BACKGROUND AND OBJECTIVE: Percutaneous transluminal coronary angioplasty of chronic total occlusion has been limited by a relatively low success rate and a high restenosis rate. This study investigated procedural outcome, factors predictive of procedural success and safety of coronary angioplasty for chronic total coronary occlusion. MATERIALS AND METHODS: The study population was composed of 45 lesions attempting PTCA with or without stent implantation for recanalization of chronic total coronary occlusion between January 1997 and July 1999. The clinical and angiographic data of the 45 lesions were reviewed. The results of successful PTCA in 28 lesions were compared with those in 17 lesions whose PTCA was failed. RESULTS: The overall success of balloon angioplasty and stenting was achieved in 28 lesions (62.2%) and did not differ significantly by clinical variables. The most common cause of failure of balloon angioplasty was inability to pass the guide wire across the occlusion( 14 of 23 lesions, 61%). Procedural success was more common in patients with occlusions with a tapered entry configuration(77.2% vs. 47.8%, p=.042), with lesions without side branches(82.3% vs. 50%, p=.03). Multiple logistic regression analysis identified the absence of side branch(p<0.01) and the presence of a tapered entry configuration(p<0.05) as independent predictors of procedural success. One case(2.2%) needed emergency coronary bypass surgery after failure to recanalize the occluded vessel. There was no Q wave acute myocardial infarction, death. CONCLUSIONS: The favorable cases(>60%) of chronic total coronary occlusions can be successfully dilated by balloon angioplasty with or without stent implantation, with a major complication rate of 2.2%. Therefore, with careful patient selection, we need to try the aggressive recanalization for chronic total coronary occlusion.
Angioplasty ; Angioplasty, Balloon ; Angioplasty, Balloon, Coronary* ; Coronary Occlusion ; Emergencies ; Humans ; Logistic Models ; Myocardial Infarction ; Patient Selection ; Stents

STUDY DESIGN: A prospective study. PURPOSE: To assess postoperative changes in cerebral glucose metabolism in anxiety patients with lumbar spinal stenosis (SS). OVERVIEW OF LITERATURE: Although an association between preoperative anxiety and abnormal cerebral glucose metabolism may exist, only a limited number of studies using F-18 fluorodeoxyglucose positron emission tomography (FDG PET) have evaluated preoperative to postoperative changes in cerebral glucose metabolism in SS patients in detail. METHODS: The present study was designed to assess preoperative to postoperative changes in cerebral glucose metabolism in anxiety patients with SS. F-18 FDG PET with statistical parametric mapping analyses was used to compare preoperative and postoperative regional brain glucose metabolism in 18 SS patients. RESULTS: F-18 FDG PET scans showed postoperative activation of several brain clusters in gray matter. These included left parahippocampus, left cerebellar tonsil, left inferior semi-lunar lobule, and right cerebellar tonsil. Areas that were deactivated postoperatively were the right insula, left fusiform gyrus, left orbitofrontal cortex, left inferior frontal gyrus, left middle frontal gyrus, left precuneus, and left inferior frontal gyrus. CONCLUSIONS: SS patients with preoperative anxiety showed altered cerebral glucose metabolism at postoperative follow-up.
Anxiety ; Brain ; Follow-Up Studies ; Glucose ; Humans ; Palatine Tonsil ; Positron-Emission Tomography ; Prospective Studies ; Spinal Stenosis

Schwannoma is a benign tumor derived from Schwann cells which are usually found in the head, neck, trunk, upper and lower extremities, and rarely in the thoracolumbar junction. Also, osteopetrosis is an idiopathic genetic skeletal disease that rarely occurs. Most reports of osteopetrosis are about long bone fractures, but spinal tumor in osteopetrosis has been rarely reported. Furthermore, there is no report about thoracolumbar intradural Schwannoma and its treatment in patient with osteopetrosis. Thus, we report the clinical results of a thoracolumbar Schwannoma in a 36 year-old female osteopetrotic patient who had progressive weakness, and dysesthesia of the left lower limb. The patient underwent laminectomy and total excision of tumor through a posterior approach, and a favorable clinical outcome was achieved.
Female ; Fractures, Bone ; Head ; Humans ; Laminectomy ; Lower Extremity ; Neck ; Neurilemmoma ; Osteopetrosis ; Paresthesia ; Schwann Cells

Background: We aimed to investigate whether densitometry results and volumetric bone mineral density (vBMD) can predict vertebral fragility fractures (VFF) in postmenopausal women. Methods: We enrolled 271 postmenopausal women aged >45 years who visited our hospital for health check-ups between September 2016 and September 2017. The lumbar spine (LS) and femoral neck (FN) densitometry results and trabecular bone score (TBS) were calculated using dual energy X-ray absorptiometry. vBMD was assessed using central quantitative computed tomography (cQCT). Baseline and follow-up X-ray images were reviewed to evaluate thoracolumbar vertebral compression fractures (CFs), according to the Genant criteria. Results: At baseline, 76 patients (28.0%) had CF. Additional or progressive fractures were noted in 26 participants (9.6%) with a median follow-up of 19.5 months. The median TBS and cQCT were significantly higher in participants without baseline CF than those with baseline CF (p<0.001). During the follow-up, Kaplan–Meier analysis showed that T-scores of the LS and FN <-2.5, degraded microarchitecture based on the TBS (≤1.200), and vBMD <80 mg/cm3 was significantly associated with future osteoporotic CF. The final multivariate Cox regression analysis showed that baseline CF and low TBS and vBMD were significant risk factors for future VFF. Conclusions Participants with baseline CF and degraded microarchitecture had higher CF predisposition. Moreover, cQCT can predict future vertebral fractures.

STUDY DESIGN: A prospective study. PURPOSE: To identify associations between psychiatric factors and patient-reported outcomes after corrective surgery in patients with lumbar degenerative kyphosis (LDK). OVERVIEW OF LITERATURE: Thus far, to the best of our knowledge, patient factors that may help predict patient-reported outcomes after corrective surgery for LDK have not been studied. METHODS: We prospectively investigated 46 patients with LDK who underwent surgical correction with a minimum follow-up of 2 years. Demographic data were collected. Short form-36, mental component scores (MCS), physical component scores (PCS), Scoliosis Research Society-22 (SRS-22) scores, and Roland-Morris Disability Questionnaire (RMDQ) scores were determined before the surgery and after 2 years of follow-up. Psychiatric conditions were preoperatively evaluated using the Zung depression scale (ZDS) and Zung anxiety scale (ZAS). Patients were divided into two groups (with or without psychiatric issues), according to baseline ZDS and ZAS scores. RESULTS: Patients included 43 women and 3 men. Twelve patients were deemed to have psychiatric problems (P group) and 34 patients had no psychiatric problems (NP group). No significant intergroup differences were found in MCS, PCS, SRS-22, and RMDQ scores preoperatively. However, at the 2-year follow-up, a significant intergroup difference was observed between PCS and RMDQ scores. Multiple regression analysis revealed that only the presence of a preoperative psychiatric problem can predict PCS and RMDQ scores. Other factors, such as, gender, age, body mass index, bone mineral density, osteotomy site, number of fusion segments, and instrumented levels did not affect PCS or RMDQ scores. CONCLUSIONS: The presence of a psychiatric factor may be an important risk factor underlying poor physical and pain scores after corrective surgery in patients with LDK. The findings presented here suggest that psychiatric factors should be evaluated prior to surgery for determining the risk of a poor outcome.
Anxiety ; Body Mass Index ; Bone Density ; Depression ; Female ; Follow-Up Studies ; Humans ; Kyphosis ; Lumbar Vertebrae ; Male ; Mental Disorders ; Osteotomy ; Prospective Studies ; Risk Factors ; Scoliosis

Methods: Adolescent idiopathic scoliosis (AIS) patients ages 10 to 19 years completed the Korean version of the Quality of Life Profile for Spinal Deformities (K-QLPSD), the Scoliosis Research Society-22 self-image subscale (K-SRS-22-si), Korean version of the Spinal Appearance Questionnaire (K-SAQ), Korean version of the Body Image Disturbance Questionnaire-Scoliosis (K-BIDQ-S), and Korean version of the Italian Spine Youth Quality of Life (K-ISYQOL). Four body image questionnaires were compared with K-ISYQOL and radiographic major curve magnitude, coronal balance, and sagittal balance. Spearman’s correlation was performed to compare the four body image questionnaires. Results: The study included 84 AIS patients, with a mean age of 12.6 years and a major Cobb angle of 29.4°. The four surveys were correlated with major curve magnitude and K-ISYQOL. K-SAQ and K-BIDQ-S were correlated better than K-QLPSD, and K-SRS-22-si was correlated with K-ISYQOL. The four surveys were moderately correlated with major curve magnitude, but there was no correlation with age, coronal balance, and sagittal balance. Conclusions K-SAQ and K-BIDQ-S correlate better with K-ISYQOL than K-QLPSD and K-SRS-22-si.

Background: The aim of this study was to develop a scoring system to stratify the risk of papillary thyroid cancer (PTC) and to select the proper management. Methods: We performed a systematic search of MEDLINE and Embase. Data regarding patients’ prognoses were obtained from the included studies. Odds ratios (ORs) with statistical significance were extracted from the publications. To generate a risk scoring system (RSS), ORs were summed (RSS1), and summed after natural-logarithmic transformation (RSS2). RSS1 and RSS2 were compared to the eighth edition of the American Joint Committee on Cancer (AJCC) staging system and the 2015 American Thyroid Association (ATA) guidelines for thyroid nodules and differentiated thyroid carcinoma. Results: Five meta-analyses were eligible for inclusion in the study. Eight variables (sex, tumour size, extrathyroidal extension, BRAF mutation, TERT mutation, histologic subtype, lymph node metastasis, and distant metastasis) were included. RSS1 was the best of the analysed models. Conclusion We developed and validated a new RSS derived from previous meta-analyses for patients with PTC. This RSS seems to be superior to previously published systems.

STUDY DESIGN: Prospective study. PURPOSE: To evaluate the reliability and validity of the adapted Korean version of the Quality of Life Questionnaire of the European Foundation for Osteoporosis (ECOS-16). OVERVIEW OF LITERATURE: The validity of the Korean version of ECOS-16 has not been completely demonstrated. METHODS: Translation/retranslation of the English version of ECOS-16, and full cross-cultural adaptation were performed. The Korean version of a visual analog scale measure of pain, and the Korean versions of ECOS-16 and of the previously validated short form-36 (SF-36) were mailed to 158 consecutive patients with osteoporosis. Factor analysis and reliability assessment using kappa statistics of agreement for each item, intraclass correlation coefficient, and Cronbach's α were done. Construct validity was evaluated by comparing responses to ECOS-16 with responses to SF-36 using Pearson's correlation coefficient. RESULTS: Factor analysis extracted three factors. All items had a kappa statistics of agreement >0.6. The ECOS-16 showed good test/re-test reliability (0.8469) and internal consistency of Cronbach's α (0.897). The Korean version of ECOS-16 showed significant correlation with SF-36 total scores and with single SF-36 domains scores. CONCLUSIONS: The adapted Korean version of the ECOS-16 was successfully translated and showed acceptable measurement properties. It is considered suitable for outcome assessments in Korean patients with osteoporosis.
Humans ; Osteoporosis* ; Postal Service ; Prospective Studies ; Quality of Life ; Reproducibility of Results ; Visual Analog Scale

STUDY DESIGN: A prospective study. PURPOSE: To evaluate the reliability and validity of the adapted Korean version of the Neck Pain and Disability Scale (NPDS). OVERVIEW OF LITERATURE: The validity of Korean version of NPDS has not been completely demonstrated yet. METHODS: Translation/retranslation of the English version of NPDS was conducted, and all steps of the cross-cultural adaptation process were performed. The Korean version of the visual analog scale (VAS) measure of pain, NPDS and the previously validated Short Form-36 (SF-36) were mailed to 91 patients, who had been surgically treated for degenerative cervical disease. Eighty-one patients responded to the first mailing of questionnaires and 69 of the first time responder returned their second survey. Factor analysis and reliability assessment by kappa statistics of agreement for each item, the intraclass correlation coefficient and Cronbach's alpha were conducted. Concurrent and construct validity were also evaluated by comparing the responses of NPDS with the results of VAS and responses of SF-36. RESULTS: Factor analysis extracted 3 factors. All items had a kappa statistics of agreement greater than 0.6. The NPDS showed excellent test/re-test reliability. Internal consistency of Cronbach's alpha was found to be very good. The NPDS was correlated with the VAS. The Korean version of NPDS showed good significant correlation with SF-36 total score and with single SF-36 domains scores. CONCLUSIONS: The adapted Korean version of the NPDS was successfully translated and is considered suitable for outcome assessments in the Korean-speaking patients with neck pain.
Humans ; Neck ; Neck Pain ; Prospective Studies ; Reproducibility of Results ; Surveys and Questionnaires