone metastasis, and he refused all management.
Aged ; Carcinoma, Small Cell* ; Drug Therapy ; Esophageal Neoplasms ; Esophagus ; Humans ; Lung ; Male ; Middle Aged ; Neoplasm Metastasis ; Pancreas ; Prognosis ; Salivary Glands ; Skin ; Stomach ; Urinary Bladder ; Uterus

Irritable bowel syndrome (IBS) is a gastrointestinal disorder characterized by chronic abdominal pain and altered bowel habits in the absence of any organic cause. As the clinical manifestations are very diverse and associated with nonspecific symptoms, research seeking to identify organic causes to rule out IBS and to enable differential diagnosis is required. A 24-year-old man was referred to our hospital for specialized management of IBS. He had a 7-month history of intermittent epigastric and lower abdominal pain. On the basis of clinical examination, he was diagnosed with IBS and administered medication at a primary clinic. However, his symptoms did not improve after treatment. We performed capsule endoscopy at our hospital and identified a parasite (Ancylostoma duodenale) in the proximal jejunum. We therefore report a case of parasitic infection found by additional examination while evaluating symptoms associated with a previous diagnosis of refractory IBS.
Abdominal Pain ; Ancylostoma ; Ancylostomatoidea ; Capsule Endoscopy ; Diagnosis* ; Diagnosis, Differential ; Humans ; Irritable Bowel Syndrome* ; Jejunum ; Parasites* ; Young Adult

BACKGROUND AND OBJECTIVES: Biochemical markers are useful for the prediction of cardiac events in patients with acute coronary syndrome (ACS). The N-terminal fragment of the BNP prohormone (NT-proBNP), which is synthesized by cardiac ventricles in response to increased wall stress, may be a prognostic marker in ACS. The relation between the NT-pro BNP levels on admission and major adverse cardiovascular events (MACEs) were assessed in a cohort of patients with ACS. SUBJECTS AND METHODS: Between October 2002 and April 2004, blood samples for the determination of NT-proBNP level were obtained on admission from 78 patients with ST-elevation myocardial infarction (STEMI), 32 with non-ST elevation MI(NSTEMI) and 66 with unstable angina (UA). Patients were followed concerning MACEs (death, MI, heart failure, stroke and revascularization) for a median of 7 months in median. RESULTS: 22 patients (13%) had events. The mean NT-proBNP level was significantly lower in the event-free survivors than in those with events (1342+/-1598 versus 6129+/-6522 pg/mL, p<0.0001). The optimal cut-off value of the NT-proBNP level using a receiver-operating-characteristic curve was 1445 pg/mL. The unadjusted risk ratio of patients with an NT-proBNP level greater than the threshold was 7.0 (95% confidence interval, 2.6 to 19.0). In a multivariate Cox regression model, including clinical background factors and other biochemical markers, the NT-proBNP level was the most powerful indicator of MACEs (risk ratio, 8.0 [95% confidence interval, 1.7 to 37.1]). The coronary angiographic Gensini score was also a predictor of prognosis in ACS (risk ratio, 3.8 [95% confidence interval, 1.0 to 14.0]). CONCLUSION: A single measurement of the NT-proBNP level on admission appears to be useful as a prognostic factor in the prediction of MACEs in patients after ACS.
Acute Coronary Syndrome* ; Angina, Unstable ; Biomarkers ; Cohort Studies ; Heart Failure ; Heart Ventricles ; Humans ; Myocardial Infarction ; Odds Ratio ; Prognosis ; Stroke ; Survivors