OBJECTIVE: To characterize neuropathic pain in patients with spinal cord injury (SCI) according to classification used in the study by Baron et al. (Baron classification), a classification of neuropathic pain based on the mechanism. To also compare the patterns of neuropathic pain in SCI patients with those in patients with other etiologies and to determine the differences in patterns of neuropathic pain between the etiologies. METHODS: This was a descriptive cross-sectional study. We used the Baron classification to investigate the characteristics of neuropathic pain in SCI. Sixty-one SCI patients with neuropathic pain (The Leeds assessment of neuropathic symptoms and signs score > or =12) were enrolled in this study between November 2012 and August 2013, after excluding patients <20 of age, patients with visual analog scale (VAS) score <3, pregnant patients, and patients with systemic disease or pain other than neuropathic pain. RESULTS: The most common pain characteristic was pricking pain followed by electrical pain and numbness. The mean VAS score of at-level neuropathic pain was 7.51 and that of below-level neuropathic pain was 6.83. All of the patients suffered from rest pain, but 18 (54.6%) patients with at-level neuropathic pain and 20 (50.0%) patients with below-level neuropathic pain suffered from evoked pain. There was no significant difference in between at-level and below-level neuropathic pains. CONCLUSION: The result was quite different from the characteristics of post-herpetic neuralgia, but it was similar to the characteristics of diabetic neuropathy as shown in the study by Baron et al., which means that sensory nerve deafferentation may be the most common pathophysiologic mechanism of neuropathic pain after SCI. Since in our study, we included short and discrete symptoms and signs based on diverse mechanisms, our results could be helpful for determining further evaluation and treatment.
Classification ; Cross-Sectional Studies ; Diabetic Neuropathies ; Humans ; Hypesthesia ; Neuralgia* ; Spinal Cord Injuries* ; Visual Analog Scale

OBJECTIVE: To quantify the activation of the paraspinalis muscles (multifidus and erector spinae) at different walking velocities and slope with surface electromyography. METHODS: This study was a prospective experimental study involving ten healthy male participants. Surface electrodes were placed over the multifidus and erector spinae muscles at the L5 and L3 level. After the electrode was placed at the lumbar paraspinalis muscles, electromyography signals were recorded over 20 seconds. Data were collected three times during the walking exercise at a 0degrees gradient with the speed from 3 to 6 km/hr. At 7degrees gradient and 15degrees gradient, data were also collected three times but a walking speed of 4 km/hr. The area under the curve was calculated for quantitative measurement of muscle activation. RESULTS: While the muscle activation was increased at higher walking velocities at the L5 and L3 levels of the multifidus, the erector spinae muscle activation did not show any change at higher walking velocities. At L3 level of the multifidus and erector spine muscles, the muscle activation was significantly increased in 15degrees gradient compared to those seen in at 0degrees gradient. At L5 level, the multifidus and erector spinae muscle activation in 0degrees gradient was not significantly different from that those seen in 7degrees or 15degrees gradient. CONCLUSION: Fast walking exercise activates lumbar multifidus muscles more than the slow walking exercise. Also, the mid lumbar muscles are comparatively more activated than low lumbar muscles when the walking slope increases.
Electrodes ; Electromyography ; Humans ; Low Back Pain ; Male ; Muscles ; Paraspinal Muscles* ; Prospective Studies ; Spine ; Walking*

This study aimed to identify the factors affecting dry eye syndrome and quality of life (QoL) among college students. Methods: This cross-sectional study administered a descriptive survey to 184 college students across Korea. Data collection was conducted from August 27 to 28, 2024, using an online survey platform (Google Forms). The self-reported survey comprised the Health-Related Quality of Life Instrument with 8 Items scale, the Dry Eye Questionnaire 5, and the Ocular Surface Disease Index. Data analysis was performed using SPSS version 27.0. Results: The participants had a mean age of 21.37 (standard deviation 1.96) years. Regression analysis identified sleep satisfaction, vision-related functions, and dry eye symptoms as statistically significant predictors of QoL, accounting for 18.4% of the variance (F = 14.71, p < .001). Dry eye symptoms were significantly influenced by the use of artificial tears, vision-related functions, and environmental factors, which accounted for 41.3% of the variance (F = 43.93, p < .001). Additionally, significant determinants of ocular surface disease included the use of vision correction tools, the presence of ophthalmic diseases, sleep satisfaction, and dry eye symptoms. These factors explained 45.7% of the variance, confirming the model's robustness (F = 31.84, p < .001). Conclusion: It is necessary to identify strategies to alleviate dry eye syndrome in college students and develop comprehensive prevention and management programs to improve their QoL.

This study aimed to identify the factors affecting dry eye syndrome and quality of life (QoL) among college students. Methods: This cross-sectional study administered a descriptive survey to 184 college students across Korea. Data collection was conducted from August 27 to 28, 2024, using an online survey platform (Google Forms). The self-reported survey comprised the Health-Related Quality of Life Instrument with 8 Items scale, the Dry Eye Questionnaire 5, and the Ocular Surface Disease Index. Data analysis was performed using SPSS version 27.0. Results: The participants had a mean age of 21.37 (standard deviation 1.96) years. Regression analysis identified sleep satisfaction, vision-related functions, and dry eye symptoms as statistically significant predictors of QoL, accounting for 18.4% of the variance (F = 14.71, p < .001). Dry eye symptoms were significantly influenced by the use of artificial tears, vision-related functions, and environmental factors, which accounted for 41.3% of the variance (F = 43.93, p < .001). Additionally, significant determinants of ocular surface disease included the use of vision correction tools, the presence of ophthalmic diseases, sleep satisfaction, and dry eye symptoms. These factors explained 45.7% of the variance, confirming the model's robustness (F = 31.84, p < .001). Conclusion: It is necessary to identify strategies to alleviate dry eye syndrome in college students and develop comprehensive prevention and management programs to improve their QoL.

This study aimed to identify the factors affecting dry eye syndrome and quality of life (QoL) among college students. Methods: This cross-sectional study administered a descriptive survey to 184 college students across Korea. Data collection was conducted from August 27 to 28, 2024, using an online survey platform (Google Forms). The self-reported survey comprised the Health-Related Quality of Life Instrument with 8 Items scale, the Dry Eye Questionnaire 5, and the Ocular Surface Disease Index. Data analysis was performed using SPSS version 27.0. Results: The participants had a mean age of 21.37 (standard deviation 1.96) years. Regression analysis identified sleep satisfaction, vision-related functions, and dry eye symptoms as statistically significant predictors of QoL, accounting for 18.4% of the variance (F = 14.71, p < .001). Dry eye symptoms were significantly influenced by the use of artificial tears, vision-related functions, and environmental factors, which accounted for 41.3% of the variance (F = 43.93, p < .001). Additionally, significant determinants of ocular surface disease included the use of vision correction tools, the presence of ophthalmic diseases, sleep satisfaction, and dry eye symptoms. These factors explained 45.7% of the variance, confirming the model's robustness (F = 31.84, p < .001). Conclusion: It is necessary to identify strategies to alleviate dry eye syndrome in college students and develop comprehensive prevention and management programs to improve their QoL.

This study aimed to identify the factors affecting dry eye syndrome and quality of life (QoL) among college students. Methods: This cross-sectional study administered a descriptive survey to 184 college students across Korea. Data collection was conducted from August 27 to 28, 2024, using an online survey platform (Google Forms). The self-reported survey comprised the Health-Related Quality of Life Instrument with 8 Items scale, the Dry Eye Questionnaire 5, and the Ocular Surface Disease Index. Data analysis was performed using SPSS version 27.0. Results: The participants had a mean age of 21.37 (standard deviation 1.96) years. Regression analysis identified sleep satisfaction, vision-related functions, and dry eye symptoms as statistically significant predictors of QoL, accounting for 18.4% of the variance (F = 14.71, p < .001). Dry eye symptoms were significantly influenced by the use of artificial tears, vision-related functions, and environmental factors, which accounted for 41.3% of the variance (F = 43.93, p < .001). Additionally, significant determinants of ocular surface disease included the use of vision correction tools, the presence of ophthalmic diseases, sleep satisfaction, and dry eye symptoms. These factors explained 45.7% of the variance, confirming the model's robustness (F = 31.84, p < .001). Conclusion: It is necessary to identify strategies to alleviate dry eye syndrome in college students and develop comprehensive prevention and management programs to improve their QoL.

OBJECTIVE: To investigate the prognostic value of cross-sectional areas (CSA) of paraspinal (multifidus and erector spinae) and psoas muscles on magnetic resonance imaging (MRI) in chronicity of low back pain. METHOD: Thirty-eight subjects who visited our hospital for acute low back pain were enrolled. Review of their medical records and telephone interviews were done. Subjects were divided into two groups; chronic back pain group (CBP) and a group showing improvement within 6 months after onset of pain (IBP). The CSA of paraspinal and psoas muscles were obtained at the level of the lower margin of L3 and L5 vertebrae using MRI. RESULTS: CSA of erector spinae muscle and the proportion of the area to lumbar muscles (paraspinal and psoas muscles) at L5 level in the CBP group were significantly smaller than that of the IBP group (p<0.05). The mean value of CSA of multifidus muscle at L5 level in the CBP group was smaller than that of the IBP group, but was not statistically significant (p>0.05). CSA of psoas muscle at L5 level and all values measured at L3 level were not significantly different between the groups (p>0.05). CONCLUSION: CSA of erector spinae muscle at the lower lumbar level and the proportion of the area to the lumbar muscles at the L5 level can be considered to be prognostic factors of chronicity of low back pain.
Back Pain ; Interviews as Topic ; Low Back Pain ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Magnetics ; Magnets ; Medical Records ; Muscles ; Organothiophosphorus Compounds ; Psoas Muscles ; Spine

OBJECTIVE: To investigate the recognition about clinical application of "neurodevelopmental treatment (NDT)". METHOD: We surveyed on the recognition for Bobath and NDT concepts and its training programs provided by Korean Academy of Rehabilitation Medicine from Jan 2009 to Feb 2009. The survey was made for physiatrists and physical therapists (PTs), separately. One hundred twelve physiatrists and 322 PTs have participated. RESULTS: In physiatrist, interest in NDT was very high (98%), and the need for further knowledge of NDT was also high (95%). Though the NDT was mainly used techniques in neuro-rehabilitation setting, the expectation about effectiveness of it was moderate (56%) and the requirement of changing concepts of the NDT was very high (93%). PTs have carried out NDT most frequently with Bobath's concepts, but they also did not regard NDT as the best procedure. PTs emphasized the importance of their handling technique in NDT practices and also had high interest in the other maneuvers beside Bobath's. CONCLUSION: Physiatrists and PTs regard NDT as one of the most important treating method for patients with brain lesions, but it is not approved as the most effective method yet. Nowadays NDT is changing or adapting, with discarding some of the old Bobath's concepts and adding new modern scientific knowledge. Therefore we suggest that physiatrists to give PTs the revised NDT concepts and evidence based the other therapeutic methods. And the NDT needs to be verified its therapeutic efficacy with evidence based view points through proper studies.
Brain ; Handling (Psychology) ; Humans ; Physical Therapists

BACKGROUND/AIMS: In the management of choledocholithiasis, T-tube drainage was the most common treatment modality after common bile duct (CBD) exploration. However, the T-tube drainage has several problems and risk of complications such as abdominal discomfort, long duration of drainage, or bile leakage. We evaluated the effectiveness of primary closure of CBD after choledochotomy and the possibility of substitution for T-tube drainage. METHODS: Seventy six patients with choledocholithiasis who had undergone CBD exploration were enrolled in this study from January 1999 to March 2001. 20 patients among them had undergone primary closure of CBD with preoperative endoscopic nasobiliary drainage (ENBD) or percutaneous transhepatic biliary drainage (PTBD) in situ after exploration (primary closure group), 56 patients had undergone T-tube drainage (T-tube group). We compared the clinical characteristics and outcome between two groups. RESULTS: There was no difference in postoperative complication (19.6% vs. 20%), the mean amount of biliary drainage (326 ml/day vs. 320 ml/day) and the duration of hospitalization (11.6 day vs. 9.2 days) between the both groups. The duration of biliary drainage was significantly longer in the T-tube group (45.3 days) than in the primary closure group (9.2 days; p<0.01). The rate of remnant stone was higher in the T-tube group (32.1%) than the primary closure group (20%), there was not statistically significant. CONCLUSION: The primary closure of CBD with the preoperative biliary drainage was relatively safe and resulted in no difference of clinical outcome. Furthermore, this method induced going back early to normal life. These result suggest that the primary closure of CBD may be a feasible technique after choledochotomy when the patients are selected by specialized indications.
Bile ; Choledocholithiasis ; Common Bile Duct* ; Drainage* ; Hospitalization ; Humans ; Postoperative Complications

PURPOSE: Avascular necrosis (AVN) of the femoral head is a major complication after internal fixation of a femoral neck fracture and determines the functional prognosis. We investigated postoperative bone single-photon emission computed tomography/computed tomography (SPECT/CT) for assessing the risk of femoral head AVN.METHODS: We retrospectively reviewed 53 consecutive patients who underwent bone SPECT/CT within 2 weeks of internal fixation of a femoral neck fracture and follow-up serial hip radiographs over at least 12 months.RESULTS: Nine patients developed femoral head AVN. In 15 patients who showed normal uptake on immediate postoperative SPECT/CT, no AVN occurred, whereas 9 of 38 patients who showed cold defects of the femoral head later developed AVN. The negative predictive value of immediate postoperative SPECT/CT for AVN was 100 %, whereas the positive predictive value was 24 %. Among 38 patients with cold defects, 1 developed AVN 3 months postoperatively. A follow-up bone SPECT/CT was performed in the other 37 patients at 2??0 months postoperatively. The follow-up bone SPECT/CT revealed completely normalized femoral head uptake in 27, partially normalized uptake in 8, and persistent cold defects in 2 patients. AVN developed in 3.7 % (1/27), 62.5 % (5/8), and 100 % (2/2) of each group, respectively.CONCLUSION: According to the time point of imaging, radiotracer uptake patterns of the femoral head on postoperative bone SPECT/CT indicate the risk of AVN after internal fixation of femoral neck fractures differently. Postoperative bone SPECT/CT may help orthopedic surgeons determine the appropriate follow-up of these patients.
Femoral Neck Fractures ; Femur Neck ; Follow-Up Studies ; Head ; Hip ; Humans ; Necrosis ; Orthopedics ; Prognosis ; Retrospective Studies ; Surgeons