• Title/Summary/Keyword: Pain improvement

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MR Imaging of Carpal Tunnel Syndrome : The Usefulness of MRI in Treatment Decisions (수근관 증후군의 자기공명 영상 : 치료 결정의 유용성)

  • Lee, Kyu-Yong;Lee, Young Joo;Kim, Seung Hyun;Song, Hyoung Gon;Kim, Juhan
    • Annals of Clinical Neurophysiology
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    • v.4 no.2
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    • pp.114-118
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    • 2002
  • Backgrounds : Carpal tunnel syndrome (CTS) is a common condition that is usually diagnosed by electrophysiologic studies. However, CTS provide limited information to determine the causes of CTS and to choose the treatment method. We evaluated diagnostic sensitivity of MR imaging and treatment decisions by MR imaging in electrodiagnosed CTS. Methods : 14 patients (26 wrists) with electrodiagnosed CTS were studied using MR imaging. In 26 wrists for which axial T1 & T2 weighted images were obtained at 1.5T with a decided wrist coil. Previously described MR imaging of CTS such as increased median nerve signal, flattening of median nerve, reticular bowing, tenosynovitis and space occupying lesions were retrospectively evaluated. Degree of improvement was evaluated by global symptom score (GSS). The GSS rated symptoms from 0 (no symptoms) to 10 (severe) in each of five categories: pain, numbness, paresthesia, weakness/clumsiness, and nocturnal awakening. Subjects' GSS was recorded at baseline, 2 weeks, 1 month, 6 months after treatment. We decided to medical treatment that showed mainly inflammatory sign such as increased median nerve signal, tenosinovitis and to surgical treatment such as space occupying lesion, high canal pressure sign. Results : MR imaging showed that increased median nerve signal were in 20 wrists (77%), flattening of median nerve were in 6 wrists (23%), reticular bowing were in 3 wrists (12%), tenosynovitis were in 8 wrists (32%), decreased canal size in 2 wrists (7.6%), space occupying lesion were in 1 wrist (4%). A good outcome was revealed in 21 wrists by medical treatment that showed mainly increased median nerve signal, tenosynovitis. The mean GSS were 27.7 at baseline, 11.2 at 2 weeks, 11.0 at 6 months in medical treatment group. Another 5 wrist had surgical treatment shown by ganglion and high canal pressure sign such as median nerve flattening, reticular bowing, decreased canal size: 3 wrists had good prognosis, but 2 wrists (one patient) had no significant improvement due to small carpal tunnel size. Conclusions : Our results are in agreement with most previously described MR imaging signs of CTS. MR imaging plays an important role in several cases and especially in the assessment of failure of surgical treatment. Knowledge of MR findings may permit more rational choice of treatment.

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Clinical Analysis of Spinal Cord Tumor (척수종양의 임상적 분석)

  • Choi, Weon-Rim;Shin, Won-Han;Cho, Sung-Jin;Kim, Bum-Tae;Choi, Soon-Kwan;Byun, Bak-Jang
    • Journal of Korean Neurosurgical Society
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    • v.30 no.1
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    • pp.47-53
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    • 2001
  • Objective : This study was undertaken to evaluate operative results and prognosis according to preoperative clinical status and histopathological finding of spinal cord tumor. Methods : We analyzed of clinical feature, tumor location, histopathologic finding, operative results and prognosis in 55 patients with spinal cord tumor during last 10 years. Results : 1) The incidence of spinal cord tumors varies with the age of affected patients who are 2 to 75 years of age. Peak incidences were in the 5th & 7th decade of life, and the ratio of male to female was 1.2:1. 2) The most common histopathologic type was neurinoma(41.9%). 3) The tumors were located most frequently in the thoracic area(22 cases, 40.0%) and in the intradural extramedullary space(30 cases, 54.5%). 4) The most common initial clinical feature was pain in 20 cases(36.4%). For neurologic status on admission, 30 cases(54.5%) showed motor disturbance. 5) In radiologic studies, there were abnormal finding in 21 cases from plain X-rays among 37 cases. The entire 20 cases in when myelography was done showed subarachnoid blockade, either complete or incomplete. The magnetic resonance imaging, regard as the most accurate diagnostic method, revealed the exact location of the tumor and the relationship of the tumor with the adjacent anatomical structure. 6) The total removal was possible in 36 cases(65.5%), subtotal removal in 17 cases(30.9%) and biopsy in 2 cases (3.6%). Nineteen cases(90.5%) among 21 cases with preoperative radiculopathy group showed recovery or improvement, where as only 11 cases(36.7%) among 30 cases with preoperative motor weakness group showed recovery or improvement, with statistically significant difference(p<0.01). Pathologically, 26 cases(83.9%) among 31 cases of neurinoma and meningioma showed postoperative recovery or improved, but only 1 case(6.3%) among 16 cases of metastatic tumor, astrocytoma and ependymoma recovered. Postoperative complication noted in 5 cases(9.1%), and were noted postoperative hematoma, pneumonia, pulmonary edema and spinal cord infarction. Conclusion : Preoperative neurologic status and histopathologic finding are considered important factors of Postoperative outcome in patients with spinal cord tumor.

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A Case of Lymphocytic Interstitial Pneumonitis (임파구형 간질성 폐렴 1예)

  • Jung, Hee-Jin;Cho, Eun-Rae;Shim, Jae-Jung;In, Kwang-Ho;Yu, Sae-Hwa;Kang, Kyung-Ho;Won, Nam-Hee;Choi, Young-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.5
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    • pp.602-609
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    • 1993
  • Lymphocytic interstitial pneumonitis (LIP) is one of parenchymal pulmonary infiltrative diseases first described at 1966 by Carrington and Liebow. In LIP, there is a predominance of mature small lymphocytes in the interstitium of the lung which form germinal centers. The disease process surrounds, but dose not invade lung parenchyme, tracheobronchial tree and vascular structures. The etiology remains still unknown and the clinical features of this disorder have not been clearly defined. Therefore, the therapeutic modality is obscure. Development of LIP association with AIDS is often reported currently and possibility of progress to malignant lymphoma is emphasized. We experienced a case of primary LIP with pnemomediastinum. She was adimitted due to chest and anterior nuchal pain with chronic coughing, and diagnosed as pneumomediastinum with LIP. Medication with steroid was begun and some improvement of symptoms was observed, but an X-ray film of the chest remained same without improvement. We report above case with review of the literatures.

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Ways to Educational Improvement of Korean Oriental Medicine (한국 한의학교육의 발전방안)

  • Lee Sun-Dong;Han Yong-Joo;Shin Kyu-Won
    • Journal of Society of Preventive Korean Medicine
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    • v.8 no.2
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    • pp.99-113
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    • 2004
  • Problems and current situation of public health globally and domestically were analyzed in this study and based on these findings, ways to improve from western medicine and Oriental medicine can be deduced as follows: 1. Current problems of public health in Korea and the world 1) Increase of diseases resulted from daily habits and infectious diseases, many are at the brink of being ill. Quality of life from extended life span and unbalanced health care must be solved. 2) Natural and societal factors including host factors, public health service, and other external and internal factors play an important role in deciding healthy and being ill. 3) Some of the limits and problems of modem medicine include insufficient academic knowledge and incomplete theory, as well as misled approach to the treatment. Human itself isn't perfect organism and other realistic problems hinder one's well-being. 4) Regardless of western medicine or Oriental medicine, patients were approached as someone with diseases and disorders, and wholistic approach was disregarded. Lack of clinical training, absence of clear educational philosophy and goal are some of the reasons why the education isn't under concrete system 2. Important factors for the medical education and proper direction for the education of Oriental medicine 1) Important factors for medical education - Education should not be limited on the human health and illness, but also cover qualities such as well-being, social welfare, service, and happiness. Every aspects of human life must be considered and attended for more productive outcome. - Basic understanding of humanity must be included in the educational curriculum - Foundation of human diseases and pain are associated with inner life and surrounding causes including family, society, nature, race, culture, religion, politics, and etc., thus the education must be approached to recognize aforementioned criteria. 2) Proper direction for the education of Oriental medicine - Values of Oriental medicine for medical principles and importance of lifehood must be educated. - Educational goal, limits, and levels must be established for the school of Oriental medicine - Respect for life must be the top priorities of educational direction which should lead to solution based education for the human health. Latest medical theory and technology should be accommodated as well as prevention, treatment, and balancing of basic courses and clinical training for optimal education.

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A Clinical Case Study of Common Peroneal Nerve Palsy(Foot Drop) Following Entrapment Neuropathy (압박성 신경병증에 의한 족하수(足下垂) 환자(患者) 1례(例)에 대한 임상적(臨床的) 고찰(考察))

  • Shin, Jeong-Cheol;Lee, Dong-Hyun;Wei, Tung-Shuen;Kim, Seon-Jong;Choe, Won-Hwak;Ryu, Chung-Ryul;Yun, Yeo-Choong;Cho, Myung-Rae;Che, Wu-Suk;Na, Gun-Ho
    • Journal of Acupuncture Research
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    • v.22 no.4
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    • pp.1-12
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    • 2005
  • Objectives : The Purpose of this study is to report in patient with common peroneal nerve palsy, who improved by oriental medical treatament. Methods : We Checked the temperature of a leg by Digital Infrared Thermal Imaging(DITI) at intervals of 10 days, angle of active dorsiflexion and range of active motion for estimating the improvement of symptoms. We used the Visual Analogue Scale(VAS) for estimating the degree of pain, too. Results : After 4 weeks treatment, the movement and power of ankle joint improved to nearly normal range. The degree of active dorsiflexion of the ankle increased from $-40^{\circ}\;to\;15^{\circ}$ and range of active motion increased from Gr III to Gr I. The difference of temperature between the both legs decreased remarkably. Conclusion : In this case we experienced improvement of symptoms by conservative oriental medical therapy, e.g acupuncture stimulation, herbal medication, physical therapy. It should be needed further investigation on common peroneal nerve palsy and its symptoms in order to set up a reasonable standard about a surgical operation.

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Effects of the Inspiratory Muscle Strengthening Training on the Respiratory Functions and the Quality of Life in Patients with Cervical Spinal Cord Injury Patients (들숨근 훈련이 경수손상환자의 호흡기능 및 삶의 질에 미치는 영향)

  • Shim, Yu-Jin;Moon, Ok-Kon;Choi, Wan-Suk;Kim, Bo-Kyung
    • The Journal of the Korea institute of electronic communication sciences
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    • v.8 no.11
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    • pp.1785-1792
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    • 2013
  • For patients suffering from spinal cord injuries, both of the possibility of having complications with the respiratory system and the related fatal rate are still high, while pneumonia is the most important cause of these fatalities. This research was carried out to find out what effects does a breathing exercise have on the respiratory functions and the improvement in the quality of life. The study was carried out for male patients suffering cervical spinal cord injuries for the purpose of inspiratory muscle strengthening. The objects of the study were 17 non-smoking-at-present male patients with C4 to C6 cervical spinal cord injuries. They had practiced inspiratory muscle strengthening training for three times a week for six weeks. The quality of life and the dyspnea (breathing difficulty) were self-measured before and after the training. As a result, the change in respiratory function was only significantly reduced (p<0.01) within the chronic group. In terms of the changes in the quality of life, the sub-acute group has only seen a significant improvement (p<0.05) for the VT(vitality), while the chronic group has seen significant improvements(p<0.05, p<0.01) in: GH(general health); BP(back pain); and VT(vitality). In this research, the inspiratory muscle strengthening has reduced the dyspnea (breathing difficulties) and improved the quality of life.

Development of Fall Prevention Program for Improvement of Healthcare in Rehabilitation Patients Based on Image Processing : A Preliminary Investigation (영상처리 기반 재활 환자의 헬스케어 개선을 위한 낙상예방 프로그램 개발 : 예비연구)

  • Kang, So-La;Yoon, Jung-Dae;Yoo, Jin-Won;Na, Chang-Ho;Heo, Sung-Jin;Kim, Ye-Soon;Moon, Jong-Hoon
    • The Journal of the Korea institute of electronic communication sciences
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    • v.13 no.4
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    • pp.887-896
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    • 2018
  • The purpose of this preliminary study was to investigate the effect of fall prevention program on the occurrence of falls in inpatients at general hospital. Before the intervention, we identified the occurrence of the rate of falls in I hospital at Incheon and 190 patients received rehabilitation treatment. The causes of falls were carelessness of caregivers and therapists, increased burden of therapists, and height of beds. After recognizing the problems, the authors developed a fall prevention program through the PDCA model. The fall prevention program consisted of a video of fall prevention education and education for the patients and caregivers, environmental improvement and education of therapists for two months. After intervention, 230 patients were subjected to be included as analysis of the incidence of falls included As a result, the fall incidence was reduced by 34.1~66.7% in the pain clinic and 21.3~40.8% in the exercise clinic / department of occupational therapy compared to the before intervention. These findings show that the fall prevention program has a positive effect on the fall of inpatients, and it can be used as a model for fall prevention.

A Case of Cauda Equina Syndrome Treated with Additional Carthami Semen Herbal Acupuncture Therapy (홍화자(紅花子) 약침요법(藥鍼療法)을 가미한 한방치료로 호전된 마미증후군(馬尾症候群) 환자(患者) 1례(例))

  • Seo, Bo-Myung;Lee, Yoon-Kyoung;Kim, Sung-Woong;Lee, Sea-Youn;Lim, Seong-Chul;Jung, Tae-Young;An, Hee-Duk;Han, Sang-Won;Seo, Jung-Chul
    • Korean Journal of Acupuncture
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    • v.22 no.1
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    • pp.33-41
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    • 2005
  • Objectives : This study was to investigate the effect of the Carthami Semen Herbal acupuncture therapy on a Cauda equina syndrome patient who has a complex of low back pain, bilateral sciatica, saddle anesthesia and motor weakness in the lower extremity and paraplegia with bladder and bowel incontinence. Methods : Oriental Medical Therapy was performed on the Cauda equina syndrome patient from July 15th 2004 to July 29th 2004. The patient was treated with Carthami Semen Herbal acupuncture at BL22, BL23, BL25, BL28 and GV3 in combination with herbal medicine and conventional body acupuncture. We evaluated The Visual Analog Scale(VAS), Improvement index, The Oswestry Diability Index(ODI), gaiting, dyschezia, bladder incontinence, duration of urination and area of anesthesia, Digital Infrared Thermographic Imaging(DITI) before and after treatment. Results : 1. After treatment, VAS, Improvement index, ODI were improved each from 10 to 2, from 21 to 73, from 333 to 166. 2. After treatment, gaiting, bladder incontinence, duration of urination and area of anesthesia and DITI were improved well, but dyschezia was remained. Conclusions : From this case it is thought Carthami Semen herbal acupuncture therapy is very effective to Cauda Equina Syndrome and further study is needed for the confirmation of the effect of Carthami Semen Herbal acupuncture.

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A Case Report of Non-Motor Symptoms Evaluated Using the Non-Motor Symptom Scale in a Patient with Secondary Parkinsonism Presumed to be Probable Lewy Body Dementia and Improved with Combined Treatment with Herbal Medicine and Acupuncture (루이소체 치매로 추정되는 이차성 파킨슨증 환자의 Non-Motor Symptom Scale(NMSS)로 평가한 비운동성 증상을 한약과 침의 복합치료로 호전시킨 증례보고 1례)

  • Roh, Min-yeong;Lee, Ji-hyun;Han, Yang-hee;Leem, Jung-tae
    • The Journal of Internal Korean Medicine
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    • v.42 no.5
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    • pp.833-845
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    • 2021
  • Parkinson's syndrome is a degenerative brain disease that presents characteristic motor symptoms of tremor, rigidity, and gait disturbance. In addition to these motor symptoms, Parkinson's syndrome also presents non-motor symptoms (NMSs) such as sleep disturbance and cognitive decline. NMSs reduce patient's quality of life and psychosocial functioning and cause economic burden on the patient, so appropriate evaluation and treatment are required. Lewy body dementia is one of the several diseases belonging to Parkinson's syndrome. Its symptoms such as cognitive function, memory impairment, and hallucinations occur with Parkinsonism. Although drug therapy is being used with drug treatment to treat non-motor symptoms, it has limitations such as side effects, which stimulated interest in other complementary treatment methods such as oriental medicine treatment, dance, and yoga. The patient in this case complained of tremor in the right upper extremity, muscle hypertension and pain, and persistent vision, memory, and cognitive decline. The patient was diagnosed with probable Lewy body dementia. The patient was hospitalized for 4 months and received acupuncture and herbal medicines. After treatment, the patient's NMS scale scores decreased from 90 to 63, and the Unified Parkinson's Disease Rating Scale scores (summed I, II, and III) decreased from 17 points to 8 points. The Beck Depression Inventory score decreased from 22 points to 13 points. In addition, the patient's subjective evaluation revealed improvement. In this case, a patient diagnosed with probable Lewy body dementia who did not respond to the standard treatment and did not want to take medications showed improvement in not only motor symptoms but also NMSs after integrative Korean medicine treatment.

A Study on Work Experience of the Life Rehabilitation Teacher in Residence Institution of Mental Retardation (지적장애인거주시설 생활재활교사의 직무수행 경험에 관한 연구)

  • Nam, Yeun Hee;Noh, Jun
    • 재활복지
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    • v.21 no.1
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    • pp.141-171
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    • 2017
  • The purpose of this study is to investigate the job experience of the life rehabilitation teacher who is working in the residence with mental retardations. The purpose of this study is to suggest the intervention plan that can enhance the capacity of the living rehabilitation teachers and seek improvement points of residence institution of mental retardation. The results of this study show the meaning of experience in the job performance of the welfare facility workers. Through in -depth interviews through the candid stories of the research participants during the research, meaningful results could be obtained. There are 7 workers who participated in the study who worked in the institute for more than a year. Four sections are categorized made of 15 sub-categories constituted by 60 subjects collected by significant worker's answers. Four categories are the beginning of life rehabilitation teacher, adaptation as a life rehabilitation teacher, the pain of life rehabilitation teacher, the growth and the wish. The results of this study are expected to contribute to the improvement of the professionalism of the life rehabilitation teacher. It will also contribute to the development of the operation of residential facilities for people with mental retardation.