BACKGROUND: Neck and shoulder pain is fairly common among adolescents in Korea and results in significant health problem. The aims of this prospective study was to identify the effects of education, in terms of recognition of this issue and posture correction, on prevalence and severity of neck and shoulder pain in Korean adolescents. METHODS: A prospective, observational cohort design was used. The 912 students from two academic high schools in the city of Seoul were eligible for the current study and 887 completed this study. After a baseline cross-sectional survey, students listened to a lecture about cervical health, focusing on good posture, habits, and stretching exercises to protect the spine, and were encouraged by their teachers to keep the appropriate position. And follow-ups were conducted 3 months later, to evaluate the effect of education. RESULTS: The prevalence of neck and shoulder pain was decreased 19.5% (from 82.5 to 66.4%). The baseline mean usual and worst numeric rating scale were 19.9/100 (95% CI, 18.1-21.7) and 31.2/100 (95% CI, 28.7-33.2), respectively. On the follow-up survey, the mean usual and worst numeric rating scale were decreased significantly by 24.1 and 21.7%, respectively, compared with baseline (P < 0.01). Of the 570 students reporting neck and shoulder pain, 16.4% responded that they had experienced improvement during the 3 months. CONCLUSIONS: Education; recognition of this issue and posture correction, for cervical health appeared to be effective in decreasing the prevalence and severity of neck and shoulder pain at a 3 month follow-up.
Adolescent* ; Cohort Studies ; Cross-Sectional Studies ; Education* ; Exercise ; Follow-Up Studies ; Humans ; Korea ; Longitudinal Studies* ; Neck Pain ; Neck* ; Posture ; Prevalence* ; Prospective Studies ; Seoul ; Shoulder Pain* ; Spine

OBJECTIVE: This study aimed to examine the association between normal-but-low folate levels and cognitive function in the elderly population using a prospective cohort study. METHODS: We analyzed 3,910 participants whose serum folate levels were within the normal reference range (1.5–16.9 ng/mL) at baseline evaluation in the population-based prospective cohort study named the “Korean Longitudinal Study on Cognitive Aging and Dementia.” The association between baseline folate quartile categories and baseline cognitive disorders [mild cognitive impairment (MCI) or dementia] was examined using binary logistic regression analysis adjusting for confounding variables. The risks of incident MCI and dementia associated with the decline of serum folate level during a 4-year follow-up period were examined using multinomial logistic regression analysis. RESULTS: The lowest quartile group of serum folate (≥1.5, ≤5.9 ng/mL) showed a higher risk of cognitive disorders than did the highest quartile group at baseline evaluation (odds ratio 1.314, p=0.012). Over the 4 years of follow-up, the risk of incident dementia was 2.364 times higher among subjects whose serum folate levels declined from the 2nd–4th quartile group to the 1st quartile than among those for whom it did not (p=0.031). CONCLUSION: Normal-but-low serum folate levels were associated with the risk of cognitive disorders in the elderly population, and a decline to normal-but-low serum folate levels was associated with incident dementia. Maintaining serum folate concentration above 5.9 ng/mL may be beneficial for cognitive status.
Aged ; Cognition ; Cognition Disorders ; Cognitive Aging ; Cohort Studies ; Confounding Factors (Epidemiology) ; Dementia ; Folic Acid ; Follow-Up Studies ; Humans ; Logistic Models ; Longitudinal Studies ; Prospective Studies ; Reference Values

OBJECTIVE: The purpose of this study was to evaluate the safety and efficacy of cervical midline-splitting French-door laminoplasty with a polyether ether ketone (PEEK) plate. The authors retrospectively analyzed the results of patients with cervical laminoplasty miniplate (MAXPACER(R)) without bone grafts in multilevel cervical stenosis. METHODS: Fifteen patients (13 males and 2 females, mean age 50.0 years (range 35-72)) with multilevel cervical stenosis (ossification of the posterior longitudinal ligament and cervical spondylotic myelopathy) underwent a combined surgery of midline-splitting French-door laminoplasty with or without mini plate. All 15 patients were followed for at least 12 months (mean follow-up 13.3 months) after surgery, and a retrospective review of the clinical, radiological and surgical data was conducted. RESULTS: The radiographic results showed a significant increase over the postoperative period in anterior-posterior diameter (9.4+/-2.2 cm to 16.2+/-1.1 cm), open angles in cervical lamina (46.5+/-16.0degrees to 77.2+/-13.1degrees), and sectional volume of cervical central canal (100.5+/-0.7 cm2 to 146.5+/-4.9 cm2) (p<0.001). The sagittal alignment of the cervical spine was well preserved (31.7+/-10.0degrees to 31.2+/-7.6degrees, p=0.877) during the follow-up period. The clinical results were successful, and there were no significant intraoperative complications except for screw displacement in two cases. The mini plate constructs did not fail during the 12 month follow-up period, and the decompression was maintained. CONCLUSION: Despite the small cohort and short follow-up duration, the present study demonstrated that combined cervical expansive laminoplasty using the mini plate is an effective treatment for multilevel cervical stenosis.
Cohort Studies ; Constriction, Pathologic ; Decompression ; Ether* ; Female ; Follow-Up Studies ; Humans ; Intraoperative Complications ; Longitudinal Ligaments ; Male ; Postoperative Period ; Retrospective Studies ; Spine ; Spondylosis* ; Transplants

OBJECTIVE: To investigate the physical function of Korean elderly by age and gender and to assess the impact of declined physical function on their quality of life. METHOD: The Korean Longitudinal Study on Health and Aging (KLoSHA) is designed as a populationbased prospective cohort study on health and aging of Korean elderly aged 65 years and over. In one city among the central metropolitan area for one year, 1,000 subjects includeing a simple random sample and an oldest-old subpopulation participated in baseline study. All subjects are older than 65 years (76.3+/-14.8, 65~98 years). We surveyed their general characteristics and symptoms related physical function and examined physical function, functional disabilities, balance function and quality of life with standardized assessment tools. RESULTS: The strengths of quadriceps were preserved over the functional level, but BMI was significantly reduced according to age irrespective of sex. Physical function and quality of life were consistently decreased according to age in female elderly, especially over 80 years. On the contrary, male elderly under 85 years preserved their physical function. In 85~89 year group, they showed the remarkable disabilities related to musculoskeletal conditions or pain and decrease of balance. Elderly people had greater disabilities and lesser confidence for balance, lower quality of life irrespective of sex. CONCLUSION:Significant gender differences in Korean elderly were found in the patterns of functional decline. Physical dysfunctions and disabilities are main factors lowering quality of life.
Aged* ; Aging* ; Cohort Studies ; Female ; Humans ; Longitudinal Studies* ; Male ; Prospective Studies ; Quality of Life*

BACKGROUND: Although relapses are known to be common in optic neuritis, there are only a few follow-up studies concerning recurrent optic neuritis. The aim of this study is to characterize the difference between monophasic and recurrent optic neuritis by analyzing clinical and laboratory spectrums of index event. METHODS: We performed a partially retrospective and prospective cohort study of patients with optic neuritis. The patients with optic neuritis were included by review of their medical records and neuroimaging studies and then followed up for the relapses of optic neuritis. Excluded were those who showed any evidence of multiple sclerosis, and those with prior demyelinating attacks. RESULTS: Thirteen of 43 enrolled patients had a recurrent optic neuritis during a mean (SD) follow up period of 58.0 (21.2) months, yielding a 5-year cumulative rate of recurrence of 39.5 percent. The patients who had CSF pleocytosis were more likely to develop a recurrent attacks (P<0.05), but neither clinical findings nor the other laboratory results appeared to influence recurrence. CONCLUSIONS: We suggest that this disorder have a distinctive feature in terms of relapse and CSF pleocytosis compared with monophasic optic neuritis.
Cohort Studies ; Follow-Up Studies ; Humans ; Leukocytosis ; Medical Records ; Multiple Sclerosis ; Neuroimaging ; Optic Neuritis* ; Prospective Studies ; Recurrence ; Retrospective Studies

PURPOSE: The Medina Embolic Device (MED) is a new intrasaccular device with promising early results. Previously we documented our initial experience of this device both alone and in combination with other devices including flow diverter stents (FDS). We sought to determine the effect of the MED + FDS strategy for the treatment of selected aneurysms. MATERIALS AND METHODS: We performed a retrospective analysis of prospectively collected data to identify all patients with aneurysms treated using both the MED and intraluminal FDS. We present our technical success rate, early and mid-term angiographic follow-up, and clinical outcome data. RESULTS: We identified 25 non-consecutive patients. The treatment was staged in 9 patients and in a single session 16 patients. The average age was 61±12.8 years (range 40–82). The average fundus height was 11±3.6 mm and average fundus width was 10.1±3.4 mm. In the staged cohort (n=9) at delayed angiography (mean 10 mths) 8 aneurysms (89%) showed complete exclusion (mRRC 1) and in one patient there was a parent vessel occlusion. In the simultaneous cohort delayed angiography (n=10, mean 8.1 months) demonstrated complete occlusion (mRRC 1) in 6 aneurysms (60%), 3 neck remnants (mRRC 2) (30%) and 1 patient (10%) showed persistent aneurysmal filling (mRRC 3a). There were 5 complications with permanent morbidity (mRS >2) in two patients. There were no mortalities. CONCLUSION: The MED can be successfully used in combination with intraluminal FDS and in selected aneurysms this may represent an alternative to FDS and adjunctive coiling.
Aneurysm ; Angiography ; Cohort Studies ; Follow-Up Studies ; Humans ; Intracranial Aneurysm* ; Mortality ; Neck ; Parents ; Prospective Studies ; Retrospective Studies ; Stents

No abstract available.
Cohort Studies ; Prospective Studies

No abstract available.
Cohort Studies ; Prospective Studies

BACKGROUND: We performed a retrospective longitudinal study on the effects of changes in weight, body composition, and homeostasis model assessment (HOMA) indices on glycemic progression in subjects without diabetes during a four-year follow-up period in a community cohort without intentional intervention. METHODS: From 28,440 non-diabetic subjects who participated in a medical check-up program in 2004, data on anthropometric and metabolic parameters were obtained after four years in 2008. Body composition analyses were performed with a bioelectrical impedance analyzer. Skeletal muscle index (SMI, %) was calculated with lean mass/weightx100. Subjects were divided into three groups according to weight change status in four years: weight loss (< or =-5.0%), stable weight (-5.0 to 5.0%), weight gain (> or =5.0%). Progressors were defined as the subjects who progressed to impaired fasting glucose or diabetes. RESULTS: Progressors showed worse baseline metabolic profiles compared with non-progressors. In logistic regression analyses, the increase in changes of HOMA-insulin resistance (HOMA-IR) in four years presented higher odds ratios for glycemic progression compared with other changes during that period. Among the components of body composition, a change in waist-hip ratio was the strongest predictor, and SMI change in four years was a significant negative predictor for glycemic progression. Changes in HOMA beta-cell function in four years was a negative predictor for glycemic progression. CONCLUSION: Increased interval changes in HOMA-IR, weight gain and waist-hip ratio was associated with glycemic progression during a four-year period without intentional intervention in non-diabetic Korean subjects.
Body Composition ; Body Weight ; Cohort Studies ; Electric Impedance ; Fasting ; Follow-Up Studies ; Glucose ; Homeostasis ; Logistic Models ; Longitudinal Studies ; Metabolome ; Muscle, Skeletal ; Obesity, Abdominal ; Odds Ratio ; Prediabetic State ; Retrospective Studies ; Waist-Hip Ratio ; Weight Gain ; Weight Loss

The effect of self rated health on all cause mortality was. examined in a community residents sample of 2, 848 men and 3, 534 women aged 55 years or over who has been followed for eight years, 1985-1993. This longitudinal study, conducted in Kangwha County, Keanggido, began in 1985 with baseline examinations of physical and life style characteristics. The results indicate that the self-rated health has a profound and independent effect on all cause mortality during the study period. Cox's hazard model estimates that persons with 'poor' self-rated health has 1.7 times (CI 1.2-2. 6) higher risk of all cause mortality than persons with 'excellent' self-rated health and persons with 'worst' one has 4.2 (CI 2.6-6.2) in male. Estimates for women are similar to those of men. Further researchs to investigate the effects on cause specfic mortality and effects to reveal the work mechanism of self-rated health are highly expected.
Aged* ; Cohort Studies* ; Female ; Follow-Up Studies* ; Humans ; Life Style ; Longitudinal Studies ; Male ; Mortality* ; Proportional Hazards Models