BACKGROUND: Recently, it is substituted automatic sphygmomanometer for mercury sphygmomanometer. But it seems to be insufficient for data of its accuracy. A sample accurate automatic sphygmomanometer could have an important role in the management of hypertension. The aim of this study is to assess the accuracy of the automatic sphygmomanometer that is used common practice and at home. METHODS: We collected 247 patients who visited the department of Famiiy Practice of Taegu medical center from April to August 1996. BP was measured sequentially same arm by standard device(mercury. sphygmomanometer), test device A(A&D TM-2650), test device B(seine SE-2000). We assessed the automatic sphygmomanometer according to the standards set out by the British Hypertension Society(BHS) protocol and the American Association for the Advancement of Medical Instrumentation(AAMI). These data were analysed using pearson' correlation and paired t-test. RESULTS: Test device A was highly correlated to mercury sphygmomanometer in systolic and diastolic BP(r=0.90, r=0.88). Also test device B was highly correlated to that(r=0.90, r=0.87). The mean difference between BP value obtained by the standard device and those obtained by the test device A were 0.59+/-7.66mmHg systole(mean+/-SD) and 3.83+/-6.43mmHg diast.ole, whereas the difference between the former and those obtained by the test device B were 1.70+/-7.99mmHg systole.and 5.58+/-6.38mmHg diastole. Comparing to standard device, there were a signifioant difference except systolic BP of test device A(P<0.05). According to the criteria of the AAMI, the diastolic BP of test device B was not enough and according to the criteria of the BHS, the diastolic BP of both test device were not enough. CONCLUSIONS: Both test device were highly correlated to mercury sphygmomanometer. But according to the criteria of the BHS and AAMI, there were not enough. Because the use of automatic sphygmomanometer was popularized, I think that further study will be required to assess of accuracy.
Arm ; Blood Pressure* ; Daegu ; Diastole ; Humans ; Hypertension ; Sphygmomanometers*

Bowing of one or both bones of the forearm in children following acute trauma was first recognized by Borden in 1974. Since then, a total of 30 cases have been reported in the English literature. The injury is a result of an acute plastic deformation of the tubular bones due to mainly a longitudinal compression force, and is charactcrized by: 1) a broad fixed curvature of the entire bone, 2) absence of periosteal new bone formation on later roentgenograms, and 3) partial correction of the curvature through cortical remodeling in young children. In this paper, three cases of traumatic bowing of the tubular bone in children are presented: one traumatic bowing of both forearm bones in 15 years old girl and two traumatic bowing of fibulae in combination with fractures of diaphysis of the tibiae of the same legs in 6 years old girl and 6 years old boy respectively. Manipulative reduction for the bowing of the both forearm bones corrected remarkably the plastic curvature, whereas manipulation for the bent fibulae with fractures of the tibiae failed to reduce the curvature, causing no delay in fracturt healing. These three cases are of special interest from two points of view. The first case was caused by tangential force instead of a longitudinal one and was associated with ulnar nerve paralysis which has eventually been recovered. The other two cases occurred in the lower leg in which plastic deformation, according to previous report, would not develop because of the lack of intrinsic curvature of the tibia and fibula.
Child ; Diaphyses ; Female ; Fibula ; Forearm ; Humans ; Leg ; Male ; Osteogenesis ; Paralysis ; Plastics ; Tibia ; Ulnar Nerve

OBJECTIVE: Our purpose was to investigate the distribution of the result of 17,744 cervicovaginal smears and their pathologic results in Inha University Hospital to make a reference data. METHODS: During 28 months, May 1996 to August 1998, we performed 17,774 cervicovaginal smears and arranged them by the Bethesda system and compared them with their pathologic results. RESULTS: Among 17,744 smears, there were 93.2% of benign results, 2.9% of ASCUS, 0.9% of LSIL, 1.4% of HSIL, and 0.8% of SCC. The ASCUS/SIL ratio was 1.28. Among ASCUS, the high grade histologic outcome was composed 4.0%. Among LSIL, there were 15.7%, and HSIL 48.0%, SCC 56.1%, AGUS 9.3%, and Adenocarcinoma, the results was 69.2%. CONCLUSION: Among 17,744 smears, there were 93.2% of benign results, 2.9% of ASCUS, 0.9% of LSIL, 1.4% of HSIL, and 0.8% of SCC. The ASCUS/SIL ratio was 1.28. These results were very similar to other data and we would like to add our data to them as a reference. And the worse the smear results were, the worse the pathologic results were.
Adenocarcinoma

The authors report three cases of ossification of ligamentum flavum causing thoracic myelopathy. The symptoms of all cases were numbness in the legs and feet and motor weakness. Preoperative diagnosis were simple spine X-ray, metrizamide CT and magnetic resonance imaging. There was satisfactory improvement in all cases after total laminectomy and medial facetectomy.
Diagnosis ; Foot ; Hypesthesia ; Laminectomy ; Leg ; Ligamentum Flavum* ; Magnetic Resonance Imaging ; Metrizamide ; Spinal Cord Diseases* ; Spine

BACKGROUNDS: Thymic carcinomas are very rare tumors that are often associated with extrathoracic metastasis to other organs. However, it is well known that thymic carcinomas rarely metastasize to the spine, and the prognosis, treatment, and natural course of this disease are not yet standardized. METHODS: We describe seven thymic carcinoma patients with spinal metastasis who were diagnosed and treated in our institute from January 2006 to December 2011. We performed surgical treatment and adjuvant chemotherapy and/or radiation therapy, in consideration of each individual disease's course, and we regularly followed up the patients. RESULTS: Of the seven patients, five were male and two were female. Six had metastases in the thoracic spine, and one had metastases in the lumbar spine. An extradural lesion was found in five patients, and two patients had both extradural and intradural lesions. The period from the primary diagnosis to spinal metastases varied widely (range, 1.23-14 years). After surgery, all patients showed an improvement of back pain and radicular pain. Two patients were lost to follow-up, but the other five maintained ambulatory function until their final follow-up. Four patients died because of pulmonary complications accompanied with the disease's progression. One patient died from uncontrolled brain metastases. After surgery, the median survival was 204+/-111.43 days. CONCLUSION: Because metastasis to the spine from thymic carcinoma is very rare, there are no treatment guidelines. Nevertheless, we suggest that appropriate surgical management of the metastatic lesion is necessary for the preservation of the patient's quality of life during survival.
Back Pain ; Brain ; Chemotherapy, Adjuvant ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Lost to Follow-Up ; Male ; Neoplasm Metastasis* ; Prognosis ; Quality of Life ; Spine ; Thymoma*

The aim of this study was to examine the incidence and trends of clinically relevant venous thromboembolism (VTE) including deep vein thrombosis (DVT) and pulmonary embolism (PE) after hip and knee replacement arthroplasty (HKRA) in Korea. Between January 1 and December 31, 2010, 22,127 hip replacement arthroplasty (HRA) patients and 52,882 knee replacement arthroplasty (KRA) patients were enrolled in the analysis using the administrative claims database of the Health Insurance Review and Assessment Service (HIRA). All available parameters including procedure history and clinically relevant VTE during the 90 days after HKRA were identified based on diagnostic and electronic data interchange (EDI) codes. The overall incidence of VTE, DVT, and PE during the 90 days was 3.9% (n=853), 2.7% (n=597), and 1.5% (n=327) after HRA, while the incidence was 3.8% (n=1,990), 3.2% (n=1,699), and 0.7% (n=355) after KRA. The incidence of VTE after HKRA was significantly higher in patients who had previous VTE history (odds ratio [OR], 10.8 after HRA, OR, 8.5 after KRA), chronic heart failure (2.1, 1.3), arrhythmia (1.8, 1.7), and atrial fibrillation (3.4, 2.1) than in patients who did not. The VTE incidence in patients with chemoprophylaxis was higher than that in patients without chemoprophylaxis. The incidence of VTEs revealed in this retrospective review was not low compared with the results of the studies targeting other Asian or Caucasian populations. It may warrant routine prevention including employment of chemoprophylaxis. However, the limitation of the reviewed data mandates large scale prospective investigation to affirm this observation.
Adult ; Aged ; Aged, 80 and over ; *Arthroplasty, Replacement, Hip ; *Arthroplasty, Replacement, Knee ; Databases, Factual ; Female ; Humans ; Incidence ; Male ; Middle Aged ; National Health Programs ; Odds Ratio ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Factors ; Venous Thromboembolism/*diagnosis/epidemiology

OBJECTIVE: The measurement of liver size can be used for the diagnosis of the fetal growth abnormality (FGR, macrosomia etc.). The purpose of this study was to evaluate a mathematical relationship between the fetal liver size(liver length or volume) and the gestational age in the normal pregnancies. Brief comparisons were also tried on the base of the degree of the correlation between liver length and its volume. METHODS: We collected 54 singleton pregnancies of 20 to 36weeks of gestation for measuring fetal liver length and 57 singleton pregnancies for measuring fetal liver volume. We used Combison 530 utrasonic machine(Kreztechnik AG, Zipf, Austria). RESULTS: There was significant correlation between liver size( length and volume) and gestation age. And the liver volume better correlated with gestational age than liver length(r=0.93 : r=0.78, p<0.0001, p<0.0001). CONCLUSION: Ultrasonic measurement of fetal liver size is a reliable indicator of fetal growth, especially liver volume. Therefore these data may have a potential value for the prediction of abnormal fetal growth(FGR, macrosomia).
Diagnosis ; Fetal Development ; Gestational Age* ; Liver* ; Pregnancy* ; Ultrasonics

Idiopathic hypertrophic spinal pachymeningitis (IHSP) is a chronic, progressive, inflammatory disorder characterized by marked fibrosis of the spinal dura mater with unknown etiology. According to the location of the lesion, it might induce neurologic deficits by compression of spinal cord and nerve root. A 58-year old female with a 3-year history of progressive weakness in both lower extremities was referred to our institute. Spinal computed tomography (CT) scan showed an osteolytic lesion involving base of the C6 spinous process with adjacent epidural mass. Magnetic resonance imaging (MRI) revealed an epidural mass involving dorsal aspect of cervical spinal canal from C5 to C7 level, with low signal intensity on T1 and T2 weighted images and non-enhancement on T1 weighted-enhanced images. We decided to undertake surgical exploration. At the operation field, there was yellow colored, thickened fibrous tissue over the dura mater. The lesion was removed totally, and decompression of spinal cord was achieved. Symptoms improved partially after the operation. Histopathologically, fibrotic pachymeninges with scanty inflammatory cells was revealed, which was compatible with diagnosis of idiopathic hypertrophic pachymeningitis. Six months after operation, motor power grade of both lower extremities was normal on physical examination. However, the patient still complained of mild weakness in the right lower extremity. Although the nature of IHSP is generally indolent, decompressive surgery should be considered for the patient with definite or progressive neurologic symptoms in order to prevent further deterioration. In addition, IHSP can present as an osteolytic lesion. Differential diagnosis with neoplastic disease, including giant cell tumor, is important.
Decompression ; Diagnosis ; Diagnosis, Differential ; Dura Mater ; Female ; Fibrosis ; Giant Cell Tumors ; Humans ; Lower Extremity ; Magnetic Resonance Imaging ; Meningitis* ; Neurologic Manifestations ; Physical Examination ; Spinal Canal ; Spinal Cord

Hypertriglyceridemia is a rare cause of pancreatits. However the relationship between acute pancreatits and severe hypertrigyceridemia is well recognized. It can be a life- threatening complication if the degree of hypertrigyceridemia is severe enough. A serum triglyceride level of more than 1,000 to 2,000 mg/dL is the identifiable risk factor. The clinical course and management of hypertriglyceridemia induced acute pancreatitis is not different from other causes. The clinical course and management of hypertriglyceridemia induced acute pancreatitis during pregnancy are similar to the one during nonpregnant state. The prevalence of acute pancreatitis in pregnancy ranges between 1 in 1,000 to 1 in 3,000. Gestational hypertrigyceridemic pancreatits can be fatal, and maternal morbidity rate has an upward trend of 20%. We report a 31-year-old woman with coexistence of hypertrigyceridemia and acute pancreatits at 32 weeks gestation with a brief review of the literatures.
Adult ; Female ; Humans ; Hypertriglyceridemia ; Pancreatitis ; Pregnancy ; Prevalence ; Risk Factors

Treatment of pain related to various types of deafferentation remains a neurosurgical challenge. Medical therapy and conventional surgical techniques for pain relief have not been effective due to this problem. Six patients with intractable pain following a brachial plexus injury were treated with dorsal root entry zone(DREZ) lesions. These lesions were made with CO2 laser. All patients were followed from 5 months to 5 years after surgery. Two-third of the patients were relieved of more than 50% of their preoperative pain. Post-operative neurosurgical complications were ipsilateral leg weakness and loss of proprioception in 2 cases. The laser technique is exact, makes uniform lesion, shortens the duration of the procedure, lessens cord manipulation and makes shalow penetration into the surrounding spinal cord. Dorsal root entry zone(DREZ) lesions made with CO2 laser appeared to be a satisfactory treatment for brachial plexus injury patients who have failed to respond to more conservative modes of therapy.
Brachial Plexus* ; Causalgia ; Humans ; Lasers, Gas* ; Leg ; Pain, Intractable ; Proprioception ; Spinal Cord ; Spinal Nerve Roots*