Objective: To compare the convenience and effectiveness of the existing lumbosacral orthoses (LSO) (classic LSO and Cybertech) and a newly developed LSO (V-LSO) by analyzing postoperative data. Methods: This prospective cohort study was performed from May 2019 to November 2019 and enrolled and analyzed 88 patients with degenerative lumbar spine disease scheduled for elective lumbar surgery. Three types of LSO that were provided according to the time of patient registration were applied for 6 weeks. Patients were randomized into the classic LSO group (n=31), Cybertech group (n=26), and V-LSO group (n=31). All patients were assessed using the Oswestry Disability Index (ODI) preoperatively and underwent plain lumbar radiography (anteroposterior and lateral views) 10 days postoperatively. Lumbar lordosis (LS angle) and frontal imbalance were measured with and without LSO. At the sixth postoperative week, a follow-up assessment with the ODI and orthosis questionnaire was conducted. Results: No significant differences were found among the three groups in terms of the LS angle, frontal imbalance, ODI, and orthosis questionnaire results. When the change in the LS angle and frontal imbalance toward the reference value was defined as a positive change with and without LSO, the rate of positive change was significantly different in the V-LSO group (LS angle: 41.94% vs. 61.54% vs. 83.87%; p=0.003). Conclusion The newly developed LSO showed no difference regarding its effectiveness and compliance when compared with the existing LSO, but it was more effective in correcting lumbar lordosis.

Objective: We evaluated the efficacy of a newly-developed spinal orthoses (V-LSO) by comparing the stabilizing effect, abdominal pressure, and comfort of 3 different semirigid LSOs (classic LSO, V-LSO, and CybertechⓇ ) during various body movements. Methods: Thirty healthy volunteers (23∼47 years, 24 males, 6 females) were selected. A dual inclinometer measured the range of motion (ROM) while the participants performed flexion/extension and lateral flexion of the lumbar spine with 3 LSOs.The LSO’s pressure on the abdominal surface was measured using 9 pressure sensors while lying, sitting, standing, flexion/extension, lateral flexion, axial rotation, and lifting a box. Comfort and subjective immobilization were analyzed by a questionnaire. Results: V-LSO had a statistically significant effect on flexion over CybertechⓇ . No significant differences were noted during extension and lateral flexion between the 3 LSOs. The abdominal pressure showed no significant differences while supine. While sitting, standing, and lifting a box, the mean abdominal pressure for V-LSO were significantly higher than those for Cybertech Ⓡ . During lumbar flexion, the mean abdominal pressures for classic LSO and V-LSO were significantly higher than that of CybertechⓇ . For extension, lateral flexion and axial rotation, the abdominal pressure for V-LSO was significantly higher than those of classic LSO and CybertechⓇ . In the subjective analysis, V-LSO and CybertechⓇ scored best for comfort. Conclusion The V-LSO and CybertechⓇ were more comfortable than the classic LSO, and hence, may have improved compliance with decreased discomfort. V-LSO may be superior to the other LSOs in restricting lumbar movement and increasing intraabdominal pressure.

Objective: We evaluated the efficacy of a newly-developed spinal orthoses (V-LSO) by comparing the stabilizing effect, abdominal pressure, and comfort of 3 different semirigid LSOs (classic LSO, V-LSO, and CybertechⓇ ) during various body movements. Methods: Thirty healthy volunteers (23∼47 years, 24 males, 6 females) were selected. A dual inclinometer measured the range of motion (ROM) while the participants performed flexion/extension and lateral flexion of the lumbar spine with 3 LSOs.The LSO’s pressure on the abdominal surface was measured using 9 pressure sensors while lying, sitting, standing, flexion/extension, lateral flexion, axial rotation, and lifting a box. Comfort and subjective immobilization were analyzed by a questionnaire. Results: V-LSO had a statistically significant effect on flexion over CybertechⓇ . No significant differences were noted during extension and lateral flexion between the 3 LSOs. The abdominal pressure showed no significant differences while supine. While sitting, standing, and lifting a box, the mean abdominal pressure for V-LSO were significantly higher than those for Cybertech Ⓡ . During lumbar flexion, the mean abdominal pressures for classic LSO and V-LSO were significantly higher than that of CybertechⓇ . For extension, lateral flexion and axial rotation, the abdominal pressure for V-LSO was significantly higher than those of classic LSO and CybertechⓇ . In the subjective analysis, V-LSO and CybertechⓇ scored best for comfort. Conclusion The V-LSO and CybertechⓇ were more comfortable than the classic LSO, and hence, may have improved compliance with decreased discomfort. V-LSO may be superior to the other LSOs in restricting lumbar movement and increasing intraabdominal pressure.

Objectives: . This study aimed to elucidate the patterns of upper airway collapse in obstructive sleep apnea (OSA) patients with a low body mass index (BMI). Methods: . We designed and conducted a retrospective cohort study. Consecutive patients diagnosed with OSA who underwent drug-induced sleep endoscopy (DISE) were included. Patients were classified into four groups according to their BMI. Age, sex, and polysomnography data were investigated. The patterns of upper airway collapse were characterized by the structures involved (soft palate, tongue base, lateral pharyngeal wall, and epiglottis). We compared the patterns of upper airway collapse in the supine and lateral decubitus position among the four BMI groups using the chi-square test and multivariate binary logistic regression analysis. Results: . A total of 627 patients (male, 517; mean age, 47.6±12.8 years) were included, consisting of 45, 79, 151, and 352 patients who were underweight or lower normal-weight (defined as the low BMI group), upper normal-weight, overweight, and obese, respectively. Severity indicators of OSA, such as the overall apnea-hypopnea index and duration of SaO2 below 90%, were significantly lower in patients with a low BMI than in obese patients, while their average oxygen saturation was significantly higher. The most common obstruction site in the supine position was the tongue base in patients with a low BMI (100%), whereas this obstruction site was significantly less common in obese patients (54.8%). Tongue base obstruction was mostly relieved in the lateral position, with no discernible obstruction in 86.7% of the low BMI patients. Conclusion . Airway obstruction in OSA patients with a low BMI is mostly due to tongue base obstruction, which improves in the lateral position. These characteristics should be kept in mind when considering treatment options for this subgroup of OSA patients.

BACKGROUND/AIMS: The objective of this study was to evaluate a monoclonal antibody-based test to detect Helicobacter pylori-specific antigen in gastric aspirates from humans. METHODS: Sixty-one volunteers were enrolled in the study. All of the subjects underwent a 13C-urea breath test (UBT) before esophagogastroduodenoscopy. Gastric aspirates were analyzed for pH and ammonia and used for polymerase chain reaction (PCR), culture, and monoclonal antibody-based detection of H. pylori. Multiple biopsies of the gastric antrum and body were obtained for a rapid urease test (RUT) and histological evaluation. RESULTS: Thirty-six subjects were H. pylori-positive and 25 were H. pylori-negative according to the UBT results. Compared with the H. pylori-negative subjects, H. pylori-positive subjects had a higher pH (4.77+/-1.77 vs 3.49+/-1.30, p<0.05) and ammonia level (1,130.9+/-767.4 vs 184.2+/-126.3, p<0.0001). The sensitivities and specificities of the PCR test, RUT, culture test, and monoclonal antibody-based test were 100% and 72%, 89% and 100%, 47% and 100%, and 78% and 100%, respectively. CONCLUSIONS: The monoclonal antibody-based test for diagnosing H. pylori infection in gastric aspirates has increased sensitivity compared with the culture test and specificity as high as that of the RUT. The test may be useful as an additive test for examining gastric aspirates.
Ammonia ; Biopsy ; Breath Tests ; Endoscopy, Digestive System ; Helicobacter ; Helicobacter pylori ; Hydrogen-Ion Concentration ; Polymerase Chain Reaction ; Pyloric Antrum ; Sensitivity and Specificity ; Urease

BACKGROUND AND OBJECTIVES: Vestibular evoked myogenic potential (VEMP) is muscle reflex caused by surface electrodes following repeated high-intensity auditory stimulation. The current study attempted to determine whether VEMP can be consistently evoked from the sternocleidomastoid muscle (SCM) by the 100 dB air-conducted and 50 dB bone-conducted 500 Hz-tone burst. SUBJECTS AND METHOD: Air-conducted and bone-conducted VEMPs in response to 500 Hz-tone burst were recorded from the SCM of 13 normal volunteers. Subjects were seated on their chairs and made to hold their heads turned up as far as possible towards the side, contralateral to the stimulated ear voluntarily. Two different sound durations (rise/fall time=2 msec, plateau time=2 msec[2/2] and rise/fall time=5 msec, plateau time=5 msec[5/5]) were presented through a insertphone or bone vibrators. Latencies and amplitudes of p13 and n23 responses were measured. RESULTS: All normal volunteers showed p13-n23 responses to 50 dB bone-conducted tone burst as well as to 100 dB air-conducted tone burst. The values of latency of p13 and n23 were the most reliable at 5/5 air-conducted in evaluation by coefficiency of variance. Mean p13 and N23 latencies by airconducted tone burst were significantly longer than those of bone-conducted. Mean p13-n23 amplitudes by air-conducted tone burst were significantly larger than those by bone-conducted at 2/2 sound duration. CONCLUSION: VEMP could be consis-tently evoked by the 100 dB air-conducted and 50 dB bone-conducted 500 Hz-tone burst, especially at 5/5 air-conducted.
Acoustic Stimulation ; Ear ; Electrodes ; Head ; Healthy Volunteers ; Reflex ; Vestibular Evoked Myogenic Potentials*

No abstract available.
Cytoplasm*

We report a case of pure red cell aplasia due to parvovirus B19 infection in a renal transplant recipient. The patient was a 32-year-old male with end stage renal disease due to chronic glomerulonephritis, who had been undergoing regular hemodialysis. He received a living nonrelated renal transplant and immumosuppressive therapy including prednisolone, tacrolimus, and mycophenolate mofetil. One week after kidney transplantation, severe anemia was persisted despite recombinant human erythropoietin administration and packed red blood cell transfusion. His bone marrow aspiration smear demonstrated erythroid hypoplasia and giant pronormoblasts with prominent intranuclear inclusions. Both serum and bone marrow were positive for parvovirus B19 DNA polymerase chain reaction and anti-parvovirus B19 IgM. He was treated with intravenous immunoglobulin and conversion of tacrolimus to cyclosporine. His hemoglobin level was completely recovered three months later.
Adult ; Anemia ; Bone Marrow ; Cyclosporine ; DNA ; Erythroblasts ; Erythrocyte Transfusion ; Erythropoietin ; Glomerulonephritis ; Humans ; Immunoglobulin M ; Immunoglobulins ; Intranuclear Inclusion Bodies ; Kidney Failure, Chronic ; Kidney Transplantation ; Male ; Parvovirus* ; Polymerase Chain Reaction ; Prednisolone ; Red-Cell Aplasia, Pure* ; Renal Dialysis ; Tacrolimus ; Transplantation*

A nephrocolic fistula is uncommon complication resulting from chronic inflammatory processes in the kidney. We report here a case of nephrocolic fistula associated with staghorn calculi. A 61-year-old female with known renal stones for three years was admitted to our hospital because of left flank pain and gross hematuria. Abdominal CT scan showed pyonephrosis with staghorn calculi in the left kidney. We performed percutaneous nephrostomy because of pelvocaliceal dilatation and high fever. Leakage of contrast dye was also detected in antegrade pyelogram, and drainage of fecal contents from nephrostomy was noted, suggesting fistulous formation between left kidney and colon. Clinical and laboratory findings of the patient deteriorated rapidly in spite of conservative management including antibiotics administration, so we performed nephrectomy with excision of the fistulous tract and partial colectomy. However, she showed delirium and had several attacks of generalized seizure, and she died of sepsis and multiple organ failure on the 33rd hospital day. In conclusion, when a nephrocolic fistula develops in patient with renal stone, prompt investigation and appropriate surgical treatment should be considered to improve the clinical outcome.
Anti-Bacterial Agents ; Calculi* ; Colectomy ; Colon ; Delirium ; Dilatation ; Drainage ; Female ; Fever ; Fistula* ; Flank Pain ; Hematuria ; Humans ; Kidney ; Middle Aged ; Multiple Organ Failure ; Nephrectomy ; Nephrostomy, Percutaneous ; Pyonephrosis ; Seizures ; Sepsis ; Tomography, X-Ray Computed

Hypertension and atherosclerosis are the most important factors contributing to the development of aortic dissection. Primary aldosteronism is a rare cause of hypertension. The concurrence of aortic dissection is very rare in primary aldosteronism. However, when aortic dissection is found as a life-threatening complication of primary aldosteronism, then the diagnosis of primary aldosteronism is important because the therapeutic intervention can be curative. Only 3 cases of primary aldosteronism with aortic dissection have been reported in the literature. We report here on a case of primary aldosteronism with aortic dissection, which was treated by laparoscopic adrenalectomy. We lowered the blood pressure with antihypertensive drugs and potassium replacement was done to treat the aortic dissection. After stabilization of aortic dissection, we removed his left adrenal mass by laparoscopic adrenalectomy. Postoperatively, the patient's blood pressure has been within normal limits and the serum potassium increased to a normal level without supplementation. The aortic dissection has remained in a stable state
Adrenalectomy ; Antihypertensive Agents ; Atherosclerosis ; Blood Pressure ; Diagnosis ; Hyperaldosteronism* ; Hypertension ; Potassium