• Title/Summary/Keyword: Symptom Improvement

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Arthroscopic Treatment for the Pigmented Villonodular Synovitis in the Knee (관절경을 이용한 슬관절의 색소 응모 결절성 활액막염의 치료)

  • Kim, Kyung-Taek;Kim, Chul-Hong;Lee, Myung-Jin
    • Journal of the Korean Arthroscopy Society
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    • v.5 no.2
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    • pp.111-115
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    • 2001
  • Purpose : To confirm the efficacy of arthroscopic synovectomy for the pigmented villonodular synovitis in the knee. Materials and Methods : We analysed 8 patient(9 cases) that were diagnosed and performed arthroscopic synovectomy as pigmented villonodular synovitis from July 1992 to May 2000. The diagnosis was confirmed by pathologist. The average follow-up period was 29 months(range, $15\~48$ months). The average age at initial visit was 40.4 years(rage, $15\~67$ years). Male were 6 cases and female 2 cases. The average duration from onset of the symptom to the operation was 23 months($2\~86$ months). Previous history of the trauma was noted in 2 case. There was 1 case involved both knee joints. Results : According to the athroscopic findings, there were 4 localized forms and 5 diffuse forms. At preoperational examinations, the average of flexion contracture was $4.4^{\circ}(0\~5^{\circ})$ and that of the further flexion was $117.8^{\circ}(90\~135^{\circ})$. At last follow-up examinations, the knee range of motion was normalized, the average of flexion range was $133.9^{\circ}(120\~140^{\circ})$. All patients had improvement in pain, swelling and range of motion and there was no evidence of recurrence. Conclusion : In the pigmented villonodular synovitis, arthroscopic synovectomy can be considered one of the good modality to expect good results.

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Long-term Follow-up Results of the Localized Pigmented Villonodular Synovitis of the Knee (more than 5 years) (슬관절 국소형 색소융모결절성 활액막염의 장기 추시 결과 (5년이상))

  • Lee, Byung-Il;Choi, Hyung-Suk;Min, Kyung-Dae;Rah, Soo-Kyun;Cho, Sang-Hyuck
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.7 no.1
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    • pp.37-44
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    • 2008
  • Purpose: To purpose of this study was to review the long-term follow up results of surgical treatment of the localized pigmented villonodular synovitis in the knee. Materials and Methods: We evaluated and analyzed 6 patients (6 cases) who underwent arthroscopy and excisional biopsy as pigmented villonodular synovitis from March 1988 to June 2002. The clinical diagnosis was confirmed by pathologic findings. All patients had been managed with arthroscopic excision, but two patients underwent mini-open excision. The recurrence was evaluated by the loss of preoperative symptom and physical examination for range of motion, pain and finding of swelling. Results: According to the arthroscopic findings, all patients had localized form of pigmented villonodular synovitis. Three patients had pedunculated type (one of them had torsion) and the two patients had nodular type and one patient had mixed type. All patients had improvement in pain, swelling and range of motion and there was no evidence of recurrence. Conclusion: In terms of long term follow up results, precise preoperative diagnosis and the adequate surgical treatment, especially arthroscopic excision for the localized pigmented villonodular synovitis, would be considered one of the fundamental modality to expect the good results.

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Bronchoscopic Cryotherapy in Patients with Central Airway Obstruction (기관지 내시경적 냉동치료를 통한 중심성 기도폐쇄의 치료)

  • Lyu, Ji-Won;Song, Jin-Woo;Hong, Sang-Bum;Oh, Yeon-Mok;Shim, Tae-Sun;Lim, Chae-Man;Lee, Sang-Do;Koh, Youn-Suck;Kim, Woo-Sung;Kim, Dong-Soon;Choi, Chang-Min
    • Tuberculosis and Respiratory Diseases
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    • v.68 no.1
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    • pp.6-9
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    • 2010
  • Background: The efficacious use of interventional bronchoscope for patients with central airway obstruction due to malignant or benign lesions has been proven. Among many therapeutic bronchoscopic procedures, endobronchial cryotherapy is an established recanalization method for the obstruction of the respiratory tract. Recently, the use of this procedure has been increasing in Korea. However, limited data are available in the literature regarding its efficacy in Korea. Methods: Thirty patients, who had been treated with a flexible cryoprobe for cryotherapy were enrolled; clinical characteristics and treatment outcomes were analyzed. The patients had been treated with the technique using nitrous oxide as a cryogen under local anesthesia. Objective outcomes were 3 different degrees of therapeutic success by use of follow-up bronchoscopic findings as follows: successful, partially successful, and unsuccessful response. Subjective outcomes were evaluated as an improvement in symptoms. Results: The mean age of enrolled patients was $59{\pm}11$ years and there was a male (22/30) dominance. Twenty-three patients had malignant tumor and 7 patients had benign lesions with central airway obstruction. Successful recanalization was achieved in 11 (37%) patients, and partially successful response was achieved in 15 (50%) patients. Dyspnea was improved in 84.2% (16/19) of patients. At least one respiratory symptom was resolved in 91.3% (21/23) patients. Seven patients (23.3%) needed additional bronchoscopic electrocautery because of the bleeding as a complication of cryotherapy. Conclusion: Endobronchial cryotherapy is an effective and less expensive procedure for the management of central airway obstruction. However, the procedure should be performed under the preparing for an emergency situation, such as massive bleeding.

Impact of symptoms of Work-related Musculoskeletal Disorders on health related Quality of Life in firefighter under the IT environment (IT 환경에서 소방공무원의 근골격계 증상이 건강관련 삶의 질에 미치는 영향)

  • Oh, Gyung-Jae;Lee, Jeong-Mi;Yang, Chung-Yong;Park, Hyung-Ju;Park, Yun-Hee;Yoo, Chan-Uk;Kang, Eun-Yeong;Chong, Bok-Hee
    • The Journal of the Korea institute of electronic communication sciences
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    • v.9 no.3
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    • pp.311-322
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    • 2014
  • This study was conducted to assess the impact of work-related musculoskeletal disorders (WMSDs) on health related quality of life (QoL) in the firefighter under the recent IT environment. The data were collected by face to face interview using a structured questionnaire in the 366 respondents. WMSDs symptoms were measured by a self-assessed questionnaire on symptom table of NIOSH and health-related QoL was measured by SF-36. The prevalence of WMSDs was 38.0% in upper limbs, 35.5% in the low back, 21.6% in lower limbs, and 59.3% in two or more parts of the body. Subjects with symptoms of WMSDs had significantly lower scores in 7 dimensions of QoL except 'emotional role limitation' than those without symptoms of WMSDs at the area of upper extremities (neck, shoulder, arm/wrist, and hand/wrist/fingers). On the other hand, subjects with symptoms of WMSDs had significantly lower scores on all QoL dimensions than those without symptoms of WMSDs at the area of lower back or lower extremities. These results suggest that WMSDs had a negative effect on QoL. Therefore, prevention of WMSDs should be considered intervention strategies for improvement of QoL, especially in firefighters.

The Telescopic Findings and Clinical Manifestations of Laryngeal Tuberculosis (후두 결핵의 후두 내시경 소견과 임상 양상 분석)

  • Lee, Sang-Hyuk;Lee, Seung-Suk;Lee, No-Hee;Ban, Jae-Ho;Lee, Kyung-Chul;Jin, Sung-Min
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.17 no.1
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    • pp.38-42
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    • 2006
  • Background and Objectives: There has been a gradual decline in the incidence of laryngeal tuberculosis due to effective an-tituberculous chemotherapy and improvement in the standard of living. During the last decade, however, the disease has changed its clinical pattern. We aimed to study a clinical and telescopic evaluation of laryngeal tuberculosis. Materials and Method: A retrospective clinical analysis was done for 16 patients who diagnosed laryngeal tuberculosis from January 2000 through December 2004. All patients had a complete clinical and laboratory work-up including telescopy, chest X-rays, sputum cultures, Tbc PCR(polymerase chain reaction). Laryngeal biopsies were performed in some cases. All the patients received proper antituberculous chemotherapy. Results: The patients age ranged from 21 to 59 with a mean age 43. The male to female ratio was 10:6. The prominent presenting symptom was hoarseness. The various telescopic findings were categorized: 7 patients showed ulcerative, 4 patients granulomatous, 3 patients ulcerofungative, 2 patients had nonspecific inflammatory lesions. Involving sites were true vocal cord most commonly in 12 patients. Three of 16 patients had normal chest X-ray fmding. Among 16 patients, 4 patients showed positive response for AFB stain, 13 patients showed positive for Tbc PCR. Biopsy was done for 3 patients who were not confirmed in initial tuberculous test. All patients responded satisfactorily to antituberculous medication. Conclusion: The telescopic findings and clinical manifestations of laryngeal tuberculosis have changed and seemed to be different from those of classic reports. Thus, the clinicians who deal with the various symptoms and diseases should be aware of the existence of laryngeal tuberculosis and the changing patterns of the disease.

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Effect of nutrition care process-based nutrition intervention on improvement of intake in the elderly in-patients with malnutrition (영양관리과정에 근거한 영양중재가 노인 영양불량 입원환자의 식사섭취량 증진에 미치는 효과)

  • Park, Ji-Hyun;Kang, Min-Ji;Seo, Jung-Sook
    • Journal of Nutrition and Health
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    • v.51 no.4
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    • pp.307-315
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    • 2018
  • Purpose: This study evaluated the effects of personalized nutrition intervention for increasing hospital meal intake by elderly patients with malnutrition. Methods: The subjects were 30 elderly patients with malnutrition who visited a general hospital located in Daegu. An individual nutrition intervention such as change of meal types or special meal service was given to the patients according to nutrition diagnosis related to inadequate intake of hospital meals. Nutritional intake status of the subjects was assessed by analyzing energy intake, protein intake, index of nutritional quality (INQ), nutrient adequacy ratio (NAR) and mean adequacy ratio (MAR). Results: The causes of inadequate intake in the subjects were poor appetite or preference problems (46.7%), symptom-related problems (30.0%) and mastication problems (23.3%). The INQ of protein in the subjects was significantly increased from $0.81{\pm}0.17$ to $1.41{\pm}0.25$ after the nutrition intervention (p < 0.05). The NAR of protein (before $0.50{\pm}0.21$, after $0.58{\pm}0.17$), iron (before $0.72{\pm}0.30$, after $0.84{\pm}0.29$) and vitamin $B_2$ (before $0.31{\pm}0.16$, after $0.37{\pm}0.14$) was also increased after the nutrition intervention (p < 0.05). The MAR of five nutrients, protein, calcium, iron, vitamin A and vitamin $B_2$, was significantly increased by the nutrition intervention (p < 0.05). Conclusion: Personalized nutrition intervention according to nutrition diagnosis related to inadequate intake of hospital meals may improve the intake amount of elderly patients with malnutrition.

Surgical treatment of benign esophageal disease (양성 식도질환의 외과적 요법)

  • Kim, Eung-Jung;Kim, Yong-Jin
    • Journal of Chest Surgery
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    • v.17 no.4
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    • pp.762-774
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    • 1984
  • A clinical analysis was performed on 49 cases of the benign esophageal diseases experienced at Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital during 7 year period from 1977 to 1983. Of 49 cases Of the benign esophageal diseases, there were 19 patients of esophageal stricture, 11 of achalasia, 6 of perforation, 3 of bronchoesophageal fistula, 3 of esophageal perforation, 3 of esophageal leiomyoma and one of esophageal foreign body. Twenty three patients were male and 26 were female. Ages ranged from 4 years to 74 years with the average age of 34.7 years. Of 19 patients of esophageal strictures, 7 patients were male and 12 were female and ages ranged from 6 years to 74 years with the average being 33.8 years. Causes of esophageal strictures were corrosive of esophageal strictures were dysphagia, vomiting, general weakness, weight loss and pain that order and developed on several different parts of esophagus. Operations were performed in 18 cases, of whom 7 patients were performed by esophagocologastrostomy, 4 gastrostomy, 4 esophagogastrostomy, 1 esophageal resection and esophagoesophagostomy, 1 esophagotomy and dilatation and 1 scar revision. Five patients had one or two complications; 2 anastomotic leakage, 1 wound infection, 1 localized empyema, 1 bilateral pneumothorax and 1 respiratory failure. One patient expired due to respiratory failure arising from aspiration pneumonia. The average age of achalasia patients was 33.1 years and symptom durations were from 2 months to 10 years with the average of 3.3 years. Main symptoms were dysphagia, vomiting, weight loss, pain and cough in that order. Modified Hellers myotomy was performed in 11 patients with one complication of restenosis. One patient was operated on by using longitudinal incision and transverse sutures with good result. Of 6 patient of esophageal diverticulum, 2 patients were traction diverticulum on the midesophagus, 2 were pulsion diverticulum on the midesophagus and 2 were pulsion diverticulum on the lower esophagus. Diverticulectomy was performed on 2 cases of traction diverticulum and esophagocardiomyotomy with or without diverticulectomy was erformed on 4 cases of pulsion diverticulum with good results. Of 5 patients of congenital bronchoesophageal fistula, the chief complaints were productive cough in 4 patients and hematemesis without respiratory symptoms in one patient. Two patients were operated on by using fistulectomy only and 3 by fistulectomy with pulmonary lobectomy. Of 3 patients of esophageal perforation, causes were foreign body ingestion, esophageal stricture after ECG and corrosive esophagitis. Two patient were operated on by using drainage and gastrostomy with symptomatic improvement but one patient died due to septic shock after thoracotomy. Three patients of esophageal leiomyoma were all male and 2 patients were operated on by using enucleation and one by distal esophagectomy with esophagogastrostomy. In one patient of esophageal foreign body, it was removed by esophagotomy through the right thoracotomy.

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Neurolysis for Megalgia Paresthetica

  • Son, Byung-Chul;Kim, Deok-Ryeong;Kim, Il-Sup;Hong, Jae-Taek;Sung, Jae-Hoon;Lee, Sang-Won
    • Journal of Korean Neurosurgical Society
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    • v.51 no.6
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    • pp.363-366
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    • 2012
  • Objective : Meralgia paresthetica (MP) is a syndrome of pain and/or dysesthesia in the anterolateral thigh that is caused by an entrapment of the lateral femoral cutaneous nerve (LFCN) at its pelvic exit. Despite early accounts of MP, there is still no consensus concerning the effectiveness of neurolysis or transaction treatments in the long-term relief for medically refractory patients with MP. We retrospectively analyzed available long-term results of LFCN neurolysis for medically refractory MP in an effort to clarify this issue. Methods : During the last 7 years, 11 patients who had neurolysis for MP were enrolled in this study. Nerve entrapment was confirmed preoperatively by electrophysiological studies or a positive response to local anesthetic injection. Decompression of the LFCN was performed at the level of the iliac fascia, inguinal ligament, and fascia of the thigh distally. The outcome of surgery was assessed 8 weeks after the procedure followed at regular intervals if symptoms persisted. Results : Twelve decompression procedures were performed in 11 patients over a 7-year period. The average duration of symptoms was 8.5 months (range, 4-15 months). The average follow-up period was 33 months (range, 12-60 months). Complete and partial symptom improvement were noted in nine (81.8%) and two (18.2%) cases, respectively. No recurrence was reported. Conclusion : Neurolysis of the LFCN can provide adequate pain relief with minimal complications for medically refractory MP. To achieve a good outcome in neurolysis for MP, an accurate diagnosis with careful examination and repeated blocks of the LFCN, along with electrodiagnosis seems to be essential. Possible variation in the course of the LFCN and thorough decompression along the course of the LFCN should be kept in mind in planning decompression surgery for MP.

Dynamics and Liver Disease Specific Aspects of Quality of Life Among Patients with Chronic Liver Disease in Yunnan, China

  • Che, Yan-Hua;You, Jing;Chongsuvivatwong, Virasakdi;Li, Li;Sriplung, Hucha;Yan, Yuan-Zhi;Ma, Si-Jia;Zhang, Xiaoli;Shen, Ting;Chen, He-Min;Rao, Shao-Feng;Zhang, Ru-Yi
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.12
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    • pp.4765-4771
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    • 2014
  • Background: Patients with chronic liver diseases (CLD) may have compromised health related quality of life (HRQoL). Hepatitis B virus (HBV) infection has long been the leading cause of CLD including liver cancer and cirrhosis. Knowledge on different symptom profiles of CLD should help in development of comprehensive treatment and patient care plans. Objective: To access the facets of HRQoL in chronic liver diseases throughout their spectrum of severity. Materials and Methods: A cross-sectional study was conducted in the First Affiliated Hospital of Kunming Medical University in Yunnan Province of China. Both out- and inpatients undergoing treatment protocols for different HBV related liver disease states were consecutively collected from December 2012 to June 2013. ANOVA was used to compare the mean scores of EQ-5D and chronic liver disease questionnaire (CLDQ) among 5 disease groups. The relationship between demographic variables predicting global CLDQ scores and the domains of CLDQ was analysed. Results: A total of 1040 patients including 520 without complications, 91 with compensated cirrhosis, 198 with decompensated cirrhosis, 131 with HCC and 100 with liver failure were recruited. All domains of CLDQ, the means of EQ-5D value and EQ VAS exhibited significant decline with worsening of disease severity from uncomplicated HBV to liver failure. The multivariate regression demonstrated the reduction of mean scores of CLDQ domain at advanced stage. Patients with liver failure and HCC had more HRQoL impairment than other disease states. No effect of patient gender was found. Patient age was associated with 'fatigue' and 'worry' domains (p=0.006; p=0.004) but not with other domains and global scores of CLDQ and ED-5D. Conclusions: The HRQoL in chronic hepatitis B patients is greatly affected by disease states. Care for HBV-related diseases should consider not only the outcomes of treatment strategies but also improvement in patient wellbeing.

A clinical study of Aroma Acupuncture on chronic headache patients (만성두통환자에 대한 아로마침의 임상적 연구)

  • Jung, In-tae;Kim, Su-young;Kim, Keon-sik;Lee, Doo-ik;Lee, Jae-dong;Lee, Yun-ho;Choi, Do-young
    • Journal of Acupuncture Research
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    • v.21 no.5
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    • pp.123-136
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    • 2004
  • Objective : Because the cause and etiology of chronic headache is not yet fully explained, the treatment of this symptom is not simple. This study compares the effects of aroma acupuncture and normal acupuncture applied on chronic headache patients, in order to establish a primary data for further studies of new treatments and developments of new practical acupunctures. Methods : 38 clinical experiment participants were gathered and through a questionnaire patients who experienced headache for more than 4 hours a day and more than 15 days per month were qualified as Chronic Headache patients. The qualified patients were classified in to two groups, aroma acupuncture group(Aroma AT group, n=23) and normal acupuncture group(AT group, n=15). Treatment was applied 2 times a weeks for 8 weeks. The acupoints, GV20, HN23, ST8, HN46, TE17, GB20, LI20, LI11, LI14, ST36, and LR3 were stimulated for 20 minutes in both the groups. The effects of both groups were analyzed using VAS scores and BPI (Brief Pain Inventory). Results : The VAS pain scores improved significantly in both groups. The decrease rate was larger in the Aroma AT group(p<0.05). The BPI scores for the both groups also decreased. The improvement in the Aroma AT group was larger(p<0.05). Conclusion : Aroma acupuncture applied on chronic headache patients showed effects of relieving pain, improving general activities, changing the mood, and improving sleeping behaviors. These effects were analyzed using VAS scores and BPI. The Aroma AT group showed significant changes of VAS and BPI compared to the AT group, suggesting that this new practical acupuncture is very effective when treating chronic headaches. Further researches are needed to evaluate the distinct functional mechanism of aroma acupuncture, but this study is meaningful in the sense that it will act as a fundamental study to build on.

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