BACKGROUND: The common causes of lower back pain with or without leg pain includes disk disease and spinal stenosis. A definitive diagnosis is usually made by means of magnetic resonance imaging (MRI), but treatment is often difficult because the MRI findings are not consistent with the symptoms of the patient in many cases. The objective of this study was to observe the correlation between the patterns of epidurography performed in patients having lower back pain with or without leg pain and the position or severity of the pain as subjectively described by the patients. METHODS: The subjects of this study were 69 outpatients with lower back pain with or without leg pain who visited our clinic and complained of predominant pain on one side. We performed caudal epidural block using an image intensifier. A mixture of the therapeutic drug and the contrast agent (10 ml) was injected to observe the contrast flow pattern. The patients who complained of predominant pain on one side were divided into the left side group and the right side group. A judgment of inconsistency was made if the contrast agent flowed to the side of the pain, while a judgment of consistency was made if the contrast agent flowed to the opposite side of the pain. The degree of the drug distribution was evaluated by counting the number of cells to which the contrast agent's flowed for evaluating the correlation between the contrasted cell and the severity of pain (one group < or = VAS 7, the other group > or = VAS 8) the degree of the contrast agent's contrast was evaluated by dividing and counting an image into 15 cells (the left, right, and middle sections at each level of L4, L5, S1, S2, and S3). RESULTS: Thirty out of the 69 patients who had laterality in pain, that is, those who complained of predominant pain on one side, showed that the laterality of the pain and the contrast agent flow was consistent, while 39 patients showed that the laterality was inconsistent (P: 0.137). The evaluation of the correlation between the pain and the contrast agent flow showed that the mean number of contrasted cells was 9.0 +/- 2.2 for the 46 patients in the group with a VAS of 7 or lower and 6.5 +/- 2.0 for the 23 patients in the group with a VAS of 8 or higher, indicating that the former group showed a significantly greater number of contrasted cells (P < 0.001). CONCLUSIONS: This study, conducted with patients having lower back pain with or without leg pain, showed that the contrast flow pattern of caudal epidurography had a significant correlation with the severity of the pain but not with the laterality of the pain.
Humans ; Judgment ; Leg ; Low Back Pain ; Magnetic Resonance Imaging ; Outpatients ; Spinal Stenosis

Eight patients in the state of ASA classification l, ll were investigate. Blood samples were collected before, just after, 30 minutes after and 60 minutes after induction of anesthesia. Glucose and electrolyte changes in relation to maintenance fluids in balanced and halothane anesthesia were as follows. 1) In both anesthetic techniques blood sugar level showed increasing tendency according to duration of anesthesia. 2) There were no specific changes in serum electrolytes related to type of anesthesia. 3) The administration of D/S and H/D showed a little increase in Na+ and Cl- level compared to the administration of just DsW. 4) The administration of H/d showed less increase in K+ level than the administration of DsW or D/S. 5) Just after induction of anesthesia the K+ level increased a little and decreased gradually thereafter.
Anesthesia ; Anesthesia, General* ; Blood Glucose* ; Classification ; Electrolytes* ; Glucose ; Halothane ; Humans

There are many studies on the neurobehavioral symptoms due to organic solvent exposure using questionnaire. However there is little published evidence on validity and reliability of the questionnaire on the neurobehavioral symptoms. In present study, the authors tested the validity and reliability of our questionnaire, which was designed for screening neurobehavioral disturbance in organic solvent exposer. Questionnaire was administered to the workers of one paint manufacturing plant and one coil manufacturing plant. In order to evaluate validity of the questionnaire, the average questionnaire scores of two plants were compared. The average score of paint manufacturing plant were higher than that of coil manufacturing plant and the difference was statistically significant. After adjustment of age, duration of employment, education, smoking history and alcohol consumption, significance was maintained. Test-retest reliability was evaluated by kappa statistics. More than 50% of question items showed values of kappa above 0.4, Cronbach coefficient alpha whoch reflects internal consistency of the questionnaire was 0.86. Overall the data showed that validity and reliability of the questionnaire were generally acceptable.
Alcohol Drinking ; Education ; Employment ; Mass Screening ; Paint ; Plants ; Questionnaires* ; Reproducibility of Results* ; Smoke ; Smoking

Injuries from sea urchins are induced by from penetration of the calcareous spines into the skin. Apart from the transient episode of excruciating pain, there is usually no residual disability. Complications arise, however, when spines are embedded over bony prominences, or within joints. Two cases are reported with injury and protracted disability of fingers resulting from contact with the purple sea urchin, Anthocidaris crassispina, a common echinoderm inhabitant of the Korean east coast. After a latent period of several months in both cases, Case 1 presented as caseating granulomas in the synovium and case 2 exhibited as the usual soft tissue nonsynovial foreign body and noncaseating granulomas. There appears to be a paucity of published data regarding the effects of puncture wounds caused by the spines of this animal. The granulomas have appeared after a latent interval of several months in a proportion of the sufferers, suggests a delayed hyperserisitivity reaction similar to that produced by Mycobacterium species.
Animals ; Anthocidaris ; Bites and Stings* ; Fingers ; Foreign Bodies ; Granuloma ; Hand* ; Hypersensitivity, Delayed ; Inflammation* ; Joints ; Mycobacterium ; Punctures ; Sea Urchins* ; Skin ; Spine ; Strongylocentrotus purpuratus ; Synovial Membrane ; Wounds and Injuries

The incidence of post-dural puncture meningitis is very low. A 44-year-old patient developed a fever (38degrees C, headache, neck stiffness, nausea, and vomiting after combined spinal epidural (CSE) anesthesia and surgery for closed reduction and internal fixation (CRIF) with intramedullary (IM) nailing, tibia, Rt. With a preliminary diagnosis of bacterial meningitis, empiric broad spectrum antimicrobial treatment was immediately started after cerebrospinal fluid (CSF) sampling. The CSF was clear and revealed a white blood cell count, protein, glucose, and pressure of 146/micrometer, 225 mg/dl, 48 mg/dl (serum 151 mg/dl), and 26 cmH2O, respectively. The CSF stain and culture were negative. Considering the injection of preventive antibiotics before CSE anesthesia, partially treated bacterial meningitis was suspected. Four weeks later, clinical symptoms had improved before the patient was discharged.
Adult ; Anesthesia ; Anti-Bacterial Agents ; Fever ; Glucose ; Headache ; Humans ; Incidence ; Leukocyte Count ; Meningitis ; Meningitis, Bacterial ; Nails ; Nausea ; Neck ; Punctures ; Tibia ; Vomiting

BACKGROUND: Bone mineral density (BMD) is influenced by many factors. Despite the reported association between body components and BMD, most of these studies investigated the relationship between absolute muscle mass or fat mass and BMD in postmenopausal women or elderly subjects. The aim of this study is to investigate the association between muscle mass deficits (MMD) estimated from bioelectrical impedance analysis (BIA) and lumbar spinal BMD in Korean adults 20 to 49 years of age. METHODS: This cross-sectional study included 1,765 men and women who visited a health promotion center for a routine checkup. The lumbar spinal BMD was measured by dual energy X-ray absorptiometry. Body composition analysis was performed using BIA. RESULTS: The mean age of the subjects was 40.2±6.3 years. Ten thousand subjects (56.7%) were males and 126 subjects (7.1%) belonged to the low BMD (Z-score ≤-2.0). MMD had the strongest influence on BMD after adjusting for all covariates. The adjusted odds ratio of Group 3 (MDD >2.6 kg) for low BMD was 2.74 (95% CI, 1.46-5.15) after adjusting for age, gender, body mass index, height, and smoking. CONCLUSIONS: MMD estimated by BIA showed a significant association with BMD and could be regarded as an independent risk factor for low BMD in adults 20 to 49 years of age. These findings support that interventions such as physical activity or lifestyle changes may simultaneously modify both muscle and bone health in this age group.
Absorptiometry, Photon ; Adult* ; Aged ; Body Composition ; Body Mass Index ; Bone Density* ; Cross-Sectional Studies ; Electric Impedance* ; Female ; Health Promotion ; Humans ; Life Style ; Male ; Motor Activity ; Muscles ; Odds Ratio ; Osteoporosis ; Risk Factors ; Smoke ; Smoking ; Spine*

BACKGROUND: The purpose of this study was to evaluate the value of phosphorylated tau with epitopes threonine 181(p-tau181) in cerebrospinal fluid (CSF) for the differential diagnosis of Alzheimer's disease typed dementia from other type of dementia. METHODS: A systematic literature search was performed to identify studies on p-tau181. Two evaluators independently evaluated the quality of the ten studies using the Scottish Intercollegiate Guidelines Network (SIGN) tool. The literature review covered from October 27, 1946 to October 22, 2013, and eight domestic databases including KoreaMed and international databases including Ovid-MEDLINE, EMBASE, and Cochrane Library were used. Tau concentrations were compared to healthy controls and to subjects with Alzheimer's disease (AD) using random effect meta-analysis. Outcome measures were Cohen's delta, sensitivity and specificity. RESULTS: Finally, 8 studies (8 diagnostic evaluation studies) were identified to evaluate CSF p-tau181. The effectiveness of this test was evaluated based on diagnostic accuracy. The diagnostic accuracy for identifying AD by ELISA was high which revealed pooled sensitivity as 0.843 (95% CI 0.818-0.867), pooled specificity as 0.799(95% CI 0.768-0.828) and summary receiver operating characteristic area under the curve 0.9082+/-0.0236. CONCLUSIONS: CSF p-tau181 concentrations in other type of dementia are intermediate between controls and AD patients. Overlap between both controls and AD patients results in insufficient diagnostic accuracy, and the development of more specific biomarkers for these disorders is needed.
Alzheimer Disease* ; Biomarkers ; Cerebrospinal Fluid ; Dementia ; Diagnosis, Differential* ; Enzyme-Linked Immunosorbent Assay ; Epitopes ; Humans ; Outcome Assessment (Health Care) ; ROC Curve ; Sensitivity and Specificity ; tau Proteins ; Threonine

Myasthenia Gravis is a chronic disease of disputed etiology, possibly an auto-immune reaction to the moter end-plate, characterized by exacerbations and remissions, a rare disease entity in Korea. Myasthenia Gravis has offered many anesthetic problems because it affects respiratory muscles occasionally and bronchial secretion from preoperative anticholinesterase therapy. The chief concern is to ensure adequate respiration both during and after operation. During the year 1976-1982, we have experienced the anesthetic management of 8 patients with myasthenia gravis and thymectomy. From our experiences, we conclude that respiratory care and disuse of relaxants is the key to successful management.
Chronic Disease ; Humans ; Korea ; Myasthenia Gravis* ; Rare Diseases ; Respiration ; Respiratory Muscles ; Thymectomy

Oxygen deficiency has been frequent in a closed space. Wood consumes oxygen and discharges carbon dioxide instead of photosynthesis in closed space without light, so do some microorganisms on the surface. We experienced a case that a healthy insect-proofer fell down and died of asphyxia on stair-board at 7 m below the hatch of the cargo-hold shipping wood. Analysis of gases in cargo-hold revealed O2; 12.3%, CO; 105 ppm, CH4; 2.7%, and H2S; 1.9% at 1 m below the hatch, and then O2; 6.1%, CO; 220 ppm, CH4; 2.9%, and H2S; 2.3 ppm at 2.5 m below the hatch. Autopsy findings were unremarkable. We justiced the cause of death asphyxia due to oxygen deficiency. As seen in this case, the serious oxygen deficiency was accounted for oxygen consumption by wood and microorganisms.
Anoxia* ; Asphyxia* ; Autopsy ; Carbon Dioxide ; Cause of Death ; Gases ; Oxygen Consumption ; Oxygen* ; Photosynthesis ; Ships* ; Wood*

Oxygen deficiency has been frequent in a closed space. Wood consumes oxygen and discharges carbon dioxide instead of photosynthesis in closed space without light, so do some microorganisms on the surface. We experienced a case that a healthy insect-proofer fell down and died of asphyxia on stair-board at 7 m below the hatch of the cargo-hold shipping wood. Analysis of gases in cargo-hold revealed O2; 12.3%, CO; 105 ppm, CH4; 2.7%, and H2S; 1.9% at 1 m below the hatch, and then O2; 6.1%, CO; 220 ppm, CH4; 2.9%, and H2S; 2.3 ppm at 2.5 m below the hatch. Autopsy findings were unremarkable. We justiced the cause of death asphyxia due to oxygen deficiency. As seen in this case, the serious oxygen deficiency was accounted for oxygen consumption by wood and microorganisms.
Anoxia* ; Asphyxia* ; Autopsy ; Carbon Dioxide ; Cause of Death ; Gases ; Oxygen Consumption ; Oxygen* ; Photosynthesis ; Ships* ; Wood*