Park, Ho-Young;Lee, Sun-Ho;Park, Se-Jun;Kim, Eun-Sang;Lee, Chong-Suh;Eoh, Whan
Journal of Korean Neurosurgical Society
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제57권2호
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pp.100-107
/
2015
Objective : To report a minimally invasive treatment option using percutaneous pedicle screw fixation with adjuvant treatment for metastatic thoraco-lumbar and lumbar spinal tumors. Methods : This is a retrospective study of charts of patients with spinal metastases. All were older than 18 years of age and were considered to have more than 3 months of life expectancy. The patients had single or two level lesions, and compression fracture or impending fracture. Exclusion criterion was metastasis showing severe epidural compression with definite neurological symptoms. Usually spinal segments from one level above to below pathology were stabilized. Visual analog scale (VAS) score for pain assessment and Frankel scale for neurological deficit were used, while pre- and post-operative performance status was evaluated using the Eastern Cooperative Oncology Group (ECOG). Results : Twelve patients (nine men, three women; median age 54.29 years) underwent surgery. All patients presented with back pain with/without radicular pain. There were no early complications and perioperative mortalities. Following surgery, a significant difference between average pre- and post-operative VAS scores was found (p=0.003). Overall, 91.8% of patients (11/12) experienced improvement in their ECOG score post-operatively. The mean ambulation time was 196.9 days [95% confidence interval (CI), 86.2-307.6 days; median, 97 days]. During follow-up, nine patients died and the mean overall survival time in enrolled twelve patients was 249.9 days (95% CI, 145.3-354.4 days; median, 176 days). Conclusion : Minimally invasive treatment using percutaneous pedicle screw fixation with adjuvant treatment is a good alternative treatment option for potential instability of the thoraco-lumbar and lumbar spinal metastasis.
Objectives : The purpose of this study was to investigate the characteristics of inpatients who were admitted to Korean medicine hospital due to traffic accident. Methods : We analyzed statistical study in 137 patients, who had admitted to M korean medicine hospital, in Gimpo city, Gyeonggi Province from January 1st, 2017 to June 31th, 2017 according to medical charts. Results : 1. In distribution according to age and sex, people in their 50s numbered the most. The 137 inpatients comprised of male (46.0%) and female (54.0%). 2. In distribution according to types of accident, Rear-end collision accident numbered the most (34.3%), followed by Frontal collision (21.2%) and Lateral collision (14.6%). 3. In distribution according to duration of treatment, most (54.7%) patients discharged within 1 week, followed by 1 week to 2 weeks(37.2%) 4. In distribution according to mean elevation of symptoms, Neck pain was the most (75.9%) symptom, followed by Low back pain (67.2%), Shoulder pain (46.0%) and Headache (37.2%). 5. In distribution according to treatment results, symptom improvement was the most (62.8%), followed by excellent (19.7%), mild improvement (14.6%). 6. In distribution according to duration of treatment, Most frequently prescribed herbal decoction was Tongdosan (45.7%), followed by Dangguijakyaksangagam (29.6%), and most frequently prescribed extract powder was Yunkyopaedocksan and Ojeoksan (12.7%). Conclusions : This study shows that aftereffects from the traffic accident tend to occur with various symptoms in various age groups. Korean medicine treatments are effective in patient who were admitted to Korean medicine hospital due to traffic accident.
Objectives The purpose of this study was to find out the characteristics of children patients who had been treated in the Oriental Medical Hospital due to traffic accidents. Methods The study was carried out with 121 children patients who visited the Oriental Medical Hospital from April 2011 to March 2012 and was analyzed by reviewing the patients' charts. Results In the distribution of sex the ratio between boys and girls were similar, but regarding the age, 0~6 year-old group was more than that of 7~15 year-old group. In the traffic accident patterns, 87.6% of the entire children patients were injured by car crash. The highest type in the collision between cars was rear-ending impact. The most patients (48.8%) visited our hospital for oriental medical treatment in less than 3 days after the traffic accident. The number of the first visitors in the Oriental Medical Hospital were 77 (63.6%) and those who visited other western hospitals before and were 44 (36.4%). The most frequent duration of admission and treatment in OPD was less than 7 days. Sleeping disorders (37.1%) were diagnosed the highest in 0~6 year-old group and C-spine sprain (49.0%) was diagnosed the highest at 0~7 years-old group. Herb medications were prescribed to relieve anxiety for 0~6 year-old group and for 7~15 year-old group, those were prescribed to activate blood eliminating phlegm and to normalize Qi flow. The highest effective treatment period was less than 7 days. Conclusions This data suggested that the oriental medical care could be more effective in treating children victims of traffic accidents by confirming many different symptoms depending on the age.
Purpose: McCune-Albright syndrome (MAS) is caused by activating mutations in the GNAS gene, resulting in peripheral precocious puberty, caf$\acute{e}$-au-lait spots, and polyostotic fibrous dysplasia (POFD). The aim of the present study was to describe the diverse clinical and endocrine characteristics of patients with MAS. Methods: Seven patients with MAS were included in this study and medical charts were reviewed retrospectively for following parameters: patient's sex and age at diagnosis, POFD, ovarian cysts, and precocious puberty. Results: The mean age at diagnosis was $5.8{\pm}4.2$ years. One patient was male (14%) and the other six patients were female (86%). Peripheral precocious puberty was associated with 6 patients (86%). Five patients manifested premature menarche as early as 2 to 5 years of age. Letrozole was administered to 4 patients, tamoxifen to one patient and GnRH agonist to one patient. Five females developed ovarian cysts. Thyroid function tests were performed in all patients and one patient showed hyperthyroidism (14%) and has been treated with methimazole. One patient presented with pseudohypoparathyroisdism, phosphaturia, calciuria suggesting hypophosphatemic rickets. Six patients (86%) revealed POFD. One patient had symptoms of optic nerve compression and secondary esotropia and 2 patients had bone pain. Conclusion: This study described clinical characteristics and endocrine complications of patients with MAS. Careful physical examinations with history taking and serial endocrine function tests should be needed to detect complications such as endocrinologic hyperfunction and POFD.
Arbash, Mahmood Ali;Parambathkandi, Ashik Mohsin;Baco, Abdul Moeen;Alhammoud, Abduljabbar
Asian Spine Journal
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제12권6호
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pp.1053-1059
/
2018
Study Design: Retrospective review. Purpose: To detect the effect of cannulated (poly-axial head) and solid (mono-axial head) screws on the local kyphotic angle, vertebral body height, and superior and inferior angles between the screw and the rod in the surgical management of thoracolumbar fractures. Overview of Literature: Biomechanics studies showed that the ultimate load, yield strength, and cycles to failure were significantly lower with cannulated (poly-axial head) pedicle comparing to solid core (mono-axial head). Methods: The medical charts of patients with thoracolumbar fractures who underwent pedicle screw fixation with cannulated or solid pedicle screws were retrospectively reviewed; the subjects were followed up from January 2011 to December 2015. Results: Total 178 patients (average age, $36.1{\pm}12.4years$; men, 142 [84.3%]; women, 28 [15.7%]) with thoracolumbar fractures who underwent surgery and were followed up at Hamad Medical Corporation were classified, based on the screw type as those with cannulated screws and those with solid screws. The most commonly affected level was L1, followed by L2 and D12. Surgical correction of the local kyphotic angle was significantly different in the groups; however, there was no significant difference in the loss of correction of the local kyphotic angle of the groups. Surgical correction of the reduction in the vertebral body height showed statistical significance, while the average loss of correction in the reduction of the vertebral body height was not significantly different. The measurement of the angles made by the screws on the rods was not significantly different between the cannulated (poly-axial head) and solid (mono-axial head) screw groups. Conclusions: Solid screws were superior in terms of providing increased correction of the kyphotic angle and height of the fractured vertebra than the cannulated screws; however, no difference was noted between the screws in the maintenance of the superior and inferior angles of the screw with the rod.
Purpose: This study aimed to investigate the clinical features of macrocephaly at birth in Korea using ultrasonography. Methods: We retrospectively investigated the medical records of full-term birth neonates in Cheil General Hospital & Women's Healthcare Center from January 2000 to June 2012. The following parameters were recorded and analyzed: gestational age, sex, birth weight, height, occipitofrontal circumference (OFC), physical examination, perinatal problems, and ultrasonography results. Macrocephaly was diagnosed when the OFC was greater than two standard deviations, based on the 2007 Korean National Growth Charts. Results: There were 75 neonates with macrocephaly at birth (52 boys and 23 girls), with a mean OFC of $38.1{\pm}0.49cm$. A comparison of the birth weight and height with the OFC value showed that height was correlated with OFC (r=0.35) but birth weight was not correlated with OFC (r=0.06). There were no remarkable findings in 56 cases (75%). Germinal matrix hemorrhage was identified in 10 cases (13%). An enlarged cerebrospinal fluid space was found in 5 cases (6.7%). There were 3 cases of mega-cisterna magna (4%), 1 case of ventriculomegaly, and 1 case of an enlarged interhemispheric space (6 mm) among these patients. In addition, a choroid plexus cyst was seen in 1 case. Mineralizing vasculopathy in both basal ganglia with no evidence of congenital infection was found in 2 cases and an asymptomatic subarachnoid hemorrhage was found in 1 case. Conclusion: Our results indicate that macrocephaly at birth has benign ultrasonography findings and shows a pattern of male dominance.
Background: Infection is a serious cause of mortality in febrile neutropenia of pediatric cancer patients. Recently, monotherapy has replaced the combination therapy in empirical treatment of febrile neutropenia. Since there has been no reported trial comparing the efficacy of meropenem and piperacillin-tazobactam (PIP/TAZ) monotherapies, the present retrospective study was conducted to compare safety and efficacy in febrile neutropenic children with cancer. Materials and Methods: Charts of febrile, neutropenic children hospitalized at our center between March 2008 and April 2011 for hemato-oncological malignancies were reviewed. Patients received PIP/TAZ 360 mg/kg/day or meropenem 60 mg/kg/day intravenously in three divided doses. Duration of fever and neutropenia, absolute neutrophil count, modification, and success rate were compared between the two groups. Resolution of fever without antibiotic change was defined as success and resolution of fever with antibiotic change or death of a patient was defined as failure. Modification was defined as changing the empirical antimicrobial agent during a febrile episode. Results: Two hundred eighty four febrile neutropenic episodes were documented in 136 patients with a median age of 5 years. In 198 episodes meropenem and in 86 episodes PIP/TAZ were used. Duration of fever and neutropenia, neutrophil count, sex, and primary disease were not different between two groups. Success rates and modification rate between two groups showed no significant differences (p>0.05). Overall success rate in the meropenem and PIP/TAZ groups were 92.4% and 91.9% respectively. No serious adverse effects occurred in either of the groups. Conclusions: Meropenem and PIP/TAZ monotherapy are equally safe and effective in the initial treatment of febrile neutropenia in children with cancer.
Park, Sung Bae;Chung, Chun Kee;Lee, Sang Hyung;Yang, Hee-Jin;Son, Young-Je;Chung, Young Seob
Journal of Korean Neurosurgical Society
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제54권6호
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pp.496-500
/
2013
Objective : To evaluate the successful fusion rate in postmenopausal women with single-level anterior cervical discectomy and successful fusion (ACDF) and identify the significant factors related to bone successful fusion in pre- and postmenopausal women. Methods : From July 2004 to December 2010, 108 consecutive patients who underwent single-level ACDF were prospectively selected as candidates. Among these, the charts and radiological data of 39 women were reviewed retrospectively. These 39 women were divided into two groups : a premenopausal group (n=11) and a postmenopausal group (n=28). To evaluate the significant factors affecting the successful fusion rate, the following were analyzed : the presence of successful fusion, successful fusion type, age, operated level, bone mineral density, graft materials, stand-alone cage or plating with autologous iliac bone, subsidence, adjacent segment degeneration, smoking, diabetes mellitus, and renal disease. Results : The successful fusion rates of the pre- and postmenopausal groups were 90.9% and 89.2%, respectively. There was no significant difference in the successful fusion rate or successful fusion type between the two groups. In the postmenopausal group, three patients (10.8%) had successful fusion failure. In the postmenopausal group, age and subsidence significantly affected the successful fusion rate (p=0.016 and 0.011, respectively), and the incidence of subsidence in patients with a cage was higher than that in patients with a plate (p=0.030). Conclusion : Menopausal status did not significantly affect bone successful fusion in patients with single-level ACDF. However, in older women with single-level ACDF, the combination of use of a cage and subsidence may unfavorably affect successful fusion.
Objectives and Methods : This study was conducted to investigate chief complaints among famers. The subjects of this study were 640 famers who live in the rural area in Wanju-gun Jeonbuk province. They were received medical treatment by oriental doctors who visited each village from July 1996 to June 1999. The data of this study were collected from their medical charts . Results and Conclusions : The number of female patients was 449(70.16%) and the number of male patients was 191(29.84%). The group of patients above 70 years was 32.81%, 60-69 years 32.03%, 50-59 years 20.15%, 40-49 years 8.90%, and bellow 39 years 6.09%. The most frequent complaint in farmers was low back pain(27.16%) the second was knee joint pain(16.14%), the third was shoulder Pain(12.06%), and the fourth was headache-dizziness(9.59%). The frequency of musculoskeletal disease(64.48%) was most high, and cardiovascular disease(11.33%) was the second, gstrointestinal disease(10.73%) was the third, respiratory disease(3.42%) was the fourth. It is necessary to pay attention to musculoskeletal disease-especially low back pain and knee joint pain- in study and treatment of farmer's disease.
Kos, F. Tugba;Civelek, Burak;Seker, M. Metin;Arik, Zafer;Aksoy, Sercan;Uncu, Dogan;Ozdemir, Nuriye;Zengin, Nurullah
Asian Pacific Journal of Cancer Prevention
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제13권12호
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pp.6151-6153
/
2012
Background: An association between the ABO groups and pancreatic cancer has been shown previously, group A being significantly commoner in affected patients. We conducted the present study to investigate the prognostic effect of ABO blood group on overall survival of pancreas cancer patients. Methods: Patients who were diagnosed between 2005 and 2010 with pancreas cancer at Ankara Numune Education and Research Hospital were analyzed retrospectively. Patient demographics and ABO blood groups were obtained from medical charts. Results: Fifty pancreas cancer patients with known ABO blood group were included, 26 (52%) group A, 12 patients (24%) group 0, 9 (18%) group B, and 3 (6%) group AB. Blood group A pancreas cancer patient median age was 61.5 (39-80) years, with the median age of the other blood groups (B, AB,O) being 55.5 (32-74) years (p=0.14). 18% of patients with blood group A and 11% of the other blood group patients had metastasis (p=0.17) at the time of diagnosis. The median overall survival of blood group A pancreas patients was significantly lower than the other blood group patients, 7.6 (95%CI: 5.0-10.2) months versus 29.0 (95%CI: 0.0-68.8) months (p=0.05). Conclusions: Acccording to previously published cohort studies a relation may exist between ABO blood groups and cancer of pancreas. In this study we observed that pancreas cancer patients with blood group A have significantly worse overall survival than other blood groups.
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