• The Korean Journal of Physiology and Pharmacology
• /
• v.12 no.6
• /
• pp.299-306
• /
• 2008

Sometimes, spinal cord injury (SCI) results in various chronic neuropathic pain syndromes that occur diffusely below the level of the injury. It has been reported that behavioral signs of neuropathic pain are expressed in the animal models of contusive SCI. However, the observation period is relatively short considering the natural course of pain in human SCI patients. Therefore, this study was undertaken to examine the time course of mechanical and cold allodynia in the hindpaw after a spinal cord contusion in rats for a long period of time (30 weeks). The hindpaw withdrawal threshold to mechanical stimulation was applied to the plantar surface of the hindpaw, and the withdrawal frequency to the application of acetone was measured before and after a spinal contusion. The spinal cord contusion was produced by dropping a 10 g weight from a 6.25 and 12.5 mm height using a NYU impactor. After the injury, rats showed a decreased withdrawal threshold to von Frey stimulation, indicating the development of mechanical allodynia which persisted for 30 weeks. The withdrawal threshold between the two experimental groups was similar. The response frequencies to acetone increased after the SCI, but they were developed slowly. Cold allodynia persisted for 30 weeks in 12.5 mm group. The sham animals did not show any significant behavioral changes. These results provide behavioral evidence to indicate that the below-level pain was well developed and maintained in the contusion model for a long time, suggesting a model suitable for pain research, especially in the late stage of SCI or for long term effects of analgesic intervention.

• PNF and Movement
• /
• v.9 no.2
• /
• pp.29-37
• /
• 2011

Purpose : The purpose of this study was to find out of an effect of forward, backward walking using partial weight bearing on walking of the patient with incomplete spinal cord injury. Methods : The average age, and the term of being sick of 6 patients who were selected as the subjects with incomplete spinal cord injury and who received medical attention in the National Rehabilitation Hospital, was 50.3 years old, and 10.7 months, and those were also the patients that were classified as ASIA-C or D by ASIA. The forward, backward walking using a partial weight bearing system as the research method, took total 6 weeks, 3 days per week, 3 times per day, total 45 minutes for each time(15 minutes for a time, 5 minutes for a breathing time), and the 15 minutes was used for forward walking 7.30 minutes, backward walking for 7.30 minutes, to find out before and after the test of WISCI, PCI, Walking Speed, Motor Score of Lower Limbs for the selected patients with incomplete spinal cord injury. Results : The result was showed WISCI from 17 points to 17 points that is, no change occurred at all, and PCI from $161.01{\pm}103.06$ to $74.97{\pm}58.19$, some amount of reduction that is not statistically significant(p<.05). Regarding walking speed, it increased from $24{\pm}.07m/sec$ to. $61{\pm}.35m/sec$, that is statistically significant(p<.05), and motor score of lower limbs showed statistically significant increase like from $33.17{\pm}7.08$ to $37{\pm}5.14$(P<.05). Conclusion : The 4 evaluation categories seem to have shown differences due to an insufficient number of subjects, and short test term, and it seems the more diverse task-oriented walking exercises should be studied in the coming days.

• The Korean Journal of Pain
• /
• v.36 no.4
• /
• pp.408-424
• /
• 2023

Central post-stroke pain (CPSP) is an incapacitating disorder that impacts a substantial proportion of stroke survivors and can diminish their quality of life. Conventional therapies for CPSP, including tricyclic antidepressants, anticonvulsants, and opioids, are frequently ineffective, necessitating the investigation of alternative therapeutic strategies. Repetitive transcranial magnetic stimulation (rTMS) is now recognized as a promising noninvasive pain management method for CPSP. rTMS modulates neural activity through the administration of magnetic pulses to specific cortical regions. Trials analyzing the effects of rTMS on CPSP have generated various outcomes, but the evidence suggests possible analgesic benefits. In CPSP and other neuropathic pain conditions, high-frequency rTMS targeting the primary motor cortex (M1) with figure-eight coils has demonstrated significant pain alleviation. Due to its associaton with analgesic benefits, M1 is the most frequently targeted area. The duration and frequency of rTMS sessions, as well as the stimulation intensity, have been studied in an effort to optimize treatment outcomes. The short-term pain relief effects of rTMS have been observed, but the long-term effects (> 3 months) require further investigation. Aspects such as stimulation frequency, location, and treatment period can influence the efficacy of rTMS and ought to be considered while planning the procedure. Standardized guidelines for using rTMS in CPSP would optimize therapy protocols and improve patient outcomes. This review article provides an up-to-date overview of the incidence, clinical characteristics, outcome of rTMS in CPSP patients, and future perspective in the field.

• Journal of Chest Surgery
• /
• v.56 no.5
• /
• pp.346-352
• /
• 2023

Background: A significant proportion of cardiac surgery intensive care unit (CSICU) patients require long-term ventilation, necessitating tracheostomy placement. The goal of this study was to evaluate the long-term postoperative outcomes and complications associated with percutaneous dilatational tracheostomy (PDT) in CSICU patients. Methods: All patients undergoing PDT after cardiac, thoracic, or vascular operations in the CSICU between January 1, 2013 and January 1, 2021 were identified. They were evaluated for mortality, decannulation time, and complications including bleeding, infection, and need for surgical intervention. Multivariable regression models were used to identify predictors of early decannulation and the complication rate. Results: Ninety-three patients were identified for this study (70 [75.3%] male and 23 [24.7%] female). Furthermore, 18.3% of patients had chronic obstructive pulmonary disease (COPD), 21.5% had history of stroke, 7.5% had end-stage renal disease, 33.3% had diabetes, and 59.1% were current smokers. The mean time from PDT to decannulation was 39 days. Roughly one-fifth (20.4%) of patients were on dual antiplatelet therapy and 81.7% had anticoagulation restarted 8 hours post-tracheostomy. Eight complications were noted, including 5 instances of bleeding requiring packing and 1 case of mediastinitis. There were no significant predictors of decannulation prior to discharge. Only COPD was identified as a negative predictor of decannulation at any point in time (hazard ratio, 0.28; 95% confidence interval, 0.08-0.95; p=0.04). Conclusion: Percutaneous tracheostomy is a safe and viable alternative to surgical tracheostomy in cardiac surgery ICU patients. Patients who undergo PDT have a relatively short duration of tracheostomy and do not have major post-procedural complications.

• Women's Health Nursing
• /
• v.12 no.2
• /
• pp.106-114
• /
• 2006

Purpose: The purpose of this study was to explore the effects of abdominal breathing on relieving anxiety in women diagnosed with preterm labor. Method: This was a pilot study, which was based on a repeated pre-post experiment design without a control group. Seven patients with preterm labor who were admitted to Y university medical center, Seoul, Korea, participated in the experiment. They were under receiving ritodrine hydrochloride(Yutopa) as tocolytic therapy and did not have any other complications. The patients were taught abdominal breathing, which is a modified version of Mason's breathing technique. The experimental treatments were done 33 times from February 18 to June 19 in 2005. Result: After abdominal breathing, the average psychological anxiety level decreased significantly. The physical anxiety levels of preterm labor patients were measured by blood pressure, pulse, and skin temperature. After abdominal breathing, the average systolic and diastolic blood pressure decreased from 117.3mmHg to 107.6 mmHg (z=-3.85, p<.001) and from 67.3mmHg to 62.7 mmHg (z=-3.14, p<.005), respectively. The average pulse rate also decreased from 97.2/min to 89.8/mim (z=-4.76, p<.001). The average skin temperature increased from 94.0 to 94.9(z=-4.80. p<.001). Conclusion: Abdominal breathing is effective for relieving anxiety of women diagnosed with preterm labor. This study, however, has been limited to short-term effects, and therefore further studies are required in order to examine the long-term effects of abdominal breathing.

• The Korean Journal of Pain
• /
• v.36 no.2
• /
• pp.173-183
• /
• 2023

Background: Understanding the stability of quantitative sensory tests (QSTs) over time is important to aid clinicians in selecting a battery of tests for assessing and monitoring patients. This study evaluated the short- and long-term reliability of selected QSTs. Methods: Twenty healthy women participated in three experimental sessions: Baseline, 2 weeks, and 6 months. Measurements included pressure pain thresholds (PPT) in the neck, upper back, and leg; Pressure-cuff pain tolerance around the upper-arm; conditioned pain modulation during a pressure-cuff stimulus; and referred pain following a suprathreshold pressure stimulation. Intraclass correlation coefficients (ICC) and minimum detectable change (MDC) were calculated. Results: Reliability for PPT was excellent for all sites at 2 weeks (ICC, 0.96-0.99; MDC, 22-55 kPa) and from good to excellent at 6 months (ICC, 0.88-0.95; MDC, 47-91 kPa). ICC for pressure-cuff pain tolerance indicated excellent reliability at both times (0.91-0.97). For conditioned pain modulation, reliability was moderate for all sites at 2 weeks (ICC, 0.57-0.74; MDC, 24%-35%), while it was moderate at the neck (ICC, 0.54; MDC, 27%) and poor at the upper back and leg at 6 months. ICC for referred pain areas was excellent at 2 weeks (0.90) and good at 6 months (0.86). Conclusions: PPT, pressure pain tolerance, and pressure-induced referred pain should be considered reliable procedures to assess the pain-sensory profile over time. In contrast, conditioned pain modulation was shown to be unstable. Future studies prospectively analyzing the pain-sensory profile will be able to better calculate appropriate sample sizes.

• Annals of Hepato-Biliary-Pancreatic Surgery
• /
• v.28 no.1
• /
• pp.34-41
• /
• 2024

Backgrounds/Aims: Liver transplantation (LT) provides a favorable outcome for patients with hepatocellular carcinoma (HCC) and was launched in Vietnam in 2004. In this study, we evaluated the short-term and long-term outcomes of LT and its risk factors. Methods: This retrospective study analyzed HCC patients who underwent LT at Viet Duc University hospital, Vietnam, from 01/2012-03/2022. The following data were gathered: demographics, virus infection, tumor characteristics, alpha-fetoprotein (AFP) level, Child-Pugh and MELD scores, selection criteria, type of LT, complications, 30-day mortality, and disease-free and overall survival (DFS and OS). Results: Fifty four patients were included, the mean age was 55.39 ± 8.46 years. Nearly 90% had hepatitis B virus-related HCC. The median (interquartile range) AFP level was 16.2 (88.7) ng/mL. The average MELD score was 10.57 ± 5.95; the rate of Child-Pugh A and B were 70.4% and 18.5%, respectively. Nearly 40% of the patients were within Milan criteria, brain-dead donor was 83.3%. Hepatic and portal vein thrombosis occurred in 0% and 1.9%, respectively; hepatic artery thrombosis 1.9%, biliary leakage 5.6%, and postoperative hemorrhage 3.7%. Ninety-day mortality was 5.6%. Five-year DFS and OS were 79.3% and 81.4%, respectively. MELD score and ChildPugh score were predictive factors for DFS and OS (p < 0.05). In multivariate analysis, Child-Pugh score was the only significant factor (p < 0.05). Conclusions: In Vietnam, LT is an effective therapy for HCC with an acceptable complication rate, mortality rate, and good survival outcomes, and should be further encouraged.

• Journal of dental hygiene science
• /
• v.17 no.1
• /
• pp.46-55
• /
• 2017

Many people in Korea suffer from a fear of dental treatments; however, only a few studies have focused on this population. This study assessed the effectiveness of cognitive behavioral therapy (CBT) and its interventions in reducing dental anxiety, especially when administered by trained dental staff. Using case studies, the authors analyzed the content of each session and examined the process of reducing dental anxiety. First, the authors observed that the results of both dental fear scale and subjective unit of disturbance decreased significantly with changes in cognitive distortions related to dental anxiety and that rapid improvements were noted after two therapy sessions. Second, the study reported that practicing relaxation (deep-breathing) and muscle relaxation techniques; using hand signals to indicate anxiety or discomfort; establishing an empathic relationship with the therapist; making an anxiety list; and graded insensitive and exposure along with rehearsal, were effective in coping with dental anxiety and in changing negative thoughts towards the dentist. Third, a simple cognitive behavioral intervention can be effective in reducing dental anxiety. In summary, a short-term, five-session psychological intervention with CBT produced a sustained decrease in the symptoms of dental anxiety, allowing the patients to receive the required procedures. The authors discussed the study limitations and the implication of their results on future research.

• Journal of Korean Society of Forest Science
• /
• v.104 no.4
• /
• pp.657-667
• /
• 2015

This study examined the effectiveness of 'Forest Therapy (FT)' from the biological, neurocognitive and psychosocial perspectives. Adolescents who were classified as potential internet addicts took part in a FT program for two (once or twice) or three days. Before and after participating the program, Serum Brain-derived neurotrophic factor (BDNF), Comprehensive Attention Test (CAT), Children's Depression Inventory (CDI), and State Anxiety Inventory (STAI) were measured. It was found that FT led to positive consequences, indicated by increased serum BDNF, improved CAT performance, reduced internet use desire, greater resilience, and better social relationship. In addition, FT was partially effective in alleviating state anxiety level, when the participants were classified in accordance with FT exposure lengths. Overall, this study provides evidence that FT reduces symptoms related to internet addiction and promotes various qualities required for well-being.

• Tuberculosis and Respiratory Diseases
• /
• v.46 no.5
• /
• pp.685-696
• /
• 1999

Background : Idiopathic pulmonary fibrosis (IPF) is a diffuse inflammatory and fibrosing process that occurs within the interstitium and alveolus of the lung with invariably poor prognosis. The major problem in management of IPF results from the variable rate of disease progression and the difficulties in predicting the response to therapy. The purpose of this retrospective study was to evaluate the short-term efficacy of steroid and immunosuppressive therapy for IPF and to identify the pre-treatment determinants of favorable response. Method : Twenty patients of IPF were included. Diagnosis of IPF was proven by thoracoscopic lung biopsy and they were presumed to have active progressive disease. The baseline evaluation in these patients included clinical history, pulmonary function test, bronchoalveolar lavage (BAL), and chest high resolution computed tomography (HRCT). Fourteen patients received oral prednisolone treatment with initial dose of 1mg/kg/day for 8 to 12 weeks and then tapering to low-dose prednisolone (0.25mg/kg/day). Six patients who previously had experienced significant side effects to steroid received 2mg/kg/day of oral cyclophosphamide with or without low-dose prednisolone. Follow-up evaluation was performed after 6 months of therapy. If patients met more than one of followings, they were considered to be responders : (1) improvement of more than one grade in dyspnea index, (2) improvement in FVC or TLC more than 10% or improvement in DLco more than 20% (3) decreased extent of disease in chest HRCT findings. Result : One patient died of extrapulmonary cause after 3 month of therapy, and another patient gave up any further medical therapy due to side effect of steroid. Eventually medical records of 18 patients were analyzed. Nine of 18 patients were classified into responders and the other nine patients into nonresponders. The histopathologic diagnosis of the responders were all nonspecific interstitial pneumonia (NSIP) and that of nonresponders were all usual interstitial pneumonia (UIP) (p<0.001). The other significant differences between the two groups were female predominance (p<0.01), smoking history (p<0.001), severe grade of dyspnea (p<0.05), lymphocytosis in BAL fluid ($23.8{\pm}16.3%$ vs $7.8{\pm}3.6%$, p<0.05), and less honeycombing in chest HRCT findings (0% vs $9.2{\pm}2.3%$, p<0.001). Conclusion : Our results suggest that patients with histopathologic diagnosis of NSIP or lymphocytosis in BAL fluid are more likely to respond to steroid or immunosuppressive therapy. Clinical results in large numbers of IPF patients will be required to identify the independent variables.