OBJECTIVES: In order to standardize the CRP, ESR and WBC count after three types of spinal surgery and get clinical usefulness from these laboratory dadas after spinal surgery and clincal usefulness of laboratory datas. MATERIAL AND METHODS: Three groups of patients(microdisectomy, anterior and posterior fusion) were chosen for the study. CRP, ESR and WBC levels were prospectively determined before surgery and at days 1-5, 10, 14,21 and 42 after surgery. RESULTS: In all patients, preoperative normal CRP level(<10mg/L) increased, reaching peak levels on the second day after anterior fusion(84.6mg/L), and at the third day after microdiscectomy(54.5mg/L) and posterolateral intercorporal fusion(152.2mg/L), with normalization in 5-10 days. Preoperative normal ESR level increased to peak level on the forth day after microdiscectomy(33.0mm/hr), and increased double peak levels after anterior(postoperative days 2&5) and posterolateral intercorporal fusion(postoperative days 3&5). ESR followed by a slow and irregular decrease, and at 42 days after surgery often remained elevated. WBC increased to variable peak level within normal limit in all patients. CONCLUSIONS: The rapid decline in CRP will probably be interrupted by a second rise or persisting elevation if infection occurs. CRP is presumably a better test than ESR for early detection of postoperative infection.
Blood Sedimentation* ; C-Reactive Protein* ; Erythrocytes* ; Humans ; Prospective Studies

BACKGROUND: Cardiogenic pulmonary edema increases nonspecific airway responsiveness in humans and animals. Increased extravascular lung water from overt pulmonary edema to subclinical interstitial edema is a common finding in patients with chronic renal failure. Several studies carried out to assess pulmonary function disturbances in this condition have documented a reduction in forced expiratory volume that usually reverses after hemodialysis, suggesting airway edema as the underlying mechanism. This interstitial edema may also lead to nonspecific bronchial hyperre- sponsiveness. We hypothesized that patients with chronic renal failure may present nonspecific bronchial hyperresponsiveness due to subclinical interstitial pulmonary edema. METHODS: We studied 18 chronic renal failure undergoing regular hemodialysis 3 times a week (New York Heart Association Class II) without concomittent disease. These patients were checked pulmonary function test and metacholine provocation test before hemodialysis and same procedure was repeated if responsive, after hemodialysis. RESULTS: 1) 12 out of 18 patients before hemodialysis were reactive in metacholine provocation test (66.7%) before hemodialysis. This airway hyperresponsiveness were decreased after hemodialysis. 2) Pulmonary function was improved after hemodialysis and change in FEV1 was correlated with change in weight(r= -0.62, p<0.01). 3) There was a close correlation between log PD20 and FEF25, which is one of the variables of the peripheral airways(r=0.58, p<0.05). CONCLUSION: We speculated interstitial pulmonary edema may play a significant role in bronchial hyperresponsiveness and lung function impaired in patients with chronic renal failure.
Animals ; Edema ; Extravascular Lung Water ; Forced Expiratory Volume ; Heart ; Humans ; Kidney Failure, Chronic* ; Lung ; Pulmonary Edema ; Renal Dialysis* ; Respiratory Function Tests

PURPOSE: To evaluate the effects of a logotherapy program entitled 'Finding meaning in my life' for adolescents with terminal cancer. METHODS: A nonequivalent control group, non-synchronized design was conducted with a convenience sample of 44 late adolescents with terminal cancer. The experimental group (n=22) participated in the 'Finding meaning in my life' program which consisted of five-day sessions for one week. The control group (n=22) received the usual nursing care. The effects were measured using adolescent meaning in life (AMIL), and quality of life (QOL) scales. The collected data were analyzed by descriptive statistics, Chi-square, and t-test using SPSS/PC 17.0 program. RESULTS: There were significant differences in AMIL (t=3.36, p<.05) and QOL (t=2.67, p<.05) between the experimental and control groups. CONCLUSION: Logotherapy is effective in improving the meaning in life and quality of life of late adolescents with terminal cancer, and can be used to prevent existential distress.
Adolescent ; Demography ; Female ; Humans ; Male ; Neoplasms/psychology/*therapy ; Patient Education as Topic ; Program Evaluation ; *Psychotherapy ; Quality of Life ; Questionnaires ; Young Adult

PURPOSE: To compare the effect of nerve regeneration with infiltration of normal saline and nerve growth factor after vein graft to the resected sciatic nerve of rat. MATERIALS AND METHODS: Eighty Sprague-Dawley rats were divided into five experimental groups: orthotopic nerve graft as control group, inside-in vein graft with normal saline infiltration, inside-out vein graft with normal saline infiltration, inside-in vein graft with nerve growth factor infiltration and inside-out vein graft with nerve growth factor infiltration group. Animals of each group were sacrificed after electromyography at 2, 4, 8 and 12 weeks after operation. Also the light microscopy and transmission electron microscopy were performed to observe histologic change of grafted sites. RESULTS: This study demonstrates that autogenous vein graft serves as a conduit for nerve regeneration, and inside-out vein graft technique and nerve growth factor induce faster and more numerous axonal regeneration and earlier recovery of muscle power. CONCLUSION: Inside-out vein graft with nerve growth factor infiltration is supposed to be a promising technique to take the place of autogenous nerve graft.
Animals ; Axons ; Electromyography ; Microscopy ; Microscopy, Electron, Transmission ; Nerve Growth Factor* ; Nerve Regeneration* ; Rats ; Rats, Sprague-Dawley ; Regeneration ; Sciatic Nerve* ; Transplants* ; Veins*

PURPOSE: To compare the effect of nerve regeneration with infiltration of normal saline and nerve growth factor after vein graft to the resected sciatic nerve of rat. MATERIALS AND METHODS: Eighty Sprague-Dawley rats were divided into five experimental groups: orthotopic nerve graft as control group, inside-in vein graft with normal saline infiltration, inside-out vein graft with normal saline infiltration, inside-in vein graft with nerve growth factor infiltration and inside-out vein graft with nerve growth factor infiltration group. Animals of each group were sacrificed after electromyography at 2, 4, 8 and 12 weeks after operation. Also the light microscopy and transmission electron microscopy were performed to observe histologic change of grafted sites. RESULTS: This study demonstrates that autogenous vein graft serves as a conduit for nerve regeneration, and inside-out vein graft technique and nerve growth factor induce faster and more numerous axonal regeneration and earlier recovery of muscle power. CONCLUSION: Inside-out vein graft with nerve growth factor infiltration is supposed to be a promising technique to take the place of autogenous nerve graft.
Animals ; Axons ; Electromyography ; Microscopy ; Microscopy, Electron, Transmission ; Nerve Growth Factor* ; Nerve Regeneration* ; Rats ; Rats, Sprague-Dawley ; Regeneration ; Sciatic Nerve* ; Transplants* ; Veins*

PURPOSE: To compare the effect of nerve regeneration with infiltration of normal saline and nerve growth factor after vein graft to the resected sciatic nerve of rat. MATERIALS AND METHODS: Eighty Sprague-Dawley rats were divided into five experimental groups: orthotopic nerve graft as control group, inside-in vein graft with normal saline infiltration, inside-out vein graft with normal saline infiltration, inside-in vein graft with nerve growth factor infiltration and inside-out vein graft with nerve growth factor infiltration group. Animals of each group were sacrificed after electromyography at 2, 4, 8 and 12 weeks after operation. Also the light microscopy and transmission electron microscopy were performed to observe histologic change of grafted sites. RESULTS: This study demonstrates that autogenous vein graft serves as a conduit for nerve regeneration, and inside-out vein graft technique and nerve growth factor induce faster and more numerous axonal regeneration and earlier recovery of muscle power. CONCLUSION: Inside-out vein graft with nerve growth factor infiltration is supposed to be a promising technique to take the place of autogenous nerve graft.
Animals ; Axons ; Electromyography ; Microscopy ; Microscopy, Electron, Transmission ; Nerve Growth Factor* ; Nerve Regeneration* ; Rats ; Rats, Sprague-Dawley ; Regeneration ; Sciatic Nerve* ; Transplants* ; Veins*

PURPOSE: Although most peritrochanteric fractures in old age necessitates surgical treatment, daily life functions are still impaired after discharge. We assessed the types of peritrochanteric fracture, risk factors, and functional recovery in elderly patients who were over 65 years old. We also tried to determine factors for recovery to daily life. MATERIALS AND METHODS: From January 2006 to December 2007, among 61 patients who were over 65 years old with the possibility of 1 year follow-up, 50 patients were selected through interviews. After verifying age, sex, mode, types of fracture, and method, we analyzed daily living activities with a functional recovery index and estimated recovery of daily life functions after surgery, assuming a score increase if functional recovery was good. RESULTS: The mean age was 75.8 years, and females (31 patients, 62%) exceeded males. Slipping (27 patients, 54%) was the most common cause of fracture, and the intertrochanteric femur fracture was the most common fracture type (34, 68%). The average functional recovery index decreased 16.24% compared with the pre-operation value, having a tendency to decrease more in old age and female patients. Subtrochanteric femur fracture showed a 17.6% decrease in functional recovery index among the fracture types. CONCLUSION: In elderly patients over 65 years, the functional recovery index after peritrochanteric fracture decreased 16.24% on average compared with the preoperation state. The largest decrease was in basic life ability. The functional recovery index decreased more in old age, females, and subtrochanteric femur fracture, which indicates these factors influence functional recovery.
Activities of Daily Living ; Aged ; Female ; Femur ; Follow-Up Studies ; Humans ; Life ; Male ; Risk Factors

STUDY DESIGN: Level III, Retrospective studies. OBJECTIVES: This study was conducted to evaluate the effects and usefulness of the selective nerve root block in advance for the Degenerative Lumbar Scoliosis patients, with radiating pain, who were scheduled for an operation. SUMMARY OF LITERATURE REVIEW: Selective nerve root block was introduced in 1971, by Macnab and it was used to make improvements for radiating pain, as a treatment of multiple lesions or a tool to help making a surgical decision, and to predict the result. After an introduction by Cooper, selective root block on degenerative sclerosis, with lower leg radiating pain, showed fine results on a short term follow-up and moderate to good results on long term follow-up. MATERIALS AND METHODS: Between January 2005 to December 2009, 47 cases were selected from the patients, who underwent selective nerve root block, before the operation. The mean follow-up period was 38.4 months and the mean age was 67.1 years. The patients were divided into the operation group and the only selective nerve root block group. The treatment results in the SNRB group and the operation group were analyzed using Kim's criteria and the Visual Analog Scale score. The groups were radiologically evaluated for the neural compression rate. RESULTS: Among the 47 cases that were scheduled for an operation, 30 cases did not proceed to the operation. The average VAS score for the selective root block group and the operation group were 7.56 and 8.12, at the preoperative state and the preinjection state, respectively. After the selective nerve root block and surgical treatment, the scores were 3.71 and 2.64 at 1year follow up, respectively. There was no correlation with statistical significance between the initial VAS score and the degree of stenosis noted in the MRI (P>0.05). There was no statistical significant correlation between the initial relief from selective nerve root injections and the degree of stenosis noted in the MRI (P>0.05). However, there was a correlation with statistical significance between the operation rate and the degree of stenosis noted in the MRI (P<0.05). CONCLUSION: Selective nerve root block is considered to be an effective treatment for the Degenerative Lumbar Scoliosis patients with radiating pain, who are scheduled for an operation.
Constriction, Pathologic ; Follow-Up Studies ; Humans ; Leg ; Radiculopathy ; Retrospective Studies ; Sclerosis ; Scoliosis

STUDY DESIGN: Level III, retrospective studies. OBJECTIVES: This study is conducted to evaluate the effect and usefulness of ultrasound guided facet block for the outpatients who complained of chronic lower back pain. SUMMARY OF THE LITERATURE REVIEW: Facet joint syndrome was introduced in 1976, by Mooney V. It was considered to be one of the major causes of low back pain. MATERIALS AND METHODS: Between October 2009 to March 2011, 98 cases were selected from the outpatients who complained of chronic lower back pain for more than 3 months. The patients had no surgery history and did not complain of neuromuscular symptoms, and they had more than three times outpatient care at least and could be followed up for 1 year. The patients were divided into three groups; first was the ultrasound guided facet block group (27 cases), second was the Fluoroscopy guided facet block group (39cases) and third was the conservative group (32 cases).The clinical results were analyzed using Kim's criteria and the Visual Analog Scale score, ODI score, Physician's global assessment (subjective), Patient's global assessment (Objective). RESULTS: The VAS score was improved from an average of 7.75+/-1.5 to 4.47+/-2.4 in the ultrasound guided facet block group, and from 7.81+/-1.4 to 4.39+/-2.6 in the Fluoroscopy guided facet block group, and from 7.87+/-1.3 to 6.24+/-2.1 in the conservative group. The VAS score, Kim's criteria, ODI score, Physician's global assessment (subjective), and Patient's global assessment (Objective) showed statistically significant improvement in the ultrasound guided facet block group and Fluoroscopy guided facet block group. CONCLUSION: In the outpatient clinics, comparing with the group that underwent conservative treatment with medication, the group treated with ultrasound for block could have better results in clinical improvement.
Ambulatory Care ; Ambulatory Care Facilities ; Fluoroscopy ; Humans ; Low Back Pain ; Outpatients ; Retrospective Studies ; Zygapophyseal Joint

No abstract available.
Humans ; Kidney Diseases* ; Kidney* ; Procollagen*