• Title/Summary/Keyword: Symptom severity

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Radiological Significance of Ligamentum Flavum Hypertrophy in the Occurrence of Redundant Nerve Roots of Central Lumbar Spinal Stenosis

  • Hur, Junseok W.;Hur, Junho K.;Kwon, Taek-Hyun;Park, Youn Kwan;Chung, Hung Seob;Kim, Joo Han
    • Journal of Korean Neurosurgical Society
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    • v.52 no.3
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    • pp.215-220
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    • 2012
  • Objective : There were previous reports of redundant nerve roots (RNRs) focused on their clinical significance and pathogenesis. In this study, we investigated the significant radiologic findings that correlate with RNRs occurrence. These relations would provide an advanced clue for clinical significance and pathogenesis of RNRs. Methods : Retrospective research was performed with data from 126 patients who underwent surgery for central lumbar spinal stenosis (LSS). Finally, 106 patients with common denominators (inter-observer accuracy : 84%) were included on this study. We divided the patients into two groups by MRI, patients with RNRs and those with no RNRs (NRNRs). Comparative analyses were performed with clinical and radiologic parameters. Results : RNRs were found in 45 patients (42%) with central LSS. There were no statistically significant differences between the two groups in severity of symptoms. On the other hand, we found statistically significant differences in duration of symptom and number of level included (p<0.05). In the maximal stenotic level, ligamentum flavum (LF) thickness, LF cross-sectional area (CSA), dural sac CSA, and segmental angulation are significantly different in RNRs group compared to NRNRs group (p<0.05). Conclusion : RNRs patients showed clinically longer duration of symptoms and multiple levels included. We also confirmed that wide segmental angulation and LF hypertrophy play a major role of the development of RNRs in central LSS. Together, our results suggest that wide motion in long period contribute to LF hypertrophy, and it might be the key factor of RNRs formation in central LSS.

Therapeutic Potential of Atopy-camp: A pilot study

  • Lee, Nam-Ryul;Kim, Hyung-Geug;Seo, Kyoung-Suk;Son, Chang-Gue
    • The Journal of Korean Medicine
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    • v.31 no.6
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    • pp.40-46
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    • 2010
  • Objective: This study investigated the therapeutic possibility of natural therapy in atopy-camp for children with atopic dermatitis. Methods: 30 children (19 boys and 11 girls, median age 11.5 years, ranging from 9 to 15) participated in natural environment-based activities in a camp-village located in Geumsan-gun for five days. Assessment of symptom change was conducted by self-reporting numeric scale (NRS) for pruritus and sleeping difficulty, investigator global assessment (IGA), eczema area and severity index (EASI score), serum histamine and IgE concentration before and after the camp period. Statistical significance was analyzed by paired t-test. Results: NRS for pruritus ($4.7{\pm}2.0$ into $4.3{\pm}2.1$), sleeping difficulty ($3.1{\pm}2.1$ into $2.9{\pm}2.0$), and serum histamine concentration ($4.27{\pm}7.39$ mol / L into $3.21{\pm}6.08$ mol / L) showed positive changes but didn't reach statistical significance (p > 0.05). IGA ($3.8{\pm}0.9$ into $4.13{\pm}1.0$), while EASI score ($10.8{\pm}9.7$ into $9.1{\pm}9.2$) and IgE ($408{\pm}320$ IU / mL into $385{\pm}3.8$ IU / mL) were significantly improved (p < 0.01). Conclusions: In spite of the limitation of the clinical trial protocol, this study may provide the possibility of natural environment-based therapy for children with atopic dermatitis.

A Clinical study on the Treatment of Nasal disease using TonggyutangGamibang (통규탕가미방(通竅湯加味方)의 비질환(鼻疾患) 치료에 대한 임상고찰)

  • Kim, Ki-Hoon;Cho, Hyung-Jun;Lee, Jin-Yong;Cho, Baek-Gun
    • The Journal of Pediatrics of Korean Medicine
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    • v.18 no.1
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    • pp.153-163
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    • 2004
  • Objective: For last 20 years our living environment has been changed rapidly. Accordingly. there have been many changes in prevalence of diseases; In nasal disease of the pediatrics, the number of children suffering from chronic rhinorrhea and nasal obstruction has been increased. And respiratory symptoms suggesting rhinitis and sinusitis also were increased. Allergic disease is considered as an important cause of this phenomenon while importance of infection as pathogen is fading today. The aim of this study is to investigate the effect of TonggyutangGarnibang on the nasal disease of children. Methods: Children with nasal disease answer the questionnaires on their chief complaints and medical past history on their first visit to our clinic. They were treated 'With TonggyutangGarnibang for 4weeks. After treatment they answered the questionnaire on improvement of their symptoms. Results: Among treated patients, 70 were male(69%) and 32 were female(31%); sex ratio was 2.2.3:l(male:female). And children from 3-8 years old took majority of patients(64%). Major symptoms of children with nasal disease were as follows; nasal obstruction 9lchildren(62%), rhinorrhea 86children(84%), sneezing 63children(62%), cough 63children(62%), snoring 48children (47%), poor appetite 44children(43%), itching 39children(38%), headache 32children(31%), stomache 25children(25%), epistaxis 23children(23%), constipation 17children(17%), diarrhea 12children(12%). Past history and impression of the disease of the patients were as follows; allergic rhinitis(66%), atopic dermatitis(42%), sinusitis(40%), asthma(25%), urticaria(12%). Severity of symptom improved after TonggyutangGamibang treatment, it showed high treatment efficacy as follows; sneezing 70%, cough 70%, rhinorrhea 63%, nasal obstruction 59% Conclusion: This study shows TonggyutangGamibang has distinctive treatment effect on children with nasal disease.

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Acute Gastritis and Splenic Infarction Caused by Epstein-Barr Virus

  • Jeong, Ji Eun;Kim, Kyung Moon;Jung, Hye Lim;Shim, Jae Won;Kim, Deok Soo;Shim, Jung Yeon;Park, Moon Soo;Park, Soo Kyung
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.21 no.2
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    • pp.147-153
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    • 2018
  • Epstein-Barr virus (EBV) infection can be presented with various clinical manifestations and different levels of severity when infected. Infectious mononucleosis, which is most commonly caused by EBV infection in children and adolescents, is a clinical syndrome characterized by fatigue, malaise, fever, sore throat, and generalized lymphadenopathy. But rarely, patients with infectious mononucleosis may present with gastrointestinal symptoms and complicated by gastritis, splenic infarction, and splenic rupture. We encountered a 16-year-old girl who presented with fever, fatigue, and epigastric pain. Splenic infarction and EBV-associated gastritis were diagnosed by using esophagogastroduodenoscopy and abdominal computed tomography. Endoscopy revealed a generalized hyperemic nodular lesion in the stomach, and the biopsy findings were chronic gastritis with erosion and positive in situ hybridization for EBV. As splenic infarction and acute gastritis are rare in infectious mononucleosis and are prone to be overlooked, we must consider these complications when an infectious mononucleosis patient presents with gastrointestinal symptom.

The effect of dry mouth improvement by oral exercise program in elderly people (노인 대상 입체조 프로그램의 구강건조증 개선 효과)

  • Jeon, Young-Joo;Choi, Jun-Seon;Han, Su-Jin
    • Journal of Korean society of Dental Hygiene
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    • v.12 no.2
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    • pp.293-305
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    • 2012
  • Objectives : The purpose of this study was to confirm effects of oral exercise program intended to improve the condition of salivary hypofunction and to provide basic data for development of oral health program for the elderly Methods : The subjects were 125 elderly women who resided in Gyeong-In area and were aged 65 years and older. During a 2-month period, an oral exercise was conducted twice a week. A survey was conducted by interviewing the selected elders to determine the state of their subjective dry mouth. Unstimulated whole saliva was measured before and after the oral exercise program. Results : There was a significant improvement in subjective dry mouth symptoms, severity scores of dry mouth after the oral exercise, and there were affected by age and income level. There was a significant increase in unstimulated whole-saliva after the oral exercise program. There was positive interrelationship between dry mouth Symptom improvement level and inconvenience improvement level, and between inconvenience improvement level and the increase of unstimulated whole-saliva. Conclusions : This study showed the effects of the oral exercise program. It is suggested that this oral exercise program has positive effects on the condition of dry mouth. For the explicit improvement effect on the condition of dry mouth, the oral exercise program needs to be carried out in consideration of the elderly's general characteristics.

한방진단시스템 DSOM의 진단결과에 따른 월경통 환자의 허실(虛實) 진단에 대한 연구

  • Lee, In-Sun;Cho, Hye-Sook;Youn, hyoun-Min;Jung, Kyoung-Keun;Kim, Kyu-Kon;Park, Ji-Eun;Choi, Sum-Mi
    • Journal of Pharmacopuncture
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    • v.10 no.1 s.22
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    • pp.137-155
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    • 2007
  • Purpose : This study was undertaken to make a diagnosis weakness and firmness (虛實) of Dysmenorrhea patients by diagnosis questionnaires system(Diagnosis System of Oriental Medicine-DSOM) Methods : The subjects were 58 volunteers who was suffering for dysmenorrhea, employed using Measure of Menstrual Pain (MMP) questionnaire. The had agreed to take part in this experiment, with didn't take any anodyne drugs. The MMP score by using 7 questions and the Menstrual Symptom Severity List(MSSL-D) was measured before and after menstruation cycle. Results and Conclusions : The findings of this study were as follows; 1. We examined Pathogenic Factor's frequency of DSOM, Coldness(寒) was 45 persons 80.36%, Damp(濕) was 40 persons 71.43%, Heart(心) was 37 persons 66.07%, Heat syndrom(熱) was 9 persons 16.07%, insufficiency of Yang(陽虛) was 6 persons 10.71%. 2. We divided Dysmenorrhea patients into two groups(weakness and firmness) by Results of DSOM, Firmness was 25 Persons 43.1%, Weakness was 23 persons 39.7%, Unknown was 10 persons 17.2%. 3. In estimation based on Measure of Menstrual Pain (MMP) questionnaire Severe menstrual pain is weakness, Mild menstrual pain is Firmness. 4. In estimation of coldness and heat syndrom, Coldness was 40 persons 69.0%, Heat syndrom, was 2 persons 3.5%, Possess both coldness and heat syndrom was 9 persons 15.5%.

Reflection of Pain in Cancer Patients Using a New Screening Tool for Psychological Distress

  • Oh, Seung-Taek;Lee, San;Lee, Hyeok;Chang, Myung Hee;Hong, Soojung;Choi, Won-Jung
    • Korean Journal of Psychosomatic Medicine
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    • v.25 no.1
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    • pp.56-62
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    • 2017
  • Objectives : The objective of this study was to investigate the relationship between psychological distress and pain in cancer patients. Methods : 249 patients with cancer who visited National Health Insurance Service Ilsan Hospital between April 2013 and March 2014 were evaluated with National Cancer Center Psychological Symptom Inventory(NCC-PSI) which consisted of Modified Distress Thermometer(MDT) and Modified Impact Thermometer(MIT). Each scale was divided into 3 subscales targeting separate symptoms: insomnia, anxiety, and depression. Psychological distress was defined as positive for those who scored above the cutoff values in at least one of all six subscales. The Numeric Rating Scale for Pain(NRS-Pain) was used to assess the subjective severity of pain. Logistic regression was performed to investigate the association between psychological distress and pain. Results : Univariate logistic regression analysis showed that pain, gender, compliance, and two subscale scores of Hospital Anxiety and Depression Scale(HADS) were significantly associated with psychological distress. Multivariate logistic regression analysis showed that pain and HADS anxiety subscale score maintained a statistically significant association with psychological distress adjusted for variables including age, gender, years of education, Eastern Cooperative Oncology Group performance status, cancer stage, Charlson Comorbidity Index, compliance, and HADS depression subscale score. One point increase in pain was 1.31 times more likely to cause psychological distress. In secondary analysis, pain was significantly associated with all subscales of NCC-PSI, except MIT-anxiety subscale. Conclusions : This study suggests that NCC-PSI, a screening tool for psychological distress, reflects pain. We recommend that physicians who treat cancer patients consider the examination of psychological distress which provides comprehensive evaluation of various factors regarding quality of life.

Psychometric Properties of the Korean version of the PTSD Checklist-5 in Elderly Korean Veterans of the Vietnam War (월남전 참전 노인에서 한글판 외상후 스트레스 장애 체크리스트-5의 정신측정학적 특성)

  • Kim, Jong Won;Chung, Hae Gyung;Choi, Jin Hee;So, Hyung Seok;Kang, Suk-Hoon;Kim, Dong Soo;Moon, Jung Yoon;Kim, Tae Yong
    • Anxiety and mood
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    • v.13 no.2
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    • pp.123-131
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    • 2017
  • Objective : The PTSD Checklist (PCL) is a self-report screen for posttraumatic stress disorder (PTSD) that can be scored for both diagnostic assessment and symptom severity measurement. The most recent revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) contains a number of changes to the definition of PTSD, and the aim of this study was to assess the psychometric properties of the Korean version of the PCL for the DSM-5 (PCL-5-K). Methods : The participants were 204 Korean veterans of the Vietnam War who completed the PCL-5-K, the Mini Mental Status Examination (MMSE), PTSD module of Structured Clinical Interview for DSM-5, Research Version (SCID5-RV PTSD module), Korean version of Impact of Event Scale-Revised (IES-R-K) and Combat Exposure Scale (CES-K). Results : The PCL-5-K demonstrated good internal consistency (${\alpha}=0.972$) and test-retest reliability (r=0.96); the suggested cut-off score for PTSD diagnosis was ${\geq}37$ with 0.88 sensitivity and 0.96 specificity. The PCL-5-K scale correlated highly with the IES-R-K and CES-K. Factor analysis identified only one factor. Conclusion : Among elderly Korean veterans of the Vietnam War, the PCL-5-K demonstrated similar psychometric qualities to those of both the original PCL and subsequent versions. It is expected that the PCL-5-K will be a useful PTSD screening tool.

Chronic postsurgical pain: current evidence for prevention and management

  • Thapa, Parineeta;Euasobhon, Pramote
    • The Korean Journal of Pain
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    • v.31 no.3
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    • pp.155-173
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    • 2018
  • Chronic postsurgical pain (CPSP) is an unwanted adverse event in any operation. It leads to functional limitations and psychological trauma for patients, and leaves the operative team with feelings of failure and humiliation. Therefore, it is crucial that preventive strategies for CPSP are considered in high-risk operations. Various techniques have been implemented to reduce the risk with variable success. Identifying the risk factors for each patient and applying a timely preventive strategy may help patients avoid the distress of chronic pain. The preventive strategies include modification of the surgical technique, good pain control throughout the perioperative period, and preoperative psychological intervention focusing on the psychosocial and cognitive risk factors. Appropriate management of CPSP patients is also necessary to reduce their suffering. CPSP usually has a neuropathic pain component; therefore, the current recommendations are based on data on chronic neuropathic pain. Hence, voltage-dependent calcium channel antagonists, antidepressants, topical lidocaine and topical capsaicin are the main pharmacological treatments. Paracetamol, NSAIDs and weak opioids can be used according to symptom severity, but strong opioids should be used with great caution and are not recommended. Other drugs that may be helpful are ketamine, clonidine, and intravenous lidocaine infusion. For patients with failed pharmacological treatment, consideration should be given to pain interventions; examples include transcutaneous electrical nerve stimulation, botulinum toxin injections, pulsed radiofrequency, nerve blocks, nerve ablation, neuromodulation and surgical management. Physical therapy, cognitive behavioral therapy and lifestyle modifications are also useful for relieving the pain and distress experienced by CPSP patients.

Anthropometric Measurements and Dietary patterns of North Korean Migrant Children in China (연변지역 탈북 아동 및 청소년의 체위와 식생활 양상)

  • 장남수
    • Journal of Nutrition and Health
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    • v.33 no.3
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    • pp.324-331
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    • 2000
  • A deteriorating North Korean economy, coupled with a devastating natural disaster such as flooding and drought in recent years, brought about a severe food shortage and malnutrition problem which caused a migration of its population including young children to neighboring countries. We conducted a nutritional survey on a total of 436 children, aged 4-19 years old, who migrated to the China side of the border from July to September, 1999. The study subjects were interviewed by Korean-Chinese interviewers who were trained for anthropometric measurements and dietary surveys. Heights, weights, and chest circumference of the subjects were 70-90% of the South Korean reference values for the corresponding age and sex. Dietary intakes of the subjects were found to be extremely poor-the average number of food, mostly of plant origin, consumed in a day was 2.8, and the proportion of the subject who reported to take all three meals in a day while residing in North Korea was as low as 36.2%. Ninety five percent of the subjects had at least one clinical symptom related to malnutrition, 68.6% had 2-4 symptoms, and 15.1% had 5 or more symptoms. The results of this study provided an objective data for the first time on the severity of the food crisis and malnutrition problem that afflicted North Korean older children and adolescents as well as children aged 7 or under as previously reported elsewhere. the wasted and stunted children and youths prevailing in North Korea could exert a negative influence on the country's health and economy. More researches are needed in the future to investigate on the impact of malnutrition in North Korean children on the country's social, economic, and cultural state as well as on the health and nutrition situation.

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