• Title/Summary/Keyword: Conservative Surgery

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Arthroscopic Treatment for Residual Pain after Ankle Fracture (족근관절 골절 치료후 발생한 동통에 대한 관절경의 이용)

  • Lee Beom Koo;Park Hong Kee;Seong In Ho;Kim Keon Beom;Jang Young hun;Choi Jang Seok
    • Journal of the Korean Arthroscopy Society
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    • v.4 no.1
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    • pp.61-66
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    • 2000
  • Purpose : The diagnosis of the causes of residual pain after ankle fractures and the treatment is not simple. The authors analyzed the clinical results of the patients with residual pain after ankle fracture fur whom ankle arthroscopy was undertaken, for the purpose of evaluating the efficacy of arthroscopic diagnosis and treatment. Materials and Methods : From January 1997 to June 1998, ankle arthroscopy was done for the seventeen patients suffering from residual ankle pain and limitation of motion after ankle fracture. Their symptoms were not improved despite conservative treatment. There were sixteen men and one woman, and their mean age was 37.4 years. Result : Radiological examination revealed loose bodies in two patients, and osteophytes at the anterior rim of the tibia in fourteen patients. By the classification of osteoarthritic change, three ankles were assigned to grade 0, eight to grade I, six to grade II, and none to grade III. On arthroscopic examination, soft tissue impingement was found In thirteen cases, loose bodies in five cases, and osteochondral lesions in four cases. For arthroscopic treatments, removal of soft tissue, abrasion of osteophytes, cartilage shaving and removal of loose bodies were done. Clinical results were evaluated using Evanski and Waugh score. Preoperative overall score of 58.7 points jumped to 74.6 points after the operation, and in fourteen patients$(82\%)$ the symptoms were improved. Conclusion : Ankle arthroscopy is considered to be a very useful diagnostic and treatment method fer the patients with residual complaints after ankle fracture.

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Diagnostic and Therapeutic Utility of Ultrasonography-guided Facet Joint Block in Chronic Cervical Spinal Pain (만성 경추 동통 환자에서 초음파를 이용한 후관절 차단술의 진단 및 치료적 유용성)

  • Kim, Tae Kyun;Shim, Dae Moo;Oh, Sung Kyun;Choi, Byong San;Han, Sang Su
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.3 no.2
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    • pp.54-58
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    • 2010
  • Purpose: In patients with chronic cervical pain, the facet joint is the source of the majority. Due to the difficulty of identifying the exact location of the joint that causes these symptoms, the possibility of complications and the placebo effect brings clinical application into question. In this study, we assessed the prevalence of patients with chronic cervical pain and report the diagnostic and therapeutic usefulness of ultrasonography - guided facet joint block therapy. Materials and Methods: Patients with nonspecific chronic cervical pain for more than 6 months were selected. Patients with disc herniation, sciatica-related pain were excluded from the study and 160 patients who failed in conservative treatment (physical therapy, chiropractic therapy, medication) were included in the study. Diagnostic Ultrasonography-guided facet joint block was performed with 1% lidocaine, and after two weeks, Bupivacaine 0.25% was used in patients who tested positive for lidocaine. Patients with more than 75% pain reduction during movement after facet joint block were considered positive. Results: Among the 160 patients with chronic cervical pain, 96 patients(60%) had a positive reaction after facet block using lidocaine. Among the 64 patients with a negative reaction to lidocaine, 48 patients(75%) had a positive reaction to bupivacaine. There were 48 false positive patients(50%) who showed a positive reaction to lidocaine but a negative reaction to bupivacaine. The mean VAS of the total 160 patients before blocks was 8.5, after 2 weeks follow up it decreased to 2.7 (p = 0.001) and after 4weeks 3.6 (p = 0.001). The 8 patients as an initial improvement of symptoms are not satisfied with the procedure and the 3 patients had been worsened during observation, were showed pain relief after additional ultrasonography-guided facet joint block at 4th week. Conclusion: A single ultrasonography-guided block to chronic cervical pain patients has relatively low diagnostic value since high false positive rate. The twice facet joint blocks is thought to be a useful method for interventional pain management of patients with chronic cervical pain.

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Results of Arthroscopic Debridement of the Elbow Osteoarthritis (주관절 골관절염에서 관절경적 변연절제술 후 결과)

  • Chun, Churl-Hong;Kim, Jung-Woo;Lim, Jae-Chang
    • Clinics in Shoulder and Elbow
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    • v.12 no.1
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    • pp.53-60
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    • 2009
  • Purpose: Primary osteoarthritis on the elbow is the result of the growth of osteophytes and contracture of the capsule. It often causes disability on joint motion and pain while exercising. As arthroscopy has developed, the arthroscopic diagnosis and treatment of the elbow have recently become more generalized as well. Therefore, we like to report on arthroscopy for treating elbow arthritis and its results. Materials and Methods: This study includes 23 cases of elbow arthritis that were seen between 2005 June to 2007 June and these patients didn't response to conservative treatment. From this we excluded 18 cases that underwent arthroscopic surgery and among these 18 cases, 6 cases underwent ulnar nerve transfer. The average observation time was 21.3 months and the average age was 48.4 years (range: 22-66 years). The pre and post operative pain was evaluated with using the Visual Analogue Scale (VAS) and functional evaluation was done with using the Mayo elbow Performance Score (MEPS) with the range of joint motion. Results: The VAS score at the last follow up was significantly decreased from 3.4 to 1.9 compare to the preoperative score. The range of joint motion was improved by 25 (0-40) to 8.5 (0-20) in extension and 101.7 (80-140) to 125.2 (85-140) in flexion (p<0.05). The MEPS always showed significant improvement by showing an increase from 65.4 (40-85) to 87.9 (55-100). However, 3 cases showed a decreased range of motion after the operation. One case showed ulnar nerve symptoms after surgery. Conclusion: An arthroscopic procedure can treat the pathologic processes associated with arthritis of the elbow and it was safe and effective in this series.

A Study on the Dental Fear, Anxiety, Depresison and the Stress Symptom in Orafacial Region in Dental Outpatients (치과외래환자에서 공포, 불안, 우울 및 구강안면부 스트레스증상에 관한 연구)

  • 박미성;한경수
    • Journal of Oral Medicine and Pain
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    • v.23 no.4
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    • pp.387-401
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    • 1998
  • This study was performed to investigate the emotional state related to dental fear, hospital anxiety and depresison, and frequency of stress symproms of orofacial region. For this study, Dnetal Fear Surfey(DFS) scale, the Hospital ANxiety and Depression(HAD) scale, and Stress Symptom Questionnaire(SSQ) designed by the author were used in 549 dental outpatients. Dental Fear Survey scale is composed of avoidance of dentistry(AVOI), physiologic response scale(PRS) and dental stimulus response scale(DSRS). The Hospital anxiety and Depresiosn scale is composed of hospital anxiety(HA) and hospital depressoin (HD). Data were analyzed statistically with SPSS program and the results were as follows : 1. The item of the highest positive response rate in DFS scale was 'feeling drill'(82.0%), and in the HAD scale was ' feel as if I am slowed down'(84.1%). 2. Mean score of AVOI, PRS, DSRS and HD were higher in the older group(>25yr) than the yoiunger group(<25yr) and female patients showed higher score of DSRS, HA than male patients. 3. Mean number of items of stress symptoms in extraoral region were 3.4, and in intraoral region, were 4.7. Tongue wymptoms were increased in the older toup and female patients had more stress symptoms than male patients. 4. Correlation between DFS scale and HAD scale were significantly positive and these scales were also apositively correlated with tongue symptoms. 5. As for treatment types, the patients treated in the department of periodontics,conservative dentistry, and oral surgery showed higher score of DFS scale than the patients with temporomandibular disorders or treatedin the department of orthodontics.

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A Case of Idiopathic Chylothorax and Chyluria (원인 미상으로 Chylothorax와 Chyluria가 병발한 1예)

  • Choi, Jung Min;Oh, Hyoung-Chul;Yi, Myung Zoon;Yun, Jae Pil;Kim, Jae Il;Kim, Woo Sung;Kim, Dong Soon;Kim, Won Dong;Shim, Tae Sun
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.4
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    • pp.377-380
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    • 2004
  • We report a rare case of idiopathic chylothorax and chyluria. A 31 year-old woman was referred to our hospital with a right-sided pleural effusion. Cream-colored pleural fluid and urine were confirmed as chylothorax and chyluria, respectively, by a lipoprotein electrophoresis. Even though she had previously underwent surgery for pelvic fibrosarcoma and experienced its recurrence, there has been no change of mass size and no evidence of thoracic duct or urinary tract obstruction as of the moment. Hence, idiopathic chylothorax and chyluira was diagnosed. Because she responded poorly to conservative treatment, thoracic duct ligation and pleurodesis were performend ; wherease chyluria was resolved spontaneously.

Effects of hand grip strength on shoulder muscle activity in breast cancer patients

  • Yun, Tae-Won;Lee, Byoung-Hee
    • Physical Therapy Rehabilitation Science
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    • v.5 no.2
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    • pp.95-100
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    • 2016
  • Objective: The purpose of this study was to investigate effects of hand grip strength on the muscle activation of shoulder joint in breast cancer patients. Design: Cross-sectional study. Methods: Ten breast cancer patients who agreed to active participation were included. These patients were operated with either conservative surgery or segmental mastectomy, and then were treated with radiation therapy and chemotherapy. The activity of the upper trapezius, lower trapezius, supraspinatus and serratus anterior muscle were measured using surface electrodes during 4 hand gripping tasks (lowered their arms in standing position, 0%, 30%, and 50% of maximum voluntary contraction) in the scapular abduction plane. Results: The results were analyzed using a one-way repeated measures ANOVA. There was a significant difference in the lower trapezius and supraspinatus muscles according to grip strength, lower trapezius and supraspinatus muscles showed significantly difference according to grip strength (p<0.05). The result of the muscle activation according to hand strength (0%, 30%, and 50%) it showed a significant difference between the upper trapezius and supraspinatus in 0% grip strength (p<0.05). In addition, it did not show a significant difference between muscles in 30%, 50% hand strength. Conclusions: This study showed an increase in shoulder muscle activation with increasing hand grip strength with the upper trapezius muscle being more activated than other muscles in 0% grip strength. The finding of this study suggests usefulness for development of preventative measures and rehabilitation strategies for increasing shoulder motor function in patients with breast cancer.

Laser therapy in peri-implantitis treatment: literature review (임플란트주위염 처치에서 레이저의 이용: 문헌고찰)

  • Lee, Kyung-Joong;Lee, Jong-Ho;Kum, Kee-Yeon;Lim, Young-Jun
    • Journal of Dental Rehabilitation and Applied Science
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    • v.31 no.4
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    • pp.340-348
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    • 2015
  • Peri-implantitis is the most common reason for a late failure and can occur even after years of successful osseointegration. The role of microbial plaque accumulation in the development of peri-implantitis has been well documented. On the other hand, the ideal method of implant surface decontamination to re-establish the health of peri-implant tissue remains to be determined. Removal of bacterial deposits is essential in the treatment of peri-implant infections, and various therapeutic approaches have been described in the literature, including mechanical debridement, disinfection with chemotherapeutic agents, and laser therapy. Recently, there has been a plenitude of scientific data regarding the use of laser irradiation to achieve titanium surface decontamination. Thus, research is focusing on lasers' potential use in the treatment of peri-implantitis. The aim of this literature review is to analyze and evaluate the efficacy of laser therapy for the treatment of peri-implantitis.

ORAL SELF-MUTILATION IN THE LESCH-NYHAN SYNDROME : CASE REPORT (Lesch-Nyhan syndrome 환아의 oral self-mutilation에 대한 증례보고)

  • Jeon, Jin-Yong;Lee, Jae-Ho;Choi, Hyung-Jun;Choi, Byung-Jai
    • Journal of the korean academy of Pediatric Dentistry
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    • v.26 no.1
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    • pp.151-156
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    • 1999
  • Self-injurious behavior is defined as deliberate harm to one's own body without suicidal intent. It usually occurs as head banging or hitting, skin cutting, or finger biting and includes ocular, genital and oral self-mutilation. Lesch-Nyhan syndrome is a rare X-linked recessively inherited disorder, caused by complete absence of hypoxanthin-guanine phosphoribosyl transferase(HPRT) activity. Clinical presentation is characterized by mental retardation, chorea, athetosis, hyperuricemia, uricosuria and self-mutilating behavior. In these patients, the most typical feature is loss of tissue from biting themselves, even though they are not insensitive to pain. The dental management of self-mutilation includes treatment with appliances such as soft mouthguard or lip bumper, extraction of all the teeth, and orthognathic surgery. We report a 25-month-old boy who was a known case of Lesch-Nyhan syndrome and presented with severe self-mutilation wound on his lower lip. Vital pulpectomy and coronal resection was done as a more conservative approach than extracting all primary anterior teeth. Due to maintaining the root portion of the teeth in the bone, it is expected that the normal growth of the alveolar bone will be achieved.

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Minimum 3-Year Outcomes in Patients with Lumbar Spinal Stenosis after Bilateral Microdecompression by Unilateral or Bilateral Laminotomy

  • Yang, Sang-Mi;Park, Hyung-Ki;Chang, Jae-Chil;Kim, Ra-Sun;Park, Sukh-Que;Cho, Sung-Jin
    • Journal of Korean Neurosurgical Society
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    • v.54 no.3
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    • pp.194-200
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    • 2013
  • Objective : Lumbar spine stenosis (LSS) can result in symptomatic compression of the neural elements, requiring surgical treatment if conservative management fails. Minimally invasive surgery has come to be more commonly used for the treatment of LSS. The current study describes outcomes of bilateral microdecompression by unilateral or bilateral laminotomy (BML) for degenerative LSS after a minimum follow-up period of 3 years and investigates factors that result in a poor outcome. Methods : Twenty-one patients who were followed-up for at least 3 years were included in this study. For clinical evaluation, the Japanese Orthopedic Association (JOA) scoring system for low back pain was used. The modified grading system of Finneson and Cooper was used for outcome assessment. Radiographic evaluation was also performed for spondylolisthesis, sagittal rotation angle, and disc height. Results : Twenty-one patients (10 men, 11 women) aged 53-82 years ($64.1{\pm}8.9$ years) were followed-up for a minimum of 3 years (36-69 months). During follow-up, two patients underwent reoperation. Average preoperative JOA score and clinical symptoms, except persistent low back pain, improved significantly at the latest follow-up. There were no significant differences in radiological findings preoperatively and postoperatively. Thirteen patients (61.9%) had excellent to fair outcomes. Conclusion : BML resulted in a favorable and persistent outcome for patients with degenerative LSS without radiological instability over a mid-term follow-up period. Persistent low back pain unrelated to postoperative instability adversely affects mid-term outcomes.

A Case of Ascending Colon Diverticulitis with Perforation in a Child (소아 상행 대장 게실염 천공 1예)

  • Baek, Joon-Woo;Shin, Jae-Young;Lee, Jee-Hyun;Jung, So-Young;Jung, Ah-Young;Kim, Jeong-Won;Lee, Kon-Hee
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.13 no.2
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    • pp.193-198
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    • 2010
  • A diverticulum is a blind pouch communicating with the gut. The term "diverticulitis" indicates inflammation of a diverticulum or diverticula, which is commonly accompanied by gross or microscopic perforation. Acute diverticuitis is a rare disorder in early childhood. Itis difficult to diagnose acute right colon diverticulitis from common causes of RLQ pain. We report a case of acute diverticulitis in the right colon in a 6-year-old girl. She complained of typical RLQ pain mimicking acute appendicitis,but was diagnosed with acute diverticulitis by CT scanning. Conservative treatment failed because of peritonitis due to perforation of an inflamed diverticulum. After the diverticulcetomy, the symptoms resolved.