• 제목/요약/키워드: Symptomatic

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성인의 유연성 편평족에 대한 종골 연장술 (Calcaneal Lengthening Osteotomy for the Symptomatic Flexible Flatfoot in Adults)

  • 최홍준;조재호;왕배건
    • 대한족부족관절학회지
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    • 제17권2호
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    • pp.115-120
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    • 2013
  • Purpose: Calcaneal lengthening osteotomy is one option for the treatment of symptomatic flexible flatfoot in adults. The aim of the study was to evaluate the short term clinical and radiologic results and analyze its complications. Materials and Methods: Twelve feet who had undergone calcaneal lengthening osteotomy without flexor digitorum longus transfer between December 2009 and July 2011 were included. The mean age was 40.6 years (23~75 years). The mean followup was 17.3 months (13~25 months). Clinical outcome were assessed using American Orthopadics Foot ans Ankle Society (AOFAS) score and visual analogue scale (VAS) for pain. Four radiologic parameters were measured from weightbearing radiographs to evaluate the difference between preoperatively and postoperatively measures. To analyze the complications, calcaneocuboid joint subluxation and degenerative change were measured postoperatively. Results: The mean AOFAS score improved from 55.3 points preoperatively to 82.2 points at lastest follow-up (p=0.000). The mean VAS improved from 6.3 points preoperatively to 3.2 points postoperatively (p=0.002).All radiologic parameters, the mean talonavicular coverage angle on AP view, the mean talo-1st metatarsal angle on AP and lateral view and the mean calcaneal pitch angle, significantly improved after calcaneal lengthening osteotomy. Nine feets (75%) were shown the degenerative change in the calcaneocuboid joint at latest follow-up radiographs. Conclusion: Calcaneal lengthening osteotomy for the symptomatic flexible flatfoot in adults produced significant improvement in clinical and radiologic parameters, but calcaneocuboid joint osteoarthritis occurred postoperatively remained a major problem.

Different Clinical Outcomes of Entamoeba histolytica in Malaysia: Does Genetic Diversity Exist?

  • Anuar, Tengku Shahrul;Al-Mekhlafi, Hesham M.;Abdul Ghani, Mohamed Kamel;Azreen, Siti Nor;Salleh, Fatmah Md.;Ghazali, Nuraffini;Bernadus, Mekadina;Moktar, Norhayati
    • Parasites, Hosts and Diseases
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    • 제51권2호
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    • pp.231-236
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    • 2013
  • The present study was conducted to investigate the clinical outcomes of Entamoeba histolytica infection in symptomatic and asymptomatic Orang Asli (aborigine) communities in Malaysia. Examination was performed on 500 stool samples obtained from Orang Asli communities in 3 different states using formalin-ether concentration, trichrome staining, and single-round PCR techniques. Out of 500 stool samples, single infection of E. histolytica, Entamoeba dispar, and Entamoeba moshkovskii was identified in 3.2%, 13.4%, and 1%, respectively. In addition, 10 samples had mixed infections with E. histolytica and E. dispar. Six samples containing E. dispar were also positive for E. moshkovskii, and only 2 samples had E. histolytica in association with E. dispar and E. moshkovskii. Seventeen E. histolytica-positive samples were from symptomatic subjects, whereas the remaining 11 samples came from asymptomatic subjects. These findings suggest a predominant distribution of pathogenic potential of E. histolytica strains in this community. Therefore, further studies on genotyping of E. histolytica is required, to find out association between E. histolytica genotype and the outcome of the infection.

거리환경미화원의 근골격계 증상의 특징 및 인간공학적 평가 (Ergonomic Workload Evaluation and Musculo-skeletal Symptomatic Features of Street Cleaners)

  • 이향기;명준표;정은희;정혜선;구정완
    • 대한인간공학회지
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    • 제26권4호
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    • pp.147-152
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    • 2007
  • The aim of this study was to evaluate the musculo-skeletal symptomatic features of municipal sanitation workers and to compare differences of the musculo-skeletal symptoms by work types. We conducted descriptive cross-sectional survey concerning the musculo-skeletal symptomatic features of 315 street cleaners in Seoul and GyeongGi Province, Korea, during 2 weeks of September 2006. Questionnaires were consisted of general characteristics, occupational characteristics and musculo-skeletal symptoms. And we observed their works and evaluated their movement and posture by REBA. For work types, tools and subjective physical work loading, there were statistical difference whether or not NIOSH symptom positive on upper limb. Musculo-skeletal symptoms on upper limb were claimed from 43.2% of street cleaners, more than in 32.4% of cleaners. Musculo-skeletal symptoms on upper limb were reported higher in the group who felt their subjective physical work loading severe than in the otherwise group. The REBA results were over 'high risk stage' in street cleaners. Street cleaners had more repetitive motions than solid waste collectors on upper limbs. Works according to the criteria of musculoskeletal burdened work by the Ministry of Labor results were over 'high risk stage' of No. 2 and No. 4 in street cleaners. We found that street cleaners complained musculo-skeletal symptoms on upper limb more than solid waste collectors. This study suggests that it is necessary for street cleaners to carry out the prevention program of musculo-skeletal diseases. For street cleaner, the measure plans such as job rotation, automatic street sweepers, reducing work hours are helpful in preventing musculoskeletal symptoms on the upper limb.

International Scoring System in Symptomatic Multiple Myeloma: Experience from a Tertiary Care Center

  • Sultan, Sadia;Irfan, Syed Mohammed;Parveen, Saira;Taufiq, Ufaq
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권4호
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    • pp.2031-2033
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    • 2016
  • Background: Symptomatic multiple myeloma (MM) is an acquired B-cell malignant proliferation of antibody secreting plasma cells, characterized by end organ damage due to monoclonal immunoglobulin secretion. The aim of this study wa to determine the stage stratification according to an international scoring system in adult Pakistani MM patients at presentation. Materials and Methods: This single centre retrospective study extendedfrom January 2012 to December 2015. Data were retrieved from the departmental maintained records. Results: A total of 39 patients were diagnosed at our center with MM during the period of the study, 25 males and 14 females. Age ranged between 36 and 81 with a mean of $54.5{\pm}14.8$ and a median of 57 years. Common presenting complaints included fatigue (80.9%), backache (79.3%) and bone pain (66.2%). Overall, 9 patients were in ISS stage I (23%), 12 were in stage II (30.7%) and 18 were in stage III (46.1%). Out of the total, 29 (74.3%) had kappa immunoglobulin andthe remaining 10 (25.6%) had lambda type myelomas. IgG myeloma was commonest, seen in 26 (66.6%) followed by IgA in 11 (28.2%) with non secretory myeloma in one (2.5%) and light chain disease also in one patient (2.5%). Conclusions: MM in Pakistani patients is seen in a relatively young population with male predominance. Primarily patients are symptomatic and risk stratification revealed a predominance of advanced stage III disease in our setting.

Compression Angle of Ossification of the Posterior Longitudinal Ligament and Its Clinical Significance in Cervical Myelopathy

  • Lee, Nam;Yoon, Do Heum;Kim, Keung Nyun;Shin, Hyun Chul;Shin, Dong Ah;Ha, Yoon
    • Journal of Korean Neurosurgical Society
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    • 제59권5호
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    • pp.471-477
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    • 2016
  • Objectives : The correction of clinical and radiologic abnormalities in patients with symptomatic ossification of the posterior longitudinal ligament (OPLL) is the current mainstay of treatment. This study aimed to identify radiographic predictors of severity of myelopathy in patients with symptomatic OPLL. Methods : Fifty patients with symptomatic cervical OPLL were enrolled. Based on Japanese Orthopedic Association (JOA) scores, patients were divided into either the mild myelopathy (n=31) or severe myelopathy (n=19) group. All subjects underwent preoperative plain cervical roentgenogram, computed tomography (CT), and MR imaging (MRI). Radiological parameters (C2-7 sagittal vertical axis, SVA; C2-7 Cobb angle; C2-7 range of motion, ROM; OPLL occupying ratio; and compression angle) were compared. Compression angle of OPLL was defined as the angle between the cranial and caudal surfaces of OPLL at the maximum level of cord compression Results : The occupying ratio of the spinal canal, C2-7 Cobb angle, C2-7 SVA, types of OPLL, and C2-7 ROM of the cervical spine were not statistically different between the two groups. However, the OPLL compression angle was significantly greater (p=0.003) in the severe myelopathy group than in the mild myelopathy group and was inversely correlated with JOA score (r=-0.533, p<0.01). Furthermore, multivariate regression analysis demonstrated that the compression angle (B=-0.069, p<0.001) was significantly associated with JOA scores (R=0.647, p<0.005). Conclusion : Higher compression angles of OPLL have deleterious effects on the spinal cord and decrease preoperative JOA scores.

Lumbar Disc Herniation Presented with Contralateral Symptoms

  • Kim, Pius;Ju, Chang Il;Kim, Hyeun Sung;Kim, Seok Won
    • Journal of Korean Neurosurgical Society
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    • 제60권2호
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    • pp.220-224
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    • 2017
  • Objective : This study aimed to unravel the putative mechanism underlying the neurologic deficits contralateral to the side with lumbar disc herniation (LDH) and to elucidate the treatment for this condition. Methods : From January 2009 to June 2015, 8 patients with LDH with predominantly contralateral neurologic deficits underwent surgical treatment on the side with LDH with or without decompressing the symptomatic side. A retrospective review of charts and radiological records of these 8 patients was performed. The putative mechanisms underlying the associated contralateral neurological deficits, magnetic resonance imaging (MRI), electromyography (EMG), and the adequate surgical approach are discussed here. Results : MRI revealed a similar laterally skewed paramedian disc herniation, with the apex deviated from the symptomatic side rather than directly compressing the nerve root; this condition may generate a contralateral traction force. EMG revealed radiculopathies in both sides of 6 patients and in the herniated side of 2 patients. Based on EMG findings and the existence of suspicious lateral recess stenosis of the symptomatic side, 6 patients underwent bilateral decompression of nerve roots and 2 were subjected to a microscopic discectomy to treat the asymptomatic disc herniation. No specific conditions such as venous congestion, nerve root anomaly or epidural lipomatosis were observed, which may be considered the putative pathomechanism causing the contralateral neurological deficits. The symptoms resolved significantly after surgery. Conclusion : The traction force generated on the contralateral side and lateral recess stenosis, rather than direct compression, may cause the contralateral neurologic deficits observed in LDH.

Feasibility of Posterior Cervical Foraminotomy for Adjacent Segmental Disease after Anterior Cervical Fusion

  • Kim, Hyun Jun;Kang, Min Soo;Lee, Sang Ho;Park, Chan Hong;Chung, Seok Won;Shin, Yong Hwan;Lee, Shin Young;Park, Eun Soo
    • Journal of Korean Neurosurgical Society
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    • 제63권6호
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    • pp.767-776
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    • 2020
  • Objective : The aim of this study is to evaluate the feasibility of posterior cervical foraminotomy (PCF) for adjacent segmental disease (ASD) after anterior cervical fusion (ACF). As ACF is accepted as the standard treatment for cervical spondylosis, many studies have been conducted to evaluate the efficacy of various surgical techniques to overcome symptomatic ASD after the previous surgery. Herein, PCF was performed for the treatment of symptomatic ASD and the feasibility of the surgery was evaluated. Methods : Forty nine patients who underwent PCF due to symptomatic ASD from August 2008 to November 2017 were identified. For demographic and perioperative data, the sex, age, types of previous surgery, ASD levels, operation times, and bleeding amount were recorded. The clinical outcome was assessed using the visual analogue scale for the neck and arm, the modified Odom's criteria as well as neck disability index. Radiologic evaluations were performed by measuring disc softness, disc height, the cervical 2-7 sagittal vertical axis, cervical cobb angle, and facet violation. Results : Thirty-seven patients were enrolled in this study. The patients were divided into two groups based on the location of the pathology; paracentral (group P) or foramina (group F). Both groups showed significant clinical improvement (p<0.05). The proportion of calcified disc and facet violations was significantly larger in group F (p<0.05). The minimal disc height decrease with mild improvement on sagittal alignment and cervical lordosis was radiologically measured without statistical significance in both groups (p>0.05). Conclusion : PCF showed satisfactory clinical and radiologic outcomes for both paracentral and foraminal pathologies of ASD after ACF. Complications related to anterior revision were also avoided. PCF can be considered a feasible and safe surgical option for ASD after ACF.

The Effect of Breast Hypertrophy on Patient Posture

  • Lapid, Oren;de Groof, E. Joline;Corion, Leonard U.M.C.;Smeulders, Mark J.C.;van der Horst, Chantal M.A.M.
    • Archives of Plastic Surgery
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    • 제40권5호
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    • pp.559-563
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    • 2013
  • Background One of the reasons women with macromastia chose to undergo a breast reduction is to relieve their complaints of back, neck, and shoulder pain. We hypothesized that changes in posture after surgery may be the reason for the pain relief and that patient posture may correlate with symptomatic macromastia and may serve as an objective measure for complaints. The purpose of our study was to evaluate the effect of reduction mammaplasty on the posture of women with macromastia. Methods A prospective controlled study at a university medical center. Forty-two patients that underwent breast reduction were studied before surgery and an average of 4.3 years following surgery. Thirty-seven healthy women served as controls. Standardized lateral photos were taken. The inclination angle of the back was measured. Regression analysis was performed for the inclination angle. Results Preoperatively, the mean inclination angle was 1.61 degrees ventrally; this diminished postoperatively to 0.72 degrees ventrally. This change was not significant (P-value=0.104). In the control group that angle was 0.28 degrees dorsally. Univariate regression analysis revealed that the inclination was dependent on body mass index (BMI) and having symptomatic macromastia; on multiple regression it was only dependent on BMI. Conclusions The inclination angle of the back in breast reduction candidates is significantly different from that of controls; however, this difference is small and probably does not account for the symptoms associated with macromastia. Back inclination should not be used as a surrogate "objective" measure for symptomatic macromastia.

형방지황탕(荊防地黃湯)으로 증상 호전을 보인 성인형 스틸병 후유증 소양인(少陽人) 환자 1례(例) (A Case Study of 1 Soyangin patient with sequence of Adult type Still's disease who reported symptomatic improvement after being treated with Hyeongbangjihwang-tang)

  • 강미정;이지원;장현수;김윤희;이준희;이의주;고병희
    • 사상체질의학회지
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    • 제21권2호
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    • pp.144-152
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    • 2009
  • 1. Objective : This study aims to report symptomatic improvement of a Soyangin patient reporting general weakness, dizziness, gait disturbance, cold sensitivity, nocturnal sweating, and anorexia after treatment with Hyeongbangjihwang-tang. 2. Method : The patient's subjective and objective symptoms were observed daily, and the VAS scores for the main symptoms were recorded daily throughout the hospitalization period. 3. Result : The general condition of the patient improved by the end of the hospitalization period, where the VAS score dropped from VAS 10 to VAS 5 and the symptoms of dizziness, general weakness, cold sensitivity, and nocturnal sweating disappeared by day 4 of admission without recurrence. 4. Conclusion : Although the patient did not report diarrhea, one of the main Mangeum symptoms, the general symptoms improved with Hyeongbangjihwang-tang medication. This indicates that Hyeongbangjihwang-tang can be used to treat chief and subsidiary symptoms related to Mangeum symptomatic pattern when applied to the appropriate base and manifesting symptomology.

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PCR을 이용한 벚나무 빗자루병균(Taphrina wiesneri)의 월동부위 검출 (Detection of Overwintering Sites Inhabited by Cherry Witches' Broom Pathogen Taphrina wiesneri with Species-specific PCR in Korea)

  • 손수연;이선근;서상태
    • 한국산림과학회지
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    • 제104권2호
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    • pp.332-335
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    • 2015
  • 자낭균인 Taphrina wiesneri는 한국의 공원과 도로 주변에 주로 식재되는 왕벚나무에 빗자루병을 발생시킨다. 이 병원균은 생태적 특성이 잘 알려져 있지 않아 방제법 등을 개발하는데 어려움이 있다. 이번 연구에서는 빗자루 병원균의 월동부위를 조사하기 위해 빗자루 병징을 보이는 왕벚나무의 건전가지와 이병가지, 그리고 병징이 나타나지 않은 건전한 왕벚나무 가지에서 종 특이적 primer (TwITSF와 TwITSR)를 사용하여 월동부위를 조사하였다. 그 결과 빗자루병에 감염된 왕벚나무의 이병가지 뿐만 아니라 건전가지에서도 종 특이적인 PCR 증폭산물이 관찰되었으며, 그 이외의 건전한 왕벚나무와 감염목 주변의 다른 식물 종 샘플에서는 PCR 증폭산물이 관찰되지 않았다.