Objective : Cases of contralateral radiculopathy after a transforaminal lumbar interbody fusion with a single cage (unilateral TLIF) had been reported, but the phenomenon has not been explained satisfactorily. The purpose of this study was to determine its incidence, causes, and risk factors. Methods : We did retrospective study with 546 patients who underwent a unilateral TLIF, and used CT and MRI to study the causes of contralateral radicular symptoms that appeared within a week postoperatively. Clinical and radiological results were compared by dividing the patients into the symptomatic group and asymptomatic group. Results : Contralateral symptoms occurred in 32 (5.9%) of the patients underwent unilateral TLIF. The most common cause of contralateral symptoms was a contralateral foraminal stenosis in 22 (68.8%), screw malposition in 4 (12.5%), newly developed herniated nucleus pulposus in 3 (9.3%), hematoma in 1 (3.1%), and unknown origin in 2 patients (6.3%). 16 (50.0%) of the 32 patients received revision surgery. There was no difference in visual analogue scale and Oswestry disability index between the two groups at discharge. Both preoperative and postoperative contralateral foraminal areas were significantly smaller, and postoperative segmental angle was significantly greater in the symptomatic group comparing to those of the asymptomatic group (p<0.05). Conclusion : The incidence rate is not likely to be small (5.9%). If unilateral TLIF is performed for cases when preoperative contralateral foraminal stenosis already exists or when a large restoration of segmental lordosis is required, the probability of developing contralateral radiculopathy is increased and caution from the surgeon is needed.
Pulmonary function tests were conducted on 815 healthy primary school children (390 males and 425 female) in rural area using Collins Survey Spirometer (Warren E. Collins, Inc., U.S.A.) with X-Y Recorder. Respiratory symptoms(cough, sputum, sore throat, chest pain, chest tightness, dyspnea, coryza) were surveyed by the interviews. Multiple regression analysis and regression diagnostics were done for prediction equations of FVC, $FEV_1,\;PEFR\;and\;FEF_{25-75%}$. FVC, $FEV_1,\;PEFR\;and\;FEF_{25-75%}$ values in 3 groups of children classified by the number of symptom were compared each other through standard variable value. FVC, $FEV_1,\;PEFR\;and\;FEF_{25-75%}$ showed highly significant correlation with age, height and weight. Prediction equations for FVC, $FEV_1,\;PEER,\;FEF_{25-75%}$ are functions of height only in both male and female children aged between 6 and 12 years old. PEFR showed a significant difference related with the number of symptom in female. These results suggest that the PEFR is sensitive PFT parameter in this study.
Background: This study is aimed to verify individual and regional-level factors affecting the depression of Koreans and to develop social programs for improving the depressive status. Methods: This study used individual-level variables from the Korean Community Health Survey (2018) and used the e-regional index of the Korean Statistical Information Service as the regional-level variable. A multi-level logistic regression was executed to identify individual and regional-level variables that were expected to affect the extent of depressive symptoms and to draw the receiver operating characteristic curve to compare the volume of impact between variables from both levels. Results: The results of the multi-level logistic regression analysis in regards to individual-level factors showed that older age, female gender, a lower income level, a lower education level, not having a spouse, the practice of walking, the consumption of breakfast higher levels of stress, and having high blood pressure or diabetes were associated with a greater increase in depressive symptoms. In terms of regional factors, areas with fewer cultural facilities and fewer car registration had higher levels of depressive symptoms. The comparison of area under the curve showed that individual factors had a greater influence than regional factors. Conclusion: This study showed that while both, individual and regional-level factors affect depression, the influence of the latter was relatively weaker as compared to the first. In this sense, it is necessary to develop programs focused on the individual, such as social prescribing at the local or community-level, rather than the city and nation-level approach that are currently prevalent.
Objective : We investigated the clinical and radiological advantages of unilateral laminectomy in posterior lumbar interbody fusion (PLIF) procedure comparing with bilateral laminectomy, under the same procedural condition including bilateral instrumentation and insertion of two cages, in patients with degenerative lumbar disease with unilateral leg symptoms. Methods : We retrospectively reviewed 124 consecutive cases of PLIF via unilateral or bilateral approach between January 2006 and April 2010. In 80 cases (bilateral group), two cages were inserted via bilateral laminectomy, and in 44 cases (unilateral group), via unilateral laminectomy. The average follow-up duration was 29.5 months. The clinical outcomes were evaluated with the Visual Analogue Scale (VAS) and the Oswestry disability index (ODI). The fusion rates and disc space heights were determined by dynamic standing radiographs and/or computed tomography. Operative times, intra-operative and post-operative blood losses and hospitalization periods were also evaluated. Results : In clinical evaluation, the VAS and ODI scores showed excellent outcomes in both groups. There were no significant differences in term of fusion rate, but the perioperative blood loss and the operative time of the unilateral group were lower than that of the bilateral group. Conclusion : Unilateral laminectomy can minimize the operative time and perioperative blood loss in PLIF procedure. However, the different preoperative disc height between two groups is a limitation of this study. Despite this limitation, solid fusion and satisfactory symptomatic improvement could be achieved uniquely by our surgical method. This surgical method can be an alternative surgical technique in patients with unilateral leg pain.
Dashti, Sareh;Latiff, Latiffah A;Hamid, Habibah Abdul;Sani, Suriani Mohamad;Akhtari-Zavare, Mehrnoosh;Bakar, Azrin Shah Abu;Inani Binti, Nur Amirah;Ismail, Maimunah;Esfehani, Ali Jafarzadeh
Asian Pacific Journal of Cancer Prevention
/
v.17
no.8
/
pp.3747-3751
/
2016
Background: Polycystic ovary syndrome (PCOS) is a combination of chronic anovulation, obesity, and hyperandrogenism and can affect sexual function in women of reproductive age. It is also associated with endometrial cancer. Our aim was to evaluate the frequency and predisposing factors of sexual dysfunction in PCOS patients. Materials and Methods: In this cross-sectional study, 16 married women with a definite diagnosis of PCOS were recruited. Sexual function was assessed in the domains of desire, arousal, lubrication, orgasm, satisfaction and pain using the female sexual function index (FSFI) questionnaire. Patients were also assessed for mental health using the depression, anxiety and stress (DASS-21) questionnaire. Presence of hirsutism was assessed using the Ferriman-Gallwey (FG) scoring system. Demographic data were obtained from patients during in-person interview. Results: Sexual dysfunction was present in 62.5% of patients with the domains of arousal and lubrication particularly affected (93.8% and 87.5%, respectively). Patients with symptoms of depression and anxiety were significantly more likely to suffer sexual dysfunction than those without these symptoms (p=0.04 and p=0.03 respectively). Patients with stress symptoms reported higher orgasm dysfunction than those without (p=0.02). No significant difference in any of the FSFI score domains was observed between patients with and without hirsutism. Conclusions: PCOS patients markedly suffer from sexual dysfunction and therefore it seems appropriate to be screened for intervention. Poor mental health conditions that may be the result of infertility or other complications of PCOS should also be considered as curable causes of sexual dysfunction in these patients.
Seo, SungChul;Cho, YongMin;Ryu, SeungHun;Lee, Seung Kil;Lee, Ji Yeon;Choung, Ji Tae
Journal of Environmental Health Sciences
/
v.39
no.4
/
pp.383-390
/
2013
Objectives: We evaluated the effects of an allergy control program on children with atopic dermatitis (AD) in five schools located within Gyeonggi-do. Methods: Based on the results of the 12-month prevalence of AD symptoms from an International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire of all students (n=2109; 1040 boys, 1069 girls) at five randomly selected schools, 227 students with AD symptoms were screened. Finally, 188 students with greater than 1 on SCORAD (SCORing Atopic Dermatitis) determined by a physician were selected. The allergy control program includes education related to allergic diseases, skin prick tests, and SCORAD evaluation, as well as keeping a daily journal to check the usage of moisturizer at least once a day. To determine the effectiveness of the allergy control program, SCORAD evaluation was performed again six weeks later. Results: The most common symptom for 12-month prevalence was rhinorrhea (33.9%), followed by atopic skin lesions (14.8%) and wheezing (4.0%). The 12-month prevalences of the three allergic diseases were higher for boys than for girls, and a significant difference was found for allergic rhinitis (P<0.001). The mean SCORAD index decreased significantly from 26.1 to 17.5 after the completion of the six-week control program (P<0.01). In particular, these differences were more pronounced for the group which used the daily journal (P<0.001). Conclusions: Our findings indicate that the allergy control program including usage of a daily journal as well as regular monitoring could be a promising tool for preventing and alleviating the symptoms of allergic diseases.
Kim, Jae Hong;Kim, Jung Ho;Cho, Sung Il;Park, Sang Hag;Kim, Sang Hoon;Choo, Il Han;Kim, Seung Gon
Korean Journal of Biological Psychiatry
/
v.22
no.1
/
pp.7-13
/
2015
Objectives The purpose of this study was to examine the psychiatric characteristics of outpatients with tinnitus. Methods A total of 88 subjects were included in this study. According to Tinnitus Handicap Inventory (THI) scores, the subjects were classified into two group ; a mild tinnitus symptoms (mild-tinnitus) group and a severe tinnitus symptoms (severe-tinnitus) group. A questionnaire was used for an assessment of demographic characteristics, and the THI, the Visual Analogue Scale (VAS) about tinnitus, the Beck Depression Inventory (BDI), and the Beck Anxiety Inventory (BAI) are applied for evaluation of other clinical psychiatric characteristics. Results Higher THI scores were positively correlated with tinnitus course, the number of accompanying symptoms, and the VAS. BDI total scores, BDI factors, and BAI total scores were significantly higher in the severe-tinnitus group than in the mild-tinnitus group. Also suicidal ideation, interpersonal problems, sleep problems, occupational impairment, and fatigue were significantly higher in the severe-tinnitus group than in the mild-tinnitus group. Conclusions Tinnitus is a common disorder of hearing which is associated frequently with psychiatric problems. This study suggests that psychiatric interventions should be taken into consideration in the treatment of patients suffering from tinnitus.
Cho, Seong Woo;Lee, Yeon Jung;Lee, Seong Ae;Hong, Minha;Lee, Sang Min;Park, Jin Cheol;Bahn, Geon Ho
Journal of the Korean Academy of Child and Adolescent Psychiatry
/
v.28
no.3
/
pp.183-189
/
2017
Objectives: The study aimed to identify the characteristics of attention-deficit hyperactivity disorder (ADHD) that was not diagnosed in childhood or adolescence, but only in adulthood. Methods: The characteristics of patients diagnosed with ADHD in adulthood were compared with those of patients diagnosed in childhood were assessed via a retrospective review of the medical records at one university hospital from 2005 to 2013. If the age at which they were confirmed as having ADHD was less than 19 years old, they were grouped as childhood-diagnosed group (CD); if they were 19 years old or more, they were grouped as adulthood-diagnosed group (AD). Results: The CD and AD included 50 (46.3%) and 58 (53.7%) patients, respectively. Inattention was the most common symptom in both groups. Behavioral and emotional problems were the second most frequent symptoms in the CD and AD, respectively. The intelligent quotient was significantly higher in the AD than in the CD. The most common comorbidity was depression in the CD and personality disorder in the AD. The most common reason for visiting the hospital was referral by acquaintances in the CD and media coverage in the AD. Conclusion: Clinicians should put ADHD on the index of suspicion when they examine adults with various psychiatric symptoms, because the diagnosis of ADHD might have been missed in childhood and the symptoms of ADHD might have changed as they grew up.
Objective : The correlation between age of onset and symptoms/severity of panic disorder has not yet been determined. The aim of this research is to determine the different clinical features of panic disorder according to the age of onset. Methods : Patients diagnosed with panic disorder were placed into two groups according to onset of age. The subjects were checked for 13 different panic symptoms presented in the DSM-IV. The investigation was also executed by severity, the anxiety sensitivity index, the scale for depression and anxiety. Results : The early onset group had significantly higher frequencies than the late onset group in the areas of "choking feeling" and "derealization or paresthesia". It was found that only "choking feeling" was statically significant as a risk factor of early onset panic disorder. Among the objective anxiety scale, the subscale of psychological anxiety was higher in the early onset group compared to the late onset group. Conclusion : "Choking feeling" was the only panic symptom that showed a significant difference in accordance with onset age. Earlier onset patients tend to experience a more frequent "choking feeling," which is related to respiratory symptoms. This could mean that earlier onset patients are more likely to have higher psychological anxiety.
Polycystic Ovarian Syndrome (PCOS) has now become more common in occurrence in women of reproductive age, particularly in urban and semi-urban population in India. So there is a need to investigate this phenomenon taking into consideration various aspects including possible treatment method to ameliorate/eradicate this syndrome, which has far reaching socio-economic impact and consequences, in view of infertility and irregular menstrual cycles frequently associated with this syndrome. Homeopathy is a branch of traditional alternative medicine which is gaining popularity in India and some other developing countries, as also in some of the developed countries in Europe. With this background scenario, we have made an attempt to treat cases of confirmed PCOS and tried to compare the relative efficacy of two potentized homeopathic drugs, namely, Lycopodium clavatum (Lyco) and Calcarea carbonica (Calc), most frequently used by homeopathic practitioners, selecting different potencies of the drugs, depending on condition/guiding symptom(s) of the patients. While the main focus was pointed on total/partial removal of cysts, data pertaining to different PCOS associated symptoms were also compared for the sake of learning if the two drugs had differential effects on these symptoms also. The study parameters in this investigation included: regularity/irregularity of menstrual cycle, presence/absence of acne, hirsutism, male type alopecia, acanthosis nigricans, body/mass index (BMI) and waist-hip ratio. Overall results provided clear evidences that both these homeopathic drugs had great ameliorating effects on PCOS, although each drug had a little different effect in respect of the individual parameters of this study.
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