Prosthetic rehabilitation by double-processing technique for edentulous patient with soft palate defect after maxillectomy: A case report / 대한치과보철학회지

A patient who went through maxillectomy can have soft palate defects including oronasal fistulas and suffer from dysphagia and dysarthria due to velopharyngeal insufficiency. This defect causes the food to enter nasal cavity and creates hypernasal sound which debilitates a quality of life. An obturator can rehabilitate the substantial oral tissue defects. The maxillary obturator separates the nasopharynx from the oropharynx during speech and deglutition by closing of the defect. For edentulous obturator patient, it is difficult to obtain proper retention due to reduced peripheral sealing. Therefore, the contours of the defects must be used to maximize the retention, stability, and support. Hollow type obturator can improve physiologic function by reducing weight than the traditional obturator. This case report describes a patient with hemi-maxillectomy who recovers mastication, speech, deglutition, and appearance with a maxillary obturator using physiological border molding of the velopharyngeal area and double-processing method.

Fatal Peripartum Cardiomyopathy after Bupivacaine Local Injection in Elective Cesarean Section: A Case Report

Bupivacaine is frequently used for pain control and local anesthesia. However, it is associated with certain acute and fatal side effects, although rare, including cardiac and central nervous system toxicities. In particular, bupivacaine-induced cardiac toxicity may be fatal. This condition can be diagnosed as bupivacaine-induced cardiotoxicity by excluding other causes and determining a history of bupivacaine administration. However, in emergency situations, recognizing bupivacaine toxicity can be difficult due to the physician's lack of awareness regarding the condition or in the absence of clear communication regarding the patient's medical history. In the current case report, we describe our experience with strong suspected bupivacaine-induced cardiotoxicity in a patient who underwent cesarean section along with a review of the literature.

Fistula Formation between Right Upper Bronchus and Bronchus Intermedius Caused by Endobronchial Tuberculosis: A Case Report / 결핵및호흡기질환

Endobronchial tuberculosis is defined as a tuberculous infection of the tracheobronchial tree and has a prevalence of up to 50% in active pulmonary tuberculosis cases. The most common complication of endobronchial tuberculosis is bronchial stenosis; benign fistula formation by endobronchial tuberculosis is rare, especially inter-bronchial fistula formation. We reported a rare case of a 73-year-old woman with a fistula between the right upper bronchus and bronchus intermedius. A diagnosis of inter-bronchial fistula caused by endobronchial tuberculosis was based on the results of chest computed tomography scans, bronchoscopy, and microbiological and pathological tests. The patient was treated with anti-tuberculous medication, and her symptoms gradually improved.

Delayed Presentation of Catheter-Related Subclavian Artery Pseudoaneurysm / 대한중환자의학회지

Central venous catheterization is a common diagnostic and therapeutic procedure in modern clinical practice. Pseudoaneurysms of the subclavian artery are rare and usually occur immediately after the causative event, whether the cause was trauma or a medical procedure. Here we report the rare case of a 71-year-old woman with delayed presentation of catheter-related subclavian pseudoaneurysm. The patient was treated for aspiration pneumonia with respiratory failure in another hospital. The patient's chest wall swelling began two weeks after the initial catheterization in the other hospital, probably because of slow leakage of blood from the injured subclavian artery caused by incomplete compression of the puncture site and uremic coagulopathy. She was successfully treated with ultrasound-guided thrombin and angiography-guided histoacryl injection without stent insertion or surgery. Her condition improved, and she was discharged to her home.

Delayed Presentation of Catheter-Related Subclavian Artery Pseudoaneurysm / 대한구급학회지

Central venous catheterization is a common diagnostic and therapeutic procedure in modern clinical practice. Pseudoaneurysms of the subclavian artery are rare and usually occur immediately after the causative event, whether the cause was trauma or a medical procedure. Here we report the rare case of a 71-year-old woman with delayed presentation of catheter-related subclavian pseudoaneurysm. The patient was treated for aspiration pneumonia with respiratory failure in another hospital. The patient's chest wall swelling began two weeks after the initial catheterization in the other hospital, probably because of slow leakage of blood from the injured subclavian artery caused by incomplete compression of the puncture site and uremic coagulopathy. She was successfully treated with ultrasound-guided thrombin and angiography-guided histoacryl injection without stent insertion or surgery. Her condition improved, and she was discharged to her home.

A Case of Necrotizing Colitis Presenting with Hepatic Portal Venous Gas and Pneumatosis Intestinalis / 대한소화기학회지

Hepatic portal venous gas is a very rare radiologic sign which is characterized by gas accumulation in the portal venous circulation. Pneumatosis intestinalis is also very rare and is characterized by multiple air cysts in the serosal or submucosal layers of the gastrointestinal tract walls. These two findings are caused by various pathological conditions and can develop individually or simultaneously. The latter is clinically more significant because it is frequently related to bowel ischemia or necrosis, and represents a poor prognosis. However, prognosis is more influenced by the severity of underlying disease rather than hepatic portal venous gas or pneumatosis intestinalis itself. If bowel ischemia or necrosis is the primary cause, emergency operation is very important to improve patient's prognosis. Herein, we report a case of necrotizing colitis presenting as hepatic portal venous gas and pneumatosis intestinalis which was successfully managed by early surgery.

A Comparison between Asia-Pacific Region Criteria and Entropy Model Criteria about Body Mass Index of Elderly Females Using Morbidity of Chronic Disease / 대한지역사회영양학회지

OBJECTIVES: This study was conducted to propose the need of re-establishing the criteria of the body weight classification in the elderly. We compared the Asia-Pacific Region Criteria (APR-C) with Entropy Model Criteria (ENT-C) using Morbidity rate of chronic diseases which correlates significantly with Body Mass Index (BMI). METHODS: Subjects were 886 elderly female participating in the 2007-2009 Korea National Health and Nutrition Examination Survey (KNHANES). We compared APR-C with those of ENT-C using Receiver Operating Characteristics (ROC) curve and logistic regression analysis. RESULTS: In the case of the morbidity of hypertension, the results were as follows: Where it was in the T-off point of APR-C, sensitivity was 67.5%, specificity was 43.1%, and Youden's index was 10.6. While in the cut-off point of ENT-C, it was 56.7%, 56.6%, and 13.3 respectively. In the case of the morbidity of diabetes, the results were as follows: In the cut-off point of APR-C, Youden's index was 14.2. While in the cut-off point of ENT-C, it was 17.2 respectively. The Area Under the ROC Curve (AUC) of the subjects who had more than 2 diseases among hypertension, diabetes, and dyslipidemia was 0.615 (95% CI: 0.578-0.652). Compared to the normal group, the odds ratio of the hypertension group which will belong to the overweight or obesity was 1.79 (95% CI: 1.30-2.47) in the APR-C, and 2.04 (95% CI: 1.49-2.80) in the ENT-C (p > 0.001). CONCLUSIONS: We conclude that the optimal cut-off point of BMI to distinguish between normal weight and overweight was 24 kg/m2 (ENT-C) rather than 23 kg/m2 (APR-C).

A Case of Juvenile Polyposis Syndrome with Whole Gastrointestinal Tract Involvement / 대한소화기내시경학회지

Juvenile Polyposis Syndrome is a rare condition that is characterized by the development of multiple polyps in the gastrointestinal tract. It is a hamartomatous disorder that was first described in families in 1964. Both sporadic and familial cases with autosomal dominant inheritance have been reported on. Juvenile Polyposis Syndrome is regarded as a distinct from the solitary juvenile polyps that develop in 2% of children and adolescents, and the latter have no malignant potential. We report here on a case of Juvenile Polyposis Syndrome in an 18 year old male along with a review of the relevant literature. The patient had various numbers of different sized pedunculated polyps that were observed throughout the entire gastrointestinal tract.

Trend in the eradication rates of Helicobacter pylori infection in the last 11 years / 대한내과학회지

BACKGROUND/AIMS: The standard triple therapy used as the first-line treatment for Helicobacter pylori that combines a proton pump inhibitor (PPI), amoxicillin, and clarithromycin had an initial eradication rate of 90%. However, many recent studies have not found this level of effectiveness. This study evaluated the trend in the eradication rates of H. pylori infection over the last 11 years. METHODS: This was a retrospective study of patients diagnosed with H. pylori infection between 1997 and 2007 and treated with triple therapy (PPI, amoxicillin, and clarithromycin). The patients answered questions about compliance and side effects within 2 weeks of completing their treatment. In addition, we assessed whether the H. pylori had been eradicated at least 4 weeks after the treatment using a 13C-urea breath test, rapid urease test, or histopathological examination. RESULTS: The eradication rate with first-line triple therapy decreased over the study period. There was no change in the eradication rate with second-line quadruple therapy (PPI, bismuth, metronidazole, and tetracycline). There were no differences in the eradication rate and recrudescence between 1- and 2-week regimens. CONCLUSIONS: The effectiveness of the recommended first-line triple therapy for H. pylori eradication has decreased significantly in the last decade. Therefore, the first-line therapy based on the combination of PPI, amoxicillin and clarithromycin may need to be changed in the near future.

Myositis due to Cryptococcus neoformans in a Diabetic Patient / 대한임상미생물학회지

We report a rare case of cryptococcal myositis with dissemination to lung in a 66-year-old diabetic woman who had no apparent risk factors for cryptococcal disease. She visited the hospital with a continuous pain in the right thigh and fever despite of treatment with antibiotics. She developed a localized lung infiltration. Crytococcus neoformans was isolated from the abscess of the right thigh and confirmed by molecular identification with DNA sequence analysis. Biopsy of the involved lung showed numerous budding yeasts consistent with Cryptocococcus species. The patient was successfully treated with surgical drainage and systemic antifungal agents.

The Bone Morphogenesis Protein-2 (BMP-2) is Associated with Progression to Metastatic Disease in Gastric Cancer / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: Bone Morphogenetic Proteins (BMPs) are members of the TGF-beta superfamily and it has been demonstrated that BMPs enhance migration, invasion and metastasis. The purpose of this study was to identify the association between the serum BMP-2 level and the progression status of gastric cancer. MATERIALS AND METHODS: Fifty-five patients with metastatic gastric cancer (metastatic disease group), six patients with early gastric cancer without lymph node metastasis (the EGC group), and ten healthy control subjects were enrolled in this study. The serum BMP-2 level was quantified by use of a commercially available ELISA kit. In EGC group patients and patients with metastatic disease, whole blood was obtained before endoscopic mucosal resection and before the commencement of a scheduled cycle of systemic chemotherapy, respectively. RESULTS: No significant difference in the mean serum BMP-2 levels was observed between the control subjects and the EGC group patients (87.95 pg/ml for the control subjects and 84.50 pg/ml for the EGC group, p=1.0). However, the metastatic disease group patients had a significantly higher level of serum BMP (179.61 pg/ml) than the control subjects and EGC group patients (87.95 pg/ml for the control subjects and 84.50 pg/ml for the EGC group, p<0.0001). Moreover, the mean serum BMP-2 level from patients with a bone metastasis was significantly higher than the mean serum BMP-2 level from patients without a bone metastasis (204.73 pg/ml versus 173.33 pg/ml, p=0.021). CONCLUSIONS: BMP-2 seems to have a role in progression to metastatic disease in gastric cancer, especially in the late stage of tumorigenesis, including invasion and metastasis. BMP-2 may facilitate bone metastasis in gastric cancer. To confirm these findings, further studies are required with tissue specimens and the use of a cancer cell line.

A Case of Systemic Amyloidosis with Pancreatic Involvement Mimicking Autoimmune Pancreatitis / 대한소화기학회지

Systemic amyloidosis is a disorder characterized by extracellular deposition of amyloid in various organs and tissues including the kidney, heart, and liver. However, pancreatic involvement is rare, and has not been reported in Korea. Systemic amyloisosis involving pancreas needs to be differentiated from several pancreatic diseases because of diffuse pancreatic enlargement and partial stricture or obstruction of main pancreatic duct. Recently, we experienced a 60-year old man who was suspected as autoimmune pancreatitis or infiltrative disorders on imaging studies, and finally diagnosed as systemic amyloidosis involving pancreas and liver on biopsy examination. We report the case with review of the relevant literatures.

Clinical Characteristics and Risk factors of Community-Acquired Methicillin-Resistant Staphylococcus aureus Infections: Comparison of Community-Acquired Methicillin-Susceptible Staphylococcus aureus Infections

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is an emerging cause of infections in many communities. MRSA is usually resistant to beta-lactam antibiotics which are commonly used to treat methicillin-susceptible S. aureus (MSSA) infections, and initial discordant therapy for community-acquired (CA)-MRSA infections frequently lead to treatment failure. This study evaluated the clinical characteristics and risk factors associated with CA-MRSA infections among patients admitted to a large urban public hospital. MATERIALS AND METHODS: From January 1st 2001 through December 31st 2004, all patients for whom S. aureus was isolated from clinical specimen cultures within first 72 hours after admission to Gyeongsang National University Hospital were retrospectively analyzed. CA-MRSA isolate was defined as MRSA isolates from patients who had no established risk factors for MRSA infections. Patients with CA-MRSA infections were compared with patients with CA-MSSA infections. RESULTS: During the 4 years of the study, 41 patients with CA-MRSA infection and 102 patients with CA-MSSA infection were included, respectively. In univariate analysis, CA-MRSA infections were more common in such conditions that were the previous isolation of MRSA from 1 year through 3 years before admission (17.5% vs. 1.0%, O.R=21.4, P=0.001), previous hospitalization from 1 year through 3 years before admission (33.3% vs. 10.7%, O.R=4.16, P=0.007), and previous alcohol drinking history (22% vs. 6.9%, O.R=3.81, P=0.017). Bone and joint infections (22.0% vs. 7.8%, O.R=3.30, P=0.025) were more common in CA-MRSA infections than CA-MSSA infections. Multiple logistic regression analysis showed that the previous isolation of MRSA from 1 year through 3 years before admission (OR:6.59 [95% CI, 1.040-41.741]) was the only significant risk factor for CA- MRSA infections. CONCLUSION: The previous isolation of MRSA from 1 year through 3 years before admission was an independent risk factor for CA-MRSA infections.

Clinical Characteristics and Risk factors of Community-Acquired Methicillin-Resistant Staphylococcus aureus Infections: Comparison of Community-Acquired Methicillin-Susceptible Staphylococcus aureus Infections

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is an emerging cause of infections in many communities. MRSA is usually resistant to beta-lactam antibiotics which are commonly used to treat methicillin-susceptible S. aureus (MSSA) infections, and initial discordant therapy for community-acquired (CA)-MRSA infections frequently lead to treatment failure. This study evaluated the clinical characteristics and risk factors associated with CA-MRSA infections among patients admitted to a large urban public hospital. MATERIALS AND METHODS: From January 1st 2001 through December 31st 2004, all patients for whom S. aureus was isolated from clinical specimen cultures within first 72 hours after admission to Gyeongsang National University Hospital were retrospectively analyzed. CA-MRSA isolate was defined as MRSA isolates from patients who had no established risk factors for MRSA infections. Patients with CA-MRSA infections were compared with patients with CA-MSSA infections. RESULTS: During the 4 years of the study, 41 patients with CA-MRSA infection and 102 patients with CA-MSSA infection were included, respectively. In univariate analysis, CA-MRSA infections were more common in such conditions that were the previous isolation of MRSA from 1 year through 3 years before admission (17.5% vs. 1.0%, O.R=21.4, P=0.001), previous hospitalization from 1 year through 3 years before admission (33.3% vs. 10.7%, O.R=4.16, P=0.007), and previous alcohol drinking history (22% vs. 6.9%, O.R=3.81, P=0.017). Bone and joint infections (22.0% vs. 7.8%, O.R=3.30, P=0.025) were more common in CA-MRSA infections than CA-MSSA infections. Multiple logistic regression analysis showed that the previous isolation of MRSA from 1 year through 3 years before admission (OR:6.59 [95% CI, 1.040-41.741]) was the only significant risk factor for CA- MRSA infections. CONCLUSION: The previous isolation of MRSA from 1 year through 3 years before admission was an independent risk factor for CA-MRSA infections.

A Case of Left Ventricular Pseudoaneurysm Extending to Lateral Side of Left Atrium after Myocardial Infarction

Left ventricular pseudoaneurysm is a rare but fatal complication of acute myocardial infarction. It occurs as a consequence of rupture of the ventricular free wall and is confined by a portion of pericardium. The pseudoaneurysm extended to lateral side of the left atrium is rare. We report a case of left ventricular pseudoaneurysm extended to lateral side of the left atrium in a 83-year-old man.

The Impact of Apolipoprotein E Genetic Polymorphism on Bone Mineral Density in Postmenopausal Women with Rheumatoid Arthritis / 대한류마티스학회지

OBJECTIVE: To evaluate the relationship between the presence of apolipoprotein E (Apo E) 4 allele and bone mineral density (BMD) and severity of joint destruction in postmenopausal women with rheumatoid arthritis (RA). METHODS: Apo E genotypes were analyzed in 113 postmenopausal women who were first diagnosed with RA and had not receiving antiresorptive therapy for osteoporosis at the time of enrollment. BMD was measured using dual-energy X-ray absorptiometry (DEXA), and joint destruction was evaluated on plain radiographs according to 'Larsen score'. The differences in BMD and severity of joint destruction in groups with and without an Apo E4 allele were analyzed in 94 patients with clinical information available. RESULTS: BMD (g/cm2) of the lumbar spine in the Apo E4 (-) group was 0.94+/-0.16 (n=67), whereas that in the Apo E4 (+) group was 0.87+/-0.14 (n=27; p=0.049). BMD of the femoral neck and great trochanter in the Apo E4 (-) group was 0.74+/-0.12 and 0.63+/-0.11, while that in the Apo E4 (+) group was 0.68+/-0.11 (p=0.039) and 0.57+/-0.11 (p=0.008). However, there were no significant differences in Larsen scores and erosive disease (%) between the Apo E4 (+) and Apo E4 (-) groups. CONCLUSION: The Apo E4 allele is associated with a reduced bone mass in postmenopausal RA patients. Therefore, Apo E4 allele is considered to be an independent risk factor for generalized osteoporosis in postmenopausal RA patients.

Molecular identification of Ca(2+)channels in human sperm

The acrosome reaction is a Ca(2+)-dependent exocytotic process that is a prerequisite step for fertilization. External calcium entry through voltage-activated Ca(2+)channels is known to be essential in inducing the acrosome reaction of mammalian spermatozoa. Due to their complex geometry, however, electrophysiological identification of sperm Ca(2+)channels has been limited. Here we identified Ca(2+)channel mRNAs expressed in motile human sperm using RT-PCR and their levels were compared using RNase protection assays. L-type, non- L-type, and T-type Ca(2+)channel mRNAs were detected by RT-PCR using degenerate primers. Cloning and sequencing of the PCR products revealed alpha1B, alpha1C, alpha1E, alpha1G, and alpha1H sequences. RT-PCR using specific primers repeatedly detected alpha1B, alpha1C, alpha1E, alpha1G, and alpha1H mRNAs, and additionally alpha1I mRNA. But alpha1A and alpha1D messages were not detected. Relative expression levels of the detected Ca(2+)channel subtypes were compared by RNase protection assays. The abundance of detected mRNA messages was in the following order: alpha1H> or =alpha1G> or =alpha1E> or =alpha1B>alpha1C>alpha1I. These findings indicated that human motile sperm express multiple voltage-activated Ca(2+)channel RNAs among which T-type and non-L-type channel messages are likely to be predominantly expressed. Based on their relative expression levels, we propose that not only T-type but also non-L-type calcium channels may be major gates for the external calcium influx, required for the acrosome reaction.

Recurrent Pyogenic Cholangitis: Efficacy of Two-Phase Helical CT

PURPOSE: To evaluate the usefulness of two-phase helical CT in patients with recurrent pyogenic cholangitis (RPC) for the detection of acute inflammation and assessment of the degree of portal vein (PV) stenosis as a cause of hepatic parenchymal atrophy. MATERIALS AND METHODS: We retrospectively reviewed two-phase CT findings in 30 patients with RPC diagnosed by CT, ERCP (endoscopic retrograde cholangiopancreatography), and surgery. Two-phase helical CT scans were obtained 30 sec (arterial phase, AP) and 70 sec (portal phase, PP) after the start of IV administration of contrast material. Without prior information, we analyzed periductal parenchymal and ductal wall enhancement during the AP and PP, and the degree of PV stenosis during the PP. Acute inflammation was diagnosed on the basis of symptoms and laboratory findings. To evaluate the relationship between parenchymal atrophy and PV stenosis, the degree of PV stenosis in affected parenchyma was classified as one of three types (mild,75%), as compared with the diameter of normal PV in unaffected parenchyma. RESULTS: Ten of the 30 patients underwent CT during the acute inflammatory stage and 20 during the remission stage. Of the ten patients with acute inflammation, eight (80%) showed transient periductal parenchymal enhancement during the AP (p0.05). There was no significant difference in parenchymal and ductal wall enhancement during the PP between patients with acute inflammation and those who showed remission (p>0.05). Hepatic parenchymal atrophy of the lesion was seen in 24 patients. Among these, PV stenosis was mild in five (21%), moderate in 14 (58%), and severe in five (21%). Degree of PV stenosis correlated closely with severity of parenchymal atrophy during the PP. In six patients without parenchymal atrophy, PV caliber was normal. CONCLUSION: Our results suggest that in patients with RPC, two-phase helical CT is useful for the detection of transient periductal parenchymal enhancement accompanying acute inflammation during the AP, and for assessment of the degree of PV stenosis as a cause of hepatic parenchymal atrophy during the PP.

Gastric Stromal Tumor: Two-Phase Dynamic CT Findings with Water as Oral Contrast Agents

PURPOSE: To evaluate two-phase dynamic CT with water as oral contrast agents in the CT diagnosis of gastric stromal tumors. MATERIALS AND METHODS: We retrospectively reviewed the CT findings in 21 patients with pathologically proven gastric stromal tumors. Six were found to be benign, twelve were malignant, and there were three cases of STUMP (stromal tumor uncertain malignant potential). Two-phase dynamic CT scans with water as oral contrast agents were obtained 60-70secs (portal phase) and 3 mins (equilibrium phase) after the start of IV contrast administration. We determined the size, growth pattern, and enhancement pattern of the tumors and overlying mucosa, the presence or absence of ulceration and necrosis, tumor extent, and lymph node and distant metastasis. The CT and pathologic findings were correlated. RESULTS: All six benign tumors and three STUMP were less than 5.5 cm in size, and during the portal phase showed round endogastric masses with highly enhanced, intact overlying mucosa. Twelve malignant tumors were 4.5-15.5 cm in size (mean, 11.5cm); an endogastric mass was seen in three cases, an exogastric mass in one, and a mixed pattern in eight. On portal phase images the tumors were not significantly enhanced, but highly enhanced feeding vessels were noted in five larger tumors (> 10 cm). All 12 malignant tumors showed ulceration and necrosis, and interruption of overlying mucosa was clearly seen during the portal phase. We were readily able to evaluate tumor extent during this phase, and in ten malignant tumors there was no invasion of adjacent organs. Seven malignant tumors showed air density within their necrotic portion (p<0.05). On equilibrium phase images, all malignant tumors showed heterogeneous enhancement due to necrosis, and poorly enhanced overlying mucosa. CONCLUSION: Dynamic CT during the portal phase with water as oral contrast agents was useful for depicting the submucosal origin of gastric stromal tumors and for evaluating the extent of malignant stromal tumors. Our results suggest that these CT findings may be helpful for differentiating between benign and malignant stromal tumors, and in distinguishing them from other gastric tumors.

Unilateral and Bilateral Lumbosacral Transitional Vertebrae: Comparison of the Incidence of Combined Diseases

PURPOSE: The purpose of this study was to evaluate the radiologic findings of lumbosacral transitional verte-brae (LSTV), as seen on plain radiographs and MRI, and to compare the incidence of combined diseases be-tween unilateral and bilateral groups. MATERIALS AND METHODS:We retrospectively evaluated the plain radiographs and MR images of 63 patients with LSTV, classifying its type according to Castellvi 's criteria, and evaluated disc herniations, facet joint os-teoarthritic change, scoliosis, and spondylolisthesis. We then compared the incidence of each combined diseases between unilateral and bilateral groups, and as a control group, 63 patients without LSTV were also eval-uated. RESULTS: Forty of 63 cases of LSTV (63.5%) were bilateral, and 23 (36.5%) unilateral. According to Castellvi 's criteria, the incidence of type I was 41.3% (unilateral 7 cases, bilateral 19), type III30.2% (unilateral 8 cases, bilateral 11), type II23.8% (unilateral 8 cases, bilateral 7), and type IV 4.8% (unilateral 0 cases, bilateral 3).With combined diseases, the incidence of disc herniation was 66.7% (unilateral 15 cases, bilateral 27), moderate to severe facet joint osteoarthritic change 28.6% (unilateral 11 cases, bilateral 7), scoliosis 27.0% (unilateral 9 cases, bilateral 8), and spondylolisthesis 9.5% (unilateral 2 cases, bilateral 4). The incidence of facet joint os-teoarthritic change was significantly higher in the unilateral group (47.8%) than in the bilateral group (17.5%) (p=0.02), and scoliosis occurred at a higher rate in the unilateral group (39.1%) than in the bilateral group (20.0%) (p=0.18). There was, however, no significant difference in the incidence of disc herniation and spondylolisthesis between the two groups (unilateral group: 65.2% and 8.7%; bilateral group: 67.5% and 10.0%, respectively). CONCLUSION: With LSTV, the incidence of facet joint osteoarthritic change was significantly higher in the unilat-eral group than in the bilateral group, and scoliosis also showed a higher rate of occurrence in the unilateral group.