BACKGROUND: Hypertension is the major risk factor for cardiovascular disease. The increased left ventricular mass has been recognized as an independent predictor of morbidity and mortality in hypertensive patients. The assessment of the regression of left ventricular(LV) mass after antihypertensive therapy offers prognostic information. 2D echocardiography has proved a sensitive tool for the detection of the change of LV mass. METHOD: LV mass and LV mass index were measured by area-length method of 2D echocardiography in 26 hypertensive patients and 10 normal control to evaluate the effect of betablocker(group I, n=16) and angiotensin converting enzyme(ACE) inhibitor(group II, n=10) on the regression of LV mass. RESULT: There was a significant increase of LV mass and LV mass index in the hypertensive patients(199.0+/-37.7gm, 119.2+/-21.2gm/m2) compaired to the control(129.7+/-11.7gm, 87.4+/-8.8gm/m2)(p<0.01, p<0.01). After 13.1 week treatment, LV mass was significantly decreased in group I(200.9+/-35.3gm vs 164.7+/-25.4gm)(p<0.01) and group II(195.9+/-43.3gm vs 152.4+/-27.1gm)(p<0.01). The LV mass index was also significantly decreased in group I(120.3+/-20.7gm/m2 vs 98.8+/-15.5gm/m2)(p<0.01) and group II(117.5+/-22.9gm/m2 vs 91.5+/-13.6gm/m2)(p<0.01). CONCLUSION: This results showed that LV mass can be reduced in hypertensive patients who receive beta blocker and ACE inhibitor. The effect of antihypertensive therapy on LV mass should be considered in treatment of the hypertensive patients who had hypertrophied LV.
Angiotensins ; Cardiovascular Diseases ; Echocardiography ; Humans ; Hypertension ; Mortality ; Risk Factors

PURPOSE: To evaluate the efficacy of the postoperative oral antibiotics in acute appendicitis. METHODS: This study compared 126 patients diagnosed with appendicitis in 2004, who did not take oral antibiotics after the postoperative treatment (group 2), with 119 patients diagnosed with appendicitis in the year of 2003, who did take oral antibiotics after the parenteral postoperative antibiotics regimen (group 1). RESULTS: The clinical, operative, and bacterial outcomes were similar. Only one infectious complication was detected in each group (group1; 1/119, group2; 1/126). CONCLUSION: This study suggests that adding a course of oral antibiotics, after completing a course of parenteral antibiotics, does not decrease The rate of postoperative infectious complications in appendicitis patients.
Anti-Bacterial Agents* ; Appendicitis* ; Humans

No abstract available.
Cataract* ; Chlorpromazine* ; Skin Pigmentation* ; Skin*

Background: In this study, we aimed to investigate the recent trends for health care indicators including maternal mortality ratio, infant mortality rate, under-five mortality rate, life expectancy, years of life lost, and healthcare resources in South Korea, North Korea, Germany, Russian Federation, Mongolia, Vietnam, China, Czech Republic, Poland, and Hungary. Methods: We used data from five sources: World Health Organization, Federal Institute for Population Research, World Bank, Organization for Economic Cooperation and Development health statistics, and national statistics. Results: In the early 1990s, health indicators continued to improve in countries that switched to the health insurance system, but the gap widened in North Korea as health indicators worsened. Conclusion The establishment of a sustainable health care system after unification of the Korean peninsula requires substantial changes in the health care system and efforts to improve the health of North Koreans.

Objective: This study aimed to review domestic and international literature on oral health interven-tions for pregnant women and provide basic data for the development of oral health intervention programs. Methods: We used domestic and international search databases, such as Medline, Embase, Re-search Information Sharing Service, Science On, Korea Citation Index, and DBpia. Among papers published between 2003 and 2023, 22 met the selection criteria by combining “pregnant women,” “oral hygiene,” and “oral health.” Results: Since 2007, foreign literature has steadily increased; however, domestic literature has decreased. Overseas research designs were mostly randomized control trials, whereas domestic designs were mostly non-equivalent control group pretest-posttest. The intervention methods in-cluded three preventive programs, five specialized oral care programs, and 14 oral health education programs. Conclusions In-depth research should be conducted to increase the understanding and interest of pregnant women. Systematic intervention programs that consider the effectiveness and sus-tainability of intervention methods should be developed, and policy support should be provided to strengthen the importance of oral health education by experts and institutional improvements.

STUDY DESIGN: Retrospective study. OBJECTIVES: To evaluate the correlation of adjacent segmental disease with tilt angles of the upper and lower instrumented vertebra after instrumented posterolateral fusion for degenerative lumbar scoliosis. SUMMARY OF LITERATURE REVIEW: There has been no study of radiologic measurement and decision of fusion level using the angle of pedicle screws inserted for treatment of degenerative lumbar scoliosis. MATERIALS AND METHODS: From 2004 to 2008, 74 patients that underwent decompression and posterolateral fusion for degenerative lumbar scoliosis were included in this study. In all cases, instrumentation and posterolateral fusion were both performed. The sex ratio was 31:43, the mean age was 68.7 years and the mean follow up duration was 37.4 months. The angle between each upper end plate of the upper vertebral body and lower end plate of the lower vertebral body of the fusion, and the line parallel to the axis of the sagittal line of vertebrae was each defined as UIV-a and LIV-b. The correlation of development of adjacent segment disease and UIV-a, and LIV-b angle was investigated. RESULTS: Sum of the absolute value of UIV-a and LIV-b had a statistically significant positive correlation with that of adjacent segment disease. Also, UIV-a alone, had a statistically positive correlation with the development of proximal adjacent segment disease. CONCLUSIONS: Since it is proven that adjacent segment disease has positive correlation with the sum of the absolute value of UIV-a and LIV-b, the extent of fusion should be adjusted to make the line parallel to the line perpendicular to the sagittal surface.
Axis, Cervical Vertebra ; Decompression ; Follow-Up Studies ; Humans ; Retrospective Studies ; Scoliosis ; Sex Ratio ; Spine

OBJECTIVES: To analogize the test results through analyzing the correlation of bone mineral density (BMD) values between 2 sites (proximal femur and lumbar spine). MATERIALS AND METHODS: Among the 1557 cases that underwent BMD test on their proximal femur and lumbar spine without history of trauma or disease of the hip or lumbar region, according to their age, they were divided into 4 groups, and the T-score and Z-score of the proximal femur and lumbar spine were each investigated. RESULTS: The correlation figured out through the regression analysis was that, considering the lumbar spine value as the independent variable (L), and the proximal femur value as the dependant variable (H), the T-score was H=0.508xL-0.723 in group 1, H=0.445xL-0.649 in group 2, H=0.363xL-1.124 in group 3 and H=0.404xL-1.467 in group 4. The correlation coefficient of T-score value of the 2 sites of each group was 0.58, 0.59, 0.47, 0.54 each, and which were statistically significant. Z-score was H=0.485xL-0.514 in group 1, H=0.451xL-0.141 in group 2, H=0.390xL-0.401 in group3, L=0.897xH-0.481 in group 4. CONCLUSION: On the BMD test performed in an age group of over 40 years old, T-score and Z-score each showed significant increase and this is thought to be related to low bone mineral due to bone mineral decrease because of the old age. Also, in cases with lesion in the hip joint or spine, there is a clinical usefulness of analogizing the result of the other region with a result of a single region.
Bone Density ; Femur ; Hip ; Hip Joint ; Humans ; Lumbosacral Region ; Spine

PURPOSE: Mycoplasma pneumoniae is one of the most common causes of pneumonia in children and adolescents. Though cold agglutinin test and specific antibody test are used in the diagnosis of mycoplasma pneumonia, there are some limitations in early diagnosis. In this study, we evaluated the availability and usefulness of polymerase chain reaction (PCR) in the diagnosis of M. pneumoniae pneumonia and compared it with serologic test. METHODS: One hundred twenty four children who were clinically diagnosed with pneumonia and admitted to Kyunghee Hospital from January 1998 to March 2001 were enrolled. Mycoplasma specific antibody test using commercial kit (Serodia-MYCO II, Fusirebio Inc., Tokyo, Japan) and PCR using mycoplasma DNA obtained from throat swabs were done. The sensitivity and specificity of PCR were evaluated. RESULTS: M. pneumoniae pneumonia was diagnosed when the mycoplasma specific antibody titer was over 1: 160 or when the titer increased more than fourfold during follow-up period. The specificity, sensitivity, false-positive rate and false-negative rates of PCR were 93.0%, 58.3%, 33.3%. and 9.7%, respectively. CONCLUSION: PCR has shown high specificity. But, the positive result in PCR don't correlate with the disease activity and PCR does not have high sensitivity. So PCR must be used alongside with serologic test in the diagnosis of pneumonia. But, it seems possible to improve sensitivity by delicate handling of samples and by improving PCR technology, and PCR will possibly be used in the diagnosis of early infections of M. pneumoniae pneumonia and in the evaluation of treatments in the future.
Adolescent ; Child* ; Diagnosis ; DNA ; Early Diagnosis ; Follow-Up Studies ; Humans ; Mycoplasma pneumoniae* ; Mycoplasma* ; Pharynx ; Pneumonia* ; Pneumonia, Mycoplasma* ; Polymerase Chain Reaction* ; Sensitivity and Specificity ; Serologic Tests

The device for intervertebral assisted motion (DIAM) is a dynamic implant that consists of a silicone bumper enveloped by a polyethylene terephthalate (PET) fiber sack. Silicone and PET were used because of their biological inertness, but repetitive motion of the spine can cause wear on the implant nonetheless. The purpose of this study is to report a case of foreign body reaction (FBR) against a DIAM. A 72-year-old female patient presented with lower back pain and both legs radiating pain. She had undergone DIAM implantation at L4–5 for spinal stenosis 5 years previously. The intervertebral disc space of L4–5, where the DIAM was inserted, had collapsed and degenerative scoliosis had developed due to left-side collapse. MRI showed L3–4 thecal sac compression and left L4–5 foraminal stenosis. The patient underwent removal of the DIAM and instrumented fusion from L3 to L5. During surgery, fluid and granulation tissue were evident around the DIAM. Histopathology showed scattered wear debris from the DIAM causing chronic inflammation due to the resulting FBR. A FBR due to wear debris of a DIAM can induce a hypersensitivity reaction and bone resorption around the implant, causing it to loosen.
Aged ; Bone Resorption ; Constriction, Pathologic ; Female ; Foreign Bodies* ; Foreign-Body Reaction* ; Granulation Tissue ; Humans ; Hypersensitivity ; Inflammation ; Intervertebral Disc ; Leg ; Low Back Pain ; Magnetic Resonance Imaging ; Polyethylene Terephthalates ; Scoliosis ; Silicon ; Silicones ; Spinal Stenosis ; Spine

Understanding depth of anesthesia is essential for the anesthesiologist. Although electroencephalogram (EEG) has been proposed and studied as a method of determining anesthetic depth, major limitations restrict its usefulness. For example, spectral edge frequency (SEF) dose not correlate well with the level of sedation. However, recently introduced bispectral index (BIS) which is derived from frequency, amplitude and coherence of the EEG is strongly correlated with clinical measurements of sedation and hypnosis. BIS monitoring may be used to guide the titration of anesthetic agents to achieve effective dosing without increasing the risk of awareness and to allow a better balance of hypnotic and analgesic administration. We report two cases of successful BIS monitoring for the measurement of intraoperative hypnotic state of patient during propofol target controlled infusion (TCI).
Anesthesia ; Anesthesia, General* ; Anesthetics ; Electroencephalography ; Humans ; Hypnosis ; Propofol*