Background: The aim of this study was to clarify the topographical relationship between the accessory nerve (AN) and transverse cervical artery (TCA) to provide safe and convenient injection points for AN blockade. Methods: This study included 21 and 30 shoulders of 14 embalmed Korean adult cadavers and 15 patients, respectively, for dissection and ultrasound (US) examination. Results: The courses of the TCA and AN in the scapular region were classified into four types based on their positional relationships. Type A indicated the nerve that was medial to the artery and ran parallel without changing its location (38%). In type B (38%), the nerve was lateral to the artery and ran parallel without changing its location. In type C (19%), the nerve or artery traversed each other only once during the whole course. In type D (5%), the nerve or artery traversed each other more than twice forming a twist. At the levels of lines I-IV, the nerve was relatively close to the artery (approximately 10 mm). TCAs were observed in all specimens around the superior angle of the scapula at the level of line II, whereas they were not found below line VI. In US images of the patients, the TCA was commonly observed at the level of line II (93.3%) where all ANs and TCAs were observed in cadaveric dissection. Conclusions: The results expand the current knowledge of the relation between the AN and TCA, and provide helpful information for selective diagnostic nerve blocks in the scapular region.
Kim, Sin Rak;Park, Jin Hyung;Han, Yea Sik;Ye, Byeong Jin
Archives of Craniofacial Surgery
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v.12
no.1
/
pp.17-21
/
2011
Purpose: It is difficult to objectively evaluate the outcomes of plastic surgical procedures. The combination of aesthetic and medical factors makes outcome quantification difficult. In this study, fracture reduction accuracy was objectively evaluated in patients with zygomatic complex fractures. Patients satisfaction with the accuracy was also examined. In addition, the patients' overall satisfaction and discomfort due to complications were analyzed. Methods: Eighty-five patients who had surgeries via bicoronal incision for zygomatic complex fracture from March 2006 to December 2009 were included in this study. Two plastic surgeons evaluated the accuracy of the fracture reduction with postoperative computed tomography. A survey questionnaire was administered to evaluate the patients' overall satisfaction and the impact of symptoms associated with the procedure on the patients' daily lives. Results: The overall patient satisfaction rate was $82.1{\pm}10.9%$ (range, 45~100%). The level of deformation was $6.7{\pm}10.9%$, the levels of discomfort in daily life due to pain, paresthesia, scar, and facial palsy were $8.5{\pm}13.2%$, $5.8{\pm}8.9%$, $4.4{\pm}9.9%$, and $1.9{\pm}9.2%$, respectively. According to the visual analogue scale, paresthesia was found to be the most frequent symptom (43.5%), and pain was the most troublesome symptom. Conclusion: The use of bicoronal incision for treating zygomatic complex fractures can cause various complications due to wide incision and dissection. However, this technique can provide optimized reduction and rigid fixation. Most of these postoperative complications can cause significant discomfort in the patient. It is thought that the use of correct surgical technique and the accurate knowledge of craniofacial anatomy will result in a reduction of complications and significantly increase patient satisfaction.
Objectives: This review aims to report the efficacy of Oriental herbal medicine for Female Idiopathic Precocious Puberty Methods: We searched clinical study about precocious puberty from Pubmed, OASIS, Korea Traditional Knowledge Portal and National Assembly Library up to July 2017. Results: Four case reports have been identified. Six cases in total were found. And in the four cases where estradiol (E2) levels were above the normal levels in pre-treatment, the figures dropped to the normal levels in post-treatment. In the three cases with breast development and breast pain in pre-treatment, symptoms improved after the treatment. And, the sustained growth of height was reported in the four cases with the treatment duration of 30 days or more. Conclusions: It has been identified that oriental medicine assisted improvements of hormone levels and breast pain and growth of height on patients with precocious puberty, yet more case reports and well-designed studies would be necessary to guide better oriental herbal medicine treatment of precocious puberty.
Background: Occipital neuralgia (ON) is an established risk factor for headaches in the posterior cervical region. Several conservative treatments by nerve decompression and pain relief are available for ON, but these treatments have limitations. Acupuncture treatment, which is known to demonstrate analgesic effects, involves various stimulation methods, and several studies have reported their clinical benefit. No recent systematic review (SR) has compared each acupuncture type for ON treatment. Thus, this SR aims to investigate the clinical effectiveness of each acupuncture type for treating ON. Methods: We will identify relevant studies using electronic databases, including EMBASE, MEDLINE, Cochrane Library, China National Knowledge Infrastructure (CNKI), Korean Studies Information Service System (KISS), Korean Medical Database, KoreaMed, and National Digital Science Library (NDSL) from the inception until August 2023. The primary outcome will include the numerical change of pain symptoms (visual analog scale and numerical rating scale) and effective rate. Safety and secondary outcomes will include adverse events and quality of life. We will compare the conservative treatment with the acupuncture treatment using network meta-analysis. The Cochrane Collaboration "risk of bias" tools will be used to assess the quality of included trials. The Grades of Recommendation, Assessment, Development, and Evaluation will be used to examine the evidence level. Conclusion: This study will provide clinical evidence of several acupuncture types for ON and help clinicians decide on the best.
In-hwa Park;Yun-Yeop Cha;Min-Jeong Kim;In Heo;Byung-Jun Kim
Journal of Korean Medicine Rehabilitation
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v.34
no.3
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pp.53-63
/
2024
Objectives This study aims to analyze the effectiveness of manual therapy for the treatment of plantar fasciitis by reviewing existing randomized controlled trials. Specifically, it seeks to identify various manual therapy techniques and evaluate their applicability in clinical settings. Methods The study reviewed literature from six databases (PubMed, the Cochrane Library, China National Knowledge Infrastructure, ScienceON, Research Information Sharing Service, Korean studies Information Service System) up to April 2024. Studies were selected based on criteria including randomized controlled trials involving manual therapy for plantar fasciitis. Results An analysis of ten studies involving 714 patients revealed the use of techniques such as joint mobilization, muscle relaxation, and pressure point techniques. Manual therapy was found to be more effective in reducing pain than both extracorporeal shock wave therapy and routine physical therapy alone. However, caution is needed in generalizing these results due to the limited number of studies analyzed. No significant adverse effects were reported. Conclusions Manual therapy demonstrates potential as an effective treatment for plantar fasciitis, offering benefits in pain management and functional recovery. However, further high-quality randomized controlled trials are necessary to strengthen the clinical evidence and establish standardized treatment protocols.
Objectives Despite the treatment with antibiotics, patients with sepsis has a high mortality (80%) in the underlying disease group. The aim of this study was to report the improvement of septic condition of the cholangiocarcinoma patient after the treatment with Handayeolso-tang, Fel Tauri, and antibiotics. Methods We retrospectively reviewed the medical records. The patient's subjective symptoms such as chilling and abdominal pain were evaluated by NRS and the performance status was evaluated by ECOG. This case was literally compared with relevant published studies on prognosis of sepsis. Results Despite poor prognostic factor(MEDS score 18), the patient's symptoms such as fever, chilling, abdominal pain, and diarrhea and ECOG(Eastern Cooperative Oncology Group) improved. The patient was hemodynamically stabilized on 3rd day from the treatment, and her laboratory test results were normalized on 7th day. Conclusions A female patient of metastatic cholangiocarcinoma came to the hospital for cholangitis, later causing septic shock. Both her symptoms and laboratory tests showed significant improvement after the treatment of antibiotics, Handayeolso-tang and Fel Tauri. To our knowledge, this is the first case reporting the synergistic combination of Korean oriental medicine and Western medicine approaching to sepsis.
Jung, Jong-myung;Chung, Chun Kee;Kim, Chi Heon;Yang, Seung Heon
Journal of Korean Neurosurgical Society
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v.62
no.4
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pp.467-475
/
2019
Objective : There is a lack of knowledge regarding whether decompression is necessary in treating patients with epidural spinal cord compression (ESCC) grade 2. The purpose of this study was to compare the outcomes of minimally invasive surgery (MIS) without decompression and conventional open surgery (palliative laminectomy) for patients with hepatocellular carcinoma (HCC) spinal metastasis of ESCC grade 2. Methods : Patients with HCC spinal metastasis requiring surgery were retrospectively reviewed. Patients with ESCC grade 2, medically intractable mechanical back pain, a Nurick grade better than 3, 3-6 months of life expectancy, Tomita score ${\geq}5$, and Spinal Instability Neoplastic Score ${\geq}7$ were included. Patients with neurological deficits, other systemic illnesses and less than 1 month of life expectancy were excluded. Thirty patients were included in the study, including 17 in the open surgery group (until 2008) and 13 in the MIS group (since 2009). Results : The MIS group had a significantly shorter operative time ($94.2{\pm}48.2minutes$ vs. $162.9{\pm}52.3minutes$, p=0.001), less blood loss ($140.0{\pm}182.9mL$ vs. $1534.4{\pm}1484.2mL$, p=0.002), and less post-operative intensive care unit transfer (one patient vs. eight patients, p=0.042) than the open surgery group. The visual analogue scale for back pain at 3 months post-operation was significantly improved in the MIS group than in the open surgery group ($3.0{\pm}1.2$ vs. $4.3{\pm}1.2$, p=0.042). The MIS group had longer ambulation time ($183{\pm}33days$ vs. $166{\pm}36days$) and survival time ($216{\pm}38days$ vs. $204{\pm}43days$) than the open surgery group without significant difference (p=0.814 and 0.959, respectively). Conclusion : MIS without decompression would be a good choice for patients with HCC spinal metastasis of ESCC grade 2, especially those with limited prognosis, mechanical instability and no neurologic deficit.
Kim, Sueun;Ok, Jong Sun;Choi, Jin Yi;Choi, Heejung
The Journal of Korean Academic Society of Nursing Education
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v.29
no.4
/
pp.381-394
/
2023
Purpose: This study aimed to develop an intentional rounding protocol to enhance the clinical competence of nursing students. Methods: An intentional rounding protocol for nursing students' clinical practice was developed following the ADDIE (Analysis, Design, Development, Implementation, and Evaluation) model. A convenient sampling method was used to select 23 junior year university nursing students during their clinical practice in adult nursing. The program evaluation included a quantitative assessment (communication and relationship efficacy, empathy, and patient safety competency) and focus group interviews. Results: The intentional rounding protocol focused on the 4Ps (pain, position, potty, and possessions) and encompassed aspects such as level of consciousness, pain management, personal care needs, intravenous injection, oxygen administration, nasogastric/nasoenteric tube care, maintenance of urine collection bags, and the identification of environmental fall risks. Nursing students performed intentional rounding at least twice a day. Following the implementation of this protocol, nursing students demonstrated a significant improvement in communication and interpersonal efficacy. The focus group interviews revealed four main themes: growth of human relationships, acquiring knowledge in and about the clinical field, becoming a nurse, and barriers in reality. Conclusion: The intentional rounding protocol has the potential to enhance nursing students' communication and interpersonal skills during clinical practice and to provide them with positive experiences in nursing clinical education. Therefore, it is recommended that this protocol be incorporated into nursing clinical practice education.
Objectives : To research trends of studies on treatments of lumbar herniated intervertebral disc in Korean medicine. Methods : We searched papers using Korean Traditional Knowledge Portal, OASIS, KISS. We used "low back pain", "radiculopathy", "lumbar herniated intervertebral disc" as keyword. Limitations were as follows; Domestic studies, published from 2000 to 2011, mentioning the treatments of lumbar herniated intervertebral disc in Korean medicine. This study researched and classified the papers according to the fields of the treatment and methods of study. Results : The results were obtained as below ; 1. The number of papers published in 2000 was only three, but steadily increased to 15 in 2010 and the total number of papers was 93. 2. When categorized according to the fields of treatment, 93 researches are classified as acupuncture, moxibustion, Chuna therapy, drug, various physical therapies and collaborative Oriental-Western medicine therapy. 3. When categorized according to the methods of study, 70 researches were the simple case report and non-RCT(non-randomized controlled trial) were 11 and RCT(randomized controlled trials) has been reported in 11 researches. 4. General assessment tools were VAS, ODI before, however these days, Physical examination(ROM, SLRT, etc.), Radiologic tests(MRI, X-ray), DITI etc. are used more in order to evaluate objective therapeutic effects. Conclusions : These results indicate that researches on lumbar herniated intervertebral disc in Korean medicine have been investigated by various method and steadily increasing.
The development of standards and guidelines of rehabilitation nursing has been the major concerns for providing better nursing to the rehabilitation clients. As the patients with stroke and spinal cord injuries are the most prevalent physical disabilities in Korea, this study focussed on the nursing diagnoses of these two groups of patients. In order to identify the nursing diagnoses frequently used In their practice for the patients with stroke and spinal cord injuries, a survey was done with the questionnaire form developed by the research team. The surveyee were the staff nurses working at rehabilitation wards more than 2 years from 8 general hospitals in Korea, They identified and set the priorities of 13 nursing diagnoses from 79 stroke patients and 10 nursing diagnoses from 35 patients with spinal cord injuries during the periods from March 1 to June 2, 1999. The identified nursing diagnoses for the stroke patients are impaired physical immobility, sensory-perceptual alteration, activity intolerance, self-care deficit, altered defecation, altered urination, risk for injury, unilateral neglect, impaired skin integrity, altered thought processes, pain, altered health maintenance, dysreflexia. The identified nursing diagnoses for spinal cord injuries are altered urination, altered defecation, impaired skin integrity, pain, risk for injury, reflex incontinence, impaired physical immobility, self-care deficit, activity intolerance, knowledge deficit.
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