Recently, the aging society is facing with the rapid increase of chronic diseases. Despite the advanced medical technology, chronic diseases have not comprehensively managed yet. In the modern society, many people have to spend their extended life span suffering from chronic diseases and disabilities, and also a huge medical cost has emerged as a serious social problem. With IT improvement, u-health system has been developed to link home and medical service systems by arranging medical data, decision making and medical guidelines for various situations. It can promote the therapeutic compliance for the patients with chronic diseases. And also for the medical service providers, it can provide useful data to make an accurate medical decision. As we know, the chronic disease is caused by inactivity and the management of chronic disease requires the modification of inactive life style. U-health medical fitness system can not only prescribe proper activity to control the chronic disease but also it can monitor the patients' physical activity in everyday life. By the successful management of chronic diseases based on u-health system, we want to achieve the expansion of disease-free and disability-free life expectancy and a solution to reduce the burden of medical expenses in modern society eventually.
Aging ; Aluminum Hydroxide ; Carbonates ; Chronic Disease ; Compliance ; Decision Making ; Humans ; Life Expectancy ; Life Style ; Motor Activity ; Organothiophosphorus Compounds ; Social Problems ; Stress, Psychological

STUDY DESIGN: Retrospective. OBJECTIVES: To investigate outcomes between short and long segment posterior instrumentation of thoracolumbar burst fractures with a load sharing score of 7 or more. SUMMARY OF LITERATURE REVIEW: Short segment instrumentation has been recommended in thoracolumbar burst fractures with a load sharing score of 6 or less, and long segment instrumentation has been recommended for those with a score of 7 or more. However, this standard is controversial. MATERIALS AND METHODS: From March 2006 to January 2014, 45 patients with thoracolumbar fractures with a load sharing score of 7 or more were treated with posterior instrumentation. They were divided into two groups: short (group S) and long segment (group L) groups. Radiologic results were evaluated on the basis of the kyphotic angle and anterior column height. Complications were also reviewed. RESULTS: Groups S and L consisted of 13 and 32 patients and had mean ages of 48.3 and 47.3 years, respectively. In group S, the anterior column height increased from 56.62% to 76.23% postoperatively, and remained at 71.15% at follow-up. The kyphotic angle decreased from 16.27degrees to 7.55degrees postoperatively, and was 13.17degrees at follow-up. In group L, the anterior column height recovered from 49.67% to 70.52% postoperatively, and was 63.73% at follow-up. The kyphotic angle decreased from 20.08degrees to 6.80degrees postoperatively, and was 14.18degrees at follow-up. The changes in the anterior column height and kyphotic angle were not significantly different between groups S and L. Seven cases had complications and the number of cases with complications was not significantly different between groups S and L. CONCLUSIONS: Short and long segment instrumentation of thoracolumbar fractures with a load sharing score of 7 or more did not achieve significantly different results.
Follow-Up Studies ; Humans ; Retrospective Studies

STUDY DESIGN: Retrospective. OBJECTIVES: To investigate factors related to early postoperative complications of surgery for cervical spondylotic myelopathy (CSM). SUMMARY OF LITERATURE REVIEW: Factors associated with increased risk of complications from surgery for CSM are greater age, greater estimated blood loss, longer operative duration, and anterior-posterior combined procedures. MATERIALS AND METHODS: The records of patients (male 32, female 19, mean age 61 years) who underwent surgery for CSM between November 2004 and December 2014 were investigated for early postoperative complications and potentially related factors. Factors considered were age, gender, duration of symptoms, diabetes, smoking, comorbidity, preoperative Japanese Orthopedic Association (JOA) score, numbers of cervical levels involved, ossification of the posterior longitudinal ligament (OPLL), operative approach, fusion, operative duration, estimated blood loss (EBL), maximal cord compression ratio on MRI, and cord signal intensity change on T2-weighted MRI. RESULTS: Early postoperative complications were observed in 12 of 51 patients and included motor weakness in 3, pneumonia in 2, and delirium, dysphagia, hematoma, pulmonary thromboembolism, sore, seizure, wound dehiscence, and superficial infection, each in 1. Factors associated with early postoperative complications were operative duration (p=0.024), maximal cord compression ratio on MRI (p=0.009), and cord signal intensity change on T2-weighted MRI (p=0.009). The other factors were not found to correlate significantly. CONCLUSIONS: Factors associated with early postoperative complications for CSM are operative duration, compression ratio at the level of maximal cord compression on MRI, and cord signal intensity change on T2-weighted MRI.
Asian Continental Ancestry Group ; Comorbidity ; Deglutition Disorders ; Delirium ; Female ; Hematoma ; Humans ; Longitudinal Ligaments ; Magnetic Resonance Imaging ; Orthopedics ; Pneumonia ; Postoperative Complications* ; Pulmonary Embolism ; Retrospective Studies ; Seizures ; Smoke ; Smoking ; Spinal Cord Diseases* ; Wounds and Injuries

Both death certificates and postmortem examination certificates are used as proof of death. These certificates sometimes contain erroneous information but how frequently they do so is unknown. In particular, only a few studies have measured the accuracy of the cause and manner of death on Korea death documents. In this study, we compared the cause and manner of death on both kinds of certificates with those on autopsy reports to determine the frequency of errors, and to identify way to improve the accuracy of these certificates. In 2012, 528 autopsies were requested of out institute, and certificates were submitted in 241 of the cases. The manner of death was classified as natural, unnatural, or unknown. The cause of death in the autopsy report matched that on the death certificate in 37 of 63 cases (58.7%), and the manner of death matched in 40 of 63 cases (63.5%). The cause of death in the autopsy report matched that on the postmortem examination certificate in 62 of 178 cases (34.8%), and the manner of death matched in 74 of 178 cases (41.6%). Death certificates and postmortem examination certificates are important documents. We identified many incorrect reports of causes and manners of death on both kinds of documents, especially the postmortem death certificates. These inaccuracies are presumably due to a lack of forensic information and education, as well as lack of interest on the part of medical doctors.
Autopsy* ; Cause of Death ; Death Certificates* ; Education ; Korea

PROBLEM: The several studies were reported to the effects of individual tooth tray with the parallel tooth, but not reported to the effect of individual tooth tray with severe undercut in impression making. PURPOSE: The purpose of this study is to examine the effect of individual tooth tray; 1) the accuracy of impression in in terms of distance. 2) reproducibility of pocket. MATERIAL AND METHODS: In this study, a metal model with 3 teeth including tooth prepared 30-degree undercut and gingival crevice of the depth 5mm, width 0.4mm was cast. Impressions of the metal model were taken in 5 times used 4 kinds of impression materials with individual tooth tray and another impression taking were made with conventional method without individual tooth, used same materials, procedure. The stone models were made. Distances between abutments were measured with a Micromeasurescoup-mm. RESULT: The following results were obtained; 1. In the comparison of inter-abutment distance between parallel tooth without individual tooth tray, 4elastomeric materials have not significant difference to the metal model(p>0.05). 2. In the comparisonof inter-abutment distance with undercut tooth without individual tooth tray, 4elastomeric materials have a significant difference to the metal model(p<0.05), especially polyether's dimensional change is large. 3. If individual tooth tray was used to take impression in abutment teeth with severe undercut, more stable results was achieved easily than conventional metho.(p>0.05). 4. It is not true that the pressure of impression material with individual tooth tray increased to gingival sulcus. CONCLUSION: By the results, I knew the fact that individual tooth tray was useful impression method on the teeth with severe undercut for the dimensional stability. Also, I could not confirm the fact that individual tooth tray would increase the penetrating pressure into cervice.
Tooth*

STUDY DESIGN: Retrospective study. OBJECTIVES: To investigate radiologic and clinical outcomes of teriparatide in women with osteoporosis after instrumented lumbar posterolateral fusion (PLF) or posterior lumbar interbody fusion (PLIF). SUMMARY OF LITERATURE REVIEW: Teriparatide accelerated lumbar posterolateral fusion in women with postmenopausal osteoporosis. MATERIALS AND METHODS: Eighty-six women older than 65 years old with osteoporosis underwent PLF or PLIF with bone graft between Februar, 2011 ato May, 2012 pPatients were divided into four group: teriparatide group with local bone (A-1: 13 patients;, teriparatide group with composite bone (A-2: 27 patients; non-teriparatide group with local bone (B-1: 14 patients; and non-teriparatide group with composite bone (B-2: 32 patients). At 3, 6, and 12 months postoperatively, the Oswestry Disability Index (ODI), visual analog scale (VAS), fusion rate, and period of bone union were evaluated. RESULTS: VAS and ODI improved after surgery in all groups, but no significant differences were notell among the groupses Further, there was no significant difference among the groups for agef fusion level, and fusiops(p>0.05). Fusion rate was 94.44% in the A-1 group, 92.59% in the A-2 group, 79.17% in the B-1 group, and 76.92% in the B-2 group. Average period of bone union was 3.25 months, 3.65 months, 5.67 months, anand 5.65 months respectively. Fusion rate and average bone union time made no significant differeneen among the groups divided by graft materials (p>0.05). However, those in the teriparatide group were significantly superior to those in the non-teriparatide group (p<0.05). CONCLUSIONS: In women with osteoporosis after PLF or PLIF with bonegraft, teriparatide showed superiority in the rate of fusion and the period of bone union.
Female ; Humans ; Osteoporosis* ; Osteoporosis, Postmenopausal ; Parathyroid Hormone ; Retrospective Studies ; Teriparatide* ; Transplants ; Visual Analog Scale

No abstract available.
Paraplegia* ; Tuberculosis, Spinal*

No abstract available.
Spine*

OBJECTIVE: Unperforated and perforated acute appendicitis need to be differentiated because appendicitis with a free perforation requires an emergency operation to prevent contamination inside the bowel from spreading into the peritoneal cavity. The sensitivity of imaging tests is not reliable enough alone for determining the existence of a perforation. The aim of this study was to determine the differences in laboratory values between unperforated and perforated acute appendicitis to help distinguish perforated acute appendicitis. METHODS: The laboratory values and demographic data of a total of 175 patients who visited the emergency room and were diagnosed with acute appendicitis were collected. The time elapsed from symptom presentation to the ER visit, length of admission, patient demographics, and laboratory values, including sex, age, leukocyte count, neutrophil %, neutrophil count, C-reactive protein (CRP), platelet count, prothrombin time (PT), activated partial thromboplastin time, international normalized ratio (INR), serum glucose, blood urea nitrogen, creatinine, total and direct bilirubin, aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, and gamma-glutamyltransferase were analyzed. RESULTS: The factors associated with appendix perforations were an elevated leukocyte count, neutrophil count, neutrophil %, CRP, serum glucose and total bilirubin; and delayed PT and INR. CONCLUSION: Acute appendicitis patients without definite imaging evidence of the perforation but with the laboratory values suggesting a perforation, such as elevated leukocyte count, neutrophil count, neutrophil %, CRP, serum glucose, and total bilirubin; and delayed PT, and INR should raise concern for a possible undiscovered perforation.
Abdomen, Acute ; Alanine Transaminase ; Alkaline Phosphatase ; Appendicitis ; Appendix ; Aspartate Aminotransferases ; Bilirubin ; Blood Glucose ; Blood Urea Nitrogen ; C-Reactive Protein ; Creatinine ; Demography ; Diagnosis, Differential ; Emergencies ; Emergency Service, Hospital ; gamma-Glutamyltransferase ; Humans ; International Normalized Ratio ; Leukocyte Count ; Neutrophils ; Partial Thromboplastin Time ; Patient Admission ; Peritoneal Cavity ; Platelet Count ; Prothrombin Time

BACKGROUND: Recently, there has been an increase in acute poisonings in the elderly, which may be associated with attempts at suicide. The purpose of this study was to compare and analyze the clinical aspects and outcomes of acute poisonings in aged individuals with those of younger individuals. METHODS: We performed a retrospective analysis of 207 patients seen in the emergency department (ED) with acute poisoning from January 2009 to December 2010. Two groups were created, >65 years and <65 years. The following were carefully compared-annual frequency, gender distribution, cause of poisoning, poisoning substance, motive for suicide, past psychiatric history, psychiatric interview, psychiatric diagnosis, disposition after ED visit, disposition after admission, poisoning severity score (PSS), duration of hospitalization, intensive care unit (ICU) admission rate, and mortality. RESULTS: The annual frequency was 0.1% in the >65 group and 0.3% in the <65 group, 0.4% in total. The cause of poisoning was accidental more often in those >65 years than in those <65 years. As motive for suicide, health problem was cited more often in the older group (p=0.000). The older group had fewer interviews with psychiatrists and were more often diagnosed with depressive disorder (p=0.010, p=0.041, respectively). PSS and mortality were higher in the older group (p=0.002, p=0.010, respectively). CONCLUSION: A better understanding for the cause of poisonings and the poisonous substance used in the aged population is needed. And because of the more serious effects of acute poisonings to the elderly patient, they should readily receive regular comprehensive care including psychiatric care.
Aged ; Depressive Disorder ; Emergencies ; Hospitalization ; Humans ; Intensive Care Units ; Mental Disorders ; Psychiatry ; Retrospective Studies ; Suicide