Relationship between Lumbar Extensor Muscle Degeneration Classification and Osteoporotic Vertebral Compression Fracture

STUDY DESIGN: Retrospective study. OBJECTIVES: To investigate the reliability of the lumbar extensor muscle degeneration classification as an indicator of potential risk for osteoporotic vertebral compression fractures (OVCF). SUMMARY OF LITERATURE REVIEW: Fatty degeneration of lumbar extensor muscles has attracted increased interest in the literature as a risk factor for OVCF. MATERIALS AND METHODS: Ninety-one patients with OVCF (group 1) and 60 patients without OVCF (group 2) were investigated. Magnetic resonance imaging was used to measure and to analyze the muscle mass and fatty degeneration of the lumbar extensor muscle. The degree of fatty degeneration of the lumbar extensor muscle was classified into 4 stages: less than 10%, 10%–25%, 25%–50%, and more than 50%. RESULTS: Fatty degeneration of the lumbar extensor muscle and the bone mineral density T-score were 29.66%±12.28% and −3.56±1.13 in group 1 and 24.04%±13.29% and −2.27±1.46 in group 2, which were statistically significant differences (p < 0.05). Logistic regression analysis revealed that as the fatty degeneration of the lumbar extensor muscle increased, the risk of OVCF increased (odds ratio [OR]=1.21; p=0.01). The risk of OVCF increased as the lumbar extensor muscle degeneration classification scores increased (OR=13.53; p=0.02). Furthermore, as the muscle mass of the multifidus decreased, lumbar lordosis and sacral inclination decreased (β=0.33; p=0.01 and β=0.25; p=0.04, respectively). However, no factor affected thoracic kyphosis. CONCLUSIONS: Fatty degeneration of the lumbar extensor muscle was correlated with OVCF. A lumbar extensor muscle degeneration classification higher than stage 3 should be considered a risk factor of OVCF.

Relationship between Lumbar Extensor Muscle Degeneration Classification and Osteoporotic Vertebral Compression Fracture

OBJECTIVES@#To investigate the reliability of the lumbar extensor muscle degeneration classification as an indicator of potential risk for osteoporotic vertebral compression fractures (OVCF).SUMMARY OF LITERATURE REVIEW: Fatty degeneration of lumbar extensor muscles has attracted increased interest in the literature as a risk factor for OVCF.@*MATERIALS AND METHODS@#Ninety-one patients with OVCF (group 1) and 60 patients without OVCF (group 2) were investigated. Magnetic resonance imaging was used to measure and to analyze the muscle mass and fatty degeneration of the lumbar extensor muscle. The degree of fatty degeneration of the lumbar extensor muscle was classified into 4 stages: less than 10%, 10%–25%, 25%–50%, and more than 50%.@*RESULTS@#Fatty degeneration of the lumbar extensor muscle and the bone mineral density T-score were 29.66%±12.28% and −3.56±1.13 in group 1 and 24.04%±13.29% and −2.27±1.46 in group 2, which were statistically significant differences (p < 0.05). Logistic regression analysis revealed that as the fatty degeneration of the lumbar extensor muscle increased, the risk of OVCF increased (odds ratio [OR]=1.21; p=0.01). The risk of OVCF increased as the lumbar extensor muscle degeneration classification scores increased (OR=13.53; p=0.02). Furthermore, as the muscle mass of the multifidus decreased, lumbar lordosis and sacral inclination decreased (β=0.33; p=0.01 and β=0.25; p=0.04, respectively). However, no factor affected thoracic kyphosis.@*CONCLUSIONS@#Fatty degeneration of the lumbar extensor muscle was correlated with OVCF. A lumbar extensor muscle degeneration classification higher than stage 3 should be considered a risk factor of OVCF.

An anomalous union of the pancreaticobiliary duct that was treated by drainage of the accessory ampulla / 대한내과학회지

An anomalous union of the pancreaticobiliary duct is defined as a condition in which the junction between the common bile duct and the pancreatic duct is located outside the duodenal wall. Therefore, the sphincter of Oddi does not influence the junction; there is always communication between these ducts, and so pancreatic juice flows into the biliary tract through the communication, which may cause pancreaticobiliary diseases. Pancreas divisum is a congenital variant of the pancreatic ductal anatomy, and the mechanism is that the dorsal and ventral pancreatic buds fail to fuse during the gestation. We report here on a 21 year old woman who previously had suffered with recurrent pancreatitis, and an anomalous union of the pancreaticobiliary duct associated with the incomplete type of pancreas divisum was revealed by ERCP. She was treated with minor papilla sphincterotomy and stent insertion.

A Case of Systemic Sclerosis Combined with Ovarian Cancer / 대한류마티스학회지

We report a 54-year old female who had mild dyspnea, coughing, abdominal distension, tightening and thickening of the skin, and Raynaud's phenomenon. Clinical manifestations, laboratory and radiologic examinations were compatible with systemic sclerosis. She was also diagnosed to have ovarian cancer on histopathologic study. The possible causative relation between systemic sclerosis and malignant neoplasms is a controversial issue, but several studies have demonstrated an increased frequency of cancer in patients with systemic sclerosis, especially lung and breast cancers. Ovarian cancer was rarely reported in association with systemic sclerosis. We present this case with a review of literatures.

Two Cases of Sigmoid Volvulus Treated by Emergency Colonoscopic Reduction Procedure / 대한소화기내시경학회지

A volvulus of the colon is a twisting of a redundant segment of the colon at its narrow mesentery. A sigmoid volvulus is the most common type. This disorder may spontaneously reduce and recur as a chronic problem. However, it more frequently becomes acute as a result of an obstruction, which can lead to strangulation and gangrene with a high mortality if not treated promptly. Colonoscopic reduction and decompression is the preferred initial treatment for patients with a sigmoid volvulus who show no signs of bowel strangulation, which may be the cause of the high mortality associated with emergency surgery. We experienced 2 cases of a sigmoid volvulus in a 44-year-old female and a 51-year-old male. The sigmoid volvulus was diagnosed by simple abdominal film and treated successfully by an emergency colonoscopic reduction. We report our experience on the use of colonoscopy to treat sigmoid volvulus with a reviews of the relevant literlature.

5 cases of stones occurred in Kock pouch / 대한비뇨기과학회지

During follow-up of Kock pouch, we found 5 cases of stones in the pouches (3 cases in male and 2 cases in female). Follow-up period was ranged from 34 to 62 months. The size of the stones varied from 0.5 to 4.3cm. 4 cases of stones were managed by endourological procedures, using ultrasonic and electrohydraulic lithotripsy. A case fail to manage by endourological procedure end so needs open operation. No complication occurred during or after the procedure. Spinal anesthesias were necessary in 5 patients. The stones were usually developed around suture materials near efferent nipple valve. The major component of the stones was struvite. We suggest that causes of stone development in Kock pouch may be suture materials and infected residual urine.

A Giant Retroperitoneal Neurofibroma / 대한비뇨기과학회지

Nerve sheath tumors of genitourinary tract are a rare and sometimes have challenging problems. Neurofibroma is a benign tumor characterized by diffuse proliferation of peripheral nerve elements. It rarely occurs in the retroperitoneal region. Although neurofibroma may occur as a solitary lesion, its common manifestation is in the syndrome of neurofibromatosis with a variable clinical Herein we report a case of giant retroperitoneal neurofibroma and review the subject briefly.

Experience of Percutaneous Nephrolithotomy / 대한비뇨기과학회지

Sixteen patients with renal and pelvis stones were treated by eighteen percutaneous nephrolithotomy(PNL) from December, 1986 to March, 1988 in Chonbuk National University Hospital. We discussed our experience with regard to the failures and complications of PNL. With accumulation of experiences, operation efficiencies were increased from 62.6 per cent early in this series to 75.0 per cent in the recent cases. The most common cause of failure was inability to find stone because of bleeding. No patient required nephrectomy, but five patients underwent open surgery for stone removal because of unsuccessful PNL(four in kidney, one in pelvis). Major complications occurred in 7 patients ;hemorrhage in four cases, urine extravasation into the retroperitoneal cavity, colon perforation, and remnant stone in a case respectively. We concluded that percutaneous nephrolithotomy appears to be a preferable procedure to open stone surgery and a useful alternative to ESWL.

Experience of Percutaneous Nephrolithotomy / 대한비뇨기과학회지

Sixteen patients with renal and pelvis stones were treated by eighteen percutaneous nephrolithotomy(PNL) from December, 1986 to March, 1988 in Chonbuk National University Hospital. We discussed our experience with regard to the failures and complications of PNL. With accumulation of experiences, operation efficiencies were increased from 62.6 per cent early in this series to 75.0 per cent in the recent cases. The most common cause of failure was inability to find stone because of bleeding. No patient required nephrectomy, but five patients underwent open surgery for stone removal because of unsuccessful PNL(four in kidney, one in pelvis). Major complications occurred in 7 patients ;hemorrhage in four cases, urine extravasation into the retroperitoneal cavity, colon perforation, and remnant stone in a case respectively. We concluded that percutaneous nephrolithotomy appears to be a preferable procedure to open stone surgery and a useful alternative to ESWL.

A Clinical Review of the Pyeloplasty / 대한비뇨기과학회지

A total of 33 patients underwent repair of congenital ureteropelvic junction obstruction during a 10-year period. A majority of patients (85%) presented with flank pain. Hydronephrosis was demonstrated in all patients. A majority of the patients (94%) underwent dismembered pyeloplasty with intubation. In 9 cases, pyelolithotomy was performed at the time of pyeloplasty. One hypertensive patient became normotensive postoperatively. Seven patients underwent secondary procedures after a previous failed pyeloplasty, including 3 cases of dismembered pyeloplasty, 3 cases of ileal ureteral replacement and a case of nephrectomy. The clinical success rate was 79% with one operation.

A Case of Cystic Pelvic Mass / 대한비뇨기과학회지

Cystic natured pelvic mass in males are very rare condition in the field of urology. Recently, we experienced a cystic pelvic mass in a 24-year old male, so we report this case with brief review of literature.