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Effect of Acupotomy Treatment for Lateral Epicondylitis: A Systematic Review and Meta-Analysis (외측상과염의 도침 치료에 대한 체계적 문헌고찰 및 메타분석)

  • Jong Chan Choi;Min Jun Ji;Kyung Jun Ser;Do Young Kwon;Jae Eun Yang;Ji Hyang Gu;Eun Jung Lee;Min Seok Oh
    • Journal of Korean Medicine Rehabilitation
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    • v.34 no.2
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    • pp.101-134
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    • 2024
  • Objectives The purpose of this study is to observe the effectiveness of acupotomy treatment for lateral epicondylitis by comparing it with various control groups. Methods We searched 11 domestic and international databases for systematic reviews and meta-analysis. The subjects were studies published from January 1, 2017 to September 1, 2023, and only randomised controlled trials were included. Results 208 studies were searched, of which 21 studies were finally selected. Among the studies published after 2017, the largest number of studies was published in 2019. The average number of participants per study was 72.28±20.26 and the average age was in the 40s. The most frequent intervention in the study was acupotomy alone, and the treatment most often mentioned as a control group was local nerve block. The most used evaluation tool is efficiency. Acupotomy+manipulation had statistically better effect than that of local nerve block in terms of pain (standard mean difference -1.87, 95% confidence interval, -2.18 to -1.57, p<0.00001) and elbow joint function (standard mean difference 2.25, 95% confidence interval, 1.65 to 2.86, p<0.00001). Conclusions As a result of the meta-analysis, the effect of acupotomy added manual therapy treatment was statistically significant compared to the local nerve block frequently used for lateral epicondylitis. Based on these results, it appears that more research on combination treatments other than acupotomy treatment will be needed. Also, it appears that more large-scale randomized controlled studies that strictly adhere to the standards for reporting interventions in controlled trials of acupuncture, risk of bias 2 criteria will be needed.

Epidemiology of Pesticide Poisoning in Kyungpook (경북지방(慶北地方)의 농약중독(農藥中毒)에 대한 역학적(疫學的) 조사(調査))

  • Chung, Jong-Hak;Cho, Jae-Yeun
    • Journal of agricultural medicine and community health
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    • v.8 no.1
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    • pp.28-34
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    • 1983
  • In spite of the world-wide increase of incidence of pesticide poisoning due to greater use of pesticides, the epidemiological study of pesticide poisoning in Korea has been grossly neglected. The author gained access to the medical records for two year period (1981 through 1982) from local clinics, hospitals and health centers of Kyungpook area to investigate the status of the pesticide poisoning. During these two years, there were 1,618 cases of documented pesticide poisoning, of which in 1981 were 765 and in 1982 were 853. Those in the twenties decade of age was the most frequent and the male(70%) was more liable than the female (30%). In view of manner of poisoning, occupational poisoning was 27.8%, accidental 5.6%, and suicidal 66.6%. There are three distinct groups which make up the large majority of both fatal and nonfatal cases; young children who accidentally ingest pesticides, young to middle age adult who are occupationally poisoned, and middle age to older adults who suicidally ingest pesticides. The seasonal distribution of these poisonings disclosed the peak month to be July, with August next, followed by June and September. Only 11% of cases occurred during the three-month winter season of December to February. Thus pesticide caused poison- ing was primarily a summer and early fall occurrence. During these two years, average of 67 cases of poisoning was observed monthly. Of the pesticide poisoning documented, 49% were treated with poisoning patients from local clinic and 43% from hospital. The case fatality rate of occupational poisoning was 0.9%, accidental 5.6% and suicidal 20.3%. The mean overall case fatality rate was 14.1%. Annual incidence of pesticide poisoning was 25.4 per 100,000 population in the study area. There is a nationwide need for more reliable date on pesticide poisoning. This need can only grow more acute with the passage of time because of the increasing importance of pesticides as a cause of morbidity and mortality.

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Paleomagnetism and K-Ar Age of Volcanic Rocks from Guryongpo Area, Korea (구룡포에서 산출(産出)되는 화산암(火山岩)에 대(對)한 고지자기(古地磁氣)와 K-Ar연령(年齡))

  • Kim, Kwang Ho;Won, Jong Kwan;Matsuda, Jun-ichi;Nagao, Keisuke;Lee, Moon Won
    • Economic and Environmental Geology
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    • v.19 no.3
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    • pp.231-237
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    • 1986
  • Samples of porphyries, andesites, decites and sandstones were collected from 14 sites in order to study paleomagnetism and to determine K-Ar age in Guryongpo area. K-Ar age dating indicates that porphyries and volcanic rocks formed 41.7 and 22.7~19.4Ma, respectively. The mean direction of remanent magnetization for each site was generally well grouped after alternating field demagnetization. Both normal and reversed directions are present. The mean magnetic direction of the porphyries of Late Eocene and that of the volcanic rocks of Late Oligocene to Early Miocene have similar, easterly declinations. Overall magnetic direction is $Dm=43.8^{\circ}$, $Im=53.5^{\circ}$, ${\alpha}95=12.2^{\circ}$. the reliability of the observed paleomagnetic directions is ascertained by the presence of normal and reversed polarities. This is also conformed by the similarity of the declinations of the normal and reversed polarities. Observed easterly declinations in this area are attributed to local clockwise rotation of the land mass by approximately 40~50 degrees since early Miocene.

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Therapeutic Effect of Combined Radiotherapy and Hyperthermia in Primary Hepatocellular Carcinoma (원발성 간암의 방사선치료및 온열요법의 병용치료 효과)

  • Kang Ki Mun;Choi Ihl Bohng;Kay Chul Seung;Choi Byung Ok;Chung Su Mi;Kim In Ah;Han Sung Tae;Sun Hee Sik;Chung Kyu Won;Shinn Keyong Sub
    • Radiation Oncology Journal
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    • v.12 no.2
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    • pp.191-199
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    • 1994
  • Purpose : This study was undertaken to show the clinical results of combined radiotherapy and hyperthermia in primary hepatoma Materials and Methods : Between December 1989 and March 1993, 50 patients with hepatomas were treated by combined radiotherapy and hyperthermia. Among them, we analyzed retrospectively 33 patients who received the complete course of treatment. The ages of the patients ranged from 36 to 75(mean age: 55.5 years). Twenty-six patients ($78.8\%$) were men, and 7 ($21.2\%$ were women. According to Child's classification, nine patients ($27.3{\%}$) were A group, 9 ($27.3\%$) were B group, 15 ($45.4\%$) were C group. Radiation therapy was done by a 6 MV and 15 MV linear accelerator. Patients were treated with daily fractions of 150-180 cCy to doses of 2550 cGy -4950 cGy (median : 3000 cGy). Local hyperthermia was done by 8 MHZ RF capacitive heating device (Cancermia. Green Cross Co., Korea), 50-60 min/session, 1-2 sessions/wk, and 8.5 sessions (median number)/patient. We analyzed the prognostic factors including age, sex, tumor type, Child's classification, $\alpha$-fetoprotein, liver cirrhosis, ascites, portal vein invasion, esophageal varix, number of hyperthermia, chemotherapy, total bilirubin level, Karnofsky perfomance status. Results : The overall 1-year survival was $24.2\%$, with a mean survival of 10months. Of 33 patients, tumor regression (PR+MR) was seen in $30.4\%$, no response was seen in $52.2\%,\;17.4\%$ patient was progressed. In patients who had tumor regression, the overall 1-year survival was $42.1\%$ with a mean survival of 14 months. Factors influencing the survival were sex (p=0.05), tumor type (p=0.0248), Child's classification (p=0.0001), liver cirrhosis (p=0.0108), ascites (p=0.0009), and Karnofsky perfomance status (p=0.0028). Complications developed in 28 patients, including 18 hot pain,5 fat necrosis, 3 transient fever, 2 nausea and vomiting. Conclusion : In this study, the results suggests that combined radiotherauy and hyperthermia may improve the survival rate of hepatoma.

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Efficacy of sucrose application in minimizing pain perception related to dental injection in children aged 3 to 9 years: a randomized control trial

  • Ishani Ratnaparkhi;Jasmin Winnier;Divya Shetty;Sanjana R. Kodical;Reema Manoj;Shilpa S Naik
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.24 no.2
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    • pp.109-117
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    • 2024
  • Background: Dental fear and anxiety are significant challenges in managing behavior in children. Oral administration of sucrose or sweet-tasting solutions has shown effectiveness in reducing procedural pain in infants and neonates. This study aimed to investigate whether pre-application of sucrose solution had an effect on minimizing pain perception during injection and to assess the potential impact of the child's age and sweet preference. Methods: A randomized control clinical trial was conducted on 60 children aged 3-9 years requiring buccal infiltration injections. Following parental consent, demographic data of the children were recorded. Sweet preferences was assessed using a modified forced-choice test. Children were equally and randomly allocated into study (sucrose) and control groups using a lottery method. Sucrose solution or distilled water, respectively, was applied to the lateral surface of the tongue for 2 min. Topical anesthetic was applied at the site of injection, followed by local anesthesia administration. The children rinsed their mouths thrice with water immediately after anesthetic injection. A video was recorded during injection which was then scored by three blinded examiners on the Sound Eye Motor (SEM) scale. The children also self-evaluated using Wong-Baker Faces Pain Rating Scale (WBFPS). Results: The mean SEM scores and WBFPS scores were analyzed using the Kruskall-Wallis test. The mean SEM score in the study group was 1.37 ± 0.61, compared to 3.17 ± 0.87 in the control group, showing a statistically significant difference (P < 0.001). Mean pain scores assessed by WBFPS in the study group were 0.60 ± 1.4, while in the control group, they were 6.27 ± 2.33, also showing a statistically significant difference (P < 0.001). Children with a sweet preference demonstrated a subjective reduction in pain perception. Conclusion: Application of sucrose before dental injections in children helps to minimize pain upon injection across all age groups.

The Preservation of Joint Function in Treatment of Giant Cell Tumor of Bone (거대세포종의 치료시 관절 기능의 보존)

  • Bae, Dae-Kyung;Han, Chung-Soo;Sun, Seung-Deok;Baek, Chang-Hee;Rhee, Jae-Hoon
    • The Journal of the Korean bone and joint tumor society
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    • v.1 no.2
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    • pp.145-153
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    • 1995
  • Giant cell tumor is most frequently found in juxtaarticular region, and difficult to treat because of local recurrence. Although primary resections reduce recurrence, the joint function will be markedly impaired. Techniques involving physical adjuncts(high speed burr and electric cauterization), acrylic cement or en bloc resection with VFG(vascularized fibular graft) have been employed to reduce local recurrence. From October 1984 to April 1994, twenty-nine patients diagnosed as giant cell tumor were treated at department of Orthopaedic Surgery, School of Medicine, Kyung Hee University. There were eleven men and 18 women, ranging in age from 17 to 52 years(mean: 34 years). The average follow-up period was four years and five months. The location of the lesion was around the knee in 15, distal radius in three, femoral head in three, and others in eight patients. Fifteen patients around the knee joint were treated with several modalities; curettage with bone graft in five, curettage with cement filling in three, curettage with bone graft and physical adjuncts in five, en bloc resection with VFG in one and en bloc resection with arthroplasty in one patient. The functional results, according to the Marshall's knee score, were excellent in one, good in two, and fair in two after the curettage with bone graft, good in three after the curettage with bone cement filling, excellent in one, good in four after the curettage with bone graft and physical adjuncts, and good in two after the en bloc resection with VFG or arthroplasty. Three patients had local recurrence among 15 patients with giant cell tumor around knee. Vascularized fibular graft around wrist joint provided good functional restoration without local recurrence in all three patients who had giant cell tumor in distal radius. Although there is no statistical significance, it seems that curettage with bone graft using physical adjuncts or acrylic cement reveals better results than simple curettage with bone graft. Excellent functional result were obtained without local recurrence by using vascularized fibular graft after en bloc resection.

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The Study of Vascular Dynamics for the Effect of a Compress Pack on Pain Relief using Magnetic Resonance Angiography (자기공명영상을 이용한 찜질 자극에 의한 통증 완화 효과에 대한 혈류 영상학적 고찰)

  • Baek, Ji-Won;Lim, Young-Khi
    • Journal of Radiation Protection and Research
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    • v.40 no.4
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    • pp.277-282
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    • 2015
  • This study was to investigate the effects of the hot compress pack on alleviating local muscular discomfort, stiffness in limbs as well as the chronic pains such as migraine in terms of hemodynamics. In this study, the hot compress band was put on the neck and the local physiological change on the stimulation site and the cranial blood circulation change were examined. We recruited healthy volunteers (n=8, mean age: 32.13 (4.61)), who participated in the magnetic resonance imaging (MRI) study. Local skin color and temperature were measured for the local effect of the hot compress band and the changes of intra-cranial and extra-cranial blood vessels were examined with MR angiography (MRA) images. The skin temperature increased from $36.4^{\circ}C$ at the rest condition to $36.7^{\circ}C$ and $37.1^{\circ}C$ after 15 min and 30 min stimulation, respectively. The change of the extra-cranial blood vessels between pre-stimulation and post-stimulation of 30 min was significantly increased (+38.8%), while the change of the intra-cranial blood vessels was negligible. In this study, we demonstrated that the hot compress band on the neck yielded the increase of local skin temperature on the stimulation site and it made an effect on the extracranial circulation. In conclusion, the stimulation with a hot compress could facilitate the blood circulation, causing to relieve the muscular discomfort, stiffness in limbs as well as the chronic pains such as migraine.

Gamma Knife Radiosurgery for Brainstem Metastasis

  • Yoo, Tae-Won;Park, Eun-Suk;Kwon, Do-Hoon;Kim, Chang-Jin
    • Journal of Korean Neurosurgical Society
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    • v.50 no.4
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    • pp.299-303
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    • 2011
  • Objective : Brainstem metastases are rarely operable and generally unresponsive to conventional radiation therapy or chemotherapy. Recently, Gamma Knife Radiosurgery (GKRS) was used as feasible treatment option for brainstem metastasis. The present study evaluated our experience of brainstem metastasis which was treated with GKRS. Methods : Between November 1992 and June 2010, 32 patients (23 men and 9 women, mean age 56.1 years, range 39-73) were treated with GKRS for brainstem metastases. There were metastatic lesions in pons in 23, the midbrain in 6, and the medulla oblongata in 3 patients, respectively. The primary tumor site was lung in 21, breast in 3, kidney in 2 and other locations in 6 patients. The mean tumor volume was $1,517mm^3$ (range, 9-6,000), and the mean marginal dose was 15.9 Gy (range, 6-23). Magnetic Resonance Imaging (MRI) was obtained every 2-3 months following GKRS. Follow-up MRI was possible in 24 patients at a mean follow-up duration of 12.0 months (range, 1-45). Kaplan-Meier survival analysis was used to evaluate the prognostic factors. Results : Follow-up MRI showed tumor disappearance in 6, tumor shrinkage in 14, no change in tumor size in 1, and tumor growth in 3 patients, which translated into a local tumor control rate of 87.5% (21 of 24 tumors). The mean progression free survival was 12.2 months (range, 2-45) after GKRS. Nine patients were alive at the completion of the study, and the overall mean survival time after GKRS was 7.7 months (range, 1-22). One patient with metastatic melanoma experienced intratumoral hemorrhage during the follow-up period. Survival was found to be associated with score of more than 70 on Karnofsky performance status and low recursive partitioning analysis class (class 1 or 2), in terms of favorable prognostic factors. Conclusion : GKRS was found to be safe and effective for management of brainstem metastasis. The integral clinical status of patient seems to be important in determining the overall survival time.

Definitive Concurrent Chemoradiotherapy in Cervical Cancer - a University of Malaya Medical Centre Experience

  • Zamaniah, W.I. Wan;Mastura, M.Y.;Phua, C.E.;Adlinda, A.;Marniza, S.;Rozita, A.M.
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.20
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    • pp.8987-8992
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    • 2014
  • Background: The efficacy of concurrent chemoradiotherapy in the treatment of locally advanced cervical cancer is well established. We aimed to investigate the long-term efficacy of definitive concurrent chemoradiotherapy for cervical cancer in the University of Malaya Medical Centre. Materials and Methods: A cohort of 60 patients with FIGO stage IB2-IVA cervical cancer who were treated with definitive concurrent chemoradiotherapy with cisplatin followed by intracavitary brachytherapy or external beam radiotherapy (EBRT) boost between November 2001 and May 2008 were analysed. Patients were initially treated with weekly intravenous cisplatin ($40mg/m^2$) concurrent with daily EBRT to pelvis of 45-50Gy followed by low dose rate brachytherapy or EBRT boost to tumour. Local control rate, progression free survival, overall survival and treatment related toxicities graded by the RTOG criteria were evaluated. Results: The mean age was 56. At the median follow-up of 72 months, the estimated 5-year progression-free survival (PFS) (median PFS 39 months) and the 5-year overall survival (OS) (median OS 51 months) were 48% and 50% respectively. The 5-year local control rate was 67.3%. Grade 3-4 late gastrointestinal and genitourinary toxicity occurred in 9.3% of patients. Conclusions: The 5-year PFS and the 5-year OS in this cohort were lower than in other institutions. More advanced stage at presentation, longer overall treatment time (OTT) of more than fifty-six days and lower total dose to point A were the potential factors contributing to a lower survival.

Breast Lymphoma Treatment Outcomes in a Pakistani Population: 20 Years of Experience at a Single Center

  • Bano, Razia;Zafar, Waleed;Khan, Amina Iqbal;Fiaz, Sohaib Adil;Abid, Mahwish;Chaudhary, Mohammad Zulqarnain;Siddique, Neelam;Khan, Huma Majeed
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.7
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    • pp.3631-3635
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    • 2016
  • Background: Breast lymphomas constitute a rare disease entity. To date, limited relevant data have been reported. We therefore here present a review of breast lymphoma patients treated at a single center over a 20 year period, focusing on histological types, treatment modalities and outcomes. Materials and Methods: We identified patients who were diagnosed and treated for breast lymphoma at a single center from January 1995 to January 2014 and extracted data regarding patients' demographics and clinical data. Results: Twenty-seven patients with breast lymphoma were identified, of which 3 were males. The median age at diagnosis was 37 years (range: 22-76 years). Chemotherapy was the main stay of treatment and 55.6% patients also received radiation to the affected breast. At our institute, only 3 patients, all with progressive disease, had surgery performed to achieve local palliation. Complete response after chemotherapy was seen in 63% patients and partial response in 7.4%, while 26% patients demonstrated disease progression. The mean follow up was 46.8 months. Seven patients (33.3%) who were alive at last follow up, as well as 1 patient who died, survived more than 5 years after diagnosis. Conclusions: Patients with breast lymphoma should receive aggressive treatment, with combination of chemotherapy and radiation therapy. Surgery should be limited for diagnosis and palliation of local symptoms in cases of progressive disease.