STUDY DESIGN: A retrospective study. OBJECTIVES: To compare the outcome of percutaneous vertebroplasty (VP), with kyphoplasty, in the treatment of osteoporotic painful vertebral compression fractures (VCF). SUMMARY OF LITERATURE REVIEW: There is much controversy relating to the treatment of painful osteoporotic VCF. Recent analytical data exists on VP and kyphoplasty. MATERIALS AND METHODS: A consecutive group of patients, undergoing VP and kyphoplasty at our institution, between July 2000 and November 2002, were retrospectively reviewed. A total of 23 patients underwent 25 VP procedures under local anesthesia, and 8 underwent 8 kyphoplasty procedures, 3 under general and 5 under local anesthesia. A radiological assessment was achieved by the percentage of height restored, using both the preoperative and postoperative radiographs. The Visual analog scale (VAS) scores, obtained pre and postoperatively were used for the clinical assessment. The activity levels were assessed preoperatively, after discharge and at the last follow up period, by the ambulatory stati. RESULTS: The VP restored 27.62% (anterior*) and 30.26% (middle**) of the lost height. The kyphoplasty restored 35.52% (anterior*) and 53.43% (middle**) of the lost height (P=0.3334*, P=0.0264**). The postoperative pain was improved in all patients after both procedures. The postoperative VAS score was 3.826 after the VP and 2.875 after the kyphoplasty (P=0.5647). The activity levels were improved in all patients after both procedures. CONCLUSIONS: The kyphoplasty was more efficient in restoring the middle vertebral body height than the VP in the treatment of osteoporotic painful VCF. However, both procedures showed similar clinical improvements in the pain and restoration of the anterior vertebral body height in the treatment of painful osteoporotic VCF. Both kyphoplasty and VP safely increased the vertebral body height, decreased the acute back pain and quickly returned geriatric patients to higher activity levels, resulting in an increased independence and quality of life.
Anesthesia, Local ; Back Pain ; Body Height ; Follow-Up Studies ; Fractures, Compression* ; Humans ; Kyphoplasty* ; Osteoporosis ; Pain, Postoperative ; Quality of Life ; Retrospective Studies ; Vertebroplasty* ; Visual Analog Scale

By using differential display, we identified one of the genes encoding the multi-subunit complex protein V-ATPase, c subunit gene (ATP6L), and showed alterations of the gene expression by oxidative stresses. Expression of the ATP6L gene in Neuro-2A cells was increased by the treatment with H2O2 and incubation in hypoxic chamber, implying that the expression of the ATP6L gene is regulated by oxidative stresses. To examine mechanisms involved in the regulation of the gene expression by oxidative stresses, the transcriptional activity of the rat ATP6L promoter was studied. Transcription initiation site was determined by primer extension analysis and DNA sequencing, and promoter of the rat ATP6L and its deletion clones were constructed in reporter assay vector. Significant changes of the promoter activities in Neuro-2A cells were observed in two regions within the proximal 1 kbp promoter, and one containing a suppressor was in -195 to -220, which contains GC box that is activated by binding of Sp1 protein. The suppression of promoter activity was lost in mutants of the GC box. We confirmed by electrophoretic mobility shift and supershift assays that Sp1 protein specifically binds to the GC box. The promoter activity was not changed by the H2O2 treatment and incubation in hypoxic chamber, however, H2O2 increased the stability of ATP6L mRNA. These data suggest that the expression of the ATP6L gene by oxidative stresses is regulated at posttranscriptional level, whereas the GC box is important in basal activities of the promoter.
Animals ; Clone Cells ; Gene Expression* ; Hydrogen Peroxide ; Oxidative Stress* ; Rats ; RNA, Messenger ; Sequence Analysis, DNA ; Transcription Initiation Site ; Vacuolar Proton-Translocating ATPases*

OBJECTIVES: The purpose of this study was to identify and compare the difference and related factors with general characteristic and health behaviors, a experience of diagnosis and treatment of chronic diseases between rural and urban among elderly in Korea. METHODS: We used the data of Community Health Survey 2017 which were collected by the Korean Center for Disease Control and Prevention. The study population comprised 67,835 elderly peopled aged 65 years or older who participated in the survey. The chi-square test, univariate and multivariate logistic regression analysis were used to analyze data. RESULTS: We identified many significant difference of health behaviors, an experience of diagnosis and treatment with chronic diseases between rural and urban. Compared to urban elderly, the odds ratios (ORs) (95% confidence interval) of rural elderly were 1.136 (1.092–1.183) for diagnosis of diabetes, 1.278 (1.278–1.386) for diagnosis of dyslipidemia, 0.940 (0.904–0.977) for diagnosis of arthritis, 0.785(0.736–0.837) for treatment of arthritis, 1.159 (1.116–1.203) for diagnosis of cataracts, and 1.285(1.200–1.375) for treatment of cataracts. In the experience of diagnosis and treatment of chronic diseases, various variables were derived as contributing factors for each disease. Especially, there were statistically significant difference in the experience of diabetes diagnosis, arthritis diagnosis, cataract diagnosis and dyslipidemia except for hypertension diagnosis (p<0.01) between urban and rural elderly. There were statistically significant differences in the experience of treatment for arthritis and cataract (p<0.01), but there was no significant difference in the experience of treatment for hypertension, diabetes, dyslipidemia between urban and rural elderly. CONCLUSION Therefore, it would be necessary to implement a strategic health management project for diseases that showed significant experience of chronic diseases with diagnosis and treatment, reflecting the related factors of the elderly chronic diseases among the urban and rural areas.