No abstract available.
Humerus*

PURPOSE: The aim of this study was to examine the relationship between tooth loss and sub-clinical atherosclerosis in Korean adults. MATERIALS AND METHODS: The subjects were part of a cohort study conducted in Ansan city by the Korea University medical school as part of the Korean Genome project. 749 subjects over than 40 years old were evaluated. After taking panoramic radiography, the amount of tooth loss was calculated. The intima-media thickness (IMT) was assessed by using ultrasonography at the common carotid artery. Traditional cardiovascular risk factors for atherosclerosis were also evaluated. The relationship between tooth loss and the IMT was evaluated using ANOVA with Scheffe's multiple comparison method in univariate analysis. Multiple regression analysis was also performed to determine the significance between the IMT and tooth loss. RESULTS: With age, tooth loss increased, but there was no significant increase in other traditional cardiovascular risk factors. Univariate analysis revealed the IMT to be positively related with the amount of tooth loss. Regression analysis of the IMT in the anterior and posterior tooth loss revealed that only the posterior tooth loss was significantly related with the IMT at all sites of the common carotid artery (right far wall, P = .015; left far wall, P = .008; right near wall, P < .001; left near wall, P = .001). CONCLUSION: This study verified the positive relationship between the increased tooth loss at the posterior area and the accumulation of atheroma in arteries.
Adult ; Arteries ; Atherosclerosis ; Carotid Artery, Common ; Carotid Intima-Media Thickness ; Cohort Studies ; Genome ; Humans ; Korea ; Plaque, Atherosclerotic ; Radiography, Panoramic ; Risk Factors ; Schools, Medical ; Tooth ; Tooth Loss

The authors have experienced with three cases of Leber's hereditary optic atrophy one family which is a relatively rare condition characterized by acute or subacute failrure of central vision presenting as a retrobulbar neuritis or optic atrophy typically inypung males in late teens or in the early twenties, though the age range is very wide. The literature relating to Leber's hereditary optic atrophy was briefly reviewed.
Adolescent ; Humans ; Male ; Optic Atrophy ; Optic Atrophy, Hereditary, Leber* ; Optic Neuritis

A mandibular continuity defect can be repaired using either a prosthetic device or autogenous bone. A titanium reconstruction plate can be used with a localized or vascularized flap over the defect of the mandible. Unfortunately, the plate may fail due to plate exposure, screw loosening, fracture, or infection, and will need to be removed. Plate exposure though the skin or mucosa is one of the main reasons for failure. In the present work, the authors introduced a lingually positioned reconstruction plate fabricated via three-dimensional printed bending support. This custom reconstruction plate can avoid plate re-exposure as well as reduce surgical errors and operation time.

OBJECTIVE: This study is a retrospective cost-benefit analysis of cervical anterior interbody fusion and cervical artificial disc replacement, which are the main surgical methods to treat degenerative cervical disc disease.METHODS: We analyzed 156 patients who underwent anterior cervical disc fusion and cervical artificial disc replacement from January 1, 2008 to December 31, 2009, diagnosed with degenerative cervical disc disorder. In this study, the costs and benefits were analyzed by using quality adjusted life year (QALY) as the outcome index for patients undergoing surgery, and a Markov model was used for the analysis. Only direct medical costs were included in the analysis; indirect medical costs were excluded. Data were analyzed with TreeAge Pro 2015™ (TreeAge Software, Inc, Williamstown, MA, USA).RESULTS: Patients who underwent cervical anterior fusion had a total cost of KRW 2501807/USD 2357 over 5 years and obtained a utility of 3.72 QALY. Patients who underwent cervical artificial disc replacement received 4.18 QALY for a total of KRW 3685949/USD 3473 over 5 years. The cumulative cost-effectiveness ratio of cervical spine replacement surgery was KRW 2549511/QALY (USD 2402/QALY), which was lower than the general Korean payment standard.CONCLUSION: Both cervical anterior fusion and cervical artificial disc replacement are cost-effective treatments for patients with degenerative cervical disc disease. Cervical artificial disc replacement may be an effective alternative to obtain more benefits.
Cervical Vertebrae ; Cost-Benefit Analysis ; Female ; Humans ; Quality-Adjusted Life Years ; Retrospective Studies ; Spinal Fusion ; Spine ; Total Disc Replacement

A mandibular continuity defect can be repaired using either a prosthetic device or autogenous bone. A titanium reconstruction plate can be used with a localized or vascularized flap over the defect of the mandible. Unfortunately, the plate may fail due to plate exposure, screw loosening, fracture, or infection, and will need to be removed. Plate exposure though the skin or mucosa is one of the main reasons for failure. In the present work, the authors introduced a lingually positioned reconstruction plate fabricated via three-dimensional printed bending support. This custom reconstruction plate can avoid plate re-exposure as well as reduce surgical errors and operation time.

Pyogenic liver abscess with metastatic septic complications is a rare and serious infectious disease if not treated properly. Pyogenic liver abscesses are caused by bacterial, fungal, or parasitic organisms. Escherichia coli used to be the predominant causative agent, but Klebsiella pneumoniae emerged as a major cause in the 1990s. Liver abscesses are caused by hepatic invasion via many routes, such as, the biliary tree, portal vein, hepatic artery, direct extension, or penetrating trauma. Furthermore, diabetes mellitus and malignant conditions are established important risk factors of K. pneumoniae liver abscesses and of septic metastasis, and several recent studies have asserted that K. pneumoniae liver abscess might be a presentation of occult or silent colon cancer. We report a case of K. pneumoniae liver abscess, metastatic septic pulmonary embolism, and endophthalmitis associated with diabetes and advanced gastric cancer.
Biliary Tract ; Colonic Neoplasms ; Communicable Diseases ; Diabetes Mellitus ; Endophthalmitis ; Escherichia coli ; Hepatic Artery ; Klebsiella pneumoniae ; Liver Abscess* ; Liver Abscess, Pyogenic ; Neoplasm Metastasis ; Pneumonia ; Portal Vein ; Pulmonary Embolism ; Risk Factors ; Stomach Neoplasms*

The diagnosis rate of adult spinal deformity (ASD) is increasing with increased life expectancy and the prevalence of degenerative spinal diseases. The prevalence of ASD in adults aged >60 years has been reported to be up to 68%. ASD has significant impact on the pain, disability, and mental health. Therefore, it is necessary to establish an effective surgical plan by accumulating modern knowledge on ASD, developing surgical techniques, and improving pre- and post-operative care so as to achieve optimal surgical outcomes.Current Concepts: ASD results from coronal and sagittal malalignments caused by degenerative diseases or iatrogenic factors. Recently, the significance of sagittal alignment correction has been emphasized, and the SRSSchwab classification of ASD is generally accepted. Individualized correction goals can be set through sufficient preoperative evaluations and imaging studies, and appropriate coronal and sagittal alignment correction can be achieved through intraoperative positioning of patient, anterior and posterior approach spine surgery, screw fixation, and osteotomies.Discussion and Conclusion: It is necessary to establish an optimal correction target and select the appropriate surgical approach for each patient with ASD, so as to improve patients’ quality of life. Surgical interventions for ASD can be safely completed by adequately comprehending and anticipating perioperative complications.

BACKGROUND: Hypothermia following the induction of anesthesia is caused by core to peripheral redistribution of body heat. It has been reported that propofol causes more severe hypothermia than sevoflurane by inhibiting thermoregulatory vasoconstriction during surgical procedures. Therefore, we evaluated the induction and maintenance of anesthesia with intravenous propofol to determine if it causes more core hypothermia than inhaled sevoflurane. METHODS: Forty-five patients who underwent hysterectomy were divided into two groups randomly, a propofol-remifentanil (PR) anesthesia group and a sevoflurane-remifentanil (SR) anesthesia group. Each group was subjected to anesthetic induction with either 1.5 mg/kg propofol or inhalation of 5% sevoflurane, respectively. Anesthesia in the former group was maintained with propofol while it was maintained with sevoflurane in the latter group. Specifically, 6-10 mg/kg/hr propofol, 3 L/min medical air, 2 L/min O2, and 0.25 mg/kg/hr remifentanil were used in the PR group for maintenance, while 1.5 vol% sevoflurane, 3 L/min medical air, 2 L/min O2 and 0.25 mg/kg/hr remifentanil were used for maintenance in the SR group. We measured the core temperature 8 times, prior to induction and 10, 20, 30, 45, 60, 75 and 90 minutes after induction. RESULTS: Core temperatures decreased in both the PR and SR group during surgical operation, but there was no significant difference between the two groups. CONCLUSIONS: Anesthesia induced and maintained by propofol did not cause a greater degree of hypothermia than sevoflurane.
Anesthesia ; Hot Temperature ; Humans ; Hypothermia ; Hysterectomy ; Inhalation ; Methyl Ethers ; Piperidines ; Propofol ; Vasoconstriction

A 46-year-old woman underwent a right thyroidectomy with left neck dissection under general anesthesia. The operation was performed successfully for over the course of 3 hours 30 minutes. After extubation, the patient was transferred to post-anesthetic care unit (PACU). After 10 minutes, dyspnea, chest discomfort, desaturation was suddenly occurred. Intubation was performed in PACU. The emergency chest X-ray revealed a right pneumothorax, and the patient was treated by chest tube insertion. The patient was improved and was discharged uneventfully from hospital 8 days later.
Anesthesia, General ; Chest Tubes ; Dyspnea ; Emergencies ; Female ; Humans ; Intubation ; Middle Aged ; Neck ; Neck Dissection ; Pneumothorax ; Thorax ; Thyroidectomy