No abstract available in English.
Tibia

Objective: Recently, the lipid profile of atherogenic dyslipidemia has become important in cerebrovascular diseases. Atherogenic index of plasma (AIP), an index that reflects this lipid profile as a single number, has been proposed, but there are still few related studies in cerebrovascular disease. In this study, we evaluated the relationship between AIP and cerebral small vessel disease (cSVD) in health check-up participants. Methods: We assessed consecutive health check-ups participants between 2006 and 2013. cSVD was measured including the following three subtypes: white matter hyperintensity (WMH), lacuens, and cerebral microbleeds (CMBs). WMH quantitatively measured the volume, and lacunes and CMBs qualitatively evaluated the presence. AIP was calculated according to the following formula based on blood test results: AIP=log [triglyceride (mg/ dL)/high-density lipoprotein cholesterol (mg/dL)]. Results: A total of 3,170 participants were evaluated (mean age: 56.5 years, male sex: 53.8%). In multivariable linear regression analysis, AIP (β=0.129, 95% confidence interval [CI]=0.003–0.255) was associated with WMH. Age, hypertension, diabetes, lipid-lowering agents, and intracranial atherosclerosis were also associated with WMH volume. In multivariable logistic regression analysis, AIP (adjusted odds ratio=1.72 1.79, 95% CI=1.03– 2.90) showed close association with lacunes. Age and intracranial atherosclerosis were also related to lacunes. CMBs did not show a statistically significant association with AIP. Conclusion High AIP was associated with cSVD in health check-up participants. Since this close relationship was only seen in WMH and lacunes, these subtypes may have arisen from a more atherosclerosis-related pathology.

A 51-year-old female had disseminated, symmetrically distributed, brownish black pigmentation and papillary hypertrophy on the intertriginous and flexural areas for 6 months, and gastric adenocarcinoma was confirmed during the evaluation of internal malignancy, The cutaneous finding of acanthosis nigricans was a significant cutaneous marker of internal malignancy in this case.
Acanthosis Nigricans* ; Adenocarcinoma* ; Female ; Humans ; Hypertrophy ; Middle Aged ; Pigmentation

PURPOSE: Rectoceles are often associated with anorectal symptoms. Various surgical techniques have been described to repair rectoceles, but the surgical results vary. The aim of this study was to compare transanal repair (TAR) and transanal repair with posterior colporrhaphy (TAR+PC). METHODS: The records of 58 patients operated on during a 56-month period were reviewed. Of those 26 patients had a TAR, and 32 patients had a TAR+PC. Interviews and anorectal physiologic studies were performed preoperatively and postoperatively. RESULTS: The recurrence rate after a TAR+PC was lower than the recurrence rate after a TAR (TAR 19.2% vs. TAR+PC 3.1%). The rectal sensation (sensory threshold: TAR 64.8+/-18.9 ml vs. TAR+PC 56.1+/-23.67 ml; earliest defecation urge: TAR 116.4+/-29.5 ml vs. TAR+PC 104.8+/-31.2 ml) was more improved after a TAR+PC. CONCLUSIONS: A TAR+PC for treatment of a rectocele is safe and effectively corrects obstructed defecation. The improvement probably relates, at least in part, to rectal sensational factors other than the dimensions of the rectocele.
Defecation ; Humans ; Rectocele* ; Recurrence ; Sensation

PURPOSE: Generally, the constipation is a medical disease, but recently, there are many reports showing the good results after correction of rectocele in constipated patients. The authors try to show the effect of surgery in rectocele cases and also analyse the relationship between the anatomical distortion and clinical symptoms by using anorectal physiologic study before and after operation. METHODS: 31 cases of rectocele are surgically corrected from June 1998 to August 2001. 31 cases of them could be followed up and with them, pre- and post-operative anal ultrasonography, anorectal manommetry and defecography were tried. Personal interview was also done to each patient. RESULTS: After trasanal rectocele repair, the rectocele size decreased and clinical symptoms improved remarkably. In defecography, anorectal angle (pre-op; 105.9+/-6.0 degrees vs. post-op; 109.5+/-3.7 degees) and perineal descent (1.6+/-0.7 cm vs. 2.4+/-1.2 cm) increase in pushing state after operation. In anorectal manometry, mean resting anal pressure (29.2+/- 3.4 mmHg vs. 17.9+/-4.6 mmHg) and maximal squeeze pressure (84.5+/-20.8 mmHg vs. 47.6+/-12.1 mmHg) decreased and rectal sensation improved after operation. CONCLUSIONS: Current results suggest that the surgical correction aims not only the decrement of the rectocele size but changing the vector power on pushing more physiologically and also improving the rectal sensibility.
Constipation ; Defecography ; Humans ; Manometry ; Prospective Studies* ; Rectocele* ; Sensation ; Ultrasonography

No abstract available.
Ehlers-Danlos Syndrome*

PURPOSE: The purpose of this study is to identify job stress and psychological health of female household head workers and investigate the relationship between them. METHODS: This study was cross-sectionally designed. We analysed the secondary data extracted from the 2nd and 3rd Korean Working Condition Survey. 4,807 female employees were included in the final analysis. χ² test and multiple logistic regression using IBM SPSS 23.0 were performed. RESULTS: 46.7% of female household head workers were in poor psychological health. In the area of job stress-related characteristics affecting the level of psychological health, it was found that female household head workers had a higher likelihood of becoming psychologically unhealthy due to organizational relationships and inadequate compensation factors. CONCLUSION: Considering the fact that the number of female household head workers is gradually expanding as a breadwinner, it is necessary to find a way of paying attention to their job stress and psychological health in order to support them.
Compensation and Redress ; Family Characteristics* ; Female* ; Humans ; Logistic Models ; Mental Health*

Recently, nalbuphine has been used for reversal of opioid indueed respiratory depression. Because of its structural chsracter, nalbuphine has been known as a better nareotic antagonist with keeping analgesic potency and without considerable cardiovascular responses. Some investigators reported nalbuphine can decrease minimum alveolar concentration(MAC) of major inhalation anesthetic agents and can be a intravenous anesthetic adjuvant but can accompany several adverse reactions such as hypertension and tachycardia etc. To evaluate the eligibility and efficacy of nalbuphine as a intravenous narcotic adjuvant for cardiac anesthesia, we selected 24 adult cardiac patients and divided them into 3 groups. Valvular surgerys were performed for group I patients, aorto-coronary-bypass surgerys(CABG) for group II and correction of congenital heart disease for group III, respectively, All patients were inducted general anesthesia with 0.3 mg/kg nalbuphine+0.1 mg/kg diazepam+2 mg/kg thio- pental sodium and maintained with intermittent injection of 0.3-0.5 mg/kg nalbuphine and O.l mg/kg diazepam just before the time of most stressful surgical stimuli with 1/2 MAC halothane inhalation under vecuronization for muscle relaxation. We measured heart rate(HR), systolic blood pressure(BP), central venous pressure(CVP) at pre-induction as a control data, and just after endotracheal intubation, skin incision, sternotomy, and skin closure respectively to compare basic cardiovascular responses of patients at surgical stimuli with control data. We also checked recovery time of consciousness and presence of awareness during operation. The results were as follows: 1) Significant HR changes occurred in group I at just after intubation time from 104+/-18.6 to 134+/-25.9 and in group II from 83+/-10.5 to 115+/-32.3 respectively. 2) There were few significant changes of systolic blood pressure during anesthesia of all groups except just after intubation in group II from 135+/-32.8 torr to 168+/-37.9 torr.3) A significant CVP decrease occurred only in group I at the time of skin closure from 13+/-3. 5 cmHO to 10+/-3.8 cmH2O because of operative correction of tricuspid regurgitation of group I patients rather than anesthesia effects. 4) Recovery of consciousness needed average 1 hr 30 mins in group I and 2 hr 45 mins in group II. None of patients complained awareness during operations. Above results demonstrate that Nalbuphine-Diazepam-O2-1/2 MAC Halothane can be a anesthetic method for open heart surgery without any significant cardiovascular responses at surgical and anesthetic stimuli except intubation stimulus, but for more evaluation study of Nalbuphine-Diazepam-O2 Anesthesia will be needed.
Adult* ; Anesthesia ; Anesthesia, General* ; Anesthetics ; Blood Pressure ; Consciousness ; Diazepam* ; Halothane* ; Heart Defects, Congenital ; Heart* ; Humans ; Hypertension ; Inhalation ; Intubation ; Intubation, Intratracheal ; Muscle Relaxation ; Nalbuphine* ; Research Personnel ; Respiratory Insufficiency ; Skin ; Sodium ; Sternotomy ; Tachycardia ; Thoracic Surgery* ; Tricuspid Valve Insufficiency

Dislocations of the toes are comparatively rare. The majority of the these injuries occur in the great toe at the metatarsophalangeal joint. Dislocations of the interphalangeal joint of the great toes are extremely unusual, especially interphalangeal dislocation of the grcat toe with interposition of a sesamoid bone is extremely rare. Authors wishes to report two cases of interphalangeal dislocation of the great toe with interposition of the interphalangeal sesamoid.
Dislocations ; Joints ; Metatarsophalangeal Joint ; Sesamoid Bones ; Toes

It is well known that the early diagnosis and treatment are very important for the patient with ankle instability to provide a favorable occupational function through the whole life. Therefore, to evaluate the result of treatment of lateral ankle instability, we analyzed the 10 cases with 3.1 years follow-up period who were treated at the Orthpaedic department, National police Hospital, from January, 1980 to December, 1986. The results were as follows : l. Among the 10 patients, 4 patients were female, 6 patients were male and all patients were required operative procedures. 2. The aversge age was 21.3 years ranging from 18 years to 24 years and average follow-up period was 3.1 yesrs ranging from 6 months to 7 years. 3. In occupstional distribution, volley ball players were 4 patients, soccer players were 2, combat police were 3, student was 1 snd athletes were 6 patients (60%) among the 10 patients. 4. In the method of treatment, surgical treatment by Evans or Watson-Jones reconstructive procedure was used for 10 pstients. 5. The results of treatment were Excellent in 6 patients (60%), Good in 2 (20%) and Poor in 2(20%) by author's rating system. 6. The most common complication was the degenerative arthritis.
Ankle ; Athletes ; Early Diagnosis ; Female ; Follow-Up Studies ; Humans ; Male ; Methods ; Osteoarthritis ; Police ; Soccer ; Surgical Procedures, Operative