Measuring discomfort towardthe car seat is important as the act of driving requires a driver to remain at the car seat while controlling the car. The seat condition, including sitting position as well as the driver’s posture can lead to discomfort and fatigue. The objective of this study is to investigate a driver’s pressure distribution in static and dynamic circumstances for two types of cars; the sedan and compact car. This study involved both subjective and objective evaluations of 12 respondents. For the subjective evaluation, the Visual Analog Scales (VAS) were used to obtain respondents' perception of discomfort. For the objective evaluation, pressure distribution readings of the seat interface were obtained using piezo capacitive sensors. The findings showed that the highest pressure was recorded for the compact car. Furthermore, the static circumstance showed greater pressure compared to the dynamic state. Subjective evaluation indicated that the right buttocks and the lower back (lumbar)experience the highest discomfort for both types of seats.The type of seat found to contribute to the value of different pressure. Thus, it can be concluded that appropriate seat selection can reduce pressure as well as discomfort.
Pressure ; car seat ; back rest ; static ; dynamic ; sedan ; compact

We describe a case of a 61-year-old Korean man who was diagnosed with renal cell carcinoma that was discovered on abdominopelvic computed tomography obtained after the patient complained of back pain. A radical nephrectomy was performed, and the surgical specimen showed a relatively well-circumscribed and yellowish lobulated hard mass. Microscopically, the tumor showed sheets and nests of hypercellular pleomorphic cells with thick fibrous septation, frequent mitoses, and areas of adrenal cortical-like tissue. Immunohistochemical staining revealed that the tumor cells were positive for inhibin-α, vimentin, synaptophysin, and melan A. It also revealed that the tumor cells were negative for pan-cytokeratin, epithelial membrane antigen, paired box 8, α-methylacyl-coenzyme A racemase, CD10, cytokeratin 7, carbonic anhydrase 9, c-Kit, renal cell carcinoma, transcription factor E3, human melanoma black 45, desmin, smooth muscle actin, S-100, chromogranin A, CD34, anaplastic lymphoma kinase, and integrase interactor 1. Based on these histopathological and immunohistochemical findings, we diagnosed the tumor as intrarenal adrenocortical carcinoma arising in an adrenal rest. Several cases of intrarenal adrenocortical carcinoma have been reported, although they are very rare. Due to its poor prognosis and common recurrence or metastasis, clinicians and pathologists must be aware of this entity.
Actins ; Adrenal Rest Tumor ; Adrenocortical Carcinoma ; Back Pain ; Carbonic Anhydrases ; Carcinoma, Renal Cell ; Chromogranin A ; Desmin ; Humans ; Integrases ; Keratin-7 ; Lymphoma ; MART-1 Antigen ; Melanoma ; Middle Aged ; Mitosis ; Mucin-1 ; Muscle, Smooth ; Neoplasm Metastasis ; Nephrectomy ; Phosphotransferases ; Prognosis ; Recurrence ; Synaptophysin ; Transcription Factors ; Vimentin

Spontaneous intracranial hypotension in childhood is rare, and a few cases have been reported as a cause of headache in children. A 9-year-old boy was admitted to our hospital with a 3-day history of new-onset headache that worsened upon standing or walking, and aggravating low back pain. No medical history of injury, connective tissue disorder or migraine was detected. A neurological examination revealed neck stiffness. His initial blood tests suggested acute kidney injury by increased blood urea nitrogen (BUN) and creatinine. Brain computed tomography (CT) and cerebral spinal fluid (CSF) analysis were normal: however, opening pressure was low (< 60 mm H₂O). Magnetic resonance imaging (MRI) of the spine showed a collection of cerebral spinal fluid in the dorsal extradural space throughout the entire thoracic and lumbar spine level. The patient was diagnosed as having spontaneous intracranial hypotension accompanied by acute kidney injury. Magnetic resonance myelography and spinal MRI performed 14 days later did not show any cerebrospinal fluid leak. The headache and back pain were alleviated with strict bed rest and hydration. He remained free of headache and back pain at the 2-month follow-up. Here, we report a case of a 9-year-old boy with spontaneous intracranial hypotension.
Acute Kidney Injury* ; Back Pain ; Bed Rest ; Blood Urea Nitrogen ; Brain ; Cerebrospinal Fluid Leak ; Child* ; Connective Tissue ; Creatinine ; Follow-Up Studies ; Headache ; Hematologic Tests ; Humans ; Intracranial Hypotension* ; Low Back Pain ; Magnetic Resonance Imaging ; Male ; Migraine Disorders ; Myelography ; Neck ; Neurologic Examination ; Spine ; Walking

BACKGROUND: Low back pain is a frequent condition that results in substantial disability and causes admission of patients to neurosurgery clinics. To evaluate and present the therapeutic outcomes in lumbar disc hernia (LDH) patients treated by means of a conservative approach, consisting of bed rest and medical therapy. METHODS: This retrospective cohort was carried out in the neurosurgery departments of hospitals in Kahramanmaraş city and 23 patients diagnosed with LDH at the levels of L3−L4, L4−L5 or L5−S1 were enrolled. RESULTS: The average age was 38.4 ± 8.0 and the chief complaint was low back pain and sciatica radiating to one or both lower extremities. Conservative treatment was administered. Neurological examination findings, durations of treatment and intervals until symptomatic recovery were recorded. Laségue tests and neurosensory examination revealed that mild neurological deficits existed in 16 of our patients. Previously, 5 patients had received physiotherapy and 7 patients had been on medical treatment. The number of patients with LDH at the level of L3−L4, L4−L5, and L5−S1 were 1, 13, and 9, respectively. All patients reported that they had benefit from medical treatment and bed rest, and radiologic improvement was observed simultaneously on MRI scans. The average duration until symptomatic recovery and/or regression of LDH symptoms was 13.6 ± 5.4 months (range: 5−22). CONCLUSIONS: It should be kept in mind that lumbar disc hernias could regress with medical treatment and rest without surgery, and there should be an awareness that these patients could recover radiologically. This condition must be taken into account during decision making for surgical intervention in LDH patients devoid of indications for emergent surgery.
Bed Rest ; Cohort Studies ; Decision Making ; Diagnostic Imaging ; Hernia ; Humans ; Intervertebral Disc Displacement* ; Low Back Pain ; Lower Extremity ; Lumbar Vertebrae ; Magnetic Resonance Imaging ; Neurologic Examination ; Neurosurgery ; Retrospective Studies ; Sciatica

A 47-year-old female patient was admission for back pain after she fell down on the table. T12 compression fracture was found for spinal magnetic resonance imaging. Absolute bed rest and pain control for non-steroidal anti-inflammatory drugs and muscle relaxant were received. After 7 days, she complained febrile sense, abdominal pain, and diarrhea. Septic shock was suspected, and then use of antibiotics and proper management were performed. Computed tomography of chest and abdomen was not revealed specific finding. Blood culture showed growth of Klebsiella pneumoniae. After patients completely resolved symptoms, colonoscopy was performed that showed erosive lesions of cecum, proximal A-colon, and rectum.
Abdomen ; Abdominal Pain ; Adult* ; Anti-Bacterial Agents ; Back Pain ; Bed Rest ; Cecum ; Colitis* ; Colonoscopy ; Diarrhea ; Female ; Fractures, Compression ; Humans ; Klebsiella pneumoniae* ; Klebsiella* ; Magnetic Resonance Imaging ; Middle Aged ; Rectum ; Sepsis* ; Shock, Septic ; Thorax

STUDY DESIGN: Retrospective review. PURPOSE: We retrospectively reviewed our patients with ankylosing spondylitis (AS) to identify their patterns of spinal fractures to help clarify management strategies and the morbidity and mortality rates associated with this group of patients. OVERVIEW OF LITERATURE: Because of the brittleness of bone and long autofused spinal segments in AS, spinal fractures are common even after minor trauma and often associated with overt instability. METHODS: Between January 1, 1998 and March 2011, 30 patients (23 males, 7 females; mean age, 70.43 years; range, 45 to 95 years) with the radiographic diagnosis of AS of the spinal column had 42 fractures. Eight patients presented with significant trauma, 17 after falls, and 5 after minor falls or no recorded trauma. Eleven patients presented with a neurological injury, ranging from mild sensory loss to quadriplegia. RESULTS: There were 16 compression and 10 transverse fractures, two Jefferson's fractures, one type II and two type III odontoid process fractures, and five fractures of the posterior spinal elements (including lamina and/or facet, three spinous process fractures, three transverse process fractures). Twenty-four fractures affected the craniocervical junction and/or cervical vertebrae, 17 were thoracic, and one involved the lumbar spine. The most affected vertebrae were C6 and T10. The mean follow-up was 29.9 months. One patient was lost to follow-up. Eighteen patients were treated conservatively with bed rest and bracing. Twelve patients underwent surgery for spinal stabilization either with an anterior, posterior or combined approach. CONCLUSIONS: Nonsurgical treatment can be considered especially in the elderly patients with AS and spinal trauma but without instability or major neurological deficits. The nonfusion rate in conservatively treated patients is low. When treatment is selected for patients with spinal fractures and AS, the pattern of injury must be considered and the need for individualized treatment is paramount.
Accidental Falls ; Aged ; Bed Rest ; Braces ; Cervical Vertebrae ; Diagnosis ; Epidemiology ; Female ; Follow-Up Studies ; Humans ; Lost to Follow-Up ; Low Back Pain ; Magnetic Resonance Imaging ; Male ; Mortality ; Odontoid Process ; Quadriplegia ; Retrospective Studies ; Spinal Fractures ; Spinal Injuries* ; Spine ; Spondylitis, Ankylosing*

PURPOSE: Lumbar puncture is an essential and commonly practiced diagnostic tool and post-lumbar puncture headache and post-lumbar puncture back pain are common neurological complications. The aim of this study is to identify the factors that might cause post-lumbar puncture back pain and to reduce those complaints by eliminating the causes. METHODS: From June 5, 2013 to July 29, 2013, we studied 155 patients, male and female between the age 1 and 18,who received diagnostic or therapeutic lumbar puncture at Pusan National University Hospital and Pusan National University Yangsan Hospital. We collected data of variable aspects that may influence post-lumbar puncture back pain, by reviewing the medical records retrospectively. The independent variables were sex, age, symptoms, diagnosis, number of trials to successful lumbar puncture, year of the resident who carried out the procedure, opening pressure of cerebrospinal fluid(CSF), spinal level of punctured site, duration of strict bed rest, and use of sedatives for the procedure. RESULTS: Among the 155 patients whounderwent lumbar puncture, 36 (23.2%) experienced back pain after the procedure. Back pain subsided within 48hours in 24 ofthe 36 patients. Only one patient suffered from post-lumbar puncture back pain for more than 5days. There is no clear causality between the occurrence rate of post-lumbar puncture back pain and the independent variables which includeage, sex, duration of bed rest, symptoms, diagnosis, number of trials, skill, opening pressure, anatomic location, and use of sedatives. CONCLUSION: Back pain was a frequent complication of lumbar puncture. Various factors we expected to influence on the incidence of post-lumbar puncture back pain had no statistical significance. Further studies should be performed to investigate the causes and risk factors of post-lumbar puncture back pain.
Back Pain* ; Bed Rest ; Busan ; Child* ; Diagnosis ; Female ; Gyeongsangnam-do ; Humans ; Hypnotics and Sedatives ; Incidence ; Male ; Medical Records ; Post-Dural Puncture Headache ; Punctures* ; Retrospective Studies ; Risk Factors ; Spinal Puncture

PURPOSE: The purpose of this study was to identify the effectiveness of back pain prevention intervention program on reducing back pain of patients undergoing percutaneous coronary intervention (PCI). METHODS: The patients were divided into two groups as the experimental group and control group. In the experimental group, the participants took bedrest for 4 hours after PCI and then received back pain prevention intervention program (BPPIP). Total of 5 times BPPIP with 1 hour interval for 5-10 minutes per each intervention was administered to the patients taking bedrest for 4 hours after PCI. In the control group, total of 5 times routine nursing care with 1 hour interval was administered to the patients taking bedrest for 4 hours after PCI. The data were collected on admission in the ICU and after the 5 exercise sessions. The collected data were analyzed using SPSS/WIN program. RESULTS: No significant differences in the occurrence of hemorrhage after the BPPIP were observed between the experimental group and the control group. After the BPPIP, back pain outcomes were significantly low in the experimental group. However, urination disorder and cortisol level did not show a statistically significant differences between two groups. CONCLUSION: It is clear that BPPIP is a useful nursing intervention for reducing back pain of patients undergoing PCI.
Back Pain* ; Bed Rest ; Hemorrhage ; Humans ; Hydrocortisone ; Nursing ; Nursing Care ; Percutaneous Coronary Intervention* ; Urination Disorders

A 68-year-old diabetic man, who had been on dialysis for 3 years, suffered a five week history of severe back pain that was unresponsive to bed rest, analgesics, and bracing. The vertebral cleft formed by an injury gradually increased in size on sequential plain films. Hence, he underwent calcium phosphate cement-assisted percutaneous transpedicular balloon kyphoplasty to treat a painful interbody vacuum cleft. Immediate pain relief and firm bone union were obtained.
Aged ; Analgesics ; Back Pain ; Bed Rest ; Braces ; Calcium ; Calcium Phosphates ; Dialysis ; Humans ; Kyphoplasty ; Renal Dialysis ; Vacuum

OBJECTIVETo investigate the recovery duration of manual lifting tasks.

METHODS30 college student volunteers with gender equally distributed were involved in the simulated stoop-, squart- and semi squart-lifting tasks in the laboratory. Signals of electromyography (EMG) at the back muscles (left and right thorax m. erector spinae, LT(10) and RT(10); left and right lumbar m. erector spinae, LL(3) and RL(3)) and electrocardiography (ECG) were recorded during the rest intervals. The percentage of maximum voluntary electrical activation (MVE%), EMG median frequency (MF), and heart rate (HR) were analyzed to predict the recovery time required.

RESULTSDuring the break, MVE% at 4 back muscles of all the male subjects were recovered to resting level within 5 minutes and 91.8% were within 2 minutes. Except for RL(3) after squat- and stoop-lifting task, the MVE% of female subjects went back to resting level within 3 minutes and 67.8% were within 2 minutes. The MF of male subjects were recovered in 10 minutes and 74.9% within 2 minutes, with the exception of RL(3) after stoop- and squat-lifting tasks. All the female MF were recovered in 8 minutes and 83.4% were within 2 minutes. However, during the last 20 minute break after the lifting tasks, the MVE% and MF of all male and female subjects were recovered, while HR came back to resting level within 14 and 5 minutes, respectively.

CONCLUSIONSFor the three manual lifting tasks with 25% MVC workload lasting for 4.5 min, a break of 15 minutes is sufficient for most erectors spinae to recover from local muscle load. However, in terms of the HR, a break of 15 minutes is enough for the recovery of systematic load.

Adult ; Back ; Electrocardiography ; Electromyography ; Female ; Humans ; Lifting ; Lumbosacral Region ; Male ; Muscle, Skeletal ; physiology ; Posture ; Rest ; physiology ; Weight-Bearing ; Young Adult