• Title/Summary/Keyword: Pain evaluation

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Comparative Study of Posterior Lumbar Interbody Fusion via Unilateral and Bilateral Approaches in Patients with Unilateral Leg Symptoms

  • Seong, Ji-Hoon;Lee, Jong-Won;Kwon, Ki-Young;Rhee, Jong-Joo;Hur, Jin-Woo;Lee, Hyun-Koo
    • Journal of Korean Neurosurgical Society
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    • v.50 no.4
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    • pp.363-369
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    • 2011
  • Objective : We investigated the clinical and radiological advantages of unilateral laminectomy in posterior lumbar interbody fusion (PLIF) procedure comparing with bilateral laminectomy, under the same procedural condition including bilateral instrumentation and insertion of two cages, in patients with degenerative lumbar disease with unilateral leg symptoms. Methods : We retrospectively reviewed 124 consecutive cases of PLIF via unilateral or bilateral approach between January 2006 and April 2010. In 80 cases (bilateral group), two cages were inserted via bilateral laminectomy, and in 44 cases (unilateral group), via unilateral laminectomy. The average follow-up duration was 29.5 months. The clinical outcomes were evaluated with the Visual Analogue Scale (VAS) and the Oswestry disability index (ODI). The fusion rates and disc space heights were determined by dynamic standing radiographs and/or computed tomography. Operative times, intra-operative and post-operative blood losses and hospitalization periods were also evaluated. Results : In clinical evaluation, the VAS and ODI scores showed excellent outcomes in both groups. There were no significant differences in term of fusion rate, but the perioperative blood loss and the operative time of the unilateral group were lower than that of the bilateral group. Conclusion : Unilateral laminectomy can minimize the operative time and perioperative blood loss in PLIF procedure. However, the different preoperative disc height between two groups is a limitation of this study. Despite this limitation, solid fusion and satisfactory symptomatic improvement could be achieved uniquely by our surgical method. This surgical method can be an alternative surgical technique in patients with unilateral leg pain.

Effects of Gait Training Using Functional Electrical Stimulation on Stroke Patients' Balance and Gait Velocity

  • Kang, Kwon-Young;Choi, Wan-Suk;An, Ho-Jung;Koo, Ja-Pung;Lee, Joon-Hee;Yun, Young-Dae;Lee, Jung-Sook;Jung, Joung-Youl;Lee, Sang-Bin
    • Journal of International Academy of Physical Therapy Research
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    • v.2 no.2
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    • pp.288-293
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    • 2011
  • The purpose of this study is to examine the effects of gait training using functional electrical stimulation on the improvement of hemiplegic patients' functions for balance and gait velocity. The subjects of the experiment were determined to be 10 each hemiplegic patients who had been diagnosed with stroke or brain damage six months or longer earlier assigned to an experimental group and a control group respectively. The subjects were evaluated before the experiment using Tetrax and 10M gait tests, received gait training five times a week for four weeks using functional electrical stimulation and were evaluated after the experiment in the same method as used in the evaluation before the experiment. In order to examine differences between the experimental group that received gait training using functional electrical stimulation and the control group that was treated by functional electrical stimulation and received gait training thereafter, differences between before and after the experiment were analyzed using paired sample t-tests and differences in changes after the experiment between the experimental group and the control group were analyzed using independent sample t-tests in order to compare the two groups with each other. Experimental results showed significant differences in weight bearing, balance and gait velocity between before and after the experiment in the experimental group(p<.05). In the control group, whereas weight bearing and gait velocity did not show any significant difference between before and after the experiment(p>.05), balance showed significant differences(p<.05). Weight bearing, balance and gait velocity change rates showed significant differences between the experimental group and the control group(p<.05). In conclusion, it was indicated that gait training using functional electrical stimulation is effective for enhancing stroke patients' weight bearing rates, balance abilities and gait velocity.

A Review of Clinical Shoulder Assessment Scales (견관절의 임상적 평가도구에 관한 고찰)

  • Yang, Dong-Hoon;Kim, Kun-Hyung;Kim, Haeng-Beom;Choi, Yang-Sik;Park, Young-Bae
    • Journal of Acupuncture Research
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    • v.24 no.6
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    • pp.123-135
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    • 2007
  • Objectives : A number of instruments have been developed to measure the quality of life in patients with various shoulder disorders. Much progress has been made in this area, and currently an appropriate instrument exists for each shoulder state. The purpose of this study is to review the instruments that are currently in use for assessing the shoulder joint. Methods : A literature research was performed to choose appropriate scales for assessment of function and the disability of the shoulder. Theoretically based scales were selected for review. Therefore, 11 scales were reviewed. The status of scales involved in shoulder treatment of acupuncture throughout several countries was evaluated. Results : 11 scales: The American shoulder and elbow surgeons evaluation form(ASES), Constant Shoulder Score, The disabilities of the arm, shoulder and hand(DASH), Shoulder Disability Questionnaire (SDQ), The Shoulder Pain And Disability index(SPADI), The simple shoulder test(SST), Oxford Shoulder Questionnaire(OSQ), The Rotator Cuff quality-of-life Measure(RC-QoL), Western Ontario Shoulder Instability Index(WOSI), Western Ontario Osteoarthritis of the Shoulder Index(WOOS), Western Ontario Rotator Cuff Index(WORC), wereevaluated. Each measurement has its own composition and characteristics. Their validity, reliability, responsiveness and practical characteristics were already evaluated. We found 3 domestic and 10 overseas papers about shoulder treatments using acupuncture assessed with shoulder scales. Conclusions : In clinical research, the selection of the measurement scale should take account of the condition of disease, the patient's traits and the characteristics of the research. Moreover, appropriate scales, which havevalidity, reliability, responsiveness and practical characteristics, are needed to enhance the quality of research.

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Clinical Evaluation of the Mediastinal Tumors (종격동 종양의 임상적 고찰)

  • 이준복;서성구
    • Journal of Chest Surgery
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    • v.29 no.10
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    • pp.1148-1151
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    • 1996
  • For the purpose of clinical analysis In mediastinal tumors, 51 patients with mediastinal tumor who were surgically treated from February 1984 to February 1994 in Chunan hospital of Soonchunhyang university were reviewed. There were 21 male and 30 female patients in the study. Age ranges from 11 months to 75 years, with the mean 39.4$\pm$ 18.8 years. Symptoms and signs were asymptom(21.6%), chest d scomfort(19.6%), dyspnea(15.7%), ptosls(15.7%), general weakness(13.7%) and chest pain(9.8%). The most frequent tumor location was anterosuperior mediastinum(60.8%) followed by posterior(25.5%) and middle(13.7%) mediastinum. In the pathological viewpoint, thymoma(33.3%) was the most frequent type followed by neurogenic tumor(25.5%) an'd germ cell tumor(19.6%). All of benign tumors(46 cases) were completely removed and malignant tumors(5 cases) were treated with rAdiotherapy after operation. The postoperative complications were 2 wound dehesences, 1 pneumothorax, 1 vocal cord palsy and 1 prolonged mechanical ventilation.

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Long Term Follow-up of Avascular Necrosis after Talar Fracture and Dislocation: 5 Cases (거골 골절 탈구 후 무혈성 괴사의 장기 추시: 5예)

  • Kim, Byung-Cheol;Choi, Sung-Jong;Kim, Hui-Taek;Yoo, Chong-Il;Jung, Sung-Won;Eun, Il-Soo;Ku, Jeong-Mo;Kim, Jong-Kyun
    • Journal of Korean Foot and Ankle Society
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    • v.9 no.1
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    • pp.31-37
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    • 2005
  • Purpose: To report our opinions of management about avascular necrosis following operative treatment of talar fracture and dislocation. Materials and Methods: We followed up 5 patients who were diagnosed as talar avascular necrosis after operation of talar fracture and dislocation. Clinical and radiological analysis were performed. The mean age of patients was 36 years. There were 4 males and 1 females. The average follow up was 51 months. Hawkins scoring system was used as clinical evaluation. Results: Regardless of radiological sclerotic finding, all patients showed satisfactory clinical result. Despite arthritic change in one patient, there were no further radiological and clinical deterioration to require salvage procedure. Conclusion: Most avascular necrosis after operative treatment of talar fracture and dislocation showed satisfactory result with conservative treatment. Thus, salvage operation such as talectomy or ankle fusion should be reserved in cases of intractable ankle pain and claudication.

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Operative Treatment for Hallux Valgus with Proximal Metatarsal Osteotomy in Patients over 55 Years Old (55세 이상 무지외반증 환자의 근위부 절골술을 이용한 치료)

  • Park, Han-Sung;Park, Hyung-Taek;Lee, Ghun-Shik;Kim, Sang-Hyo;Lee, Kyung-Tai
    • Journal of Korean Foot and Ankle Society
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    • v.9 no.1
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    • pp.69-73
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    • 2005
  • Purpose: The purpose of our report was to evaluate the result of operative treatment of hallux valgus in old age patients. Materials and Methods: We studied about the clinical & radiologic results of the 31 patients over 55 years old, who had operative treatment of hallux valgus. Clinical evaluation, such as pain, activity limitation, footwear requirement, 1st metatarsophalangeal joint motion, and callosity, was done using AOFAS scale and preoperative and postoperative radiologic parameters, such as hallux valgus angle, intermetatarsal angle, tibial sesamoid position, 1st metatarsal shortening, were evaluated by conventional methods. Results: Objectively, according to AOFAS, the score improved from average of 57.8 to 71.5 postoperatively. The range of motion of first metatarsophalangeal joint was decreased from average of 60.7 to 56.8 degrees. Radiologically, the hallux valgus angle improved from average of 35 to 6.5 degrees and the first intermetatarsal angle improved from average of 14.2 to 4.4 degrees. The position of sesamoid was collected from an average of grade 3.6 to grade 2.2. Conclusion: The combination of proximal metatarsal osteotomy, distal soft tissue procedure and Akin osteotomy may yield rather satisfactory clinacal result in severe elderly hallux valgus patients with massive degenerative change and poor soft tissue condition.

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Ankle Lesions, Associated with Anterior Soft Tissue Impingement (전방 연부조직 충돌과 동반된 족관절 병변)

  • Sung, Il-Hoon;Kim, Suk-Hwan;Shim, Kyu-Dong;Lee, Jun-Hwan;Kang, Chang-Nam
    • Journal of Korean Foot and Ankle Society
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    • v.14 no.2
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    • pp.115-118
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    • 2010
  • Purpose: To evaluate clinical features of ankle lesions, associated with anterior soft tissue impingement. Materials and Methods: We retrospectively reviewed 21 patients who had chronic anterior ankle pain as initial symptom and associated ankle lesions with anterior soft tissue impingement. Based on preoperative radiologic findings, physical examination intra-operative findings, appropriate procedures were done for lesions by either arthroscopic or minimal open procedure or combined. Clinical evaluation was done using American Orthopedic Foot and Ankle Society, ankle-hind foot score (AOFAS score) and visual analog scale (VAS) on last follow up. Results: Associated lesion(s) to anterior soft tissue impingement of the ankle were 16 cases of osteochondral lesion of talus, 14 cases of bony impingement, 6 cases of ankle lateral instability, 5 cases of loose body, 4 cases of os subfibulare. AOFAS score was $58.9\;{\pm}\;5.1$ preoperatively and $74\;{\pm}\;9.1$ on last follow up. Clinical satisfaction score using VAS showed excellent in 3 cases, good in 11, fair in 3, poor in 4. Conclusion: The patients who had anterior soft tissue impingement would have various associated lesions on their ankle. In such cases, preoperative counseling for variety of postoperative results would be needed.

PULP TREATMENT OF PRIMARY TEETH USING A COMBINATION OF ANTIBIOTICS (항생제를 사용한 유치의 치수치료)

  • Kim, Dae-Eop
    • Journal of the korean academy of Pediatric Dentistry
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    • v.32 no.1
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    • pp.126-131
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    • 2005
  • The purpose of this study was to observe the potentiality of a mixture of antibiotics to relieve the endodontic and periapical infections in primary teeth. A mixture of metronidazole, ciprofloxacin, and minocyclin in distilled water or in a root canal sealer were used to disinfect the infected endodontic and periapical lesions. For application of this mixture, medication cavities were prepared at orifices of root canals by using the $Fissurotomy^{(R)}$ burs(S S White, USA). The cavities and bottom of pulp chamber were filled with antibiotics mixture. In this cases, clinical symptoms were improved following a single application of that mixture. Gingival swelling, pain, and fistulae were disappeared within a week. More long term evaluation will be needed. Although there were no reports of side effects, care should be taken if children are sensitive to antibiotics. Within the limitations of this case, the mixture of 3 antibiotics provided an excellent improvement in treatment of infected primary teeth under the physiologic root resorption.

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Treatment of life-threatening acute osteomyelitis of the jaw during chemotherapy: a case report

  • Jung, Junhong;Kim, Sumin;Park, Jun-Sang;Lee, Choi-Ryang;Jeon, Jae-ho;Kwon, Ik-Jae;Myoung, Hoon
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.20 no.4
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    • pp.251-259
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    • 2020
  • Oral and maxillofacial infection is a common complication in patients undergoing chemotherapy. The treatment of oral diseases in such patients differs from that administered to healthy patients. This paper reports a case of acute osteomyelitis of odontogenic origin following a recent chemotherapy session. The patient's condition was life-threatening because of neutropenic fever and sepsis that developed during the inpatient supportive care. However, the patient showed prompt recovery within 40 days following the use of appropriate antibiotics and routine dressing, without the requirement for surgical treatment, except tooth extraction. As seen in this case, patients undergoing chemotherapy are more susceptible to rapid progression of infections in the oral and maxillofacial areas. Therefore, accurate diagnosis through prompt clinical and radiological examination, identification of the extent of infection, and assessment of the patient's immune system are crucial for favorable outcomes. It is also necessary to eliminate the source of infection through appropriate administration of antibiotics. In particular, a broad-spectrum antibiotic with anti-pneumococcal activity is essential. Proper antibiotic administration and wound dressing are essential for infection control. Furthermore, close consultation with a hemato-oncologist is necessary for effective infection management based on the professional evaluation of patients' immune mechanisms.

The Motion Evaluation of Arthritis Patients' Dressing and Undressing Corresponding to their Joint Range of Motion (관절염질환자의 관절가동범위에 대응한 착탈의 동작평가)

  • Han, Seung-Hee;Choi, Mi-Sung
    • Journal of the Korea Fashion and Costume Design Association
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    • v.14 no.2
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    • pp.75-87
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    • 2012
  • This study aims at measuring and comparing the joint range of motion(ROM) of the elderly, quantitatively understanding the joint ROM and duration for their dressing and undressing of pants with 3D motion analysis equipment, and thereby providing basic data necessary for the future development of clothes carrying functional designs. The findings are as follows. As for the study method, the 9-item joint ROM measurements were conducted with goniometer, and the questionnaire analyses were carried out for t-test, ANOVA, and regression analysis with spss12.0 program. The 3D motion analyses were handled with 3D Motion Analysis Package Version 3.1 Program. The findings are as follows. First, the ROM was shown to be significantly low, as the arthritis-pain consciousness level was felt higher by the subject than the average one. Seven ROM variables, such as hip flexion, hip adduction, hip internal rotation, hip external rotation, knee flexion, ankle dorsiflexion, and ankle plantar flexion, were shown to significantly affect the discomfort level experienced at the time of dressing or undressing. Second, in the motion of inserting the remaining leg into the pant crotch part(3e), the difference of angles in the hip joint and knee joint was the largest between the women in their 20s and the elderly women with arthritis. Third.

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