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Post-Laminectomy Kyphosis in Patients with Cervical Ossification of the Posterior Longitudinal Ligament : Does It Cause Neurological Deterioration?

  • Cho, Won-Sang;Chung, Chun-Kee;Jahng, Tae-Ahn;Kim, Hyun-Jib
    • Journal of Korean Neurosurgical Society
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    • v.43 no.6
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    • pp.259-264
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    • 2008
  • Objective : Total laminectomy (TL) is an effective surgical technique for the treatment of cervical ossification of the posterior longitudinal ligament (OPLL) along multiple levels. However, kyphosis and probable neurological deterioration have been frequently reported after laminectomy. We analyzed the changes in the cervical curvature after TL and subsequent changes in neurological status. Methods : We retrospectively reviewed the records of 14 patients who underwent TL for the treatment of cervical OPLL between Jan. 1998 and Dec. 2003. TL was selected according to the previously determined criteria. The curvature of the cervical spine was visualized on a lateral cervical spine X-ray and measured using Ishihara's Curvature Index (CI) before the operation and at the last follow-up examination. Perioperative neurological status was estimated using the modified Japanese Orthopedic Association score and the Improvement Rate (IR) at the same time as the images were evaluated. Results : The mean age of the patients was 57 years, the male/female ratio was 10:4, and the mean follow-up period was 41 months. The mean number of OPLL was 4.9, and the mean number of operated levels was also 4.9. The CI decreased after TL (p=0002), which was indicative of a kyphotic change. However, this kyphotic change showed no correlation with the length of the follow-up period, number of operated levels and preoperative CI. Neurological examination at the last follow-up showed an improved neurological status in all patients (p=0.001). There was no neurological deterioration in any case during the follow-up period. Moreover, there was no correlation between IR and the degree of kyphotic change. Postoperative complications, such as C5 radiculopathy and epidural bleeding, resolved spontaneously without neurological sequelae. Conclusion : Kyphotic change was observed in all but one patient who underwent TL for the treatment of cervical OPLL. However, we did not find any contributing factors to kyphosis or evidence of postoperative neurological deterioration.

Related Factors of Oral health of scaling Patients in Dental hygiene department (치위생과 스켈링 실습실 내원자의 구강건강에 영향을 미치는 요인 분석)

  • Lee, Yun-Hui;Choi, Sung-Suk
    • The Journal of Korean Society for School & Community Health Education
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    • v.13 no.1
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    • pp.55-64
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    • 2012
  • Objectives: The purpose of this study was related factors of oral health of scaling patients in dental hygiene department. Methods: The sample consisted of 218 at the scaling practice room of dental hygiene department in D College from March to November 2011. Chi-square test was used to analyze the relation the oral health behavior or oral hygiene and oral health, and losistic regression analysis was performed to analyze the factors asociated with oral health. Results: Scaling patients was 43.6% of the male and 56.4% of the women. Their age group was 79.8% of the twenty. Lately they was smoking status 69.7%. Brushing three times a day, 55.8% in male and female were 74.0% with significant differences(p=0.019). Kind of toothbrush "normal" the response was the highest, 45.3% male, 62.6% women were significantly higher in women(p=0.012). Toothbrushing educational experienced 33.7% men, women's educational experience rate of 52.8% was significantly higher(p=0.006), use of oral hygiene products education experienced 15.8% of the men and women 27.6% had significant difference(p=0.049). Scaling experience is not in the Dental plaque index the number of "bad" was significantly higher(p=0.035), toothbrushing educational experience is not in the Dental plaque index the number of "bad" and significantly higher(p=0.008) and Gingival bleeding index was significantly higher(p=0.033). Use of oral hygiene products educational experience if you do not have the number of the Dental plaque index "bad" were higher(p=0.011). Gingival bleeding index, affecting demographic variables were smoking(p=0.024). Dental plaque index the influence of experience with oral hygiene products factors(p=0.044) and gingival bleeding index was influenced Toothbrushing of educational experience(p=0.029). Conclusion: The results reported here confirm the factors associated with the oral health were education of oral hygiene products factors and Toothbrushing experience.

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Prognostic Value of Lymph Node Ratios in Node Positive Rectal Cancer Treated with Preoperative Chemoradiation

  • Nadoshan, Jamal Jafari;Omranipour, Ramesh;Beiki, Omid;Zendedel, Kazem;Alibakhshi, Abbas;Mahmoodzadeh, Habibollah
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.6
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    • pp.3769-3772
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    • 2013
  • Background: To investigate the impact of the lymph node ratio (LNR) on the prognosis of patients with locally advanced rectal cancer undergoing pre-operative chemoradiation. Methods: Clinicopathologic and follow up data of 128 patients with stage III rectal cancer who underwent curative resection from 1996 to 2007 were reviewed. The patients were divided into two groups according to the lymph node ratio: LNR ${\leq}$ 0.2 (n=28), and >0.2 (n=100). Kaplan-Meier and the Cox proportional hazard regression models were used to evaluate the prognostic effects according to LNR. Results: Median numbers of lymph nodes examined and lymph nodes involved by tumour were 10.3 (range 2-28) and 5.8 (range 1-25), respectively, and the median LNR was 0.5 (range, 0-1.6). The 5-year survival rate significantly differed by LNR (${\leq}$ 0.2, 69%; >0.2, 19%; Log-rank p value < 0.001). LNR was also a significant prognostic factor of survival adjusted for age, sex, post-operative chemotherapy, total number of examined lymph nodes, metastasis and local recurrence (${\leq}$ 0.2, HR=1; >0.2, HR=4.8, 95%CI=2.1-11.1) and a significant predictor of local recurrence and distant metastasis during follow-up independently of total number of examined lymph node. Conclusions: Total number of examined lymph nodes and LNR were significant prognostic factors for survival in patients with stage III rectal cancer undergoing pre-operative chemoradiotherapy.

Evaluation of national health insurance coverage of periodontal scaling: A nationwide cohort study in Korea (국민건강보험공단 표본코호트 DB를 이용한 스케일링 보험급여화 전후 실태조사)

  • Kim, Young-Taek;Lee, Jae-Hong;Kweon, Helen Hye-In;Lee, Jung-Seok;Choi, Jung-Kyu;Kim, Dong-Wook;Choi, Seong-Ho
    • The Journal of the Korean dental association
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    • v.54 no.8
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    • pp.604-612
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    • 2016
  • The aim of this study was to evaluate the effect of national health insurance coverage of periodontal scaling using the National Health Insurance Service-National Sample Cohort for 2009-2013. After the enforcement of periodontal scaling covered by national health insurance, the number of patients diagnosed with periodontal disease and received treatment, has increased from 35,234 to 99,576 people in the last 4 years. Further, the number of patients who received the treatment of periodontal disease more than once, have also increased to around 69% in 2013 when compared to 2012. Moreover, the number of patients receiving periodontal scaling has been steadily increasing every year. Among the patients who visited hospital for periodontal disease, there has been an increase of 280%. As a result, continuous public relations and long-term research on the effect of periodontal scaling as a prophylactic treatment is necessary.

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A Clinical Study of Urticaria and an Assessment Guideline (두드러기에 대한 임상 연구 및 평가 지침)

  • Lee Gil-Young;Kim Hae-Jung
    • The Journal of Korean Medicine
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    • v.26 no.2 s.62
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    • pp.25-31
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    • 2005
  • Objectives: This study was designed to assess traditional Korean medical therapy for urticaria and establish a clinical assessment guideline. Methods: Duration of symptoms, personal and family history of allergic diseases, serum IgE level, suspected causes and Provocation factors were investigated in 56 patients. Frequency of wheals, duration of wheals, number of wheals, itch severity and antihistamine counts on a 6-point (0-5) scale were assessed in 34 patients. The change of total scores and each criterion between baseline and follow up were analyzed using paired t-test (p<0.05). Results: 1. Acute urticaria within 6 weeks was $26.8\%$ and chronic urticaria over 6 weeks was $73.2\%$. The mean duration of symptoms was $19.2\pm38.8$ months. 2. $57.1\%$ of patients had a personal history of allergic diseases and $50\%$had a family history. $29.1\%$ had over 200 IU/mL serum IgE level. 3. The suspected causes were none $(39.3\%)$, foods $(32.1\%)$, drugs $(12.5\%)$, contact $(5.4\%)$ and maternity$(5.4\%)$. 4. The suspected provocation factors were foods $(41.1\%)$, none $(26.8\%)$, fatigue $(12.5\%)$, heat and sweating $(12.5\%)$, pressure $(10,7\%)$ and stress $(7.1\%)$. 5. The total scores between baseline and follow up of 34 patients were lowered from $15.38^{\circ}\;{\ae}3.75\;to\;8.82^{\circ}\;{\ae}5.21$, which was significant statistically (p=0.000). 6. Itch severity, frequency of wheals and number of wheals were the most significantly lowered of all criteria. Conclusions: Traditional Korean medical therapy was proven to be effective for urticaria, while itch severity, frequency of wheals and number of wheals should be assessed clinically with greater priority.

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A CLINICOSTATISTICAL STUDY OF FASCIAL SPACE INFECTIONS OF THE ORAL AND MAXILLOFACIAL REGION (구강 악안면 영역의 근막간극 감염증에 관한 임상 통계학적 연구)

  • Ahn, Shin-Young;Kim, Su-Gwan;Kim, Hak-Kyun;Park, Chul-Min
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.33 no.2
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    • pp.162-168
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    • 2007
  • Oral and maxillofacial infection is the oldest and most common disease in human history. The infection ranges from the low-grade infection that only requires minimal treatment to the high-grade and life-threatening fascial space infection. In this study, the data on oral and maxillofacial infections were analyzed to aid in the diagnosis and treatment, and to predict the prognosis. This report was based on data from 831 patients with oral and maxillofacial infection (394 males and 437 females) who were hospitalized in the Department of Oral and Maxillofacial surgery of Chosun University Dental Hospital from January 1998 to May 2005. The ratio of males to females was 0.9:1. By age, patients between 60 and 70 years old were the greatest in number (17.1%), while only 5.9% of the patients were between 10 and 20 years old. The most common cause of infection was odontogenic origin (84.4%), followed by post-extraction infection (6.2%), unknown (5.9%), and trauma (3.5%). The most common fascial space involved was the buccal space (39.4%), followed by the canine (20.6%), submandibular (15.9%), pterygomandibular (9.5%), submental (7.6%) and sublingual (2.8%) space. The number of the involved fascial space was one (75.2%), two (19.8%), or more than three (5.0%). In terms of the treatment duration, the hospitalization period of 6 to 10 days was the greatest in number (49.9%). All patients had uneventful recovery without major complication. There are statistically significant correlations between age and treatment period, and the involved space and treatment period, but no correlations between the variables of sex and treatment.

Facial injury burden of personal mobility devices: a single-center retrospective analysis

  • Yoon, Jae Hee;Jeon, Hong Bae;Kang, Dong Hee;Kim, Hyonsurk
    • Archives of Craniofacial Surgery
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    • v.23 no.4
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    • pp.163-170
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    • 2022
  • Background: Personal mobility devices (PMDs) have become an increasingly popular transport modality globally. With increasing social interest in and demand for PMDs, the number of individuals visiting emergency departments with PMD-related injuries has also increased annually. This study aimed to evaluate injury patterns and treatment costs for patients treated in the department of plastic surgery in a trauma center. Methods: In this retrospective study, data concerning patients with PMD-related injuries from January 2017 to December 2021 were reviewed. The data retrieved included age, sex, alcohol consumption, helmet use, the type of impact, onset of injury, place of first visit, type of injury, admission status, operation status, and treatment cost. Multiple linear regression analysis was performed to determine the effects of various factors on cost. Results: Data were collected from 93 patients. Until 2019, the annual number of PMD-related accidents was less than 10; however, this number increased sharply in 2020. The average cost of hospitalization was USD 7,698 whereas the average cost of non-hospitalization was USD 631. Only fractures had a significant association with total cost in linear regression analysis (p< 0.001). Conclusion: The prevalence of PMD use and related injuries requiring plastic surgery during the study period showed significant health and financial costs both to the patients involved and to society. This cost could be reduced through stricter regulations concerning PMD use, advocating the use of protective gear, and promoting greater awareness of safety measures and of the consequences of PMD-related accidents.

Fate of pulmonary nodules detected by computer-aided diagnosis and physician review on the computed tomography simulation images for hepatocellular carcinoma

  • Park, Hyojung;Kim, Jin-Sung;Park, Hee Chul;Oh, Dongryul
    • Radiation Oncology Journal
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    • v.32 no.3
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    • pp.116-124
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    • 2014
  • Purpose: To investigate the frequency and clinical significance of detected incidental lung nodules found on computed tomography (CT) simulation images for hepatocellular carcinoma (HCC) using computer-aided diagnosis (CAD) and a physician review. Materials and Methods: Sixty-seven treatment-$na{\ddot{i}}ve$ HCC patients treated with transcatheter arterial chemoembolization and radiotherapy (RT) were included for the study. Portal phase of simulation CT images was used for CAD analysis and a physician review for lung nodule detection. For automated nodule detection, a commercially available CAD system was used. To assess the performance of lung nodule detection for lung metastasis, the sensitivity, negative predictive value (NPV), and positive predictive value (PPV) were calculated. Results: Forty-six patients had incidental nodules detected by CAD with a total of 109 nodules. Only 20 (18.3%) nodules were considered to be significant nodules by a physician review. The number of significant nodules detected by both of CAD or a physician review was 24 in 9 patients. Lung metastases developed in 11 of 46 patients who had any type of nodule. The sensitivities were 58.3% and 100% based on patient number and on the number of nodules, respectively. The NPVs were 91.4% and 100%, respectively. And the PPVs were 77.8% and 91.7%, respectively. Conclusion: Incidental detection of metastatic nodules was not an uncommon event. From our study, CAD could be applied to CT simulation images allowing for an increase in detection of metastatic nodules.

A Study of Clinical Efficacy of GnRH Antagonist (Cetrorelix) Single and Multiple Dose Protocol for Controlled Ovarian Hyperstimulation (과배란유도에서 GnRH Antagonist (Cetrorelix) Single 및 Multiple Dose Protocol의 임상적 효용성에 관한 연구)

  • Ko, Sang-Hyeon;Kim, Dong-Ho;Bae, Do-Hwan;Lee, Sang-Hoon
    • Clinical and Experimental Reproductive Medicine
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    • v.29 no.4
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    • pp.259-267
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    • 2002
  • Objective: This study was performed to compare the clinical outcomes of GnRH antagonist (Cetrorelix) single dose and multiple dose protocols for controlled ovarian hyperstimulation with GnRH agonist long protocol. Materials and Method: From September 2001 to March 2002, 48 patients (55 cycles) were performed controlled ovarian hyperstimulation for ART using by either GnRH antagonist and GnRH agonist. Single dose of 3 mg GnRH antagonist was administered in 15 patients (17 cycles, single dose group) at MCD #8 and multiple dose of 0.25 mg of GnRH antagonist was administered in 15 patients (18 cycles, multiple dose group) from MCD #7 to hCG injection day. GnRH agonist was administered in 18 patients (20 cycles, control group) by conventional GnRH agonist long protocol. We compared the implantation rate, number of embryos, and clinical pregnancy rate among three groups. Student-t test and Chi-square were used to determine statistical significance. Statistical significance was defined as p<0.05. Results: There were no significant differences in ampules of used gonadotropins, number of mature oocytes, obtained embryos between single and multiple dose group, but compared with control group, ampules of used gonadotropins, number of mature oocytes, obtained embryos were decreased significantly in both groups. Clinical pregnancy rate and implantation rate were not different in three groups. There were no premature LH surge and ovarian hyperstimulation syndrome in three groups. Multiple pregnancy were occurred 1 case in multiple dose group and 2 case in control group. Conclusions: GnRH antagonist is a safe, effective, and alternative method in the controlled ovarian hyperstimulation compared with GnRH agonist. Clinical outcomes and efficacy of both single and multiple dose protocol are similar between two groups.

Factors Influencing Medication Adherence in Patients with Hypertension: Based on the 2008 Korean National Health and Nutrition Examination Survey (고혈압 환자의 약물복용 이행에 영향을 미치는 요인: 2008년 국민건강영양조사를 이용하여)

  • Cho, Eunhee;Lee, Chung Yul;Kim, Insook;Lee, Taewha;Kim, Gwang Suk;Lee, Hyeonkyeong;Ko, Jisook;Lee, Kyongeun
    • Research in Community and Public Health Nursing
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    • v.24 no.4
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    • pp.419-426
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    • 2013
  • Purpose: The purpose of this study is to examine factors influencing medication adherence in patients with hypertension. Methods: This study carried out a secondary analysis of data from the 2008 Korean National Health and Nutrition Examination Survey (KNHANES). Stratified sampling was used to select a participant sample that was representative of patients with hypertension throughout the country. Using the SPSS/WIN 18.0 program, data were analyzed using descriptive statistics, $x^2$ test, t-test, and logistic regression. Results: Of the patients with hypertension, 8.8% had showed non-adherence to medication. Medication adherence was associated with age, spouse, Medicare insurance, number of other diseases, and current smoking status. The cases with older age, a spouse, Medicare insurance, higher number of other diseases, and no current smoking status showed significantly high medication adherence. Conclusion: Nursing interventions and further studies are needed to achieve high levels of medication adherence based on factors influencing medication adherence such as age, spouse, Medicare insurance, number of other disease, and current smoking status.