PURPOSE: The Singh index which is based on a plain radiograph has commonly used in assessing the grade of osteoporosis. We studied value of the Singh index in assessing the grade of osteoporosis by obtaining reliability of the Singh index and correlation between the Singh index and bone mineral density. MATERIALS AND METHODS: Six observers assessed radiographs of 60 patients suspected osteoporosis. The interobserver and intraobserver agreement of the Singh index were obtained by using kappa statistics. The bone mineral density of proximal femur was measured by dual energy X-ray absorptiometry in all patients, and then the results of bone mineral density were compared with those of Singh index by using percentage of variance. RESULTS: The kappa values of interobserver agreement ranged from 0.28 to 0.76 (mean value: 0.45) and the strength of the agreement was moderate. The percentage of variance of BMD which was explained by Singh index was 7.1%. CONCLUSIONS: The results of this study suggest that the Singh index has low clinical value in assessing the grade of osteoporosis
Absorptiometry, Photon ; Bone Density ; Femur ; Humans ; Osteoporosis*

OBJECTIVE: The purpose of this study was to investigate a correlation between the muscle strength of trunk and bone mineral density (BMD) in women. METHOD: A total of 218 healthy women participated in the study. Their age ranged from 26 to 72 years. Dual X-ray absorptiometry was used to measure the BMD of lumbar spine and the trunk muscle strength was assessed by a Cybex NORMTM system. Under the standard criteria of World Health Organization for the dual X-ray absorptiometry analysis, we divided spine T-score into three groups(group 1: osteoporosis, group 2: osteopenia, and group 3: normal). RESULTS: The data revealed a siginificant correlation (r= 0.455, p=0.0001) between the age and BMD of lumbar spine. Trunk extensor muscle strength revealed 56.27+/-18.08 Nm (mean+/-SD) in osteoporosis group, 72.84+/-21.69 Nm in osteopenic group, and 77.90+/-22.28 Nm in normal group. Trunk flexor muscle strength was 82.73+/-23.30 Nm in osteoporosis group, 86.00+/-19.77 Nm in osteopenic group, and 98.91+/-18.29 Nm in normal group. CONCLUSION: These results indicated that the trunk extensor muscle was weaker than the flexor muscle in osteoporotic group. As the bone mineral density reduced, the strength of both trunk extensor and flexor decreased. However the weakness of trunk flexor occurred at the earlier stage of osteoporosis than the weakness of trunk extensor.
Absorptiometry, Photon ; Bone Density* ; Bone Diseases, Metabolic ; Female ; Humans ; Muscle Strength* ; Osteoporosis ; Spine ; World Health Organization

OBJECTIVE: To evaluate (1) the effect of chronic low back pain on bone mineral density, and (2) the effect of chronic low back pain on trunk muscle strength in women. METHOD: Subjects were 118 women patients (ages of 28~65 years) suffering from chronic low back pain more than three months and control groups were 218 healthy women (age of 26~72 years). We measured bone mineral density (BMD) at the lumbar spine and proximal femur using Dual X-ray absorptiometry and trunk muscle strength using Cybex 660 dynamometer. RESULTS: There was no significant difference between groups in lumbar spine BMD, in proximal femur BMD, or in trunk flexor muscle strength. However, trunk extensor muscle strength was reduced significantly in patient group. Trunk extensor muscle peak torque was 64.69+/-18.48 Nm in the patient group and 73.84+/-22.50 Nm in the control group in 30 degrees/sec, and 58.65+/-18.59 Nm in the patient group and 65.68+/-20.28 Nm in the control group in 60 degrees/sec. CONCLUSION: The results suggest that chronic low back pain does not affect the BMD. However, it causes trunk extensor muscle weakness; therefore, trunk extension exercise will be help to the patients with chronic low back pain.
Absorptiometry, Photon ; Back Pain ; Bone Density* ; Female ; Femur ; Humans ; Low Back Pain* ; Muscle Strength* ; Muscle Weakness ; Spine ; Torque

The salt-sensitivity has been generally accepted as a mechnism of high blood pressure in elderly hypertensive patients, and so it may result in a difference of renal handling of sodium and potassium between normal healthy control and elderly hypertensive patient. So to evaluate an lbove difference, the amount of 24 hours' urinary excretion of Na+ & K+ were measured in healthy normotensive control (10 case) and elderly hypertensive group(10 case) according to normal diet (12-15gm of NaCl) for first 3 days and low salt diet (3~5)gm of NaCi) for next 3 days, also blood rewwure was mintored. The results were followed : 1) 24 hours' urinary excretion of NA+ was increased in hypertensive group more than control group at first day of normal diet and low salt diet significantly. 2) After a replacement of normal diet to low salt diet, a maximal decrement of 24 hours' urinary excretion of Na+ was 25% at first day in control but 40% at second day in hypertensive group only. 3) There was a similar pattern of urinary excretion of K+ as Na+ in hypertensive group, but it was not stastically significant. 4) There was no significant changes of blood pressure, serum electrolyte and BUN/creatinine according to salt intake in both group. From above findings. We can conclude that a urinary excretion of sodium is delayed in elderly hypertensive group, and it is suggested that a delayed excretion of sodium. is associated with retention of sodium in body. So a persistent restriction of sodium is recommended in elderly hypertensive patient.
Aged ; Blood Pressure ; Diet ; Humans ; Hypertension ; Potassium* ; Sodium*

Arterio-ureteral fistulas are uncommon but potentially cause a life-threatening hemorrhage that manifest as gross hematuria. Approximately 90 cases of arterio-ureteral fistulas have been reported in the English-language literature. To our knowledge, there have been no report about this issue in Korea. We experienced 1 patient with arterio-ureteral fistula after pelvic operation and radiation therapy followed by ureteral stent. Arterio- ureteral fistula was diagnosed by selective arteriography and treated by surgical management successfully without complications.
Angiography ; Fistula* ; Hematuria ; Hemorrhage ; Humans ; Iliac Artery* ; Korea ; Rupture* ; Stents ; Ureter

To date, there have been no reports of patients showing a Tessier number 7 cleft with unilateral complete cleft lip and palate. Furthermore, no studies have established the sequence, plan, or timing of surgical methods for treating patients presenting the above anomalies simultaneously. We report a case of a Tessier number 7 cleft with unilateral complete cleft lip and palate. Two months after birth, lip adhesion was performed on the unilateral complete cleft lip and total excision was performed on the skin tag. At 4 months of age, Tessier number 7 cleft was corrected. At 6 months of age, surgery involving two small triangular flaps was performed on the unilateral incomplete cleft lip after performing lip adhesion. At 13 months of age, two-flap palatoplasty with a vomer flap was performed on the complete cleft palate. At 6 years of age, open rhinoplasty was performed on the unilateral cleft lip nose deformity. At 9 years of age, bone grafting was performed for the alveolar cleft. At follow-up appointments up to 13 years of age, there were no major complications. Here, we present this patient, surgical procedures and timelines, and show our results demonstrating good postoperative outcomes.

Background: Cleft lip and cleft palate are the most frequent congenital craniofacial deformities, with an incidence of approximately 1 per 700 people. Postoperative palatal fistula is one of the most significant long-term complications. This study investigated the incidence of postoperative palatal fistula and its predictive factors based on 25 years of experience at our hospital. Methods: We retrospectively reviewed 636 consecutive palatal repairs performed between January 1996 and October 2020 by a single surgeon. Data from patients’ medical records regarding cleft palate repair were analyzed. The preoperative extent of the cleft was evaluated using the Veau classification system, and the cleft palate repair technique was chosen according to the extent of the cleft. SPSS version 25.0 was used for all statistical analyses, and exploratory univariate associations were investigated using the t-test. Results: Fistulas occurred in 20 of the 636 patients; thus, the incidence of palatal fistula was 3.1%. The most common fistula location was the hard palate (9/20, 45%), followed by the junction of the hard and soft palate (6/20, 30%) and the soft palate (5/20, 25%). The cleft palate repair technique significantly predicted the incidence of palatal fistula following cleft palate repair (P=0.042). Fistula incidence was significantly higher in patients who underwent surgery using the Furlow double-opposing Z-plasty technique (12.1%) than in cases where the Busan modification (3.0%) or two-flap technique (2.0%) was used. Conclusions The overall incidence of palatal fistulas was 3.1% in this study. Moreover, the technique of cleft palate repair predicted fistula incidence.

BACKGROUND: There has been controversy over the prevalence of recoarctation in infants treated by subclavian flap aortoplasty (SFA) for coarctation of the aorta. To assess the rate of recurrence of coarctation after SFA, we reviewed the surgical results of SFA in infants with coarctation of the aorta. MATERIAL AND METHOD: Between 1986 and 1998, a total of 25 patients less than 1 year of age (12 neonates and 13 infants) underwent SFA for aortic coarctation. Age at operation was 3.0+/-3.0 months (mean +/- standard deviation); mean weight was 5.0+/-1.4kg. Classic SFA was performed in 20 patients, reversed SFA in 2 patients, subclavian artery reimplantation in 2 patients and the combined resection-flap aortoplasty in one. The aortic clamping time ranged from 20 to 88 minutes(mean 35.8 minutes). There were one operative death and two late deaths. There was no case of paraplegia or left arm ischemia in complications. Twenty-one (84%) of 24 hospital survivors were followed for 26.0+/-24.0 months. The risk of recoarctation in neonates (33.3%) was a little greater than infants (25.0%) without statistical significance. CONCLUSION: This study revealed that SFA resulted a relatively high incidence of recarctation in infants. It is desirable to select other methods of surgical treatment (combined resection-flap aortoplasty, extended end-to-end repair etc.) for severe isthmic coarctation or hypoplasia of the distal aortic arch in infants, instead of choosing SFA indiscriminately.
Aorta, Thoracic ; Aortic Coarctation* ; Arm ; Constriction ; Humans ; Incidence ; Infant* ; Infant, Newborn ; Ischemia ; Paraplegia ; Prevalence ; Recurrence ; Replantation ; Subclavian Artery ; Survivors

No abstract available.
Adenoma* ; Hyperaldosteronism*

BACKGROUND: Minimally invasive techniques for open heart surgery are widely accepted in these days. There are minimally invasive approaches by the right or left parasternal incision and another approaches by mini-sternotomy of upper or lower half or sternum. We report the safety and efficacy of minimally invasive technique with right parasternal incision compared with the routine full sternotomy. MATERIAL AND METHOD: From April 1997 through February 1999, 20 patients (Group A) underwent minimally invasive cardiac operations. We chose 41 patients (Group B) whose preoperative diagnosis were the same and general conditions were similar and who underwent routine full sternotomy before April 1997. We compared A group and B group in many aspects. We performed routine full median sternotomy in B group but we did a minimally invasive technique through a small right parasternal incision in A group. RESULT: mean age was 36.1 years in both groups. In disease entities, there were 11 cases of ASD, 9 cases of mitral valve disease in group A, and 16 cases of ASD, 25 cases of mitral valve diseases in group B. In ASD, operation time, cardiopulmonary bypass time of aortic occulusion time were 263 min, 82 min, and 41 min in group A and 180 min, 53 min, and 32 min in group B. In mitral valve disease, operation time, cardiopulmonary bypass time and aortic occlusion time were 267min, 106 min, and 70min in A group and were 207 min, 82 min, and 69 min in group B. There were significant differences in operation time, CPB time, and ACC time between group A and group B. There was a significant difference in the amount of bleeding in postoperative day 1 between group A and group B of mitral diasease. However, there was no significant difference in the amount of bleeding in other comparisons. Mean length of incision was 8.7 cm in group A. There was no significant difference in postoperative complications between A group and B group. There was no mortality in either group. CONCLUSION: We conclude that this minimally invasive technique with right parasternal incision is cosmetically excellent but it is not effective in reducing operative time and there was no significant difference in recovery time and postoperative complications compared with routine full sternotomy.
Cardiopulmonary Bypass ; Diagnosis ; Hemorrhage ; Humans ; Mitral Valve ; Mortality ; Operative Time ; Postoperative Complications ; Sternotomy ; Sternum ; Thoracic Surgery*