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Effects of Intraarticular Prolotherapy on Sacroiliac Joint Pain (천장관절 증후군 환자에서 관절강 내 증식치료의 효과)

  • Lee, Jae Dam;Lee, Dae Wook;Jeong, Cheol Won;Lee, Hyung Gon;Yoon, Myung Ha;Kim, Woong Mo
    • The Korean Journal of Pain
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    • v.22 no.3
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    • pp.229-233
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    • 2009
  • Background: Sacroiliac (SI) joint pain is a challenging condition that causes lower back or buttock pain; however, there is no universally accepted long-term treatment. There have been several reports of ligament prolotherapy for SI joint pain, but these have had inconsistent results, probably due to the lack of a specific diagnosis for patient selection and variability in the volume, number and sites of injection. Therefore, this study was conducted to assess the efficacy of intraarticular prolotherapy for relieving SI joint pain diagnosed by local anesthetic intraarticular injection. Methods: Twenty-two patients with SI joint pain confirmed by 50% or more improvement in response to local anesthetic block underwent intraarticular prolotherapy with 25% dextrose water every other week three times. The numeric rating scale (NRS) for pain and Oswestry disability index (ODI) were assessed at the initial visit and after completion of a series of prolotherapy and the NRS was checked during monthly follow-up sessions to evaluate the long-term effectiveness of this technique. Results: Twenty patients completed prolotherapy and followed up as scheduled. The NRS and ODI were significantly improved from 6 (4-8) and $34.1{\pm}15.5$ to 1 (0-3) and $12.6{\pm}9.8$ (P < 0.01), respectively, at 1 month after prolotherapy. The mean duration of pain relief of 50% or more was 12.2 months (95% CI, 10.0-14.3) as determined by Kaplan-Meier survival analysis. Conclusions: Intraarticular prolotherapy provided long-term relief of sacroiliac joint pain and may have more benefits than ligament prolotherapy or neurolysis.

Effect of Sequential Intermittent Pneumatic Compression for Lymphedema (임파부종 환자의 간헐적 공기압박 치료의 효과)

  • Kim, Seng-Jung;Rhee, Hyeon-Sook;Kim, Soon-Hee
    • Journal of Korean Physical Therapy Science
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    • v.5 no.2
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    • pp.595-602
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    • 1998
  • The purpose of this study was to investigate the effect of sequential intermittent pneumatic compression in patients with lymphedema who were hospitalized for three days at Samsung Medical Center. Thirty-three subjects with lymphedema was selected by physician referral. A selection of the patients was made according to the following criteria : 1) no known metastases, 2) no infection after the a difference of at least 10% in the volumes of edematous limb. All patients were treated with the Lympha-Press(Model 103-A). Circumferential limb mesurements was done before and after a 3-day treatment period. As a result of sequential intermittent pneumatic compression therapy. All extremity showed a decrease in circumferential measurements with the maximal reduction occurring at the wrist(55.75 %) for the upper extremities and at the lower 1/3 of calf (40.61%) for the lower extremities. Upper extremity arm was reduced by 42.1% and lower extremity leg by 33.61%. In contrast with this, the proximal levels of arm patients and leg showed comparatively poor reduction than distal levels. Almost 44.44% of arm patients and 5.26% of leg patients experienced significant reduction(> 50%) after compression therapy. These data clearly indicates that Sequential Intermittent Pneumatic Compression Therapy was effective treatment for reducing of extremity volume in patients with lymphedema. but this was variable degree and dependent on the amount of pre-existing lymphedema. Other factors such as duration of edema, etiology, previous history of radiology, age did not appear to influence the extend of improvement. Further sutdies will be necessary to determine long term benefit of this therapy.

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Non-point Source Pollution Modeling Using AnnAGNPS Model for a Bushland Catchment (AnnAGNPS 모형을 이용한 관목림지의 비점오염 모의)

  • Choi Kyung-Sook
    • Journal of The Korean Society of Agricultural Engineers
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    • v.47 no.4
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    • pp.65-74
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    • 2005
  • AnnAGNPS model was applied to a catchment mainly occupied with bushland for modeling non-point source pollution. Since the single event model cannot handle events longer than 24 hours duration, the event-based calibration was carried out using the continuous mode. As event flows affect sediment and nutrient generation and transport, the calibration of the model was performed in three steps: Hydrologic, Sediment and Nutrient calibrations. The results from hydrologic calibration for the catchment indicate a good prediction of the model with average ARE(Absolute Relative Error) of $24.6\%$ fur the runoff volume and $12\%$ for the peak flow. For the sediment calibration, the average ARE was $198.8\%$ indicating acceptable model performance for the sediment prediction. The predicted TN(Total Nitrogen) and TP(Total Phosphorus) were also found to be acceptable as the average ARE for TN and TP were $175.5\%\;and\;126.5\%$, respectively. The AnnAGNPS model was therefore approved to be appropriate to model non-point source pollution in bushland catchments. In general, the model was likely to result in underestimation for the larger events and overestimation fur the smaller events for the water quality predictions. It was also observed that the large errors in the hydrologic prediction also produced high errors in sediment and nutrient prediction. This was probably due to error propagation in which the error in the hydrologic prediction influenced the generation of error in the water quality prediction. Accurate hydrologic calibration should be hence obtained for a reliable water quality prediction.

Quantification of Flood Reduction Effect of Small Stormwater Detention Facilities by NRCS Curve Number (유출곡선지수를 이용한 소규모 저류시설의 유출저감효과 정량화)

  • Yoo, Chul-Sang;Kim, Kyoung-Jun;Park, Min-Kyu;Yoon, Jeong-Su
    • Journal of the Korean Society of Hazard Mitigation
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    • v.10 no.3
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    • pp.109-118
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    • 2010
  • This study quantified the flood reduction effect of small stormwater detention facilities by the NRCS curve number. The modified rational equation was used to calculate the inflow volume into the detention facilities. The NRCS curve number in the cases w/ and w/o storage facility was calculated with respect to the rainfall characteristics(rainfall frequency, duration) and the size of storage facilities. Finally, diagrams showing the curve number reduction rate versus the size of storage facility were developed. The diagrams can be used to evaluate the flood reduction effect of storage facility reasonably and efficiently when estimating the optimal location and size of storage facility. The results based on the methodology propsed in this study were also compared with those of previous study for their validation.

P wave dispersion on 12-lead electrocardiography in adolescents with neurocardiogenic syncope

  • Lee, Dong-Hyuk;Lee, Kyung-Min;Yoon, Jung-Min;Lim, Jae-Woo;Kho, Kyung-Ok;Kil, Hong-Ryang;Cheon, Eun-Jung
    • Clinical and Experimental Pediatrics
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    • v.59 no.11
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    • pp.451-455
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    • 2016
  • Purpose: Neurocardiogenic syncope (NCS) is the most frequent cause of fainting during adolescence. Inappropriate cardiovascular autonomic control may be responsible for this clinical event. The head-up tilt test has been considered a diagnostic standard, but it is cumbersome and has a high false-positive rate. We performed a study to evaluate whether P-wave dispersion (PWD) could be a useful electrocardiographic parameter of cardiac autonomic dysfunction in children with NCS. Methods: Fifty-four patients with NCS (28 boys and 26 girls; mean age, $12.3{\pm}1.4$ years) and 55 age- and sex-matched healthy controls were enrolled. PWD was obtained as the difference between maximum and minimum durations of the P wave on standard 12-lead electrocardiography in all patients and controls Results: The value of PWD was significantly higher in the syncope group than in the control group ($69.7{\pm}19.6$ msec vs. $45.5{\pm}17.1$ msec, respectively; P<0.001). The minimum duration of P wave was shorter in the syncope group than in the control group ($43.8{\pm}16.8$ msec vs. $53.5{\pm}10.7$ msec, respectively; P<0.001). Left atrial volume was not different between the groups on transthoracic echocardiography. Conclusion: PWD on echocardiography could be used as a clinical parameter in patients with NCS.

Anatomical Considerations in Gamma Knife Radiosurgery for Idiopathic Trigeminal Neuralgia

  • Kim, Young-Hoon;Park, Chul-Kee;Chung, Hyun-Tai;Paek, Sun-Ha;Kim, Dong-Gyu
    • Journal of Korean Neurosurgical Society
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    • v.40 no.3
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    • pp.148-153
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    • 2006
  • Objective : The authors conducted this study to present the long-term treatment outcomes [minimum 2 years] of Gamma knife radiosurgery[GKS] for trigeminal neuralgia[TN] and to demonstrate the correlation of treatment outcomes and the anatomical characteristics of TN. Methods : From 1997 to 2003, 44 consecutive patients suffering from medically intractable pain underwent GKS for TN. A single 4mm collimator was used with a median maximum dose of 80Gy [range $75{\sim}80Gy$] prescribed to the root entry zone of the trigeminal nerve. Median follow up duration was 30 months [range $24{\sim}78\;months$]. Anatomical measurements of trigeminal nerve in magnetic resonance images during GKS planning were correlated with clinical outcome. Results : Twenty-two patients [50%] achieved an excellent outcome [BNI grade I & II], 20 patients [45.5%] a good outcome [grade IIIa & IIIb], and only 2 patients [4.5%] a poor outcome [grade IV & V]. Eleven patients [25.0%] experienced pain recurrence after initial pain relief. Smaller volume of trigeminal nerve area irradiated more than 40Gy was significantly correlated with excellent outcome in both univariate and multivariate analyses respectively [P=0.033 and 0.040]. Conclusion : Anatomical considerations during the planning of GKS would be helpful for predicting clinical outcome in TN.

Gamma Knife Surgery for Brain Metastasis from Renal Cell Carcinoma : Relationship Between Radiological Characteristics and Initial Tumor Response

  • Kim, Jin-Wook;Han, Jung-Ho;Park, Chul-Kee;Chung, Hyun-Tai;Paek, Sun-Ha;Kim, Dong-Gyu
    • Journal of Korean Neurosurgical Society
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    • v.42 no.2
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    • pp.92-96
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    • 2007
  • Objective : The authors have speculated that metastatic brain lesions from renal cell carcinoma (RCC) show diverse radiological patterns and tumor responses after Gamma knife surgery (GKS), and have hypothesized that these can be predicted from tumor radiological characteristics. The goal of the current study was to identify the radiological characteristics of RCC brain metastases and the predictors of initial radiosurgical response after GKS. Methods : A retrospective analysis was performed on 48 lesions in 18 patients with RCC brain metastasis treated by GKS. The radiological characteristics of these lesions in magnetic resonance images (MRI) were classified into 3 categories according to enhancement patterns in T1-weighted images and signal intensity characteristics in T2-weighted images. Responses to GKS were analyzed according to these categories, and in addition, other potential predictive factors were also evaluated. Results : MRI findings in the three categories were diverse, though numbers of the lesion were comparable. At 2-month MRI follow-ups after GKS, response rate was 54% and the local tumor control rate 83%. T2 signal intensity was found to be the principal predictive factor of response to GKS, namely negative predictive factor. Other variables such as age, sex, tumor volume, dose, duration from initial diagnosis to GKS, and previous systemic therapies failed to show significant relationships with treatment response by multivariate analysis. Conclusion : Careful evaluation of the radiological characteristics of brain metastases from RCC is important prior to GKS because MRI heterogeneity has predictive value in terms of determining initial tumor response.

Stereotactic Radiosurgery with the CyberKnife for Pituitary Adenomas

  • Cho, Chul-Bum;Park, Hae-Kwan;Joo, Won-Il;Chough, Chung-Kee;Lee, Kyung-Jin;Rha, Hyoung-Kyun
    • Journal of Korean Neurosurgical Society
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    • v.45 no.3
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    • pp.157-163
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    • 2009
  • Objective : In recent years, CyberKnife has emerged as an important treatment modality in the management of pituitary adenomas. Treatment results after performing CyberKnife and the complications of this procedure are reviewed. Methods : Twenty-six patients with pituitary adenomas received stereotactic radiosurgery with the CyberKnife (CKRS). The follow-up periods ranged from 7 months to 47 months (mean$\pm$SD : $30{\pm}12.7$ months). The patients consisted of 17 with non-functioning adenomas, 3 with prolactinomas and 6 with acromegaly. The change in the tumor volume, visual acuity, hormonal function, and complications by this therapy were analyzed in each case. Results : The tumor control rate was 92.3%. Hormonal function was improved in all of the 9 (100%) functioning adenomas. Hormonal normalization was observed in 4 of the 9 (44%) patients with a mean duration of 16 months. In two patients (7.6%), visual acuity worsened due to cystic enlargement of the tumor after CKRS. No other complications were observed. Conclusion : CyberKnife is considered safe and effective in selected patients with pituitary adenomas. However, longer follow-up is required for a more complete assessment of late toxicity and treatment efficacy.

The Effect of Different Type of Exercise on SOD, Neutrophils and T Lymphocytes (훈련방법의 차이가 SOD, Neutrophils 및 T세포에 미치는 영향)

  • Kwak, Yi-Sub;Um, Sang-Yong;Kim, Dong-Eun;Hwang, Hye-Jin
    • IMMUNE NETWORK
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    • v.5 no.4
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    • pp.232-236
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    • 2005
  • Background: A physically active lifestyle and regular exercise training incurs many health benefits. One recently recognized benefit of regular moderate exercise is stress reduction and immune enhancement. Thus, a physical stress such as exercise may act at any number of points in the complex sequence of events collectively termed the immune response. Although exercise causes many propound changes in parameters of immune function, the nature and magnitude of such changes rely on several factors including the immune parameters of interest; type, intensity, and duration of exercise; fitness level or exercise history of the subject; environmental factors such as ambient temperature and humidity. Methods: This study was undertaken to investigate the effect of different type of exercise on superoxide dismutase (SOD), neutrophils, and T lymphocytes of Sprague-Dawley rats. Sprague-Dawley rats were randomly divided into three groups; a non-Trained group (NTG, n=6), a swim-Trained group (STG), and a treadmill-Trained group (TTG). The exercise regimen was designed in a treadmill (5 times/5 days/week) during 8-weeks for TTG, and swim training (5 times/5 days/week) during 8-weeks for STG, and the volume of exercise training was the same in both groups. Results: 8 weeks of regular swim and treadmill training significantly increased liver SOD concentration however, muscle SOD concentration was not statistically significant. In the level of neutrophils, TTG and STG showed significant difference, compared to NTG. TTG was the highest level of neutrophils. In the level of immune cell counts, there was significant difference among TTG, STG, and NTG both in the spleen and thymus. Conculsion: In conclusion, it can be stated that eight weeks swim and treadmill exercise training has beneficial effect in improving immune response and antioxidant defence capacity by augmenting immune cells and SOD activities of SD rats.

Effect of the Balance Exercise on the Unstable Surfaces for the Vital Capacity in Healthy Adults: A Preliminary Study (불안정한 지지면에서의 균형운동이 건강한 성인의 폐활량에 미치는 효과: 사전 연구)

  • Kim, Taeho;Park, Hankyu
    • Journal of The Korean Society of Integrative Medicine
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    • v.4 no.3
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    • pp.17-25
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    • 2016
  • Purpose : This study attempts to examine the effect of the balance exercise on the unstable surfaces for the vital capacity in healthy adults. Methods : A total of 13 subjects was randomly divided into a breathing exercise training group (n=7) and a breathing and balance exercise training group (n=6). Changes in vital capacity and respiratory muscle activity were measured before and after the intervention. The intervention was performed three times a week for four weeks. Forced vital capacity (FVC), forced expiratory volume at one second (FEV1) and maximal voluntary ventilation (MVV) were used as measurement tools for the vital capacity test. Electromyography (EMG) was also used to examine respiratory muscle activity. Result : The breathing exercise training group showed significant improvement in terms of FVC, FEV1 and external oblique (EO), and transverse abdominis/internal oblique (TrA/IO) of MVV. The breathing and balance exercise training group showed significant improvement in terms of FVC, MVV and EO, TrA/IO of FVC and rectus abdominis (RA), EO, and TrA/IO of MVV. However, in comparing changes in vital capacity and respiratory muscle activity before and after the training, the breathing exercise training group and the breathing and balance exercise training group showed a significant difference in terms of MVV. Conclusion : This study is as a preliminary study to find out the relation between a balance exercise and a vital capacity, it is considered to require a further study with several revisions of subjects, duration and time for an intervention.