Objectives: The purpose of this case study was to report the effect of Korean Medicine treatment on a patient diagnosed with nontuberculous mycobacterial lung disease. Methods: A 61-year-old female patient with nontuberculous mycobacterial lung disease was admitted to the clinic from October 15th, 2018 to November 7th, 2018. The patient was treated using Korean medical treatments of Jinhae-tang-gami, Ssanghwa-tang-gami, Haeyeol-tang, Jinhae-tang plus Ssanghwa-tang-gami, and Jinhae-tang plus Bojungikgi-tang-gami. We evaluated the improvement of symptoms by a numeric rating scale (NRS) score, C-reactive protein (CRP) levels, erythrocyte sedimentation rate (ESR), and body temperature. Results: After Korean medicine treatment, the patient's cough and sputum amounts were decreased as measured by the NRS score. CRP levels and ESR were also decreased and fever was relieved. Conclusion: This study suggested that Korean medicine treatment might be effective in treating patients diagnosed with nontuberculous mycobacterial lung disease.
Objectives: The objective of this study was to report the general characteristics, satisfaction, and changes before and after treatment to foreign athletes and officials who were received Korean Medicine at the 2019 Chungju World Martial Arts Masterships Korean Medical Clinic. Methods: We investigated age, gender, nationality, type of sports, and, onset through medical records. Besides, we developed the patient satisfaction survey to determine how satisfied the patients were with the treatment they received. The survey included type of injury, location of the injury, cause of injury, Numeric Rating Scale (NRS) before and after treatment, and treatment satisfaction. Result: This study showed that knee and lower leg injuries (S80-S89) were the most frequent injuries in the Korean Medicine(KM) clinic of the 2019 Chungju World Martial Arts Masterships. We provided KM treatments including acupuncture, cupping therapy, Chuna manual therapy, herbal medicine, dressing, and taping. Acupuncture was the most frequently performed and the most satisfactory treatment. The average NRS after treatment significantly decreased, suggesting that KM is effective in controlling pain in sports injuries. The overall satisfaction was also high with KM treatments.
The $12^{th}$ rib syndrome is a disease that causes pain between the upper abdomen and the lower chest. It is assumed that the impinging on the nerves between the ribs causes pain in the lower chest, upper abdomen, and flank. A 74-year-old female patient visited a pain clinic complaining of pain in her back, and left chest wall at a 7 on the 0-10 Numeric Rating scale (NRS). She had a lateral fixation at T12-L2, 6 years earlier. After the operation, she had multiple osteoporotic compression fractures. When the spine was bent, the patient complained about a sharp pain in the left mid-axillary line and radiating pain toward the abdomen. On physical examination, the $10^{th}$ rib was not felt, and an image of the rib-cage confirmed that the left $10^{th}$ rib was severed. When applying pressure from the legs to the $9^{th}$ rib of the patient, pain was reproduced. Therefore, the patient was diagnosed with $9^{th}$ rib syndrome, and ultrasound-guided $9^{th}$ and $10^{th}$ intercostal nerve blocks were performed around the tips of the severed $10^{th}$ rib. In addition, local anesthetics with triamcinolone were administered into the muscles beneath the $9^{th}$ rib at the point of the greatest tenderness. The patient's pain was reduced to NRS 2 point. In this case, it is suspected that the patient had a partial resection of the left $10^{th}$ rib in the past, and subsequent compression fractures at T8 and T9 led to the deformation of the rib cage, causing the tip of the remaining $10^{th}$ rib to impinge on the $9^{th}$ intercostal nerves, causing pain.
Background: Lumbar radicular pain is a frequent and often debilitating event. Although many treatment methods have been described in several studies, the available evidences regarding efficacy is not sufficient enough to draw definitive conclusions on an optimal therapy regime. Pulsed radiofrequency (RF) treatment was found to exert a beneficial effect on intractable radicular pain in individuals. The purpose of this study was to assess the efficacy of pulsed RF of the dorsal root ganglion for chronic lumbar radicular pain. Methods: Twenty five patients with chronic lumbar radicular pain that was refractory to selective nerve root blockage met the inclusion criteria of our study and received pulsed RF treatment. The average numeric rating scale (NRS) for leg pain during usual activities and the Oswestry disability index (ODI) were measured at 1 and 3 months after the procedure. Results: Of the 25 patients accepted for pulsed RF treatment, one dropped out due to a vertebral compression fracture during this study. ODI and NRS showed a positive trend in favor of the pulsed RF treatment. No significant complications were observed during the study period. Conclusions: It appears that pulsed RF treatment of the lumbar spinal dorsal root ganglion may be an effective treatment method for patients suffering from lumbar radicular pain, and who were not responsive to selective nerve root blockage.
Background: Conventional spinal saddle block is performed with the patient in a sitting position, keeping the patient sitting for between 3 to 10 min after injection of a drug. This amount of time, however, is long enough to cause prolonged postoperative urinary retention. The trend in this block is to lower the dose of local anesthetics, providing a selective segmental block; however, an optimal dose and method are needed for adequate anesthesia in variable situations. Therefore, in this study, we evaluated the question of whether only 1 min of sitting after drug injection would be sufficient and safe for minor anorectal surgery. Methods: Two hundred and sixteen patients undergoing minor anorectal surgery under spinal anesthesia remained sitting for 1 min after completion of subarachnoid administration of 1 ml of a 0.5% hyperbaric bupivacaine solution (5 mg). They were then placed in the jack-knife position. After surgery, analgesia levels were assessed using loss of cold sensation in the supine position. The next day, urination and 11-point numeric rating scale (NRS) for postoperative pain were assessed. Results: None of the patients required additional analgesics during surgical manipulation. Postoperative sensory levels were T10 [T8-T12] in patients, and no significant differences were observed between sex (P = 0.857), height (P = 0.065), obesity (P = 0.873), or age (P = 0.138). Urinary retention developed in only 7 patients (3.2%). In this group, NRS was $5.0{\pm}2.4$ (P = 0.014). Conclusions: The one-minute sitting position for spinal saddle block before the jack-knife position is a safe method for use with minor anorectal surgery and can reduce development of postoperative urinary retention.
Background: Patient-controlled epidural analgesia (PCEA) is known to provide good postoperative analgesia in many types of surgery including laparoscopic surgery. However, no study has compared PCEA with patient-controlled intravascular analgesia (PCIA) in laparoscopic radical prostatectomy (LARP). In this study, the efficacy and side effects of PCEA and PCIA after LARP were compared. Methods: Forty patients undergoing LARP were randomly divided into two groups: 1) a PCEA group, treated with 0.2% ropivacaine 3 ml and 0.1 mg morphine in the bolus; and 2) a PCIA group, treated with oxycodone 1 mg and nefopam 1 mg in the bolus. After the operation, a blinded observer assessed estimated blood loss (EBL), added a dose of rocuronium, performed transfusion, and added analgesics. The numeric rating scale (NRS), infused PCA dose, and side effects were assessed at 1, 6, 24, and 48 h. Results: EBL, added rocuronium, and added analgesics in the PCEA group were less than those in the PCIA group. There were no significant differences in side-effects after the operation between the two groups. Patients were more satisfied with PCEA than with PCIA. The NRS and accumulated PCA count were lower in PCEA group. Conclusions: Combined thoracic epidural anesthesia could induce less blood loss during operations. PCEA showed better postoperative analgesia and greater patient satisfaction than PCIA. Thus, PCEA may be a more useful analgesic method than PICA after LARP.
Kim, Ji Yong;Oh, Chang Hyun;Yoon, Seung Hwan;Park, Hyeong-Chun;Seo, Hyun Sung
Journal of Korean Neurosurgical Society
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제55권5호
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pp.255-260
/
2014
Objective : The purpose of this study was to compare the radiological and neurological outcomes between two atlantoaxial fusion method for atlantoaxial stabilization; C1 lateral mass-C2 pedicle screws (screw-rod constructs, SRC) versus C1-2 transarticular screws (TAS). Methods : Forty-one patients in whom atlantoaxial instability was treated with atlantoaxial fixation by SRC group (27 patients, from March 2005 to May 2011) or TAS group (14 patients, from May 2000 to December 2005) were retrospectively reviewed. Numeric rating scale (NRS) for pain assessment, Oswestry disability index (ODI), and Frankel grade were also checked for neurological outcome. In radiologic outcome assessment, proper screw position and fusion rate were checked. Perioperative parameters such as blood loss during operation, operation time, and radiation exposure time were also reviewed. Results : The improvement of NRS and ODI were not different between both groups significantly. Good to excellent response in Frankel grade is shown similarly in both groups. Proper screw position and fusion rate were also observed similarly between two groups. Total bleeding amount during operation is lesser in SRC group than TAS group, but not significantly (p=0.06). Operation time and X-ray exposure time were shorter in SRC group than in TAS group (all p<0.001). Conclusion : Both TAS and SRC could be selected as safe and effective treatment options for C1-2 instability. But the perioperative result, which is technical demanding and X-ray exposure might be expected better in SRC group compared to TAS group.
Background: The aim of this study was to assess the change in radiating leg pain after traffic accidents in patients with and without herniated intervertebral disc (HIVD) and improvement of radiating leg pain after traffic accidents. Methods: This was an retrospective study of 188 patients. Patients who had been admitted to the Hospital of Korean Medicine with the complaint of radiating leg pain after traffic accidents, and who had undergone lumbar spine magnetic resonance imaging to determine the presence or absence of HIVD were observed from April to June 2016. We analyzed sex, age, length of admission, direction (to a single leg or to both legs) and locations, (medial, anterior, lateral or posterior side of the lower limb) of radiating leg pain, presence or absence of HIVD, and number, grade and position of HIVD. The Numeric Rating Scale (NRS) and Oswestry Disability Index (ODI) were used to evaluate the impact of radiating leg pain on patients. Results: Radiating leg pain NRS score decreased significantly in both the HIVD group (from $6.12{\pm}2.39$ to $4.31{\pm}1.87$, p < 0.001) and the no HIVD group (from $5.76{\pm}1.64$ to $3.85{\pm}1.41$, p < 0.001). ODI score also decreased significantly in both groups (HIVD, from $44.67{\pm}17.38$ to $26.83{\pm}13.18$; no HIVD, from $39.24{\pm}15.58$ to $19.69{\pm}12$.; both p < 0.001). Conclusion: There was no significant change in radiating leg pain after traffic accidents in patients with and without HIVD and improvement of radiating leg pain after traffic accidents.
Kim, Jung-Eun;Kim, Sung-Phil;Kim, Ae-Ran;Park, Hyo-Ju;Kwon, Ojin;Jung, So-Young;Cho, Jung-Hyo;Kim, Joo-Hee;Choi, Sun-Mi
Journal of Acupuncture Research
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제35권3호
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pp.120-128
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2018
Background: Adhesive capsulitis (AC) is a common condition that includes shoulder pain and limited movement. Despite more than 100 years of AC treatment, the most efficacious treatment remains unclear. The aim of this study was to evaluate the feasibility of a randomized controlled trial (RCT) using acupuncture for AC. Methods: Thirty participants with AC were randomly assigned to acupuncture (A) or sham acupuncture (SA) groups. The participants received 15 acupuncture sessions over 6 weeks, and follow-up occurred for an additional 4 weeks thereafter. The primary clinical outcome was the numeric rating scale (NRS) for shoulder pain 6 weeks from the baseline. Secondary outcomes included range of motion (ROM) in the shoulder, the shoulder pain and disability index (SPADI), the EuroQol-5 dimensions (EQ-5D), the Pittsburgh sleep quality index (PSQI), and the patient global impression of change (PGIC). Results: Thirty participants were enrolled out of 37 screened individuals. Recruitment was conducted between August 2014 until May 2015. A total of 28 participants (93%) completed the 6-week intervention, and 26 participants (87%) completed the study. NRS, ROM, SPADI, EQ-5D, PSQI, and PGIC scores improved in both the experimental group and the sham group after 6 weeks, but the difference between the groups was not statistically significant. Adverse events were reported by 12 participants, although these events were not associated with acupuncture. Conclusion: A future RCT for AC may be feasible with some modifications to the recruitment plan and the secondary outcome measurement methods.
Objectives This study aimed to evaluate the effectiveness of postoperative Korean rehabilitation treatment for patients with musculoskeletal disorders. Methods The medical records of patients undergoing Korean medical rehabilitation after a musculoskeletal surgery, from January 1, 2016, to December 31, 2019, were analyzed retrospectively. The effect of treatment was evaluated by using a numeric rating scale (NRS) and questionnaire for each surgical site. When the same patient was re-admitted after discharge, it was treated as the same case if it was within 7 days from the discharge date; otherwise, it was treated separately. If the period of hospitalization was within 7 days or the chief complaint was not related to musculoskeletal surgeries, the case was excluded. Results In total, 480 cases were included in this study. Acupuncture (99.8%), moxibustion (95.6%), cupping (97.5%), Chuna manual therapy (81.5%), Korean medical physiotherapy (61.0%), Daoyin exercise therapy (26.3%), and herbal medicine (87.7%) were used as the Korean medical rehabilitation treatments. A significant improvement was noted when comparing the NRS and questionnaire results for each surgical site at the time of admission and discharge. Conclusions Korean medical rehabilitation can be effectively used for patients who have undergone musculoskeletal surgeries, to relieve pain and enable returning to daily activities. However, further research with a high level of evidence is necessary to support this finding.
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