• Journal of Trauma and Injury
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• v.22 no.1
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• pp.37-43
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• 2009

Purpose: A missed fracture is a very common occurrence in the Emergency Department (ED) and can have serious results because of delays in treatment, resulting in long-term disability. It is also one of the most common causes leading to medical legal issues. We analyzed the causes of missed fractures by using a bone scan which is known to be an effective tool for diagnosing bony lesions. Methods: We reviewed the medical records of trauma patients who underwent a bone scan after being discharged the ED from September 2006 to March 2008. Cases of missed fractures were identified by using electronic medical records to review each diagnosis. Definition of missed fracture was read after bone scan by radiologist. We decided that there was no fracture if we read 'trauma-related lesion' or 'cannot rule out fracture' on a bone scan read by a radiologist. Enrolled patients were analyzed by age, sex, time until bone scan and Injury Severity Score (ISS). Patients were divided into two groups, alert mentality and not-alert mentality, so there were split between a diagnosis group and a missed fracture group. ISS was also used in determining the severity of the patient's injury upon discharge from the ED. Results: A total of 532 patients were enrolled in this study. Of those, 487 patients were in the diagnosis group, and 45 patients (8.4%) were discovered to have had a fracture. Of the 45 missed fracture patients, 34 patients (6.4%) had one-site fractures, 8 patients (1.5%) had two-site fractures, and 3 patients (0.6%) had three-site fractures. The most commonly missed fracture was multiple rib fractures (18 patients, 30.5%), followed by lumbosacral (LS) spine fractures (10 patients, 16.9%), thoracic spine fractures (8 patients, 13.6%), and clavicle fractures (6 patients, 10.2%). Mean age was $50.12{\pm}18.54$ years in the diagnosis group and $57.38{\pm}16.88$ years in the missed fracture group. For the diagnosis group, the mean ISS was $9.03{\pm}8.26$, but in the missed fracture group it was $17.53{\pm}9.69$. Missed fractures were much more frequent in the not-alert mentality (p<0.01) and in the high (ISS$ ISS{\geq}16$) group (p<0.01). Conclusion: Missed fractures occur most frequent in patients of old age, not-alert mentality, and high ISS. Multiple rib and spine fractures were found to be the most frequent missed fractures, regardless of trauma severity. This study also shows a high possibility of clavicle and scapula fractures in patients with severe trauma.

• Journal of Korean Physical Therapy Science
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• v.31 no.2
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• pp.15-29
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• 2024

Background: This study investigated the effects on the range of motion, pain, disability index, and quality of life when applying thoracic mobility exercise in middle-aged women with chronic back pain. Design: pretest-posttest control group design Methods: The study subjects were 32 patients with chronic back pain of 3 months or more among middle-aged women divided 2 groups. All groups were tested thrice a week for 30 minutes per session for four weeks. Each subject was evaluated using the thoracic rotation Range of Motion, the numerical pain rating scale and pressure pain threshold, Disability Index(Oswestry Disability Index), the Quality of Life(SF-36) before and after treatment. Results: As a result of the study, the range of motion at T1 and T2 of the exercise group to which thoracic mobility exercise was applied was significantly increased in both left and right rotations(p<0.05). In the evaluation of pain, the number pain rating scale(NPRS) score decreased significantly(p<0.05), and the pressure pain threshold was significantly increased (p<0.05), but there was no significant difference from the control group. In the evaluation of the disorder index, the Oswestry disorder index decreased significantly after the experiment (p<0.05), and there was a significant difference in group comparison with the control group (p<0.05). In quality of life, there was a significant increase in PCS of SF-36(p<0.05), but there was no significant difference from the control group. Conclusion: Through this study, thoracic mobility exercise can be used as an effective exercise therapy intervention method to improve and promote physical factors of range of motion, pain and disability index, and physical components of quality of life when treating middle-aged women with chronic back pain in the future.

• The Journal of Internal Korean Medicine
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• v.39 no.3
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• pp.372-388
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• 2018

Objective: This study evaluates the effectiveness and safety of moxibustion for benign prostatic hyperplasia (BPH). Methods: Using the keywords "benign prostatic hyperplasia", "benign prostatic hypertrophy", "benign prostatic enlargement", "prostatic hyperplasia", and "moxibustion", we searched papers in numerous databases, including National Discovery for Science Leaders (NDSL), Korean Traditional Knowledge Portal (KTKP), Oriental Medicine Advanced Searching Integrated System (OASIS), Research Information Sharing Service (RISS), PubMed, Embase, and CENTRAL. The search range included randomized controlled trials (RCTs). Papers not matched with inclusion criteria were excluded. The methodological quality of each RCT was assessed using the Cochrane risk-of-bias tool. Where appropriate, meta-analyses were performed. Results: Initially, 77 studies were found. Of these, 11 duplicate studies were removed and 27 were excluded following title and abstract screening. After the remaining 39 papers were scanned, 13 RCTs were selected and analyzed. Among these 13 RCTs, five compared moxibustion therapy and oral medication, seven compared moxibustion plus acupuncture therapy and oral medication, and one compared moxibustion plus acupuncture therapy and sham-moxibustion. The meta-analysis showed positive results for the use of moxibustion therapy in terms of International Prostate Symptom Score (IPSS), Quality Of Life (QOL), Maximum Flow Rate (Qmax), Prostate Volume (PV), and the efficacy rate. The meta-analysis showed positive results for the use of moxibustion plus acupuncture therapy in terms of IPSS, QOL, and the efficacy rate. Conclusions: This meta-analysis of clinical trials suggests that moxibustion is effective intreating BPH patients. The results of this study could be applied to clinical treatment of BPH. However, additional large-scale clinical researches should be conducted.

• Journal of Nutrition and Health
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• v.33 no.2
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• pp.193-201
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• 2000

This study was conducted to investigate the effectiveness of nutrition counseling on the dietary intake and nutritional status cancer patients undergoing radiotherapy treatment. The study was conducted over 6 week period and included 104 patients : 66 received nutrition counseling as the variable group of 42 male and 24 female and 38 patients received no counseling as the control group of 19 male and 19 female. Nutrition counseling was accompanied with the radiation therapy and adminstered via counseling session and distribution of printed material during radiation therapy for 6 weeks. Nutrition counseling aimed at maintaining a balanced diet and preventing weight loss of subjects, guideline used for energy and protein intake were 35kcal/kg IBW and 1.5-2.0g/kg IBW, respectively. Over the course of the study, the counseling group increased significantly in comparison to the control group's energy intake, evidenced by the counseling group's initial mean daily energy intake of 1932.0kcal, and 4 and 6 week mean energy intake values of 2046.6kcal, 2066kcal, respectively. But mean energy values of control group was 1614.3kcal at 4 week. Th energy intake per weight values and protein intake per weight values for initial, 4 and 6 week intervals for counseling group were 33.2kcal/kg, 33.7kcal/kg, 34.0kcal/kg, and 1.48g/kg, 1.58g/kg, 1.59g/kg, respectively. Based on results, nutrition counseling had positive effects on both the variety of diet and energy intake of the variable group, mostly due to an increase in dairy product and egg consumption. In addition, the percentage of counseling group patients who consumed all 5 food group increased from 48.5% to 54.5%. Sufficient energy intake and protein consumption seem to be important factors in weight loss prevention, evidenced by weight gain by subjects in the counseling group who had 36.1kcal/kg/day mean energy intake and 1.77g/kg/day mean protein intake after 4 weeks. Counseling group subjects experiencing weight loss had lower intake and 1.77g/kg/day mean protein intake after 3 weeks. Counseling group subjects experiencing weight loss had lower intakes of 29.3kcal/kg/day for energy and 1.33g/kg/day for protein during the same period. Another significant factor in weight loss prevention of the counseling group could be the variety of diet. The dietary variety scores(DVS) of both counseling and control groups differed significantly : the counseling group had a mean score of 34 while the control group of patients. At the end of the study, the mean percentage of subjects within each group having a DDS 5 was higher in the counseling group (54.5% v.s. 24.0%). In this study, nutrition counseling for cancer patients undergoing radiation therapy proved to be effective in preventing weight loss, a major complication during radiotherapy. Nutrition counseling not only increased protein and energy intake, but also had desirable effects on variety or diversity of diet.

• Journal of dental hygiene science
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• v.15 no.3
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• pp.369-376
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• 2015

The purposes of this study were to assess dental fear and anxiety level of patients attending a dental clinic using the dental fear survey (DFS) scale, to apply interventions chosen by patients for reducing dental fear and anxiety and measure their effects. This study surveyed 34 patients who visited a dental clinic in Seoul about their self-rated health and their experience of dental fear, and measured the level of dental fear using DFS. Trained dental hygienists applied interventions desired by the patients for reducing dental fear and anxiety and, for each intervention, examined the patients' satisfaction (very helpful [5 point]~not helpful at all [1 point]). Collected data were analyzed using IBM SPSS Statistics ver. 21.0 through independent t-test or one-way ANOVA for difference in level of fear according to related characteristics, and through Wilcoxon signed rank test for comparison between before and after the intervention. The subjects' mean level of fear (DFS score) was 44.53, which was an average level, and the level of dental fear was relatively high for stimulus-response (2.72). The level of dental fear was higher in those who had experienced pains or indirect dental fear from dental treatment in the past, and those whose subjectively perceived health state was poor (p<0.05). With regard to the applied dental fear intervention, 'Helpful (3.57)' was the most common answer. Overall satisfaction before and after the application of dental fear intervention was generally high as 4.37 and 4.35, respectively, but it decreased slightly after the intervention. In order to lower the level of dental fear, it is considered effective to survey not only the level of dental fear but also patients' need of dental fear interventions and to apply a suitable intervention. It is also required to educate dental workers and to develop related manuals.

• Journal of Oriental Neuropsychiatry
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• v.25 no.4
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• pp.319-332
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• 2014

Objectives: This study was conducted to evaluate the clinical effects of group therapy for Panic disorder patients based on Mindfulness & Li-Gyeung-Byun-Qi therapy. Methods: The FFMQ, BDI, STAI, STAXI, Panic attack, Anticipatory anxiety and subjective improvement of three Panic disorder patients were compared pre- and post-treatment when given Mindfulness & Li-Gyeung-Byun-Qi therapy. Results: 1) After the patient in case 1 underwent 5 weeks of group therapy for Panic disorder, the Mindfulness meditation score was slightly improved, anxiety and depression were significantly decreased, and expression of anger was also improved. In addition, the Panic attack and Anticipatory anxiety became more stable in the objective evaluation, while 'Extreme improvement' was shown in the subjective evaluation. 2) After the patients in case 2 and 3 underwent 5 weeks of group therapy for Panic disorder, Mindfulness meditation scores were slightly improved, anxiety and depression were significantly decreased, and expression of anger was also improved. In addition, the Panic attack and Anticipatory anxiety became more stable in the objective evaluation, while 'Moderate improvements' were shown in the subjective evaluation. Conclusions: As per the results in these cases, it was shown that group therapy for Panic disorder utilizing Mindfulness & Li-Gyeung-Byun-Qi therapy was effective to maintain meditation and control the emotions of anxiety, depression, anger and so on. Therefore, it was considered that expansion of clinical utilization through the standardization of a group therapy program for Panic disorder is needed. Furthermore, it was also considered that a comparative study of the effects of previous cognitive programs for Panic disorder according to the objectified and standardized manual is needed in the future.

• Journal of Pharmacopuncture
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• v.13 no.1
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• pp.53-61
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• 2010

Purpose : To investigate the effects of the lavender, lemon and eucalyptus oil mixture on the atopy dermatitis skin lesions induced on NC/Nga Mice by dinitrochlorobenzene (DNCB). Material and Method : For this purpose, we fabricated the oil mixture blending three essential oils (lavender, lemon, eucalyptus : ELL) with one carrier oil (jojoba) and apply it on the atopic dermatitis skin lesions of NC/Nga Mice. Atopic dermatitis in NC/Nga Mice was induced by DNCB treatment on the dorsal skin of mice for 8 weeks. The mixture of ratio of each essential oil drop was 1 (eucalyptus) : 2 (lemon) : 2 (lavender) and this mixture was blended with jojoba oil 50ml (0.025%). The ELL-ointment was supplied for 8 weeks. We evaluated the effects of ELL on cell viability of mouse lung fibroblast, clinical skin features and severity, the level of serum Immunoglobulin (Ig) E & Ig G1, Interleukin (IL)-4, IL-13 and Interferon (IFN)-$\gamma$. Results : ELL showed safety on the cell viability of mouse lung fibroblast compared with control group. The cell viability was measured by SRB method. The effects of ELL on clinical skin features and severity in DNCB-induced dermatitis model of NC/Nga mice was significant compared with control group. EEL also showed significant effects on clinical symptom score compared with control group. Serum IgE & IgG1 level and development of atopy dermatitis skin lesions were evaluated. Serum IgE & IgG1 production was significantly down-regulated in EEL group compared with control group. ELL also down-regulated the levels of IL-4 and IL-13, and up-regulated the level of IFN-$\gamma$ compared with control group significantly. Conclusion : ELL was effective on atopy dermatitis by modulating Th2 related factors.

• Proceedings of the Plant Resources Society of Korea Conference
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• 2019.10a
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• pp.92-92
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• 2019

Excessive or chronic inflammation contributes to the pathogenesis of many inflammatory diseases such as sepsis, rheumatoid arthritis, and ulcerative colitis. Hibiscus syriacus L. has been used as a medicinal plant in many Asian countries, even though its anti-inflammatory activity has been unclear. Therefore, we investigated the anti-inflammatory effect of anthocyanin fractions from the H. syriacus L. varieties Pulsae (PS) on the lipopolysaccharide (LPS)-induced expression of proinflammatory mediators and cytokines in RAW264.7 macrophages. PS suppressed LPS-induced nitric oxide (NO) and prostaglandin $E_2$ ($PGE_2$) secretion concomitant with downregulation of inducible NO synthase (iNOS) and cyclooxygenase-2 (COX-2) expression. Furthermore, PS inhibited the production of proinflammatory cytokines such as tumor necrosis factor-alpha ($TNF-{\alpha}$), interleukin-6 (IL-6), and IL-12 in LPS-stimulated RAW264.7 macrophages. Further study showed that PS significantly decreased LPS-induced nuclear translocation of the nuclear $factor-{\kappa}B$ ($NF-{\kappa}B$) subunits, p65 and p50. Molecular docking data showed that many anthocyanins from PS fit into the hydrophobic pocket of MD2 and bound to Toll-like receptor 4 (TLR4), indicating that PS inhibits the TLR4-MD2-mediated inflammatory signaling pathway. Especially, apigenin-7-O-glucoside most powerfully bound to MD2 and TLR4 through LYS122, LYS122, and SER127 at a distance of $2.205{\AA}$, $3.098{\AA}$, and $2.844{\AA}$ and SER441 at a distance of $2.873{\AA}$ (docking score: -8.4) through hydrogen bonding, respectively. Additionally, PS inhibited LPS-induced TLR4 dimerization/expression on the cell surface, which consequently decreased MyD88 recruitment and IRAK4 phosphorylation. PS completely blocked LPS-mediated mortality in zebrafish larvae by diminishing the recruitment of neutrophil and macrophages accompanied by low levels of proinflammatory cytokines. Taken together, our results indicate that PS attenuates LPS-mediated inflammation in both in vitro and in vivo by blocking the TLR4/MD2-MyD88/IRAK4-$NF-{\kappa}B$ axis. Therefore, PS might be used as a novel modulatory candidate for effective treatment of LPS-mediated inflammatory diseases.

• The Journal of Korean Obstetrics and Gynecology
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• v.36 no.4
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• pp.96-120
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• 2023

Objectives: This study reports the findings that support the efficacy of herbal medicine (HM) for premenstrual syndrome (PMS). Methods: We conducted meta-analysis of findings from randomized controlled trials (RCTs) for PMS treated with HM. The articles were published before July 2022, located using 9 databases (Pubmed, EMBASE, Cochrane Library, CINAHL, CNKI, CiNii, SCIENCE ON, KoreaMed, OASIS). Results: We observed 2,034 studies, of which 23 RCTs met our inclusion criteria. The risk of bias in the included studies was relatively unclear or high. Meta-analysis of 3 RCTs showed that HM group had a significantly higher total effective rate than the western medicine group (RR 1.20 [95% CI 1.06, 1.36, p=0.004]). Meta-analysis of 1 RCT showed that HM group had a significantly lower symptom score (MD -3.04 [95% CI -5.36, -0.72, p=0.01]), while there was no significant difference in daily record of severity of problems scale (MD -20.52 [95% CI -49.33, 8.29, p=0.16]). Conclusions: HM significantly improved PMS symptoms than general treatment and no serious adverse events were reported. However, the evidence on the effectiveness and safety of HM for PMS was not enough to provide reliable results due to the small number and low quality of included studies. We believe that rigorous RCTs will lead to more reliable evidence of the intervention.

• Clinics in Shoulder and Elbow
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• v.10 no.1
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• pp.59-64
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• 2007

Purpose: The purpose of this study was to evaluate the results of bioabsorbable knotless suture anchoring for isolated type II SLAP. Materials and Methods: Fourteen patients with isolated type II SLAP underwent a surgical repair with bioabsorbable knotless anchor arthroscopically. Instability, rotator cuff tears or simple subacromial decompression were excluded. The UCLA and pain of VAS (Visual Analogue Scale), ADL (Activity of Daily Living, from the American Shoulder and Elbow Society) were evaluated and patients underwent a thorough shoulder examination at a minimum follow-up period of 2 years postoperatively. Results: At a mean of 27.1 months follow-up. The mean UCLA score improved from 14.4 pre-operatively to 31.2 on last follow-up. The mean VAS for pain was 4.9 and on last follow-up 1.0. The mean VAS for instability was 2.6 and on last follow-up 0.5. The mean ADL was 10.4 and on last follow-up 25.0. 12 patients reported their satisfaction as good to excellent and 10 of the 14 patients returned to their pre-injury level of activity (athletics) (P<0.05). Conclusion: Arthroscopic repair with bioabsorbable knotless suture anchors is an effective surgical technique for the treatment of an isolated unstable type II SLAP lesion. Overall satisfaction was only 85.7%. 1 patient had severe stiffness and 1 patient had shoulder pain.