• Title/Summary/Keyword: duration of illness

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Anterior Interbody Grafting and Instrumentation for Advanced Spondylodiscitis

  • Lim, Jae-Kwan;Kim, Sung-Min;Jo, Dae-Jean;Lee, Tae-One
    • Journal of Korean Neurosurgical Society
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    • v.43 no.1
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    • pp.5-10
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    • 2008
  • Objective : To evaluate the surgical outcomes of ventral interbody grafting and anterior or posterior spinal instrumentation for the treatment of advanced spondylodiscitis with patients who had failed medical management. Methods : A total of 28 patients were evaluated for associated medical illness, detected pathogen, level of involved spine, and perioperative complications. Radiological evaluation including the rate of bony union, segmental Cobb angle, graft- and instrumentation-related complications, and clinical outcomes by mean Frankel scale and VAS score were performed. Results : There are 14 pyogenic spondylodiscitis, 6 postoperative spondylodiscitis, and 8 tuberculous spondylodiscitis. There were 21 males and 7 females. Mean age was 51 years, with a range from 18 to 77. Mean follow-up period was 10.9 months. Associated medical illnesses were 6 diabetes, 3 pulmonary tuberculosis, and 4 chronic liver diseases. Staphylococcus was the most common pathogen isolated (25%), and Mycobacterium tuberculosis was found in 18% of the patients. Operative approaches, either anterior or posterior spinal instrumentation, were done simultaneously or delayed after anterior aggressive debridement, neural decompression, and structural interbody bone grafting. All patients with neurological deficits improved after operation, except only one who died from aggravation as military tuberculosis. Mean Frankel scale was changed from $3.78{\pm}0.78$ preoperatively to $4.78{\pm}0.35$ at final follow up and mean VAS score was improved from $7.43{\pm}0.54$ to $2.07{\pm}1.12$. Solid bone fusion was obtained in all patients except only one patient who died. There was no need for prolongation of duration of antibiotics and no evidence of secondary infection owing to spinal instrumentations. Conclusion : According to these results, debridement and anterior column reconstruction with ventral interbody grafting and instrumentation is effective and safe in patients who had failed medical management and neurological deficits in advanced spondylodiscitis.

A study on Allergic Rhrnitis (알레르기성 비염의 임상적(臨床的) 연구(硏究))

  • Lee Hai-Ja;Park Eun-Jeong
    • The Journal of Pediatrics of Korean Medicine
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    • v.15 no.2
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    • pp.167-175
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    • 2001
  • Background : Allergic rhinitis is found in approximately 20% of the general population. And the prevalence of allergic rhinitis in the pediatric population also appears to be rising. Despite allergic rhinitis reportedly occurs very frequently, this disease is often overlooked or undertreated. The oriental medicine, allergic rhinitis is belong to the BiGu, BunChe. The symptoms are watery rhinorrhea, sneezing and nasal obstruction. The cause of disease is the weak of lung, spleen and kidney, and invasion in to nasal cavity of Poong Han etc a wrong air. Objective : To allergic rhinitis patients, we use herbal medicine and acupuncture treated. To demonstrate the effect of oriental medicine therapy in the allergic rhinitis before and after treatment. Materials and methods: Thirty five patients (18 male and 17 female) treated in our hospital between February 2001 and October 2001 were studied. Ages ranged from 10 to 56 years (mean age : 27 years). Seventy seven patients had a underlying family history (allergy or sinusitis of parents or brothers). In the past history, 63% patients have atopic disease. Illness period was from 1 month to 20 years (mean period : 5.7 year). Mean duration of treatment were 39 days. Gamihyunggyeyungyo-tang was administered mainly. Result : The symptoms of allergic rhinitis were nasal obstruction(94%), rhinorrhea(86%), itching(80%), sneezing(60%), eye itching(17%), headache(11%), nose bleeding(8%) and nose pain(6%). Compared with before and after treatment, the fourth symptoms of allergic rhinitis - sneezing, rhinorrhea, nasal obstruction and itching- improved significant statistically. (significant <0.005) Conclusion : We know that herbal medicine therapy and acupuncture were the effective treatment of Allergic rhinitis.

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Psychophysiologic States of Insomnia Patients -Pre-Sleep Arousal, Self Efficacy, Sleep Hygiene Awareness and Practice, Depression, and Anxiety- (불면증 환자의 정신생리 상태 -수면 직전 각성 정도, 자기 효율 정도, 수면 위생, 불안과 우울 정도-)

  • Oh, Kang-Seob;Lee, So-Hee;Lee, Si-Hyung
    • Sleep Medicine and Psychophysiology
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    • v.2 no.1
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    • pp.82-90
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    • 1995
  • Objectives : Insomnia is significantly influenced by the pre-sleep arousal, self efficacy, sleep hygiene, depression and anxiety. The authors tried to explore how these factors are related with the clinical features of sleep. Methods : Fifty three patients diagnosed as insomnia by DSM-IV criteria were studied. They filled up the pre-sleep arousal scale(PSAS), sleep efficacy scale(SES), sleep hygiene awareness and practice scale, BDI, and state and trait anxiety scales. Results: 1) The mean values of sleep-related variables were as follows : Sleep latency,136.89 minutes ; frequences of awakening during a night, 2.28 ; minutes to get back to sleep, 42.70 ; total sleep time, 180.19 minutes ; duration of illness, 72.00 months. 2) The mean scores of scales were as follows : PSAS(cognitive), 22.40 ; PSAS(somatic), 17.32 ; SES, 20.16 ; sleep hygiene knowledge, 25.96 ; caffein knowledge, 59.78 ; sleep hygiene practice, 42.12 ; BDI. 18.2 ; state anxiety, 41.24 ; trait anxiety ; 44.50. 3) In the subjects with superimposed depression, the mean frequency of awakening during a night and the mean pre-sleep arousal scale score were higher than in those without depression. 4) Frequency of awakening were correlated positively with a PSAS(a tight tense feeling in your muscle) and sleep hygiene awareness. PSAS(cognitive) were correlated positively with a PSAS(somatic). BDI correlated positively with a PSAS item(a jittery, nervous feeling in your body)and a SES item (not allow a poor night's sleep to interfere with daily activities). Anxiety scales were correlated positively with sleep hygiene practice scale sleep, and PSAS were correlated negatively with SES. Conclusions : The mean scores of PSAS, SES, sleep hygiene awareness and practice scale, BDI, state and trait anxiety scales of insomniacs were correlated either positively or negatively in insomnia patients. These factors seem to contribute to the development and maintainence of insomnia.

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Long-Term Treatment Response to Lithium and Valproate in Patients with Bipolar 1 Disorder Treated More Than 2 Years : A Retrospective Study (1형 양극성 장애 환자에서 리튬과 발프로산의 장기간 치료 효과에 대한 후향적 평가 : 2년 이상 치료받은 환자의 효과 비교)

  • Ahn, Sung Woo;Yang, So-Yung;Choi, Yujin;Hong, Kyung Sue
    • Korean Journal of Biological Psychiatry
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    • v.23 no.4
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    • pp.185-192
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    • 2016
  • Objectives Treatment response of bipolar disorders (BDs) to long-term mood stabilizers maintenance has not been well explored because of complicated clinical and treatment courses. This study aims at investigating long-term clinical response of BDs to lithium and/or valproate in a naturalistic setting of a tertiary-care university-affiliated hospital. Methods Subjects were 65 patients with bipolar I (BD-I) disorders who had been treated with lithium and/or valproate for more than two years at single bipolar disorder clinic. Long-term response to the best treatment based on treatment algorithms and the current clinical standard of care was retrospectively evaluated using the Alda Scale and the Clinical Global Impression Scale for use in bi-polar illness (CGI-BP). Patients were classified into full responder and partial/non responder groups based on the total score of the Alda Scale with the cut-off score generated from the frequentist mixture analysis of the authors' previous study. Results The mean duration of treatment with the index medication was 69.2 months. Baseline demographic and clinical characteristics were not different among three mood stabilizer groups (valproate, lithium, and combination groups). Twenty-one subjects were classified into full responder group (32.3%). Treatment response assessed by the Alda Scale and CGI-BP scores was not different between lithium and valproate groups. The Alda Scale scores were well correlated with the CGI-BP scores (p < 0.05). Conclusions One third of the patients showed a full response to the long-term lithium and/or valproate treatment in BD-I. The degree of response was similar between lithium and valproate groups.

A Clinical Study of Thyroid Diseases (갑상선 질환에 관한 임상적 관찰)

  • Min Byoung-Sam;Nam Young-Soo;Park Chan-Heun;Pai Soo-Tong
    • Korean Journal of Head & Neck Oncology
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    • v.10 no.2
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    • pp.112-121
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    • 1994
  • During the 7 years period from March 1987 to Febrary 1994, 344 patients with thyroid nodules, were admitted and operated at Department of Surgery, Collage of Medicine, Hallym university. We obtained following results: 1) The thyroid nodules were prevalent in female with ratio 1:17.1, both benign and malignant nodules were prevalent in the forth decade(37.8%:25.8%). 2) The duration of illness within 6 months was most common: 47.1% and within 1 years was 66.6%. 3) The most prominent symptoms & sign were palpable mass in anterior neck(96.8%). 4) The right-sided thyroid nodules were most common. 5) Thyroid scaning and thyroid function test were found to be not much value in differentiating malignancy. 6) Accuracy of the fine needle aspiration cytology was 75.5%. 7) There were 251 cases(73.0%) of benign and 93 cases(27.0%) of malignant nodules: most frequent benign nodule was adenomatous goiter(67.7%) and the most frequent malignant nodule was papillary adenocarcinoma (86.0%). 8) The most commonly performed surgical procedure was unilateral lobectomy with isthmectomy in both benign(41.0%) and malignant(33.3%). 9) Postoperative complications are as follows: transient hypothyroidism 22cases, transient hoaseness 16 cases, hypothyroidism 6 cases, wound infection 4 cases, hematoma 3 cases, permanent hoaseness 2 cases.

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Review of Clinical Studies for Herbal Medicine Treatment on Acute Leukemia - Focusing on Studies from the China Academic Journal (CAJ) - (중의학 데이터베이스 (CAJ)를 이용한 급성백혈병의 한약치료에 대한 임상 연구 동향)

  • Kim, Jeong Eun;Jang, Jin Woo;Park, Beom Chan;Kim, Ki Bong;Cheon, Jin Hong
    • The Journal of Pediatrics of Korean Medicine
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    • v.35 no.1
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    • pp.48-62
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    • 2021
  • Objectives The purpose of this study is to obtain knowledge from clinical studies conducted in China to examine the effectiveness of herb medicine in childhood acute leukemia. Methods We searched the randomized controlled trials (RCTs) with herbal medicine treatment on childhood acute leukemia from the 'CAJ', Chinese Academic Journal from China National Knowledge Infrastructure (CNKI). And then, demographic data, duration of illness, intervention, treatment period, outcome, adverse events, and composition of herbal medicine were analyzed for this study. Result 10 RCT studies were selected and analyzed. The control group were given western medicine therapy, the treatment group was given herbal medicine on the basis of the control group. The most commonly used herbal medicine were 淸熱解毒藥, 補氣藥, 補陰藥, 活血祛瘀藥 in 'boosting vital force and driving out evil spirit (扶正祛邪)' way to 'relieve heat (熱毒)' and 'assist the vital force (正氣)'. In the treatment group, complete remission was significantly higher than control group and the decrease in TCM syndrome scores also showed significant effects. Adverse events were significantly lower in the treatment group. Conclusions Herbal medicine treatment on childhood acute leukemia can be suggested as a new treatment for children who have less response to the conventional therapy, and can supplement the limitations of the western medicine by increasing complete remission and reducing adverse events.

Review of Recent Clinical Research for Oral Herbal Medicine Treatment on Primary Hyperhidrosis in Children - Focused on Chinese Randomized Controlled Trials - (소아 일차성 다한증의 경구 한약치료에 대한 중의학 임상연구 동향 - 중국 무작위 대조군 임상연구를 중심으로 -)

  • Choil, Il Shin;Kim, Ki Bong;Cheon, Jin Hong
    • The Journal of Pediatrics of Korean Medicine
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    • v.36 no.3
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    • pp.75-86
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    • 2022
  • Objectives The purpose of the study is to review the trend of clinical trials conducted in China with oral herbal medicine treatment on childhood primary hyperhidrosis. Methods We searched the randomized controlled trials (RCTs) with oral herbal medicine treatment on childhood primary hyperhidrosis from the China National Knowledge Infrastructure (CNKI). The demographic data, duration of illness, intervention, treatment period, outcome and composition of herbal medicine were analyzed for this study. Results A total of five RCTs were selected and analyzed. The effectiveness of the oral administration of herbal medicines on childhood primary hyperhidrosis was found to be significant. In one study, there was no statistical difference between the treatment group and the control group when curative effect was evaluated two weeks after the intervention; however, the treatment group showed a statistically higher curative effect than the control group at one and two months after intervention, and also one month after the intervention was terminated. Conclusions Oral herbal medicine has been shown to be an effective treatment for childhood primary hyperhidrosis, and it takes at least one month for the administered oral herbal medicines to take effect. However, further well-designed large-scale randomized controlled trials are needed to confirm the efficacy and safety of oral herbal medicines in childhood primary hyperhidrosis.

Proposal on the Diagnostic Criteria of Definite Isolated Otolith Dysfunction

  • Park, Han Gyeol;Lee, Jun Ho;Oh, Seung Ha;Park, Moo Kyun;Suh, Myung-Whan
    • Journal of Audiology & Otology
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    • v.23 no.2
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    • pp.103-111
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    • 2019
  • Background and Objectives: Dizzy patients with abnormal otolith function tests, despite a normal caloric response, are defined as having specific (isolated) otolith organ dysfunction. This study was performed to compare the differences in clinical presentation between isolated otolith dysfunction (iOD) patients with lab- and Sx-based iOD group and lab-based iOD symptoms. Subjects and Methods: The medical records of 23 iOD patients with normal caloric response but abnormal cervical vestibular evoked myogenic potential (VEMP), ocular VEMP, or subjective visual vertical were reviewed. Non-spinning vertigo was considered as otolith-related symptoms. The patients' age, onset of dizziness, Numeric Rating Scale on the severity of dizziness, and concomitant vestibular disorders were analyzed. Results: Patients in the lab-based iOD group were significantly older than those in the lab- and Sx-based iOD group. Known vestibular disorders were significantly more common in the lab-based iOD group (83.3%) compared to the lab- and Sx-based iOD group (18.2%). Despite the normal caloric response, catch-up saccade was found in the video head impulse test in more than half (54.5%) of the lab-based iOD group patients. There was no catch-up saccade in the lab- and Sx-based iOD group. There were no significant differences in gender ratio, frequency of dizziness attacks, and duration of illness. Conclusions: We propose new definitions of definite iOD (lab- and Sx-based iOD) and probable iOD (lab- or Sx-based iOD). These new definitions may help researchers to identify patients who are more likely to have true iOD, and facilitate comparisons of results between different studies.

Proposal on the Diagnostic Criteria of Definite Isolated Otolith Dysfunction

  • Park, Han Gyeol;Lee, Jun Ho;Oh, Seung Ha;Park, Moo Kyun;Suh, Myung-Whan
    • Korean Journal of Audiology
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    • v.23 no.2
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    • pp.103-111
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    • 2019
  • Background and Objectives: Dizzy patients with abnormal otolith function tests, despite a normal caloric response, are defined as having specific (isolated) otolith organ dysfunction. This study was performed to compare the differences in clinical presentation between isolated otolith dysfunction (iOD) patients with lab- and Sx-based iOD group and lab-based iOD symptoms. Subjects and Methods: The medical records of 23 iOD patients with normal caloric response but abnormal cervical vestibular evoked myogenic potential (VEMP), ocular VEMP, or subjective visual vertical were reviewed. Non-spinning vertigo was considered as otolith-related symptoms. The patients' age, onset of dizziness, Numeric Rating Scale on the severity of dizziness, and concomitant vestibular disorders were analyzed. Results: Patients in the lab-based iOD group were significantly older than those in the lab- and Sx-based iOD group. Known vestibular disorders were significantly more common in the lab-based iOD group (83.3%) compared to the lab- and Sx-based iOD group (18.2%). Despite the normal caloric response, catch-up saccade was found in the video head impulse test in more than half (54.5%) of the lab-based iOD group patients. There was no catch-up saccade in the lab- and Sx-based iOD group. There were no significant differences in gender ratio, frequency of dizziness attacks, and duration of illness. Conclusions: We propose new definitions of definite iOD (lab- and Sx-based iOD) and probable iOD (lab- or Sx-based iOD). These new definitions may help researchers to identify patients who are more likely to have true iOD, and facilitate comparisons of results between different studies.

A Study of the Relationship of Self-Efficacy, Knowledge, and Self-Care Behavior to Metabolic Level in Patients with NIDDM (인슐린 비의존성 당뇨환자의 자기효능, 지식, 자기간호행위와 대사조절간의 관계)

  • Lee Sook-Hee
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.10 no.2
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    • pp.171-180
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    • 2003
  • Purpose: The purpose of this study was to investigate the relationship of self-efficacy, knowledge about the disease, and self-care behavior to the metabolic level in patients with NIDDM. Method: Data were collected from March 15 to April 15, 2001. Participants in the study were 48 patients with NIDDM who were seen regularly at the endocrinology out-patient department of Gwangju Christian Hospital. The data were collected through individual interviews and patient blood samples. The data were analyzed with SPSS/PC+, using t-test, ANOVA, Pearson correlation coefficients and Cronbach's Alpha. Result: 1. The mean score for self-efficacy was $71.37{\pm}15.56$, knowledge $15.00{\pm}2.84$, self-care behavior $63.18{\pm}13.10$. The mean score for HbAlc level was $7.66{\pm}1.77%$, HDL cholesterol level, $46.22{\pm}13.04 mg/dl$ and total cholesterol level, $187.93{\pm}41.45 mg/dl$. 2. There was a significant difference between patients with a spouse and those without one (t=-2.08, p=0.042), in knowledge according to level of obesity (t=5.14, p=0.010), duration of illness (t=3.22, p=0.031) and presence of complications related to diabetes (t=-2.58, p= 0.013). There were no significant differences in self-care behavior, but there were significant differences in sugar metabolic level according to sex (t=-2.02, p=0.050). 3. The correlation between diabetic patients' self-efficacy, knowledge and self-care behaviour and metabolic control was significantly related only to self-efficacy and self-care behavior (r=.692, p=0.000). Conclusion: It is necessary to improve self-efficacy, knowledge, and self-care behavior for patients with NIDDM by using nursing intervention programs to promote and maintain metabolic control.

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