• Title/Summary/Keyword: short-term outcome

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The role of percutaneous neurolysis in lumbar disc herniation: systematic review and meta-analysis

  • Manchikanti, Laxmaiah;Knezevic, Emilija;Knezevic, Nebojsa Nick;Sanapati, Mahendra R.;Kaye, Alan D.;Thota, Srinivasa;Hirsch, Joshua A.
    • The Korean Journal of Pain
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    • v.34 no.3
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    • pp.346-368
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    • 2021
  • Background: Recalcitrant disc herniation may result in chronic lumbar radiculopathy or sciatica. Fluoroscopically directed epidural injections and other conservative modalities may provide inadequate improvement in some patients. In these cases, percutaneous neurolysis with targeted delivery of medications is often the next step in pain management. Methods: An evidence-based system of methodologic assessment, namely, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was used. Multiple databases were searched from 1966 to January 2021. Principles of the best evidence synthesis were incorporated into qualitative evidence synthesis. The primary outcome measure was the proportion of patients with significant pain relief and functional improvement (≥ 50%). Duration of relief was categorized as short-term (< 6 months) and long-term (≥ 6 months). Results: This assessment identified one high-quality randomized controlled trial (RCT) and 5 moderate-quality non-randomized studies with an application of percutaneous neurolysis in disc herniation. Overall, the results were positive, with level II evidence. Conclusions: Based on the present systematic review, with one RCT and 5 non-randomized studies, the evidence level is II for percutaneous neurolysis in managing lumbar disc herniation.

Eclectic rehabilitation for bell's palsy: A case report

  • Jha, Jyoti;Khan, Huma;Zaidi, Sahar
    • CELLMED
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    • v.12 no.3
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    • pp.11.1-11.5
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    • 2022
  • Bell's Palsy is one of the most common mononeuropathies or disorders affecting a single nerve and is associated with facial nerve weakness and paralysis. Though self-limiting the disorder may leave its long-lasting residual manifestations in the form of abnormal facial symmetry, inability to close the eyes, and other poor outcomes leading to disability and impairment in societal functioning among patients. Treatment strategies include pharmacological, surgical, and therapeutic options and to limit the long-term devastating effects therapeutic options play a vital role. Physiotherapeutic techniques have been widely used among patients with Bell's Palsy but not all techniques are performed in combination. One is compared with the other and also for short durations. We planned this study to see the outcome of combined techniques available in Physiotherapy on a patient with long-term follow-up. This is a case of 38 years old male patient diagnosed with right-sided bell palsy who received 7 weeks of rehabilitation in the form of electrotherapy, facial exercises, facial PNF, massage, and education on eye care. The implementation of 7 weeks of physiotherapeutic rehabilitation led to improved facial functions and a reduction in the level of disability in the patient.

The Strategy of Regulatory Reform in Korea : Performance and Task of Participatory Government (규제개혁의 전략 - 참여정부 규제개혁의 성과와 과제 -)

  • Kim, Sin
    • 한국디지털정책학회:학술대회논문집
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    • 2006.06a
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    • pp.113-123
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    • 2006
  • The purpose of this paper is twofold; 1) to evaluate the efforts of participatory government in regulatory reform, 2) to propose the strategies and tasks for future regulatory reform in Korea. An ex-post evaluation model for regulatory performance is applied to process, output, and outcome of the regulatory reform. The results of the evaluation show that there is still room for improvement in many aspects of regulatory reform. While there has been substantial advance in regulatory quality and management, carefully planned strategies are essential for Korean regulatory reform to move to the next stage of regulatory reform. Thus, based on the evaluation, future strategies and tasks for regulatory reform are presented as short-term tasks, mid to long range tasks, and continuous tasks.

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Lisfranc Injury Repair with the TightRope$^{TM}$ Device (A Case Report) (TightRope$^{TM}$ Device를 이용한 족근 중족 관절 손상의 치료(1예 보고))

  • Cho, Jae-Ho;Oh, In-Suk
    • Journal of Korean Foot and Ankle Society
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    • v.15 no.4
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    • pp.243-246
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    • 2011
  • Lisfranc injury is complex and difficult to treat. Making the correct diagnosis and achieving an anatomical reduction are important factors in regard to achieving a favorable outcome with this injury. We describe a new technique that we have found to be useful for stabilizing Lisfranc injury. This method is relatively fast and simple, and it provides non-rigid fixation. Also, it eliminates the need for implant removal. To date, we have achieved predictable results for stabilizing and treating this injury with the use of a $TightRope^{TM}$ Device, instead of traditional interfragmental screw fixation. In this report, we describe a case in which this method was used with satisfactory short-term results.

Successful Management of Pulmonary and Inferior Vena Cava Tumor Embolism from Renal Cell Carcinoma

  • Shim, Hunbo;Kim, Wook Sung;Kim, Young-Wook;Yang, Shin-Seok;Kim, Duk-Kyung
    • Journal of Chest Surgery
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    • v.45 no.5
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    • pp.323-325
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    • 2012
  • Pulmonary tumor embolism can be a cause of respiratory failure in patients with cancer even though it occurs rarely. We describe a 56-year-old man who underwent a pulmonary tumor embolectomy using cardiopulmonary bypass on beating heart combined with inferior vena cava embolectomy and right radical nephrectomy. Aggressive surgical treatment in this severe case is necessary not only to reduce the fatal outcome of pulmonary embolism in the short run, but also to improve the oncological prognosis in the long term.

The Impact of Air Pollution on Human Health in Suwon City

  • Jeong, Sang Jin
    • Asian Journal of Atmospheric Environment
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    • v.7 no.4
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    • pp.227-233
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    • 2013
  • Scientific evidence shows that ambient air quality is one of the major environmental issues related to human health. The aim of this paper was to provide quantitative data on the short-term impact of air pollution on the mortality and morbidity of people living in Suwon city. There are some studies that have conducted health impacts of the air pollution in Seoul, Korea. However, there are few studies of the health effects on air pollution conducted in satellite cities of the Seoul Metropolitan area. For this reason, we investigated the health effects of air pollution in Suwon city, one of the highly populated satellite cities of Seoul. In order to estimate the short-term mortality impact of air pollution, this study applied the approach suggested by the World Health Organization (WHO), using AirQ2.2.3 software. Daily concentrations of $PM_{10}$, $O_3$, $NO_2$, and $SO_2$ were used to assess human exposure and health effects, in terms of attributable proportion of the health outcome, annual number of excess cases of mortality for all causes, and cardiovascular and respiratory diseases. Among the four considered air pollutants, $PM_{10}$ had the highest health impact on the 1,118,000 inhabitants of Suwon city, causing an excess of total mortality of 105 out of 4,254 in a year. Sulfur dioxide had the least health impact. Ozone and nitrogen dioxide each caused 42.7 and 81.3 excess cases of total mortality in a year. The results are also in line with those of other international studies that apply AirQ software.

Short-Term Results of a Modified Kidner Procedure Using a Suture Bridge Technique for Symptomatic Type II Accessory Navicular (증상을 동반한 제 2형 부주상골에서 교량형 봉합술을 이용한 변형 Kidner 술식의 단기 치료 결과)

  • Kim, Eungsoo;Moon, Jinseon
    • Journal of Korean Foot and Ankle Society
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    • v.20 no.2
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    • pp.73-77
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    • 2016
  • Purpose: The purpose of this study was to evaluate the clinical outcome of a modified Kidner procedure using a suture bridge technique in symptomatic type II accessory navicular. Materials and Methods: Between January 2013 and December 2014, a total of 35 cases with symptomatic type II accessory navicular were treated with a modified Kidner procedure using the suture bridge technique. The patients were evaluated preoperatively, 3 months after surgery, and at the latest follow-up (at least six months postoperatively) clinically via the American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score, visual analogue scale (VAS), and the self-subjective satisfaction score. Results: The mean AOFAS midfoot score demonstrated significant improvement from a mean of 45.3 preoperatively to a mean of 89.2 at 3 months after surgery. At the latest follow-up, the mean AOFAS midfoot score was 92.6 (p<0.001). The mean VAS also improved significantly, decreasing from 6.7 out of 10 preoperatively to 1.8 at 3 months after surgery. At the latest follow-up, the VAS was 1.2 (p<0.001). The mean time of a single-limb heel raise was 4.6 months postoperatively and the self-subjective satisfaction score was 1.4 out of 4 at the latest follow-up. Conclusion: The short-term surgical results of the modified Kidner procedure with a suture bridge technique for symptomatic type II accessory navicular were good to excellent in terms of pain, functional and clinical assessments. In conclusion, the modified Kidner procedure with the suture bridge technique is a reasonable treatment option for symptomatic type II accessory navicular.

Short-Term Results of Surgical Treatment Using TightRopeTM for Acute Ankle Syndesmosis Injury (급성 족근 관절 원위 경비인대결합 손상에서 TightRopeTM를 이용한 수술의 단기 치료 결과)

  • Kim, Do Young;Lee, Jun Hyuck;Park, Jung Hyun;Cho, Jaeho
    • Journal of Korean Foot and Ankle Society
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    • v.20 no.4
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    • pp.176-181
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    • 2016
  • Purpose: The purpose of this study was to evaluate the clinical and radiologic outcome of syndesmosis fixation using TightRope$^{TM}$ (Arthrex, Naples, FL, USA) in acute syndesmosis injuries. Materials and Methods: Twenty-five consecutive patients with acute syndesmosis injuries, treated using TightRope$^{TM}$, were reviewed. Patients were evaluated preoperatively and at the last follow-up (at least 12 months postoperatively). Clinical outcomes were assessed using American Orthopaedics Foot and Ankle Society (AOFAS) ankle-hindfoot score and self-subjective satisfaction survey. Three radiologic parameters were evaluated two times at the preoperative and final follow up from the nonweightbearing ankle anteroposterior radiographs. Results: The mean AOFAS ankle-hindfoot score was 95.5 at the final follow-up. According to the satisfaction survey, 21 patients chose excellent, and four patients chose good. All radiologic parameters, including the mean tibiofibular clear space, mean tibiofibular overlap, and mean medial clear space on nonweightbearing ankle anteroposterior view, significantly improved after surgery. Complications occurred in only one patient who experienced knot irritation with infection. Conclusion: The short-term surgical results of syndesmosis fixation using TightRope$^{TM}$ were good to excellent, both clinically and radiographically. These results suggest that the fixation using TightRope$^{TM}$ is a valid option for acute syndesmosis injury.

Pylorus-Preserving Gastrectomy for Gastric Cancer

  • Oh, Seung-Young;Lee, Hyuk-Joon;Yang, Han-Kwang
    • Journal of Gastric Cancer
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    • v.16 no.2
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    • pp.63-71
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    • 2016
  • Pylorus-preserving gastrectomy (PPG) is a function-preserving surgery for the treatment of early gastric cancer (EGC), aiming to decrease the complication rate and improve postoperative quality of life. According to the Japanese gastric cancer treatment guidelines, PPG can be performed for cT1N0M0 gastric cancer located in the middle-third of the stomach, at least 4.0 cm away from the pylorus. Although the length of the antral cuff gradually increased, from 1.5 cm during the initial use of the procedure to 3.0 cm currently, its optimal length still remains unclear. Standard procedures for the preservation of pyloric function, infra-pyloric vessels, and hepatic branch of the vagus nerve, make PPG technically more difficult and raise concerns about incomplete lymph node dissection. The short- and long-term oncological and survival outcomes of PPG were comparable to those for distal gastrectomy, but with several advantages such as a lower incidence of dumping syndrome, bile reflux, and gallstone formation, and improved nutritional status. Gastric stasis, a typical complication of PPG, can be effectively treated by balloon dilatation and stent insertion. Robot-assisted pylorus-preserving gastrectomy is feasible for EGC in the middle-third of the stomach in terms of the short-term clinical outcome. However, any benefits over laparoscopy-assisted PPG (LAPPG) from the patient's perspective have not yet been proven. An ongoing Korean multicenter randomized controlled trial (KLASS-04), which compares LAPPG and laparoscopy-assisted distal gastrectomy for EGC in the middle-third of the stomach, may provide more clear evidence about the advantages and oncologic safety of PPG.

Short-term Comparison of Supervised Rehabilitation and Home-based Rehabilitation for Earlier Recovery of Shoulder Motion, Pain, and Function after Rotator Cuff Repair

  • Song, Si-Jung;Jeong, Tae-Ho;Moon, Jung-Wha;Park, Han-Vit;Lee, Si Yung;Koh, Kyoung-Hwan
    • Clinics in Shoulder and Elbow
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    • v.21 no.1
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    • pp.15-21
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    • 2018
  • Background: This study was undertaken to compare the outcome of supervised and home exercises with respect to range of motion (ROM), pain, and Single Assessment Numeric Evaluation (SANE). We further correlated the ROM recovery and pain reduction as well. Methods: The study included 49 patients who underwent arthroscopic rotator cuff repair. Rehabilitation was initiated after 4 weeks of immobilization. A total of 29 patients performed supervised exercise 3 times a week. Standardized education and brochures for review were provided to the remaining 20 patients who insisted on home rehabilitation. Statistical analysis was performed for comparing pain Numerical Rating Scale (NRS), SANE, and ROM. In addition, we also evaluated the correlation between pain and ROM. Results: Comparison of the two groups revealed no significant differences in forward flexion, internal rotation, abduction, and pain NRS. However, SANE at the 9th week (63.8 vs. 55.0, p=0.038) and improvement of external rotation from the 5th to the 9th week (17.6 vs. 9.3, p=0.018) were significantly higher in the supervised exercise group as compared to the home exercise group. Correlation of pain NRS with forward flexion, external rotation, internal rotation and abduction were statistically not significant (correlation coefficient=0.032 [p=0.828], -0.255 [p=0.077], 0.068 [p=0.642], and -0.188 [p=0.196], respectively). Conclusions: The supervised rehabilitation after arthroscopic rotator cuff repair showed better improvement in external rotation and higher SANE score after 4 weeks of rehabilitation exercise. However, no statistically significant correlation was observed between the recovery of ROM and short-term pain relief.