Ossification of the ligamentum flavum (OLF) has been recognised as a definite clinical entity as an ossification of the posterior longitudinal ligament. It has been known that the incidence of OLF is high in Japan and OLF usually occurs in the thoracic and lumbar region. Recently OLF has received considerable attention as a cause of myelopathy. OLF is quite distinct from “hypertrophy” of the ligamentum flvum. We experienced 2 cases of OLF with neurological symptom, which were treated by decompressive laminectomy and removal of the ossified ligamentum flavum. So remarkable symptomatic improvement was obtained.
Incidence ; Japan ; Laminectomy ; Ligamentum Flavum ; Longitudinal Ligaments ; Lumbosacral Region ; Spinal Cord Diseases ; Spine

In order to investigate the efficacy and safety of oral fosinopril, a new phosphorus containing angiotensin converting enzyme inhibitor, a single dose of 10 to 20mg was administered in 23 hypertensive patients with diastotic blood pressure above 95mmHg and all other anti-hypertensive agents were not administered during 4 weeks of study. Blood pressure and heart rate were measured on the 2nd and 4th week of therapy. The complete blood count with platelet count, blood chemistry by SMA-12 and serum electrolytes were performed at the begining and 4th week of therapy. The urinalysis and electrocardiography were performed at the beginning and 4th week of therapy. Any kinds of side effects were actively questioned by the examining physicians. The following results were obtained : 1) At the beginning and 4th weeks of therapy, the average systolic and diastolic pressure were 170.0+/-17.6/101.6+/-6.1mmHg, 142.7+/-15.1/87.3+/-6.7mmHg respectively. The systolic and diastolic blood pressure were declined statistically significantly(p<0.05) throughout the period of treatment and diastolic blood pressure of all subjects except 3 patients(86%) was maintained below 90mmHg after 4th week of treatment. 2) There was no significant change in the pulse rate before and after therapy. 3) There were no significant changes in blood chemistry, serum electrolytes, hematologic findings, urinalysis and electrocardiographic findigns. 4) side effect were developed in 5 patients(23%) with dry cough, 3 patients(13%) with headache and 2 patients with facial edema but side effects were mostly mild in nature without potenitally serious episodes. These results suggested that antihypertensive therapy with onec-daily fosinopril was effective and well tolerated in essential hypertensive patients.
Antihypertensive Agents ; Blood Cell Count ; Blood Pressure ; Chemistry ; Cough ; Edema ; Electrocardiography ; Electrolytes ; Fosinopril* ; Headache ; Heart Rate ; Humans ; Hypertension ; Peptidyl-Dipeptidase A ; Phosphorus ; Platelet Count ; Urinalysis

OBJECTIVE: This study was conducted in order to evaluate the cognitive function of the elderly and to delineate the effects of sex, age and education on cognitive function. METHODS: The Cognitive Impairment Diagnosing Instrument(CIDI) was administered to the residents aged 70 years or more in Jookjang-Myun, Pohang City, Kyungpook. RESULTS: Mean percent decline were different among the CIDI subtests: concentration/calculation showed the greatest deterioration, performances on abstract thinking, higher cortical functions, and orientation in time declined by 20.3 to 29.5%, and long-term memory, memory registration, judgement object naming, and orientation in place showed modest decline. Performances on all the CIDI subtests were significantly correlated with age with correlation coefficients between -0.262 and -0.477. All subtest, but for short-term memory, scores were shown to be affected by education. Men scored better than women on all the CIDI subtests except for short-term memory and memory registration. CONCLUSION: All total and subtest performances of the CIDI were shown to be affected by sex, age, and education. However, memory registration and short-term memory revealed different pattern of decline according to the demographic factors.
Aged* ; Cognition ; Demography ; Education ; Female ; Gyeongsangbuk-do ; Humans ; Male ; Memory ; Memory, Long-Term ; Memory, Short-Term ; Rural Population* ; Thinking

Laryngoscopy and intubation cause an adrenergic response manifested by tachycardia and hypertension. Various phamacological agents have been administered prior to induction in an attempt to attenuate the adrenergic response but they all have limitations. The objective of our study was to determine if esmolol would be equally effective when adrninistered in a bolus with and without fentanyl. A double-blind, randomized trial was conducted in sixty ASA physical status 1 patients undergoing elective surgery. All patients were premedicated with 0.2 mg/kg diazepam orally and glycopyrrolate 0.04 mg/kg intramuseularyly 1 hour beforehand. Induction of anesthesia was accomplished with 4 mg/kg thiopental intravenously foUowed immediately by 0.15-0.2 mg/kg vecuronium and study drug (placebo, esmolol 150 mg, esmolol 150 mg and fentanyl 100 mcg). Endotracheal intubation was performed at 2 minutes after study drug adrninistration. Anesthesia was maintained with 1 MAC (+/-10%) isoflurane in 60% nitrous oxide in oxygen at a 5 L/min flow for 6 minutes. Heart rate and blood pressure were measured every minute by an automatic recording device. After laryngoscopy and intubation, maximum increase in stolic blood pressure above awake levels was 33 mmHg (p<0.05) and 14 mmHg (p<0.05) in esmolol 150 mg, esmolol 150 mg with fentanyl 100 mcg respectively, whereas systolic blood pressure increased 62 mmHg after tracheal intubation in patients with placebo. In six patients with esmolol 150 mg, rate-pressure product reached a level considered potentially dangerous to patients with coronary artery disease. However, when used with fentanyl, esmolol provides effectvie protection against the adrenergic response and increase of the rate-pressure product to laryngoscopy and intubation.
Anesthesia ; Blood Pressure* ; Coronary Artery Disease ; Diazepam ; Fentanyl* ; Glycopyrrolate ; Heart Rate* ; Heart* ; Humans ; Hypertension ; Intubation ; Intubation, Intratracheal* ; Isoflurane ; Laryngoscopy ; Nitrous Oxide ; Oxygen ; Tachycardia ; Thiopental ; Vecuronium Bromide

PURPOSE: To report the anatomic and visual results of vitrectomy without scleral buckling in rhegmatogenous retinal detachment. METHODS: Primary vitrectomy without scleral buckling for the treatment rhegmatogenous retinal detachment was done in 41 eyes (41 patients) and followed up for a mean period of 21.5 months(range 6~65 months). Indications of primary vitrectomy were uncertain preoperative breaks, the presence of large breaks, the presence of breaks near equator, multiple breaks, proliferative vitreoretinopathy not related to breaks and presence of inferior vitreous hemorrhage. RESULTS: The anatomic success rate after a single operation was 90.2%. Visual acuity was improved or stable in 37 eyes (90.2%). Progression of lens opacity (35.7%) and formation of epiretinal membrane (12.2%) constituted the major complications after primary vitrectomy. CONCLUSIONS: Primary vitrectomy without scleral buckling can be a safe, effective method to repair primary rhegmatogenous retinal detachments in selective cases.
Cataract ; Epiretinal Membrane ; Retinal Detachment* ; Retinaldehyde* ; Scleral Buckling ; Visual Acuity ; Vitrectomy* ; Vitreoretinopathy, Proliferative ; Vitreous Hemorrhage

PURPOSE: Management of major renal injury caused by blunt trauma is still somewhat controversial. We investigated the characteristics of grades IV and V blunt renal injury patients who underwent conservative or operative treatment, and determined the feasibility of conservative treatment of such injury. MATERIALS AND METHODS: We retrospectively reviewed the records of 25 patients who presented our hospital with grades IV or V blunt renal injury. The 10 patients treated conservatively were assigned to group 1, and the 15 patients treated surgically to group 2. Each group was compared with respect to initial evaluation, radiologic findings, associated injuries, duration of hospital and intensive care unit stay, transfusion requirements, complications and follow-up imaging. RESULTS: We found that shock was the only characteristic sign of the surgical treatment group and that the degree of hematuria did not correlate with treatment options. Radiologic findings which differed significantly between the 2 groups were the proportion of devitalized segments to total renal parenchyma and the presence of ureteral opacification despite urinary extravasation. Patients in group 1 had lower transfusion requirements but longer hospitalization, both significantly. Follow-up imaging of group 1 patients revealed functioning renal parenchyma with resolution of retroperitoneal hematoma in 8 of the 10 cases (80%). CONCLUSIONS: This study shows that conservative treatment of blunt grades IV and V renal injury should be considered for patients with hemodynamic stability, no significant associated intra-abdominal organ injuries, devitalized segments less than 25% of renal parenchyma and ureteral opacification despite urinary extravasation on radiologic finding.
Follow-Up Studies ; Hematoma ; Hematuria ; Hemodynamics ; Hospitalization ; Humans ; Intensive Care Units ; Kidney ; Retrospective Studies ; Shock ; Ureter

Objectives: This study examined the level of depression and anxiety and the related factors, especially the knowledge and attitudes towards dementia, of people caring for a family member with dementia. Methods: Data on the demographics, care burdens, and clinical characteristics of dementia patients and their family caregivers were collected. The Center for Epidemiologic Studies Depression Scale (CES-D) and Korean Screening Tool for Anxiety disorders (K-ANX), Dementia Knowledge Scale (DKS), and Dementia Attitudes Scale (DAS) were performed. This study investigated whether depression and anxiety of caregivers differed according to the caregivers, patients, and the burden of caregivers. Multiple regression analysis was performed to investigate the potential factors that may influence the psychological symptoms in family caregivers. Results: There were 135 respondents. The scores of CES-D and K-ANX were 19.18±12.05 (probable depression) and 11.48±8.88 (mild anxiety), respectively. There was a significant difference in the degree of depression according to the level of education (F=4.14, p<0.05), the severity of dementia (F=3.63, p<0.05), and cohabitation with patients with dementia (t=2.07, p<0.05). On the other hand, the difference in the degree of anxiety was not significant depending on the stratified potential factors. The degree of depression in caregivers was positively associated with severe dementia (β=0.252, p<0.01) and negatively associated with the DAS score (β= -0.392, p<0.001). Anxiety was only inversely affected by the DAS score (β=-0.369, p<0.001). Conclusion This study shows that family caregivers of people with dementia experience high levels of depression and anxiety, which are influenced by the patient’s severity of dementia and the caregiver’s attitude toward dementia.

Strongyloides stercoralis is an intestinal nematode that is able to infect the host tissue and persist for many years through autoinfection, and it causes life-threatening hyperinfection in immunocompromised hosts. We report here on two cases of strongyloidiasis that were diagnosed by colonoscopic biopsy. One case was a 73-year-old woman who was hospitalized with complaints of melena. She was being treated with corticosteroid due to her asthma and rheumatoid arthritis. The other case was a 63-year-old man who suffered with abdominal discomfort and severe loss of body weight (18 kg) for 2 months. In both cases, colonoscopic examination revealed polyps and petechiae at the entire colon. Microscopically, a small illdefined granuloma with a longitudinally sectioned parasite was seen on the colonoscopic biopsy. Endoscopic examination was done after suspecting parasitic infestation. The gastric and duodenal mucosa showed numerous cross sections of adult worms, eggs and larvae that were developing in crypts. Even if such a patient is in an asymptomatic state, this illness must be treated due to the potential for fatal autoinfection.
Adult ; Aged ; Arthritis, Rheumatoid ; Asthma ; Asymptomatic Diseases ; Biopsy* ; Body Weight ; Colon ; Colonoscopy ; Eggs ; Female ; Granuloma ; Humans ; Immunocompromised Host ; Larva ; Melena ; Middle Aged ; Mucous Membrane ; Ovum ; Parasites ; Polyps ; Purpura ; Strongyloides stercoralis ; Strongyloidiasis*

Edema ; Humans ; Lifting ; Maxillary Sinus ; Sinus Floor Augmentation ; Sinusitis ; Stress, Psychological ; Transplants

BACKGROUND: Skin lesions and pain are the most distinctive features of herpes zoster. Light-emitting diode (LED) therapy is an effective treatment known for its wound-healing effects. OBJECTIVE: To determine whether the LED treatment affects wound healing and acute pain in acute herpes zoster ophthalmicus. METHODS: We recruited 28 consecutive Korean patients with acute herpes zoster ophthalmicus for the study. In the control group (group A), 14 subjects received oral famcyclovir. In the experimental group (group B), 14 subjects received oral famcyclovir and 830 nm LED phototherapy on days 0, 4, 7, and 10. In order to estimate the time for wound healing, we measured the duration from the vesicle formation to when the lesion crust fell off. The visual analogue scale (VAS) was used for the estimation of pain on days 4, 7, 10, and 14. RESULTS: The mean time required for wound healing was 13.14+/-2.34 days in group B and 15.92+/-2.55 days in group A (p=0.006). From day 4, the mean VAS score showed a greater improvement in group B, compared with group A. A marginal but not statistically significant difference in the VAS scores was observed between the two groups (p=0.095). CONCLUSION: LED treatment for acute herpes zoster ophthalmicus leads to faster wound healing and a lower pain score.
Acute Pain ; Herpes Zoster ; Herpes Zoster Ophthalmicus ; Humans ; Phototherapy ; Pilot Projects ; Skin ; Wound Healing