No abstract available.
Genitalia* ; Poroma*

BACKGROUND: Discrepancies exist in the existing researches regarding the association between social capital and self-efficacy, and most of these researches have been done in developed countries. The aims of this study were to assess the independent association between individual social capital and self-efficacy and to assess the associations between individual social capital, self-efficacy and self-rated health. METHODS: Data were obtained from the Gyeongnam health survey (6,500 persons) conducted in 2008. A self-administered questionnaire was additionally administered to gather information on demographic variables, health behaviors, chronic diseases, self-efficacy, social capital, and self-rated health status. Total study population was 3,843 as those with chronic diseases were excluded. RESULTS: In males, trust was positively associated with confidence and preference to task difficulty, and participation was negatively associated with confidence and positively associated with regulation and preference to task difficulty. In females, trust was positively associated with confidence and preference to task difficulty and negatively associated with regulation. Participation was positively associated with preference to task difficulty. In males, the odds for self-rated health status was better for persons with confidence (95% confidence interval, CI 1.088-1.705), trust (95% CI 1.172-1.821) and participation (95% CI 1.268-2.117). In females, the odds for self-rated health status was better for those with confidence (95% CI 1.250-1.803), preference of task difficulty (95% CI 1.019-1.683) and participation (95% CI 1.024-1.555). CONCLUSIONS: High social capital measured at an individual level may promote self-efficacy and health status.
Chronic Disease ; Developed Countries ; Female ; Health Behavior ; Health Surveys ; Humans ; Male ; Self Efficacy ; Surveys and Questionnaires

No abstract available.
Vulva*

BACKGROUND: Carotid endarterectomy has been proven to be beneficial for the prevention of strokes in both symptomatic and asymptomatic patients with significant carotid stenosis. Even if there is no consensus as to the most appropriate monitoring method for detecting cerebral ischemia during carotid endarterectomy, electroencephalography (EEG) and/or somatosensory evoked potential (SSEP) has been extensively used to evaluate cerebral functions. We estimated the efficacy of EEG and SSEP for detecting cerebral ischemia during carotid endarterectomy in conscious patients. METHODS: One or both of 16-channel EEG and SSEP monitoring were performed in 103 patients scheduled for carotid endarterectomy under cervical plexus block. We estimated the sensitivity and specificity of EEG and SSEP for detecting cerebral ischemia expressed by altered consciousness and shunt insertion. RESULTS: During carotid clamp in 74 cases studied, significant EEG changes were noted in 5 of the 16 patients who had cerebral ischemia, however 11 patients had no EEG changes despite cerebral ischemia. During carotid clamp in 84 cases studied, significant SSEP changes were noted in 7 of the 19 patients who had cerebral ischemia, however 12 patients had no SSEP changes despite cerebral ischemia. The sensitivity and specificity for detecting cerebral ischemia were 31% and 86% for EEG and 37% and 95% for SSEP, respectively. CONCLUSIONS: We conclude that EEG and SSEP monitoring during carotid endarterectmy under regional anesthesia is not a sensitive method for detecting cerebral ischemia.
Anesthesia, Conduction* ; Brain Ischemia* ; Carotid Stenosis ; Cervical Plexus ; Consciousness ; Consensus ; Electroencephalography* ; Endarterectomy, Carotid* ; Evoked Potentials, Somatosensory* ; Humans ; Sensitivity and Specificity ; Stroke

BACKGROUND: Following musculoskeletal injuries, axons are exposed to tumor necrosis factor-alpha (TNF-alpha) and other inflammatory mediators. Exposure of axons to TNF-alpha and complete Freund's adjuvant (CFA) can cause hyperalgesia or allodynia in the distribution of the affected axons. The hypothesis that TNF-alpha, inflammatory mediators, and inflammation secondary to CFA activate nociceptor axons was tested using teased fiber techniques in the rat. METHODS: Electrophysiologic recordings were made from single nociceptors innervating both deep and cutaneous receptive fields (RF) supplied by the sciatic nerve. The axons proximal to the RF were exposed to either TNF-alpha, a mixture of inflammatory mediators (histamine, serotonin, bradykinin, and prostaglandin), or CFA. RESULTS: In a minority of nociceptors (15%), TNF-alpha rapidly evoked a response that was dose- dependent and transient. There was no difference between deep and cutaneous nociceptors in the incidence of TNF-alpha responses. The majority of neurons responded to TNF-alpha injected into their RFs. No neurons responded to axonal application of either the mixed inflammatory mediators or CFA. CONCLUSIONS: Our data supports that TNF-alpha can induce ectopic electrogenesis in nociceptor axons that innervate both deep and cutaneous tissues. This activity may correlate to the human perception of radicular pain that is often associated with neuritis.
Animals ; Axons* ; Bradykinin ; Freund's Adjuvant ; Humans ; Hyperalgesia ; Incidence ; Inflammation ; Neuritis ; Neurons ; Nociceptors ; Rats ; Sciatic Nerve ; Serotonin ; Tumor Necrosis Factor-alpha*

BACKGROUND: Local anesthetics can reduece excitotoxic neuronal injury from ischemia. We investigated neuroprotective effects of intrathecally administered bupivacaine and hypothermia in rat model of transient spinal cord ischemia. METHODS: A PE-10 intrathecal catheter was implanted into thirty six male Sprague-Dawley rats through L4-5 interlaminar space. Animals of normothermia (N) and hypothermia (H) groups were administered 15microliter of normal saline, and 15microliter of 0.5% bupivacaine for bupivacaine (B) and bupivacaine-hypothermia (BH) groups. Transient spinal cord ischemia was induced by inflation of a 2 F Fogarty catheter placed into aortic arch for 12 minutes. During ischemia, rectal temperature was maintained to 37.0+/-0.5 degrees C for N and B groups, 34.5 +/- 0.5degrees C for H and BH groups. Motor and sensory deficit score were assessed 2 and 24 hour after reperfusion. Lumbar spinal cords were harvested for histopathology, and for immunoreactivity of heat shock protein 70 (HSP70). RESULTS: The motor and sensory deficit score of N and B group was significantly higher than H group (P < 0.05) and BH group (P < 0.05). There were also significant difference in the motor and sensory deficit score between H and BH group at 24 hr (P < 0.05). Neuronal cell death and immunoreactivity of HSP70 was frequently observed in the N and B groups, but not in the H and BH groups. CONCLUSIONS: These results suggest that intrathecal bupivacaine did not provide neuroprotection during normothermic transient spinal cord ischemia in rats, but it can enhance neuroprotective effects of hypothermia.
Anesthetics, Local ; Animals ; Aorta, Thoracic ; Bupivacaine* ; Catheters ; Cell Death ; HSP70 Heat-Shock Proteins ; Humans ; Hypothermia* ; Inflation, Economic ; Ischemia ; Male ; Models, Animal ; Neurons* ; Neuroprotective Agents ; Rats* ; Rats, Sprague-Dawley ; Reperfusion ; Spinal Cord Ischemia* ; Spinal Cord*

Congenital neonatal neuroblastoma is not uncommon but bilateral adrenal neuroblastoma is rare, accounting for about ten percent of neuroblastomas in children. We report the US and MR findings of a stage IV-S congenital bilateral neuroblastoma occurring in a one-day-old neonate.
Child ; Humans ; Infant, Newborn ; Neuroblastoma*

OBJECTIVE: The surgical treatment of symptomatic degenerative disc disease remains one of the most controversial topics among spine surgeons. Recently, advances in many endoscopic surgical techniques have resulted in lowered morbidity, expense, and suffering associated with their open surgery counterparts. The purpose of this study is to evaluate the efficacy of laparoscopic anterior lumbosacral interbody fusion in our patients with symptomatic degenerative disc disease. PATIENTS AND METHODS: We performed laparoscopic anterior interbody fusion for degenerative disc disease at L5-S1 in 26 patients who were unresponsive to conservative treatments for 1 year, from Oct. 1996 to Dec. 1997. This technique consists of a four-puncture laparoscopic approach with a 10mm trocar at the umbilicus for laparoscope, two 5mm trocars at left and right flanks for dissection, and a 15mm trocar at suprapubic area for working port. We performed complete discectomy and stabilized the spine with carbon interbody fusion cages filled with allograft bone. RESULTS: Laparoscopic fusion at L5-S1 was successful in 22 of 26 patients and the remaining four patients were successfully converted to minilaparotomy. The operation time averaged 150 minutes, hospitalization 4.1 days and average blood loss was 90cc. The mean follow-up period was 16.8 months. Radiographic fusion was achieved in 23 of 26 patients(88.5%) and clinical results showed excellent in 11/26, good in 11/26, fair in 3/26, poor in 1/26 according to Macnab's criteria. There were four complications; retroplacement of cages(1), transient dry ejaculation (1), transient urinary bladder dysfunction(1) and malposition of cages(1). CONCLUSION: Laparoscopic fusion at L5-S1 in degenerative disc disease seems to be safe, with satisfactory clinical results. Main advantage are early recovery and short hospitalization time compared with conventional technique.
Allografts ; Carbon ; Diskectomy ; Ejaculation ; Follow-Up Studies ; Hospitalization ; Humans ; Laparoscopes ; Laparotomy ; Male ; Spine* ; Surgical Instruments ; Umbilicus ; Urinary Bladder

BACKGROUND: The purpose of this study is to report a modified transtibial technique to approach the center of anatomical femoral footprint in anterior cruciate ligament (ACL) reconstruction and to investigate the accurate femoral tunnel position with 3-dimensional computed tomography (3D-CT) and radiography after reconstruction. METHODS: From December 2010 to October 2011, we evaluated 98 patients who underwent primary ACL reconstruction using a modified transtibial technique to approach the center of anatomical femoral footprint in single bundle ACL reconstruction with hamstring autograft. Their femoral tunnel positions were investigated with 3D-CT and radiography postoperatively. Femoral tunnel angle was measured on the postoperative anteroposterior (AP) radiograph and the center of the femoral tunnel aperture on the lateral femoral condyle was assessed with 3D-CT according to the quadrant method by two orthopedic surgeons. RESULTS: According to the quadrant method with 3D-CT, the femoral tunnel was measured at a mean of 32.94% +/- 5.16% from the proximal condylar surface (parallel to the Blumensaat line) and 41.89% +/- 5.58% from the notch roof (perpendicular to the Blumensaat line) with good interobserver (intraclass correlation coefficients [ICC], 0.766 and 0.793, respectively) and intraobserver reliability (ICC, 0.875 and 0.893, respectively). According to the radiographic measurement on the AP view, the femoral tunnel angles averaged 50.43degrees +/- 7.04degrees (ICC, 0.783 and 0.911, respectively). CONCLUSIONS: Our modified transtibial technique is anticipated to provide more anatomical placement of the femoral tunnel during ACL reconstruction than the former traditional transtibial techniques.
Adolescent ; Adult ; Anterior Cruciate Ligament Reconstruction/*methods ; Female ; Femur/*radiography/surgery ; Humans ; Imaging, Three-Dimensional/*methods ; Male ; Middle Aged ; Surgery, Computer-Assisted/*methods ; Tibia/radiography/surgery ; Tomography, X-Ray Computed/*methods

PURPOSE: Diabetic foot gangrene has a high morbidity rate and a great influence on the quality of life. Amputation is an appropriate treatment if conservative treatment is impossible according to the severity of gangrene and infection. The purpose of this study was to evaluate the usefulness of preoperative percutaneous transluminal angioplasty for the postoperative outcome. MATERIALS AND METHODS: From February 2013 to April 2016, among 55 patients with diabetic foot gangrene, who require surgical treatment, percutaneous transluminal angioplasty was performed on patients with an ankle brachial index (0.9 and stenosis) 50% on angiographic computed tomography. The study subjects were 49 patients, comprised of 37 males (75.5%) and 12 females (24.5%). The mean age of the patients was 70.0±9.6 years. The treatment results were followed up according to the position and length of the lesion and the changes during the follow-up period. RESULTS: As a result of angiography, there were 13 cases of atherosclerotic lesions in the proximal part, 11 cases in the distal part and 25 cases in both the proximal and distal parts. As a result of the follow-up after angiography, in 13 patients, the operation was not performed and only follow-up and dressing were performed around the wound. Sixteen patients underwent debridement for severe gangrene lesions and 20 patients, in whom the gangrene could not be treated, underwent amputation (ray amputation or metatarsal amputation, below knee amputation). CONCLUSION: Preoperative percutaneous angioplasty in diabetic foot gangrene patients with peripheral vascular occlusive disease is simple, and 59.2% of the patients with diabetic foot gangrene could be treated by conservative treatment or debridement.
Amputation ; Angiography ; Angioplasty* ; Ankle Brachial Index ; Bandages ; Debridement ; Diabetic Foot* ; Female ; Follow-Up Studies ; Gangrene* ; Humans ; Knee ; Male ; Metatarsal Bones ; Quality of Life ; Wounds and Injuries