• Korean Journal of Psychosomatic Medicine
• /
• v.25 no.2
• /
• pp.129-135
• /
• 2017

Objectives : Little is known about the influence of urinary incontinence and depression on individual's QOL(Quality of life). We aimed to clarify how the interaction between urinary incontinence and depression influences one's QOL. Methods : A total of 1262 patients were enrolled in this study from April, 2011 to July, 2011. We estimated the severity of depressive symptoms and QOL, using SGDS-K, EQ-5D. We also investigated the morbidity of urinary incontinence for each patient in person or by questionnaire. Comparisons of QOL between groups with or without depression, with or without urinary incontinence were established using t-test, ANOVA and Scheffe's post hoc analysis. The interaction between urinary incontinence and depression was analyzed by each domain of QOL, using multiple regression analysis. Results : Patients with depression and urinary incontinence showed significantly higher EQ-5D scores on every domain of QOL than other patients, which means significantly lower QOL. Patients with depression, no urinary incontinence reported lower QOL, especially in the domain of 'usual activity', 'anxiety' and 'visual analogue scale(VAS)', whereas those with urinary incontinence, no depression showed lower QOL in 'motility', 'usual activities' and 'pain' domain. Statistically significant interaction effects of two diseases were observed in the domain of 'VAS', 'self care' and 'anxiety'. Conclusions : Comorbidity of urinary incontinence and depression showed significantly lower QOL of patients, compared with urinary incontinence or depression respectively, which implies additive interaction effects of the two diseases. Optimal diagnosis and treatment of depression should be emphasized for patients with urinary incontinence.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.17 no.7
• /
• pp.326-333
• /
• 2016

This case study identified the effects of joint mobilization on knee pain, isokinetic strength, muscle tone, and muscle stiffness in an elite volleyball player with a knee injury. The subject had experienced cartilage defects of the left knee joint and underwent surgery to correct the condition. The patient complained of continuous pain in the left knee joint in daily life in addition to pain during exercise. The study was conducted from August 5 to 12, 2015 and joint mobilization was applied to the left knee joint for 15 minutes once a day for 8 days. Knee pain was measured using a visual analogue scale, and the concentric peak torque of the quadriceps and hamstring muscles was measured using an isokinetic muscular strength measurement device. The muscle tone and stiffness of the rectus femoris muscle, vastus medialis, and vastus lateralis on the injured side were measured using a myotonometer. All the measurements were conducted before and after the intervention. Joint mobilization was effective in reducing knee pain on the injured side, increasing the concentric peak torque of the quadriceps and hamstring muscles on both sides, and increasing the muscle stiffness of the quadriceps muscle on the injured side. Concentric peak torque of the quadriceps muscle on the injured side increased a great deal as the number of joint mobilizations was increased, largely diminishing the difference in concentric peak torque between the normal side and injured side. On the other hand, joint mobilization was ineffective in improving the hamstring to quadriceps strength ratio on the injured side. While this study suggests that joint mobilization can be an effective intervention to improve the knee pain, isokinetic strength, and muscle stiffness of elite volleyball players, it should be performed alongside training for an appropriate strength ratio.

• Journal of Acupuncture Research
• /
• v.22 no.6
• /
• pp.17-26
• /
• 2005

Objectives : The purpose of this study is to investigate the correlation between assessment measurements of knee osteoarthritis and obesity. Methods : Data on assessment measurements of knee osteoarthritis and obesity were obtained from 63 patients suffering from knee osteoarthritis from February to April, 2005. The assessment measurements consisted of BMI (body mass index), WHR (waist-hip ratio), two disease-specific questionnaires (Western Ontario and McMaster Universities (WOMAC) index and Lequesne's Functional Severity Index (LFI)), one generic instrument (Korean Health Assessment Questionnaire (KHAQ)), and VAS (Visual Analogue Scale). Statistical correlations among assessment measurements were evaluated by examining the Pearson's correlation coefficients. Results : 1. The sexual ratio in this study was 1: 5.3 (male: female= 10: 53). The average age of all patients was $59.1{\pm}6.6$ (male: $58.3{\pm}7.1$, female: $59.2{\pm}6.5$), and the group of 60-69 (34 patients, 54%) was biggest in the age distribution. 2. The average BMI of all patients was $25.4{\pm}3.1\;kg/m^2$ (male: female= $23.6{\pm}2.6\;kg/m^2:\;25.8{\pm}3.0\;kg/m^2$), and the group of $20-25\;kg/m^2$ was biggest in the BMI distribution. According to clinical definition of obesity by WHO (1997), 52.4% of all patients was within normal weight, 42.9% was overweight, and 4.8% was obese. 3. The average WHR of all patients was $0.91{\pm}0.06$ (male: female= $0.90{\pm}0.05:\;0.92{\pm}0.06$). According to definition of abdominal obesity, 73.0% of all patients (46 patients were all female) was in the state of abdominal obesity. 4. There were no significant correlations in statistics among assessment measurements except between BMI and WHR. Conclusion : Though there is significant correlation between knee osteoarthritis and obesity according to many clinical and experimental researches, there is no assessment measurement reflecting knee osteoarthritis and obesity simultaneously. For this, further studies on correlation between knee osteoarthritis and obesity and development of assessment measurement or questionnaire on this are needed.

• Journal of the Korean Arthroscopy Society
• /
• v.12 no.3
• /
• pp.185-190
• /
• 2008

Purpose: The purpose of this study is to provide the clinical outcomes of arthroscopic type II SLAP repair in non-athletes, and to compare the clinical outcomes between those who had isolated type II SLAP lesion and those who had combined partial thickness supraspinatus tear that did not required a combined repair. Materials and Methods: From July 2005 to January 2007, 142 consecutive type II SLAP lesions were treated with arthroscopic surgery. The inclusion criteria for the study were; (1) younger than 50 years old; and (2) non-athletes. Exclusion criteria were; (1) prior surgery, fracture or combined recurrent dislocation history on the affected shoulder; (2) combined full thickness rotator cuff tear or PTST (>50% thickness) patient that needed repair; and (3) combined infection, arthritis or inflammatory disease. Remaining 19 patients meet the criteria. Among them, 13 had combined PTRCT that did not require repair (Group I), and 6 had isolated type II SLAP lesion without combined supraspinatus tear (Group II). The mean age was 36.7 years (29~49 years), mean symptom duration was 39.1 months (3~216 months) and mean follow-up was 19.0 months (12~27 months). In all patients, the range of motion of affected shoulder, pain and function visual analogue scale (PVAS, FVAS), the Constant score and UCLA score were evaluated preoperatively and postoperatively. Results: In group I, external rotation at side was decreased significantly (p=0.003),but there were no statistical significant change at the remains(p>0.05). And there were no differences between groups (p>0.05). At the final follow-up, all clinical outcome measurements improved after surgery with statistical significance (p<0.05): UCLA score, $22.8{\pm}5.2$ to $32.8{\pm}2.1$; Constant score, $79.4{\pm}8.6$ to $94.9{\pm}4.3$; PVAS $5.4{\pm}2.7$ to $1.1{\pm}1.4$; FVAS $63.2{\pm}15.3$ to $93.4{\pm}7.3$. But, in group comparison of the mean UCLA score and Constant score, there were no statistical significant differences between two groups. Conclusion: Arthroscopic repair of type II SLAP lesion provided good clinical outcomes in nonathletic population. Combined partial thickness supraspinatus tear does not seem to hamper the final outcome at minimal 1 year follow-up.

• Journal of Music and Human Behavior
• /
• v.2 no.1
• /
• pp.1-15
• /
• 2005

The purpose of this study is to develop Music Recall Technique for affect modification using programmed series of classical music, and further to apply the technique as therapeutic intervention for clients with anorexia nervosa. Music Recall Technique is composed of two sub-technique: first one is 'Music Recall(MR)' which is the way to reproduce of existing music on one's head and mind after listening to the music, and second intervention is 'Creative Music Recall(CMR)' which is the way to modify the exposed musical pieces or newly learned musical pieces. A client with anorexia nervosa with severe anxiety, anger and depression participated in this case study. The MRT is implemented in different stages pertaining to client's level of utilizing the music recall skill for the period of 10 sessions. Situations eliciting negative emotions were identified and music recalling was reinforced for the pertaining situation in order for the negative emotion to be coped and reduced by the end of session time. The client participated for 10 sessions, and was asked to fill out self-report on the affect change using MRT. Visual Analogue Scale was used for pre and post test for each session to measure the self perceived level of negative affect. State-trait anxiety inventory was also used to measure the anxiety level following the implementation of MRT. As results, negative emotions, such as anxiety, anger and depression were modified during stimulative-sedative music recall process. These negative emotions were decreased mostly during stimulative MR, especially, in the beginning process. Each negative affect on negative situation measured by VAS during each and entire session have been decreased. Negative emotion measured by state-trait anxiety inventory, state-trait anger expression inventory, and hopelessness-depression inventory were decreased as well. The results suggest that stimulative music using contemporary classic music was effective in reduction and modification of negative affect such as anxiety, anger and depression. It shows that Music Recall Technique can be a meaningful intervention for affect modification, and further it can be utilized as self-help in the outside of music therapy setting.

• Clinical and Experimental Pediatrics
• /
• v.50 no.7
• /
• pp.672-677
• /
• 2007

Purpose : To assess the prevalence and characteristics of headache comorbidity with epilepsy in children and adolescents in a specialty epilepsy clinic. Methods : Two hundred twenty nine consecutive patients attending the Chosun University Hospital Pediatric Epilepsy Clinic (mean age $10.0{\pm}4.1\;years$, range 4-17, M:F ratio 1.1:1.0) were interviewed with a standardized headache questionnaire. Headache was classified according to the International Classification of Headache Disorders, 2nd Edition and epilepsy was classified according to the International League Against Epilepsy. Disability was assessed using pediatric migraine disability assessment (PedMIDAS). Results : Of the 229 epilepsy patients, 86 (37.6%) had co-morbid headache. Of the headache patients, 64 (74.4%) had migraine (65.6%- migraine without aura, 20.3% - migraine with aura, 14.1% - probable migraine). The mean headache frequency was $7.2{\pm}8.4$ per month, mean duration was $2.2{\pm}4.0$ hours, mean severity was $5.2{\pm}2.2$ out of 10, and mean PedMIDAS score was $13.0{\pm}35.4$. The proportion of females was not higher in epilepsy with headache patients (48.8%) compared to epilepsy patients alone (48.0%). In the patients with migraine, 48.4% had complex partial seizures, 17.2% had simple partial seizures, and 34.4% had generalized seizures (P=0.368). A postictal association of migraine was reported in 18.8% with 17.2% reporting a preictal headache, and 7.8% reporting an ictal headache. Conclusion : The prevalence of headache in pediatric epilepsy is higher than that in general pediatric population, suggesting a co-morbidity of headache in epilepsy patients with migraine being the most frequent headache disorder. Altered cerebral excitability resulting in an increased occurrence of spreading depression may explain the headache comorbidity with epilepsy. Further studies are needed to assess the etiology of this co-morbidity as well as assess the frequency, duration, severity and disability response to antiepileptic drugs.

• Journal of Hospice and Palliative Care
• /
• v.12 no.4
• /
• pp.194-198
• /
• 2009

Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea Purpose: Malignant bowel obstruction causes gastrointestinal symptoms and leads to diminished quality of life in patients with advanced cancer. Several studies have shown the efficacy of octreotide for the relief of malignant bowel obstruction-related symptoms. The aim of this study is to assess the efficacy and safety of octreotide in patients with malignant bowel obstruction. Methods: We retrospectively reviewed medical records of twenty nine patients who had suffered from malignant bowel obstruction without clinical improvement of conservative care and subsequently, received octreotide treatment. Initial dosage of octreotide was 0.1 mg/day, and dose was escalated depending on the clinical effect. For each patient, we assessed visual analogue scale (VAS) of pain, number of vomiting episode, and amount of nasogastric tube drainage. Results: Median dosage of octreotide was 0.2 mg/day (range 0.1~0.6), and median duration from initial medication to death was 20 days (range 2~103). VAS before and after octreotide treatment were 5.6$\pm$1.24, and 2.7$\pm$0.96, respectively. The numbers of vomiting episode before and after octreotide treatment were 3.6/day$\pm$2.5, and 0.4/day$\pm$0.8, respectively. The mean amounts of nasogastric tube drainage before and after octreotide treatment were 975$\pm$1,083 cc/day and 115$\pm$196 cc/day, respectively. Statistically significant reduction in VAS, the number of vomiting episode and the amount of nasogastric tube drainage were observed after octreotide treatment (P<0.05). Conclusion: Administration of octreotide in patients with malignant bowel obstruction, which is uncontrolled by other medication, was effective and safe. In such clinical situations, physicians should consider to add of octreotide for symptomatic control.

• Journal of Oral Medicine and Pain
• /
• v.38 no.2
• /
• pp.161-174
• /
• 2013

This study was designed to evaluate the pain control effect by morphine injection to masticatory muscle pain patients. Patients with masticatory muscle pain visited the Department of Oral Medicine, Kyung Hee University Dental Hospital were recruited to this study and diagnosed by RDC/TMD. Experimental group were divided into four group; saline injection group (n=10), lidocaine injection group (n=10), morphine 1.5 mg injection group (n=10) and morphine 3 mg injection group (n=10). Evaluation list was the subjective pain evaluation(visual analogue scale, Mc Gill pain questionnaire, pain drawing) and the objective pain evaluation(pressure pain threshold, pressure pain tolerance) and evaluation time was injection before, after 1 hour, 24 hour, 48 hour and then it was analyzed statistically. The results were as follows : 1. The subjective pain evaluation were significantly different statistically in morphine 3 mg group after 48 hour. (VAS: p<0.01, MGQ: p<0.001, PD: p<0.05) 2. The objective pain evaluation were significantly different statistically in morphine 1.5 mg group after 1 hour. (PPT: p<0.01, PPTol: p<0.05) 3. The morphine 3 mg group were more significantly different than lidocaine group and morphine 1.5 mg group statistically in the McGill pain questionnaire evaluation. (1h: p<0.01, 24h: p<0.01, 48h: p<0.001) Therefore, it was revealed that the morphine 3 mg injection was effective to pain control for masticatory muscle pain patients within 48 hours and more effect than lidocaine injection.

• Clinics in Shoulder and Elbow
• /
• v.12 no.2
• /
• pp.150-158
• /
• 2009

Purpose: With the better understanding of cuff function, partial repair or "force couple repair" for treating massive irreparable rotator cuff tear has gained some popularity. However, there were few reports on the results of partial repair. The purpose of this study was to report the clinical outcome of massive irreparable rotator cuff tears who received arthroscopic force-couple repair or partial repair. Materials and Methods: From June 2005 to Feb 2008, arthroscopic partial repairs were performed for 16 irreparable rotator cuff tears among the 101 large to massive rotator cuff tears that were operated on. Clinical and radiographic evaluation were done at the final follow-up. Results: There were 7 men and 9 women with a mean age of 66.6 years. The mean follow-up period was 27.3 month (range: 15-46). The pain VAS improved from 4.4 ($\pm2.50$) to 2.1 ($\pm2.26$) and the functional VAS improved from 46.9 ($\pm16.64$) to 70.0 ($\pm22.80$). The ASES score improved from 39.0 ($\pm10.80$) to 80.3 ($\pm16.78$) and the KSS score was 81.9 ($\pm16.74$) at the final follow-up. The acromio-humeral distance was 6.6 cm ($\pm1.74$) preoperatively and 6.2 cm ($\pm1.69$) postoperatively without significant change (p=0.3874). The degenerative changes had no statistically progressed (p=0.2663). Conclusion: Partial repair for massive rotator cuff injury patients showed improvement in the clinical score without progression of arthritic change at a mean of 2.3 years follow-up.

• Clinics in Shoulder and Elbow
• /
• v.12 no.2
• /
• pp.199-206
• /
• 2009

Purpose: Our goal for this study was to prospectively evaluate the functional & structural outcomes, by means of CT arthroscopy, of arthroscopic double-row fixation for treating rotator cuff tear. We also attempted to determine the variants that affect the functional & structural outcomes. Materials and Methods: Twenty seven consecutive patients underwent arthroscopic rotator cuff repair with double-row fixation. The average age at the time of the operation was fifty six years. The preoperative and postoperative examinations consisted of determining the Constant score, the score for the visual analogue scale for pain, the UCLA score, the American Shoulder and Elbow Surgeons (ASES) score, as well as a full physical examination of the shoulder. Preoperative MR arthrography was used to evaluate the integrity and atrophy of the rotator cuff. We measured the intraoperative tear size in the sagittal and coronal planes. Postoperative CT arthrography was used at one year postoperatively to evaluate the integrity and atrophy of the repaired tendons and muscles. Results: Preoperative MR arthrography revealed an average 29.22 mm tear size in the sagittal plane and an average 22.72 mm tear size in the coronal plane. Twelve cases of supraspinatus muscle atrophy and two cases of infraspinatus atrophy were observed on the preoperative MR arthrography. The average clinical outcome scores all significantly improved at the time of follow-up. At a mean of one year postoperatively, CT arthrography revealed 48.1% of the shoulders had healed, 11.1% showed incomplete healing and 40.7% showed retear of the repaired tendon. Conclusion: Arthroscopic double-row repair can result in improved clinical outcomes and good patient satisfaction. However, the problems about how to enhance healing of the repaired tendon still remain.