• Title/Summary/Keyword: Pain and Disability

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Anterior Lumbar Interbody Fusion with Stand-Alone Interbody Cage in Treatment of Lumbar Intervertebral Foraminal Stenosis : Comparative Study of Two Different Types of Cages

  • Cho, Chul-Bum;Ryu, Kyeong-Sik;Park, Chun-Kun
    • Journal of Korean Neurosurgical Society
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    • v.47 no.5
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    • pp.352-357
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    • 2010
  • Objective : This retrospective study was performed to evaluate the clinical and radiological results of anterior lumbar interbody fusion (ALIF) using two different stand-alone cages in the treatment of lumbar intervertebral foraminal stenosis (IFS). Methods : A total of 28 patients who underwent ALIF at L5-S1 using stand-alone cage were studied [Stabilis$^{(R)}$ (Stryker, Kalamazoo, MI, USA); 13, SynFix-LR$^{(R)}$ (Synthes Bettlach, Switzerland); 15]. Mean follow-up period was 27.3 ${\pm}$ 4.9 months. Visual analogue pain scale (VAS) and Oswestry disability index (ODI) were assessed. Radiologically, the change of disc height, intervertebral foraminal (IVF) height and width at the operated segment were measured, and fusion status was defined. Results : Final mean VAS (back and leg) and ODI scores were significantly decreased from preoperative values (5.6 ${\pm}$ 2.3 ${\rightarrow}$ 2.3 ${\pm}$ 2.2, 6.3 ${\pm}$ 3.2 ${\rightarrow}$1.6 ${\pm}$ 1.6, and 53.7 ${\pm}$ 18.6 ${\rightarrow}$ 28.3 ${\pm}$ 13.1, respectively), which were not different between the two devices groups. In Stabilis$^{(R)}$ group, postoperative immediately increased disc and IVF heights (10.09 ${\pm}$ 4.15 mm ${\rightarrow}$ 14.99 ${\pm}$ 1.73 mm, 13.00 ${\pm}$ 2.44 mm ${\rightarrow}$ 16.28 ${\pm}$ 2.23 mm, respectively) were gradually decreased, and finally returned to preoperative value (11.29 ${\pm}$ 1.67 mm, 13.59 ${\pm}$ 2.01 mm, respectively). In SynFix-LR$^{(R)}$ group, immediately increased disc and IVF heights (9.60 ${\pm}$ 2.82 mm ${\rightarrow}$ 15.61 ${\pm}$ 0.62 mm, 14.01 ${\pm}$ 2.53 mm ${\rightarrow}$ 21.27 ${\pm}$ 1.93 mm, respectively) were maintained until the last follow up (13.72 ${\pm}$ 1.21 mm, 17.87 ${\pm}$ 2.02 mm, respectively). The changes of IVF width of each group was minimal pre- and postoperatively. Solid arthrodesis was observed in 11 patients in Stabilis group (11/13, 84.6%) and 13 in SynFix-LR$^{(R)}$ group (13/15, 86.7%). Conclusion : ALIF using stand-alone cage could assure good clinical results in the treatment of symptomatic lumbar IFS in the mid-term follow up. A degree of subsidence at the operated segment was different depending on the device type, which was higher in Stabilis$^{(R)}$ group.

Evaluation 4D-CT Simulation used of Motion Organ and Tumor for Respiratory Gated Radiation Therapy (호흡동조방사선치료를 위한 4D-CT simulation을 이용한 동적장기와 종양 움직임 평가)

  • Kim, Seung-Chul;Kim, Min-A
    • The Journal of the Korea Contents Association
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    • v.15 no.9
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    • pp.395-402
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    • 2015
  • when the radiation therapy of chest and abdomen, evaluation of the tumor motion and the data was used to minimize damage to normal tissues by separating the tumor and normal tissue and maximize tumor therapeutic effect. Lung and liver cancer each 20 patients based on the 50% top phase using 4D-CT simulation and Light speed-16 of shooting equipment 30 ~ 70 % gating phase interval and 0 ~90 % movement in the full phase interval was measured. If the full phase 0 ~ 90% with gating phase 30~70% of tumors in the liver and lung is shown the biggest difference compared to the motion and the size of the GTV was the largest difference in the I(inferior), full phase 0~90% degree of tumor motion only when a relatively large, gating phase to 30~70% of the tumor when the movement has been found that the reduced average 7.1mm. In the 4D-CT simulation comparing the motion value when the full phase 0~90 % and gating phase 30~70 % when the motion value, twice in the gating phase 30~70 % more than full phase 0~90 % showed a small movement value. The exposure to normal tissues, based on the results obtained from the 4D-CT simulation can be significantly alleviated, After treatment will reduce pain and disability in patients with radiation is expected to be able to effective treatment.

SMITH-MAGENS SYNDROME (SMS) : A CASE REPORT (Smith-Magenis Syndrome (SMS) 환아의 증례 보고)

  • Kim, Eun-Young;Lee, Keung-Ho;Choi, Yeong-Chul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.30 no.3
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    • pp.341-347
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    • 2003
  • Smith-Magenis syndrome (SMS) is a clinically recognizable multiple congenital anomaly and mental retardation syndrome caused by an interstitial deletion of chromosome 17 p11.2. Physical features include short stature, characteristic facial appearance: flattened mid-face, down-turned mouth, prominent and often rosy cheeks; prominent jaw in older children and adults, chronic ear infections, hearing impairment, eye problems, including: strabismus (an eye which turns in or out) and myopia (nearsightedness), hoarse voice, short fingers and toes, heart defects or murmurs, problems related to the urinary system, scoliosis (curvature of the spine), an unusual gait (walking pattern), and decreased sensitivity to pain. Behavioral and developmental characteristics include speech delay and articulation problems, developmental delay, learning disability, mental retardation, hyperactivity, self-injury, including: head banging; hand biting; picking at skin, sores and nails; pulling off finger- and toenails; inserting foreign objects into ears, nose, or other body orifices, explosive outbursts, prolonged tantrums, destructive and aggressive behavior, excitability, arm hugging or hand squeezing when excited. This report is the case of a Korean 3-year-3-month old male with Smith-Magenis syndrome referred from local clinic for the treatment of dental caries. The patient was treated by physical restraint after prophylatic administration of antibiotic(Amoxacillin 50mg/kg).

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An Assessment of the Needs of Crippled Persons Staying at Home (지역사회중심 재활서비스를 위한 재가 장애인의 요구 사정에 관한 연구)

  • Yang, Sook-Ja;Kim, Hee-Jeoung
    • Research in Community and Public Health Nursing
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    • v.9 no.2
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    • pp.280-290
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    • 1998
  • This study was carried out to idenify the health problems and needs of crippled persons in order to develop a community based rehabilitation service program through public health center. Information on health problems and needs were obtained from 120 crippled persons staying at home by questionaire and a measuring ADL. The results were summarized as follows 1. Among 120 subjects, male crippled (70.3%) outnumbered female crippled (29.7%). Many crippled persons belonged to the 40-49 age group (33.6%) while others were over 60 years (17.4%). There were 36.8% crippled persons with an elementary education, 26.5% had completed high school, 14.5% had completed middle school. 31% of the crippled persons were employed but most of them had unskilled jobs. 80% of the respondents replied that their monthly income was under 800,000 won. 2. The major causes of their handicap were due to acquired factors(92%) such as accidents, in fectious & communicable diseases and chronic diseases rather than congenital factors(8%). Crippled persons who belong to the first grade of disabilities were 14.8%, the second grade 35.7%, the third grade 21.7%, the forth grade 12.2%, the fifth grade 12.2% and the sixth grade 3.5%. 3. This study measured the degree of the ADL of crippled persons by a modified Barthel Index including 11 items. 73.5% of them were fully independent, 8.5% required minimal help, 2.7% required moderate help, 6.0% required substantial help and 9.4% were unable to perform task. In response to the 11 items of ADL, crippled persons required more help in stair climbing, ambulation and bathing than in other items. 4. In responding to concerning health problems, 10.3% of the subjects replied with incontinence, 8.5% malnutrition, 7.6% fecal incontinence and bedsores 2.6%. Chronic diseases which needs treatment were chronic pain(61.0 %), hypertension(16.5%) and diabetes(16.5%) 5. To the question of what type of rehabilitation services subjects required, chronic diseases management(52.1%) and physical therapy (41.2%) were the highest. The most important social welfare services subjects required were economics support (51.3%) and introductions to job opportunities(42%).

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Effect of K-ADL·K-IADL and Quality of life in Day Hospital Program for Stroke Patients (뇌졸중 환자의 낮병원 프로그램이 도구적·일상생활활동 수행 능력과 삶의 만족도에 미치는 영향)

  • Park, Chang-Sik;Song, Byung-Ho
    • The Journal of the Korea Contents Association
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    • v.12 no.11
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    • pp.267-277
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    • 2012
  • This study was to evaluate the effects how to have an influence on activities daily living and quality of life in day hospital program for the stroke patient. 41 experimental groups and 41 control groups in National rehabilitation hospital selected and examined K-ADL, K-IADL and quality of life. The result of this study indicated that experimental group was higher than control group in activity daily living performance and instrumental activity daily living performance. also experimental group was higher than control group all of total items in quality of life. age and economic state of general characteristic had an effect on K-ADL, K-IADL and quality of life and economic state, scholarship, marriage, job, helper had effect on quality of life. pain, social function, mental health, physical role in item of quality of life had effect on K-ADL and limit of physical role had best effect on K-IADL. Consequently we found that it needs to continuous rehabilitation to maintain body function, to prevent secondary disability, to improve social integration and quality of life for stroke patient actually.

Relationship Between Work Ability, Self-efficacy, Work Satisfaction, Sequelae and Workplace Relationships of Reemployed Workers Who Experienced Industrial Accidents (재취업한 산재 노동자의 업무능력, 자기효능감, 직무 만족, 후유증, 동료관계의 구조적 관계)

  • Kim, Do-Hee
    • Journal of Digital Convergence
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    • v.20 no.2
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    • pp.463-477
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    • 2022
  • The current study examined the mediating effect of self-efficacy (SE) in the relationship between work ability (WA) and work satisfaction (WS) perceived by reemployed workers who have experienced industrial accidents based on social cognitive career theory (SCCT), and investigated the effect of Industrial accident sequelae and workplace relationships (WR) on these variables. The data of 976 newly employed workers were selected from the data of the Panel Study of Worker's Compensation Insurance collected in 2018. The data were analyzed by Structural Equation Modeling through SPSS and AMOS programs. It was found that WA had a positive effect on WS through SE. In addition, it was found that the level of pain, the severity of the disability, and the activities of daily living had a negative effect on WS through WA and SE sequentially. Meanwhile, it was found that the WR was affected by the activities of daily living, and had a positive effect on WS through WE. These results emphasize that it is important to provide support to manage sequelae and increase SE in order to help victims of industrial accidents return to the job market and live satisfactorily. It also suggests that SCCT is useful in explaining WS of industrially injured workers.

A Clinical Trial of Acupuncture Treatment for Frozen Shoulder (Frozen Shoulder의 침치료에 대한 임상연구)

  • Hong, Kwon-Eui;Kim, Young-Il;Yim, Yun-Kyoung;Ahn, Taek-Won;Kang, Wee-Chang;Choi, Sun-Mi;Lee, Hyun
    • Journal of Acupuncture Research
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    • v.23 no.1
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    • pp.165-177
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    • 2006
  • Objectives : 1. Clinical trial for the efficacy evaluation of Korean acupuncture techniques in treating frozen shoulder. 2. Development of the standard clinical guidelines of the acupuncture treatment for the frozen shoulder. 3. Development of the new clinical protocol for the acupuncture treatments. 4. Verification of the hypothesis that treating at both the remote and the nearby acupoints according to the meridian theory is more effective than treating at only the nearby acupoints. Methods : 1. Research designed as Single blind, Randomized, Sham acupuncture controlled clinical Trial. 2. Assignment of 86 patients to one of three groups treated at nearby acupoints(group A), remote & nearby acupoints(group B), and sham points(group C) respectively. 3. Trial conducted at KIOM CRC of Dunsan oriental medical hospital, Daejeon Univ. 4. Estimation of the recovery rate of the frozen shoulder in subjects aged over 40. 5. Efficacy evaluation using VAS, SPADI, ROM and Improvement rate. Results : 1. There was no significant difference in VAS among the three groups. 2. Pain related scores in SPADI of the group B were significantly lower than those of the group A. 3. There was no significant difference in disability related scores of SPADI among the three groups. 4. External rotation of upper arm in the group B was significantly improved in comparison with that in the group C. 5. Abduction of upper arm in group A was improved with weak statistical significance in comparison with that in the group C. Conclusion : Acupuncture at both the remote and the nearby acupoints according to the meridian theory is effective to improve external rotation of frozen shoulder, and acupuncture at the nearby acupoints is effective to improve adduction of frozen shoulder. However it is not clear that acupuncture treatment at both the remote and the nearby acupoints according to the meridian theory is more effective than treating at only the nearby acupoints in the treatment of frozen shoulder. Since our study was a short term trial, a long term trial for a more precise evaluation of acupuncture treatment for frozen shoulder will be needed in the future.

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Predictive Factors for MDCT as a Primary Survey in Traumatic Cervical Spine Injury (외상환자에 있어서 일차조사로서 경추부 전산화 단층 촬영의 예측인자)

  • Pak, Guen-E.;Han, Chul;Cho, Young-Duck;Kim, Jung-Youn;Yoon, Young-Hoon;Lee, Sung-Woo;Moon, Sung-Woo;Choi, Sung-Hyuk
    • Journal of Trauma and Injury
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    • v.24 no.1
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    • pp.18-24
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    • 2011
  • Purpose: Missing cervical pathology after injury may lead to disability and influence long-term survival. Controversies continue to evolve concerning the initial screening methods used to predict cervical spine injury. Through a retrospective chart review, we attempted to analyze and propose factors predictive of cervical trauma. Methods: Of all the patients who had visited the Emergency Department of Korea University, from January 2009 to December 2009, a retrospective review of the clinical records of the 217 patients who had undergone cervical spine computed tomography was done. We investigated whether we could predict the need for cervical spine computed tomography shortly after presentation in trauma patients by comparing the group with fractures and group without fractures and by finding risk factors showing significant differences between the two groups that might be used as guides in decision making. Results: Of the 217 subjects who underwent cervical spine computed tomography scans, 33 were identified with fractures of the cervical spine while 184 were not. The most common mechanisms of trauma, in order, for those with fractures were falls, followed by traffic accidents. We found that the injury severity score, multiple injuries, a high-energy injury mechanism, neurologic deficit, and pain and tenderness of the cervical spine showed statistically significant differences between the two groups. Conclusion: Fractures of the cervical spine that are not observed with simple radiography occur with a relatively high frequency in trauma patients. Consideration should be given to the risk factors for cervical spine fracture, and if pertinent, cervical spine computed tomography should be performed with speed for early diagnosis of cervical spine fractures.

Factors affecting on Health-Related Quality Of Life Among Cancer Survivors: Focusing on Gender Difference (암생존자의 건강관련 삶의 질에 대한 영향 요인 -성차를 중심으로)

  • Lee, In-Jeong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.2
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    • pp.497-507
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    • 2018
  • Objectives: The purpose of this article was to evaluate the health related quality of life (HRQoL) of cancer survivors and to identify its predictors according to gender. Methods: The research was conducted with the data for 203 (cancer survivors?) taken from the 6th wave of the Korea National Health and Nutrition Examination Survey and the EQ-5D index score was used for the measurement of the health-related quality of life (HRQoL). The independent variables inluded socio-demographic data, health related factors (survival duration, disability, subjective health recognition), and psychosocial factors (stress, unmet medical needs). The data were analyzed by the t-test, ANOVA, and hierarchical multiple regression analysis. Results: the HRQoL of the female cancer survivors was significantly worse than that of the males in terms of their mobility, usual activities, pain/discomfort and anxiety/depression quality of life. The only statistically significant factor affecting the HRQoL of the male cancer survivors was their subjective health recognition. In the case of the female cancer survivors, the statistically significant factors were their age, subjective health recognition and unmet medical needs. Conclusions: the results of this study showed a different pattern of predictors according to the gender of the cancer survivors. Therefore, gender should be considered when assessing and addressing the individual care needs of cancer survivors, in order to obtain optimal treatment outcomes.

Relationship of Self-Perceived Symptoms of Periodontal Disease to Quality of Life in Adults (일부 성인에서 치주질환 자각증상과 삶의 질의 관련성)

  • Lee, Mi-Ra;Choi, Jun-Seon
    • Journal of dental hygiene science
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    • v.12 no.2
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    • pp.115-121
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    • 2012
  • The aim of this study was to investigate the correlations between the self-reported symptoms of periodontal diseases and the quality of life. This study conducted its questionnaire survey over the subjects of 450 adults who had ever visited dental clinics among the adults of age 35-65 living in Seoul and Gyeonggi-do region from January 7 to March 14, 2010. The data were analyzed using a chi-square test, t-test, binominal logistic regression analysis in the SPSS version 12.0 program. Among the self-reported symptoms of periodontal diseases, 65% of respondents perceived that 'I bleed from the gums in brushing my teeth', which was the most, whereas 18.8% of respondents perceived to 'tooth mobility', which was the least. Self-reported symptoms of periodontal diseases was associated with socio-demographic characteristics such as sex, age, level of education and periodic oral examination, dental scaling(p<0.05). People who perceived the symptoms of periodontal diseases experienced functional limitation, physical pain, psychological discomfort, disability in diverse domains, and social handicap more than the group who did not perceive them(p<0.001). OHIP-14 scores were significantly correlated with sex, bleeding gums, swollen gums and bad breath(p<0.05). This study showed the self-reported periodontal problem had a negative impact on the public's leading their happy life. Therefore, in order to enhance the quality of life in adults, it is necessary to prevent periodontal diseases and reduce the subjective symptoms.