No abstract available.
Pregnancy*

OBJECTIVES: The purposes of this study were to investigate the frequency and clinical characteristics of pain among the psychiatric out-patients in three clinics. METHODS: A Total of 843 psychiatric adult out-patients (298 subjects from a private clinic, 99 subjects from a general hospital, 446 subjects from a university hospital) were assessed for the presence of pain during OPD follow-up and at the time assessed. And, the presence of organic causes, duration and site of pain, aggravating factors, compensation problems, and prescribed drugs were also investigated. RESULTS: 1) The frequency of pain among psychiatric out-patients was overall 41.3% (44.9% in private clinic, 44.5% in general hospital, and 38.1% in university hospital, respectively). 2) The frequency of pain at the time assessed was 24.1%. In severity of pain, the average of VAS was 46.7+/-18.0mm. Patients of private clinic showed more severe pain than that of general hospital. Moreover, patients who experienced over 'marked' occupied 34.0% and pain as over 'distressed' occupied 26.2%. 3) Only a few subjects had the definite organic causes (1.5-5.9%). The most common site of pain was on head. The patients having a pain over 6 months (i.e. chronic pain) occupied 68.7%. 4) The most common drugs prescribed were anxiolytics; 41.4% of patients were prescribed. The analgesics were prescribed only in 3.2% of patients. CONCLUSION: This result revealed that more than 40% of patients experienced pain in psychiatric OPD and two third of patients were suffered from chronic pain. Therefore, the evaluation and management of pain should be more emphasized.
Adult ; Analgesics ; Anti-Anxiety Agents ; Chronic Pain ; Compensation and Redress ; Follow-Up Studies ; Head ; Hospitals, General ; Humans ; Outpatients*

OBJECTIVE: The lack of anatomical knowledge for the anterior cervical microforaminotomy is liable to injure the neurovascular structures. The surgical anatomy is examined with special attention to the ventral aspect exposed in anterior cervical microforaminotomy. METHODS: In 16 adult formalin fixed cadaveric cervical spine, the author measured the distances from the medical margin of the longus colli to the medical wall of the ipsilateral vertebral artery and the angle for the ipsilateral vertebral artery. The distances from the lateral margin of the posterior longitudinal ligament to the medial margin of the ipsilateral medial wall of the vertebral artery, to the ipsilateral dorsal root ganglion was measured too. RESULTS: The distance from the medial margin of the longus colli to the ipsilateral vertebral artery was 13.3~14.7mm and the angle for the ipsilateral vertebral artery was 41~42.5 degrees. The range of distance from the lateral margin of the posterior longitudinal ligament to the ipsilateral vertebral artery was 11.9~16.1mm, to the ipsilateral dorsal root ganglion was 11.6~12.9mm. CONCLUSION: These data will aid in reducing neurovascular injury during anterior cervical approaches.
Adult ; Cadaver ; Formaldehyde ; Ganglia, Spinal ; Humans ; Longitudinal Ligaments ; Spine ; Vertebral Artery

OBJECTIVE: Morphometric data for the sympathetic ganglia (SG) of the upper thoracic spine was investigated to identify the exact location of the SG in order to reduce normal tissue injury in the thoracic cavity during thoracoscopic sympathectomy. METHODS: In 46 specimens from 23 formalin-fixed adult cadavers, the authors measured the shortest distance from the medial margin of the T1, T2 and T3 SG to the most prominent point and medial margin of the corresponding rib heads, and to the lateral margin of the longus colli muscle. In addition, the distance between the most prominent point of the rib head and the lateral margin of longus colli muscle and the width of each SG were measured. RESULTS: The shortest distance from the medial margin of the SG to the prominent point of corresponding rib head was on average 1.9 mm on T1, 4.2 mm, and 4.1 mm on T2, T3. The distance from the medial margin of the SG to the medial margin of the corresponding rib head was 4.2 mm on T1, 5.9 mm, and 6.3 mm on T2, T3. The mean distance from the medial margin of the SG to the lateral margin of the longus colli muscle was 6.7 mm on T1, 8.8 mm, 9.9 and mm on T2, T3. The mean distance between the prominent point of the rib head and the lateral margin of the longus colli muscle was 4.8 mm on T1, 4.6 mm, and 5.9 mm on T2, T3. The mean width of SG was 6.1 mm on T1, 4.1 mm, and 3.1 mm on T2, T3. CONCLUSION: We present morphometric data to assist in surgical planning and the localization of the upper thoracic SG during thoracoscopic sympathectomy.
Adult ; Cadaver ; Ganglia, Sympathetic ; Head ; Humans ; Muscles ; Ribs ; Spine ; Sympathectomy ; Thoracic Cavity ; Thoracic Vertebrae ; Thoracoscopy

This study was conducted to assess the relationship between estimated glomerular filtration rate (eGFR) and bone mineral density (BMD) in Korean postmenopausal women with mild renal dysfunction. A total of 328 postmenopausal women who underwent BMD measurement during health check-up was investigated. BMD was measured in lumbar spine (L1-L4), femoral neck, total proximal femur and femoral trochanteric areas by dual energy radiography absorptiometry and renal function was estimated by eGFR using Cockcroft-Gault equation. Of the 328 subjects, 317 (96.6%) had an eGFR > or =60 mL/min/1.73 m2. By using simple linear regression analysis, age, height, weight and eGFR were significantly associated with BMD for the 4 aforementioned anatomic sites, while serum levels of creatinine and blood urea nitrogen did not influence BMD. When multiple regression analyses were applied, age and body weight still had significant associations with BMD at 4 different anatomic sites (P < 0.001). A significant association of eGFR with BMD remained in the lumbar spine, femoral neck and proximal total femur (P < 0.05) but not in the trochanteric area (P = 0.300). Our study suggests that a decline of renal function is associated with lower BMD in the lumbar spine, femoral neck and total proximal femur areas in Korean menopausal women with mild renal dysfunction.
Absorptiometry, Photon ; Aged ; Blood Urea Nitrogen ; *Bone Density ; Creatinine/blood ; Female ; Femur Neck/physiology ; *Glomerular Filtration Rate ; Humans ; Kidney Diseases/*physiopathology ; Kidney Function Tests ; Lumbar Vertebrae/physiology ; Middle Aged ; Osteoporosis, Postmenopausal/*physiopathology ; Republic of Korea

OBJECTIVE: The purpose of this study was to determine the normal morphometric landmarks of the uniting and dividing points of the brachial plexus (BP) in the periclavicular region to provide useful guidance in surgery of BP injuries. METHODS: A total of 20 brachial plexuses were obtained from 10 adult, formalin-fixed cadavers. Distances were measured on the basis of the Chassaignac tubercle (CT), and the most lateral margin of the BP (LMBP) crossing the superior and inferior edge of the clavicle. RESULTS: LMBP was located within 25 mm medially from the midpoint in all subjects. In the supraclavicular region, the upper trunk uniting at 21 +/- 7 mm from the CT, separating into divisions at 42 +/- 5 mm from the CT, and dividing at 19 +/- 4 mm from the LMBP crossing the superior edge of the clavicle. In the infraclavicular region, the distance from the inferior edge of the clavicle to the musculocutaneous nerve (MCN) origin was 49 +/- 1 mm, to the median nerve origin 57 +/- 7 mm, and the ulnar nerve origin 48 +/- 6 mm. From the lateral margin of the pectoralis minor to the MCN origin the distance averaged 3.3 +/- 10 mm. Mean diameter of the MCN was 4.3 +/- 1.1 mm (range, 2.5-6.0) in males (n = 6), and 3.1 +/- 1.5 mm (range, 1.6-4.0) in females (n = 4). CONCLUSION: We hope these data will aid in understanding the anatomy of the BP and in planning surgical treatment in BP injuries.
Adult ; Brachial Plexus ; Cadaver ; Clavicle ; Female ; Humans ; Male ; Median Nerve ; Musculocutaneous Nerve ; Pectoralis Muscles ; Ulnar Nerve

This study was conducted to investigate the association between Helicobacter pylori (H. pylori) infection and the lipid profile among elderly Koreans. A total of 462 subjects (mean age 66.2 +/- 7.6 yr, 84% males) who underwent health check-up were investigated. Each subject underwent gastroduodenoscopy with gastric mucosal biopsy, and H. pylori infection was determined by histopathological examination using the updated Sydney System score. The presence of H. pylori infection was significantly associated with the elevated serum levels of total cholesterol and low density lipoprotein (LDL) cholesterol (P < 0.05 for each) in univariate analysis. H. pylori infection was not associated with triglyceride and high density lipoprotein (HDL) cholesterol levels (P > 0.05 for each). After controlling confounders, multiple logistic regression analysis showed that the odds ratio of H. pylori infection for high LDL cholesterol level (> 140 mg/dL) was 3.113 (95% confidence interval, 1.364-7.018; P = 0.007). There were no significant associations between the presence of H. pylori infection and elevated total cholesterol levels (> 200 mg/dL) in this model (P = 0.586). The results of this study demonstrate that H. pylori infection is associated with the elevated serum LDL cholesterol levels in elderly Koreans, supporting the hypothesis that H. pylori plays a role in promoting atherosclerosis by modifying lipid metabolism.
Aged ; Aged, 80 and over ; Atherosclerosis/microbiology ; Cholesterol, LDL/*blood ; Endoscopy ; Female ; Gastric Mucosa/anatomy & histology/microbiology ; Gastritis ; Helicobacter Infections/*blood/*epidemiology ; *Helicobacter pylori ; Humans ; Inflammation/microbiology ; Male ; Middle Aged ; Peptic Ulcer ; Republic of Korea/epidemiology

OBJECTIVE: Pterional craniotomy (PC) using myocutaneous (MC) flap is a simple and efficient technique; however, due to subsequent inferior displacement (ID) of the temporalis muscle, it can cause postoperative deformities of the muscle such as depression along the inferior margin of the temporal line of the frontal bone (DTL) and muscular protrusion at the inferior portion of the temporal fossa (PITF). Herein, we introduce a simple method for reconstruction of the temporalis muscle using a contourable strut plate (CSP) and evaluate its efficacy. MATERIALS AND METHODS: Patients at follow-ups between January 2014 and October 2014 after PCs were enrolled in this study. Their postoperative deformities of the temporalis muscle including ID, DTL, and PITF were evaluated. These PC cases using MC flap were classified according to two groups; one with conventional technique without CSP (MC Only) and another with reconstruction of the temporalis muscle using CSP (MC + CSP). Statistical analyses were performed for comparison between the two groups. RESULTS: Lower incidences of ID of the muscle (p < 0.001), DTL (p < 0.001), and PITF (p = 0.001) were observed in the MC + CSP than in the MC Only group. The incidence of acceptable outcome was markedly higher in the MC + CSP group (p < 0.001). ID was regarded as a causative factor for DTL and PITF (p < 0.001 in both). CONCLUSION: Reconstruction of the temporalis muscle using CSP after MC flap is a simple and efficient technique, which provides an outstanding outcome in terms of anatomical restoration of the temporalis muscle.
Congenital Abnormalities ; Craniotomy* ; Depression ; Follow-Up Studies ; Frontal Bone ; Humans ; Incidence ; Myocutaneous Flap

OBJECTIVE : The purpose of this study was to characterize the Rolandic fissure(Rf) and was to identify the Rf using the surface bony landmarks which can be usually exposed on craniotomy. METHODS : After morphological evaluation of the Rfs using 21 Korean adult formalin fixed cadavers, craniometric measurement was carried out from the surface bony landmarks of nasion, glabella, bregma, and lambda. RESULTS : The Rfs of both hemispheres did not show the mirror image. The Rfs ran forward and downward toward the sylvian fissure keeping the mean angle of 67degrees from mid-sagittal line as elongated S-shape in left and the elongated reverse S-shape in right hemisphere. Connections between the Rf and the longitudinal fissure and between the Rf and the sylvian fissure were found in 3 (7.1%) and 2 (4.8%) of 42 hemispheres, respectively. Most Rfs extended superiorly to 2-3mm lateral to the most superomedial surface of hemispheres and extended inferiorly to 3-5mm superior to the sylvian fissures. The mean distances from the nasion, glabella, bregma, and lambda to the most superomedial aspect of the Rf were 18.8+/-0.9cm, 16.6+/-0.8cm, 5.2+/-0.6cm, and 6.9+/-1.0cm, respectively. The mean distance measured between the Rf and the nasion using traditional method was 18.4+/-0.6cm. CONCLUSION : The distance between the Rf and the nasion roughly correspond within the range of mean 4 mm compared with that measured by the traditional measurement. These data may be more helpful to delineate the Rf after the placement of drapes for craniotomy.
Adult ; Cadaver ; Craniotomy ; Formaldehyde ; Humans

We present a retrospective study on 63 patients who underwent decompressive craniectomy from April 1985 to June 1990. All patients were comatose(Glasgow Coma Score;3-8) at the time of operation. There were 42 males and 21 females with an age range of 7 to 80 years(mean age, 43 years). Bifrontal craniectomy was performed in 15 patients(23.8%) and frontotemporoparietal craniectomy was done in 48 patients(76.2%). Pupils were abnormal in 41 patients(65.1%) on arrival. However, those became abnormal in 60 patients(95.2%) preoperatively. Fourty nine of the 63 patients died within the first 30 days of surgery (operative mortality, 77.8%). Late mortality was 3.2%, making the total mortality for this series 81.0%. Only eight patients(12.7%) could have favorable outcome(good recovery and moderate disability). The operative method did not affect on the prognosis. The most common primary mass lesion was acute subdural hematoma(35 patient;55.6%). Skull fracture was found in 48 patients(76.2%). Postoperative CT scanning were obtained in 18 patients(28.6%). Moderate to marked degree of edema was found in 14 patients(77.8%). Delayed lesions were found in 13 patients(72.2%). Intracerebral hematoma was the most common delayed lesion. In nine patients(50.0%), the degree of midline shift was more severe than the preoperative CT scans. These results stroly suggested that the WDCE was not an effective surgical method due to its high mortality, morbidity and possible harmful effect such as enhanced edema formation and hastened delayed lesions.
Coma ; Craniocerebral Trauma* ; Decompressive Craniectomy* ; Edema ; Female ; Head* ; Hematoma ; Humans ; Male ; Mortality ; Prognosis ; Pupil ; Retrospective Studies ; Skull Fractures ; Tomography, X-Ray Computed