• Clinics in Shoulder and Elbow
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• 제26권1호
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• pp.49-54
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• 2023

Background: Lateral epicondylitis is an increasingly debilitating condition in working population. Evidence for conservative treatment modalities has been inconclusive. Percutaneous pie crusting of the common extensor origin at the lateral epicondyle at the time of local corticosteroid injection (CSI) has been proposed sparsely. The objective of this study was to analyze if concomitant CSI and pie-crusting of the common extensor origin provides better outcome than CSI alone in lateral epicondylitis. Methods: This case-control study on 236 patients was conducted at a single center between January 1, 2020, and May 31, 2022. Patients were divided into two groups (n=118 each) based on their preference. Group A underwent CSI alone and group B underwent pie crusting along with CSI. The clinical and functional outcomes of all patients were evaluated at 2, 4, 6, and 12-week post-procedure using the visual analog scale (VAS) and Nirschl score. The mean time for return to daily activities was also compared. Results: Both groups showed significant improvement in post-procedure outcome at successive follow-ups on intragroup longitudinal analysis (VAS: F=558.384 vs. F=1,529.618, Nirschl: F=791.468 vs. F=1,284.951). On intergroup analysis, VAS of group B was superior to that of group A; however, it was statistically significant (P<0.05) only from the 6-week follow-up onwards. Nirschl score of group B was significantly better throughout the period of follow-up (P<0.05). Group B returned to daily activities faster than Group A (6.2±0.44 weeks vs. 7.18±0.76 weeks). Conclusions: Concomitant pie crusting with CSI is recommended for lateral epicondylitis as it provides significantly better results than CSI alone.

• The Journal of the Society of Stroke on Korean Medicine
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• 제17권1호
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• pp.9-14
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• 2016

■ Objectives This clinical study is to report the effect of Korean medicine on two patients with glossodynia. ■ Methods Two patients who suffered from glossodynia were treated with herbal medicine 'Gami Cheongsim-tang', acupuncture, and pharmaco-acupuncture. The intensity of symptoms were measured using Visual Analog Scale(VAS). ■ Results After treatment, the patients' symptoms including pain, burning, tingling, and numbness of tongue were improved. ■ Conclusion These case reports suggest that Korean medicine could be effective in the treatment of Glossodynia.

• Korean Journal of Radiology
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• 제25권2호
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• pp.157-165
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• 2024

Objective: We aimed to evaluate the clinical and imaging factors associated with hemorrhagic complications and patient discomfort following ultrasound (US)-guided breast biopsy. Materials and Methods: We prospectively enrolled 94 patients who were referred to our hospital between June 2022 and December 2022 for US-guided breast biopsy. After obtaining informed consent, two breast radiologists independently performed US-guided breast biopsy and evaluated the imaging findings. A hemorrhagic complication was defined as the presence of bleeding or hematoma on US. The patients rated symptoms of pain, febrile sensation, swelling at the biopsy site, and dyspnea immediately, 20 minutes, and 2 weeks after the procedure on a visual analog scale, with 0 for none and 10 for the most severe symptoms. Additional details recorded included those of nausea, vomiting, bleeding, bruising, and overall satisfaction score. We compared the clinical symptoms, imaging characteristics, and procedural features between patients with and those without hemorrhagic complications. Results: Of 94 patients, 7 (7%) developed hemorrhagic complications, while 87 (93%) did not. The complication resolved with 20 minutes of manual compression, and no further intervention was required. Vascularity on Doppler examination (P = 0.008), needle type (P = 0.043), and lesion location (P < 0.001) were significantly different between the groups. Patients with hemorrhagic complications reported more frequent nausea or vomiting than those without hemorrhagic complications (29% [2/7] vs. 2% [2/87], respectively; P = 0.027). The overall satisfaction scores did not differ between the two groups (P = 0.396). After 2 weeks, all symptoms subsided, except bruising (50% 2/4 in the complication group and 25% [16/65] in the no-complication group). Conclusion: US-guided breast biopsy is a safe procedure with a low complication rate. Radiologists should be aware of hemorrhagic complications, patient discomfort, and overall satisfaction related to this procedure.

• Hip & pelvis
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• 제35권4호
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• pp.238-245
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• 2023

Purpose: Elderly patients with degenerative diseases undergo treatment for the hip and spine; these patients present with various symptoms. This study focused on patients with residual symptoms, predominantly pain, even after receiving treatment for their spinal lesions. Materials and Methods: Patients who underwent total hip arthroplasty (THA) between 2016 and 2022 at a single tertiary hospital were included in the study. Of the 417 patients who underwent primary THA, a retrospective review of 40 patients with previous lesions of the spine was conducted. Patients were stratified to two cohorts: Patients with symptoms related to the spine (Group A), and those with hip-related symptoms (Group B). Preand postoperative comparisons of groups A and B were performed. Results: Improvements in patients' symptoms were observed in groups A and B after THA. In Group A, the mean preoperative visual analog scale (VAS) score was 5.10±0.876, which showed a postoperative decrease to 2.70±1.767. In Group B, the mean preoperative VAS score was 5.10±1.539, which showed a postoperative decrease to 2.67±1.493. Conclusion: According to the findings, promising results were achieved with THA in treatment of debilitating diseases of the hip for both the prognosis of the disease, as well as the patients' symptoms. In addition, in some cases elderly patients with dual pathologies underwent treatment for spinal lesions without performance of any evaluation related to the hip. Thus, evaluation of a patient's hip must be performed and performance of THA in patients with symptoms even after treatment of spinal lesions is recommended.

• Clinics in Shoulder and Elbow
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• 제17권4호
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• pp.152-158
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• 2014

Background: To investigate the effectiveness of reverse total shoulder arthroplasty (RTSA) in treating irreparable massive rotator cuff tears (RCTs). Methods: Twenty-nine patients who underwent RTSA for the treatment of irreparable massive RCTs and completed follow-up for at least 1 year were selected. Their mean age was 69.7 years (range, 59-80 years). The mean follow-up was 17.7 months (range, 12-42 months). The shoulder range of motion was measured preoperatively and at final follow-up. The functional result was evaluated using visual analog scale (VAS) for pain, American Shoulder and Elbow Surgeon (ASES) score, and Korean Shoulder Society (KSS) score. Additionally, the shoulders were categorized into two groups depending on prior history of surgery and the clinical outcomes were analyzed between two groups. Results: Mean pain VAS improved, from $6.6{\pm}1.2$ to $2.7{\pm}0.9$ (p=0.001), and the mean functional VAS from $35.7{\pm}4.2$ to $73.3{\pm}5.4$ (p=0.006). The mean ASES score improved from $37.2{\pm}2.8$ to $75.0{\pm}3.8$ (p=0.012). The mean KSS improved from $36.5{\pm}7.2$ to $75.6{\pm}5.4$ (p=0.009), the mean forward elevation from $66.3{\pm}4.7$ to $135.6{\pm}8.4$ (p=0.0001), and the mean abduction from $45.2{\pm}4.2$ to $119.0{\pm}6.5o$ (p=0.0001). Internal rotation differed significantly from the first sacral to the third lumbar vertebrae (p=0.036). External rotation did not change significantly (p=0.076). There was also no statistically significant difference between groups (no previous operation versus none). Four complications occurred: one superficial infection, one with anterior dislocation, one acromial fracture, and one clavicle fracture. Conclusions: RTSA provides reliable pain relief and recovery of shoulder function in patients with massive irreparable RCTs in short-term follow-up.

• The Journal of Korean Medicine
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• 제28권1호통권69호
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• pp.87-93
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• 2007

Objectives : This study was to assess the effectiveness of Oriental medical treatment on carpal tunnel syndrome, comparing its outcome with that of Western medical treatment. Methods : After being diagnosed with carpal tunnel syndrome by electromyography, subjects were enrolled in Kyung Hee Medical Center from March 2006 to January 2007. We prescribed Kejibokryung-hwan to the Oriental medical therapy group (OM group) and NSAIDS to the Western medical therapy group (WM group). Effectiveness was assessed by degree of pain using visual analog scale (VAS) before and after 3 weeks' treatment. Adverse effects were also monitored. Results : There were 21 patients in the OM group and 19 in the WM group. No statistical significant difference was detected at the baseline assessment. After 3 weeks of medication, pain was reduced about 26% in the OM group and 46% in the WM group. These findings might be explained by that more than half of the WM group received local steroid injection, which has been known to have more rapid analgesic effect that oral medication. Although pain reduction rate was higher in the WM group than in the OM group, we suggest that Oriental medical treatment is still effective, faking into consideration the fact that completely recovered cases were found only in the OM group. No adverse effect was found in either of the groups. Conclusion : This work could help us to understand the effectiveness of Oriental medical treatment on carpal tunnel syndrome.

• Journal of The Korean Society of Integrative Medicine
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• 제9권2호
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• pp.119-130
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• 2021

Purpose : We aimed to validate a new manual therapy to treat tension type headache(TTH) by applying myofascial release techniques to the scalp and to examine the changes in the quality of life and the headache characteristics after treatment and at the 6-month follow-up. Methods : Thirty patients were recruited in this study and were assigned to two groups through simple random sampling. Fifteen patients were assigned to the manual therapy group (MT) and 15 patients to the scalp myofascial release technique (SMT) group. However, five patients from the MT group and one from the SMT group were excluded. Therefore, 24 patients with TTH (10 males, 14 females) participated in the study. Patients underwent either MT or SMT. The procedures were performed by a physical therapist twice per week for 4 weeks. The quality of life [using the brief pain inventory (BPI) and the headache impact test (HIT)], and the frequency, duration, and intensity of the headache [on a visual analog scale (VAS)] were assessed before and after the treatment, and at the follow-up. Results : After 4 weeks of SMT, the frequency (p<.001), duration (p<.05), and intensity (p<.001) of the headache and the quality of life (HIT; p <.001, BPI; p<.001) significantly improved in the patients with TTH. The improvement in these parameters remained significant even after 6 months of follow-up. Similarly, After 4 weeks of MT, the frequency (p<.05), duration (p<.05), and intensity (p<.01) of the headache, and the quality of life (HIT; p<.05, BPI; p<.001) significantly improved in the patients with TTH. The improvement in these parameters remained significant even after 6 months of follow-up. There was no significant difference in these parameters between the two groups. Conclusion : It has been suggested that MT using the SMT can be used as a non-invasive treatment to treat the frequency, duration, and intensity of the TTH, and to improve the quality of life.

• Journal of Dental Anesthesia and Pain Medicine
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• 제22권2호
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• pp.145-153
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• 2022

Background: Postoperative analgesia (POA) is an important determinant of successful treatment. Dexmedetomidine (DEX) has recently gained attention as a promising adjuvant to local anesthetics (LA). The present study aimed to evaluate the efficacy and safety of levobupivacaine (LB) as an adjuvant during inferior alveolar nerve block (IANB) in the extraction of lower impacted third molars (LITM). Methods: A prospective, randomized, placebo-controlled, triple-blind, parallel-arm, and clinical study was performed on 50 systemically healthy participants who required removal of an asymptomatic LITM. Using a 1:1 distribution, the participants were randomized into two groups (n = 25). Group L (control group) received 1.8 mL of 0.5% LB and 0.2 mL normal saline (placebo) and Group D (study group) received a blend of 1.8 mL of 0.5% LB and 0.2 mL (20 ㎍) DEX. The primary outcome variable was the duration of POA and hemodynamic stability, and the secondary variable was the total number of analgesics required postoperatively for up to 72 h. The participants were requested to record the time of rescue analgesic use and the total number of rescue analgesics taken. The area under the curve was plotted for the total number of analgesics administered. The pain was evaluated using the visual analog scale. Data analysis was performed using paired students and unpaired t-test, Mann-Whitney U test, Chi-square test, and receiver operating characteristic analysis. Statistical significance was set at P < 0.05. Results: The latency, profoundness of anesthesia, and duration of POA were statistically significant (P < 0.05). The differences between mean pain scores at 6, 12, 24, 48, and 72 h were found to be significant (each P = 0.0001). Fewer analgesics were required by participants in group D (2.12 ± 0.33) than in L (4.04 ± 0.67), with a significant difference (P = 0.0001). Conclusion: Perineurally administered LA with DEX is a safe, effective, and therapeutic approach for improving latency, providing profound POA, and reducing the need for postoperative analgesia.

• Journal of Dental Anesthesia and Pain Medicine
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• 제22권4호
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• pp.305-314
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• 2022

Introduction: This clinical trial aimed to evaluate the anesthetic effect of the addition of 2 mg (4 mg/ml) of dexamethasone to 2% lidocaine (plain or with 1:80,000 epinephrine). The solutions were injected for a primary inferior alveolar nerve block (IANB) to provide mandibular anesthesia for the endodontic treatment of mandibular molars with symptomatic irreversible pulpitis. Methods: In a double-blinded setup, 124 patients randomly received either of the following injections: 2% lidocaine with 1:80,000 epinephrine, 2% lidocaine with 1:80,000 epinephrine mixed with 2 mg dexamethasone, or plain 2% lidocaine mixed with 2 mg dexamethasone, which were injected as a primary IANB. Ten minutes after injection, patients with profound lip numbness underwent electric and thermal pulp sensibility tests. Patients who responded positively to the tests were categorized as "failed" anesthesia and received supplemental anesthesia. The remaining patients underwent endodontic treatment using a rubber dam. Anesthetic success was defined as "no pain or faint/weak/mild pain" during endodontic access preparation and instrumentation (HP visual analog scale score < 55 mm). The effect of the anesthetic solutions on the maximum change in heart rate was also evaluated. The Pearson chi-square test at 5% and 1% significance was used to analyze anesthetic success rates. Results: The 2% lidocaine with 1:80,000 epinephrine, 2% lidocaine with 1:80,000 epinephrine mixed with 2 mg dexamethasone, and plain 2% lidocaine mixed with 2 mg dexamethasone groups had anesthetic success rates of 34%, 59%, and 29%, respectively. The addition of dexamethasone resulted in significantly better results (P < 0.001, 𝛘² = 9.07, df = 2). Conclusions: The addition of dexamethasone to 2% lidocaine with epinephrine, administered as an IANB, can improve the anesthetic success rates during the endodontic management of symptomatic mandibular molars with irreversible pulpitis.

• Journal of Dental Anesthesia and Pain Medicine
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• 제22권5호
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• pp.339-348
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• 2022

Background: To compare the anesthetic efficacy of supplemental buccal infiltration (BI) (1.7 ml) versus intraligamentary (IL) injection containing 0.4 ml of 4% articaine with 1:100.000 epinephrine after an inferior alveolar nerve block (IANB) with 1.7 ml 2% lidocaine in the first and second mandibular molars diagnosed with irreversible pulpitis (IP). Methods: One hundred subjects diagnosed with IP of either the mandibular first (n = 50) or second molars (n = 50) and failed profound anesthesia following an IANB were selected. They randomly received either the IL or BI techniques of anesthesia. Pain scores on a 170 mm Heft-Parker visual analog scale were recorded initially, before, and during supplemental injections. Furthermore, pulse rate was measured before and after each supplemental injection. During the access cavity preparation and initial filing, no or mild pain was assumed to indicate anesthetic success. The chi-square test, Mann-Whitney U test, and independent samples t-test were used for the analyses. Results: The overall success rates were 80% in the IL group and 74% in the BI group, with no significant difference (P = 0.63). In the first molars, there was no significant difference between the two techniques (P = 0.088). In the second molars, IL injection resulted in a significantly higher success rate (P = 0.017) than BI. IL injection was statistically more successful (P = 0.034) in the second molars (92%) than in the first molars (68%). However, BI was significantly more successful (P = 0.047) in the first molars (88%) than in the second molars (64%). The mean pulse rate increase was significantly higher in the IL group than in the BI group (P < 0.001). Conclusions: Both the IL and BI techniques were advantageous when used as supplemental injections. However, more favorable outcomes were observed when the second molars received IL injection and the first molars received BI.