Recently anterior spinal device in the treatment of the unstable thoraco-lumbar spine has been used. We have experienced 11 patients of the unstable thoraco-lumbar spine, which were composed of 8 patients with burst fracture and 3 patients with tuberculous spondylitis. The 11 patients with neurological deficit were treated with an one stage anterior operation consisting of anterior decompression through vertebrectomy, realignment with Kanedae device. No patient showed neurologic deterioration after surgery. The anterior spinal instrumentation with Kaneda device afford enough stability to enable early ambulation with good alignment and solid fusion.
Decompression ; Early Ambulation ; Humans ; Spine ; Spondylitis

BACKGROUND: Bispectrum and bicoherence analysis that is the frequency domain methods of EEG analysis was examined to elucidate the correlation with the depth of anesthesia. METHODS: 25 patients under the gynecological surgery were studied. EEG was surveyed by PhysioLab 400. Analysis of EEG was done according to the progress of anesthesia, normal state before anesthesia, before incision of skin, operation 1, operation 2, awake and post-anesthesia. EEG is applied to filtering of signal, base line correction, linear detrend removal to get more reliable analysis. The appearance rate of bispectrum peaks are calculated by bispectrum operation. And bicoherences are calculated by bispectrum and power spectrum of AR model. RESULTS: In awaking state of patient in pre-anesthesia and post anesthesia, appearance rate of bispectral coupling was observed that a strong appearance rate was represented in all area (0-35 Hz). During the anesthesia, the low frequency area (3-15 Hz) revealed a strong appearance. Also the 2D map of a appearance rate is divided into four sections for more objectivity. Of four sections Bipara#4 is considered that the best parameter which showed progress of anesthesia (P < 0.01). In bicoherence study, in awake state which patient is in pre-anesthesia and post anesthesia, appearance rate of bicoherence value was observed that a strong appearance rate was represented in high frequency range (15-30 Hz). However, under the anesthesia of patients, the low frequency area (0-10 Hz) revealed a strong appearance. And, of four sections Bicpara#2 and Bicpara#4 are considered that the best parameter which showed progress of anesthesia effectively (P < 0.01). CONCLUSIONS: The analysis of the peak appearance of bispectrum and bicoherence is useful monitoring for the depth of anesthesia.
Anesthesia ; Electroencephalography ; Female ; Gynecologic Surgical Procedures ; Humans ; Skin

Purpose: To report a rare case of slow progression of carotid cavernous fistula (CCF) with central retinal vein occlusion (CRVO).Case summary: A 66-year-old man presented with conjunctival injection and proptosis in the right eye. Best-corrected visual acuity was 0.8 and 0.5 in the right and left eye, respectively, and conjunctival vessel enlargement and subconjunctival hemorrhage were observed in the right eye on slit lamp examination. Due to suspicion of CCF, computed tomography, computed tomography angiography, magnetic resonance imaging, and magnetic resonance angiography were performed. These analyses showed no vascular abnormalities associated with arteriovenous shunt, so the patient was followed up closely. About 1 month later, his conjunctival vessel engorgement became severe and CRVO derived from venous stasis by CCF occurred, so transfemoral cerebral angiography was performed and a diagnosis of CCF was made. Intravitreal anti-vascular endothelial growth factor injection was performed for CRVO, and best corrected visual acuity improved to 1.0 in the right eye. Conclusions Slowly progressing CCF can be accompanied with rare intraocular disease, such as CRVO, so appropriate diagnosis through detailed evaluation is important for treatment.

Linear focal elastosis is characterized clinically by horizontal yellowish palpable striae on the lower back and histologically fragmentation or aggregation of elastic fibers. We herein report four cases of linear focal elastosis in male patients. They were 12 to 17 years old and the disease duration was 1 to 3 years. We suggest linear focal elastosis is a variant of striae distensae affecting elastic fibers.
Adolescent ; Elastic Tissue ; Humans ; Male ; Striae Distensae

BACKGROUND:In this study, a distribute characteristics on the bispectral coupling of EEG were examined according to the depth of anesthesia by using bispectum analysis a type of nonlinear signal processing. METHODS: 25 patients during the general anesthesia were studied. In the preprocess, base line correction and linear detrend was used. During the awakening state, preoperatively and postoperatively, appearance rate of bispectral coupling was observed that a strong appearance rate was represented in major frequency zone such as (15, 15) Hz but weak appearance rate investigated in the other minor frequency zone. Whilst anesthetized, a strong appearance rate revealed the low frequency range below (10, 10) Hz and a weak appearance rate viewed in the other frequency range. As such was compared with the delta ratio and spectrum edge frequency (SEF). RESULTS: The delta ratio showed significantly lower values at induction (3.60 +/- 0.98) and during the maintenance (5.0+/-1.74) of anaesthesia than preoperatively (10.30 +/- 2.44) and postoperatively (13.03 +/- 2.29)(P < 0.05). These results were consistent with the trend of delta ratio, namely that the index of evaluation for the depth of anesthesia, known as the reflex of the conscious level of patient's during anesthesia. While these results were not consistent with SEF analysis results that the index of evaluation for suppression level of patient's during recovery stage of anesthesia. SEF shows lower values at maintenance (17.00 +/- 1.22) and postoperatively (12.20 +/- 1.53) than preoperatively (22.50 +/- 1.75) and at the induction (22.40 +/- 1.18) of anesthesia(P < 0.05). CONCLUSIONS: The bispectrum analysis method provided useful information about the index of evaluation according to the level of unconsciousness and suppression among other evaluation factor on depth of anesthesia.
Anesthesia* ; Anesthesia, General ; Electroencephalography* ; Humans ; Reflex ; Unconsciousness

PURPOSE: To determine the relative accuracy of barium enema findings of Hirschsprung's disease (HD) and to calculate a level of probability for three signs combined. MATERIAL AND METHODS: Barium enema findings in 45 patients who had undergone rectal biopsy to prove or exclude the diagnosis of HD were retrospectively analyzed by evaluating the presence of a transition zone, irregular contractions and delayed evacuation of barium. Seventeen were neonates (group 1) and the other 28 were infants and children (group 2). The sensitivity, specificity, and positive and negative predictive values of the findings were compared. RESULTS: In visualization of a transition zone, sensitivity, specificity and positive predictive value were 76.5%, 72.7% and 89.7%, respectively. Sensitivity for irregular contractions and delayed evacuation of barium was 76.5% and 91.7%, respectively, whereas for specificity, the corresponding values were 63.6% and 40%. Sensitivities for radiologic signs were higher in group 1 than in group 2, but, the specificities were lower. If two or three findings were positive, the level of probability was 85 - 100%. If two findings were negative, however, the corresponding value was 30%. CONCLUSION: We conclude that the most reliable HD finding is the presence of a transition zone. Irregular contractions and the delayed evacuation of barium are not specific. Two or three positive findings may suggest a higher probability of HD than any single positive finding alone.
Barium* ; Biopsy ; Child ; Diagnosis* ; Enema* ; Hirschsprung Disease* ; Humans ; Infant ; Infant, Newborn ; Retrospective Studies ; Sensitivity and Specificity

PURPOSE: To study characteristics of bicycle and motorcycle injured patients in a university hospital and in an edited national injury surveillance report. METHODS: Between July 2007 and January 2010, we collected data on bicycle and motorcycle injured patients in a university hospital. First, we compared the characteristics of each group. Second, we analyzed injury severity using their injury severity score (ISS) and their revised trauma score (RTS). We compared the categories of an edited national injury surveillance report with our university-acquired data. RESULTS: The total number of patients in traffic accidents was 4,111 (including 204 bicycle riders and 165 motorcycle riders). For those in bicycle accidents, a large fraction was < 10 years old or > 51 years old. For those in motorcycle accidents. Those in motorcycle accidents had an increased proportion of liver cirrhosis and of previous experience with a similar accident. Bicycle accidents had a higher proportion of cases where just the driver or just the passenger was injured. Just falling was the most cause of injury. Others were injured by collision with a car or by both. Motorcycle riders who wore helmets were better protected. Most accidents occurred after 19:00: motorcycle accidents most frequently between 0:00 and 7:00 and between 13:00 and 18:00 hours. Injury severity score were not different. Admission to the hospital and fatalities were highest for motorcycle accidents. The place of injury and alcohol intoxication status were reported for traffic accidents. CONCLUSION: Bicycle and motorcycle injuries were already considered as important factors in traffic accidents included in the injury surveillance report. More factors, including age, time, past history, etc. should be added.
Accidents, Traffic ; Head Protective Devices ; Humans ; Hypogonadism ; Injury Severity Score ; Liver Cirrhosis ; Mitochondrial Diseases ; Motorcycles ; Ophthalmoplegia

Granular cell tumor was described in the testis of two rabbits. Testis from each rabbit was surgically removed and submitted for histopathological diagnosis. Both testes were about 2.0 cm in diameter, firm, and tan. Microscopically, testicular mass consisted of compact sheets of round to polygonal and occasional spindle-shaped cells. The neoplastic cells contain a large amount of eosinophilic granular material in the cytoplasm. The cytoplasmic eosinophilic granules were positive for periodic acid Schiff stain. Immunohistochemically, the neoplastic cells were immunoreactive to Melan-A and vimentin. Based on these results, the testicular mass was diagnosed as a granular cell tumor.

BACKGROUND: Cleanroom air is extremely dry, as it is maintained within 1 % of relative humidity. Few studies have assessed the dermatologic life quality of workers in ultralow-humidity environments. Therefore, we aimed to evaluate the dermatologic life quality of cleanroom workers using the Skindex-29, compared to those of non-cleanroom workers. METHODS: Study participants were 501 cleanroom workers and 157 non-cleanroom workers from a secondary battery factory, who underwent an employee health examination at a single university hospital from September 2014 to September 2015. Results of the self-administered Skindex-29, and McMonnies questionnaire were analyzed. Other information and disease history were also collected during physician's medical examination. Descriptive and multivariate logistic regression analysis were performed. RESULTS: The Skindex-29 score was significantly higher in cleanroom workers than in non-cleanroom workers for all domains, Symptom (16.0 ± 15.9 vs. 6.3 ± 10.2, p < 0.001), Emotion (11.3 ± 17.4 vs. 2.5 ± 7.4, p < 0.001), Function (5.2 ± 11.1 vs. 1.6 ± 4.0, p < 0.001), and Overall (10.8 ± 13.4 vs. 3.5 ± 6.2, p < 0.001). The Skindex-29 score of cleanroom workers was similar to that of patients with skin diseases such as psoriasis, other dermatitis, corns, alopecia etc. Among the cleanroom workers, 37 workers had one or more skin diseases. Among the risk factors, ‘working at cleanroom’, ‘possessing skin disease’ and ‘McMonnies score’ had significant strong correlations with Skindex-29 score, meanwhile age, sex, smoking, drinking and exercise had weak correlations with it.‘Working at cleanroom’ and ‘possessing skin disease’ had highest odds ratios with overall 14.0 (C.I.: 5.9–33.1) and 13.4 (C.I.: 4.5–29.2), and the lowest odds ratios with function domain 3.5(C.I.: 1.7–7.1) and 4.5(C.I.: 2.1–9.5), respectively. The McMonnies score had the highest odds ratio with overall, 6.9(C.I.: 4.5–10.8) and lowest odd ratio with emotion domain 4.2 (C.I.: 2.7–6.4). CONCLUSIONS: Dermatologic life quality among cleanroom workers in the secondary battery factory is shown to be lower than that among non-cleanroom workers in this study. The study suggests that the Skindex-29 may provide helpful information on the dermatologic life quality of cleanroom workers. Therefore, regarding evaluation of dermatologic life quality using Skindex-29, preventive care is necessary for cleanroom workers in ultralow humidity environment.
Alopecia ; Callosities ; Dermatitis ; Drinking ; Humans ; Humidity ; Logistic Models ; Occupational Health ; Odds Ratio ; Psoriasis ; Quality of Life* ; Risk Factors ; Skin ; Skin Diseases ; Smoke ; Smoking ; Zea mays

BACKGROUND: Inhaled glucocorticoids are the medical treatment of choice in asthma patients. Fluticasone propionate is one of the most effective inhaled corticosteroids and has been reported to have minimal effect on the hypothalamic-pituitary-adrenal axis at the recommended dose. However, reports of long-term trials characterizing their systemic safety with chronic use are rare. This study was designed to evaluate the long-term safety of inhaled fluticasone propionate to the hypothalamic-pituitary-adrenal axis. METHOD: This study was conducted on 21 patients to evaluate the adrenal response to rapid ACTH stimulation test after 6 months of treatment with fluticasone propionate from 200 µg to 750 µg daily. The serum cortisol levels was measured to assess its effect on the hypothalamic-pituitary-adrenal axis just prior to the injection, at 30 minutes and 60 minutes after an intramuscular injection of synthetic ACTH. RESULT: The mean dose of inhaled fluticasone propionate was 355 µg per day(SD=174 µg, range=200 µg to 750 µg). The mean serum cortisol levels of the patients was 11.0 µg/dl(SD=6.4 µg/dl) prior to the injection, 20.0 µg/dl(SD=7.7 µg/dl) after 30 minutes, and 23.0 µg/dl(SD=6.3 µg/dl) after 60 minutes. Sixteen patients of the 21 patients had a normal response(>18 µg/dl), and 5 out of the 21 patients had serum cortisol levels below the normal range after the rapid ACTH stimulation test. CONCLUSION: Adrenal suppression occurred in 5 out of 21 patients with 6 months treatment with inhaled fluticasone propionate.
Adrenal Cortex Hormones ; Adrenocorticotropic Hormone ; Asthma* ; Axis, Cervical Vertebra* ; Cosyntropin ; Diethylpropion* ; Glucocorticoids ; Humans ; Hydrocortisone ; Injections, Intramuscular ; Reference Values ; Fluticasone