STUDY DESIGN: Retrospective study. OBJECTIVES: Whether osteoporotic vertebral fracture is associated with obesity is under debate. Therefore, this study aims to determine the relationship between osteoporotic vertebral fracture and body mass index (BMI) by comparing it with other types of osteoporotic fractures. SUMMARY OF LITERATURE REVIEW: Several authors have reported the factors that predict the risk of osteoporotic vertebral fracture in individuals with obesity, but the objective risk factors are still controversial. MATERIALS AND METHODS: A retrospective study was conducted on postmenopausal women, including 100 people with osteoporotic vertebral fractures, 104 with femur neck fractures, 107 with distal radius fractures, and 103 with osteoporosis or osteopenia but without fractures. The BMI was calculated and bone mineral density (BMD) test was administered within 3 days after injury. For each type of fracture, the relationships with age, height, weight, BMI, and BMD were investigated. The relationship with the number of osteoporotic vertebral fractures according to BMI was also evaluated. RESULTS: In comparing osteoporotic vertebral fractures and osteoporotic non-vertebral fractures, there were no significant differences in the relationship with age, height, or BMD (p>0.05). Osteoporotic vertebral fractures showed a statistically higher average weight and BMI, compared to other osteoporotic non-vertebral fracture groups (p<0.05). Among those with osteoporotic vertebral fractures, the number of fractures did not show a significant relationship with BMI (p=0.177). CONCLUSIONS: In osteoporotic vertebral fracture patients, compared to groups with other types of osteoporotic fractures, average weight and BMI were higher.
Body Mass Index* ; Bone Density ; Bone Diseases, Metabolic ; Female ; Femoral Neck Fractures ; Humans ; Obesity ; Osteoporosis ; Osteoporotic Fractures ; Radius Fractures ; Retrospective Studies ; Risk Factors

STUDY DESIGN: A retrospective study OBJECTIVES: To examine the influence of cervical spondylosis on an acute cervical spinal cord injury. SUMMARY OF LITERATURE REVIEW: There are no reports on the relationship between cervical spondylosis and acute cervical spinal cord injuries. MATERIALS AND METHODS: Twenty six patients who underwent operative treatment for acute cervical injuries with spinal cord injury were evaluated. The mean age and follow-up period was 58 years and 2.2 years, respectively. The evaluation was performed by examining the causes of the injuries, and the classification of fractures according to the presence of cervical spondylosis. This study compared the degrees of postoperative neurological recovery with motor index score in the groups with and without cervical spondylosis. RESULTS: Cervical cord injuries were more prevalent in the group 60 years and older; 17 cases vs. 9 cases in the group under 60 years. Eleven (65%) and 6 (35%) cases in the group 60 years and older had sustained a high and low energy injury, respectively. In contrast, mostly high energy injuries (8 in 9 cases) were encountered in the group under 60 years of age. A low energy injury could cause a acute cervical cord injury in the group 60 years and older, who also had cervical spondylosis. In those cases, previous cervical spondylosis might be one of the etiologic factors. CONCLUSIONS: The cases with cervical spondylosis in the group 60 years and older tended to show incomplete cord injury and good postoperative neurological recovery when they had sustained cervical cord injuries.
Follow-Up Studies ; Humans ; Retrospective Studies ; Spinal Cord ; Spinal Cord Injuries ; Spondylosis

STUDY DESIGN: This is a retrospective study. OBJECTIVES: We wanted to clarify the association between the position of the atlantoaxial fusion angle and the change of the subaxial cervical spine alignment (SCA) and the reduction loss after atlantoaxial fusion (AAF) using the posterior wiring technique (PWT), transarticular screw fixation (TAF) and posterior screw-rod fixation (PSR) for treating atlantoaxial instability (AAI). SUMMARY OF LITERATURE REVIEW: There are not many studies on the change of the SCA and the reduction loss after AAF. MATERIALS AND METHODS: Thirty five patients underwent AAF for AAI from 1986 to 2008. The mean follow-up period was 59.5 months. The surgical techniques were divided into three groups, that is, PWT: 17 patients, TAS: 10 and PSR: 8. The causes of instability were transverse ligament rupture in 12 patients, rheumatoid arthritis in 11, Os odontoideum in 6 and nonunion of an odontoid fracture in 6. Plain radiographs were used to assess the atlanto-dental interval, the posterior arch-lamina angle, the change of the SCA and the time of fusion. RESULTS: Fusion was achieved in all the patients within 3.5 months (range: 3-5 months). The radiologic findings in the 5 PWT patients showed a reduction loss and 3 patients showed subaxial cervical kyphosis (SCK). The TAS group had no reduction loss or SCK. The PSR group had no reduction loss and one patient showed SCK. A statistically significant reduction loss and SCK occurred in the group in which there was a posterior arch-laminar angle greater than 10 degrees before and after surgery. CONCLUSIONS: For the treatment of AAI, the position of the AAF is associated with the change of the postoperative SCA. The preoperative lodortic position of C1-2 should be maintained to prevent the change of the SCA.
Arthritis, Rheumatoid ; Atlanto-Axial Joint ; Congenital Abnormalities ; Follow-Up Studies ; Humans ; Kyphosis ; Ligaments ; Retrospective Studies ; Rupture ; Spine

PURPOSE: Atopy and specific immunogloguline (Ig) E to individual aeroallergen are considered a hallmark of allergic diseases, including asthma. However, the association between these parameters and lung function or bronchial hyperresponsiveness (BHR) is still controversial in previous studies. METHODS: A total of 234 atopic asthmatic children was recruited in this study. The amounts of total IgE and specific IgE were determined by employing the CAP system FEIA (Pharmacia Diagnostics, Uppsala, Sweden). Specific IgE was focused on two major inhalant allergens in Korea, Dermatophagoides pteronyssinus (Der p) and Dermatophagoides farinae (Der f). To evaluate BHR, methacholine and exercise challenge tests were performed. RESULTS: In the atopic asthmatic group, total IgE correlated negatively with methacholine PC20 and positively with a maximum percentage fall in FEV1 after exercise. Specific IgE to Der f strongly correlated with a maximum percentage fall in FEV1 after exercise in atopic asthmatics, particularly exercise-induced asthma (EIA) (r=0.176, P=0.007 and r=0.199, P=0.011, respectively) and specific IgE to Der p weakly correlated with a maximum percentage fall in FEV1 after exercise only in EIA-positive children with atopic asthma (r=0.140, P=0.073), while neither of them correlated with methacholine PC20 (P> 0.05). However FEV1, FVC, and FEF25-75% were not associated with total IgE and specific IgE to Der p or Der f regardless of positivity of EIA in atopic asthmatic children. CONCLUSION: The severity of atopy and sensitization to house dust mites are significantly correlated with BHR, especially challenged by exercise but not pulmonary function in atopic asthmatic children.
Allergens ; Asthma ; Asthma, Exercise-Induced ; Child* ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Humans ; Immunoglobulin E ; Korea ; Lung ; Methacholine Chloride ; Pyroglyphidae

PURPOSE: The pro-inflammatory cytokine, tumor necrosis factor-alpha (TNF-alpha), is a central mediator of the immune response involved in a wide range of immuno-inflammatory and infectious diseases. There is increasing evidence that TNF-alpha may promote the development and spread of the cancer. Polymorphisms in the TNF-alpha promoter have been related to TNF-alpha production. Therefore, we investigated the potential association of TNF-alpha genotypes with gastric cancer in the Korean population. METHODS: The study included 66 patients with gastric adenoma, 75 patients with gastric carcinoma, and 551 healthy controls. The -308 and -238 polymorphisms in the TNF-alpha promoter were analyzed by PCR- restriction fragment length polymorphism (RFLP). Distributions of TNF-alpha promoter polymorphisms were compared between groups by chi2 test. P values smaller than 0.05 were considered to be significant. RESULTS: The proportion of individuals carrying the TNF-alpha -308A allele was higher in the carcinoma group compared to controls and adenomas, but the differences were not significant (P=0.124). However, the TNF-alpha -308A allele was significantly associated with advanced gastric carcinoma (P=0.026), serosa invasion (P=0.004), neural invasion (P= 0.021), and lymph node metastasis (P=0.005). On the other hand, the TNF-alpha -238G/A polymorphism was not associated with the development of gastric adenoma and carcinoma and the severity of gastric carcinoma. CONCLUSION: These results suggest that the TNF-alpha -308A allele is associated with the severity of gastric carcinoma in terms of invasion and metastasis in the Korean population. Therefore, TNF-alpha promoter polymorphism could be used as a predictive marker of the severity of gastric carcinoma.
Adenoma ; Alleles ; Communicable Diseases ; Genotype ; Hand ; Humans ; Lymph Nodes ; Necrosis* ; Neoplasm Metastasis ; Polymorphism, Restriction Fragment Length ; Serous Membrane ; Stomach Neoplasms ; Tumor Necrosis Factor-alpha

A posterior 3-portal arthroscopic approach with the patient in the prone position provides a novel and optimal approach for isolated subtalar arthrodesis. This approach facilitates access to the posterior talocalcaneal facet and facilitates safe access with regard to the posteromedial neuromuscular bundle. The technique involves prone positioning, establishment of two posterolateral portals and one posteromedial portal, arthroscopic posterior talocalcaneal facet debridement, percutaneous morcellized bone grafting and internal screw fixation. Preliminary results have shown high patient satisfaction, an excellent fusion rate and less postoperative morbidity than open subtalar arthrodesis.
Arthrodesis* ; Arthroscopy ; Bone Transplantation ; Debridement ; Humans ; Patient Satisfaction ; Prone Position ; Subtalar Joint

A posterior 3-portal arthroscopic approach with the patient in the prone position provides a novel and optimal approach for isolated subtalar arthrodesis. This approach facilitates access to the posterior talocalcaneal facet and facilitates safe access with regard to the posteromedial neuromuscular bundle. The technique involves prone positioning, establishment of two posterolateral portals and one posteromedial portal, arthroscopic posterior talocalcaneal facet debridement, percutaneous morcellized bone grafting and internal screw fixation. Preliminary results have shown high patient satisfaction, an excellent fusion rate and less postoperative morbidity than open subtalar arthrodesis.
Arthrodesis* ; Arthroscopy ; Bone Transplantation ; Debridement ; Humans ; Patient Satisfaction ; Prone Position ; Subtalar Joint

BACKGROUND: Research on next-generation sequencing (NGS)-based HLA typing is active. To resolve the phase ambiguity and long turn-around-time of conventional high resolution HLA typing, this study developed a NGS-based high resolution HLA typing method that can handle large-scale samples within an efficient testing time. METHODS: For HLA NGS, the condition of nucleic acid extraction, library construction, PCR mechanism, and HLA typing with bioinformatics were developed. To confirm the accuracy of the NGS-based HLA typing method, the results of 192 samples HLA typed by SSOP and 28 samples typed by SBT compared to NGS-based HLA-A, -B and -DR typing. RESULTS: DNA library construction through two-step PCR, NGS sequencing with MiSeq (Illumina Inc., San Diego, USA), and the data analysis platform were established. NGS-based HLA typing results were compatible with known HLA types from 220 blood samples. CONCLUSION: The NSG-based HLA typing method could handle large volume samples with high-throughput. Therefore, it would be useful for HLA typing of bone marrow donation volunteers.
Bone Marrow ; Computational Biology ; Gene Library ; Histocompatibility Testing ; HLA-A Antigens* ; Methods* ; Polymerase Chain Reaction ; Statistics as Topic ; Volunteers

PURPOSE: Infants and children with cardiovascular diseases often present with respiratory symptoms. However, missed or delayed evaluation for potential airway problem may complicate overall prognosis. The aim of this study is to determine the clinical characteristics of these patients and explore the cause of airway problem. METHODS: We reviewed the medical records of 64 patients (M: F=33: 31, mean age: 6.3+/-7.5 months) whose airway problems were proven by computed tomography or bronchoscopy in perioperative periods at the Asan Medical Center from January 1997 to June 2004. Patients were divided into two groups based on the duration of ventilator care: < or =7 days (group 1: 23 cases, M: F=10: 13) and > 7 days (group 2: 41 cases, M: F=23: 18). RESULTS: The patients in group 2 significantly developed more post-operative respiratory symptoms than group 1 (P< 0.001) and had more airway problems including extrinsic obstruction, intrinsic anomaly, and combined problem than group 1 although not significantly different (P=0.082). Among underlying diseases, the most common diseases were vascular anomaly (26.2 percent) and aortic arch anomaly (26.2 percent) in group 1 and pulmonary atresia with ventricular septal defect (22.4 percent) in group 2. The most frequent respiratory symptoms were recurrent wheezing pre-operatively and failure of ventilator weaning post-operatively. The major types of airway anomaly were tracheomalacia and tracheal stenosis (in each case 18.2 percent). Nineteen patients with persistent airway problems underwent aortopexy or other vascular correction. Of the 19 patients, 13 (68.4 percent) were improved, but 2 failed in weaning ventilator and 4 died of non-airway problems. CONCLUSION: Early evaluation and treatment for potential airway problems may affect natural or surgical prognosis in patients with cardiovascular diseases presenting with respiratory symptoms.
Aorta, Thoracic ; Bronchoscopy ; Cardiovascular Diseases* ; Child* ; Chungcheongnam-do ; Heart Septal Defects, Ventricular ; Humans ; Infant* ; Medical Records ; Perioperative Period ; Prognosis ; Pulmonary Atresia ; Respiratory Sounds ; Tracheal Stenosis ; Tracheomalacia ; Ventilator Weaning ; Ventilators, Mechanical ; Weaning