• Title/Summary/Keyword: VAS score

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Arthroscopic Ankle Arthrodesis Using Three Cannulated Screws (3개의 유관 나사를 이용한 관절경적 족근 관절 고정술)

  • Kim, Kyung-Tae;Lee, Song;Ko, Dong-Oh;Yang, Seung-Jin;Chun, Tae-Hwan;Yang, Jong-Hwa
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.3
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    • pp.249-253
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    • 2009
  • Purpose: We evaluated the clinical and radiographic results of arthroscopic ankle arthrodesis using 3 cannulated screws for the treatment of arthritis of ankle. Materials and Methods: From May 2006 to February 2009, 17 cases of arthritis of ankle were treated by ankle arthrodesis using 3 cannulated screws under arthroscopy. There were 8 male and 7 female and the average age was 62.2 years. We evaluated them clinically using AOFAS ankle-hindfoot functional scale, VAS pain score and patient’s satisfaction. For the radiographic evaluation, we checked them by simple AP, lateral and mortise view. The average follow-up period was 24.2 months. Results: The ankle-hindfoot functional scale was improved from an average of 47.4 points preoperatively to an average of 82.5 points at the last follow-up. The visual analogue scale pain score was decreased from an average of 8.6 to 2.4. Patient's satisfaction had favorable results with excellent in 7 cases(41.2%), good in 8 cases(47.0%), fair in 1 case(5.9%) and poor in1 case(5.9%). All ankles were successfully fused and the mean period of fusion was 9.1 weeks. Conclusion: Arthroscopic ankle arthrodesis using 3 cannulated screws was good modality of ankle arthrodesis with good clinical results and high union rate in the case of advanced ankle arthritis.

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Humeral Head Decentralization of Preoperative Magnetic Resonance Images and the Treatment of Shoulder Dislocations in Large to Massive Rotator Cuff Tears in Elderly over 65 Years Old (65세 이상 고령의 회전근 개 대파열 및 광범위 파열에 동반된 견관절 탈구의 치료 및 술 전 자기공명영상의 상완골두 탈중심화)

  • Lee, Bong-Ju;Song, In-Soo;Cha, Kihun
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.5
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    • pp.418-426
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    • 2019
  • Purpose: This study analyzed the features of humeral head decentralization in large to massive rotator cuff tears with a shoulder dislocation in the elderly. Moreover, shoulder instability and treatment were reviewed. Materials and Methods: From May 2005 to February 2017, Group A containing 45 cases (45 patients) over 65 years old accompanied by a large or massive rotator cuff tear with a shoulder dislocation and Group B containing 45 cases (45 patients) without a shoulder dislocation were enrolled. The mean ages in Groups A and B were 73.2 and 72.1 years old, and the mean follow-up periods were 30.7 and 31.3 months, respectively. Twenty-one cases (46.7%) in Group A underwent rotator cuff repair, and 8 cases (17.8%) underwent concomitant rotator cuff repair with Bankart repair. Sixteen cases (35.6%) underwent reverse total shoulder arthroplasty for cuff tear arthropathy. 45 cases (100%) in Group B underwent rotator cuff repair. The off-the center and head elevation were measured in the preoperative magnetic resonance imaging (MRI) of Groups A and B. The preoperative and postoperative visual analogue scale (VAS) score, American Shoulder and Elbow Surgeons (ASES) score, and University of California Los Angeles (UCLA) score in Groups A and B were compared. Results: In Groups A and B, the mean off-the centers were posterior 7.41 mm and posterior 2.02 mm (p=0.03), and the mean head elevations were superior 6.66 mm and superior 2.44 mm (p=0.02), respectively. The mean ASES scores of Groups A and B were 32.8 and 33.4 before surgery, and 77.1 (p=0.02) and 78.1 (p=0.02) after surgery (p=0.18), respectively. The mean UCLA scores of Groups A and B were 13.1 and 12.8 before surgery, and 28.9 (p=0.02) and 29.5 (p=0.01) after surgery (p=0.15), respectively. Conclusion: Patients over 65 years old with a shoulder dislocation in large to massive rotator cuff tears had higher off-the center and head elevation on the preoperative MRI than those without a shoulder dislocation. This measurement can help predict preceding shoulder instability. Early rotator cuff repairs should be performed and other treatments, such as Bankart repair and reverse total shoulder arthroplasty, should also be considered.

Epidemiology and clinical characteristics of headache comorbidity with epilepsy in children and adolescents (소아청소년 간질 환자에서 동반된 두통의 역학과 임상적 특징)

  • Rho, Young Il
    • Clinical and Experimental Pediatrics
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    • v.50 no.7
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    • pp.672-677
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    • 2007
  • Purpose : To assess the prevalence and characteristics of headache comorbidity with epilepsy in children and adolescents in a specialty epilepsy clinic. Methods : Two hundred twenty nine consecutive patients attending the Chosun University Hospital Pediatric Epilepsy Clinic (mean age $10.0{\pm}4.1\;years$, range 4-17, M:F ratio 1.1:1.0) were interviewed with a standardized headache questionnaire. Headache was classified according to the International Classification of Headache Disorders, 2nd Edition and epilepsy was classified according to the International League Against Epilepsy. Disability was assessed using pediatric migraine disability assessment (PedMIDAS). Results : Of the 229 epilepsy patients, 86 (37.6%) had co-morbid headache. Of the headache patients, 64 (74.4%) had migraine (65.6%- migraine without aura, 20.3% - migraine with aura, 14.1% - probable migraine). The mean headache frequency was $7.2{\pm}8.4$ per month, mean duration was $2.2{\pm}4.0$ hours, mean severity was $5.2{\pm}2.2$ out of 10, and mean PedMIDAS score was $13.0{\pm}35.4$. The proportion of females was not higher in epilepsy with headache patients (48.8%) compared to epilepsy patients alone (48.0%). In the patients with migraine, 48.4% had complex partial seizures, 17.2% had simple partial seizures, and 34.4% had generalized seizures (P=0.368). A postictal association of migraine was reported in 18.8% with 17.2% reporting a preictal headache, and 7.8% reporting an ictal headache. Conclusion : The prevalence of headache in pediatric epilepsy is higher than that in general pediatric population, suggesting a co-morbidity of headache in epilepsy patients with migraine being the most frequent headache disorder. Altered cerebral excitability resulting in an increased occurrence of spreading depression may explain the headache comorbidity with epilepsy. Further studies are needed to assess the etiology of this co-morbidity as well as assess the frequency, duration, severity and disability response to antiepileptic drugs.

Arthroscopic Rotator Cuff Repair For Partial Articular-Surface Tendon Avulsion (PASTA) Lesion (회전근 개 관절내 부분 파열 환자의 관절경적 봉합술)

  • Lee, Bong-Gun;Cho, Nam-Su;Park, Keun-Ho;Moon, Seong-Cheol;Rhee, Yong-Girl
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.3
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    • pp.242-248
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    • 2009
  • Purpose: To evaluate the clinical and radiologic results of the arthroscopic rotator cuff repair for partial articular surface tendon avulsion lesion. Materials and Methods: Twelve patients with symptomatic, partial articular surface tendon avulsion underwent arthroscopic rotator cuff repair between Mar. 2006 and Sep. 2008. The mean follow-up period was 18.3 months(12~36 months), and the mean age at the time of surgery was 46.9-year-old(19~64 years). Three cases had underwent rotator cuff repair after conversion to full-thickness tear and nine cases had transtendon repair with preserving bursal side cuff. Results: The mean VAS during motion was 6.2 before treatment and 2.0 at final follow-up (p<0.001). The passive forward flexion improved from $163.3^{\circ}$ preoperatively to $169.8^{\circ}$ postoperatively (p=0.038). The mean UCLA score improved from 18.4 preoperatively to 30.1 with 2 excellent, 8 good and 2 fair results at final follow-up. The mean KSS improved from 61.8 preoperatively to 76.8 at final follow-up. By examining the postoperative MR images of 5 patients, complete healing was observed in all of them. Conclusion: Arthroscopic rotator cuff repair may be an effective procedure for partial articular surface tendon avulsion in pain relief and improvement of the range of motion. If the remaining bursal side cuff fibers are intact, transtendon repair procedure with preserving the intact bursal layer of the tendon can be considered. If the remaining bursal side cuff fibers are friable or little, completion from partial-thickness to full-thickness tears with subsequent cuff repair can be considered.

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The Effect of Continuous Positive Pressure Therapy for Obstructive Sleep Apnea on Quality of Life : A Single-Institution Study (폐쇄성수면무호흡증에 대한 지속적 양압치료가 삶의 질에 미치는 영향 : 단일기관 연구)

  • Shin, Hyun Suk;Choi, Mal Rye;Kim, Shin il;Hong, Se Yeon;Eun, Hun Jeong
    • Sleep Medicine and Psychophysiology
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    • v.27 no.2
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    • pp.56-66
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    • 2020
  • Objectives: In this study, the clinical characteristics of OSA patients and the quality of life before and after CPAP use were compared to determine the degree of improvement in quality of life according to CPAP use. Methods: Age, sex, height, weight, body mass index, Epworth Sleepiness Scale, Modified Mallampatti Score, Montreal Cognitive Assessment-Korean, and Pittsburgh Sleep Quality Index were compared between men and women through medical records. To understand the degree of improvement in quality of life resulting from use of CPAP, a personal telephone call was made to compare the VAS scores for quality of life before and after CPAP use. Results: In height (HT) (Z = -4.525, p < 0.001), weight (BW) (Z = -2.844, p < 0.05), sleep quality (PSQI) (Z = -2.671, p < 0.05), and arousal index (AI) (Z = -2.105, p < 0.05), there was a difference between men and women (p < 0.05). There was no difference in the remaining variables. Cross-analysis (Chi-square test) confirmed a difference between severity and sex of OSA. It has been found that there is no statistically significant order in size according to level-specific severity of OSA for PreCPAP QOL, PostCPAP QOL, CPAPUse Months, and CPAP4Hr/d (%) (p > 0.05). The difference between AHI before and after CPAP was 36.48 ± 21.54 (t = 11.609, p < 0.001) and the difference between QOL before and after CPAP was -25.43 ± 22.06 (t = -7.901, p < 0.001), both of which were significant (p < 0.001). Conclusion: Among OSA patients, there were differences in height (HT), weight (BW), sleep quality (PSQI), arousal index (AI), and severity of OSA between men and women, but the quality of life before and after CPAP was different. However, there was no difference between men and women in quality of life before and after CPAP. In addition, quality of life in OSA patients improved after using CPAP.

Clinical Study on the Effect of Moxa-pellet Treatment in Allergic Rhinitis Patients (알레르기 비염 환자에 대한 압봉치료의 임상효과 연구;증상과 삶의 질을 중심으로)

  • Kim, Joo-Hee;;Lee, Seung-Won;Kim, Kun-Hyung;Ko, Young-Jin;Lee, Ro-Min;Kim, Chang-Hwan;Park, Dong-Suk
    • Journal of Acupuncture Research
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    • v.24 no.3
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    • pp.175-185
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    • 2007
  • Objectives : The purpose of this study is to evaluate the clinical effect of Moxa-Pellet treatment for nasal symptoms and quality of life(QOL) in patients with allergic rhinitis. Methods: Subjects were voluntarily recruited through newspaper and internet advertisement. In this randomized, single blind and controlled study, experimental group (n=19) received real Moxa-Pellet treatment and control group(n=20) received sham Moxa-Pellet treatment for 3 weeks. Acupuncture points used were $LI_4$, $ST_{36}$, $LU_7$, $GV_{14}$ and $GB_{20}$. Patient's nasal symptoms and QOL were assessed before and after 3 weeks treatment by the Nasal Symptom Scores(NSS) and the Medical Outcomes Study 36-Item Short-Form Health Survey(SF-36). Results : The results were as follows; 1. Among items of NSS, Sneezing' Rhinorrhea' Itching scores and Total Nasal Symptom Scores(TNSS) were significantly improved in experimental group after 3 weeks Moxa- Pellet treatment(p<0.05). In control group, there was no significant difference in all items except Headache item of NSS. 2. Among 8 domains of SF- 36, experimental group showed significant difference in Role-Emotional(RE), Mental Health(MH) and Bodily Pain(Bp) after 3 weeks Moxa- Pellet treatment(p<0.05). Control group showed no significant difference in all domains except one domain(Role limitation-physical). Conclusions: These results suggest that Moxa-Pellet treatment can be applicable to improve nasal symptoms and QOL in the patients with allergic rhinitis. Further long tenn studies on the Moxa-Pellets treatment's sustaining power and safety is needed.

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Psychometrics of Task Self-Efficacy Scale for Korean Elderly (노인의 일상활동수행에 대한 자기효능척도의 신뢰도 및 타당도 평가)

  • ;;;;Beverly L. Roberts
    • Journal of Korean Academy of Nursing
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    • v.27 no.4
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    • pp.831-842
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    • 1997
  • The purpose of the study was to test the reliability and validity of the Korean version of Task Self-Efficacy Scale for activities of dally living (ADL). The Task Self-Efficacy Scale was developed by Roberts(1996) for low-intensity exercise study with older people to predict their performance of ADL. The scale was translated and back translated by bilingual persons, and then was modified to resolve variations in the translations. The Korean version of Self-Efficacy Scale for ADL was then administered to 193 elderly people including 95 hospitalized patients and 98 outpatients or healthy people. Face to face interview was used to fill out the structured questionnaire, and each interview took approximately 30 minutes. The subjects for the study were 80 women and 112 men with an age range of 65 to 95 years(M=71 years) of whom 82.6% classified themselves as moderate or quite active Most subjects(80.2%) had an education level of elementary school or less. The Self-Efficacy Scale for ADL is measured on a 0 to 10 VAS, assessing three areas of ADL : self care activities, household tasks, and motor tasks. The higher the score is, the higher person's confidence in performing ADL. Psychometric testing revealed that the scale was found to be internally consistent, showing a Cronbach's alpha of .97 The scale was significantly correlated with subjects' level of activity and subjective assessment of their health status. Moderate correlation with health-related hardiness scale also supported the validity. Factor analysis was performed to confirm whether the scale represents the three sub-areas as suggested in the literature. The results of the factor analysis led to a three factor solution according to Kaiser's criterion, but the items were not strongly and cleanly loaded for the third factor. This can be explained in that, among the three sub-ADL areas of the self-efficacy scale, the areas of self care activities and household tasks seem to have similar levels of difficulty in performance with not enough differences for the self-efficacy scale to distinguish between the two areas. Therefore, one factor solution was suggested since ADL can be seen as a unit of activities at similar level of difficulty in performance. One factor solution explained 68.1% of variance of the 19-item scale and all items were correlated over .6 with the factor, showing that the selected factor solution fits the model. The results indicated that the Korean version of Task Self-Efficacy Scale for ADL was reliable and valid in producing useful information to evaluate the effects of various interventions toward promoting health and quality of life for elderly people.

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A Study of Comparing Thermal Stimulation between Commercial Indirect Moxibustion and Traditional Indirect Moxibustion (격물구와 상용 간접구의 온열자극 비교 연구)

  • Jang, Min-Ki;Kim, Eun-Jung;Jung, Chan-Yung;Yoon, Eun-Hye;Hwang, Ji-Hoo;Kim, Kap-Sung;Choi, In-Hwa;Lee, Seung-Deok
    • Journal of Acupuncture Research
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    • v.27 no.3
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    • pp.35-45
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    • 2010
  • Backgrounds : Recently, commercial indirect moxibustion has been widely used as a substitute for traditional indirect moxibustion by clinicians due to its convenience in using. But, there has been lack of studies about the similarity of thermal stimulation between commercial indirect moxibustion and traditional indirect moxibustion. Objectives : To demonstrate commercial indirect moxibustion can substitute for traditional indirect moxibustion by comparing thermal stimulation between the two. Methods : We measured bottom temperature of commercial indirect moxibustion and traditional indirect moxibustion with various thicknesses of ginger and garlic. A clinical trial was performed on 18 healthy subjects to evaluate thermal stimualtion. The subjects were randomly assigned into two groups, traditional indirect moxibustion with ginger and garlic. The skin temperature and heating time were measured. They received moxibustion therapy with commercial indirect moxibustion and traditional indirect moxibustion according to their groups. Acupoint Chogcoe($LU_6$), Zusanli($ST_{36}$) and Tianshu($ST_{25}$) were used in each group for 3 times. Results : There was no difference in bottom temperature among commercial indirect moxibustion, traditional indirect moxibustion with 2mm ginger and 3mm garlic. No major difference was detected in the subjects' baseline data. There was no difference in skin temperature and heating time among these 3 type of moxibustions. Also, No major difference was detected in VAS score of thermal stimulation and frequency of burns among these 3 type of moxibustions. But, most subjects regarded their sensation weren't identical because of its own distinct characteristics. Conclusions : Commercial indirect moxibustion, traditional indirect moxibustion with 2mm ginger and 3mm garlic have same thermal stimulation. Thus, commercial indirect moxibustion can substitute for traditional indirect moxibustion.

Clinical Results of Surgical Treatment with Minimally Invasive Percutaneous Plate Osteosynthesis for Displaced Intra-articular Fractures of Calcaneus (최소침습적 금속판 내고정술을 이용한 전위된 관절 내 종골 골절의 임상적 치료결과)

  • Suh, Jae Wan;Yang, Jong Heon;Park, Hyun-Woo
    • Journal of Korean Foot and Ankle Society
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    • v.24 no.2
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    • pp.87-93
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    • 2020
  • Purpose: This study evaluated the clinical results of surgical treatment with minimally invasive plate osteosynthesis for treating displaced intra-articular fractures of the calcaneus in comparison with conventional lateral extensile approach plate osteosynthesis. Materials and Methods: Of 79 cases of Sanders type II or III calcaneus fractures, 15 cases treated with the minimally invasive calcaneal plate (group M) and 64 cases treated with lateral extensile approach calcaneal plate (group E) were identified. After successful propensity score matching considering age, sex, diabetes mellitus history, and Sanders type (1:3 ratio), 15 cases (group M) and 45 cases (group E) were matched and the demographic, radiologic, and clinical outcomes were compared between the two groups. Results: The median time of surgery from injury was 2.0 days in group M and 6.0 days in group E (p=0.014). At the six months follow-up, group M showed results comparable with those of group E in radiographic outcomes. In the clinical outcomes, group M showed better postoperative American Orthopaedic Foot and Ankle Society (AOFAS) and visual analogue scale (VAS) scores than did group E (p=0.001, p=0.008). A greater range of subtalar motion was achieved at the six months follow-up in group M (inversion 20.0° vs. 10.0°, p=0.002; eversion 10.0° vs. 5.0°, p=0.025). Although there were no significant differences in complications between the two groups (1 [6.7%] vs. 7 [15.6%], group M vs. group E; p=0.661), there was only one sural nerve injury and no wound dehiscence and deep infection in group M. Conclusion: Minimally invasive plate osteosynthesis showed superior clinical outcomes compared with that of the conventional lateral extensile approach plate osteosynthesis in Sanders type II or III calcaneus fractures. We suggest applying minimally invasive plate osteosynthesis in Sanders type II or III calcaneus fractures.

Pilot Study on Characterization of Patients with Low Back Pain: Multi-center, Prospective, Observation Study (요통 환자의 특성 조사 예비 연구: 다기관, 전향적, 관찰연구)

  • Park, Chang-Hyun;Jang, Bo-Hyoung;Ko, You-Me;Park, Dong-Su;Kim, Soon-Joong;Park, Won-Hyung;Cha, Yun-Yeop;Ko, Seong-Gyu;Song, Yun-Kyung
    • Journal of Korean Medicine Rehabilitation
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    • v.26 no.2
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    • pp.123-132
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    • 2016
  • Objectives The aim of this study done as pilot study is to analyze the current state of patients who have low back pain through registry. Methods This study is done under approval of Gil Oriental Medical Hospital of Gachon University, Oriental Medical Hospital of Sangji University, Jecheon Oriental Medical Hospital of Se-Myung University IRB. Among subjects who signed the consent form by their own will, we decided whom to register as subjects of this study by the standard of selection and exception. We collected the sociological investigation, character of low pack pain, degree of symptom which they felt before and after the hospitalization from registered subjects. Results 1. The number of the subjects is 16. The average age is 41.0. 9 of them are female, 7 of them are male. Most of the subjects have history illness which has connection with low pack pain. 2. According to the patient's free description of the back pain, 6 of them suffered throbbing pain. And 8 of the patients have chronic pain, 6 of them have intermittent pain of back pain analysing the character of the low back pain. They answered the pain lasted for 47.6 minutes on average. 3. About the change on the average R.O.M. of L-spine, R.O.M. of Lateral bending, Extension, Flexion, Rotation has increased after leaving the hospital compared with before hospitalization. 4. The amount of discomfort or strength of pain, which was checked by VAS on the day of leaving the hospital, has decreased than they were before the hospitalization. And there was the improvement on the dysfunction score and EQ-5D. Conclusions Through this study, we specifically analyzed the symptoms of the low back pain by accumulating the analysis about the symptoms using several indicators and description which is freely spoken by patients about their symptoms. Further research is expected to complete multi-center registry by building registry and by using it, to get various epidemiologic informations about low back pain.