There are many classifications for idiopathic scoliosis but none of these is perfect. In the treatment of idiopathic scoliosis, it is essential to understand the characteristics of each classification system and exploit their individual advantages.
Classification* ; Scoliosis*

This Study has been carried out to make a recommendation for the next amendment of the Infectious Disease Prevention Act with a specific focus on the kind of notifiable disease. Korean, Japanese, German, U.S, English and French acts on infectious diseases prevention were reviewed, compared with and analyzed in regards of numbers and kinds of notifiable infectious diseases and their tendency of amendments. An criteria was designed to assess the level of validity of diseases to be designated in the act. Four items, the fatality (greater than 10% or not), the possibility to make a big epidemic, the availability of efficient vaccination and the usefulness of isolation, are used in the assessment. This index is applied to the diseases in Korean and other countries' Infectious Disease Prevention Acts. Results are as follows : 1. The Korean Infectious Disease Prevention Act has a unique way of classifying the notifiable infectious disease, that is, the first, the second and the third class. But the author cannot find the basis of classification. No other countries reviewed have the similar classification. 2. The ten diseases, cholera, plague, yellow fever, diphtheria, typhoid fever, poliomyelitis, rabies, tetanus, malaria, and meningococcal meningitis are designated as the notifiable diseases not only in Korea but also in Japan, Germany, United States, England and France. 3. Thirty seven diseases including small pox, Lassa fever, anthrax, influenza, German measles, Legionellosis, infection with E. coli O157:H7, Q-fever, brucellosis, Lyme disease are designated as legal disease at least one of the above mentioned countries. 4. The Korea has been coped with the change of the infectious disease occurrence for last fifty years in amendment of the Infectious Disease Prevention Act. 5. Japan has a special infectious surveillance system composed of 3,880 clinics throughout the whole country. 6. Germany has classified infectious diseases in five categories which are based on seriousness of disease. Any confirmed death, cases and suspected cases in class I should be reported within 24 hours. But only confirmed death and cases in class II, but not suspected cases, are repotable in Germany. 7. Plague, bacillary dysentery, pertussis, mumps, Japanese encephaltis and Korean hemorrhagic fevers are diseases with high credits validity index among Korean legal disease. 8. German measles, anthrax, E. coli O157:H7 infection, Lassa fever, Q-fever, brucellosis are high in validity index among those which are not designated in Korea but designated in other countries. In conclusion, the Korean Infectious Disease Prevention Act has well been coped with the changes of infectious disease occurrence for last fifty years, but the classification basis and the validity of diseases to be designated as legal diseases is worth reevaluating.
Anthrax ; Asian Continental Ancestry Group ; Brucellosis ; Cholera ; Classification ; Communicable Diseases* ; Diphtheria ; Dysentery, Bacillary ; England ; Fever ; France ; Germany ; Humans ; Influenza, Human ; Japan ; Korea ; Lassa Fever ; Legionellosis ; Lyme Disease ; Malaria ; Meningitis, Meningococcal ; Mumps ; Plague ; Poliomyelitis ; Rabies ; Rubella ; Tetanus ; Typhoid Fever ; United States ; Vaccination ; Whooping Cough ; Yellow Fever

PURPOSE: To assess the relationship between biochemical bone turnover marker and bone mineral density(BMD) and to evaluate the predictive role of biochemical bone marker in postmenopausal osteopenic woman. MATERIALS AND METHODS: Ninety two postmenopausal women (50-65 years old), who have the T-score from -1.0 to -2.5 by the dual-energy X-ray absorptiometry (DEXA), were examined consecutively with BMD of the lumbar spine and biochemical bone turnover marker including urine Cross-linked N-telopeptide of type I collagen (u-NTX), urine deoxy-pyridinoline (u-DPD), serum Cross-linked C-telopeptide of type I collagen (s-CTX), serum bone-specific alkaline phosphatase (s-BAP), serum osteocalcin (s-OC) for six months. We evaluated the relation between the changes in the biochemical markers and the rate of bone loss. RESULTS: Seventy four postmenopausal women completed this study. All biochemical bone turnover marker and BMD at one time point including the baseline and the end point did not show any significant correlation. Another longitudinal study found no significant correlation between the baseline biochemical bone turnover marker and the change in lumbar spine BMD. The other study showed significant correlation between the changes in s-CTX/s-OC and the change in lumbar spine BMD (p=0.04, 0.03). The changes of u-NTX and s-OC were larger in the group of aggravation in BMD (p=0.032, 0.041). CONCLUSION: The relationship between bone turnover marker and BMD at one time point was not clear. The predictive role of baseline bone turnover marker was limited to predict the magnitude of changes in lumbar BMD in untreated osteopenic individuals. The changes of s-OC showed significant predictive role in the bone loss in osteopenic postmenopausal women.
Absorptiometry, Photon ; Alkaline Phosphatase ; Biomarkers ; Bone Diseases, Metabolic ; Collagen Type I ; Female ; Humans ; Longitudinal Studies ; Osteocalcin ; Osteoporosis ; Peptides ; Spine

PURPOSE: An experimental animal study was performed to compare the bone fusion capacity of an allograft and porous hydroxyapatite. MATERIALS AND METHODS: Three milliliters of allograft or porous hydroxyapatite particles were inserted between the 4th and 5th lumbar transverse processes of New Zealand white rabbits weighing 3-3.5 kg. The total number of rabbits was 30, which were divided randomly into 2 groups. The bone formation and fusion capacity were evaluated 12 weeks after surgery through the gross findings and manual palpation, as well as radiological, biomechanical, and histological studies. Six rabbits in the allograft group died during breeding but the autopsy finding did not show any evidence suggesting an infection or graft rejection. The allograft was harvested from the iliac crest of the rabbits of the same species aseptically and was preserved at ??80oC for at least 7 days before implantation. RESULTS: The fusion rates were 55.6% (5/9) and 66.7% (10/15) in the allograft and porous hydroxyapatite groups, respectively. The mean values of the tensile strengths were 140.7 N in the allograft group and 189.6 N in the porous hydroxyapatite group. Histological analysis of 2 specimens from each group revealed theporous hydroxyapatite group to show a slightly better osteoconduction capacity. CONCLUSION: The porous hydroxyapatite group showed better bony union capacity even though there was no significant difference between the 2 groups.
Allografts* ; Animals ; Autopsy ; Bone Regeneration ; Bone Substitutes* ; Breeding ; Durapatite* ; Graft Rejection ; Osteogenesis ; Palpation ; Rabbits ; Tensile Strength

OBJECTIVES: The aim of this study was to estimate musculo-skeletal symtoms of municipal sanitation workers and to evaluate working conditions of municipal sanitation workers to search for the factors related to musculo-skeletal symptoms. METHODS: We conducted a descriptive cross-sectional survey. The study subjects were comprised of 543 municipal sanitation workers in some divisions of Seoul and the Gyeonggi province. Musculo-skeletal analysis was done by using the modified criteria of NIOSH musuclo-skeletal symptoms, RULA and, REBA. Statistical analysis was done by using the chi-square test, multiple logistic regression analysis. RESULTS: 72.2% of the subjects complained musculo-skeletal symptoms (39.6% on the upperlimbs, 30.0% on the lumbar region, 27.4% on the legs). For the musculo-skeletal symptoms criteria (1~3), street cleaners complained of more musculo-skeletal symptoms than the solid waste collectors, after classifying the jobs of sanitation workers. On logistic regression analysis of the musculo-skeletal "symptoms criteria1" positive groups, age was related to the criteria positive (prevalence odds ratio=1.018, 95% CI: 0.993-1.046). The worktime was significantly related to 'criteria positive 1 and, 2' (prevalence odds ratio=2.165 (95% CI: 1.156-4.131), 2.187 times (95% CI: 1.071-4.651)). The RULA score, the subtotal A score of RULA, the REBA score and , the total A REBA score of the upperlimbs of solid waste collectors were higher than those of the street cleaners. CONCLUSIONS: In spite of the lower ergonomic evaluation score of the street cleaner, the street cleaners complained of more musculo-skeletal symptoms than did the solid waste collectors due to more frequent repetitive motions, a longer work time (over 10 hours) etc. It is suggested that the sanitation workers need to use the proper methods to avoid musculo-skeletal disease.
Cross-Sectional Studies ; Human Engineering ; Humans ; Logistic Models ; Lumbosacral Region ; National Institute for Occupational Safety and Health (U.S.) ; Sanitation ; Solid Waste ; Task Performance and Analysis ; Upper Extremity

STUDY DESIGN: Retrospective study. OBJECTIVES: To compare the radiologic results of unilateral or bilateral minimal invasive transforaminal lumbar interbody fusion (MIS TLIF) and conventional open lumbar interbody fusion. SUMMARY OF LITERATURE REVIEW: Only a few studies have compared the slip reduction and fusion rate between unilateral or bilateral MIS TLIF and conventional open TLIF. MATERIALS AND METHODS: Between March 2007 and May 2015, 80 patients with single-level low-grade spondylolisthesis underwent unilateral MIS TLIF (26 patients), bilateral MIS TLIF (10 patients), or open TLIF (44 patients) by a single surgeon. Radiologic studies were performed preoperatively, 2 weeks postoperatively, and 12 months postoperatively. Slip reduction, the lumbar lordortic angle, and the fusion rate were analyzed. RESULTS: The 3 groups exhibited significantly improved slip after operation. Significant differences were found among the 3 groups (p=0.015) and between the MIS TLIF group (31.76%±14.42%) and the open TLIF group (41.66%±15.98%) (p=0.01) in the slip reduction rate at 2 weeks after the operation. However, no significant difference was found between unilateral MIS TLIF and bilateral MIS TLIF (37.61%±15.0% vs. 29.5%±13.82%, p=0.148). In the lumbar lordotic angle, no significant difference was found among the 3 groups. There were no significant differences among the 3 groups in slip reduction or the fusion rate at 12 months after the operation. CONCLUSIONS: Our study suggests that unilateral MIS TLIF showed a similar slip reduction and fusion rate to bilateral MIS TLIF, but that conventional open TLIF showed better slip reduction than MIS TLIF, although it had a similar fusion rate.
Humans ; Retrospective Studies ; Spondylolisthesis*

BACKGROUND/AIMS: The diagnostic value of PET-CT, in gastric cancer is well known, but the prognostic value of pretreatment PET-CT has not been adequately evaluated. This study aimed to investigate the preoperative prognostic value of PET-CT in gastric cancer patients. METHODS: A total of 107 patients underwent surgical treatment for gastric cancer from April 2007 to December 2010 at Dong-A University Medical Center after confirming the presence of F-18 fluorodeoxyglucose (FDG) uptake on preoperative PET-CT. Among these patients, the following subjects were excluded: follow-up loss (13), palliative resection (5), neoadjuvant chemotherapy (1), and unrelated death (1). The remaining 87 patients were included in this study and data were collected by retrospectively reviewing the medical records. The median follow-up duration, defined as the period from operation to last imaging study date, was 34.2+/-14.8 months. FDG uptake values were represented by maximal standardized uptake value (SUVmax). In order to assess the correlation between SUVmax and recurrence, Kaplan-Meier's survival analysis with log-rank test and cox proportional hazard model were performed. Receiver operating characteristic (ROC) curve was employed to determine the optimal cutoff value of SUVmax. RESULTS: The result of Kaplan-Meier's survival analysis with log-rank test were significantly different between high SUVmax group and low SUVmax group (p=0.035), the cutoff value of which was 5.6. However, in multivariate analysis with cox proportional hazard model, T-staging, N-staging and SUVmax did not show statistical significance (p=0.190, p=0.307, and p=0.436, respectively). CONCLUSIONS: High SUVmax on PET-CT in gastric cancer can be a useful prognostic factor.
Adult ; Aged ; Area Under Curve ; Female ; Fluorodeoxyglucose F18 ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Neoplasm Grading ; Neoplasm Staging ; Positron-Emission Tomography ; Prognosis ; Proportional Hazards Models ; ROC Curve ; Radiopharmaceuticals ; Retrospective Studies ; Risk Factors ; Stomach Neoplasms/*diagnosis/mortality/surgery ; Tomography, X-Ray Computed

BACKGROUND/AIMS: The diagnostic value of PET-CT, in gastric cancer is well known, but the prognostic value of pretreatment PET-CT has not been adequately evaluated. This study aimed to investigate the preoperative prognostic value of PET-CT in gastric cancer patients. METHODS: A total of 107 patients underwent surgical treatment for gastric cancer from April 2007 to December 2010 at Dong-A University Medical Center after confirming the presence of F-18 fluorodeoxyglucose (FDG) uptake on preoperative PET-CT. Among these patients, the following subjects were excluded: follow-up loss (13), palliative resection (5), neoadjuvant chemotherapy (1), and unrelated death (1). The remaining 87 patients were included in this study and data were collected by retrospectively reviewing the medical records. The median follow-up duration, defined as the period from operation to last imaging study date, was 34.2+/-14.8 months. FDG uptake values were represented by maximal standardized uptake value (SUVmax). In order to assess the correlation between SUVmax and recurrence, Kaplan-Meier's survival analysis with log-rank test and cox proportional hazard model were performed. Receiver operating characteristic (ROC) curve was employed to determine the optimal cutoff value of SUVmax. RESULTS: The result of Kaplan-Meier's survival analysis with log-rank test were significantly different between high SUVmax group and low SUVmax group (p=0.035), the cutoff value of which was 5.6. However, in multivariate analysis with cox proportional hazard model, T-staging, N-staging and SUVmax did not show statistical significance (p=0.190, p=0.307, and p=0.436, respectively). CONCLUSIONS: High SUVmax on PET-CT in gastric cancer can be a useful prognostic factor.
Adult ; Aged ; Area Under Curve ; Female ; Fluorodeoxyglucose F18 ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Neoplasm Grading ; Neoplasm Staging ; Positron-Emission Tomography ; Prognosis ; Proportional Hazards Models ; ROC Curve ; Radiopharmaceuticals ; Retrospective Studies ; Risk Factors ; Stomach Neoplasms/*diagnosis/mortality/surgery ; Tomography, X-Ray Computed

STUDY DESIGN: Literature review. OBJECTIVES: The aim of this study was to demonstrate surgical strategies for successful minimally invasive transforaminal lumbar interbody fusion (TLIF). SUMMARY OF LITERATURE REVIEW: Although many studies have reported the benefits and disadvantages of minimally invasive TLIF, few have described surgical strategies to improve the success rate or to reduce complications. MATERIALS AND METHODS: We searched for studies reporting the clinical and radiological outcomes of minimally invasive TLIF, and analyzed the optimal indications, technical pitfalls, and tips for successful surgical outcomes. RESULTS: The ideal candidate for minimally invasive TLIF is a patient with single or 2-level low-grade adult degenerative or isthmic spondylolisthesis. Incomplete decompression, dura tearing, nerve root injury, and implant-related complications were found to be the most commonly reported adverse events, especially in the early periods of a surgeon's experience. Precise positioning for skin incision and tube insertion, complete neural decompression, proper interbody preparation for bone graft and cage insertion, and the correct placement of percutaneous pedicle screws are critical strategies for successful surgical outcomes. Fully understanding the surgical pitfalls and tips described in this review is also important to avoid potential complications. CONCLUSIONS: It is imperative not only to carry out a comprehensive preoperative evaluation and proper patient selection, but also to perform meticulous surgical procedures with thoughtful considerations of potential pitfalls, in order to improve the success rate and to reduce the complications of minimally invasive TLIF.
Adult ; Decompression ; Humans ; Patient Selection ; Pedicle Screws ; Skin ; Spondylolisthesis ; Tears ; Transplants

BACKGROUND: There are few comparative studies about the optimal method of pneumatic compression to prevent deep vein thrombosis (DVT). The aim of this prospective randomized study was to compare venous hemodynamic changes and their clinical influences between two graded sequential compression groups (an alternate sequential compression device [ASCD] vs. a simultaneous sequential compression device [SSCD]). METHODS: In total, 34 patients (68 limbs) undergoing knee and spine operations were prospectively randomized into two device groups (ASCD vs. SSCD groups). Duplex ultrasonography examinations were performed on the 4th and 7th postoperative days for the detection of DVT and the evaluation of venous hemodynamics. Continuous data for the two groups were analyzed using a two-tailed, unpaired t-test. Relative frequencies of unpaired samples were compared using Fisher exact test. Mixed effects models that might be viewed as ANCOVA models were also considered. RESULTS: DVT developed in 7 patients (20.6%), all of whom were asymptomatic for isolated calf DVTs. Two of these patients were from the ASCD group (11.8%) and the other five were from the SSCD group (29.4%), but there was no significant difference (p = 0.331). Baseline peak velocity, mean velocity, peak volume flow, and total volume flow were enhanced significantly in both device groups (p < 0.001). However, the degrees of flow and velocity enhancement did not differ significantly between the groups. The accumulated expelled volumes for an hour were in favor of the ASCD group. CONCLUSIONS: Both graded sequential compression devices showed similar results both in clinical and physiological efficacies. Further studies are required to investigate the optimal intermittent pneumatic compression method for enhanced hemodynamic efficacy and better thromboprophylaxis.
Aged ; *Arthroplasty, Replacement, Knee/adverse effects ; *Fracture Fixation/adverse effects ; Hemodynamics ; Humans ; *Intermittent Pneumatic Compression Devices ; Knee/surgery ; Prospective Studies ; Risk Factors ; *Spinal Fusion/adverse effects ; Spine/surgery ; Treatment Outcome ; Venous Thrombosis/etiology/physiopathology/*prevention & control/ultrasonography