• Title/Summary/Keyword: clinical efficacy

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Extracorporeal Shockwave Therapy for Medial or Lateral Epicondylitis of the Elbow (주관절 내, 외상과염에 대한 체외충격파 치료의 임상적 결과)

  • Yum, Jae-Kwang;Bae, Su-Young;Park, Sung-Bum
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.2 no.2
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    • pp.79-84
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    • 2009
  • Purpose: Medial or Lateral epicondylitis is one of the most common causes of elbow pain and recently ESWT (Extracorporeal Shockwave Therapy) is welcomed as a new treatment modality and has been performed in many clinics. The purpose of this study is to report the clinical result after the ESWT treatment for the lateral or medial epicondylitis of the elbow. Materials and Methods: From Nov. 2005 to Jan. 2009, seventy four cases of seventy two (11 male, 61 female) patients diagnosed as medial or lateral epicondylitis of the elbow are included in this study. The average age was 52.4 years old. Authors used visual analogue scale (VAS) to assess the degree of pain at rest and during work, comparing the score before the ESWT treatment with that of $6^{th}$, $12^{th}$ and $24^{th}$ week after the treatment. Authors also checked the number of awakeness during sleep due to pain and compared them before and after the ESWT treatment. Results: Average resting pain score improved from 4.60 before the treatment to 2.01 at $6^{th}$ week, 0.43 at $12^{th}$ week and 0.16 at $24^{th}$ week. Average pain score during working also showed quite an improvement with time from 7.20 before the treatment to 4.05 at $6^{th}$ week, 2.01 at $12^{th}$ week and finally 0.36 at $24^{th}$ week. We checked the frequency of sleep arousal during a week, and also found similar significant treatment efficacy as the average frequency decreased from 9.64 per week before the treatment to 1.21, 0.08 and 0.09 per week at $6^{th}$ week, $12^{th}$ week and $24^{th}$ week, respectively. Conclusion: ESWT for medial or lateral epicondylitis is thought to be one of the effective treatment modalities for those patient group not quite responsive to other conservative treatment.

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Efficacy of Weekly 0.1% Amitraz Dip with 4% Chlorhexidine Shampoo on Juvenile Onset Generalized Pyodemodicosis Unresponsive to Ivermectin Therapy in Japanese Chin Dog (Japanese Chin 종에서 발생한 Ivermectin에 반응을 보이지 않은 전신성 농성 모낭충 감염증에 대한 0.1% Amitraz와 4% Chlorhexidine의 국소치료 일례)

  • Jeong, Hyo-Hoon;Jeong, A-Young;Hoh, Woo-Pil;Eom, Ki-Dong;Lee, Keun-Woo;Oh, Tae-Ho
    • Journal of Veterinary Clinics
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    • v.20 no.2
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    • pp.237-241
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    • 2003
  • A case of juvenile onset generalized demodicosis of one year old, intact female Japanese Chin dog weighing 3.1kg was presented to the Small Animal Clinic of the College of Veterinary Medicine of Kyungpook National University. The diagnosis was made based on the physical examination, deep skin scrapings, hematology, serum chemistry, endocrinologic evaluation and bacterial culture. Numerous D. canis mites of various stages were observed in multiple skin scraping samples. CBC, serum chemistry, $T_3$, $T_4$ and free $T_4$ values were within normal range and Staphylococcus intermedius was isolated in bacterial culture of pustules. The dog was healthy other than skin lesions at the presentation. The three different treatment protocols were tried for the case. No clinical improvement was observed during 13 weeks of orally given daily basis ivermectin therapy at 600ug/kg and 2 weeks of spot-on weekly basis selamectin therapy at 30 mg/kg with cephalexin given orally twice a day at 25 mg/kg. However, a remarkable remission was seen by 0.1% amitraz dip on weekly basis with 4% chlorhexidine bath given twice a week. The secondary staphylococcal infection and accompanied pruritus was almost disappeared in two weeks and she was recovered clinically normal in 9 weeks of therapy. The therapy was continued for 4 more weeks to prevent relapse. The dog is clinically normal and being monitored for development of any abnormal dermatological signs for the time being.

Utilization Rate and Related Factors of Unified Health Sub-center Among Rural Residents (통합보건지소 설치 전후 주민들의 보건지소 이용율 변화 및 관련요인)

  • Hwang, Tae-Yoon;Kang, Pock-Soo;Kim, Seok-Beom;Lee, Kyeong-Soo;Kang, Young-Ah
    • Journal of agricultural medicine and community health
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    • v.27 no.2
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    • pp.107-126
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    • 2002
  • Health sub-centers(HSCs) have played an important role in primary health care in rural area in Korea. The unification of neighboring HSCs was a strategy to improve the role of HSCs. This study was conducted to reveal the efficacy of the unified HSC established in Yangbuk-myeon, Gyeongju-si in1997. The utilization patterns of HSC and its related factors, and satisfaction of consumer on HSC were compared before and after unification of two HSCs in Gampo-eup, Yangnam-myeon using questionnaire survey, and also the statistics of medical care services and public health services were compared. Four hundred forty nine subjects were questioned in survey, 156 from Gampo-eup, 147 from Yangbuk-myeon, and 146 from Yangnam-myeon. Following unification, the utilization rates and the frequency of visits in Gampo-eup declined. In all three areas, chronic illness was the common factor influencing the utilization and change in frequency of visits to the unified HSC. Following unification, aspects of consumer satisfaction, for example; accessibility and affordability decreased in Gampo-eup, but increased in both Yangbuk-myeon and Yangnam-myeon. The statistics relating to medical care, X-ray examination, home visiting service, vaccination, and health education showed an increase for the unified HSC when compared to the sum of the statistics for the previous two. The execution rates for other public health services were the same, or a little decreased. Clinical laboratory examinations and the issuing of civil affair documents were new services offered by the unified HSC. It is concluded, the overall consumer satisfaction with the unified HSC was improved. In Gampo-eup, where after unification there was no HSC, it seemed to be a barrier to accessing the unified HSC. The effect of the unified HSC, in the respect of medical care and public health services, was not as significant as expected at the time of being established. Therefore, the strategies to reenforce the unified HSC should be developed to provide all residents with comprehensive primary health care services.

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Clinical Efficacy of Toothpaste Containing Chitosan;Multicenter study (키토산 함유 치약의 임상적 효과;Multicenter study)

  • Kim, Min-Kyoung;Choi, Seong-Ho;Shin, Seung-Yun;Rhyu, In-Chul;Herr, Yeek;Park, Joon-Bong;Cho, Kyoo-Sung
    • Journal of Periodontal and Implant Science
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    • v.33 no.2
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    • pp.167-178
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    • 2003
  • Many researches are being done to study the effect of toothpaste containing natural extracts. The aim of this study was to evaluate the plaque control effect and therapeutic effect of toothpaste products containing chitosan extract. 120 healthy subjects with gingivitis or early periodontitis were divided into two groups. Subjects in the experimental group only used toothpaste containing chitosan and subjects in the control group used toothpaste without chitosan. At first, subjects received scaling and tooth brushing instruction. Gingival index, bleeding index, probing pocket depth, probing attachment level were scored at baseline, 2 months, and 3 months, and plaque index were scored at baseline, 1 month, 2 months, 3 months. Gingival index of experimental group and control group at baseline, 2 months, and 3 months use were 0.71${\pm}$0.66, 0.49${\pm}$0.55, 0.36${\pm}$0.49 and 0.62${\pm}$0.58, 0.51${\pm}$0.52, 0.48${\pm}$0.50 (mean${\pm}$SD), respectively (statistically significant different at p <0.05 ). Plaque index of experimental group and control group at baseline, 1 month, 2 months, and 3 months were 0.52${\pm}$0.50, 0.43${\pm}$0.50, 0.39${\pm}$0.49, 0.29${\pm}$0.46 and 0.49${\pm}$0.50, 0.50${\pm}$0.50, 0.51${\pm}$0.50, 0.45${\pm}$0.50, respectively (statistically significant different at p<0.05 ). Bleeding index of experimental group and control group were 0.40${\pm}$0.49, 0.33${\pm}$0.47, 0.24${\pm}$0.43 and 0.40${\pm}$0.49,0,38${\pm}$0.49,0.30${\pm}$0.46, respectively (statistically significant different at p<0.05). Probing depth of experimental group and control group were 2.41${\pm}$0.64, 2.31${\pm}$0.60, 2.28${\pm}$0.55 and 2.51${\pm}$0.67, 2.47${\pm}$0.63,2.42${\pm}$0.62, respectively (statistically significant different at p${\pm}$0.66, 2.32${\pm}$0.62 and 2.54${\pm}$0.70, 2.51${\pm}$0.69,2.46${\pm}$0.66, respectively (statistically significant different at p<0.05 ). From these finding, it can be concluded that toothpaste containing chitosan have better plaque control effect and therapeutic effect on gingivitis and early periodontitis compared to conventional toothpastes.

Characteristics of Intravenous Midazolam Sedation with Nitrous Oxide in Pediatric Dental Treatment (소아환자에서 midazolam 정주 및 아산화질소 흡입진정법 하 치과치료의 특성)

  • Kim, Hyuntae;Song, Ji-Soo;Hyun, Hong-Keun;Kim, Young-Jae;Kim, Jung-Wook;Jang, Ki-Taeg;Lee, Sang-Hoon;Shin, Teo Jeon
    • Journal of the korean academy of Pediatric Dentistry
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    • v.47 no.1
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    • pp.53-61
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    • 2020
  • Midazolam is a short-acting benzodiazepine that is widely used in pediatric dental sedation. However, its clinical effectiveness as an intravenous sedative agent in children has not been widely documented. A retrospective study was conducted to evaluate the efficacy and safety of intravenous midazolam and nitrous oxide inhalation sedation in pediatric dental treatment. The subjects were 115 patients (118 cases) who received dental treatment under intravenous midazolam and nitrous oxide inhalation sedation. Demographic factors, general health status, sedation time, midazolam and nitrous oxide dosage, and success rate of sedation were evaluated from electronic medical records. Behavioral management was the main reason of choosing sedation. Mean duration of sedation was 56.7 minutes for surgical treatment, and 74.4 minutes for restorative treatment. The initial dosage of intravenous midazolam was 0.051 ± 0.019 mg/kg. In 34 cases (28.8%), additional midazolam of 0.036 ± 0.057 mg/kg was delivered during the treatment. The concentration of nitrous oxide was maintained between 40% and 50%. The success rate of sedation was 99% (n = 117). In 1 case, laryngospasm occurred and the patient was reversed with benzodiazepine antagonist, flumazenil. Intravenous midazolam sedation with nitrous oxide was shown to be clinically effective for the dental treatment in children, if administered by trained personnel and patients are carefully selected in accordance with guidelines.

The Adjuvant Effect of Subcutaneous Interferon-gamma in the Treatment of Refractory Multidrug-resistant Pulmonary Tuberculosis (난치성 다제내성 폐결핵에서 피하주사 Interferon-gamma 치료의 효과: 예비연구)

  • Kim, Eun Kyung;Shim, Tae Sun;Lee, Jung Yeon;Oh, Yeon-Mok;Lim, Chae-Man;Lee, Sang Do;Koh, Younsuck;Kim, Dong Soon;Kim, Won Dong;Kim, Woo Sung
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.3
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    • pp.226-233
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    • 2004
  • Background : Interferon-gamma (IFN-${\gamma}$) is a critical cytokine in the defense against a Mycobacterium tuberculosis infection. Even though IFN-${\gamma}$ has occasionally been used in the treatment of refractory multidrug-resistant tuberculosis (MDR-TB) with some promising results, there is still some controversy regarding the therapeutic efficacy of IFN-${\gamma}$. This study was performed to examine the effect of subcutaneous IFN-${\gamma}$ in the treatment of MDR-TB patients. Methods : Six patients with refractory MDR-TB were enrolled in this study. Two million IU of IFN-${\gamma}$ was administered subcutaneously three times a week with the concomitant administration of antituberculous drugs for at least for 28 weeks. During the IFN-${\gamma}$ therapy, the sputum smear and culture, radiological and clinical evaluations were performed every 4 weeks throughout the study period. Results : The mean age of the 6 patients was 37 years (ranges, 15-61 years). The drug susceptibility test to standard antituberculous drugs revealed resistance to an average of 6.8 (${\pm}1.2$) agents including isoniazid and rifampicin. An average of 10.8 (${\pm}1.3$) antituberculous drugs were prescribed before IFN-${\gamma}$ therapy. The culture became negative in 2 patients (33%) after initiating IFN-${\gamma}$ therapy; one at 8 weeks, and the other at 24 weeks. Finally, after stopping the IFN-${\gamma}$ therapy after 28 weeks, the culture became positive again in the two patients who were culture-negative. The other 4 patients who failed in the culture conversion are still on antituberculous treatment except for one who died of tuberculosis. Conclusion : Even though 28 weeks of subcutaneous IFN-${\gamma}$ therapy in combination with antituberculous drugs was successful in inducing the culture-negative conversion in some patients with refractory MDR-TB, the culture became positive again after stopping the IFN-${\gamma}$ therapy. This suggests that subcutaneous IFN-${\gamma}$ therapy may have suppressive effect on tuberculosis only during the IFN-${\gamma}$ therapy period in some patients. Further studies will be needed to determine the optimum dose, the administration route, the duration of therapy, and the predicting factors of the response to adjuvant IFN-${\gamma}$ therapy.

The effect of growth hormone treatment in short children born small for their gestational ages (만삭 부당경량아로 출생한 저신장증 환아에서의 성장호르몬 치료 효과)

  • Seo, Joo Hee;Kim, Duk Hee
    • Clinical and Experimental Pediatrics
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    • v.49 no.3
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    • pp.312-316
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    • 2006
  • Purpose : Growth hormone(GH) has been recognized as an effective treatment for short children born small for their gestational ages(SGA), and nowadays it has been widely used for the treatment of short children born SGA. The aim of this study is to assess the efficacy of GH treatment for the children born SGA. Methods : The study population was made of 40 short children born SGA with GH-treated(n=26) and untreated control group(n=14). In order to evaluate the effect of GH treatment, the changes in standard deviation scores(SDS) of the GH-treated group were compared to the changes in SDS before and after treatment from the control group in the same period. Results : There were no differences between the GH-treated group and the control group in gestational age, birth weight, chronological age, target height and the period of follow-up observation; however, the GH-treated group had lower height SDS($-3.3{\pm}0.9$) than the control group($-2.4{\pm}0.4$) before treatment(P<0.05). The GH-treated group had gained $1.2{\pm}1.0$ height SDS during GH treatment while the control group had gained $0.5{\pm}0.6$ height SDS. In the GH treatment group, HDL-cholesterol increased from $48.5{\pm}9.9mg/dL$ to $56.1{\pm}8.7mg/dL$(P<0.05) and LDL-cholesterol decreased from $88.1{\pm}23.3mg/dL$ to $76.4{\pm}19.4mg/dL$(P<0.05) after treatment. There were no changes in total cholesterol, triglyceride, free fatty acid and fasting blood sugar. IGF-I increased from $224.9{\pm}191.3{\mu}g/L$ to $443.2{\pm}152.5{\mu}g/L$(P<0.05) and IGFBP-3 also increased from $3.7{\pm}1.3mg/L$ to $5.6{\pm}1.2mg/L$(P<0.05). Conclusion : We conclude that growth hormone treatment is effective in the treatment of short children born SGA.

Pain reducing effect of vapocoolant spray during injection and heelstick procedure in neonates (신생아에서 근육 주사 및 발뒤꿈치 천자 시 냉각 분사의 통증감소효과: 냉각 분사와 30% 경구 포도당액의 비교)

  • Choi, Eun Kyong;Jung, Ji Mi;Sin, Jong Beom
    • Clinical and Experimental Pediatrics
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    • v.51 no.5
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    • pp.481-486
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    • 2008
  • Purpose : The aims of this study were to test the efficacy of vapocoolant spray to decrease the symptoms associated with pain in newborns undergoing heel stick and intramuscular injection and compare the pain relief effect of oral glucose. Methods : Randomized, controlled study including sixty newborns undergoing heel stick and intramuscular injection. Group 1 was heelsticked, Group 2 was intramuscular injected, Group A did not recieve any treatment, Group B recieved 30% glucose solution orally, Group C was applied vapocoolant spray symptoms and signs associated with pain at heel stick and intramuscular injection were measured with the premature Infant Pain Profile (PIPP) scale. Results : There was no significant difference in the PIPP score between intramuscular injected group control and heel stick group control (P=0.07). The mean PIPP score of Group 1A (control) $10.6{\pm}2.4$, Group 1B $5.5{\pm}2.0$, Group 1C $5.2{\pm}1.8$. The mean PIPP score 1B and 1C were significantly lower than control (1B P<0.001, 1C P<0.001). The mean PIPP score of Group 2A (control) $12.5{\pm}1.4$, Group 2B $7.0{\pm}1.7$, Group 2C $6.4{\pm}1.6$. The mean PIPP score 2B and 2C were significantly lower than control (2B P<0.001, 2C P<0.001). Conclusion : The antinociceptive effect of vapocoolant sparay is as effective as 30% oral glucose solution for pain control. So this study support the use of vapocoolant spray for reducing pain during painful procedure in the neonatal intensive care units.

Comparison of Efficacy of Overlapped Versus Long Eluting Stent in Acute Myocardial Infarction Patients with Diffuse Long Lesion (미만성 긴 병변이 있는 급성심근경색환자에서 긴 단일 용출 스텐트 시술과 중첩 스텐트 시술의 효과 비교)

  • Kim, Won Hyo;Kim, In Soo;Kong, Chang gi;Han, Jae Bok
    • Journal of the Korean Society of Radiology
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    • v.14 no.3
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    • pp.319-336
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    • 2020
  • The purpose of this study was to compare the outcomes of two interventional methods, overlapping drug-eluting stents (DES) and long DES, for long-term clinical outcomes in patients with acute myocardial infarction (AMI). A total of 438 patients with AMI (65.9±11.0 years, 306 males) from June 2008 to March 2019 who had diffuse long coronary artery lesion, more than 30mm were divided into two groups; group I (overlapped DES group; n=140) and group II (long DES group; n=298). We compared the incidences of major adverse cardiac events [MACEs; cardiac death, myocardial infaction (MI), target lesion revascularization (TLR) and stent thrombosis (ST)] during 12 months between the two groups. Everolimus-eluting stent was more commonly used in group II than in group I (28.1% vs. 51.8% p<0.001). Mean lesion diameter was slightly longer in group II (3.1±0.3mm vs. 3.2±0.3mm, p=0.042), and prevalence of ACC/AHA lesion type C was higher in group I (41.7% vs. 25.4%, p<0.001). Incidences of MACEs during 12 months were higher in group I than group II (18.5% vs. 14.4%, p=0.034). The rates of cardiac death (2.1% vs. 4.4%, p=0.667), MI (5.0% vs. 2.7%, p=0.260) and stent thrombosis rate (0.7% vs. 1.7%, p=0.669) were similar between the two groups. However, TLR rate was higher in group I (10.7% vs. 5.6%, p=0.041). In multivariate logistic regression analysis, presence of diabetes mellitus [Hazard ratio (HR) 2.383, 95% confidence interval (CI) 1.332-4.260, p=0.003] and use of paclitaxel-eluting stent (HR) 2.367, 95% CI 1.371-4.086, p=0.002) were independent predictors of 12-month MACEs, without significant differences in prevalence between the two groups. In AMI patients with diffuse long lesion, TLR rate was higher in the overlapped DES group during 12-month follow-up. Presence of diabetes and use of paclitaxel-eluting stent were independent predictors of MACEs.

Assessment of Patency of Coronary Artery Bypass Grafts Using Segmented K-space Breath-hold Cine Cardiovascular Magnetic Resonance Imaging: A Clinical Feasibility Study (호흡멈춤상태에서 K-space분할 CINE 자기공명 영상기법을 이용한 관상동맥우회로의 혈류개방성의 검사)

  • Oh-Choon Kwon;Sub Lee;Jong-Ki Kim
    • Investigative Magnetic Resonance Imaging
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    • v.7 no.1
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    • pp.22-30
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    • 2003
  • Purpose : The efficacy of magnetic resonance imaging for evaluating coronary artery disease has been reported. In this study, we evaluated the usefulness of breath-hold segmented K-space cine MR imaging for evaluating the patency of coronary artery bypass grafts (CABG). Materials and Method s : Thirty eight patients with a total of 92 CABGs (36 internal thoracic arteries and 56 saphenous vein grafts) were evaluated using segmented K-space cardiac-gated fast gradient echo sequence (2D-FASTCARD) MR imaging. MR magnitude images were evaluated from the hard copies by two independent observers. A graft was defined as patent if it was seen as a bright small round area on at least two consecutive images throughout the cardiac cycle at a position consistent with the expected location for that graft. Results : MR images were obtained successfully for 23 patients (61%). The sagittal planes were most helpful in visualizing the cross-section of sapheneous vein bypass graft to left circumflex artery branch, whereas the transverse planes were used for identification of internal mammary artery grafts to left anterior descending coronary artery or its branch and identification of saphenous vein grafts to right coronary artery. Forty five grafts were visible using this MR technique, while the grafts were not visible on seven saphenous vein grafts and two internal mammary artery grafts. In two patients showing symptoms of myocardial ischemia, one or two bypass grafts were not visible. Imaging, perpendicular plane to a CABG was important to visualize the flow inside the CABG with maximum sensitivity. Conclusion : Evaluation of patency of the bypass graft was clinically feasible by 2D-FASTCARD MR imaging, whereas any invisible bypass grafts should be further studied by contrast-enhanced MR angiography or by conventional angiography for confirmation of abnormalities.

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