Background: White matter hyperintensity (WMH) is a risk factor for dementia and ischemic stroke. The atherogenic index of plasma (AIP) is a simple and cost-effective marker for the prediction of various vascular diseases. In this study, we evaluated the relationship between AIP and WMH in adults without cerebrovascular accidents. Methods: We analyzed the data of 281 adults, aged ≥26 years, who underwent brain magnetic resonance imaging (MRI) at the health promotion center of an education hospital between January 2014 and December 2018. Participants were divided into three categories according to tertiles of the AIP scores (T1: <0.20; T2: 0.20–0.48; and T3: >0.48). WMH was defined as a modified Fazekas scale score of 1–3 on brain MRI. A cubic spline curve was used to determine the linearity of the relationship between AIP and WMH. Multiple logistic regression analysis was used to evaluate the relationship between the AIP and WMH. Results: The prevalence of WMH was 45.7% in T1, 57.0% in T2, and 66.0% in T3 (T3 vs. T1, P for post-hoc analysis=0.005). The increased odds of WMH were associated with increased AIP. The odds ratio (OR) with a 95% confidence interval (CI) for WMH of T2 and T3 compared with T1 were 1.57 (0.88–2.80) and 2.30 (1.28–4.14), respectively. After adjusting for confounding variables, the OR with a 95% CI for WMH in the T2 and T3 groups vs. the referent T1 were 1.55 (0.76–3.13) and 2.27 (1.06–4.84), respectively. Conclusion AIP is independently and positively associated with WMH in a healthy population.

As a result of comparing the phenolic components of cinnamon medicines, the total phenolic component content of Cinnamomi Cortex in China was about 2.65 times higher than that of Cinnamomi Cortex in Vietnam. In addition, the total phenolic component content of Vietnamese Cinnamomi Cortex Spissus was about 1.80 times higher than that of Chinese Cinnamomi Cortex Spissus. Meanwhile, Vietnamese Cinnamomi Ramulus showed a content about 3.29 times higher than that of Chinese Cinnamomi Ramulus. Cinnamaldehyde, the main component of cinnamon medicines, showed the same tendency as the total phenolic component content. In terms of the average content of the total phenolic components, Cinnamomi Cortex showed the highest content at 23964 μg/g, followed by Cinnamomi Cortex Spissus at 17489 μg/g and Cinnamomi Ramulus at 5435.8 μg/g. These results showed that Cinnamomi Cortex and Cinnamomi Cortex Spissus with stem bark as usage sites had about 3.22 to 4.41 times higher content of phenolic components than Cinnamomi Ramulus with young branches as usage sites.

STUDY DESIGN: Clinical and radiographic results of spine fracutre treated with pedicle screws and hooks were reviewed. OBJECTIVES: Evaluate the efficacy of tile pedicle screw and hook for thoracolumar bursting fracture. SUMMARY OF LITERATURE REVIEW: Despite of the mechanical advantage of the pedicle screw, the metal failure in short segment fusion has been reported. A biomechanical study showed additional laminar hook increased rotational strength. MATERIALS AND METHODS: Between 1994 and 1996, seventeen patients who had a Denis type B bursting fracture of the thoracolumbar spine were treated by posterior instrumentation with pedicle screws and laminar hooks and auterior interbody fusion after partial corpectomy. They have been followed for an average of 13.4 months. RESULTS: At last follow-up, radiographs showed successful fusion of the injured spinal segment in all patient. The subsidence of grafts which were used In anterior interbody fusion was an average of 0.76mm. There was a loss of 2.6 degrees on average in the correction of the kyphosis. No patients had screw breakage or loosening. CONCLUSIONS: We concluded that posterior fixation with screws and hooks, anterior decompression by partial corpectomy, and strut-grafting in patient who had a Denis type B bursting frafture of the thoracolumbar spine yielded good radiographic and functional results.
Decompression ; Follow-Up Studies ; Humans ; Kyphosis ; Spine* ; Transplants

BACKGROUND: Whether monitored anesthetic care (MAC) under total intravenous anesthesia can substitute for spinal anesthesia in knee arthroscopic surgery in regard to frequency of postoperative complications, degree of postoperative pain and degree of the satisfaction of patients and operator was investigated. METHODS: Sixty healthy patients were allocated randomly into a spinal group (n = 30) who received spinal anesthesia and an MAC group (n = 30) who received TIVA for anesthesia for arthroscopic surgery. All patients were NPO for 8 hours before surgery were premedicated and monitored with an EKG, noninvasive blood pressure and pulse oximeter. Heavy 0.5% bupivacaine, 10 - 12 mg, was used for spinal anesthesia and fentanyl 2ng/kg, propofol 1 mg/kg, ketamine 0.3 mg/ kg, and ketorolac 30 mg were given intravenously for induction and propofol was maintained at 3 - 4 mg/kg/h for TIVA. Local anesthetics infiltration was done at the arthroscopic portal site and fentanyl 25ng and propofol 20 mg were added intermittently. Postoperative complication (nausea, vomitting, back pain, dizziness, pain or voiding difficulty) and satisfaction of the patients and surgeon were investigated by VAS and 5 grade methods, respectively. RESULTS: The frequency and degree of back pain, pain at the operative site and voiding difficulty occured less and the VAS was decreased in the MAC group while in the recovery room, 6 hours and the day after the operation. The grade of satisfaction of the patients and that of the surgeon were also high in the MAC group. CONCLUSIONS: These results show that, if careful airway management is provided, MAC under TIVA is a more useful anesthetic method than spinal anesthesia in an arthroscopy.
Airway Management ; Anesthesia ; Anesthesia, Intravenous* ; Anesthesia, Spinal* ; Anesthetics, Local ; Arthroscopy* ; Back Pain ; Blood Pressure ; Bupivacaine ; Dizziness ; Electrocardiography ; Fentanyl ; Humans ; Ketamine ; Ketorolac ; Knee ; Pain, Postoperative* ; Postoperative Complications* ; Propofol ; Recovery Room

PURPOSE: Pancretojejunostomy leakage is the most dreaded complication after a pancratoduodenectomy. However, little is known about what causes the leakage and how to prevent it. The aim of this study was to dentify the risk factors for pancreatic leakage. This paper describes our experience of its management. METHODS: Between Aug. 1996 and Aug. 2003, 75 consecutive patients with periampullary cancer or benign disease received a pancreatoduodenectomy. The patients' clinical characterisitcs, pathological features and surgical findings were retrospectively evaluated. The patients were classified into those with major complication and rhose with no complications and the risk factors were analyzed. Pancreatic leakage, intraabdomnial fluid collection and abscess, intraabdomnial bleeding were categorized as major complications related to a pancreatic fistula. RESULTS: The postoperative mortality and morbidity rate was 2.6% and 36%, respectively. Univariate analysis showed that the pancreatic texture, pathologic diagnoses and comorbidity were significant risk factors for major complications (P= 0.003, 0.045, 0.02). Multivariate analyses revealed that the, pancreatic texture was the only significant risk factor (P=0.003). The preoperative serum albumin level and pancreatic texture were significant risk factors for pancreatic leakage (p=0.03, 0.025) and multivariate analysis showed that the pancreatic texture was also the most significant risk factor. CONCLUSION: Considering that the pancreatic texture is the most significant risk factor for a pancreatic fistula, the technical skill and experience of the surgeon appears to be important for its prevention.
Abscess ; Comorbidity ; Diagnosis ; Hemorrhage ; Humans ; Mortality ; Multivariate Analysis ; Pancreatic Fistula* ; Pancreaticoduodenectomy ; Retrospective Studies ; Risk Factors* ; Serum Albumin

Serous cystic neoplasm (SCN) represents 10–16% of cystic pancreatic lesions, first classified by Compagno and Oertel at 1978. In contrast to mucinous cystic neoplasm or intraductal papillary mucinous neoplasm of pancreas which have malignant potential, SCN is thought to be exclusively benign as solitary lesion in nearly all cases. There has been rare reported association between the SCN and pancreatic ductal adenocarcinoma, and few cases were documented their coexistence. In this report, we present the case of SCN of the pancreas with literature review in which synchronous pancreatic ductal adenocarcinoma and pancreatic intraepithelial neoplasm coexist together.

BACKGROUND: We examined the usefulness of urine osmolality, as a predictive factor in the treatment of monosymptomatic nocturnal enuresis (NE) with combination therapy of imipramine and desmopressin. METHODS: From May 2014 to April 2015, 59 monosymptomatic NE patients participated in this study. Early morning urine osmolality was measured at 1 week and 1 day before combination therapy of imipramine and desmopressin, and at 1 week and 2 weeks after therapy. The response to combination therapy was evaluated at 3 months after treatment. The mean period of combination therapy was 6.4+/-4.2 weeks. Therapeutic response was classified as complete (0-1 wet night/week), partial (over 50% reduction of night) and non-responders (less than 50% reduction of night). RESULTS: The cumulative rate of the complete and partial responders was 76.3%. Among the 3 groups, the statistically lowest value of pre-treatment urine osmolality was observed in the complete responder group (p<0.001). Urine osmolality increased in all groups after treatment, however, statistically the greatest difference between pre and post-treatment urine osmolality was observed in the complete responder group (p=0.024). No serious side effects were observed. CONCLUSION: Early morning urine osmolality and change of urine osmolality between pre and post-treatment have predictive values in the response to combined imipramine and desmopressin for treatment of monosymptomatic NE.
Deamino Arginine Vasopressin* ; Enuresis ; Humans ; Imipramine* ; Nocturnal Enuresis* ; Osmolar Concentration*

PURPOSE: Owing to the trend of a nuclear family the concern and protection are still more increasing than before. The patients admitted to hospital for intussusception, as well as their parents, seem to be under great stress when non- operative treatments fail. In order to identify those patients likely to fail an attempted non-operative treatment, and to administer prompt treatment, the patients that came to our hospital for pediatric intussusception were analyzed. METHODS: 285 cases, between 2000 and 2003 were reviewed. They were divided into two groups from their medical records, and retrospectively compared. Group I included 243 pneumoreduction cases and group II 42 operation cases. To find the probability of non-operative treatment failure, an attempt was made to analyze and score the risk factors that increase the possibility of operative treatment. RESULTS: The factors contributing to an increased possibility of operative treatment were fever, leukocyte count, plain abdominal X-ray findings and duration of symptoms. CONCLUSION: This study revealed that fever, leukocyte count, plain abdominal X-ray findings and duration of symptoms contributed to an increased possibility of operative treatment. An increase in the sum of the scores of each factor increased the possibility of operative treatment. This simple scoring system could eliminate excessive and repeated pneumoreduction, thus indicating its potential value as a useful aid in surgical decision making for high failure rate cases of pneumoreduction in intussusception.
Decision Making ; Fever ; Humans ; Intussusception* ; Leukocyte Count ; Medical Records ; Nuclear Family ; Parents ; Retrospective Studies ; Risk Factors ; Treatment Failure

BACKGROUND: We compared the analgesic efficacy and side effects of ketorolac and nefopam that were co-administered with fentanyl via intravenous patient-controlled analgesia. METHODS: One hundred and sixty patients scheduled for laparoscopic cholecystectomy were randomly assigned to ketorolac (Group K) or nefopam (Group N) groups. The anesthetic regimen was standardized for all patients. The analgesic solution contained fentanyl 600 µg and ketorolac 180 mg in Group K, and fentanyl 600 µg and nefopam 120 mg in Group N. The total volume of analgesic solution was 120 ml. Postoperative analgesic consumption, recovery of pulmonary function, and pain intensities at rest and during the forced expiration were evaluated at postoperative 2, 6, 24, and 48 h. The postoperative side effects of analgesics were recorded. RESULTS: Cumulative postoperative analgesic consumptions at postoperative 48 h were comparable (Group K: 93.4 ± 24.0 ml vs. Group N: 92.9 ± 26.1 ml, P = 0.906) between the groups. Pain scores at rest and during deep breathing were similar at the time of each examination. The recovery of pulmonary function showed no significant differences between the groups. Overall, postoperative nausea and vomiting incidence was higher in Group N compared with Group K (59% vs. 34%, P = 0.015). The other side effects were comparable between both groups. CONCLUSIONS: Analgesic efficacies of ketorolac and nefopam that were co-administered with fentanyl for postoperative pain management as adjuvant analgesics were similar. However, postoperative nausea and vomiting incidence was higher in the nefopam-fentanyl combination compared with the ketorolac-fentanyl combination.
Analgesia, Patient-Controlled* ; Analgesics* ; Cholecystectomy, Laparoscopic ; Fentanyl ; Humans ; Incidence ; Ketorolac* ; Nefopam* ; Pain, Postoperative ; Postoperative Nausea and Vomiting ; Prospective Studies* ; Respiration

Eccrine syringofibroadenoma (ESFA) is a rare benign cutaneous adnexal lesion characterized by a hyperplastic epithelium and eccrine ductal differentiation. In the present case, a 73-year-old Korean male presented with symmetrical numerous widespread, pinkish nodules with a cobblestone appearance over both legs for 2 years. He had a history of generalized erythematous scaly patches over his entire body for 20 years. On histopathologic findings, diagnosis of ESFA was confirmed. Our unusual and interesting case emphasizes the first report described one case in which multiple cobblestone like ESFAs arising from long-standing exfoliative dermatitis.
Aged ; Dermatitis, Exfoliative* ; Diagnosis ; Epithelium ; Humans ; Leg ; Male