STUDY DESIGN: We analyzed the segmental mobility of the lumbar spine after anterior stabilization in the thoracolumbar spinal fractures, and the data were compared with those obtained from an asymptomatic control group. OBJECTIVE: To determine the effects of anterior stabilization on the unfused segments of the lumbar spine. SUMMARY OF LITERATURE REVIEW: Spinal fusions are commenly used to stabilize unstable motion segments and to help the maintenance of correction afforded by the instrumentation applied in surgery for spinal deformity or injuries. How the presence of the fusion effects upon the remaining infused spine is not well understood. MATERIALS AND METHODS: We measured the segmental deformations of the lumbar spine radiologically, from maximum flexion to maximum extension, right and left maximum lateral bending, in 20 asymptomatic volunteers( the control group ) and 30 patients who had the anterior stabilization of the thoracolumbar spinal fractures(the study group). We assessed the percentage of segmental deformations which were obtained by multipling one hundred after the segmental deformation value was divided by the total lumbar deformation value. We made the comparison between the White and Panjabi's results and the control group, between the control group and the study group, between the segmental deformations and the percentage of segmental deformations. RESULTS: In the control group , the segmental deformations were smaller than those of the corresponding segmenus in the White and Panjabi's results. In the flexion-extension rotation of the lumbarspine, the segmental deformations had a tendency to increase from cephalad to caudal in the controland study group. In the residual lumbar spinal mobility, the segmental deformations of the study group had decreased rather than those of the control group. Especially the segmental deformation below the juxtafused segment had increased more than those of the corresponding segment of the control group in the right lateral bending rotation. The residual lumbar spinal mobility tended to decrease from T12 vertebral stabilization to L2 vertebral stabilization. CONCLUSION: The unfused segments had accommodated a greater percentage of segmental deformations in spite of diminishing the segmental deformations in comparison with those of the corresponding control subjects. It suggests that the greater percentage of segmental deformations predisposes to early degeneration of unfused segments.
Congenital Abnormalities ; Humans ; Spinal Fractures* ; Spinal Fusion ; Spine

No abstract available.
Lung*

Osteonecrosis of the femoral head usually affects young or middle-aged adults and frequently leading to femoral head collapse and hip arthritis. This review reports the updated treatments of the disease.

Purpose: The aim of this study was to compare the short-term outcomes of two-dimensional (2D) and three-dimensional (3D) laparoscopic surgery for total extraperitoneal (TEP) primary inguinal hernia repair. Methods: This was a single-center, retrospective, observational database study of 38 patients who underwent laparoscopic TEP inguinal hernia repair from March 1, 2019 to August 30, 2019 at Kyung Hee University Hospital at Gangdong in Seoul, Korea. Results: There was no significant difference in sex ratio, age, or body mass index between the two groups. The 2D group had two patients with direct hernia and 18 patients with indirect hernia. The 3D group had five patients with direct hernia, 11 patients with indirect hernia, and two patients with femoral hernia. The mean operation time was 38.2 minutes in the 2D group compared with 37.2 minutes in the 3D group. There was no severe intraoperative bleeding in either group. During the operation, peritoneal tearing occurred in 12 out of 20 patients in the 2D group compared with five out of 18 patients in the 3D group (p = 0.02). The average length of hospital stay was 1.3 days in both groups. The numeric rating scale score was 3.3 and 3 in the 2D group and the 3D group, respectively. In the 2D group, two patients revisited the outpatient clinic because of the postoperative occurrence of seroma and varicocele. Conclusion A 3D laparoscopic surgery is feasible and safe for inguinal hernia repair and showed less peritoneal tearing compared with 2D laparoscopic surgery for primary inguinal hernia repair.

Purpose: The aim of this study was to compare the short-term outcomes of two-dimensional (2D) and three-dimensional (3D) laparoscopic surgery for total extraperitoneal (TEP) primary inguinal hernia repair. Methods: This was a single-center, retrospective, observational database study of 38 patients who underwent laparoscopic TEP inguinal hernia repair from March 1, 2019 to August 30, 2019 at Kyung Hee University Hospital at Gangdong in Seoul, Korea. Results: There was no significant difference in sex ratio, age, or body mass index between the two groups. The 2D group had two patients with direct hernia and 18 patients with indirect hernia. The 3D group had five patients with direct hernia, 11 patients with indirect hernia, and two patients with femoral hernia. The mean operation time was 38.2 minutes in the 2D group compared with 37.2 minutes in the 3D group. There was no severe intraoperative bleeding in either group. During the operation, peritoneal tearing occurred in 12 out of 20 patients in the 2D group compared with five out of 18 patients in the 3D group (p = 0.02). The average length of hospital stay was 1.3 days in both groups. The numeric rating scale score was 3.3 and 3 in the 2D group and the 3D group, respectively. In the 2D group, two patients revisited the outpatient clinic because of the postoperative occurrence of seroma and varicocele. Conclusion A 3D laparoscopic surgery is feasible and safe for inguinal hernia repair and showed less peritoneal tearing compared with 2D laparoscopic surgery for primary inguinal hernia repair.

Cerebral vasospasm is one of most serious complication after subarachnoid hemorrhage due to aneurysmal rupture and a very important cause affecting to prognosis. The most reliable diagnostic assessment of cerebral vasospasm is angiography, but this is limited to perform because of complications such as neurological deficits or death, especially to repeat studdy. It seems likely that assessment of evoked elective, a much simpler and safer than the repeated study of angiography, will be of use in following the condition of patients with clinical vasospasm following SAH. In order to study relationship between clinical vasospasm and electrical activity, we traced SSEP from upper extremity by median nerve stimulation and lower extremity by posterior tibial stimulation which manifest the neurophysiologic function of cerebral ischemia. MN(Me-dian n.) and PTN(Posterior tibial n.)were performed simultaneously. Over 2 years period (1986 through 1988), 41 patients were performed SSEP and evaluated the relationship between SSEP and clinical or angiographic vasospasm in patients of SAH.
Aneurysm ; Angiography ; Brain Ischemia ; Humans ; Lower Extremity ; Median Nerve ; Prognosis ; Rupture ; Subarachnoid Hemorrhage ; Upper Extremity ; Vasospasm, Intracranial

PURPOSE: To report a case of nasal-type NK/T cell lymphoma occurring in the sphenoid and ethmoid sinuses of an orbital apex syndrome patient. CASE SUMMARY: A 61-year-old male patient visited our hospital for the impairment of vision in the right eye for the previous month, and for right-side blepharoptosis, pain around the eyeball, and limitation of extraocular movement in the right eye for three days earlier. In MRI (magnetic resonance image) and CT (computed tomography), shades with vague boundaries were observed in the right sphenoid and ethmoid sinuses, and open biopsy and decompression were performed for the lesions. After the surgery, the vision of the right eye increased, and improvement was observed in the right blepharoptosis, the pain around the eyeball, and in the limitation of motility of the extraocular muscle in the right eye. The patient was diagnosed with nasal type NK/T cell lymphoma in biopsy, and radiotherapy and chemotherapy were performed.
Biopsy ; Blepharoptosis ; Decompression ; Ethmoid Sinus ; Eye ; Humans ; Lymphoma ; Male ; Middle Aged ; Muscles ; Orbit ; Vision, Ocular

Phase and Amplitude Image were developed to overcome the subjective nature of interpretation for cinematic endless loop display of radionuclide gated blood pool scan. To evaluate the usefulness of color coded phase image in coronary artery disease, we conducted a clinical study with coronary angiography and phase image in 23 patients, and compared the results of those studies. 1) The results of coronary angiography revealed normal coronary artery in 6, 1 vessel disease in 11, 2 vessel disease in 4, and 3 vessel disease in 2 patients. 2) Color-coded Phase Image revealed abnormal phase area in 2/2(100%) of 3 vessel disease patients and in 3/4(75%) of 2 vessel disease patients, in 5/11(45%) of 1 vessel disease patients, and only 1/6(16%) of normal coronary artery. 3) Among the patients who disclosed abnormal phase image, 5 patients of 2-or3-vessl disease revealed abnormal phase through whole left ventricular area, but 3 patients with right coronary artery lesion and 2 patients with left antrior descending artery lesion showed localized abnormal phase area, infero-apical and anterior portion respectively, which were in accord with each coronary lesion. We concluded that the phase image may be useful in evaluation of the regional wall motion abnormalities in the patients of coronary artery disease. Further studies seem to be neccessary to clarify the sensitivity and specificity of the phase image in the each disease entity group.
Arteries ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Vessels* ; Humans ; Sensitivity and Specificity

BACKGROUND: Physicians find fever of unknown origin (FUO) a difficult problem to solve. Analysis of the causes of FUO may be useful in the diagnosis of FUO. We investigated the causes of FUO in the last two decades from 1980 to 1999 and compared the two decades to seek for a trend of changes of the causes of FUO. METHODS: Among 854 patients diagnosed as FUO on discharge, we retrospectively reviewed 278 patients compatible with the Petersdorf's criteria through inpatient and outpatient medical records. RESULTS: There were 144 (51.5%) men and 134 (48.2%) women. Among the 98 patients in the 1980s, infectious disease was the cause in 37 (37.8%) patients, collagen vascular disease in 17 (17.3%), malignancy in 8 (8.2%), miscellaneous in 11 (11.2%), and unidentifiable cause in 25 (25.5%) patients. Among the 180 patients in the 1990s, infectious disease was the cause in 45 (25.0%) patients, collagen vascular disease in 37 (20.5%), malignancy in 34 (18.9%), miscellaneous in 45 (25.0%), and unidentifiable cause in 19 (10.6%) patients. According to the order of frequency, the causes of infectious disease were pulmonary tuberculosis (19.4%), extrapulmonary tuberculosis (8.2%), liver abscess (4.1%) in the 1980s and extrapulmonary tuberculosis (17.2%), pulmonary tuberculosis (4.4%), liver abscess (1.1%) in the 1990s. The diagnostic methods for evaluation of FUO were culture (45.6%), radiology (17.6%), serology (16.2%), and biopsy (10.3%) in the 1980s and radiology (31.5%), biopsy (26.9%), culture (21.5%) and serology (20.0%) in the 1990s. CONCLUSION: Among the causes of FUO, infectious disease decreased and collagen disease and malignancy increased with time. The most common cause of infectious disease was pulmonary tuberculosis in the 1980s but extrapulmonary tuberculosis in the 1990s. Use of radiology and biopsy as diagnostic methods for FUO increased.
Biopsy ; Collagen ; Collagen Diseases ; Communicable Diseases ; Diagnosis ; Female ; Fever of Unknown Origin* ; Fever* ; Humans ; Inpatients ; Liver Abscess ; Male ; Medical Records ; Outpatients ; Retrospective Studies ; Tuberculosis ; Tuberculosis, Pulmonary ; Vascular Diseases

PURPOSE: Few data exist regarding cardiopulmonary resuscitation (CPR) education status in relationship to characteristics of socio-economic status and health and medical conditions in Korea. The purpose of this study is to describe the characteristics associated with the CPR educated populationand to develop and analyze a simple predictive model of the CPR education status. METHODS: Based on a health survey of Incheon Metropolitan City adults (5,114), differences between a CPR-educated group (n=220) and a CPR non-educated group (n=4,894) were analyzed and a logistic regression analysis of the two groups was performed to evaluate socio-economic status-gender, age, marital status, education level, number of family members, and monthly household income-and health-medical conditions-disease, accidental history, EMS (emergency medical service) experience, and health status. RESULTS: The participation rate in CPR education in Korea is only 4.3% which is vastly lower than in other developed countries, and there are statistically significant differences between the CPR-educated and CPR not-educated in gender (0.000), age (0.000), marital status (0.000), education level (0.000), and diseases (0.003). Similarly, gender (OR: 0.247, 0.000), age (OR: 0.964, 0.000), marital status (OR: 0.463, 0.000), education level (OR: 1.797, 0.000), numbers of family members (OR: 1.231, 0.004), and health status (OR: 0.894, 0.009) are statistically significant predictors of participation in CPR education. CONCLUSION: Monthly household income, accident history, and EMS experience are not statistically significant factors for participation in CPR education in Korea. It may be necessary to determine the optimal fees of CPR education based on social characteristics and economic conditions, Certain subgroups of lay persons such as high-risk patients and family members need targeted outreach programs.
Adult ; Cardiopulmonary Resuscitation* ; Developed Countries ; Education* ; Emergency Medical Services ; Family Characteristics ; Fees and Charges ; Health Surveys ; Humans ; Incheon ; Korea ; Logistic Models ; Marital Status ; Sociology