Predictive Factors for the Short-Term Efficacy of Epidural Injections in Lumbar Disc Herniation Treatment

Objectives@#The purpose of this study was to analyze several factors affecting the efficacy of epidural steroid injections as a nonoperative treatment modality in lumbar disc herniation patients.Summary of Literature Review: Despite several studies, the normal course of intervertebral disc herniation is not fully understood, and the optimal timing of surgery is unclear. @*Methods@#From January 2017 to April 2019, among outpatients in our hospital, 64 patients diagnosed with 3-4 or 4-5 single-level lumbar disc herniation and followed up for at least 6 weeks were included. Epidural steroid injection was performed in all patients during their 1-week admission. Symptoms improved in 36 patients (group 1) and persisted or recurred in 28 patients (group 2), who were finally treated surgically. Demographic factors, magnetic resonance imaging findings, and clinical assessments were analyzed. @*Results@#The only demographic factor with a significant difference between groups was symptom duration. In magnetic resonance imaging, significant differences were found in disc sequestration and the degree of the herniated disc. At 6 weeks after the injection, significant differences were found between the 2 groups in visual analog scale scores and the Korean version of the Oswestry Disability Index. @*Conclusions@#Several factors must be considered when treating patients with lumbar disc herniation. Of note, longer symptom duration was found to be associated with a lower effectiveness of conservative treatment. The effects of treatment could also be influenced by the disc form and the degree of disc herniation.

Predictive Factors for the Short-Term Efficacy of Epidural Injections in Lumbar Disc Herniation Treatment

Objectives@#The purpose of this study was to analyze several factors affecting the efficacy of epidural steroid injections as a nonoperative treatment modality in lumbar disc herniation patients.Summary of Literature Review: Despite several studies, the normal course of intervertebral disc herniation is not fully understood, and the optimal timing of surgery is unclear. @*Methods@#From January 2017 to April 2019, among outpatients in our hospital, 64 patients diagnosed with 3-4 or 4-5 single-level lumbar disc herniation and followed up for at least 6 weeks were included. Epidural steroid injection was performed in all patients during their 1-week admission. Symptoms improved in 36 patients (group 1) and persisted or recurred in 28 patients (group 2), who were finally treated surgically. Demographic factors, magnetic resonance imaging findings, and clinical assessments were analyzed. @*Results@#The only demographic factor with a significant difference between groups was symptom duration. In magnetic resonance imaging, significant differences were found in disc sequestration and the degree of the herniated disc. At 6 weeks after the injection, significant differences were found between the 2 groups in visual analog scale scores and the Korean version of the Oswestry Disability Index. @*Conclusions@#Several factors must be considered when treating patients with lumbar disc herniation. Of note, longer symptom duration was found to be associated with a lower effectiveness of conservative treatment. The effects of treatment could also be influenced by the disc form and the degree of disc herniation.

Treatment and clinical outcome of needle-track seeding from hepatocellular carcinoma / 대한간학회지

BACKGROUND/AIMS: Needle-track seeding is a rare but important complication of diagnostic and therapeutic ultrasound (US)-guided procedures in hepatocellular carcinoma (HCC). We examined the frequency of needle-track seeding after US-guided percutaneous ethanol injection (PEI), fine-needle aspiration biopsy (FNAB), and percutaneous transhepatic biliary drainage (PTBD) in order to determine the appropriate treatment for needle-track seeding and its clinical outcome. METHODS: We analyzed the clinical characteristics and treatment outcomes in eight patients who experienced needle-track seeding from HCC after an US-guided procedure (FNAB, PEI, or PTBD) between January 1990 and July 2004. RESULTS: Seven (0.14%) of 5,092 patients who experienced needle-track seeding (2 after PEI, 4 after FNAB, and 1 after PTBD) during the study period and 1 other patient who experienced needle-track seeding recently were recruited for this study. Two of the eight patients underwent mass excision and the other six patients underwent en-bloc wide excision for the needle-track seeding. Tumors recurred in the needle-tracks in both patients who underwent mass excision but not in the six patients who underwent en-bloc wide excision. Mortality occurred in three patients who experienced the recurrence and progression of intrahepatic HCC. CONCLUSIONS: The incidence of needle-track seeding after US-guided procedures in HCC was 0.14%. En-bloc wide excision seems to be the optimal treatment for minimizing the probability of tumor recurrence due to needle-track seeding.

A follow-up study on the chronological changes of HBV serologicmarkers in a rural community, Korea / 한국역학회지

No abstract available.

The Effect of Monopolar and Bipolar Electrocoagulation in Spinal Cord

The monopolar and bipolar coagulation lesions were generated in the spinal cord of rabbits. Microscopic study, and the distance from surface lesion center to its margin, the lesion depth, the extent of lesion in cross section, and the area of cross section through the lesion center of monopolar and bipolar electrocoagulation in generation of spinal cord lesion were studied by Evans blue and hematoxylin-eosin stain. The results were as follows : 1) Microscopically, the lesions were characterized by ground substance depigmentation, vacuolization and neuronal damage with pyknotic and angulated nuclei and loss of detail. In section stained with Evans blue, the lesion was demarcated with blue-green discoloration of the parenchyma and superficial necrosis was at coagulation sites. 2) The distance from surface lesion center to its margin was proportionally increased as the increase of magnitude of electric current for monopolar and bipolar coagulation, while the distance was independent of the mode coagulation and stain. 3) The depth of lesion was proportionally increased as the increase of magnitude of electric current for monopolar and bipolar coagulation, while the depth was also independent of the mode coagulation, but the depth of Evans blue stain was 2 times than H-E stain. 4) The extent of lesion in cross section was increased as the increase of magnitude of electric current for both coagulation modes, while the extent was independent of the mode of coagulation and stain, too. 5) The area of cross section through the lesion center was gradually increased as the increase of magnitude of electric current for both coagulation modes, while the area was independent of the mode of coagulation and stain.

A Case of Penetrating Cranial Injury by a Wooden Foreign Body

Many objects create penetrating cranial injuries. Metallic objects and low velosity missiles are the most common offenders. Wood as wounding agent of the brain, has some characteristics. It has profound risk of infection, a significant propensity to fragmentation that is virtually undetechable on routine X-ray screening and very low atteunation value in CT scan. Because of its characteristics and rarity, we report a case of penetrating cranial injury by a wooden foreign body with review of literature.