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Is conventional radiofrequency ablation of the superolateral branch, one of the three genicular nerves targeted as standard, necessary or not? A non-inferiority randomized controlled trial

  • Osman Albayrak;Canan Sanal Toprak;Osman Hakan Gunduz;Savas Sencan
    • The Korean Journal of Pain
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    • v.37 no.3
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    • pp.264-274
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    • 2024
  • Background: Radiofrequency ablation is an effective treatment modality in the symptomatic treatment of knee osteoarthritis. Our aim was to compare the efficacy of radiofrequency ablation of the superomedial and inferomedial genicular nerves (2 branches) with the superolateral, superomedial, and inferomedial genicular nerves (3 branches) and to show whether the 2-branch procedure is inferior to the 3-branch procedure. Methods: This study is a prospective, randomized, single-blind clinical study. Eligible participants were randomized into 2 groups: group A, which applied the procedure to the superomedial and inferomedial genicular nerves, and group B, which applied it to the superomedial, superolateral and inferomedial genicular nerves. Pain was evaluated with the numerical rating scale, quality of life with the Short Form-36 (SF-36), and disability with the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index before, and at 1 and 3 months after the procedure. Results: A total of 41 patients were included. There were no differences between the groups except for the SF-36 physical health sub-score at baseline. A significant improvement was seen in the numeric rating scale (NRS) score, SF-36 sub-scores, WOMAC Index total, as well as pain and physical function scores in both groups, though no significant difference was detected between the groups during follow-up. Conclusions: Although we were unable to establish the noninferiority of conventional radiofrequency ablation (CRFA) applied to 2 branches to CRFA applied to 3 branches, in this trial, significant and similar improvement was observed in NRS, WOMAC total, pain, and physical function and SF-36 scores in both groups.

A Review of Questionnaire for the Clinical Trials on Chronic Low Back Pain (만성 요통 임상연구에 사용된 설문지 현황 고찰)

  • Kim, Doo-Hee;Shin, Woo-Suk;Lee, Jin-Won;Park, Won-Hyung;Cha, Yun-Yeop;Ko, Youn-Seok;Lee, Jung-Han;Chung, Won-Suk;Shin, Byung-Cheul;Song, Yun-Kyung;Go, Ho-Yeon;Sun, Seong-Ho;Jeon, Chan-Yong;Jang, Bo-Hyoung;Ko, Seong-Gyu
    • Journal of Korean Medicine Rehabilitation
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    • v.23 no.4
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    • pp.95-115
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    • 2013
  • Objectives The aim of this review is to provide fundamental data for low back pain scales which can be used in clinical trial. Methods We investigated the latest studies on chronic low back pain via PubMed. And we also investigated domestic studies through "http://oasis.kiom.re.kr". 95 research papers were analyzed. Scales were classified into pain scale, function scale, generic health status scale and psychological scale. Results 1) According to foreign clinical studies, Visual Analog Scale (VAS) and Numerical Rating Scale (NRS) were used 18 times as pain scale. Oswestry Disability Index (ODI) was used 20 times as function scale, Roland-Morris Disability Questionnaire (RMDQ) was 17, and Hannover Functional Ability Questionnaire (HFAQ) was used 3 times. 36-item Short Form Health Survey (SF-36) was used 13 times as generic health status scale, Euroqol-5 Dimentions Questionnaire (EQ-5D) was 11, and 12-item Short Form Health Survey (SF-12) was used 3 times. Fear-Avoidance Beliefs Questionnaire (FABQ) was used 9 times as psychological scale, Pain Catastrophizing Scale (PCS) and Tampa Scale for Kinesiophobia (TSK-R) both were used 3 times. 2) According to domestic clinical studies, VAS was used 37 times as pain scale, NRS was 11, and Short Form McGill Pain Questionnaire (SF-MPQ) was used 6 times. ODI was used 30 times as function scale, RMDQ was 2 times only. SF-36 was used once as generic health status scale and Beck's Depression Inventory (BDI) was used 3 times as psychological scale. Conclusions We recommend VAS or NRS as a measure to evaluate pain, and ODI as a measure to evaluate functional disability. And we also recommend SF-36 or SF-12 and EQ-5D as a measure to evaluate generic health status. Finally, we recommend FABQ for use in measuring psychological scale.

Development of a comprehensive health promotion program for North Korean young adult defectors in South Korea (북한이탈 청소년을 위한 통합적 건강증진 프로그램 개발)

  • Choi, Seul-Ki;Park, Sang-Min;Joung, Hyo-Jee
    • Journal of the Korean Society of School Health
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    • v.22 no.1
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    • pp.73-83
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    • 2009
  • Purpose: The purpose of this study was to develop a comprehensive health promotion program for North Korean young adult defectors in South Korea. Methods: The comprehensive health promotion program consisted of nutrition, mental healthcare, physical activity and sexual behavior was developed on the basis of need assessment results. For the evaluation of the program, 70 North Korean young adults who were attending two alternative schools for North Korean defectors were recruited. The program had taken place once a week for 13 or 19 weeks. Effectiveness of the health promotion program was evaluated using anthropometric measurement, 3-day food records and a questionnaires that comprised the Hospital Anxiety and Depression Scale (HADS), the Short Form with 36 questions (SF-36) and health behaviors. The surveys were proceeded at the beginning and after the program. Results: After health promotion program, participants' height was significantly increased (p=0.004) and body fat mass (0=0.004) and percentage of body fat mass (p=0.003) were significantly decreased. The number of subjects who ate breakfast alone was decreased whereas the number of subjects who ate breakfast with friends was increased (p<0.001). There were no significant changes in dietary intakes, mental health status and quality of life. North Korean young adult defectors' willingness to participate and interests in the health promotion program were high, however the practice rate was low. Conclusion: The health promotion program could induce interests and willingness to participate, but bring about limited effects on the health behaviors. These results imply that a health promotion program for North Korean young adult defectors should have a long-term strategy as well as short-term plan. Furthermore, it should be based on their health problems, health related behaviors, academic performance and daily life matters.

A Study of the Depressive Symptoms and the Quality of Life in Patients with Breast Cancer in a University Hospital (일 대학병원 유방암 환자의 우울증상과 삶의 질)

  • Jang, Seung-Ho;Lee, Dae-Bo;Choi, Un Jong;Lee, Kwang-Man;Lee, Sang-Yeol
    • Korean Journal of Psychosomatic Medicine
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    • v.21 no.1
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    • pp.11-17
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    • 2013
  • Objectives : This study was designed to investigate the prevalence of depressive symptoms in patients with breast cancer and to identify demographic variables and clinical characteristics impact on depressive symptoms and health related quality of life in patients with breast cancer in a university hospital. Methods : Fourty-one patients with breast cancer were selected, who had visited the department of General surgery of the Wonkwang University hospital with a diagnosis of breast cancer regularly during the period November, 2010-May, 2011. All of subjects were evaluated for the depression, anxiety and the health related quality of life with Beck Depression Inventory(BDI), anxiety subscale of Personality Assessment Inventory(PAI) and Short-Form 36 Health Survey-Korean version(SF-36-K). Patients were divided into depressive symptoms and non-depressive symptoms group according to the BDI score. We compared SF-36-K between two groups, and analized multiple regression with depression and health related quality of life as criterion variables and demographic and clinical characteristics. Results : The prevalence of depression in patients with breast cancer in a University hospital was 36.4%. Compared to the non-depression, depressed patients with breast cancer appeared significantly lower mean scores on six subscales in SF-36-K : Physical function(p<.01), Role-physical(p<.001), General health(p<.05), Social function(p<.001), Role-emotional(p<.001) and Mental health(p<.001). But there was no significant difference between two groups in Vitality and Bodily pain. Anxiety, level of education and presence of enforcement of chemotherapy(63.6%) were significant explanation variables for depressive symptoms. And type of surgery and age(55.8%) were significant explanation variables for health related quality of life. Conclusions : The prevalence of depressive symptoms in patients with breast cancer in a University hospital was 36%. The depressive symptoms had not only negative impact on the health related quality of life but also important explanation variable for health related quality of life. These results suggest that depressive symptoms in patients with breast cancer should be evaluated and treated for improving patient's health related quality of life.

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The Relationship between Social Support, Health Status, College Adjustment and Academic Achievement in College Students (대학생들의 사회적 지지와 건강상태, 대학생활 적응 및 학업성취도와의 관계)

  • Jeon, So-Youn
    • The Journal of Korean Society for School & Community Health Education
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    • v.11 no.1
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    • pp.93-115
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    • 2010
  • Objectives: This study intends to understand the difference of social support levels and the relationship between social support the health status, college adjustment and academic achievement in the college student. Methods: Data were obtained from self-administered questionnaire of 416 college student. We measured the demographic characteristics, social support (tangible support, appraisal support, belonging support, self-esteem support), health status (36-item short-form health survey(SF-36), center for epidemiologic studies-depression(CES-D), perceived stress scale(PSS)), student adaptation to college questionnaire(SACQ), average grades point. Chi-square test, t-test, ANOVA test, pearson correlation analysis were used for analysis factors relation of the social support of the college students. Results: In considering the degree of social support by the demographic characteristics in the college students, the social support was better for the female college students. In considering the relation between social support and health status, the students who get better social support, were good in health depression and perceived stress status. When they got better social support their college adjustment and academic achievement were good. The result was statistically significant. Conclusions: Social support for students has great influence on health, college adjustment and academic achievement of students. Psychological aspects of students should be included in the strategy of social support for students.

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A Clinical Study of Climacteric Symptoms after Hysterectomy (자궁적출술 후에 갱년기 증후군으로 이행된 환자의 임상보고)

  • Park, Chan-Soo;Jung, Min-Yung;Sohn, Young-Joo
    • The Journal of Korean Obstetrics and Gynecology
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    • v.19 no.3
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    • pp.267-276
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    • 2006
  • Purpose : The purpose of this study was to investigate the clinical application of Traditional Korean Medicine(TKM) treatment to climacteric symptoms after hysterectomy. Methods : The patient was a 51-years-old woman who suffered from hot flush, arthralgia, fatigue et al after hysterectomy. The patient was treated by TKM such as herb medication and acupuncture therapy. And her health status was evaluated by Kupperman's index and Medical Outcome Study Short Form 36( SF-36). Results : Climacteric symptoms after hysterectomy was reduced( Kupperman's index from 40 to 20). It got better that Physical Functioning(PF), General health(GH), Bodily pain(BP), Role limitation-Emotion(RE) and Mental Health(MH). So, it means that her health status was improved. Conclusion : TKM is expected to have positive effects on climacteric symptoms after hysterectomy, and can be improve woman's health status after hysterectomy.

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Formation of globular clusters in cosmological radiation hydrodynamic simulation

  • Yi, Sukyoung K.;Kimm, Taysun
    • The Bulletin of The Korean Astronomical Society
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    • v.41 no.2
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    • pp.36.1-36.1
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    • 2016
  • This is a presentation of the paper published as Kimm et al. 2016, ApJ, 823, 52. We investigate the formation of metal-poor globular clusters (GCs) at the center of two dark matter halos with $Mhalo{\sim}4{\times}107Msun$ at z>10 using cosmological radiation-hydrodynamics simulations. We find that very compact (${\leq}1$ pc) and massive (${\sim}6{\times}105Msun$) clusters form rapidly when pristine gas collapses isothermally with the aid of efficient $Ly{\alpha}$ emission during the transition from molecular-cooling halos to atomic-cooling halos. Because the local free-fall time of dense star-forming gas is very short (${\ll}1Myr$), a large fraction of the collapsed gas is turned into stars before stellar feedback processes blow out the gas and shut down star formation. Although the early stage of star formation is limited to a small region of the central star-forming disk, we find that the disk quickly fragments due to metal enrichment from supernovae. Sub-clusters formed in the fragmented clouds eventually merge with the main cluster at the center. The simulated clusters closely resemble the local GCs in mass and size but show a metallicity spread that is much wider than found in the local GCs. We discuss a role of pre-enrichment by Pop III and II stars as a potential solution to the latter issue. Although not without shortcomings, it is encouraging that a naive blind (not tuned) cosmological simulation presents a possible channel for the formation of at least some massive GCs.

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Health Perception, Body Image, Sexual Function and Depression in Menopausal Women according to Menopausal Stages (폐경기 중년여성의 폐경단계에 따른 건강지각, 신체상, 성기능 및 우울)

  • Kim Jung-Hee;Moon Hyun-Sook
    • Journal of Korean Academy of Nursing
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    • v.36 no.3
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    • pp.449-456
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    • 2006
  • Purpose: The purpose of this study was to investigate the influences of health perception, body image and sexual function on depression according to the menopausal stage in Korean middle aged women. Methods: Subjects were 182 perimenopausal and postmenopausal women who had not received hormonal replacement therapy. A five-item General HealthShort Form (SF-36) Health Survey Questionnaire (Ware & Sherbourne, 1992) was used to measure health perception. Body image was measured Semantic Differential scale, CES-D was used to measure the level of depression, and sexual function was measured by FSFI. Results: The subjects rated their health as 'moderate', their body image as 'moderate, and level of depression as 'high'. However, there were no significant differences in health perception, body image, and depression between perimenopasual and postmenopausal women. Postmenopausal women experienced lower levels of sexual function than perimenopausal women in sexual arousal, lubrication, orgasm, satisfaction, and pain. In stepwise regression analysis, 21.7% of variance in depression was shown to be perceived health and body image in postmenopausal women. However, in perimenopausal women, perceived health and sexual function explained 34.5% of variance in depression. Conclusion: These findings indicate that nurses must consider the menopasusal stage when counseling their patients.

Nutritional Risk, Stress, and Health related Quality of Life among Older Women with a Foreign Daughter-in-Law (외국인 며느리를 둔 여성노인의 영양위험, 스트레스 및 건강관련 삶의 질)

  • Park, Mikyung;Sung, Kiwol
    • Journal of Korean Public Health Nursing
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    • v.29 no.2
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    • pp.312-324
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    • 2015
  • Purpose: This study addressed the relationship among nutritional risk, stress, and health related quality of life for older women with a foreign daughter-in-law. Methods: A descriptive research design was used for this study. The subjects of this study were 112 older women with a foreign daughter-in-law all of whom were over 65 years and living in D city. Personal interview was used for data collection. Nutritional risk, stress, and health related quality of life were measured using Nutrition Screening Initiative (NSI), Family Inventor of Life Events and Changes (FILE), and Medical Outcome Study (MOS) Short-form 36-Item Health Survey (SF-36), respectively. Results: Older women with a foreign daughter-in-law showed negative correlation between quality of life related health and nutritional risk, stress and age, and positive correlation between Activities of Daily Living (ADL); 46% of variance in health related quality of life of older women with a foreign daughter-in-law was explained by nutritional risk, ADL, stress and occupation. Conclusion: Based on the results of this study, we suggested that specialized programs should be established to help in development of social relationship networks for older women who have a foreign daughter-in-law.

The Effect of wool in patients with chronic obstructive pulmonary disease

  • Emine, Kiyak
    • CELLMED
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    • v.7 no.3
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    • pp.12.1-12.6
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    • 2017
  • The purpose of this study was to analyze the effect wool in patients with chronic obstructive pulmonary disease. The study was conducted experimentally on 53 patients with chronic obstructive pulmonary disease attending the chest diseases polyclinic of a hospital located in Erzurum. A randomized selection method was used to categorize patients into two groups; a treatment (n = 27), and a control group (n = 26). Patients in the treatment group (pre-test measurements were taken) wore wool vests for a period of three months, while patients in the control group wore cotton vests (placebo) for the same duration; post-test measurements were taken for both groups at the end of the three-month period. The Medical Outcomes Study Short Form 36, the St. George's Respiratory Questionnaire, and pulmonary function tests were used to collect data. Results concluded that there was a significant decrease (p < 0.05) in the overall score of the St. George's Respiratory Questionnaire, and the symptom, effect, and activity mean scores, while there was a significant increase (p < 0.05) in the SF-36 physical functioning, general health, bodily pain, role physical, vitality, role emotional, social functioning, mental health, physical and mental component summary mean scores of patients in the treatment group. Results of the study concluded that the symptoms, activity, disease effectiveness, and quality of life improved in patients that wore wool vests.