• Title/Summary/Keyword: Subjective Pain

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Late-term effects of hypofractionated chest wall and regional nodal radiotherapy with two-dimensional technique in patients with breast cancer

  • Yadav, Budhi Singh;Bansal, Anshuma;Kuttikat, Philip George;Das, Deepak;Gupta, Ankita;Dahiya, Divya
    • Radiation Oncology Journal
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    • v.38 no.2
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    • pp.109-118
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    • 2020
  • Purpose: Hypofractionated radiotherapy (RT) is becoming a new standard in postoperative treatment of patients with early stage breast cancer after breast conservation surgery. However, data on hypofractionation in patients with advanced stage disease who undergo mastectomy followed by local and regional nodal irradiation (RNI) is lacking. In this retrospective study, we report late-term effects of 3 weeks post-mastectomy hypofractionated local and RNI with two-dimensional (2D) technique in patients with stage II and III breast cancer. Methods: Between January 1990 and December 2007, 1,770 women with breast cancer who were given radical treatment with mastectomy, systemic therapy and RT at least 10 years ago were included. RT dose was 35 Gy/15 fractions/3 weeks to chest wall by two tangential fields and 40 Gy in same fractions to supraclavicular fossa (SCF) and internal mammary nodes (IMNs). SCF and IMNs dose was prescribed at dmax and 3 cm depth, respectively. Chemotherapy and hormonal therapy was given in 64% and 74% patients, respectively. Late-term toxicities were assessed with the Radiation Therapy Oncology Group (RTOG) scores and LENT-SOMA scales (the Late Effects Normal Tissue Task Force-Subjective, Objective, Management, Analytic scales). Results: Mean age was 48 years (range, 19 to 75 years). Median follow-up was 12 years (range, 10 to 27 years). Moderate/marked arm/shoulder pain was reported by 254 (14.3%) patients. Moderate/marked shoulder stiffness was reported by 219 (12.3%) patients. Moderate/marked arm edema was seen in 131 (7.4%) patients. Brachial plexopathy was not seen in any patient. Rib fractures were noted in 6 (0.3%) patients. Late cardiac and lung toxicity was seen in 29 (1.6%) and 23 (1.3%) patients, respectively. Second malignancy developed in 105 (5.9%) patients. Conclusion: RNI with 40 Gy/15 fractions/3 weeks hypofractionation with 2D technique seems safe and comparable to historical data of conventional fractionation (ClinicalTrial.gov Registration No. NCT04175821).

A Study on Oral Health Behaviors Depending on Oral Examination of Students at S Boys' High School (S고교 남학생의 구강검진에 따른 구강보건행태조사)

  • Jeong, Mi-Ae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.10 no.9
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    • pp.2478-2484
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    • 2009
  • The purpose of this study is to conduct an oral examination of total 220 students (1st grade) at S Boys' High School in Seoul metropolitan City. The results of oral examination can be outlined as follows: According to survey on experience of oral symptoms 85.5% students had no experience of tooth fracture, 76.8% students had no experience of hemodia, and 90.9% students had no experience of toothache. And it was found that 86.4% students had no experience of periodontal disease, 98.2% students had no experience of intraoral pain, and 88.2% had no experience of subjective halitosis symptom. According to survey on oral health behaviors, 73.6 % students had no experience of visiting any dental clinic over last one year. In particular, it was found that 57.3% students brushed their teeth after breakfast every day, 19.1% students didn't enjoy having any confectionery or sweet stuff, or taking soft drink like coke on a daily basis, and 19.5% students used fluoride toothpaste for toothbrushing as of this survey. According to oral health examination, 55.9% students had no dental caries, and 44.1% students had dental caries. And it was found that most students (79.2%) had dental calculus resulting from periodontal disease.

A Case Report of Non-Motor Symptoms Evaluated Using the Non-Motor Symptom Scale in a Patient with Secondary Parkinsonism Presumed to be Probable Lewy Body Dementia and Improved with Combined Treatment with Herbal Medicine and Acupuncture (루이소체 치매로 추정되는 이차성 파킨슨증 환자의 Non-Motor Symptom Scale(NMSS)로 평가한 비운동성 증상을 한약과 침의 복합치료로 호전시킨 증례보고 1례)

  • Roh, Min-yeong;Lee, Ji-hyun;Han, Yang-hee;Leem, Jung-tae
    • The Journal of Internal Korean Medicine
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    • v.42 no.5
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    • pp.833-845
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    • 2021
  • Parkinson's syndrome is a degenerative brain disease that presents characteristic motor symptoms of tremor, rigidity, and gait disturbance. In addition to these motor symptoms, Parkinson's syndrome also presents non-motor symptoms (NMSs) such as sleep disturbance and cognitive decline. NMSs reduce patient's quality of life and psychosocial functioning and cause economic burden on the patient, so appropriate evaluation and treatment are required. Lewy body dementia is one of the several diseases belonging to Parkinson's syndrome. Its symptoms such as cognitive function, memory impairment, and hallucinations occur with Parkinsonism. Although drug therapy is being used with drug treatment to treat non-motor symptoms, it has limitations such as side effects, which stimulated interest in other complementary treatment methods such as oriental medicine treatment, dance, and yoga. The patient in this case complained of tremor in the right upper extremity, muscle hypertension and pain, and persistent vision, memory, and cognitive decline. The patient was diagnosed with probable Lewy body dementia. The patient was hospitalized for 4 months and received acupuncture and herbal medicines. After treatment, the patient's NMS scale scores decreased from 90 to 63, and the Unified Parkinson's Disease Rating Scale scores (summed I, II, and III) decreased from 17 points to 8 points. The Beck Depression Inventory score decreased from 22 points to 13 points. In addition, the patient's subjective evaluation revealed improvement. In this case, a patient diagnosed with probable Lewy body dementia who did not respond to the standard treatment and did not want to take medications showed improvement in not only motor symptoms but also NMSs after integrative Korean medicine treatment.

Temporomandibular joint disc plication with MITEK mini anchors: surgical outcome of 65 consecutive joint cases using a minimally invasive approach

  • Lee, Bu-Kyu;Hong, Jun Hee
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.42
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    • pp.14.1-14.11
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    • 2020
  • Background: The purpose of this study is to introduce our modified disc plication technique using MITEK mini anchors and to evaluate the clinical outcome for patients with internal derangement (ID) of the temporomandibular joint (TMJ). Patients and methods: We evaluated 65 joints in 46 patients, comprised 32 women and 14 men, who first visited the Asan Medical Center from December 2012 to December 2016. The age of the patients ranged from 14 to 79 years, with a mean age of 36.6 years. The patients presented with joint problems including pain, joint noise, and mouth opening limitation (MOL). Patients who met our inclusion criteria underwent unilateral or bilateral disc repositioning surgery with our minimally invasive disc plication technique using MITEK mini anchors and No. 2-0 Ethibond® braided polyester sutures. The variables taken into account in this study were the range of maximum mouth opening (MMO), painful symptoms (evaluated with the visual analog scale, VAS), and the type of noise (click, popping, crepitus) in the TMJ. Results: Preoperative examination revealed painful symptoms in 50.7% (n = 35) of the operated joints (n = 69) and the presence of clicks in 56.5% (n = 39). Postoperative examination revealed that 4.3% (n = 3) of the operated joints had painful symptoms with lower intensity than that in the preoperative condition. Additionally, 17.4% (n = 12) had residual noise in the TMJ, among which two were clicking and the other 10 had mild crepitus. The intensity of the postoperative residual noise was significantly decreased in all cases compared to that in the preoperative condition. Among patients with MOL below 38 mm (n = 18), the mean MMO was 31.4 mm preoperatively and 44.2 mm at 6 months postoperatively, with a mean increase of 13.8 mm. A barely visible scar at the operation site was noted during the postoperative observation period, with no significant complications such as facial palsy or permanent occlusal disharmony. Conclusion: Subjective symptoms in all patients improved following the surgery. TMJ disc plication using MITEK mini anchors with our minimally invasive approach may be a feasible and effective surgical option for treating TMJ ID patients who are not responsive to conservative treatment.

Data-driven Co-Design Process for New Product Development: A Case Study on Smart Heating Jacket (신제품 개발을 위한 데이터 기반 공동 디자인 프로세스: 스마트 난방복 사례 연구)

  • Leem, Sooyeon;Lee, Sang Won
    • Journal of the Korea Convergence Society
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    • v.12 no.1
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    • pp.133-141
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    • 2021
  • This research suggests a design process that effectively complements the human-centered design through an objective data-driven approach. The subjective human-centered design process can often lack objectivity and can be supplemented by the data-driven approaches to effectively discover hidden user needs. This research combines the data mining analysis with co-design process and verifies its applicability through the case study on the smart heating jacket. In the data mining process, the clustering can group the users which is the basis for selecting the target groups and the decision tree analysis primarily identifies the important user perception attributes and values. The broad point of view based on the data analysis is modified through the co-design process which is the deeper human-centered design process by using the developed workbook. In the co-design process, the journey maps, needs and pain points, ideas, values for the target user groups are identified and finalized. They can become the basis for starting new product development.

Development and Effectiveness Evaluation of Acupressure Bed with Variable Type Bogie (변동형 대차 구동방식의 지압 침대 개발 및 유효성 평가)

  • Heo, Sung-Phil;Park, Se-Jin;Ahn, Do-Hyun
    • Journal of Korea Society of Industrial Information Systems
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    • v.25 no.6
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    • pp.47-54
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    • 2020
  • The acupressure is a treatment that applies pressure to certain parts of the body and has been mainly used for pain relief in the field of oriental medicine. However, the treatment effect is often different depending on the practitioner's ability, experience, and physical strength, so standardized acupressure is needed. In this regard, the equipment is being released, but this is mainly a rolling massage method, which reduces energy concentration and poses a risk of injury. Therefore, in this study, a device that provides vertical acupressure based on variable bogie (wheel truck) was implemented. As a result of experimenting with load and body pressure distribution and desirability to validate the device's bearing pressure, the acupressure rod held up to 150kg, the body pressure ratio was measured lower than the body pressure ratio of the comparison item in section 0%

A Case of Adult Otitis Media with Effusion Accompanied by Atopic Dermatitis (아토피피부염을 동반한 성인 삼출성 중이염 치험례)

  • Song, Ji-Hoon;Yu, Pei-Yen;Kim, Jong-Han;Jung, Min-Yeong;Choi, Jung-Hwa;Park, Soo-Yeon
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.35 no.2
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    • pp.95-104
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    • 2022
  • Objectives : This study is to report a case of otitis media with effusion accompanied by atopic dermatitis improved by Korean medicine monotherapy. Methods : A 31-year-old woman patient visited our clinic for aural fullness, hearing loss, and tinnitus of the left ear on August 14th, 2021. She also had abdominal pain, diarrhea, and general weakness because of side effects of antibiotics. Besides, she had nasal congestion, rhinorrhea, and dry skin. Through otoscopy, her tympanum was fully filled with yellow effusion. She only took Korean medicine therapy including acupuncture and herbal medicine weekly. The treatment continued for about 4 months(total 14 visits) until December 4th, 2021. Otoscopy, numerical rating scale(NRS), scoring atopic dermatitis(SCORAD) index were used to assess the symptoms. Results : On August 30, 2021, her intestinal symptoms improved. The left tympanum was recovered to normal condition as the treatment continued. The effusion disappeared on October 16th, 2021. On November 6th, 2021, peritympanic blood congestion also almost alleviated. Subjective symptoms including aural fullness, hearing loss, and tinnitus disappeared on October 16, 2021. Nasal symptoms and dry skin also improved. The SCORAD index dropped from 15 to 4. Conclusions : These results suggests that otitis media with effusion can be sufficiently managed by Korean medicine therapy. Further, active application of Korean medicine therapy to common otolaryngological diseases is necessary.

A Systematic Review of Mobile Health Applications Using Self-Acupressure (자가혈위지압을 활용한 모바일 의료 어플에 대한 체계적 문헌고찰)

  • Seokyung Park;Johyun Lee;Ga-Young Jung;Celine Jang;Sang-Ho Kim
    • Korean Journal of Acupuncture
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    • v.40 no.1
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    • pp.1-12
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    • 2023
  • Objectives : This study aims to provide information regarding the status and quality of mobile applications (MAs) using self-acupressure by performing a systematic review. Methods : We conducted comprehensive searching on five international databases and two app markets from inception to July 31, 2022 to identify MAs using self-acupressure. We analyzed the characteristics of each MA regarding the name of the MA, registered app markets, target symptoms, developers, the year and country of development, cost, target age, media function, and expertise. We assessed the quality of each MA using Mobile Application Rating Scale (MARS). Results : We identified a total of 30 MAs using self-acupressure (25 MAs from the app market and 6 MAs from clinical studies, with 1 MA in common). 17 out of 24 MAs from the app market provided self-acupressure regimens for various symptoms and the others provided regimens for specific symptoms such as memory, anxiety, depression, asthma, allergy, low back pain, and headache. 14 developers were reported. 23 MAs were developed after 2013. The largest number of MAs were developed in the United States. The target age group of 12 MAs was above the age of 3, and that of 11 MAs was above the age of 12. 14 MAs provided multimedia functions such as videos. 13 MAs provided information of expertise. From clinical studies, only 3 out of 6 MAs were accessible through the app market. 4 MAs were developed by the researchers of the study. In terms of MARS, the score of MAs from the app market was higher than that of MAs from clinical studies in both objective and subjective evaluation areas. Conclusions : This study summarizes the characteristics of MAs using self-acupressure. More MAs using self-acupressure should be developed and further clinical research for MA on each symptom and disease is warranted for the diversification of MA fields using self-acupressure.

Feasibility of TRPM8 Agonist Agent for Management of Skin Graft Donor Site (화상 재건을 위한 식피술 공여부의 반흔 관리에 있어 TRPM8 Agonist 제재의 유용성)

  • Choi, Jangyoun;Jung, Ee Room;Cho, Jin Tae;Seo, Bommie Florence;Choi, Jong Yun;Kwon, Ho;Jung, Sung-No
    • Journal of the Korean Burn Society
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    • v.22 no.2
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    • pp.30-33
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    • 2019
  • Purpose: Wound healing and scar management of donor site after skin graft should not be overlooked. Patients continue to complain of dryness, itching sensation. Such discomfort can cause irritation to the patients and lead to delayed healing or secondary infection. Thus, the author predicted Eucalyptus Oil, which acts on Transient Receptor Potential Melastatin 8 would be effective in regulating scar by reducing itching sensation in donor site when combining conventional silicone materials. Methods: The study was performed on 30 patients who underwent split thickness skin graft with lateral thigh as donor site between January 2017 and August 2018. First, primary evaluation of fully epithelized donor site scar three weeks after surgery was conducted. Control group (n=15) applied silicone gel (Kelo-cote, USA) solely two times a day. study group (n=15) applied Eucalyptus oil, combined with silicone gel. After 3 months of follow up, donor scar was evaluated using Vancouver scar scale and VAS scores of subjective patient reports regarding pain and itching sensation. Results: It was confirmed that both groups showed stable scar improvement comparing scar quality for 3 months. After 3 months, scar quality in study group showed superiority in pigmentation, pliability and pruritus compared to control group. Conclusion: Application of Eucalyptus Oil combined with conventional silicone gel is favorable to scar management and may give additional benefit of alleviating pruritis symptoms.

Clinical characteristics of patients with the hardware failure after surgical stabilization of rib fractures in Korea: a case series

  • Na Hyeon Lee;Sun Hyun Kim;Seon Hee Kim;Dong Yeon Ryu;Sang Bong Lee;Chan Ik Park;Hohyun Kim;Gil Hwan Kim;Youngwoong Kim;Hyun Min Cho
    • Journal of Trauma and Injury
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    • v.36 no.3
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    • pp.196-205
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    • 2023
  • Purpose: Surgical stabilization of rib fractures (SSRF) is widely used in patients with flail chests, and several studies have reported the efficacy of SSRF even in multiple rib fractures. However, few reports have discussed the hardware failure (HF) of implanted plates. We aimed to evaluate the clinical characteristics of patients with HF after SSRF and further investigate the related factors. Methods: We retrospectively reviewed the electronic medical records of patients who underwent SSRF for multiple rib fractures at a level I trauma center in Korea between January 2014 and January 2021. We defined HF as the unintentional loosening of screws, dislocation, or breakage of the implanted plates. The baseline characteristics, surgical outcomes, and types of HF were assessed. Results: During the study period, 728 patients underwent SSRF, of whom 80 (10.9%) were diagnosed with HF. The mean age of HF patients was 56.5±13.6 years, and 66 (82.5%) were men. There were 59 cases (73.8%) of screw loosening, 21 (26.3%) of plate breakage, 17 (21.3%) of screw migration, and seven (8.8%) of plate dislocation. Nine patients (11.3%) experienced wound infection, and 35 patients (43.8%) experienced chronic pain. A total of 21 patients (26.3%) underwent reoperation for plate removal. The patients in the reoperation group were significantly younger, had fewer fractures and plates, underwent costal fixation, and had a longer follow-up. There were no significant differences in subjective chest symptoms or lung capacity. Conclusions: HF after SSRF occurred in 10.9% of the cases, and screw loosening was the most common. Further longitudinal studies are needed to identify risk factors for SSRF failure.