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Selective Neurotomy of Sacral Lateral Branches for Pain of Sacroiliac Joint Dysfunction

  • Kim, Hyo-Joon;Shin, Dong-Gyu;Kim, Hyoung-Ihl;Shin, Dong-A
    • Journal of Korean Neurosurgical Society
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    • v.38 no.5
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    • pp.338-343
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    • 2005
  • Objective : The sacroiliac joint complex is often related with functionally incapacitating pain in old aged people. The purpose of this study is to delineate the investigation strategies and to determine the long-term effect of radiofrequency [RF] neurotomies for pain arising from sacroiliac Joint dysfunction[SIJD]. Methods : Sixteen patients were diagnosed as having chronic pain from SIJD by comparative controlled blocks on L5 dorsal rami, sacroiliac Joints and deep interosseous ligaments. After confirming the positive response [more than 50% of pain relief], sensory stimulation was applied to detect the 'pathological' branches. Subsequently, RF neurotomies were performed on the selected nerve branches. Surgical outcome was graded as successful, moderate improvement, and failure after a 6month follow-up period. Results : Stimulation intensity was 0.45V to elicit pain response in the L5 dorsal rami and lateral sacral branches. The number of RF-lesioned nerve branches was 6per patient. The average number of lesions for each branch was 1.3. Most commonly selected branches were L5 dorsal ramus [88%] and S2-upper division [88%]. Ten patients [63%] reported a successful outcome according to the outcome criteria after 6months of follow-up, and five patients [31%] reported complete relief [100%]. Five patients [31%] showed moderate improvements. One patient reported failure. Conclusion : RF neurotomy of lateral sacral branches is an excellent treatment modality for the pain due to SIJD, provided that comparative controlled block shows a positive response.

CHANCE IN CONCENTRATION OF SALIVARY STREPTOCOCCUS MUTANS FOLLOWING THE APPLICATION OF VARNISH CONTAINING CHLORHEXIDINE IN ORTHODONTIC PATIENTS (교정 치료 환자에 있어 항균 varnish 처치 전후의 타액 내 Streptococcus mutans 균주의 변화에 관한 연구)

  • Chang, Young-Il;Kim, Tae-Woo;Chung, Chong-Pyoung;Nahm, Dong-Seok;Yang, Won-Sik;Suhr, Cheong-Hoon
    • The korean journal of orthodontics
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    • v.24 no.3 s.46
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    • pp.659-672
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    • 1994
  • Dental caries is one of the most prevalent dental diseases in Korea and its prevention is very important in orthodontic therapy. For the cleansing action of saliva itself and/or tooth-brushing is lowered in patient with fixed orthodontic appliance, oral hygiene of the patient becomes worse, which provides more favorable environment for micro-organisms. Chlorhexidine, one of the series of bisguanide, has been reported to be strong antimicrobial agent and very effective on Streptococcus mutans. The purpose of this study is to evaluate the possibility of chlorhexidine as a anticariogenic agent in fixed orthodontic therapy. We used the varnish containing chlorhexidine as a main ingredient for the chemical control of salivary S.mutans in patients with fixed appliance therapy We applied the varnish containing chlorhexidine on the labial and interproximal surface of the teeth before bonding and banding teeth of our patients(N=20) and compared to control group patients(N=20). Before the application of chlorhexidine varnish and four times periodically after the completion of fixed appliance set-up, we sampled saliva of both group patients and incuvate S.mutans for 24 hours. In the culture study of sampled saliva, counting the number of S.mutans colonies, we founded as follows : 1. In patients with fixed appliance therapy, the risk of dental caries increase when it compared to that of preorthodontic treatment ; The number of salivary S.mutans increase in Patient's oral cavity. 2. The experimental agent that contain chlorhexidine is effective to reduce the number of salivary S.mutans. 3. For the effect of this agent is not ever-lasting, periodical application is needed, and additional study for economical interval and number of application is needed.

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Functional Impairment and Psychological Status in Patients with Chronic Arthritis (만성 관절염 환자의 기능적 손상과 심리적 상태 분석)

  • Lim, Nan-Young;Lee, Eun-Young
    • Journal of muscle and joint health
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    • v.5 no.1
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    • pp.72-82
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    • 1998
  • The purpose of this study was to identify functional impairment and psychological status and to analyze their relationships in patients with chronic arthritis. The sample was consisted of 75 arthritic patients who visited H hospital and S welfare center. Functional impairment was measured by ADL, pain, and the number of painful joint. Psychological status was measured by depression, self-efficacy, and quality of life. Data was analyzed by frequency, mean ${\pm} SD$, Pearson's correlation coefficient, and Stepwise multiple regression. The results of this study were as follows : 1. In functional Impairment, ADL was below average which means somewhat difficult, pain was above average, and the number of painful joint was 9.20. 2. In psychological status, scores of quality of life was 97.89, depression was 41.28, self-efficacy was 895.35. 3. Pain was negatively correlated to self-efficacy, ADL and quality of life, and positively correlated to depression. 4. Self efficacy and depression explained 45% of the variance in quality of life. Therefore, it is suggested that nursing intervention improving psychological status would be useful for patients with chronic arthritis. Especially, it is very important to implement nursing intervention focused on increasing self-efficacy and decreasing depression.

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Effects of Imagery on Stress, Anxiety, and Immune Cells in Patients with Acute Leukemia Receiving Chemotherapy (심상요법이 항암화학요법을 받는 급성 백혈병 환자의 스트레스, 불안 및 면역세포에 미치는 효과)

  • Shim, Soo Kyung;Kim, Nam-Cho
    • Korean Journal of Adult Nursing
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    • v.19 no.5
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    • pp.115-126
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    • 2007
  • Purpose: The present study is a quasi-experimental research for examining the effects of imagery on stress, anxiety and immune cells in acute leukemia patients receiving chemotherapy and utilizing the therapy for their self control and stress management. Methods: The subjects were 60 patients who were diagnosed with acute leukemia and scheduled to receive chemotherapy at A hospital in Seoul during the period from November 2006 to March 2007. After the start of chemotherapy, the experimental group received imagery for 4 weeks, three sessions a week, so a total of 12 sessions and 156 minutes. Results: The decrease of stress was larger in the experimental group than in the control group. Systolic blood pressure decreased significantly more in the experimental group than in the control group. In the experimental group, state anxiety decreased significantly in the 2nd week of the experiment and after the final stage of the experiment. The total number of white blood cells, and the absolute number of neutrophils and lymphocytes were showing significant differences between the time points. Conclusion: Imagery is an effective intervention for reducing stress and state anxiety and stabilizing blood pressure in acute leukemia patients receiving chemotherapy.

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Profile and Survival of Tongue Cancer Patients in "Dharmais" Cancer Hospital, Jakarta

  • Sutandyo, Noorwati;Ramli, Ramadhan;Sari, Lenny;Soeis, Dewi Syafriyetti
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.5
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    • pp.1971-1975
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    • 2014
  • Background: Tongue cancer is still a major health problem in most developing countries around the world. Statistics shown the number of tongue cancers, especially in early age, to be increasing, with poor survival. Objective: To analyze the characteristic profile of tongue cancer patients in Indonesia as well as the survival rate. Materials and Methods: A cross sectional study was conducted in Dharmais National Cancer Hospital by collecting general, clinical, and survival data of tongue cancer patients from medical records for January 2009 to April 2012. Results: Tongue cancer incidence increased year by year. The average age of tongue cancer patients was 47.5 years, and males predominated, accounting for 64.5% of cases. Most patients presented at an advanced stage (69.6%). The histopathology type was squamous cell carcinoma in the vast majoriy (96.8%). The therapies applied were surgery (45.6%), radiation (63.6%) and chemotherapy (57.6%). The survival rate after one year is 60.6% and after two years was 12.1%. In addition, median survival of tongue cancer patients was 20 months (95% confidence interval 9.07-30.9). The significant factor affecting survival was size of tumor with a hazard ratio of 3.18 (95% CI, 1.02-9.93; p 0.046) for largest versus smallest categories. Conclusions: In each year, the number of tongue cancer incidents in Indonesia is increasing. The age of tongue cancer patients in Indonesia is younger compared to other countries. Moreover, the survival rates are not high.

A Clinical Research about the Effects of Seunggaltang on Patients with Atopic Dermatitis (승갈탕(升葛湯)을 사용한 아토피 피부염 환자에 대한 임상시험)

  • Shin, Sang-Ho;Kim, Ja-Hye;Kim, Mi;Yoon, Hwa-Jung;Lyu, Sun-Ae;Lee, Seung-Yeon;Lee, Mi-Yeon;Kim, Kyu-Kon;Ko, Woo-Shin
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.20 no.2 s.33
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    • pp.199-212
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    • 2007
  • Objective : The purpose of this clinical research was to investigate the effects of Seunggaltang on patients with atopic dermatitis. Methods : Thirteen patients were treated with Seunggaltang and ten patients were treated with placebo for 8 weeks. We observed skin humidity, skin sebum,, transepidermal water loss, skin melanin, skin erythema, total IgE class and number of allergen. And Clinic Index of Atopic Dermatitis(Extent, Intensity, Subjective symptoms, Total score) was used to evaluate the effects of Seunggaltang. Statistical analysis was performed by using paired sample T-test. Statistical significance was achieved if the probability was less than 5%(P<0.05). The result were as follows : 1. Statistically, Seunggaltang didn't showed significant effect on skin humidity, skin sebum, skin transepidermal water loss, skin melanin and skin erythema. 2. Statistically, Seunggaltang showed significant effect on Clinic Index of atopic dermatitis. 3. Statistically, Seunggaltang didn't showed significant effect on total IgE class and number of allergen. 4. Before and after treatment, the results of blood test and urinalysis were normal. Conclusion : We speculate that Seunggaltang has some therapeutic effects in mitigating the symptoms of atopic dermatitis.

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Difference in Outpatient Medical Expenditure and Physician Practice Patterns between Medicaid and Health Insurance Patients (건강보험환자와 의료급여환자 간 의원 외래 의료이용 차이와 공급자 진료행태)

  • Joo, Jung-Mi;Kwon, Soon-Man
    • Health Policy and Management
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    • v.19 no.3
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    • pp.125-141
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    • 2009
  • The purpose of this study was to examine the role of provider practice patterns in the difference in health expenditure between the two types of patients: Health Insurance and Medical Aid type 1. The study used the outpatient claim data for all Medicaid and health insurance patients of hypertension who received medical services from 8,454 primary care physicians during the first half of 2006. The data were stratified by patient's gender and age for the two groups of patients who received care from the same physician. The dependent variables were the differences in medical expenditure per case, patient days per case and medical expenditure per patient day between Medicaid patients and health insurance patients. Empirical results showed that physician characteristics, such as physicians under age 50, greater proportion of pediatric Medicaid patients, lower proportion of new Medicaid patients and the greater number of comorbidity of Medicaid patients are associated with the greater difference between the two types of patients (i.e., greater expenditure of Medicaid patients relative to health insurance patients). This study shows that factors associated with provider practice patterns need to be taken into account in Medicaid policy.

Comorbidity Analysis on ICU Big Data

  • Hyun, Sookyung;Newton, Cheryl
    • International Journal of Advanced Culture Technology
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    • v.7 no.2
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    • pp.13-18
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    • 2019
  • Comorbidity isthe simultaneous presence of two chronic diseases or conditions in a patient. As part of a larger research study, the aims of this study were to explore comorbid conditions in intensive care unit (ICU) patients and to compare the comorbidity across different demographic groups, and to determine what comorbid health problems coexisted in the patients with hospital-acquired pressure injury (HAPI). The average number of comorbid conditions was 6.4 with range from 0-20 in the ICU patients. African American patients had significantly more comorbid health problems than other race/ethnicity groups. Asian and Hispanic female patients showed higher comorbidity than male patients across age. The patients with HAPIs had significantly more comorbid health problems than the patients without HAPIs -- the average numbers were almost two-fold. We found comorbid health problems that existed with HAPI in ICU patients. 'Other diseases of lung' and 'Disorders of fluid, electrolyte, and acid-base balance' were most frequently coexisting health problems in the ICU patients with HAPI. Exploratory plots are helpful to discover patterns or hypotheses relevant to clinical management in critical care. Inclusion of patients' comorbid health problems to ICU HAPI risk assessment may be helpful. Identification of patients at a high risk for the development of HAPI and the early preventative interventions can help reduce length of stay as well as costly complications.

Factors Affecting Regular Medical Services Utilization of Chronic Disease Patients - Focusing on the Hypertension, Diabetes Mellitus, Hyperlipidemia - (만성질환자의 정기적 의료이용에 영향을 미치는 요인 - 고혈압, 당뇨병, 고지혈증을 중심으로 -)

  • Seo, Young-Suk;Park, Jong-Ho;Lim, Ji-Hye
    • Korean Journal of Health Education and Promotion
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    • v.31 no.3
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    • pp.27-37
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    • 2014
  • Objectives: This study aims to identify the factors associated with regular medical services utilization of chronic disease patients. Methods: The research selected 4,489 adults aged over 30, diagnosed with hypertension, diabetes, hyperlipidemia, hypercholesterolemia, from the Korea health panel. We analyzed states of regular medical service utilization using descriptive statistics. Multiple regression analysis was used to examine the main factors associated with regular medical services utilization in chronic disease patients. Results: In terms of socio-demographic factors, gender, age, marital status, education level, employment, household income and disability were significantly different between hypertension, diabetes, hyperlipidemia and hypercholesterolemia. Among health status and behavioral factors, number of chronic diseases, subjective health status, smoking, high risk drinking, regular meals, physical activity, obesity were significantly different. From the multiple logistic regression analysis, age, number of chronic diseases, obesity, type of chronic diseases were associated with regular medical services utilization. Conclusions: It is necessary to develop effective health education programs and individualized approach to improve continuous management in chronic diseases patients.

Fragile-X Mental Retardation: Molecular Diagnosis in Argentine Patients

  • Florencia, Giliberto;Irene, Szijan;Veronica, Ferreiro
    • BMB Reports
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    • v.39 no.6
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    • pp.766-773
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    • 2006
  • Fragile-X-syndrome (FXS) is the most common type of inherited cognitive impairment. The underlying molecular alteration consists of a CGG-repeat amplification within the FMR-1 gene. The phenotype is only apparent once a threshold in the number of repeats has been exceeded (full mutation). The aim of this study was to characterize the FMR-1 CGG-repeat status in Argentine patients exhibiting mental retardation. A total of 330 blood samples from patients were analyzed by PCR and Southern blot analysis. Initially, DNA from 78 affected individuals were studied by PCR. Since this method is unable to detect high molecular weight alleles, however, we undertook a second approach using the Southern blotting technique to analyze the CGG repeat number and methylation status. Southern blot analysis showed an altered pattern in 14 out of 240 (6%) unrelated patients, with half of them presenting a mosaic pattern. Eight out of 17 families (47%) showed a (suggest deleting highlight). The characteristic FXS pattern was identified in 8/17 families (47%), and in 4 of these families 25% of the individuals presented with a mosaic model. The expansion from pre-mutation to full mutation was shown to occur both at the pre and post zygotic levels. The detection of FXS mutations has allowed us to offer more informed genetic counseling, prenatal diagnosis and reliable patient follow-up.