The incidence of spine trauma has been increasing. To investigate the incidence, characteristics, and difficulty in management of the acute spine-injuried patients in suburban area we analyzed 50 cases treated conservatively or by operative fusion over a recent one-year period. This study comprised of 26 females and 24 males, between 23 and 83 years old patients with injury of whole column of spine. The most frequent cause of injury was traffic accident. The most common lesion was the compression fracture of the first lumbar spine. Most patients complained neck or back pain on admission. In 3 cases, neurological deficits were noted. For six patients, surgical treatment were performed and 44 patients has been conservatively managed with halo brace, neck collars, and thoracolumbar orthoses. The average period of admi-ssion and immobilzation for the conservatively treated patients was 6 weeks. During which time a few complications such as progressive kyphosis, hypoalbuminemia, thrombophlebitis, urinary tract infection, paralytic ileus, bed sore, and alcohol withdrawal syndrome were aroused. In most cases, good outcomes were achieved. Most of geriatric patients, concomitant systemic diseases with cardiovascular and pulmonary dysfunction were usually present and absence of the insight on spine injury made difficulties in managment. On the basis of these results we concluded that most elderly patients with spine fracture coulde be effectively treated by conservative methods, and also careful and systemic management with adequate education for patients and their families were required.
Accidents, Traffic ; Aged ; Aged, 80 and over ; Back Pain ; Braces ; Education ; Female ; Fractures, Compression ; Humans ; Hypoalbuminemia ; Incidence ; Intestinal Pseudo-Obstruction ; Kyphosis ; Male ; Neck ; Orthotic Devices ; Pressure Ulcer ; Spine ; Thrombophlebitis ; Urinary Tract Infections

An spinal epidural injection is a relatively benign procedure and widely used for symptomatic relief of back and radicular leg pain. The authors evaluated the efficacy of caudal epidural injection with corticosteroids and local anesthetics which was performed by a neurosurgeon for the treatment of ongoing lumbosacral radicula, symptoms. Between July 1997 and June 1998, 20 patients with back pain and radiating leg pain invloving lumbosac ral degenerative spine disease, who refused operation or were unsuitable for general anesthesia, were treated and followed for more than 6 months. All procedure was done under radiogaphical guidance aseptically. The authors used the mixed solution of 1% lidocaine(6 cases) or 0.25% bupivacaine(14 cases) with methylprednisolone acetate(1- 2ml). The mean total volume of the mixture was 15.6 ml. The preoperative neurosurgical diagnosis included 11 lumbar disc herniation,6 lumbar stenosis and 3 spondylolisthesis and the invloved nerve roots presenting with typical radiculopathy were L5 root(17 patients), S1 root(15 patients), L4 root (4 patients), and S2 root(1 patient). The responses from patients were classified into 4 groups, and excellent or good results with marked reduction on radicular leg pain we re noted in 19 cases. There were a few transient complications such as headahce, leg numbness, perisacral hypesthesia, injection pain, constipation and malpositioned spinal needle. The authors suggest that the cadual epidural injections is a reasonable alternative to spinal surgery if patients pain is severe enough and you a re exhausted other methods to relieve the pain.
Adrenal Cortex Hormones ; Anesthesia, General ; Anesthetics, Local ; Back Pain ; Constipation ; Constriction, Pathologic ; Diagnosis ; Humans ; Hypesthesia ; Injections, Epidural ; Leg* ; Methylprednisolone ; Needles ; Radiculopathy ; Spine ; Spondylolisthesis

Objective: To calculate the numbers of weekly infections and prevalence of malaria, and to predict future trend of malaria incidences in South Korea. Methods: Weekly incidences of malaria for 13 years from the period 2001-2013 in South Korea were analyzed. The back-calculation equations were used with incubation period distributions. The maximum likelihood estimation for Poisson model was also used. The confidence intervals of the estimates were obtained by a bootstrap method. A regression model for time series of malaria incidences over 13 years was fitted by the non-linear least squares method, and used to predict futuretrend. Results: The estimated infection curve is narrower and more concentrated in the summer than in the incidence distribution. Infection started around the 19th week and was over around the 41st week. The maximum weekly infection 110 was obtained at the 29th week. The prevalence at the first week was around 496 persons, the minimum number was 366 at 22nd week, and the maximum prevalence was 648 at 34th week. Prevalence drops in late spring with people that falling ill and had had long incubation periods and rose in the summer with new infections. Our future forecast based on the regression model was that an increase at year 2014 compared to 2013 may reach a peak (at maximum about 70 weekly cases) at year 2015, with a decreasing trend after then. Conclusions: This work shows that back-calculation methods could work well in estimating the infection rates and the prevalence of malaria. The obtained results can be useful in establishing an efficient preventive program for malaria infection. The method presented here can be used in other countries where incidence data and incubation period are available.