• Title/Summary/Keyword: Pain evaluation

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Arthroscopic Release of the Extensor Carpi Radialis Brevis Tendon for Chronic Recalcitrant Lateral Epicondylitis (만성 불응성 외 상과염에서 시행한 관절경적 단 요 수근 신건 유리술)

  • Ku, Jung Hoei;Hwang, Tae Hyok;Lee, Jung Su;Cho, Hyung Lae;Kim, Jung Woo
    • Journal of the Korean Arthroscopy Society
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    • v.16 no.2
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    • pp.140-146
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    • 2012
  • Purpose: The objective of this study was to assess the clinical outcome of arthroscopic release of the extensor carpi radialis brevis (ECRB) tendon in chronic recalcitrant lateral epicondylitis and tried to determine any prognostic factors. Materials and Methods: A retrospective review of 24 patients with lateral epicondylitis treated by arthroscopic ECRB release was performed. Outcome measures included a patient self rating and visual analog scale (VAS). Functional evaluation was made with Quick-disabilities of the arm, shoulder and hand (DASH) score system to identify preoperative factors that might be associated with the outcomes. Results: Twenty one (88%) elbows received benefit from the procedure. A mean preoperative VAS pain score and the mean Quick-DASH were significantly improved at final follow up. Age, sex, dominant arm and duration of symptom, presence of capsular tear or calcification did not correlate significantly with the clinical outcome. Three of four patients without T2-weighted high signal focus of the ECRB origin on preoperative magnetic resonance imaging (MRI) showed higher Quick-DASH score. Conclusion: Arthroscopic release of the ECRB is an effective option for chronic recalcitrant lateral epicondylitis. Lack of high signal focus on preoperative MRI is significantly associated with a poor surgical outcome and a considerable factor for the proper surgical indication.

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Effect on bone formation of the autogenous tooth graft in the treatment of peri-implant vertical bone defects in the minipigs

  • Kim, Seok Kon;Kim, Sae Woong;Kim, Kyung Wook
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.37
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    • pp.2.1-2.9
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    • 2015
  • Background: The aim of this study was to evaluate the effect of autogenous tooth bone as a graft material for regeneration of bone in vertical bony defects of the minipigs. Material and Methods: Six minipigs were used in this study. Four molars were extracted in the right mandibular dentition and sent to the Korea Tooth Bank for fabrication of autogenous tooth bone. Ten days later, each extraction site was implanted with MS Implant Narrow Ridge $3.0{\times}10mm$ fixture (Osstem, Seoul, Korea) after standardized 2mm-sized artificial vertical bony defect formation. Pineappleshaped Root-On type autogenous tooth bones were applied to the vertical defects around the neck area of the posterior three fixtures and the fore-most one was not applied with autogenous bone as a control group. Each minipig was sacrificed at 4, 8, 12 weeks after fixture installation and examined radiologically and histologically. Histological evaluation was done under light microscope with Villanueva osteochrome bone staining with semi-quantitative histomorphometric study. Percentage of new bone over total area (NBF) and bone to implant contact (BIC) ratio were evaluated using digital software for area calculation. Result: NBF were $48.15{\pm}18.02%$, $45.50{\pm}28.37%$, and $77.13{\pm}15.30%$ in 4, 8, and 12 weeks, respectively for experimental groups. The control group showed $37.00{\pm}11.53%$, $32.25{\pm}26.99%$, and $1.33{\pm}2.31%$ in 4,8,12 weeks, respectively. BIC ratio were $53.08{\pm}19.82%$, $45.00{\pm}28.37%$, and $75.13{\pm}16.55%$ in 4,8,12 weeks, respectively. Those for the control groups were $38.33{\pm}6.43%$, $33.50{\pm}29.51%$, and $1.33{\pm}2.31%$ in 4, 8, 12 weeks, respectively. Conclusion: Autogenous tooth bone showed higher score than control group in NBF and BIC in all the data encompassing 4,8,12 weeks specimens, but statistically significant only 12 weeks data in both NBF and BIC.

Peripheral Nerve Injuries Associated with Rotator Cuff Tears (견관절 회전근 개 파열과 동반된 말초 신경 손상)

  • Lee, Kwang-Won;Lee, Ho;Na, Kyu-Hyun;Choy, Won-Sik
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.5 no.2
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    • pp.117-122
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    • 2006
  • Purpose: The purpose of this study is to investigate the relationship between rotator cuff tear and nerve injury, and prevalence of nerve injury using electromyographic study. Materials and Methods: From May 2004 to Feb. 2005, 19 cases, who underwent surgery for full-thickness rotator cuff tear, were evaluated for nerve injury using electomyogram instruments preoperatively. Rotator cuff tears caused by acute high energy trauma were excluded in this study. Mean age was 59 (range, 45-87) years and mean duration of symptoms was 45 (range, 1-360) month. Results: There were six nerve injuries (31.6%). All of them were incomplete brachial plexus injuries, and mainly postganglionic lesions. Four cases among them had minor trauma history. There were no significant differences in terms of cuff tear size, range of motion, pain score and functional score between groups with and without nerve injury. Conclusion: This study showed high prevalence (31.6%) of nerve injury in full-thickness rotator cuff tear. So careful physical examination and evaluation for nerve injury are needed in rotator cuff tear.

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Arthroscopy for the Diagnosis and Treatment of Failed Trochleoplasty in a Dog (활차구 성형술이 실패한 개에서 관절경을 이용한 진단과 치료)

  • Hwang, Junho;Heo, Suyoung;Kim, Bumseok;Lee, Sanghoon;Jeong, Seongmok;Lee, Haebeom
    • Journal of Veterinary Clinics
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    • v.32 no.3
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    • pp.251-254
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    • 2015
  • A 3-year-old castrated male Spitz dog (8.4 kg) was referred for hindlimb lameness. The dog had undergone corrective surgery for bilateral medial patellar luxation 6 weeks prior to presentation. Intermittent lameness of both hind limbs was evident on general inspection. Physical examination revealed moderate pain and crepitus upon flexion and extension of the stifle joints. Radiography revealed features consistent with distal deviation of the cartilage flaps and effusion in both stifle joints. Detachment and deviation of both osteochondral blocks were suspected based on the physical and radiographic findings. Arthroscopy confirmed failed osteochondral blocks (right $1.5cm{\times}0.9cm{\times}0.2cm$, left $1.3cm{\times}0.9cm{\times}0.1cm$), which were removed. After removal of the osteochondral blocks, the stepped trochlear grooves were located and debrided using an arthroscopic burr, to prevent patellar tracking disorder. The dog resumed normal ambulation without medial patellar luxation 2 weeks postoperatively, and there were no complications. Arthroscopy is an effective surgical modality for the diagnosis and treatment of canine joint disorders. It offers a magnified view of the joint, which allows accurate evaluation of intra-articular structures. In addition, arthroscopic surgery can reduce the postoperative complications associated with surgical wound.

Clinical Evaluation of Pleural Fluid (늑막강내 저류액의 임상적 고찰)

  • 정황규
    • Journal of Chest Surgery
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    • v.21 no.2
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    • pp.316-325
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    • 1988
  • Author made a clinical study of 248 cases of pleural effusion patients who were diagnosed and treated at departments of chest surgery and internal medicine, Pusan National University Hospital, during the period from Jan. 1983 to Dec. 1985. The age distribution ranged from 1 to 76 years old and the ratio of male to female was 1.38:1. The cardinal symptoms were chest pain[69.4%], dyspnea[66.1%], cough[57.7%], fever[37.1%], sputum[26.2%], general malais[13.7%] and cyanosis[1.6%] in this order. The causes of pleural effusion were pulmonary tuberculosis[42.4%], pneumonia[23.0%], malignancy[16.5%], congestive heart failure[9.3%], liver cirrhosis[2.8%] and nephrosis[2.0%] in this order. The protein in the pleural effusions was 1.61*0.90[mean*SD] gm% in transudate and 5.05*1.10[Mean*SD] gm% in exudate. In 34 cases[89.5%]out of 38 transudates, the protein was under 3 gm% and in 201 cases [95.7%] out of 210 exudates, the protein was over 3 gm%. The protein ratio of pleural effusion to serum was 0.2650.11[Mean LSD] in transudates and 0.73*0.12[Mean LSD] in exudate. The ratio under 0.5 was in 36 cases[94.8%] out of 38 transudates and over 0.5 was in 206 cases[98.1%] out of 210 exudates. The LDH in the pleural effusion was 114.7550.3[mean*SD] units / ml in transudate and 627.05325.9[mean*SD] units / ml in exudate. The LDH less than 200 units / ml was in 36 cases[94.6%] out of 38 transudates and more than 200 units / ml was in 199 cases[94.7%] out of 210 exudates. The LDH ratio of pleural effusion to serum was 0.34k 0.11[mean*SD] in transudate and 1.15*1.12[mean*SD] in exudate. The LDH ratio of pleural effusion to serum was less than 0.6 in 36 cases[94.8%]out of 38 transudates and more than 0.6 in 200 cases[95.2%] out of 210 exudates. Etiologic organisms were confirmed in 78 cases[48.1%] among the requested 162 cases. In the 78 cases of etiologic organisms, staphylococcus was 33 cases[20.3%], streptococcus 24 cases[14.8%], Klebsiella pneumonia 7 cases[4.3%], pseudomonas 6 cases[3.7%], E. coli[3.1%], enterobacter 3 cases[1.9%]. 43 patient of pleural effusion from malignancy were undergone three or more thoracenteses. In 13 cases[31.7%], three specimen were negative and in 7 cases[17.1%], three specimens were positive for malignancy. In the remaining of 21 cases[51.2%], malignant cells were found in one or more of the specimens but not in all. Methods of treatment of pleural effusion by closed thoracotomy was 188 cases[75.8%], thoracentesis 27 cases[10.9%], decortication 16 cases[6.5%], thoracoplasty 6 cases[2.4%] and decortication with thoracoplasty 3 cases[1.2%].

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Thoracoscopic Lung Biopsy for Diffuse Interstitial Lung Disease (미만성 간질성 폐질환에서 흉강경폐생검)

  • Son, Dong-Seop;Jo, Dae-Yun;Yang, Ki-Min
    • Journal of Chest Surgery
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    • v.30 no.12
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    • pp.1232-1236
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    • 1997
  • Diffuse lung disease is amenable to diagnosis by means of clinical evaluation, bronchoalveolar lavage, transbronchial biopsy, and lung biopsy. The recently introduced technique of thoracoscopic wedge biopsy provides the potential advantages of greater selection of biopsy sites and reduced postoperative pain compared with those associated with standard open lung biopsy. Video assisted thoracoscopic lung biopsy was performed in 22 patients for the diagnosis of diffuse lung disease during the period from August 1994 to December 1996, and the following results were obtained: 1. The patients were 14 men and 8 women. The average age was 54.6 years. 2. 13 lung biopsy specimens were obtained from the right lower lobe, 4 from he right upper lobe, 3 from the right middle lobe, 3 from the left upper lobe, and 3 from the left lower lobe. 3. A comparison of pulmonary function tests between preoperative and postoperative values showed no significant differences in FVC, FEVI, and FEVl/FVC(p>0.05). All patients were pathologically diagnosed and the most common disease was usual interstitial pneumonia(8/22). In conclusion, thoracoscopic lung biopsy was a safe and effective diagnostic method of diffuse lung disease.

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Evaluation of Coronary Artery Disease with Gated Blood Pool Scan Using Dipyridamole (Dipyridamole 부하 심장 풀 스캔을 이용한 관동맥질환의 평가)

  • Kim, Gwang-Weon;Choi, Chung-Il;Chung, Byung-Cheon;Lee, Jae-Tae;Lee, Kyu-Bo;Chae, Shung-Chull;Jun, Jae-Eun;Park, Wee-Hyun;Park, Hee-Myung
    • The Korean Journal of Nuclear Medicine
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    • v.25 no.1
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    • pp.27-36
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    • 1991
  • Thirty-one patients with coronary artery disease and twenty-sir normal subjects underwent $^{99m}Tc-GBPS$ before and after coronary vasodilatation was induced by dipyridamle 0.54 mg/kg given IV over 4 min. LVEF, ${\Delta}EF$ and regional wall motion by phase analysis were measured during rest and dipyridamole infusion. The results were as follows: 1) Mean LVEF of normal subjects was significantly higher than that of MI group (p=0.001), but similar to that of angina group during rest. Among MI group, mean LVEF of anterior MI group was significantly lower than that of inferior MI group during rest (p=0.024). 2) The normal subjects had a significaat increase in mean LVEF during dipyridamole infusion $(+12{\pm}3.8)$, while the CAD group had no increase $(+2{\pm}5.0)$ (p<0.001). If an increase of LVEF during stress is less than 5%, it suggests an abnormality. The sensitivity and specificity of LVEF changes after dipyridamole infusion were 81%, 96%, respectively. 3) With phase analysis, LV mean phase angle of normal subjects and CAD patients was $143{\pm}20.5^{\circ},\;132{\pm}20.6^{\circ}$ respectively, durign rest (p=0.049). But an ncrease of LV mean phase angle during dipyridamole infusion in these two groups was not significantly different. Dipyridamole infusion did not affect standard deviation and FWHM of phase angle. 4) Regional wall motion was abnormal in 5 patients (16%) during dipyridamole infusion. 5) Side effects with dipyridamole infusion include; headache, angina pain, chest discomfirt, nausea, weakness sense. In conclusion, dipyridamole GBPS might be useful in detection and follow up of CAD.

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A Case of a Solitary Fibrous Tumor of the Pleura Presenting as Pneumonia and Acute Respiratory Failure (폐렴과 급성 호흡부전으로 나타난 흉막의 고립성 섬유성 종양 1예)

  • Park, Hye Sun;Kwak, Hyun Jung;Park, Dong Won;Koo, Tai Yeon;Kim, Hye Young;Park, So Yeon;Ahn, Seong Eun;Kim, Sang-Heon;Kim, Tae Hyung;Sohn, Jang Won;Chung, Won Sang;Yoon, Ho Joo;Shin, Dong Ho;Park, Sung Soo
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.4
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    • pp.334-338
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    • 2008
  • Solitary fibrous tumors of the pleura (SFTPs) are relatively rare tumors that originate from the mesenchymal cells of the submesothelial tissue of the pleura. Patients with SFTPs are often asymptomatic, while some patients experience pleuritic chest pain, cough and/or dyspnea. We report here on a case of SFTP, and the patient presented with septic shock and respiratory failure that required mechanical ventilation. A 68-year-old woman was admitted for the evaluation of her dyspnea and generalized edema. Chest imaging studies showed an 18 cm-sized voluminous mass occupying the right thoracic cavity with anterior displacement of hilar structures and atelectasis of the right lung. Immediately after admission, she developed pneumonia and septic shock that required antibiotics and mechanical ventilation. She displayed a partial response to medical treatment, and then complete excision of the tumor was performed and the pathologic examination revealed benign SFTP. Afterward, she fully improved without evidence of recurrence until now.

A Clinical Evaluation of Tuberculous Pleurisy -Report of 52 Cases (결핵성 흉막염 환자의 임상적 고찰)

  • Choe, Hyeong-Ho;Kim, Chang-Nam;Jeong, Hae-Dong
    • Journal of Chest Surgery
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    • v.30 no.8
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    • pp.793-802
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    • 1997
  • A clinical analysis was performed on 52 cases of tuberculous pleurisy experienced in the department of thoracic and cardiovascular surgery and department of medicine, Chosun University Hospital during a period from Jan. 1994 to Dec. 1995. Among them, male was 39 cases, female was 13 cases, with age ranged from 7 to 73 years. The common symptoms were chest pain 75%, dyspnea 59.6%, cough 55.8%. The most common diagnostic tool was pleural biopsy. The protein levels in the tuberculous pleural effusion were 0.9∼6.5 gmojo, and ratios of effusion protein to serum protein were 0.48 ∼ 1.06. The glucose levels in the tuberculous pleural effusion were 37∼ 112 mg%. The LDH levels in the tuberculous pleural effusion were 80 ∼ 2440 unitlml, and ratios of tuberculous p eural effusion LDH to serum LDH were 0.48 ∼ 1.03. The ADA levels in the tuberculous pleural effusion were 24-63 lU/L. The common surgical methods of treatment in the tuberculous pleurisy were closed thoracostomy in 18 cases(66.7%), and thoracentesis in 5 cases(18.5%). This study compares the clinical results of group A and group B. There were no significant differences for age and sex, lag period from initial symptoms to admission, diagnostic method, and protein, pH, LDH, glucose, ADA levels in tuberculous pleural effusion. Authors noted that the discharge after admission on the tuberculous pleurisy was more faster in patients with surgical treatment than in patients with only medical treatment. (Korean J Thorac Cardiovasc Surg 1997;30:793-802)

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Anti-osteoarthritis Effects on Fruit Extract of Litsea japonica (까마귀쪽나무 열매 추출물의 골관절염 억제 효과)

  • Yoon, Weon-Jong;Song, Sang Mok;Ham, Young-Min;Oh, Dae-Ju;Ko, Chang-Sik;Yoon, Sun-A;Lee, Yong-Bum;Park, Dae Won;Jeong, Yong Joon;Kwon, Jung Eun;Cho, Young-Mi;Cho, Ju-Hyun;Kim, Chang-Sook;Kang, Se Chan
    • Korean Journal of Plant Resources
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    • v.28 no.5
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    • pp.591-599
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    • 2015
  • Osteoarthritis (OA) is a degenerative disease characterized by the progressive degradation of joint cartilage and is accompanied by secondary inflammation of synovial membranes. The purpose of this study describes a preliminary evaluation of the anti-inflammatory activity on test material of Litsea japonica. fruit (LJTM) Also, this study was to evaluate the effects of LJTM on the joint cartilage of rat with OA induced by monosodium iodoacetate (MIA). To study for anti-inflammatory agents effectively, we first examined the inhibitory effect of the LJTM on the production of pro-inflammatory factors and cytokines stimulated with lipopolysaccharide. We identified anti-nociceptive effects of the LJTM by using in vivo peripheral and central nervous pain models. In addition, the aim of this study was to evaluate the effects on mRNA expression of MMP-2, -3, -7, -9, -13, TIMP-1 and –2 in cartilage of OA. In the LJTM inhibited production of pro-inflammatory mediators (NO and PGE2) and pro-inflammatory cytokines (TNF-α and IL-6). In cartilage, Expression of MMPs and TIMPs mRNA was suppressed in LJTM treatment group than in the control group. This study suggests that LJTM are potential candidates as anti-inflammation and anti-osteoarthritis agents (painkillers) for the treatment of OA.