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2.
Article | WPRIM | ID: wpr-832870

ABSTRACT

Purpose@#This study aimed to identify independent predictors of favorable outcomes associated with emergent carotid artery stenting (CAS) in patients with acute anterior circulation stroke. @*Materials and Methods@#This study included 93 patients with acute stroke who underwent emergent CAS to treat stenoocclusive lesions in the cervical internal carotid artery (ICA) within 6 hours of the onset of the associated symptoms. Data were compared between patients with and without favorable outcomes. The independent predictors of a favorable outcome were determined via logistic regression analysis (modified Rankin Scale 0–2 at 90 days). @*Results@#Intracranial tandem occlusion was noted in 81.7% of patients (76/93) among which (76/93), 55 of whom underwent intracranial recanalization therapy. Intracranial reperfusion was successful in 74.2% (69/93) and favorable outcomes were noted in 51.6% of patients (48/93). The mortality rate was 6.5% (6/93). In logistic regression analysis, diffusion-weighted imaging-Alberta Stroke Program Early CT Score [odds ratio (OR), 1.487; 95% confidence interval (CI), 1.018–2.173, p = 0.04], successful reperfusion (OR, 5.199; 95% CI, 1.566–17.265, p = 0.007), and parenchymal hemorrhage (OR, 0.042; 95% CI, 0.003–0.522, p = 0.014) were independently associated with a favorable outcome. @*Conclusion@#Baseline infarct size, reperfusion status, and parenchymal hemorrhage were independent predictors of favorable outcomes after emergent CAS to treat stenoocclusive lesions in the cervical ICA in patients with acute anterior circulation stroke.

3.
Article in English | WPRIM | ID: wpr-915015

ABSTRACT

Periventricular nodular heterotopia (PNH) is a malformation of cortical development in which normal neurons inappropriately cluster in periventricular areas. Patients with Mowat–Wilson syndrome (MWS) typically present with facial gestalt, complex neurologic problems (e.g., severe developmental delay with marked speech impairment and epilepsy), and multiple anomalies (e.g., Hirschsprung disease, urogenital anomalies, congenital heart defects, eye anomalies, and agenesis of the corpus callosum [CC]). MWS is mostly caused by haploinsufficiency of the gene encoding zinc-finger E-box-binding homeobox 2 (ZEB2) due to premature stops or large deletions. We present a case report of a 9-year-old girl with PNH, drug-responsive epilepsy, severe intellectual disability, and facial dysmorphisms only in whom we performed whole-exome sequencing and found a de novo heterozygous missense mutation (c.3134A>C; p.His1045Pro) of ZEB2 (NM_014795.3; NP_055610.1). This mild case of MWS caused by a rare novel missense mutation of ZEB2 represents the first report of MWS with isolated PNH.

4.
Article in Korean | WPRIM | ID: wpr-916815

ABSTRACT

PURPOSE@#To evaluate the neural mechanism of second language processing in Korean-English bilingual children using functional MRI (fMRI).@*MATERIALS AND METHODS@#The study was conducted on 20 Korean elementary school children who were learning English as a foreign language. fMRI was performed during short-passage comprehension tasks in Korean and English languages. We analyzed which brain areas were activated according to the language, English proficiency, and task difficulty.@*RESULTS@#Higher activities were observed in the dorsolateral prefrontal cortex, supplementary motor area, precentral gyrus, left basal ganglia, and left temporoparietal and occipital lobes during English comprehension than during Korean comprehension. The low English proficiency group showed higher activities than the high English proficiency group in the frontotemporal cortex, including the prefrontal cortex. Higher activities were observed in the right inferior frontal gyrus and right temporoparietal lobe during the English comprehension task of intermediate difficulty compared to that of low difficulty. However, the brain activities significantly decreased while performing a high-difficulty English task.@*CONCLUSION@#Brain activities significantly increased during English comprehension in the lower English proficiency group while performing an intermediate-difficulty task. However, brain activation decreased when the task difficulty exceeded the moderate comprehension level. These results suggest that a proper level of education is important to learn a second language.

5.
Journal of Stroke ; : 97-103, 2017.
Article in English | WPRIM | ID: wpr-121538

ABSTRACT

BACKGROUND AND PURPOSE: Predictive factors associated with stent-retriever thrombectomy for patients with acute anterior circulation stroke remain to be elucidated. This study aimed to investigate clinical and procedural factors predictive of good outcome and mortality after stent-retriever thrombectomy in a large cohort of patients with acute anterior circulation stroke. METHODS: We analyzed clinical and procedural data in 335 patients with acute anterior circulation stroke treated with stent-retriever thrombectomy. A good outcome was defined as a modified Rankin Scale score of 0 to 2 at 3 months. The associations between clinical, imaging, and procedural factors and good outcome and mortality, respectively, were evaluated using logistic regression analysis. RESULTS: Using multivariate analysis, age (odds ratio [OR], 0.965; 95% confidence interval [CI], 0.944-0.986; P=0.001), successful revascularization (OR, 4.658; 95% CI, 2.240-9.689; P<0.001), parenchymal hemorrhage (OR, 0.150; 95% CI, 0.049-0.460; P=0.001), and baseline NIHSS score (OR, 0.908; 95% CI, 0.855-0.965; P=0.002) were independent predictors of good outcome. Independent predictors of mortality were age (OR, 1.043; 95% CI, 1.002-1.086; P=0.041), successful revascularization (OR, 0.171; 95% CI, 0.079-0.370; P<0.001), parenchymal hemorrhage (OR, 2.961; 95% CI, 1.059-8.276; P=0.038), and a history of previous stroke/TIA (OR, 3.124; 95% CI, 1.340-7.281; P=0.008). CONCLUSIONS: Age, revascularization status, and parenchymal hemorrhage are independent predictors of both good outcome and mortality after stent retriever thrombectomy for acute anterior circulation stroke. In addition, NIHSS score on admission is independently associated with good outcome, whereas a history of previous stroke is independently associated with mortality.


Subject(s)
Brain Infarction , Cohort Studies , Hemorrhage , Humans , Logistic Models , Mortality , Multivariate Analysis , Prognosis , Stents , Stroke , Thrombectomy
6.
Article in English | WPRIM | ID: wpr-166337

ABSTRACT

PURPOSE: A limited number of studies have examined the link between F-wave abnormalities and clinical presentation in pediatric Guillain-Barré syndrome (GBS). Therefore, this study examined the importance of F-wave abnormalities as a prognostic factor in pediatric GBS patients. METHODS: The records and electrodiagnostic studies (EDS) of 70 GBS patients were retrospectively evaluated, and divided into 2 groups according to the results of EDS. Group A (n=33) presented with F-wave abnormalities, and group B (n=26) exhibited normal findings. We compared laboratory reports, clinical features, response to treatment, and prognosis between the 2 groups. RESULTS: Motor weakness was the most frequently observed symptom for either group. Clinically, the incidence of fever and upper respiratory symptoms differed between the 2 groups, while the prevalence of abnormal deep tendon reflex (DTR) was significantly higher in group A than B (P<0.05). Patients diagnosed with GBS had received intravenous immunoglobulin treatment: 94% in group A and 58% in group B. Furthermore, significantly greater numbers of patients in group A showed H-reflex abnormalities and poor prognosis compared with group B (P<0.05). CONCLUSION: This study demonstrated that F-waves are a clinically important prognostic factor in GBS. F-wave abnormalities were associated with abnormal DTR and poor prognosis in patients. Limited studies have examined the link between F-wave abnormalities and clinical results; therefore, further randomized controlled studies are needed to confirm the clinical characteristics and efficacy of treatments.


Subject(s)
Child , Fever , Guillain-Barre Syndrome , H-Reflex , Humans , Immunoglobulins , Incidence , Prevalence , Prognosis , Reflex, Abnormal , Retrospective Studies
7.
Article in English | WPRIM | ID: wpr-44148

ABSTRACT

Chlorfenapyr is a widely used, moderately hazardous pesticide. Previous reports have indicated that chlorfenapyr intoxication can be fatal in humans. We reported the first non-fatal case of chlorfenapyr-induced toxic leukoencephalopathy in a 44-year-old female with resolution of extensive and abnormal signal intensities in white matter tracts throughout the brain, brain stem, and spinal cord on serial magnetic resonance imaging.


Subject(s)
Adult , Brain/diagnostic imaging , Brain Stem/diagnostic imaging , Female , Humans , Insecticides/toxicity , Leukoencephalopathies/etiology , Magnetic Resonance Imaging , Pyrethrins/toxicity , Spinal Cord/diagnostic imaging , White Matter/diagnostic imaging
8.
Article in Korean | WPRIM | ID: wpr-89916

ABSTRACT

BACKGROUND: Rotavirus is the most common cause of severe gastroenteritis in children <5 years of age. The first vaccine, RotaShield was developed, but withdrawn because of its association with increased risk of intussusception. Then, RotaTeq and Rotarix were developed. Although in pre-licensure studies, they were not associated with an increased risk of intussusceptions, in recent studies, it has been controversial. Regarding increased risk of intussusception, we studied the difference in the age of intussusception after rotavirus vaccination. METHODS: A retrospective analysis was conducted on 136 patients diagnosed with intussusception at Yeungnam University Medical Center for 4 years in the pre-vaccination period (group A) and in the post vaccination period (group B). Sex, mean age and age distribution of intussusceptions were compared according to the type of rotavirus vaccine (group B-1, RotaTeq; group B-2, Rotarix). RESULTS: The median ages of group A and group B were 18.8+/-19.6 months and 15.5+/-10.2 months, with no significant differences (p=0.23). The median ages of group B-1 and group B-2 were 15.3+/-9.3 months and 15.6+/-10.8 months, with no significant differences (p=0.91). And No significant difference in the distribution of onset age was observed between groups, and only 6 patients were diagnosed with intussusceptions within 1 month after vaccination. CONCLUSION: No difference was observed in the distribution of onset age of intussusception after rotavirus vaccination and according to the type of rotavirus vaccine. Our study has a limitation in that it was conducted in part of the Daegu area. Additional study is needed.


Subject(s)
Academic Medical Centers , Age Distribution , Age of Onset , Child , Gastroenteritis , Humans , Intussusception , Retrospective Studies , Rotavirus , Vaccination
9.
Article in English | WPRIM | ID: wpr-156152

ABSTRACT

Cecal volvulus is uncommon in pediatric patients and there are few reports of cecal volvulus with cerebral palsy. Here, we report the case of a 19-year-old male patient who presented with abdominal distension, a history of cerebral palsy, refractory epilepsy due to lissencephaly, and chronic constipation. An abdominal x-ray and computed tomography without contrast enhancement showed fixed dilated bowel intensity in the right lower abdomen. Despite decompression with gastric and rectal tube insertion, symptoms did not improve. The patient underwent an exploratory laparotomy that revealed cecal volvulus. Cecal volvulus usually occurs following intestinal malrotation or previous surgery. In this patient, however, intestinal distension accompanying mental disability and chronic constipation resulted in the development of cecal volvulus. We suggest that cecal and proximal large bowel volvulus should be considered in patients presenting with progressive abdominal distension combined with a history of neuro-developmental delay and constipation.


Subject(s)
Abdomen , Cecum , Cerebral Palsy , Constipation , Decompression , Epilepsy , Humans , Intestinal Volvulus , Laparotomy , Lissencephaly , Male
10.
Article in Korean | WPRIM | ID: wpr-133299

ABSTRACT

BACKGROUND: This study was performed to investigate the epidemiologic and clinical features of acute respiratory viral infection in hospitalized children. METHODS: From 2010 to 2012, we tested nasopharyngeal swab specimen in 1,584 hospitalized children with multiple real-time polymerase chain reactions to identify 10 kinds of respiratory viruses (including influenza virus A, B (FluA, FluB), respiratory syncytial virus (RSV), human metapneumovirus (MPV), adenovirus (AdV), human coronavirus (CoronaV), human enterovirus (HEV), human bocavirus (HBoV), parainfluenza virus (PIV), and human rhinovirus (Rhinovirus)). We analyzed the positive rate, annual and seasonal variations, and clinical features (respiratory tract and non-respiratory tract) according to the retrospective review of medical records. RESULTS: Respiratory viruses were detected from 678 (42.8%) of 1,584 patients. The most common detected virus was RSV (35.0%), and then AdV (19.0%), HEV (18.1%). The critical period of the respiratory viral infection was during the first 12 months of a child's life. PIV increased by 8.4%, 12.1%, and 21.1% annually. Bronchiolitis was most frequently caused by RSV, and croup was frequently caused by PIV. The most common cause of meningitis was HEV. Hepatitis-associated respiratory virus was developed 111 in 678 cases. CONCLUSION: Although this study was confined to a single medical center for three years, we identified the epidemiology and clinical feature of respiratory viruses in Daegu from 2010 to 2012. Future surveillance will be necessary for annual and seasonal variations.


Subject(s)
Adenoviridae , Bronchiolitis , Child , Child, Hospitalized , Coronavirus , Critical Period, Psychological , Croup , Enterovirus , Epidemiology , Human bocavirus , Humans , Inpatients , Medical Records , Meningitis , Metapneumovirus , Orthomyxoviridae , Paramyxoviridae Infections , Polymerase Chain Reaction , Respiratory Syncytial Viruses , Respiratory Tract Infections , Retrospective Studies , Rhinovirus , Seasons , Viruses
11.
Article in Korean | WPRIM | ID: wpr-133298

ABSTRACT

BACKGROUND: This study was performed to investigate the epidemiologic and clinical features of acute respiratory viral infection in hospitalized children. METHODS: From 2010 to 2012, we tested nasopharyngeal swab specimen in 1,584 hospitalized children with multiple real-time polymerase chain reactions to identify 10 kinds of respiratory viruses (including influenza virus A, B (FluA, FluB), respiratory syncytial virus (RSV), human metapneumovirus (MPV), adenovirus (AdV), human coronavirus (CoronaV), human enterovirus (HEV), human bocavirus (HBoV), parainfluenza virus (PIV), and human rhinovirus (Rhinovirus)). We analyzed the positive rate, annual and seasonal variations, and clinical features (respiratory tract and non-respiratory tract) according to the retrospective review of medical records. RESULTS: Respiratory viruses were detected from 678 (42.8%) of 1,584 patients. The most common detected virus was RSV (35.0%), and then AdV (19.0%), HEV (18.1%). The critical period of the respiratory viral infection was during the first 12 months of a child's life. PIV increased by 8.4%, 12.1%, and 21.1% annually. Bronchiolitis was most frequently caused by RSV, and croup was frequently caused by PIV. The most common cause of meningitis was HEV. Hepatitis-associated respiratory virus was developed 111 in 678 cases. CONCLUSION: Although this study was confined to a single medical center for three years, we identified the epidemiology and clinical feature of respiratory viruses in Daegu from 2010 to 2012. Future surveillance will be necessary for annual and seasonal variations.


Subject(s)
Adenoviridae , Bronchiolitis , Child , Child, Hospitalized , Coronavirus , Critical Period, Psychological , Croup , Enterovirus , Epidemiology , Human bocavirus , Humans , Inpatients , Medical Records , Meningitis , Metapneumovirus , Orthomyxoviridae , Paramyxoviridae Infections , Polymerase Chain Reaction , Respiratory Syncytial Viruses , Respiratory Tract Infections , Retrospective Studies , Rhinovirus , Seasons , Viruses
12.
Article in Korean | WPRIM | ID: wpr-201622

ABSTRACT

BACKGROUND: A patient with a pleural effusion that is difficult to safely drain by a "blind" thoracentesis procedure is generally referred to a radiologist for ultrasound-guided thoracentesis. But such a referral increases the cost and the patient's inconvenience, and it causes delay in the diagnostic procedures. If ultrasound-guided thoracentesis is performed as a bedside procedure by a medical resident, then this will reduce the previously mentioned problems. So these patients with pleural effusions were treated by medical residents at our medical center, and the procedures included bedside ultrasound-guided thoracenteses. METHODS: We studied 89 cases of pleural effusions from March 2003 to June 2005. A "blind" thoracentesis was performed if the amount of pleural effusion was moderate or large. Bedside ultrasound-guided thoracentesis was performed for small or loculated effusions or for the cases that failed with performing a "blind" thoracentesis. RESULTS: "Blind" thoracenteses were performed in 79 cases that had a moderate or large amount of uncomplicated pleural effusions and the success rate was 93.7% (74/79 cases). Ultrasound-guided thoracentesis by the medical residents was performed in 15 cases and the success rate was 66.7% (10/15 cases). The 5 failedcases included all 3 cases with loculated effusions and 2 cases with a small amount of pleural effusion. All the failed cases were referred to one radiologist and they were then successfully treated. If we exclude the 3 cases with loculated pleural effusions, the success rate of ultrasound-guided thoracentesis by the medical residents increased up to 83% (10/12 cases). Two cases of complications (1 pneumothorax, 1 hydrohemothorax) occurred during ultrasound-guided thoracentesis. CONCLUSION: Ultrasound-guided thoracentesis performed as a bedside procedure by a medical resident may be relatively effective and safe. If a patient has a loculated effusion, then it would be better to first refer the patient to a radiologist.


Subject(s)
Humans , Internship and Residency , Paracentesis , Pleural Effusion , Pneumothorax , Referral and Consultation
13.
Article in English | WPRIM | ID: wpr-167453

ABSTRACT

Medullary thyroid carcinoma accounts for 3% of all thyroid gland malignancies. It commonly metastasizes to liver, lung, and bone. It rarely metastasizes to skin, and only a few such cases have been documented. Cutaneous metastasis suggests a poor prognosis, with a mean survival of 7.5-19 months. The most effective treatment for skin metastasis is complete surgical removal of all local and regional lesions. The response to systemic chemotherapy is typically poor. We report a case of medullary thyroid carcinoma with cutaneous metastases, which responded to chemotherapy.


Subject(s)
Liver , Lung , Neoplasm Metastasis , Prognosis , Skin , Thyroid Gland , Thyroid Neoplasms
14.
Korean Journal of Medicine ; : 183-191, 2007.
Article in Korean | WPRIM | ID: wpr-7869

ABSTRACT

BACKGROUND: Lung uptake during liver scanning has been considered as a passing phenomenon related to several diseases, and especially infectious diseases and malignancy. Some reports have shown diffuse lung uptake during liver scanning of malarial patients. Therefore, we tried to determine the relationship between the abnormalities of the clinical features, including the hematobiochemical indices and the lung uptake during liver scanning, by analyzing the information of the malarial patients. METHODS: We performed 99mTechnethium(Tc)-sulfur colloid liver scanning on 20 of the 45 malarial patients who were admitted from 1999 to 2004. We divided them into two groups, the Lung-Uptake (LU) group and the Non-Lung-Uptake (NLU) group. We analyzed the hematobiochemical indices and clinical features, including the respiratory symptoms, between the two groups. RESULTS: 10 of the 20 malarial patients showed lung uptake on the liver scan. The mean platelet counts were 74,000/L and 165,000/L, respectively, in the LU group and the NLU group (p=0.012). Also, the mean total cholesterol levels were 80.3 mg/dL and 105.7 mg/dL, respectively, in the LU group and the NLU group (p=0.033). The scores ofthe bone marrow (BM) uptake in the LU group were higher than those in the NLU group (p=0.008). Yet the other values such as Hb, ALT, albumin and total bilirubin were not statistically significant, nor were the peak body temperatureand other features. CONCLUSIONS: Half of the patients had lung uptake on the liver scanning, and this may be considered as a characteristic of vivax malaria. The BM uptake during liver scanning in the LU group was more increased, and this is supposed to be a consequence of hyperstimulated reticuloendothelial system, which was accompanied by thrombocytopenia and a lower level of total cholesterol in malarial patients.


Subject(s)
Bilirubin , Bone Marrow , Cholesterol , Colloids , Communicable Diseases , Humans , Liver , Lung , Malaria , Malaria, Vivax , Mononuclear Phagocyte System , Platelet Count , Thrombocytopenia
15.
Article in Korean | WPRIM | ID: wpr-222576

ABSTRACT

PURPOSE: The cutting seton technique is a world-wide operative method in management of a complex anal fistula. However it has still some risks of anal deformity and fecal incontinence because of sphincter injury, and also required two-stage operation under the anesthesia. We have modified this conventional method into sphincter-preserving technique using the seton and evaluated the clinical effect of patients with complex anal fistula. METHODS: The operative steps consisted of excision of the fistular tract without cutting the sphincter, and insertion of a non-absorbable suture material as a seton around the sphincter. When enough fibro-granulated tissues grew and pus discharge decreased markedly, the seton was just cut out from the wound without anesthesia at the outpatient basis. The clinical effect following treatment by using this method was assessed retrospectively in 81 patients, including 33 recurrent cases, who were treated during the four and a half-year period. RESULTS: The average follow-up period to remove the seton and to eradicate the fistula was 68.9+/-39.5 and 82.1+/-45.6 days, respectively. No patients experienced fecal incontinence after surgery. The fistula was healed without recurrence in 78 patients (96.3%), preserving integrity of the sphincter. Recurrence developed in 3 patients who had two suprasphincteric fistulas and one transsphincteric fistula with supralevator abscess. CONCLUSION: We suggest that this method is good for treating complex anal fistulas without two-stage operation because it has some advantages such as a lower recurrence, a lower functional impairment, and less anal deformity.


Subject(s)
Abscess , Anesthesia , Congenital Abnormalities , Fecal Incontinence , Fistula , Follow-Up Studies , Humans , Outpatients , Rectal Fistula , Recurrence , Retrospective Studies , Suppuration , Sutures , Wounds and Injuries
16.
Article in Korean | WPRIM | ID: wpr-163373

ABSTRACT

Glycogen-rich clear cell carcinoma of the breast is a very rare malignancy whose incidence is about 1~3% of the total breast cancers. Histologic features are usually those of ductal carcinoma, but it contains the cells that is characterized by the abundant cytoplasm and centrally-located nuclei. We report a case of glycogen-rich clear cell carcinoma of the breast. The case is a 63-year-old woman with a palpable lump of the right breast. The operation is partial mastectomy with axillary lymph node dissection. The tumor consists of round or polygonal cells. The cell membranes are distinct, and the cytoplasm is clear. Most of the nulcei are centrally-located and hyperchromatic. The tumor cells are PAS positive and D-PAS negative. Immunohistochemically, the tumor cells are positive to the epithelial membrane antigen (EMA), and negative to vimentin, smooth muscle actin, desmin. Estrogen receptors are positive, but progesterone receptors are negative.


Subject(s)
Actins , Breast , Carcinoma, Ductal , Cell Membrane , Cytoplasm , Desmin , Female , Humans , Incidence , Lymph Node Excision , Mastectomy, Segmental , Middle Aged , Mucin-1 , Muscle, Smooth , Receptors, Estrogen , Receptors, Progesterone , Vimentin
17.
Article in Korean | WPRIM | ID: wpr-648082

ABSTRACT

BACKGROUND AND OBJECTIVES: Ideal treatment for vocal cord paralysis is to restore normal movement of the vocal cord and to bring back the natural voice. Pulsed electromagnetic stimulation (PEMS)has been known to bring early nerve regeneration as well as better functional recovery. The purpose of this investigation is to learn the effect of PEMS on regeneration of the recurrent laryngeal nerve. MATERIALS AND METHOD: Using 36 healthy male Sprague-Dawley rats, we made transections on their left recurrent laryngeal nerves and performed primary anastomosis under the operating microscope. Rats were divided into an experimental group and a control group, each having 18 rats by random sampling. For the experimental group, PEMS was carried out three hours a day and five days a week for twelve weeks. For the control group, PEMS was not given while other conditions were kept the same as in the experimental group. The extent of functional recovery was observed for each group by performing videostroboscopic examination once every week. After twelve weeks, a test for the functional recovery was performed electrophysiologically through laryngeal electromyography during respiration. RESULTS: After the twelve-week experiment, 14 out of 18 rats survived in the group which received PEMS while 8 out of 18 rats stayed alive in the control group. Ten rats (71%)in the PEMS performed group and 3 rats (38%)in the control group showed recovery of vocal cord movement, but it did not reveal any significant difference statistically. However, the time it took for functional recovery was 3.93+/-0.27 weeks and 7.87+/-0.85 weeks for the PEMS performed group and the control group, respectively. And the difference was statistically significant. CONCLUSION: This investigation confirmed the efficacy of PEMS on the early functional recovery in rats with surgically transected and reanastomosed recurrent laryngeal nerve. Further studies to understand the mechanism of action of these effects as well as the local stimulation rather than the total body stimulation seem to be necessary.


Subject(s)
Animals , Electromyography , Humans , Magnets , Male , Nerve Regeneration , Rats , Rats, Sprague-Dawley , Recurrent Laryngeal Nerve , Regeneration , Respiration , Vocal Cord Paralysis , Vocal Cords , Voice
18.
Article in Korean | WPRIM | ID: wpr-183115

ABSTRACT

BACKGROUND: Osteoarthritis(OA) of the knee represents a common chronic disease, especially in the elderly, leading to functional impairment and disability. And OA patients have depressive symptoms frequently. Several factors contribute to the level of depressive symptoms. Authors tried to assess these factors and show effect of these factors to depressive symptoms. Through this study in the future physicians must consider psychiatric problems besides the pain itself in the treatment of OA patients. METHODS: Subjects included in this study were 64 knee joint OA patients. We obtained depressive symptoms from the CES-D(The Korean version of the Center for Epidemiological Studies-Depression Scale), level of pain, stiffness, functional disability from KWOMAC(WOMAC Korean Version 2, The Korean version of Western Ontario and Macmaster Osteoarthritis Index Score) and other factors able to contribute to depressive symptoms. RESULT: We divided the patients into two groups using CES-D cut-off score of 21. Each group consists of 46(CES-D or =21) patients. Frequency of sleep disturbance and pain consistency and level of pain, stiffness and functional disability were different significantly between two groups(p<0.0l). Through the correlation analysis level of pain, stiffness and functional disability were associated with CES-D score significantly(p<0.0l). And through the stepwise multiple regression analysis we demonstratred that the CES-D score influenced by level of functional disability, BMI, disease duration and, pain but only level of functional disability and BML were statistically significant(p<0.0l). Level of functional disability explained 46% of CES-D score(partial R2=0.46) so influenced on depressive symptoms most effectively. CONCLUSION: This study suggested that functional disability was most important factors to explain depressive symptoms of knee joint OA patients.


Subject(s)
Aged , Chronic Disease , Depression , Humans , Knee Joint , Knee , Ontario , Osteoarthritis
19.
Article in Korean | WPRIM | ID: wpr-646669

ABSTRACT

BACKGROUND AND OBJECTIVES: The airway interruption method was developed as a combination of the measurement of expiratory pressure, mean air flow, intensity, and frequency. We evaluated the clinical usefulness of the airway interruption method in measuring vocal frequency, vocal intensity, mean air flow rate and expiratory air pressure. MATERIALS AND METHODS: We performed phonatory function tests in the patients with vocal nodule (n=380), vocal polyp (n=41), vocal sulcus (n=20), laryngitis (n=72), vocal paralysis (n=10) and glottic cancer, T 1 (n=5). And these results were compared with normal values which were reported previously. In 91 patients with vocal nodule and 5 patients with polyp, phonatory function test was followed up after laryngomicrosurgery and compared with preoperative test. RESULTS: In patients with vocal nodule and polyp, mean air flow rate was significantly increased (p<0.05). In polyp, these differences were greater than nodule group. In vocal paralysis, mean air flow rate was significantly increased than other groups. In glottic cancer (T1), expiratory air pressure was significantly increased than other groups. In laryngitis and sulcus vocalis, mean air flow rate was increased in some phonation methods. But their differences were less significant than other groups. After laryngomicrosurgery, mean air flow rate and expiratory air pressure were decreased in both groups. CONCLUSION: The aerodynamic test using the airway interruption method is a noninvasive, easy to perform and reliable for evaluation of aerodynamic conditions at the glottis. This research finds that the interruption method is effective both in evaluation of the treatment and in postoperative assessments of the laryngeal disorder patients.


Subject(s)
Air Pressure , Glottis , Humans , Laryngitis , Paralysis , Phonation , Polyps , Reference Values
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