• Title/Summary/Keyword: Pain Clinics

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Do Knots Matter in Superior Labrum Anterior to Posterior Lesions Repair?

  • Jeong, Hyeon Jang;Joung, Ho Yun;Kim, Dae Ha;Rhee, Sung Min;Yang, Seok Hoon;Kim, Woo;Oh, Joo Han
    • Clinics in Shoulder and Elbow
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    • v.20 no.2
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    • pp.68-76
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    • 2017
  • Background: In general, the outcomes of arthroscopic repair for superior labrum anterior to posterior lesions (SLAP) are favorable, however, persistent pain and limitation of motion are not rare complications. One of the possible cause is a "knot-ache". This study evaluated the results of reoperation of symptomatic recurrent SLAP lesions and asked whether the knot is associated with postoperative complications. Methods: Between 2005 and 2015, a total of 11 patients who had undergone arthroscopic SLAP repair were reoperated for recurrent symptomatic SLAP lesion. By retrospective chart review, operative findings, the visual analogue scale for pain (pVAS), the range of motion (ROM), and functional scores were analyzed. Results: The mean age of the study participants was 38.3 years, and the mean follow-up period was 42.5 months. In the primary operation, there were nine cases of repairs with conventional knot-tying anchors and three cases with knotless anchors. Impingement of the knots during abduction and external rotation of the shoulder was observed in the all cases with knot-tying anchors. The mean pVAS, ROM, and functional scores significantly improved with reoperation. At the final follow-up, the mean satisfaction VAS was 8.3. Conclusions: The knots of suture anchor maybe a possible etiology of the pain, which we termed a "knot-ache". Considering that reoperation is performed due to pain after primary repair, the use of knotless suture anchor may have benefits of eliminating one of possible cause, "knot-ache". Therefore, authors suggest the use of knotless anchors during reoperation for recurrent or recalcitrant pain after primary SLAP repair.

Is a Suction Drain Necessary in Arthroscopic Rotator Cuff Repair?

  • Park, Jin-Young;Sim, Ju Hyun;Lee, Jae Hyung;Oh, Kyung Soo;Chung, Seok Won
    • Clinics in Shoulder and Elbow
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    • v.19 no.3
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    • pp.137-142
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    • 2016
  • Background: The purpose of this study was to evaluate the efficacy of suction drain use following arthroscopic rotator cuff repair by comparing early pain score and range of motion (ROM) between groups with and without suction drains. Methods: The study included 153 patients with rotator cuff tears who underwent arthroscopic repairs at our clinic from April 2014 to March 2015. Following surgery, a suction drain was used in 85 patients (group D) and not used in 68 patients (group ND). There was no statistical difference between the groups in terms of age, gender, or total operation time. The clinical outcome with regard to pain (assessed by pain scores and analgesic requests) and passive ROM was assessed preoperatively and postoperatively. Results: Immediate postoperative analgesic requirement was significantly higher in group D (p=0.001), although there was no difference in pain outcomes between the groups during the 3-month follow-up period. A statistically significant difference in passive ROM was observed at the postoperative 2- and 6-week follow-ups (p=0.036, 0.035, and 0.034 in forward elevation (FE), external rotation at the side (ER) and 90 ER at weeks 2, respectively; 0.045 and 0.009 in FE and ER at weeks 6, respectively); however no significant difference was observed at the end of 3 months. During the study period, no complication was reported in either group. Conclusions: Use of suction drains after arthroscopic rotator cuff repair provided little benefit in terms of ROM or pain in the early postoperative period (up to 3 months).

Analysis of Factors Related to the Use of Korean Medicine Treatment in Patients with Mood Disorders: Based on 2019 Korea Health Panel Annual Data (기분장애 환자에서 한의치료 이용과 관련된 요인분석: 제2기 한국의료패널 자료를 중심으로)

  • Kyoungeun Lee;Chan-Young Kwon
    • Journal of Oriental Neuropsychiatry
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    • v.34 no.4
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    • pp.349-358
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    • 2023
  • Objectives: We used the 2019 Korea Health Panel Annual Data to analyze factors related to visits to Korean medicine (KM) outpatient clinics among patients with mood disorders in Korea. Methods: Individuals aged 19 years or older, with depressive or bipolar disorders, and with a record of using Western medicine (WM) and/or the KM medical service were included. The 266 subjects were classified into the WM group or the integrative medicine (IM) group. The Andersen healthcare utilization model was used to analyze factors that potentially influenced the subjects' healthcare utilization. Binomial logistic regression analysis was used to analyze factors influencing the use of IM medical services. Results: Among the subjects, 75.56% (n=201) were in the WM group, and 24.44% (n=65) were in the IM group. Statistically significant differences were observed in residential areas, total annual income, the presence of disability, and the level of pain/discomfort between the two groups. Regression analysis found that residential areas and pain/discomfort were factors related to the use of IM services. Specifically, reporting "a lot" of pain/discomfort compared to "no" pain/discomfort showed a significant positive relationship with the use of IM (odds ratio=4.57, 95% confidence interval=1.79 to 11.70). Conclusions: This study was the first to analyze the status of KM medical service use and related factors among patients with mood disorders in Korea. The finding that the presence of pain/discomfort was positively correlated with the use of KM services is potentially related to medically unexplained physical symptoms or somatization phenomena.

Recombinant Tissue Plasminogen Activator Therapy for Aortic Thromboembolism in Four Dogs

  • Han, Sei-Myoung;Lee, Ji-Ye;Kweon, Kyeong;Choi, Min-Cheol;Yoon, Jung-Hee;Youn, Hwa-Young
    • Journal of Veterinary Clinics
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    • v.33 no.3
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    • pp.155-159
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    • 2016
  • Four dogs were brought to the Veterinary Medicine Teaching Hospital of Seoul National University (VMTH SNU) with a history of hind limb ataxia, three with pain, one without pain. Three of the four showed weak to absent femoral pulses and cold extremities. Thromboembolism was identified by ultrasonography in the external and/or internal iliac arteries. A thrombolytic agent, recombinant tissue plasminogen activator (rt-PA), was administered (0.5-1 mg/kg, every 60-120 min, 3-5 doses). Two dogs (Cases 2 and 3), which were instantly provided rt-PA treatment, survived 6 and 17 months, respectively, although hematemesis and hematochezia were observed during treatment. In the other two dogs (Cases 1 and 4), rt-PA was administered 4 and 28 days after the appearance of pelvic limb symptoms, which may have limited the benefits of the treatment. When rt-PA treatment is instituted instantly and the side effects are monitored thoroughly during treatment, a good prognosis might be expected in canine aortic thromboembolism. For this reason, we suggest that rt-PA treatment should be initiated immediately if thromboembolism is identified.

Laparoscopic Retrieval of Ectopic Adult Heartworms from the Abdominal Cavity of a Dog with Heartworm Infestation (심장사상충 복강내 이소기생 개에서 복강경적 치료 1예)

  • Kang, Min-Hee;Song, Kun-Ho;Lim, Chae-Yung;Park, Hee-Myung
    • Journal of Veterinary Clinics
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    • v.28 no.6
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    • pp.595-597
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    • 2011
  • A 5-year-old, intact male Beagle was presented with chronic abdominal pain. The dog was diagnosed with dirofilariasis by positive heartworm antigen detection via ELISA and concurrent microfilaria. Thoracic radiographs revealed cardiomegaly with dilation of the main pulmonary artery. Echocardiography revealed the adult worms in the main pulmonary arteries, but other abnormalities other than heartworm infection were not present. To find the cause of the abdominal pain, exploratory laparoscopy was performed. Ectopic migrating adult heart worms were visualized through exploratory laparoscopy and the clinical sign resolved after removing the heart worm. This report describes removing the ectopic migrating adult heartworms using exploratory laparoscopy in the abdominal cavity.

A Study on the Life Expectancy of the Dental Prosthetic Restorations (치과보철물의 평균수명에 관한 연구)

  • Young-Ku Kim
    • Journal of Oral Medicine and Pain
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    • v.20 no.2
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    • pp.317-325
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    • 1995
  • This study was performed to investigate the mean life expectancy of dental prosthetic restorations. The author has examined 352 dental prosthesis clinically and radiologically, and decided the success(survival) and failure(mortality) of the dental prosthesis. The dental prosthesis which had been treated in the Seoul National University Dental Hospital, two private clinics in Seoul, one university dental hospital, and two private clinics in local province were included in this study. The survival analysis using product limit estimator was used and the mean life expectancy of each type of dental prosthesis was calculated. The results were as follows : 1. The life expectancies were 10.5 years in gold crown and bridge, 8.5 years in porcelain fused to metal crown and bridge, 8.3 years in nonprecious metal crown and bridge, 8.1 years in removal partial denture, and 7.7 years in full denture. 2. The causes of mortality were in the order of dental caries(24.6%), fracture of dental prosthesis(19.2%), periodontal problems(18.6%), chronic chewing difficulty and dysfunction due to dental prosthesis(15.0%), excessive exposure of abutments due to the marginal defect of dental prosthesis(14.4%), abnormal occlusion due to severe attrition of artificial teeth in dentures(3.0%), periapical problems(2.4%), perforation of dental prosthesis(1.8%), and loose contacts with neighboring tooth(1.2%). 3. Among survival cases, 66.5% showed normal chewing ability and 31.9% showed partial chewing ability. However, 1.6% of them complained loss of chewing ability. 4. Among failure cases, 6.6% showed normal chewing ability and 38.9% showed partial chewing ability. However, 54.5% of them complained loss of chewing ability.

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Survey on Satisfaction of Outpatients with Chronic Musculoskeletal Pain Using Physical Therapy in North Gyeong-buk (경북 북부지역에서 물리치료를 받는 만성 근골격계 질환을 가진 외래 환자의 만족도 조사)

  • Kim, Jin-Seop
    • Journal of Digital Convergence
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    • v.11 no.6
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    • pp.205-212
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    • 2013
  • The purpose of this study was to analyze the factors of health services that satisfy chronic musculoskeletal patients in the northern part of Gyeong-buk, South Korea. One hundred and seven chronic musculoskeletal patients who had visited a clinic in Gyeong-buk were recruited for this study. The data were collected through a questionnaire survey administered from May 7 to June 6, 2012. The collected data were analyzed by multiple regression analysis. The major findings of this research are as follows. The chronic musculoskeletal patients' satisfaction was determined by the "physical therapist's explanation," "registration process," "home exercise," "respect from staff," and whether the physical therapist and staff "listened to concerns." The chronic musculoskeletal patients' likely to revisit is strongly related to "physical therapist's explanation," "registration process," and "up-to-date equipment." Therefore, it is very important for clinics to improve the quality of the "physical therapist's explanation," "registration process," "respect from staff," "informed consent," "up-to-date equipment," and "home exercise." Furthermore, it is expected that the outcomes of this study will contribute to the customer satisfaction of chronic musculoskeletal patients in clinics.

Development of Instrument for Korean Osteoarthritis Impact Measurement Scale (KAIMS) in Hip and Knee Osteoarthritis (한국형 골관절염영향측정척도(KAIMS) 도구개발 - 무릎 및 엉덩관절의 골관절염환자 중심 -)

  • Yi, Seung-Ju;Kim, Jin-Seop
    • The Journal of Korean Physical Therapy
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    • v.26 no.2
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    • pp.82-89
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    • 2014
  • Purpose: This study was conducted in order to develop an instrument for the Korean Osteoarthritis Impact Measurement scale (KAIMS) in hip and knee osteoarthritis patients. Methods: A sample of 426 subjects was recruited in Ulsan metropolitan city (six hospitals and clinics) and Andong city (five hospitals and clinics) from June 2010 to May 2011. Item internal consistency and item discriminant validity were analyzed on the item-level, and floor (%) and ceiling (%) effect were analyzed on the scale-level. Exploratory factor analysis was performed for construction of items in the KAIMS instrument; confirmative factor analysis was also performed to test the fit of the model. Results: In 426 respondents, age was 64.3 years. The reliability for r coefficient 0.90 (mobility) and 0.89 (pain and stiffness) (Cronbach's alpha 0.95, 0.95 respectively) was high in the test-retest, and there was no significant difference in paired t-test (p>0.05). Item internal consistency (${\alpha}=0.92$, ${\alpha}=0.87$ respectively) was also high. It was constructed of two factors (mobility, pain and stiffness dimension) and nine items in explanatory factor analysis; results of confirmatory factor analysis also indicated that the dimensional structure model was fitted well in the test of model fit (${\chi}^2=83.83$, df=26, p=0.000; RMR=0.05; GFI=0.96; AGFI=0.83). Conclusion: In conclusion, the results of this study showed that the KAIMS that was developed was a reliable and valid instrument for measurement of osteoarthritis (OA) patients. We recommend further research for additional development of the instrument on OA in Korea.

Factors associated with Patient Activation for Self-management among Community Residents with Osteoarthritis in Korea

  • Ahn, Yang Heui;Kim, Bong Jeong;Ham, Ok Kyung;Kim, Seong Hoon
    • Research in Community and Public Health Nursing
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    • v.26 no.3
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    • pp.303-311
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    • 2015
  • Purpose: The purpose of this study was to survey patient activation for self-management and to identify factors associated with patient activation for self-management among community residents with osteoarthritis in Korea. Methods: Cross-sectional study design was used. Survey data were collected from 270 community residents with osteoarthritis through direct interviews. Studied factors included patient activation, joint pain, physical function, depression, and general characteristics. Data were analyzed using chi-squared test, t-test and multivariate logistic regression analysis. Results: The participants' mean score of patient activation was $56.0{\pm}16.61$. The mean score of each factor was $10.6{\pm}5.89$ for joint pain, $5.5{\pm}3.56$ for physical function, and $19.3{\pm}10.01$ for depression. The patient activation level was significantly associated with depression and general characteristics such as education, religion, comorbid hypertension, and use of medical clinics (p<.05). Conclusion: The findings suggest that depression, education, religion, comorbid hypertension, and use of medical clinics may be important factors to be considered when developing programs of patient activation for self-management. This is the first study that measured patient activation, and further studies are suggested to find factors associated with patient activation for self-management among community residents with other chronic diseases.

Aneurysmal Bone Cyst in a Pomeranian (포메라이언견에서 발생한 동맥류성 골낭종 1례)

  • Shin, Beom-Jun;Lee, Jae-Yeon;Kim, Soo-Hyun;Park, Ji-Young;Lee, Young-Won;Cho, Sung-Whan;Kim, Myung-Cheol;Jeong, Seong-Mok
    • Journal of Veterinary Clinics
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    • v.27 no.1
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    • pp.117-120
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    • 2010
  • A 5-years-old 3.7 kg intact female Pomeranian dog was presented with the history of swelling and pain in the distal part of the right forelimb. The swollen lesion was firm as bony material on palpation. On radiographic examination, there was a well-marginated, radiolucent, and expansile bone lesion in the distal metaphysis of the right ulna. Because of very narrow zone of transition, well-defined margins and absence of any periosteal reactivity, benign bone cyst was strongly suspected. The lesion was removed by en bloc resection and packed the space with $Gelfoam^{(R)}$ and aneurysmal bone cyst was finally diagnosed according to histopathological examination. Normal gait was showed on postoperative day 9 and there have been no pain and complication for 1 year since then.