OBJECTIVE: To compare the effects of intermittent mechanical traction with spinal decompression therapy (SDT), using the newly introduced device DRX 3000(R), in patients suffering from low back pain associated with lumbosacral disc herniation documented on MRI. METHOD: Thirty-five patients with low back pain with or without lower extremity radiating pain were prospectively enrolled in this study. They were all diagnosed with lumbosacral disc herniation according to physical examinations and MRI. Patients over age 60 years or those with previous spinal surgery, spondylolisthesis, severe osteoporosis, rheumatic diseases, hypertension, and other serious medical problems were excluded. Patients were randomly assigned to intermittent mechanical traction group (15 patients) or SDT group (20 patients) and compared visual analog pain scale (VAS) pre- and post-treatment. RESULTS: There was a significant improvement in VAS in SDT group compared to intermittent mechanical traction group. The mean reduction in VAS for intermittent mechanical traction group equaled 1.93+/-0.83 (from 6.4+/-1.28 to 4.5+/-1.22) while the mean reduction in VAS in SDT group equaled 4.35+/-2.21 (from 6.9+/-1.86 to 2.6+/-1.43) (p=0.0006). CONCLUSION: Spinal decompression therapy can be used as an effective treatment for discogenic low back pain without serious complications.
Decompression ; Humans ; Hypertension ; Low Back Pain ; Lower Extremity ; Osteoporosis ; Pain Measurement ; Physical Examination ; Prospective Studies ; Rheumatic Diseases ; Spondylolisthesis ; Stress, Psychological ; Traction

A primary pulmonary malignant lymphoma is a rare disease. It is thought to be a category of non-Hodgkin's lymphoma arising from the bronchous-associated lymphoid tissue (BALT). The majority of primary pulmonary lymphomas are low-grade, small B-cell lymphomas, which are associated with Sjogren's syndrome and similar autoimmune disorders. A case of primary pulmonary low-grade B-cell lymphoma arising from the BALT was encountered in a patient with systemic lupus erythematosus. A 54-year-old man was admitted to the hospital for the evaluation of left pleuritic chest pain and multiple joint pain in both hands. Serologic tests for collagen vascular disease were performed. The results of ANA and anti-ds-DNA were all positive. The computed tomography of the chest showed patchy concolidations in the left lower lobe with a pleural effusion and a video-assisted thoracoscopic biopsy was performed. Here we report a case of low-grade B-cell lymphoma of BALT in a patient with systemic lupus erythematosus with a review of the relevant leteratures.
Arthralgia ; Biopsy ; Chest Pain ; Collagen ; Hand ; Humans ; Lupus Erythematosus, Systemic ; Lymphoid Tissue* ; Lymphoma* ; Lymphoma, B-Cell ; Lymphoma, Non-Hodgkin ; Middle Aged ; Pleural Effusion ; Rare Diseases ; Serologic Tests ; Sjogren's Syndrome ; Thorax ; Vascular Diseases

OBJECTIVES : The aim of this study was to identify the characteristic symptoms for diagnosis of Hwabyung (HB), a culture-related anger syndrome in Korea; to construct a rating scale for HB and test its validity and reliability; and propose diagnostic criteria for HB. METHODS : Subjects were male and female Korean patients, who were diagnosed following Structured Clinical Interview (SCID) as having depressive disorders, anxiety disorders and somatoform disorders and who reported as having self-labeled HB. A HB Scale was constructed with 22 of the most common symptoms of HB as identified by previous studies. The HB scale's inter-rated reliability was tested with 60 subjects. Its validity was tested by comparison between a HB only group(n=47) and depressive disorder only group (n=44). Logistic regression analysis was conducted to make a predictive model of HB. Based on these results diagnostic criteria for HB was proposed. RESULTS : Inter-rated reliability in each of all the items and the total score of the HB Scale were statistically significant. The HB scale differentiated HB from depressive disorder with statistical significance. In logistic regression analysis, the ability of the HB model to predict symptoms of heat sensation, ukwool/boon (feeling of unfairness), and subjective anger was high with sensitivity of 80.0%, specificity of 88.4%, accuracy of 84.1% and area under ROC of 0.92. Based on these results and information from previous research, diagnostic criteria of HB were formulated. CONCLUSION : The HB Scale was found to be reliable and valid. Consequently, diagnostic criteria of HB were proposed, to include subject anger, "kwool/boon" (Feeling of unfairness), expressed anger, heat sensation, hostility, "haan", pushing-up in the chest, epigastric mass, respiratory stuffiness, palpitation, dry mouth, sighing, racing thoughts, and lamentation.
Anger ; Anxiety Disorders ; Continental Population Groups ; Depressive Disorder ; Female ; Hemoglobin, Sickle ; Hostility ; Hot Temperature ; Humans ; Logistic Models ; Male ; Mouth ; Sensation ; Sensitivity and Specificity ; Somatoform Disorders ; Thorax

Those composing temporomandibular joint (TMJ) complex such as the temporal bone, the disc and the mandibular condyle perform their own functions with organic relation. The retrodiscal tissue is the main area of pain induction and contributes to compositional change of synovial fluid. If displacement of the disc lasts long time, not only adaptive changes, but also destructive or degenerative changes may happen. It was reported that these changes and symptoms appear mostly to female rather than male and especially, in the case of patients suffering from TMJ disorder, a large quantity of female sex hormone is found in the joint synovium. And that may play a role in bone resorption and inflammation. Also, the frequency and the intensity of pain perception for female is reported to be much more than for male. In this study, we investigated the expression extents of estrogen receptors (ER) and progesteron receptors (PR) in retrodiscal tissue with immunohistochemistry among the patients received TMJ surgery and compared with MRI findings and surgical findings. We report the relations between the expression of ER in retrodiscal tissue and the pathological change in TMJ, such as inflammation, internal derangement and osteoarthritis.
Bone Resorption ; Displacement (Psychology) ; Estrogens ; Female ; Gonadal Steroid Hormones ; Humans ; Immunohistochemistry ; Inflammation ; Joints ; Male ; Mandibular Condyle ; Osteoarthritis ; Pain Perception ; Receptors, Estrogen ; Stress, Psychological ; Synovial Fluid ; Synovial Membrane ; Temporal Bone ; Temporomandibular Joint ; Temporomandibular Joint Disorders

PURPOSE: This study was conducted to determine the association between intake of milk and dairy products as well as calcium and biomarkers related to lipid metabolism in Korean female patients with type 2 diabetes. MATERIALS AND METHODS: A cohort of 509 female subjects (mean age: 59.0 years; range: 35-80 years) was recruited from Huh's Diabetes Clinic in Seoul between 2005 and 2010. Dietary intake was assessed using a validated food-frequency questionnaire. Subjects were divided into three groups on the basis of their daily intake of milk and dairy products [<50 g/day (0<50 g/day), 50-200 g/day, and >200 g/day (>200-1201 g/day)] and then further divided into two groups according to their daily calcium intake: below and above the estimated average requirement (EAR). RESULTS: After adjustment for age, body mass index, energy intake, exercise, use of nutritional supplements and cholesterol medication, the level of serum high-density lipoprotein (HDL)-cholesterol was significantly higher in subjects with milk and dairy products consumption of >200 g/day than in subjects in the other two groups. Those subjects with a milk and dairy products consumption of >200 g/day had significantly higher levels of apolipoprotein A-1 and a significantly lower atherogenic index than the other two groups. Patients with a calcium intake above the EAR exhibited a significantly greater serum HDL-cholesterol level than those with a calcium intake below the EAR. CONCLUSION: Milk and dairy products, good sources of calcium, play a positive role in lipid profiles in female patients with type 2 diabetes.
Adult ; Aged ; Aged, 80 and over ; Animals ; Apolipoprotein A-I/blood ; Biological Markers/metabolism ; *Calcium, Dietary ; Cholesterol, HDL/blood ; Diabetes Mellitus, Type 2/*metabolism ; Diet ; Female ; Humans ; *Lipid Metabolism ; Middle Aged ; *Milk

Postinfectious glomerulonephritis (PIGN) is most commonly caused by Streptococcus pyogenes in children, but PIGN associated with other pathogens has been described in the literature. A previously healthy 6-year-old boy was admitted with complaints of cough, fever, and right chest pain. The patient was diagnosed with pneumococcal bacteremia and influenza A virus infection and treated with antibiotics and antiviral agent. During hospitalization, generalized edema, hematuria, proteinuria, and increased blood pressure were observed; therefore, we started administering diuretics. The boy was discharged with gross hematuria, and even microscopic hematuria disappeared 14 weeks after discharge. We report a case of PIGN associated with bacteremic pneumococcal pneumonia and influenza A virus infection in children. A urine test and blood pressure measurement should be considered for the early detection of PIGN in children with pneumococcal or influenza A virus infection when they present with nephritic symptoms.
Anti-Bacterial Agents ; Bacteremia ; Blood Pressure ; Chest Pain ; Child ; Cough ; Diuretics ; Edema ; Fever ; Glomerulonephritis ; Hematuria ; Hospitalization ; Humans ; Influenza A virus ; Influenza, Human ; Male ; Pneumonia ; Pneumonia, Pneumococcal ; Proteinuria ; Streptococcus pneumoniae ; Streptococcus pyogenes

Male osteoporosis is known to progress slowly and is less severe compared to female osteoporosis, and the incidence of lumbar compression fracture is considerably lower in male population. Hypogonadism which can develop from various causes including hypopituitarism is a common cause for secondary male osteoporosis. Hypopituitarism as a late complication of severe form of hemorrhagic fever with renal syndrome (HFRS) is known to occur occasionally but its clinical symptoms rarely appear. A 75-year-old male patient who had recovered from HFRS 13 years ago was admitted due to severe low back pain. He presented with gradually developed symptoms of hypogonadism and hypothyroidism resulting from hypopituitarism. MRI revealed collapsed pituitary gland and empty sella. This case presents with a male patient with multiple lumbar compression fractures due to severe osteoporosis secondary to hypogonadism, which resulted from hypopituitarism as a late complication of HFRS.
Aged ; Female ; Fever ; Fractures, Compression ; Hemorrhagic Fever with Renal Syndrome ; Humans ; Hypogonadism ; Hypopituitarism ; Hypothyroidism ; Incidence ; Low Back Pain ; Male ; Osteoporosis ; Pituitary Gland

Jaw Fixation Techniques ; Mandibular Condyle ; Mandibular Fractures ; Mouth

BACKGROUND/AIMS: Obesity is correlated with numerous diseases, including thyroid cancer, but the clinical significance of obesity with regard to the clinical characteristics of thyroid cancer remains unclear. Neck circumference is an index of upper-body adipose tissue distribution. METHODS: In total, 401 patients with papillary thyroid carcinoma (PTC) measuring < or = 2 cm were included. Neck circumference was measured horizontally at the level just below the thyroid cartilage on preoperative neck computed tomographic images. RESULTS: Neck circumference correlated significantly with tumor size in men (p = 0.001) but not in women (p = 0.930). Body mass index (BMI) did not significantly correlate with tumor size in either sex. Neck circumference was significantly larger in men with lateral lymph node (LN) metastasis than in those without (p = 0.004). Neck circumference and BMI did not differ significantly in women according to other factors such as tumor size, multifocality, extrathyroid extension, and LN metastasis. Tumor size and the prevalence of lateral LN metastasis in men tended to increase in the middle/large neck circumference subgroup compared with those in the low neck circumference subgroup. Multivariate logistic regression analysis revealed that neck circumference (p = 0.009) was a predictor for the presence of lateral LN metastasis in men. BMI was not a predictive factor for lateral LN involvement in either sex. CONCLUSIONS: Neck circumference, an indicator of central or visceral obesity but not BMI, may be associated with some prognostic factors in men with small PTC.
Adiposity ; Adolescent ; Adult ; Aged ; Anthropometry ; Body Mass Index ; Carcinoma/*secondary/surgery ; Chi-Square Distribution ; Cross-Sectional Studies ; Female ; Humans ; Logistic Models ; Lymph Nodes/*pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Multivariate Analysis ; Neck/*pathology ; Obesity/*diagnosis/pathology/physiopathology ; Odds Ratio ; Predictive Value of Tests ; Prognosis ; Risk Factors ; Sex Factors ; Thyroid Neoplasms/*pathology/secondary/surgery ; Tomography, X-Ray Computed ; *Tumor Burden ; Young Adult

BACKGROUND: Whether thyroid lobectomy alone is a sufficient treatment for papillary thyroid microcarcinoma (PTMC) remains controversial. The aim of this study is to evaluate the predictive factors for incidental contralateral carcinoma in patients confirmed of unilateral PTMC preoperatively. METHODS: Between January 2007 and December 2009, 393 patients underwent thyroid surgery for unifocal and unilateral PTMC preoperatively at Pusan National University Hospital. A total thyroidectomy with central neck dissection was routinely performed for these patients during this study period. RESULTS: Among the 393 cases in the cohort, 77 patients (19.6%) had incidental PTMC in the contralateral lobe. In patients with incidental contralateral carcinoma, there was higher prevalence in extrathyroid extension, occult ipsilateral carcinoma, pathologic Hashimoto's thyroiditis, and central lymph node metastasis compared to those without contralateral carcinoma. The mean tumor size also increased in patients with contralateral carcinoma. Multivariate logistic regression showed that extrathyroid extension (P = 0.049), occult ipsilateral carcinoma (P < 0.001), pathologic Hashimoto's thyroiditis (P = 0.038), and central lymph node metastasis (P = 0.002) were predictive factors for incidental contralateral carcinoma. CONCLUSION: In conclusion, multifocality in the ipsilateral lobe, central lymph node metastasis, extrathyroid extension, and Hashimoto's thyroiditis is associated with the presence of contralateral carcinoma. Thus, if these factors are found by preoperative and/or postoperative evaluation, total thyroidectomy or completion thyroidectomy is necessary for the treatment of PTMC.
Carcinoma ; Carcinoma, Papillary ; Cohort Studies ; Hashimoto Disease ; Humans ; Incidental Findings ; Logistic Models ; Lymph Nodes ; Neck Dissection ; Neoplasm Metastasis ; Prevalence ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy ; Thyroiditis