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Background@#Rosacea is a chronic inflammatory facial disorder, leading to impaired skin barrier function. Many factors, including skin care habits, affect its occurrence and progress. @*Objective@#This study aimed to investigate clinical manifestation and aggravating factors of rosacea, focusing on skin care habits and lifestyle and to compare them with those of acne patients. @*Methods@#We conducted a cross-sectional survey among 222 patients with rosacea and 127 with acne who visited a university hospital and local dermatologic clinic between July 2021 and June 2022. The patients answered questionnaires consisting of information, such as demographic characteristics, clinical symptoms and signs, skin care habits, and aggravating factors. @*Results@#Age distribution of the patients with rosacea showed a peak incidence among those in their twenties, and the most common comorbidity was metabolic disease. The most common symptom and sign was itching, followed by burning sensation. Regarding skin care habits, 72.8% and 45.0% of the patients practiced excessive cleansing and double cleansing, respectively. The most frequently-used cleanser and basic cosmetic were foaming cleanser (77.5%) and toner (57.5%), respectively. Foundation was used by nearly half of the woman, many of whom used liquid type.Irregular or insufficient sleep and food were the two most common aggravating factor. When compared to patients with acne patients, those with rosacea tended to carry more systemic comorbidities and practiced double cleansing with basic cosmetics more actively. @*Conclusion@#It is important for clinicians to understand various factors affecting occurrence and aggravation of rosacea and educate patients on appropriate skin care habits and lifestyle.
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Background@#Exercise is an important method to control the progression of diabetes. Since diabetes compromises immune function and increases the risk of infectious diseases, we hypothesized that exercise may affect the risk of infection by its immunoprotective effects.However, population-based cohort studies regarding the association between exercise and the risk of infection are limited, especially regarding changes in exercise frequency. The aim of this study was to determine the association between the change in exercise frequency and the risk of infection among patients with newly diagnosed diabetes. @*Methods@#Data of 10,023 patients with newly diagnosed diabetes were extracted from the Korean National Health Insurance Service-Health Screening Cohort. Self-reported questionnaires for moderate-to-vigorous physical activity (MVPA) were used to classify changes in exercise frequency between two consecutive two-year periods of health screenings (2009–2010 and 2011–2012). The association between changes in exercise frequency and the risk of infection was evaluated using multivariable Cox proportional-hazards regression. @*Results@#Compared with engaging in ≥ 5 times of MVPA/week during both periods, a radical decrease in MVPA (from ≥ 5 times of MVPA/week to physical inactivity) was associated with a higher risk of pneumonia (adjusted hazard ratio [aHR], 1.60; 95% confidence interval [CI], 1.03–2.48) and upper respiratory tract infection (aHR, 1.15; 95% CI, 1.01–1.31). In addition, a reduction of MVPA from ≥ 5 to < 5 times of MVPA/week was associated with a higher risk of pneumonia (aHR, 1.52; 95% CI, 1.02–2.27), whereas the risk of upper respiratory tract infection was not higher. @*Conclusion@#Among patients with newly diagnosed diabetes, a reduction in exercise frequency was related to an increase in the risk of pneumonia. For patients with diabetes, a modest level of physical activity may need to be maintained to reduce the risk of pneumonia.
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Background@#Little is known about the adverse events (AEs) associated with coronavirus disease 2019 (COVID-19) vaccination in patients with type 2 diabetes mellitus (T2DM). @*Methods@#This study used vaccine AE reporting system data to investigate severe AEs among vaccinated patients with T2DM. A natural language processing algorithm was applied to identify people with and without diabetes. After 1:3 matching, we collected data for 6,829 patients with T2DM and 20,487 healthy controls. Multiple logistic regression analysis was used to calculate the odds ratio for severe AEs. @*Results@#After COVID-19 vaccination, patients with T2DM were more likely to experience eight severe AEs than controls: cerebral venous sinus thrombosis, encephalitis myelitis encephalomyelitis, Bell’s palsy, lymphadenopathy, ischemic stroke, deep vein thrombosis (DVT), thrombocytopenia (TP), and pulmonary embolism (PE). Moreover, patients with T2DM vaccinated with BNT162b2 and mRNA-1273 were more vulnerable to DVT and TP than those vaccinated with JNJ-78436735. Among patients with T2DM administered mRNA vaccines, mRNA-1273 was safer than BNT162b2 in terms of the risk of DVT and PE. @*Conclusion@#Careful monitoring of severe AEs in patients with T2DM may be necessary, especially for those related to thrombotic events and neurological dysfunctions after COVID-19 vaccination.
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Background/Aims@#While distal radial artery (DRA) access is increasingly being used for diagnostic coronary angiography, limited information is available regarding DRA size. We aimed to determine the DRA reference diameters of Korean patients and identify the predictors of DRA diameter < 2.3 mm. @*Methods@#The outer bilateral DRA diameters were assessed using a linear ultrasound probe in 1,162 consecutive patients who underwent transthoracic echocardiography. The DRA diameter was measured by the perpendicular angle in the dorsum of the hand, and the average values were compared by sex. DRA diameter < 2.3 mm was defined as unsuitable for routine diagnostic coronary angiography using a 5 Fr introducer sheath. @*Results@#The mean DRA diameters were 2.31 ± 0.43 mm (right) and 2.35 ± 0.45 mm (left). The DRA was smaller in women than men (right: 2.15 ± 0.38 mm vs. 2.43 ± 0.44 mm, p < 0.001; left: 2.18 ± 0.39 mm vs. 2.47 ± 0.45 mm, p < 0.001). The DRA diameter was approximately 20% smaller than the radial artery diameter. A total of 630 (54.2%) and 574 (49.4%) patients had DRA diameter < 2.3 mm in the right and left hands, respectively. Female sex, low body mass index (BMI), and low body surface area (BSA) were significant predictors of DRA diameter < 2.3 mm. @*Conclusions@#We provided reference DRA diameters for Korean patients. Approximately 50% of the studied patients had DRA diameter < 2.3 mm. Female sex, low BMI, and low BSA remained significant predictors of DRA diameter < 2.3 mm.
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Background/Aims@#Recently, distal radial approach (DRA), called as snuffbox approach, has gained the interest of interventional cardiologists, but there is a lack of data about the feasibility of DRA as an alternative route for primary percutaneous coronary intervention (PCI). @*Methods@#A total of 138 patients presenting with ST-elevation myocardial infarction (STEMI) in whom primary PCI via the DRA was attempted at three hospitals from October 2017 to September 2019 were analyzed. @*Results@#The success rate of snuffbox puncture in the setting of STEMI was 92.8% (128/138). Successful primary PCI via the DRA was achieved in all 128 patients. The snuffbox puncture time, defined as the time interval from local anesthesia induction to successful sheath cannulation, was 2.7 ± 1.6 minutes, and snuffbox puncture was performed within 5 minutes in 95.3% of patients. Moreover, the percentage of the puncture time in the door-to-balloon time was 3.3%. The left DRA was selected in 103 patients (80.5%), and primary PCI via the DRA was performed using a 6-Fr guiding catheter in 125 patients (97.7%). There was no major bleeding; however, there were four cases (3.1%) of access-site complications, including three cases of local hematoma (≤ 5 cm diameter) and one case of local numbness, which improved 3 months later. @*Conclusions@#In the setting of STEMI, the DRA could be a feasible alternative access route for primary PCI.
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Background@#Increasing numbers of individuals are getting tattoos in recent times; however, the possible adverse effects of tattoos performed by non-medical practitioners are often overlooked. Limited information is available regarding the actual numbers of individuals getting tattoos and the perception regarding tattoos in the general population. @*Objective@#We investigated the prevalence of tattoos and public perception of tattoos. @*Methods@#Between August and September 2019, we performed a questionnaire survey that included 1,000 individuals aged ≥20 years. @*Results@#Among the 1,000 participants in this survey, 370 (37%) had received a tattoo; the number of participants with cosmetic tattoos (68.4%) was nearly 2-fold higher than the number of participants with body tattoos (31.6%). The most common motivation for getting a tattoo was “for beauty” (44.9%), followed by “convenience of make-up” (34.1%), and “recommendation from friends or others” (14.6%). In the tattoo-related satisfaction category, information regarding injected dye-induced adverse effects, facility hygiene, and pre-allergy testing were commonly rated as unsatisfactory by respondents. Only 322 (32.2%) participants were aware that semi-permanent tattoos could not be erased. Furthermore, 780 (78.0%) participants had a negative impression regarding body tattoos, and 844 (84.4%) participants preferred to get tattoos at specialized medical institutions based on the national regulations to minimize possible tattoo-induced adverse effects. @*Conclusion@#This study confirmed that a relatively large number of individuals had received tattoos but had a negative impression regarding this procedure. Educational and institutional management for public safety are necessary owing to a lack of awareness regarding tattoos and tattoo-related safety.
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Purpose@#The Enhanced Recovery After Surgery (ERAS) protocol enhances recovery rate after laparoscopic distal gastrectomy (LDG). An ERAS protocol has been applied to most patients who underwent LDG at our center. In this study, we determined the actual compliance rate of the ERAS protocol and analyzed the risk factors for noncompliance. @*Methods@#Medical records of 1,013 patients who underwent LDG from March 2016 to December 2017 were reviewed retrospectively. The compliance group (A) included 327 patients who were discharged within four days postoperatively. The noncompliance group (B) comprised 686 patients who were not discharged within four days postoperatively. @*Results@#The compliance rate of the ERAS protocol was 32.3%. Potential compliance rate was 53.2%. Most common reasons for noncompliance were fever (n = 115) and ileus (n = 111). The 30-day emergency room visit rate was significantly lower in group A than that in group B (p = 0.006). Median age, American Society of Anesthesiologists (ASA) physical status classification, operation time, and pathologic stage were significantly higher in group B than those in group A (p < 0.001, p < 0.001, p = 0.005, and p < 0.001, respectively). Risk factors for noncompliance were ASA classification of ≥III (odds ratio [OR], 2.251; p = 0.007), age of ≥70 years (OR, 1.572; p = 0.004), operation time of ≥180 minutes (OR, 1.475; p = 0.003), and pathologic stage of ≥III (OR, 2.224; p < 0.001). @*Conclusion@#The current ERAS protocols should be applied to patients without risk factors.
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Background and Objectives@#Snoring is the most common symptom of obstructive sleep apnea (OSA) and is caused by turbulent airflow due to narrowing of the upper airways. In patients with positional OSA, a change in sleep posture from supine to lateral is known to reduce snoring and sleep apnea. This study was performed to compare changes in snoring sound intensity and formant frequencies according to sleep position.Subjects and Method A total of 19 patients (male: 18; female: 1) diagnosed with positional OSA by polysomnography (PSG) were enrolled in this study. The snoring sounds recorded during PSG were analyzed acoustically and compared according to sleep position (i.e., supine vs. lateral). @*Results@#Snoring disappeared on changing sleep position in five patients, all of whom had Apnea-Hypopnea Index (AHI) <15. In other patients, the snoring sounds tended to decrease with posture change, and the degree of decrease was inversely proportional to AHI (p=0.015) and respiratory disturbance index (RDI) (p=0.013). Formant frequencies 1, 3, and 4 (F1, F3, and F4, respectively) decreased when sleeping in the lateral position (p=0.02, 0.03, and 0.01, respectively). @*Conclusion@#In patients with positional OSA, a change in sleep posture from supine to lateral during sleep reduced the intensity and frequency of snoring sound.
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BACKGROUND@#Laser therapy can be used as an alternative treatment for onychomycosis; however, there are somelimitations to its efficacy as a single agent.@*OBJECTIVE@#To evaluate the effectiveness of combination therapy with 1,064-nm neodymium-doped yttrium aluminum garnet (Nd:YAG) laser and topical efinaconazole in onychomycosis treatment and identify factors influencing the therapeutic outcomes of combination treatment.@*METHODS@#Big toenails with onychomycosis were treated by 1,064-nm Nd:YAG laser at 4-week intervals with daily application of topical efinaconazole. Therapeutic response was assessed through onychomycosis severity index (OSI) and percentage of nail infected (PNI), and its association with a variety of factors that may affect treatment outcome was evaluated.@*RESULTS@#One hundred big toenails were included in the study and significant clinical improvements were observed after treatment (OSI improvement score = 76.68 ± 28.83, PNI improvement score = 72.37 ± 30.37). There was no difference in treatment response according to the number of laser treatments, onychomycosis clinical type, or initial severity. However, patient age was negatively correlated with clinical improvement (p = 0.019). Also, female patients had better therapeutic responses than male patients.@*CONCLUSION@#Combined treatment with Nd:YAG laser and topical efinaconazole has a significant therapeutic effect on onychomycosis. A randomized controlled trial is warranted in the future.
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PURPOSE: To evaluate the classification, diagnosis, and natural course of ophthalmoplegia associated with mitochondrial disease. MATERIALS AND METHODS: Among 372 patients with mitochondrial disease who visited our hospital between January 2006 and January 2016, 21 patients with ophthalmoplegia were retrospectively identified. Inclusion criteria included onset before 20 years of age, pigmentary retinopathy, and cardiac involvement. The 16 patients who were finally included in the study were divided into three groups according to disease type: Kearns-Sayre syndrome (KSS), KSS-like, and chronic progressive external ophthalmoplegia (CPEO). RESULTS: The prevalences of clinical findings were as follows: ptosis and retinopathy, both over 80%; myopathy, including extraocular muscles, 75%; lactic acidosis, 71%; and elevated levels of serum creatine kinase, 47%. Half of the patients had normal magnetic resonance imaging findings. A biochemical enzyme assay revealed mitochondrial respiratory chain complex I defect as the most common (50%). The prevalence of abnormal muscle findings in light or electron microscopic examinations was 50% each, while that of large-scale mitochondrial DNA (mtDNA) deletions in a gene study was 25%. We compared the KSS and KSS-like groups with the CPEO patient group, which showed pigmentary retinopathy (p < 0.001), cardiac conduction disease (p=0.013), and large-scale mtDNA deletions (p=0.038). KSS and KSS-like groups also had gastrointestinal tract disorders such as abnormal gastrointestinal motility (p=0.013) unlike the CPEO group. CONCLUSION: Patients with KSS had gastrointestinal symptoms, which may indicate another aspect of systemic involvement. The presence of large-scale mtDNA deletions was an objective diagnostic factor for KSS and a gene study may be helpful for evaluating patients with KSS.
Subject(s)
Humans , Acidosis, Lactic , Classification , Creatine Kinase , Diagnosis , DNA, Mitochondrial , Electron Transport , Enzyme Assays , Gastrointestinal Motility , Gastrointestinal Tract , Genes, vif , Kearns-Sayre Syndrome , Magnetic Resonance Imaging , Mitochondrial Diseases , Muscles , Muscular Diseases , Ophthalmoplegia , Ophthalmoplegia, Chronic Progressive External , Prevalence , Retinitis Pigmentosa , Retrospective StudiesABSTRACT
STUDY DESIGN: Retrospective study. OBJECTIVES: To evaluate changes in the adjacent segment after posterior instrumentation and fusion in thoracolumbar spinal fractures. SUMMARY OF LITERATURE REVIEW: The incidence of adjacent-segment disease is increasing as spinal surgery becomes more common. Many studies have been conducted on the risk factors for adjacent-segment changes in the lumbar spine, but few articles have been published on this topic in the thoracolumbar spine. MATERIALS AND METHODS: The records of 50 patients who received treatment from 2000 to 2013 were reviewed retrospectively. They underwent posterior instrumentation and fusion due to thoracolumbar fracture and were followed up for more than 2 years. To evaluate changes in the adjacent segment, immediate postoperative and last follow-up values of the sagittal angle, disc height, and disc angle were compared between groups divided by age (more or less than 50 years), laminectomy, and fusion levels. The Pfirrmann grade of the discs proximal and distal to the fusion level was also measured using preoperative magnetic resonance imaging. RESULTS: Thirty-six patients were male and 14 were female. The average age of the 50 patients was 45.6 years, and the mean follow-up period was 4.3 years. There were no cases of adjacent-segment disease. The mean kyphotic sagittal angle progression was 6.8° (range, −11° to 28.5°, p=0.000). The mean change of disc height of the proximal adjacent segment was 0.3 mm (range, −1.6 to 3.4 mm, p=0.013) and 0.6 mm (range, −4.1 to 5.8 mm, p=0.013) in the distal adjacent segment. Laminectomy did not make a significant difference. In the group below 50 years of age, the angle of the adjacent segment discs increased by 0.8° (range, −3.1° to 5.1°, p=0.004) at the proximal adjacent segment and by 0.5°(range, −4.8° to 2.9°, p=0.016) at the distal adjacent segment. Proximal adjacent disc height decreased as the fusion levels increased. As the preoperative Pfirrmann grade increased, degenerative changes in the proximal adjacent segment disc tended to accelerate. CONCLUSIONS: Adjacent-segment disease after lumbar fusion surgery was not found in adjacent segments of the thoracolumbar spine. This seems to be due to the anatomical characteristics of the lumbar spine, which is more flexible than the thoracolumbar vertebra. The mobile segments of the lumbar spine may account for this difference, rather than the instrumentation and fusion procedure itself.
Subject(s)
Female , Humans , Male , Follow-Up Studies , Incidence , Laminectomy , Magnetic Resonance Imaging , Retrospective Studies , Risk Factors , Spinal Fractures , SpineABSTRACT
BACKGROUND AND OBJECTIVES: The recurrence rate of patients with Graves' disease (GD) is estimated to be 50-55% after withdrawal of antithyroid drug therapy, and relapse is frequent in the first year after discontinuing the medication. Follow-up examination of these patients frequently reveals laboratory findings consistent with subclinical thyrotoxicosis in the first year after stopping the antithyroid agents. We investigated the risk of recurrence of GD among patients with resurfacing subclinical thyrotoxicosis state after remission of initial GD with antithyroid treatments. MATERIALS AND METHODS: We reviewed the patients diagnosed with GD who visited the Department of Endocrinology at two tertiary medical centers: Wonju Severance Christian Hospital and Gangneung Asan Hospital. We enrolled patients whose GD was completely treated after initial treatment with antithyroid agents who then developed subclinical thyrotoxicosis after discontinuation of antithyroid agents. RESULTS: We reviewed a total of 44 patients (29 females, 15 males; age, 48.93±18.04; range, 17-85 years). The recurrence rate was 27.3% (12/44 patients), and recurrence occurred 3 months to 12 months later resurfacing of subclinical thyrotoxicosis. Patients with recurred GD was significantly older than non-recurred patients (44.63±17.75 years vs. 58.58±15.48 years, p=0.02). Other clinical parameters measured at the time of initial diagnosis were not different between the two groups. CONCLUSION: The recurrence rate of GD in patients with resurfacing subclinical thyrotoxicosis after initial remission of the disease was less than 30%. A close monitoring is recommended in these subgroup patients, especially in older patients.
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Female , Humans , Male , Antithyroid Agents , Diagnosis , Drug Therapy , Endocrinology , Follow-Up Studies , Graves Disease , Recurrence , ThyrotoxicosisABSTRACT
BACKGROUND: Skin laser treatment has improved significantly and has become an effective treatment approach for many skin diseases while also having applications for beauty treatments. However, since skin laser transfers energy directly to the skin, the misuse of such treatment may result in permanent damage to skin tissues. OBJECTIVE: This survey of Korean adults, conducted to obtain their perspectives on and their treatment experience with skin laser treatment, will be used to determine the current status of skin laser treatment and to identify necessary changes to ensure proper and safe conduct of skin laser treatment. METHODS: From April 5th to April 12th, 2016, a survey was conducted to obtain information regarding the perspectives and the treatment experience of adults aged 20~59 years. RESULTS: Approximately 50% of the participants had experience with skin laser treatment, and among these, 24.7% had not received treatment at a dermatology clinic. Compared to treatment at a dermatology clinic, the danger of side effects was 1.7 times higher at a non-dermatology clinic, 2 times higher at a skin care shop, and 5.3 times higher at an Oriental medical clinic. Among patients who received skin laser treatment, 16.1% experienced side effects, and among these, 1 out of 4 patients visited a non-dermatologist for treatment of these side effects. CONCLUSION: The results of the survey showed that in order for the public to receive safe and effective skin laser treatment based on professional diagnosis, there is a definitive need to provide correct information to the public and to implement changes to ensure proper understanding of skin laser treatment among this population.
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Adult , Humans , Beauty , Dermatology , Diagnosis , Skin Care , Skin Diseases , SkinABSTRACT
BACKGROUND: Cosmetics can affect the skin condition profoundly, and yet no survey has been performed in Koreans visiting dermatology clinics. OBJECTIVE: To assess knowledge and consumer behavior regarding cosmetics in Koreans visiting dermatology clinics. METHODS: A questionnaire consisting of 43 questions concerning demographics and use/knowledge/selection/purchase of cosmetics was given to patients and accompanying persons who visited dermatologic clinics in university and private clinic settings. RESULTS: In total 1,015 subjects (73.2% females, mean age 32.5 years) completed the survey. Education level was college or higher in 72.8%. Thirty-one percent had been diagnosed with a skin disorder, atopic dermatitis and seborrheic dermatitis being the most frequent diagnoses (33.7% and 16.8%, respectively). The frequency of makeup/sunscreen/functional cosmetics use, amount of sunscreen use, recognition of functional cosmetics, and knowledge of shelf life were significantly correlated with level of education. Among “functional cosmetics,” whitening products were used most frequently (29.2%). Regardless of education level, 79.2% purchased cosmetics without checking ingredients, and 85.7% were unaware of the all-ingredient-labelling regulations, and yet subjects considered ingredient the most important factor when purchasing a product. CONCLUSION: Outpatient subjects in their twenties and thirties are the most knowledgeable about cosmetics in Korea.
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Female , Humans , Consumer Behavior , Demography , Dermatitis, Atopic , Dermatitis, Seborrheic , Dermatology , Diagnosis , Education , Korea , Outpatients , Skin , Skin Care , Social Control, FormalABSTRACT
Gallbladder cancer (GBC) is the most common primary hepatobiliary carcinoma and the sixth most common gastrointestinal malignancy. Adenocarcinoma accounts for the vast majority of GBCs (80–95%), whereas squamous cell carcinoma constitutes only 0–3.3% of GBCs. A 69-year-old man was suspected to have GBC with a cholecystoduodenal fistula on an abdominal computed tomography scan. He underwent esophagogastroduodenoscopy, which revealed that the duodenum was obstructed by the mass. Duodenal and biliary stents were successfully placed using endoscopic retrograde cholangiopancreatography. Pathology obtained from the duodenum revealed the mass to be a squamous cell carcinoma.
Subject(s)
Aged , Humans , Adenocarcinoma , Carcinoma, Squamous Cell , Cholangiopancreatography, Endoscopic Retrograde , Duodenum , Endoscopy, Digestive System , Epithelial Cells , Gallbladder Neoplasms , Gallbladder , Intestinal Fistula , Pathology , StentsABSTRACT
A bent lighted stylet has demonstrated effectiveness for intubating patients with difficult airways. We report a case of successful intubation using a lighted stylet that was bent to configure the upper airway passage in a patient with ankylosis of the temporo-mandibualr joint and a small inter-incisor gap with diffuse submandibular abscesses. We suppose that lighted stylets with different bends can be used in difficult airway cases. The usefulness of a bent lighted stylet to fit the upper airway passage needs further evaluation for additional clinical application.
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Humans , Abscess , Ankylosis , Decompression Sickness , Intubation , Intubation, Intratracheal , Joints , Temporomandibular JointABSTRACT
OBJECTIVES: In this study, the authors evaluated the correlation between levels of serum lipid, homocysteine, and folate with volumes of hippocampus, amygdala, corpus callosum, and in patients with amnestic mild cognitive impairment (aMCI) or Alzheimer's disease (AD) type. METHODS: The study recruited patients who visited the dementia clinic of Haeundae Paik Hospital in Korea between March 2010 and June 2014. Among those, patients who had taken the neurocognitive test, brain magnetic resonance imaing, tests for serum lipid, homocysteine, folate, and apolipoprotein E (APOE) genotyping and diagnosed with aMCI or AD were included for analysis. Bilateral hippocampus, entorhinal cortex, amygdala and corpus callosum were selected for region of interest (ROI). The cross-sectional relationships between serum lipid, homocysteine, folate and ROI were assessed by partial correlation analysis and multiple linear regression analysis. RESULTS: In patients with aMCI, old age (> 80) and APOE epsilon4 carrier were associated with AD [odds ration (OR) : 12.80 ; 95% confidence interval (CI) : 2.25-72.98 and OR : 4.48 ; 95% CI : 1.58-12.67, respectively]. In patients with aMCI or AD, volumes and thickness of ROI were inversely correlated with levels of serum lipid and homocysteine. In multiple linear regression analyses, higher total cholesterol level was related to lower left, right hippocampus volume and left amygdala volume ; higher low-density lipoprotein cholesterol was related to lower right entorhinal cortex thickness ; higher homocysteine level was related to lower corpus callosum volume. CONCLUSIONS: Higher serum lipid and homocysteine levels are associated with decreased volume of hippocampus, amygdala, corpus callosum and entorhinal cortex thickness in patients with aMCI or AD. These findings suggest that serum lipid and homocysteine levels are associated with AD as a modifiable risk factor.
Subject(s)
Humans , Alzheimer Disease , Amygdala , Apolipoproteins , Apolipoproteins E , Brain , Cholesterol , Corpus Callosum , Dementia , Entorhinal Cortex , Folic Acid , Hippocampus , Homocysteine , Korea , Linear Models , Lipoproteins , Cognitive Dysfunction , Risk FactorsABSTRACT
STUDY DESIGN: A retrospective study on the outcomes of surgical treatment for degenerative lumbar spinal disease. OBJECTIVES: To evaluate the pre-operative paravertebral muscle condition as a predictive factor in patients with degenerative lumbar spinal disease who undergo surgery. SUMMARY OF LITERATURE REVIEW: Previous studies have reported that the atrophy of the paravertebral muscle is associated with chronic low back pain. However, few studies have reported on the relationship of the pre-operative paravertebral muscle status with the postoperative functional disability scale. MATERIALS AND METHODS: In this study, we reviewed the history of 20 patients with degenerative lumbar spinal disease treated by decompression and posterior lumbar interbody fusion with posterior instrumentation between 2010 and 2011. The evaluation included the paravertebral muscle volume, fat infiltration on magnetic resonance imaging (MRI), preoperative lumbar lordosis, levels operated on, and the Oswestry Disability Index (ODI). Further, the inter-relationship of the pre-operative paravertebral muscle status, lumbar lordosis, and levels operated on with the post-operative ODI was analyzed. RESULTS: The mean cross-sectional area (CSA) of the paravertebral muscle at the L3-4 and L4-5 levels was 21.9+/-3.4 cm2 and 21.4+/-3.3 cm2, respectively. The mean pre- and post-operative lumbar lordotic angle was 41.0+/-17.5degrees, and 42.3+/-11.1degrees, respectively. The lumbar lordotic angle and the levels operated on were not correlated with the post-operative ODI. However, the CSA of the paravertebral muscle at the L3-4 (r=-0.582, p<0.01) and L4-5 (r=-0.568, p<0.01) levels showed a negative correlation with the post-operative ODI. The levels operated on showed a positive correlation with the post-operative ODI (r=0.420, p<0.01). CONCLUSIONS: The mean CSA of the paravertebral muscle and the levels operated on in patients with degenerative lumbar spinal disease have a significant correlation with the post-operative clinical outcome.