To evaluate a relationship of lumbar lordosis between asymptomatic group and low back pain group, lumbar lordotic angle was measured from standing lateral lumbosacral roentogenogram of 360 men and women between 20 and 49 years of age. We excluded the patients with back deformity, moderate to severe degenerative change of lumbosacral spine, leg length discrepency, and degenerative change of lower leg in both groups. The lumber lordodsis angle was measured with two ways, lumbosacral angle and lumbolumbar angle respectively. Two angles have a line parallel to the top of second lumbar vertebra as the proximal boundary. The distal border of the lumbosacral angle is a line parallel to the top of sacrum. The distal border of the lumbolumbar angle is a line parallel to the bottom of fifth lumbar vertebra. With statistical analysis of the results, we came to followiing conclusion: 1. The mean lumbolumbar angle was 33.62° +0.62° (SEM: standard error of the mean) and the mean lumbosacral angle was 49.91° +0.59° in asymptomatic group. 2. The mean lumbolumbar angle was 34.79° +0.68° and the mean lumbosacral angle was 50.35° +0.76° in low back pain group. 3. No significant difference in lumbosacral and lumbolsacral angle between asymptomatic and low back pain group was identified using general linear models procedure(P>0.5). 4. Analyzing the data by sex, no significant difference in lumbosacral and lumbosacral angle was identified using general linear models procudure(P>0.05). 5. Analyzing the data by age group, no significant difference in lumbosacral angle was identified (P>0.05), but significant difference in lumbolsacral angle was identified using general linear models procedure(P=0.0045).
Animals ; Congenital Abnormalities ; Female ; Humans ; Leg ; Linear Models ; Lordosis ; Low Back Pain ; Male ; Sacrum ; Spine

Plastic surgeons have been in pursuit of natural appearance in rhinoplasty, which means harmonious relationship between nasal tip and dorsum. If silicone implant is used alone for the augmentation of the nasal tip, there is a possibility of the thinning of the nasal tip skin and exposure of implant. For these reasons, plastic surgeons have used a cartilage fixation over the silicone implant for nasal tip augmentation. However, fixation by sutures is technically challenging, so authors tried to use Histoacryl glue instead of sutures. Twelve New Zealand white rabbits were used in this study. Four 5mm diameter and 1mm thick cartilages were harvested from ear. Two cartilages were fixed to the silicone blocks by chromic catgut and the others were attached by Histoacryl glue. Four cartilage-silicone complexes were implanted into the subcutaneous pocket of the rabbit's head. In the 1st, 3rd and 5th week, the cartilage- silicone complexes were harvested and the shearing forces between cartilages and silicones were measured by texture analysis. The shearing forces were not changed in the Histoacryl group with the lapse of time but decreased in the suture group. However, the difference between the 2 groups were not statistically significant. The histologic findings of both groups showed progressive fibrosis. This study showed the possibility of using Histoacryl glue as a simple method of fixing cartilage to the silicone.
Adhesives* ; Cartilage* ; Catgut ; Ear ; Enbucrilate* ; Fibrosis ; Head ; Rabbits ; Rhinoplasty ; Silicones* ; Skin ; Sutures

No abstract available.
Adult* ; Cholesterol* ; Gyeongsangbuk-do* ; Humans ; Jeollanam-do* ; Triglycerides*

OBJECTIVE: To assess the pre-pregnancy and pregnancy factors influencing pregnancy outcome in renal transplanted women Materials and METHODS: This retrospective study included all pregnancies in renal transplanted women in Asan Medical Center between June 1996 and February 1998. We collected data from the medical records of allograft recipients. Pre-pregnant status and pregnancy outcome were described. RESULTS: Seventeen pregnancies in 13 allograft recipients resulted in 7 term deliveries, 4 preterm births, 2 spontaneous abortions, and 4 therapeutic abortions. All but one patient received immunosuppressive therapy with cyclosporin A, azathioprine, and prednisolone during pregnancy. The mean interval from the time of transplantation to conception was 28.8+/-14.3 months(range 6-60 months). In live birth group, the mean gestational age at delivery was 37.7+/-1.2 weeks and the mean birth weight of their offspring was 2.85+/-0.37 kilogram. Apgar scores at 5 minutes were 8 or more in all of them. The obstetric complications were distributed as follows: pregnancy induced hypertension in 6 cases(55%), pregnancy aggravated hypertension in 2 cases(18%), fetal growth restriction in 1 case(9%), prematurity in 4 cases(36%). Cesarean sections were done in 4 cases(36%) because of previous Cesarean section(3 cases) and uncontrolled hypertension(1 case). Neonatal complication, transient tachypnea of the newborn, was found in one case. Graft rejection after transplantation occurred in 4 cases: 3 cases in preterm births and 1 case in therapeutic abortions. Maternal renal functions were normal during pregnancy and postpartum period whose pre-pregnant renal functions had been normal. No patient experienced any rejection episode or graft loss during pregnancy. CONCLUSION: Successful pregnancy can be expected in women with a renal transplant, although there was high incidence of pregnancy-related complications, especially hypertensive disorders. Pregnancy can be encouraged to these allograft recipients if they have good renal function.
Abortion, Spontaneous ; Abortion, Therapeutic ; Allografts* ; Azathioprine ; Birth Weight ; Cesarean Section ; Chungcheongnam-do ; Cyclosporine ; Female ; Fertilization ; Fetal Development ; Gestational Age ; Graft Rejection ; Humans ; Hypertension ; Hypertension, Pregnancy-Induced ; Incidence ; Kidney Transplantation ; Live Birth ; Medical Records ; Postpartum Period ; Prednisolone ; Pregnancy ; Pregnancy Outcome* ; Pregnancy* ; Premature Birth ; Retrospective Studies ; Transient Tachypnea of the Newborn ; Transplants

PURPOSE: The objective of this study was to develop a new scoring tool that is comprehensively applicable and predicts fatality within 24 h of intoxication. METHODS: This was a cohort study conducted in two emergency medical centers from 2011 to 2012. We identified factors associated with severe/fatality. Through a discriminant analysis, we devised the aBIG (age, Base deficit, Infection, and Glasgow coma scale) score. To compare the ability of aBIG to predict intoxication severity with that of previous scoring systems such as APACHE II, MODS, SAPS IIe, and SOFA, we determined the receiver operating characteristic curves of each variable in predicting severe-to-fatal toxicity. RESULTS: Compared with the mild/moderate toxicity group (n=211), the severe/fatal group (n=143) had higher incidences of metabolic acidosis, infection, serious mental change, QTc prolongation and hepato-renal failure. Age, base deficit, infection-WBC count, and Glasgow Coma Scale were independently associated with severe/fatal poisoning. These variables were combined into the poisoning "aBIG" score [0.28xAge group+0.38xWBC count/10(3)+0.52xBase deficit+0.64x(15-GCS)], which were each calculated to have an area under the curve of 0.904 (95% confidence interval: 0.868-0.933). The aBIG poisoning score had an equivalent level of severity predictability as APACHE II and a superior than MODS, SOFA, and SAPS IIe. CONCLUSION: We developed a simplified scoring system using the four variables of age, base deficit, infected leukocytosis, and GCS. The poisoning aBIG score was a simple method that could be performed rapidly on admission to evaluate severity of illness and predict fatal severity in patients with acute intoxications.
Acidosis ; Adult* ; APACHE ; Cohort Studies ; Coma ; Emergencies ; Fatal Outcome ; Glasgow Coma Scale ; Humans ; Incidence ; Leukocytosis ; Multiple Organ Failure ; Poisoning* ; Prognosis ; ROC Curve

PURPOSE: The objective of this study was to develop a new scoring tool that is comprehensively applicable and predicts fatality within 24 h of intoxication. METHODS: This was a cohort study conducted in two emergency medical centers from 2011 to 2012. We identified factors associated with severe/fatality. Through a discriminant analysis, we devised the aBIG (age, Base deficit, Infection, and Glasgow coma scale) score. To compare the ability of aBIG to predict intoxication severity with that of previous scoring systems such as APACHE II, MODS, SAPS IIe, and SOFA, we determined the receiver operating characteristic curves of each variable in predicting severe-to-fatal toxicity. RESULTS: Compared with the mild/moderate toxicity group (n=211), the severe/fatal group (n=143) had higher incidences of metabolic acidosis, infection, serious mental change, QTc prolongation and hepato-renal failure. Age, base deficit, infection-WBC count, and Glasgow Coma Scale were independently associated with severe/fatal poisoning. These variables were combined into the poisoning "aBIG" score [0.28xAge group+0.38xWBC count/10(3)+0.52xBase deficit+0.64x(15-GCS)], which were each calculated to have an area under the curve of 0.904 (95% confidence interval: 0.868-0.933). The aBIG poisoning score had an equivalent level of severity predictability as APACHE II and a superior than MODS, SOFA, and SAPS IIe. CONCLUSION: We developed a simplified scoring system using the four variables of age, base deficit, infected leukocytosis, and GCS. The poisoning aBIG score was a simple method that could be performed rapidly on admission to evaluate severity of illness and predict fatal severity in patients with acute intoxications.
Acidosis ; Adult* ; APACHE ; Cohort Studies ; Coma ; Emergencies ; Fatal Outcome ; Glasgow Coma Scale ; Humans ; Incidence ; Leukocytosis ; Multiple Organ Failure ; Poisoning* ; Prognosis ; ROC Curve

Baseball-related injuries are on the rise due to its increasing popurity as an international sports. Among them, Little League Shoulder is characterized by pain when pitching and is associated with specific roentgenographic changes in adolescent baseball pitchers. Ball thrower's fracture is defined as a fracture of the humeral diaphysis resulting from overhead throwing without any external contact but it is rare in adolescents. We report a case of Little League Shoulder with a contralateral thrower's fracture of the humeral shaft related to baseball pitching in an ambidextrous adolescent baseball pitcher with a review of the relevant literature.
Adolescent ; Baseball ; Diaphyses ; Epiphyses, Slipped ; Humans ; Humerus ; Shoulder ; Sports

Background: Sudden cardiac arrest (SCA) has not been well studied in Asian countries. This study investigated the temporal trends in the incidence and outcomes of SCA and the impact of age, gender, economic state, and urbaniza‑ tion on SCA using a nationwide population-based sample cohort of South Korea. Methods: In the Korean National Health Insurance Service—Sample Cohort consisting of one million persons from 2003 through 2013, we identified 5,675 (0.56%) patients with SCA using ICD-10 code I46 and I49.0. We evaluated the impact of the age, gender, household income, and urbanization level on the incidence and outcome of SCA. Results: During the study period, the overall age- and gender-adjusted annual incidence of SCA increased by 46.9% from 30.9 in 2003 to 45.4 in 2013 (per 100,000 person-years, p < 0.001 for trend). The medical cost per 100,000 personyears also greatly increased about four times (p < 0.001 for trend). The overall adjusted survival to hospital discharge rate increased from 8.9% in 2003 to 13.2% in 2013 (adjusted rate ratio per year 1.05; p < 0.001 for trend). Old age and low household incomes of the population was related to increased SCA and poor survival to hospital discharge rate. The proportion of patients with intensive or advanced therapeutic modalities after SCA greatly increased from 1.6% in 2003 to 10.0% in 2013 (p < 0.001 for trend). This increase was consistent regardless of age, gender, economic state, and urbanization level. Conclusions Although the incidence of SCA was increased, the outcome was improved for the decade. However, in the elderly and low-income population, the incidence of SCA continued to rise and survival outcome was not improved.

OBJECT: The effective management of carotid occlusive disease still remains a challenge to neurosurgeons. The authors analyzed the series of management of carotid occlusive disease in order to determine whether our management strategy affected patient's clinical outcomes. Methods of identifying patients who stand to benefit from this therapy need to be established. METHOD: Clinical findings, management, complications and outcome in 52 patients with high grade carotid stenosis of at least 70% and occlusion were investigated. The patients were treated by percutaneous transluminal angioplasty (PTA) and/or stent (PTAS), Extracranial-Intracranial (EC-IC) bypass surgery, carotid endarterectomy (CEA) according to the neurologic status, medical condition, severerity of stenosis, collateral blood flow. RESULTS: The causes of carotid stenosis were 40 atherosclerosis arteries, 9 spontaneous dissections and 2 traumas, 1 fibomuscular dysplasia (FMD) of 52 patients. 9 patients were treated by PTA alone, and 28 patients by PTAS, 9 patients by EC-IC bypass surgery, 3 patients by PTAS followed by EC-IC bypass surgery, 3 patients by CEA. For the outcome according to management, 26 patients (100% of all bypass surgery only and CEA, 35% of all PTA and PTAS) recovered excellently, 14 patients (35% of all PTA and PTAS) had a good outcome. 2 patients died. CONCLUSION: The results of this study suggest that PTAS should be a useful and effective treatment method for some patients with the severe atherosclerotic stenosis or carotid artery dissection. However, the surgical management must be considered for the high risk, high grade carotid stenosis patients with collateral blood flow, and with or without mild or moderate deficits.
Angioplasty ; Arteries ; Atherosclerosis ; Carotid Arteries* ; Carotid Stenosis ; Constriction, Pathologic ; Endarterectomy, Carotid ; Humans ; Prognosis* ; Stents

BACKGROUND: The use of dacron-cuffed tunneled double-lumen catheters for hemodialysis has become more common as patients wait for creation and maturation of a permanent access. Placement of the catheters is done by interventional radiologists, vascular surgeons or nephrologists, and the differences in success rates, complications, blood flow rates and the durations of catheter uses are reported. This study evaluated the usefulness, complications, blood flow rates and duration of use of tunneled cuffed hemodialysis catheters implanted via the internal jugular veins by an interventional radiologist and a vascular surgeon together. METHODS: The outcomes were retrospectively analyzed of 31 hemodialysis catheters placed from December 1999 through January 2001. We investigated age, sex, indications and locations of insertion, catheter performance, complications and causes of catheter removal. All the catheters were placed via the internal jugular veins by an interventional radiologist and a vascular surgeon together. RESULTS: Catheter placements were successful in all patients. Procedural complication was limited to clinically unimportant minor local bleeding. No instances of pneumothorax, hemothorax, vessel injury, substantial bleeding, obstruction, malposition or stenosis occurred. The blood flow rate on the first hemodialysis after placement of the catheter was 230+/-35.5 mL/min and that after 1 month was 248+/-18.6 mL/min. Late complications included catheter breakage in two cases (6.5%) and bacteremia in four cases (12.9%). Catheters were removed because of catheter-related bacteremia in four cases (12.9%) and death of patients in three cases (9.7%). In 22 cases (71.0%) the catheters were removed because the A- V vascular accesses were available for hemodialysis. Mean duration of the catheter use before removal was 134+/-96 days. CONCLUSION: Tunneled cuffed catheters inserted via the internal jugular veins are safe and durable vascular accesses for hemodialysis with good blood flow rate and long duration of use, especially placed by the co-operation of an interventional radiologist and a vascular surgeon.
Bacteremia ; Catheters* ; Constriction, Pathologic ; Hemorrhage ; Hemothorax ; Humans ; Jugular Veins* ; Pneumothorax ; Renal Dialysis* ; Retrospective Studies