Biomedical subjects

E Lau

Publications and source records attributed to E Lau.

At least 19 recordsLinked to original sources

PubMed2007

Positron emission tomography of stage IV mucosa-associated lymphoid tissue lymphoma confined to the four major salivary glands.

In a patient with stage IVA marginal zone lymphoma, (18)F-fluorodeoxyglucose-positron emission tomography indicated that the disease was confined to the four major salivary glands. The positron emission tomography findings encouraged the use of radiotherapy with curative intent in this case. After 30 Gy of external beam radiotherapy to the parotid and submandibular glands, the patient entered a complete remission and remains free from progression more than 4 years later.

Female↗

PubMed2006

In vivo tracking of macrophage activated killer cells to sites of metastatic ovarian carcinoma.

Radio-labelling of blood cells is an established technique for evaluating in vivo migration of normal cells to sites of pathology such as infection and haemorrhage. A limitation of cellular immunotherapies to induce anti-tumour responses is in part due to the uncertain ability of cellular effectors to reach their intended target. We extended the approach of cell radiolabelling to accurately examine the in vivo distribution of cellular immunotherapy with ex-vivo macrophage activated killer (MAK) cells. We describe the use of two methods of cell labelling for tracking the destination of autologous-derived macrophage activated killer (MAK) cells linked to the bi-specific antibody MDX-H210 delivered either by intravenous (i.v.) or intraperitoneal (i.p.) injection in ten patients with peritoneal relapse of epithelial ovarian carcinoma. Our results demonstrate the feasibility of generating high numbers and purity of GMP quality MAK cells, which can be radiolabelled with (18)F-FDG or (111)In-oxime. MAK cell administration produced minimal infusional toxicity and demonstrated a reproducible pattern of in vivo distribution and active in vivo tracking to sites of known tumour following 8 of 16 i.v. infusions or 4 of 6 i.p. infusions. However, the leakage of (18)F-FDG limited the ability to confidently confirm the tracking of MAK cells to tumour in all cases and improved PET labels are required. The addition of MDX-H210 bispecific antibody did not alter the distribution of cells to tumour sites, but did accelerate the clearance of i.v. administered MAK cells from the pulmonary circulation. This data demonstrates that cellular cancer immunotherapies may be successfully delivered to the sites of active tumour following either i.v. or i.p. injection in a proportion of patients with metastatic cancer. Incorporation of tracking studies in early cycles of cellular immunotherapy may allow selection of patients who demonstrate successful targeting of the immunotherapy for ongoing treatment.

Antibodies, Bispecific↗

PubMed2006

Nutrient intake and psychological health in an elderly Chinese population.

BACKGROUND: Associations between nutrition and cognitive impairment, and nutrition and depression, have been observed. Elderly people are at risk of under nutrition, and also have higher prevalence of cognitive impairment and depression. OBJECTIVE: To examine the relationship between nutrient intake and psychological health in the elderly, adjusting for confounding factors. SUBJECTS: Three thousand nine hundred and ninety-nine men and women aged 65 years and over living in the community, with approximately equal numbers in three age groups: 65-69, 70-74, 75+ years. METHODS: Dietary intake was assessed using a 7-day food frequency questionnaire. Cognitive function was assessed by the cognitive part of the Community Screening Instrument for Dementia (CSID). Depression was assessed using the Geriatric Depression Scale (GDS). Information was also collected for confounding factors: demographics, educational level, socioeconomic status, medical history, smoking, alcohol intake, and physical activity. Logistic regression analyses were carried out to examine associations between lifestyle and dietary variables, and CSID and GDS, controlling for confounders. RESULTS: Both CSID and GDS scores were associated with co-morbidity, demographic and socioeconomic factors. Few associations between lifestyle factors and CSID score were observed. Dietary factors inversely associated with GDS score include total fat intake, vitamins A, B2, B3, C, fibre, and vegetables. In terms of nutrient density, iron and isoflavone intake were additional factors. CONCLUSION: Association exists between intake of various nutrients and psychological health independent of other confounding factors in the elderly population. A follow-up study of this cohort or interventional studies are needed to elucidate cause effect relationship.

Aged↗

PubMed2006

Economic burden of revision hip and knee arthroplasty in Medicare enrollees.

UNLABELLED: The economic burden to Medicare due to revision arthroplasty procedures has not yet been studied systematically. The economic burden of revisions was calculated as annual reimbursements for revision arthroplasties relative to the sum total reimbursements of primary and revision arthroplasties. We evaluated this revision burden for total hip and knee arthroplasties through investigation of trends in charges and reimbursements in the Medicare population (Parts A and B claims from 1997-2003), while taking into account age and gender effects. Mean annual economic revision burdens were 18.8% (range, 17.4-20.2%) and 8.2% (range, 7.5-9.2%) for total hip arthroplasties and total knee arthroplasties, respectively. Procedural charges increased while reimbursements decreased over the study period, with higher charges observed for revisions than primary arthroplasties. Reimbursements per procedure were 62% to 68% less than associated charges for primary and revision total hip and knee arthroplasties. The effect of age and gender on reimbursements varied by procedure type. Unless some limiting mechanism is implemented to reduce the incidence of revision surgeries, the diverging trends in reimbursements and charges for total hip and knee arthroplasties indicate that the economic impact to the Medicare population and healthcare system will continue to increase. LEVEL OF EVIDENCE: Prognostic study, level II-1 (retrospective study). See Guidelines for Authors for a complete description of levels of evidence.

Aged↗

PubMed2006

Natural history of patients with recurrent chronic hepatitis C virus and occult hepatitis B co-infection after liver transplantation.

It is uncertain whether occult hepatitis B virus co-infection will hasten progressive liver disease in chronic hepatitis C patients after liver transplantation. This study evaluated fibrosis progression and severe fibrosis in 118 consecutive hepatitis B surface antigen-negative patients with virological and histological evidence of recurrent chronic hepatitis C infection co-infected with occult hepatitis B virus after liver transplantation. HBV DNA was detected from serum at the time of recurrent chronic hepatitis C infection by polymerase chain reaction. Each subject underwent a repeat liver biopsy 5 years post-liver transplantation. Occult hepatitis B virus co-infection was present in 41 of the 118 (34.7%) patients. At 5 years post-liver transplantation, 13 of the 41 occult hepatitis B virus co-infected patients compared with 16 of the 77 patients without occult hepatitis B virus co-infection developed fibrosis progression (31.7% vs. 20.8%, respectively, p = 0.39). Eight of 41 the occult hepatitis B virus co-infected patients compared with 13 of the 77 patients without occult hepatitis B virus co-infection had severe fibrosis (19.5% vs. 16.9%, respectively, p = 0.97). In conclusion, occult hepatitis B virus co-infection in patients with recurrent chronic hepatitis C infection was not associated with accelerated fibrosis progression or severe fibrosis after liver transplantation.

Adult↗

PubMed2005

Correlates for a low ankle-brachial index in elderly Chinese.

This study examines the prevalence of atherosclerosis (using ankle-brachial index (ABI) value <0.9) and associated socioeconomic and lifestyle factors in elderly Chinese, adjusting for presence of cardiovascular diseases and body mass index, in a cross-sectional survey of 1999 men and 1999 women aged 65 years and over living in the community. A questionnaire containing information regarding socioeconomic status, medical history and lifestyle factors was administered. Measurement included height, weight, percentage body fat using dual-energy X-ray absorptiometry and ABI. The Hong Kong population (2000) age adjusted prevalence of ABI <0.9 was 5.3% for men and 11.0% for women. In multivariate analysis, old age, female gender, presence of cardiovascular diseases, cognitive impairment, prolonged 6 m walk, smoking habit and alcohol intake were positively associated with ABI <0.9, while negative associations were observed with Vitamin C intake >100 mg per day, with the lowest OR for the range 141-190 mg (OR 0.4). Physical activity level, and self rated higher social standing in the community, while significant in univariate analysis, were not included as independent significant factors in the multivariate model. Lifestyle factors and the female gender were independent risk factors for atherosclerosis in the elderly Chinese population.

Aged↗

PubMed2005

Editorial.

Explore the source record for details and available documents.

Aged↗

PubMed2004

Weather changes associated with hospitalizations for cardiovascular diseases and stroke in California, 1983-1998.

Poisson regression models were used to evaluate associations between temperature, precipitation, days of extreme heat, and other weather changes (lagged 7 days), as well as El Niño events, with hospitalizations for acute myocardial infarction, angina pectoris, congestive heart failure, and stroke in three California regions. Temperature changes were defined as a 3 degrees C decrease in maximum temperature or a 3 degrees C increase in minimum temperature. Temperature and precipitation were analyzed separately for normal weather periods and El Niño events, and for both weather periods combined. Associations varied by region, age, and gender. In Los Angeles, temperature changes resulted in small changes in hospitalizations. Among San Francisco residents 70+ years of age, temperature changes increased hospitalizations for nearly all outcomes from 6% to 13%. Associations among Sacramento residents were similar to those in San Francisco: among men 70+ years of age, temperature changes increased hospitalizations by 6%-11% for acute myocardial infarction and congestive heart failure, and 10%-18% for stroke. El Niño events were consistently and significantly associated with hospitalizations only in San Francisco and Sacramento, and then only for angina pectoris (increasing hospitalizations during El Niño events). These exploratory analyses merit further confirmation to improve our understanding of how admissions to hospitals for cardiovascular disease and stroke change with changing weather. Such an understanding is useful for developing current public health responses, for evaluating population vulnerability, and for designing future adaptation measures.

Aged↗

PubMed2004

Prevalence of Parkinson's disease in a Chinese population.

BACKGROUND: Ethnic differences in the prevalence of Parkinson's disease have been observed, but may be due to differences in screening instruments and diagnostic criteria. AIMS: To compare the prevalence of Parkinson's disease in Hong Kong Chinese and Australians in Sydney. METHODS: A door-to-door community survey in the Hong Kong Chinese population was carried out using a two-staged procedure (screening questionnaire followed by physical examination), which had been validated for use in the community in a survey among Australians, to determine the prevalence in Chinese and to compare with that in Australians. RESULTS: A total of 1080 households were contacted, the non-response rate was 27%. The prevalence among those aged 55 years in the community and above was 0.5%, and 0.186% for the overall population assuming no subjects were below 55 years. These figures are lower than the 3.6% for Australians, aged >55 years. CONCLUSION: There appears to be a difference in prevalence of Parkinson's disease between Hong Kong Chinese and Australians in Sydney. Such differences may be due to documented differences in prevalence of genetic polymorphisms associated with Parkinson's disease between Chinese and Australians, or to differences in environmental factors.

Adult↗

PubMed2003

Outcomes of interferon alpha and ribavirin treatment for chronic hepatitis C in patients with normal serum aminotransaminases.

INTRODUCTION: Information on treatment outcomes with interferon plus ribavirin combination therapy in chronic hepatitis C patients with normal alanine aminotransaminase (ALT) levels is limited. AIM: The aims of this study were to assess outcomes of treatment with interferon plus ribavirin in patients with normal ALT levels (normal ALT group, n=52) compared with those with elevated ALT levels (raised ALT group, n=53), and to document the rate at which patients with normal ALT levels have an apparent worsening of disease, as shown by increases in ALT levels. RESULTS: At the end of treatment (week 48), 31 patients (59.6%) in the normal ALT group and 30 patients (56.6%) in the raised ALT group had undetectable hepatitis C virus (HCV) RNA (p=0.75). A sustained virological response (SVR) was achieved in 20 patients (38.5%) in the normal ALT group and in 21 patients (39.6%) in the raised ALT group (p=0.90). Patients were subsequently followed up for a median of 29.8 (interquartile range 25th-75th percentile (IQR) 20.8-36.2) months in the normal ALT group and for a median of 26.1 (IQR 17.7-36.3) months in the raised group (p=0.20) after week 72 of treatment. Among patients without SVR in the normal ALT group, only three patients (9.4%) developed persistently raised ALT levels following therapy. CONCLUSIONS: Combination therapy with interferon plus ribavirin is associated with a similar SVR in patients with normal ALT levels compared with those with elevated ALT levels. In patients with normal ALT levels, virological non-response to therapy results in new elevations in serum ALT levels in a small minority only.

Administration, Oral↗

PubMed2002

Display of positron emission tomography with Cadplan.

Recent clinical experience at Peter MacCallum Cancer Institute (PMCI) with the use of unregistered Positron Emission Tomography (PET) images for radiotherapy target marking in the lung suggests that co-registered PET images would be invaluable. PMCI has three radiotherapy treatment planning systems but none of them currently is able to display or co-register PET images with Computed Tomography (CT) images. This paper details the approach taken to display co-registered PET images with the CADPLAN treatment planning system. CT Image files are normally transferred to Cadplan by DICOM transfer, but the Cadplan DICOM server will not receive (has no presentation context for) PET images. The fundamental design of the CADPLAN system envisages display of only a single image dataset, which must be a CT scan for planning reasons. The problem of data transfer is crudely solved by File Transfer Protocol (FTP) over the network. Fortunately the multislice format of the PET image files makes individual transfer manageable. A menu based C program running at the same time as Cadplan is invoked to sample the DICOM PET Image and create multiple Cadplan CART image format files that are co-registered with each existing transverse CT slice. With the Cadplan in contour mode, the program allows the co-registered PET images to be swapped in and out of the image section of the CART files promptly, while keeping the contour information. This allows radiotherapy target volumes to be marked using transverse PET emission images, and effectively circumvents the design constraints prohibiting the display of more than one image set. Contours can be over-laid for review on reconstructed sagittal or coronal views of CT or PET images constructed using the standard Cadplan tools. Co-registration is facilitated by identical positioning with the aid of lasers and FDG loaded fiducial markers on the PET scanner and CT couch. A polyurethane cast fixed with EFFILOCK is used to ensure identical patient orientation on the CT and PET couches. Since both imaging modalities are without significant geometric distortion the co-registration is then simply a translation. PET transmission images can be used for co-registration verification. The practical implementation of display of PET images with CADPLAN has enabled us to begin a trial of 10 patients, the results of which will be reported separately.

Data Display↗

PubMed2001

Population bone mineral density measurements for Chinese women and men in Hong Kong.

The aim of the study was to establish population ranges of bone mineral density (BMD) for Hong Kong Chinese men and women for the Hologic QDR 2000 bone densitometer, to compare these values with the manufacturer's reference ranges, to compare these values with population ranges for women obtained for the Norland X26 bone densitometer, and to examine variations between the two densitometers. The subjects were 164 men aged 40-79 years and 436 women aged 20-89 years, who were all ethnic Chinese, recruited from volunteers, social centers for the elderly and general practice clinics. BMD in women began to decline rapidly between ages 50 and 79 years, averaging about 10% loss per decade from the young adult (20-29 years) mean. The percentage losses from young adult mean values in the spine, femroal neck, trochanter and total femur were 23%, 30%, 31% and 33%, respectively, from 20 to 79 years. In the ninth decade no further decrease in BMD occurred with the exception of a further 4% at the hip sites. In men, no decrease in spine BMD occurred between 40 and 70 years. Compared with BMD in the fourth decade, 10%, 13%, and 11% of BMD was lost at the femoral neck, trochanter and total femur, respectively, by the seventh decade. These values show differences compared with the manufacturer's reference ranges for Caucasians and Japanese. BMD values for the spine were comparable between Hologic and Norland densitometers, but Hologic values for femoral neck and trochanteric regions were lower than the Norland values. Data provided by this study may thus be used as normative values for the Hologic QDR2000 bone densitometer, instead of values provided by the manufacturer. BMD values at the hip sites are not interchangeable between Norland and Hologic bone densitometers, and estimation of numbers of the population with osteoporosis will depend on the model of densitometer used.

Absorptiometry, Photon↗

PubMed2001

Prediction of body fat by anthropometry in older Chinese people.

OBJECTIVE: To derive regression equations for fat percentage by using simple anthropometric measurements applicable in normal and immobile (cannot stand or walk) older people. RESEARCH METHODS AND PROCEDURES: The study population comprised 352 females and 261 males, apparently well and community-dwelling, aged 69 to 82 years. Fifty-one females and 27 males were recruited for external validation. Body weight, standing height, arm span, triceps and biceps skinfold thicknesses (SFTs), and midarm circumference were measured. The reference method of total body fat percentage was dual-energy X-ray densitometry. Predictive equations for fat percentages were derived by stepwise multiple linear regression on anthropometric indices and gender. RESULTS: Upper-limb SFTs, body mass index, and gender yielded the more predictive equation. The SEE was 4.1% weight. There was a significant trend of underestimation in overweight subjects, especially in females. The equation using SFTs and midarm circumference was less reliable but more applicable to older immobile people and those with significant kyphoscoliosis. CONCLUSIONS: The combination of body mass index and upper-limb SFTs gives reliable prediction of fat percentages in older Chinese people, except in the obese.

Absorptiometry, Photon↗

PubMed2001

Characterization of the Co(2+) and Ni(2+) binding amino-acid residues of the N-terminus of human albumin. An insight into the mechanism of a new assay for myocardial ischemia.

Patients suffering from myocardial ischemia reportedly exhibit reduced in vitro binding of exogenous Co(2+) to the N-terminal of human serum albumin (HSA). The purpose of our investigation was to simulate changes in the N-terminus of HSA that may account for these ischemia-induced modifications to the cobalt binding site. HPLC, LC-MS and (1)H NMR analyses have shown that the N-terminal region of HSA Asp-Ala-His-Lys binds the transition metals Co(2+) and Ni(2+). Synthetic peptides with the first 2-12 amino acids of the HSA sequence demonstrated that the first three amino acids, Asp-Ala-His, are essential for strong binding of cobalt. Modification of the N-terminus peptide of HSA by way of N-acetylation or the deletion of one or more amino acid resulted in no binding of cobalt. Because the degradation of the susceptible, specific transition metal binding site of HSA may account for the decreased cobalt binding observed during ischemic events, an assay that detects this reduced binding could be useful in the diagnosis of ischemia.

Alanine↗

PubMed2001

Reduced albumin-cobalt binding with transient myocardial ischemia after elective percutaneous transluminal coronary angioplasty: a preliminary comparison to creatine kinase-MB, myoglobin, and troponin I.

BACKGROUND: Previous reports suggest that ischemic conditions rapidly reduce the capacity of human albumin to bind exogenous cobalt. A new assay based on human albumin-cobalt binding (ACB) may help detect early myocardial ischemia. We investigated altered ACB during the first 24 hours after transient ischemia induced during elective percutaneous transluminal coronary angioplasty (PTCA). We then compared ACB assay results with creatine kinase isoenzyme (CK-MB), myoglobin, and cardiac troponin I (cTn-I) values after PTCA. METHODS AND RESULTS: In 41 patients undergoing elective PTCA, plasma samples were tested for the ACB assay, CK-MB, myoglobin, and cTn-I before, immediately after, and 6 and 24 hours after PTCA. Thirteen additional patients served as a control group with albumin-cobalt assays performed before and after diagnostic coronary catheterization without angioplasty. ACB assay results demonstrated a significant mean percent difference (10.1%) immediately after PTCA compared with baseline (P < .000001) and returned to baseline by 6 hours after PTCA. ACB assay differences immediately after PTCA were significantly greater than in the control group (10.1% vs -0.9%, P < .001). Mean CK-MB, myoglobin, and cTn-I values were not elevated above baseline immediately after PTCA but were significantly elevated above baseline 6 and 24 hours after PTCA. CONCLUSIONS: These preliminary results suggest that human albumin undergoes a significant reduction in its capacity to bind exogenous cobalt soon after transient coronary occlusion during human PTCA and before significant elevations of CK-MB, myoglobin, or cTn-I. Further confirmatory investigations are warranted to determine if the ACB assay is a useful diagnostic test for early myocardial ischemia.

Adult↗

PubMed2001

Beryllium sensitization, chronic beryllium disease, and exposures at a beryllium mining and extraction facility.

In this study, we examine beryllium sensitization, chronic beryllium disease (CBD), and workplace exposures at a beryllium mining (mine) and extraction facility (mill) in Delta, Utah. Historical airborne beryllium data collected between 1970-1999 included general area (GA), breathing zone (BZ), and personal lapel (LP) measurements and calculations of job-specific quarterly daily-weighted averages (DWVAs). We compared GA, BZ, and DWA data to airborne beryllium data from a mixed beryllium products facility and a beryllium ceramics facility located in Elmore, Ohio and Tucson, Arizona, respectively. At the Delta facility, jobs involving beryllium hydrolysis and wet-grinding activities had the highest air concentrations; annual median GA concentrations were less than 0.3 microg/m3 or both areas. Annual median GA sample concentrations ranged from 0.1-0.4 microg/m(-3) at Delta. These levels were generally lower than Elmore (0.1-1.0 microg/m3) and were comparable to the Tucson facility (0.1-0.4 microg/m3). Median BZ concentrations were higher, whereas DWAs were lower at the Delta facility than at the other two facilities. Among the 87 employees at the Delta facility, 75 participated in the medical survey; there were three persons sensitized, one with CBD. The individual with CBD previously worked at the Elmore facility for 10 years. Cumulative CBD incidence rates were significantly lower at the Delta facility: 0.3 percent compared to 2.0 percent for Elmore and 2.5 percent for the Tucson facility. Sensitization and CBD prevalence rates determined from cross-sectional surveys for the Delta facility were lower than but not significantly different from rates at the other two facilities. There was no sensitization or CBD among those who worked only at the mine where the only exposure to beryllium results from working with bertrandite ore. Although these results are derived from a small sample, this study suggests that the form of beryllium may affect the likelihood of developing CBD. Specifically, exposure to beryl and bertrandite ore dusts or to beryllium salts, in the absence of exposure to beryllium oxide particulates appears to pose a lower risk for developing CBD.

Adult↗

PubMed2001

Association of normal weather periods and El Niño events with hospitalization for viral pneumonia in females: California, 1983-1998.

OBJECTIVES: This study examined associations between weather and hospitalizations of females for viral pneumonia during normal weather periods and El Niño events in the California counties of Sacramento and Yolo, San Francisco and San Mateo, and Los Angeles and Orange. METHODS: Associations between weather and hospitalizations (lagged 7 days) for January 1983 through June 1998 were evaluated with Poisson regression models. Generalized estimating equations were used to adjust for autocorrelation and overdispersion. Data were summed over 4 days. RESULTS: Associations varied by region. Hospitalizations in San Francisco and Los Angeles increased significantly (30%-50%) with a 5 degrees F decrease in minimum temperature. Hospitalizations in Sacramento increased significantly (25%-40%) with a 5 degrees F decrease in maximum temperature difference. The associations were independent of season. El Niño events were associated with hospitalizations only in Sacramento, with significant decreases for girls and increases for women. CONCLUSIONS: The results suggest that viral pneumonia could continue to be a major public health issue, with a significant association between weather and hospitalizations, even as the global mean temperature continues to rise. An understanding of population sensitivity under different weather conditions could lead to an improved understanding of virus transmission.

Adolescent↗

PubMed2000

Provocative discography in patients after limited lumbar discectomy: A controlled, randomized study of pain response in symptomatic and asymptomatic subjects.

STUDY DESIGN: This was a prospective observational study of patients with low back pain and those without after laminotomy and discectomy. OBJECTIVES: To determine, using a strict experimental design, the relative pain intensity response to provocative discography in symptomatic and asymptomatic subjects after lumbar discectomy for intervertebral disc herniation. BACKGROUND: Provocative discography frequently is used to evaluate persistent or recurrent low back pain syndromes in patients who have undergone posterior discectomy. The validity of interpreting painful injections during this procedure has not been critically assessed. The prevalence of significantly painful disc injections in a group with good outcomes after surgery is not known. Knowing the rates of significantly painful injections in asymptomatic patients after lumbar discectomy may clarify the meaning of painful injections in symptomatic patients. METHODS: From a cohort of 240 patients who had undergone single-level limited discectomy for sciatica, 20 asymptomatic volunteers were recruited for experimental three-level lumbar discography. Inclusion criteria required nearly perfect scores on standardized back pain rating instruments, no other spinal pathology, and normal psychometric screening. A control group of 27 symptomatic patients, after single-level discectomy with intractable low back pain syndrome, and without other spinal pathology, underwent discography. Seven patients in the control group had normal psychometric tests. Experienced raters who were blinded to control versus experimental status of the subjects scored the magnetic resonance imaging, discogram, psychometric tests, and discography videotapes of the subjects' pain behavior. RESULTS: There were 8 of 20 (40%) positive injections of discs that had previous surgery in the asymptomatic group and 17 of 27 (63%) positive injections in the symptomatic group. Specifically with regard to the symptomatic group, there were 3 of 7 (43%) positive injections (all concordant) in patients with normal psychometric scores, as compared with 14 of 20 (70%) positive injections (12 concordant) in patients with abnormal psychometric scores. Injections of discs that had previous surgery resulted in a mean pain score of 2.1 of 5 in the asymptomatic group, 2.1 in the symptomatic group with normal psychometric scores, and 3.4 in the symptomatic group with abnormal psychometric scores. Of the discs not treated with surgery, 2 were positive in the asymptomatic group (10%), 3 in 2 symptomatic subjects with normal psychological testing (29), and 18 in 13 symptomatic subjects with abnormal psychometric testing (76%). CONCLUSIONS: A high percentage of asymptomatic patients with normal psychometric testing who previously have undergone lumbar discectomy will have significant pain on injection of their discs that had previous surgery (40%). This is not significantly different from the experience of symptomatic patients with normal psychometric testing undergoing discography on discs that had previous surgery. Patients with abnormal psychological profiles have significantly higher rates of positive disc injections than either asymptomatic volunteers or symptomatic subjects with normal psychological screening.

Adult↗