Comparative study of the treatment outcomes of osteoporotic compression fractures without neurologic injury using a rigid brace, a soft brace, and no brace : a prospective randomized controlled non-inferiority trial

BACKGROUND:The efficacy of brace application for the treatment of osteoporotic compression fractures remains unclear. The purpose of this study was to compare the treatment outcomes in patients with osteoporotic compression fractures with regard to whether the patients had no braces, rigid braces, or soft braces.METHODS:We randomly assigned sixty patients with acute one-level osteoporotic compression fractures within three days of injury to the no-brace, soft-brace, and rigid-brace groups through 1:1:1 allocation. The primary outcome was the baseline adjusted Oswestry Disability Index score at twelve weeks after compression fracture. The non-inferior margin of the Oswestry Disability Index was set at an average of 10 points.RESULTS:The baseline adjusted Oswestry Disability Index score at twelve weeks after compression fracture in the no-brace group was not inferior to that in the soft-brace or rigid-brace groups. The mean adjusted Oswestry Disability Index score was 35.95 points (95% confidence interval, 25.42 to 46.47 points) in the no-brace group and 37.83 points (95% confidence interval, 26.77 to 48.90 points) in the soft-brace group, with a difference of -1.88 points (95% confidence interval, -7.02 to 9.38 points) between the groups. Similarly, the mean adjusted Oswestry Disability Index score was 35.95 points (95% confidence interval, 25.42 to 46.47 points) in the no-brace group and 33.54 points (95% confidence interval, 23.79 to 43.29 points) in the rigid-brace group, with a difference of 2.41 points (95% confidence interval, -7.86 to 9.27 points) between the groups. During the follow-up assessment period, there was no significant difference among the groups for the overall Oswestry Disability Index scores (p = 0.260), visual analog scale for pain scores for back pain (p = 0.292), and anterior body compression ratios (p = 0.237). However, the Oswestry Disability Index scores and the visual analog scale scores for back pain significantly improved with time after the fractures (p < 0.001), and the body compression ratios significantly decreased with time in all three groups (p < 0.001).CONCLUSIONS:The Oswestry Disability Index scores for the treatment of compression fractures without a brace were not inferior to those with soft or rigid braces. Moreover, the improvement in back pain and progression of anterior body compression were similar among the three groups.OAIID:oai:osos.snu.ac.kr:snu2014-01/102/0000004226/15SEQ:15PERF_CD:SNU2014-01EVAL_ITEM_CD:102USER_ID:0000004226ADJUST_YN:NEMP_ID:A079510DEPT_CD:801CITE_RATE:4.309DEPT_NM:의학과SCOPUS_YN:NCONFIRM:

Ecological connectivity analysis based on the fish community in Jeongan Stream

This study focused on the longitudinal connectivity analysis, based on fish communities in the aspect of spatial variations of 34 sites from upstream to downstream. The Fish Assessment Index (FAI), based on ecological guilds and species composition, was applied to compare the ecological health among the sampling sites. The total number of 35 fish species, were sampled during the study period with dominant species of Zacco platypus (35.4%) and Zacco koreanus (11.8%). Cluster analysis showed that all sites were categorized as 4 distinct group communities (A, B, C, D). Non-metric multidimensional scaling analysis showed distinct difference between upstream (A, B) and downstream groups (C, D). Indicator Value Analysis (IndVal method), conducted to identify indicator species within each group, indicated that the species favoring upstream environments Rhynchocypris oxycephalus for the Group A and Iksookimia koreensis for the Group B. In contrast, the analysis indicated that the species with a preference for downstream habitats Pseudogobio esocinus for the Group C and Carassius auratus for the Group D. Ecological health, based on the FAI scores, showed a declining pattern toward the downstream, along with an increasing proportion of tolerant species and omnivores within the fish community. Overall these findings suggest the compositions of fish communities, as four groups, were modified by the weir structures and organic matter, nutrient pollutions

Comparative observational study of surgical outcomes of lumbar foraminal stenosis using minimally invasive microsurgical extraforaminal decompression alone versus posterior lumbar interbody fusion: a prospective cohort study.

INTRODUCTION:There is no comparative study regarding surgical outcomes between microsurgical extraforaminal decompression (MeFD) and posterior lumbar interbody fusion (PLIF) for the treatment of lumbar foraminal stenosis (LFS). Therefore, the purpose of this study was to compare the surgical outcomes of LFS using two different techniques: MeFD alone or PLIF.METHODS:For the purposes of this study, a prospectively collected observational cohort study was conducted. Fifty-five patients diagnosed with LFS who were scheduled to undergo spinal surgery were included in this study. According to the chosen surgical technique, patients were assigned to either the MeFD group (n = 25) or the PLIF group (n = 30). The primary outcome was Oswestry Disability Index (ODI) score at 1 year after surgery.RESULTS:The baseline patient characteristics and preoperative ODI score, visual analog scale (VAS) scores for back and leg pain, and Short Form-36 score were not significantly different between the two groups. At 12 months postoperative, the mean ODI score in the MeFD and PLIF groups was 25.68 ± 14.49 and 27.20 ± 12.56, respectively, and the 95 % confidence interval (-9.76-6.73) was within the predetermined margin of equivalence. The overall ODI score and VAS scores for back and leg pain did not differ significantly over the follow-up assessment time between the two groups. However, the ODI score and VAS scores for back and leg pain improved significantly over time after surgery in both groups. In the MeFD group, revision surgery was required in three patients (12 %).CONCLUSIONS:This study demonstrated that MeFD alone and PLIF have equivalent outcomes regarding improvement in disability at 1 year after surgery. However, the higher rate of revision surgery in the MeFD group should emphasize the technically optimal amount of decompression.OAIID:oai:osos.snu.ac.kr:snu2015-01/102/0000004226/6SEQ:6PERF_CD:SNU2015-01EVAL_ITEM_CD:102USER_ID:0000004226ADJUST_YN:NEMP_ID:A079510DEPT_CD:801CITE_RATE:2.473DEPT_NM:의학과SCOPUS_YN:YCONFIRM:

Spatiotemporal Variation Analyses of Water Quality, Fish Ecological Guilds, and the Longitudinal Connectivity in Musim Stream

The main objectives of this study were to analyze the spatiotemporal variations of water quality, fish ecological guilds and longitudinal connectivity in the weirs of Musim Stream. Fish were collected at 44 sites during spring and fall seasons for the analysis of trophic guilds, tolerance guilds, and the ecological stream health, based on FAI model. Total 33 species were observed in the stream and the dominant species were Zacco platypus and Squalidus qracilis majimae. Mean values of BOD and COD, as an indicator of organic matter pollution, showed high in the drought spring and low in fall (post-monsoon season). Also, TP showed same pattern with the BOD and COD pattern. The hierarchical clustering, based on the fish compositions, classified as three groups (up-stream, mid-stream and the down-stream). Based on the NMDS (Non-metric Multidimensional Scaling) analysis of fish abundance, high similarity was observed between S1-S5 sites, which were consistent with the results of hierarchical cluster analysis. Fish ecological guilds in the upper stream showed a high similarity between the insectivore and sensitive species, while in the middle and lower reaches, high similarity was found between the omnivore and intermediate species. Evaluations of longitudinal connectivity, based on the structural and hydrological characteristics of the weir, indicated all disconnections by the weirs, except for S15, in the spring. Stream ecological health, based on the FAI model, was significantly (p < 0.05, n=37) influenced by the height of overflow (Hu1). Overall, our study suggests that the longitudinal connectivity, based on the weir structures, flow regime and fish swimming capacity, were blocked off by the weirs in the stream. The results provide valuable insights for securing river management strategies and served as the fundamental data for stream restoration in the future

Indirect effects of decompression surgery on glycemic homeostasis in patients with Type 2 diabetes mellitus and lumbar spinal stenosis

BACKGROUND CONTEXT: Lumbar spinal stenosis (LSS) patients with diabetes mellitus (DM) are presumed to experience difficulty when performing regular daily exercise, although such exercise is of paramount importance for glucose homeostasis and control. Therefore, decompression surgery, which can help patients perform regular physical activity, would have indirect positive effects on blood glucose control in LSS patients with DM.PURPOSE: To evaluate the indirect effects of spinal surgery on hemoglobin A(1c) (HbA(1c)) levels in the patient with Type 2 DM and LSS.STUDY DESIGN: Prospectively collected observational cohort data.PATIENT SAMPLE: Patients with degenerative LSS and DM.OUTCOME MEASURES: The fasting total cholesterol (TC), fasting blood glucose (FBG), and HbA(1c) levels and visual analog scale (VAS) for back pain, VAS for leg pain, and Oswestry Disability Index (ODI).METHODS: According to the treatment methods, 31 and 37 patients were allocated to the surgical and conservative treatment groups, respectively. The HbA(1c), TC, and FBG levels and the ODI and VAS for back/leg pain were recorded for all patients before surgical and conservative treatments. At the first and second follow-up assessments after surgical or conservative treatment, the data were reassessed for all patients.RESULTS: In both groups, the VAS for back/leg pain and the ODI scores significantly decreased after surgical or conservative treatment. In the surgical treatment group, the HbA(1c) levels were significantly decreased at the first and second assessments after surgery, whereas the conservative treatment group did not show significant reductions in HbA(1c) levels at the first and second follow-up assessments. In both groups, the FBG levels did not differ between the initial and follow-up assessments. The TC levels were significantly decreased at the second follow-up assessment, only in the surgical treatment group. The amount of ODI score reduction correlated positively with the degree of HbA(1c) level reduction at the first follow-up assessment.CONCLUSIONS: The present study demonstrates the reduction in HbA(1c) level in patients with DM and LSS after decompression surgery with or without fusion. We believe this reduction in the HbA(1c) level may be a result of increased physical activity, subsequent to successful surgical decompression of the cauda equina. (C) 2015 Elsevier Inc. All rights reserved.OAIID:oai:osos.snu.ac.kr:snu2015-01/102/0000004226/4SEQ:4PERF_CD:SNU2015-01EVAL_ITEM_CD:102USER_ID:0000004226ADJUST_YN:YEMP_ID:A079510DEPT_CD:801CITE_RATE:2.8FILENAME:tsj-2015_kim_indirect effects of decompression surgery on glycemic homeostasis in patients.pdfDEPT_NM:의학과SCOPUS_YN:YCONFIRM:

Translation, cross-cultural adaptation, and validity of the korean version of the pain sensitivity questionnaire in chronic pain patients.

The purpose of this study was to translate pain sensitivity questionnaires (PSQ) into the Korean language, perform a cross-cultural adaption of the PSQ, and validate the Korean version of PSQ in patients with degenerative spinal disease. The PSQ was translated forward and backward, cross-culturally adapted by 2 independent translators, and approved by an expert committee. The final Korean version of the PSQ was tested on 72 patients with degenerative spinal disease. Test-retest reliability was evaluated for 60 patients (83%) who completed the second assessment in an interval of 4 weeks. The mean PSQ-minor, PSQ-moderate, and PSQ-total (standard deviation [SD]) were 5.40 (2.02), 6.46 (1.98), and 5.93 (1.93), respectively. The PSQ-total, PSQ-minor, and PSQ-moderate of the Korean version showed very good internal consistencies determined by the Cronbach's α of 0.926, 0.869, and 0.877, respectively. For convergent validity, the PSQ scores of the Korean version showed significant correlations with pain catastrophizing scale (PCS) (r = 0.377, P = 0.002; r = 0.365, P = 0.003; r = 0.362, P = 0.003 for PSQ-total, PSQ-minor, and PSQ-moderate of the Korean version, respectively). For test-retest reliability, the intraclass correlation coefficients were 0.782 for PSQ-total, 0.752 for PSQ-minor, and 0.793 for PSQ-moderate. In conclusion, the validated Korean version of PSQ is a transculturally equivalent, reliable, and valid tool to assess individual pain sensitivity.OAIID:oai:osos.snu.ac.kr:snu2014-01/102/0000004226/11SEQ:11PERF_CD:SNU2014-01EVAL_ITEM_CD:102USER_ID:0000004226ADJUST_YN:NEMP_ID:A079510DEPT_CD:801CITE_RATE:2.183DEPT_NM:의학과SCOPUS_YN:YCONFIRM:

Allergic rhinitis and rhinosinusitis synergistically compromise the mental health and health-related quality of life of Korean adults: A nationwide population-based survey.

Allergic rhinitis (AR) and rhinosinusitis (RS) negatively impact psychological well-being and health-related quality of life (HRQoL). However, few population-based studies have investigated the effects of these conditions on mental health and HRQoL.To explore independent associations of AR and/or RS with mental health and HRQoL using data from the 2013-2015 Korea National Health and Nutrition Examination Survey (KNHANES).The KNHANES is a nationwide cross-sectional survey of the non-institutionalized population of Korea. A total of 15,441 adults completed the clinical examination and the health questionnaire. We divided all participants into four groups: AR-/RS-, AR-/RS+, AR+/RS-, and AR+/RS+. Logistic regression analyses were performed after adjustment for sociodemographic characteristics, general health behaviors, and other comorbidities.The AR+/RS+ group contained the highest proportion of subjects with perceived stress and depressed mood. Subjects with AR+/RS+ also had more frequent problems in terms of pain/discomfort and anxiety/depression. After adjusting for all confounders, the odds ratios (ORs) were 2.96 (p = 0.009) for depressed mood and 3.17 (p = 0.013) for suicidal ideation in the AR+/RS+ group compared with in the AR-/RS- group. The AR+/RS- group reported more perceived stress (OR, 1.56, p = 0.003) and depression (OR, 1.72, p = 0.024) compared with the AR-/RS- group. In terms of the ORs for HRQoL, the AR+/RS+ group reported more problems in terms of self-care (OR, 3.73, p = 0.038) and more pain/discomfort (OR 2.19, p = 0.006) compared with the AR-/RS- group.In the Korean population, AR and RS exerted a synergistic negative impact on mental health and HRQoL, especially suicidal ideation. Most patients seek help from clinicians for impaired HRQoL. Therefore, clinicians should consider the underlying mental health and HRQoL of patients with AR and/or RS, as these may be impaired by their conditions

Efficacy of a Topical Gelatin-Thrombin Matrix Sealant in Reducing Postoperative Drainage Following Anterior Cervical Discectomy and Fusion

Study DesignRetrospective fusion level(s)-, age-, and gender-matched analysis.PurposeTo determine whether the application of a topical gelatin-thrombin matrix sealant (Floseal) at the end of anterior cervical discectomy and fusion (ACDF) can reduce the amount of postoperative hemorrhage.Overview of LiteratureThe effect of the matrix sealant in decreasing postoperative hemorrhage following ACDF has not been reported.MethodsMatrix sealant was (n=116, study group) or was not applied (n=58, control group) at the end of ACDF. Patients were selected by 1:2 matching criteria of fusion level(s), age, and gender. Seven parameters described below were compared between the two groups.ResultsThe total drain amount for the first 24 hours (8±9 versus 27±22 mL), total drain amount until the 8-hour drainage decreased to ≤10 mL (8±10 versus 33±26 mL), and the total drain amount until 6 AM on the first postoperative day (7±8 versus 24±20 mL) were significantly lower in the study group than the control group (all p<0.001). The time for the 8-hour drainage to decrease to ≤10 mL was significantly lower in the study group (10±5 versus 26±14 hours, p<0.001). The 8-hour drainage decreased to ≤10 mL on the operation day in most patients (88%) in the study group versus mostly on the first (48%) or second (33%) postoperative day in the control group (p<0.001). The total drain amount until 6 AM on the first postoperative day was 0 mL in 43% of patients in the study group and in 7% in the control group (p<0.001). No patient in either group required hematoma evacuation.ConclusionsApplication of the topical matrix sealant at the end of ACDF can significantly reduce the amount of postoperative hemorrhage

Distribution of the four groups by age.

<p>The proportions of AR+/RS- and AR+/RS+ patients decreased as a function of age.</p

Proportions of subjects reporting problems in their health-related quality of life by the presence and/or absence of allergic rhinitis and rhinosinusitis.

<p>Proportions of subjects reporting problems in their health-related quality of life by the presence and/or absence of allergic rhinitis and rhinosinusitis.</p