• Title/Summary/Keyword: clinical grading

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Comparative Study of Lumbar Magnetic Resonance Imaging and Myelography in Young Soldiers with Herniated Lumbar Disc

  • Kang, Suk-Hyung;Choi, Seung-Hong;Seong, Nak-Jong;Ko, Jung-Min;Cho, Eun-Suk;Ko, Kwang-Pil
    • Journal of Korean Neurosurgical Society
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    • v.48 no.6
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    • pp.501-505
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    • 2010
  • Objective : This study was undertaken to compare the diagnostic performances of magnetic resonance imaging (MRI), MR myelography (MRM) and myelography in young soldiers with a herniated lumbar disc (HLD). Methods : Sixty-five male soldiers with HLD comprised the study cohort. A visual analogue scale for low back pain (VAS-LBP), VAS for leg radiating pain (VAS-LP), and Oswestry disability index (ODI) were applied. Lumbar MR, MRM, and myelographic findings were checked and evaluated by four independent radiologists, respectively. Each radiologist was asked to score (1 to 5) the degree of disc protrusion and nerve root compression using modified grading systems devised by the North American Spine Society and Pfirrmann and the physical examination rules for conscription in the Republic of Korea. Correlated coefficients between clinical and radiological factors were calculated. Interpretational reproducibility between MRI and myelography by four bases were calculated and compared. Results : Mean patient age was $20.5{\pm}1.1$. Mean VAS-LBP and VAS-LP were $6.7{\pm}1.6$ and $7.4{\pm}1.7$, respectively. Mean ODI was $48.0{\pm}16.2%$. Mean MRI, MRM, and myelography scores were $3.3{\pm}0.9$, $3.5{\pm}1.0$, and $3.9{\pm}1.1$, respectively. All scores of diagnostic performances were significantly correlated (p < 0.05). However, none of these scores reflected the severity of patients' symptoms. There was no statistical difference of interpretational reproducibility between MRI and myelography. Conclusion : Although MRI and myelography are based on different principles, they produce similar interpretational reproducibility in young soldiers with a HLD. However, these modalities do not reflect the severity of symptoms.

A Survey on Clinical Outcomes in Climacteric womens had improved by Received only Daejo-hwan at 3 months after the End of Treatment (대조환(大造丸) 투약만으로 호전된 갱년기 환자에서 치료 3개월 후 임상경과에 대란 조사연구)

  • Kim, Su-Min;Lee, Jung-Eun;Yoo, Dong-Youl;Kim, Eui-Il
    • The Journal of Korean Obstetrics and Gynecology
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    • v.19 no.1
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    • pp.251-260
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    • 2006
  • Purpose : To assess the duration of the therapeutic effect and recurrence symptoms after stopping Herb Medication therapy for climacteric womens. Methods : 28 climacteric womens received only Daejo-hwan(DJH): 2pills(4g) a time, three times a day for a total 8 weeks as maintenance therapy and were followed up for 3 months. Grading of climacteric symptoms were measured by Kupperman's index(K.I.), Greene scale(G.S.) and MRS. Results : The results were as follows. 1. After DJH-treatment, the climacteric symptoms were improved and each mean score of K.I., G.S., and MRS reduced significantly. 2. At 3 months after the end of treatment(EOT), each mean score of K.1., G.S., and MRS reduced significantly as compared with Baseline, and increased significantly as compared with EOT. 3. At 3 months after EOT, each climacteric symptoms kept up the favorable turn and the mean score of MRS reduced significantly as compared with Baseline, but made no significant difference as compared with EOT. Conclusion : In this study, we can consider the DJH-treatment therapeutic effect was kept up for 3 months after EOT and recurrence symptoms did not appeared after EOT to climacteric womens.

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Study on Clinical Effects of Oak-Mushroom Herbal-Acupuncture on Osteoarthritis in Knee Joint (표고버섯 약침의 퇴행성 슬관절염 치료효과에 관한 임상연구)

  • Jeong Hyung-Seob;Baek Jong-Yeob;Lee Sang-Mu;Han Hee-Cheol;Ahn Ho-Jin;Jeong Dong-Hwa;Hwang Kyu-Seon
    • Journal of Acupuncture Research
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    • v.18 no.6
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    • pp.141-150
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    • 2001
  • Objective : This study is designed to find out the effects of Oak-mushroom Herbal acupuncture on osteoarthritis in knee joint. Methods : We investigated 33 cases of patients with osteoarthritis in knee joint that are visited in Hospital of Dong-Seo oriental medicine. We evaluated knee joint function that before and after its treatment by Lysholm score and satisfaction of treatment by Baumgaertner nine point scale and visual analog scale. Results : These results showed that female patients are 26 cases and these are more 19 cases than male patients. On the age of patients, above 61 are mainly distributed as 17 cases. According to Ahlaback's grading system, grade Ⅲ are more than others as 11 cases. We estimated effects of Oak-mushroom Herbal-acupuncture by Lysholm score, those results showed that the mean of Lysholm score before treatment is 51.42, and after treatment is 76.55. That showed statistically meaningful increase. In evaluating of satisfaction, excellent are 11 cases and good are 15 cases. The percentage of above good is 78.8%. Conclusion : According to the results, Oak-mushroom Herbal-acupuncture may be effects on the increase of knee joint function and the decrease of pain in osteoarthritis in knee joint.

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A Clinical Analysis of Pediatric Teratoma (소아 기형종의 분포 및 예후)

  • Nam, So-Hyun;Kim, Dae-Yeon;Kim, Seong-Chul;Kim, In-Koo
    • Advances in pediatric surgery
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    • v.13 no.2
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    • pp.169-178
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    • 2007
  • Teratomas arising from totipotential primitive germ cell are composed of 2 or 3 germ cell layers. We reviewed the records of 166 children who underwent the operation for teratoma from Jan, 1990 through April, 2007. There were 40 boys and 126 girls (average age $6.93{\pm}5.83$ years). Primary sites were ovary (n = 88), sacrococcygeum (n = 24), testis (n = 16), retroperitoneum (n = 16), mediastinum (n = 8), brain (n = 4), thymus (n = 3) and a single tumor involved the adrenal gland, neck, middle ear, oropharynx, stomach, pelvis, omentum, chest wall and scalp. Teratomas were mature in 141 patients, and immature in 25. Six patients who had ovarian immature teratomas grade 2 or 3 with peritoneal gliomatosis underwent adjuvant chemotherapy. During follow up period, 6 mature teratomas recurred at sacrococcygeal area (n = 1) and contralateral ovary (n = 5). Five patients of them underwent reoperation and diagnosed as a mature teratoma, but one who had underwent a left salpingooophrectomy with right ovary cystectomy at initial operation was observed carefully. Teratomas were dominant in female patients and developed at various organs. Complete excision was needed for good prognosis. In case of immature teratoma, complete excision and appropriate chemotherapy according to grading can contribute to favorable results.

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A Study of Symmetry in the Patterns of Muscle Coordination and Interjoint Coordination in the Upper Limb Activity Among Subjects With Stroke (뇌졸중 환자의 상지에서 근육협응 패턴과 관절협응 패턴의 유사성에 관한 연구)

  • Lee, Jung-Ah;Shin, Hwa-Kyung;Chung, Yi-Jung;Cho, Sang-Hyun
    • Physical Therapy Korea
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    • v.13 no.1
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    • pp.54-60
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    • 2006
  • This study aimed to compare movement patterns of shoulder joints between the right and left symmetry in stroke patients and control subjects. This study proposes use of the voluntary response index (VRI) calculated from quantitative analysis of surface electromyographic (sEMG) and motion data recorded during voluntary movement as a feeding task. The VRI is comprised of two numeric values, one derived from the total muscle activity recorded for the voluntary motor task (magnitude), and the other from the sEMG distribution across the recorded muscles with the similarity index (SI). Five stroke patients and five age-matched healthy controls were recruited. Feeding motion was performed using the provided spoon five times with rests taken on a chair in between tasks. EMG data were digitized and analyzed on the basis of the root mean square (RMS) envelope of activity. The average amplitude of responses was calculated. Responsiveness and clinically meaningful levels of discrimination between stroke patients and control for EMG magnitude and SI were determined. The similarity index of the results from two successive examinations of both sides apart for stroke patients and control subjects were .86 and .95 in motion analysis and .84 and .99 in electromyographic analysis. The SI of sEMG data and motion data was significantly correlated in stroke patients. The data suggest that SI is a sensitive program for comparing and analyzing the symmetry of muscle activity and motion in both sides. This analysis method has a clinical value in grading muscular activity and movement impairment after brain injury.

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The Modified Brostr$\ddot{O}$m Procedure for Chronic Ankle Lateral Instability without associated injury (동반 손상이 없는 만성 족관절 불안정성 환자에 대한 변형 Brostr$\ddot{O}$m 술식)

  • Lee, Kyung-Tai;Choi, Sung-I;Young, Ki-Won;Bae, Sang-Won;Lee, Seung-Hwan
    • Journal of Korean Foot and Ankle Society
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    • v.6 no.2
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    • pp.167-171
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    • 2002
  • Purpose: To analyze the result of Modified Brostr$\ddot{O}$m procedure for Chronic ankle lateral instability without associated injury. Materials and Methods: Forty-one patients(Forty-one feet) diagnosed and operated with chronic ankle lateral instability without associated injury were evaluated retrospectively from June 1995 to December 1999. Twenty-three patients were athletes. For the evaluation of clinical outcome, a subjective grading scale of modified Hamilton was used, and pain relief, relief of instability symptom and anterior drawer test were evaluated. Results: Among forty-one operations, there were six excellent, thirty-five good results as a whole. All cases showed over the grade good. The average time to ordinary life in the non-atheletes was 2.5 months and average time to sport activity in the athletes was 4 months postoperatively. Conclusion: The modified Brostr$\ddot{O}$m procedure seems to be effective method for chronic ankle lateral instability without associated injury.

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Calcium hydroxide intracanal medication effects on pain and flare-up: a systematic review and meta-analysis

  • Ibrahim, Ahmed Mohamed;Zakhary, Siza Yacoub;Amin, Suzan Abdul Wanees
    • Restorative Dentistry and Endodontics
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    • v.45 no.3
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    • pp.26.1-26.18
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    • 2020
  • Objectives: This study aimed to systematically review the pain and flare-up effects of calcium hydroxide (CH) as intracanal medication (ICM) in non-vital mature teeth. Materials and Methods: Electronic-databases searching for published and grey literature and manual searching were conducted. Only randomized clinical trials (RCTs) were included comparing CH to other ICMs in non-vital mature teeth. The risk of bias was assessed using the RoB 2.0 Cochrane tool. The main outcomes were pain and flare-up. Qualitative and quantitative analysis, wherever applicable, was performed. The certainty of evidence (CoE) was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE). Results: Sixteen articles were included in 6 comparisons at different time points for different outcomes. CH reduced pain risk than no ICM within the 1-14-days interval (p < 0.05) and than triple-antibiotic paste within the first day (p < 0.05) and was similar to corticosteroid/antibiotics combination (p > 0.05). Chlorhexidine (CHX) or CH/CHX, however, reduced pain levels than CH alone (p < 0.05). CH showed higher flare-up risk than CHX (p < 0.05). CoE, however, ranged from very low to moderate. Conclusion: Most comparisons for different outcomes are based on very few studies, mostly low-powered, with an overall low CoE. Thus, the available evidence is considered insufficient to either support or refute CH effectiveness or to recommend one ICM over another. Therefore, further well-designed, larger RCTs are required.

Preoperative chemoradiation for locally advanced rectal cancer: comparison of three radiation dose and fractionation schedules

  • Park, Shin-Hyung;Kim, Jae-Chul
    • Radiation Oncology Journal
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    • v.34 no.2
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    • pp.96-105
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    • 2016
  • Purpose: The standard radiation dose for patients with locally rectal cancer treated with preoperative chemoradiotherapy is 45-50 Gy in 25-28 fractions. We aimed to assess whether a difference exists within this dose fractionation range. Materials and Methods: A retrospective analysis was performed to compare three dose fractionation schedules. Patients received 50 Gy in 25 fractions (group A), 50.4 Gy in 28 fractions (group B), or 45 Gy in 25 fractions (group C) to the whole pelvis, as well as concurrent 5-fluorouracil. Radical resection was scheduled for 8 weeks after concurrent chemoradiotherapy. Results: Between September 2010 and August 2013, 175 patients were treated with preoperative chemoradiotherapy at our institution. Among those patients, 154 were eligible for analysis (55, 50, and 49 patients in groups A, B, and C, respectively). After the median follow-up period of 29 months (range, 5 to 48 months), no differences were found between the 3 groups regarding pathologic complete remission rate, tumor regression grade, treatment-related toxicity, 2-year locoregional recurrence-free survival, distant metastasis-free survival, disease-free survival, or overall survival. The circumferential resection margin width was a prognostic factor for 2-year locoregional recurrence-free survival, whereas ypN category was associated with distant metastasis-free survival, disease-free survival, and overall survival. High tumor regression grading score was correlated with 2-year distant metastasis-free survival and disease-free survival in univariate analysis. Conclusion: Three different radiation dose fractionation schedules, within the dose range recommended by the National Comprehensive Cancer Network, had no impact on pathologic tumor regression and early clinical outcome for locally advanced rectal cancer.

Clinical Studies on the General Features and the Obesity-Skinniness of Patients with Bell's Palsy (구안괘사(口眼喎斜)환자의 일반적 특성 및 비수(肥瘦)에 따른 임상적 고찰)

  • Choi, Gyu-Ho;Jang, Sao-Young;Shin, Hyeon-Cheol
    • The Journal of Internal Korean Medicine
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    • v.30 no.1
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    • pp.129-143
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    • 2009
  • Objective : This study was aimed to investigate the general features and differences between obesity and skinniness of patients with Bell's palsy. Methods : We measured the sex, age. BMI. pulse diagnosis and HBGS (House-Brackmann Grading System) of 234 patients who were diagnosed with Bell's palsy. Results and Conclusions : The results with statistical significance were as follows (1) The distribution of age revealed that 40s was the most at 30.8 %: (2) The improvement period in facial palsy patients with sub-paralysis was shorter than whole-paralysis. And in one part the more we treated, the shorter the improvement period was: (3) In distribution of fat rate in facial palsy patients, obesity was the most at 61.37%, low weight 15.88%. So we found that the fatter the patients was. the higher the onset rate was: (4) In distribution of pulse diagnosis in facial palsy patients with obesity. the ratio of Xu mai (虛脈) was 67.06%. Shi mai (實脈) 32.94%. The Xu mai was similar to Qi xu (氣虛). So we found that the facial palsy patients with obesity were more Qi xu than with low weight. In distribution of pulse diagnosis in facial palsy patients with skinniness, the ratio of Chi mai (遲脈) was none. Shuo mai (數脈) was most: (5) In distribution of region in facial palsy patients with obesity-Xu mai. the ratio of left was 45.10%, right 54.90%, but this result was not statistically significant.

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Comparison of the Results of Balloon Kyphoplasty Performed at Different Times after Injury

  • Oh, Gun-Soek;Kim, Hyeun-Sung;Ju, Chang-Il;Kim, Seok-Won;Lee, Seung-Myung;Shin, Ho
    • Journal of Korean Neurosurgical Society
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    • v.47 no.3
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    • pp.199-202
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    • 2010
  • Objective : Balloon kyphoplasty is a minimally invasive procedure that is mainly performed for refractory pain due to osteoporotic compression fractures. The purpose of this study was to evaluate the results of balloon kyphoplasty performed at different times after an injury. Methods : In this retrospective study, the records of 99 patients who underwent one level of balloon kyphoplasty between January 2005 and December 2007 were reviewed. The patients were divided into three groups : 21 patients treated within 3 weeks of an injury (the acute group), 49 treated within 3 weeks to 2 months of an injury (the subacute group), and 29 patients treated at more than 2 months after an injury (the chronic group). Clinical outcomes were assessed using a visual analogue scale (VAS). In addition, modified MacNab's grading criteria was used to assess the subjective patient outcome. The radiology findings, including vertebral height restoration and procedure related complications, were analyzed based on the different time intervals after the injury. Results : Patients in all three groups achieved marked pain relief in terms of the VAS within 7 days of the procedure. Good or excellent results were achieved by most patients in all three groups. However, the height restoration, the main advantage to performing a balloon kyphoplasty, was not achieved in the chronic group. Moreover, evidence of complications including cement leakage was observed significantly less frequently in the subacute group compared to the other two groups. Conclusion : Although balloon kyphoplasty is an effective treatment for osteoporotic compression fractures, with regard to pain relief, the subacute stage appears to be optimal for treating patients with a balloon kyphoplasty in terms of achieving the best outcomes with minimal complications.