The present study was carried out to clarify the anatomical changes of lumbar intervertebral discs by aging. Anterior height, posterior height, anteroposterior diameter of intervertebral discs were measured on 512 normal plain lateral radiographs of lumbosacral spine. And the indices of disc wedging and relative disc height were calculated. There was a cephalocaudal gradient of increase in the indices of disc wedging in all age groups. The indices of relative disc height were constant at all lumbar levels. These suggest that the lower disc is more wedge shaped and the height of discs changes in the constant ratio with that of vertebral body.
Aging* ; Humans ; Intervertebral Disc* ; Spine

We perfomed this study to evaluate the incidence of the oculocardiac reflex(OCR) and its difference relative to each extraocular muscles. In addition, preventive methods for oculocardiac reflex were also evaluated. From Febrary 1997 to January 1998, we examined the occurrence of the OCR of 65 patients who underwent strabismus surgery in 123 extraocular muscles under the general anesthesia. Those who showed severe OCR were prepared with retrobulbar injection of 1% lidocaine 2cc or 1% intravenous atropine and observed wheather OCR was prevented. The overall incidence of the OCR was 66.2% and there was no significant difference between the incidence in both eyes(p>0.999). The incidence in each of the extraocular muscles did not show statistically significance when the patients were prepared with preoperative intramuscular atropine(p=0.018). The incidence after intraoperative retrobulbar injection or intravenous atropine was decreased to 27.3% but was not statistically significant(p=0.34).
Anesthesia, General ; Atropine ; Humans ; Incidence ; Lidocaine ; Muscles ; Reflex, Oculocardiac* ; Strabismus*

The objective of this study is to measure eosinophil count and Eosinophil Cationic Protein (ECP) levels of tears and sera in patients with acute allergic conjunctivitis and normal subjects and to assess the correlation of this mediator with allergic conjuctivitis and the clinical usefulness. Seventeen subjects were selected on the basis of clinical manifestation, history, skin prick test, total IgE. Serum IgE and eosinophil count were increased in 10patients, and eosinophilia in conjunctival epithelium were present in 11subjects. ECP in tears were increased in patients significantly (12.0+/-8.0 vs 3.9+/-3.8ng/ml,p=0.01), but not in serum (52.5+/-43.1 vs 28.3+/-25.9ng/ml). There was significant relationship beween serum and tear eosinophil count(p=0.004,r=0.66). But there was no significant correlation between eosinophil count and ECP in serum (p>0.05m r=0.19), and no significant correlation between eosinophil count of conjectival epithelium and tears ECP (p=0.043, r=0.05). In conclusion, ECP in tears may be very important role in allergic conjunctivitis and is more reliable indicatior of diagnosis clinically rather than eosinophil count in tear and conjunctival epithelium.
Child* ; Conjunctivitis, Allergic* ; Diagnosis ; Eosinophil Cationic Protein* ; Eosinophilia ; Eosinophils* ; Epithelium ; Humans ; Immunoglobulin E ; Skin

The treatment outcome of advanced squamous cell carcinoma involving the head and neck is well known to be dire and usually needs multimodality treatment even including optimal reconstruction after ablative surgery. When a significant area of the soft tissue is resected, reconstruction of oral cavity or pharynx needs to minimize morbidities while achieving adequate functional outcomes. For the better functional outcome, invasive approaching procedures such as lip and jaw splitting, or extensive floor of mouth or pharyngeal muscle ablation should be avoided. Without these surgical procedures, reconstructive surgeons may encounter technical difficulties in flap inset due to deep and narrow space after head and neck cancer resection. In a deep and narrow surgical defect, accurate approximation and suture is extremely difficult. Eventually, repeated flap manipulation and stretch might be inevitable, and even pedicle kinking or injury could happen. Herein, we suggested the “parachute” technique, which was generally used in blood vessels or aortic valve suturing in a narrow surgical field and for avoiding mismatched suture. We applied this “parachute” technique for free-flap inset to head and neck defect, and we herein report our successful outcomes.

Bosworth fracture, fracture-dislocation of ankle with entrapment of fibula behind the tibia, is a rare condition. Diagnosis of this fracture-dislocation may not he easy, and closed reduction of this injury is difficult because of entrapment of fibula by the tieht interosseous membrane. We report a case of Bosworth fracture treated with the anti-glide plate technique.
Ankle ; Diagnosis ; Fibula ; Membranes ; Tibia

BACKGROUND/AIMS: Little is known for the capacity and quality of colonoscopy, and adherence to colonoscopy surveillance guidelines in Korea. This study aimed to investigate the present and potential colonoscopic capacity, colonoscopic quality, and adherence to colonoscopy surveillance guidelines in Korea. METHODS: We surveyed representative endoscopists of 72 endoscopy units from June to August 2015, using a 36-item questionnaire regarding colonoscopic capacity, quality, and adherence to colonoscopy surveillance guidelines of each hospitals. RESULTS: Among the 62 respondents who answered the questionnaire, 51 respondents were analyzed after exclusion of 11 incomplete answers. Only 1 of 3 of endoscopy units can afford to perform additional colonoscopies in addition to current practice, and the potential maximum number of colonoscopies per week was only 42. The quality of colonoscopy was variable as reporting of quality indicators of colonoscopy were considerably variable (29.4%–94.1%) between endoscopy units. Furthermore, there are substantial gaps in the adherence to colonoscopy surveillance guidelines, as concordance rate for guideline recommendation was less than 50% in most scenarios. CONCLUSIONS: The potential capacity and quality of colonoscopy in Korea was suboptimal. Considering suboptimal reporting of colonoscopic quality indicators and low adherence rate for colonoscopy surveillance guidelines, quality improvement of colonoscopy should be underlined in Korea.
Colonoscopy ; Colorectal Neoplasms ; Endoscopy ; Korea ; Quality Improvement ; Surveys and Questionnaires

PURPOSE: The objective of this study was to analyze the brain volume according to the brain image of healthy adults in the 20s taken with different inversion time (TI). MATERIALS AND METHODS: Brain images of healthy adults in the 20 s were acquired using magnetization prepared rapid acquisition gradient echo (MPRAGE) pulse sequence with 1.5 mm thickness of pieces and four inversion times (1100 ms, 1000 ms, 900 ms, 800 ms). The acquired brain images were analyzed to measure the volume of white matter (WM), gray matter (GM), intracranial volume (ICV). The statistical difference according to brain volume and gender was analyzed for each TI. RESULTS: The brain volume calculated using Freesurfer was WM=486.52+/-48.64 cm3 and GM=646.86+/-57.12 cm3 in mean when adjusted by mean ICV=1278.94+/-154.92 cm3. Men's brain volume(WM, GM, ICV) was larger than women's brain volume. In the intrarater reliability test, all of the intraclass correlation coefficients were high (0.992 for WM, 0.988 for GM, and 0.997 for ICV). In the repeated measures analysis of variance, GM and ICV did not show a significant difference at each TI (GM p=0.143, ICV p=0.052), but WM showed a significant (p=0.001). In the linear structure relation analysis, all of the Pearson correlation coefficients were high. CONCLUSION: WM, GM, and ICV indicated high reliability and solid linear structure relations, but WM showed significant differences at each TI. The brain volume of healthy adults in the 20s could be used in comparison with that of patients for reference purposes and to predict the structural change of brain. It would be needed to conduct additional studies to examine the contract, SNR, and lesion detection ability according to variable TI.
Adult ; Brain* ; Healthy Volunteers* ; Humans

BACKGROUND AND OBJECT: We want to know reference values of mitral annulus velocity by Doppler tissue imaging which has been thought as a new parameter of left ventricular diastolic function. Including mitral inflow parameters, many parameters which have been used in the evaluation of left ventricular diastolic function are affected by several conditions, so sometimes they can not provide information about left ventricular diastolic function. The knowledge of mitral annulus velocity by Doppler tissue imaging will provide new guidelines for evaluation of diastolic function. However, reference values in normal and changes according to an age have not been fully evaluated. METHODS: We examined 246 patients with no symptoms related to the cardiac systolic and diastolic dysfunction and 80 healthy volunteers according to an age. Early ( E ) and late ( A ) transmitral flow velocity and the ratio of early to late peak velocity ( E/A ) were obtained by pulsed Doppler echocardiography. Early diastolic velocity of mitral annulus ( E' ) and peak atrial systolic velocity of mitral annulus ( A' ) were obtained from the medial ( or septal ) corner of the mitral annulus and subsequently from lateral corner by Doppler tissue imaging. We obtained E', A' and the ratio of E' to A' ( E'/A' ) and E/ E' according to an age. RESULTS: E' from medial corner was the highest in subjects in their twenties and declined gradually and A' from medial corner was the lowest in a same age group and increased gradually. E'/A' ratio from medial corner was the highest in subjects in their twenties and declined gradually and reversed in subjects in their forties. E', A' and E'/A' from lateral corner were showed like as medial corner similarly but E'/A' was reversed in the subjects in their fifties. E/ E' from medial and lateral corner was the lowest in subjects in their twenties and increased gradually with age. In comparison between transmitral flow velocity and mitral annulus velocity, there are good relationship in E/A and E'/A' ( p=0.01 ). CONCLUSION: We measured reference values of mitral annulus velocity by Doppler tissue imaging and E/ E' according to an age.
Echocardiography, Doppler, Pulsed ; Healthy Volunteers ; Humans ; Reference Values

Meigs' syndrome is characterized by the pleural effusion and ascites in patient with solid benign ovarian tumors and the resolution of the effusion after resection of the tumor. Elevated serum CA125 levels in postmenopausal women with solid adnexal masses, ascites and pleural effusion are highly suggestive for malignant ovary tumor. We present a case of Meigs' syndrome with elevated serum CA125.
Ascites ; Female ; Humans ; Meigs Syndrome* ; Ovary ; Pleural Effusion

BACKGROUNDS: As Korea has advanced into the aging society, Acute Coronary Syndrome is increased in number, especially elderly age group. The symptoms of acutecoronary syndrome in eldery were presented in atypical feature frequently. We studied the relation of the first symptom and diagnosis of acutecoronary syndrome and distribution of risk factor and coronary angiographic finding in elderly patient of korea society. METHODS: The subjects who were under went coronary angiography between 2002.5 and 2003.8 were dividedunder 65 years old group and over 65 years old group. And each group described diagnosis, risk factor, first symptom and coronary angiographic finding retrospectively. RESULTS: The diagnosis of unstable angina are more higher(46.5% vs. 26.1%, p<0.01) in the over 65 years old group and the first significant symptom of typical chest pain was more higher(57.4% vs. 47.6%, p<0.01) in the under 65 years old group and dyspnea was more higher(22.8% vs. 9.2%, p<0.01) in the over 65 years old group. The number of abnormal vessel were more higher(66.3% vs. 46.9%, p<0.01) in the over 65 years old group. CONCLUSION: Over 65 years old group compared with younger age group were prewented more frequently angina equivalent symptom than typical chest pain. And at the diagnosis of Acute Coronary Syndrome, over 65 years old group showed more severe coronary angiographic finding. Consequently, early stage of diagnostic approach and treatment need scrupulous attention in the elderly patients.
Acute Coronary Syndrome* ; Aged* ; Aging ; Angina, Unstable ; Chest Pain ; Coronary Angiography ; Diagnosis* ; Dyspnea ; Humans ; Korea* ; Retrospective Studies ; Risk Factors