• Radiation Oncology Journal
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• v.24 no.4
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• pp.263-271
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• 2006

$\underline{Purpose}$: To evaluate the effectiveness and safety of fentanyl-TTS in the management of radiotherapy induced acute pain and cancer pain treated with radiotherapy. $\underline{Materials\;and\;Methods}$: Our study was open labelled prospective phase IV multi-center study. the study population included patients with more 4 numeric rating scale(NRS) score pain although managed with other analgesics or more than 6 NRS score pain without analgesics. Patients divided into two groups; patients with radiotherapy induced pain (Group A) and patients with cancer pain treated with radiotherapy (Group B). All patients received 25 ug/hr of fentanyl transdermal patch. Primary end point was pain relief; second end points were change in patient quality of life, a degree of satisfaction for patients and clinician, side effects. $\underline{Results}$: Between March 2005 and June 2005, 312 patients from 26 participating institutes were registered, but 249 patients completed this study. Total number of patients in each group was 185 in Group A, 64 in Group B. Mean age was 60 years and male to female ratio was 76:24. Severe pain NRS score at 2 weeks after the application of fentanyl was decreased from 7.03 to 4.01, p=0.003. There was a significant improvement in insomnia, social functioning, and quality of life. A degree of satisfaction for patients and clinician was very high. The most common reasons of patients' satisfactions was good pain control. Ninety six patients reported side effect. Nausea was the most common side effect. There was no serious side effect. $\underline{Conclusion}$: Fentanyl-TTS was effective in both relieving pain with good tolerability and improving the quality of life for patients with radiotherapy induced acute pain and cancer pain treated with radiotherapy. The satisfaction of the patients and doctors was good. There was no major side effect.

• Korean Journal of Psychosomatic Medicine
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• v.25 no.1
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• pp.56-62
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• 2017

Objectives : The objective of this study was to investigate the relationship between psychological distress and pain in cancer patients. Methods : 249 patients with cancer who visited National Health Insurance Service Ilsan Hospital between April 2013 and March 2014 were evaluated with National Cancer Center Psychological Symptom Inventory(NCC-PSI) which consisted of Modified Distress Thermometer(MDT) and Modified Impact Thermometer(MIT). Each scale was divided into 3 subscales targeting separate symptoms: insomnia, anxiety, and depression. Psychological distress was defined as positive for those who scored above the cutoff values in at least one of all six subscales. The Numeric Rating Scale for Pain(NRS-Pain) was used to assess the subjective severity of pain. Logistic regression was performed to investigate the association between psychological distress and pain. Results : Univariate logistic regression analysis showed that pain, gender, compliance, and two subscale scores of Hospital Anxiety and Depression Scale(HADS) were significantly associated with psychological distress. Multivariate logistic regression analysis showed that pain and HADS anxiety subscale score maintained a statistically significant association with psychological distress adjusted for variables including age, gender, years of education, Eastern Cooperative Oncology Group performance status, cancer stage, Charlson Comorbidity Index, compliance, and HADS depression subscale score. One point increase in pain was 1.31 times more likely to cause psychological distress. In secondary analysis, pain was significantly associated with all subscales of NCC-PSI, except MIT-anxiety subscale. Conclusions : This study suggests that NCC-PSI, a screening tool for psychological distress, reflects pain. We recommend that physicians who treat cancer patients consider the examination of psychological distress which provides comprehensive evaluation of various factors regarding quality of life.

• Journal of muscle and joint health
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• v.22 no.1
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• pp.1-12
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• 2015

Purpose: The purpose of this study was to explore the relationships among pain, depression, health behaviors, and activities of daily living (ADL) in older adults after femur fracture surgery. Methods: This was a descriptive correlational study. Ninety seven outpatients aged 65 or older were selected, who agreed to participate and visited the four hospitals located in G providence. Numeric Rating Scale (NRS) for pain, a Short form Geriatric Depression Scale (SGDS) for depression, health behavior scale and Korean version of Bathel Index for ADL were used. Data were analyzed using t-test and ANOVA, Pearson's correlation and the hierarchical regression analysis in SPSS 18. Results: Pain and depression were positively correlated (r=.35, p<.001). Pain and health behaviors (r=-.30, p=.010), pain and ADL (r=-.21, p=.044), depression and health behaviors (r=-.51, p<.001), depression and ADL (r=-.29, p=.004) were negatively correlated. The variables affecting the ADL was intake of a painkiller or not (${\beta}$=-.32), age (${\beta}$=-.25), transitional period after discharge (${\beta}$=.23) and depression (${\beta}$=-.23). ADL was accounted for 33.4% in total by these four variables. Conclusion: Interventions for alleviating pain, and managing depression would be effective in enhancing ADL in older adults after femur fracture surgery.

• The Journal of Internal Korean Medicine
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• v.44 no.2
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• pp.87-96
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• 2023

Objective: This study reports the effectiveness of the Korean medicine treatment of patients with intracerebral and intraventricular hemorrhages suffering unilateral neglect symptoms. Case presentation: The patient was treated using Korean medicine, including acupuncture, herbal medicine, moxibustion, and a limb activation exercise. We measured Unilateral Neglect Symptom progress with a numeric rating scale, Albert's test, Line bisection test, Clock drawing test, and Catherine Bergego Scale. After eight days of combined Korean medicine and rehabilitation exercise, the Unilateral Neglect Symptom intensity reduced from NRS 8 to 6. In addition, Albert's test score decreased from 2.5% to 0%. The Line bisection test score decreased from 19 mm to 12 mm, and the Clock drawing test score improved from 8 to 10. Last, the Catherine Bergego Scale decreased from 12 to 9. No adverse events were observed during treatment. Conclusion: This study suggested that a complex treatment including Jaeumkunbi-tang, acupuncture, moxibustion, and limb activation exercise can be effective for an intracerebral hemorrhage with intraventricular hemorrhage patient suffering from Unilateral Neglect Symptoms. Consequently, more research is needed in the future.

• The Journal of Internal Korean Medicine
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• v.44 no.5
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• pp.968-978
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• 2023

Objectives: The purpose of this study is to report the effectiveness of Korean medicine treatment on postoperative state patients with cervical spinal cord injury due to ossification of the posterior longitudinal ligament. Methods: A 55-year-old Korean male patient diagnosed with cervical spinal cord injury due to ossification of the posterior longitudinal ligament was treated in an inpatient setting with Korean medicine treatment consisting of herbal medicine, acupuncture, and others from May 22 to August 21. The outcome was evaluated with the American Spinal Injury Association Impairment Scale (AIS), Spinal Cord Independence Measure-III (SCIM-III), modified Japanese Orthopaedic Association scale (mJOA), Numeric Rating Scale (NRS) before and after, or during the treatment period. Results: After 92 days of treatment, the patient's scores on all scales improved. Conclusion: The results suggest that Korean medicine treatment may be effective for postoperative patients with cervical spinal cord injury due to ossification of the posterior longitudinal ligament. Further studies should be conducted on a larger number of patients.

• The Journal of Internal Korean Medicine
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• v.38 no.3
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• pp.392-400
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• 2017

Objective: To report the case of a patient suffering from cervical vertigo who was treated with a combination of Korean medicine treatments (including acupuncture, pharmaco-acupuncture, and Chuna manual therapy). Method: An outpatient with cervical vertigo was given a combination of Korean medicine treatments five times, from December 5 to 16, 2016. All of the treatments, acupuncture with electric stimulation and pharmaco-acupuncture, were applied on the trigger points (TP) of the cervical muscles and the upper trapezoid muscles. Chuna manual therapy was then applied on the cervical area. The Numeric Rating Scale (NRS) - according to outpatient's statement on vertigo, neck pain and headache - and the Korean Dizziness Handicap Inventory (DHI), which is a self-evaluating scale of dizziness in daily life, were used to evaluate the effects of this treatment. Results: At the end of the treatment, the vertigo and the headache disappeared. The NRS decreased from 9 to 0 for vertigo and from 5 to 0 for headache. Although the neck pain also decreased, it did not disappear; this NRS decreased from 7 to 1. The DHI score also decreased significantly, from 64 to 4. Conclusion: Since the symptoms of the patient with cervical vertigo improved after the very first treatment and the improvement of the symptoms was observed as the treatment progressed, this case report is worth supporting the efficacy of combined Korean medical treatments. However, because there was only one subject, it is hard to say that this efficacy can be generalized. Moreover, this report cannot prove the individual efficacy since various treatments were combined. While there are many researches related to cervical vertigo in Western medicine, the studies in Korean medicine are comparably insufficient; therefore, follow-up research on more subjects is needed.

• Journal of Pharmacopuncture
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• v.13 no.2
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• pp.93-100
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• 2010

Background: Auricular acupressure is one of the traditional health care treatments in oriental medicine. Approximately, 30~40% of the cancer patients have said to be suffering from insomnia and half of them having chronic and severe insomnia at the same time. Insomnia caused cancer patients feel more pain, fatigue, depression and anxiety and it sometimes let the power to have the best of cancer pull down. Objective: To investigate how effective the auricular acupressure treatment to cancer patients suffering from insomnia. Methods: We recruited participants from East-West Cancer Center of Daejeon University. Finally, of the people whose age range from 20 to 75, 12 patients who got less than 40 points from the score of Oh's sleeping score (OSS) were recruited. Single-blind, randomized pilot study was performed. The treatment group received auricular acupressure treatment (AAT) on active points and the control group had received sham acupressure treatment (SAT) for five times. Sleep parameters were checked by using OSS and numeric rating scale (NRS). We checked the scale everytime, both before and after treatment. We analyzed the data statistically by using independent T-test, paired T-test and analysis of variance (ANOVA) test. (p<0.05) Results: Twelve cancer patients participated in this pilot study and there was no significant difference between control and treatment group. Only 7 of them had completed the whole treatment process, 4 patients of AAT group and 3 participants of SAT. The OSS of AAT group had increased from $34.0{\pm}4.3$ to $39.5{\pm}3.1$ and that of SAT group had increased from $38.3{\pm}3.5$ to $40.0{\pm}0.0$. There was no significant difference between them. The NRS of AAT group had increased from $6.3{\pm}2.9$, $04.8{\pm}2.1$ and that of SAT group had increased from $7.0{\pm}1.0$ to $5.0{\pm}2.6$. No significant difference was observed between them. Conclusion: Although both groups did not show significant differences, most of the experimental participants showed increasing OSS and NRS after treatments. Significant participants' number will be needed in the next study.

• The Journal of Internal Korean Medicine
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• v.43 no.2
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• pp.166-174
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• 2022

Objective: The aim of this study is to report the effectiveness of Korean medicine for a patient with dizziness following anterior inferior cerebellar artery infarction. Methods: The patient was treated with traditional Korean methods including acupuncture, herbal therapy, moxibustion, and vestibular rehabilitation exercise during an admission period of seven days. The patient's dizziness was assessed using a numeric rating scale (NRS) and the Korean Dizziness Handicap Inventory (K-DHI), Korean Activities-specific Balance Confidence (K-ABC), Korean Vestibular Disorders Activities of Daily Living (K-VADL), the modified Rankin scale (mRS), and the Korean version of the Modified Barthel Index (K-MBI). Results: After seven days of combined treatment with traditional methods and vestibular rehabilitation, the patient's dizziness was reduced from NRS 6-7 to NRS 2. In addition, K-DHI decreased from 84 to 22; K-ABC improved from 52% to 78.125%; K-VADL reduced from 175 to 37; the mRS score changed from 4 to 1; and the K-MBI score increased from 86 to 98. No adverse events were observed during treatment. Conclusion: This study suggests that combined therapy of Korean medicine and vestibular rehabilitation can be effective treatment for anterior inferior cerebellar artery infarction patients.

• The Journal of Internal Korean Medicine
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• v.41 no.2
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• pp.132-140
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• 2020

Objectives: This research study aimed to determine the effect of Korean medicine treatments on a patient with lumbar disc herniation accompanying polycystic kidney disease. Methods: Acupuncture, herbal medicine, pharmacopuncture, spine decompression therapy, Motion Style Acupuncture Treatment (MSAT), and Chuna were preceded for treatment. We checked the patient's Oswestry Disability Index (ODI), numeric rating scale (NRS), and straight leg raise test (SLRT) on admission and discharge; we also used the NRS and SLRT to evaluate the patient's symptoms on every third day during the hospital stay. Because it is important to manage blood urea nitrogen (BUN), serum creatinine, and blood pressure during the early stage of polycystic kidney disease, BUN and serum creatinine levels were checked weekly while blood pressure was checked every morning. Results: Twelve days after admission, the NRS for lower back pain and right leg pain decreased from 7 to 3 and from 7 to 2, respectively. The ODI value also decreased from 56 to 20 while the SLRT value increased from 30/70 to 60/70. The BUN and serum creatinine levels and the blood pressure readings were all within normal range every time they were checked. Conclusions: The use of Korean medicine treatments resulted in improvements in NRS, ODI, and SLRT on a patient with a herniated lumbar disc herniated who had a past history of polycystic kidney disease; thus, the patient was able to maintaining kidney functioning. Herbal medicine, an alternative method of analgesic anti-inflammatory drugs that has been evaluated as relatively safe on liver and kidney function, could be suggested on a patient with a past history of polycystic kidney disease to maintain kidney function when renal function and blood pressure are monitored.

• Journal of Hospice and Palliative Care
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• v.20 no.2
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• pp.131-135
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• 2017

Purpose: Oral naloxone is combined with oxycodone to alleviate or prevent opioid-induced constipation in cancer pain patients. However, there is still concern that oral naloxone may precipitate opioid withdrawal symptoms in patients on opioids. We retrospectively investigated clinical characteristics of cancer patients who experienced opioid withdrawal symptoms. Methods: We reviewed medical records of all patients who were prescribed with oral oxycodone/naloxone at a tertiary cancer center from January 1, 2012 through December 31, 2016. Eligible patients were screened based on demographics, opioid and naloxone dosages, clinical manifestation and pain intensity. Results: Among a total of 1,641 patients, 10 patients were selected. Seven patients were male, and the average age was 68.1 years. The median dose of naloxone that induced withdrawal symptoms was 20 mg. Most common withdrawal symptom was shivering (seven patients) followed by cold sweating (five), and muscle twitching (five). Other symptoms included restlessness, fever, dizziness, and yawning. Pain was exacerbated from the median intensity of numeric rating scale (NRS) 3 to NRS 6. Conclusion: Opioid withdrawal symptoms may occur when switching to oral oxycodone/naloxone for cancer patients who have been treated with other strong opioids. A prospective, multicenter study on this issue should be conducted in future.