Biomedical subjects

N H Kim

Publications and source records attributed to N H Kim.

At least 73 records · Page 4Linked to original sources

PubMed2000

Role of vascular endothelial growth factor in diabetic nephropathy.

BACKGROUND: Vascular endothelial growth factor (VEGF) is a potent cytokine that is considered to be an important mediator in the pathogenesis of endothelial dysfunction in diabetes. METHODS: This study investigates the effect of high glucose on the signaling and production of VEGF in rat mesangial cells in culture and measures the urinary VEGF level in patients with different stages of diabetic nephropathy. To elucidate the role of VEGF in vivo further, expression of VEGF in control and diabetic kidneys was examined using immunohistochemistry. RESULTS: A high ambient glucose concentration in the culture medium increased VEGF mRNA expression and protein production within 3 h in a concentration-dependent manner. A protein kinase C (PKC) inhibitor and PKC down-regulation inhibited glucose-induced increases in VEGF production. Urinary excretion of VEGF significantly increased according to the degree of proteinuria in patients with diabetes. A weak but significant correlation was found between urinary VEGF excretion and the levels of serum creatinine, creatinine clearance, microalbuminuria, and proteinuria. Immunohistochemistry revealed marked differences in the extent of mesangial VEGF staining between diabetic and control kidneys. Pronounced up-regulation of VEGF was observed in the glomerular epithelial cell in the early phase of diabetic kidney disease, whereas widespread expression of VEGF was found in the tubular segments, especially the proximal segment, in advanced diabetic nephropathy. CONCLUSIONS: These results suggest that VEGF may play a role in the pathogenesis of diabetic nephropathy.

Animals↗

PubMed2000

Simultaneous determination of fenfluramine and phentermine in urine using gas chromatography mass spectrometry with pentafluoropropionic anhydride derivatization.

Fenfluramine and phentermine ('fen-phen') are stimulants used primarily for weight loss that have a causative association with serious health problems. Though voluntarily removed from the market by their manufacturers and the FDA in September of 1997, both drugs occasionally reappear in the clinical and forensic setting from individuals who retained old prescriptions, transported the drugs from foreign countries, or 'stockpiled' the medications immediately before their removal from the market. The authors describe an analytical method for simultaneous detection of fenfluramine, phentermine, and the internal standard, N-propylamphetamine, in urine using pentafluoropropionic anhydride derivatization. Detection using and mass spectrometry is described. Baseline resolution of the analytes was achieved in the presence of four other common sympathomimetic amines. The increased molecular weights, better peak profiles, and characteristic fragments containing portions of both derivatizing agent and parent compound aid in the unambiguous identification of these analytes.

Appetite Depressants↗

PubMed2000

Successful management of intractable coronary spasm with a coronary stent.

Although the long-term survival of patients suffering from coronary spasm is usually excellent, serious complications can develop, such as disabling pain, myocardial infarction, ventricular tachyarrhythmias, atrioventricular block and sudden cardiac death. A 40-year-old man who had intractable chest pain from coronary artery spasm suffered ventricular fibrillation and an acute anterior myocardial infarction upon first admission. The patient underwent a coronary angiogram, which revealed a spontaneous focal spasm at the proximal left anterior descending coronary artery (LAD). He was treated by the combination of nitrate and calcium channel blocker, but continued to complain of severe chest pain despite intensive medical therapy and he had to be treated in the emergency room 5 times during an 8-month follow-up period. An ergonovine coronary angiogram was performed and an intracoronary ultrasound examination, which revealed a focal spasm at the same site of the proximal LAD with a small amount of localized eccentric atheromatous plaque. A coronary artery stent was placed in the proximal LAD and his symptoms resolved. A follow-up coronary angiogram was performed 3 years after stenting and the stent remained patent without any in-stent restenosis or spasm.

Adult↗

PubMed2000

Expression of vascular endothelial growth factor in response to high glucose in rat mesangial cells.

Diabetic nephropathy associated with hyperglycemia is characterized by glomerular hyperfiltration and endothelial dysfunction. Vascular endothelial growth factor (VEGF) is known to be primarily involved in neoangiogenesis and increased endothelial permeability. The purpose of this study was to investigate VEGF expression in response to high glucose in rat cultured mesangial cells and to identify its signal pathway via protein kinase C (PKC). Rat mesangial cells were cultured with different concentrations of glucose: normal (5 mM d-glucose), medium (15 mM d-glucose) and high (30 mm d-glucose). Calphostin-C as a PKC inhibitor and phorbol myristate acetate (PMA) as a PKC downregulator were instillated into culture media to evaluate the role of PKC in mediating the glucose-induced increase in VEGF expression. High glucose increased expression of VEGF at the mRNA and protein levels, identified by semi-quantitative RT-PCR and western blotting, within 3 h and in a time- and glucose concentration-dependent manner. Calphostin-C and PMA inhibited glucose-induced increases in VEGF expression at the mRNA and protein levels. In conclusion, high glucose can directly increase VEGF expression in rat mesangial cells via a PKC-dependent mechanism. These results suggest that VEGF could be a potential mediator of glomerular hyperfiltration and proteinuria in diabetic nephropathy.

Animals↗

PubMed2000

Erythropoietin does not affect nitric oxide system in rats with chronic renal failure.

We investigated to see whether an altered role of nitric oxide (NO) system is involved in erythropoietin (EPO)-induced hypertension in chronic renal failure (CRF). Male Sprague-Dawley rats were five-sixths nephrectomized to induce CRF. Six weeks after the operation, EPO or vehicle was injected for another 6 weeks. Plasma and urine nitrite/nitrate (NOx) levels were determined. Expression of NO synthase (NOS) proteins in the aortae and kidneys were also determined. In addition, the isometric tension of isolated aorta in response to acetylcholine and nitroprusside was examined. Blood pressure progressively rose in CRF groups, the degree of which was augmented by EPO treatment. Plasma NOx levels did not differ among the groups, while urine NOx levels were lower in CRF groups. Endothelial NOS expression was lower in the kidney and aorta in CRF rats, which was not further affected by EPO-treatment. The inducible NOS expression in the kidney and aorta was not different among the groups. Acetylcholine and sodium nitroprusside caused dose-dependent relaxations of aortic rings, the degree of which was not altered by EPO-treatment. Taken together, EPO-treatment aggravates hypertension in CRF, but altered role of NO system may not be involved.

Acetylcholine↗

PubMed2000

Serum ferritin in healthy subjects and type 2 diabetic patients.

In order to study the relationship between the serum ferritin level and the components of the insulin resistance syndrome in type 2 diabetic patients, we evaluated fifty type 2 diabetic patients who were selected according to NDDG/WHO criteria from those patients attending Korea University Hospital from 1997 to 1998. Twenty-five healthy non-diabetic subjects of comparable age and sex distribution acted as a control group. The results showed that the value of log ferritin was higher in the type 2 diabetes patients than the control subjects, but not at a statistically significant level (p = 0.09). Log ferritin was correlated with fasting blood sugar level (r = 0.235, p = 0.048) and body mass index (BMI) (r = 0.285, p = 0.05). In the type 2 diabetic patients, log ferritin was correlated with fasting C-peptide (r = 0.478, p = 0.009). In the control subjects, log ferritin was correlated only with BMI (r = 0.477, p = 0.012). In a stepwise multiple regression analysis, the diabetic group showed a significant correlation between fasting C-peptide and log ferritin (p = 0.001). In the control group, the fasting sugar level was significantly correlated with log ferritin (p = 0.034). These results suggest that serum ferritin can be employed as a marker of not only glucose homeostasis but also insulin resistance both in type 2 diabetic and control subjects.

Aged↗

PubMed2000

Serum insulin, proinsulin and proinsulin/insulin ratio in type 2 diabetic patients: as an index of beta-cell function or insulin resistance.

BACKGROUND: Although insulin resistance and decreased insulin secretion are characteristics of established type 2 DM, which of these metabolic abnormalities is the primary determinant of type 2 DM is controversial. It is also not well known how insulin resistance and beta cell dysfunction influence serum insulin, proinsulin, proinsulin/insulin ratio in type 2 DM. METHODS: We compared serum insulin, proinsulin and proinsulin/insulin ratio in type 2 diabetic patients and control subjects. We also investigated the relationship between serum insulin, proinsulin and proinsulin/insulin ratio and several biochemical markers which represent insulin resistance or beta cell function. RESULTS: Insulin, proinsulin and proinsulin/insulin ratio were significantly higher in type 2 DM than control(p < 0.001). In diabetic patients, total insulin level was correlated with urinary albumin excretion rates(r = 0.224, p = 0.025) and body mass index(r = 0.269, p = 0.014). Proinsulin level was correlated with fasting C-peptide(r = 0.43, p = 0.002), postprandial 2 hour blood glucose(r = 0.213, p = 0.05) and triglyceride(r = 0.28, p = 0.022). Proinsulin/insulin ratio was positively correlated with fasting C-peptide(r = 0.236, p = 0.031), fasting blood glucose (r = 0.264, p = 0.015), postprandial 2 hour blood glucose(r = 0.277, p = 0.001) and triglyceride(r = 0.428, p < 0.001). In control subjects, insulin level was correlated with triglyceride(r = 0.366, p = 0.002). Proinsulin/insulin ratio was correlated with age(r = 0.241, p = 0.044). CONCLUSION: The serum levels of insulin and proinsulin seem to be associated with several markers of insulin resistance. Whereas proinsulin/insulin ratio might represent beta cell function rather than insulin resistance. But more studies are needed to clarify the mechanisms of elevated proinsulin/insulin ratio in type 2 DM.

Aged↗

PubMed1999

Anterior interbody fusion versus posterolateral fusion with transpedicular fixation for isthmic spondylolisthesis in adults. A comparison of clinical results.

STUDY DESIGN: Clinical and radiographic results were assessed in adult patients who had undergone operation for isthmic spondylolisthesis. OBJECTIVES: To compare the results between anterior interbody fusion and posterolateral fusion with those of transpedicular fixation for the treatment of isthmic spondylolisthesis in adults. BACKGROUND DATA: Successful clinical results after fusion can be expected in adolescents, but the adult type differs in that stability through fusion alone fails to ensure satisfactory outcomes. The role of decompression in the surgical treatment of adult isthmic spondylolisthesis remains controversial. Anterior interbody fusion has an indirect effect of nerve root decompression through widening of the intervertebral space, whereas posterolateral fusion with transpedicular fixation provides direct decompression. METHODS: The clinical data of 40 adult patients who had undergone operations for isthmic spondylolithesis from June 1977 through June 1994 were reviewed. Anterior interbody fusion was performed in 20 patients (Group I) and posterolateral fusion with transpedicular fixation in 20 patients (Group II). The mean age of Group I was 44.1 years (range, 21-62 years), and that of Group II was 41.3 years (range, 21-57 years). Group I contained B men and 12 women, Group II contained 5 men and 15 women. The symptoms and signs in Groups I and II were similar. The duration of follow-up averaged 3.6 years (range, 1.1-16 years) in Group I and 2.3 years (range, 1.1-6 years) in Group II. RESULTS: The anterior slippage in Group I, assessed by the Taillard method, was 16.1% and was corrected to 10.4% after surgery. Anterior slippage in Group II was 15.2% and was corrected to 9.8% after surgery. The fusion rate 12 months after surgery was 90% in Group I and 95% in Group II. The clinical results were analyzed by Kim's criteria, according to variables on the improvement of clinical symptoms. Satisfactory results were obtained in 85% of Group I and 90% of Group II. CONCLUSIONS: There was no statistically significant difference in clinical results between anterior interbody fusion and posterolateral fusion with transpedicular fixation for the treatment of isthmic spondylolisthesis in adults (P < 0.05).

Adult↗

PubMed1999

Neurologic injury and recovery in patients with burst fracture of the thoracolumbar spine.

STUDY DESIGN: A retrospective study of factors affecting neural deficits and recovery in burst fracture of the thoracolumbar spine with an evaluation of the computed tomography scans and Frankel grades of 148 consecutive cases. OBJECTIVES: To evaluate the relation between the degree of traumatic canal impingement and neurologic improvement. SUMMARY OF BACKGROUND DATA: Previous studies on this subject have been reported, but the results have varied. METHODS: From 1986 to 1993, 148 consecutive cases of burst fracture of the thoracolumbar spine were evaluated by studying the following: 1) the cross-sectional area of the spinal canal by computed tomography scans, 2) damage to the posterior element of injured vertebra by computed tomography scans, 3) the neurologic deficits and improvement by Frankel grade. RESULTS: The average percentage of canal compromise was higher in the patients with neurologic deficit (52%) than in the patients with no neurologic deficit (35%). The degree of neurologic impairment was higher in the group with disruption of the posterior elements (62.9%) than in the group with intact posterior elements (29.8%). The degree of neural improvement was greater in the group with disruption of the posterior elements (60.7%) than in the group with no disruption of the posterior elements (25%). These differences were statistically significant (P < 0.05). CONCLUSION: The disruption of posterior elements indicated a more significant neurologically injured status on first examination; in those cases, however, the presence of disrupted posterior elements indicated a high possibility of neurologic recovery.

Adult↗

PubMed1999

Intracytoplasmic injection of porcine, bovine, mouse, or human spermatozoon into porcine oocytes.

We determined the incidence of activation, male pronuclear formation, and apposition of pronuclei in porcine oocytes following intracytoplasmic injection of various porcine sperm components and foreign species spermatozoa, such as that of cattle, mouse or human. The porcine oocytes were activated by injection of a spermatozoon or an isolated sperm head. In contrast, injection of either sperm tail or a trypsin- or NaOH-treated sperm head failed to induce oocyte activation. Because injection of mouse, bovine, or human spermatozoon activated porcine oocytes, the sperm-borne activation factor(s) is not strictly species-specific. Male pronuclear formation and pronuclear apposition were observed in porcine oocytes following injection of porcine, bovine, mouse or human spermatozoa. Electrical stimulation following sperm cell injection did not enhance the incidence of male pronuclear formation or pronuclear apposition compared with sperm cell injection alone (P > 0.1). Following porcine sperm injection, the microtubular aster was organized from the neck of the spermatozoon, and filled the whole cytoplasm. In contrast, following injection of bovine, mouse, or human spermatozoon, the maternal-derived microtubules were organized from the cortex to the center of the oocytes, which seems to move both pronuclei to the center of oocytes. Cleavage to the two-cell stage was observed at 19-21 hr after injection of porcine spermatozoon. However, none of the oocytes following injection of mouse, bovine, or human spermatozoa developed to the mitotic metaphase or the two-cell stage. These results suggested that the oocyte activating factor(s) is present in the perinuclear material and that it is not species-specific for the porcine oocyte. Self-organized microtubules seemed to move the pronuclei into center of oocytes when foreign species spermatozoa were injected into porcine oocytes.

Animals↗

PubMed1999

Fertilization and in vitro development of porcine oocytes following intracytoplasmic injection of round spermatid or round spermatid nuclei.

The objective of this study was to determine fertilization rates and developmental ability of porcine oocytes following injection of round spermatid and round spermatid nucleus with artificial activation either 2 h before or immediately after injection. Electrical stimulation at 2 h before spermatid injection significantly increased the incidence of normal fertilization compared with that following injection without stimulation or with stimulation immediately after injection. Incidences of formation of 2 pronuclei and of apposition were not different in oocytes following intracytoplasmic spermatid and spermatid nucleus injection. Chromosome analysis revealed that most oocytes were diploid either following round spermatid or round spermatid nucleus injection. There was no diploid set of chromatin in oocytes at 20 h following sham injection. At 6 d following injection blastocoele formation was seen in the oocytes following round spermatid (25%) and round spermatid nucleus injection (27%). However, none of the oocytes developed to the blastocyst stage 6 d following sham injection. The average cell numbers of blastocysts 8 d after injection of spermatid and spermatid nucleus were 99 and 87, respectively. These results suggest that electrical stimulation before injection enhances the incidence of fertilization following round spermatid injection in the pig. Our study also indicates that either the round spermatid or it's nucleus can be used to produce viable embryos by injection into unfertilized porcine oocytes.

Animals↗

PubMed1999

BCG vaccine prevents insulitis in low dose streptozotocin-induced diabetic mice.

Autoimmune type 1 diabetes mellitus is caused by the immunologic destruction of pancreatic beta-cells; therefore, there have been many attempts at immunologic modulation as a block or prevention of the underlying process. The aim of this study is to investigate the effect of BCG vaccination on low dose streptozotocin-induced diabetic (LDSD) mice. The mice were pretreated with BCG 7 days before starting low dose streptozotocin (STZ), observed body weight and blood glucose for 2 months, then analyzed the severity of the STZ-induced insulitis after the animals were sacrificed. In this experiment, the mean body weights in the BCG-STZ group on days 1, 19, 33, 47, and 61 of the experiment were 37.5 +/- 3.6, 37.3 +/- 3.6, 37.5 +/- 3.5, 39.4 +/- 3.9, and 39.3 +/- 4.5 (g), respectively. Those in the STZ group were 37.7 +/- 3.5, 38.3 +/- 4.5, 38.4 +/- 3.9, 36.2 +/- 4.5, and 36.3 +/- 4.0 (g), respectively (P < 0.05). The mean blood glucose levels in the BCG-STZ group on days 1, 19, 33, 47, and 61 were 106.5 +/- 8, 150 +/- 37, 147 +/- 54, 143 +/- 60, and 142 +/- 66 (mg/dl), respectively. Those in the STZ group were 103 +/- 12, 196 +/- 90, 261 +/- 236, 236 +/- 91, and 224 +/- 89 (mg/dl), respectively (P < 0.05). The numbers developing grade 0, I, II, III, and IV insulitis in the BCG-treated group were 63, 48, 33, 4, and 2, respectively, and in the control group were 16, 23, 31, 45, and 35, respectively. This study indicates that BCG vaccination reduces the development of insulitis and overt diabetes in LDSD mice.

Animals↗

PubMed1999

The changes in hair growth pattern after autologous hair transplantation.

BACKGROUND: Recently donor dominance has been emphasized in autologous hair transplantation while the influence of the recipient site has been considered negligible. In fact, there have been few studies that show this. OBJECTIVE: This study was performed to examine the influence of the recipient site on transplanted hairs. A clinical study of 19 leprosy patients was performed. These patients had received single hair transplantation due to madarosis and were admitted to The Leprosy Mission, Jesus Hospital, Taegu, Korea, or had visited its outpatient clinic. METHODS: In this study, the rate of growth, thickness of shaft, and graying rate between the transplanted eyebrow hair in the recipient site and scalp hair near the donor site were compared to observe the changes in the growth pattern of the hairs after transplantation. RESULTS: For most of the patients, the growth rate and graying rate of transplanted hairs were lower than those of hairs in the donor site. CONCLUSION: It seems that the recipient site may have an influence on the transplanted hairs. Further studies are needed, including clinical, histopathologic, and molecular biological methods.

Aged↗

PubMed1999

Expression of vascular endothelial growth factor in otitis media.

Increased vascular permeability and endothelial cell growth are important in the pathogenesis of otitis media with effusion (OME) and the vascular endothelial growth factor (VEGF) is known to play an important role in the increased vascular permeability and angiogenesis. To date, at least five isoforms of the VEGF family have been identified as VEGF transcripts, encoding polypeptides of 206, 189, 165, 145 and 121, but their physiological roles are unclear. The purpose of this study was to investigate the expression of VEGF, in both endotoxin-induced OME of the rat and human otitis media. We instilled endotoxin and saline as a control into the middle ear cavity of the rat. Middle ear mucosa were taken at 0 h, 1 h, 3 h, 6 h, 12 h, 1 day, 3 days, 7 days and 14 days and the expression of VEGF mRNA and VEGF protein was evaluated using semi-quantitative RT-PCR and immunohistochemistry. Expression of VEGF164 mRNA and VEGF120 mRNA was first identified 1 h after endotoxin instillation and was dramatically increased over the period 6 h-1 day and then progressively decreased by day 7. The level of expression of VEGF120 mRNA was slightly higher than that of VEGF164 mRNA and that of VEGF164 mRNA was much higher than that of VEGF188 mRNA. Immunostaining revealed expression of VEGF during 6 h to day 3 and its expression was localized to ciliated cells and some inflammatory cells. We also performed RT-PCRs of cDNA from middle ear fluids of 8 human OME patients and middle ear mucosa of 4 chronic otitis media patients for the identification of VEGF mRNA expression. VEGF121 mRNA was highly expressed in all samples compared with VEGF165 mRNA. These results suggest that VEGF may be primarily responsible for increased vascular permeability and endothelial cell growth in OME and that VEGF seems to play a significant role in the pathogenesis of OME.

Animals↗

PubMed1999

Effects of L-arginine on cyclosporin-induced alterations of vascular NO/cGMP generation.

BACKGROUND: Cyclosporin (CsA)-induced vascular dysfunction has been attributed to a diminished role of the nitric oxide (NO)/cGMP-mediated vasodilator mechanism. The present study was aimed at investigating whether L-arginine, the substrate of NO synthesis, ameliorates CsA-induced vascular dysfunction. METHODS: Male Sprague-Dawley rats were used throughout the study. The thoracic aorta was isolated from normal rats and acutely treated with CsA (10(-4) mol/l, 60 min) in vitro, or the aorta was taken from rats treated with CsA (25 mg/kg/day, i.m., 1 week). The vascular relaxation response to acetylcholine, and tissue levels of NO metabolites and cGMP were determined. The vascular expression of NO synthase (NOS) isoforms was also determined by western blot analysis. RESULTS: Acute treatment with CsA in vitro markedly attenuated the vasorelaxation response to acetylcholine, which was completely restored by L-arginine. The vascular accumulation of NO metabolites in response to acetylcholine was decreased significantly by CsA, which was prevented by cotreatment with L-arginine. CsA decreased the cGMP accumulation in response to both acetylcholine and sodium nitroprusside. L-Arginine restored, although not completely, acetylcholine-stimulated cGMP generation, whereas it did not affect sodium nitroprusside-stimulated cGMP generation. Following chronic CsA treatment in the whole animal, the vasorelaxation response to acetylcholine was decreased significantly along with tissue levels of NO metabolites; this was preserved by L-arginine-supplementation. Vascular expression of iNOS protein was decreased by CsA treatment along with decreased tissue accumulation of NO metabolites. L-Arginine supplementation did not modify the altered expression of NOS proteins. CONCLUSION: These results suggest that CsA causes an L-arginine-sensitive vascular dysfunction which is associated with impaired generation of NO and cGMP.

Acetylcholine↗

PubMed1999

The effects of antiplatelet agents in the prevention of ventricular tachyarrhythmias during acute myocardial ischemia in rats.

Experiments were performed in rat models to study the effectiveness of various antiplatelet agents in the prevention of ventricular tachyarrhythmias during acute myocardial ischemia. The time to the onset of ST-segment elevation and initiating ventricular arrhythmias, frequency and incidence of ventricular arrhythmias, and mortality rates were observed during acute myocardial ischemia (20 minutes) induced by ligation of the proximal left anterior descending coronary artery (LAD) in anesthetized rats. Four groups were studied: Control group (n = 10, not pretreated); Aspirin pretreated group (n = 10, 300 mg/kg p.o. for 1 wk); Ticlopidine pretreated group (n = 10, 200 mg/kg p.o. for 1 wk); and Abciximab (Platelet glycoprotein IIb/IIIa receptor antagonist) pretreated group (n = 10, 2 mg/kg i.v. 10-20 minutes before an experiment). No significant difference was observed in the time to the onset of ST-segment elevation and ventricular arrhythmias between the groups. The incidence of ventricular tachycardia (VT) in the abciximab group was significantly lower than in the control group (p < 0.05) and ventricular fibrillation (VF) in the aspirin and ticlopidine group was significantly lower than in the control group (p < 0.05). The mortality rate in the ticlopidine group was significantly lower than in the control group (p < 0.01). This study suggests aspirin, ticlopidine, and abciximab can effectively prevent VT or VF during acute myocardial ischemia induced by nonthrombotic occlusion and its antiarrhythmic effect may lead to prolonged survival.

Abciximab↗

PubMed1999

A case of prominent epicardial fat mimicking a tumor on echocardiography.

Epicardial fat may anteriorly produce an echo-free space that can be mistaken for pericardial fluid. We recently experienced a 67-year-old woman with prominent epicardial fat which was presented as an echogenic tumor-like mass. She underwent open pericardiostomy to relieve large amount of pericardial effusion. Operative findings revealed only prominent epicardial fat. Biopsy of the pericardial and fat tissues revealed an inflammation and normal fat cells without any malignant cell infiltration.

Adipose Tissue↗

PubMed1999

Clinical and radiological differences between traumatic and idiopathic coccygodynia.

Several reports of coccygodynia have been confined to the causes, the methods of treatment, and the methods of radiological examination. As far as we know, there has been no previous study about the objective measurement of the coccyx. The purpose of this study was to find the possible cause of idiopathic coccygodynia by comparing the clinical and radiological differences between traumatic and idiopathic coccygodynia by innovative objective clinical and radiological measurements. Thirty-two patients with coccygodynia were evaluated retrospectively. We divided the patients into two groups. Group 1 consisted of 19 patients with traumatic coccygodynia and group 2 consisted of 13 patients with idiopathic coccygodynia. We reviewed medical records and checked age, sex distribution, symptoms, and treatment outcome in each group. We also reviewed coccyx AP and lateral views of plain radiological film and measured the number of coccyx segments and the intercoccygeal angle in each group. The intercoccygeal angle devised by the authors was defined as the angle between the first and last segment of the coccyx. We also checked the intercoccygeal angle in a normal control group, which consisted of 18 women and 2 men, to observe the reference value of the intercoccygeal angle. The outcome of treatment was assessed by a visual analogue scale based on the pain score. Statistical analysis was done with Mann-Whitney U test and Chi-square test. Group 1 consisted of 1 male and 18 female patients, while group 2 consisted of 2 male and 11 female patients. There were no statistically significant differences between the traumatic and idiopathic coccygodynia groups in terms of age (38.7 years versus 36.5 years), male/female sex ratio (1/18 versus 2/11), and the number of coccyx segments (2.9 versus 2.7). There were significant differences between the traumatic and idiopathic coccygodynia groups in terms of the pain score (pain on sitting: 82 versus 47, pain on defecation: 39 versus 87), the intercoccygeal angle (47.9 degree versus 72.2 degrees), and the satisfactory outcome of conservative treatment (47.4% versus 92.3%). The reference value of the intercoccygeal angle in the normal control group was 52.3 degrees, which was significantly different from that of the idiopathic group. In conclusion, the intercoccygeal angle of the idiopathic coccygodynia group was greater than that of the traumatic group and normal control group. Based on the results of this study, the increased intercoccygeal angle can be considered a possible cause of idiopathic coccygodynia. The intercoccygeal angle was a useful radiological measurement to evaluate the forward angulation deformity of the coccyx.

Adult↗