• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.29 no.2
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• pp.83-86
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• 2018

Background and Objectives : This study aimed to evaluate efficacy and complication of injection laryngoplasty using calcium hydroxyapatite (CaHA) for unilateral vocal fold paralysis in Asian. Materials and Methods : A prospective study was conducted on the adult patients with unilateral vocal fold paralysis from May 2015 through January 2016. Injection laryngoplasty was performed by one laryngologist. All patients underwent prospective voice evaluation using the subjective and objective comprehensive battery of assessments, before the procedure and after the procedure at 3 months, and 6 months. Results : A total of 7 patients (5 males and 2 females) were included in this study. VHI-10 was significantly decreased after injection laryngoplasty, at postoperative 6 months (p=0.031), while VAS score and MDADI showed no difference. GRBAS scale gradually decreased in 3 months and 6 months follow-up without statistical significance. Acoustic analysis revealed that jitter, shimmer, and noise-to-harmonic ratio continuously decreased from the baseline at 3 months and 6 months, although statistical significance was not attained. In the aerodynamic analysis, maximal phonation time was gradually increased at 3months and 6 months with significant difference (p=0.016, 0.031, respectively). There was no side effect associated with the procedure. Conclusion : CaHA can be safely used in Asian patients and the onset of maximal efficacy seems to be slow than other studies with Caucasian patients.

• Journal of Dental Anesthesia and Pain Medicine
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• v.21 no.1
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• pp.29-39
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• 2021

Background: Impacted mandibular third molar removal is one of the most commonly performed oral surgical procedures. This procedure can lead to several postoperative complications, such as trismus, facial swelling, and pain, which occur as a result of the inflammatory responses to surgery. This study compared the efficiency of preoperative injections of 4 mg versus 8 mg dexamethasone into the pterygomandibular space to reduce postoperative sequelae. Methods: This was a randomized, prospective, split-mouth, controlled study, including 52 mandibular third molar surgeries in 26 patients. Each patient was randomized to either the 4 mg or 8 mg dexamethasone injection group. Dexamethasone was injected into the pterygomandibular space after numbness from local anesthesia. Data were collected for trismus, facial swelling, visual analog scale (VAS) pain score, and the number of analgesics taken during the evaluation period. The level of significance was set at P < 0.05. Results: Statistically significant differences in postoperative facial swelling (P = 0.031, diff = 1.4 mm) and pain (P = 0.012, diff = 0.020) were found between the 8 mg and 4 mg dexamethasone groups. However, there were no significant differences between the groups for trismus and the total number of analgesics consumed (P > 0.05). Conclusion: Compared to the 4 mg preoperative dexamethasone injection, the 8 mg preoperative dexamethasone injection into the pterygomandibular space was more effective in reducing postoperative swelling and pain following the surgical removal of the impacted mandibular third molar. However, the difference in trismus could not be evaluated clinically. Therefore, the recommendation of administering the 4 mg dexamethasone preoperative injection is optimal in the third molar surgical procedure.

• Journal of The Korean Society of Integrative Medicine
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• v.11 no.1
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• pp.87-98
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• 2023

Purpose : This study was to verify the effectiveness of eccentric training and to make clinical recommendations on detailed application methods by comparing the effects of changes in acromiohumeral distance (AHD), pain intensity, muscle strength, and functional performance after applying a 12-week eccentric training program (ET group) or concentric training program (CT group) for patients with partial rotator cuff (supraspinatus) tears with moderate to severe shoulder pain. Methods : A total of 29 subjects were assigned to either the "ET group (n=15)" or the "CT group (n=14)" through simple randomization and were measured in the same way at baseline before intervention, 4 weeks and 12 weeks after intervention. All subjects received a physical therapy program 12 sessions 3 times a week for the first 4 weeks, and physical therapy program, 12 sessions a week, from 4 weeks to 12 weeks, for a total 20 sessions. Ultrasound machine was used for AHD, visual analog scale (VAS) was used for pain intensity, electronic hand held dynamometer was used for muscle strength, Korean Constant shoulder score (K-CSS) used for functional performance. Results : AHD, pain intensity, and muscle strength did not show significant differences at 4 weeks, but improved numerically, and showed significant differences at 12 weeks (p<.05), showing superior results in the eccentric training group compared to the concentric training group. Functional performance showed significant changes at both 4 and 12 weeks (p<.05), and excellent results were also found in the eccentric training group. Conclusion : In patients with partial rotator cuff tears with moderate to severe shoulder pain, an eccentric training program increased acromiohumeral distance (AHD), reduced pain, and increased muscle strength. Therefore, it can be clinically presented as an intervention method that can quickly and effectively improve functional performance, which is the ultimate goal of physical therapy.

• Clinics in Shoulder and Elbow
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• v.26 no.2
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• pp.109-116
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• 2023

Background: Golf is a popular sport involving overhead activity and engagement of the rotator cuff (RC). This study aimed to determine to what level golfers were able to return to golf following RC repair, the barriers to them returning to golf and factors associated with their failure to return to golf. Methods: Patients preoperatively identifying as golfers undergoing RC repair at the study centre from 2012 to 2020 were retrospectively followed up with to assess their golf-playing status, performance and frequency of play and functional and quality of life (QoL) outcomes. Results: Forty-seven golfers (40 men [85.1%] and 7 women [14.9%]) with a mean age of 56.8 years met the inclusion criteria, and 80.1% were followed up with at a mean of 27.1 months postoperatively. Twenty-nine patients (76.3%) had returned to golf with a mean handicap change of +1.0 (P=0.291). Golf frequency decreased from a mean of 1.8 rounds per week preinjury to 1.5 rounds per week postoperatively (P=0.052). The EuroQol 5-dimension 5-level (EQ-5D-5L) index and visual analog scale (EQ-VAS) score were significantly greater in those returning to golf (P=0.024 and P=0.002), although functional outcome measures were not significantly different. The primary barriers to return were ipsilateral shoulder dysfunction (78%) and loss of the habit of play (22%). Conclusions: Golfers were likely (76%) to return to golf following RC repair, including mostly to their premorbid performance level with little residual symptomatology. Return to golf was associated with a greater QoL. Persistent subjective shoulder dysfunction (78%) was the most common barrier to returning to golf.

• Clinics in Shoulder and Elbow
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• v.26 no.1
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• pp.64-70
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• 2023

Background: This study aimed to analyze the efficacy of single-dose corticosteroid injection (CSI) administered at 6 weeks postoperative to treat stiffness following arthroscopic rotator cuff repair (ARCR). Methods: In this prospective, multicentric, case-control study, post-ARCR stiffness at 6 weeks was treated with either a single dose of intra-articular CSI (CSI group) or physical therapy with oral analgesics (non-CSI group). Pain intensity according to visual analog scale (VAS), functional outcome using the Constant Murley Shoulder Score, time to return to activities of daily living (ADLs), and retear rate were recorded at 6 weeks, 9 weeks, 12 weeks, 6 months, 12 months, and 18 months postoperatively in both groups. Results: A total of 149 patients (54.5%) in the CSI group and 124 patients (45.5%) in the non-CSI group were included in this study. Pain and function were significantly better in the CSI group at 9-week, 12-week, and 6-month (P<0.001) follow-up, whereas they were not significantly different when the groups were compared at 12- and 18-month follow-up. The mean duration to return to ADLs was significantly shorter (P<0.001) in the CSI group. The incidence of retears was not significantly different (P=0.36) between groups at the end of 18 months of follow-up. Conclusions: Single-dose intra-articular CSI administered at 6 weeks postoperative to treat post-ARCR stiffness significantly improved pain, function, and duration of return to ADLs without increasing the risk of retears compared to patients who did not receive intra-articular CSI. Level of evidence: III.

• The Journal of Korean Obstetrics and Gynecology
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• v.36 no.3
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• pp.211-225
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• 2023

Objectives: The purpose of this study is to report the effects of Korean medical treatment including Sanhuhyulpung-tang on three postpartum patients who suffered from hyperhidrosis. Methods: We treated three patients complained of postpartum symptoms including hyperhidrosis. The patients were treated by Traditional Korean Medicine including herbal medicine, acupuncture, moxibustion, and cupping therapy. Sanhuhyulpung-tang is a herbal medicine prescription which is used in clinical practice for the treatment of postpartum sweating, anxiety, flushing, and joint pain. Three patients were hospitalized for treatment for 6, 8, and 19 days respectively. During hospitalization, patients took Sanhuhyulpung-tang three times a day, and acupuncture, moxibustion, and cupping were performed once a day. To evaluate the degree of improvement, we used VAS score of the patient's chief complaint during hospitalization. Results: After the treatment, symptoms including hyperhidrosis were improved. The degree of excessive sweating decreased to 30% in two patients, and 55% in one patient. Combined symptoms including lower coldness, burning sensation, chilling, and multiple site pain also improved on discharge day. Conclusions: This case report shows that Korean medicine treatment including Sanhuhyulpung-tang can improve postpartum symptoms including hyperhidrosis.

• Journal of The Korean Society of Integrative Medicine
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• v.12 no.2
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• pp.33-45
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• 2024

Purpose : This study aimed to compare the effects of spinal manipulation combined with medication on low back pain (LBP), range of motion, and disability in patients with chronic LBP. Methods : Twenty patients with chronic LBP were included in this study. The participants were randomly assigned to the spinal manipulation with medication group (n=10) or the medication only group (n=10). The intervention group received spinal manipulation for 15 minutes, twice a week, and took medication twice a day for eight weeks. The control group received the medication twice daily for eight weeks. Pain intensity assessed using the visual analog scale (VAS), range of motion, and disability due to LBP assessed using the Oswestry disability index were measured before and after the intervention. Results : The intervention group showed a significant improvement in pain intensity compared to the control group (p<.05), and the intervention and control groups significantly improved low back pain after the intervention (p<.05). The intervention group showed a significant improvement in the range of motion in flexion, extension, right lateral flexion, left lateral flexion, and right rotation (p<.05). The intervention group also showed a significant improvement in the change of disability in total score, pain intensity, personal care, lifting and standing compared to the control group (p<.05). Conclusion : This study showed that the combination of spinal manipulation and medication can benefit patients with chronic LBP, as evidenced by significant improvements in pain intensity, ROM, and disability. These findings suggest that utilizing both spinal manipulation and medication can positively affect individuals with chronic LBP. The results of this study should be applied in clinical settings to optimize treatment outcomes in patients with chronic LBP.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.30 no.1
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• pp.51-60
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• 2024

Background: Ankle sprains are a common clinical ankle disorder and alternations in tibiofibular joint biomechanics along with the talus are thought to contribute to its occurrence. During ankle joint dorsi flexion, proper movement requires the talus to glide posteriorly. Due to the wider front of the talus head, achieving the end range of dorsi flexion necessitates both superior and posterior glide of the distal fibula and anterior glide of the proximal fibula. The purpose of this study was to investigate the effects of tibiofibular joint mobilization on pain, range of motion, and balance in patients with lateral ankle sprains. Methods: Participants were randomly assigned to a control group (n=33) or an experimental group (n=31). Both groups underwent ankle joint mobilization three times a week for two weeks. Additionally, the experimental group received proximal and distal tibiofibular joint mobilization three times a week for two weeks. Measurements were obtained pre-intervention and post-intervention (after 2 weeks). Results: Evaluation parameters included the visual analog scale score (VAS), range of motion (ROM), and one-leg standing test (OLS). Post-intervention, both groups demonstrated significantly improved results for all assessments (p<.01). A significant intergroup difference was observed only in the ROM (p<.01) and OLS (p<.05). Conclusion: Our findings suggest that tibiofibular joint mobilization, combined with ankle joint mobilization, may be beneficial in enhancing outcomes for individuals with lateral ankle sprains.

• Korean Circulation Journal
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• v.54 no.3
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• pp.113-123
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• 2024

Background and Objectives: Previous studies have reported an association between impaired renal function and poor outcomes after radiofrequency catheter ablation in patients with atrial fibrillation (AF). However, outcomes of cryoballoon ablation (CBA) in patients with renal insufficiency are not fully elucidated. This study aimed to compare outcomes of CBA in AF patients with chronic kidney disease (CKD) versus those without CKD and to assess changes in renal function over 12 months following CBA. Methods: A total of 839 patients (65.1% with non-paroxysmal AF [PAF]) who underwent de novo CBA were prospectively enrolled. We divided patients into two groups based on creatinine clearance rate (CCr) and performed intracardiac echocardiography (ICE)-guided contrast agent-free CBA. Results: In comparison with patients without CKD (CCr >50, n=722), those with CKD (CCr ≤50, n=117) were older and predominantly female, had a lower body mass index, and showed a higher prevalence of heart failure and hypertension. Mean CHA₂DS₂-VAS score was significantly higher in CKD group than in non-CKD group. Procedure-related complications were not significantly different between two groups. During a mean follow-up period of 25.4±11.9 months, clinical recurrence occurred in 182 patients (21.7%) and not significantly different between two groups. In multivariate analysis, non-PAF and left atrial size were independent predictors of AF recurrence. CCr levels significantly improved over 12 months after CBA in CKD group. Conclusions: ICE-guided contrast-agent-free CBA showed comparable long-term clinical outcomes without increasing procedure-related complications and improvement of renal function over 12 months following CBA in AF patients with CKD.

• Clinics in Shoulder and Elbow
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• v.14 no.1
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• pp.67-72
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• 2011

Purpose: There are various known methods for arthroscopic rotator cuff repair. The purpose of this retrospective study is to report on the clinical results and anatomical results of UU repair surgery, which is a new repair method. Materials and Methods: We enrolled 156 patients (88 men and 68 women) who underwent UU repair for rotator cuff tears from January 2009 to May 2010 in our hospital. Their average age was 55 years old (range: 38~75 years old) and the average follow-up period was 12 months (range: 6~23 months). For determining the results, we evaluated the VAS for pain, the daily living index (ADL) in the ASES scores, the UCLA and KSS scores, and all these tests were conducted at the first hospital visit and 6 months and 1 year after surgery and at the final follow-up. During the follow-up period, MRI was performed 3 and 6 months after surgery only in the patients who consented to MRI scans to confirm the presence of re-rupture. Results: The average scores of the VAS as a pain indicator decreased from 7.0 before surgery to 2.7 after surgery (p<0.05). The UCLA and KSS scores increased from 22.2 to 32.5 and from 83.7 to 91.5, and the changes was significant (p<0.05). For the active joint range of motion, the average forward flexion was improved from 125 to 175 degrees, the average lateral external rotation was improved from 38 to 58 degrees, and the average abduction was improved from 104 to 169 degrees. Out of a total of 156 patients, re-rupture was observed in 4 cases (3%) of 117 cases (75%) for which MRI was performed (with consent) between 3 and 6 months after surgery. Conclusion: UU repair surgery as arthroscopic repair of rotator cuff tear is a good repair method that shows excellent clinical results and a low re-rupture rate.