Purpose: The aim of this study was to evaluate the short-term outcome of physiotherapy in patients with acetabular labral tears and to assess the effectiveness of physiotherapy according to the severity of the labral tear. Materials and Methods: Thirty-five patients who underwent physiotherapy for treatment of symptomatic acetabular labral tears were enrolled. We evaluated the severity of the acetabular labral tears, which were classified based on the Czerny classification system using 3-T MRI. Clinical findings of microinstability and extra-articular pathologies of the hip joint were also examined. The International Hip Outcome Tool 12 (iHOT12) was use for evaluation of outcome scores pre- and post-intervention. Results: The mean iHOT12 score showed significant improvement from 44.0 to 73.6 in 4.7 months. Compared with pre-intervention scores, significantly higher post-intervention iHOT12 scores were observed for Czerny stages I and II tears (all P<0.01). However, no significant difference was observed between pre-intervention and post-intervention iHOT12 scores for stage III tears (P=0.061). In addition, seven patients (20.0%) had positive microinstability findings and 22 patients (62.9%) had findings of extra-articular pathologies. Of the 35 patients, eight patients (22.9%) underwent surgical treatment after failure of conservative management; four of these patients had Czerny stage III tears. Conclusion: The iHOT12 score of patients with acetabular labral tears was significantly improved by physiotherapy in the short-term period. Improvement of the clinical score by physiotherapy may be poor in patients with severe acetabular labral tears. Determining the severity of acetabular labral tears can be useful in determining treatment strategies.
Objective: To quantitatively assess the pulmonary vasculature using non-contrast computed tomography (CT) in patients with chronic thromboembolic pulmonary hypertension (CTEPH) pre- and post-treatment and correlate CT-based parameters with right heart catheterization (RHC) hemodynamic and clinical parameters. Materials and Methods: A total of 30 patients with CTEPH (mean age, 57.9 years; 53% female) who received multimodal treatment, including riociguat for ≥ 16 weeks with or without balloon pulmonary angioplasty and underwent both non-contrast CT for pulmonary vasculature analysis and RHC pre- and post-treatment were included. The radiographic analysis included subpleural perfusion parameters, including blood volume in small vessels with a cross-sectional area ≤ 5 mm2 (BV5) and total blood vessel volume (TBV) in the lungs. The RHC parameters included mean pulmonary artery pressure (mPAP), pulmonary vascular resistance (PVR), and cardiac index (CI). Clinical parameters included the World Health Organization (WHO) functional class and 6-minute walking distance (6MWD). Results: The number, area, and density of the subpleural small vessels increased after treatment by 35.7% (P < 0.001), 13.3% (P = 0.028), and 39.3% (P < 0.001), respectively. The blood volume shifted from larger to smaller vessels, as indicated by an 11.3% increase in the BV5/TBV ratio (P = 0.042). The BV5/TBV ratio was negatively correlated with PVR (r = -0.26; P = 0.035) and positively correlated with CI (r = 0.33; P = 0.009). The percent change across treatment in the BV5/TBV ratio correlated with the percent change in mPAP (r = -0.56; P = 0.001), PVR (r = -0.64; P < 0.001), and CI (r = 0.28; P = 0.049). Furthermore, the BV5/TBV ratio was inversely associated with the WHO functional classes I-IV (P = 0.004) and positively associated with 6MWD (P = 0.013). Conclusion: Non-contrast CT measures could quantitatively assess changes in the pulmonary vasculature in response to treatment and were correlated with hemodynamic and clinical parameters.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
v.46
no.3
/
pp.174-182
/
2020
Objectives: Joint injuries frequently lead to progressive joint degeneration that causes articular disc derangement, joint inflammation, and osteoarthritis. Such arthropathies that arise after trauma are defined as post-traumatic arthritis (PTA). Although PTA is well recognized in knee and elbow joints, PTA in the temporomandibular joint (TMJ) has not been clearly defined. Interestingly, patients experiencing head and neck trauma without direct jaw fracture have displayed TMJ disease symptoms; however, definitive diagnosis and treatment options are not available. This study will analyze clinical aspects of PTA in TMJ and their treatment outcomes after joint arthrocentesis and lavage. Materials and Methods: Twenty patients with history of trauma to the head and neck especially without jaw fracture were retrospectively studied. Those patients developed TMJ disease symptoms and were diagnosed by computed tomography or magnetic resonance imaging. To decrease TMJ discomfort, arthrocentesis and lavage with or without conservative therapy were applied, and efficacy was evaluated by amount of mouth opening and pain scale. Statistical differences between pre- and post-treatment values were evaluated by Wilcoxon signed-rank test. Results: Patient age varied widely between 20 and 80 years, and causes of trauma were diverse. Duration of disease onset was measured as 508 post-trauma days, and 85% of the patients sought clinic visit within 2 years after trauma. In addition, 85% of the patients showed TMJ disc derangement without reduction, and osteoarthritis was accompanied at the traumatized side or at both sides in 40% of the patients. After arthrocentesis or lavage, maximal mouth opening was significantly increased (28-44 mm on average, P<0.001) and pain scale was dramatically decreased (7.8-3.5 of 10, P<0.001); however, concomitant conservative therapy showed no difference in treatment outcome. Conclusion: The results of this study clarify the disease identity of PTA in TMJ and suggest early diagnosis and treatment options to manage PTA in TMJ.
With the advent of multidetector-row CT, lung cancer imaging is much more promising than before. However, the effectiveness of multidetector-row CT in making an initial diagnosis, staging, and evaluating post-treatment changes of lung cancer still remains to be proved. Fast imaging along with volumetric data set and attendant multi-planar imaging provide much more details on the anatomic changes and pathology associated with lung cancer. However, with images showing anatomic and pathologic changes only, radiologists confront with several questions the answers of which may help evaluate lung cancer more thoroughly. The frequent questions that I have in dally practice of chest CT interpretation are as follows.
Objectives : This studies were performed to investigate the correlation between the treatment effects and the changes of the thermal differences at the pre and post-treatment by using the digital infrared computer thermographic imaging (D.I.T.I) to the irritable colon syndrome 30 patients. Methods : The extracts of the gwakhyangjunggisan were administerd to the patients by oral method three times per day during four weeks. we selected the Chung-Wan($CV_{12}$), Chunchu($S_{25}$). Hapkok($LI_4$), Naegwan($P_6$), Yongdo($H_4$) acupoints and treated the patients two times per week during four weeks. One week later, we investigated the changes of the pressure pain around left side Pokkyol($SP_{14}$), the symptoms. and the skin temperature changes on Pokkyol($SP_{14}$) and Kimun($LR_{14}$) around, by using the D.I.T.I. Results : In the correlation between the severity of the pressure pain around left side Pokkyol($SP_{14}$) and the thermal differences on Pokkyol($SP_{14}$) and Kimun($LR_{14}$) around, before the treatment, the more the pain was severe, the more the skin temperature was differential significantly. In the correlation between the severity of the symptoms and the thermal differences on Pokkyol($SP_{14}$) and Kimun($LR_{14}$) around, before the treatment, the more the symptom was severe, the more the skin temperature was differential significantly. In the changes of the pressure pain around left side of Pokkyol($SP_{14}$), the improved were significantly higher than the unimproved. In the changes of the symptoms, the improved were significantly higher than the unimproved. In the correlation between the changes of the pressure pain around left side Pokkyol($SP_{14}$) and the changes of the thermal differences at the pre and post- treatment, the more the pain was improved, the more the thermal change was widened significantly. In the correlation between the changes of the symptoms and the changes of thermal differences at the pre and post-treatment, the more the symptom was improved. the more the thermal change was widened significantly. Conclusions : Above the results, the treatments was effective and the digital infrared computer thermographic imaging (D.I.T.I) was useful to prove the improvements of the pressure pain and the symptom with the irritable bowel syndrome patients.
Purpose : The purpose of this study was to examine the patient- and treatment-related etiologic factors of external root resorption. Materials and Methods : This study consisted of 163 patients who had completed orthodontic treatments and taken the pre- and post-treatment panoramic and lateral cephalometric radiographs. The length of tooth was measured from the tooth apex to the incisal edge or cusp tip on the panoramic radiograph. Overbite and overjet were measured from the pre- and post-treatment lateral cephalometric radiographs. The root resorption of each tooth and the factors of malocclusion were analyzed with an analysis of variance. A paired t test was performed to compare the mean amount of root resorption between male and female, between extraction and non-extraction cases, and between surgery and non-surgery groups. Correlation coefficients were measured to assess the relationship between the amount of root resorption and the age in which the orthodontic treatment started, the degree of changes in overbite and overjet, and the duration of treatment. Results : Maxillary central incisor was the most resorbed tooth, followed by the maxillary lateral incisor, the mandibular central incisor, and the mandibular lateral incisor. The history of tooth extraction was significantly associated with the root resorption. The duration of orthodontic treatment was positively correlated with the amount of root resorption. Conclusion : These findings show that orthodontic treatment should be carefully performed in patients who need the treatment for a long period and with a pre-treatment extraction of teeth.
Objective : This study was conducted to examine the correlation between clinical outcomes and the size of the syrinx in post-operative magnetic resonance imaging[MRI] and symptom duration. Methods : The authors investigated twelve patients who underwent various operations for syringomyelia from January 1995 to December 2003. The authors retrospectively analyzed medical records. pre- and post-operative MRI findings, features and durations of symptoms, and the method of surgical treatments. The clinical outcomes were assessed on Prolo scale at 6 months of post-operative period. Results : Neurologic symptoms did not promptly disappear after the shrinkage of syrinx, but post-operative MRI demonstrated most patients showed reductions in the size of the syrinx. There is no statistical relationship between clinical improvements and decrements of the syrinx size. However, patients who underwent surgical treatment within 2 years from the symptom onset had more favorable outcome than those who had operations after 2 years from the onset of symptoms. Conclusion : Change in the size of the syrinx in post-operative MRI is not directly proportional to favorable clinical outcomes. However, symptom duration before surgical treatment has considerable impact on the clinical outcomes.
Object : This study is designed to evaluate effects of acupuncture and herb-medication by the data of DITI(Digital Infrared Thermographic Imaging) examination and the changes of clinical symptoms after the therapy of acupuncture and herb-medication in the patients with Bell's palsy. Contents : The conservative therapy with acupuncture and herb-medication was performed during 1-8weeks. The acupuncture points of S4, S6, G14, S2, BL2, SI18, TE23, LI4 and S36 was used. In the pre- and post therapy, DITI examinations were performed in patients who had Bell's palsy and were treated by acupuncture simultaneously, and then tried to correlate the results of clinical symptoms with the difference of thermographic findings at pre-and post acupuncture. Setting : The standard routine themographic examinations were performed with thermography (DITI) in the 16 patients with Bell's palsy at pre- and post acupuncture. patients : Thermographic imaging of 16cases was analyzed. They had diagnosed Bell's palsy. They were treated by acupuncture and moxibustion therapy in Wonkwang Oriental Hospital from Jauary, 1999 to February, 2000. Results : The results of treatment showes that 56.25% of patients achieved excellent recovery and 31.25% achieved good recovery. After compairing the DITI results before and after treatment, we found 43.75% of patients achieved excellent recovery and 43.75% achieved good recovery. Conclusion :Acupuncture showed good results over 87.5% in clinical evaluation and 87.5% in DITI. Thermographic examination showes terapeutic effect of acupuncture treatment.
Treatment-resistant depression (TRD) is a major public health problem. It is estimated that about 30% of patients with major depressive disorder do not show substantial clinical improvement to somatic or psychosocial treatment. Most of studies for TRD have focused on the subjects already known as TRD. Patients with unipolar depressive episodes that do not respond satisfactorily to numerous sequential treatment regimens were included in the TRD studies. Such post hoc experimental design can be regarded only as consequences of having TRD, rather than as causal risk factors for it. Although informative, data derived from such studies often do not allow a distinction to be made between cause and effect. So, we should shift paradigm toward examining the risk for developing TRD in untreated depressed patients. To deal with this problem, untreated depressed patients should be enrolled in the study to identify biological markers for treatment resistance. The peripheral or central biological markers should be explored before starting treatment. Subsequent systematic administration of treatments with appropriate monitoring in the subjects can determine the risk for developing treatment resistance in untreated individuals. Such information could give a cue to improve the initial diagnosis and provide more effective treatment for TRD.
Stroke makes several physical deficits. Dysarthria is one of the most difficult problems in conventional medicine because of the weakness of neuromotor control. The purpose of this study is to find the acoustic characteristics of acupuncture therapy effects on post-stroke dysarthria. Seven patients with stroke(infarction or hemorrhage) were selected by CT or MR imaging. The authors applied acupuncture therapy by inserting needles into 8 acupuncture points, ipsilateral ST4, ST6 and contralateral LI4, ST36 on facial palsy side, and CV23, CV24, bilateral "Sheyu" for 4 weeks. Speech sample were composed of five simple vowels /a,e,i,o,u/ and meaningless polysyllabic words CVCVC(C: stops, affricated, fricative sounds, v: /e/). .VOT, total duration of each speech samples and vowel formant (F1&F2) were analyzed on Spectrogram. The results are as follows: 1. VOT of bilabial and velar stops was decreased post treatment. The VOT of bilabial glottalized pre and post treatment were statistically significant (p < 0.05). 2. Total duration of polysyllabic words was decreased post treatment. Decrement of total duration containing the bilabial was statistically significant (p<0.05). 3. First formant of round vowel /o/ pre and post treatment was statistically significant (p<0.05).
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