• Asian Pacific Journal of Cancer Prevention
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• v.17 no.6
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• pp.2853-2856
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• 2016

Background: Many studies have pointed to strategies to cope with patient anxiety in colposcopy. Evidence shows that patients experienced considerable distress with the large loop excision of transformation zone (LLETZ) procedure and suitable interventions should be introduced to reduce anxiety. This study aimed to investigate the effects of music therapy in patients undergoing LLETZ. Materials and Methods: A randomized controlled trial was conducted with patients undergoing LLETZ performed under local anesthesia in an out patient setting at Ramathibodi Hospital, Bangkok, Thailand, from February 2015 to January 2016. After informed consent and demographic data were obtained, we assessed the anxiety level using State Anxiety Inventory pre and post procedures. Music group patients listened to classical songs through headphones, while the control group received the standard care. Pain score was evaluated with a visual analog scale (VAS). Statistical analysis was conducted using Pearson Chi-square, Fisher's Exact test and T-Test and p-values less than 0.05 were considered statistically significant. Results: A total of 73 patients were enrolled and randomized, resulting in 36 women in the music group and 37 women in the non-music control group. The preoperative mean anxiety score was higher in the music group (46.8 VS 45.8 points). The postoperative mean anxiety scores in the music and the non-music groups were 38.7 and 41.3 points, respectively. VAS was lower in music group (2.55 VS 3.33). The percent change of anxiety was greater in the music group, although there was no significant difference between two groups. Conclusions: Music therapy did not significantly reduce anxiety in patients undergoing the LLETZ procedure. However, different interventions should be developed to ease the patients' apprehension during this procedure.

• Journal of Korean Neurosurgical Society
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• v.60 no.2
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• pp.211-219
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• 2017

Objective : This study aimed to compare the clinical and radiologic outcomes of patients with subaxial cervical injury who underwent anterior cervical discectomy and fusion (ACDF) with autologous iliac bone graft or polyetheretherketone (PEEK) cages using demineralized bone matrix (DBM). Methods : From January 2005 to December 2010, 70 patients who underwent one-level ACDF with plate fixation for post-traumatic subaxial cervical spinal injury in a single institution were retrospectively investigated. Autologous iliac crest grafts were used in 33 patients (Group I), whereas 37 patients underwent ACDF using a PEEK cage filled with DBM (Group II). Plain radiographs were used to assess bone fusion, interbody height (IBH), segmental angle (SA), overall cervical sagittal alignment (CSA, C2-7 angle), and development of adjacent segmental degeneration (ASD). Clinical outcome was assessed using a visual analog scale (VAS) for pain and Frankel grade. Results : The mean follow-up duration for patients in Group I and Group II was 28.9 and 25.4 months, respectively. All patients from both groups achieved solid fusion during the follow-up period. The IBH and SA of the fused segment and CSA in Group II were better maintained during the follow-up period. Nine patients in Group I and two patients in Group II developed radiologic ASD. There were no statistically significant differences in the VAS score and Frankel grade between the groups. Conclusion : This study showed that PEEK cage filled with DBM, and plate fixation is at least as safe and effective as ACDF using autograft, with good maintenance of cervical alignment. With advantages such as no donor site morbidity and no graft-related complications, PEEK cage filled with DBM, and plate fixation provide a promising surgical option for treating traumatic subaxial cervical spine injuries.

• Journal of Korean Neurosurgical Society
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• v.63 no.6
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• pp.794-805
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• 2020

Objective : Teriparatide is known as an effective anabolic agent not only for severe osteoporosis but also for bone healing and union. We explored the possibility of teriparatide as an alternative treatment option for osteoporotic thoracolumbar (TL) burst fracture. Methods : This retrospective study enrolled 35 female patients with mean age of 73.77±6.71 years (61-88) diagnosed as osteoporotic TL burst fracture with ≥4 of thoracolumbar injury classification and severity (TLICS) score and no neurological deficits. All patients were treated by teriparatide only (12 of group A), teriparatide plus vertebroplasty (12 of group B), or surgical fixation with fusion (11 of group C), and followed up for 12 months. Radiological outcomes were evaluated using radiological parameters including kyphotic angle (KA), segmental vertebral kyphotic angle (SVKA), compression ratio (CR), and vertebral body height (anterior [AH], middle [MH], posterior [PH]). Functional outcomes were evaluated using visual analog scale (VAS) and Macnab classification (MC). Results : There were no statistical significant differences in age, bone mineral density (-3.36±0.73), and TLICS score (4.34±0.48) among the three groups (p>0.05). Teriparatide was administered during 8.63±2.32 months in group A and B. In 12-month radiological outcomes, there were significant restoration in SVKA, CR, AH, and MH of group B and KA, SVKA, CR, AH, and MH of group C compared to group A with no radiological changes (p<0.05). All groups showed similar significant improvements in 12-month functional outcomes, although group B and C showed a better 1-month VAS, 1-month MC, 3-month MC compared to group A (p<0.05). Conclusion : Non-surgical treatment with teriparatide showed similar 12-month functional outcomes compared to surgical fixation with fusion. The additional vertebroplasty to teriparatide and surgical fixation with fusion were more helpful to improve short-term functional outcomes with structural restoration compared to teriparatide only.

• Journal of Korean Neurosurgical Society
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• v.50 no.5
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• pp.441-445
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• 2011

Objective : There are technical limitations of multi-level posterior pedicle screw fixation performed by the percutaneous technique. The purpose of this study was to describe the surgical technique and outcome of minimally invasive multi-level posterior lumbar interbody fusion (PLIF) and to determine its efficacy. Methods : Forty-two patients who underwent mini-open PLIF using the percutaneous screw fixation system were studied. The mean age of the patients was 59.1 (range, 23 to 78 years). Two levels were involved in 32 cases and three levels in 10 cases. The clinical outcome was assessed using the visual analog scale (VAS) and Low Back Outcome Score (LBOS). Achievement of radiological fusion, intra-operative blood loss, the midline surgical scar and procedure related complications were also analyzed. Results : The mean follow-up period was 25.3 months. The mean LBOS prior to surgery was 34.5, which was improved to 49.1 at the final follow up. The mean pain score (VAS) prior to surgery was 7.5 and it was decreased to 2.9 at the last follow up. The mean estimated blood loss was 238 mL (140-350) for the two level procedures and 387 mL (278-458) for three levels. The midline surgical scar was 6.27 cm for two levels and 8.25 cm for three level procedures. Complications included two cases of asymptomatic medial penetration of the pedicle border. However, there were no signs of neurological deterioration or fusion failure. Conclusion : Multi-level, minimally invasive PLIF can be performed effectively using the percutaneous transpedicular screw fixation system. It can be an alternative to the traditional open procedures.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.7 no.1
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• pp.103-112
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• 2012

Objectives : This study was performed to report the effect of oriental medical treatments on the 4 patients with lateral epicondylitis of the elbow. Methods : The 4 patients were treated by Bee Venom acupuncture, Dong-Qi acupuncture, acupuncture on tender points of the origin of the extensor carpi radialis and taping on the extensor carpi radialis. The state of patients was measured by visual analog scale(VAS), elbow range of motion(ROM) and patient's subjective symptom grade(PSSG). Results : After mean 9.5 times of treatments, the recovery of elbow ROM was measured and significant pain relief was seen as the average of VAS changed from 10 to 1.25 and average of PSSG changed from 2.75 to 0.5 grade. Conclusions : These results suggest that oriental medical treatments including Bee Venom acupuncture, Dong-Qi acupuncture, acupuncture, taping are effective to improve the lateral epicondylitis of the elbow.

• Physical Therapy Rehabilitation Science
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• v.9 no.3
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• pp.149-154
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• 2020

Objective: This study aimed to evaluate the effects of the Kaltenborn-Evjenth concept of nerve mobilization combined with intermittent cervical segment traction (ICST) on pain, Neck Disability Index (NDI) scores, range of motion (ROM) and endurance in persons with cervical radiculopathy (CR). Design: Two-group pretest-posttest design. Methods: Thirty subjects participated in this study and were randomly assigned to two groups. The ICST group (n=15) was performed simultaneously with nerve mobilization and cervical traction for the segment with cervical pain at the same time. The intermittent cervical total traction (ICTT) group (n=15) performed nerve mobilization and cervical traction for the whole cervical area at the same time. In this study, outcome measures such as the Visual Analog Scale (VAS), NDI, ROM, endurance (cranio-cervical flexion test), and passive intervertebral motion performed before and 4 weeks after the experiment were compared to investigate the effects of each intervention. Results: In both groups, there were significant differences in the VAS, NDI scores, and endurance, and there were significant differences between the two groups except for endurance (p<0.05). In the ICST group, significant differences were found in all ROM, and in the ICTT group, significant differences were found in only extension, and there were significant differences between the two groups (p<0.05). Conclusions: The ICST group showed more improvement than the ICTT group in pain, NDI scores and ROM. Moreover, our findings show that the ICST could be used as a new strategy for manual therapy in persons with CR.

• The Journal of Korean Physical Therapy
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• v.16 no.3
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• pp.176-191
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• 2004

The purpose of this study was to find the effects of the eccentric exercise induced delayed muscle soreness on proprioception, muscle strength, muscle fatigue, and muscle pain of the elbow flexor muscles. Thirty one healthy male subjects were participated in this study. Before resisted eccentric exercise of the elbow flexors and immediately and at 1, 3, 5, and 7 days post-exercise, pain threshold, proprioception, tension tracking, initial median frequency, and fatigue index were measured. Pain pressure threshold and visual analog scale (VAS) was used to measure muscle pain. Proprioception of the elbow joint was measured by using 3 dimension motion analysis system. Maximum isometric contraction was measured by using digital tensiometer. Electromyography and power spectrum analysis was used to measure initial median frequency (IMF) and fatigue index (FI). Immediately post-exercise, a significant decrease pain threshold was observed that continued to 5 days post-exercise. VAS score was significantly increased at 1 and 3 days post-exercise compared to that of immediately post-exercise. Maximum isometric contraction, IMF, tension tracking ability of the exercised elbow joint were significantly decreased at 1, 3, and 5 days post-exercise compared to that of pre-exercise. FI was significantly increased at 1 and 3 days post-exercise compared that of pre-exercise. Proprioception sense of exercised elbow joint was significantly decreased immediately and at 1, 3, and 5 days post-exercise compared to that of pre-exercise. Proprioception sense of the contralateral elbow joint was significantly decreased immediately post-exercise compared to that of pre-exercise. However, proprioception sense that was measured in close chain kinematic position was not significantly difference between pre-exercise and post-exercise. These results could be useful to determine the resume time for exercising and participating sports activities.

• The Journal of Korean Physical Therapy
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• v.30 no.5
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• pp.159-165
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• 2018

Purpose: The aims of this study were to determine if game-based training with constraint-induced movement therapy (CIMT) is effective in improving the balance ability in female patients with a total knee replacement, and to provide clinical knowledge of CIMT game-based training that allows the application of total knee replacement. Methods: Thirty-six patients who had undergone a total knee replacement were assigned randomly to CIMT game training (n=12), general game training (n=12), and self-exercise (n=12) groups. All interventions were conducted 3 times a week for 4 weeks. All patients used a continuous passive motion machine 5 times a week and 2 times a day for 4 weeks. The visual analog scale (VAS), muscle strength of knee flexion and extension, and range of motion (ROM) of knee flexion and extension were assessed, and the functional reach test (FRT), and timed up and go (TUG) test were performed to evaluate the balance ability. Results: All 3 groups showed significant improvement in the VAS, knee flexion and extension muscle strength, FRT, and TUG test after the intervention (p<0.05). Post hoc analysis revealed significant differences in FRT, and TUG of the CIMT game training group compared to the other group (p<0.05). Conclusion: Although the general game training and CIMT game training improved both the knee extension muscle strength and dynamic balance ability, CIMT game training had a larger effect on dynamic balance control.

• The Journal of Korean Medicine
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• v.32 no.5
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• pp.25-40
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• 2011

Objectives: This study was performed to assess whether herbal medicine and acupuncture before in vitro fertilizationembryo transfer (IVF-ET) is effective on clinical pregnancy. Methods: From May 2010 to January 2011, a prospective analysis study was performed in 38 patients planning to undergo IVF-ET after taking herb medicine and acupuncture treatment. This study investigated the pregnancy rate and analyzed the change of dysmenorrhea by visual analog scale (VAS), body heat and condition of premenstrual syndrome (PMS), vaginal discharge and menstruation status. Results: 1. During herbal medicine and acupuncture treatment, five patients (13.16%) naturally became pregnant and six patients (15.79%) withdrew. After treatment, 15 patients (39.47%) received IVF-ET, 12 patients (31.58%) did not. 2. The biochemical pregnancy rate was 26.67%, the clinical pregnancy rate 26.67%, miscarriage rate 25% and ectopic pregnancy rate was 0%. 3. After treatment, PMS, dysmenorrhea and dysmenorrhea VAS was significantly decreased and the overall menstrual status improved. 4. After treatment, temperature difference of CV17-CV12 and CV4-CV12 increased, but it was not a statistically significant difference. 5. After treatment, decrease of hemoglobin and protein and increase of total bilirubin and creatinine were statistically significant. All the blood test results were within normal levels which proves safety of treatment. Conclusions: This study suggests that herbal medicine and acupuncture treatment before IVF-ET shows similar pregnancy rates with existing rates, but contributes to increasing the possibility of natural pregnancy.

• Journal of Periodontal and Implant Science
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• v.40 no.4
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• pp.188-193
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• 2010

Purpose: The aim of this study is to assess the influence exerted by the observer's dental specialization and compare patients' opinion with observers' opinion of the esthetics of maxillary single-tooth implants in the esthetic zone. Methods: Forty-one adult patients, who were treated with a single implant in the esthetic zone, were enrolled in this study. Eight observers (2 periodontists, 2 prosthodontists, 2 orthodontists and 2 senior dental students) applied the pink esthetic score (PES)/white esthetic score (WES) to 41 implant-supported single restorations twice with an interval of 4 weeks. We used a visual analog scale (VAS) to assess the patient's satisfaction with the treatment outcome from an esthetic point of view. Results: In the PES/WES, very good and moderate intraobserver agreements were noted between the first and second rating. The mean total PES/WES was $11.19{\pm}3.59$. The mean PES was $5.17{\pm}2.29$ and mean WES was $6.02{\pm}1.96$. In the total PES/WES, the difference between the groups was not significant. However, in the WES, the difference between the groups was significant and prosthodontists were found to have assigned poorer ratings than the other groups. Periodontists gave higher ratings than prosthodontists and senior dental students. Orthodontists were clearly more critical than the other observers. The statistical analysis revealed statistically significant correlation between patients' esthetic perception and dentists' perception of the anterior tooth. However, the correlation between the total PES/WES and the VAS score for the first premolar was not statistically significant. Conclusions: The PES/WES is an objective tool in rating the esthetics of implant supported single crowns and adjacent soft tissues. Orthodontists were the most critical observers, while periodontists were more generous than other observers. The statistical analysis revealed a statistically significant correlation between patients' esthetic perception and dentists' perception of the anterior tooth.