The conservative treatment for impingement and rotator cuff tear includes rest, nonsteroidal anti-inflammatory drugs (NSAIDs), local steroid injection and physiotherapy depending on the purpose to relieve the pain and inflammation, in addition, stretching exercise to recover flexibility and strengthening exercise to recover the function could be used. When these conservative treatments are divided into multiple steps, the first one contains pain relief, modification of daily activity and stretching exercise. Second step includes strengthening exercise of the anterior/posterior cuff and peri-scapular muscles and eventually. The third step includes training program to return to job, housework and hobby activities and maintain. Thus, the key of these step wise approach for the treatment of impingement and rotator cuff tear is exercise program. Understanding of various exercise program and apply to the patients properly is most important for the conservative treatment of impingement and cuff tear.
Jeong, Hoon;Kim, Dong-Sub;Kim, Mi-Riong;Kim, Eun-Soo;Park, Ji-Yong;Park, Hyun-Min;Cho, Nam-Hoon;Kim, Ha-Neul;Woo, In
Journal of Korean Medicine Rehabilitation
/
v.23
no.3
/
pp.177-186
/
2013
Objectives This study is to evaluate the current situation of Russian tourists for medical tourism of Spine Specialty Korean Medicine Hospital. Methods 133 Russian tourists visiting Spine Specialty Korean Medicine Hospital from January 1, 2012 to December 31, 2012, were analysed in the statistics. Their data was sourced from the computerized medical records. And 87 of them answer a questionnaire about reasons for selection of Spine Specialty Korean Medicine Hospital and satisfactory for medical service. Results A total of 133 Russian visited Spine Specialty Korean Medicine Hospital for medical service, consisting of 73 females (54.8%), the fourties to fifties 58.9% by age. They avoided visiting in the winter. The average number of visiting was 7.1 times. The average treatment period was 9.9days. Majority of the elapsed time from the onset to the arrival was more than 1 year (56.6%). Low back pain (56.4%) is the most in musculoskeletal disorders and obesity (21.7%) and gynecological diseases (30.4%) were the most in a non-musculoskeletal disorders. Medication and acupuncture was the major treatment. 89.2% of the prescribed medication was the efficacy of musculoskeletal. Russian medical tourists most visited by support of travel agent (58.6%). The main reason of their visiting was non-surgical treatment for spinal disorder (31%). 96.6% of them were satisfied because rapid pain relief and kindness. Conclusions For this study, we confirmed a possibility for the Korean medical treatment of Russian tourists for medical tourism. Still, more research and goverment support for the expansion of Korean medical tourism is needed.
Cho Moon-June;Kim Ki-Hwan;Kim Byung-Kook;Song Chang-Joon;Kim Jun-Sang;Kim Jae-Sung;Jang Ji-Young
Korean Journal of Head & Neck Oncology
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v.17
no.1
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pp.59-62
/
2001
Objectives: We report an interim result of conformal radiotherapy in a patient with early stage cancer at the base of the tongue, which developed in a previously irradiated area. Materials and Methods: A 64-year-old male patient was diagnosed with T4N0M0 supraglottic cancer. He received 72Gy of radiation therapy from 21 November 1988 to 24 February 1989. He had local failure and underwent a salvage total laryngectomy on 28 August 1989. Subsequently, he did well. In early 1999, he suffered from throat pain. He had a 2.5cm ulcerative mass at the base of his tongue, in the area that had been irradiated previously. Biopsy showed squamous cell carcinoma. After workup, he was diagnosed with base of tongue cancer with T2N0M0. Surgery was not feasible because the morbidity was not acceptable. Since it was difficult to re-irradiate the area with a curable dose using conventional 2D radiation therapy with an acceptable morbidity, we decided to try conformal radiotherapy. We used 7 static beam ports with field sizes from $7x6.4\;to\;8x8cm^2$, using 6 and 10MV photons. The fractionation regimen was 1.8Gy, 5 times per week. He received 64.8Gy in 36 fractions from 9 April 1999 to 1 June 1999. Results: In the 21 months since radiotherapy, the patient has not experienced any acute or chronic complications, such as xerostomia. He experienced relief of pain shortly after the start of radiotherapy, showed a complete response, and is still doing well. Conclusion: Conformal radiotherapy can be used to treat cancer that develops within a previously irradiated field, with curative intent.
Purpose : The purpose of this study was to identify attitudes of hospice volunteers toward care of for terminally ill patients. Method : This was a descriptive study with a sample of 84 adults who were registered for a hospice volunteer education program at Severence Hospice Center. The Frommelt (FATCOD) scale on attitudes toward the care of the dying (Cronbach alpha=.778) and an open ended questions on "what if you only have 6 months to live" were used to collect the data. The data was analyzed using SPSS/W and content analysis. Results : 1) The hospice volunteers were mostly female, with an average age of 45 years, half of them were college graduates and their religious preference was Protestant. 2) The participants of this study demonstrated positive attitudes to care for the dying which is in coherence with hospice philosophy and principles. However they indicated difficulties in maintaining close relationships with people who are dying, and in communicating and sharing, and encouraging those who are dying to express their feelings. In the open ended questions, they identified that their most important issues would be guilt feelings toward their children, family concerns, and the burden of unfinished business in their lives. They also identified the fear of pain in the dying process and fear of the afterlife. The care they would like to receive was to have peace of mind, have a good listener, spiritual counselling, and pain relief and to be respected as a human being. The source of strength would be faith in God and they would like to overcome their of dying. The FATCOD scale has limitation in describing and identifying the need and attitude toward the care of the dying revisions were made. Conclusion : We all are the potential clients for the hospice rare. In a hospice volunteer education program, communication and interpersonal skill are essential. The fear of dying, afterlife, concerns about family with children, and human dignity are major concerns in hospice and palliative care.
This paper attempts to re-read Tennessee William's A Streetcar Named Desire from a non-Aristotelian perspective, particularly focusing on the audience performativity. In Chapter 6 of the Poetics, Aristotle says that tragedy has a final purpose or end (telos) and that is to inspire a catharsis (literally "purification") of pity and fear by means of representation and to give pleasure from experiencing their relief. However, a dramatic theoretician Augusto Boal argues that Aristotelian catharsis is not to get rid of pity and fear through their vehement discharge; rather, the basic function of catharsis is the purging of antisocial elements from the social body and the restoration of order because catharsis occurs when the spectator, terrified by the spectacle of the catastrophe, is purified of his "hamartia" which looks similar to the tragic flaw of the hero in the play. Thus, Boal asserts that Aristotle's coercive system of tragedy manipulates the emotions of the passive spectator. By contrast, in non-Aristotelian aesthetics, tragedy functions not as legitimation for a particular political configuration but as the performance of ethical acts-through which all the participants, including not only the actors but also the audience, communicate more actively about practical problems and actively work in order to make sense of themselves, others, and society. Here, the audience is required to restore and reinforce his/her capacity to think and to act; thus, an unquestioning, passive, indifferent attitude is not allowed. In these contexts, this paper explores how Tennessee William's A Streetcar Named Desire involves the audience in the responsibility for what occurs on the stage, in order to urge the audience's ethical judgements and responsible acts. This paper argues that what this play asks of us is not catharsis, the purging of pity and fear, but empathy toward the other's pain, beyond pity and fear, to carry out our responsibility of sharing in and caring for the other's suffering. That is to say that it will be an ethical way to "re-member" Blanche DuBoi-the iconic Williams victim "dis-membered" by traumatic memories and open wounds and is thus unable to complete her grieving and mourning-as one of us, not as the other. It will be the only way to remember right regarding her tragedy.
Park, Jung-Hyun;Yang, Doo-Hwa;Woo, Chang-Hoon;An, Hee-Duk
Journal of Korean Medicine Rehabilitation
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v.31
no.1
/
pp.17-32
/
2021
Objectives The present study was designed to find out the therapeutic effects and possible underlying mechanism of Buja-tang, a herbal complex formula on experimental monosodium iodoacetate (MIA)-induced osteoarthritis. Methods Osteoarthritis models were created via intra-joint injection of MIA (50 μL with 80 mg/mL) in rats. Rats were divided into five groups and each group consisted of seven. Normal group was not injected MIA and did a normal diet. Control group injected MIA and received distilled water. Indo injected MIA and oral administration of 5 mg/kg of indomethacin. BJTL injected MIA and oral administration of 100 mg/kg of Buja-tang. BJTH injected MIA and oral administration of 200 mg/kg of Buja-tang. We analyzed weight-bearing ability of hind paws, oxidative stress related factor, antioxidant protein, inflammatory protein, inflammatory messenger and cytokine in joint tissue. Pathological observation of knee cartilage tissue structures was also performed with hematoxylin & eosin and safranin-O chromosomes. Results Weight-bearing ability of hind paws showed a tendency to reduce pain. The incidence of nicotinamide adenine dinucleotide phosphate oxidase and p22phox in articular tissue was significantly reduced, and the incidence of nuclear factor-erythroid 2-related factor 2 and heme oxygenase-1 and superoxide dismutases was significantly increased. The incidence of phosphorylated inhibitor of κBα, nuclear factor-kappa B p65, inducible nitric oxide synthase, cyclooxygenase-2, tumor necrosis factor alpha, interleukin (IL)-6, and IL-1β decreased significantly. In pathological observation, cartilage tissue damaged by MIAs in biopsy has significantly recovered from Buja-tang administration. Conclusions Buja-tang has anti-inflammation, antioxidation and pain relief effects. So this is thought to inhibit the progress of osteoarthritis in rat caused by the MIA.
This study was conducted by applying Selby and Joiner (2009)'s Emotional Cascade Model to the phenomenon of non-suicidal self-injury of adolescents, focusing on the school counselor's counseling experience. To this end, a focus group interview(FGI) was conducted with 56 counselors who had experience in counseling self-injured adolescents, and this study applied Braun and Clake's thematic analysis(2012). As a result, 8 categories and 16 subtopics were derived: 'negative emotional experience', 'maladaptive cognitive emotional dysregulation strategy', 'experience of emotional cascade', 'temporary relief of psychological pain', 'aggravation of the emotional cascade state', 'emotional pain from nonsuicidal self-injury', 'vicious cycle of nonsuicidal self-injury' and 'difficulty in controlling behavior that co-occurs with nonsuicidal self-injury'. These results are significant in expanding the understanding regarding the non-suicidal self-injury of adolescents through the perspective of school counselors who are in a position to consider the various systems surrounding adolescents in an integrated manner. Based on the research results, implications, limitations and future research were discussed.
Jun Ik Son;Young-Seok Lee;Myeong Jin Ko;Seong-Hyun Wui;Seung Won Park
Journal of Korean Neurosurgical Society
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v.67
no.3
/
pp.354-363
/
2024
Objective : This study aims to determine the optimal dose of recombinant-human bone morphogenic protein-2 (rhBMP-2) for successful bone fusion in minimally invasive lateral lumbar interbody fusion (MIS LLIF). Previous studies show that rhBMP is an effective alternative to autologous iliac crest bone graft, but the optimal dose remains uncertain. The study analyzes the fusion rates associated with different rhBMP doses to provide a recommendation for the optimal dose in MIS LLIF. Methods : Ninety-three patients underwent MIS LLIF using demineralized bone matrix (DBM) or a mixture of rhBMP-2 and DBM as fusion material. The group was divided into the following three groups according to the rhBMP-2 usage : group A, only DBM was used (n=27); group B, 1 mg of rhBMP-2 per 5 mL of DBM paste (n=41); and group C, 2 mg of rhBMP-2 per 5 mL of DBM paste (n=25). Demographic data, clinical outcomes, postoperative complication and fusion were assessed. Results : At 12 months post-surgery, the overall fusion rate was 92.3% according to Bridwell fusion grading system. Groups B and C, who received rhBMP-2, had significantly higher fusion rates than group A, who received only DBM. However, there was no significant increase in fusion rate when the rhBMP-2 dosage was increased from group B to group C. The groups B and C showed significant improvement in back pain and Oswestry disability index compared to the group A. The incidence of screw loosening was decreased in groups B and C, but there was no significant difference in the occurrence of other complications. Conclusion : Usage of rhBMP-2 in LLIF surgery leads to early and increased final fusion rates, which can result in faster pain relief and return to daily activities for patients. The benefits of using rhBMP-2 were not significantly different between the groups that received 1 mg/5 mL and 2 mg/5 mL of rhBMP-2. Therefore, it is recommended to use 1 mg of rhBMP-2 with 5 mL of DBM, taking both economic and clinical aspects into consideration.
The Journal of the Korean bone and joint tumor society
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v.9
no.1
/
pp.12-17
/
2003
Purpose: In this report we are going to discuss about the functional evaluation and the outcome of treatment of metastatic tumor in the lower extremities treated with tumor prosthetic arthroplasty. Materials and Methods: This report is based on nine patients diagnosed as a metastatic tumor and treated by tumor prosthetic arthroplasty, from June 1998 to December 2001. Age of the patients ranged from 49 to 63 with the average of 56.3. The average follow up period was 23.4 months. Two patients had lung cancer, three had breast cancer, two had renal cancer, one colon cancer, and one had multiple myeloma. All these were primary cancers. The site of metastasis were six in proximal femur, two in distal femur, and one in proximal tibia. Tumor excision was performed after biopsy in following the principle of primary tumor management. Excision with wide surgical margin was tried as possible could. Six cases were treated with tumor prosthesis, and the other three cases were reconstructed with bone cement and arthroplasty. Results: The functional evaluation in the extremities at the last follow up was performed on Enneking evaluation score with 6 categories. The highest scored 26, and the lowest scored 10, with an average of 19.5. A case in which the patient died 15 days after the operation was excluded from the evaluation. Among the categories, emotional acceptance to postoperative function and pain relief were highly scored. At the final follow up, seven patients survived, and one colon cancer patient died 68 days after operation. Conclusion: Metastatic tumor occurring in joints of lower extremities could be treated in accordance to the treatment principle of primary tumor. By insertion of tumor prosthesis, we can get satisfactory results of function in the lower extremity and pain relief especially. So, this aspect of medical favor must be considered in treating patients.
The Journal of the Korean bone and joint tumor society
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v.13
no.1
/
pp.48-54
/
2007
Purpose: To evaluate clinical results of the tumor prosthetic replacement for pathologic fracture of the proximal femur with extensive bony destruction due to metastatic bone tumors. Materials and Methods: From 2005 October to 2006 October, resection of proximal femur and tumor prosthesis replacement was performed for metastatic bone tumors extensively involving trochanteric area in 6 patients. The mean age of overall patients was 61(range, 48~77). Mean clinical follow up was 10.5 months (range, 6~16). Primary tumor consisted with multiple myeloma in 2 patients, lung cancer in 1, breast cancer in 1, transitional cell carcinoma of the renal pelvis in 1, unknown origin in 1 patient. $MUTARS^{(R)}$ proximal femur (Implantcast, Munster, Germany) were used in all cases. The functional evaluation in the lower extremities was performed with Musculoskeletal Tumor Society 1993 scores. The degree of pain relief after surgical treatment was assessed with Visual Analogue Scale (VAS). Results: At the final follow up, all of the patients survived. The mean lower extremities functional score of Musculoskeletal Tumor Society 1993 was 17.8(59.3%)(range, 12~25). VAS was improved to 2.5 from 8.5 after the surgical treatment. Ambulation was encouraged as soon as possible and mean duration after surgery for ambulation was 7.3(range, 3~16) days. Post-operatively, there was no surgical infection, periprosthetic fracture or loosening. Dislocation occurred in one out of six cases. Conclusion: Resection of proximal femur and tumor prosthesis replacement for metastatic bone tumors around proximal femur extensively involving trochanteric area seems to be safe procedure in view of post-operative complication, and effective for functional restoration as well as pain relief. Thus, it is accordant to the treatment principle of the metastatic bone tumors.
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