• Title/Summary/Keyword: Clinical scoring system

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A Comparison of Operative Treatment of Hallux Valgus with a Proximal Metatarsal Osteotomy and with a Modified Chevron Osteotomy (근위 중족골 절골술과 변형 chevron 절골술을 이용한 무지 외반증의 수술적 치료의 비교)

  • Choi, Jae-Yeol;Shin, Hun-Kyu;Kim, Young-Hun;Kim, Hong-Kyun;Lee, Ho-Jin
    • Journal of Korean Foot and Ankle Society
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    • v.8 no.1
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    • pp.64-70
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    • 2004
  • Purpose: We compared the result of a proximal metatarsal closed wedge osteotomy and soft tissue procedure with a modified chevron osteotomy and soft tissue procedure in the treatment of hallux valgus. Materials and Methods: Between March 1999 and February 2003, we performed proximal metatarsal closed wedge osteotomy and soft tissue procedure on 17 feet (12 patients), and modified chevron osteotomy and soft tissue procedure on 12 feet (9 patients). Results: According to Mayo clinic forefoot scoring system (FFSS), group 1, with proximal metatarsal closed wedge osteotomy, shows 67.2 points postoperatively and group 2, with modified chevron osteotomy, shows 68.5 points postoperatively. In group 1, the average correction of hallux valgus angle and intermetatarsal angle was 20.8 degrees and 4.8 degrees, respectively. In group 2, the average correction of hallux valgus angle and intermetatarsal angle was 19.9 degrees and 4.7 degrees, respectively. The average shortening was 3.15 mm in group 1 and 1.38 mm in group 2. Conclusion: We obtained relatively good clinical and radiographic result in this study. The effect on shortening of the first metatarsal was greater in the proximal metatarsal closed wedge osteotomy than modified chevron osteotomy, but the metatarsal shortening did not related with metatarsalgia. So, both techniques seems optimal surgical treatment for hallux valgus deformity.

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Open Treatment of Anterior Impingement Syndrome of the Ankle in Elite Level Soccer Players (축구 선수에서 발생한 족관절 전방 충돌 증후군의 개방적 수술의 치료 결과)

  • Lee, Kyung-Tai;Young, Ki-Won;Kim, J-Young;Kim, Eung-Soo;Cha, Seung-Do
    • Journal of Korean Foot and Ankle Society
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    • v.8 no.1
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    • pp.76-80
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    • 2004
  • Purpose: We assessed the results of open treatment of anterior impingement syndrome of the ankle in elite level soccer players and concomitant injuries were idenfied. Materials and Methods: We retrospectively reviewed twenty one elite level soccer players diagnosed with anterior impingement syndrome who underwent open debridement between January 1997 and January 2002. All were men and the mean age at the operation was 21 years (range 16 to 27). The mean follow-up duration was 31 months (13 to 71). Concomitant abnormalities were idenfied through physical examination, bone scan and MRI. On a preoperative lateral radiograph, patients were classified according to McDermott's stage. Anteromedial or anterolateral approach was used at the operation and osteophyte was removed with osteotome and rongeur. When chronic ankle instability was accompanying, we performed Modified Brostrom-Gould procedure and for osteochondral lesion, multiple drilling was applied. The Ogilvie-Harris scoring system was used as a clinical scale to evaluate pain, swelling, stiffness and limitation of activity. The results were scored as excellent (15 to 16 points), good (13 to 14) and otherwise unsatisfactory. The time to return to full activity including sports activity was determined. Results: Eighteen of twenty one patients had an excellent outcome. Three patients were graded unsatisfactory and two of them abandoned their career due to the persistence of residual pain. Concomitant abnormalities were found including twelve cases of chronic ankle instability, three cases of osteochondral lesion and two cases of flexor hallucis longus tendinitis. Conclusion: Open debridement was successfully applied to the elite level soccer player with anterior impingement syndrome of the ankle. Considerable coexistence of other abnormalities such as chronic ankle instability may encourage us to consider additional operative procedure.

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The Effect of Acupuncture on the Post-Thoracotomy Pain Control (개흉술후 동통억제를 위한 침의 효과)

  • 조규석;김수철
    • Journal of Chest Surgery
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    • v.30 no.2
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    • pp.187-194
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    • 1997
  • The management of post-thoracotomy pain is on of the difficult clinical problems. A variety of pain management methods have been used with variable efficacy. We compared the effect of acupuncture with the effect of analgesics for the post-thoracotomy pain control. From March 1995 to September 1995, 20 patients who underwent elective thoracotomy were randomized into two groups. The patients were treated with analgesics in control group(n=10) and acupuncture in the other group(n: 10). Postoperative analgesic effects were evaluated by the scoring system which was made by the Department of Thoracic and Cardiovascular Surgery, Korea University Medical Center. No significant difference was observed between two groups concerning the subjective pain and limitation of motion of operated side. Although the number of analgesic requirement was reduced significantly in the acupuncture group(P < 0.05). We conclude that acupuncture is an effective method to control post-thoracotomy pain and it is safer than the analgesics bacause of its lower side effects.

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Effect of Step-up and Step-down Hyperthermia on Skin of Mice (온열요법시 온도변화가 정상조직에 미치는 영향)

  • Choi, Ihl-Bohng;Kim, Choon-Yul;Bahk, Yong-Whee
    • Radiation Oncology Journal
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    • v.6 no.2
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    • pp.155-161
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    • 1988
  • The usefulness of hypertermia for cancer therapy have well been established. The purpose of the present investigation was to ascess the effect of step-up $(42^{\circ}{\rightarrow}44^{\circ}C$ sequence) and step-down $(44^{\circ}{\rightarrow}42^{\circ}C$ sequence) heating on the skin of the hind foot of the mouse. Hyperthermic treatments were given by immersion the hind foot of the mouse in circulating water baths. Skin response was studied by the leg reaction, which was scored according to a numerical scoring system proposed by Urano et al (1980). The results were as follows 1. The skin damage of $44^{\circ}C$ control group was more severe than $42^{\circ}C$ control group (P<0.05), except for 15 min. heating group. 2. The Skin damage of step-down group was more severe than step-up group (P<0.05). 3. The skin damage of $44^{\circ}C$ control group was more severe than step-up group when there is no difference in $44^{\circ}C$ heating time of step-up group from $44^{\circ}C$ control group (P<0.05). 4. In step-down group, the skin damage was more severe than $44^{\circ}C$ control group after preheating 45 min at $44^{\circ}C$ (P<0.05). Therefore, the above findings suggest the normal tissue damage by step-up heating was correlated with heating time of post step-up. The dropping of heating temperature in late phase had more severe damage of the skin than that in early phase during hyperthermia, and so contineous control of satisfactory temperature should be considered as the one of the most important factor for prognosis, complications of clinical hyperthermia

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Mini-Open Repair in Large and Massive Rotator Cuff Tears (소절개 봉합술을 이용한 대범위 이상 회전근 개 파열 환자의 치료 결과)

  • Chung, Soo-Tai;Kim, Hyung-Soo;Yoo, Jeong-Hyun;Park, Jae-Hyung;Kim, Joo-Hak;Jung, Kwang-Gyu;Lee, Joong-Hyo
    • Clinics in Shoulder and Elbow
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    • v.9 no.2
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    • pp.176-180
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    • 2006
  • Purpose: Although surgical arthroscopic repair of rotator cuff has become much more common as surgeons have developed proficient techniques, it is still technically difficult. The purpose of this study was to evaluate the clinical results and the usefulness of mini-open repair in large and massive size tears. Materials & Methods: From January 2000 to December 2004, sixteen patients were treated with mini-open repair. There were 10 male and 6 female patients with the average age of 62.5 years. The size of tear was massive in 4 cases and large in 12 cases. All tears were repaired with metal anchor sutures. The mean duration of follow-up period was 23 months. Postoperative results were evaluated based on American Shoulder and Elbow Society scoring system. Results: Five patients showed excellent results, five good, and two fair in large tears while one patient showed excellent result, one good, and two fair in massive tears. Poor outcome was not seen during the follow-up period. There was no significant relationship between the patient's age and the size of tear, and postoperative results. However, the relationship between the duration of symptomatic period in preoperation and postoperative results showed significant correlation. Conclusion: Mini-open repair combined with the preservation of deltoid and early rehabilitation is clinically useful in large and massive size rotator cuff tear patients treatment.

Effects of Insamsansa-eum (Renshenshanzha-yin) on Hypercholesterolemia and Analysis of Its Effects according to the Pattern Identification

  • Park Seong-Uk;Jung Woo-Sang;Moon Sang-Kwan;Cho Ki-Ho;Kim Young-Suk;Bae Hyung-Sup;Ko Chang-Nam
    • The Journal of Korean Medicine
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    • v.27 no.2 s.66
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    • pp.253-261
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    • 2006
  • Backgrounds : Hyperlipidemia is a major cause of cardiovascular disease (CVD). Lowering serum cholesterol levels could reduce the risk of CVD. Insamsansa-eum (Renshenshanzha-yin, ISE), composed of Ginseng Radix and Crataegii Fructus, is a new medicine developed to treat hyperlipidemia and CVD. Objectives : In this study, we intended to explore the clinical effects of ISE on patients with hypercholesterolemia, and moreover we also compared its effects according to the pattern identification. Methods : Subjects were administered ISE with the dose of 600 mg three times a day for 4 weeks. Patterns of subjects were identified with diagnostic scoring system for Yin-Yang and the condition of Excess-Deficiency before treatment. Serum lipids were measured at baseline and after 4 weeks of medication. Results : ISE lowered total cholesterol(TC), triglyceride(TG), total lipid(TL), phospholipid(PL) and low density lipoprotein cholesterol(LDL) significantly. Compared with the data of our previous study, it was less effective than Atorvastatin but showed equal lipids-lowering effect to Chunghyul-dan (Qingxue-dan, CHD). In Yang pattern group, ISE was less effective in lowering TG and LDL than it was in not-Yang-not-Yinpattern group. On safety assessment, there was no adverse effect, hepatic or renal toxicity. Conclusions : We suggest that ISE is a safe and useful herbal medicine for hypercholesterolemia, and moreover it could be more useful when it is used for patients with not Yang pattern.

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A prospective study to assess the efficacy and safety of oral propranolol as first-line treatment for infantile superficial hemangioma

  • Yun, Yeong Ju;Gyon, Yun Hee;Yang, Sohyoung;Lee, Youn Kyung;Park, Joohyun;Park, Meerim
    • Clinical and Experimental Pediatrics
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    • v.58 no.12
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    • pp.484-490
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    • 2015
  • Purpose: To determine the efficacy and safety of oral propranolol as a first-line treatment for superficially located infantile hemangioma (IH) and propose an assessment tool to measure treatment response. Methods: Patients with superficial IH under 1 year of age were prospectively recruited between May 2012 and December 2013 at the Department of Pediatrics of Chungbuk National University Hospital. Propranolol was administered to 12 infants (median age, 3.8 months) while monitoring cardiovascular and adverse metabolic effects. If a patient showed no adverse events, the dosage was gradually increased up to 3 mg/kg/day and maintained for 1 year. We used our own scoring system to assess treatment response using parameters like change in color, and longest diameter, and thickness of the IH. Results: Eleven out of 12 patients completed the protocol with consistent improvement of hemangiomas during therapy. Patients on propranolol showed a more than 50% involution in the first 3 months, with additional steady involution until 1 year. Patients with the highest scores at 1 month maintained their score and showed better responses until treatment termination. The patient with the lowest score at 1 month did not show any further regression and stopped propranolol treatment 4 months after initiation. In two children with recurrences after successful therapeutic regression, propranolol was effective after being reintroduced. Propranolol treatment was not interrupted in any patient due to adverse events. Conclusion: Oral propranolol at 3 mg/kg/day showed a consistent, rapid, and therapeutic effect on superficial IHs without significant adverse events.

Simple Decompression of the Ulnar Nerve for Cubital Tunnel Syndrome

  • Cho, Yong-Jun;Cho, Sung-Min;Sheen, Seung-Hoon;Choi, Jong-Hun;Huh, Dong-Hwa;Song, Joon-Ho
    • Journal of Korean Neurosurgical Society
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    • v.42 no.5
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    • pp.382-387
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    • 2007
  • Objective : Cubital tunnel syndrome is the second most common entrapment neuropathy of the upper extremity. Although many different operative techniques have been introduced, none of them have been proven superior to others. Simple cubital tunnel decompression has numerous advantages, including simplicity and safety. We present our experience of treating cubital tunnel syndrome with simple decompression in 15 patients. Methods : According to Dellon's criteria, one patient was classified as grade 1, eight as grade 2, and six as grade 3. Preoperative electrodiagnostic studies were performed in all patients and 7 of them were rechecked postoperatively. Five patients of 15 underwent simple decompression using a small skin incision (2 cm or less). Results : Preoperative mean value of motor conduction velocity (MCV) within the segment (above the elbow-below the elbow) was $41.8{\pm}15.2\;m/s$ and this result showed a decrease compared to the result of MCV in the below the elbow-wrist segment ($57.8{\pm}6.9\;m/s$) with statistical significance (p<0.05). Postoperative mean values of MCV were improved in 6 of 7 patients from $39.8{\pm}12.1\;m/s$ to $47.8{\pm}12.1\;m/s$ (p<0.05). After an average follow-up of $4.8{\pm}5.3$ months, 14 patients of 15 (93%) reported good or excellent clinical outcomes according to a modified Bishop scoring system. Five patients who had been treated using a small skin incision achieved good or excellent outcomes. There were no complications, recurrences, or subluxation of the ulnar nerve. Conclusion : Simple decompression of the ulnar nerve is an effective and successful minimally invasive technique for patients with cubital tunnel syndrome.

Expression of BMP6 is Associated with its Methylation Status in Colorectal Cancer Tissue but Lacks Prognostic Significance

  • Sangplod, Patcharaporn;Kanngurn, Samornmas;Boonpipattanapong, Teeranut;Ruangrat, Pritsana;Sangkhathat, Surasak
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.17
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    • pp.7091-7095
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    • 2014
  • Background: The study aimed to evaluate the incidence of CpG island promoter methylation of BMP6, a member of the transforming growth factor beta family, in tissue samples from colorectal cancers (CRC) and look for its association with BMP6 expression and clinicopathological correlation. Materials and Methods: Methylation specific PCR for the BMP6 promoter region was performed with 85 frozen tissue samples of CRC and 45 of normal colon. Methylation status of MLH1 was also determined by the same method. Expression of BMP6 was evaluated by immunohistochemistry (IHC), using Allred's scoring system. The methylation status was analyzed against clinical and pathological parameters in CRC. Results: The study revealed BMP6 hypermethylation in 34 of 85 tumor specimens (40%), and 15 out of 45 normal tissue samples from CRC (33%). The incidence of hypermethylation was inversely correlated with IHC score. Allred's scores of 7 or more were correlated with lower frequency of BMP6 hypermethylation (29% compared to 50% in the remaining, p-value 0.049). However, there was no association between hypermethylation status and any clinicopathological parameters. The methylation status of BMP6 was not correlated with that of MLH1, a key methylation determinant in CRC. On survival analysis, there was no significant difference in progress-free survival (PFS) between the cases with and without hypermethylation (2-year PFS 74% and 76%, respectively). Conclusions: CpG island methylation of BMP6 is found in high frequency in CRC and this epigenetic event is associated with suppressed protein expression in the tumor tissue. However, the marker is not associated with tumor progression of the disease.

Extracts of Desmodii Herba Suppresses of Rheumatoid Arthritis (류마티스 관절염에서 광금전초 추출물의 관절염 억제 효과)

  • Noh, Eun Mi;Song, Hyun Kyung;Kim, Jeong Mi;Lee, Guem San;Kwon, Kang Beom;Lee, Young Rae
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.31 no.6
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    • pp.328-333
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    • 2017
  • Desomodii Herba (DH) has been shown to exhibit pharmacologyical activities, such as increase myocaridal contraction and secretion of hepatic bile. DH is used to reduce pain caused by rheumatoid arthritis(RA) in Korean medicine. However, the DH exact(DHE) effect and mechanism on rheumatoid arthritis are unknown. In this study, we aimed at the inhibitory effect of DHE on rheumatoid arthritis, and investigated the effect in collagen-induced mice arthritis model and TNF-${\alpha}$ induced MMP-1 and MMP-3 expression including the molecular basis in rheumatoid arthritis synovial fibroblasts (RASFs).The effect of DHE on RA was measured by clinical scoring system. In RASFs, expression of MMP-1 and MMP-3 was assessed by Western blotting and real-time PCR. Also, Western blotting used to evaluate the phosphorylation levels of p38, ERK and JNK and activation of NF-${\kappa}B$ and AP-1. Our results showed that DHE reduced collagen-induced arthritis in mice. DHE inhibits TNF-${\alpha}$ induced MMP-1 and MMP-3 expression and mRNA levels in RASFs. The inhibitory effect of DHE was mediated by the inhibition of the AP-1/JNK signaling pathway. Taken together, our results suggest that the DHE may have preventive potential for rheumatoid arthritis.