Kim, Jeong Eun;Jung, Hee-Won;Gwak, Ho-Shin;Paek, Sun Ha;Kim, Dong Gyu;Choi, Kil Soo
Journal of Korean Neurosurgical Society
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v.29
no.6
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pp.754-762
/
2000
Objectives : The surgical results of 80 patients with growth hormone(GH)-producing pituitary adenoma were analyzed retrospectively to evaluate the clinical manifestations and to determine which preoperative factors significantly influenced the surgical outcome. Patients and Methods : The patients consisted of 39 men and 41 women and the age of patients at the time of initial operation ranged from 17 to 67 years(mean age, 40.5 years) Between January 1990 and June 1996, 77 patients underwent transsphenoidal surgery and 3 patients underwent craniotomy for GH-producing pituitary adenoma at our institution. Preoperative administration of octreotide was performed in 18 patients. Surgical control was defined as a postoperative serum basal level of GH less than 5ng/ml. A logistic regression model was used for univariate and multivariate analysis. Probability value of less than 0.05 was considered as statistically significant. Results : The most common presenting symptom was acromegaly, followed by headache, visual disturbance, and fatigability. Visual symptoms were present in 39% of the patients. Diabetes mellitus was associated in 24 patients and hypertension in 12. Preoperative mean basal level of GH was 93.2ng/ml(range 72-500ng/ml) which was closely related with tumor size(p<0.05). Grade II by Hardy's classification was the most common radiological type. Preoperative octreotide treatment significantly reduced the level of GH(p<0.05), but not enough to induce endocrinological remission. One patient died of cerebral infarction after craniotomy. The most common surgical complication was transient diabetes insipidus. The symptom of the earliest improvement after surgery was paresthesia and tightness of the hand and foot, followed by headache and easy fatigability. The preoperative visual symptom was improved in all patients. The patients who had hypertension or DM experienced alleviated symptoms in 67% and 92%, respectively. The overall rate of endocrinological remission was 44%. By multivariate logistic regression analysis, the size of tumor, extrasellar extension, and extent of removal were significant prognostic factors for endocrinologial remission. Conclusion : Early detection of a small tumor without extrasellar extension followed by a complete resection is highly recommended in order to achieve endocrinological cure of GH-producing pituitary adenomas.
Lee, Gi-Cheol;Shin, Won-Han;Park, Suhyun;Heo, Hyun A
Journal of Korean Dental Science
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v.5
no.2
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pp.68-76
/
2012
Purpose: The headache is a symptom that various somatic or non-somatic disorders gives an effect to head and neck system. The neck and the shoulder pain is a common muscle pain that can not control and bothers the patient after chronic state. The headache and the neck and the shoulder muscle pain are treated with various conventional treatment methods. But, there are cases that symptoms did not resolve or increased in some clinical cases. And generally, the result of temporomandibular disorders (TMD) treatment is good. But, despite of a normal treatment was performed for TMD, there are cases that TMD symptoms did not resolved in clinical cases. In template clinic of Soonchunhyang University Bucheon Hospital, co-operative neurophysiologic treatment of Department of Neurosurgery and Dentistry are done for patients, who had head and neck pain or atypical symptoms that did not treated with various conventional treatment method such as surgery or medication etc. Materials and Methods: Four hundred fifty one patients who have treated in the template clinic, Soonchunhyang University Bucheon Hospital, from January of 2006 to December of 2008 were subjected in this study. Result: Overall average age was 31.9 years old. Ratio of numbers is 74.3% in female and 25.7% in male. The success rate of treatment in TMD symptom was 89.9%, in headache was 88.8%, in muscle pain was 81.6%. Statistically significance of differences visual analogue scale evaluation between before and after had been treated patients who have over average grade headache was calculated by paired t-test. P<0.05 was considered significant. Conclusion: We suggest the template appliance can be attempted for cases whose headache, the neck and the shoulder muscle pain and TMD are not resolved with various conventional treatment methods.
Objectives : The purpose of this study was designed to estimate the effect of Damjeonggyeok acupuncture on Post-Traumatic Stress Disorder patient due to a series of traffic accidents by using Symptoms Check List-90-Rivision(SCL-90-R). Methods : This report have been observed among 30 patients who admitted our department for whiplash injury associated disorders during 04-01-2009 to 09-31-2009. The PTSD patients was divided into 2 groups. One group was treated general oriental medical treatment(Group A) and the other group was treated Damjeonggyeok acupuncture with general oriental medical treatment(Group B). SCL-90-R and visual analogue scale(VAS) were checked before and after treatment for evaluating the improvement of whiplash injury associated disorders with PTSD. Results : 1. Both Group A and Group B showed good effect on decreasing of VAS and improving of psychological symptoms after traffic accident. 2. Group B symptoms about SCL-90-R Conclusions : Damjeonggyeok acupuncture with general oriental medical treatment can be recommended as a useful therapy to treat patients who have PTSD. Further study is needed to confirm the effectiveness of Damjeonggyeok acupuncture on whiplash injury associated disorders with PTSD.
Purpose: The purpose of this study is to report the effect of Traditional Korean Medicine therapy for patient in the state of post stillbirth by oligohydramnios Methods: The patient in this case was 33-year-old female who was pregnant by artificial insemination in 2010. Intrauterine growth restriction was discovered at 17 weeks after gestation. And oligohydramnios was found at 20 weeks after gestation. Amnioinfusion was done three times, amniotic fluid infection occurred in the process of amnioinfusion and she had a stillbirth. After stillbirth she came to our clinic with symptoms of abdominal tenderness, distention, mammalgia. The patient was treated by traditional herbal medicine therapy such as Saenghwa-tang(生化湯), Gungguijohyeol-eum(芎歸調血飮), Silso-san(失笑散) and Sasang constitution medicine(荊防地黃湯, 荊防敗毒散, 荊防瀉白散). The progresses of symptoms were evaluated by visual analogue scale. Results: After Traditional Korean Medicine therapy, the patient's symptoms caused by stillbirth was improved. Conclusion: This case study shows that the postpartum treatment in Traditional Korean Medicine therapy and Sasang constitution medicine is effective for the patient in the state of post stillbirth.
Purpose: The purpose of this study is to analyze the clinical features of plantar fascia rupture. Materials and Methods: We retrospectively reviewed 312 patients with plantar fasciitis between March 2008 and February 2013. We investigated age, sex, site, visual analogue scale (VAS), body mass index (BMI), characteristics of pain, awareness of rupture, and duration of symptoms. Acute rupture was defined as a rupture that occurred during exercise; chronic rupture was defined as a degenerative rupture after plantar fasciitis. We investigated the frequency of acute and chronic rupture. Results: Among 312 patients, 38 patients (12.2%) were diagnosed with plantar fascia rupture. Thirty-eight patients consisted of 14 men (36.8%) and 24 women (63.2%). The mean age of plantar fascia rupture was $58.29{\pm}12.54years$. The mean VAS score was 5.92 points (3~9 points). The mean BMI was $25.92{\pm}1.59kg/m^2$. Among the 38 patients, 2 patients had acute plantar fascia rupture and 36 had chronic plantar fascia rupture. In 34 patients-out of 36 chronic plantar fascia rupture, there were no subjective symptoms. Conclusion: Chronic rupture of the plantar fascia that occurred after plantar fasciitis was more common than acute rupture. Chronic rupture occurred at approximately 12% of patients treated with plantar fasciitis. In chronic rupture of the plantar fascia, there were no subjective symptoms of rupture. Therefore, we should doubt chronic rupture of plantar fascia when plantar fasciitis is prolonged.
Objective : Cases of contralateral radiculopathy after a transforaminal lumbar interbody fusion with a single cage (unilateral TLIF) had been reported, but the phenomenon has not been explained satisfactorily. The purpose of this study was to determine its incidence, causes, and risk factors. Methods : We did retrospective study with 546 patients who underwent a unilateral TLIF, and used CT and MRI to study the causes of contralateral radicular symptoms that appeared within a week postoperatively. Clinical and radiological results were compared by dividing the patients into the symptomatic group and asymptomatic group. Results : Contralateral symptoms occurred in 32 (5.9%) of the patients underwent unilateral TLIF. The most common cause of contralateral symptoms was a contralateral foraminal stenosis in 22 (68.8%), screw malposition in 4 (12.5%), newly developed herniated nucleus pulposus in 3 (9.3%), hematoma in 1 (3.1%), and unknown origin in 2 patients (6.3%). 16 (50.0%) of the 32 patients received revision surgery. There was no difference in visual analogue scale and Oswestry disability index between the two groups at discharge. Both preoperative and postoperative contralateral foraminal areas were significantly smaller, and postoperative segmental angle was significantly greater in the symptomatic group comparing to those of the asymptomatic group (p<0.05). Conclusion : The incidence rate is not likely to be small (5.9%). If unilateral TLIF is performed for cases when preoperative contralateral foraminal stenosis already exists or when a large restoration of segmental lordosis is required, the probability of developing contralateral radiculopathy is increased and caution from the surgeon is needed.
Objective : We investigated the clinical and radiological advantages of unilateral laminectomy in posterior lumbar interbody fusion (PLIF) procedure comparing with bilateral laminectomy, under the same procedural condition including bilateral instrumentation and insertion of two cages, in patients with degenerative lumbar disease with unilateral leg symptoms. Methods : We retrospectively reviewed 124 consecutive cases of PLIF via unilateral or bilateral approach between January 2006 and April 2010. In 80 cases (bilateral group), two cages were inserted via bilateral laminectomy, and in 44 cases (unilateral group), via unilateral laminectomy. The average follow-up duration was 29.5 months. The clinical outcomes were evaluated with the Visual Analogue Scale (VAS) and the Oswestry disability index (ODI). The fusion rates and disc space heights were determined by dynamic standing radiographs and/or computed tomography. Operative times, intra-operative and post-operative blood losses and hospitalization periods were also evaluated. Results : In clinical evaluation, the VAS and ODI scores showed excellent outcomes in both groups. There were no significant differences in term of fusion rate, but the perioperative blood loss and the operative time of the unilateral group were lower than that of the bilateral group. Conclusion : Unilateral laminectomy can minimize the operative time and perioperative blood loss in PLIF procedure. However, the different preoperative disc height between two groups is a limitation of this study. Despite this limitation, solid fusion and satisfactory symptomatic improvement could be achieved uniquely by our surgical method. This surgical method can be an alternative surgical technique in patients with unilateral leg pain.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.39
no.1
/
pp.14-20
/
2013
Objectives: This study sought to evaluate the effect of simultaneous application of arthrocentesis and occlusal splint. Materials and Methods: A retrospective study of 43 patients (3 males, 40 females) whose symptoms had improved was conducted at the Department of Oral and Maxillofacial Surgery, Dong-A University Hospital between 2008 and 2010. Subjects were divided into three groups: Group A (17 patients with arthrocentesis and occlusal splints simultaneously applied), Group B (13 patients whose symptoms did not improve with occlusal splints, undergoing arthrocentesis after occlusal splint use for 8 weeks), and Group C (13 patients that only used occlusal splints). We compared these groups in maximum comfortable opening (MCO) and the visual analogue scale of pain and noise. Follow-up was performed at 1 week, 1 month, 3 months, and 6 months. Results: The improvement of symptoms was noted in all three groups, but Group A had a quicker improvement than the other groups, in terms of pain reduction and MCO increases. Conclusion: The simultaneous application of arthrocentesis and occlusal splints can reduce patient discomfort more quickly.
Kim, Jae Hong;Kim, Jung Ho;Cho, Sung Il;Park, Sang Hag;Kim, Sang Hoon;Choo, Il Han;Kim, Seung Gon
Korean Journal of Biological Psychiatry
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v.22
no.1
/
pp.7-13
/
2015
Objectives The purpose of this study was to examine the psychiatric characteristics of outpatients with tinnitus. Methods A total of 88 subjects were included in this study. According to Tinnitus Handicap Inventory (THI) scores, the subjects were classified into two group ; a mild tinnitus symptoms (mild-tinnitus) group and a severe tinnitus symptoms (severe-tinnitus) group. A questionnaire was used for an assessment of demographic characteristics, and the THI, the Visual Analogue Scale (VAS) about tinnitus, the Beck Depression Inventory (BDI), and the Beck Anxiety Inventory (BAI) are applied for evaluation of other clinical psychiatric characteristics. Results Higher THI scores were positively correlated with tinnitus course, the number of accompanying symptoms, and the VAS. BDI total scores, BDI factors, and BAI total scores were significantly higher in the severe-tinnitus group than in the mild-tinnitus group. Also suicidal ideation, interpersonal problems, sleep problems, occupational impairment, and fatigue were significantly higher in the severe-tinnitus group than in the mild-tinnitus group. Conclusions Tinnitus is a common disorder of hearing which is associated frequently with psychiatric problems. This study suggests that psychiatric interventions should be taken into consideration in the treatment of patients suffering from tinnitus.
Kim, Eun-Seok;Han, Kyung-Wan;Lee, Han;Jung, Ho-Suk;Lee, Hyo-Eun;Cho, Jae-Hee;Kim, Chang-Youn
The Journal of Churna Manual Medicine for Spine and Nerves
/
v.4
no.2
/
pp.185-196
/
2009
Objective: The purpose of this study is to investigate the effects of oriental medicine conservative treatment on patients who show symptoms at the legion opposed to that shown in Magnetic Resonance Image(MRI) findings. Subject & Method: Oriental medicine treatment such as acupuncture and herbs was applied to two patients who were diagnosed as lateral herniated intervertebral disc of lumbar spine via MRI but whose pain and muscular force attenuation were shown at the opposed lower limb, for measuring its effects. Results: As for the two cases, the patients were favored in the Visual Analog Score (VAS) and the Straight leg Raising(SLR) test after the oriental medicine conservative treatment. In one case, the muscular force in the lower limb was favored. Conclusion: Based on the results in this study, oriental medicine conservative treatment might be effective on patients who show symptoms at the legion opposed to that shown in MRI findings.
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