Objectives: Medically unexplained fatigue includes chronic fatigue syndrome (CFS) and idiopathic chronic fatigue (ICF). These disorders quite impair quality of life while no effective therapies exist. Therefore, patients with CFS or ICF frequently choose treatments based on traditional Korean medicine. The study aimed to analyze characteristic of patients visiting an Oriental clinic with CFS or ICF. Methods: Patients who met criteria for CFS or ICF were enrolled in this study, from March 2011 to Jun 2013. Clinical information focused on symptom differentiation and Sasang constitution was analyzed. Pearson's chi-square test was used to compare the frequency among sub-groups. Results: In total, 77 patients (49 male and 28 female) were diagnosed with CFS (17 male and 13 female) or ICF (32 male and 15 female). The symptom differentiation was 37.7%, 26.0%, 13.0%, and 23.3% for "Qi deficiency of both spleen and lung (脾肺氣虛)", "Yin deficiency of both liver and kidney (肝腎陰虛)", "Blood deficiency of both heart and spleen (心脾血虛)" and "Yang deficiency of both spleen and kidney (脾腎陽虛)", while Sasang constitutional distribution was 59.7%, 22.1% and 18.2% Soeumin, Taeumin and Soyangin, respectively. The fatigue severity was notably different between CFS ($63.7{\pm}12.1$) or ICF ($52.2{\pm}15.3$) according to the Chalder fatigue scale (10-point scale for eleven questions). There was statistical significance regarding symptom differentiation and Sasang constitution (p < 0.05). Conclusions: In the process of traditional Korean medicine-based development of therapeutics for patients with chronic fatigue or related conditions, this report can serve as reference data.
Background: Chronic headache (CH) constitutes a significant public health problem, impacting on both the individual sufferer and society. Patients with CH, unresponsive to drug therapy or nerve block, suffer considerable disability due to the frequency and severity of attacks; therefore, they should be considered for novel therapy. Botulinum toxin type A (BoNT-A) has shown significant promise in the management of CH. In this paper, we review recent evidence on the efficacy of BoNT-A, and also report our experience with this treatment in CH patients. Methods: BoNT-A was used to treat 69 CH patients, including 47 in a chronic migraine group and 22 in a non-migraine CH group, who showed therapy-resistance to palliative drug or nerve block. We investigated the demography, dosage and site of BoNT-A injection, and used a visual analogue scale (VAS) for pain and the degree of satisfaction. The data were analyzed using t-tests and a Friedman repeated measures analysis of variance on ranks. Results: Significant decreases in the VAS for pain were found in both the chronic migraine and non-migraine CH groups, from 2, 4 and 12 weeks and from 4 and 12 weeks, respectively, after BoNT-A administration (P < 0.05). The chronic migraine group showed significantly lower VAS scores for pain than the non-migraine CH group from 2, 4 and 12 weeks after the BoNT-A administration (P < 0.05). Twenty eight patients (59.2%) in the chronic migraine group and eight (36.4%) in the non-migraine CH were satisfied with the BoNT-A treatment. Conclusions: This clinical study revealed that the use of BoNT-A demonstrated efficacy for CH patients resistant to drug therapy or nerve block. Moreover, BoNT-A proved itself more effective in the chronic migraine than non-migraine CH group.
Hye Jeon Hwang;Sang Min Lee;Joon Beom Seo;Jae Seung Lee;Namkug Kim;Sei Won Lee;Yeon-Mok Oh
Korean Journal of Radiology
/
제21권9호
/
pp.1104-1113
/
2020
Objective: To assess the regional ventilation in patients with asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) using xenon-ventilation dual-energy CT (DECT), and to compare it to that in patients with COPD. Materials and Methods: Twenty-one patients with ACOS and 46 patients with COPD underwent xenon-ventilation DECT. The ventilation abnormalities were visually determined to be 1) peripheral wedge/diffuse defect, 2) diffuse heterogeneous defect, 3) lobar/segmental/subsegmental defect, and 4) no defect on xenon-ventilation maps. Emphysema index (EI), airway wall thickness (Pi10), and mean ventilation values in the whole lung, peripheral lung, and central lung areas were quantified and compared between the two groups using the Student's t test. Results: Most patients with ACOS showed the peripheral wedge/diffuse defect (n = 14, 66.7%), whereas patients with COPD commonly showed the diffuse heterogeneous defect and lobar/segmental/subsegmental defect (n = 21, 45.7% and n = 20, 43.5%, respectively). The prevalence of ventilation defect patterns showed significant intergroup differences (p < 0.001). The quantified ventilation values in the peripheral lung areas were significantly lower in patients with ACOS than in patients with COPD (p = 0.045). The quantified Pi10 was significantly higher in patients with ACOS than in patients with COPD (p = 0.041); however, EI was not significantly different between the two groups. Conclusion: The ventilation abnormalities on the visual and quantitative assessments of xenon-ventilation DECT differed between patients with ACOS and patients with COPD. Xenon-ventilation DECT may demonstrate the different physiologic changes of pulmonary ventilation in patients with ACOS and COPD.
Background: The purpose of this study was to systematic review the effect of exercise programs for chronic low back pain patients. We needs systematic development of low back pain exercise program to reduce economic cost further doing great service to public health promotion. Methods: We searched to the effects of exercise programs for chronic low back pain patients by Dankook University electronic library databases of DBPIA, KSI KISS, CINAHL, MEDLINE and PEDro combined with a hand search of papers published in relevant journals. Any type of study relevant to the topic published during time period from 1970 to 2007 was included. Results: The literature search identified 30 studies. 1.Performing the flexion exercise increased abdominal muscle activity but acute herniated intervertebral disc should be avoided. 2.The general lumbar extension exercise used lumbar extension machine and the muscle power increases, significant probability the change. 3.The spinal segments exercise for the patients offered significant efficacy and appeared to be a reasonable therapeutic option. 4.Spinal stabilization exercises appear to improve trunk endurance and balance to patients with chronic low back pain. This exercise programs had effective decrease pain and disability. Conclusion: The review suggests that although the exercise programs for chronic low back pain patients, and we expected the efficacy of the exercise programs for chronic low back pain patients used in this study should be further investigated in a long period study and objective outcomes.
The object of this study is in the comparison of level of depression between patients with chronic low back pain & normal adult, of the relation between reduction of pain & level of depression and in the examination of the influence of traditional physical therapy against the reduction of pain & level of depression of the patients with chronic low back pain for the new recognition of psychological factors to the physical therapists as well as patients. This study was targeted for 40 patients with chronic low back pain who were diagnosed as lumbar sprain & herniated intervertebral disk and compared & analyzed how traditional physical therapy has an influence to their reduction of pain and level of depression by questioning with visual an analog scale of Beck's depression inventory & pain inventory to them. The results are as follows. 1. Traditional physical therapy has an effect in the reduction of pain of the patients with chronic low back pain. 2. Although traditional physical therapy relieved a little the level of depression of patients with chronic low back pain. there was no evident effect statistically. 3. In the relation between the reduction of pain and level of depression, level of depression also showed somewhat relief according to the reduction of pain and appeared that they have some relationship. However, it's degree was not big. 4. In the comparison of the level of depression between the normal adult and the patient with chronic low back pain, the level of depression of the patient with low back pain are high rather than that of normal adult.
Purpose: Temporomadibular disorders (TMDs) can result in chronic pain, which is often associated with psychological and sleep disturbance. Increased levels of psychological and sleep impairments are often related with poor treatment outcomes. The purpose of the present study was to evaluate clinical features, psychological profiles and the prevalence of clinical insomnia in TMD patients with chronic pain and to suggest an effective treatment approach. Methods: A total of 200 TMD patients who had visited the Pusan National University Hospital dental clinic for treatment of their pain were recruited from June 2018 through December 2019. TMD patients were classified into an acute (n=100) and chronic (n=100) group and compared the clinical symptoms. The primary diagnosis of TMD were categorized as TMD with joint pain group (TMD_J), TMD with muscle pain group (TMD_M) and TMD with joint-muscle mixed pain group (TMD_JM). Self- report measures of sleep quality and psychological profiles were evaluated via the Insomnia Severity Index (ISI) and the Korean Stress Response Inventory (SRI). Independent t-tests, Mann-Whitney U-tests, and chisquared test were used for the statistical analysis. Results: Chronic TMD patients showed higher pain intensity, as well as higher prevalence of related symptoms (headache, musculoskeletal pain) and myogenous pain. They also had significantly higher scores in all SRI parameters and a higher percentage of clinical insomnia than acute TMD patients. Conclusions: Based on the above results, psychological profiles and sleep quality assessments are necessary to provide essential data that will allow for improved treatment of chronic TMD patients.
The purpose of this study was to identify the differences of the static and the dynamic balance reactions in the flexion syndrome (FS) and the extension syndrome (ES) group of the patients with chronic lowback pain (LBP) and healthy subjects. Twenty subjects were included in each group. By using EquiTest 5.02, the static balance was measured by the equilibrium score and the strategy score of sensory organization test (SOT), while the dynamic balance was measured by the latency of motor control test (MCT) and the sway energy of adaptation test (ADT). Oswestry Disability Index (OSI) was used to measure level of the disability in patients with chronic LBP. The equilibrium scores, the strategies of SOT, and thelatencies of MCT of three groups were compared with one way ANOVA, while the sway energy of ADT was compared with repeated measures one way ANOVA. The results of this study showed that the equilibrium scores and the strategy scores of SOT were significantly lower in patients with chronic LBP than in healthy subjects. The equilibrium scores and the strategy scores of SOT were significantly differences between the FS and ES groups in condition 5 (support surface was sway-referenced and visual information waseliminated by eye closure), and 6 (support surface was sway-referenced and visual information was altered by sway-referencing). The FS group showed delayed average reaction time at large posterior translation, however, the ES group showed delayed average reaction time at large anterior translation, Even though the sway energy of the patients with chronic LBP were greater than that of healthy subjects during the toe down (plantar flexion rotation), the values between the FS and ES groups didn't show any significant difference. The disability level showed highly correlation with the equilibrium score of the condition 5. As the results, the FS and ES groups divided by the their symptoms and signs in patients with chronic LBP showed different balance reaction. Therefore, more accurate evaluation and balance treatments are needed to focus on their symptoms and signs in patients with chronic LBP.
Purpose : The purpose of this study is to examine the effect of the electro-acupuncture stimulation into the multifidus for the lumbar flexibility improvement and pain reduction. The subjects were consisted of 20 women patients with chronic low back pain. Methods : 20 women patients with chronic low back pain voluntary participated for the research. 15 minute electro-acupuncture stimulation(frequency: 4Hz, Intensity: below threshold of pain) with Infra-red therapy, 3 times a week during 6 weeks period. Acupuncture application given to the patients' trigger point of the multifidus. The Application of multifidus was L3, L4, L5 spinal vertebra levels Short form McGill pain questionnaire (SFMPQ) was used to measure patient's pain level. Lumbar flexibility measurement was trunk flexion and trunk extension. Global Perceived Effect Scale(GPES) was used to measure recovery or worse of patient's condition. Results : SFMPQ was after treatment showed significantly decreased more than before stimulation treatment (P<.05). Lumbar flexibility was after treatment showed significantly increase more than before treatment(P<.05). GPES was after treatment showed significantly increased more than before treatment(p<.05). Conclusion : This study will be used as treatment method of patient with chronic LBP. The multifidus muscle in chronic LBP patients clinical significance. Most of chronic LBP patients have multifidus contraction pattern. So chronic LBP patients necessary multifidus muscle release treatment.
Purpose: At the beginning of the Coronavirus disease (COVID-19) epidemic, physicians paid close attention to children with chronic diseases to prevent transmission or a severe course of infection. We aimed to measure the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody levels in children with chronic gastrointestinal and liver diseases to analyze the risk factors for infection and its interaction with their primary disease. Methods: This cross-sectional study analyzed SARS-CoV-2 antibody levels in patients with gastrointestinal and liver diseases (n=141) and in healthy children (n=48) between January and February 2021. Results: During the pandemic, 10 patients (7%) and 1 child (2%) had confirmed COVID-19 infection (p=0.2). The SARS-CoV-2 antibody test was positive in 36 patients (25.5%) and 11 children (22.9%) (p=0.7). SARS-CoV-2 antibody positivity was found in 20.4%, 26.6%, 33.3%, and 33.3% of patients with chronic liver diseases, chronic gastrointestinal tract diseases, cystic fibrosis, and liver transplantation recipients, respectively (p>0.05, patients vs. healthy children). Risk factors for SARS-CoV-2 antibody positivity were COVID-19-related symptoms (47.2% vs. 14.2%, p=0.00004) and close contact with SARS-CoV-2 polymerase chain reaction-positive patients (69.4% vs. 9%, p<0.00001). The use, number, and type of immunosuppressants and primary diagnosis were not associated with SARS-CoV-2 antibody positivity. The frequency of disease activation/flare was not significant in patients with (8.3%) or without (14.2%) antibody positivity (p=0.35). Conclusion: SARS-CoV-2 antibodies in children with chronic gastrointestinal and liver diseases are similar to that in healthy children. Close follow-up is important to understand the long-term effects of past COVID-19 infection in these children.
Objectives: Current studies are debating on the association of vascular calcification and the benefit of treatment to lower serum phosphorus level in patients with chronic kidney disease. The aim of this study was to evaluate the association of mortality and risk of vascular calcification in patients with CKD who were taking phosphate binders. Methods: This study was conducted through retrospective medical chart review for 420 patients aged 18 years and older who were admitted for chronic kidney disease. Results: Vascular calcification was not statistically significantly associated with increased mortality in patients with CKD [16.7% vs. 19.2%; 95% CI; 0.388 to 1.818 (p=0.656)]. Intervention of calcium-based phosphate binders was not significantly associated with vascular calcification in patients with CKD [9.1% vs. 12.5%; 95% CI; 0.364 to 1.358 (p=0.292)]. Ca x P product ${\geq}55mg^2/dL^2$ was not significantly associated with increased 1 year mortality in patients with CKD [25.4% vs. 17.5%; 95% CI; 0.851 to 3.013 (p=0.142)]. Intervention of sevelamer was significantly associated with reduced 1 year mortality in patients with CKD than that of patients who did not take sevelamer [6.3% vs. 25.3%; 95% CI; 0.044 to 0.880 (p=0.020)]. Conclusion: There was not a statistically significant association between vascular calcification and phosphate binder's use. But phosphate binder use was significantly associated with decreased mortality in patients with CKD.
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