We attempted to define the sources of sodium intake for the Korean population at prepared dish level to provide a basis for developing sustainable nutrition policies and feasible programs for sodium intake reduction. Dietary intake data from 2008 and 2009 Korea National Health and Nutrition Examination Survey was used in the analysis for sodium intake sources. Sodium intake from individual dish consumed by each subject was calculated and used in delineating major sodium sources at dish and dish group level for sub-populations of different sex and age. Also, sodium intake was compared between eaters and non-eaters of some specific dish groups with considerable contribution to total sodium intake. The number of subjects included in the analysis was 18,022 and mean sodium intake was 4,600 mg/capita/day. Major sources of sodium intake at dish group level were in the following order: kimchi (1125 mg, 24.5%), noodles (572 mg, 12.4%), soups (488 mg, 10.6%), stews (399 mg, 8.7%), and cooked rice (284 mg, 6.2%). The magnitude of contribution to total sodium intake by soups and stews was different by age group. Sodium intake difference between eaters and non-eaters was much larger for kimchi group (2,343 mg for male, 1,452 mg for female) than for soups or stews. Interaction between consumption of aforementioned specific dish groups and age was highly significant (p < 0.0005) for both sexes. This study revealed an importance of having not only the control over sodium content of foods/dishes, but also the customized approach for different groups of population to accomplish an appreciable reduction in sodium intake.
Humans ; Korea ; Male ; Nutrition Policy ; Nutrition Surveys ; Sodium

In this study, we compared the paramedian interfascial approach (PIA) and the traditional midline approach (MA) for lumbar fusion to determine which approach resulted in the least amount of postoperative back muscle atrophy. We performed unilateral transforaminal posterior lumbar interbody fusion via MA on the symptomatic side and pedicle screw fixation via PIA on the other side in the same patient. We evaluated the damage to the paraspinal muscle after MA and PIA by measuring the preoperative and postoperative paraspinal muscle volume in 26 patients. The preoperative and postoperative cross-sectional area, thickness, and width of the multifidus muscle were measured by computed tomography. The degree of postoperative paraspinal muscle atrophy was significantly greater on the MA side than on the contralateral PIA side (-20.7% and -4.8%, respectively, p<0.01). In conclusion, the PIA for lumbar fusion yielded successful outcomes for the preservation of paraspinal muscle in these 26 patients. We suggest that the success of PIA is due to less manipulation and retraction of the paraspinal muscle and further studies on this technique may help confirm whether less muscle injury has positive effects on the long-term clinical outcome.
Adult ; Aged ; *Bone Screws ; Female ; Humans ; Lumbar Vertebrae/*surgery ; Male ; Middle Aged ; Muscle, Skeletal/pathology ; Muscular Atrophy/etiology/pathology ; Postoperative Complications/etiology/pathology ; Reproducibility of Results ; Retrospective Studies ; Spinal Fusion/adverse effects/instrumentation/*methods ; Tomography, X-Ray Computed

OBJECTIVE: The goal of this study was to establish the benefit and prognostic factors of lumbar medial branch block(MBB) for low back pain. METHODS: A retrospective analysis was based on the data obtained from 281 patients with low back pain, who visited our hospital between January 2001 and November 2004. Pain relief was evaluated at 2 weeks, 1 month and 3 months. The authors analyzed the results of MBB according to the patient's age, sex, symptom duration, pathologic condition, and presence of radiating pain. RESULTS: Two hundred eighty one patients had sprain (151), lumbar fracture (27), spinal stenosis (50), herniated lumbar disc (24) acute post-operative pain (8), and chronic post-operative pain (21) with success rate of 63.6%, 59.3%, 26.0%, 25.0%, 87.5% and 42.9%, respectively. The effects of MBB in sprain, lumbar fracture, and acute post-operative pain were significantly better than those in stenosis, hern iated lumbar disc and chronic post-operative pain patients. The patients in young age group (<60 years), with short symptom duration (<6 months) and without radiating pain showed good response to lumbar MBB. CONCLUSION: The lumbar MBB appears to be safe and effective for low back pain in certain selected patients. Good prognostic factors were low back pain without surgical conditions and radiating pain, with short symptom duration (<6 months), and in relatively young age (<60 years) group.
Constriction, Pathologic ; Humans ; Low Back Pain* ; Retrospective Studies ; Spinal Stenosis ; Sprains and Strains

OBJECTIVE: Radiofrequency facet rhizotomy(RFFR) has been widely performed for treatment of chronic neck pain caused by cervical dorsal ramus syndrome(CDRS). To evaluate the therapeutic effectiveness of RFFR in the patients with CDRS, we analyzed patients with various cervical pathologic conditions. METHODS: The therapeutic results in forty-four patients who underwent RFFR for CDRS from January, 2000 to December, 2002 were analyzed according to the underlying pathologic conditions causing CDRS. The pathologic conditions were sprain (33 cases), herniated nucleus pulposus (6), foraminal stenosis (4), and compression fracture (1). The therapeutic results were evaluated one month after the operation and graded as excellent, good, fair or poor. Treatments were considered successful if the therapeutic results were graded as either excellent or good. RESULTS: The overall success rate in all patients was 72.7%. The success rate for treatment of cases with cervical sprain was 87.9%, but treatment of cases with herniated nucleus pulposus, foraminal stenosis, and fracture showed unsatisfactory results (mean success rate was 27.3%). Some patients complained of transient hypesthesia (4 cases) or transient dull pain at the electrode insertion sites (2 cases). CONCLUSION: RFFR is an effective and safe treatment for CDRS caused by cervical sprain, regardless of the patient's age, the duration of the symptoms, and the presence of radiating pain.
Constriction, Pathologic ; Electrodes ; Fractures, Compression ; Humans ; Hypesthesia ; Neck Pain ; Rhizotomy* ; Sprains and Strains

OBJECTIVE: Posterior lumbar interbody fusion(PLIF), the current leading method of pedicle screw fixation combined with interbody fusion via posterior route, sometimes requires too much destruction of the facet joint than expected especially for the patient with a narrow spine. On the other hand, tranforaminal lumbar interbody fusion(TLIF) technique provides potential advantages over PLIF and can be chosen as a better surgical alternative to more traditional fusion methods in certain surgical conditions. METHODS: From October 1999, 99 PLIF and 29 TLIF procedures were done for the patients with spinal stenosis and instability. Radiological data including the interpedicular distance and the size of the pedicles as well as the clinical parameters were collected retrospectively. The degree of resection of the inferior articular process was compared with the interpedicular distance in each patient who received PLIF. RESULTS: No significant differences were found between PLIF and TLIF regarding the operation time, blood loss, duration of hospital stay, or short term postoperative clinical result. There were no complication with TLIF, but PLIF resulted in 9(9.1%) complications. During PLIF procedure, all patients(n=24) except one with the interpedicular distance shorter than 27mm required near complete or complete resection of the inferior articular processes, whereas only 6(31.5%) of 19 patients with the interpedicular distances longer than 30mm required the similar extent of resection. CONCLUSION: TLIF is better than PLIF in terms of the complication rate. The patient who had narrow interpedicular distance(<27mm) might be better candidate for TLIF.
Hand ; Humans ; Length of Stay ; Retrospective Studies ; Spinal Stenosis ; Spine ; Zygapophyseal Joint

We report five patients of esophageal injuries confirmed by clinical signs and radiological evidences. They include a partial tear and a perforation which were not noticed during the operation, a perforation which was primarily repaired during the operation, and two perforations which occurred during the reoperations for the removal of mal-positioned screws or plate. The partial tear was not repaired. The perforation which occurred during the operation was primarily sutured and didn't receive further treatment. Two perforations which occurred during the reoperations were treated by irrigation, debridement with surgical drainage, and systemic antiobiotics. One who was diagnosed later after the operation showed the poorest outcome and required longest hospital days among our series. Early detection and appropriate treatment of esophageal injury following anterior spinal surgery can only improve the prognosis by preventing secondary complications.
Debridement ; Drainage ; Humans ; Prognosis

In the present study, we investigated whether ginseng total saponins (GTSs) protect hippocampal neurons after experimental traumatic brain injury (TBI) in rats. A moderate-grade TBI was made with the aid of a controlled cortical impact (CCI) device set at a velocity of 3.0 m/sec, a deformation of 3.0 mm, and a compression time of 0.2 sec at the right parietal area for adult male Sprague-Dawley rats. Shamoperated rats that underwent craniectomy without impact served as controls. GTSs (100 and 200 mg/kg) or saline was injected intraperitoneally into the rats immediately post-injury. Twenty-four hours after the injury, the rats underwent neurological evaluation. Contusion volume and the number of hippocampal neurons were calculated with apoptosis evaluated by TUNEL staining. 24 hr post-injury, salineinjected rats showed a significant loss of neuronal cells in the CA2 region of the right hippocampus (53.4%, p<0.05) and CA3 (34.6%, p<0.05) compared with contralateral hippocampal region, a significant increase in contusion volume (34 +/-8microliter), and significant increase in neurologic deficits compared with the GTSs groups. Treating rats with GTSs seemed to protect the CCI-induced neuronal loss in the hippocampus, decrease cortical contusion volume, and improve neurological deficits.
Animals ; Brain Injuries/*drug therapy/pathology ; In Situ Nick-End Labeling ; Male ; Neuroprotective Agents/*therapeutic use ; Panax ; Rats ; Rats, Sprague-Dawley ; Research Support, Non-U.S. Gov't ; Saponins/*therapeutic use ; Staining and Labeling

OBJECTIVE: The authors investigate the spatial characteristics of apoptotic genes expressed around the focal cerebral infarction, and attempted to explain the penumbra with them. METHODS: A delayed focal cerebral infarction was created in twelve adult Sprague-Dawley rats. We performed the immunohistochemical staining for the apoptosis, bcl-2 and p53 proteins and measured the local cerebral blood flow (CBF) at the infarction core area and peri-infarct area pre- and intra-operatively. The peri-infarct area was divided into six sectors by distance from the infarction border. RESULTS: The size (mm2) of apoptosis, bcl-2, and p53 areas were 3.1+/-1.2, 4.7+/-2.1, and 6.8+/-2.4, respectively. Apoptosis, bcl-2 or p53 positive cells were concentrated at the peri-infarct area adjacent to the infarction core. Their numbers reduced peripherally, which was inversely proportional to the local CBF. The p53 area seems to overlap with and larger than the ischemic penumbra. CONCLUSION: The p53 positive area provides a substitutive method defining the penumbra under the molecular base of knowledge.
Adult ; Animals ; Apoptosis ; Cerebral Infarction* ; Humans ; Infarction ; Rats* ; Rats, Sprague-Dawley

An animal model of spinal cord trauma is essential for understanding the injury mechanisms, cord regeneration, and to aid the development of new therapeutic modalities. This study focused on the development of a graded experimental contusion model for spinal cord injury (SCI) using a pneumatic impact device made in Korea. A contusive injury was made to the dorsal aspect of the cord. Three trauma groups were defined according to the impact velocity (IV). A control group (n=6), received laminectomy only. Group 1 (n=10), 2 (n=10), and 3 (n=10) had IVs of 1.5 m/sec, 2.0 m/sec, and 3.5 m/sec respectively. Functional assessments were made up to the 14th day after injury. The cord was removed at the 14th post-injury day and prepared for histopathologic examination. Significant behavioral and histopathological abnormalities were found in control and each trauma group. All trauma groups showed severe functional impairment immediately after injury but following different rates of functional recovery (Fig. 5). As the impact velocity and impulse increased, the depth of contusive lesion revealed to be profound the results show that the rat model reproduces spinal cord lesions consistently, has a distinctive value in assessing the effects of impact energy.
Animals ; Behavior, Animal/physiology ; Humans ; Laminectomy ; Male ; *Models, Animal ; Motor Activity/physiology ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Recovery of Function ; Research Support, Non-U.S. Gov't ; *Spinal Cord Injuries/pathology/therapy

OBJECTIVE: We report an investigation of cerebral blood flow(CBF) and the expression of p53 and p21 at peri-infarct area of focal cerebral infarction in rats. METHODS: Adult Sprague-Dawley male rats were used for the experiment. In Group 1(n=7), the right middle cerebral artery(MCA) was coagulated. In Group 2(n=11), the right MCA and common carotid artery(CCA) were coagulated, and the left CCA was occluded for 30 minutes. Cerebral blood flow was measured at two areas, 2mm and 8mm distal to the MCA coagulation site. The rats were killed after 24 hours. After immunohistochemical staining, the width of the p53 or p21 positive area was measured. The p53 and p21 positive glial cells were counted at the peri-infarct area adjacent to the infarction core in Group 2. RESULTS: A focal infarction was found invariably in Group 2. CBF's at 2 mm and 8 mm areas were 8.3+/-2.1, 36.4+/-4.2 in Group 1 and 0.0+/-0.0, 6.7+/-1.5ml/100g/min in Group 2, respectively. All of the measured CBF's except that of the 8mm site in Group 1 were significantly lower than preoperative level(p<0.001), which were between 20.8+/-4.5% and 16.3+/-3.3% of preoperative CBF. The ratio of p21 and p53 positive cells was 1.0+/-0.1. CONCLUSION: We could note that the expression of p53 and p21 was the highest at an adjacent peri-infarct area. The degree of CBF reduction is more responsible for infarction than CBF itself.
Adult ; Animals ; Cerebral Infarction* ; Humans ; Infarction ; Male ; Neuroglia ; Rats* ; Rats, Sprague-Dawley