No abstract available.

OBJECTIVE: We estimated the number of Korean adults with back pain and evaluated population-based associated factors of back pain from a representative sample data from the Fourth Korea National Health and Nutrition Examination Survey. METHODS: The number of Korean adults who experienced back pain (experienced patients), those who experienced back pain lasting for three or more months during the past year (chronic patients), and those who were currently suffering from back pain (current patients) were estimated by analyzing the data from the fourth Korea National Health and Nutrition Examination Survey conducted in 2007 using surveyfreq procedure of the SAS statistical package. Population-based odds ratios for being experienced, chronic, and current patient according to demographic (age and gender), socioeconomic (education and occupation), and lifestyle factors (smoking, drinking, and exercise) were estimated using surveylogistic procedure. RESULTS: It was estimated that there were 5,554,256 (proportion, 15.4%; 95% CI, 4,809,466 - 6,299,046) experienced patients, 2,060,829 (5.7%; 1,557,413-2,564,246) chronic patients, and 3,084,188 (8.5%; 2,600,197 - 3,568,179) current patients among 36,107,225 Korean adults aged 20-89 years in 2007. Each of explanatory variables was significantly associated with at least one of the response variables for back pain. CONCLUSION: Based on our study results, further efforts to investigate epidemiology of back pain, to evaluate associated factors, and to improve treatment outcomes are needed.
Adult ; Aged ; Back Pain ; Drinking ; Humans ; Korea ; Life Style ; Nutrition Surveys ; Odds Ratio ; Phenothiazines ; Stress, Psychological ; Surveys and Questionnaires

OBJECTIVE: The aim of this study was to conduct three-dimensional finite element analysis of individual tooth displacement and stress distribution when a posterior retraction force of 200 g was applied at different positions of the retraction hook on the transpalatal arch (TPA) of a molar, and over different lengths of the lever arm on the maxillary anterior teeth in lingual orthodontics. METHODS: A three-dimensional finite element model, including the entire upper dentition, periodontal ligaments, and alveolar bones, was constructed on the basis of a sample (Nissan Dental Product, Kyoto, Japan) survey of Asian adults. Individual movement of the incisal edge and root apex was estimated along the x-, y-, and z-coordinates to analyze tooth displacement and von Mises stress distribution. RESULTS: When the length of the lever arm was 15 mm and 20 mm, the incisal edge and root apex of the anterior teeth was displaced lingually, with a maximum lingual displacement at the lever arm length of 20 mm. When the posterior retraction hook was on the root apex, the molars showed distal displacement. When the length of the lever arm was 20 mm, anterior extrusion was reduced and the crown of the canine displaced toward the buccal side, in which case, the retraction hook was on the edge, rather than at the center, of the TPA. CONCLUSIONS: The results of the analysis showed that when 6 anterior teeth were retracted posteriorly, lateral displacement of the canine and lingual displacement of the incisal edge and root apex of the anterior teeth occur without the extrusion of the anterior segment when the length of the lever arm is longer, and the posterior retraction hook is in the midpalatal area.
Adult ; Arm ; Asian Continental Ancestry Group ; Crowns ; Dentition ; Displacement (Psychology) ; Finite Element Analysis ; Humans ; Mechanics ; Molar ; Periodontal Ligament ; Tooth

Cardiovascular changes has been reported eating and digestion. Experimental studies showed an early rise in cardiac output during eating which was attributable to an increased heart rate. This changes reverted to baseline valuse at the end of eating. To investigate postprandial cardiac functional change, we studied 20 healthy young men(average age 27 years) nonivasively with BP measurement, electrocardiography and M-mode echocardiohrapy before, 30 minutes and 3 hours after a lunch(600 Kcal). There was no significant changes in mean blood pressure after eating. On echocardiography, diastolic and systolic left ventricular internal dimensions were 4.9+/-0.4 and 3.1+/-0.4cm before meal and 4.9+/-0.4 and 2.9+/-0.3cm 30 minutes after eating. There was an average increase of 9% in cardiac output 30 minutes after meal. Fractional shortening was 36.4+/-6.4% before meal and 40.4+/-6.1(p<0.05) 30 minutes after eating. Ejection fraction changed from 73.5+/-7.9% to 78.2+/-6.3%(p<0.05) at postprandial 30 minutes. Myocardial contractility index assessed by the ratio of systolic BP to end-systolic volume was 4.3+/-1.6mgHg/ml before and 5.3+/-2.2mmHg/ml 30 minutes after eating. Peripheral resistance index as the ratio of mean blood pressure divided by cardiac index changed from 2,536+/-1,120dynesdSdcm-5/m2 to 2,048+/-472dynesdSdcm-5/m2 at postprandial 30 minutes. Electorcardiographic study revealed no changes in ST SE segment, T wave and heart rate after a meal. In conclusion, the increase of cardiac output after a moderate meal in healthy young men was associated with an increase in myocardial contractility and a decrease in peripheral vascular resistance.
Blood Pressure ; Cardiac Output ; Digestion ; Eating ; Echocardiography* ; Electrocardiography ; Heart Rate ; Humans ; Male ; Meals* ; Vascular Resistance

Objectives: We aimed to investigate the demographics and medical management factors associated with dependence on hypnotics among outpatients with neurological disorders and insomnia. Methods: We reviewed electronic medical records of patients who received an initial hypnotic prescription between January 2014 and January 2016 and had later visited a neurological outpatient clinic before January 2018. We assessed patient demographics, the effectiveness of hypnotics, prescription periods, and hypnotic intake methods during the follow-up period. Results: Of 242 patients diagnosed with insomnia, we enrolled 114 patients (more women than men, at 61.4 versus 38.6%) who visited outpatient clinics regularly during the follow-up period. The mean age at onset was 65.8 ± 14.4 years. The most frequent neurological disorder was cerebrovascular disease, followed by neurodegenerative disease. During the 2-year period, 35.9% of participants remained hypnotics-free. Patients on zolpidem showed significantly greater insomnia improvement with hypnotic discontinuation than those on benzodiazepines and combination therapy (p=0.004). However, the type of hypnotics and demographic factors were not found to be independent risk factors. Multivariable analysis showed that longer periods between regular visits and a lower ratio of receiving number of pills to the time interval (days) between regular visits were independent risk factors for dependence on hypnotics. Conclusions: We found that low-dose and/or intermittent intake of hypnotics as well as frequent doctor visits could prevent dependence on hypnotics. It is important to establish the best practical guidelines for medical hypnotics management in outpatient primary care settings, including neurological clinics.

Recent advances in stent technology have allowed the introduction of more flexible stents that may be tracked more easily in the intracranial vessels. We present a patient with improved cerebral perfusion as assessed by single-photon emission computed tomographic(SPECT) scan after stent-assisted angioplasty for symptomatic middle cerebral artery stenosis. A 72-year-old man presented with multiple episodes of transient verbral disturbance and right-sided motor weakness for 5 months despite treatment with aspirin and clopedigrel. Angiography revealed a 50% to 60% stenosis of the left middle cerebral artery. 99m Tc-exametazime-SPECT scan demonstrated decreased cerebral blood flow in the left cerebral hemisphere, particularly in the left middle cerebral artery territory. The patient was recommended a stent-assisted angioplasty for middle cerebral artery stenosis. The patient underwent uncomplicated stenting with S-660 2.5- by 9-mm stent(Arterial Vascular Engineering, Santa Rosa, CA) of the left middle cerebral artery, with excellent angiographic results. Follow-up brain SPECT scan showed markedly improved perfusion. Stent-assisted percutaneous transluminal angioplasty can provide a favorable clinical course as well as improved cerebral perfusion for a patient with middle cerebral artery stenosis. Long-term follow-up data and additional clinical experience are required to assess the durability of this procedure.
Aged ; Angiography ; Angioplasty* ; Aspirin ; Brain ; Cerebrum ; Constriction, Pathologic* ; Follow-Up Studies ; Humans ; Middle Cerebral Artery* ; Perfusion* ; Rosa ; Stents ; Tomography, Emission-Computed, Single-Photon

Recent advances in stent technology have allowed the introduction of more flexible stents that may be tracked more easily in the intracranial vessels. We present a patient with improved cerebral perfusion as assessed by single-photon emission computed tomographic(SPECT) scan after stent-assisted angioplasty for symptomatic middle cerebral artery stenosis. A 72-year-old man presented with multiple episodes of transient verbral disturbance and right-sided motor weakness for 5 months despite treatment with aspirin and clopedigrel. Angiography revealed a 50% to 60% stenosis of the left middle cerebral artery. 99m Tc-exametazime-SPECT scan demonstrated decreased cerebral blood flow in the left cerebral hemisphere, particularly in the left middle cerebral artery territory. The patient was recommended a stent-assisted angioplasty for middle cerebral artery stenosis. The patient underwent uncomplicated stenting with S-660 2.5- by 9-mm stent(Arterial Vascular Engineering, Santa Rosa, CA) of the left middle cerebral artery, with excellent angiographic results. Follow-up brain SPECT scan showed markedly improved perfusion. Stent-assisted percutaneous transluminal angioplasty can provide a favorable clinical course as well as improved cerebral perfusion for a patient with middle cerebral artery stenosis. Long-term follow-up data and additional clinical experience are required to assess the durability of this procedure.
Aged ; Angiography ; Angioplasty* ; Aspirin ; Brain ; Cerebrum ; Constriction, Pathologic* ; Follow-Up Studies ; Humans ; Middle Cerebral Artery* ; Perfusion* ; Rosa ; Stents ; Tomography, Emission-Computed, Single-Photon

Recurrent hyperhidrosis after thoracic sympathectomy is an uncomfortable condition, and compensatory hyperhidrosis (CH) is one of the most troublesome side effects. Here, we describe two patients with recurrent palmar hyperhidrosis (PH) and CH over the whole body simultaneously. They were treated with bilateral T4 sympathetic clipping and reconstruction of the sympathetic nerve from a T5 to T8 sympathetic nerve graft, which was transferred to the resected T3 sympathetic bed site. They reported improvements in sweating and were fully satisfied with the results. Our method can be considered as an alternative approach for patients with recurrent PH and CH.
Adult ; Female ; Humans ; Hyperhidrosis/*surgery ; Male ; Recurrence ; Thermography ; Thoracoscopy ; Treatment Outcome

PURPOSE: Percutaneous transluminal angioplasty(PTA) with a balloon catheter is a standard method of treatment for membranous obstruction of inferior vena cava(MOIVC). But, correct therapeutic approach has not been established for MOIVC patients whose lesion is associated with extensive thrombotic IVC occlusion. We tried to treat MOIVC associated with or without thrombus. MATERIALS AND METHODS: We treated 13 cases of MOIVC(associated with thrombus in 7 cases, no thrombus in 6 cases) with PTA, thrombolysis and self-expandable metallic stents. RESULTS: PTA was successful in 8 cases, but failed in 5 cases. The recurred cases were retreated with PTA, but follow up study revealed recoiling restenosis in 4 cases and intimal hyperplasia in 1 case at previous PTA site which could be overcome with a self-expandable metallic stent. The complication were occurred in 3 cases which were hemothorax, hemopericardium, and hemoperitoneum respectively. However, those were resolved by conservative treatment only. CONCLUSION: Recanalization and dilatation could be done in MOIVC patients with or without thrombosis for improvement of patient's symptom. Gianturco self-expandable metallic stent is sueful in treatment of recurred MOIVC after balloon dilatation and preventing reocclusion of the IVC after PTA.
Catheters ; Dilatation ; Follow-Up Studies ; Hemoperitoneum ; Hemothorax ; Humans ; Hyperplasia ; Pericardial Effusion ; Stents* ; Thrombosis

No abstract available.
Breech Presentation* ; Female ; Fetus* ; Pregnancy