• Title/Summary/Keyword: First-visit Patients

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Comparison of the effectiveness of extensor muscle strengthening exercise by itself, exercise with polydeoxyribonucleotide injection, and exercise with extracorporeal shockwave therapy in lateral epicondylitis: a randomized controlled trial

  • Shim, Bum Jin;Seo, Eun-Min;Hwang, Jung-Taek;Kim, Do-Young;Yang, Jae-Shin;Seo, Su-Jung;Hong, Myung Sun
    • Clinics in Shoulder and Elbow
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    • v.24 no.4
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    • pp.231-238
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    • 2021
  • Background: Extensor muscle strengthening exercises with counterforce braces (EX) is a conventional conservative treatment for lateral epicondylitis (LE) of the elbow. In addition, polydeoxyribonucleotide (PDRN) or extracorporeal shockwave therapy (ESWT) has been recently used for LE. Methods: Sixty-three patients with chronic LE participated in this study and randomly allocated in three groups (G1: EX, G2: EX+PDRN injection, and G3: EX+ESWT). All of the three groups were taught to perform EX at the first out-patient department (OPD) visit. Group 2 was injected with 3 mL PDRN (5.625 mg/3 mL), while group 3 received ESWT at the first OPD visit. Visual analog scale pain score, Mayo elbow performance score (MEPS), and ultrasonographic examination were checked before, 6 weeks, and 12 weeks after the treatments. Results: Overall functional scores and ultrasonographic findings in all three groups improved after treatment. The mean MEPS in group 2 improved more than groups 1 and 3 at 6 weeks (G1, 56.9>62.4; G2, 54.3>65.0; G3, 55.7>62.6), and more than group 1 at 12 weeks (G1, 56.9>67.9; G2, 54.3>73.6). The mean common extensor tendon depth (CETD) on ultrasonography in group 2 increased more than groups 1 and 3 at 6 and 12 weeks (6 weeks: G1, 0.385>0.386; G2, 0.332>0.392; G3, 0.334>0.357; 12 weeks: G1, 0.385>0.409; G2, 0.332>0.438; G3, 0.334>0.405 [cm]). Conclusions: PDRN injections combined with EX exhibited a greater improvement in mean MEPS and mean CETD compared to EX only or EX combined with ESWT for LE within the 12 weeks follow-up.

Cumulative survival rate and associated risk factors of Implantium implants: A 10-year retrospective clinical study

  • Park, Jin-Hong;Kim, Young-Soo;Ryu, Jae-Jun;Shin, Sang-Wan;Lee, Jeong-Yol
    • The Journal of Advanced Prosthodontics
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    • v.9 no.3
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    • pp.195-199
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    • 2017
  • PURPOSE. The objective of this study was to determine the cumulative survival rate (CSR) and associated risk factors of Implantium implants by retrospective clinical study. MATERIALS AND METHODS. Patients who received Implantium implants (Dentium Co., Seoul, Korea) at Korea University Guro Hospital from 2004 to 2011 were included. The period between the first surgery and the last hospital visit until December 2015 was set as the observation period for this study. Clinical and radiographic data were collected from patient records, including all complications observed during the follow-up period. Kaplan-Meier analysis was performed to examine CSR. Multiple Cox proportional hazard model was employed to assess the associations between potential risk factors and CSR. RESULTS. A total of 370 implants were placed in 121 patients (mean age, 56.1 years; range, 19 to 75 years). Of the 370 implants, 13 failed, including 7 implants that were lost before loading. The 10-year cumulative survival rate of implants was 94.8%. The multiple Cox proportional hazard model revealed that significant risk factor of implant failure were smoking and maxillary implant (P<.05). CONCLUSION. The 10-year CSR of Implantium implants was 94.8%. Risk factors of implant failure were smoking and maxillary implant.

Relationships between Intermittent Locking History and Self-Reported Bruxism in Temporomandibular Joint

  • Lee, Myeong-Ok;Lee, Yeon-Hee;Kang, Soo-Kyung;Chun, Yang-Hyun;Hong, Jung-Pyo;Auh, Q-Schick
    • Journal of Oral Medicine and Pain
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    • v.42 no.2
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    • pp.29-34
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    • 2017
  • Purpose: To evaluate aggravating factors of intermittent locking among temporomandibular joint using magnetic resonance imaging (MRI) and diagnostic criteria for temporomandibular disorder (DC/TMD) diagnosis. Methods: A retrospective analysis was conducted of 35 patients with intermittent locking history but normal intra-articular findings between September 2012 and June 2015 in Kyung Hee University Dental Hospital. A standardized DC/TMD assessment was performed on subjects with MRI findings. Clinical findings were assessed on the basis of maximum mouth opening (active & passive), self-reported habits, patients' age, gender, systemic diseases at the initial visit. First, chi square test was used to examine differences with variables and then risk factors for intermittent locking were assessed using multivariate logistic regression. Results: Self-reported bruxism was strongly associated with intermittent locking history. Conclusions: The new DC/TMD protocol is intended for use within any clinical setting and supports the full range of diagnostic activities from screening to definitive evaluation and diagnosis. Self-reported sleep bruxism has been associated with a higher likelihood of intermittent locking. Comorbidity is therefore a factor that must be assessed. It is necessary to consider the amount of contact of the teeth and the duration.

Benefits of Cervical Cancer Screening by Liquid-Based Cytology as Part of Routine Antenatal Assessment

  • Parkpinyo, Nichamon;Inthasorn, Perapong;Laiwejpithaya, Somsak;Punnarat, Tippawan
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.9
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    • pp.4457-4461
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    • 2016
  • Purpose: To determine the prevalence of abnormal cervical cytology, as diagnosed using a liquid-based cytology technique, in pregnant women attending the Antenatal Care (ANC) clinic at Siriraj Hospital. Materials and Methods: This cross-sectional study included 655 first-visit pregnant women who attended ANC clinic at Siriraj Hospital during June to November 2015 study period. After receiving routine antenatal care, cervical cytology screening was performed with the Siriraj liquid-based cytology technique. All specimens were reviewed by a certified cytopathologist using Bethesda System 2001 criteria. Patients with abnormal PAP results characterized as epithelial cell abnormalities were referred to a gynecologic oncologist for further management according to ASCCP Guidelines 2012. Results: Mean age of participants was $28.9{\pm}6.2$ years. Prevalence of abnormal cervical cytology was 3.4% (95% CI: 2.0-4.7). Among this group, there were ASC-US, ASC-H, LSIL, HSIL for 12(1.8%), 2(0.3%), 7(1.1%) and 1(0.2%), respectively. In 633 specimens of the normal group, infection was identified in 158 specimens (24.1%) which were caused by Candida spp. and Trichomonas vaginalis. Regarding patient perception about the importance of cervical cancer screening, although most women perceived screening to be important, 54% of participants had never been screened for cervical cancer. Rate of loss to follow-up in the postpartum period was as high as 41.8%. Conclusions: Prevalence of abnormal cervical cytology in pregnant women attending the ANC clinic at Siriraj Hospital was 3.4%. Inclusion of cervical cancer screening as part of antenatal assessment can help to identify precancerous lesions or cervical cancers in patients who might otherwise not be screened, thereby facilitating early treatment and improved patient outcomes.

Clinical Study for Visual Application of Circle Pattern with 3G Color on Attention Deficit/Hyperactivity Disorder Patients (주의력결핍-과잉행동장애 (ADHD) 환아에 대한 집중력 개선과 심리적 안정을 위한 3G 색과 원문양의 시각적 활용의 효과 연구)

  • Choi, Hyeon;Kim, Jeong-Sin;Lee, Eun-Hye
    • The Journal of Korean Medicine
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    • v.31 no.1
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    • pp.47-56
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    • 2010
  • Objective: Many drug or non-drug therapies are reported to be effective in reducing the severity of attention deficit/hyperactivity disorder (ADHD). The aim of this study was to assess the effect of color and pattern on the severity of ADHD in young ADHD patients. Method: We randomly assigned 30 children into two groups and had them participate in 15-minute block play sessions once in a week. The experimental group used blocks with green (3G, Munsell color system) circle patterns on them, while the control group played with plain white blocks. We also provided a set of playing cards with the corresponding patterns. This trial continued for 4 weeks and 29 children (96.7%) completed. The primary outcome measurement was the ADHD rating scale-IV and was evaluated on every visit. Results: After the trial, ADHD score decreased in both groups but not significantly ($34.4{\pm}8.0$ to $30.0{\pm}4.3$; $34.0{\pm}6.0$ to $30.3{\pm}3.2$). However, there were significant differences in 4 items of ADHD rating scale between the two groups. These consisted of 3 inattention (Q3, Q7, Q15) and 1 hyperactivity-impulsivity (Q12) items and the reduction between the first and final visits was significant (p=0.0240, p=0.0498, p=0.0237 and p=0.0012 respectively). Conclusion: Repeated exposure to a green circle pattern might not influence the total score of ADHD rating scale but reduced 3 inattention items and 1 hyperactivity-impulsivity significantly in children with ADHD. Proper visual stimuli are partially helpful for pediatric ADHD.

Clinical Study for Tremor in 30 Admission Cases (진전(震顫)을 주(主) 증상(症狀)으로 입원(入院)한 환자(患者) 30례(例)에 대(對)한 임상적(臨床的) 고찰(考察))

  • Park, Ji-un;Lee, Sang-ryong
    • Journal of Haehwa Medicine
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    • v.10 no.1
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    • pp.437-451
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    • 2001
  • The clinical study was carried out the 30 patients with tremor who were treated in Daejeon University Oriental Hospital from 1 April 1997 to 31 March 2001. The results were summarized as follows. 1. The ratio of female was higher, especially in the psychosomatic tremor, the ratio of female was higher and in the age distribution the aged over 50 were higher frequence. 2. The case without past history was most, the most ordinary preceding disease was hypertention and the next was diabetes, drinking history had no concern with tremor, first visit was most, in the psychosomatic tremor complication by relation was the most inducing factor and both parkinson tremor and essential tremor were no inducing factor. 3. Tremor appeared to be busy in extremities, parkinson tremor appeared to be accompanied with musculoskeletal system symptoms and they were in descending order lower limb weakness, extremities numbness, general body weakness e.t.c. both essential tremor and psychosomatic tremor appeared to be accompanied with psychosomatic symptoms and they were in descending order dizziness, headache e.t.c. 4. In classification of Four Human coporeal constitution the number of patients, Tae-Eum-In(太陰人) was most, the prescription drugs of tranquillizing the liver and relieving anxiety such as GYEJIYONGGOLMORYETANG(桂枝加龍骨牡蠣湯) and nourishing Yin, blood and relieving anxiety such as SAMULANSINTANG(四物安神湯) were used to be busy. 5. The rate of treatment was collectively improved and was higher in the yaung age than in the old age, the period of the clinical history was the shorter within one month, the rate of improvement was the better.

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Cost-Effectiveness of Denosumab for Post-Menopausal Osteoporosis in South Korea (폐경기 골다공증 환자에서 데노수맙 사용에 대한 비용-효과 분석)

  • Bae, Green;Kwon, Hye-Young
    • Korean Journal of Clinical Pharmacy
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    • v.28 no.2
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    • pp.131-137
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    • 2018
  • Background: In South Korea, 22.3% of women ${\geq}50years$ of age and 37% of women ${\geq}70years$ of age visit the doctor to obtain treatment for osteoporosis. According to the analysis of the National Health Insurance Services claim data between 2008 and 2012, the number and incidence of hip and vertebral fractures increased during the same period. Denosumab, a newly marketed medicine in Korea, is the first RANK inhibitor. Methods: A cost-utility analysis was conducted from a societal perspective to prove the superiority of denosumab to alendronate. A Markov cohort model was used to investigate the cost-effectiveness of denosumab. A 6-month cycle length was used in the model, and all patients were individually followed up through the model, from their age at treatment initiation to their time of death or until 100 years of age. The model consisted of eight health states: well; hip fracture; vertebral fracture; wrist fracture; other osteoporotic fracture; post-hip fracture; post-vertebral fracture; and dead. All patients began in the well-health state. In this model, 5% discounted rate, two-year maximum offset time, and persistence were adopted. Results: The total lifetime costs for alendronate and denosumab were USD 5,587 and USD 6,534, respectively. The incremental cost-effectiveness ratio (ICER) for denosumab versus alendronate was USD 20,600/QALY. Given the ICER threshold in Korea, the results indicated that denosumab was remarkably superior to alendronate. Conclusion: Denosumab is a cost-effective alternative to the oral anti-osteoporotic treatment, alendronate, in South Korea.

Clinical Studies on 5 Cases of Acute Viral Hepatitis A Treated by Oriental Medicine (급성 바이러스성 A형 간염의 한방치료 5례에 관한 임상보고)

  • Ie, Jae-Eun;Heo, Su-Jung;Kim, Hyun-Jin;Cho, Hyun-Ju;Kim, Hyuck
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.23 no.6
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    • pp.1480-1485
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    • 2009
  • We conducted this study to report the clinical manifestations of 5 acute viral hepatitis type A treated by oriental medical treatment. Five hepatitis A patients who visited OO oriental hospital from May 2008 to July 2009 were treated by oriental medical treatment, including herbal acupuncture, acupuncture and herbal medicine and western medical treatment, including fluid therapy and peroral medicine. Prodromes were similar to influenza and duration from symptom onset to first visit were $5.0\;{\pm}\;1.6$ days. Chief symptoms included jaundice, itching, dark urine, anorexia, fatigue, nausea, vomiting, abdominal discomfort. The mean values of the initial laboratory test were serum total bilirubin(TB) of $3.62\;{\pm}\;2.77\;mg/dL$, aspartate aminotransferase(AST) of $729\;{\pm}\;422\;IU/L$, alanine aminotransferase(ALT) $774\;{\pm}\;754\;IU/L$. The peak mean values of those were $6.30\;{\pm}\;2.13\;mg/dL$, $2177\;{\pm}\;2573\;IU/L$, $2238\;{\pm}\;1682\;IU/L$ respectively. The mean duration of hospitalization were $15\;{\pm}\;3$ days. Follow-up at 3 weeks after discharge showed that all patients recovered without complications. Treatment of oriental medicine has effectiveness on acute viral hepatitis type A. Further study is needed.

Torticollis Management Using the Customized Soft Neck Collar in CATCH 22 Syndrome Combined with Klippel-Feil Anomaly: A Case Report

  • Moon, Myung-Hoon;Kim, Soo-Yeon
    • Journal of Interdisciplinary Genomics
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    • v.1 no.2
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    • pp.19-22
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    • 2019
  • CATCH 22 syndrome is rare genetic disease that has various manifestations. Cervical vertebral anomaly, such as Klippel-Feil anomaly, is frequently observed in the patients with CATCH22 syndrome. We present the case of an 11-year-old female patient with CATCH22 syndrome and Klippel-Feil anomaly who had been treated torticollis using the customized soft neck collar. During the patient's first visit to our clinic, she presented with low ear set, skull deformity, intellectual disability, and tilting of the head to the left by approximately 25 degrees. Imaging studies revealed multisegmental fusion and C3 hemivertebrae of the cervical spine and left thoracic scoliosis at T4 with 50 degrees of Cobb's angle. We instructed passive stretching and applied the customized soft neck collar we invented. The ipsilateral aspect of the neck collar is designed to provide vertical support between the clavicle and mandibular angle and is adjustable in height. The Velcro was attached to the neck collar at the point of contact with the ipsilesional mandibular angle, which provides negative sensory feedback, inducing her to tilt neck to the contralesional side. We applied the neck collar for 2 hours a day. After 1 year of treatment, her neck inclination angle improved from 25 to 10 degrees. Providing negative sensory feedback using the customized soft neck collar can be one of the treatment options of postural management in patients with torticollis in cases of CATCH 22 syndrome combined with Klippel-Feil anomaly.

Long-Term Observations of Korean Medicine Treatment in Patients with Mild Cognitive Impairment: Two Case Reports (경도인지장애 환자의 장기간 한의약 치료 경과관찰 증례보고 2례)

  • Son, Sung-Eun;Lee, Go eun;Lee, Na-hyun;Lyu, Yeoung-Su;Cheong, Moon Joo;Kang, Hyung Won
    • Journal of Oriental Neuropsychiatry
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    • v.32 no.3
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    • pp.285-302
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    • 2021
  • Objectives: To examine the effect of long-term Korean medicine treatment on mild cognitive impairment (MCI). Methods: This study was conducted on two patients who were diagnosed with mild cognitive impairment and received long-term Korean medicine treatment. In order to evaluate the degree of cognitive decline, SNSB and K-MMSE were performed 2~3 times at the first visit and during the treatment process. Results: Both cases 1 and 2 were diagnosed with MCI with a high possibility of developing dementia. In case 1, MCI progressed to early dementia at one year after the diagnosis of MCI. However, in case 2, that MCI status was maintained without progressing to dementia for 4 years after the diagnosis of MCI. The cause of such difference in the course of MCI might be attributed to the fact that Case 1 had lower K-IADL level but higher SGDS level than Case 2 at the time of initial diagnosis, with weak family support and irregular herbal medicine intake. Conclusions: Korean medicine treatment could improve and manage symptoms of cognitive decline due to MCI.