Objective : The purpose of this study was to compare clinical and radiological outcomes of percutaneous endoscopic lumbar discectomy (PELD) and open lumbar microdiscectomy (OLM) for recurrent disc herniation. Methods : Fifty-four patients, who underwent surgery, either PELD (25 patients) or repeated OLM (29 patients), due to recurrent disc herniation at L4-5 level, were divided into two groups according to the surgical methods. Excluded were patients with sequestrated disc, calcified disc, severe neurological deficit, or instability. Clinical outcomes were assessed using Visual Analogue Scale (VAS) score and Oswestry Disability Index (ODI). Radiological variables were assessed using plain radiography and/or magnetic resonance imaging. Results : Mean operating time and hospital stay were significantly shorter in PELD group (45.8 minutes and 0.9 day, respectively) than OLM group (73.8 minutes and 3.8 days, respectively) (p < 0.001). Complications occurred in 4% in PELD group and 10.3% in OLM group in the perioperative period. At a mean follow-up duration of 34.2 months, the mean improvements of back pain, leg pain, and functional improvement were 4.0, 5.5, and 40.9% for PELD group and 2.3, 5.1, and 45.0% for OLM group, respectively. Second recurrence occurred in 4% after PELD and 10.3% after OLM. Disc height did not change after PELD, but significantly decreased after OLM (p = 0.0001). Neither sagittal rotation angle nor volume of multifidus muscle changed significantly in both groups. Conclusion : Both PELD and repeated OLM showed favorable outcomes for recurrent disc herniation, but PELD had advantages in terms of shorter operating time, hospital stay, and disc height preservation.
Objectives Bee venom acupuncture (BVA) is emerging as a potential therapeutic option for several conditions. However, evidence regarding accurate estimates of its adverse events are not available. Therefore, by combining occurrence rates of adverse events in relevant randomized controlled trials (RCTs), we have aimed to give an overall estimated rate of each adverse event following BVA intervention. Methods A systematic search for adverse events of BVA in Pubmed, Cochrane Central Register of Controlled Trials, Embase, NDSL, KoreaMed, KISS, RISS, KISTI, and KMbase was performed. For the quality assessment of the trials, we applied the CONSORT harms reporting recommendations. The overall occurrence rate of each adverse event was assessed as the primary outcome. The overall drop-out rate due to adverse events was assessed as the secondary outcome. Results Ten RCTs reported adverse events following BVA. Two RCTs were eligible of further synthesis. Adverse events of pruritus, localized edema, and erythema occurred significantly more frequently in the BVA group compared to the control group. Data of drop-outs were available in seven RCTs. However, no comparisons showed a significant difference. Conclusions Currently evidence of adverse events is far from sufficient for assessing a reliable, precise occurrence rate. Still, limited evidence shows a tendency that adverse events occur more frequently after the appliance of BVA compared to the control. Thus, we await well designed future studies of BVA with more proper and strict harms reporting methods.
Objectives The purpose of this study is to research current trends of acupuncture treatment of lumbar herniated intervertebral disc using the PubMed database. Methods We set up the search strategy and investigated clinical trials on acupuncture treatment of lumbar herniated intervertebral disc through PubMed search. This study analyzed previous researched papers published from January 1st, 2000 to April 30th, 2014, and classified them by publication year, journal names, types of literature, treatment methods and evaluation scales. To assess the quality of the reviewed literature, randomized controlled trial (RCT) studies were assessed by Cochrane's risk of bias (ROB) tool and non-RCT studies were assessed by risk of bias for non-randomized studies (RoBANS). Results We found 35 studies on the acupuncture treatment of lumbar herniated intervertebral disc. Papers on this topic have been published, on average, three to four times annually in 9 journals since the mid-2000's. The journal with the largest number of publications was Chinese Acupuncture & Moxibustion, and most of articles were classified as RCT. Acupuncture treatment was performed individually or together with other treatments. The most frequently used pain evaluation index was visual analogue scale (VAS). The index of effective rate was used frequently but there was a lack of objectivity. In regards to the quality of the studies, outcome assessment in RCT showed that random sequence generation, allocation concealment, and the blinding of participants and personnel increase potential of risk of bias. For non-RCT assessment, outcome showed that confounding variable, measurement of intervention were at high risk of bias. Conclusions In order to obtain objective clinical evidence of acupuncture treatment of lumbar herniated intervertebral disc, further clinical studies should be designed to minimize the risk of bias, using STRICTA with larger sample sizes.
PURPOSE: This study examine the effect of community ambulation training on gait, depression and self - efficacy of stroke patients in order to develop more effective training methods of community rehabilitation. METHODS: In the experimental group, community ambulation training combined with indoor and outdoor walking was performed for 30 minutes three times a week for six weeks. In the control group, general indoor walking training was performed. The physical factors were assessed by a 10-meter walking test, six-minute walking test and community gait test. Psychological factors were assessed by the Korean version of the Epidemiology Center Depression Scale and Activity-Specific Balance Confidence Scale. RESULTS: In the 10-meter walking test, the normal walking speed was significantly improved after the intervention in both the experimental group and the control group (p<.05). However, the fast walking speed was significantly improved only in the experimental group (p <.05). ln the community gait test, the experimental group showed significant improvement (p<.05), but the control group did not. Depression and self-efficacy were significantly improved in the experimental group (p<.05) but not in the control group. CONCLUSION: Community ambulation training may improve the gait ability of stroke patients and reduce their depression and improve self-efficacy.
Introduction: Tobacco use is a global health care problem. Repetitive exposure to nicotine produces neuroadaptation resulting in nicotine dependence. Smoking is associated with a range of diseases, causing high levels of morbidity and mortality and is one of the leading causes of preventable deaths, with more than 4.6 million smokers worldwide dying each year from smoking related illnesses. Stopping smoking has major health benefits. Quitting at any age provides both short and long term benefits. Materials and methods: 45 patients attending the outpatient department at the Oxford Dental College, Bangalore, were randomly allocated to three groups of interventions namely placebo, counseling and nicotine replacement therapy (NRT). Initially each one was assessed for carbon monoxide levels using a breath analyser (pico smokerlyser bedfont UK). They were followed up for six months and the carbon monoxide levels were again assessed using the same instrument. The paired t test was used to compare the results before and after the intervention. Results: The scores before the initiation of intervention and after treatment were compared and all three interventions were found to be statistically significant after six months. It was noticed that patients with very low or low dependence followed by high dependence had good response in the placebo group (68% and 47.6% respectively), in the counseling group maximum response was seen in the medium followed by the very low group (61% and 59% respectively), and maximum response was seen in very high followed by the very low group with NRT (78.7% and 60.5% respectively). Conclusion: The inference that can be drawn from the present study is that non-invasive, non pharmacological methods like placebo and counseling are effective in low to medium groups, and NRT is effective with higher nicotine dependence.
Etiz, Durmus;Ataizi, Fulya Colak;Bayman, Evrim;Akcay, Melek;Acikalin, Mustafa Fuat;Colak, Ertugrul;Ciftci, Evrim
Asian Pacific Journal of Cancer Prevention
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제14권9호
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pp.5175-5178
/
2013
Background: The prognostic value of tumor osteopontin (OPN) in patients with squamous-cell head and neck cancer (SCHNC) was investigated. Materials and Methods: OPN expression was assessed by immunohistochemical methods in 50 patients, who were treated with primary radiotherapy (RT) for locally advanced SCHNC. The effects of OPN on clinical parameters, local-regional control after RT and metastasis-free survival, was assessed. Results: The rate of OPN expression in tumor tissue was 76%. OPN positive cases had lower Hb levels (p=0.088). Mean time to local recurrence was 53.8 months (SE 3.9) in OPN-negative cases and 39.1 months (SE 4.7) in OPN-positive cases (p=0.047). OPN increased the risk of local recurrence 5.9 times (p=0.085). It had no effect on metastasis-free (p=0.116) or overall survival (p=0.123). OPN was positive in 12 of 19 cases that developed grade 3-4 acute radiation dermatitis (p=0.096). Conclusions: OPN expression is associated with an increase in local recurrence in patients who were treated with primary RT for locally advanced SCHNC.
Objectives : The purpose of this study is to review RCTs on pharmacopuncture treatment for musculoskeletal diseases and to establish standards of pharmacopuncture treatment model. Methods : We searched articles up to date of March 2009 via computerized databases of Pubmed, The Journal of Korean Acupuncture & Moxibustion, Journal of Korean institute of Herbal Acupuncture, Journal of Oriental Rehabilitation and Journal of Korean Oriental Medicine. Only Randomized Controlled Trials (RCT) concerning the effects of pharmacopuncture on musculoskeletal diseases. The pharmacopuncture treatment methods were assessed based on STRICTA and items considering the feature of pharmacopuncture. And the methodological quality of the trials was assessed by FEAS and modified Jadad score. Results : Eighteen trials of pharmacopuncture on musculoskeletal diseases were analyzed. Except for 4 trials comparing the effect of SBV and BV, positive outcome was reported in ten trials. Among eighteen trials; most of the trials were about Bee Venom acupuncture, and most of the trials used about five acupuncture points, mainly local acupuncture points. But, the amount of injection to each point and total injection were various. And most of trials were lack in the information about method of stimulation. The adjusted FEAS score ranged from 0 to 12, and modified Jadad scoreranged from 1 to 5. Conclusions: To standardize pharmacopuncture treatment, we need more well-designed, high quality clinical trials. And methodological assessment tools designed for pharmacopuncture treatment are also needed.
Kim, Jae-Hong;Kim, Ki-Baek;Kim, Woong-Chul;Kim, Ji-Hwan;Kim, Hae-Young
대한치과교정학회지
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제44권2호
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pp.69-76
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2014
Objective: This study aimed to evaluate the accuracy and precision of polyurethane (PUT) dental arch models fabricated using a three-dimensional (3D) subtractive rapid prototyping (RP) method with an intraoral scanning technique by comparing linear measurements obtained from PUT models and conventional plaster models. Methods: Ten plaster models were duplicated using a selected standard master model and conventional impression, and 10 PUT models were duplicated using the 3D subtractive RP technique with an oral scanner. Six linear measurements were evaluated in terms of x, y, and z-axes using a non-contact white light scanner. Accuracy was assessed using mean differences between two measurements, and precision was examined using four quantitative methods and the Bland-Altman graphical method. Repeatability was evaluated in terms of intra-examiner variability, and reproducibility was assessed in terms of interexaminer and inter-method variability. Results: The mean difference between plaster models and PUT models ranged from 0.07 mm to 0.33 mm. Relative measurement errors ranged from 2.2% to 7.6% and intraclass correlation coefficients ranged from 0.93 to 0.96, when comparing plaster models and PUT models. The Bland-Altman plot showed good agreement. Conclusions: The accuracy and precision of PUT dental models for evaluating the performance of oral scanner and subtractive RP technology was acceptable. Because of the recent improvements in block material and computerized numeric control milling machines, the subtractive RP method may be a good choice for dental arch models.
BACKGROUND: Cultivation of genetically modified(GM) crops rapidly has increased in the global agricultural area. Among those, herbicide resistant GM crops are reported to have occupied 89.3 million hectares in 2010. However, cultivation of GM crops in the field evoked the concern of the possibility of gene transfer from transgenic plant into soil microorganisms. In our present study, we have assessed the effects of herbicide-resistant GM Chinese cabbage on the surrounding soil microbial community. METHODS AND RESULTS: The effects of a herbicide-resistant genetically modified (GM) Chinese cabbage on the soil microbial community in its field of growth were assessed using a conventional culture technique and also culture-independent molecular methods. Three replicate field plots were planted with a single GM and four non-GM Chinese cabbages (these included a non-GM counterpart). The soils around these plants were compared using colony counting, denaturing gradient gel electrophoresis and a species diversity index assessment during the growing periods. The bacterial, fungal and actinomycetes population densities of the GM Chinese cabbage soils were found to be within the range of those of the non-GM Chinese cabbage soils. The DGGE banding patterns of the GM and non-GM soils were also similar, suggesting that the bacterial community structures were stable within a given month and were unaffected by the presence of a GM plant. The similarities of the bacterial species diversity indices were consistent with this finding. CONCLUSION: These results indicate that soil microbial communities are unaffected by the cultivation of herbicide-resistant GM Chinese cabbage within the experimental time frame.
Objectives : Hemiplegic shoulder pain is one of the common sequelae of stroke. Although many different methods of treatment are applied, none have yet been proved to be effective. In this study we assessed the effectiveness of bee venom in patients with shoulder pain after stroke. Methods : This study was a double blinded, randomized, placebo-controlled clinical trial. All subjects received either 0.6 ml bee venom injection (venom:saline = 1:10000) or 0.6ml physiological saline solution (placebo) at three acupoints. The effectiveness was assessed by visual analogue scale, pain rating score, Fugl-Meyer assessment and passive external rotation. Results : There were 24 patients in the venom group and 22 patients in the placebo group. The venom group5,hewed more effectiveness in VAS and PRS than the placebo group. Conclusions : This study suggests that bee venom injection has significant analgesic effect on hemiplegic shoulder pain. Further study based on multi-centers, larger population, and long term 1311ow-up is needed to confirm this suggestion.
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