• Title/Summary/Keyword: VAS(Visual analog scale)

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Comparison of Therapeutic Effect on Carpal Tunnel Syndrome between Oriental and Western Medicine (수근관증후군 환자에 대한 한방과 양방치료효과의 비교)

  • Bae, Hyung-Sup;Hong, Jin-Woo;Choi, Chang-Min;Na, Byung-Jo;Park, Seong-Uk;Moon, Sang-Kwan;Park, Jung-Mi;Ko, Chang-Nam;Cho, Ki-Ho;Kim, Young-Suk;Jung, Woo-Sang
    • The Journal of Korean Medicine
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    • v.28 no.1 s.69
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    • pp.87-93
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    • 2007
  • Objectives : This study was to assess the effectiveness of Oriental medical treatment on carpal tunnel syndrome, comparing its outcome with that of Western medical treatment. Methods : After being diagnosed with carpal tunnel syndrome by electromyography, subjects were enrolled in Kyung Hee Medical Center from March 2006 to January 2007. We prescribed Kejibokryung-hwan to the Oriental medical therapy group (OM group) and NSAIDS to the Western medical therapy group (WM group). Effectiveness was assessed by degree of pain using visual analog scale (VAS) before and after 3 weeks' treatment. Adverse effects were also monitored. Results : There were 21 patients in the OM group and 19 in the WM group. No statistical significant difference was detected at the baseline assessment. After 3 weeks of medication, pain was reduced about 26% in the OM group and 46% in the WM group. These findings might be explained by that more than half of the WM group received local steroid injection, which has been known to have more rapid analgesic effect that oral medication. Although pain reduction rate was higher in the WM group than in the OM group, we suggest that Oriental medical treatment is still effective, faking into consideration the fact that completely recovered cases were found only in the OM group. No adverse effect was found in either of the groups. Conclusion : This work could help us to understand the effectiveness of Oriental medical treatment on carpal tunnel syndrome.

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Credibility of a Newly Developed Sham Moxibustion (피부 열전도 온도에 근거를 둔 거짓 뜸 개발 및 평가 연구)

  • Jang, Min-Ki;Yoon, Eun-Hye;Jung, Chan-Yung;Byun, Hyuk;Kim, Eun-Jung;Kim, Kyung-Ho;Kim, Kap-Sung;Lee, Seung-Deok
    • Journal of Acupuncture Research
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    • v.27 no.1
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    • pp.117-127
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    • 2010
  • Background : To demonstrate the efficacy of moxibustion therapy, randomized controled trials are required. But, clinical trials of moxibustion had limitations due to the absence of a sham moxibustion model for an appropriate placebo. Objectives : To develop a new sham moxibustion model based on the thermal characteristics of commercial indirect moxibustion, especially temperature, and to evaluate whether it could be applied in clinical trials. Methods : By applying heat insulation, we created a sham moxibustion device that was indistinguishable from a real one with the naked eye. It also stimulated heat but had inert remedial value. A clinical trial was performed on subjects to test double blinding. The subjects were randomly assigned into two groups, a treatment group and a sham group. Acupoint Zusanli($ST_{36}$) was used in each group for 3 times. A sham acupuncture credibility questionnaire was modified into a moxibustion credibility questionnaire and was filled out after treatment. Results : No major difference was detected in the subjects' baseline data. Most subjects and practitioners could not distinguish the sham moxibustion device from the real one. But, subjects who had experience of moxibustion therapy more likely to distinguish the sham moxibustion device from the real one than subjects who didn't have experience of moxibustion therapy. The treatment group showed a significant difference in the VAS(Visual Analog Scale) for intensity of sensation during treatment than that of the sham group. Conclusions : The sham moxibustion device in this study is proved sufficient and credible to be applied in investigations of the effect of moxibustion. But it is more appropriate for the people who don't have experience of moxibustion therapy.

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.

Effects of Scalp Myofascial Technique and Manual Therapy on Pain and Quality of Life in Tension Type Headache Patients : Six Month Follow-up Results (두피근막이완기법과 도수치료가 긴장성두통 환자의 통증과 삶의 질에 미치는 영향 : 6개월 추적연구)

  • Lee, Hwa-Gyeong;Kim, Seong-Yeol
    • Journal of The Korean Society of Integrative Medicine
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    • v.9 no.2
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    • pp.119-130
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    • 2021
  • Purpose : We aimed to validate a new manual therapy to treat tension type headache(TTH) by applying myofascial release techniques to the scalp and to examine the changes in the quality of life and the headache characteristics after treatment and at the 6-month follow-up. Methods : Thirty patients were recruited in this study and were assigned to two groups through simple random sampling. Fifteen patients were assigned to the manual therapy group (MT) and 15 patients to the scalp myofascial release technique (SMT) group. However, five patients from the MT group and one from the SMT group were excluded. Therefore, 24 patients with TTH (10 males, 14 females) participated in the study. Patients underwent either MT or SMT. The procedures were performed by a physical therapist twice per week for 4 weeks. The quality of life [using the brief pain inventory (BPI) and the headache impact test (HIT)], and the frequency, duration, and intensity of the headache [on a visual analog scale (VAS)] were assessed before and after the treatment, and at the follow-up. Results : After 4 weeks of SMT, the frequency (p<.001), duration (p<.05), and intensity (p<.001) of the headache and the quality of life (HIT; p <.001, BPI; p<.001) significantly improved in the patients with TTH. The improvement in these parameters remained significant even after 6 months of follow-up. Similarly, After 4 weeks of MT, the frequency (p<.05), duration (p<.05), and intensity (p<.01) of the headache, and the quality of life (HIT; p<.05, BPI; p<.001) significantly improved in the patients with TTH. The improvement in these parameters remained significant even after 6 months of follow-up. There was no significant difference in these parameters between the two groups. Conclusion : It has been suggested that MT using the SMT can be used as a non-invasive treatment to treat the frequency, duration, and intensity of the TTH, and to improve the quality of life.

Pilot Study of Single Session Song-Based Music Therapy for Decreasing ICU Caregiver Anxiety (중환자 보호자의 불안 감소를 위한 단회기 노래중심 음악치료 적용 예비연구)

  • Jung, Yu Sun;Na, Sungwon
    • Journal of Music and Human Behavior
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    • v.16 no.1
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    • pp.25-46
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    • 2019
  • This pilot study involved a single session of song-based music therapy to relieve the anxiety of intensive care unit (ICU) caregivers. Six caregivers of ICU patients participated in the intervention session individually. During the initial stage of the intervention, the participants' current emotional states were identified. Then they listened to familiar songs and playing a tone chime, which was intended to help them relax their body and reduce their psychological resistance. During singing experiences as an essential part of the intervention, the participants discussed the lyrics of songs in an attempt to find the meaning related to them. Also, they sang the songs with a live accompaniment in which their emotional states were reflected with changes in musical elements (e.g., tempo, dynamics, rhythm, or chords). In the final stage, they identified personal application to their everyday lives. To analyze the results, the State-Trait Anxiety Inventory (STAI) and a visual analog scale on emotional states were completed by participants before and after the session, and participants' verbal responses during the session were also recorded. According to the results, STAI anxiety scores significantly declined following the session. Also, they showed significant increases in positive emotions and significant decreases in negative emotions. This suggests that short-term music therapy can be an effective intervention for relieving the psychological distress of ICU caregivers.

Intraosseous anesthesia in symptomatic irreversible pulpitis: Impact of bone thickness on perception and duration of pain

  • Nilius, Manfred;Mueller, Charlotte;Nilius, Minou Helene;Haim, Dominik;Leonhardt, Henry;Lauer, Guenter
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.20 no.6
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    • pp.367-375
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    • 2020
  • Background: Intraosseous anesthesia (IO) allows the anesthetic solution to be injected directly into the cancellous bone. The anesthetic solution immediately reaches the periapical region, and thus the axonal area of the nerve, where it can temporarily disable the sodium pump. The effect is felt almost without any time delay, and only a small amount of anesthetic solution is required. Methods: This study aims to investigate the efficacy of IO using the AnestoⓇ device after infiltration anesthesia (IA) and/or inferior alveolar nerve block anesthesia (IANB) failed to work in symptomatic irreversible pulpitis (hot tooth). The 33 patients included in the study were treated additionally with 1.7 ml articaine hydrochloride with 1:100,000 epinephrine hydrochloride (UltracainⓇ D-S, Sanofi-Aventis, Frankfurt, Germany) IO. Results: The electrical pulp test showed that 95.76% of the volunteers reacted positively to the combination of IANB or IA with the IO. In women, the additive IO was effective at 97.22%. In men, the IO led to pain elimination in 94.00% of cases. The duration of the IO was less than a quarter of an hour (13.03 min). The IO worked longer in women than in men (13.61 min vs. 12.33 min). Overall, more than every third tooth that needed trepanation was located in the posterior area of the mandible (36.4%). Treatment of hot teeth in this area was associated with an increased pulse rate and increased residual pain. There was a moderate correlation (Spearman-Rho [IRI] = 0.280) between the Visual Analog Scale (VAS) score and bone density, and a significant correlation (IRI = 0.612) between subjective residual pain and bone width. The IO resulted in a moderate, transient increase in the pulse rate by approximately 20 bpm. This is similar to the temporary increase in heart rate after conventional anesthesia techniques in non-preloaded patients and can be considered clinically irrelevant. Conclusion: IO with the AnestoⓇ device as an extension and deepening of local pain elimination is recommended for the treatment of hot teeth.

Effect of Vertically Rising Pressure Providing Spinal Canal Segment Motion on Symptom Relief in Patients with Parkinson's Disease (척추관 분절운동을 제공하는 수직 상승 압력이 파킨슨병 환자의 증상 완화에 미치는 영향)

  • Do-Hyun, Ahn;Hyeun-Woo, Choi;Kyung-Mi, Jung;Na-Young, Kim;Jong-Min, Lee
    • Journal of the Korean Society of Radiology
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    • v.16 no.6
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    • pp.787-797
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    • 2022
  • The purpose of this study was to confirm the reduction of pain and symptom relief of Parkinson's disease by vertically stimulating the spine through the application of a mechanical bed capable of thermal and massage stimulation. For this purpose, after confirming the segmental motion of the spine due to the use of a medical combination stimulation bed for Parkinson's disease patients, VAS, ODI, gait ability, and spiral drawing tests were performed, and the relationship between the variables was identified. In the 10-day visual analog scale and evaluation of low back pain dysfunction, the average trend of decreasing after bed use was confirmed. For walking ability, a decrease in the moving time and an increase in the moving distance were observed. In the spiral drawing test, the mean test time after using bed was significantly lower than before. As a result, it suggested the possibility of using it as an auxiliary method for recovery and pain relief of Parkinson's disease patients due to spinal segmental movement with mechanical heating and massage. However, this study is a preliminary study, and there is a small number of subjects, so additional research is needed that considers the number and condition of future subjects in detail.

Variability in Drug Interaction According to Genetic Polymorphisms in Drug Metabolizing Enzymes

  • Jang, In-Jin;Yu, Kyung-Sang;Cho, Joo-Youn;Chung, Jae-Yong;Kim, Jung-Ryul;Lim, Hyeong-Seok;Shin, Sang-Goo
    • Environmental Mutagens and Carcinogens
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    • v.24 no.1
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    • pp.15-18
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    • 2004
  • There are significant differences in the extent of drug interactions between subjects. The influence of the genetic make up of drug metabolizing enzyme activities (CYP3A5, CYP2C19 and UDP-glucuronosyl transferase) on the pharmacokinetic drug interaction potential were studied in vivo. Nineteen healthy volunteers were grouped with regard to the $CYP3A5^{*}3$ allele, into homozygous wild-type (CYP3A5^{*}1/1^{*}1$, n=6), heterozygous $(CYP3A5^{*}1/^{*}3$, n=6), and homozygous variant-type $(CYP3A5^{*}3/^{*}3$, n=7) subject groups. The pharmacokinetic profile of intravenous midazolam was characterized before and after itraconazole administration (200 mg once daily for 4 days), and also following rifampin pretreatment (600 mg once daily for 10 days), with a washout period of 2 weeks in between. For omeprazole and moclobemide pharmacokinetic interaction study 16 healthy volunteers were recruited. The volunteer group comprised 8 extensive metabolizers and 8 poor metabolizers of CYP2C19, which was confirmed by genotyping. Subjects were randomly allocated into two sequence groups, and a single-blind, placebo-controlled, two-period crossover study was performed. In study I, a placebo was orally administered for 7 days. On the eighth morning, 300 mg of moclobemide and 40 mg of placebo were coadministered with 200 mL of water, and a pharmacokinetic study was performed. During study n, 40 mg of omeprazole was given each morning instead of placebo, and pharmacokinetic studies were performed on the first and eighth day with 300 mg of moclobemide coadministration. In the UGT study pharmacokinetics and dynamics of 2 mg intravenous lorazepam were evaluated before and after rifampin pretreatment (600 mg once daily for 10 days), with a washout period of 2 weeks in between. The subjective and objective pharmacodynamic tests were done before and 1, 2, 4, 6, 8, and 12 hrs after lorazepam administration. The pharmacokinetic profiles of midazolam and of its hydroxy metabolites did not show differences between the genotype groups under basal and induced metabolic conditions. However, during the inhibited metabolic state, the $CYP3A5^{*}3/^{*}3$ group showed a greater decrease in systemic clearance than the $CYP3A5^{*}1/^{*}1$ group $(8.5\pm3.8$ L/h/70 kg vs. $13.5\pm2.7$ L/h/70 kg, P=0.027). The 1'-hydroxymidazolam to midazolam AUC ratio was also significantly lower in the $CYP3A5^{*}3/^{*}3$,/TEX> group $(0.58\pm0.35,$ vs. $1.09\pm0.37$ for the homozygous wild-type group, P=0.026). The inhibition of moclo-bemide metabolism was significant in extensive metabolizers even after a single dose of omeprazole. After daily administration of omeprazole for 1 week, the pharmacokinetic parameters of moclobemide and its metabolites in extensive metabolizers changed to values similar to those in poor metabolizers. In poor meta-bolizers, no remarkable changes in the pharmacokinetic parameters were observed. The area under the time-effect curves of visual analog scale(VAS), choice reaction time, and continuous line tracking test results of lorazepam was reduced by 20%, 7%, 23% respectively in induced state, and in spite of large interindividual variablity, significant statistical difference was shown in VAS(repeated measures ANOVA, p=0.0027).

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Variability in Drug Interaction According to Genetic Polymorph isms in Drug Metabolizing Enzymes

  • Jang, In-Jin;Yu, Kyung-Sang;Cho, Joo-Youn;Chung, Jae-Yong;Kim, Jung-Ryul;Lim, Hyeong-Seok;Shin, Sang-Goo
    • Environmental Mutagens and Carcinogens
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    • v.23 no.4
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    • pp.131-134
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    • 2003
  • There are significant differences in the extent of drug interactions between subjects. The influence of the genetic make up of drug metabolizing enzyme activities (CYP3A5, CYP2C19 and UDP-glucuronosyl transferase) on the pharmacokinetic drug interaction potential were studied in vivo. Nineteen healthy volunteers were grouped with regard to the $CYP3A5^{*}3$ allele, into homozygous wild-type (CYP3A5^{*}1/1^{*}1$, n=6), heterozygous $(CYP3A5^{*}1/^{*}3$, n=6), and homozygous variant-type $(CYP3A5^{*}3/^{*}3$, n=7) subject groups. The pharmacokinetic profile of intravenous midazolam was characterized before and after itraconazole administration (200 mg once daily for 4 days), and also following rifampin pretreatment (600 mg once daily for 10 days), with a washout period of 2 weeks in between. For omeprazole and moclobemide pharmacokinetic interaction study 16 healthy volunteers were recruited. The volunteer group comprised 8 extensive metabolizers and 8 poor metabolizers of CYP2C19, which was confirmed by genotyping. Subjects were randomly allocated into two sequence groups, and a single-blind, placebo-controlled, two-period crossover study was performed. In study I, a placebo was orally administered for 7 days. On the eighth morning, 300 mg of moclobemide and 40 mg of placebo were coadministered with 200 mL of water, and a pharmacokinetic study was performed. During study n, 40 mg of omeprazole was given each morning instead of placebo, and pharmacokinetic studies were performed on the first and eighth day with 300 mg of moclobemide coadministration. In the UGT study pharmacokinetics and dynamics of 2 mg intravenous lorazepam were evaluated before and after rifampin pretreatment (600 mg once daily for 10 days), with a washout period of 2 weeks in between. The subjective and objective pharmacodynamic tests were done before and 1, 2, 4, 6, 8, and 12 hrs after lorazepam administration. The pharmacokinetic profiles of midazolam and of its hydroxy metabolites did not show differences between the genotype groups under basal and induced metabolic conditions. However, during the inhibited metabolic state, the $CYP3A5^{*}3/^{*}3$ group showed a greater decrease in systemic clearance than the $CYP3A5^{*}1/^{*}1$ group $(8.5\pm3.8$ L/h/70 kg vs. $13.5\pm2.7$ L/h/70 kg, P=0.027). The 1'-hydroxymidazolam to midazolam AUC ratio was also significantly lower in the $CYP3A5^{*}3/^{*}3$,/TEX> group $(0.58\pm0.35,$ vs. $1.09\pm0.37$ for the homozygous wild-type group, P=0.026). The inhibition of moclo-bemide metabolism was significant in extensive metabolizers even after a single dose of omeprazole. After daily administration of omeprazole for 1 week, the pharmacokinetic parameters of moclobemide and its metabolites in extensive metabolizers changed to values similar to those in poor metabolizers. In poor meta-bolizers, no remarkable changes in the pharmacokinetic parameters were observed. The area under the time-effect curves of visual analog scale(VAS), choice reaction time, and continuous line tracking test results of lorazepam was reduced by 20%, 7%, 23% respectively in induced state, and in spite of large interindividual variablity, significant statistical difference was shown in VAS(repeated measures ANOVA, p=0.0027).

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Usefulness of Ultrasonographic Examination in Diagnosis and Follow-up of the Frozen Shoulder (동결견의 진단과 치료 경과 판정에 대한 초음파 검사의 유용성)

  • Choi, Chang-Hyuk;Kim, Seok-Jun;Lee, Sang-Hwa;Kim, Hee-Soo;Shim, Jung-Hyun
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.7 no.1
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    • pp.1-6
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    • 2014
  • Purpose: In order to know the effectiveness of ultrasonographic examination in diagnosis and follow-up evaluation for the frozen shoulder, we compared those with contralateral side in initial and after steroid injection. Materials and Methods: For the 20 unilateral frozen shoulder from July 2012 to July 2013, ultrasonographic examination was tried using reference line 1 (CBT: distance from coracoid process to LHB tendon) and line 2 (CBG: distance from coracoid process to bicipital groove). We tried 1 time steroid injection and compared the improvement in gross motion and reference line with 2 month, 4 month, and 6 month's serial ultrasonographic examination. Results: The differences on CBT line between lesion side and normal side were -5.6 mm, -5.0 mm, and -4.3 mm in neutral (Neut), external rotation (ER) and internal rotation (IR), respectively. The differences on CBG line were -6.1 mm, -4.7 mm, and -5.0 mm respectively (p<0.05). The changes in the reference line after steroid injection were evaluated at 2 month (CBT: -4.8 mm, -3.5 mm, -2.6 mm / CBG: -4.7 mm, -4.0 mm, -3.6 mm), 4 month (CBT: -4.7 mm, -3.2 mm, -1.7 mm / CBG: -4.3 mm, -3.7 mm, -1.2 mm), and 6 month (CBT: -1.1 mm, -2.9 mm, -0.5 mm / CBG: -1.2 mm, -0.7 mm, -0.9 mm). The gross motion was improved at 4 month after injection, from elevation $108^{\circ}$, ER $32^{\circ}$, IR L5 in initial to $133^{\circ}$, $42^{\circ}$, L3 respectively (p<0.05). Pain improved from 7.5 in initial to 3.0 at 2 month on visual analog scale (VAS). Conclusion: The serial examination after steroid injection revealed that the delayed improvement on reference line (6 month) compared with pain (2 month) or gross motion (4 month). Dynamic ultrasonogram was useful in diagnosis and follow-up evaluation of frozen shoulder.

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